This article, derived from a three-year ethnography of distributed medical education provision in a Canadian university, explores the ways in which information and communication technologies are used by teachers and students in their everyday work within technologically rich teaching environments. The environments being researched are two university campuses: a campus at the main university site and a satellite campus in a neighbouring province. The article seeks to contrast dominant, institutional discourses of technology use in higher education teaching with the everyday practices of staff and students. The article concludes that there is a gap between policy and practice in distributed education and that the teaching and learning experience and context of staff and students in different sites need to be analysed in depth, in terms of: whether the experience of learning across sites can be positioned as being comparable; the extent to which technology ameliorates learning and teaching; and understanding the work done by staff.