Project TOUCH (Telehealth Outreach for Unified Community Health) is a collaborative effort between University of New Mexico and University of Hawaii. The purpose of the project is to demonstrate the feasibility of using advanced technologies to overcome geographical barriers to delivery of medical education and to enhance the learning process within a group setting. This has led to the design and implementation of a new system that addresses the critical requirements for collaborative virtual environments: consistency, networking, scalability, and system integration. The objective of this study is to evaluate the performance of the collaborative system based on use patterns during Project TOUCH sessions.