Lessons learned from video conferencing didactic sessions

I've been using two different video conferences platforms over the last few years to beam our didactic sessions on the neurology clerkship to students who are at remote sites - in our case community sites in Bend, and Eugene.  I've had mixed success, and wanted to see if other people have found ways to improve the use of the technology to overcome some of the hurdles I've found.  Our didactic sessions are really set up to be a series of cases which the facilitator works through with the students.  They are usually an hour, and are intended to be very interactive with the students working together as a group to learn about various disease states from a case described by a facilitator.

Here are some things I've learned:

1)  Tech savviness is good.  I'm MUCH more likely to succeed at getting the student to keep coming back to the didactic sessions, and find that they are satisfied with the experience if that student has some technical savvy.  If the student is relatively not as literate with navigation of the web or more in depth programming than a word processor, it is more likely to fail technically.  Also, there is a much lower tolerance if problems start with the less savvy student bailing out earlier.  We're now using Abobe Connect and had used Microsoft LiveMeeting in the past.  Both are decent, but both have a bit of a learning curve, which less computer literate students aren't often willing to overcome.

2)  Better microphones = better experience.  Much more involvement when I spent more money (around $100) on a nice area mic that covers the whole conference room than trying to squeak by with cheaper mics.

3)  Works better with help.  I don't always have help, but I think the whole experience works better if you have some tech help who can monitor the feed, and problem solve for you if issues arrive.  When I'm the only tech help, I try a few things, but often just tell the student to try again the next time, as I can't hijack the whole lecture to spend even 5 minutes finding out what's wrong.  I'm not saying I have help now...

4)  Video feed can just provide a distraction.  Students have said that if the only thing they can see is my head, but there are lots of people talking at a table, it can almost take away from the experience.  I'm going to just sending the slides/whiteboard to try to get around that.  I don't have a whole table cam, and don't have help to run an external camcorder to focus on the person whose talking.  Haven't found a great way around that.

5)  Bigger computers are better.  I recently switched to using my newer, faster, sleeker laptop from an older one we had stowed in the conference room.  Audio has been our main tech issue, and it seemed to run better with the combination of a better computer and a hardwired line on the presenter's side.  We don't always have students hard wired in, but it is harder for them to do that as they have a netbook with them, and are not always in a predictible spot to participate in the lecture.  With that limitation, I'm not sure how to get around the student side of the problem.

What are your insights or experiences?  Have you found other ways to get around the problems I've had?  I hope to be able to improve my abilities to run this over time (as I'm hoping the software will become more reliable, and the hardware will become cheaper and smarter).