We evaluated a realtime, distance-learning first-aid course at three schools. From September 1997 to January 1998, 180 students took the course (60 at each of three sites, one of which was the broadcast site). Self-administered questionnaires were distributed to students at the end of the course. The overall response rate was 86%. Sixty-three per cent of students at the remote sites and 83% of students at the broadcast site rated the programme as good or excellent. Students at the broadcast site had a significantly higher degree of satisfaction with the video (79% vs 30%) and audio (83% vs 44%) quality than those at the remote sites. Students at the broadcast site also had a significantly higher degree of satisfaction with slides (75% vs 43%) and transparencies (60% vs 44%) as teaching tools than those at remote sites. The three most important factors affecting the course at the remote sites were teaching aids (video, slides, transparencies), the teacher's body language and self-expression, and equipment stability. Satisfaction at the broadcast site was significantly lower when the course involved demonstrations or practice procedures such as cardiopulmonary resuscitation, dressing, bandaging or splinting. Teaching aids and equipment therefore appear to be important factors at remote sites for a first-aid telemedicine course. Limitations in teachers' movements during demonstration and practice were important at the broadcast site. The evaluation and selection of appropriate teaching models, teaching tools and methods are important when implementing these types of educational programme.