Current research on telepresence tends to engage a celebratory, taken-for-granted view of technology as a vehicle for improved communication and a mere backdrop against which communication unfolds. However, a growing body of literature interrogates the neutrality of technological environments in education. This paper considers the practice of lectures within distributed (multi-campus) medical education. Applying a sociomaterial theoretical lens, we analyze ethnographic data from a three-year study focused on the use of telepresence technology in the undergraduate medical program at Dalhousie University in Nova Scotia, Canada. Our research question was: How are material telepresence tools, processes and spaces enmeshed with student learning in the distributed lecture? We identified three sociomaterial complexities related to the practice of asking questions in this context: 1. Material presence and process of the button and screen in asking questions; 2. The ways in-class questions disrupt the flow of the distributed lecture; and 3. Tensions between ways in which questions are managed across sites. Attending to the seam between the social and material in the distributed lecture illuminates the challenges, barriers, and opportunities for student participation while unearthing innovative learning strategies. [For the complete proceedings, see ED579395.]