Several lectures were followed by informal discussions regarding the overall telehealth experience. These discussions informed the following lectures in an unofficial improvement cycle. Throughout our experience with telehealth for education, we observed that the learners were much more engaged if the didactic portion was limited to 30 min and interspersed with interactive questions supplied by the instructor and real patient cases brought by the CHNs. Engagement was not specifically measured by the instructors but was discussed after lectures among team members. Also, limiting the use of video and audio transmission for those instructors not directly teaching improved the clarity and focus of the lead instructor and allowed the lead instructor to see and hear the learners better. This allowed for reengagement, questions, and breaks as necessary, similar to the way a live teacher can respond to a class. The CHNs reported preference for a larger screen for viewing, especially compared to a small laptop screen as was most commonly used. In the future, it will be important to provide a larger screen and speakers to allow for better video conferencing at the rural LMIC site. Flexibility and patience from both the learners and instructors were also important since some lectures had to be delayed or postponed due to poor connectivity, although this was rare. Anecdotally, the instructors noted that experience with telehealth, especially in understanding the delay in videoconferencing, allowed for better interactions and stronger feelings of connection.