The University of Kentucky Center for Rural Health has used interactive video (IAV) instruction for place-committed students since 1991. Without adequate planning and training, new IAV instructors are likely to underestimate the differences between IAV and traditional instruction. This paper focuses on problems encountered in early stages of IAV implementation. The problems related to preparation and delivery of course materials, instructional coordination, student-faculty interaction, instructional technique, and equipment. Instructors initially emphasized control of IAV technology rather than adopting appropriate instructional methods or graphics, and misjudged the time needed to prepare and deliver course materials. Team teaching diminished student-faculty interaction, and faculty interacted more with local-site than remote-site students. Traditional teaching methods were less effective when applied to IAV. Equipment failures forced development of contingency plans. Recommendations for the avoidance or minimization of such problems are provided. Methods for the evaluation of student mastery of course content are briefly described.