Aims: This study aimed to explore the differences between conversations carried out face-to-face and those via video link, to see if the latter was suitable for supporting health care students. The study's objectives were: to determine perceived differences between supportive conversations conducted via video link and those carried out face-to-face; and to explore potential causes of any perceived differences between the two methods of conversation. Methods: The study used a mix of methods including dialogue simulation, transcript annotation, a questionnaire and focus group. Nine participants' perceptions of differences between the two media and causative factors were explored. Findings: Participants expressed concerns over the use of video communication for emotionally-based dialogue because they perceived problems with eye contact, interpretation of non-verbal communication cues and limitations related to the two-dimensional nature of video conferencing. Conclusions: Reduced perceptions of shared space (a phenomenon that is present in face-to-face dialogue) with two-dimensional communication may explain participant discomfort with video communications. New three-dimensional technologies may overcome this. The findings suggest there are implications for using video conferencing in health care delivery. Careful consideration is needed before non-direct support/contact methods are introduced in both education and health care in general.