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Science museums have long recognized the importance of physical interaction in informal learning. However, many hands-on experiences also require facilitation, creating a challenge to balance visitor-driven exploration with more structured, facilitator-led activities. In this study we analyze video of visitors’ interactions with a medical patient simulator during a field trip. By examining moments of facilitated and non-facilitated interaction, we highlight tensions inherent in the activity design. When the facilitator had to step away, participants engaged in collaborative exploration and learning with the patient simulator and role-played as medical professionals. Returning to the activity, the facilitator resorted to direct-instruction due to time constraints. Building on frameworks from human-computer interaction and visitor studies, we reflect on these pedagogical tensions.