Bruno Latour, one of the architects of actor-network theory, has now enfolded this approach within a larger project, An Inquiry into Modes of Existence-AIME. Framed as an empirical inquiry into the ontological and epistemological conditions of modernity, Latour argues for a radical shift in how 'objective truth', 'scientific fact' and 'meaning' are established within the world. In this chapter I draw on several elements of AIME to illustrate how Latour's ontology, building on, augmenting and responding to criticisms of actor-network theory, can be used to explore higher education, focussing on one episode derived from a larger ethnography of medical education. Introduction: reflections on places where people learn In May 2018, I was walking through different wards and rooms in a training hospital in Nova Scotia, Canada, with the other members of the research team of which I am a member. Our current project, Becoming a Professional Through Distributed Learning: a Sociomaterial Ethnography, is exploring distributed medical education (DME) in Canada. As we walked through the spaces where the students practice their clinical skills with medical simulation dummies or manikins, we discussed the relationship between these practices, and the real-life experiences that they would encounter when taking up their clerkships in geriatric or emergency medicine, discussions that we returned to as we watched video recordings of the students as they fitted Foley catheters to the manikins (a catheter is a flexible tube used to drain urine from the bladder, named after Frederic Foley who originally designed them). Many of our conversations focussed on the proliferation of material artefacts that the medical students were using: artefacts that had to be learned about so that they could be correctly and safely employed, but also artefacts that in themselves carried aspects of the medical curriculum, reified in particular forms. The students had to practice fitting Foley catheters correctly as a technical or mechanical skill, but also needed to know about Foley catheters: what they are and what they do, how they have come to be in the forms that they are, how they are adapted toand therefore how the students would have to learn through their practice to adapt todifferent physiologies. Our previous research into the same curriculum provision had focussed on the ways in which the curriculum is delivered across two sites, geographically distant from one another, but linked through a rich network of technologies, staff, students, and processes (