In running these courses in the future, facilitators should concentrate on those characteristics that were only somewhat supported.

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Medical education can be emotionally charged for many reasons, while simulation-based activities in particular are designed to generate emotional reactions. However, few studies have concentrated on the relationship between learning and emotions in this field, despite widespread interest in the topic in other areas. The aim of this research was to study the emotional experiences of participants before and after simulation-based teaching and learning activities. Data were collected from 238 participants using pre- and post-questionnaires and analysed using descriptive statistics, a paired samples t test, factor analysis, Cronbach’s alpha, a linear regression analysis and k-means cluster analysis. Participants were clustered into engaged, neutral and anxious learners based on their emotional profiles. The results showed that simulation-based learning invoked mainly positive emotions, whereas negative emotions decreased to a slight degree during an educational course. This study also revealed variables that may explain emotional variations. The article provides practical implications of the findings for simulation-based medical education and higher education in general. Implications for practice or policy: Positive emotions in simulation-based education can be promoted by challenging participants and providing activities at the appropriate level of difficulty. Learners may benefit from individual guidance and support, reducing their anxiety and building their sense of medical competence. Being cognisant of emotional subgroups among participants can help tailor instruction for individual learners. Simulation-based education can be targeted to educate learners to cope with difficult emotions and how to seek help.

<span>Expectations for simulations in healthcare education are high; however, little is known about healthcare students' expectations of the learning process in virtual reality (VR) and simulation-based learning environments (SBLEs). This research aims to describe first-year healthcare students' (N=97) expectations regarding teaching, studying, and learning in such environments. In addition, it measures students' expectations of instructors, their academic self-perception, and atmosphere, as well as whether there are differences between the expectations of adult and young students. Data was collected through a questionnaire from two different universities of applied sciences in Finland in spring 2009, and analysed using statistical and qualitative methods. Overall, students have quite high expectations of the activities that take place in VR and SBLEs. Adult learners in particular seem to have high expectations compared to younger students.</span>

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