Medical graduates lack procedural skills experience required to manage emergencies. Recent advances in virtual reality (VR) technology enable the creation of highly immersive learning environments representing easy-to-use and affordable solutions for training with simulation. However, the feasibility in compulsory teaching, possible side effects of immersion, perceived stress, and didactic benefits have to be investigated systematically. VR-based training sessions using head-mounted displays alongside a real-time dynamic physiology system were held by student assistants for small groups followed by debriefing with a tutor. In the pilot study, 36 students rated simulation sickness. In the main study, 97 students completed a virtual scenario as active participants (AP) and 130 students as observers (OBS) from the first-person perspective on a monitor. Participants completed questionnaires for evaluation purposes and exploratory factor analysis was performed on the items. The extent of simulation sickness remained low to acceptable among participants of the pilot study. In the main study, students valued the realistic environment and guided practical exercise. AP perceived the degree of immersion as well as the estimated learning success to be greater than OBS and proved to be more motivated post training. With respect to AP, the factor “sense of control” revealed a typical inverse U-shaped relationship to the scales “didactic value” and “individual learning benefit”. Summing up, curricular implementation of highly immersive VR-based training of emergencies proved feasible and found a high degree of acceptance among medical students. This study also provides insights into how different conceptions of perceived stress distinctively moderate subjective learning success.