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 solutionsfor training with simulation. However, the feasibility in compulsory teaching, possible side effects of immersion, perceivedstress, and didactic benefits have to be investigated systematically. VR-based training sessions using head-mounted displaysalongside a real-time dynamic physiology system were held by student assistants for small groups followed by debriefing witha tutor. In the pilot study, 36 students rated simulation sickness. In the main study, 97 students completed a virtual scenarioas active participants (AP) and 130 students as observers (OBS) from the first-person perspective on a monitor. Participantscompleted questionnaires for evaluation purposes and exploratory factor analysis was performed on the items. The extent ofsimulation sickness remained low to acceptable among participants of the pilot study. In the main study, students valued therealistic environment and guided practical exercise. AP perceived the degree of immersion as well as the estimated learn-ing success to be greater than OBS and proved to be more motivated post training. With respect to AP, the factor “sense ofcontrol” 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 founda high degree of acceptance among medical students. This study also provides insights into how different conceptions of perceived stress distinctively moderate subjective learning success.

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