Learning with simulations has been characterized as highly intuitive and heavily rooted in students' subjective knowledge base, and therefore the effects of simulation-based learning are not revealed by tests of knowledge and skills, which are used in a majority of studies. However, the effects of simulation-based learning should be measured by tests that require learners to apply their knowledge and skills in new situations (tests of application and transfer).

In many studies, simulations are found to be very motivating for students and to have positive effects on participants’ attitudes. However, if students are not getting enough guidance or they use simulation just for simple practicing of their skills, the best evidence is that simulation-based learning does not necessarily lead to a positive attitude towards the learning environment

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