Collaborative learning through case-based or problem-based learning (PBL) scenarios is an excellent way for students to acquire knowledge and develop decision-making skills. However, the process is threatened by the movement towards more self-directed learning and the migration of students from campus-based to workplace-based learning. Paper-based PBL cases can only proceed in a single direction which can prevent learners from exploring the impact of their decisions. The PREVIEW project, outlined in this article, trialled a replacement to traditional paper PBL with virtual patients (VPs) delivered through a virtual world platform. The idea was that an immersive 3D environment could provide (a) greater realism (b) active decision-making and (c) a suitable environment for collaboration amongst work-based learners meeting remotely. Five VP scenarios were designed for learners on a Paramedic Foundation Degree within the virtual world second life (SL). A player using the MedBiquitous VP international standard allowed cases to be played both within SL and on the web. Three testing days were run to evaluate the scenarios with paramedic students and tutors. Students unfamiliar with the SL environment worked through five PBL scenarios in small groups, shadowed by 'in-world' facilitators. Feedback indicated that the SL environment engages students effectively in learning, despite some technology barriers. Students believed SL could provide a more authentic learner environment than classroom-based PBL.