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.