This chapter will present game-based learning activities developed forvirtual patients based on the four-dimensional framework developed by De Freitasand Martin, as well as other design considerations that look at emergent narrativesand modes of representation. This chapter will also present the interaction and callmanagementstructure implemented between the Second LifeTM (SL) virtual worldenvironment and the world wide web environment. This chapter also represents anoverview of the finding of a recent trial aimed to explore attitude towards two elearningdelivery methods including the delivery of game-based learning for virtualpatients in SL.