Introduction:
Clinical simulation (CS) is an innovative methodology in Physiotherapy that enhances the learning of students with and without clinical experience. Its application in theoretical subjects, such as the Pathology of the Locomotor System, reinforces concepts and promotes clinical reasoning. The DANA storm in Valencia during the 2024-2025 academic year challenged face-to-face teaching, forcing the implementation of alternative strategies. In this context, the effectiveness of live CS versus recorded CS as an emerging educational resource was compared. The objective was to evaluate the differences in students' perceptions between live CS and recorded CS, analyzing their impact on content comprehension, interaction with faculty, and development of clinical skills. Additionally, exploring the advantages and limitations of each method for future implementations in the Physiotherapy Degree program.

Methods:
Six live CS sessions were planned, but only three were conducted due to the interruption of face-to-face teaching. For the remaining sessions, pre-recorded cases were used. In each session, three simulations were conducted in both live and recorded formats. Students' perceptions were evaluated using a 5-point Likert scale, where 1 was strongly disagree and 5 was strongly agree, across 18 items measuring aspects of CS, interaction with faculty, and learning experience. A t-test was applied to analyze the differences between the two methods.

Results:
Both modalities scored above 4 on the Likert scale. Ten items showed similar values between live CS and recorded CS. However, eight items showed significant differences (p < 0.05) in favor of live CS, highlighting instructor feedback (4.59 vs. 4.45, p = 0.004) and the applicability of learning to clinical practice (4.41 vs. 4.17, p = 0.03). Live CS allowed for greater active participation of students, improving knowledge consolidation and perception of the learning process. Students perceived that live CS facilitated better interaction and promotion of clinical reasoning, as well as greater realism in simulated practice.

Conclusion:
CS, whether live or recorded, is an effective tool for reflection and the acquisition of clinical skills. However, live CS is associated with a higher perception of learning due to immediate interaction and quality feedback. Additionally, it strengthens real-time decision-making and improves students' self-confidence in simulated clinical situations. Qualitative results suggest that live CS fosters a more dynamic and participatory learning environment, while recorded CS allows for content review at any time. Although recorded CS is a valid alternative in emergencies, live CS remains the preferred option to optimize learning in Physiotherapy. Integrating both methodologies in a hybrid approach could maximize the benefits of each format.

Keywords: Clinical simulation, Recorded vs live, Experiences, Learning, Physiotherapy.