User-created virtual worlds, such as Second Life, are a hot topic in higher education. Thousands of educators are currently exploring and using Second Life, and hundreds of colleges and universities have purchased and developed their own private islands in Second Life, including the University of Kansas Medical Center (KUMC). Because it is so easy and inexpensive to develop and modify user-created virtual worlds, especially when compared to the real world, the authors suggest an alternative approach to developing virtual world learning spaces. Instead of anticipating possible educational needs and trying to develop flexible learning spaces for those possible needs, virtual world learning spaces can be developed for very specific instructional needs. Although KUMC Isle, their private island in Second Life, does have a few familiar learning spaces--an auditorium, a sandbox, and a beach area--the majority of their island is devoted to specific course projects: a home to practice assessing and remediating disability issues, a community living center as the context for database development, and an operating room simulation for learning complex medical procedures. In this article, the authors provide an in-depth examination of the design, development, and use of one of these virtual world learning spaces, their Nurse Anesthesia operating room simulation for learning the basic induction process. They also briefly describe the learning spaces they developed for several other projects. The authors' goal is to provide some insights into developing virtual world learning spaces and highlight the advantages of those virtual world spaces over real world spaces. Most importantly, the authors want to encourage institutions to target their virtual world development efforts on specific learning spaces for specific project needs. In this way, course objectives and learning tasks can truly drive the learning space development, rather than having to adjust objectives and tasks to the limitations of an existing learning space. (Contains 4 endnotes.