Effectively presenting complex material is a crucial component of instructional design within simulation-based training (SBT) environments. One approach to facilitate the acquisition of higher-order knowledge is to embed instructional strategies within the systems themselves. Currently, however, there are few established guidelines to inform developers how best to implement such strategies. In response, this study aims to explore the presentation of one such strategy--feedback--during SBT of a complex decision-making task. Specifically, this study extends past research on the modality principle of multimedia learning by comparing the use of spoken- versus printed-text real-time feedback in an SBT environment. During two primarily visual training scenarios, participants received spoken-text (Spoken Group), printed-text (Printed Group), or no feedback (Control Group) based on their performance. Results indicated that the Spoken Group demonstrated greater decision-making performance during training and assessment compared to the Printed Group. These findings are consistent with those of past research and suggest that the modality principle can be extended to the presentation of real-time feedback during SBT of higher-order cognitive skills.