agree with the others that there are two very different methods -- however both use paper. One is generally done by hand (EPP) using a specific set of shapes such as hexies, elongated hexagons, diamonds, squares, etc and hand sewn together. Whereas the other is a pattern for a block where the shapes generally aren't regular and you use the paper as the specific pattern and sew in a specific order. It is often done to get very sharp crisp matching points and is generally done on a sewing machine.