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Emotion has a profound effect on decision-making. Chris Hicks demonstrates this as he discusses medical simulation and its ability to teach us skills to manage challenging emotions. As scientists and rational beings, we like to believe that we can control our emotions and make good decisions regardless of the context in which those decisions must be executed – The reality is, that is far from the truth. We rarely take the opportunity to deliberately examine how emotional valence can influence the choices we make, or how we sort and process information as clinicians. Simulation-based training often provokes strong emotions, both positive and negative, whether we intend it to or not. Simulation may be an ideal tool for eliciting challenging emotions – anger, fear, anxiety, joy, prejudice – and developing skills to manage them in real time. Chris highlights a number of strategies to make this process more effective. He recommends starting with developing a fiction contract. This creates by in and ensures psychol