<p>Simulation-Based Learning (SBL) has emerged as a transformative pedagogical approach in healthcare education, addressing the challenges of limited clinical placement and the need for experiential learning. This theoretical paper explores the psychological and pedagogical dimensions of SBL, demonstrating its alignment with learning theories and the SOLO taxonomy. While SBL provides a safe and realistic environment for engaging with ethically complex scenarios, it also places significant cognitive and emotional demands on lecturers, an area typically underexplored in the literature. This paper presents a conceptual analysis drawing on existing literature and standards, highlighting the often-overlooked psychological impact of SBL on lecturers, including emotional labour, role transformation, and the need for moral imagination. Drawing on McNaughton’s discourses of emotion and INACSL simulation standards, the paper underscores the dual responsibility of lecturers to manage both students’ and their own emotions in high stakes learning environments. It also addresses the ethical and technological challenges of integrating AI into simulation in resource constrained environments. This conceptual article calls for greater institutional support, consideration of the simulation context and applicability to developing worlds and research into the educator experience of SBL.</p>