Simulation-based training is rapidly becoming an integral part of surgical training. However, the effectiveness of this type of training is as dependent on the manner in which it is implemented and delivered as it is on the simulator itself. In this article, the authors identify specific elements from the science of learning and human performance that may assist educators in optimizing the effects of simulation-based training. These elements include scenario design, feedback, conditions of practice, and others. Specific guidelines for simulation-based surgical training are provided.