A few thoughts. I have been in more simulators than care to remember as Captain, Co-pilot and Instructor - thankfully I will never enter one again !
There are many ways to use a simulator to best effect. Systems training aid, procedural training, emergency procedures, loft exercises etc etc. Any simulator session should be used for both training and refreshing pilots allied to test and check items as required.
It is easy to overload even the most experienced and skilled pilot should the console operator choose to do so - in my experience such an approach does not achieve a great deal.
The lack of 'real aircraft handling' in recent years has meant an ever increasing tendency to fly aircraft by numbers. There are legions of training captains out there who have never shut down an engine in flight in anything bigger than a Seneca - that is a fact of life based upon airline economics but in my view not a good thing.
The 'startle factor' which began this thread is a problem that many pilots will have faced in both the aeroplane and simulator. The much quoted Hudson birdstrike was ample proof that even the most skilled pilots will need a finite period of time to analyse any problem and in particular an unusual problem which they may not have encountered in training which I guess leads us onto the 737-800 Max accidents.
In the UK, many companies have adopted the 'first look' principle in recurrent simulator training - in simple terms, guaranteed engine failure at or just above V1 in marginal weather, perhaps at max weight on the first take-off. If the handling pilot does not excel in that first problem, the whole tenor of that session may go downhill. To my mind the aim of the simulator is to train, refresh and finally examine with an assessment of the pilot made at the end of the series of sessions in the sim. Mistakes may be made, perhaps items repeated but there is no need to do anything other than gradually raise the 'pressure' on the pilots according to their level of performance.
When I hear of pilots practicing in the real aeroplane in preparation for the simulator, I do feel that we are beginning to get things a little out of synch !