Twice a year in the simulator for a couple minutes is simply not enough training.
Last year, a Boeing Company check pilot talked to pilots of a major Hong Kong based airline. In his travels, he noted that some airline pilots tended to avoid the opportunity to practice hand flying skills until the very last minute before a simulator session. This was a waste of time - he said - because manual flying skills had to be maintained throughout the year and that a hand flown ILS in good weather after months on autopilots did nothing for basic flying skills.