I had my sim assessment with CAE OAA earlier this week - it was relatively straight forward.
You sit in the left seat and are told to fly certain headings with a few turns and climbs/descents. You only have to ask for certain throttle settings (such as "can I have climb thrust please...")
The tricky bit is being asked basic maths questions such as ETA whilst you are performing a turn but even then it doesn't really matter if you get it wrong. The assessor wants to see that you can follow instructions and learn from your mistakes. For example, if you are performing a turn and you lose altitude whilst doing so then the assessor will politely warn you that you have done so. Just make sure that the next turn is better.
Afterwards, the assessor let's you have a go at doing some fun stuff like steep turns and stalls (time permitting).
I did not have to land. I did not have to use flaps. I certainly didn't have to know speeds. I most definitely didn't have to fly with one engine. Renting a sim for practice would be a waste of time and money.
Some of the rubbish I read in here absolutely astounds me!