This chapter examines the use of simulation-based education (SBE) to address structural racism and implicit bias in healthcare. It emphasizes creating psychologically safe learning environments where learners can integrate their lived experiences and identities. Establishing a culture that respects diverse identities and addresses power dynamics is key to improving engagement and professional identity development. The chapter discusses the importance of pre-learning, self-reflection, and debriefing to support learner participation and counter resistance, especially among those with intersecting identities. Facilitators must undergo continuous development to manage uncomfortable topics, foster vulnerability, and navigate microaggressions and defensiveness. Creating “brave spaces” for learners to explore biases and facilitating bias interruption skills are essential for promoting psychological safety for learners, facilitators, and simulated participants (SPs). Outcome measures must extend beyond learner reactions to capture behavior changes, patient experiences, and shifts in workplace culture. Tools like the Implicit Association Test (IAT) can help assess the effectiveness of SBE interventions. The chapter highlights barriers such as time constraints, limited research, and the need for ongoing facilitator support to overcome challenges in addressing bias and structural racism. Through thoughtful facilitation, learner support, and comprehensive evaluation, SBE can drive lasting change in healthcare practices and culture.