They often include facets of real incidents, and real events do shape the way the sims are run. For instance, in years past, it was generally taken that in a 747-400 it would be best to fly any emergency descent with the autopilot engaged, and it was ALWAYS practiced that way. Of course, when one really happened, one of the consequences was loss of all of the autopilots, so training and reality diverged almost immediately. Now, when this exercise is practiced, you may, or may not, have an autopilot and adjust as necessary.