Five principles of magic are described that directly relate to enhancing participant engagement in the healthcare simulation setting. The principles discussed are the following: reality is in the mind of the participant, attention is easily misdirected, perception can be manipulated, various cognitive biases can be exploited, and focus must be captured. Using these principles in a healthcare simulation can help fill gaps in fidelity and bring a participant to a point where the situation and events make sense to them, they feel that they are in an appropriate environment, and they are willing to forgive the natural flaws of the simulation itself. Misuse of illusions beyond the purpose of filling fidelity gaps can break trust with the teacher and lead to disengagement of the participant.