Despite clinical guidelines recommending their avoidance, high-risk medications like benzodiazepines, sedative hypnotics, and antipsychotics are commonly prescribed to hospitalized older adults. Prior interventions have not fully addressed how physicians make prescribing decisions, particularly junior physicians experiencing stress or cognitive overload. This trial randomized first-year medical resident physicians to either brief simulation training aimed at improving prescribing decision-making or control. The intervention did not impact total high-risk prescribing to hospitalized older adults, but did influence how the interns prescribed, resulting in fewer as needed orders, suggesting possibly greater ownership of care. Results of the study will be published in 2024.