In this paper, we review the results of a qualitative thematic analysis exploring student reflections during an Objective Structured Clinical Examination Adapted for Social Work (OSCE-SW). Students interfaced with embedded participants representing either a parent-bisexual child or parent-transgender child dyad during a study examining learning outcomes. The analysis resulted in two reflection themes: complex process and different perspectives on engagement. We outline the importance of preparing students to serve LGBTQ clients and using reflective practices. This paper concludes with a discussion about applying the findings of this study to future simulations.