I am shooting down my opponents regularly and I don't get squat for medals. I'm using all of the "real" stuff except for the engine management. I do have "mods" checked but aren't using any. What's the deal? My flight times don't change but when I look at my statistics, my scores are correctly shown. I've shot down more than 10 aircraft for both sides and haven't received a single medal other than those given for flying a particular aircraft.
Engine management has by far the greatest impact on mission difficulty and subsequent rewards. Give it a go; get out in a fly now mission to get the hang of controlling the engine, fuel and radiator. Engine management is actually very easy in this sim, ensure you do not fly too hot or too cold, remember to throttle back in a dive to avoid over revving and reduce fuel flow slightly as you increase altitude to avoid flooding. Get used to using the engine sound to tell you what is going on, even without temperature gauges, it is easy to hear the health of the engine with a little practice, letting you know when to reduce/increase the radiator/fuel.
It is not impossible to get awards without enabling engine management options if you really cannot manage yourself, but it is significantly harder, however, I have a few pointers on getting medals and awards to help:
First, ensure you are flying in career mode or mp, these are the only way you will get medals and trophies, you get nothing for flying the "offline" modes and single missions.
Second, always try to hit a secondary or even multiple secondary targets once the primary objective is out of the way. Examine the map at mission start, even though you may only expect enemy aircraft at your objective given the briefing, if there are any arty, aa or transport close to the primary it is worthwhile taking a couple of bombs just to get a couple of extras in. Also, are there any additional air targets on ingress or egress, these too will boost medal chances dramatically, while recon are a pita to take down, if you can do so safely they give a substantial boost. It is these additional targets that improve your chances of being granted medals, as you are going above and beyond the mission objectives.
Third, your side's losses also have an impact, try to protect your own if you are facing superior numbers, also, if you are wounded or damaged and manage a kill and go onto land that scores heavily in your favour too.
Finally, always land your crate manually, even if you use instant distance to mission as I do (this seems to have no affect). Taking the time to fly back and land has an impact on the outcome; very often if wounded or damaged, ending the mission while still in flight can result in death or capture ending your career, while it would have been easy to get down yourself.
Hope this helps some on the way to riches and glory, well ok, no riches or glory, but a sense of satisfaction and a boost to our fragile egos...