Following family medicine residency I practiced emergency medicine in a variety of settings, from rural hospitals to level 1 trauma centers. I have served as medical director of ground and air EMS services. I have also been to Central America several times on short term medical service trips. After 16 years in emergency medicine I returned to family medicine in an academic setting and developed simulation curricula in critical patient assessment and in procedure skills using the concepts of mastery learning and deliberate practice. I have also helped develop simulation curricula incorporating deliberate practice into non procedural areas such as behavioral sciences and global health education and pre departure training for medical service teams. I have been an advocate for simulation at the University of Missouri and am currently medical director of the Shelden Clinical Simulation Center in the School of Medicine.