Following family medicine residency I practiced emergency medicine in a variety of settings, from rural hospitals to level 1 trauma centers. I have been medical director of ground and air EMS services. After 16 years I returned to family medicine in an academic setting and developed simulation curricula in critical patient assessment and in procedure skills. I have also been to Central America several times on short term mission trips. Since returning to family medicine I have been an advocate for simulation at the University of Missouri and am currently medical director of the Shelden Clinical Simulation Center at the University of Missouri.