Many pedagogy experts suggest the use of real world scenarios and simulations as a means of teaching students to apply decision analysis concepts to their field of study. These methods allow students an opportunity to synthesize knowledge, skills, and abilities by presenting a field-based dilemma. The use of real world scenarios and simulations has also proven to be an effective method for training healthcare professionals not only in the classroom, but also in the workplace (Galloway, 2009). The article examines the use of real world scenarios and simulations in graduate learning to enhance students' decision-making and leadership skills. The article will present two case examples involving the use of a real world scenario and a simulation to facilitate higher learning at the graduate level for healthcare management students. In the first case example, students in a graduate healthcare management course, Healthcare Operations Management, participated in a simulation presented by the quality team of a local hospital system. Students were asked to evaluate a given scenario and make decisions about how to best improve patient flow and efficiency, while ensuring healthcare quality and safety. In the second case example, graduate students in Strategic Planning and Marketing in Healthcare, participated in consulting projects involving two different real world clients: a national non-for-profit healthcare service organization and a local non-for-profit healthcare clinic. The students in this class conducted research, analyzed data, and ultimately developed marketing and strategy recommendations that may be implemented by the clients.