Letter of Intent Form

Aquifer Sciences Letter of Intent

Step 1 of 3

Institution Name*
Application Contact Person*
The main contact for the application process.
First Last
Application Contact Email*
For the application contact person.
Enter Email Confirm Email
Acknowledge Requirements*
- I acknowledge the above requirements. If selected, our team is committed to ensuring all participation requirements are met.
Basic Science Educator Lead
Name*
First Last
Title*
Basic Science Discipline*
Email*
Phone*
Briefly summarize your relevant career experience in medical education:*
250 words or less
Describe your leadership experience in collaboratively developing and/or implementing medical education curricula, courses or projects. Describe how you identified and addressed team challenges and barriers, and ensured key deadlines were met. Emphasis should be given to experiences that included basic science and clinician educators and students.*
250 words or less
Why do you feel the Aquifer Sciences Initiative is important? What are you hoping to accomplish through your own contributions?*
250 words or less
Please attach your CV
Accepted file types: pdf, Max. file size: 256 MB.
If you are not able to attach your file, please email it to sciences@aquifer.org.

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Team Work Plan
Describe how your school is uniquely suited for this project. How will your school contribute to the overall goals of the initiative? Please be as specific as possible.*
500 words
Our team is interested in developing:*
- Virtual Patient Cases
- Integrated Illness Scripts
- Either
Schools selected to develop virtual patient cases will be provided with a full list of Phase 1 case scenarios and relevant learning objectives, and asked to rank-order preferences based on team strengths and interests. Schools selected to develop illness scripts will provide similar input on a list of the most frequent core conditions in the Aquifer clinical cases and Aquifer Sciences curricular database.
Have the Basic Science and Clinician Educator Leads previously worked together on an integrated curriculum project at your school? If so, please describe. If not, please describe how you intend to work together to co-lead the project and your team.
250 words
Describe your plan to form a collaborative and effective team of basic science and clinical educators to complete the work in a timely manner.*
500 words
What is your plan for student recruitment and active collaboration work on the project?*
Each pilot school must have at least four medical students with a track record of excellence in both the basic science and clinical curricula at your school, and who have demonstrated the ability to work independently and in teams, and with strong follow-through skills. 500 words.
How do you intend to use the $1,500 grant funds to facilitate the project work at your school?*
250 words
What challenges or barriers do you anticipate and how do you plan to address them?*
500 words
Submit Your Letter of Intent
When you are finished, please press submit. Please be sure your application is complete. You will not be able to edit your answers after submission.
Comments
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Aquifer Sciences Letter of Intent

Step 1 of 3

Basic Science Educator Lead

Clinical Educator Lead

Team Work Plan

Submit Your Letter of Intent