Call for Participation: Calibrate Formative Assessment Pilot Program

Applications Now Open for Aquifer Curricular Partner Medical Schools

Available for Family Medicine – Internal Medicine – Pediatrics – Radiology

Aquifer is excited to announce that our transformative Calibrate Pilot Program is now accepting applications from MD and DO schools that are Aquifer Curricular Partner Programs for the 2022-23 subscription year. 

Aquifer Calibrate is an innovative and evidence-based formative assessment system that gives new insight into clinical knowledge and cognitive competence by calibrating students’ knowledge and certainty during applied problem-solving. Calibrate provides objective formative assessment data to fuel effective coaching and efficient self-directed learning. Assessments link to the national clerkship curricula, supporting a range of accreditation requirements and aligning faculty and students around an easy-to-adopt tool.

The Calibrate Pilot Program provides a unique opportunity to partner with Aquifer and play a role in driving the future of formative assessment. In addition to gaining early access to Calibrate assessments and new faculty development programs, pilot programs will provide critical feedback to inform optimizations before the availability of this new tool expands across medical and health professions education. 

Get to Know Calibrate

Benefits of Participation

Early Access to Calibrate

Pilot programs gain exclusive access to the Calibrate assessment system. Pilot access includes our user-friendly dashboard for assessment administration and actionable reports for students and faculty, all available in your Aquifer account. Access to learner cohort reports provides you with new insights into potential learning gaps in your curriculum, giving you a jump start on curricular and accreditation planning.  

Promote Self-Directed Learning

Calibrate empowers students to make the most of clinical learning experiences. By adding new dimensions for diagnosing problem areas like under or overconfidence and knowledge deficits, Calibrate empowers students to make the most of clinical learning experiences. Calibrate provides the tools needed to create targeted, individualized learning plans and supports accreditation standards on self-directed learning (LCME 6.3 and COCA 6.7). Learn more …

Access Faculty Development Coaching Training

As a pilot program, your faculty will have access to professional development focused on coaching learners to use Calibrate formative assessments to advance their learning during the clerkship and beyond. Aquifer’s Peer Trainers, a team of health professions educators experienced in the use of Aquifer and coaching, will offer training and support on how faculty can better use the information provided from Calibrate assessments to help students develop and implement more effective learning plans. Peer Trainers will be accessible throughout the pilot, providing access to a community of academic coaches working to gather feedback and refine best practices as we advance the development of Calibrate.

In addition, precepting faculty and other clinical supervisors will be able to access just-in-time tools for coaching―including agenda templates, goal setting templates, tips for giving feedback, and checklists for success, all grounded in the output of Calibrate’s reports.   

Training will also be available for all faculty on administration of assessments, interpreting reports, and advice for integrating Calibrate into your program.

Become an Innovation Partner

Pilot programs will be key partners in Aquifer’s innovation process. Feedback from faculty and students will inform the future development and optimization of everything related to Calibrate, from technology to content, orientation to coach training. Pilot programs will have the opportunity to partner with Aquifer academic leadership on future scholarly projects.

Qualifications

The pilot program is currently open to all MD or DO programs that are Aquifer Curricular Partners for the 2022-23 subscription year (July 1, 2022 – June 30, 2023).To confirm subscription status, please contact the person at your school who manages your Aquifer account, or contact [email protected].

The pilot program will open to physician assistant and nurse practitioner programs on January 9, 2023. Applications will open in the fall of 2022.

Requirements

Use Calibrate in Your Clerkship/Courses

Family Medicine – Internal Medicine – Pediatrics – Radiology
  • Enroll at least one clerkship or radiology elective (more encouraged) to administer Calibrate assessments between October 1, 2022 and January 31, 2023. We encourage pilot programs to continue using Calibrate through June 30, 2023.
  • For each enrolled clerkship/radiology elective, programs must ensure that all students:
    • complete an early Calibrate assessment within the first two weeks of the clerkship/course; 
    • complete a late Calibrate assessment (recommended in the last 2 weeks of the clerkship/course);
    • complete the Calibrate Debrief and Learning Plan Worksheet, using the results of their early assessment report; and
    • receive coaching regarding the implementation of their Learning Plan from a designed faculty member. Coaching tools & training are provided.
  • Each assessment takes about 1 hour to complete.
  • Proctoring is not required. Faculty can schedule assessments directly for groups of students in the dashboard, making the assessment available for up to 7 days; students complete the assessment on their own time.
  • Students and faculty will have immediate access to results reports after completing assessments.

Important Note: Calibrate reports are not intended and should never be used for evaluation or grading purposes (assessment of learning). The system is designed to be used as assessment for learning. Additionally, while the reports provide valuable information regarding accuracy and certainty, some aspects – such as the learning progress indicator flag, the clinical learning calibration values, and the coaching and learning tips – are undergoing additional validation throughout the pilot.

Faculty Development Training

  • Designate at least one lead faculty member per clerkship or course to participate in a maximum of 2 hours of Calibrate coaching training.
  • Ensure participating faculty and clinical supervisors are oriented to requirements and resources.
    • Aquifer Peer Trainers are available to consult and assist with training and orientation needs.
  • All designated faculty and clinical supervisors are encouraged to attend live training sessions as desired.
  • Online coaching tools and resources will be available to all faculty and clinical supervisors.

Provide Substantive Feedback to Aquifer

  • Pilot schools commit to responding to feedback requests and assisting in the collection of feedback if required. Feedback is critical to fueling the ongoing development of this new learning tool. Feedback includes:
    • Clerkship director and coaching faculty surveys (2-3 short surveys per clerkship)
    • Participating student surveys (3 short surveys)
    • A faculty coach focus group (at least 1 participant per school, more encouraged)

Timeline

Learn More

Still have questions? We recommend watching the Calibrate webinar for a full view of this exciting new tool.

Application Process

Applications to the pilot program for allopathic and osteopathic programs are now open. Interested programs are encouraged to apply early for optimal consideration. Applications will be reviewed and accepted on a continuous basis, and will not be accepted after August 1, 2022.

Only one application should be completed per program, regardless of the number of clerkships participating, via the Program Services Administrator (PSA) using the application form below. 

The PSA will be notified within four weeks of receiving your application, and no later than August 15, 2022. Please contact [email protected] with questions regarding the pilot program and application process.

Aquifer at AAIM 2022

If you are attending the AAIM/CDIM 2022 Academic Internal Medicine Week in Charlotte, NC from April 10-13, please be sure to connect with us at our booth for updates on our new learning tools and ways to make the most of your Aquifer access. We look forward to seeing you at this year’s meeting.

Join us at Booth #623

Sunday, April 7: 7:00 AM – 3:30 PM; 5:00-6:30 PM (welcome reception)
Monday, April 8: 7:00 AM – 3:30 PM; 5:30-7:00 PM (poster reception)
Tuesday, April 9: 7:00 AM -12:00 PM

Aquifer Calibrate Q&A: Monday, April 11, 11:30 AM – 12:00 PM
With Joseph Wayne, MD; Albany Medical College; Aquifer Internal Medicine Assessment Lead
Learn about our Aquifer Calibrate, our new formative assessment system, designed to provide test-enhanced learning experiences that drive self-directed learning, identify students in need of coaching, and expose curricular gaps.

New Palliative Care Cases Q&A: Sunday, April 10, 1:30 – 2:00 PM
With Susan Merel, MD; University of Washington, Aquifer Palliative Care Leadership Team Academic Lead
Coming July 1, our new Primary Palliative Care cases address critical gaps in palliative care learning.

Scholarship Opportunities Q&A: Monday, April 11, 11:00 – 11:30 AM & Tuesday, April 12, 10:15 – 10:45 AM
With Kirk Bronander, MD; University of Nevada, Reno; Aquifer Internal Medicine Senior Director
Stop by and learn about Aquifer’s scholarship opportunities. With Aquifer, your work will have an impact on a national scale.

Assessment Q&A: Sunday, April 10, 3:00 – 3:30 PM
With Valerie Lang, MD, MHPE; University of Rochester; Aquifer Academic Director for Assessment
Curious about our Internal Medicine Clinical Decision-Making Exam, included with your subscription? Come by to learn more.

New Foundations of Telemedicine Cases Q&A: Monday, April 11, 1:00 – 1:30 PM
With Amit Pahwa, MD; Johns Hopkins Hospital; Editor-in-Chief, Aquifer Foundations of Telemedicine
Explore ways to integrate these new, short telemedicine cases to prepare students for telehealth visits.

What Students are Saying: Monday, April 11, 3:00 – 3:30 PM
With Jen Bierman, MD; Northwestern University; Aquifer Student Engagement Group Co-Lead
Find out how students are effectively using Aquifer cases and tips on leveraging our cases for maximum learning impact.

New Teaching Tools

We are looking forward to sharing updates on our work, including some exciting new learning tools and programs.

  • Integrated Illness Scripts
  • Aquifer’s Curricular Partner Program
    • Take full advantage of the power of our complete content library at a deep discount, and the enhanced benefits and exclusive access to new teaching and learning tools by becoming an Aquifer Curricular Partner.

Congratulations Consortium Members

Aquifer congratulates our Consortium Members on their recent election to leadership positions within AAIM.

The Alliance for Academic Internal Medicine (AAIM) Governance Committee announced Shobhina G Chheda, MD, MPH, Chair for the FY 2023 Board of Directors. Shobina is the Aquifer Teaching and Learning Lead and Associate Dean for Medical Education at the University of Wisconsin Medical School.

Amit Pahwa, MD, appointed Councilor by Clerkship Directors in Internal Medicine (CDIM) Governance. Amit is Assessment/Teaching & Learning Lead at Aquifer and is Associate Professor of Medicine and Pediatrics at the Johns Hopkins University School of Medicine.

Susan Merel, MD, has been appointed Councilor, by Clerkship Directors in Internal Medicine (CDIM) Governance. Susan is the Aquifer Palliative Care Leadership Team Academic Lead, and is Associate Professor of Medicine of Internal Medicine at the University of Washington.

Aquifer Internal Medicine Course Board

  • Senior Director: Kirk Bronander, MD, University of Nevada, Reno School of Medicine
  • Assessment Lead: Joseph Wayne, MD, Albany Medical College
  • Curriculum Lead: Jennifer Wright, MD, University of Washington
  • Teaching & Learning Lead: Shobhina Chheda, MD, MPH, University of Wisconsin-Madison School of Medicine and Public Health
  •  Associate Editors for Aquifer Internal Medicine: 
    • Irene Alexandraki, MD, MPH, FACP, Florida State University College of Medicine
    • Amy E. Blatt, MD, University of Rochester Medical Center
    • Lisa Calvo, MD, University of Nevada, Reno School of Medicine
    • Monica Edwards, MD, MPH, FACP, Loyola University Stritch School of Medicine
    • Kendall Novoa-Takara, MD, University of Arizona College of Medicine, Phoenix
    • Homan H. Wai, MD, FACP, VCU School of Medicine Inova Campus

Call for Participation: Medical Student Advisory Group

Aquifer-Student-Advisory-Group

Medical Students: Join Us to Make an Impact

Aquifer is excited to announce an opportunity to join a national board of medical students tasked with providing critical feedback on the development of Aquifer’s learning tools. Following the success of our previous Student Advisory Groups, we are now recruiting a new group of medical students to serve on the 2022 Student Advisory Group.

Aquifer—a unique non-profit organization—makes a big impact on medical and health professions education. Used in 97% of U.S. allopathic medical schools, 66% of U.S. osteopathic programs, and a growing number of physician assistant and nurse practitioner programs—with over 15 million virtual patient cases completed since our founding in 2006—Aquifer is a leader in clinical learning.

Help us build the best possible tools to advance your clinical learning.

Aquifer is in the process of developing new assessments, cases, and other learning tools. Student voices and ideas are needed to ensure that our solutions provide the most value to students.

Selected students will be invited to preview and provide honest, constructive feedback on Aquifer’s new developing learning tools, designed to be used in medical and health professions programs across the country. Feedback from this group will be used to optimize the technology and content in our tools, inform communications, and develop training resources.

Work Commitment

  • Completing up to 1 hour of pre-work in advance of each meeting.
    • Previewing a new learning tool via interactive demo, watching a screencast, or reading/viewing background information or presentations.
    • Completing a preliminary survey with your initial feedback. 
  • Attending six 1-hour Zoom meetings (approx. every other month) to discuss and learn more about different aspects of the learning tools. Meetings will be scheduled on weekday evenings. Our first meeting is planned for February 2022.

A letter of recognition will be provided at the end of the year if all requirements are fulfilled.

Eligibility

We are accepting applications from students who have completed Aquifer cases either as part of their coursework, or have used our free cases or demo cases on their own, and meet the following requirements:

  • Medical students from MD or DO programs who are in their 2nd or 3rd year.
  • Interest in medical and health professions education.
  • Prepared to give honest, thoughtful feedback in a constructive manner.
  • Able to commit to completing all pre-work assignments and attending at least 4 out of 6 meetings.
Access Demo Cases

If you’re not familiar with Aquifer’s signature courses, you can access free demo cases here:

2022 Application

Applications closed on December 30, 2021. 

Aquifer Consortium Members Honored by AAMC

Aquifer congratulates Tracy Fulton, PhD, and Valerie Lang, MD, MHPE, on being named recipients of the prestigious 2021 Alpha Omega Alpha Robert J. Glaser Distinguished Teacher Award from the Association of American Medical Colleges (AAMC). This award, established in 1988 by the Alpha Omega Alpha medical honor society, is given to faculty members who have distinguished themselves in medical student education. Both of these talented educators are members of the Aquifer Educators Consortium, and their dedication to teaching the next generation of medical professionals is remarkable.

Tracy Fulton, Ph.D.

Dr. Tracy Fulton, Sciences Lead for Aquifer Sciences, is a professor of Biochemistry and Biophysics at the University of California, San Francisco, where she is also the Professional School Director for Biochemistry. She has been awarded this recognition for her work implementing and studying the Pathways of Human Metabolism map, a visual tool for health professions students that promotes deep learning and application of classroom concepts to clinical problems.

Valerie Lang, MD, MHPE

Dr. Valerie Lang, Academic Director of the Aquifer Clinical Decision Making Exam, has been named a recipient of this award for her work in curriculum development and teaching acumen. An Associate Professor at the University of Rochester School of Medicine and Dentistry, Dr. Lang is the Director of Meliora in Medicine, as well as the Director of Faculty Development, Hospital Medicine Division, and the Senior Associate Division Chief, Hospital Medicine.


Aquifer is a thriving, collaborative community of healthcare education leaders deeply committed to driving innovation in teaching and learning. The Aquifer Educators Consortium brings together more than 70 healthcare educators across disciplines to collaborate, innovate, and make advances in health professions education. For educators and healthcare providers, participation in the Consortium offers a unique cross-disciplinary peer community and an exciting opportunity for academic scholarship and advancement.

Vision & Principles Identified for Primary Palliative Care Course

Aquifer — supported by the Arthur Vining Davis Foundations — is moving ahead with the development of a national, standardized curriculum and quality online course that addresses critical gaps in palliative care learning across undergraduate medical and health professions education. The Aquifer Palliative Care Leadership Team, a group of expert interprofessional educators, has identified the principles and vision for the new course — “Principles and Practice of Excellence in Primary Palliative Care”

Although palliative care is an established specialty, all providers should have the skills to provide patient-centered care. By focusing on primary palliative care, the course broadens the reach beyond the specialty — moving toward overcoming provider shortages, lack of access, and lack of training — to improve outcomes and quality of life for seriously ill patients and their families. Primary palliative care knowledge and skills are critical in identifying and addressing the unmet needs of patients with serious illness, but most health professionals never receive standardized primary palliative care education.

Vision: Improve the capacity of the US health professions student to deliver humanistic, compassionate interdisciplinary care centered around patient goals of care and quality of life by applying evidence-based methods to alleviate the suffering of patients with serious illnesses and their families through the delivery of primary palliative care.

In the absence of clear national curricular standards on palliative care in medical and health professions education, the Aquifer Palliative Care Leadership Team has advanced this work by completing a needs assessment (stakeholder surveys and focus groups) and literature review. The research findings identified many common challenges that a national, standardized curriculum for health professions education could address, including educational gaps that cause providers to feel unprepared, workforce shortages among palliative care providers and faculty, balancing competing curricular demands, lack of standardization across interprofessional programs, and a lack of widely available materials for pre-professional learners. 

After completing the research activities, the leadership team held a consensus conference, synthesizing the literature review and needs assessment findings into a vision statement and key guiding principles. These principles will directly inform the development of learning objectives for the new course.

Principles of Primary Palliative Care Excellence

Based on the comprehensive needs assessment, the Aquifer Palliative Care Leadership Team has determined the Principles of Primary Palliative Care Excellence to elevate the primary palliative care education and training of all US health professions students, regardless of discipline. Each principle supports the advancement of primary palliative care as a competency for all health professionals. The principles determined by the team are:

1: Alignment of care with the goals, values, and preferences of seriously ill patients based on assessed need.

2: Interprofessional collaboration and care coordination between patients, families, healthcare teams, and systems.

3: Evidence-based and holistic approach that addresses the physical, psychological, social, and spiritual domains across the illness trajectory from diagnosis to end-of-life.

4: Equitable access to high-quality, culturally responsive palliative care services for all patient populations.

5: Education and advocacy to promote palliative care as a gold standard for serious illness care.

Next Steps

Using the vision and principles as a framework, the Aquifer Palliative Care Leadership team is now developing a national palliative care curriculum. The curriculum will be delivered via the Aquifer Principles and Practice of Excellence in Primary Palliative Care online modules and virtual patient cases. Learning objectives are now identified, and development work will begin in late 2021, using varied pedagogies to ensure that learners are equipped with the knowledge, skills, and attitudes needed to provide patient-centered care to their communities.

The Aquifer Palliative Care Leadership Team believes that elevating the primary palliative care education and training to all US health professions students, regardless of discipline, will support our goal of equipping pre-professional educational institutions to build a practice-ready healthcare workforce knowledgeable in the principles of primary palliative care and able to deliver high-value, compassionate care to seriously ill patients.


Aquifer Palliative Care Leadership Team

Academic Lead: Mandi Sehgal, MD; Florida Atlantic University Charles E. Schmidt College of Medicine/Cleveland Clinic

Aquifer Lead: Sherilyn Smith, MD; Aquifer, University of Washington

Team Members:

  • Brynn Bowman, MPA; Center to Advance Palliative Care
  • Karen Bullock, PhD, LCSW, APHSW-C; North Carolina State University
  • Rebecca Edwards, DNP, APRN, ACNP, AOCNP, ACHPN; University of Alabama
  • Susan Merel, MD; University of Washington
  • Kristen Schaefer, MD, FAAPM; Care Dimensions
  • Barbara Reville, DNP, ANP-BC, ACHPN; Harvard Medical School Center for Palliative Care
  • Paul Tatum, MD; University of Texas at Austin-Dell Medical School
  • April Zehm, MD; Medical College of Wisconsin

New Osteopathic Resources Now Available

Aquifer is excited to announce the release of new resources for Osteopathic educators. Developed by the Aquifer Osteopathic Task Force, these new Active Learning Modules will help Osteopathic faculty maximize their use of Aquifer cases in their curriculum.

The Osteopathic Considerations Active Learning Modules are specifically designed to help instructors and preceptors emphasize osteopathic approaches to diagnosis and treatment. Learners are expected to complete the traditional Aquifer case, prepare for a face-to-face discussion, and participate in a facilitated discussion with other students and a facilitator,” says Erik Langenau, DO, MS, Aquifer Osteopathic Task Force Co-Lead.Each resource includes a Facilitator Guide with instructions, prompts, materials for learners, and additional resources. We believe osteopathic educators will appreciate the flexibility and practicality of this new educator resource, specifically designed to emphasize osteopathic considerations in the care of patients.”

The new resources, now available to all subscribing osteopathic programs, include 90-minute Active Learning Sessions for the following cases:

  • Family Medicine 10: 45-year-old male with low back pain
  • Pediatrics 06: 16-year-old male preparticipation evaluation

Additional osteopathic-focused resources are currently in development. The new resources are available to Osteopathic programs with institutional subscriptions to Aquifer. To find these new tools, go to the Educator Resources section of the Courses page in your Aqueduct account and select Osteopathic Educator Resources.

Did You Know...?

The Aquifer case Geriatrics 11: 75-year-old female with neck pain includes in-depth information on osteopathic approaches, including video content showing osteopathic manipulative techniques. This case is a great resource for all medical and health professions students.

Aquifer Exam Video Proctoring Reinstated

With the rise of the Delta variant of COVID-19, Aquifer has decided to resume offering our exams remotely for all exam users. This option is being reinstated to provide flexibility for faculty and learners as they manage disruptions to the learning environment. We hope that this helps you manage virtual courses during the COVID-19 crisis. We will continue to monitor the COVID-19 situation and may return to in-person proctoring in the future. Video proctoring will be available for all Aquifer exam users through March 15, 2022. 

Although our preference remains for institutions to provide Aquifer exams in a proctored setting, spaced with social distancing, we recognize that many schools must now administer examinations outside of a classroom environment.  For more information, please contact [email protected] to reach us. Please also visit our Learning Resources to Use as COVID Surges blog post for more tips and resources on how to maximize your Aquifer subscription.

New Cases on Telemedicine Coming October 15, 2021

Aquifer is pleased to announce the launch of a new course, Aquifer Foundations in Telemedicine, on October 15, 2021. The course will include four free, publicly available cases which provide key foundational knowledge to help students get started in telehealth. The new, short cases are a quick and easy way for students to become familiar with the principles and practice of telemedicine through self-directed learning in less than an hour.

Through the Aquifer telemedicine cases, students will learn how to build a patient history based on clinical condition, perform a physical exam, and manage a patient all through telemedicine. In total, all four cases should take students less than an hour to complete, providing a fast, effective tool for faculty to incorporate this rapidly expanding facet of healthcare into their teaching. The four cases available will be:

  • Foundations of Telemedicine 01 – Introduction to Telemedicine
  • Foundations of Telemedicine 02 – Building a History
  • Foundations of Telemedicine 03 – Performing a Physical Exam
  • Foundations of Telemedicine 04 – Escalating Care

Aquifer subscribers will also have access to an Educator Guide that will accompany the Foundations in Telemedicine to help faculty quickly get up to speed and optimize the way that they use these cases in their pedagogy. 

Aquifer Foundations in Telemedicine is appropriate for both students in clinical rotations and those still in the pre-clinical phase of their education. Content for these cases is aligned with AAMC telemedicine competencies and authored by medical educator members of the Society for the Teaching of Family Medicine (STFM) and the Clerkship Directors in Internal Medicine (CDIM). The cases are designed to fit in various points in the curriculum so that programs are able to include telemedicine competencies into existing components of their curricula. By integrating these cases, students in health professions educational programs will gain a stronger basis in telemedicine, thus preparing them to deliver high-quality, safe care via this fast-growing care delivery method. This set of cases also allows for a wider range of faculty to be able to teach about telemedicine, as the cases and educator guide provide a blueprint for instruction, and saves time by providing access to ready-made course materials. 

On October 15, all Aquifer subscribers will automatically have access to Foundations in Telemedicine through their Aquifer accounts including the ability to search for them via the Searchable Content Library and combine them with other cases and or Integrated Illness Scripts into custom courses. Free access to the case content will be also available to non-subscribing teachers and learners via Aquifer.org.

Call for Participation: Support Your Colleagues by Sharing Your Success Stories

Care to share? Tell us your story.

INVITATION FOR EDUCATORS & STAFF:
Please share your Aquifer success stories and teaching strategies with our growing network of medical and health professions faculty and administrators.

THE OPPORTUNITY:
Contribute to our webinar, blog, or podcast series. 

WHY CONTRIBUTE:

  • Sharing peer stories, expertise, and innovations in teaching strategies helps other educators advance their teaching.
  • Webinars, blogs, and podcasts have a broad reach and excellent engagement through Aquifer’s community of interdisciplinary, interprofessional educators.
  • Educators are consistently impressed with the quality of the information and grateful for the generosity of their peers in sharing.
  • Participants receive a letter for their CV and recognition on the Aquifer website.

Educational Impact

With Aquifer, your work will make a big impact on medical and health professions education. Over 70,000 students use Aquifer cases each year.  

AUDIENCE:
Our audience includes interdisciplinary faculty, administrators, and program leadership from 390 programs from across the U.S. and beyond, including:

  • 97% of US medical schools
  • 66% of osteopathic medical schools
  • 100+ physician assistant programs
  • A growing number of nurse practitioner, residency, and international programs

Opportunities & Estimated Time Commitment

It’s quick and easy to contribute to Aquifer’s well-supported educator-to-educator resources. 

“Participating in Aquifer’s national webinar provided me with the opportunity to connect with my colleagues in various specialties nationally to discuss best practices in using Aquifer cases with our learners. The majority of the work was done by the amazing Aquifer staff. The webinar itself was fun, the participants enthusiastic, and it left me feeling energized about teaching during this overwhelming time.“

Mandi Sehgal, MD, Cleveland Clinic Weston

Qualifications

Any faculty, course or clerkship directors, program leaders, deans, coordinators, or staff who are actively using Aquifer–or have deep past experience using Aquifer–are encouraged to apply.

Next Steps

Apply to be an author, podcast guest, or webinar presenter by completing the short web form below, telling us about your experience with Aquifer. Our team will be in touch after your submission to confirm the status of your application and upcoming opportunities that fit with your expertise and interests. 

Please contact Karey Waters, Aquifer Communications and Insights Manager, with any questions you may have about the process. We look forward to working with you to help support your peers and share your teaching innovations.


Contributor Application

Note: You will receive an email confirmation when your application submits successfully. If you don’t receive an email confirmation, please resubmit using Google Chrome as your browser, or contact us.

  • In 1-2 sentences (or more), please share how you have implemented Aquifer in your program.
  • This field is for validation purposes and should be left unchanged.

About Aquifer

Aquifer is a non-profit organization dedicated to delivering the best health care education through collaborative development and research into innovative, high-impact virtual teaching and learning methods. With 15 million virtual patient cases completed since its founding in 2006, Aquifer is the leader in developing clinical learning tools for health professions education.

Aquifer Consortium Members Honored by AGS

Aquifer congratulates consortium members Mandi Sehgal, MD, and Becky Powers, MD, AGSH, on their honors presented by the American Geriatrics Society (AGS). 

Dr. Mandi Sehgal: Outstanding Mid-Career Clinician Educator of the Year

Dr. Mandi Sehgal was recently presented with the Outstanding Mid-Career Clinician Educator of The Year Award at the AGS Virtual Annual Meeting. This award recognizes a faculty member for impressive work in geriatrics education. Although she was the 2020 recipient of this award, because of the cancellation of last year’s event due to the COVID-19 pandemic, she was awarded her honor at this years meeting. Dr. Sehgal is a geriatric medicine clinician-educator at the Cleveland Clinic Weston. At Aquifer, she serves as the Teaching & Learning Lead, as well as a Case Author on the Aquifer Geriatrics course board.

Dr. Becky Powers: New AGS Fellow

Dr. Becky Powers has been named one of fifteen AGS Fellows – a “select group of experts recognized for their deep commitment to the AGS and to advancing high-quality, person-centered care.” A a clinician educator in the South Texas Veterans Health Care System GRECC, and an Assistant Professor of Medicine in the Division of Geriatrics, Gerontology, and Palliative Medicine, Dr. Powers is an associate editor on the Aquifer Geriatrics course board.


Aquifer is a thriving, collaborative community of healthcare education leaders deeply committed to driving innovation in teaching and learning. The Aquifer Educators Consortium brings together more than 70 healthcare educators across disciplines to collaborate, innovate, and make advances in health professions education. For educators and healthcare providers, participation in the Consortium offers a unique cross-disciplinary peer community and an exciting opportunity for academic scholarship and advancement.

Integrated Illness Scripts Work Published in Medical Science Educator

Medical Science Educator Logo

Aquifer is excited to share an important new publication in Medical Science Educator:Thinking Slow More Quickly: Development of Integrated Illness Scripts to Support Cognitively Integrated Learning and Improve Clinical Decision-Making. The article is authored by the Aquifer Sciences Leadership Team of Leslie Fall, MD; Robin English, MD; Tracy B. Fulton, PhD; David M. Harris, PhD; Khiet Ngo, DO, MS; James Nixon, MD, MHPE; Jacqueline Hembrook-Short, MA, MS, PhD; and Amy Wilson-Delfosse, PhD.

In this publication, the authors explain the evidence-based, interdisciplinary approach to developing Integrated Illness Scripts and Mechanism of Disease Maps, and outline the benefits of using these new pedagogical tools to improve developing clinical decision-making skills. Integrated Illness Scripts are specifically designed to provide a framework for cognitive integration, creating a new mental model for learners and an opportunity for faculty collaboration. By incorporating Integrated Illness Scripts, a nationally-developed learning tool into instruction, clinical learners are able to improve both inductive and deductive reasoning skills more quickly and accurately diagnose patients. Integrated Illness Scripts were designed by a multi-institutional and multidisciplinary group of leading clinical and basic science educators.

Aquifer’s Integrated Illness Scripts will be available July 1 to Aquifer Curricular Partners. Aquifer Curricular Partners are programs that subscribe to all five subscription-based Aquifer signature courses.


About the Medical Science Educator

This journal offers all who teach in healthcare the most current information to succeed in their task by publishing scholarly activities, opinions, and resources in medical science education. Articles focus on teaching the scientific skills which are fundamental to modern medicine and health, including basic science education, clinical teaching and the incorporation of modern education technologies. The Journal aims to provide its readers with a better understanding of teaching and learning techniques, in order to advance medical science education. The journal is an official peer-reviewed publication of the International Association of Medical Science Educators (IAMSE).

About Aquifer

Aquifer is a unique mission-driven non-profit organization dedicated to delivering the best health care education through collaborative development and research into innovative, high-impact virtual teaching and learning methods. With 15 million virtual patient cases completed since its founding in 2006, Aquifer is the leader in developing clinical learning tools for health professions education.

New Cases on Interventional Radiology Coming July 1

Aquifer is excited to announce that two new cases on Interventional Radiology (IR) will be added to the Aquifer Radiology course beginning on July 1, 2021. The new cases, which cover the role of IR and the basics of common problems, are designed to build a foundational understanding of how to use IR as a consultation service, providing valuable knowledge for learners advancing to any specialty.

“IR is at the forefront of modern medicine with increasing interest in and demand for IR services, but it is not a conventional part of the undergraduate medical curriculum. Student exposure to IR is frequently inadequate, as few programs across the country have included fundamentals of incorporating IR in patient care in the curriculum,” said Jeffery Hogg, MD, of West Virginia University and Senior Director of Aquifer Radiology. “Our team is excited to provide these new cases, developed specifically for undergraduate learners to fill this important gap in medical and health professions education.” 

Both of the new cases are focused on IR consultation and the interchange between the referring service and IR service, helping learners understand how IR fits into overall patient care. The first case, Radiology Case 20: Interventional Radiology – Vascular, takes place in a busy hospital-based interventional radiology practice. The team manages different vascular problems in scheduled patients along with unplanned schedule interruptions. Radiology Case 21: Interventional Radiology – Nonvascular, walks the learner through a typical day in the interventional radiology suite, where the learner will assess patients and apply ACR Appropriateness Criteria to determine appropriate nonvascular interventional procedures, and learn basic workup of patients for interventional procedures.

The new cases are applicable to medical students, as well as physician assistant and nurse practitioner students. Teams of medical educators authored and peer-reviewed the new cases, in keeping with Aquifer’s rigorous content development standards. Like all Aquifer signature cases, both Interventional Radiology cases can be added to any custom course and include student progress reporting. Subscribers to Aquifer Radiology will find the new cases accessible from the Aquifer Radiology signature course and the searchable Content Library on July 1, 2021.

Aquifer Radiology Seeks Course Board Member & Case Editor

Make an Impact: Work with Aquifer to Advance Medical Education

Aquifer—a unique non-profit organization dedicated to advancing healthcare education—is now accepting applications for two key positions supporting the Aquifer Radiology course.


Our Reach

Working with Aquifer, your work will make a big impact on medical and health professions education. Aquifer’s virtual patient cases are used in 97% of U.S. allopathic medical schools, 66% of osteopathic medical schools, and a growing number of health professions programs.

Aquifer Radiology is used by 215 programs, including medical schools, physician assistant, and nurse practitioner programs.


Open Positions

Aquifer Radiology Course Board: Teaching & Learning Lead

This position is part of the interdisciplinary Teaching & Learning Working Group and Aquifer Radiology Course Board. The Teaching & Learning Group is a unique interdisciplinary team with representatives from each Aquifer course that works to maintain and develop teaching resources, innovative pedagogies, and share approaches and participate in outreach to improve the integration of Aquifer across medical and health professions education. This position is part of the Aquifer Educators Consortium and has a one year period of service with renewable terms. 

This position is open to any educator who meets the following qualifications:

  • Member of AUR and AMSER
  • Experience using Aquifer courses in a direct role as course, clerkship, or curriculum director

The Aquifer Teaching and Learning (T&L) Lead ensures that Educators who use Aquifer in their specified discipline have up-to-date teaching materials and a clear understanding of how to use them to enhance student learning. 

Overall Activities and Responsibilities:

  • Educator Resources:
    • Oversee the review and updating of course-specific teaching materials 
    • Identify and support the development of new educator resources as appropriate
  • Along with the Aquifer Radiology Senior Director, serve as a liaison between your course board and the relevant National Organization to: 
    • Facilitate implementation of engagement approaches at national specialty organization meetings (workshops, presentations, booths, informal social gatherings etc).
  • Participate in Aquifer outreach activities that facilitate educator collaboration beyond traditional specialty silos to enhance medical student education. Activities might include: 
    • Presentations of workshops at regional and national meetings,
    • Podcasts, webinars and workshops about using Aquifer Radiology 
    • Exploratory discussions with faculty and students locally/regionally/nationally.
  • Develop expertise about effective integration of online learning and assessment tools.
  • Participate in Aquifer Course board calls.
  • Participate in T&L working group calls.
  • Participate in T&L integration/engagement projects (as interest and need dictates).
  • Attend the Aquifer annual meeting.

Aquifer’s Responsibilities to Teaching and Learning Leads 

  1. Provide materials, guidance and support for continuous course and educator resource improvement.
  2. Provide support for the Teaching and Learning Working Group Meetings.
  3. Provide support for attendance at the Aquifer Annual Meeting (Wellspring)
  4. Provide support and guidance for continuous course and educator resource improvement processes.
  5. Provide annual a letter acknowledging leadership and scholarly contributions to Aquifer and its mission (if desired).

Term

The period of service is one year, with renewable terms at the discretion of the Aquifer Radiology Senior Director and Aquifer Chief Academic Officer.

Case Editor: Aquifer Radiology 18 – Professionalism in Radiology

The Case Editor position involves a review of Aquifer Radiology Case 18: Professionalism in Radiology. This case offers unique content that helps learners  increase their awareness of the crucial influence their own professionalism exerts within systems of practice. The content prepares learners for skills and attitudes they will need to thrive in fulfilling their future ACGME Professionalism milestones as residents. Case reviews occur as part of Aquifer’s Continuous Case Improvement (CCI) process once every 18-months, in collaboration with the Associate Editor for that case from the Aquifer Radiology Course Board. Essentially, the Case Editor brings up-to-date, high level content expertise, ensures that all references and external links to resources remain relevant, correct, and current. Each online case takes about 45 minutes for students to complete, to give you an idea about the size of the task. This work is very well supported by the Aquifer Radiology Production team.

As a case editor, you would use your extensive experience and training to review virtual patient cases that address specific learning objectives. These scenarios are used in the training of medical students and other health professionals.

Your participation would require:

  • Going through a brief training.
  • Providing feedback on the quality of the case, its authenticity, and other aspects of the experience as you review it, ensuring that the content, clinical reasoning, and pedagogy within the case are current, reflective of standard practice and of the national curriculum objectives, and at the appropriate level for a core clerkship student.
  • Documenting any errors, broken links, or other changes needed.
  • At the completion of your review, discussing your review with an associate editor via a Zoom call or email, and responding to their questions and suggestions..

Aquifer will provide a detailed letter for your educator’s portfolio and recognition of your contribution on our website.

Application Process

The Aquifer Radiology Course Board will welcome your expression of interest. Please write to Aquifer Radiology Senior Director, Dr. Jeff Hogg ([email protected]) with AQUIFER RECRUITMENT in the subject line if you are interested in either of these positions.

We look forward to working with you to better serve the needs of radiology educators and students.

Sincerely, 

The Aquifer Radiology Course Board

  • Jeffery Hogg, MD; Senior Director (West Virginia University)
  • Pauline Germaine, DO; Curriculum Lead (Rowan University)
  • Jennifer Koay White, MD; Associate Editor (West Virginia University)
  • Matthew Miller, MD; Associate Editor (Allegheny Health Network)
  • Melissa Manzer, MD; Associate Editor (University of Nebraska)
  • Siddhartha Gaddamanugu, MD; Assessment Lead (University of Alabama, Birmingham)

Research Letter: Teaching Geriatrics During the COVID-19 Pandemic

Consortium Members Publish “Teaching geriatrics during the COVID-19 pandemic: Aquifer Geriatrics to the rescue”

Aquifer congratulates Ravishankar Ramaswamy, MD, Amit A. Shah, MD, Kathryn M. Denson, MD, Mandi Sehgal, MD, Quratulain Syed, MD, Becky B. Powers, MD, Andrea Wershof Schwartz, MD, MPH, Rosanne M. Leipzig, MD, PhD, and Lauren J. Gleason, MD, MPH on their recent publication of their research letter Teaching geriatrics during the COVID-19 pandemic: Aquifer Geriatrics to the rescuein the Journal of the American Geriatrics Society.

“When many institutions transitioned to online learning during the height of the pandemic, Aquifer Geriatrics came to the rescue and provided an engaging way to fill the void of in-person teaching.”

The authors investigate how the use of Aquifer Geriatrics grew exponentially during the COVID-19 pandemic, especially among Nurse Practitioner and Physician’s Assistant programs, and how programs continued to subscribe to Aquifer Geriatrics after the ending of the grant-funding period. Furthermore, the authors note that learner satisfaction grew from pre-pandemic levels, through the grant-funded period, to the subscription-based access period. The full article can be accessed here.


About the American Geriatrics Society

Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals that has—for more than 75 years—worked to improve the health, independence, and quality of life of older people. Its nearly 6,000 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit AmericanGeriatrics.org.

About Aquifer

Aquifer is a unique mission-driven non-profit organization dedicated to delivering the best health care education through collaborative development and research into innovative, high-impact virtual teaching and learning methods. With 15 million virtual patient cases completed since its founding in 2006, Aquifer is the leader in developing clinical learning tools for health professions education.

Call for Participation: Aquifer Osteopathic Task Force

Make an Impact: Work with Aquifer to Advance Medical Education

Aquifer—a unique non-profit organization dedicated to advancing healthcare education—is inviting osteopathic physicians to join the 2021 Osteopathic Task Force. The goal of this Task Force is to amplify the voice, interests, and experiences of osteopathic medical educators to Aquifer, and to participate in the review and development of teaching tools for osteopathic educators using Aquifer courses.

With 15 million virtual patient cases completed since our founding in 2006, Aquifer is the leader in developing clinical learning tools for medical and health professions education. Aquifer needs your help ensuring that our learning tools meet the needs of osteopathic physician educators. 


Our Reach

Working with Aquifer, your work will make a big impact on osteopathic medical education. Aquifer’s trusted, rigorous clinical learning tools are used in 66% of U.S. osteopathic medical schools.


Aquifer Osteopathic Task Force Details

Why: To further develop Aquifer’s teaching and learning resources as a valuable tool for osteopathic medical educators.

Who: This is an open invitation to all osteopathic educators who use Aquifer courses. The group will be supported by Aquifer staff and led by:

  • Erik Langenau, DO, MS, FAAP, FACOP
    Chief Academic Technology Officer, Dept of Professional Development and Online Learning
    Pediatrician, Dept of Family Medicine
    Philadelphia College of Osteopathic Medicine
    Aquifer Teaching & Learning Co-Lead for Osteopathic Education
  • Barbara Capozzi, DO, CNS
    Clinical Dean
    Clinical Education Department
    Touro College of Osteopathic Medicine- Harlem
    Aquifer Teaching & Learning Co-Lead for Osteopathic Education
  • Sherilyn Smith, MD
    Chief Academic Officer, Aquifer
    Professor of Pediatrics
    University of Washington School of Medicine

What: The Aquifer Osteopathic Task Force will:

  • Develop and review faculty materials to support the use of Aquifer cases in the osteopathic curriculum
  • Provide input to Aquifer leadership regarding the priorities and unique needs of osteopathic programs

When: The Task Force will work actively for approximately 6 months, with work starting in late spring 2021. Work will include:

  • Monthly video conference calls
  • Working offline on prioritized projects, with work reviewed by the group on monthly calls

If you are interested in joining or learning more about the Osteopathic Task Force, please complete this short application (by May 14, 2021).  

We look forward to working with you to better serve the needs of osteopathic educators and students.

Jen Bierman, MD Honored by CDIM

Aquifer congratulates Jennifer Bierman, MD, Aquifer Student Engagement Co-Lead, on receiving the Louis N. Pangaro, MD Educational Program Development Award. This award, presented by the Clerkship Directors in Internal Medicine (CDIM) at their Annual Meeting, recognizes a CDIM member who has contributed to the development of an outstanding educational program. CDIM is a member organization of the Alliance for Academic Internal Medicine (AAIM).

Dr. Jennifer Bierman is receiving this award based on her extensive work integrating interprofessional and online learning related to electronic health records. Her award nomination states that she “successfully led a team to pilot a case in this format and is now creating a library of cases demonstrating different medical specialty and health professions interactions with the electronic health record. Implementation of this project is ongoing but [Dr. Bierman] has created a team who is committed to the dissemination of their findings.”

At the Northwestern University Feinstein School for Medicine, Dr. Bierman serves as Associate Professor of Medicine and Medicine Education and Clerkship Director ECMH (Education Centered Medical Home). A member of CDIM since 2005, Dr. Bierman is a former member of the CDIM Program Planning Committee and has presented multiple plenary and workshop sessions at Alliance conferences. She earned her MD from the University of Minnesota Medical School and completed her residency in internal medicine at the University of Chicago Medical Center.

At Aquifer, Dr. Bierman is Student Engagement Co-Lead, where she works with the Aquifer Student Advisory Group, a group of medical and health professions students that provide essential feedback on Aquifer’s learning tools. She is also a past member of the Aquifer Internal Medicine Course Board and case author. All of us at Aquifer congratulate Dr. Bierman on this important national honor.

 


Aquifer is a thriving, collaborative community of healthcare education leaders deeply committed to driving innovation in teaching and learning. The Aquifer Educators Consortium brings together more than 70 healthcare educators across disciplines to collaborate, innovate, and make advances in health professions education. For educators and healthcare providers, participation in the Consortium offers a unique cross-disciplinary peer community and an exciting opportunity for academic scholarship and advancement.

Aquifer Launching New Social Determinants of Health Cases

Aquifer is pleased to announce the upcoming release of our new Social Determinants of Health Course on July 1, 2021. This course will include an overview module and two virtual patient cases to be available free of charge to all teachers and learners, whether or not they subscribe to Aquifer. We are proud to provide universal access to content focusing on this critically important topic in health care education.

As the leading provider of online health professions education teaching and learning tools, Aquifer is dedicated to ensuring that our educational materials do not perpetuate stereotypes in healthcare and education and that our courses incorporate continuous review and contemporary teaching about social determinants of health. The launch of this new course content is one step in advancing learning explicitly related to these topics in our content library.

As of our July 1, 2021 launch, the Aquifer Social Determinants of Health includes three modules:

  • Overview module with general information on social determinants of health and definitions
  • Two virtual patient cases illustrating the impact of language and poverty as social determinants of health. Although both cases cover pediatric patients, the topics and communication skills taught are applicable to patients of all ages. 

Programs with a current Aquifer subscription will also have access to an accompanying educator guide with learning objectives and a new active learning module, providing a ready-to-use optional classroom activity to be used in conjunction with the cases. Subscribers will also be able to view student progress reporting and add the new cases to a custom course. This course, like all Aquifer content, is evidence-based, peer-reviewed, and will be continuously updated.

From Culture in Healthcare to Social Determinants of Health

Aquifer’s previous Culture in Healthcare course was retired on October 22, 2020, in order to thoroughly update the content and teaching about bias, health inequities, and healthcare outcomes. The Aquifer Social Determinants of Health Course builds on reframed versions of two former Culture in Healthcare cases. Cases have been revised to remove language and content related to cultural competency, and thoroughly reviewed to eliminate bias and stereotyping. The shorter, reformatted cases do retain the reflective components that were a part of the original Culture in Health cases.

Programs that requested special access to Aquifer Culture in Healthcare to complete their coursework have access to the archived course through June 30, 2021. As of July 1, the new Social Determinants of Health course will be available as a contemporary replacement for all teachers and learners. If you are currently using Aquifer Culture in Healthcare, please be sure to download any case completion reports that you need for those cases prior to June 30. For more details, view our side-by-side learning objectives comparison for Aquifer Culture in Healthcare and Social Determinants of health.

Commitment to Equity & Inclusion

Following a thorough review of all existing Aquifer cases according to our peer-reviewed and published criteria, our cases continue to be regularly reviewed based on these principles by teams of medical educators, with an eye toward optimizing this process to further ensure that current best practices are consistently integrated across our course library.

Aquifer looks forward to advancing this work and continuing to support faculty and students with contemporary, inclusive teaching resources.

Connect with Aquifer at COMSEP 2021

Aquifer will be attending the COMSEP Annual Meeting from April 6 – 9, 2021, taking place virtually, to share updates on our developing projects and help faculty and staff make the most of their subscriptions.

If you are attending the meeting, we hope to see you at:

Workshop: Coaching For the Development of Master Adaptive Learners

Friday, April 9 from 11:45am – 1:15pm EDT

Coaching For the Development of Master Adaptive Learners

Presenters: Melissa Held, MD; Michael Dell, MD; Aditee Narayan, MD; Sherilyn Smith, MD

The pace of the development of new biomedical knowledge and of changes in healthcare systems requires physicians and medical students to develop the ability to seamlessly adapt new information and concepts into their existing mental frameworks in order to become experts. Never has this dynamic been more in evidence than during the COVID-19 pandemic, in which new knowledge, skills, and processes of care have arisen at a furious rate. In order to develop into what the American Medical Association has termed Master Adaptive Learners, medical students, typically highly-motivated learners, will benefit from coaching from their clinical teachers to facilitate their self-regulated learning and help them develop the habits of mind required for making clinical decisions in modern practice.

In this workshop, we will present a schemata of the Master Adaptive Learner process and introduce novel tools to aid family physician faculty as they coach their students towards their development of cognitive mastery. The workshop will combine didactic presentation and practical application of the new coaching tools so that attendees will come away with useful skills to bring back to their home institutions. The presenters will encourage active discussion and group participation so as to benefit from the shared experience in the room in developing best practices for making use of the novel cognitive coaching framework and tools.

Learning Objectives:

  • On completion of this session the participants should be able to describe the elements of Master Adaptive Learning Schemata and how they apply to clinical learning.
  • On completion of this session the participants should be able to differentiate between coaching and advising or teaching.
  • On completion of this session the participants should be able to apply coaching techniques to facilitate learners creating personalized plans for mastery learning using real world examples of formative assessment information.
  • On completion of this session the participants should be able to develop local curricula to teach these principles to community faculty.

Programs & Partners Session

Wednesday, April 7 from 1:45pm – 2:45pm

Connect directly with your COMSEP colleague members of the Aquifer Pediatrics Course Board.  Bring your questions, ask for integration and teaching advice, and get the latest updates on:

Individual Training or Q&A

If you aren’t able to make the Programs & Partners session but would like to catch up to discuss our developing projects or get answers to your questions, please contact Cate Hancock, Aquifer RelationshipManager to schedule a time to meet or talk by phone.

We look forward to seeing you!

More Recommended Presentations

We recommend attending the following presentations by Aquifer Educators Consortium members:

Friday, April 9 from 1:45 – 3:15pm EDT

Presenters: Anton Alerte, MD; Mary Brown, MD, MS; Antonette Spoto-Cannons, MD; Jennifer Koestler, MD; Melissa Held, MD; Mariann Kelley, MD; Joanne Crowley, MD; Melanie Rudnick, MD; Amy Fleming, MD, MHPE; Patricia Joyce, MD

This workshop involves collaboration among faculty from five different universities to address the subject of medical student remediation. Student success may be challenged due to a number of factors including knowledge deficits, gaps in reasoning, failure to perform in a team setting, and/or professionalism lapses.

Learning Objectives:

This workshop will provide faculty with a framework for helping the student who has failed or is failing.

Participants will:

  • List tools useful for early identification and categorization of the student with difficulty
  • Identify best practices in remediation
  • Identify strategies to create individualized remediation plans
  • Identify obstacles, including implicit biases, which may interfere with remediation plans

Aquifer Palliative Care Team Seeks Stakeholder Input

The Aquifer Palliative Care Leadership Team is moving forward with the work to create new curricular content about palliative care with the support of the Arthur Vining Davis Foundations.

Right now, this interdisciplinary team of experts from across the fields of medicine, nursing, and social work are actively working on creating a palliative care curriculum for all health professions students. The next step will be creating a new Aquifer course.

Invitation for Feedback: Faculty & Program Leadership

In order to advance this work, the team is seeking feedback from a range of stakeholders that will inform the direction of the work on this project.

At this stage, they are seeking feedback from all medical school and health professions educators in the following roles:

  • Teaching faculty
  • Course or clerkship directors
  • Deans
  • Program Directors

Input from these educators will guide the work of forming the curriculum, learning objectives, and instructional approach for the new content.

Survey

All educators in any of the roles listed above are invited to take 5-10 minutes to complete the Palliative Care in Medical & Health Professions Education survey. The survey will be open from February 23 to March 3.

Focus Groups

The Aquifer Palliative Care Leadership Team will hold several focus group discussions about palliative care in medical and health professions education. The feedback from these discussions will augment the survey data to help inform the project work.

Focus Groups are currently full.

Aquifer Palliative Care Leadership Team

Academic Lead: Mandi Sehgal, MD; Florida Atlantic University Charles E. Schmidt College of Medicine/Cleveland Clinic

Aquifer Lead: Sherilyn Smith, MD; Aquifer, University of Washington

Team Members:

  • Brynn Bowman, MPA; Center to Advance Palliative Care
  • Karen Bullock, PhD, LCSW, APHSW-C; North Carolina State University
  • Rebecca Edwards, DNP, APRN, ACNP, AOCNP, ACHPN; University of Alabama
  • Susan Merel, MD; University of Washington
  • Kristen Schaefer, MD, FAAPM; Care Dimensions
  • Barbara Reville, DNP, ANP-BC, ACHPN; Harvard Medical School Center for Palliative Care
  • Paul Tatum, MD; University of Texas at Austin-Dell Medical School

Aquifer at STFM 2021

If you’re registered for STFM’s Medical Student Education Conference on February 1-4, 2021, be sure to catch our video presentations and join your colleagues from the Aquifer Family Medicine Board for a Zoom chat. We look forward to connecting with you at this year’s virtual meeting.

On-Demand Video Presentations

You don’t want to miss these presentations–block some time on your calendar to catch these recordings.

Aligning the National Clerkship Curriculum, the NBME, and Aquifer Family Medicine’s Learning Objectives for Enhanced Curricular Mapping

On-demand Video Presentation (21 minutes) – Sign in to watch with your STFM conference registration

Presentation OD63 under EPAs, LCME and OSCEs

This is a joint presentation between members of the Aquifer Family Medicine Course Board, a representative from the STFM National Clerkship Curriculum, and an STFM representative to the NBME. We presented about the alignment of the learning objectives and issues we have discovered in our curricular mapping. 

Presenters:

  • David Anthony, MD, M.Sc (Brown University, Aquifer Family Medicine Senior Director)
  • Jason Chao, MD (Case Western Reserve University, Aquifer Family Medicine Assessment Lead)
  • Katie Margo, MD (University of Pennsylvania, Aquifer Family Medicine Curriculum Lead)
  • Annie Rutter, MD (Albany Medical College, STFM National Curriculum Editorial Board)
  • Robert Hatch, MD (NBME Family Medicine Exam Task Force)

Coaching for the Development of Master Adaptive Learners

A workshop-turned-video

On-demand Video Presentation (30 minutes) – Sign in to watch with your STFM conference registration

OD94 under Preceptors: Recruitment, Retention, and Relationships

Explore how the Master Adaptive Learner Framework applies to clinical learning and how Aquifer’s formative assessment approach supports the development of mastery learning. We will demonstrate a coaching approach to facilitate a rich student-faculty dialogue and create personalized plans for mastery learning using real-world examples from Aquifer’s formative assessment.

Presenters:

  • David Anthony, MD, M.Sc (Brown University, Aquifer Family Medicine Senior Director)
  • Jason Chao, MD (Case Western Reserve University, Aquifer Family Medicine Assessment Lead)
  • Sherilyn Smith, MD (University of Washington, Aquifer Chief Academic Officer)
  • Leslie Fall, MD (Aquifer Chief Executive Officer)

Zoom Rooms: Connect with Your Peers

Monday, February 1: Anytime from 2:30-3:30pm CT  (Direct Zoom Link)

Tuesday, February 2: Anytime from 2:30-3:30pm CT (Direct Zoom Link)

Can’t make those times but want to catch up? Contact us to set a quick meeting.

Drop-in to our “Conference Partners Meet and Greet” session and connect with members of the Aquifer Educators Consortium and our dedicated Aquifer staff to:

  • Chat with your colleagues on the Aquifer Family Medicine Course Board
  • Hear tips for improving your use of Aquifer Family Medicine (in the pandemic and beyond)
  • Bring your questions on anything Aquifer (using the cases, assessment, how-to’s, etc)
  • Hear the latest updates on our formative assessments for test-enhanced learning (pilot coming in 2022) and Aquifer Sciences Integrated Illness Scripts (available July 1 to Aquifer Curricular Partners) 

Aquifer Family Medicine Course Board

Senior Director: David Anthony, MD, MSc (Brown University)

Curriculum Lead: Katie Margo, MD (University of Pennsylvania)

Teaching & Learning Lead: Elizabeth Brown, MD (University of Rochester)

Assessment Lead: Jason Chao, MD (Case Western Reserve University)

Associate Editors:

  • Tomoko Sairenji, MD, MS (University of Washington)
  • Martha Seagrave, PA-C (University of Vermont)
  • Augustine Sohn, MD, MPH (University of Illinois)
  • John Waits, MD (University of Alabama)
  • Jordan White, MD, MPH (Brown University)

2021 Aquifer Physician Assistant Task Force Announced

Aquifer is pleased to announce the selection of participants for our 2021 Physician Assistant Task Force. This group will bring the voice, interests, and experiences of physician assistant educators to Aquifer, and work to develop educator tools and training materials to support physician assistant programs using Aquifer.

After a competitive selection process, we are pleased to welcome the following educators from institutions around the country:

  • Petar Breitinger, MPAS, PA-C, DFAAPA; University of Florida Physician Assistant Program
  • Kathleen Ehrhardt, MMS, PA-C; DeSales University
  • Tanya Fernandez, MS, PA-C, IBCLC; University of Colorado School of Medicine Physician Assistant Program
  • Kindred Harland- Shulgin, MS, PA-C; Pace University – Lenox Hill Hospital Physician Assistant Program – NYC
  • Darcie Larimore-Arenas, MSPAS, MPH, PA-C; Touro University California
  • Jensen Lewis, MSPAS, PA-C; Case Western Reserve University Physician Assistant Program
  • Shannon North, MSPAS, PA-C; Pace University – Lenox Hill Hospital Physician Assistant Program – NYC
  • Denise Ogden, MA, PA-C; University of Colorado School of Medicine Physician Assistant Program
  • Elisabeth Shell, PhD, MPAS, PA-C; Baylor College of Medicine Physician Assistant Program
  • Jana Villanueva, MSPAS, PA-C; University of Alabama at Birmingham Physician Assistant Studies Program
  • Elias Villarreal, Jr., MPAS, DMSc, PA-C, DFAAPA; Northern Arizona University
  • Anne Walsh, PA-C; Chapman University
  • Michele Zawora, MD, FAAFP; Thomas Jefferson University Center City Campus Physician Assistant Studies Program

The Aquifer Physician Assistant Task Force is led by: 

  • Cynthia Booth Lord, MHS, PA-C
    Aquifer Teaching & Learning Lead for Physician Assistant Education
    Program Director, Physician Assistant Program, Case Western Reserve University School of Medicine
  • Sherilyn Smith, MD
    Aquifer Chief Academic Officer
    Professor of Pediatrics, University of Washington School of Medicine

The Aquifer Physician Assistant Task Force was created in January 2020. The group convened to create, review, and disseminate educational materials designed to support the integration and effective use of Aquifer cases to train physician assistants. The 2020 Task Force completed a needs assessment and launched the design process for a new Physician Assistant Educator Guide for Aquifer cases. 

The 2021 Physician Assistant Task Force will advance work on the Educator Guide with the goal of completing this resource and beginning the design process for developing additional resources. This year’s task force includes a great mix of returning members and educators new to the group, all of who are actively teaching with Aquifer courses. We look forward to working with this talented group of educators.

Self-Assessment Questions Added to Aquifer Geriatrics & High Value Care

Aquifer is pleased to announce the addition of new self-assessment questions (SAQs), as of January 4, 2021, to ten Aquifer Geriatrics and nine Aquifer High Value Care cases. Students and faculty will find the new questions available at the conclusion of each case listed below. Aquifer’s multiple-choice SAQs, found at the end of cases throughout Aquifer’s signature courses, reinforce key concepts taught in the case and extend learning beyond a single scenario. Each SAQ includes an explanation for why each answer option is correct or incorrect and provides additional information to help students understand the associated clinical decision point. Each question and answer explanation is written and peer-reviewed by a team of medical educators.

For students, the self-assessment questions provide a safe space to check their understanding and practice applying knowledge to new patients and problems. Student work is not visible to faculty. 

Faculty should be aware of this new addition when assigning cases to students and understand that student work on these multiple-choice questions is not visible to preserve the student’s learning experience. As always, case completion status and time on case data will be available in reporting.

Cases with Newly Available Self-Assessment Questions

As of January 4, self-assessment questions are available for the following cases. Questions are currently in development for the rest of Aquifer’s Geriatrics and High Value Care cases.

Aquifer Geriatrics

  • Geriatrics 01: 85-year-old female using anticoagulants
  • Geriatrics 03: 88-year-old female with urinary incontinence
  • Geriatrics 04: 85-year-old female with dementia
  • Geriatrics 05: 79-year-old female with agitation
  • Geriatrics 06: 85-year-old female with delirium
  • Geriatrics 07: 78-year-old male with depression
  • Geriatrics 12: 78-year-old female and falls
  • Geriatrics 17: 86-year-old female with pneumonia
  • Geriatrics 22: 74-year-old male and hazards of hospitalization: geriatric patient safety in the acute care setting
  • Geriatrics 23: 70-year-old female and hazards of hospitalization: transitions of care and discharge planning for geriatric inpatients

Aquifer High Value Care

  • High Value Care 01: 45-year-old male – The importance of clinical reasoning
  • High Value Care 02: 25-year-old female – Making diagnostic testing count
  • High Value Care 03: 65-year-old female – Adult preventive care and value
  • High Value Care 04: 80-year-old female – Medications and value
  • High Value Care 05: 78-year-old female – High value care in the inpatient setting
  • High Value Care 06: 65-year-old male – Paying for value: Insurance Part 1
  • High Value Care 07: 7-year-old female – Rooting out waste
  • High Value Care 08: 5-month-old female and 4-year old female – Value of vaccines
  • High Value Care 09: 66-year-old female – Redefining value at end of life

Academic Contributors

Thank you to the teams of medical educators who worked hard to write and peer-review the newly available self-assessment questions to support and enhance student learning in Aquifer’s cases.

Geriatrics Question Authors & Reviewers

Aquifer Geriatrics Assessment Lead: Ravishankar Ramaswamy, MD – Icahn School of Medicine at Mount Sinai

  • Angela Beckert, MD – Medical College of Wisconsin Assistant Professor
  • Katie Denson, MD –  Medical College of Wisconsin Professor
  • Cara O’Brien, MD –  Medical College of Wisconsin Assistant Professor
  • Ayla Pelleg, MD – Icahn School of Medicine at Mount Sinai Assistant Professor
  • Samantha Lau, MD –  Icahn School of Medicine at Mount Sinai Assistant Professor

High Value Care Question Authors & Reviewers

Aquifer High Value Care Assessment Lead: Amit Pahwa, MD – John Hopkins University

  • Holli Neiman-Hart, MD – Western Michigan University Homer Stryker MD School of Medicine Program Director
  • Shadi Dowlatshahi, MD – Los Angeles County + USC Medical Center Assistant Professor
  • Stephanie Conrad, MD – Phoenix Children’s Hospital Assistant Professor, Pediatric Clerkship Director
  • Latasha Bogues, MD – Morehouse School of Medicine Assistant Clerkship Director
  • Rebecca Carter, MD – University of Maryland School of Medicine Assistant Professor
  • Kyra Len, MD – University of Hawaii John A. Burns School of Medicine Assistant Professor
  • Conrad Krawiec, MD –  Pennsylvania State College of Medicine Associate Professor
  • Zayd Razouki, MD – Mayo Clinic Assistant Professor

Call for Participation: Aquifer Student Advisory Group

Aquifer-Student-Advisory-Group

Medical & Health Professions Students: Join Us to Make an Impact

Aquifer is excited to announce an opportunity to join a national board of interprofessional students tasked with providing critical feedback on the development of Aquifer’s new learning tools. Following the success of our inaugural Student Advisory Group in 2020, we are now recruiting a new group of students to serve on the group for 2021. Medical and physician assistant students are invited to apply to serve on the 2021 Student Advisory Board.

Aquifer—a unique non-profit organization—makes a big impact on medical and health professions education. Used in 97% of U.S. allopathic medical schools, 66% of U.S. osteopathic programs, and a growing number of physician assistant and nurse practitioner programs—with over 15 million virtual patient cases completed since our founding in 2006—Aquifer is a leader in clinical learning.

Help us build the best possible tools to advance your clinical learning.

Aquifer is in the process of developing new assessments, cases, and other learning tools. Student voices and ideas are needed to ensure that our solutions provide the most value to students.

Selected students will be invited to preview and provide honest, constructive feedback on Aquifer’s new developing learning tools, designed to be used in medical and health professions programs across the country. Feedback from this group will be used to optimize the technology and content in our tools, inform communications, and develop training resources.

Work

  • Completing up to 1 hour of pre-work in advance of each meeting.
    • Previewing a new learning tool via interactive demo, watching a screencast, or reading/viewing background information or presentations.
    • Completing a preliminary survey with your initial feedback. 
  • Attending six 1-hour Zoom meetings (approx. every 8 weeks) to discuss and learn more about different aspects of the learning tools. Meetings will be scheduled on weekday evenings. Our first meeting is tentatively planned for late January 2021.

A letter of recognition will be provided at the end of the year.

Eligibility

We are accepting applications from students who have completed Aquifer cases either as part of their coursework or have used our free cases on their own and meet the following requirements:

  • Medical students from MD or DO programs who are in their 2nd or 3rd year.
  • Physician assistant students who are graduating in 2022 or later.
  • Interest in medical and health professions education.
  • Prepared to give honest, thoughtful feedback in a constructive manner.
  • Able to commit to completing all pre-work assignments and attending at least 4 out of 6 meetings.

Application Process

Applications closed on December 18, 2020. Students will be notified of their status by January 8. Please contact Karey Waters, Aquifer Communications and Insights Manager, with any questions.

Call for Participation: Physician Assistant Task Force

Make an Impact: Work with Aquifer to Advance Medical Education

Aquifer—a unique non-profit organization dedicated to advancing healthcare education—is excited to announce the call for participation for our 2021 Physician Assistant Task Force. This group will bring the voice, interests, and experiences of physician assistant educators to Aquifer, and work to develop educator tools and training materials to support physician assistant programs using Aquifer to achieve better student outcomes by integrating Aquifer into their curriculum.

This is an exciting opportunity to participate in a scholarly project on a national level and advance healthcare education through collaboration. With over 15 million virtual patient cases completed since our founding in 2006, Aquifer is the leader in developing clinical teaching and learning tools.


Our Reach

Working with Aquifer, your work will make a big impact on physician assistant education. 100 physician assistant programs are currently using Aquifer’s trusted, rigorous clinical learning tools. Aquifer courses are also used in 97% of U.S. allopathic medical schools.


Aquifer Physician Assistant Task Force Details

We are recruiting 12 active, highly engaged physician assistant educators who are ready to work. All physician assistant educators who use Aquifer courses and are actively teaching are eligible to apply. We will lead this task force, and the group will be supported by the Aquifer staff.

Work: Members of the Aquifer Physician Assistant Task Force will:

  • Participate in the development of educator resources and training materials to support integration of Aquifer cases into the PA curriculum (develop and review new material in collaboration with colleagues)

  • Participate in Aquifer webinars, blogs, and/or podcasts as available/appropriate to share best practices for solving curricular challenges using Aquifer cases

Benefits: Selected Task Force members will have the opportunity to:

  • Present task force work and your own educational innovations on a national level

  • Conduct educational research through the Aquifer Research Program

  • Influence and inform Aquifer leadership regarding the priorities and unique needs of physician assistant programs

  • Receive a letter of recognition for your scholarly work and task force participation

Commitment: This application expresses your commitment for 1 year, with work starting in January 2021. Work will include:

  • Attend one 60-minute video call meeting per month

  • Approx 2-3 hours/month of offline work

To apply, please complete our short online application, open through December 15.

We look forward to working with you to better serve the needs of physician assistant educators and students.

Thank You,

Aquifer Physician Assistant Task Force Leads

Cynthia Booth Lord, MHS, PA-C
Aquifer Teaching & Learning Lead for Physician Assistant Education
Program Director and Associate Professor, Physician Assistant Program, Case Western Reserve University School of Medicine

Sherilyn Smith, MD
Aquifer Chief Academic Officer
Professor of Pediatrics, University of Washington School of Medicine

New Case on Advance Care Planning Added to Aquifer Geriatrics

Aquifer is excited to announce that a new case on Advance Care Planning is now available in the Aquifer Geriatrics course. The new case models communication and management of end-of-life care and advance care planning (ACP), and is designed to deliver the core knowledge needed for students and providers to develop skills in these critically important topics.

The case, Aquifer Geriatrics case 27, follows a 76-year-old woman with advanced COPD, as she completes advance care planning with her daughter and primary care physician. Her daughter, who is her medical power of attorney, makes medical decisions on her mother’s behalf as she experiences debilitating events. Key learning points in the case include advance care planning, advance directives, surrogate decision-makers, and disease-specific goals of care conversations. Case content includes short videos modeling a successful discussion on ACP with a patient and family member. 

The new case is appropriate for all health professions students and fills a need for educational materials with a geriatric-specific approach to advance care planning. Teams of medical educators authored and peer-reviewed the new case, in keeping with Aquifer’s rigorous content development standards. The case content provides coverage of five learning objectives from the AAMC/JAHF Minimum Geriatrics Competencies for Medical Students. 

Like all Aquifer signature cases, Advance Care Planning can be added to any custom course and includes student progress reporting. From your Aquifer account, the new case is accessible from the Aquifer Geriatrics signature course and via the searchable Case Library.

Aquifer Plans Palliative Care Course

Made Possible by a Grant from the Arthur Vining Davis Foundations

Aquifer is pleased to announce plans to develop an online course on Principles and Practice of Excellence in Palliative Care, designed for undergraduate health professions students, made possible by a grant award from the Arthur Vining Davis Foundations. The goal of this project is to build a practice-ready healthcare workforce that knows the principles of palliative care and can use them to deliver high value, compassionate care to chronically ill patients using a shared mental model. 

The Principles and Practice of Excellence in Palliative Care will fill an important gap in healthcare professional training. Despite the existence of published competencies for teaching palliative care principles to undergraduate healthcare professional students, most existing online palliative care training is aimed at continuing medical education. Multiple medical specialties, including internal medicine, surgery, and cardiology describe a critical need to formalize training for physicians in training. (Edwards A, Nam S; Crousillat DR, Keeley BR, et al; Wancata LM, Hinshaw DB, Suwanabol PA).  A recent bill passed in the US House of Representatives and currently with the US Senate has addressed the need to fund palliative care training. (https://www.congress.gov/bill/116th-congress/house-bill/647).

Aquifer will leverage our collaborative network of educators and partners, trusted pedagogy and content, and widely used teaching and learning platform to deliver quality online training that addresses critical gaps in palliative care learning across undergraduate healthcare education. The new course will address the clear need for standardized educational curricula on palliative care.

The palliative care course development will be led by Dr. Sherilyn Smith, Aquifer Chief Academic Officer and Professor of Pediatrics at the University of Washington, and Dr. Mandi Sehgal, Geriatric Medicine Fellowship Program Director, Cleveland Clinic Florida Clinical Affiliate Professor, Florida Atlantic University Charles E. Schmidt College of Medicine.  Initial work is scheduled to begin in the fall of 2020. 

 “The grant award from the Arthur Vining Davis Foundations enables us to begin the collaborative work of developing standardized curriculum and clinical learning tools for palliative care,” said Sherilyn Smith, MD. “We are honored to be working toward supporting students and faculty with the resources they need to make a real difference in improving patient care in this critical area.”


Aquifer is a unique non-profit organization deeply committed to driving innovation in clinical teaching and learning. Used in 97% of U.S. allopathic medical schools, 66% of U.S. osteopathic programs, and a growing number of physician assistant, and nurse practitioner programs—with over 15 million virtual patient cases completed since our founding in 2006—Aquifer is a leader in clinical learning.

The Arthur Vining Davis Foundations were established in 1952 by former ALCOA chairman, Arthur Vining Davis. Grounded in Arthur Vining Davis’s principled and innovative leadership in national corporate life and philanthropy, the Arthur Vining Davis Foundations strengthen America’s intellectual life, humane instincts, and democracy through philanthropic support for private higher education, public educational media, interfaith leadership and religious literacy, the environment, and palliative care.

Aquifer’s Statement of Solidarity

Aquifer stands in solidarity with our healthcare professional colleagues and students around the United States as we work to alleviate the racial and healthcare disparities that continue to be a critical public health issue in our country.

As the leading provider of online health professions education teaching and learning tools, we feel a deep responsibility to ensure that our educational materials do not perpetuate stereotypes in healthcare and education, our courses incorporate contemporary teaching about social determinants of health and structural factors leading to bias, and that we actively promote equitable healthcare education for underrepresented student populations.

We have been dedicated to these ideals from the onset, but there is always more work to be done. Our specific next step actions will include:

  1. Certify that all of our consortium members and Aquifer staff have completed anti-bias education by September 30, 2020.
  2. Continue to use our previously published curricular checklist to ensure contemporary teaching about structural and social determinants of health in our ongoing case maintenance process
  3. Create a new leadership position within our Educators Consortium to accelerate our plans to:
    1. More fully address social and structural determinants of health and bias in our current educational materials;
    2. Ensure that all new materials meet the Aquifer standards of excellence in this content area;
    3. Advance feedback and communication mechanisms explicitly addressing racism and healthcare disparities.
  4. Actively seek new partnerships to develop sustainable educational systems to support underrepresented student populations.
  5. Provide ongoing communication to our stakeholders about our work in these areas

We are dedicated to the success of our learners and their future patients and accept the responsibility to address these issues in a respectful, inclusive, humble, and sustained manner that reflects our core values and that of the healthcare profession in which we serve.

Sherilyn Smith, MD
Aquifer Chief Academic Officer
Professor of Pediatrics, University of Washington

Leslie Fall, MD
Aquifer Chief Executive Officer

Grant Support for Full Course Library Subscriptions

As the pandemic stretches on, Aquifer recognizes the enormous financial and curricular challenges medical and health professions programs will continue to face for the foreseeable future. To support programs beyond our free access offers (expiring June 30), Aquifer has created a new grant program to help offset the cost of accessing the full Aquifer course library for the 2020-21 subscription year beginning July 1. Our partners at the NYU Grossman School of Medicine are offering a grant towards subscriptions to both WISE courses as well.

Aquifer was proud to provide 489 programs with free access through June 30 as part of our initial COVID-19 response. We believe that maintaining access to the full library of courses will provide the curricular flexibility needed to continue adapting and innovating as the next academic year unfolds.

Grants options include:

  • Aquifer Full Course Library Grant includes all Aquifer Signature courses (Aquifer Family Medicine, Geriatrics, Internal Medicine, Pediatrics, and Radiology).
  • WISE Full Course Library Grant includes both WISE-MD (Surgery) and WISE-OnCall (Readiness for Practice).
  • Aquifer + WISE Full Course Library Grant includes all the courses in the two options above.

Grants are available to current subscribers as well as programs that have been using Aquifer content via the free access we provided through June 30 as part of our initial COVID-19 response. Deadlines and grant details are specific to each program. The Grant Request Process is managed by the person at each program who is in charge of the Aquifer account, known as the Program Service Administrator. Faculty and administrators at eligible programs should contact their Program Service Administrator with any questions. If you are not sure who your Program Service Administrator is, please submit a support ticket.

Tracking Student Work with Learner-level Access

How to track students’ work in Aquifer case–for programs that do not have an institutional subscription with administrative and reporting tools.


If you don’t have an institutional subscription to Aquifer, your students might be using Aquifer cases via one of our individual learner-level access options, which include:

  • Free Learner-level access to Aquifer courses as part of the Aquifer COVID-19 response (offered to non-subscribing nurse practitioner, residency and international MD programs)
  • Individual subscriptions that students purchase with a credit card to access Aquifer a Signature course (Family Medicine, Geriatrics, Internal Medicine, Pediatrics, and/or Radiology).
  • Individual access to Aquifer’s five free interdisciplinary courses in High Value Care, DIagnostic Excellence, Oral Presentation Skills, Culture in Health,  and Medical Home, which students at non-subscribing institutions can access for free directly from aquifer.org. 

With learner-level access, students can easily track their own progress through cases and see their free form summary statement responses from cases through their Student Report available on their individual account–but faculty don’t have direct access to view these reports.

How Faculty Can Use the Student Report To Track Student Work

Faculty and administrators that want to track student work can require your students to share their Student Report from any course with you in any of the following ways:

  • Submit a screenshot 
  • Send an export of their student report
  • Share a view of their reporting screen via video call

These reports would allow you to:

  • Verify completion of assigned cases
  • View the amount of time a student spent on a case
  • Review student summary statements (available for cases in Family Medicine, Internal Medicine, Pediatrics)
Using Summary Statements

For Faculty Using the COVID-19 Learner-level Access Only

Many Aquifer cases require students to write summary statements as they move through the case. Faculty can compare student summary statements (included in the Student Report noted above) to those written by content experts. Reviewing this content will allow you to provide your students with concrete feedback, helping them to improve their clinical reasoning in a meaningful way.

At this time, expert summary statement answer keys are available only as part of the Faculty Took Kit (sent via email) for programs using the COVID-19 Free Learner-level Access. 

Student Report Views & Case Completion Details

Student Reports are available for any course available in your students’ Aquifer accounts. The Student Report includes the following information on each case in the selected course:

  • Case Number
  • Time from Case Start to Complete (Total active working  time in hours, minutes, seconds)
  • Percent Case Completed, shown as:
    • Case Complete = Green Check Mark
    • Case Partially Completed = Yellow circle showing the percentage of the case complete – Note: the percentage is NOT a grade or score!
    • Case Not Started = Red Circle
    • Case Reset = Any color circle with a black outline
  • Pages Completed
  • Start Date (local time)
  • Date Last Accessed (local time)
  • Completion Date & Time (local time displayed on screen, Eastern Time displayed in exports)
  • Case Summary statement (if applicable–not all cases require a summary statement)
  • Case Reset Status (whether a student chose to go back and re-do the case again–showing only the work from the most recent case review)

The on-screen Student Report looks like this:

The export of the Student Report looks like this:

How can I tell my students to access reporting?

We have a complete how-to article for students in our Reporting for Students support article. You will need to let your students know how you prefer to see the report (video call screen share, screenshot, or sending the csv export) and when their work is due.


Is there a more efficient way to track student work?

Direct access to student reporting is available with Aquifer institutional subscriptions.   Should your program decide to purchase an Aquifer institutional subscription in the future, you would have access to this functionality.

COVID-19 Response: Free Access Extended to New Programs

In continued response to the COVID-19 outbreak and the mounting need for trusted and proven online resources to support clinical learning, we are very pleased to let you know that Aquifer is extending our offer of free access to 146 Aquifer cases and both WISE courses to all North American medical schools and physician assistant programs—regardless of whether or not they are current subscribers—through June 30, 2020.

Aquifer’s COVID-19 Response includes access for your students, faculty, and staff to:

  • 146 cases in Aquifer’s COVID-19 Response course:
  • WISE Courses (Distributed by Aquifer on behalf of the NYU Grossman School of Medicine)
  • Aquifer’s five free courses, including 29 free cases on key topics.
  • Aquifer’s teaching and learning platform for progress tracking, curriculum planning, and user management.

Over the past two weeks, more than 125 health professions institutions with current Aquifer subscriptions have taken advantage of our free expanded access, and that number continues to grow daily. We have worked quickly to aggressively upgrade our server capacity and extend our support staff and hours to meet the growing demands. These rapid-scale improvements to our infrastructure have enabled us to extend our offer at this time.

Access requests for current subscribers opened on March 12 and will remain open through June. Request forms for those who do not have a current Aquifer subscription are targeted to open on March 26. Our goal is to begin providing access to new medical and physician assistant institutional programs no later than Monday, March 30, on a first-come, first-served basis. Please note that access may take 3-5 days from your application date depending on the volume of requests. More details are available at aquifer.org/new-programs-covid-19-response/. However, our staffing resources remain limited and we ask your patience as we push to meet your needs.

For over 15 years, our courses have provided health professions schools with the online learning platform, curriculum, reporting, and educator resources needed to meet LCME and other national accreditation requirements specifically to fill gaps in clinical learning and to supplement patient care experiences. We are deeply proud that our history of collaborative work with many of your national student education organizations may help you rise to the unprecedented and unforeseen challenges we are all facing today.

To further support you and your colleagues who may wish additional support integrating Aquifer cases into your curriculum, we are also offering one-on-one peer consultations, led by members of the Aquifer Educators Consortium.

We hope this will help in some small way to alleviate some of the difficulties you—our colleagues—and your students are facing in these unprecedented times.

 

Sherilyn Smith, MD
Aquifer Chief Academic Officer
Professor of Pediatrics and Infectious Disease
University of Washington School of Medicine

Leslie Fall, MD
Aquifer Executive Director & Chief Executive Officer

New North American Medical Schools and Physicial Assistant Programs
Current Subscribers
Non-subscribing Nurse Practitioner, International, and Other Programs

COVID-19 Response: Filling Emerging Gaps

Colleagues,

As the COVID-19 outbreak expands, student access to patient care is being restricted with unprecedented scope. The uncertainty of this evolving situation is impacting student opportunities to learn and heightening concerns about the vulnerability and quality of student education. Aquifer is committed to helping you meet this challenge, and to support you as you stretch to care for both your students and for your community’s patient population. To do our part during this difficult time, Aquifer is offering access to 146 cases and WISE-MD to our subscribing schools at no additional charge through June 30, 2020.

Rising to Meet Your Emerging Online Learning Needs

Aquifer’s virtual patient cases about core clinical conditions, developed by your colleagues to meet your national educational objectives, are—by design—available to fill the gaps you are experiencing in your student’s clinical training. We want you to be able to take full advantage of your Aquifer cases during this outbreak to help supplement clinical experiences that your students may be lacking due to access restrictions. Whether your students are impacted in the pre-clerkship phase and unable to attend preceptorships, or in the clinical phase and restricted from the inpatient units, clinics, operating or radiology reading rooms, we are here for you.

If you need more content than is currently available in your subscription in order to temporarily support impacted learners, we are taking the unprecedented step of providing free access to 146 Aquifer signature cases and WISE-MD through June 30, 2020, to all current Aquifer institutional subscribers. This includes:

Additional course access will be provided by request only and will require completion of a short application available starting on Thursday, March 12th at aquifer.org/covid19. The purpose of the application is to provide us with some additional details required to meet the needs at your school. The application must be completed by the single point of contact for your program’s Aquifer subscription, *|PSA|*.

Leveraging Trusted Tools

Remember, Aquifer’s searchable case library can help you search across all available cases by diagnosis, presenting problem, system, and more to find the cases you need to fill your emerging gaps. Our custom course feature is available to then help you build courses and assign cases to individual students or groups.

As medical educators ourselves, we understand the challenges you are facing are extraordinary and we here to support you and your students. We hope that these additional resources will alleviate some of the difficulties your students may face. We will be sending an update when the application for additional content is available. In the meantime, please visit aquifer.org/covid19 for additional details, updates, and training on using the learning tools and content available with your subscription.

Sincerely,

Sherilyn Smith, MD
Aquifer Chief Academic Officer
Professor of Pediatrics and Infectious Disease
University of Washington School of Medicine

Leslie Fall, MD
Aquifer Executive Director & Chief Executive Officer

Aquifer Launches Student Advisory Group

Aquifer-Student-Advisory-Group

Aquifer is excited to announce the launch of our Student Advisory Group. This newly formed board of medical and health professions students will provide essential feedback on Aquifer’s new learning tools.

Helping Build the Best Possible Tools for Clinical Learning

Aquifer is in the process of developing new assessments, Integrated Illness Scripts, cases, and other learning tools. Student voices and ideas are critical to ensure that our solutions provide the most value to students.

Student Advisory Group members are invited to preview and provide honest, in-depth feedback on Aquifer’s new developing learning tools, designed to be used in medical and health professions programs across the country. Feedback from this group will be used to optimize the technology and content in our tools, inform communications, and develop training resources.

After a competitive selection process, we are pleased to welcome a strong group of students from institutions around the country:

  • Julie Chew, United States University Nurse Practitioner Program
  • Parissa Ferguson, Bryant University Physician Assistant Program
  • Timothy Fisher, Cooper Medical School of Rowan University 
  • Philip Jurasinski, Des Moines University
  • Priya Kantesaria, Rutgers New Jersey Medical School
  • Hope Knochenhauer, Duke University School of Medicine 
  • Andres Lopez, University of North Carolina at Chapel Hill School of Medicine 
  • Brienna Milleson, Saint Louis University School of Medicine
  • Wafa Nabi, Case Western Reserve University School of Medicine
  • Evgeniya Rakitina, University of Miami Miller School of Medicine
  • Yana Salei, Florida Atlantic University Charles E. Schmidt College of Medicine 
  • Sapna Syal, Rutgers Robert Wood Johnson Medical School
  • Georgia Vasilakis, West Virginia University School of Medicine

The Student Advisory Group will work closely with the medical educators of the Aquifer Student Engagement Group, a working group of the Aquifer Educators Consortium, along with the teams developing Aquifer’s new learning tools. The Aquifer Student Engagement Group is led by Katherine Chretien, MD (Associate Dean for Student Affairs; George Washington University School of Medicine & Health Sciences) and Jennifer Bierman, MD (Clerkship Director, Education Centered Medical Home; Northwestern University Feinberg School of Medicine).


Aquifer—a unique non-profit organization—makes a big impact on medical and health professions education. Used in 95% of U.S. allopathic medical schools, 66% of U.S. osteopathic programs, and a growing number of physician assistant, and nurse practitioner programs—with over 13 million virtual patient cases completed since our founding in 2006—Aquifer is a leader in clinical learning.

2019 COMSEP Grant Awards Supported by Aquifer

Aquifer is pleased to congratulate the recipients of the 2019 COMSEP (Council on Medical Student Education in Pediatrics) Grant Program awards. The COMSEP Grant Program is funded in part by an annual educational grant from Aquifer to support advancing academic research in medical education.

As a non-profit organization, Aquifer is proud to continue funding this important work through COMSEP which aligns directly with our mission of advancing healthcare education through collaborative development and research into innovative, high-impact virtual teaching and learning methods. The COMSEP Grant Program promotes and supports innovative educational scholarship that is designed, implemented, and evaluated by COMSEP members.

Aquifer joins COMSEP in congratulating the 2019 COMSEP Grant Program recipients on the advancement of their research:

Nathan Gollehon, MD, University of Nebraska Medical Center

The Effect of CMS Guidelines on the Development of Medical Student Documentation Skills

This project focuses on assessing the impact of the Centers for Medicare and Medicaid Services rule change that allows student medical notes to be used by their preceptors for billing. Surveys and focus groups have been conducted to understand the impact of this change on learning and perceptions and experiences with student documentation. Investigators have submitted abstracts to present this work at the 2020 COMSEP Annual Meeting, with plans underway for publication submissions.

Molly Rideout, MD, University of Vermont Medical Center

The Effect of Pediatric Boot Camps on Performance in Early Internship

This study works to clarify whether pediatric-specific boot camp improves intern performance during the initial months of pediatric internships, and whether any difference persists at six months. Results will include faculty evaluations on interns from residency programs (17 are enrolled to date). Preliminary results will be presented at the COMSEP Annual Meeting in March 2020. This project is a joint project between COMSEP and APPD LEARN.

Aquifer (formerly MedU) has partnered with COMSEP since the 2006 launch of Aquifer Pediatrics (formerly CLIPP), which delivers on the learning objectives of the COMSEP curriculum. Aquifer’s grant program supports academic advancement through a series of partnerships with key national educator organizations. Working with our partners ensures that our grant dollars support initiatives that advance our mission and serve the needs of educators and students around the country. In 2019, Aquifer awarded grants totaling $65,000 a year to our national partner organizations:

Aquifer looks forward to the results of the 2019 COMSEP Grant Program projects and continuing to work with our partners to drive innovation in healthcare education.


Aquifer is a mission-driven non-profit organization dedicated to delivering the best healthcare education through collaborative development and research into innovative, high-impact virtual teaching and learning methods. Aquifer develops trusted, award-winning, virtual case-based courses derived from national healthcare curricula. Since Aquifer’s founding in 2006, over 13 million virtual cases have been completed by more than 300,000 students.

Call for Participation: Student Advisory Group

Medical & Health Professions Students: Join Us

Aquifer is excited to announce a new opportunity to join a national board of interprofessional students tasked with providing critical feedback on the development of Aquifer’s new learning tools. Medical, physician assistant, and nurse practitioner students are invited to apply to serve on the new Student Advisory Board.

Aquifer—a unique non-profit organization—makes a big impact on medical and health professions education. Used in 95% of U.S. allopathic medical schools, 66% of U.S. osteopathic programs, and a growing number of physician assistant, and nurse practitioner programs—with over 13 million virtual patient cases completed since our founding in 2006—Aquifer is a leader in clinical learning.

Help us build the best possible tools to advance your clinical learning. 

Aquifer is in the process of developing new assessments, cases, and other learning tools. Student voices and ideas are needed to ensure that our solutions provide the most value to students.

Selected students will be invited to preview and provide honest, constructive feedback on Aquifer’s new developing learning tools, designed to be used in medical and health professions programs across the country. Feedback from this group will be used to optimize the technology and content in our tools, inform communications, and develop training resources. 

Work will include:

  • Completing up to 1 hour of pre-work in advance of each quarterly meeting.
    • Previewing a new learning tool via interactive demo, watching a screencast, or reading/viewing a presentation.
    • Completing a preliminary survey with your initial feedback. 
  • Attending a 1-hour Zoom meeting quarterly to discuss and learn more about different aspects of the learning tools. Meetings will be scheduled on weekday evenings; tentatively scheduled in January, April, July, and October.

Student Advisory Group members will have the option to apply to attend the Aquifer Educator Consortium’s Annual Meeting in early October in Portsmouth, NH. Attendance is not required; an open application process will be announced in the late spring/early summer. Students who are selected to attend will have travel expenses paid.

A letter of recognition is available by request.


Eligibility

The Aquifer Student Engagement Group is accepting applications from students who meet the following requirements:

  • Medical students from MD or DO programs who are in their 2nd, 3rd, or 4th year

 OR

  • Physician assistant and Nurse Practitioner students who are in the clinical phase of their training.

AND

  • Interest in medical and health professions education.
  • Prepared to give honest, thoughtful feedback in a constructive manner.
  • Able to commit to completing all pre-work assignments and attending at least three out of four quarterly meetings (January – October 2020).

Application Process

If you are interested, please complete our short online application below by December 4, 2019. Students will be notified of their status by January 1. Please contact Karey Waters, Aquifer Communications and Insights Manager, with any questions.

Thank you, 

Aquifer Student Engagement Co-Leads

Katherine Chretien, MD
Associate Dean for Student Affairs
George Washington University School of Medicine & Health Sciences

Jennifer Bierman, MD
Clerkship Director, ECMH (Education Centered Medical Home)
Northwestern University Feinberg School of Medicine


Applications have closed. Thank you for your interest.

Call for Participation: Aquifer Physician Assistant Task Force

Make an Impact: Work with Aquifer to Advance Medical Education

Aquifer—a unique non-profit organization dedicated to advancing healthcare education—is excited to announce the creation of a Physician Assistant Task Force. This group will bring the voice, interests, and experiences of physician assistant educators to Aquifer, and work to develop faculty development materials and teaching tools for physician assistant educators using Aquifer courses.

This is an exciting opportunity to participate in a scholarly project on a national level and advance healthcare education through collaboration. With over 12 million virtual patient cases completed since our founding in 2006, Aquifer is the leader in developing clinical teaching and learning tools.


Our Reach

Working with Aquifer, your work will make a big impact on physician assistant education. A growing number of physician assistant programs are putting Aquifer’s trusted, rigorous clinical learning tools to work for their students. Aquifer courses are also used in 95% of U.S. allopathic medical schools.


Aquifer Physician Assistant Task Force Details

Why: To further develop Aquifer’s teaching and learning resources as a valuable tool for physician assistant educators.

Who: This is an open invitation to all physician assistant educators who use Aquifer courses. The group will be supported by Aquifer staff and led by:

  • Cynthia Booth Lord, MHS, PA-C
    Program Director and Associate Professor, Physician Assistant Program, Case Western Reserve University School of Medicine
  • Sherilyn Smith, MD
    Aquifer Academic Director for Engagement and Scholarship
    Professor of Pediatrics, University of Washington School of Medicine

What: The Aquifer Physician Assistant Task Force will:

  • Provide input to Aquifer leadership regarding the priorities and unique needs of physician assistant programs
  • Develop and review faculty materials to support the use of Aquifer cases in the physician assistant curriculum

When: The Task Force will work actively for approximately 6 months, with work starting in early 2020. Work will include:

  • Monthly video conference calls
  • Working offline on prioritized projects, with work reviewed by the group on monthly calls.

The first meeting of the Task Force will take place at PAEA on Friday, October 11 from 12 PM to 12:50 PM in Park Tower Suite 8219 at the Washington Marriott-Wardman Park Hotel. Lunch will be provided. The goal of the meeting will be to identify the top priorities for developing educator materials to support student use of the Aquifer cases from the perspectives of interested group members.

If you are interested in joining or learning more about the Physician Assistant Task Force, please let us know by contacting Leah Romano, Aquifer Relationship Manager.

We look forward to working with you to better serve the needs of physician assistant educators and students.

Thank You,

Cynthia Booth Lord, MHS, PA-C
Program Director and Associate Professor, Physician Assistant Program, Case Western Reserve University School of Medicine

Sherilyn Smith, MD
Aquifer Academic Director for Engagement and Scholarship
Professor of Pediatrics, University of Washington School of Medicine

Leslie Fall, MD
Aquifer Executive Director & Chief Academic Officer

Support Ticket

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If you’ve reviewed our resources and tools and still need tech support, please complete a support ticket here.

Please provide as many details as possible about your issue.

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Aquifer Congratulates IAMSE Travel Award Recipients

Aquifer is pleased to join the International Association of Medical Student Educators in congratulating the 19 recipients of the 2019 IAMSE Travel Awards. The awards contribute to travel and registration costs for students and junior faculty attending the IAMSE Annual Meeting, held this year in Roanoke, Virginia on June 8-11, 2019. Aquifer is proud to continue supporting this award in conjunction with IAMSE, our collaborating partner on the Aquifer Sciences Initiative. This year’s award is also sponsored by ProgressIQ.

Congratulations 2019 IAMSE Travel Award Recipients:

Students

  • Katerina Dima, International Federation of Medical Students Association; Amsterdam, Netherlands
  • Jennifer Allen, Lake Erie College of Osteopathic Medicine; Erie, PA
  • Milou Maartje Lisa Groenen, Radboud University; Nijmegen, Netherlands
  • Taylor Barber, Philadelphia College of Osteopathic Medicine; Philadelphia, PA
  • Alexander Beckstead, University of Utah School of Medicine; Salt Lake City, UT
  • Julia Chong, Mercer University School of Medicine; Macon, GA
  • Emmy Marloes Kok, Radboud University; Nijmegen, Netherlands
  • Katrina Gerbrand, Campbell University SOM; Lillington, NC
  • Galina Gheihman, Harvard Medical School; Boston, MA
  • Surya Khadilkar, Case Western Reserve School of Medicine; Cleveland, OH
  • Jacqueline Kobayashi, University of Utah School of Medicine; Salt Lake City, UT
  • Edgar Meyer, University of Mississippi Medical Center; Jackson, MS
  • Sarah Nguyen, University of Utah School of Medicine; Salt Lake City, UT
  • Amberly Reynolds, Indiana University; Bloomington, IN
  • Marek Svoboda, Dartmouth College; Hanover, NH

Junior Faculty

  • Jaehwa Choi, Mercer University School of Medicine; Macon, GA
  • Jeff Fritz, Medical College of Wisconsin; Wauwatosa, WI
  • Arundathi Jayatilleke, Drexel University College of Medicine; Philadelphia, PA
  • Khalil Eldeeb, Campbell University SOM; Lillington, NC

Aquifer, a mission-based non-profit organization, has an annual grant program that supports academic advancement through a series of partnerships with key national educator organizations. In 2018, Aquifer granted over $65,000 to collaborating organizations. Working with partner organizations ensures that Aquifer’s grant dollars support initiatives that serve the needs of educators and students around the country.


Aquifer is a mission-driven non-profit organization dedicated to delivering the best healthcare education through collaborative development and research into innovative, high-impact virtual teaching and learning methods. Aquifer develops trusted, award-winning, virtual case-based courses derived from national healthcare curricula. Since Aquifer’s founding in 2006, over 12 million virtual cases have been completed by more than 300,000 students.

Educator Guides & Resources Available

Aquifer’s Educator Guides are your complete guide to using—and making the most of—Aquifer courses in your program. The Educator Guides are ideal for educators who are looking to:

  • Start using an Aquifer course as a new staff member or new subscriber
  • Discover best-practices and new ideas for integrating Aquifer into your course or curriculum
  • Take advantage of the many free resources included with Aquifer
  • Catch up on the latest features, Educator Resources, and assessment options available
  • Access a quick reference guide to all of the cases, resources, and features

Key Features

All Educator Guides include:

  • Course overview and pedagogy
  • Integration strategies
  • Features overview (searchable Case Library, custom courses, and more)
  • Resources included with your subscription (free courses, Aquifer Sciences Curriculum Database)
  • Support resources
  • Case details (Case Synopses, Learning Objectives, clinical locations)
  • Direct links to any course-specific additional resources and tools

Educator Guide Library

We currently offer Educator Guides for the following courses. To access the guides, please see the details below—you will need to sign in to your Aquifer account.


Additional Resources

Our Educator Guides include direct links to additional course-specific teaching and learning tools created by the Aquifer Educators Consortium. These tools are fully developed, available for download, and ready to use in your teaching. Currently, our additional resources include:

User Story Videos

Hear from top educators around the country who are using Aquifer to provide consistent clinical experiences, complete coverage of national curriculum standards, self-directed learning, and remediation opportunities for their students. User Story Videos are available for each Aquifer course.

EXPLORE USER STORY VIDEOS


Accessing Educator Guides & Resources

Sign in to your Aquifer account in Aqueduct, our learning management system.

From your Courses page, click on the green Educator Resources bar.

The Educator Resources page shows all of the resources available for your program’s subscribed courses and free interdisciplinary courses. Click on resources for your desired course to view and/or download resource files.

Android & iOS Apps Now Available

Download Aquifer Clinical Learning from the Google Play or App Store

Aquifer is excited to announce that our Android app is now available for free download from the Google Play store. The Android app joins Aquifer’s previously released iOS app to provide a comprehensive mobile experience for users on a range of devices—anytime, anywhere.

Work Offline! Download cases in advance and complete work even without an internet connection. Case work will sync to individual Aquifer accounts when devices reconnect to the internet. Once a device has synced, progress can be viewed in student and course reports on your laptop or desktop computer. A few notes:

  • Only registered users can sign in to the app. Please complete your Aquifer registration before signing in on your mobile device.
  • The app is intended for viewing cases only. Administrators have unrestricted access to all of their cases, but reporting, course management, and user management are not available on the app should be completed at your laptop or desktop computer.
  • Student Learning Resources and Educator Resources are not currently available through the Android app. Please visit meduapp.com to view this content.

To download the app for your device, click on the button below, or search “Aquifer Clinical Learning” in the Google Play or App store.

Amit Pahwa, MD Honored by CDIM


Aquifer congratulates Amit Pahwa, MD, Aquifer High Value Care Teaching and Learning Lead, on receiving the Louis N. Pangaro, MD Educational Program Development Award. This award, presented by the Clerkship Directors in Internal Medicine (CDIM) at their Annual Meeting, recognizes a CDIM member who has contributed to the development of an outstanding educational program. CDIM is a member organization of the Alliance for Academic Internal Medicine (AAIM).

Dr. Amit K. Pahwa is receiving this award based on his extensive work advancing medical education on the topic of High Value Care (HVC), both at Johns Hopkins University and on a national scale. At Johns Hopkins, Dr. Pahwa serves as an Assistant Professor of Medicine and Pediatrics; Director, Internal Medicine Sub-internship; and Associate Director, Pediatrics Core Clerkship. In addition, he is a leader in high value care education serving as Co-Director of his department’s HVC Committee, and Physician Lead of the interprofessional, interdisciplinary Johns Hopkins Health System High Value Care Committee. This committee won the Society of Hospital Medicine’s 2018 Excellence in Teamwork in Quality Improvement Award, and Johns Hopkins’ 2017 Innovations in Clinical Care Award.

Dr. Pahwa’s national work includes serving as an Executive Director on the High Value Practice Academic Alliance, which he worked to form in 2016 to create a national forum for academic institutions to collaborate on quality improvement, research, and education related to high value care. The alliance now includes more than 80 partner institutions in 18 different medical specialties, and hosts an annual national conference.

At Aquifer, Dr. Pahwa is an integral part of the Aquifer High Value Care Course Board, serving as Teaching and Learning Lead and Associate Editor. All of us at Aquifer congratulate him on this important national honor.


Aquifer is a thriving, collaborative community of healthcare education leaders deeply committed to driving innovation in teaching and learning. The Aquifer Educators Consortium brings together more than 70 healthcare educators across disciplines to collaborate, innovate, and make advances in health professions education. For educators and healthcare providers, participation in the Consortium offers a unique cross-disciplinary peer community and an exciting opportunity for academic scholarship and advancement.

2019 AAIM Innovation Grant Recipients Named

Aquifer is pleased to congratulate the eight recipients of the 2019 Alliance for Academic Internal Medicine (AAIM) Innovation Grants, supported by an unrestricted educational grant from Aquifer. The AAIM Innovation Grant program seeks inventive approaches to addressing existing or emerging problems with impacts across the academic Internal Medicine community. As a non-profit organization, Aquifer is proud to continue funding this important work through AAIM which aligns directly with our mission of advancing healthcare education through collaborative development and research into innovative, high-impact virtual teaching and learning methods.

Aquifer joins AAIM commending the outstanding efforts of the grant finalists and congratulating the 2019 Innovation Grant recipients:

  • Andrew J. Varney, MD; Southern Illinois University
    Quality improvement project to create a safer workplace for residents and staff
  • Nicole Grogan, MD; University of Iowa Roy J. and Lucille A. Carver College of Medicine
    Framework to improve the quality of written and verbal feedback in UME and GME
  • Pramil Cheriyath, MD, MS, FACP; Ocean Medical Center
    Improving emotional intelligence among internal medicine residents using evidence -based medicine workshop
  • Catherine Gao, MD; Yale New Haven Hospital
    Automated scheduling tool to improve scheduling quality and resident satisfaction
  • Jessica Murphy, MD, MS; Warren Alpert Medical School of Brown University
    Developing residents’ critical consciousness through social determinants of health curriculum
  • Abby Spencer, MD, MS, FACP; Cleveland Clinic Foundation
    Key steps to rise for women trainees in leadership development
  • Julia Close, MD; University of Florida
    Integrated implicit bias curriculum for house staff addressing health care disparities in patients with sickle cell disease
  • Gretchen Diemer, MD; Thomas Jefferson University
    Creation of a self-contained pedagogical tool for the problem of opiate addiction

Aquifer (formerly MedU) has partnered with AAIM since the 2007 launch of Aquifer Internal Medicine (formerly SIMPLE), which delivers on the learning objectives of Clerkship Directors in Internal Medicine’s (CDIM) General Internal Medicine Core Medicine clerkship curriculum. Aquifer’s High Value Care and Diagnostic Excellence courses were both developed with funding from AAIM Innovation Grant awards.

Aquifer’s grant program supports academic advancement through a series of partnerships with key national educator organizations. Working with our partners ensures that our grant dollars support initiatives that advance our mission and serve the needs of educators and students around the country. In 2018, Aquifer awarded grants totaling more than $65,000 a year to the following organizations:

  • Alliance for Academic Internal Medicine (AAIM)
  • Council on Medical Student Education in Pediatrics (COMSEP)
  • Association of University Radiologists (AUR)
  • Society of Teachers of Family Medicine (STFM)
  • International Association of Medical Science Educators (IAMSE)

Aquifer looks forward to the results of the 2019 AAIM Innovation Grant funded projects and working with our partners to drive innovation in healthcare education.


Aquifer is a mission-driven non-profit organization dedicated to delivering the best healthcare education through collaborative development and research into innovative, high-impact virtual teaching and learning methods. Aquifer develops trusted, award-winning, virtual case-based courses derived from national healthcare curricula. Since Aquifer’s founding in 2006, over 12 million virtual cases have been completed by more than 300,000 students.

Article: Aquifer Geriatrics Delivers Needed Education

From the American Geriatrics Society:

We Need All Health Providers to be Proficient in Geriatrics-Informed Care; A New Online Curriculum Brings Us Closer

  • Training all health professionals to care optimally for older adults is critical as we all age; the new @AquiferOrg @AmerGeriatrics online curriculum has solutions to get us closer: http://ow.ly/Wqn130okZ8e

New York (April 5, 2019)—Among many breakthroughs that have made living longer possible, better health care—and more experts to make that care possible—loom large. Given that all of us are aging, we need more clinicians, researchers, and advocates to keep that momentum going. Ideally, for example, we’d already have more than 22,000 geriatricians in the U.S. (though at present less than 7,000 certified clinicians are practicing nationwide). With a limited number of geriatricians, how are we to train the next generation of clinicians to optimally care for older people? A new tool from the American Geriatrics Society (AGS) and Aquifer (the non-profit leader in developing clinical learning tools for health professions education) holds promise for bridging that gap. Aquifer Geriatrics (available at Aquifer.org/Courses/Aquifer-Geriatrics/), the AGS national online curriculum in geriatrics, is leveraging e-learning and geriatrics’ thought-leadership to advance much-needed training to care for older adults.

“Almost every health professional in the U.S. will care for older patients at some point in their training or careers,” explains Amit Shah, MD, Associate Dean for Faculty Affairs at the Mayo Clinic Alix School of Medicine, “yet learning about what makes that care unique has varied in duration and even content in the past, often due to a limited number of geriatrics educators at our health professions schools. Developed initially with funding from the Donald W. Reynolds Foundation, the cases that make up Aquifer Geriatrics provide up-to-date, evidence-based content in geriatrics education. They teach healthcare professionals how to appropriately care for older adults, and they make it easy to do so even if a geriatrician is not immediately available to teach some of the basics.”

The idea behind Aquifer Geriatrics is simple: Learners at subscribing institutions have instantaneous access to each of 26 evidence-based, peer-reviewed cases addressing the fundamentals of caring for older adults. The Aquifer Geriatrics curriculum was developed by experts from the AGS and Association of Directors of Geriatric Academic Programs (ADGAP) using the framework of the Association of American Medical Colleges (AAMC)/John A. Hartford Foundation Minimum Geriatrics Competencies for Graduating Medical Students. Cases meet the needs of today’s learner as they can be completed at their own pace, without being bound to a traditional “classroom.” Subscriptions ensure that the course will be sustainable, providing consistent funding for operations such as content updates from a dedicated board of top educators, maintenance, and support.

“Each of the 26 cases delivers knowledge and skills, but also models a geriatrics health professional’s approach to care,” Mandi Sehgal, MD, Associate Professor of Geriatric Medicine at Florida Atlantic University Charles E. Schmidt College of Medicine, explains. “Rather than focusing on the myth of ‘one right answer,’ each of the cases teaches clinical reasoning and reflects the nuances of what it takes to do what geriatrics does best: Deliver high quality, person-centered care with a focus on function and quality of life.”

An article published today in the Journal of the American Geriatrics Society (JAGS; DOI:10.1111/jgs.15813) introduces the Aquifer Geriatrics curriculum and walks through several of its early successes, as well as strategies to help clinicians and institutions adopt the platform. In a related editorial also published in JAGS (DOI: 10.1111/jgs.15901), independent educational experts noted that the program holds promise for “helping to fill the gap that is left by the shortage of geriatrics educators” in preparing the field to “play the long game,” thanks to innovative solutions to education.

Aquifer Geriatrics cases can be completed on smartphones, tablets, or computers, and can be used independently or by schools with curricular time available to students. The cases also are appropriate for a host of health professionals, from internal and family medicine residents to physician assistants, nurse practitioners, and geriatrics fellows. For more information or to learn about subscription options, visit Aquifer.org/Courses/Aquifer-Geriatrics/.


About the American Geriatrics Society

Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals that has—for more than 75 years—worked to improve the health, independence, and quality of life of older people. Its nearly 6,000 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit AmericanGeriatrics.org.

About Aquifer

Aquifer, formerly known as MedU, is a unique mission-driven non-profit organization dedicated to delivering the best health care education through collaborative development and research into innovative, high-impact virtual teaching and learning methods. With 12 million virtual patient cases completed since its founding in 2006, Aquifer is the leader in developing clinical learning tools for health professions education.

Dr. Valerie Lang Honored by CDIM


Aquifer congratulates Valerie J. Lang, MD, MHPE, Aquifer’s Academic Director for Assessment, on receiving the Ruth-Marie E. Fincher, MD, Service Award. This award, presented by the Clerkship Directors in Internal Medicine (CDIM) at their Annual Meeting, recognizes a CDIM member who has made an outstanding contribution to the organization. CDIM is a member organization of the Alliance for Academic Internal Medicine (AAIM).

Dr. Lang’s current and past national committee work for AAIM and CDIM includes serving on the Clerkship Directors in Internal Medicine (CDIM) Council; as CDIM President (2014-2015); on the AAIM Board of Directors; and as Co-Chair of the AAIM High Value Care Working Group. She is an Associate Professor of Medicine in the Hospital Medicine Division at the University of Rochester. Dr. Lang directed the Internal Medicine Clerkship for 13 years and the Medicine Sub-Internship for 15 years. She currently directs the Hospital Medicine Faculty Development Program and is the inaugural director of the Meliora in Medicine course and thread through all 4 years of the medical school curriculum.

As the Aquifer Academic Director for Assessment, Dr. Lang provides strategic guidance to inform Aquifer’s non-profit mission of advancing health professions education. She is currently leading the development of innovative new formative assessments for a range of disciplines, and led a multi-institution validation study of Aquifer Internal Medicine’s Clinical Decision-Making Exam (formerly the Key Features Exam) that was recently published in Academic Medicine. She is also a past Co-Editor-in-Chief of the Aquifer Internal Medicine course.

All of us at Aquifer congratulate Dr. Lang on receiving this national honor.


Aquifer is a thriving, collaborative community of healthcare education leaders deeply committed to driving innovation in teaching and learning. The Aquifer Educators Consortium brings together more than 70 healthcare educators across disciplines to collaborate, innovate, and make advances in health professions education. For educators and healthcare providers, participation in the Consortium offers a unique cross-disciplinary peer community and an exciting opportunity for academic scholarship and advancement.

Aquifer Sciences Takes the Stage at National Meetings

The latest work from the Aquifer Sciences Leadership Team will be presented at a range of national educators organization meetings this spring. Aquifer Sciences is a partnership between Aquifer and the International Association of Medical Science Educators (IAMSE) to develop and share teaching and learning tools that integrate the basic and clinical sciences. Aquifer Sciences is currently in Phase Two of development, with teams from 12 pilot schools authoring virtual patient cases and integrated illness scripts for clinical conditions routinely encountered in core clinical rotations.

Aquifer Sciences’ goal of promoting the integration of clinical and basic sciences will take the spotlight at the Southern Group on Educational Affairs meeting where Dr. Leslie Fall will deliver a plenary talk on March 28. Presentations and workshops on integrated illness scripts have been accepted at the annual meetings of the Council on Medical Student Education in Pediatrics (COMSEP), American Association of Colleges of Osteopathic Medicine (AACOM), and Alliance for Academic Internal Medicine (AAIM).


Plenary Talk

Re-Engineering Integration of Clinical and Basic Science Learning as a Road to Entrustment

Southern Group on Educational Affairs Meeting: March 28

Leslie Fall, MD

This talk will explore new evidence-based teaching methods and learning tools to re-engineer cognitive integration of basic science into clinical practice to entrust better decision-making. These methods have the power to re-engineer the teaching relationship between basic science and clinical faculty towards the mutually held goal of improving the safety and efficacy of patient care provided by trainees.

Learn More


National Meeting Presentation Schedule

Medical schools struggle to meaningfully integrate basic science core concepts into the clinical curriculum, particularly in a manner that leverages understanding of causal mechanisms underlying common conditions to inform clinical reasoning. In this session, participants will collaboratively develop “integrated” illness scripts and consider applications of this cognitive integration method into their curricula. Illness scripts have been shown to be an effective method by which novices learn clinical reasoning skills. Cognitive research demonstrates that expert scientists and clinicians have difficulty “unpacking” their knowledge and making it available to teaching novice learners. Conversely, students often struggle to transfer basic science knowledge to clinical problem-solving. Development of ‘integrated’ illness scripts, whereby the key clinical findings of a given condition are clearly combined with the underlying basic science mechanism for each finding, is an effective means for integrating basic science concepts into students’ cognitive representations of core clinical conditions. Following a brief discussion regarding barriers to transfer and an evidence-based mini-didactic, participants will work in small teams to develop integrated illness scripts that demonstrate the basic science foundation for the clinical presentation of common pediatric conditions.

Council on Medical Student Education in Pediatrics Annual Meeting:

Un-Blinded Me With Science: Integrating Basic Science Into Clinical Reasoning Using “Integrated” Illness Scripts

Wednesday, March 20: 10am – 12pm

Presenters: Michael Dell, MD; Robin English, MD; David Harris, PhD; Kathryn Miller, MD; Leslie Fall, MD


American Association of Colleges of Osteopathic Medicine Annual Conference:

Using Illness Scripts to Meaningfully Integrate Basic Sciences into Clinical Reasoning

Thursday, April 11: 11 – 11:30am; Lincoln 3

Presenters: Leslie H. Fall, MD; Leah Sheridan, PhD


Academic Internal Medicine Week:

Using “Integrated” Illness Scripts to Meaningfully Integrate Basic Sciences into Clinical Reasoning

Tuesday, April 16: 9:45 AM–11:15 AM

Presenters: L. James Nixon, MD, MHPE, Leslie H. Fall, MD, Valerie J. Lang, MD, Felise B. Milan, MD

Key Features Exam Renamed Clinical Decision-Making Exam

The Aquifer Key Features Exam, offered in conjunction with the Aquifer Internal Medicine course, is being renamed the Aquifer Internal Medicine Clinical Decision-Making Exam as of March 1, 2019. The new name highlights the link to the clinical decision-making skills assessed by the exam, with the goal of increasing understanding of this unique assessment tool in the internal medicine community.

There will be no changes to the exam content or administration. The exam will continue to be included with a subscription to Aquifer Internal Medicine, and administered in Aqueduct, our learning management system.

The Aquifer Clinical Decision-Making Exam aligns directly with CDIM’s national curriculum and the Aquifer Internal Medicine course, and it is specifically designed to test clinical decision-making skills at the end of the internal medicine clerkship. Although Key Features Exams (KFE’s) are widely used internationally, Aquifer’s exam is the first designed for use in U.S. medical schools. The key features approach focuses on the critical or challenging decisions in the diagnosis and management of a clinical problem to better target critical decision points. Key features exam structure includes a case vignette, followed by several questions specifically targeting the key clinical decisions.

A validation study on our Key Features Exam (KFE) for Internal Medicine was recently published in Academic Medicine. The article, Validity Evidence for a Brief Online Key Features Examination in the Internal Medicine Clerkship, presents a range of evidence supporting the use of the Key Features Exam as a complementary assessment during the third-year internal medicine clerkship, specifically to test clinical decision-making skills. This publication is the result of a multi-institutional validation study led by Valerie Lang, MD, MHPE, Aquifer Academic Director for Assessment, and a team that included Aquifer Educators Consortium members Dr. Kirk Bronander and Dr. Heather Harrell.

To learn more about the Aquifer Clinical Decision-Making Exam and the key features approach, please visit our Exams and Assessment page.

Race & Culture Project Published in Academic Medicine

Aquifer is excited to announce that Academic Medicine has published ahead of print an article highlighting the Phase One work of the Aquifer Student Engagement: Race and Culture project. The print version is expected in the April 2019 issue of Academic Medicine.

The article, Addressing Race, Culture, and Structural Inequality in Medical Education: A Guide for Revising Teaching Cases, was written by student contributors Aparna Krishnan, MPH, and Molly Rabinowitz, MD, MPH; Aquifer staff member Ariana Ziminsky; and Aquifer Consortium Student Engagement project leads Stephen M. Scott, MD, MPH, and Katherine C. Chretien, MD.

The Student Engagement: Race and Culture project began in Spring of 2017 with the goal of improving the way race and culture is presented and taught in Aquifer cases. Project leads Dr. Steve Scott and Dr. Katherine Chretien recruited fourth-year medical students from schools across the country to form a faculty/student workgroup. The group performed a literature review and analyzed Aquifer cases to identify key areas for improvement. Based on this analysis, a structured guide was created to assist in the review of Aquifer cases while also providing education and rationale. This practical guide is presented for medical educators to use while revising existing teaching cases to improve the delivery of critical content on race, culture, structural inequalities, and health disparities.

In addition to the Academic Medicine article, this work was also presented nationally at the 2018 Association of American Medical Colleges Learn Serve Lead meeting and 2019 STFM Conference on Medical Student Education. Upcoming presentations have been accepted at the 2019 COMSEP and AAIM national meetings.

Phase Two of the Race and Culture project took place in 2018, with six first- and second-year medical students completing full reviews of four Aquifer courses (Family Medicine, Geriatrics, Internal Medicine, and Pediatrics) using the race and culture guide. They provided individual case and course-level recommendations to case editors and reviewers for improving cases. Learn more about the ongoing work, our student contributors, and presentation schedule.


Aquifer is a thriving, collaborative community of healthcare education leaders deeply committed to driving innovation in teaching and learning. The Aquifer Educators Consortium brings together more than 70 healthcare educators across disciplines to collaborate, innovate, and make advances in health professions education. For educators and healthcare providers, participation in the Consortium offers a unique cross-disciplinary peer community and an exciting opportunity for academic scholarship and advancement.

Educators Share Aquifer User Stories

We’re excited to bring you our user story videos, filled with experiences from top health care educators using Aquifer. Find out how other programs are using the cases, benefits to faculty and administrators, and the results they are seeing in their students.

Whether you’re thinking about subscribing or have been using Aquifer for years, the videos below provide a new perspective with valuable insights into using our cases and content to maximize student engagement and teaching efficiency.


Stories by Course

Learn how Aquifer Family Medicine can benefit medical students and faculty in your program:

Learn how Aquifer Geriatrics can benefit medical students, residents, fellows, and faculty in your program:

Learn how Aquifer High Value Care can be valuable to faculty and learners at a variety of levels:

Learn how Aquifer Internal Medicine is helping medical students and faculty:

Learn how Aquifer Pediatrics can benefit medical students and faculty in your program:

Learn how Aquifer Radiology can benefit medical students, residents, and faculty in your program:

Learn how Aquifer Diagnostic Excellence—available free of charge—can benefit students and faculty in your program:


Stories by Program

66% of U.S. Osteopathic schools are using Aquifer courses to advance their students’ clinical learning. Learn how two of our users are making the most of their subscriptions.

New York Institute of Technology College of Osteopathic Medicine

Philadelphia College of Osteopathic Medicine

A growing number of Physician Assistant programs are putting Aquifer to work for their programs. Learn how one program is taking advantage of their Aquifer subscription:

Case Western Reserve University Physician Assistant Program

A growing number of nurse practitioner programs are putting Aquifer to work for their programs. Learn how one program is taking advantage of their Aquifer subscription:

University of New Hampshire Nurse Practitioner Program

Case Reset Update

As of January 2, students will manage their own case resets in Aqueduct. Administrators are no longer be able to reset student cases. This change gives students ownership of their data and empowers them to direct their own learning. It also relieves the burden of resetting cases from administrators’ workloads.

This update brings the case reset process into alignment with Aquifer’s pedagogical philosophy. Aquifer’s virtual patient cases are designed to be a safe learning environment for students. Giving students control of their own data allows them the option to enhance their learning by returning to a case and reviewing the content again in a rigorous way.

What is a Case Reset?

Students can choose to reset your cases at any time. A Case Reset means that:

  • All progress in the case will be cleared and reset. Previous data will not be available.
  • Students will need to re-take the case to record a completion.
  • Faculty and administrators can view each case reset in their reports.
  • Case resets will show on Student Reports.
  • Student notes will be deleted when cases are reset. Be sure to download notes before completing the reset process.

Case Reset Reporting

All users (administrators and students alike) can easily view case resets in reports. If a case was reset, a black outline will show around the progress circle on the Course, Case, and Student reports. In the exports for Case and Student Reports, a column is included showing the number of case resets.

Faculty and administrators, please take note of this change before starting your next course or rotation. Be sure to view the detailed information available in reports if this case reset process will affect your grading. We have contacted all administrative users, but please help us keep everyone up to speed by sharing this information with your colleagues.

Searchable Content Library

Searchable Content Library

You can now search and filter the Aquifer content available to you with your program’s subscription—plus cases from Aquifer’s free interdisciplinary courses—to quickly select the content you need.

Our searchable Content Library (formerly called the Case Library), accessible from the top navigation menu for all administrative and faculty users, is home to the advanced content search.

Searchable content library

The searchable Content Library includes a series of dropdown filters which allow you to search for cases and Integrated Illness Scripts (available to Aquifer Curricular Partners) by:

  • Presenting Problem
  • Final Diagnosis
  • Additional Diagnosis
  • Aquifer Signature Content
  • Clinical Discipline
  • Clinical Focus
  • System
  • Basic Science Discipline (currently mapped to Integrated Illness Script content only)
  • Clinical Location
  • Age Group

Use a combination of the filters above to quickly find the content you need to build a custom course or select specific content to remediate students.

Content Library Filters

You can also use the free text search field to conduct a keyword search, which includes text in the case and script titles, synopses, and learning objectives.

Content Library Keyword Search

Detailed Case List Display

The detailed content list display will include the Aquifer cases and Integrated Illness Scripts which meet your search criteria which are available through your program’s subscription.   If your program does not subscribe to a course or have access to the Integrated Illness Scripts, that content will not display in the search.

From the display list you can quickly view more information about the content to determine if it fits your needs. For cases you can scan the case synopsis, learning objectives, and the detailed case summaries which are available to students on completion of the case. For Integrated Illness Scripts you can scan the synopses and Mechanism of Disease Maps for each script.

Cases and scripts in Content Library

Aquifer cases and integrated illness scripts are authored and continuously updated by the expert healthcare educators who make up the Aquifer Consortium. Content authors and the date the content was last updated are now displayed for each item—so you can be sure your students are being provided up-to-date content written by your trusted peers.

You can also access all cases and scripts directly from this page by clicking on the title. Unlike students, as an administrative user you will have ungated access to the cases, so that you can access all content at once without answering questions as you advance.


Put Your Cases to Work

Once you have selected the content you need, you can create a custom course directly from the Content Library page. You can choose content to assign to students to prepare for or review key clinical situations or concepts.

Sign In to Aqueduct

1. Go to Aquifer.org and click Sign In in the top right corner. This will take you to Aqueduct, our learning management system.

2. Enter your institutional email address in the Email box. Then click on the Register button at the bottom of the page. If you receive a prompt on the screen stating “Please ensure you are using your institutional email. If registration issue persists, please contact your clerkship coordinator.”  you may be using the wrong email address, or your email may not have been rostered in the system by the administrators at your program.   Try to register again using your official institutional email.   If you are not successful you will need to contact your course director and ask to have your email added to the system.

Note: If you have previously registered, you will receive a notification that you have already signed in and you will be re-directed to the sign-in screen.

3. You will be sent an email with a link to complete registration. Upon receipt of the registration email, click on the link “Click Here“. You will then be brought to the profile setup page.

4. You will be asked to fill in your profile information and set up a password (8 character minimum).Once you have completed your user profile and created a password, you will receive a welcome email with links to useful information and guides. You would also be logged into the Aqueduct learning management system.

After Completing Your Registration

1. Once you have completed your user profile and created a password, your sign in will be quick and easy. Go to Aquifer.org and click Sign In in the top right corner.

2. You will then be brought to the Aqueduct sign in page. Please log in with your institutional email and account password and click “Sign In”.

5. Once your profile is completed successfully, you will be brought to your institution’s Course page.

Now your sign in will be quick and easy. Go to Aquifer.org and click Sign In in the top right corner, then enter your institutional email and password.

If you experience an issue during Sign In, please allow a few minutes for it to resolve. If the issue persists, please contact Support.

Aquifer Key Features Exam Validation Study Published

Note: The Key Features Exam is now known as the Clinical Decision-Making Exam (as of March 15, 2019). The exam is unchanged from what is described below, with the exception of the new moniker.


Aquifer is excited to share the publication of an important validation study of our own Key Features Exam (KFE) for Internal Medicine in Academic Medicine: Journal of the Association of American Medical Colleges. The article, Validity Evidence for a Brief Online Key Features Examination in the Internal Medicine Clerkship, presents a range of evidence supporting the use of the Key Features Exam as a complementary assessment during the third-year internal medicine clerkship, specifically to test clinical decision-making skills. This publication is the result of a multi-institutional validation study led by Valerie Lang, MD, MHPE, Aquifer Academic Director for Assessment, and a team that included Aquifer Educators Consortium members Dr. Kirk Bronander and Dr. Heather Harrell.

The study results show strong evidence for response-process and relationship-to-other-variables validity for using a Key Features Exam to complement other assessments in U.S. internal medicine clerkships. Results also revealed moderate internal structure validity. The study concludes that Aquifer’s nationally developed KFE is well suited as a standardized complement to other assessments in this context.

Although Key Features Exams are widely used internationally, Aquifer’s KFE is the first designed for use in U.S. medical schools. The key features approach focuses on the critical or challenging decisions in the diagnosis and management of a clinical problem to better target critical decision points. Key features exam structure includes a case vignette, followed by several questions specifically targeting the key clinical decisions.The Aquifer Key Features Exam aligns directly with CDIM’s national curriculum as well as the Aquifer Internal Medicine course, and it is specifically designed to test clinical decision-making skills at the end of the internal medicine clerkship. The exam launched in October 2017 and is currently offered to Aquifer Internal Medicine subscribers free of charge for the 2018-19 subscription year. To learn more about the Aquifer Key Features Exam and the key features approach, please visit our Exams and Assessment page.

Aquifer Sciences Update: Phase Two is Underway

Pilot School Program Teams Are Now Authoring Virtual Patient Cases and Integrated Illness Scripts

After a highly competitive process, Aquifer is pleased to announce that twelve pilot schools were selected to work on Phase Two of the Aquifer Sciences Initiative. Pilot schools were chosen from a nationwide call for participation. The Aquifer Sciences Leadership team is grateful for the overwhelming interest in this project from institutions across the country and thanks to all school applicants for their excellent submissions. The choices were difficult, and the team is confident that the selected pilot school teams will be instrumental in advancing our innovative efforts to re-engineer basic science medical education.

Work is now underway at each school, with teams of clinical and basic science educators—along with senior medical students—working together to create Virtual Patient Cases and Integrated Illness Scripts for clinical conditions routinely encountered in core clinical rotations.

Congratulations to the Phase Two Pilot School Program Teams:

Case Authoring Schools:

  • Eastern Virginia Medical School
  • Louisiana State University School of Medicine in New Orleans
  • University of California Davis School of Medicine
  • University of California San Francisco School of Medicine
  • University of Minnesota Medical School
  • University of Wisconsin School of Medicine & Public Health

Integrated Illness Script Authoring Schools:

  • Albert Einstein College of Medicine
  • Case Western Reserve University School of Medicine
  • Loma Linda University School of Medicine
  • Philadelphia College of Osteopathic Medicine
  • University of Utah School of Medicine
  • Western Michigan University Homer Stryker MD School of Medicine

The Aquifer Sciences Initiative aims to provide healthcare education programs with the teaching and learning resources they need to ensure all graduates seamlessly acquire and apply basic science foundational understanding to patient care. The new tools will promote cognitive integration and allow students to self-assess and grow their foundational understanding through safe practice in making clinical decisions.

The Phase Two work leverages Aquifer’s unique pedagogy and learning objectives drawn from Phase One of the Aquifer Sciences Initiative: the recently released Aquifer Sciences curriculum and database, which was developed in collaboration with the International Association of Medical Science Educators (IAMSE) and is open and available to anyone in the medical education community. Virtual Patient Cases and Integrated Illness Scripts authoring completion is targeted for the Summer of 2019, with beta-testing to follow. Aquifer is grateful for the hard work of all of our contributors on this project and looks forward to making these important new teaching and learning tools available.

Aqueduct Updates: November 2018

Aquifer launched several Aqueduct upgrades on November 18. The latest round of updates improves our report content, provides key details on case updates, and seeks to gain student feedback on their case experiences.

Reporting Improvements
  • An Expert Comment summary statement now appears on the case and student reports next to the student’s summary statement for each applicable case. This feature, requested by our users, will allow for quick and efficient evaluation of student summary statements for programs who include this as part of their assessment of student engagement with the cases.
  • Time from case start to complete is now more accurate! Our time on case calculation now times out after a period of inactivity to more closely reflect the time that students spend engaging with the case content.
  • For your convenience, all reports now display case start, end, and completion time in LOCAL time instead of GMT.
Content Update Details
  • Release Notes are now included at the end of each case, informing all users of any updates to the case content.
For Students:
  • Students now share their feedback by completing three rating questions at the end of each case. All three rating questions are required before completing the case and accessing the downloadable case summary. We look forward to reviewing the students’ feedback and using it to ensure that we are offering the best possible learning materials.
  • Notes entered by students in Aqueduct’s clinical reasoning toolbar are now included in the downloadable case summary, found at the end of each case.

Student Engagement: Race & Culture Project

The Aquifer Student Engagement: Race and Culture project started in Spring 2017 with the goal of improving the way race and culture are presented and taught in Aquifer cases, which reach more than 68,000 students every year.

Phase One

In the first phase of the project, project leads, Dr. Steve Scott and Dr. Katherine Chretien, recruited fourth-year medical students from schools across the country to form a faculty/student workgroup. The group performed a literature review and analyzed Aquifer cases for key areas of improvement. Based on this analysis, a structured guide was created to assist in the review of Aquifer cases while also providing education and rationale.

Presentations & Publications

This work has now been presented nationally at the Association of American Medical Colleges Learn Serve Lead meeting (Austin, TX, November 2018).

Additional presentations have been accepted for the 2019 National Meetings of STFM, COMSEP, and AAIM/CDIM.

Academic Medicine has published ahead of print (print expected in April 2019) an article highlighting the work completed on Phase One of this project.

The two students who played critical roles in the project, Molly Rabinowitz (former student at Oregon Health Sciences University, now a pediatrics resident at Kaiser Oakland) and Aparna Krishnan (MS4 at Johns Hopkins School of Medicine) are co-first authors on the manuscript.


Phase Two

In May 2018, Aquifer accepted applications from first-year medical students to participate in the second phase of the project in which six students reviewed four of Aquifer’s courses (Family Medicine, Geriatrics, Internal Medicine, and Pediatrics) using the race and culture guide and made recommendations to case editors and reviewers for improving cases.

The six students presented their work and findings at the Aquifer Annual Meeting in Boston, Massachusetts, in the first week of October. They also presented their recommendations to each course board, which resulted in important and engaging conversations between the students and Aquifer’s team of educators.

Phase Two Students

NKEMDI AGWARAMGBO

Second-Year Medical Student: University of South Alabama

Read more

Aquifer at AAMC: Are You Making the Most of Your Subscription?

Aquifer is will be at AAMC’s Annual Meeting in Austin, Texas on November 2-6, 2018. We are looking forward to connecting with you at this year’s conference to share the latest news and help ensure that you are making the most of your subscription.

Are you…

  • revising your curriculum?
  • looking to cover new content or key topics without increasing faculty time?
  • working with students in rural areas who need to work on cases offline?
  • in need of tailored courses or reports?
Aquifer’s Curriculum, Teaching, & Learning Tools can help.

See for yourself!

Stop by the booth to be sure you’re taking advantage of:

  • New – Searchable Case Library
    The Searchable Case Library will change the way you use Aquifer cases—
    selecting cases is fast and simple. You may even discover content that you didn’t know was available to you and your students!
  • New – iOS Mobile App
    Students can now complete their cases with our iOS app—anytime, anywhere! Great for students who are on the go or working in rural areas.
  • Content & Tools for Teaching & Learning
    We want to make sure you can access your account and take advantage of the valuable resources included with your program’s subscription. Make sure you’re up to speed on custom courses, reports, our five free interdisciplinary courses, educator resources, and more.

Where: Exhibition Hall—Booth 602
When: Saturday (4:30m-7pm), Sunday (10am-5pm), Monday (10am-1:30pm).

Can’t make it during booth hours? Not going to AAMC? Contact us to set up a personal meeting.


AAMC Presentations

Aquifer is proud to note that Aquifer Consortium members Stephen Scott, MD, MPH and Katherine Chretien, MD will be presenting the work of the Aquifer Student Engagement: Race and Culture Project at AAMC as part of the following session:

Highlights in Medical Education: Addressing Bias in Clinical Practice

Saturday, November 3, 10:30am-11:45am
Convention Center 18

Session includes presentations and discussion on three topics, including:

Addressing Structural Inequality in Medical Education: Guidelines for Virtual Patient Case Curricula

The following presentation will include research findings on integrating the Aquifer Diagnostic Excellence cases into 2nd and 3rd year medical student courses, presented by Frank Lefevre, MD:

Highlights in Medical Education: Innovations in Clinical Reasoning

Monday, November 5, 1:15pm-2:30pm
Convention Center 9

Session includes presentations and discussion on four topics, including:

Teaching Diagnostic Error: A Qualitative Analysis of Student Reactions to Simulated Cases


See you in Austin!

Mandi Sehgal Elected as AGS Teachers’ Section Chair

Aquifer is proud to announce that Dr. Mandi Sehgal, Teaching and Learning Lead for Aquifer Geriatrics, was elected to serve as the Teachers’ Section Chair for the American Geriatrics Society (AGS). The Teachers’ Section represents a group of interprofessional geriatrics educators who come together to encourage networking and collaboration. The section meets at the AGS Annual Scientific Meeting each year.

“I am excited and humbled by this honor,” Dr. Sehgal said. “The chair has the unique and exciting opportunity to lead wonderful colleagues and influence strategy for education sessions at the annual meeting,” she said. “My main goal during my term is to encourage and foster a sense of community among geriatric clinician educators through the use of online and social media.”

Dr. Mandi Sehgal is a Board Certified Family Medicine Physician and Geriatrician. She is an Associate Professor at Florida Atlantic University Charles E. Schmidt College of Medicine. Her roles at the College of Medicine include directing the longitudinal geriatrics curriculum thread throughout all four years of medical school, co-directing the clinical clerkship in geriatrics and palliative care, and serving as the faculty advisor to the FAU chapter of the American Geriatrics Society Geriatric Medicine Student Interest Group.

Dr. Sehgal has an academic passion for designing, implementing and evaluating geriatrics-focused educational curriculum for all learners. She is an active member of the Aquifer Geriatrics (formerly web-GEM’s) course board, currently serving as Teaching and Learning Lead, and a case co-author.

All of us at Aquifer congratulate Mandi this important national position.


Aquifer (formerly MedU) is a thriving, collaborative community of healthcare education leaders deeply committed to driving innovation in teaching and learning. The Aquifer Consortium brings together more than 200 healthcare educators across disciplines to collaborate, innovate, and make advances in health professions education. For educators and healthcare providers, participation in the Consortium offers a unique cross-disciplinary peer community and an exciting opportunity for academic scholarship and advancement.

Duplicate Courses to Create a New Custom Course


Save time creating custom courses with our Duplicate Course feature. You can copy all the content and/or users from an existing course into a new custom course in just a few quick steps.  Any course—including existing custom courses and Aquifer signature courses—may be duplicated. Once you’ve created the new custom course you can give it a new name and description, and edit it further by adding or removing content and users at any time.

1. From your courses page, select the course with the content and/or users that you want to copy.

Duplicate custom course

2. Once you are in a course, click the Duplicate Course button on the right-hand side.

Duplicate Course Button

3. On the Duplicate Course page, enter:

Course Name: We suggest using a consistent naming convention that includes course and rotation name, such as “Family Medicine Clerkship: Block 4”.

Description: We suggest including instructor name, instructions for the course, which cases and/or scripts are assigned, due date, and anything else your students need to know.

Person Responsible: Select the user responsible for the course from your list of eligible administrators. The person responsible will be visible on the course page to all students and administrators associated with the course and will be notified when the course reaches its end date to either delete or extend the date of this course.

Start Date: Will be visible to all course users.

End Date: This date will show on the courses page for all associated users. When the end date is reached, the person responsible for the course will be notified and asked to delete or extend the date for this course.

Copy Users: If this is a Custom Course to which you have assigned specific student and/or faculty users, you will have the option to copy those users over to your new course. 

Verify the Course Content: You will see a list of content available in the duplicated course. You can remove any items that are not necessary.

Once you are done, click “Create Course” to create the new course.

Duplicate New Course Info

4. You will then receive a notification of successful course creation. If you did not copy any users, you will return to the Course page.

If you checked the box for “Copy Users”, you will see the screen below. Your copied users will appear automatically in the email addresses field. Check the box to send an email invitation to users. You can select a later date, or send immediately by selecting today or leaving the date blank.

Note: You can edit the email list on this screen to add or remove users. You can also add or remove users from the course later (see below).

Duplicate Course Add Users

5. From your new course page, you can edit your custom course to add or remove users and content at any time. Learn how to add or remove users and cases.

Editing & Removing Custom Courses

Custom courses allow flexibility to meet the needs of your program or students. It’s easy to edit a custom course to update the course title, start date, or student instructions; or add or remove cases, Integrated Illness Scripts, and users assigned to your course at any time.

After your course ends, please help keep your program’s course list current by removing your old courses after you have downloaded the reports you need.

Editing Custom Courses

Note: Course reports always reflect the students and cases assigned as of the date you are accessing the report. If you remove cases or users from a custom course, they will be removed from the report as well, so you will not be able to see historic completion information.

You can edit any of the information that appears on the Courses page about a custom course at any time. This includes your custom course name, description, start date, end date, and person responsible.

1. From the Aquifer course page, open the course you wish to update and click the Edit button on the top right side.

Edit Custom Course

2. Update the information you wish to change, and click Update Course.

Update Custom Course

If you need to add cases to an existing custom course:

1. Open your custom course and click Add Cases.

Add Items to Course

2. You’ll see a list of content that is available for you to add to your course, including cases as well as Integrated Illness Scripts if your program has access to them. Use the search field to type in a case or an Integrated Illness Script to quickly find the content you want to add.  Select the content you wish to add by clicking on individual items, or using the Select All Shown button.

Add Items to course click button

3. Click Add in the upper right-hand corner. After adding cases, you’ll return to your course page and will see the new cases added to the list.

Tip! You can also use the searchable Content Library to filter and browse available cases and scripts by diagnosis, demographics, and much more. Simply click on Content Library in a separate tab, use the search and display features to make a list of the content you wish to include, and then return to the Add Items to Course page to select those cases and add them to your course.

4. After adding content, you’ll return to your course page and will see the new content added to the list.

Remove Cases from a Custom Course

1. From your custom course page, click Remove Cases.

Remove items from custom course

2. You’ll see a simple list of the cases and Illness Scripts included in your course. Select the cases or Scripts you wish to remove and click the Remove button in the upper right-hand corner.

Click remove for custom course

Add Users

There are two options to add users to a custom course. Please see the Creating Custom Courses instructions for details.


Remove Users

Removing users from a custom course will discontinue their access. Students who are removed will no longer be able to see or access the course and will longer appear in the course report. Be sure to download any needed reports before removing students.

1. From the course page, click Course Users.

Select users

2. Select the user/s you wish to remove from the course from the list. Use the search field to search by first name, last name, or email address to find your user/s quickly.

3. Click Remove Selected Users.

Remove selected users

4. You will see a pop-up message asking if you are sure you want to remove the users. Click OK.

Confirm remove user

A confirmation message will appear in the light blue bar at the top of the page if your users were successfully removed.


Deleting a Custom Course

Help keep your program’s course list current by removing old custom courses. To help you manage this process, the person responsible for each custom course created after August 3, 2018 will receive an email notification when the course end date is reached asking them to extend the date or remove the course. Any user with the role of Program Service Administrator, Curriculum Administration, or Course Administrator can remove a course.

Please be sure that ALL course users no longer need to access the course and all associated reporting before removing a course.

To remove, proceed through the steps below.

1. Be sure that you have downloaded and saved any reports that may be needed from this course. Reporting is not available for this course after it has been removed.

Download course report reminder

2. To remove a Custom Course, click on the course you want to remove. From the course page, click the Delete button on the right side.

Delete course

3. You will receive a popup warning message. Click OK and the course will be deleted.

Confirm delete course

iOS App Now Available

AquiferSM Clinical Learning: Available from the App Store

Aquifer is excited to announce that our iOS app, powered by AqueductSM is now available for free download from the App Store. Students can now complete their cases easily from an iPhone or iPad device—anytime, anywhere.

Work Offline! Download cases in advance and complete work even without an internet connection. Case work will sync to individual Aquifer accounts when devices reconnect to the internet. Once a device has synced, progress can be viewed in student and course reports on your laptop or desktop computer.

A few notes:

  • Only registered users can sign in to the iOS app. Please complete your Aquifer registration before signing in to the iOS app.
  • The app is intended for viewing cases only. Administrators have unrestricted access to all of their cases, but reporting, course management, and user management are not available on the app should be completed at your laptop or desktop computer.

To download the app, click on the button below, or search “Aquifer Clinical Learning” in the App Store.


The Aquifer Android App is coming soon! Stay tuned for updates.

Aquifer Sciences Call for Participation Open

The Aquifer Sciences Initiative is seeking six pilot medical schools to develop and beta-test tools to promote cognitive integration in medical education. Leveraging Aquifer’s unique pedagogy and learning objectives drawn from our recently released Aquifer Sciences open curriculum—developed in collaboration with the International Association of Medical Science Educators (IAMSE)—pilot school teams will initially be assigned to develop either virtual patient cases or integrated illness scripts for clinical conditions routinely encountered in core clinical rotations.

About the Aquifer Sciences Initiative

Integration of basic and clinical science knowledge is increasingly being recognized as important for safe and effective practice in the health professions. The concept of ‘cognitive integration’ places emphasis on the value of basic science in providing critical connections during clinical decision-making, while recognizing that experienced clinicians may not spontaneously articulate their use of basic science knowledge in clinical reasoning.

Aquifer, the non-profit leader in collaborative development of virtual learning resources for health professions education, has launched the Aquifer Sciences Initiative. The Initiative aims to provide medical schools with the teaching and learning resources they need to ensure all graduates seamlessly acquire and apply basic science foundational understanding to patient care.

Learn More About Aquifer Sciences

Development teams at pilot schools must:

  • Be collaboratively led by an experienced basic science educator and a clinician educator with a history of working on integrated curriculum projects.
  • Include a small, balanced, and committed team of basic science and clinical educators with expertise in the topics relevant to the team’s assigned cases or integrated illness scripts.
  • Include at least four medical students with a track record of excellence in both the school’s basic science and clinical curricula, and who have demonstrated the ability to work independently and in teams, with strong follow-through skills.
  • Participate in a scheduled two-hour training webinar.
  • Dedicate up to 16-weeks to the project, including scheduled weekly or bi-weekly working group calls with assigned project mentors, and local team meetings as required to complete tasks in the assigned time frame.

Consistent with Aquifer’s mission, project participants will innovate collaboratively within teams of leading basic, clinical, and cognitive science educators and medical students from participating schools recruited from across North America. Dedicated Aquifer staff, including eLearning designers, project managers, and software developers will enable project participants to focus on designing and implementing tools in rapid-cycle innovation loops while learning valuable new skills in product design, development, and testing.

Upon successful completion of assigned work, pilot schools will be eligible to participate in the beta launch of the initial case series and illness scripts developed by all pilot programs. Successful pilot school teams will receive priority consideration in future development phases of the project.

Pilot schools will be recognized as such on the Aquifer website and in all relevant Aquifer Sciences materials. Project leaders will be provided with a $1,500 grant to support local project activities. Project members who demonstrate significant contributions will receive scholarly recognition and evidence of multi-institutional impact and will be eligible to apply for travel grants to Wellspring —Aquifer’s annual meeting—in October 2019 to present their work and to engage with other pilot school participants.

Letter of Intent Due: August 3, 2018

LOI Status Notification: August 17, 2018

Full Application (by invitation) Due: September 15, 2018

Pilot Schools Notified: October 8, 2018

Required 2-hour Training Webinar: October 17, 2018

Phase 1 Development Commences: October 15, 2018

Phase 1 Development Work Complete: March 1, 2019

Beta-Testing Commences: July 1, 2019

Letter of Intent Submission

Thank you to all schools who submitted a Letter of Intent to become a pilot school. You will be notified of your status by August 17.

David Harris Receives IAMSE Award for Excellence

Aquifer is pleased to announce that David Harris, PhD, received the Early Career Award for Excellence in Teaching and Innovation at the 2018 International Association of Medical Science Educators (IAMSE) Annual Meeting in early June. Dr. Harris is a science lead on the Aquifer Sciences Leadership Team.

The IAMSE Early Career Award for Excellence in Teaching and Innovation honors an IAMSE member who has made significant innovations to the field in a short time toward teaching, learning, and assessment. The award is given to candidates with a record of innovation in teaching and engagement within IAMSE. The award winner is chosen by the Educational Scholarship Committee and approved by the IAMSE Board of Directors.

Dr. Harris is an Associate Professor of Physiology at the University of Central Florida. He received his PhD in physiology from the Temple University School of Medicine and later served as the course director of medical physiology at Drexel University College of Medicine. After moving to the University of Central Florida, Dr. Harris developed his scholarly interests in active learning pedagogies and the use of high fidelity patient simulation with pre-clerkship medical students. In addition to his work with Aquifer Sciences, he serves on committees of the American Physiology Society and is an Associate Editor of Advances. He is the winner of numerous awards, including the APS New Investigator Award, the APS Teaching Career Enhancement Award, and the UCF Pre-Clinical Innovative Teaching Award.

David Harris joined the Aquifer Sciences Initiative at its inception, co-leading the development efforts for Physiology concepts and learning objectives. In 2017, David joined the Initiative’s leadership team and was instrumental in re-organizing the project’s focus around body systems and seeing the Physiology concepts to completion. The success of this critical component of the curriculum could not have been achieved without David’s strong leadership of this student-driven team. “All of us at Aquifer, and especially the Aquifer Sciences team, were thrilled to see David honored at IAMSE this year. He is an integral part of this project and a talented educator. We look forward continuing to work closely with David as the next phase of the project moves ahead,” said Leslie Fall, Aquifer Executive Director and Aquifer Sciences Design/Faulty Development Lead.


Aquifer (formerly MedU) is a thriving, collaborative community of healthcare education leaders deeply committed to driving innovation in teaching and learning. The Aquifer Consortium brings together more than 200 healthcare educators across disciplines to collaborate, innovate, and make advances in health professions education. For educators and healthcare providers, participation in the Consortium offers a unique cross-disciplinary peer community and an exciting opportunity for academic scholarship and advancement.

Aquifer Consortium Members Elected to Lead CDIM and AAIM

Aquifer congratulates our consortium members and internal medicine educators Shobhina Chheda, MD, MPH, Katherine Chretien, MD, and James Nixon, MD, MPHE on their election to respective leadership roles in the Clerkship Directors in Internal Medicine (CDIM) and the Alliance for Academic Internal Medicine (AAIM).

CDIM is a professional membership organization representing educators who teach internal medicine to medical students, including clerkship directors, preceptors, and other faculty and staff involved in undergraduate medical education. AAIM, the parent organization for CDIM, supports academic internal medicine professionals and enhances health care through professional development, research, and advocacy. The terms for the elected positions begin on July 1, 2018.

Dr. Shobhina Chheda, currently the Aquifer Internal Medicine Teaching and Learning Lead, will transition from serving as CDIM President-Elect to CDIM President this year. Dr. Chheda is an Assistant Dean of Medical Education and Professor of General Internal Medicine at the University of Wisconsin.

Stepping up to the CDIM President-Elect position will be Katherine Chretien, MD. Dr. Chretien is currently the Student Engagement Lead for the Aquifer Teaching & Learning Group, and the co-faculty lead for the Aquifer Race and Culture project. She is also the Assistant Dean for Student Affairs and an Associate Professor of Medicine at George Washington University.

Shobhina Chheda and Kathy Chretien are continuing a longstanding tradition of Aquifer Consortium members holding leadership positions in CDIM. Past presidents who are also current Aquifer Consortium members include:

  • James Nixon, MD (2016-2017 term); Aquifer Internal Medicine Senior Director
  • Valerie Lang, MD (2014-2015 term); Aquifer Academic Director for Assessment
  • Heather Harrell, MD (2012-2013 term), Aquifer High Value Care Senior Director

Following his term as CDIM President, Dr. James Nixon was elected to the AAIM Board of Directors in the role of Secretary-Treasurer for the 2017-2018 term. He was recently re-elected and will continue to hold the office for the 2018-2019 year. This position also serves as the AAIM Finance and Audit Committee Chair. Dr. Nixon is currently a Professor of Internal Medicine and Pediatrics at the University of Minnesota.

AAIM is Aquifer’s collaborating national organization for the Aquifer Internal Medicine course, which delivers the learning objectives of the CDIM General Internal Medicine Core Medicine clerkship curriculum. Aquifer’s close partnership with AAIM and CDIM ensures that our course content reflects the current national curriculum standards and serves the needs of medical educators across the country. “We are so proud to have our Aquifer Consortium members so highly engaged within their professional organizations. Not only does it showcase the talented educators who work with us, but it helps to ensure that Aquifer’s content reflects national curriculum standards and aligns with the needs of students and educators,” said Leslie Fall, Aquifer Executive Director. “The entire Aquifer team congratulates Shobhi, Kathy, and James on their new and continuing leadership roles.”


Aquifer (formerly MedU) is a thriving, collaborative community of healthcare education leaders deeply committed to driving innovation in teaching and learning. The Aquifer Consortium brings together more than 200 healthcare educators across disciplines to collaborate, innovate, and make advances in health professions education. For educators and healthcare providers, participation in the Consortium offers a unique cross-disciplinary peer community and an exciting opportunity for academic scholarship and advancement.

Aquifer Welcomes New Consortium Members

Aquifer is pleased to welcome the following medical educators to the Aquifer Consortium as they join a range o course boards. We look forward to working with them to continue developing and maintaining quality courses and tools for educators and students.


Dr. Judy Gadde

Aquifer Radiology – Teaching & Learning Lead

Judy Gadde is an adult and pediatric neuroradiologist at Emory School of Medicine and the Children’s Healthcare of Atlanta. After completing her undergraduate degree, Dr. Gadde moved to Kansas City University of Medicine and Biosciences for her DO and MBA in Healthcare Leadership degrees. She completed her internship and Diagnostic Radiology residency at Christiana Care in Newark, Delaware. The University of Wisconsin Madison was the next move for her Neuroradiology Fellowship, followed by the Children’s Hospital of Philadelphia for her Pediatric Neuroradiology Fellowship. Dr. Gadde began her career at Emory by getting involved in medical student education, while also creating a Pediatric Neuroradiology Case of the Week on Twitter and assisting in the transformation of Radiology ExamWeb.


Dr. Jimmy Beck

Aquifer High Value Care – Editor-in-Chief/Associate Editor

Dr. Beck is currently a Pediatric Hospitalist at Seattle Children’s Hospital. He attended medical school at the University of Washington. He currently serves as Chair of the American Academy of Pediatrics Subcommittee on Pediatric Hospital Medicine Educators. Dr. Beck’s educational and research focus has been on promoting High Value Care. He has led a variety of multi-institution collaboratives to develop HVC educational curriculum for trainees and an HVC rounding tool. He currently is involved in a project to better under parents’ perspective on cost discussions of hospitalized children.


Dr. Lucia Ponar

Aquifer Diagnostic Excellence – Associate Editor

Dr. Ponar is currently the Medical Education Director and Assistant Professor of Medicine at John Hopkins School of Medicine. She attended the Universitatea De Medicina Si Farmacie Carol Davila for medical school and completed her fellowship at Johns Hopkins Bayview Medical Center, where she also received an award for Clinical Excellence in 2016. She has developed a Clinical Reasoning Curriculum which was implemented within the Internal Medicine Residency training at Johns Hopkins School of Medicine. Additionally, Dr. Ponar has given lectures related to clinical reasoning and involved in Transitions to Wards, which enables medical students to develop clinical thinking concepts before entering residency. She also completed her MBA at Johns Hopkins Carey School of Business in 2013.


Dr. Kathleen Lane

Aquifer Diagnostic Excellence – Associate Editor

Dr. Kathleen Lane is an Assistant Professor of Medicine at the University of Minnesota. She earned her medical degree at the University of Minnesota in Internal Medicine. Dr. Lane previously co-authored one of the Aquifer Diagnostic Excellence cases with Dr. Andrew Olson, along with staging photographs for a sample case. Her research interests span clinical reasoning, diagnostic error, and feedback. She is also a co-PI on the LOOP Study, which is a multicenter initiative utilizing feedback to improve diagnostic reasoning in trainees.


Aquifer is a thriving, collaborative community of healthcare education leaders deeply committed to driving innovation in teaching and learning. The Aquifer Consortium brings together more than 200 healthcare educators across disciplines to collaborate, innovate, and make advances in health professions education. For educators and healthcare providers, participation in the Consortium offers a unique cross-disciplinary peer community and an exciting opportunity for academic scholarship and advancement.

Study Confirms Need for Education on High Value Care

A survey conducted by the Clerkship Directors in Internal Medicine reveals a disparity between the perceived importance of teaching in high-value care (HVC) and current state of instruction on the topic in internal medicine clerkships. The research findings were presented in “Current and Optimal Training in High-Value Care in the Internal Medicine Clerkship: A National Curricular Needs Assessment”, published in the March 2018 issue of Academic Medicine, by doctors Danelle Cayea, Kimberly Taraglia, Amit Pahwa, Heather Harrell, Amy Shaheen, and Valerie J. Lang.

The study shows that high-value care (HVC) is insufficiently taught and assessed in medical school due to several factors. As part of CDIM’s 2014 annual survey, 121 U.S. and Canadian medical school clerkship directors were asked a series of questions about the importance of high-value care instruction. The majority of respondents (91.4%) agreed that medical schools have a responsibility to teach about HVC, yet only 32.9% reported that their curricula included formal instruction on this topic. A majority of clerkship directors found the amount of instruction dedicated to HVC was insufficient (70.2%).

Survey results show that lack of dedicated time in the curriculum (73.4%) and lack of faculty time to teach (68.1%) are the top barriers to implementing HVC instruction. Other contributing factors included lack of curricular materials, faculty development, and dedicated curricular time. The study cites that curricular teaching tools, including Aquifer High Value Care, are currently available and would benefit from further dissemination.

Originally developed by expert members of CDIM and adopted from the ACP and AAIM HVC resident curriculum, the Aquifer High Value Care virtual patient cases model best-practices in high-value care. The original content recently expanded to 12 cases, which include the pediatric population and specialties outside of internal medicine. All are available free of change. Dr. Heather Harrell, study co-author and Aquifer High Value Care Senior Director noted. “The Aquifer High Value Care curriculum is uniquely suited to help address this gap and perceived barriers to HVC education in U.S. medical schools. With very little faculty time required, educators can assign the entire course, or just a selection of cases depending on the needs of their program.”

Aquifer Consortium members Dr. Amit Pahwa, Dr. Heather Harrell, and Dr. Valerie Lang participated as co-authors in the study. Dr. Amit Pahwa is an Associate Director of the Aquifer High Value Care Course Board, an Assistant Professor of Medicine, and Director of Hospital Medicine Sub-Internship at Johns Hopkins University School of Medicine. Dr. Heather Harrell is the Senior Director of Aquifer High Value Care Course Board, a Professor of Medicine and Co-Director of Internal Medicine Clerkship at the University of Florida, Gainesville, and former CDIM President (2012-2013). Dr. Valerie Lang is the Aquifer Academic Director for Assessment, an Associate Professor of Medicine at the University of Rochester, and former CDIM President (2014-2015).


Aquifer (formerly MedU) is a thriving, collaborative community of healthcare education leaders deeply committed to driving innovation in teaching and learning. The Aquifer Consortium brings together more than 200 healthcare educators across disciplines to collaborate, innovate, and make advances in health professions education. For educators and healthcare providers, participation in the Consortium offers a unique cross-disciplinary peer community and an exciting opportunity for academic scholarship and advancement.

Case Updates are Here

Aquifer courses and assessments have been updated to reflect the most up-to-date guidelines and protocols. All updates take effect on July 1, 2018. The Aquifer Consortium, a group of more than 200 health care educators and experts dedicated to helping Aquifer provide the best curricular content available, reviewed and updated the cases as part of Aquifer’s Continuous Course Improvement Process.

Aquifer’s Continuous Course Improvement Process involves ongoing updates and peer-review to ensure that our educators and students have access to the most up-to-date and informative content. Over 100 cases have been updated for the 2018-19 subscription year. The updates bring our cases, assessments, and resources in line with current and ever-changing guidelines and recommendations for screening, care, and prescribing for:

  • Hypertension (ACC/AHA guidelines)
  • Cholesterol (ACC/AHA guidelines)
  • Breast screening (USPSTF guidelines)
  • Skin cancer (USPSTF guidelines)
  • Calcium and vitamin D (USPSTF guidelines)
  • HPV vaccine recommendations
  • Pain management and opioids

In addition, the Aquifer Internal Medicine course now includes new Self-Assessment Questions for all cases. Self-assessment questions at the end of each case allow students to calibrate their ability to apply their new knowledge and skills by completing five single-best answer vignette-style questions. The questions have been written and rigorously peer-reviewed by members of the Clerkship Directors in Internal Medicine (CDIM), and are tightly linked to the learning objectives of the CDIM – Society for General Internal Medicine (SGIM) Core Medicine Clerkship Curriculum.

New questions have also been added to the Aquifer Radiology Exam, which will be added to our existing questions through a carefully maintained validation process this year.

Aquifer Sciences: Curriculum Database Now Available

Aquifer is excited to announce that the Aquifer Sciences curriculum database is now available to the public free of charge via Aquifersciences.org.

The database houses the Aquifer Sciences initiative core curriculum, developed in collaboration with the International Association of Medical Science Educators. Four years in development, the Aquifer Sciences curriculum is the first nationally-developed and publicly available curriculum that comprehensively outlines the core basic sciences concepts that must be understood and mastered by health professions learners in order to provide safe, routine patient care.

The core curriculum is the result a massive collaborative effort by a nationally representative and multi-institutional team of over 100 leading science and clinical educators, along with senior medical student curriculum interns from across the country. The curriculum database includes:

  • 11 basic science disciplines
  • 9 clinical disciplines
  • 105 core concepts
  • 789 learning objectives
  • 366 common conditions
  • 5 clinical decisions
  • 15 systems

The Aquifer Sciences curriculum is delivered through a customizable search and filter database that allows users to access the information they need with ease. The carefully curated curriculum information, combined with easy-to-use, openly available online access, makes the Aquifer Sciences database an extremely valuable tool for educators and during their curriculum planning processes. The core curriculum provides a common conceptual language and integrated curricular methodology enables curricular planning and meaningful conversations between basic science and clinical educators.

“We are so thrilled to launch the Aquifer Sciences curriculum database. This is the culmination of so many years of hard work by such an incredibly dedicated team. It’s a wonderful feeling to have the database available to the public, and we look forward to hearing feedback from educators as they dig in and start making use of this tool,” said Leslie Fall, Aquifer Executive Director and Chief Academic Officer. “We believe this project fills a critical need in health care education. The team is excited to continue our mission of integrating basic science and clinical learning by moving forward with the next phase of the initiative this year—the virtual patient cases.”

The curriculum database is the key first component of the larger Aquifer Sciences initiative. Aquifer Sciences is a partnership between Aquifer, a non-profit organization, and the International Association of Medical Science Educators (IAMSE) to develop and share teaching and learning tools that integrate the basic and clinical sciences. The goal of the initiative is to promote cognitive integration and collaborative teaching of the basic and clinical sciences in health professions education. Future project components, currently in development, include the development of virtual patient cases with integrated illness scripts for over 300 core conditions, which will follow Aquifer’s proven pedagogy and existing course library model. The virtual patient cases are expected to become available via Aqueduct, Aquifer’s learning management system, in 2019. Following the launch of the cases, the Aquifer Sciences team will develop classroom resources to support active learning and collaborative faculty facilitation, tentatively available in 2020.


Learn more:

User Management Upgrades: Spring 2018

Aquifer is pleased to announce the launch of several new features in Aqueduct to help administrators better manage all types of users. This major upgrade will significantly simplify and improve the workflow for administrative users.

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  • Separate administrative and student user panels for easier user viewing
  • Batch delete administrative and student users. At the start of a new academic year, it’s fast and easy to remove students and administrators who no longer need access. Learn how to remove students and administrative users in Aqueduct.
  • Option to send invitation emails to unregistered users at any time and ability to select a send date for student invitations when they are added to your program. This is a great way to remind students and administrators who have not registered that they have this access to Aquifer courses.
  • Export your user list, including the information available in the new user panel display, to sort and work with as you wish.
  • Cleaner user panel displays, with more detailed information available at-a-glance:
    • Administrative users’ name, email, role in Aqueduct, self-reported clinical discipline, and date added to Aqueduct
    • Student users’ name, email, self-reported anticipated graduation date, and date added to Aqueduct
  • Sort and filter users by role, registration status, and any field that appears in the user panel for easy use of the export, send email invitations, or remove selected members tools.

Updated Step-by-Step Instructions

Stay current! Review our updated posts to start taking advantage of the new features:

Stephen Scott to Join Aquifer Academic Leadership

Dr. Stephen Scott, MD, MPH

Aquifer is thrilled to announce that Stephen Scott, MD, MPH will join the Aquifer Academic Leadership as a new Academic Director for Engagement. In this new academic leadership role, Dr. Scott’s will join forces with Sherilyn Smith (Academic Director for Engagement, Integration, and Research) to advance Aquifer’s outreach and engagement capabilities. His work will focus on improving Aquifer’s understanding of the needs of our subscribing educators and students, and increasing user engagement.

This new role will also extend to product research and development and providing educator-to-educator advice on effective curriculum integration and use of Aqueduct’s features. Dr. Scott will work closely with the Aquifer Relationship Management and Product Management teams, along Aquifer leadership, the Aquifer Academic Council, and the Aquifer Consortium as a whole. The new position will begin officially in July.

Dr. Scott first became involved with Aquifer (formerly MedU) in 2007, when he joined the fmCASES (now Aquifer Family Medicine) development group. He’s been an active member of the Aquifer Family Medicine Course Board (where he will continue to serve) since the launch of the course, in addition to leading workgroups to support student and educator Aquifer users.

Dr. Stephen Scott recently became the Chair of the Department of Medical Education and Director for the Longitudinal Integrated Clerkship at the newly forming Texas Christian University and UNTHSC School of Medicine in Fort Worth, Texas. Previously, he served as the Associate Dean for Student Affairs at Weill Cornell Medicine – Qatar. For more than 20 years, Dr. Scott has worked with medical students, residents, and faculty in the classroom and in clinical settings, including directing courses in patient-physician communication, clinical skills, public health, and other disciplines. Dr. Scott is the recipient of multiple grants and awards for educational leadership and innovation. He and his wife Melissa have two daughters. Steve enjoys playing the piano, the arts, reading, and exploring the world with family and friends.

“We’re thrilled to have Steve joining us in this new academic leadership role,” said Leslie Fall, Aquifer Executive Director and Chief Academic Officer. “Between his work on the Aquifer Family Medicine course, background in faculty development and student affairs, and new role building a medical school from the ground up, he is the ideal fit to help us advance Aquifer’s mission. We look forward to working with him and growing our capacity to work on the important areas where Steve will bring valuable knowledge and experience.”


Aquifer (formerly MedU) is a thriving, collaborative community of healthcare education leaders deeply committed to driving innovation in teaching and learning. The Aquifer Consortium brings together more than 200 healthcare educators across disciplines to collaborate, innovate, and make advances in health professions education. For educators and healthcare providers, participation in the Consortium offers a unique cross-disciplinary peer community and an exciting opportunity for academic scholarship and advancement.

Amit Shah Receives AGS Educator Award

Amit Shah, MD, FACP, AGSF

Aquifer congratulates our own Amit Shah, MD, FACP, AGSF, of the Aquifer Geriatrics Course Board, on being chosen as American Geriatrics Society Outstanding Mid-Career Clinician Educator of the Year Award. Dr. Shah was chosen as this year’s winner for his work as an inspiring mentor, attentive clinician, and innovative development of web-GEMs (now Aquifer Geriatrics).

The Outstanding Mid-Career Clinician Educator of the Year award is given by the American Geriatrics Society to a junior faculty member for an impressive body of work in geriatrics education, with significant contributions to training students and advancing geriatrics education. The award was presented on May 4 at the AGS National Scientific Meeting in Orlando, Florida.

Dr. Shah led the development of web-GEMs (now Aquifer Geriatrics), and served as the co-Primary Investigator of the Reynolds grant which created the course. He continues the work of providing high-quality virtual patient cases to geriatrics learners as an Associate Editor for the Aquifer Geriatrics Course Board.

Currently, Dr. Shah leads the longitudinal geriatrics curriculum and co-directs the internal medicine residency continuity clinic as an Assistant Professor of Medicine and Associate Dean for Faculty Affairs at the Mayo Clinic School of Medicine in Arizona. Previously, Dr. Shah was the Clerkship Director for Internal Medicine at the University of Texas Southwestern Medical school, where he worked to integrate geriatrics into the curriculum. During his time in Texas, he also helped to facilitate the Southwestern Aging and Geriatrics (SAGE) program, was elected to the UT Southwestern Academy of Teachers, and received a number of teaching awards.


Aquifer (formerly MedU) is a thriving, collaborative community of healthcare education leaders deeply committed to driving innovation in teaching and learning. The Aquifer Consortium brings together more than 200 healthcare educators across disciplines to collaborate, innovate, and make advances in health professions education. For educators and healthcare providers, participation in the Consortium offers a unique cross-disciplinary peer community and an exciting opportunity for academic scholarship and advancement.

In the Pipeline: Aqueduct Updates – Spring 2018

Aquifer launched Aqueduct, our new learning management system, in June 2017. Since then, our team has been working to improve the user experience of the platform, optimize existing functionality, and add newly requested features.

We want you—our users—to have the best possible experience.

We would like to highlight some of the work we’ve completed, and share some of the projects our development team is working on for future releases.


Completed Projects

We hope you’ve seen our latest improvements, including new reporting functionalities, performance enhancements, sign-in process upgrades, and more:

  • Full Reporting with Exports: Program Level Reports, Course, Case, and Student Reports are available in Aqueduct
  • Educator Resources: Our Educator Resources provide terrific tools for course integration—including active learning modules, flipped classroom workshops, and educator guides—now accessible through Aqueduct.
  • Aquifer Internal Medicine Key Features Exam: If you are using the Aquifer Internal Medicine Key Features Exam, you’ll appreciate that we have migrated it to Aqueduct and simplified the exam administration process.
  • Aqueduct Rebranding: We’re blue! When MedU changed to Aquifer, our learning management system was rebranded with our new logo, colors, fonts, and course names.
For Administrators: User Management Upgrades

We’ve added features to simplify how you view, add, and remove users from your program.

    • Separate administrative and student user panels for easier user viewing
    • Cleaner user panel displays, with more detailed information available at-a-glance:
      • Administrative users’ name, email, role in Aqueduct, self-reported clinical discipline, and date added to Aqueduct
      • Student users’ name, email, self-reported anticipated graduation date, and date added to Aqueduct
  • Export your user list, including the information available in the new user panel display, to sort and work with as you wish
  • Sort and filter users by role and status
  • Batch delete administrative and student users
  • Administrative user panel access for all administrative users providing the ability to view others in your program
  • Option to send student invitation emails when rostering students to a program for any course, and specify a “send date”

Coming Soon

As we look to the future, we’re focused on improving your user experience even more and adding the features you want, including:

For Administrators:

Course Management Optimization

  • Replicate custom and Aquifer signature courses. Reusing a set of cases will be quick and easy with the ability to copy courses. Just be sure to add a new group of students to your copied course, and update the course name if you wish.
  • A new, clean case listing page with thumbnail images for easy viewing, plus detailed author and case update information (release notes, date last updated) available at-a-glance
  • An updated course page with easy visual differentiation between Aquifer signature courses, custom courses, exams, and educator and student resources

For Students:

User Interface Improvements

  • Aqueduct is getting an updated design with a clean, modern feel, but with the same simple, easy-to-use navigation
  • Quick-view of progress through each case on an updated case listing page, plus case update information (release notes, date last updated) available at-a-glance
  • Easy visual differentiation between custom courses that students were added to and Aquifer signature courses that are part of their school’s institutional subscription

Android and iOS Mobile Applications

  • Enjoy full mobile access—anytime, anywhere, and across your devices—with the ability to download cases to work offline.

Note: The updates above will apply to all Aquifer courses. WISE-OnCall and WISE-MD are distributed by Aquifer on behalf of the NYU School of Medicine and are available on the WISE platform, accessed from your Aquifer account.

Managing & Removing Student Users


After students are added to your program, it’s easy to manage your student users in Aqueduct. Administrative users with student user management permissions (view roles and permissions) have the ability to:

  • Remove rostered students from your program
  • Export a student list
  • Send email invitations to students at any time
  • Sort and filter students in a variety of ways

At the start of each academic year, please remove students who no longer need to access Aquifer courses. This will keep your user counts accurate, make your student user list easy to manage, and keep your account up-to-date.

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The Student User Panel

To access the student user panel, click on Users in the top navigation. From the program users page, click on the Students tab.

The top of the Student User Panel displays your student user counts at a glance. Counts include:

  • Registration Pending: the number of students who have access to your program but have not registered in Aqueduct yet
  • Active: Students who have completed their registration
  • Total: All students currently rostered in your program (both registration pending and active)
  • Max: The maximum number of students that may be added based on your institution’s current subscription
student user panel

Below your student statistics, you’ll see a full list of your students with a variety of options for filtering, sorting and selecting. You will also see Send Email Invitation, Export User List, and Remove Selected Members buttons. These three options are inactive until users are selected

There are a variety of options available for sorting your student list. You can Search by last name, first name, or email address in the search field (1).

You can also sort in ascending or descending order by date added, first name, last name, email, or anticipated graduation date.

Please note first name, last name, and anticipated graduation date is entered by the students when they complete their registration status and will not be available for students who have a status of “registration pending”.

To sort, click on the button for the field you wish to select (2). The button you select will turn a darker blue while your sort is active, and a pointer will appear next to the text indicating if your list will be sorted in ascending or descending order (3). Click the button again to change the sort order.

student user panel sort and filter options

Aqueduct’s user panel allows you to Filter by Status. Use the dropdown menu to sort the list of students below by registration status.

In order to use the student user management tools, you will need to select the group of students you wish to manage. After using the filter and sort options to display the list of students as you’d like, there are two methods to select and deselect students.

  1. Use the Select All Shown or Deselect All buttons above the list.
  2. Check the box next to each student you wish to select. Check the box again to deselect the student.

Selected students are highlighted, and show a checkmark in the box next to their name.

student user select and deselect options

Student User Management Tools

Managing your student users is easy with the ability to send email invitations and export user lists.

Administrative users can send email invitations to students with a Registration Pending status only. It is recommended to re-send email invitations to students who have not logged in after several months (or a length of time that matches the needs of your program) to ensure that students are making use of their Aquifer courses.

To send an email invitation, select the students you wish to email, and click the Send Email Invitation button.

student user tools - send email invitation

You will receive a pop-up prompting you to confirm that you wish to send an email to the selected students. Click OK to continue sending the email invitation.

student user email invitation message

After emails are successfully sent, you will see a confirmation note in the box at the top of the page.

student user email invitation success message

Please note: Emails will not send to students with an Active status. If you select students with a mix of statuses, emails will send to only those who have not yet registered. After clearing the pop-up, the message at the top of your screen will show which emails were sent to students.

To export a list of users to a csv file, select the students you wish to export and click the Export User List button. Your browser will direct you to download and save the csv file for your use.

student user export list

Removing Students from Your Program

Removing students from your program will discontinue their access to your Aquifer courses.

Warning: Download Reports Before Removing Students

Be sure to download any and all reporting associated with the student/students you are planning to remove. Once removed, a student’s coursework will not appear on the case or course reports.

There are two ways to remove students from your program.

To batch remove students using a list of email addresses, click the Remove Students button at the top of the page.

remove student users buttom

On the Batch Remove Students from Program page, add the student emails (comma separated) that you wish to remove from your program and click Remove Students.

batch remove students from program

You will receive a pop-up message asking to confirm the removal of the listed students. Click OK to confirm that you wish to proceed.

student batch remove warning message

After the process completes, you will see a confirmation in the notification bar at the top of the page.

student batch remove confirmation

You can also remove students by selecting them from the student user list, and clicking on the Remove Selected Members button. This method is recommended for individual or small groups of students.

remove selected student users

Like the batch removal process, you will see a pop-up notification asking you to confirm deleting the selected students. Click OK to continue.

Remove selected students popup message

After the process completes, you will see a confirmation in the notification bar at the top of the page.

student batch remove confirmation

Note: When students are removed from a program, they are automatically added to the Aquifer Alumni program. From the Alumni program, they will be able to access Aquifer’s free course content or purchase an individual subscription or continuing education module.

Family Medicine Exam Found to be Effective Pretest

Study Shows that Using the Aquifer Family Medicine Exam as a Pretest Improves NBME Performance

Aquifer is pleased to share the findings of a recent study relating to the Aquifer Family Medicine Exam (formerly the fmCASES National Examination). The study, “fmCASES National Examination as a Pretest in a Family Medicine Clerkship”, published in the February 2018 edition of Family Medicine, was conducted by Dana R. Nguyen, MD, of Uniformed Services University, and co-authored by Jessica T. Survey, MD and LaTraia S. Scoot, MD. Results showed that students who completed the Aquifer Family Medicine Exam as a pretest at the start of the family medicine clerkship failed the NBME final exam at significantly lower rates (8.1% compared to 17.5%) than students who did not take the pretest. The study also concludes that the Aquifer Family Medicine Exam is a valuable formative assessment tool. Pretest results provided students with clear feedback on content areas most in need of study and help to form individualized study plans.

“This study adds to our knowledge about the usefulness of the Aquifer Family Medicine Exam (formerly known as the fmCASES National Exam) and should inform clerkship and curriculum directors about the exam’s utility for improving learning,” said Alexander Chessman, Aquifer Academic Director of Curriculum. “A standard criticism of using pretest scores is that ANY exam could be effective for placing a student into a risk group; the old dictum is that a bad test-taker is a bad test-taker. But this study, after adjusting for MCAT score, and undergraduate GPA, still proved that using this exam as a pretest was informative. Thank you to the study team for this great and helpful work that adds to our understanding.”

Although the Aquifer Family Medicine Exam is designed as a summative end-of-clerkship evaluation to replace or enhance another cumulative exam, its uses extend beyond. The exam, included with an Aquifer Family Medicine subscription at no additional cost, is also being utilized for remediation, or, as this study suggests, as a pretest for the NBME.

Learn more about the Aquifer Family Medicine Exam.

View the full abstract and article.


Aquifer (formerly known as MedU) is a mission-driven 501 (c)(3) non-profit organization dedicated to delivering the best healthcare education through collaborative development and research into innovative, high-impact virtual teaching and learning methods. Aquifer develops trusted, award-winning, virtual case-based courses derived from national healthcare curricula. Since Aquifer’s founding in 2006, over 10,000,000 virtual cases have been completed by more than 300,000 students. Aquifer’s cases are created and maintained by more than 400 educators from 10 leading national organizations representing more than 120 academic institutions.

Dr. Sox Publishes Study on Aquifer Oral Presentation Skills

Aquifer Oral Presentation Skills Found to be as Effective as Faculty-Led Feedback Sessions

Aquifer congratulates Colin M. Sox, MD, MS on the recent publication of his study “Efficacy of a Web-Based Oral Case Presentation Instructional Module: Multicenter Randomized Controlled Trial”, in the January 2018 issue of Academic Pediatrics. His research tested the effectiveness of the Aquifer Oral Presentation Skills course (formerly CLIPP oral case presentation modules) in improving student’s oral presentation skills, as compared to a faculty-led feedback session or no additional training.

The study reveals that the quality of oral presentations delivered by students who completed the Aquifer course did not differ from those who participated in faculty-led feedback sessions.

Dr. Sox asserts that this makes the Aquifer Oral Presentation Skills course “arguably a more efficient educational tool… it provides a flexible, independent learning opportunity that requires no faculty time.” The study also concluded that a student’s previous experience in an Internal Medicine clerkship was predictive of higher quality oral presentations. Dr. Sox’s study was funded by the MedU CLIPP Small Grant and the Joel and Barbara Alpert Endowment for the Children of the City and took place between July 1, 2013, and June 30, 2015.

Dr. Sox is an Assistant Professor of Pediatrics at Boston University School of Medicine. He earned his MD at Harvard Medical School, where he also began his research work. After completing his Pediatrics residency training at the University of California, San Francisco, he earned an M.S. in Health Services Research at the University of Washington as an RWF Clinical Scholar. While working on the faculty of Harvard Medical School and Boston University School of Medicine over the last 16 years, Dr. Sox’s research has continued, with a focus on medical education. He received the Academic Pediatric Association’s Ray E. Helfer Award for Innovation in Pediatric Education and currently, is conducting a randomized control test of a mindfulness curriculum in 15 US pediatric residency programs to test the impact of the curriculum on physician burnout.

View the abstract and access the full article.


Aquifer (formerly known as MedU) is a mission-driven 501 (c)(3) non-profit organization dedicated to delivering the best healthcare education through collaborative development and research into innovative, high-impact virtual teaching and learning methods. Aquifer develops trusted, award-winning, virtual case-based courses derived from national healthcare curricula. Since Aquifer’s founding in 2006, over 10,000,000 virtual cases have been completed by more than 300,000 students. Aquifer’s cases are created and maintained by more than 400 educators from 10 leading national organizations representing more than 120 academic institutions.

Andrew Olson, MD Honored at CDIM National Meeting

Aquifer is proud to announce that Andrew Olson, MD will receive the 2018 CDIM Early Career Medical Student Educator Award at the Clerkship Directors in Internal Medicine (CDIM) National Meeting during the Alliance for Academic Internal Medicine’s Academic Internal Medicine Week.

The CDIM Early Career Medical Student Educator Award is given to a CDIM member at the instructor or assistant professor level who demonstrates innovation and excellence in medical student education. Areas of achievement may include leadership and scholarship in medical student education, teaching, or service to CDIM or AAIM. Award nominees are reviewed by the CDIM Nominating Committee and approved by the CDIM Council.

Dr. Andrew Olson is an Assistant Professor of Medicine and Pediatrics at the University of Minnesota where he practices hospital medicine and pediatrics. He also serves as the Director of the Medical School’s Subinternship in Critical Care and as the founding Director of the Medical School’s Becoming a Doctor course. Dr. Olson was recently named the Director of Medical Educator Development and Scholarship. His areas of interest and study are in the development of expertise in decision-making, methods to improve diagnostic reasoning education and competency-based medical education.

Dr. Olson is currently serving in the Aquifer Consortium as the Senior Director for Aquifer Diagnostic Excellence. Dr. Olsen is the Primary Investigator of the DX: Diagnostic Excellence project, a national project to develop, implement, and evaluate a novel curriculum for medical students about diagnostic reasoning and error. He also is the Co-Chair of the Education Committee of the Society to Improve Diagnosis in Medicine and the co-Primary Investigator of a Macy-Foundation project to develop an Interprofessional Curriculum to Improve Diagnosis.


Aquifer (formerly MedU) is a thriving, collaborative community of healthcare education leaders deeply committed to driving innovation in teaching and learning. The Aquifer Consortium brings together more than 200 healthcare educators across disciplines to collaborate, innovate, and make advances in health professions education. For educators and healthcare providers, participation in the Consortium offers a unique cross-disciplinary peer community and an exciting opportunity for academic scholarship and advancement.

WISE-OnCall: Available from Aquifer

From our partners at the NYU School of Medicine:

NYU Langone Health

We are pleased to announce that WISE-OnCall is now available through the Aquifer system.

WISE-OnCall consists of 12 modules addressing common clinical presentations. Each module emphasizes:

  • Assessment
  • Early management
  • A review of common underlying causes
  • Distinguishing features

Dramatizations emphasize the importance of gathering information from the medical record, nursing staff, the patient, and appropriate diagnostic tests. Professionalism, communication & escalation of acute situations is also covered. Checklists and practice questions help learners to hone their clinical reasoning skills.

The modules currently available include:

  • Chest Pain
  • Abdominal Pain
  • Fever and Sepsis
  • Dyspnea
  • Oliguria
  • Pain Management
  • Hypertension
  • Hypotension/Shock
  • Loss of Consciousness
  • Lower Extremity Pain
  • Documentation
  • Certifying a Death

A research study of the impact of WISE-OnCall modules demonstrated improvement in our graduating students’ clinical skills when measured in a controlled simulation exercise*. Students have consistently graded WISE-OnCall very high with respect to content and appropriateness for their level of learning.

This course is designed specifically for upper-level clerkships and transition to residency courses. However, some residency programs are using WISE-OnCall for junior resident orientation.

NYU School of Medicine uses the modules to help prepare graduating students for residency. Last year our program directors required WISE-OnCall for 140 incoming interns as part of our patient safety orientation. Due to the overwhelmingly favorable response from faculty, participating residents and hospital administrators, WISE-OnCall will be a part of the orientation process for all new residents.

Please let us know if you would like to view WISE-OnCall program and consider it for your transition to residency curriculum. If you have questions or would like to know more about our use of the modules, feel free to contact Dawn Bornheimer at 646-854-8033.

 

Thomas S. Riles, MD

Associate Dean for Medical Education and Technology

New York University School of Medicine


*Szyld D, Uquillas K, Green BR, Yavner SD, Song H, Nick MW, Ng GM, Pusic MV, Riles TS, & Kalet A (2017). Improving the clinical skills performance of graduating medical students using “WISE OnCall,” a multimedia educational module. Simulation in Healthcare, 12(6), 385-392, 2017

Dr. Katherine Chretien Publishes Mothers in Medicine

Aquifer congratulates our own Katherine Chretien, MD on the recent publication of her book; Mothers in Medicine: Career, Practice, and Life Lessons Learned. Katherine is an Aquifer Consortium member and a prominent physician and medical educator, specializing in Internal Medicine.

Dr. Katherine Chretien is the Assistant Dean for Student Affairs and an Associate Professor of Medicine at George Washington University School of Medicine & Health Sciences. She is also a hospitalist physician at the Washington DC VA Medical Center. Katherine is the recipient of the Charles H. Griffith III Educational Research Award from Clerkship Directors in Internal Medicine (CDIM) and the Women Leaders in Medicine Award from the American Medical Student Association.

Dr. Chretien began working with Aquifer in 2014, when she became an Associate Editor on the Aquifer Internal Medicine Board (formerly SIMPLE). She is currently a Student Engagement Lead for the Aquifer Teaching & Learning Group, and a co-faculty lead for Aquifer’s Race and Culture pilot project. In addition to her work with the Aquifer Consortium, Katherine also serves on the editorial board of the Journal of Graduate Medical Education, and on the CDIM Council. She will be CDIM President-Elect beginning June 2018.

Mothers in Medicine: Career, Practice, and Life Lessons Learned draws from the best advice, wisdom, stories, and insights shared on the popular Mothers in Medicine blog (mothersinmedicine.com) over the last 10 years, as well as the authors’ personal experiences and expertise. The Mothers in Medicine group blog began in 2008 as a way to cultivate a community of support for women in medicine. The book covers a range of themes relating to the physician-mother: career decisions, having children during training, navigating life challenges, practice issues, and work-life balance. Mothers in Medicine, now available on Amazon and Springer.com, preserves the conversational tone of the blog and provides a guide for women in medicine at all stages of their careers.

“The entire Aquifer team is proud of Katherine’s tremendous achievement in completing this book,” said Leslie Fall, Aquifer Executive Director and Chief Academic Officer. “She’s an incredible asset to the Aquifer Consortium and a talented, dedicated physician and educator. It’s impressive—but not surprising—that she has added the publication of this book to her accomplishments.”


Aquifer (formerly MedU) is a thriving, collaborative community of healthcare education leaders deeply committed to driving innovation in teaching and learning. The Aquifer Consortium brings together more than 200 healthcare educators across disciplines to collaborate, innovate, and make advances in health professions education. For educators and healthcare providers, participation in the Consortium offers a unique cross-disciplinary peer community and an exciting opportunity for academic scholarship and advancement.

Student Learning Resources: Now in Aqueduct

Aquifer’s Student Learning Resources—available to all users—are easily accessible in Aqueduct. There are two types of Student Learning Resources: general and course-specific.

General Student Learning Resources

To access the general resources, sign in to Aqueduct and navigate to the Courses page. If you don’t land on the Courses page, click on Courses in the top navigation bar.

Click on the pink Student Learning Resources to access the available resources.

What Resources are Available?

The general resources section includes Clinical Practice Guidelines and Pediatric Developmental Milestones.

The Clinical Practice Guidelines include Hypertension and Cholesterol Guidelines, available in collapsible sections.

Each guideline is available for download as a pdf at the bottom of the resource.

The Pediatric Developmental Milestones tool is an interactive table with videos for each milestone.

This section also includes a video guide to the interactive table and a downloadable pdf.


Course-Specific Student Resources

Additional course-specific Student Learning Resources are now available from within their courses: Aquifer Culture in Health Care and Aquifer Medical Home. The resources appear on the Cases page and are grouped by topic.

Topics include Cultural Awareness, Medical Home, Navigating the Healthcare System, On Language, The Physician’s Role, and Caring for Children & Youth with Special Health Care Needs.

Aqueduct System Requirements

Aquifer’s teaching and learning platform, Aqueduct, is built using web standards, the program runs on Windows, Mac, Linux, iOS, Android, or any other device with a modern web browser.


Supported Operating Systems include: Windows 7 and newer; Mac OSX 10.10 Yosemite and newer; Linux; ChromeOS

Mobile Operating Systems: iOS – please install our app for iOS 13 and newer; Android – Android Oreo, Oatmeal Cookie v8.1 and newer.

Computer Speed and Processor: Best experienced on a computer 5 years old or newer; 1GB of RAM; 2GHz processor

Browsers Supported: Microsoft Edge; Safari 12 and newer (Macintosh only); Chrome 81 and newer; Firefox 64 and newer

New Programs: Whitelist our Domains

This is a critical step if your program is new to using Aquifer. Whitelisting our domains and email addresses will ensure that your faculty and students will be able to gain access to our system.

Whitelisting should be done by your program’s IT department.

Web Traffic

Email from the Aqueduct learning platform

  • Domain:  delivery.meduapp.com
  • IP:  149.72.67.97

How To Update My User Profile

You can update your User Profile while you are logged in. You will be able to change your First Name, Last Name, Professional Degree, Your Program Role, as well as other role specific options.

Note: Some of the profile options are only available to certain Aqueduct Roles.

1. Sign in to Aqueduct.


2. Once you are logged in, click on the “My Profile” link in the top navigation bar.


3. You will then be brought to your profile administration page. Here you can update your information to make it current. Once you have updated your information, click on “Update”.


4. You will then see a notification for successfully completing your profile.


 

How To Change Your Password While Logged In

It is possible to change your password while you are logged into Aqueduct.

Note: Your new password must be 8 characters or longer. You can use a combination of uppercase, lowercase, numbers and symbols.

1. Log into Aqueduct.


2. Click on My Profile.


3. You will then be brought to your profile administration page. Click on “Edit Password“.


4. You will then be brought to a password update page. Put in your new password under “Password“, put your new password in a second time to confirm under “Password confirmation” and finally put your current password under “Current password“. Now click “Update” to update your password.


5. You will then be notified that you have successfully updated your account (password).


 

How To Access Another Program If You Are Part Of Multiple Programs


Some users have access to multiple programs in Aqueduct. You can switch between these programs easily to run your administrative duties.

1.Go to Aquifer.org and click Sign In in the top right corner.


2. Click on the Programs link in the top navigation bar.


3. You will then see a list of all of the programs you have access to. Click on the program you would like to access.


 

How To Resolve “Invalid Token” Error

If you are registering for Aqueduct and you receive an “Invalid Token” error when trying to set up a new password, please try copying and pasting the link from your email into Chrome, Firefox, Internet Explorer or Edge. We currently have a bug in Safari that will give an “Invalid Token” error. We are working to get this resolved as soon as possible. If you still are having issues, please submit a ticket using the following link: Aquifer Support


 

Sign in to WISE-MD, WISE-OnCall or CARE

1. Go to Aquifer.org and click the Sign In button.


2. You will be brought to the Aqueduct Sign In page. Put in your account email address and password. Then click Sign In.


3. On the top navigation bar, click on Courses.


4. You will then see blue buttons on the right to “Launch” WISE-MD, WISE-OnCall, or CARE. Click on the button for your course to access to the content in the WISE  learning platform.


5. If this is your first time accessing the WISE platform, you will be brought to a verification page which will ask you to confirm your name, institution, and to select your appropriate clerkship/group/block.

Accessing WISE & CARE Reporting

Quick Reference Guide for WISE & CARE Reporting

Via Aqueduct, Aquifer’s Learning Management System
  1. To access WISE-MD, WISE-OnCall, or CARE reports, click on the “Launch (Course Name)” button at the top of the Course page for your program in your Aquifer account.

2. The WISE platform will open. All administrative accounts should see the following screen with an Admin navigation tab on the left-hand side. This is where you will be able to access reports. There are 3 report types: User List, User Progress, and User Activity.

Note: WISE-MD = Surgery and Skills; OnCall = WISE-OnCall


Administrators and Educator Reports

For each report type, the following are applicable:

  • Domain: Your institution or program (auto-populated)
  • Clerkship: Grouping of learners specified by the institution or program. These groupings are created on the backend by the WISE team and are useful for reporting. If you are interested in hearing more, please email [email protected].
  • Date Added: The date the user was added to the WISE database. Please note that users are added to the WISE database the first time they click on a WISE product button from Aqueduct. If a learner does not show up in the search, alter this parameter.

User List

This report will give you a list of users based on the date range you specified. The date range is the date the user was added to the database.

User Progress

This report will give you individual learner reports. If you do not specify names, then you will receive a list of all learners added within the date range specified. Click on the Progress button corresponding to the learner you are interested in to get their report.

User Activity

This report will give you group activity reporting based on two date parameters: the date the account was added and the date of activity. This report displays multiple learners at once. If you use more than one course (Surgery, OnCall, or CARE) then you are able to filter by course. The green check icon means the module is completed; the clock icon means the module is in progress.

Please note: Questions and practice cases are for learner self-assessment only and are not designed to be used for grading purposes other than completion, (i.e. you completed the questions, you get a Pass). There are no reports showing question results available to faculty/administrative staff. Learners are able to attempt the questions and practice cases as many times as they like.


Learner Reports

All questions and practice cases are meant to guide learning and the learners are able to redo the questions as many times as they need to determine the correct answer. The learner receives immediate feedback on the question (whether it is correct or incorrect) along with explanations. There are 3 types of learner facing reports available to the learner: Module Progress, Question Progress, and Quiz Activity.

Module Progress

This report displays the completion status for each module by section. If the learner is enrolled in more than one course on the WISE platform, they will be able to filter based on which course they need (Surgery/Skills, OnCall or CARE).

Question Progress

This report details the learner’s question performance by each attempt for each section of each module.

Quiz Activity

A graphical report of the learner’s question performance for each question, grouped by module and then section. 

***Faculty interested in noting completion of these questions can ask the learners to screenshot the learner facing reports and that image/file can be uploaded ***

Resetting Student Cases


As of January 2, 2019, students may reset their own cases at any time to review Aquifer cases again in a rigorous way. Please note that individual programs or courses may have specific policies on this function. Administrators can no longer reset student cases.

A Case Reset means that:

  • All progress in the case will be cleared and reset. Previous data will not be available.
  • Students will need to re-take the case to record a completion.
  • Faculty and administrators can view each case reset in their reports.
  • On Student Reports, a black outline will show around the circles indicating progress on the cases that have been reset.

Why Reset a Case?

A student may wish to reset a case to complete it again in a complete way, revealing information step-by-step as they move through the case and answering embedded assessment questions. Although the case content is available to students after case completion, the information will appear all at once (ungated) and questions will show previous answers. Resetting the case will remove all previous data, allowing students to repeat the original case experience.

Download Case Notes

Before resetting a case, be sure to download any notes that you’ve saved in Aqueduct. There are two ways to do this:

  • To download case notes ONLY in a csv file, select cases below and click the Download Case Notes button on the Case Reset page.
  • To download Case Summaries with your notes included, return to the end of the case(s) and click Download Case Summary.

How to Reset a Case

1. Select the course that contains the case(s) that you would like to reset.

2. From the course page, the progress bar next to each case indicates your current progress.

  • If you want to download the Case Summaries with your notes included from your completed cases, return to each case and download the case summary at the end of your case.

3. Click on the Case Reset button (now called Progress Reset)


4. Select the case(s) that you wish to reset. Selected cases will show in blue. You may also use the search field for Select All or Deselect All to quickly choose your cases. Note: If you need to download your case notes, click the Download Case Notes button.


5. Click on the Reset Cases button. Two warnings will come up to ensure that you wish to continue and that you have downloaded your notes. Click OK twice to reset your cases.


6. After resetting, you will land on the course page where you will see that the progress bar for your reset cases has been updated to show 0%.

Building Clinical Reasoning Skills

Building Clinical Reasoning Skills

Research shows that physicians who are able to provide a semantically rich summarization of a case are much more accurate in making a clinical diagnosis.

Teaching clinical reasoning is one of Aquifer’s foremost educational goals. In following a virtual patient from presentation to outcome, students hone their skills in recognizing and interpreting clinical signs and symptoms. Each of our cases follows a structure that highlights the components of clinical reasoning––from gathering knowledge of the patient’s history and risk factors to making an informed opinion of the patient’s clinical status to developing a differential diagnosis, selecting diagnostic studies, and implementing a management plan. Through active engagement your learners can use deliberate practice to cultivate their clinical reasoning skills.


How is clinical reasoning learned?

Contribution by Valerie Lang, MD, MHE

Medical knowledge is essential, but insufficient, for effective clinical reasoning. Students need to organize their knowledge in a way that allows them to identify and solve clinical problems. (Norman, Charlin, et al.) The “dual-processing” model of clinical reasoning identifies two processes: Type 1 (fast, “instinctive,” heuristic) and Type 2 (slow, analytical). (Norman) There is much debate over which type is more error-prone (Norman, Eva, Croskerry), but it is generally acknowledged that experts use Type 1 reasoning when faced with problems in their field, but switch to Type 2 reasoning when faced with unfamiliar problems. Novices tend to use Type 2 but tend toward Type 1 reasoning as they develop experience. (Norman, Eva, et al.)

To develop skills in clinical reasoning, students need deliberate practice applying their knowledge to clinical cases (Eva, Norman), either virtual (e.g. paper, on-line, standardized patient) or real (e.g., patient care), and have the opportunity to reflect on the diagnostic and treatment decisions they make. Real clinical experience is essential, but idiosyncratic. Students may not encounter patients with the ideal breadth of conditions or at a stage of their illness that is most helpful for developing reasoning skills. With the increase in hand-offs in inpatient settings, students are more likely to meet their patients after a diagnosis has already been established. The lost opportunity to evaluate “fresh” patients is associated with decreased learning. (Lang)

How do Aquifer cases help students learn clinical reasoning?

Aquifer cases provide students with the opportunity for deliberate practice in clinical reasoning. The context in which clinical reasoning is learned is important. Students are more likely to correctly solve a case if it is presented in the same context in which it was learned. (Durning, et al.) The real clinical environment is highly complex and data-heavy, and can cognitively overload the novice learner. (Merrienboer) By providing an authentic clinical and social context for cases, while reducing the amount of cognitive overload, Aquifer virtual patient cases give students a robust opportunity to develop their clinical reasoning skills in a setting that is specifically designed for their level.

Most of the Aquifer virtual patients present with an undifferentiated complaint or lab abnormality, such as cough or anemia. Students practice identifying the key findings from the history, physical exam, and test data. They synthesize the case into a concise summary statement, identify a differential diagnosis, and learn the relative diagnostic value of each of the key findings. They make decisions about what tests and treatments are important for identifying and resolving the patient’s problem. At each step, they must commit to a decision, then receive feedback and explanations about the correct and incorrect responses. This provides practice in a safe, but interactive environment. It gives students a framework to approach real patients with similar problems in a more sophisticated manner. (Edelbring, et al.)

Norman G. Research in clinical reasoning: past history and current trends. Medical Education 2005;39:418-27.

Liaison Committee on Medical Education. Standards for Accreditation of Medical Education Programs Leading to the M.D. Degree. May 2012.

Charlin B, Boshuizen HP, Custers EJ, Feltovich PJ. Scripts and clinical reasoning. Medical Education 2007;41:1178-84.

Boshuizen HP, Schmidt HG. The development of clinical reasoning expertise. Clinical Reasoning in the Health Professions2008:113-21.

Norman G. Dual processing and diagnostic errors. Advances in Health Sciences Education: Theory and Practice 2009;14 Suppl 1:37-49.

Norman GR, Eva KW. Diagnostic error and clinical reasoning. Medical Education 2010;44:94-100.

Croskerry P. Clinical cognition and diagnostic error: applications of a dual process model of reasoning. Advances in Health Sciences Education 2009;14:27-35.

Norman G, Young M, Brooks L. Non-analytical models of clinical reasoning: the role of experience. Medical Education 2007;41:1140-5.

Lang VJ, Mooney CJ, O’Connor AB, Bordley DR, Lurie SJ. Association between hand-off patients and subject exam performance in medicine clerkship students. Journal of General Internal Medicine 2009;24:1018-22.

Edelbring S, Dastmalchi M, Hult H, Lundberg IE, Dahlgren LO. Experiencing virtual patients in clinical learning: a phenomenological study. Advances in Health Sciences Education: Theory and Practice 2011;16:331-45.

Koens F, Mann KV, Custers EJ, Ten Cate OT. Analysing the concept of context in medical education. Medical Education2005;39:1243-9.

van Merrienboer JJ, Sweller J. Cognitive load theory in health professional education: design principles and strategies. Medical Education 2010;44:85-93.

Meeting LCME Standards with Aquifer

Aquifer helps you meet many Liaison Committee on Medical Education (LCME) Standards, particularly those related to ensuring equivalent educational experiences across teaching sites, providing deliberate practice in clinical reasoning and providing feedback on student performance. Our consortium members work with schools through personalized consultations to assist in identifying how Aquifer can help meet accreditation standards.

View LCME Accreditation Standards 2018-19


LCME 6.2 Required Clinical Experiences and 8.6 Monitoring of Completion of Required Clinical Experiences

6.2: “The faculty of a medical school define the types of patients and clinical conditions that medical students are required to encounter, the skills to be performed by medical students, the appropriate clinical settings for these experiences, and the expected levels of medical student responsibility.”

8.6: “A medical school has in place a system with central oversight that monitors and ensures completion by all medical students of required clinical experiences in the medical education program and remedies any identified gaps.”

Enhancing the range of clinical encounters

In addition to caring for real patients, like Aquifer’s are considered by the LCME to be an acceptable clinical learning experience. However, if the cases are to “count,” students should be given independent learning time to work through them, and the content of the cases should be integrated into the clerkship curriculum in methods similar to patient care (i.e., didactics, bedside teaching, etc.).

There are numerous ways to classify the spectrum of patients to be seen, including:

  • Ages/developmental stages
  • Types of illnesses
  • Systems-based categories

Aquifer cases can be similarly classified and then assigned to students.

There are several suggested methods for assigning cases, including:

  • Assign cases at the beginning of the clerkship. All of the cases can be assigned, or a subset of specific cases to prepare students to see patients with conditions they are likely to encounter, or to fill known clinical gaps.
  • Assign cases individually as needed mid-way through the clerkship, based on a review of each student’s clinical logs.
  • A combination of both.
Documentation Method

Aquifer automatically creates a log of students’ completion of virtual patient cases. The Student Report for Administrators and Managers shows the detailed progress of an individual student in each case in a course, including:

  • The cases the student has completed, partially completed, or nor yet not begun
  • Time from Case Start to Completion
  • Additional details on Date the Case was Started, Completed and Last Accessed
  • Summary Statements submitted by students for cases that require them

A program service administrator, curriculum administrator, course administrator and course manager can each access this report and view real-time data on student progress.


LCME 5.5 Resources for Clinical Instruction

“A medical school has, or is assured the use of, appropriate resources for the clinical instruction of its medical students in ambulatory and inpatient settings and has adequate numbers and types of patients (e.g., acuity, case mix, age, gender).”

Aquifer’s cases were built explicitly on a generalist foundation: the nationally accepted core clerkship curriculum for each discipline. Each case models a general approach to a broad range of problems, acuity levels, ages, genders, and ethnicities. In addition, the Aquifer cases include evidence-based references and multiple Web links to practice guidelines and other appropriate resources. Integration of basic science information is included where relevant. Peer review and ongoing maintenance of the cases by our editorial boards ensures an up-to-date and well-accepted approach to the work-up and management of these common problems.


LCME 8.7 Comparability of Education/Assessment

“A medical school ensures that the medical curriculum includes comparable educational experiences and equivalent methods of assessment across all locations within a given course and clerkship to ensure that all medical students achieve the same medical education program objectives.”

Aquifer cases provide comparable learning experiences across training sites and times of year. Because the cases and exams are available on the internet, students have access to them from all training sites, facilitating student placement in rural or community settings.


LCME 7.2 Organ Systems/Life Cycle/Primary Care/(Prevention/Wellness/Symptoms/Signs/Differential Diagnosis, Treatment Planning, Impact of Behavioral and Social Factors

“The faculty of a medical school ensure that the medical curriculum includes content and clinical experiences related to each organ system; each phase of the human life cycle; continuity of care; and preventive, acute, chronic, rehabilitative, end-of-life, and primary care in order to prepare students to:

  • Recognize wellness, determinants of health, and opportunities for health promotion and disease prevention
  • Recognize and interpret symptoms and signs of disease
  • Develop differential diagnoses and treatment plans
  • Recognize the potential health-related impact on patients of behavioral and socioeconomic factors
  • Assist patients in addressing health-related issues involving all organ systems.”

Aquifer courses provide practice with virtual patients at all stages, from birth, through childhood and adulthood, to end of life. Several virtual patient cases address wellness and preventive care. Other cases provide students practice with clinical reasoning for common medical conditions, including interpreting abnormal clinical findings, developing differential diagnoses, selecting appropriate diagnostic tests, and developing treatment plans. Rather than providing rote, depersonalized clinical data, Aquifer virtual patients are deliberately designed to illustrate a variety of socioeconomic backgrounds in order to teach students how biopsychoscial factors interact to impact patients’ health.


LCME 7.4 Critical Judgment/Problem-Solving Skills

The faculty of a medical school ensure that the medical curriculum incorporates the fundamental principles of medicine, provides opportunities for medical students to acquire skills of critical judgment based on evidence and experience, and develops medical students’ ability to use those principles and skills effectively in solving problems of health and disease.

Aquifer patient cases are evidence-based, include references to supporting literature, and are peer-reviewed, providing students multiple opportunities to practice evidence-based clinical problem solving and receive expert-programmed feedback on their work.


9.8 Fair and Timely Summative Assessment

“A medical school has in place a system of fair and timely summative assessment of medical student achievement in each course and clerkship of the medical education program. Final grades are available within six weeks of the end of a course or clerkship.”

Aquifer Final Exam reports are scored and reported to schools within days.

Case Names Update

Aquifer’s new standardized case names provide consistency across all cases and provide a common language when searching for or referring to Aquifer cases.

The Aquifer case naming convention uses the following structure: Patient age, sex, and presentation. To make case names more mobile-friendly, personal names are no longer included in titles. Patients 17 years and older are referred to as “man” or “woman” and patients under 17 years are referred to as “male” or “female”.

Are you trying to find an old case name? Or are you wondering where the patient names have gone?

View our full case name crosswalk:

Student FAQ’s

1. Go to Aquifer.org and click Sign In in the top right corner. This will take you to Aqueduct, our learning management system.


2. Enter your institutional email address in the Email box. Then click on the Register button at the bottom of the page. If you receive a prompt on the screen stating “Please ensure you are using your institutional email. If registration issue persists, please contact your clerkship coordinator.” you may be using the wrong email address, or your email may not have been rostered in the system by the administrators at your program. Try to register again using your official institutional email. If you are not successful you will need to contact your course director and ask to have your email added to the system.

Note: If you have previously registered, you will receive a notification that you have already signed in and you will be re-directed to the sign-in screen.


3. You will be sent an email with a link to complete registration. Upon receipt of the registration email, click on the link “Click Here“. You will then be brought to the profile setup page.


4. You will be asked to fill in your profile information and set up a password (8 character minimum).Once you have completed your user profile and created a password, you will receive a welcome email with links to useful information and guides. You would also be logged into the Aqueduct learning management system.


5. Once your profile is completed successfully, you will be brought to your institution’s Course page.


6. You will also receive a “Thank you for registering with Aquifer” email with links to tools, resources, and Aquifer news.

Now your sign in will be quick and easy. Go to Aquifer.org and click Sign In in the top right corner, then enter your institutional email and password.

1. Once you have completed your user profile and created a password, your sign in will be quick and easy. Go to Aquifer.org and click Sign In in the top right corner.


2. You will then be brought to the Aqueduct sign in page. Please log in with your institutional email and account password and click “Sign In”.

1. If you forget your password, Aquifer can help you regain access to your courses and information right away. From the Sign In page, click the Forgot Password link.


2. You will be brought to a page where you can enter your Account email address. After entering your email address, click “Send me instructions to set my password“.


4. You will then be brought to a page where you can reset your password. Please put in your new password twice to confirm and click on “Change my password”. You will then be logged in with your new password.


3. You will receive an email with instructions to reset your password. If you do not see this email, check your spam mailbox. Follow the instructions in the email to reset your password. Click the link to reset your password.

1. Go to Aquifer.org and click the Sign In button.


2. You will be brought to the Aqueduct Sign In page. Put in your account email address and password. Then click Sign In.


4. You will then see blue buttons on the right to launch WISE-MD, WISE-OnCall, and CARE. Click on the button for your course to access the content in the WISE learning platform.


3. On the top navigation bar, click on Courses.

Cases are complete when you click the Finish Case button in the Case Summary Download section at the end of each case. Completed cases show on all reporting as a green circle with a check mark.

If you have completed the case content but don’t see the Finish Case button, be sure to complete all three required feedback questions at the end of the case. After you have completed the three feedback questions, you can access the Finish Case button and the downloadable case summary.

If you do not complete the feedback questions and click the Finish Case button, your work will show as partially completed—as a yellow circle showing the percentage complete—on Aquifer reporting for both you and your instructor.

We hope that all learners will share their honest feedback. We will review this feedback and use it to help ensure that we are offering the best possible learning materials.

Program Level Reports

 

Program Course Usage Report

The Program Course Usage report is designed to provide a high-level view into total usage of Aquifer courses by your program during a given period of time.

To access the Program Course Usage report:

1.Select Programs from the top menu navigation.

2.This will take you to Your Programs. Click the Program Course Usage button.

3.Select a date range, if desired, and click Use Date Range to refresh the report. Click on the program name (or +) to reveal the report. Note that if you’re enrolled in multiple programs, you’ll see all of your programs listed here. Select the one you wish to view.

The Program Course Usage Report includes a list of courses your program has access to, including both standard Aquifer courses (highlighted in grey) and custom courses created by your program (not highlighted). For each course, the following data is shown:

  • Number of cases in the course
  • Number of cases started
  • Number of cases completed by users in your program during the date range you selected
  • Name of the person assigned to be responsible for Custom Courses (created after July 2018)

Program Case Usage Report

The Program Case Usage report is designed to provide a high-level view into total usage of individual cases within Aquifer courses by your program during a given period of time.

To access the Program Case Usage report:

1.Select Courses from the top menu navigation.

2.This will take you to a list of your Courses. Click the Program Case Usage button.

3.You’ll see a list of your courses displayed. Click on the course name (or +) to reveal the report of an individual course. You can reveal more than one course at a time. Select a date range, if desired, and click Use Date Range to refresh the report.

For each of your courses, the Program Case Usage Report includes:

  • A case list
  • Number of cases started
  • Cases completed
  • Average time (in minutes) it has taken students to complete each case. You may hover over the ‘i’ icon on each of the columns to get a definition of the measurement.

MedU is Now Aquifer

We are pleased to announce that as of January 29, 2018, MedU has changed its name to Aquifer! When MedU was founded back in 2006, our focus was on providing innovative online learning for third-year medical students during their pediatric clerkship. Over the past ten years, we have grown to be so much more. As Aquifer—your trusted source for clinical learning—we can better reflect who we are today, what we do, and our vision for the future.

Our new name provides an opportunity for more clarity and growth. Simplified course names will link the Aquifer brand to the quality content we provide—building better recognition and trust across our course offerings. The Aquifer brand allows us to be more inclusive of all healthcare professional learners, like Physician Assistants and Nurse Practitioners, who are so critical to health care delivery today. Our new learning management system, launched in July, continues to underlie all our courses, raising the level of your students’ skills and knowledge and delivering learning wherever and whenever it’s needed.


What’s staying the same?

We’re still the same unique non-profit organization led by Aquifer’s academic consortium, dedicated to partnering with national organizations to deliver trusted content—written by educators, for educators—that is evidence-based, peer-reviewed, and continuously updated to support best practices in clinical education.

Our courses and user data remain untouched, providing the same great content, continuously updated by our consortium of medical educators. User reports, rosters, and custom courses remain unchanged. Direct links to our learning management system, including your program-specific URL, will not change.


What has changed?

  • Simple, self-explanatory course names: Our old course-specific acronyms were replaced with intuitive names: CLIPP is now Aquifer Pediatrics, fmCASES becomes Aquifer Family Medicine, etc. View the full list of our new course names here.
  • Our learning management system has a fresh new look. The user experience hasn’t changed, but you now see the Aquifer name, new course names, and a cleaner interface. And to connect the platform to our new brand, it’s now called Aqueduct—the carrier of Aquifer’s essential learning.
  • Aquifer.org for Sign In: You’ve found our brand-new website, filled with useful news, resources, and tools. Links to Med-u.org will redirect to Aquifer.org through the summer of 2018. Please update bookmarks and course materials.
  • User Profile updates: The first time you sign in to access your courses after January 29th, you’ll be asked to update your user profile. It’s a quick and easy step that will help us serve you better in the future.

Please feel free to contact us if you have any questions or concerns about our new brand.

Thank you for flowing along with us!

Adding Administrative Users & Assigning Roles


Each program has complete control over how to manage administrative users in Aqueduct. The system is designed for flexibility to best fit your program’s needs. You can choose which users view reports, add student rosters, and access student data.

Before getting started adding administrative users, be sure to review the Roles & Permissions to decide which roles each staff member in your program will fill in Aqueduct.

Administrators and educators need to be added to Aqueduct before they will be able to access it, and they need to be assigned an appropriate role in the system.

How to Add Users and Assign Roles

Once you’ve signed in, click on Users in the top navigation.


Then you’ll see the administrative user panel. At the top of the page, you’ll see a grid that provides useful counts of how many people are in each role. All users are listed at the bottom of this page and may be sorted, filtered, and exported in a variety of ways.

The Administrators tab will be activated automatically, but please note that student users are accessed separately by clicking on the “Students” tab. Click the Add Admins button in the top right-hand corner.

admin user panel overview

Enter the official institutional email addresses for the users you would like to add to the system. To batch add users, enter a list of comma-separated email addresses for users who will share the same role. Users may also be added individually.


Once you have entered your email address(es), choose the User Role that you wish to assign to this group of users from the drop-down menu and click the Add Administrators button.


You will be redirected back to the Users page. A message will be open at the top of the page indicating whether or not you have successfully added users.


The administrators you added will now appear in the administrator user list below as “Unknown Unknown”, showing their email addresses, the role you have assigned them, and a status of “Registration Pending”. When administrative users sign in and complete their registration, their status will change to “Active” and this screen will show the values that they enter for First Name, Last Name, and Clinical Discipline.

Note: Administrative users will automatically receive an email notifying them that they have been assigned a specific role in Aqueduct, and inviting them to register in the system.

Next Steps:

Exam Administration & Proctor’s Responsibilities

There are many different aspects of successful exam administration. To ensure that everyone taking an Aquifer exam is able to do so effectively, we have detailed the activities that need to happen and the responsibilities of everyone participating in the exam, including Course Administrators, Proctors, your institution’s Technical Support Staff, and Aquifer Support Staff. Aquifer has also developed several tools to enhance exam administration that are provided here in one convenient location.


Course Administrator’s Responsibilities

Course Administrators (Clerkship Administrators and/or Clerkship Directors) play a critical role in administering exams.

  • Complete our Aquifer Annual Exam Survey so we can be prepared and identify any challenges long before you need to administer the exam.
  • Secure a computer lab/testing room for each exam being administered.
  • Arrange for proctor(s) to monitor each exam. There should be one proctor for every 20-25 students, and at least one proctor in each examination room. Make sure each proctor understands his/her responsibilities and has access to the tools needed (see below).
  • Schedule technical support to be on call while each exam is taking place and make sure they are aware of their responsibilities (see below).
  • Ensure that all technology is tested in advance of administering each exam.

When planning to administer exams, please allow the following time:

  • Aquifer Pediatrics: 2.5 Hours
  • Aquifer Family Medicine: 3 Hours
  • Aquifer Internal Medicine Clinical Decision-Making Exam: 75 Minutes
  • Aquifer Radiology: 2 Hours

In addition, you may wish to plan on an additional 15-20 minutes to allow for orientation and other logistical items.

  • Schedule the exam with Aquifer by completing the Aquifer Exam Request Form. To complete the form, you will need the following information:
    • Name of the Aquifer course for which you are ordering the exam
    • School name
    • Exam start date and time (ET)
    • Request for any additional time you will need for students with academic accommodations
    • Purpose of the exam (Pre-test, Practice, Midterm, Final)
    • Primary person to contact if there’s an issue during the exam (name, email, and phone number)
    • Any special circumstances not already cited (extended length exams, special accommodations, etc.)
  • Ensure that all students taking the exam have registered to use Aquifer courses. Students who have not registered with Aquifer at least two weeks prior to the exam will not be able to take the exam.
  • Submit an Exported List of Students scheduled to take the exam from the Aquifer Reports Section.
  • Once the Exam Request Form and the Exported List of Students have been submitted, Aquifer will provide you with pre-populated student handouts that you may provide to the proctors to use for exam orientation and to disseminate logins and passwords.

Aquifer will email exam results to the Program/Course Administrator within two business days of the completion of the exam. The Program/Course Administrator will be responsible for releasing those results at his/her school.


Proctor’s Responsibilities

Aquifer requires that proctors are present during the exam to ensure that all exams are administered in a secure, proctored setting.

Please view our Video-proctoring FAQ’s for more information on video proctoring.

Ensure a standard testing room environment, including:

  • Exam workstations in a dedicated room that can be closed off from the rest of the facility to minimize noise and outside distractions during testing.
  • Exam workstations that are forward facing with adequate spacing in order to reduce students’ ability to view another’s monitor and to ensure sufficient spacing between each workstation.
  • A designated area where students can store personal items such as cell phones, iPads, tablets, media devices, papers, books, coats, purses and backpacks. These are NOT allowed in the exam space.
  • Appropriate access to the room for people with disabilities in compliance with the Americans with Disabilities Act of 1990 (in the United States) or your country-specific requirements.
  • Proctors may also want to consider designating a separate testing room for students who have been approved for extra testing time.

Proctors should be prepared to access appropriate tools and technical support staff should any issues arise, including:

  • A dedicated workstation that has been checked for exam compatibility prior to examination day.
  • Access to a telephone with an outside line for use during the test session in case the proctor needs assistance during the exam.
  • The phone number and email address for relevant technical support staff.

Access to or a print out of Exam Troubleshooting Tips the provides suggested solutions to the most common problems that may arise during the testing session.

Proctors will fulfill duties which include:

  • Arrive at least 15 minutes before the exam session.
  • Startup institution workstations (if necessary).
  • Admit students to the exam room, ensure students do not bring phones or tablets into the room, check students off the roster, and distribute student handouts.
  • Orient students to the exam and read the following statement to students:
    “The materials used in the Aquifer examinations are the copyrighted property of Aquifer. If you distribute examination materials, by any means, including reconstruction through memorization, you are in violation of the rights of the owners. You are prohibited from communicating, publishing, reproducing, or transmitting any part of your exam, in any form, or by any means, verbal or written, for any purpose. Every legal means available to protect Aquifer examination materials and secure redress against those who violate copyright law may be pursued. If you become aware of any suspicious activity related to an Aquifer exam administration, please notify the proctor or clerkship director, or submit a report.”
  • Direct students to begin the exam at the designated time using the login and password on the student handouts.
  • Monitor the progress of all students after they launch their exams and report any issues.
  • Ensure that the exam is being monitored at all times (students should never be left alone in the room).
  • Check that each student has submitted his/her exam once they have completed the test and collect each student’s handout before he/she leaves the room.

Exam Support

If an issue arises during the exam:

    1. Contact your institution’s technical support staff.
    2. Access Aquifer Exam Troubleshooting Tips.
    3. If neither of those addresses the issue, contact Aquifer’s exam support staff weekdays 8 am – 5 pm ET, except federal holidays.

Contact [email protected] or (603) 727-7002 ext. 2 with any questions about test administration activities.


Security Reminder

Please remind all faculty and students that all exam content is confidential and should not be shared with anyone, at any time, in any way.

Exam Technical Support Information

Technical Requirements

The standard Aquifer exam requirements outlined below apply to exams delivered over both wired and wireless networks. Students may use personal laptops, either Macs or PCs, to take an exam.

  • Windows 7, Windows 8, Windows 10, Windows 11
  • Mac OS X version v10.9 thru v12 (Monterey)
  • 1GHz processor or higher
  • 17” screen or larger monitor (Desktops)
  • 13” screen or larger (Laptops)
  • Minimum screen resolution of 1024×768 with
  • 32-bit color setting
  • Turn off Windows updates or virus scanner updates to avoid interruptions during the exam.
  • Virtual machines and applications are not guaranteed to work; prior testing on your system will be required.
  • Tablet devices are not currently supported devices. This includes iPads, Android tablets, phones, Windows touchscreen/tablet computer and Microsoft Surface. Touchscreen laptop computers may work, provided you use a mouse or a trackpad and the keyboard and do not use the touchscreen. You are strongly urged to test the use of the Secure Exam Browser on your device well ahead of your scheduled exam to ensure it will work. If it does not work, you may have to find another computer on which to take the exam.
  • Broadband (DSL, Cable or T1)
  • 256Kbps or higher per workstation

Some level of encryption must be in place for wireless networks while the exam is in progress. SSL can be supplemented with another security protocol, such as but not limited to WEP, WPA or WPA2.

A secure exam browser is required to administer the Aquifer Pediatrics, Aquifer Family Medicine, and Aquifer Radiology exams; this application “locks down” the computer and prevents students from accessing other software applications during the exam. The secure exam browser will also detect any programs running on the student’s computer that could compromise exam content.

The secure exam browser application requires administrator rights to install.

Schools must confirm that each computer has the secure browser installed prior to the exam.

NOTE: THIS IS NOT REQUIRED FOR INTERNAL MEDICINE EXAMS

Download the secure exam browser.

Students using personal laptops should be advised to arrive early to detect any problems with their local firewall.

Extra workstations/laptops should be available to replace computers that may malfunction during the test session. These spares should be enabled for wired and wireless LAN use.

* Adapted from the NBME Quick Start Guide to Web-Based Exam


Technical Support Staff Responsibilities

Individuals serving as technical support for an exam are expected to ensure that all computers being used for exam administration can deliver the exam securely and successfully.

In advance of administering the exam, we recommend…
  • Set up a dedicated workstation/laptop in each testing room that will used by the proctor in that room.
  • If you would like to run a sample test to verify the secure browser has downloaded and is working successfully, please contact [email protected] to request a test login for your institution.
It is the responsibility of the technical support staff to…
  • Have knowledge of the operating system (OS), virus checker and browser version that reside on institutional workstations/laptops or examinee laptops.
  • Be knowledgeable about the network architecture of the testing rooms.
  • Verify that Internet connection speed is adequate (minimum T1) for the exam.
  • Be available to be onsite on the day of the exam to resolve technical problems that may arise.

Exam Support

If an issue arises during the exam:

    1. Contact your institution’s technical support staff.
    2. Access Aquifer Exam Troubleshooting Tips.
    3. If neither of those addresses the issue, contact Aquifer’s exam support staff weekdays 8 am – 5 pm ET, except federal holidays.

Contact [email protected] or (603) 727-7002 ext. 2 with any questions about test administration activities.


Security Reminder

Please remind all faculty and students that all exam content is confidential and should not be shared with anyone, at any time, in any way.

Create an Exam Roster


In Aqueduct, Course Administrator users are responsible for exam standards, utilization, and identifying learners who will require access to scheduled assessments.

If you’re a Course Administrator, please follow the instructions below to create an exam roster which can then be downloaded and forwarded to Aquifer’s exam management team. You will find resources for successful exam management here.

Please note that a Custom Course is required in order to utilize Aquifer Exams. Learn how to set up a Custom Course.


How to Create an Exam Roster

  1. FROM WITHIN YOUR CUSTOM COURSE: Choose the More Actions button on the top right-hand side.
  2. From the Course Management page, use the right-hand column to select those users who will need to be rostered into the exam.
  3. Please verify that your list is correct before moving onto the next step – Review the list of student emails. Please ensure that no student is listed as UNKNOWN UNKNOWN. If they are, please contact those students directly and have them complete their registration. Students not registered are ineligible for exams until they have completed their registration.
  4. When all students are correct, Choose Exam Roster button in the top right-hand corner.
  5. An Excel CSV file with a roster of these students will download onto your computer.
  6. Attach the downloaded file to your Exam Request Form.
  7. You can expect to receive a confirmation email that the roster has been received and is being processed.
  8. Approximately one week in advance of your exam date you should expect to receive an exam guide for each student with their individual password and sign in information from [email protected]
  9. If you have any questions or concerns, please direct all inquiries to [email protected] or call the exam helpline at (603) 727-7002 ext. 2.

Securing Your Exam

To ensure a private and secure exam environment, Aquifer requires its online multiple-choice exams to be administered on computers configured with a secure exam browser. A secure exam browser temporarily restricts the computer from using any other browser for the duration of the exam, preventing the access of other websites or files. The secure exam browser application used by Aquifer is called Safe Exam Browser.

For Students

If you plan to take an Aquifer exam using your own desktop or laptop, you will need to spend a few minutes installing and testing the Safe Exam Browser. This applies to students taking exams for:

  • Aquifer Family Medicine
  • Aquifer Pediatrics
  • Aquifer Radiology

To help ensure a successful online exam experience:

  1. Verify your device meets the minimum technical requirements for the Secure Exam Browser to successfully download.
  2. Install and test the Safe Exam Browser days or weeks in advance of your exam to allow time for troubleshooting if needed.
  3. Be sure to complete the steps in the order listed below.

Before the Day of Your Exam

Follow these steps to install software that will prevent access to other websites or files during your exam. These files are only intended to be used while you are testing the Safe Exam Browser or taking your exam.

Download the appropriate Safe Exam Browser application for your operating system using the links below. You will be asked whether you want to save the installer file. Choose yes. This file may be saved wherever you like.

For Windows Users:
  • Download the latest Safe Exam Browser for Windows from this link.
  • Double click on the SEB_3.3.2.413_SetupBundle.exe file and follow the installation steps. Give the installer any permissions it needs.
For Mac Users:
  • Download the latest Safe Exam Browser for Mac OS from this link.
  • Save the SafeExamBrowser-3.0.dmg file and open it (it may open automatically).
  • Drag the Safe Exam Browser icon into the Applications folder in the mount window that matches the screenshot below.

  • Make sure you don’t have another Safe Exam Brower.app version 2.x in the Applications folder of your Mac already (your config file may open the wrong version).
  • Create a folder on your desktop labeled “Aquifer Exam” to keep this start file in so you can locate it easily when you are ready to take the exam.
  • Click this Exam Portal link to begin download.
  • The download will begin in the bar at the bottom of your screen.
  • Close your download bar after the portal has completed, by clicking the X to the right on the bar.
  • Open your downloads folder and search for “Aquifer_Exam_Portal_v1.seb”
  • The Exam Portal file will have an icon that looks like this:
  • When you locate that file, drag it or move it to the folder on your desktop labeled “Aquifer Exam”, and leave it there until you are ready to test the Safe Exam Browser.

After installing the Safe Exam Browser, we recommend taking a few minutes to test it with your device before the day of your exam.

  • Click on the “Aquifer_Exam_Portal_v1.seb” file to launch the short sample exam.
  • When you reach this screen, use these case-sensitive login credentials to sign in:
    • Login: Test234
    • Password: password
  • Once you enter the platform, select START to begin the short sample exam.
  • Complete the 2-question sample exam. At the last question, choose to END TEST.
  • Click YES to submit the exam, and use the CLOSE BROWSER option.
  • If you receive a pop-up asking to leave the Safe Exam Browser, please use the QUIT option.
  • You are now prepared to take your exam on your device.

If for any reason the Safe Exam Browser does not seem to be working for your device, you can simply perform a hard shutdown of your device to disengage the Safe Exam Browser.

A “hard shutdown” is continuously holding your power button until the machine completely powers down. The operating system will generate options to shut down with a pop-up, but you should ignore those and just continue to hold the power until the machine goes completely off.

Once the machine is powered off, you can turn it back on and resume regular use.

If you are still having issues, please contact Aquifer Exam Support.


Taking Your Exam

  1. Open the folder on your desktop that you created labeled “Aquifer Exam” and find the Exam Portal file that looks similar to this:
  2. Double click the icon to open the Safe Exam Browser application.
  3. The browser will ask if you want to Quit or Start. If you are ready to take the exam, choose Start.
  4. The Exam Portal page will look like this:

5. Use the assigned login and password your proctor has given you to start the exam. This is a password assigned for this exam and is not your regular Aquifer login and password.


Having Trouble?

For Administrators & Educators
For Students

Contact Exam Support Monday through Friday 8 AM to 5 PM Eastern time, except federal holidays.

Exam Troubleshooting

For Aquifer Pediatrics – Aquifer Family Medicine – Aquifer Radiology Exams

Student results are sent to the clerkship within two business days. Aquifer does not share results directly with students.

Often students will attempt to log back into the exam platform after their administration is over. If a student is “stuck” at the login page, they will need to perform a hard reset of their device in order to return their device to off the Secure Browser. They can be instructed to do a hard reset, or they can be referred to call the helpline.

Aquifer sends two reports with students results from their exams. One is the Administrator’s report, and the other is the Student’s report. For those institutions that desire to give individual reports to students there are a few ways to do so:

  1. Print the entire document and disseminate individual paper hard copies to students directly.
  2. Create individual PDF’s for each student: Open the document and hit the “print” icon, select # of the pages (the student report is 2 pages per student, so 1-2, 3-4, 5-6, etc), click the PDF button at the lower left, save as PDF, and change the name of the PDF(to the student’s name) and save it in the correct location on your computer. When you have done this you will have an individual PDF for each student, and can send them as an email attachment to students directly.

Additional Support

For further assistance, please call the Helpline weekdays Mon-Fri 8am to 5pm Eastern Standard Time, except on federal holidays at 603-277-2060 or email at [email protected]. Extended support available till 7:00 pm Eastern Standard Time weekdays on days when exams are scheduled. If you receive a voicemail, please leave a name and number, someone will return your call as soon as possible.