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.

Aquifer Curricular Partner Financial Support Announced for 2021-22

Financial Support Available for Full Course Library Subscriptions

We are pleased to announce the creation of the Aquifer Curricular Partner Programs for the 2021-2022 subscription year (July 1, 2021 – June 30, 2022). In recognition of the extraordinary challenges that medical and healthcare education programs will continue to face in the coming year, Aquifer is continuing financial support for programs subscribing to our full library of courses. 

As a non-profit organization, Aquifer is committed to supporting faculty and students and helping to provide broad access to our trusted content. The new Curricular Partner program continues the financial support we provided with the 2020-21 Full Course Library Grants in a simplified format. 183 medical and health professions programs are currently subscribing to Aquifer’s Full Course Library. Our partners at WISE are also offering financial support to programs subscribing to their suite of courses, WISE-MD (Surgery) and WISE-OnCall (Readiness for Practice).

Aquifer Curricular Partners will receive:

  • Access to all five Aquifer Signature Courses (Family Medicine, Geriatrics, Internal Medicine, Pediatrics, Radiology) at a significantly reduced cost.
  • Exclusive access to the initial set of Aquifer Sciences Integrated Illness Scripts, beginning in July 2021.

All Aquifer subscribing programs will continue to receive:

  • Access to Exams for Your Subscribed Courses: Available for Aquifer Family Medicine, Internal Medicine, Pediatrics, Radiology.
  • 23 Free Cases on Key Topics & Skills: Aquifer High Value Care, Diagnostic Excellence, Oral Presentation Skills, and Medical Home courses
  • Educator Guides & Ready-to-Use Teaching Tools: Active learning classroom activities, flipped classroom workshops, quick case guides, & more
  • Aqueduct Teaching & Learning Platform: Reporting, Searchable Case Library, Custom Course management, user management tools.
  • Full Support Services: Peer Consultations, live custom training, educator-to-educator resources, tech support

As always, Aquifer will continue to offer single and multiple course subscriptions in addition to this subscription option. To support programs subscribing to 1-4 courses, we are holding our pricing steady for the next subscription year. 

To Learn More:

If your program subscribes to Aquifer, please reach out to the main contact person for your subscription, the Aquifer Program Service Administrator, at your institution. If you have questions about your current subscription, please contact that individual. If you aren’t sure who to contact at your program, please submit a ticket to Aquifer Support

If you aren’t sure if your program subscribes, please view our list of current subscribers.If your program does not currently subscribe to Aquifer and you would like more information or a quote, please visit our Subscribe page.

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.

Webinar: Best Practices for Using Aquifer in PA Programs

We invite you to join us for an interactive session exploring the best strategies and methods for integrating Aquifer cases into your Physician Assistant courses or curriculum. This session is designed for faculty and administrators who are new to Aquifer and those looking to improve how they are using the cases.

This free webinar will be led by:

Cindy Lord, MHS, PA-C
Cynthia Lord, MHS, PA-C

Associate Professor
Center for Medical Education
School of Medicine
Case Western Reserve University

Sherilyn-Smith-MD
Sherilyn Smith, MD

Aquifer Chief Academic Officer

Professor of Pediatrics
University of Washington School of Medicine

Webinar Recording Available

Thank you to the 140+ PA educators who joined us on April 29, 2020, at 3 PM for our webinar, Best Practices for Integrating Aquifer into Physician Assistant Education.


This session covered:

  • Learn the pedagogical underpinning of Aquifer cases and how they are designed to support the development of clinical reasoning skills

  • Explore best practices for optimizing your use of Aquifer

  • Join a break out session based on your area of interest:

    • Tips for using Aquifer cases in clinical education

    • Tips for using Aquifer cases in didactic courses

    • Finding the cases you want and building custom courses

  • Ask questions and learn what additional resources are available

Schedule a Peer Consultation

Educator-to-educator support for faculty

Did you miss the webinar? Or do you still have questions? Schedule a personalized, academic-focused session with an experienced medical educator who actively uses Aquifer in a variety of learning environments with different levels of learners.

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

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

Developing Evidence-Based Formative Assessments

Delivering Efficient, Effective Learning

Today’s medical and health professions students have no time to waste. Demands on their time are only increasing as they strive to become excellent clinicians while balancing the need to achieve the outstanding grades and test scores that are required for the next steps in their education and career paths.

At Aquifer, we wondered: How can we help without compromising our dedication to supporting high-quality, comprehensive clinical learning?

In 2019, we began our journey to create the first nationally-developed comprehensive formative assessments for health professions students. The goal is to give students—and faculty—tools for focused learning and maximum efficiency. Aquifer’s formative assessment strategy is based on the proven concepts of test-enhanced learning combined with focused, repetitive practice.

Test-Enhanced Learning

Test-enhanced learning in health professions education is a pedagogical approach in which students are continuously assessed and re-assessed as a formative process. Test-enhanced learning is the result of the ongoing evolution from assessment of learning to assessment for learning (Schuwirth and Van der Vleuten 2011).

Research has shown that the “retrieval practice” of taking multiple formative assessments over time enhances students’ ability to recall, retain, and apply information over traditional study methodology. The effects are consistent for all health professions, learner levels, formats and learning outcomes (Green et al 2018). Test-enhanced learning is useful for helping students identify relatively weaker areas in need of further study, as well as areas of relative strength on which to build further, allowing for more focused and efficient study methods. Test-enhanced learning has also been shown to improve overall student study behaviors and aid in metacognition.

Focused, Repetitive Practice

Research demonstrates that student study habits and practice over time greatly influences knowledge retention and transfer to new problems. How does test-enhanced learning differ from what currently happens in most schools? Traditionally, students are exposed to new material in a classroom, lab, or assignment–and then move on to learning other new material. Students only go back and review all the material just before a summative mid-term or final exam is looming on the horizon.

On the other hand, research has shown that spaced, or distributed practice, is much more effective. This approach requires recalling information repeatedly over shorter intervals throughout a course of study. Long term retention has been found to be four times greater with spaced learning (Kerfoot). By frequently revisiting information, students can develop purposeful study habits based on evidence.

Aquifer’s Evidence-Based Approach

In our recent survey of Course and Clerkship Directors, more than half said they would require a high-quality formative assessment if one were available. These educators expressed a desire to provide students with immediate, granular feedback, and identified a clear gap: there is no nationally-available assessment designed for formative use in clinical education.

Aquifer is combining the concepts of test-enhanced learning and distributed practice to create shorter, more frequent assessments for learning. Our new formative assessment program will provide students with individualized performance reports and granular feedback that outlines specific learning objectives and teaching points that have been mastered or may require additional study, in addition to direct links to case content for focused self-directed learning.

To make this process more efficient for faculty and administrators, Aquifer will identify which students are performing at an expected level as well as those who may be at risk. A cohort summary report will identify specific learning objectives and teaching points that may require additional attention for all students to facilitate curriculum planning.

Addressing the Competence Gap

In addition to answering the single-best answer multiple-choice questions, students will also rate how certain they feel about the accuracy of their answer for each question. Performance reports will identify specific areas of mastery and uncertainty, as well as potential knowledge gaps and misconceptions in order to support student study plans. Reports will also provide each student with feedback on their current ‘cognitive competence’—an objective calibration of their perceived certainty and the accuracy of their answers. With time and repeated testing, students become armed with a more accurate picture of their current level of understanding and can establish targeted learning goals and study plans to meet their individual needs.

Deeper Dive

Explore how the Master Adaptive Learner Framework applies to clinical learning and how Aquifer’s formative assessment approach supports the development of mastery learning. Here, we 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)

Download Workshop Handout

Learn More

Aquifer Calibrate is actively in development. This innovative new assessment system will accompany our Family Medicine, Internal Medicine, Pediatrics, and Radiology courses. We expect to begin a robust pilot testing program in 2022.

Baghdady M, Carnahan H, Lam EW, Woods NN. 2014. Test-enhanced learning and its effect on comprehension and diagnostic accuracy. Med Educ. 48:181–188. • Cook DA, Thompson WG, Thomas KG. 2014. Test-enhanced web-based learning: optimizing the number of questions (a randomized crossover trial). Acad Med. 89:169–175.

Fitch ML, Drucker AJ, Norton JA, Jr. 1951. Frequent testing as a motivating factor in large lecture classes. J Educ Psychol. 42:1–20. • Karpicke J, Grimaldi P. 2012. Retrieval-based learning: a perspective for enhancing meaningful learning. Educ Psychol Rev. 24:401–418.

Karpicke JD, Butler AC, Roediger HL, III. 2009. Metacognitive strategies in student learning: do students practise retrieval when they study on their own? Memory. 17:471–479.

Kromann CB, Bohnstedt C, Jensen ML, Ringsted C. 2010. The testing effect on skills learning might last 6 months. Adv Health Sci Educ. 15:395–401.

Kromann CB, Bohnstedt C, Jensen ML, Ringsted C. 2010. The testing effect on skills learning might last 6 months. Adv Health Sci Educ. 15:395–401.

Larsen DP, Butler AC, Roediger HL,III. 2009. Repeated testing improves long-term retention relative to repeated study: a randomised controlled trial. Med Educ. 43:1174–1181.

Larsen DP, Butler AC, Roediger HL. 2013b. Comparative effects of test enhanced learning and self-explanation on long-term retention. Med Educ. 47:674–682. • Larsen DP, Butler AC, Roediger HL, III. 2008. Test-enhanced learning in medical education. Med Educ. 42:959–966

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.

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.

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.

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.

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.

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:

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!