We all know that every student will have a slightly different experience in each of their supervised clinical practice experiences (SCPEs), dependent upon specific caseload, seasonal variations, and location. At Thomas Jefferson University Physician Assistant Program – Center City, we’ve been using Aquifer cases to augment learning, build key communication skills, and supplement clinical experiences to meet ARC-PA standards.
Matching Cases to SCPEs
Aquifer’s library offers a wide range of deep, detailed cases allowing you to select specific cases that you deem appropriate to meet your needs for student learning objectives. Aquifer’s Case Library (now known as the Content Library) feature allows you to search for specific diagnoses, clinical focus (i.e. diagnosis, management, etc), patient age, system, and more. After you’ve selected the cases that you find most useful for your topic or case setting, it’s easy to build courses to assign and track your students.
Our program uses Aquifer for four core SCPEs: Primary Care (Family Medicine), Pediatrics, Internal Medicine, and Behavioral Medicine. We also use WISE-MD for Surgery. While Aquifer does not have a specific course for psychiatry, there are many applicable cases within pediatrics, internal medicine, and family medicine that we use for our behavioral health course. At the end of the clinical year, students will have completed a minimum of 50 pre-selected virtual patient cases.
Each year, we select ten cases that fit into each of these five SCPEs and assign them to the students as they enter the rotation. Last year, we changed the process of how we selected the cases, focusing on creating courses to include not only “must see” cases but also to help address certain ARC-PA standards and help to demonstrate competencies in evaluating and managing patients across the lifespan and in different types of clinical medicine: acute, emergent, preventive and chronic. Aquifer has a wide variety of both diagnoses and care settings, so it is easy to manage both of these requirements.
ARC-PA Standards
B3.03 Supervised clinical practice experiences must enable all students to meet the program’s learning outcomes for:
a) preventive patient encounters
b) acute patient encounters
c) chronic patient encounters
Below, I’ve shared the Aquifer cases that we selected for our five SCPE custom courses and highlighted the ARC-PA standards we use Aquifer to support:
- Diagnostic Excellence 04: 10-year-old with chronic abdominal pain
- Family Medicine 03: 70-year-old with insomnia
- Family Medicine 09: 50-year-old with chest pains and palpitations
- Geriatrics 04: 85-year-old with dementia
- Geriatrics 05: 79-year-old with agitation
- Geriatrics 06: 85-year-old with delirium
- Geriatrics 07: 78-year-old with depression
- Geriatrics 10: 72-year-old and sexuality in older adults
- Internal Medicine 05: 55-year-old with fatigue
- Internal Medicine 26: 58-year-old with altered mental status and experiencing homelessness
- Family Medicine 01: 45-year-old wellness visit
- Family Medicine 02: 55-year-old wellness visit
- Family Medicine 06: 57-year-old diabetes care visit
- Family Medicine 08: 54-year-old with elevated blood pressure
- Family Medicine 10: 45-year-old with low back pain
- Family Medicine 15: 42-year-old with right upper quadrant pain
- Family Medicine 20: 28-year-old with abdominal pain
- Family Medicine 22: 70-year-old with new-onset unilateral weakness
- Family Medicine 28: 58-year-old with shortness of breath
- Family Medicine 33: 28-year-old with dizziness
- Pediatrics 02: Infant well-child visits (2, 6, and 9 months)
- Pediatrics 03: 3-year-old well-child visit
- Pediatrics 04: 8-year-old well-child check
- Pediatrics 06: 16-year-old preparticipation evaluation
- Pediatrics 11: 4-year-old with fever and adenopathy
- Pediatrics 13: 6-year-old with chronic cough
- Pediatrics 21: 6-year-old with bruising
- Pediatrics 22: 16-year-old with abdominal pain
- Pediatrics 23: 15-year-old with lethargy and fever
- Pediatrics 28: 18-month-old with developmental delay
- Internal Medicine 01: 49-year-old with chest pain
- Internal Medicine 04: 67-year-old with shortness of breath and lower-leg swelling
- Internal Medicine 07: 28-year-old with lightheadedness
- Internal Medicine 08: 55-year-old with chronic disease management
- Internal Medicine 12: 55-year-old with lower abdominal pain
- Internal Medicine 14: 18-year-old for pre-college physical
- Internal Medicine 21: 78-year-old with fever, lethargy, and anorexia
- Internal Medicine 24: 52-year-old with headache, vomiting, and fever
- Internal Medicine 25: 75-year-old with altered mental status
- Internal Medicine 29: 55-year-old with fever and chills
- Abdominal Aortic Aneurysms
- Breast Cancer
- Bowel Obstruction
- Lung Cancer
- Skin Cancer
- Carotid Stenosis
- Inguinal Hernia
- Cholecystitis
- Pyloric Stenosis
- Hypercalcemia
Building Clinical Communication Skills
Initially, we used Aquifer cases for self-directed learning, assigning cases for each specific rotation and setting a requirement for the minimum amount of time that students needed to spend on each case, which we verified using Aquifer’s reports. Now we’ve adapted our use of the cases to help address a common skill gap. We ask students to write a SOAP note for each case, which they submit for formative feedback and grading. This added exercise has helped to fill an important hole, as our faculty have noticed that as more clinical sites implement electronic health records, fewer students are writing formal notes in the clinical space–and those who do write notes are not always getting feedback from the preceptor about the quality and content of their notes. As entry-level PAs, our graduates will be expected to very quickly adapt to their new jobs and will need to write many notes for clinical care, continuity, and transitions of care that meet standards for compliance and reimbursement.
Feedback & Findings
Overall, we’ve found that Aquifer is a great tool to supplement our student learning, and can also be beneficial in further meeting specific ARC-PA standards. Aquifer cases have become even more valuable allowing the creation of hybrid SCPEs that offer virtual cases that are blended with in-person experiences. Student feedback has affirmed the usefulness of these cases to expand learning and reinforce knowledge and management strategies that they have learned in their didactic curriculum and experience in the SCPEs.
*Updated September 8, 2025
This blog was updated for the change in language in the ARC-PA standards and Aquifer case titles. At the time of writing, Aquifer did not have cases for Psychiatry, so the cases noted reflect that. Current Aquifer Psychiatry cases can be found here.