Meeting ARC-PA Standards (6th edition) with Aquifer

 

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This blog was updated June 2026 to match the 6th edition of the standards and current Aquifer cases. 

The Killer B’s Updated 

Meeting the requirements for accreditation is an ongoing challenge for PA programs. The program curriculum must prepare students to provide patient-centered care and to work collaboratively on interprofessional teams. Not only must the curriculum include applied medical, behavioral, and social sciences; health policy and professional practice issues; patient assessment and clinical medicine; and supervised clinical practice – it also requires a strong foundation in evidence-based medicine and health information technology.

PA curriculum must be consistent with program competencies and enable all students to meet the program’s learning outcomes. In doing all of this, PA curricula must place a heavy emphasis on the need to remain current in the face of an ever-changing clinical environment.

Currently serving close to 100 physician assistant programs (and over 150 U.S. allopathic medical schools), Aquifer is a trusted tool in health professions education. Aquifer’s teaching and learning tools can help programs of all shapes and sizes meet many of the ARC-PA Standards.

Resources & Strategies Map

Covering Hard to Teach ARC-PA Standards

The Resources and Strategies Map, created by the Aquifer PA Task Force and updated by the PA Affinity Group, displays links between difficult-to-teach ARC-PA standards and Aquifer resources. 

The Resources and Strategies Map includes over 70 difficult-to-address ARC-PA topics, mapped to the relevant ARC-PA Standards and PAEA Core Competencies for New PA Graduates. The map also includes the relevant Aquifer content and suggested teaching strategies. For more information on PA resources, visit: aquifer.org/pa. 

 

 

Section B: Curriculum and Instruction

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B1 Curriculum

How Aquifer Helps

Aquifer cases cover the full lifespan and take the time to walk learners through a complete patient encounter, from taking a history and conducting a physical exam, through diagnosis and testing, to creating a management plan. Many cases include details about follow-up visits. Aquifer’s proven pedagogy walks learners through each step of the process with in-depth explanations, asking questions that require students to apply their knowledge along the way and providing detailed answer explanations.

Aquifer cases are ideal for use in the flipped classroom format. Didactic/pre-clinical students find it helpful to go through cases together in class or small groups using the Case Analysis Tool (CAT). Similarly, students can also work on Aquifer cases in class in small groups (or solo) using the Case Debriefing Tool (CAT). Cases can be used as standardized patients to build assignments to meet your learning objectives. Cases are also ideal springboards for discussion in small groups, PBL, or TBL sessions.

The new Virtual Patient Encounters (VPE) provide students with the opportunity to build interview skills as they engage with a virtual patient. Students are encouraged to approach the conversation as they would with a real patient, asking appropriate questions to gather the clinical information needed to make decisions. Individualized, research-based feedback after the interview is complete creates a true virtual precepting experience. Feedback is designed to help students learn and improve clinical interviewing skills. Currently, this prototype is available in the following cases: Family Medicine (05 & 23), Geriatrics (03, 15 & 16), Internal Medicine (01 & 09), Neurology (11 & 13), Obstetrics/Gynecology (Gyn 02 & 03), Pediatrics (09 & 12), and Psychiatry (03 & 05).

B2.08d Psychiatric/Behavioral Conditions

How Aquifer Helps

The Psychiatry course involves a variety of teaching points and objectives that address key aspects of mental health care. Topics covered include collecting information for consultations, ensuring safety when dealing with agitated patients, starting the interview process, assessing suicide risk, and inquiring about psychosis and manic symptoms. The course emphasizes controlling the interview process and obtaining collateral information. Aquifer cases cover a broad range of psychiatric conditions including schizophrenia, schizoaffective disorder, bipolar with psychotic features, major depressive disorder with psychotic features, personality disorder, and substance-induced psychotic disorder.

B2.08e & B2.11a Palliative and End-of-Life Care

How Aquifer Helps

Foundational skills in communication, symptom management, transitions of care, and interprofessional collaborations are critical in improving the quality of life of patients with serious illnesses–but most health professions students don’t receive standardized education in these key principles of primary palliative care. Palliative Care cases can be used to help prepare learners to provide high-quality patient-centered care. Part of the Clinical Excellence Case Sets, the Palliative Care course begins with a primer on the principles of palliative care. Cases are shorter than the traditional Signature Courses (e.g., Family Medicine) ranging from 15 to 25 minutes in length and apply the principles of palliative care in clinical scenarios. Topics include advanced care planning, interprofessional roles and responsibilities in palliative care, and pharmacologic pain management, as well as death, dying and bereavement.

B2.08f Provision of Medical Care through Telehealth/Telemedicine

How Aquifer Helps

The Telemedicine course explores the principles and practices of telemedicine, focusing on the delivery of healthcare through technology at a distance. The four cases are short, ranging from 10 to 20 minutes in duration, and the course includes a primer on the principles of telemedicine.  

B2.10 Interprofessional Patient-Centered Teams

How Aquifer Helps

Aquifer cases can significantly help meet accreditation standards for preparing students to work collaboratively in interprofessional, patient-centered teams. Here's how:

• Holistic, Interprofessional Care:
  Aquifer cases, such as those in palliative care (cases 01, 05 and 12), illustrate the importance of interprofessional teams where professionals with different training contribute to holistic, person-centered care plans. This approach ensures that all aspects of a person's needs—medical, psychological/emotional, social, and spiritual are addressed.

• Understanding and Collaboration:
  Students are encouraged to interact with various healthcare professionals to better understand their roles and responsibilities within the team. This interaction fosters effective communication and enables students to engage in collaborative care, which is crucial for team-based care approaches. Aquifer cases that focus heavily on this area include:

  • Geriatrics 21: 70-year-old female with symptomatic end-stage COPD: An Interprofessional Case. This is designed specifically to explore interprofessional roles.

  • Geriatrics 23: 70-year-old female and hazards of hospitalization: Transitions of Care and Discharge. This case focuses on planning for geriatric inpatients. It is also an excellent case for exploring the role of interprofessional teams.

• Skill Set Diversity:
  Cases highlight how interprofessional team members like physicians, advanced practice providers, nurses, social workers, chaplains, and therapists work together. This diversity of skills and perspectives is necessary to provide comprehensive care and enhance patient outcomes.

• Patient-Centered Approach:
  The creation of a unified care plan through interprofessional discussion, with input from the patient and family, is emphasized in these cases. It enables students to see firsthand the impact of collaborative, patient-centered planning and decision-making.

• Principles and Coordination:
  Aquifer cases underscore the principle of interprofessional collaboration and care coordination, essential in delivering patient-centered care by mobilizing services efficiently. This is particularly emphasized in palliative care settings.

These elements prepare students not just to function within interprofessional teams but to thrive, recognizing the value each team member brings to patient care.

B2.11 Social & Behavioral Sciences

How Aquifer Helps

Aquifer cases through their detailed scenarios and guidance effectively support instruction of social and behavioral sciences.  Here are some key ways they contribute:

• Death, dying, and bereavement cases provide students with skills to recognize common signs and symptoms of the dying process, such as changes in respiration and consciousness, and offer approaches for managing end-of-life symptoms like pain and dyspnea. They emphasize the importance of effective communication with patients and their families during the dying process. Cases underscore the need to elicit patients' and families' cultural values and practices related to end-of-life care and incorporate these into the care plan to ensure culturally sensitive practice. Students are guided in understanding normative grief and bereavement reactions, recognizing the need for bereavement resources, and determining when a specialty referral is necessary. Reflection on personal experiences with loss help students to develop self-care practices essential for handling the emotional demands of caring for dying patients. Students learn procedural tasks such as death pronouncement and the importance of expressing condolences, which are critical in providing comprehensive support to families.

• Human sexuality cases provide students with experience eliciting a sexual history. They often include teachings on appropriate terminology regarding gender identity and sexual orientation, promoting linguistic inclusivity and understanding in clinical practice. Geriatrics 08 focuses on obtaining a comprehensive sexual history and includes information about sexual orientation and gender identity. The case highlights the importance of using inclusive language and being sensitive to cultural and personal factors influencing patients' comfort in disclosing their sexual histories. The case also educates students about the discrimination older LGBTQ patients might have faced, making them wary of discussing their sexuality. Students are informed about community resources that can assist LGBTQ patients, as well as legal issues such as advance directives, estate planning, and healthcare rights. This knowledge ensures a comprehensive psychosocial evaluation and support for patients.

• Psychosocial effects of illness stress and injury cases highlight how socioeconomic factors, personal losses, and chronic stress can exacerbate physical symptoms and complicate health management. Students are taught to assess psychosocial stressors and implement coping strategies such as stress management techniques and engagement with supportive resources. Effective communication skills are emphasized for discussing the interactions between stress, trauma, and health with patients, using nontechnical language to ensure understanding and compliance. Emphasizing the neurobiological and behavioral impacts of stress, cases explore the impact of trauma and stress on the autonomic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. For example, the effects of stress on childhood asthma are illustrated by how chronic stress can amplify an inflammatory response and worsen health outcomes. In the Trauma-Informed Care cases, students learn to use trauma-informed strategies to help patients manage stress and its effects.

• Substance use disorders Aquifer cases incorporate a focus on both identifying and managing substance use disorders effectively. For example, Obstetrics 07 focuses on managing a patient with opioid use disorder on buprenorphine maintenance therapy during pregnancy, discussing the complexity of treating opioid use while considering the effects on both the mother and the newborn. The focus of Internal Medicine 11 is on a patient with a history of intravenous drug use and ongoing alcohol use. The case discusses hepatitis C management alongside the use of the AUDIT-C screening tool for alcohol use disorder. Internal Medicine 26 examines the psychosocial and medical complexities in managing a patient with alcohol use disorder, covering aspects like ethylene glycol toxicity and the influence of homelessness on substance accessibility.

• Identification and prevention of violence cases address topics, focusing on intimate partner violence (IPV), trauma-informed care, and patient-centered strategies. Many cases include guidelines and structures for screening patients for intimate partner violence. Cases emphasize the importance of proper documentation in cases of suspected domestic abuse. They provide guidance on how to safely document abuse-related findings while maintaining patient confidentiality. Students learn to use trauma-informed, patient-centered approaches to care for patients experiencing violence and toxic stress. The role of collaborating with experts such as sexual assault nurse examiners and IPV advocates is highlighted to provide comprehensive care and minimize the retraumatization of survivors. Cases include guidance on developing safety plans and utilizing community resources. 
  

B2.12 Instruction about Basic Counseling

How Aquifer Helps

A number of cases include learning objectives around adherence to treatment plans and the incorporation of appropriate psychosocial, cultural health literacy, and family data into the management plan. These include:

• Family Medicine 06: The focus here is on counseling patients about lifestyle modifications and the importance of adhering to prescribed treatments in managing chronic conditions.

• Pediatrics 03: Reviews assessing social determinants, family supports, and tailoring counseling/education to families’ needs and literacy.

• Internal Medicine 08: This case emphasizes the importance of medication adherence and the role of motivational interviewing in helping patients manage their complex treatment plans.

Cases related to basic counseling aimed at helping patients modify their behaviors to adopt more healthful patterns include:

• Family Medicine 01: Highlights the development of a health-promotion plan, use of motivational interviewing, weight-loss counseling, and smoking cessation strategies.

• Family Medicine 02: Discusses motivational interviewing, the Five A’s and stages-of-change frameworks, and counseling on smoking cessation, diet, and exercise.

• Internal Medicine 16: This case focuses on counseling strategies for weight loss, highlighting behavior modification techniques to achieve healthier lifestyle patterns.

Trauma-Informed Care cases can be used to address learning objectives around helping patients develop coping strategies. Cases highlight the use of patient-centered communication skills and motivational interviewing principles to help patients understand the adverse effects of maladaptive coping behaviors. There is a focus on how to communicate effectively with patients from diverse backgrounds. These include:

• Trauma-Informed Care 05: 8-year-old with asthma

• Trauma-Informed Care 08: 58-year-old with gastrointestinal symptoms

Cases that involve basic counseling focused on patient-centered and culturally sensitive approaches include:

• Geriatrics 26: Applies Kleinman’s explanatory model, working with interpreters/cultural brokers, and building therapeutic alliances across cultural differences.

• Trauma-Informed Care 02: Models patient-centered, trauma-informed counseling approaches that are sensitive to cultural and psychosocial context.

Additional teaching that meets these Standards is also found throughout the Aquifer Signature cases.

B2.16a, b & d Patient Safety, Prevention of Medical Errors, and Risk Management

How Aquifer Helps

Diagnostic Excellence offers six virtual patient cases (6-20 minutes each) that teach students about cognitive processes and system issues leading to diagnostic errors. The course covers foundational content on diagnosis, contributing factors, and error mitigation strategies, encouraging reflection on personal experiences. Each case includes a 60-minute classroom session with activities, discussion questions, and worksheets.

High-Value Care cases are related to risk management in several ways. These cases highlight risk management as an integral part of delivering high-value care by minimizing potential harms and optimizing resources.

• Case 02: Making diagnostic testing count examines inappropriate testing risks, using statistical tools to weigh test benefits, harms, and costs, preventing false positives, unnecessary costs, and patient anxiety.

• Case 05: High-value care in the inpatient setting covers managing risks from hospital-associated infections, surgical procedures, and transfusions through risk assessment and infection control.

• Case 09: Redefining value at end of life addresses risks of over-screening and over-treatment in terminally ill patients by tailoring care to reduce unnecessary interventions.

B3 Clinical Curriculum

B3.01d, B3.02b, B3.03, B3.04, B3.05a, B3.05f & B3.06

How Aquifer Helps

Enhancing the Range of Clinical Encounters

According to ARC-PA, supervised clinical practice experiences (SCPEs) should include direct patient care, meet the program-defined learning outcomes, and be of sufficient breadth and depth to prepare students for the clinical practice of medicine. In addition to caring for patients, PA programs may be able to use virtual experiences, simulation, or other technology to meet some of the program-defined learning outcomes for SCPEs. (ARC-PA Compliance Manual 6th edition).

Aquifer courses and cases can be integrated into the clinical experience to enhance and supplement the student’s bedside experience. Content is derived from the core curriculum of Aquifer’s collaborating national medical educational organizations. Every Aquifer course contains cases that explore the diagnosis and treatment of common acute and chronic illnesses, as well as health maintenance visits and visits across the lifespan and in a variety of settings.

Cases are developed and maintained by teams of leading medical educators, including PAs, who collaborate with their national education organizations to build evidence-based courses that model realistic clinical experiences, preceptor interactions, and teaching. Engaged in continuous practice of their clinical reasoning skills and problem-solving abilities, students move through the stages of a patient’s presentation, assuming the role of a virtual student working with a preceptor, from eliciting the chief complaint to taking a history, performing a physical exam, composing an assessment, formulating a differential diagnosis, and on to diagnostic testing and management. Cases include results of diagnostic testing, screening and prevention guidelines, videos, audio, and images to support a complete patient encounter.

There are numerous ways to classify the spectrum of patients to be seen. With the Aquifer Content Library, it’s easy to search cases to find the content you need and assign it to students.

For example, the search and filters can cover:

• Ages/developmental stages
• Diagnosis
• Symptom
• Clinical discipline
• Body system
• Clinical setting/location
• Clinical focus

Suggested methods for assigning cases include:

• Assign strategically selected cases at the beginning of the rotation to:
  
  • prepare students to see patients with conditions they are likely to encounter
  • fill known clinical gaps
• Assign cases individually throughout the clerkship, based on a review of each student’s clinical logs.
• A combination of both.
• Cases can also be used as part of a remediation plan for struggling learners.

Documentation Method

Student Course Reports, only accessible to people with specific administrative privileges in Aquifer’s platform, shows the detailed progress of an individual student in each case in a course, including:

• The cases the student has completed, partially completed, or not yet begun
• Percent of case completed
• Time from case start to completion
• Low time check mark if the case was completed in less than 25% of the recommended time
• Additional details on the date the case was started, completed, and last accessed
• Summary Statements and Expert Comments on summary statements submitted by students for cases that require them 

 

 

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B4 Assessment