Teaching Perspectives & Pearls Blog

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Find out how your peers are making the most of Aquifer cases and teaching tools.

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Important Update to Internal Medicine Case 3

Available for all Aquifer Internal Medicine subscribers

Aquifer is excited to announce that Aquifer Internal Medicine 03 – 54-year-old female with Syncope, has been updated by the Aquifer Internal Medicine Course Board. The updated version of the case is called Aquifer Internal Medicine 03 – Four Patients with Syncope, and is available for all Aquifer Internal Medicine subscribers as of July 1, 2022.

The updated version of this case now follows four different patients instead of one, each of whom has the same concern, but with differing etiologies. By covering four patients with the same concern, the updated case allows students to sharpen their clinical reasoning skills.

Reimagining case 3 as a series of short cases with a common chief complaint like syncope allowed for the delivery of content into bite-size portions, while underscoring the concept of different causes, or differential diagnoses. The rewrite process focused on comparing and contrasting the illness scripts of each cause, allowing for the practice of clinical reasoning, thereby promoting deeper understanding and retention of the teaching points.

Trauma-Informed Care Cases Available July 1

Aquifer is excited to announce the release of Aquifer Trauma-Informed Care, including 11 cases, on July 1, 2022. The Aquifer Trauma-Informed Care course will be included with Aquifer Curricular Partner subscriptions, and available for individual subscription to all teachers or learners.

Aquifer recognizes the importance of this critically important topic and is pleased to make this content available. The impact of exposure to traumatic events on health and wellness is well-documented. The Adverse Childhood Experiences (ACE) study, and other notable research findings, have documented the prevalence of traumatic events in the United States and their impact on patient health. As a result of this data, there is a growing consensus that trauma must be addressed as a major public health issue.

Aquifer worked with an interprofessional team of physicians, psychologists, and subject matter experts, to develop these evidence-based cases and to address a clear need in clinical education. The cases have been optimized to meet the needs of undergraduate medical and health professions learners. Cases are interdisciplinary and an ideal fit for use in clerkships, pre-clinical courses, or capstone/transition to practice courses. Each Trauma-Informed Care case takes about 15 minutes to complete.

The 11 virtual patient cases cover scenarios addressing a range of published core competencies and critical learning objectives, including the prevalence and health effects of trauma, the principles of trauma-informed care, the neurobiology of trauma, clinical management of persons who have experienced traumatic events, and interprofessional collaboration methods for working with trauma-affected patients.

Cases illustrate how trauma-informed care can improve patient-provider rapport, increase patient engagement in preventive care, and facilitate integrated, patient-centered treatment plans. The types of patients cared for in the cases span the age spectrum and are seen primarily in the outpatient setting or in the emergency department.

To learn more or find out how to access the cases, please visit the Aquifer Trauma-Informed Care course page.

New Case on Frailty Coming May 1

Available for all Aquifer Geriatrics subscribers

Aquifer is excited to announce that a new Aquifer Geriatrics case on frailty will be available on May 1, 2022. The new case is divided into three short patient encounters and covers frailty from a variety of angles, directly addressing one of the American Geriatrics Society’s core competencies for medical students.

The case, Aquifer Geriatrics 28, follows three patients, two in the clinic and one in a nursing home. Students are asked to evaluate each patient’s level of frailty and how it affects their care. Key learning points in the case include defining frailty, identifying different stages of frailty, understanding the adverse outcomes among older adults, and incorporating frailty as a predictor of a patient’s long-term prognosis.

The new case was written and peer-reviewed by medical educators on the Aquifer Geriatrics Course Board and is appropriate for all health professions students. As with all Aquifer signature cases, the case on frailty can be added to any custom course and includes student progress reporting. From an Aquifer account, the new case is accessible from the Aquifer Geriatrics signature course and via the searchable Content Library.

New Osteopathic Resources Now Available

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

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

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

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

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

Did You Know...?

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

Aquifer Exam Video Proctoring Reinstated

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

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

New Cases on Telemedicine Coming October 15, 2021

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

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

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

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

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

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

New Cases on Interventional Radiology Coming July 1

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

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

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

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

Aquifer Launching New Social Determinants of Health Cases

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

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

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

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

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

From Culture in Healthcare to Social Determinants of Health

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

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

Commitment to Equity & Inclusion

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

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

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

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.

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.

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.

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.

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.

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.

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:

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.

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

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: