Integrated Illness Scripts

Aquifer Sciences Integrated Illness Scripts
Available for Aquifer Curricular Partners & Individual Subscribers

In collaboration with:

International Association of Medical Science Educators

IAMSE logo

Integrated Illness Scripts are designed specifically to promote cognitive integration and provide a framework for learners to link basic science and clinical knowledge. Building on the traditional illness script format, Integrated Illness Scripts (IIS) embed basic science core concepts and causal mechanisms within each clinical feature and display the connections visually through Mechanism of Disease Maps.

Making Connections for Deeper Understanding & Better Clinical Decisions

Bringing together clinical features, epidemiology, and basic science causal mechanisms and core concepts, Integrated Illness Scripts provide a new mental model for advancing cognitive integration in learners and unpacking encapsulated expertise from faculty. This new framework is designed to enable more effective and efficient clinical decision-making.

Designed for Integration

The first tools designed specifically for integrating basic and clinical sciences in a variety of learning environments.

For Educators, By Educators

Teams of interdisciplinary educators developed and reviewed content that meets the needs of today’s faculty and students.

Nationally Developed Tools

Fully vetted teaching tools provide a framework that can be applied and adapted to fit the needs of your program.

Cognitive integration is a process that occurs in the minds of learners and experts as they interweave relevant basic science and clinical knowledge when reasoning through a patient problem.

Research shows that the effective cognitive integration of basic and clinical science improves diagnostic accuracy, particularly in novice clinicians.

To learn more, we recommend downloading our white paper, “Fostering Cognitive Integration & Unpacking Expertise: The Need for Integrated Illness Scripts in Medical and Health Professions Education.”

Webinar: Integrating Basic Science and Clinical Education: Why It’s Important & Tools to Support You

Join Leslie Fall, MD, and Amy Wilson-Delfosse, PhD, with guest presenters Esther Dasari Dale, PhD, and Khiet Ngo, DO, MS, as they discuss the importance of integration of basic science and clinical education, the Aquifer Sciences initiative in collaboration with IAMSE (International Association of Medical Science Educators) to build a national basic science curriculum, and the Integrated Illness Scripts resources from Aquifer.

Table of Contents:

  • 0:00 – Introductions
  • 4:33 – Agenda
  • 6:40 – Barriers to Integration
  • 8:50 – Building a national sciences curriculum
  • 16:37 – Importance of Improving Cognitive Integration
  • 24:33 – Curriculum Database in use with Esther Dasari Dale, PhD
  • 30:53 – Anatomy of an Integrated Illness Script
  • 37:42 – Integrated Illness Scripts in Preclinical with Leslie Fall, MD
  • 39:24 – Integrated Illness Scripts in Clinical Year with Amy Wilson-Delfosse, PhD
  • 42:56 – Integrated Illness Scripts Across the Curriculum with Khiet Ngo, DO, MS
  • 46:50 – Aquifer Tools for Cognitive Integration
  • 48:45 – Q&A
  • 57:00 – Resources
Teaching with Aquifer Integrated Illness Scripts: A Quickstart Guide

Get up to speed on Integrated Illness Scripts (IIS) and find out how easy it is to start using them in your course or program.  Whether you’re a clerkship director, clinical faculty, or basic science educator, Integrated Illness Scripts can help your students make key connections between basic science and clinical knowledge, driving a deeper understanding and improving clinical decision-making skills.

Table of Contents:

  • 0:00 – Welcome
  • 4:22 – Introduction to Integrated Illness Scripts
  • 8:28 – About Cognitive Integration
  • 12:45 – What are Integrated Illness Scripts?
  • 15:48 – Live Integrated Illness Script Tour in Aqueduct
  • 24:39 – Using Integrated Illness Scripts
  • 36:30 – Q&A

The Aquifer Sciences Integrated Illness Scripts were created through a national, multi-institution authoring project. Following a national Call for Participation, teams from six schools were selected to draft Integrated Illness Scripts on common conditions seen in core rotations, leveraging the Aquifer Sciences Open Curriculum Database. Teams at each institution included clinician educators, basic science faculty, and medical students.

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
Peer Review Process

Following the completion of the authoring process, each script underwent an extensive peer review process that included subject experts from the Aquifer Sciences Leadership Team and basic science and clinician educators.

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.



“Thinking Slow More Quickly: Development of Integrated Illness Scripts to Support Cognitively Integrated Learning and Improve Clinical Decision-Making”

Medical Science Educator; May 4, 2021

White Paper:

“Fostering Cognitive Integration & Unpacking Expertise: The Need for Integrated Illness Scripts in Medical and Health Professions Education”

Accessing Integrated Illness Scripts

Aquifer Curricular Partner programs enjoy free access to:

Individual Learners can also purchase the full set of Integrated Illness Scripts. Please note that this access does not include educator resources or administrative reporting.

  • ABO Hemolytic Disease of the Newborn
  • Alzheimer Disease
  • Appendicitis
  • Asthma
  • Atherosclerotic Coronary Artery Disease (ACAD)
  • Cholecystitis (Acute)
  • Choledocholithiasis
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Crohn Disease
  • Deep Vein Thrombosis – Lower Extremity (DVT)
  • Diabetes Mellitus – Type 1 (T1DM)
  • Diabetes Mellitus – Type 2 (T2DM)
  • Diabetic Ketoacidosis (DKA)
  • Encephalitis (Viral)
  • Gastroesophageal Reflux Disease (GERD)
  • Heart Failure
  • Hepatitis A Viral Infection
  • Herpes Zoster (Shingles)
  • Infantile Hypertrophic Pyloric Stenosis
  • Influenza
  • Meningitis (Bacterial)
  • Myocardial Infarction (with ST-Segment Elevation) (MI)
  • Myocardial Ischemia
  • Newborn Jaundice – Breastfeeding
  • Newborn Jaundice – Physiologic
  • Osteoarthritis
  • Pancreatitis (Acute)
  • Parkinson Disease
  • Pneumonia
  • Pneumothorax
  • Pulmonary Embolism (PE)
  • Rheumatoid Arthritis
  • Shock – Cardiogenic
  • Shock – Hypovolemic
  • Shock – Septic
  • Stroke – Hemorrhagic (Intracerebral – Left Putamen)
  • Stroke – Ischemic (Left Middle Cerebral Artery)
  • Transient Ischemic Attack (Left Middle Cerebral Artery)
  • Ulcerative Colitis
  • Urinary Tract Infection: Acute Cystitis
  • Urinary Tract Infection: Pyelonephritis

Aquifer Curricular Partners receive discounted access to the full library of Aquifer content, exclusive access to new learning tools and assessments, and more.

Anatomy of An Integrated Illness Script

A live demo of an Integrated Illness Script is now available. To access the demo, you can either register for free access or sign in using your Aquifer account. Click on the button below to get started.


For each condition, Integrated Illness Scripts include:

Overview – Epidemiology – Clinical Features (up to 6) – Implications for Further Work Up – Implications for Management – Mechanism of Disease Maps


This section provides the public health context of the condition, covering gender, peak incidence, risk factors, and predisposing conditions related to this diagnosis.

Clinical Features (Up to 6)

For the given diagnosis, the Integrated Illness Script includes six prototypical clinical features seen commonly in patients with this condition.

Within each clinical feature, the Integrated Illness Script describes the underlying basic science causal mechanisms that explain why a patient with that diagnosis displays that clinical finding.

Implications for Management & Further Work Up

These sections provide students an opportunity to reflect and take notes on how this knowledge will influence their clinical practice in diagnosing and treating a patient with this condition. Responses to these sections are visible in reports for both students and faculty.

Mechanism of Disease Maps

Mechanism of Disease Maps trace the steps of pathophysiologic mechanisms from the underlying causes of disease to the observable and measurable clinical signs and symptoms.

Providing a visual representation of the relationship between the “original insult”, key findings, clinical features, and the basic science mechanisms, MOD Maps enable students to see and integrate a more holistic view of the basic science knowledge relevant to the given condition.

Using Integrated Illness Scripts

Aquifer Integrated Illness Scripts are designed to be used in a variety of learning settings, from the classroom to the clinic.

Aquifer Sciences Board

Aquifer Sciences Initiative

In collaboration with:

International Association of Medical Science Educators

IAMSE logo

The Aquifer Sciences Initiative is a partnership between Aquifer and the International Association of Medical Science Educators (IAMSE) to develop and disseminate teaching and learning tools that promote cognitive integration and collaborative teaching of basic and clinical sciences in health professions education.


The Aquifer Sciences curriculum and Integrated Illness Scripts are being developed by a nationally representative and multi-institutional team of over 100 leading science and clinical educators drawn from eleven core basic science disciplines and nine major clinical disciplines, working in collaboration with senior medical student curriculum interns selected through a competitive national process.


The goal of the Aquifer Sciences Initiative is to provide evidence-based teaching and learning resources that promote:

  1. Effective cognitive integration of the basic and clinical sciences by clinical learners, ensuring excellence in clinical decision making that places patient care, quality, value and safety at a premium.
  2. Productive and collaborative teaching by basic and clinical science faculty to ensure learner’s foundational basic science knowledge is effectively organized for clinical practice and life-long learning.

Project Phases

Aquifer Sciences Open Curriculum Database

Available to the Public (Inquire for Free Access)

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 database covers:

  • 11 Basic science disciplines
  • 11 Clinical disciplines
  • 106 Core concepts
  • 785 Learning objectives
  • 245 Common conditions
  • 5 Clinical decisions
  • 15 Systems
Aquifer Sciences Integrated Illness Scripts

Available by Subscription

Building on the traditional illness script format, Integrated Illness Scripts embed basic science core concepts as causal and explanatory mechanisms associated with clinical features. Scripts provide a mental model that helps students make connections and form a deeper understanding to make better, safer clinical decisions.

Aquifer Sciences Contributors

The Aquifer Sciences initiative curriculum is developed by over 100 leading science and clinical educators from institutions across the nation.

Aquifer Sciences Course Board


“Finally, we have a means by which to bridge the gap between basic sciences and clinical medicine!”

Amy Wilson-Delfosse, PhD. Professor of Pharmacology, Associate Dean for Curriculum, Case Western Reserve University School of Medicine

“I would have much appreciated learning from this curriculum during my transition from the classroom to the wards.”

Fourth-Year Medical Student