4 Ways to Use Aquifer High Value Care Across Your Curriculum

Aquifer High Value Care, a free course available to all faculty and learners, teaches students how their decisions about diagnostic testing, care management, and other interventions affect the costs and efficacy of care. This 12 case course is an innovative, interdisciplinary approach to teaching the fundamentals of value in healthcare. In our recent 30-minute webinar, Best Practices for Teaching About High Value Care, the Aquifer High Value Care Course Board discussed tips and strategies for teaching about high value care (HVC) throughout the curriculum.

Developing HVC Advocates in Clinical Rotations

At the University of Florida, Heather Harrell, MD, FACP, wanted to empower students to become HVC champions and give them an opportunity to reflect on the real cost of care for patients. Dr. Harrell based her internal medicine clerkship implementation on the work of Dr. Marty Muntz from the Medical College of Wisconsin, who created the role of a “Student High Value Care Champion”, based on the Choosing Wisely campaign for inpatient medicine to focus on areas of waste in medical care. In order for students to truly become advocates, they needed background in high value care, but Dr. Harrell did not have the faculty time to cover this multiple times per year with each clerkship rotation.

To overcome this lack of time, she implemented Aquifer High Value Care cases 1 & 4 as background, introducing students to the HVC curriculum and allowing students to dive deeper into the subject matter. Students were also given the opportunity to, with the patients’ signed consent, view their charges for medical care, and reflect on how choices made by clinicians affected the cost of care. These discussions lead to the incorporation of Aquifer High Value Care cases 6 & 12 to cover payment models, and thus close the loop.

Dr. Harrell noted, “Our experience is that students are so enthusiastic about high value care, and that tying content from the cases to the real patients under their care really brought it to life.” Additionally, by incorporating Aquifer’s HVC cases into their curriculum, Dr. Harrell noted that it helped faculty, many of whom did not have a background in HVC, without creating an additional burden. One of the biggest lessons learned at the University of Florida was that in order for HVC to become the culture, it must be woven throughout the curriculum and patient care.

Individualized Learning During Rotations

Jimmy Beck, MD, MEd, of Seattle Children’s Hospital, uses Aquifer’s High Value Care cases during his pediatrics rotation as a basis for 1-on-1 discussion sessions with medical students. The cases also provide a self-directed learning opportunity, especially during downtime in the hospital. Dr. Beck assigns students specific cases, and upon completion, sits down to discuss them and answer focused questions from the Aquifer High Value Care Educator Guide. These informal discussions are often related to the learning from one of the patients under their care, with the student driving the conversation.

“Students have really appreciated having one-on-one time, but also getting a break from me where they’re not sitting in the cubicle next to me for eight hours during the day,” Dr. Beck mentions. Also, because the Aquifer High Value Care cases are brief, students are able to fit them in during the day at points that are most convenient for them. This learner-centric model is beneficial for both student and faculty, as the faculty are able to better determine where the student is in terms of comprehension and understanding in the moment, so as to be able to tailor the next day’s learning to what the student needs.

Empowering Pre-Clinical Learners as HVC Champions

As a medical student at the University of South Carolina School of Medicine Greenville, Haritha Pavuluri noted that students have a gap in their education because of very little exposure to the concepts of high value care. As part of both the HVC honors track in her program, and the STARS program, she engaged faculty and other students to increase HVC education.

After gaining buy-in from faculty and leadership in her program, Haritha helped design a curricular intervention to introduce high value care to first-year students in their longitudinal “doctoring” course. An introductory lecture helped students learn more about the importance and concepts of high value care, as well as the tenets of the “Choosing Wisely” campaign. Choosing Wisely and HVC concepts were incorporated into the already assigned weekly patient cases and clinical decision-making discussions in the course, thus marrying the concepts of HVC to the material from the start of their medical school experience. Course evaluations showed that students increased their high value care knowledge and confidence in applying HVC and clinical decision-making. More than 95% of students surveyed felt that it was important for students to be educated on HVC.

“I think Aquifer’s High Value Care course has strong utility, in that it provides essential education and ways to apply that knowledge in the clinical environment. Because of this, I think the course is a great resource for faculty and learners alike and forms a great foundation to build further high value care knowledge,” said Haritha. She noted that students became passionate about HVC after being exposed to the ideas and concepts, but making it happen required faculty champions and buy-in from the top down at the school. Students also stressed the importance of faculty needing to engage students in discussions to solidify the concepts of HVC both prior to and during clinical rotations, as well as providing an avenue for discussing instances of low-value care when observed.

High Value Care Shark Tank

First Year Students

At Johns Hopkins University School of Medicine, Dr. Amit Pahwa helps preclinical students get up to speed with a three-day high value care course to introduce students to the concepts before they begin to see patients. In this course, first-year medical students used Aquifer High Value Care cases 1, 6, and 12 to provide foundational knowledge on the tenets of HVC. The material brought up in the cases was then extended through lectures and discussions on topics such as Imaging Wisely, Ordering Wisely, and more. To see how students synthesized all of the information, they were tasked with a Shark Tank project, where they had to find ways to decrease unnecessary tests and treatments for patients. Dr. Pahwa commented “We were able to see that they could put all of the knowledge they got from both the modules and the lectures into their final project.”

Although students did not have much clinical experience when beginning this course, they were able to apply this knowledge when they moved to clinic. “This course provides an opportunity to start the conversation on HVC as early as the first year.” Dr. Pahwa notes. “And this course remains one of the highest-rated in the school.”

Third and Fourth Year Students

Dr. Pahwa also used Aquifer’s High Value Care cases in a unique two-week elective course. Working with Dr. Andrew Parsons from the University of Virginia, Dr. Pahwa implemented a virtual course for third and fourth-year students using a range of resources and culminating with a High Value Care Shark Tank project. To read more about this HVC Shark Tank course and view the complete curriculum for the elective, view Dr. Parsons’ blog “From Health Systems to the Bedside: High-Value Care 101.”

Aquifer Palliative Care

Overview

Aquifer Palliative Care provides foundational knowledge and practical clinical application of the principles of palliative care that every clinician should know to improve outcomes and quality of life for seriously ill patients and their families.

Aquifer – supported by the Arthur Vining Davis Foundations – developed a national, standardized curriculum and online course that addresses critical gaps in palliative care learning across undergraduate medical and health professions education.

Aquifer Palliative Care is part of Aquifer’s Clinical Excellence Case Set, which includes 52 cases covering Palliative Care, Trauma Informed Care, Diagnostic Excellence, High Value Care, Social Determinants of Health, and telemedicine.

Why Primary Palliative Care?

Although palliative care is an established specialty, all clinicians should have the skills to provide patient-centered care. This course focuses on primary palliative care, reaching beyond the specialty—moving toward overcoming clinician shortages, lack of access, and lack of training—to teach what every medical and health professions student should know to improve outcomes and quality of life for seriously ill patients and their families.

Vision: Improve the capacity of the US health professions student to deliver humanistic, compassionate interprofessional care centered around patient goals of care and quality of life by applying evidence-based methods to alleviate the suffering of seriously ill patients and their families through the delivery of primary palliative care.

Just in Time Coverage of Palliative Care Embedded in Select Courses

In addition to the stand-alone cases on Palliative Care included as part of this Clinical Excellence Case Set, select core cases in Pediatrics, Family Medicine, Internal Medicine, Geriatrics, Neurology, and Radiology now have brief teaching on Palliative Care embedded right into the case in the form of a clinical decision making question.

Together the just-in-time curricular threads combined with the deeper principles and application cases provide a strong foundation in Palliative Care across the curriculum without adding faculty time. Learn more…

  • Part of Aquifer’s Clinical Excellence Case Set, included with Curricular Partner subscriptions and available by subscription to Limited Subscribers
  • Designed to equip learners with the knowledge, skills, and attitudes needed to provide patient-centered care to their communities regardless of their future specialty
  • Created for educators, by educators, and supported by the Arthur Vining Davis Foundations
  • Ready-made cases to support self-directed learning, appropriate to supplement pre-clinical or clinical learning
  • Cases take approximately 15-20 minutes to complete.
    • Appropriate to support pre-clinical or clinical learning.
    • Can be combined with other cases in a custom course to meet the needs of your specific curriculum.

Based on a comprehensive needs assessment, the Aquifer Palliative Care Leadership Team determined the Principles of Primary Palliative Care Excellence to elevate the primary palliative care education and training of all US health professions students, regardless of discipline. Each principle supports the advancement of primary palliative care as a competency for all healthcare professionals.

  1. Alignment of care with the goals, values, and preferences of seriously ill patients based on assessed need.
  2. Interprofessional collaboration and care coordination between patients, families, healthcare teams, and systems.
  3. Evidence-based and holistic care that addresses the physical, psychological, social, and spiritual domains across the illness trajectory from diagnosis to end-of-life.
  4. Equitable access to high-quality, culturally sensitive palliative care services for all patient populations.
  5. Education and advocacy to promote palliative care as a gold standard for serious illness care.

The Aquifer Excellence in Palliative Care cases are designed to teach and apply these principles using clinical scenarios.

After the grant award in 2020 from the Arthur Vining Davis Foundations, Aquifer established a Palliative Care Leadership team, a group of interprofessional clinician-educators and content experts representing schools around the US.

In the absence of clear national curricular standards on palliative care in medical and health professions education, the Leadership Team then completed a needs assessment (stakeholder surveys and focus groups) and literature review. After completing the research activities, the leadership team held a consensus conference, synthesizing the literature review and needs assessment findings into a vision statement and key guiding principles.

Using the vision and principles as a framework, the Leadership Team developed a national palliative care curriculum to be delivered through the Aquifer course. Learning objectives were identified, and development work on virtual patient cases began in late 2021. Case development used varied pedagogies to ensure that learners are equipped with the knowledge, skills, and attitudes needed to provide patient-centered care to their communities.

All Clinical Excellence Case Sets, including Aquifer Palliative Care, now include:

  • Principles module: covers key definitions, epidemiology, explanations of key principles and why they are important for patient care, and a harm statement that makes it explicit what harm can come to the patient if the principle is not incorporated into practice.
  • Application Cases: Brief, realistic case scenarios that focus on one area of a patient encounter, and are centered around asking students to make important clinical decisions. Content models evidence-based best practices and communication strategies, exploring the real-world impacts on care and potential harm. At the end of each case, a reflection question asks the students to consider key takeaways, implications for their future practice, or personal wellness. Each application case also includes self-assessment questions that extend the learning to other scenarios.

Aquifer Palliative Care is designed for any level student in a medical school or health professions program. The course is an ideal assignment for students to complete as preparation for clinical experiences that include telemedicine. Cases also serve as valuable reference material for students to return to as they need to refresh their knowledge during clinical rotations.

Programs with a current Aquifer subscription will also have faculty and administrator access to an accompanying educator guide. Subscribers will also be able to view student progress reporting and combine the new cases with other Aquifer content in a custom course.

Available to Aquifer Curricular Partners:

  • 01: Principles of palliative care
  • 02: Palliative care assessment
  • 03: Family meetings and establishing goals of care
  • 04: Advance care planning
  • 05: Interprofessional roles and responsibilities
  • 06: Pharmacologic pain management
  • 07: Supporting patients and families in the grieving process
  • 08: Anxiety and depression in the context of palliative care
  • 09: Understanding disparities in care for patients with serious illness
  • 10: Non-opioid pain management
  • 11: Symptom management (non-pain)
  • 12: Pediatric palliative care
  • 13: Signs and symptoms of dying

Active Learning Modules

Active learning sessions that accompany the Palliative Care course are designed to challenge students to apply what they have learned by studying the Aquifer cases in a real-world scenario. Active learning sessions can be integrated into several clerkships, including Surgery, Internal Medicine, Family Medicine, or an elective in palliative care. These active learning sessions could be completed with inpatients or outpatients.

Palliative Care Project Report

Learn More

On-Demand Webinar

Best Practices & New Tools for Teaching What Every Student Needs to Know About Palliative Care

Podcast

Listen to the Aquifer Educator Connection Podcast with April Zehm, MD, as she describes the Aquifer Palliative Care Leadership team’s creation of a national standardized curriculum and soon-to-be-available online palliative care course focused on preparing students to provide high-quality patient-centered care. She also discusses how faculty can integrate course resources into their pre-clinical and clinical teaching.

Aquifer Telemedicine

Overview

Aquifer Telemedicine provides an overview of key foundational knowledge and skills to help students prepare for telehealth experiences. 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.

Aquifer Telemedicine is part of Aquifer’s Clinical Excellence Case Set, which includes 52 cases covering Palliative Care, Trauma Informed Care, Diagnostic Excellence, High Value Care, Social Determinants of Health, and Telemedine.

Just in Time Coverage of Telemedicine Embedded in Select Cases

In addition to the stand-alone cases on Telemedicine included as part of this Clinical Excellence Case Set, select core cases in Pediatrics, Family Medicine, Internal Medicine, Geriatrics, Neurology, and Radiology now have brief teaching on Telemedicine embedded right into the case in the form of a clinical decision making question.

Together the just-in-time curricular threads combined with the deeper principles and application cases provide a strong foundation in Telemedicine across the curriculum without adding faculty time. Learn more…

  • Part of Aquifer’s Clinical Excellence Case Set, included with Curricular Partner subscriptions and available by subscription to Limited Subscribers
  • Ready-made cases for to support self-directed learning, appropriate to supplement pre-clinical or clinical learning
  • Cases take approximately 15-20 minutes to complete.
  • Appropriate to support pre-clinical or clinical learning.
  • Can be combined with other cases in a custom course to meet the needs of your specific curriculum.

These short cases are a quick and easy way for students to become familiar with the principles and practice of telemedicine through self-directed learning. The cases provide a key base of knowledge, guiding learners through building a patient history based on clinical condition, performing a physical exam, and how to manage a patient and escalate care 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.

Content for these cases is aligned with AAMC telemedicine competencies. Cases were authored and peer-reviewed by medical educator members of the Society for the Teaching of Family Medicine (STFM) and the Clerkship Directors in Internal Medicine (CDIM).

Aquifer Telemedicine provides an efficient solution for covering telemedicine, saving faculty time by providing access to high-quality, ready-made course materials.

All Clinical Excellence Case Sets, including Aquifer Telemedicine, now include:

  • Principles module: covers key definitions, epidemiology, explanations of key principles and why they are important for patient care, and a harm statement that makes it explicit what harm can come to the patient if the principle is not incorporated into practice.
  • Application Cases: Brief, realistic case scenarios that focus on one area of a patient encounter, and are centered around asking students to make important clinical decisions. Content models evidence-based best practices and communication strategies, exploring the real-world impacts on care and potential harm. At the end of each case, a reflection question asks the students to consider key takeaways, implications for their future practice, or personal wellness. Each application case also includes self-assessment questions that extend the learning to other scenarios.

Aquifer Telemedicine is designed for any level student in a medical school or health professions program. The course is an ideal assignment for students to complete as preparation for clinical experiences that include telemedicine. Cases also serve as valuable reference material for students to return to as they need to refresh their knowledge during clinical rotations.

Programs with a current Aquifer subscription will also have faculty and administrator access to an accompanying educator guide. Subscribers will also be able to view student progress reporting and combine the new cases with other Aquifer content in a custom course.

  • Case 1: Principles of Telemedicine
  • Case 2: Building a history
  • Case 3: Performing a physical exam
  • Case 4: Escalating care

Learn More

4 minute video

Learn how Aquifer Foundations of Telemedicine—available free of charge—can benefit students and faculty in your program from course editor Amit Pahwa, MD.

Podcast

Integrating Telemedicine Into Medical Education

Guest: Amit Pahwa, MD, Director, Internal Medicine Sub-Internship, Johns Hopkins Hospital, Associate Professor of Medicine, Johns Hopkins University, Editor-in-Chief, Aquifer Foundations of Telemedicine

In this episode, Dr. Amit Pahwa discusses the development of Aquifer’s new Foundations of Telemedicine course, which is freely available to all teachers and students. Dr. Pahwa talks about the genesis of the courses, how to integrate the courses into your curriculum, how the cases fit different needs of students, and how faculty members can use the cases in their instruction. Due to the rise in the use of telemedicine across all disciplines, these courses are of great importance to all medical professions students. The cases align with the AAMC’s Competencies for Telemedicine.

Full show notes can be found here.

Aquifer Social Determinants of Health

Aquifer Culture in Health Care
Aquifer Culture in Health Care

Aquifer Social Determinants of Health provides foundational knowledge and a framework for building skills that minimize the effects of social determinants of health (SDOH) on health outcomes.

Overview

Aquifer Social Determinants of Health builds a foundational understanding of social determinants of health and teaches evidence-based strategies to help improve health outcomes and equity for patients. By exploring SDOH in the context of a virtual patient case, learners have the opportunity to work through a realistic patient interaction, reflecting on their own implicit biases and cultural awareness and developing communication and clinical skills that identify underlying issues and provide patient-centered care.

Aquifer Social Determinants of Health is part of Aquifer’s Clinical Excellence Case Set, which includes 52 cases covering Palliative Care, Trauma Informed Care, Diagnostic Excellence, High Value Care, Social Determinants of Health, and Telemedine.

What are Social Determinants of Health?

Social determinants of health are the conditions in which people are born, grow, live, work, and age. These circumstances are shaped by the distribution of money, power, and resources at global, national, and local levels. Social determinants of health are a significant cause of health inequities – avoidable and unjust differences in health status seen within and between populations.

Just in Time Coverage of Social Determinants of Health Embedded in Select Courses

In addition to the stand-alone cases on Social Determinants of Health included as part of this Clinical Excellence Case Set, select core cases in Pediatrics, Family Medicine, Internal Medicine, Geriatrics, Neurology, and Radiology now have brief teaching on Social Determinants of Health embedded right into the case in the form of a clinical decision making question.

Together the just-in-time curricular threads combined with the deeper principles and application cases provide a strong foundation in Social Determinants of Health across the curriculum without adding faculty time. Learn more.

  • Part of Aquifer’s Clinical Excellence Case Set, included with Curricular Partner subscriptions and available by subscription to Limited Subscribers
  • Case content focused on learning fundamental communication skills and systems knowledge key to providing care that maximizes health equity
  • A combination of cases, readings, and tools to help students translate skills to clinical practice
  • Ready-made cases to support self-directed learning, appropriate to supplement pre-clinical or clinical learning
  • Cases take approximately 15-20 minutes to complete.
  • Appropriate to support pre-clinical or clinical learning.
  • Can be combined with other cases in a custom course to meet the needs of your specific curriculum.

The overview and resources module provides key foundational learning on SDOH, with definitions, developing an understanding of how cultural beliefs and community culture affect health outcomes, and strategies for improving clinician-patient interactions.

The two virtual patient cases provide an opportunity for students to learn in the context of a realistic patient scenario, working to develop their own cultural awareness, interpersonal skills, and professionalism. Learners are able to practice the application of the information in a safe space, working through patient and family interactions, and practicing using the tools when caring for a patient.

While the patients are children in these cases, the learning objectives are applicable to patients of all ages.

All Clinical Excellence Case Sets, including Social Determinants of Health, now include:

  • Principles module: covers key definitions, epidemiology, explanations of key principles and why they are important for patient care, and a harm statement that makes it explicit what harm can come to the patient if the principle is not incorporated into practice.
  • Application Cases: Brief, realistic case scenarios that focus on one area of a patient encounter, and are centered around asking students to make important clinical decisions. Content models evidence-based best practices and communication strategies, exploring the real-world impacts on care and potential harm. At the end of each case, a reflection question asks the students to consider key takeaways, implications for their future practice, or personal wellness. Each application case also includes self-assessment questions that extend the learning to other scenarios.

Aquifer Social Determinants of Health is designed for any level student in a medical school or health professions program. The course is an ideal assignment for students to complete as preparation for clinical experiences that include telemedicine. Cases also serve as valuable reference material for students to return to as they need to refresh their knowledge during clinical rotations.

Programs with a current Aquifer subscription will also have faculty and administrator access to an accompanying educator guide. Subscribers will also be able to view student progress reporting and combine the new cases with other Aquifer content in a custom course.

  • Case 1: Principles of social determinants of health
  • Case 2: 2-year-old with fever and headache
  • Case 3: 2-year-old with pneumonia and probable empyema

Learn More

3 Minute Video

Learn how Aquifer Social Determinants of Health—available free of charge—can benefit students and faculty in your program from Aquifer’s Chief Academic Officer Sherilyn Smith, MD.

Listen to the Aquifer Educator Connection Podcast with Regina Welkie, MSPAS, PA-C and Emily McSparin, MPA, PA-C, of DeSales Univeristy Physician Assistant Program, as they discuss how they were able to successfully integrate SDOH into a clinical curriculum by incorporating Aquifer cases into a journal club format. The Aquifer cases give students a shared experience and provide a springboard for a broader small group discussion about SDOH concepts they have experienced during clinical rotations. This approach resulted in deep, authentic conversations between students and faculty around the real impacts of SDOH on patient care.

Blog:

What Students are Saying: Social Determinants of Health Cases

Aquifer’s Social Determinants of Health (SDOH) cases focus on helping students improve health outcomes and equity for patients through realistic patient interactions, encouraging students to reflect on their own implicit biases and cultural awareness. These cases are intended to provide foundational knowledge for students, and foster discussion on this essential topic in classroom settings. By developing communication and clinical skills, students can identify underlying issues and provide patient-centered care.

Since the cases launched in July, we’ve had many positive reviews from students through our Student Advisory Group and five-star case rating comments, such as:

“The cases shed light on a really important, sometimes overlooked issue and explained it clearly in a situation that could very well be encountered in real life. This case especially explained what our role as med students is when higher-up professionals do not act in a culturally appropriate manner.” 

Aquifer Diagnostic Excellence

Aquifer Diagnostic Excellence
Aquifer Diagnostic Excellence
In collaboration with: Society to Improve Diagnosis in Medicine
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Overview

The introductory principles module and six virtual patient cases in Aquifer Diagnostic Excellence introduce students to the cognitive processes and system-related issues that can lead to errors.

Diagnostic accuracy is the foundation of safe, effective medicine—yet 15% of inpatient cases involve some degree of diagnostic error. Aquifer Diagnostic Excellence introduces students to the cognitive processes and system-related issues that can lead to errors.

Aquifer Diagnostic Excellence is part of Aquifer’s Clinical Excellence Case Set, which includes 52 cases covering Palliative Care, Trauma Informed Care, Diagnostic Excellence, High Value Care, Social Determinants of Health, and Telemedine.

Medical error is the third leading cause of death in the U.S., causing at least 250,000 deaths every year. Diagnostic error represents anywhere from 40,000 to 80,000 of those deaths, making it the sixth leading cause of death.

Just in Time Coverage of Diagnostic Excellence Embedded in Select Courses

In addition to the stand-alone cases on Diagnostic Excellence included as part of this Clinical Excellence Case Set, select core cases in Pediatrics, Family Medicine, Internal Medicine, Geriatrics, Neurology, and Radiology now have brief teaching on Diagnostic Excellence embedded right into the case in the form of a clinical decision making question.

Together the just-in-time curricular threads combined with the deeper principles and application cases provide a strong foundation in Diagnostic Excellence across the curriculum without adding faculty time. Learn more

  • Part of Aquifer’s Clinical Excellence Case Set, included with Curricular Partner subscriptions and available by subscription to Limited Subscribers
  • Created for educators, by educators, in collaboration with the Society to Improve Diagnosis in Medicine
  • Ready-made cases to support self-directed learning, appropriate to supplement pre-clinical or clinical learning
  • Cases take approximately 15-20 minutes to complete.
  • Appropriate to support pre-clinical or clinical learning.
  • Can be combined with other cases in a custom course to meet the needs of your specific curriculum.

Cases include foundational content about diagnosis, contributing factors, and strategies to avoid errors. Causes and consequences of diagnostic errors for patients, families, and providers are discussed in detail and students are encouraged to reflect on their own experiences. Aquifer Diagnostic Excellence provides tools to help students mitigate diagnostic error.

This cross-disciplinary course covers a range of topics, including internal medicine, surgery, gynecology, psychiatry, family medicine, and pediatrics.

All Clinical Excellence Case Sets, including Diagnostic Excellence, now include:

  • Principles module: covers key definitions, epidemiology, explanations of key principles and why they are important for patient care, and a harm statement that makes it explicit what harm can come to the patient if the principle is not incorporated into practice.
  • Application Cases: Brief, realistic case scenarios that focus on one area of a patient encounter, and are centered around asking students to make important clinical decisions. Content models evidence-based best practices and communication strategies, exploring the real-world impacts on care and potential harm. At the end of each case, a reflection question asks the students to consider key takeaways, implications for their future practice, or personal wellness. Each application case also includes self-assessment questions that extend the learning to other scenarios.

Aquifer Diagnostic Excellence is designed for any level student in a medical school or health professions program. The course is an ideal assignment for students to complete as preparation for clinical experiences that include telemedicine. Cases also serve as valuable reference material for students to return to as they need to refresh their knowledge during clinical rotations.

Programs with a current Aquifer subscription will also have faculty and administrator access to an accompanying educator guide. Subscribers will also be able to view student progress reporting and combine the new cases with other Aquifer content in a custom course.

  • Diagnostic Excellence 01: Principles of diagnostic excellence
  • Diagnostic Excellence 02: 35-year-old male with abdominal pain
  • Diagnostic Excellence 03: 16-year-old female with pelvic pain
  • Diagnostic Excellence 04: 10-year-old male with chronic abdominal pain
  • Diagnostic Excellence 05: 84-year-old female with sepsis
  • Diagnostic Excellence 06: 12-day-old male infant with bloody stool
  • Diagnostic Excellence 07: Two females with iron-deficiency anemia

From Our Cases

Educator Guide & Classroom Activities Available

Course Overview – Integration Strategies – Active Learning Classroom Strategies – Case Details

The Educators Guide—available to institutional subscribers—provides a quick reference guide for all cases and resources included with Aquifer Diagnostic Excellence. Integration strategies and suggestions for custom courses are also included, making it easy to include this key topic in a variety of rotations and courses. The Educator Guide provides a wealth of valuable, engaging Active Learning Classroom Strategies ready to use in your teaching.

The Educator Guide and individual activity worksheets are available in the Educator Resources section of your Aquifer account. Learn more…


Learn More

Learn how Aquifer Diagnostic Excellence can benefit students and faculty in your program:

Testimonials

“My second-year medical students valued learning about diagnostic errors in an interactive manner and appreciated being able to practice clinical reasoning while learning about patient safety.”

Laurie Broutman, MD, FACP Chicago Medical School, Rosalind Franklin University of Medicine and Science

“In our first year using Aquifer Diagnostic Excellence, we noticed that students started talking about types of errors during their clinical presentations. Clearly, it was sinking in! For me, the most rewarding part was seeing a student take what they learned from the course and create a presentation about a clinical case they observed which had a medical error. The presentation included a discussion about steps to minimize errors in the future, such as better hand-offs, clearer documentation, and avoiding diagnostic momentum.”

Darin Brink, MD University of Minnesota Medical School

Aquifer Diagnostic Excellence Course Board

Aquifer Trauma-Informed Care

Overview

11 Trauma-Informed Care virtual patient cases demonstrate the effects of trauma on physical and mental health and ways that clinicians can provide appropriate care to trauma survivors.

Trauma-Informed Care provides a training tool for a broad range of healthcare providers and their staff to learn about the prevalence and impact of trauma and how to integrate the principles of trauma-informed care into clinical practice. By understanding the behavioral, neurological, and health effects of trauma and learning specific communication skills, clinicians can improve their relationships with patients, better engage patients in all aspects of their care, and potentially reduce the risk of their own professional stress and burnout.

Aquifer Trauma-Informed Care is part of Aquifer’s Clinical Excellence Case Set, which includes 52 cases covering Palliative Care, Trauma Informed Care, Diagnostic Excellence, High Value Care, Social Determinants of Health, and telemedicine.

70% of adults in the US have experienced some type of traumatic event at least once in their lives. That’s 223.4 million people.
– The National Council for Behavioral Health

What is Trauma-Informed Care?

Trauma-informed care recognizes the signs, symptoms, and risks of trauma to better support the health needs of patients who have experienced traumatic events. It is an outgrowth of abundant and definitive research findings, such as the Adverse Childhood Experiences (ACE) Study, which demonstrates that exposure to traumatic events is highly prevalent in our society.

Recognizing this relationship between adversity, health, and well-being, Trauma-Informed Care takes the universal precaution approach, which is to assume everyone has experienced some form of trauma, which is essential, given that most patients do not disclose their history of trauma, and likely may not even be aware of the impact it has had on them.

Just in Time Coverage of Trauma-Informed Care Embedded in Select Courses

In addition to the stand-alone cases on Trauma-Informed Care included as part of this Clinical Excellence Case Set, select core cases in Pediatrics, Family Medicine, Internal Medicine, Geriatrics, Neurology, and Radiology now have brief teaching on Trauma-Informed Care embedded right into the case in the form of a clinical decision making question.

Together the just-in-time curricular threads combined with the deeper principles and application cases provide a strong foundation in Trauma-Informed Care across the curriculum without adding faculty time. Learn more…

  • Part of Aquifer’s Clinical Excellence Case Set, included with Curricular Partner subscriptions and available by subscription to Limited Subscribers
  • Cases focus on the impact of trauma and how healthcare practitioners can provide appropriate care for diverse populations
  • Ready-made cases to support self-directed learning, appropriate to supplement pre-clinical or clinical learning
  • Cases take approximately 15-20 minutes to complete.
  • Appropriate to support pre-clinical or clinical learning.
  • Can be combined with other cases in a custom course to meet the needs of your specific curriculum.

Virtual patient case scenarios address a range of 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. 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.

The cases illustrate how trauma-informed care can improve patient-provider rapport, increase patient engagement in preventive care, and facilitate integrated, patient-centered treatment plans.

All Clinical Excellence Case Sets, including Aquifer Trauma-Informed Care, now include:

  • Principles module: covers key definitions, epidemiology, explanations of key principles and why they are important for patient care, and a harm statement that makes it explicit what harm can come to the patient if the principle is not incorporated into practice.
  • Application Cases: Brief, realistic case scenarios that focus on one area of a patient encounter, and are centered around asking students to make important clinical decisions. Content models evidence-based best practices and communication strategies, exploring the real-world impacts on care and potential harm. At the end of each case, a reflection question asks the students to consider key takeaways, implications for their future practice, or personal wellness. Each application case also includes self-assessment questions that extend the learning to other scenarios.

Aquifer Trauma-Informed Care is designed for any level student in a medical school or health professions program. The course is an ideal assignment for students to complete as preparation for clinical experiences that include telemedicine. Cases also serve as valuable reference material for students to return to as they need to refresh their knowledge during clinical rotations.

Programs with a current Aquifer subscription will also have faculty and administrator access to an accompanying educator guide. Subscribers will also be able to view student progress reporting and combine the new cases with other Aquifer content in a custom course.

Trauma-Informed Care 01: Principles of trauma-informed care
Trauma-Informed Care 02: 45-year-old woman with diabetes experiencing stress
Trauma-Informed Care 03: 33-year-old female with insomnia
Trauma-Informed Care 04: 50-year-old female with stress and noncardiac chest pain
Trauma-Informed Care 05: 8-year-old male with asthma
Trauma-Informed Care 06: 48-year-old female coping with HIV
Trauma-Informed Care 07: 58-year-old female veteran with chronic pain
Trauma-Informed Care 08: 58-year-old male with gastrointestinal symptoms
Trauma-Informed Care 09: A rape exam in the emergency department
Trauma-Informed Care 10: Physician with a trauma history
Trauma-Informed Care 11: 78-year old male wellness visit
Trauma-Informed Care 12: 28-year-old pregnant woman with a history of witnessing violence

Aquifer High Value Care

Aquifer High Value Care
In collaboration with: American College of Physicians &
Alliance for Academic Internal Medicine
american-college-of-physicians-crop

Overview

The 12 cross-disciplinary virtual patient cases and introductory principles module in the High Value Care course explore the fundamentals of providing value in health care, adopted from the American College of Physicians (ACP) and the Alliance for Academic Internal Medicine’s (AAIM) High Value Care Resident curriculum.

Aquifer High Value Care teaches students how their decisions about diagnostic testing, care management, and other interventions affect the costs and efficacy of care. Including this curriculum in every healthcare professional’s education is a step toward making high value care a reality in clinical practice.

Aquifer High Value Care is part of Aquifer’s Clinical Excellence Case Set, which includes 52 cases covering Palliative Care, Trauma Informed Care, Diagnostic Excellence, High Value Care, Social Determinants of Health, and Telemedine.

Just in Time Coverage of High Value Care Embedded in Select Courses

In addition to the stand-alone cases on High Value Care included as part of this Clinical Excellence Case Set, select core cases in Pediatrics, Family Medicine, Internal Medicine, Geriatrics, Neurology, and Radiology now have brief teaching on High Value Care embedded right into the case in the form of a clinical decision making question.

Together the just-in-time curricular threads combined with the deeper principles and application cases provide a strong foundation in High Value Care across the curriculum without adding faculty time. Learn more.

  • Part of Aquifer’s Clinical Excellence Case Set, included with Curricular Partner subscriptions and available by subscription to Limited Subscribers
  • Created for educators, by educators, from the ACP-AAIM’s High Value Care Resident Curriculum
  • Ready-made cases to support self-directed learning, appropriate to supplement pre-clinical or clinical learning
  • Cases take approximately 15-20 minutes to complete.
  • Appropriate to support pre-clinical or clinical learning.
  • Can be combined with other cases in a custom course to meet the needs of your specific curriculum.

Aquifer High Value Care consists of innovative, cross-discipline, case-based modules that begin teaching the fundamentals of value in health care. The modules include short interactive virtual patient cases, brief instructional videos, key teaching points, and embedded links so that students can apply principles from the HVC modules to other cases. Topics include: making your diagnostic testing count, adult preventative care, insurance, statistics and clinical decision making, and more.

All Clinical Excellence Case Sets, including High Value Care, now include:

  • Principles module: covers key definitions, epidemiology, explanations of key principles and why they are important for patient care, and a harm statement that makes it explicit what harm can come to the patient if the principle is not incorporated into practice.
  • Application Cases: Brief, realistic case scenarios that focus on one area of a patient encounter, and are centered around asking students to make important clinical decisions. Content models evidence-based best practices and communication strategies, exploring the real-world impacts on care and potential harm. At the end of each case, a reflection question asks the students to consider key takeaways, implications for their future practice, or personal wellness. Each application case also includes self-assessment questions that extend the learning to other scenarios.

Aquifer High Value Care is designed for any level student in a medical school or health professions program. The course is an ideal assignment for students to complete as preparation for clinical experiences that include telemedicine. Cases also serve as valuable reference material for students to return to as they need to refresh their knowledge during clinical rotations.

Programs with a current Aquifer subscription will also have faculty and administrator access to an accompanying educator guide. Subscribers will also be able to view student progress reporting and combine the new cases with other Aquifer content in a custom course.

  • High Value Care 01: Principles of high value care
  • 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
  • High Value Care 10: 16-year-old female – Statistics and clinical decision making
  • High Value Care 11: 17-year-old female – High value care reproductive health care
  • High Value Care 12: 17-year-old female – Paying for value: Insurance Part 2
  • High Value Care 13: 45-year-old male – The importance of clinical reasoning

From Our Cases

Educator Guide Available

Course Overview – Integration Strategies – Real World Application Activities – Case Details

The Educators Guide—available to institutional subscribers—provides a quick reference guide for all cases and resources included with Aquifer High Value Care. Integration strategies and suggestions for custom courses are also included, making it easy to include this key topic in a variety of rotations and courses. The Educator Guide provides a wealth of valuable, engaging Real World Application Activities ready to use in your teaching.

The Educator Guide and individual Real World Application Activities are available in the Educator Resources section of your Aquifer account. Learn more…

User Story Video

Learn how Aquifer High Value Care—available free of charge—can benefit students and faculty in your program:

Testimonial

“Aquifer High Value Care was an incredibly helpful resource. High Value Care is introduced in the first and second years of medical school only as a concept. I completed the first Aquifer High Value Care case and I was hooked. The cases are built very well, and I was able to learn efficiently. I was impressed with the content and the course’s ability to bring together information that would have taken me days to compile. The hyperlinks to online resources were invaluable.”

  Third-Year Medical Student

Aquifer High Value Care Course Board