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 Excellence in Palliative Care

Available July 1, 2022 for Aquifer Curricular Partners
Aquifer Excellence in 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.

Overview

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

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.

Learn More

As of July 1, Excellence in Palliative Care will be available for subscription as part of Aquifer’s Clinical Excellence Case Sets offering. Paired with other key interdisciplinary topics, this new package provides access to 52 short cases. As part of this upgrade, a new principles module will also be added to Aquifer Excellence in Palliative Care. Learn more…

Palliative Care Project Report

  • Available by subscription as of July 1, 2023, as part of Aquifer’s Clinical Excellence Case Sets
  • Designed to equip learners with the knowledge, skills, and attitudes needed to provide patient-centered care to their communities regardless of their future specialty
  • New Aquifer course structure begins with a principles module, defining key principles, their value, and potential harm to patients if they are not understood
  • Application cases are short (15 minutes), realistic clinical scenarios with opportunities to explore constructive communication strategies, answer an interactive question about a key clinical decision in the case, consider impacts on care, and engage in reflective practice
  • Created for educators, by educators, and supported by the Arthur Vining Davis Foundations
  • Self-assessment questions emphasize key content and enable students to test their knowledge and skills
  • Proven pedagogy that standardizes experiences—overcoming geography, seasonality, and accessibility
  • Evidence-based, peer-reviewed, and continuously updated content
  • A wealth of source material—including embedded assessment questions and full references—in each case
  • Delivered via the Aqueduct teaching and learning platform, which includes user management tools, easy reporting on student progress and course usage, plus tools for creating custom courses to match a specific curriculum

Aquifer Excellence in Palliative Care debuts a new, streamlined course and case structure, delivering shorter, focused cases. Cases take approximately 15 minutes to complete.

The course begins with one principles module, which covers key definitions, epidemiology, explanation 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.

After completing the principles module, students unlock additional application cases that explore realistic case scenarios, similar to other Aquifer cases. Application cases are concise and focus on one area of a patient encounter, and are centered around a key clinical decision question. Content models evidence-based best practices and communication strategies, and explores the real-world impacts on care and potential harm. At the end of the 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 Excellence in Palliative Care is designed for any level student in a health professions program. Cases can be used to introduce principles and applications for pre-clinical students, reinforce concepts during relevant clerkships and electives, and support palliative care and hospice rotations.

Prior to the development of the course, a needs assessment was conducted. Students reported a strong desire for longitudinal education in palliative care to help their skills and understanding evolve.

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.

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 is nearing completion using varied pedagogies to ensure that learners are equipped with the knowledge, skills, and attitudes needed to provide patient-centered care to their communities.

Available to Aquifer Curricular Partners:

  • 01: Principles of palliative care
  • 02: Palliative care assessment
  • 03: Family meetings & establishing goals of care
  • 04: Advance care planning
  • 05: Interprofessional roles & responsibilities
  • 06: Pharmacologic pain management
  • 07: Supporting patients & 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

Accessing the Cases

Aquifer Excellence in Palliative Care is currently available for Curricular Partners (programs subscribing to all five of Aquifer’s signature courses). Individual subscriptions will be available in early 2023. Note: Individual subscriptions include student access only – administrative reporting, content library, custom courses, and user management tools are not included with this access.

Active Learning Modules

These new active learning sessions that accompany the Excellence in 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.

Learn More

Introduction Video
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 Foundations of Telemedicine

Overview

Aquifer Foundations of 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.

Coming July 1: New Access

As of July 1, Foundations of Telemedicine will be available for subscription as part of Aquifer’s Clinical Excellence Case Sets offering. Paired with other key interdisciplinary topics, this new package provides access to 52 short cases. Learn more…

  • Available by subscription as of July 1, 2023, as part of Aquifer’s Clinical Excellence Case Sets
  • Short cases using videos to model best practices, communication techniques, and management guidelines
  • Ready-made course for self-directed learning that provides a strong basis from which to develop clinical skills
  • Proven pedagogy that standardizes experiences—overcoming geography, seasonality, and accessibility
  • Evidence-based, peer-reviewed, and continuously updated content
  • A wealth of source material, embedded reflection questions, and full references in each case
  • Delivered via the Aqueduct teaching and learning platform, which includes user management tools, easy reporting on student progress and course usage, plus tools to create custom courses to match a 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).

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

Coming July 1: New Module & Course Structure

All Clinical Excellence Case Sets, including Foundations of Telemedicine, will follow a new course structure.

Students being with a principles module which 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.

After completing the principles module, students unlock additional application cases (the existing Foundations of Telemedicine cases) that explore realistic case scenarios. Application cases are concise and 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 Foundations of 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: Introduction to Telemedicine

  • List the benefits and indications for telemedicine visits.
  • List the types of visits that are appropriate for telemedicine encounters.
  • Describe how to prepare the environment for a telemedicine visit.
  • Define the components of consent for a telemedicine encounter.
  • Discuss barriers to using telemedicine to provide care.
  • List documentation needed for a telemedicine encounter.

Case 2: Building a History

  • Discuss methods to ensure appropriate “telepresence” during a telemedicine encounter.
  • Compare and contrast building a history during in-person and telemedicine visits.

Case 3: Performing a Physical Exam

  • List strategies to optimize the physical examination during telemedicine visits.
  • Compare types of physical examination approaches that are appropriate for telemedicine visits.

Case 4: Escalating Care

  • Proactively consider the potential need to triage from telemedicine to in-person.
  • Identify appropriate history elements to obtain during a telemedicine visit.
  • Discuss indications and methods to escalate care.
  • Accurately report history and physical findings from a telemedicine encounter.

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.

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.

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 mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries.

Coming July 1: New Module & Access

As of July 1, Social Determinants of Health will be available for subscription as part of Aquifer’s Clinical Excellence Case Sets offering. Paired with other key interdisciplinary topics, this new package provides access to 52 short cases. As part of this upgrade, a new principles module will also be added to Aquifer Social Determinants of Health. Learn more…

  • Available by subscription as of July 1, 2023, as part of Aquifer’s Clinical Excellence Case Sets
  • 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
  • Proven pedagogy that standardizes experiences—overcoming geography, seasonality, and accessibility
  • Evidence-based, peer-reviewed, and continuously updated content
  • A wealth of source material, embedded reflection questions, and full references in each case
  • Delivered via the Aqueduct teaching and learning platform, which includes user management tools, easy reporting on student progress and course usage, plus tools to create custom courses to match a 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 application of the information in a safe space, working through patient and family interactions and to practice 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.

Coming July 1: New Module & Course Structure

All Clinical Excellence Case Sets, including High Value Care, will follow a new course structure.

A new principles module will be added to the course, which 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.

After completing the principles module, students unlock additional application cases (the existing High Value Care cases) that explore realistic case scenarios. Application cases are concise and 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.

Programs with a current Aquifer subscription will also have faculty and administrator 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 combine the new cases with other Aquifer content in a custom course.

While Aquifer Social Determinants of Health is designed for independent study, students may benefit from a combination of approaches to instruction. Educators can link the course to other learning opportunities within the clinical or didactic curriculum, such as using cases as a common clinical encounter for discussion or creating assignments around the case content.

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 new Social Determinants of Health course includes reframed versions of two former Culture in Health Care cases. The two 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 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. 

View a full list of side-by-side learning objectives for Aquifer Culture in Healthcare and Social Determinants of health.

Case 1: Overview & Resources

  • Give examples of health care disparities.
  • Define health equity.
  • Define social and structural determinants of health.
  • Discuss community culture and medical culture and their impact on patient health.
  • Outline strategies to manage bias and power differentials in the clinician-patient interaction.
  • Discuss health beliefs and their impact on health care outcomes.

Case 2: 2-year-old with fever and headache

Covering language as a social determinant of health

  • Reflect on cultural norms to work toward cultural self-awareness.
  • Use negotiating and problem-solving skills in shared decision-making with patients using the LEARN model to foster shared decision making.
  • List factors related to language that affect clinician-patient communication and explain their effect on health care outcomes.
  • Identify situations where use of an interpreter is indicated and recognize how both clinician and patient comfort and desire to use an interpreter can impact care.
  • Outline elements of professional behavior in caring for patients with language barriers.

Case 3: 2-year-old with pneumonia

Covering poverty as a social determinant of health

  • Identify and address personal biases.
  • Identify strategies to improve and maximize communication.
  • Define poverty and discuss its impact on health care outcomes.
  • List strategies to assess and mitigate the effect of poverty on health care outcomes.

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

Overview

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

Coming July 1: New Module & Access

As of July 1, Diagnostic Excellence will be available for subscription as part of Aquifer’s Clinical Excellence Case Sets offering. Paired with other key interdisciplinary topics, this new package provides access to 52 short cases. As part of this upgrade, a new principles module will also be added to Aquifer Diagnostic Excellence, as well as additional self-assessment questions for each of the six current cases. Learn more…

  • Created for educators, by educators, in collaboration with the Society to Improve Diagnosis in Medicine
  • Available by subscription as of July 1, 2023, as part of Aquifer’s Clinical Excellence Case Sets
  • Proven pedagogy that standardizes experiences—overcoming geography, seasonality, and accessibility
  • Evidence-based, peer-reviewed, and continuously updated content
  • A wealth of source material, embedded assessment questions, and full references in each case
  • Foundational, interactive, realistic education about the diagnostic process, as well as how breakdowns in the process lead to diagnostic errors
  • Delivered via the Aqueduct teaching and learning platform, which includes user management tools, easy reporting on student progress and course usage, plus tools for creating custom courses to match a 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.

Coming July 1: New Module & Course Structure

All Clinical Excellence Case Sets, including Diagnostic Excellence, will follow a new course structure.

A new principles module will be added to the course, which 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.

After completing the principles module, students unlock additional application cases (the existing Diagnostic Excellence cases) that explore realistic case scenarios. Application cases are concise and 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.

Clinical rotations are a key time to introduce students to the factors that underlie diagnostic error and to help them develop skills to mitigate errors.

These cases can be easily integrated into health professions educational programs. Successful examples of integration include use in pre-clinical patient safety courses, implementation in longitudinal integrated clerkships, use in Capstone courses, and integration into traditional block curricula. With Aqueduct, it’s easy to combine these cases with another course to build a custom curriculum.

Diagnostic Excellence 01: Two females with iron-deficiency anemia

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

From Our Cases

Updated 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—available free of charge—can benefit students and faculty in your program:

Aquifer Diagnostic Excellence Course Board

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.

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 Trauma-Informed Care

Now Available to Aquifer Curricular Partners & by Individual Subscription

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.

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 demonstrate that exposure to traumatic events is highly prevalent in our society.

Recognizing this relationship among 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.

Overview

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. 

Coming July 1: New Module & Access

As of July 1, Trauma-Informed Care will be available for subscription as part of Aquifer’s Clinical Excellence Case Sets offering. Paired with other key interdisciplinary topics, this new package provides access to 52 short cases. As part of this upgrade, a new principles module will also be added to Aquifer Trauma-Informed Care. Learn more…

  • Available by subscription as of July 1, 2023, as part of Aquifer’s Clinical Excellence Case Sets
  • Created for educators, by educators, to cover key content in a critically important topic in health care education
  • Cases focus on the impact of trauma and how health care practitioners can provide appropriate care for diverse populations
  • Proven pedagogy that standardizes experiences—overcoming geography, seasonality, and accessibility
  • Evidence-based, peer-reviewed, and continuously updated content
  • Self-assessment questions emphasize key content and enable students to test their knowledge and skills
  • A wealth of source material, tools, and full references in each case
  • Delivered via the Aqueduct teaching and learning platform, which includes user management tools, easy reporting on student progress and course usage, plus tools for creating custom courses to match a 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.

Each Trauma-Informed Care virtual patient case is estimated to take about fifteen minutes to complete. 

Coming July 1: New Module & Course Structure

All Clinical Excellence Case Sets, including Trauma-Informed Care, will follow a new course structure.

A new principles module will be added to the course, which 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.

After completing the principles module, students unlock additional application cases (the existing Trauma-Informed Care cases) that explore realistic case scenarios. Application cases are concise and 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.

These cases are an ideal addition in a variety of settings throughout the medical and health professions curriculum.

For pre-clerkship students, real-life examples and a safe space to practice applying concepts from a lecture or group activities will solidify their understanding prior to seeing patients.

Leveraging this content in core clinical rotations (such as pediatrics, family medicine, internal medicine, psychiatry, and women’s health) is an ideal way to prepare students for patient care, as a realistic experience to gain a deeper understanding as part of a core curriculum didactic series or a post-encounter learning experience. 

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 are multi-disciplinary, thus providing an opportunity for all levels of students to understand how teams work together to care for patients. This content could be woven in during sessions focusing on interprofessional teams, as preparation for clinical rotations, or in capstone courses.

Trauma-Informed Care 01: 28-year-old pregnant woman with a history of witnessing violence
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 non-cardiac 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

Accessing the Cases

Aquifer Curricular Partners (programs that subscribe to all five Aquifer signature courses) will have access to Aquifer Trauma-Informed Care on July 1, 2022.

Individual subscriptions will also be available on July 1, 2022, to all teachers and learners, in order to make this content available to teachers and learners as soon as possible. Note: Individual subscriptions include student access only – administrative reporting, content library, custom courses, and user management tools are not included with this access.

Aquifer plans to offer access to Trauma-Informed Care content by institutional subscription for the 2022-23 subscription year.

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

The 12 cross-disciplinary virtual patient cases 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.

Overview

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 health care professional’s education is a step to making high value care a reality in clinical practice.

Aquifer High Value Care cases take an average of 15 minutes for students to complete.

Coming July 1: New Module & Access

As of July 1, High Value Care will be available for subscription as part of Aquifer’s Clinical Excellence Case Sets offering. Paired with other key interdisciplinary topics, this new package provides access to 52 short cases. As part of this upgrade, a new principles module will also be added to Aquifer High Value Care. Learn more…

  • Created for educators, by educators, from the ACP-AAIM’s High Value Care Resident Curriculum
  • Available by subscription as of July 1, 2023, as part of Aquifer’s Clinical Excellence Case Sets.
  • Proven pedagogy that standardizes experiences—overcoming geography, seasonality, and accessibility
  • Evidence-based, peer-reviewed, and continuously updated content
  • A wealth of source material, embedded assessment questions, and full references in each case
  • Delivered via the Aqueduct teaching and learning platform, which includes user management options, easy reporting on student progress and course usage, plus tools for creating custom courses to match a 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.

Coming July 1: New Module & Course Structure

All Clinical Excellence Case Sets, including High Value Care, will follow a new course structure.

A new principles module will be added to the course, which 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.

After completing the principles module, students unlock additional application cases (the existing High Value Care cases) that explore realistic case scenarios. Application cases are concise and 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.

This course is excellent learning tool that can be used alone or combined into a custom curriculum in Aqueduct.  Aquifer High Value Care is available free of charge for all teachers and learners. Programs and individuals can both access the content to supplement clinical learning.

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

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

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