Integrated Illness Scripts
Integrated Illness Scripts are designed specifically to promote cognitive integration and provide a framework for learners to link basic science and clinical knowledge.
In collaboration with:
Making Connections for Deeper Understanding & Better Clinical Decisions
Bringing together clinical features, epidemiology, and basic science causal mechanisms and core concepts, Integrated Illness Scripts provide a new mental model for advancing cognitive integration in learners and unpacking encapsulated expertise from faculty. This new framework is designed to enable more effective and efficient clinical decision-making.
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Trusted Content & Pedagogy
Designed for IntegrationThe first tools designed specifically for integrating basic and clinical sciences in a variety of learning environments.
For Educators, By Educators
Teams of interdisciplinary educators developed and reviewed content that meets the needs of today’s faculty and students.
Nationally Developed Tools
Fully vetted teaching tools provide a framework that can be applied and adapted to fit the needs of your program.
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What is Cognitive Integration?
Cognitive integration is a process that occurs in the minds of learners and experts as they interweave relevant basic science and clinical knowledge when reasoning through a patient problem.
Research shows that the effective cognitive integration of basic and clinical science improves diagnostic accuracy, particularly in novice clinicians.
To learn more, we recommend downloading our white paper, “Fostering Cognitive Integration & Unpacking Expertise: The Need for Integrated Illness Scripts in Medical and Health Professions Education.”
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Webinars & Webshops
Webinar: Integrating Basic Science and Clinical Education: Why It’s Important & Tools to Support You
Join Leslie Fall, MD, and Amy Wilson-Delfosse, PhD, with guest presenters Esther Dasari Dale, PhD, and Khiet Ngo, DO, MS, as they discuss the importance of integration of basic science and clinical education, the Aquifer Sciences initiative in collaboration with IAMSE (International Association of Medical Science Educators) to build a national basic science curriculum, and the Integrated Illness Scripts resources from Aquifer.
Table of Contents:
- 0:00 – Introductions
- 4:33 – Agenda
- 6:40 – Barriers to Integration
- 8:50 – Building a national sciences curriculum
- 16:37 – Importance of Improving Cognitive Integration
- 24:33 – Curriculum Database in use with Esther Dasari Dale, PhD
- 30:53 – Anatomy of an Integrated Illness Script
- 37:42 – Integrated Illness Scripts in Preclinical with Leslie Fall, MD
- 39:24 – Integrated Illness Scripts in Clinical Year with Amy Wilson-Delfosse, PhD
- 42:56 – Integrated Illness Scripts Across the Curriculum with Khiet Ngo, DO, MS
- 46:50 – Aquifer Tools for Cognitive Integration
- 48:45 – Q&A
- 57:00 – Resources
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Development & Contributors
Authors
The Aquifer Sciences Integrated Illness Scripts were created through a national, multi-institution authoring project. Following a national Call for Participation, teams from six schools were selected to draft Integrated Illness Scripts on common conditions seen in core rotations, leveraging the Aquifer Sciences Open Curriculum Database. Teams at each institution included clinician educators, basic science faculty, and medical students.
Integrated Illness Script Authoring Schools:
- Albert Einstein College of Medicine
- Case Western Reserve University School of Medicine
- Loma Linda University School of Medicine
- Philadelphia College of Osteopathic Medicine
- University of Utah School of Medicine
- Western Michigan University Homer Stryker MD School of Medicine
Peer Review Process
Following the completion of the authoring process, each script underwent an extensive peer review process that included subject experts from the Aquifer Sciences Leadership Team and basic science and clinician educators.
Aquifer is grateful for the hard work of all of our contributors on this project and looks forward to making these important new teaching and learning tools available.
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Integrated Illness Scripts
- ABO Hemolytic Disease of the Newborn
- Alzheimer Disease
- Appendicitis
- Asthma
- Atherosclerotic Coronary Artery Disease (ACAD)
- Cholecystitis (Acute)
- Choledocholithiasis
- Chronic Obstructive Pulmonary Disease (COPD)
- Crohn Disease
- Deep Vein Thrombosis – Lower Extremity (DVT)
- Diabetes Mellitus – Type 1 (T1DM)
- Diabetes Mellitus – Type 2 (T2DM)
- Diabetic Ketoacidosis (DKA)
- Encephalitis (Viral)
- Gastroesophageal Reflux Disease (GERD)
- Heart Failure
- Hepatitis A Viral Infection
- Herpes Zoster (Shingles)
- Infantile Hypertrophic Pyloric Stenosis
- Influenza
- Meningitis (Bacterial)
- Myocardial Infarction (with ST-Segment Elevation) (MI)
- Myocardial Ischemia
- Newborn Jaundice – Breastfeeding
- Newborn Jaundice – Physiologic
- Osteoarthritis
- Pancreatitis (Acute)
- Parkinson Disease
- Pneumonia
- Pneumothorax
- Pulmonary Embolism (PE)
- Rheumatoid Arthritis
- Shock – Cardiogenic
- Shock – Hypovolemic
- Shock – Septic
- Stroke – Hemorrhagic (Intracerebral – Left Putamen)
- Stroke – Ischemic (Left Middle Cerebral Artery)
- Transient Ischemic Attack (Left Middle Cerebral Artery)
- Ulcerative Colitis
- Urinary Tract Infection: Acute Cystitis
- Urinary Tract Infection: Pyelonephritis
Epidemiology
Epidemiology
Provides the public health context of the condition, covering gender, peak incidence, risk factors, and predisposing conditions related to this diagnosis.
Clinical Features
Clinical Features
Within each clinical feature (up to 6), the Integrated Illness Script describes the underlying basic science causal mechanisms that explain why a patient with that diagnosis displays that clinical finding.
Implications for Further Workup
Further workup
Provide students an opportunity to reflect and take notes on how this knowledge will influence their clinical practice in diagnosing and treating a patient with this condition.
Mechanism of Disease Maps
Mechanism of Disease Maps
Trace the steps of pathophysiologic mechanisms from the underlying causes of disease to the observable and measurable clinical signs and symptoms.
Available for Aquifer Curricular Partners & Individual Subscribers
Building on the traditional illness script format, Integrated Illness Scripts (IIS) embed basic science core concepts and causal mechanisms within each clinical feature and display the connections visually through Mechanism of Disease Maps.
For each condition, Integrated Illness Scripts include:
Overview – Epidemiology – Clinical Features (up to 6) – Implications for Further Work Up – Implications for Management – Mechanism of Disease Maps
Epidemiology
This section provides the public health context of the condition, covering gender, peak incidence, risk factors, and predisposing conditions related to this diagnosis.
Clinical Features

For the given diagnosis, the Integrated Illness Script includes six prototypical clinical features seen commonly in patients with this condition.
Within each clinical feature, the Integrated Illness Script describes the underlying basic science causal mechanisms that explain why a patient with that diagnosis displays that clinical finding.
Mechanism of Disease Maps
Mechanism of Disease Maps trace the steps of pathophysiologic mechanisms from the underlying causes of disease to the observable and measurable clinical signs and symptoms.
Providing a visual representation of the relationship between the “original insult”, key findings, clinical features, and the basic science mechanisms, MOD Maps enable students to see and integrate a more holistic view of the basic science knowledge relevant to the given condition.
Implications for Management & Further Work Up
These sections provide students an opportunity to reflect and take notes on how this knowledge will influence their clinical practice in diagnosing and treating a patient with this condition. Responses to these sections are visible in reports for both students and faculty.

Aquifer Sciences Board
Kathryn Miller, MD
Course Board: Aquifer Sciences
Role: Co-Editor-in-Chief – Clinical
Institution: University Hospitals
Leah Sheridan, PhD
Course Board: Aquifer Sciences
Role: Co-Editor-in-Chief
Former Role: Science Lead
Institution: Ohio University Heritage College of Osteopathic Medicine
Institutional Title: Professor of Physiology
Institutional Role: Faculty, Instructor of Record Preclinical Curriculum
Youngjin Cho, PhD
Course Board: Aquifer Sciences
Role: Associate Editor and Curriculum Lead
Former Role: Sciences Curriculum Editorial Board Discipline Lead
Institution: Geisinger Commonwealth School of Medicine
Institutional Title: Associate Professor of Immunology
Institutional Role: Longitudinal Curriculum Lead for Immunology, Director of Integrated Science Course
Esther Dale, PhD
Course Board: Aquifer Sciences
Role: Associate Editor, Assessment Lead
Institution: University of Minnesota Medical School
Institutional Title: Director of Psychometric Assessment
Eve Gallman, PhD
Course Board: Aquifer Sciences
Role: Associate Editor
Institution: AU-UGA Medical Partnership
Institutional Title: Associate Professor, Medical Neuroscience
Caroline Gundler, PhD
Course Board: Aquifer Sciences
Role: Associate Editor
Institution: Ohio University Heritage College of Osteopathic Medicine
Institutional Title: Assistant Professor of Medical Instruction, Department of Biomedical Sciences
David Harris, PhD
Course Board: Aquifer Sciences
Role: Associate Editor
Former Role: Science Lead
Institution: University of Central Florida College of Medicine
Institutional Title: Professor of Physiology
Institutional Role: Director, Longitudinal Curricular Integration
Julie Kerry, PhD
Course Board: Aquifer Sciences
Role: Associate Editor, Adoption & Use
Former Roles: Molecular Biology Lead for Aquifer Sciences Curriculum Integrated Illness Scripts: Ulcerative Colitis, Pneumonia, Crohn’s Disease, Meningitis (Bacterial), Influenza, Encephalitis (Viral), Zoster
Science Integration: Alzheimer Disease, Strep Throat, Influenza
Institution: Eastern Virginia Medical School
Institutional Title: Professor and Chair of Microbiology and Molecular Cell Biology
Kristal Montano, MD, MEd
Course Board: Aquifer Sciences
Role: Associate Editor
Former Roles: Pediatric Assessment Author, Sciences Clinical Integration Editor for Pediatric Cases 20, 30 and 23
Institution: University of New Mexico School of Medicine
Institutional Title: Associate Professor of Pediatrics
Jinen Thakkar, MD
Course Board: Aquifer Sciences
Role: Associate Editor
Institution: Brown University
Institutional Role: Assistant Professor in Medicine
Grace Park, MD
Course Board: Aquifer Sciences
Role: Associate Editor, Adoption and Use
Institution: Carle Illinois College of Medicine University of Illinois Urbana-Champaign
Institutional Title: Clinical Associate Professor
Institutional Role: Medical Education Facilitator and Health Systems Science Thread and Block 1 Director
Jennifer Yoest, MD
Course Board: Aquifer Sciences
Role: Associate Editor
Institution: Carle Illinois College of Medicine University of Illinois Urbana-Champaign
Institutional Title: Assistant Professor
Access Integrated Illness Scripts
Aquifer Curricular Partners enjoy free access to all 40+ Integrated Illness Scripts.

