Orienting Your Students to Aquifer

Review the Aquifer educational goals with your students and articulate how you have chosen to incorporate them into your own course goals. Discuss how the cases will advance their understanding of the foundational concepts and clinical skills within your course.

While many educators require students to complete all cases in an Aquifer course, the majority of subscribers find that selecting one case per week is the optimal strategy. Other approaches include assigning specific cases to fill an important gap in clinical experience or in faculty teaching expertise, or assigning a specified number of cases of the student's choosing.

Students are welcome to complete the remaining cases as needed. You may also wish to make your students aware of any additional courses available with your subscription.

Regardless of your approach, ensure that your students clearly understand your expectations at the beginning of the course.

Most educators choose to use our student reports feature to monitor students' case progress and engagement. Many educators document case completion to meet institutional or accreditation requirements. Be clear with students at the beginning of your course that you will be monitoring their progress, as well as how and when they will be notified if they are falling behind, or devoting insufficient time and attention to the cases.

To assist students in pacing themselves through the cases, many educators assign a minimum number of cases to be completed each week. Additionally, best practice suggests requiring students to complete a specific case prior to a didactic session or related clinical experience. Ensure students understand that case completion is a requirement and will be monitored through the student log report.

Our cases are very effective for self-directed learning and independent study. However, proactive students can further their understanding by intentionally integrating their learning from the cases with their clinical experiences. Consider suggesting these methods during your orientation.

• Complete or review Aquifer cases before or after seeing a patient with a similar presenting problem.
• Compare and contrast the presenting finding from an Aquifer case with their patients' presentation.
• Apply the Aquifer clinical reasoning approach to their patient presentations and write-ups.
• Use the Aquifer summary statement rubric when writing summary statements in the patient record.
• Review their questions about the cases with their preceptors or teaching residents.
• Apply practice guidelines identified in the cases to their own patients.

Our research has shown that intentionally building time into your course for students to work on the cases is a critical integration factor (Berman et al, Academic Medicine Academic Medicine 84(7):942-949, 2009). Identifying and listing time to work on the cases in your course calendar is a straightforward method to make this time clear to students.

Integrating assessments closes the curricular loop and demonstrates to students that you value both the Aquifer content and their time spent engaging with the cases. In addition to our Calibrate Formative Assessment, some programs assign the Aquifer Clinical Decision Making Exam for Internal Medicine as a summative assessment. Programs also leverage PracticeSmart, Aquifer’s customizable clinical question bank and quiz generator tool, to support self-directed learning and formative assessment.

Other ways programs incorporate Aquifer into grading and assessment include counting case completion as part of the course grade, reviewing students' Summary Statement responses in comparison to expert examples, assigning students to complete the Case Analysis Tool (CAT), or asking them to deliver oral reports on Aquifer cases, approaching them as standardized patient encounters. Setting clear expectations early on for how Aquifer work will be assessed helps focus student attention and deepens engagement throughout the course.