Clinical Excellence Case Set
Aquifer Palliative Care
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.
Demo a Case
Demonstration Cases for Public Use
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.
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Key Features
- 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.
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Course Content
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.
- Alignment of care with the goals, values, and preferences of seriously ill patients based on assessed need.
- Interprofessional collaboration and care coordination between patients, families, healthcare teams, and systems.
- Evidence-based and holistic care that addresses the physical, psychological, social, and spiritual domains across the illness trajectory from diagnosis to end-of-life.
- Equitable access to high-quality, culturally sensitive palliative care services for all patient populations.
- 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.
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Development Process
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.
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Course Structure
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.
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Curriculum Integration
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.
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Case List
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
On-Demand Webinar
Best Practices & New Tools for Teaching What Every Student Needs to Know About Palliative Care
Susan Merel, MD
University of Washington
Barbara Reville, DNP, ANP, ACHPN
Harvard Medical School Center for Palliative Care
Podcast
April Zehm, MD discusses how faculty can integrate Palliative Care course resources into their pre-clinical and clinical teaching.
April Zehm, MD
Assistant Professor
Medical College of Wisconsin

I like that these cases are real-life scenarios and very applicable to the patients I see in clinic with my mentors. I feel just by doing these cases in a few days, my experience in family medicine has improved by leaps and bounds and my mentors can see a marked improvement and change in me, even down to how I interact with patients and present myself. Thank you so much Aquifer, you're a lifesaver!
In the first and second years of medical school, you learn a lot about physiology and diseases—usually by organ system. Aquifer Family Medicine gives you the opportunity to start thinking about the way that patients actually present—and begin to apply what you already know. The cases are a wonderful way to start turning medical facts into clinical judgment. I just wished I had used them earlier and more often.
Aquifer Clinical Excellence Course Board
Heather Harrell, MD, FACP
Course Board: Aquifer Clinical Excellence
Role: Editor in Chief
Institution: University of Florida
Institutional Title: Professor of Medicine and Associate Dean of Medical Education
Lauren Azevedo, DO, MS, FAAP
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: Michigan State University
College of Osteopathic Medicine
Institutional Title: Assistant Dean
Kelsey Dougherty, MMSc, PA-C
Course Board: Aquifer Pediatrics
Role: Associate Editor
Institution: University of Colorado Child Health Associate/Physician Assistant Program (CHAPA)
Institutional Title: Assistant Professor
Patricia Griffith, PhD, CRNP, ACNP-BC
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: University of Pennsylvania
Institutional Title: Practice Associate Professor, Associate Director AGACNP Program
Jennifer Grumet, MD
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: Chapman University / PA Studies Program
Institutional Title: Clinical Associate Professor, Director of Admissions, Assistant Clinical Coordinator
Nivedita Gunturi, MD
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: Rush University Medical Center
Institutional Title: Assistant Program Director, Assistant Professor
Kathryn Holliday, DNP, CPNP- PC, CNE, CHSE
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: SUNY Upstate Medical University, College of Nursing
Institutional Title: Clinical Assistant Professor
Kate LaPorta, MHS, PA-C
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: University of Colorado CHA/PA Program
Institutional Title: Assistant Professor
Townes R. Leigh, Jr., DO, CAQSM, FAAFP
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: Sam Houston State University College of Osteopathic Medicine
Institutional Title: Assistant Professor of Family Medicine/Sports Medicine, Program Director SHREC Sports Medicine Fellowship
Juan Lessing, MD
Current Role: Associate Editor
Course Board: Aquifer Clinical Excellence
Institution: University of Colorado School of Medicine
Institutional Title: Associate Professor, Medicine-Hospital Medicine
J'Aimee Lippert, DO
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: Michigan State University College of Osteopathic Medicine
Institutional Title: Associate Dean of Admissions and Student Affairs
Jamie Macklin, MD, MPH
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: The Ohio State University Wexner Medical Center
Institutional Title: Associate Medical Director of Medicine
Khiet Ngo, DO, MS
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: University of California Riverside School of Medicine
Institutional Title: Associate Dean for Clinical Skills Education & Innovation
Amit Pahwa, MD
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: John Hopkins University School of Medicine
Institutional Title: Associate Professor of Medicine
Institutional Role: Director, Internal Medicine Sub-Internship
Rex Alvin D. Paulino, MD, AGSF
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: Joan and Stanford Division of Geriatric and Palliative Medicine
University of Texas Health Sciences Center at Houston
Institutional Title: Associate Professor
Manajyoti Yadav, MD, FACP, FRCP
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: University of Illinois College of Medicine Peoria
Institutional Title: Clerkship Director