Aquifer helps you meet many Liaison Committee on Medical Education (LCME) Standards, particularly those related to ensuring equivalent educational experiences across teaching sites, providing deliberate practice in clinical reasoning and providing feedback on student performance. Our consortium members work with schools through personalized consultations to assist in identifying how Aquifer can help meet accreditation standards.
LCME 6.2 Required Clinical Experiences and 8.6 Monitoring of Completion of Required Clinical Experiences
6.2: “The faculty of a medical school define the types of patients and clinical conditions that medical students are required to encounter, the skills to be performed by medical students, the appropriate clinical settings for these experiences, and the expected levels of medical student responsibility.”
8.6: “A medical school has in place a system with central oversight that monitors and ensures completion by all medical students of required clinical experiences in the medical education program and remedies any identified gaps.”
Enhancing the range of clinical encounters
In addition to caring for real patients, like Aquifer’s are considered by the LCME to be an acceptable clinical learning experience. However, if the cases are to “count,” students should be given independent learning time to work through them, and the content of the cases should be integrated into the clerkship curriculum in methods similar to patient care (i.e., didactics, bedside teaching, etc.).
There are numerous ways to classify the spectrum of patients to be seen, including:
- Ages/developmental stages
- Types of illnesses
- Systems-based categories
Aquifer cases can be similarly classified and then assigned to students.
There are several suggested methods for assigning cases, including:
- Assign cases at the beginning of the clerkship. All of the cases can be assigned, or a subset of specific cases to prepare students to see patients with conditions they are likely to encounter, or to fill known clinical gaps.
- Assign cases individually as needed mid-way through the clerkship, based on a review of each student’s clinical logs.
- A combination of both.
Aquifer automatically creates a log of students’ completion of virtual patient cases. The Student Report for Administrators and Managers shows the detailed progress of an individual student in each case in a course, including:
- The cases the student has completed, partially completed, or nor yet not begun
- Time from Case Start to Completion
- Additional details on Date the Case was Started, Completed and Last Accessed
- Summary Statements submitted by students for cases that require them
A program service administrator, curriculum administrator, course administrator and course manager can each access this report and view real-time data on student progress.
LCME 5.5 Resources for Clinical Instruction
“A medical school has, or is assured the use of, appropriate resources for the clinical instruction of its medical students in ambulatory and inpatient settings and has adequate numbers and types of patients (e.g., acuity, case mix, age, gender).”
Aquifer’s cases were built explicitly on a generalist foundation: the nationally accepted core clerkship curriculum for each discipline. Each case models a general approach to a broad range of problems, acuity levels, ages, genders, and ethnicities. In addition, the Aquifer cases include evidence-based references and multiple Web links to practice guidelines and other appropriate resources. Integration of basic science information is included where relevant. Peer review and ongoing maintenance of the cases by our editorial boards ensures an up-to-date and well-accepted approach to the work-up and management of these common problems.
LCME 8.7 Comparability of Education/Assessment
“A medical school ensures that the medical curriculum includes comparable educational experiences and equivalent methods of assessment across all locations within a given course and clerkship to ensure that all medical students achieve the same medical education program objectives.”
Aquifer cases provide comparable learning experiences across training sites and times of year. Because the cases and exams are available on the internet, students have access to them from all training sites, facilitating student placement in rural or community settings.
LCME 7.2 Organ Systems/Life Cycle/Primary Care/(Prevention/Wellness/Symptoms/Signs/Differential Diagnosis, Treatment Planning, Impact of Behavioral and Social Factors
“The faculty of a medical school ensure that the medical curriculum includes content and clinical experiences related to each organ system; each phase of the human life cycle; continuity of care; and preventive, acute, chronic, rehabilitative, end-of-life, and primary care in order to prepare students to:
- Recognize wellness, determinants of health, and opportunities for health promotion and disease prevention
- Recognize and interpret symptoms and signs of disease
- Develop differential diagnoses and treatment plans
- Recognize the potential health-related impact on patients of behavioral and socioeconomic factors
- Assist patients in addressing health-related issues involving all organ systems.”
Aquifer courses provide practice with virtual patients at all stages, from birth, through childhood and adulthood, to end of life. Several virtual patient cases address wellness and preventive care. Other cases provide students practice with clinical reasoning for common medical conditions, including interpreting abnormal clinical findings, developing differential diagnoses, selecting appropriate diagnostic tests, and developing treatment plans. Rather than providing rote, depersonalized clinical data, Aquifer virtual patients are deliberately designed to illustrate a variety of socioeconomic backgrounds in order to teach students how biopsychoscial factors interact to impact patients’ health.
LCME 7.4 Critical Judgment/Problem-Solving Skills
The faculty of a medical school ensure that the medical curriculum incorporates the fundamental principles of medicine, provides opportunities for medical students to acquire skills of critical judgment based on evidence and experience, and develops medical students’ ability to use those principles and skills effectively in solving problems of health and disease.
Aquifer patient cases are evidence-based, include references to supporting literature, and are peer-reviewed, providing students multiple opportunities to practice evidence-based clinical problem solving and receive expert-programmed feedback on their work.
9.8 Fair and Timely Summative Assessment
“A medical school has in place a system of fair and timely summative assessment of medical student achievement in each course and clerkship of the medical education program. Final grades are available within six weeks of the end of a course or clerkship.”