Getting Started with the Calibrate Pilot for Administrators

Aquifer Calibrate is designed to leverage the concepts of test-enhanced learning and spaced repetition to drive self-directed learning in clinical students

Calibrate reporting provides faculty visibility into student knowledge gaps and certainty misalignment. This allows for meaningful mid-clerkship feedback, informed coaching, and structured remediation. Let’s get started by accessing the Calibrate dashboard.

The Calibrate Dashboard

Once you log in to Aqueduct, click “Assessments” from the top menu. This will open the assessments dashboard. The dashboard is where you will request and manage your assessments.

The blue buttons on the top right allow you to access our current exam request form, request a Calibrate assessment delivery, and access Calibrate reports.

The table lists current assessments and their status.This allows you to see if an assessment has been completed or if it is still active.

Video P

To get started, click the “Request Calibrate Delivery” button. This will open the delivery request form.

  1. Start by entering your contact information.
  2. Select the date and time of your assessment. Assessments are available for a 7 day window.
  3. Select the type of student who will take the assessment.
  4. Select the course this assessment is for.
  5. Select the purpose for the assessment

For the next section, you will need to select the type of student, the assessment course, and the assessment delivery purpose.

You can sort the list by student email, first name, or last name. You also have the option to select students individually, select them all at once, or search for individual students.

If your students require additional time, you can select it from the Assessment Timing dropdown.

If you do not wish the students to take the same exam multiple times, remove the names highlighted in red before re-submitting your request. 

Once you submit your request, you will be asked to confirm your assessment delivery.

The dropdown menu provides the option of increasing the standard time by 1.5 or by 2. 

Once you have selected your students and are satisfied with the schedule and timing, click the “Submit Assessment Delivery Request” button. 

If any of the students have already taken and completed the exam, you will see a warning message. 

The students will now receive an email with all of the information they need to access the assessment. Learn how to access Calibrate reporting.

Getting Started with Calibrate: For Students

Aquifer Calibrate is a new and innovative formative assessment system designed for your learning, to help you dial in on gaps in your knowledge and identify the highest yield of clinical learning experiences to advance your skills.

Calibrate gives you what you need to create efficient study plans, track your progress, target learning before an end-of-course exam, and have productive conversations with your faculty to guide your learning. 

  1. Click the link you received in your email.
  2. The first thing you will see is the Assessments Dashboard. The dashboard lists your assessment status, the course and assessment names, the start and end date, the maximum time allowed, the date you submitted, and if there are any reports available. 
  3. To begin your assessment, click the blue “Start assessment” button on the right side of the dashboard.
    Start Assessment Screenshot
  4. When you are asked if you are sure you would like to take the assessment, click on “yes.”
  5. You will be prompted to agree to the Student Honor Code. Please read and agree to the terms and click on “continue.”
    screenshot of student honor code
  6. You are now at the last step before you start your timed assessment. Make sure you have allotted enough time to take the assessment without interruption. Once your assessment begins, you will only be allowed to pause once for a maximum of 10 minutes. Read the instructions on this page carefully, and make sure you are ready before you click on the “Start assessment” button. When you are ready, you may begin your exam.

NOTE: DO NOT USE YOUR BROWSER’S ‘BACK’ BUTTON. DOING SO MAY CAUSE ISSUES WITH YOUR EXAM’S REPORTING.

screenshot of calibrate instructions


Taking a Calibrate Assessment

Calibrate is designed to be given twice during a clerkship to help you stay on track. You’ll start by taking a 35- to 45- question assessment aligned with the goals of your clerkship. 

Once you click on ‘Start assessment,’ your exam will begin, and your timer will start. Questions are multiple-choice, board-style vignettes with a certainty rating for each question, allowing you to calibrate your knowledge and certainty.

screenshot of calibrate test platform
NOTE:
DO NOT USE YOUR BROWSER’S ‘BACK’ BUTTON. DOING SO MAY CAUSE ISSUES WITH YOUR EXAM’S REPORTING. 

The assessment screen breaks down as follows:

  1. The Progress Bar will show you how many questions you’ve answered and how many you have left to complete. 
  2. Most items present a Vignette, which presents a specific patient scenario.
  3. You are then asked a Question along with a number of options from which to choose.Select your Level of Certainty in your answer once you have answered the question. How confident are you in your response to the question? The more accurate your own assessment of certainty, the better the system can identify your strengths and weaknesses and develop a plan for moving forward.
  4. Lab Values, located on the right toolbar, provide standard lab value ranges. 
  5. Time Remaining shows how much time you have left before the exam closes. If you run out of time, your exam will be auto submitted. 
  6. The Pause Assessment button will temporarily pause the exam. You are allowed to pause only once during the assessment, for a maximum of 10 minutes. You are required to state a reason for pausing your exam. Once you enter your reason and click pause, the pop-up window will have a button to resume your assessment. The 10-minute timer will count down on the right sidebar.

screenshot of pause assessment screen
NOTE: IF YOU DO NOT RESUME THE EXAM WITHIN 10 MINUTES OF PAUSING, THE EXAM WILL BE AUTOMATICALLY SUBMITTED.

 

  1. Click on the “Next Question” button  when you have answered your question and chosen your certainty level to proceed to the next question. 
  2. When you reach the final question on the assessment, the “Next Question” button will be replaced by a “Submit Exam” button. Be sure to click this to submit your exam. 

Submitting Your Calibrate Assessment

Once you have submitted your exam, you will be taken back to your Assessments Dashboard, and you should see a blue banner across the top of your screen that reads, “Congrats on successfully completing your exam.”

screenshot of congratulations screen

Your dashboard should also be updated to show that the status of your assessment is now complete. Any new Calibrate exam that you complete will be listed here. You can sort multiple exams by clicking the blue headers in the dashboard:

screenshot of the assessments dashboard

  1. Status
  2. Course
  3. Assessment Name
  4. Availability Start Date
  5. Availability End Date
  6. Max Time Allowed
  7. Date Submitted
  8. Reports (for assessments you’ve already taken)

The last item, “Reports,” is a dropdown list that will be populated with any reports generated from your assessment results. You’ll find instructions for accessing and understanding your reports on the Accessing and Understanding Reports for Students page.

OTP Compatible Apps for Multifactor Authentication

It is an app used to calculate one-time passwords required to log into your Aqueduct account after you enable two-factor authentication. Adding an extra credential to the single password model is key for protecting data. These apps are used by popular services like Google, Amazon, GitHub, Dropbox, and many more.   

A Short List of Popular OTP Apps

All of these are free, and function well with Aqueduct.

Tracking Student Work with Learner-level Access

How to track students’ work in Aquifer case–for programs that do not have an institutional subscription with administrative and reporting tools.


If you don’t have an institutional subscription to Aquifer, your students might be using Aquifer cases via one of our individual learner-level access options, which include:

  • Free Learner-level access to Aquifer courses as part of the Aquifer COVID-19 response (offered to non-subscribing nurse practitioner, residency and international MD programs)
  • Individual subscriptions that students purchase with a credit card to access Aquifer a Signature course (Family Medicine, Geriatrics, Internal Medicine, Pediatrics, and/or Radiology).
  • Individual access to Aquifer’s five free interdisciplinary courses in High Value Care, DIagnostic Excellence, Oral Presentation Skills, Culture in Health,  and Medical Home, which students at non-subscribing institutions can access for free directly from aquifer.org. 

With learner-level access, students can easily track their own progress through cases and see their free form summary statement responses from cases through their Student Report available on their individual account–but faculty don’t have direct access to view these reports.

How Faculty Can Use the Student Report To Track Student Work

Faculty and administrators that want to track student work can require your students to share their Student Report from any course with you in any of the following ways:

  • Submit a screenshot 
  • Send an export of their student report
  • Share a view of their reporting screen via video call

These reports would allow you to:

  • Verify completion of assigned cases
  • View the amount of time a student spent on a case
  • Review student summary statements (available for cases in Family Medicine, Internal Medicine, Pediatrics)
Using Summary Statements

For Faculty Using the COVID-19 Learner-level Access Only

Many Aquifer cases require students to write summary statements as they move through the case. Faculty can compare student summary statements (included in the Student Report noted above) to those written by content experts. Reviewing this content will allow you to provide your students with concrete feedback, helping them to improve their clinical reasoning in a meaningful way.

At this time, expert summary statement answer keys are available only as part of the Faculty Took Kit (sent via email) for programs using the COVID-19 Free Learner-level Access. 

Student Report Views & Case Completion Details

Student Reports are available for any course available in your students’ Aquifer accounts. The Student Report includes the following information on each case in the selected course:

  • Case Number
  • Time from Case Start to Complete (Total active working  time in hours, minutes, seconds)
  • Percent Case Completed, shown as:
    • Case Complete = Green Check Mark
    • Case Partially Completed = Yellow circle showing the percentage of the case complete – Note: the percentage is NOT a grade or score!
    • Case Not Started = Red Circle
    • Case Reset = Any color circle with a black outline
  • Pages Completed
  • Start Date (local time)
  • Date Last Accessed (local time)
  • Completion Date & Time (local time displayed on screen, Eastern Time displayed in exports)
  • Case Summary statement (if applicable–not all cases require a summary statement)
  • Case Reset Status (whether a student chose to go back and re-do the case again–showing only the work from the most recent case review)

The on-screen Student Report looks like this:

The export of the Student Report looks like this:

How can I tell my students to access reporting?

We have a complete how-to article for students in our Reporting for Students support article. You will need to let your students know how you prefer to see the report (video call screen share, screenshot, or sending the csv export) and when their work is due.


Is there a more efficient way to track student work?

Direct access to student reporting is available with Aquifer institutional subscriptions.   Should your program decide to purchase an Aquifer institutional subscription in the future, you would have access to this functionality.

Educator Guides & Resources Available

Aquifer’s Educator Guides are your complete guide to using—and making the most of—Aquifer courses in your program. The Educator Guides are ideal for educators who are looking to:

  • Start using an Aquifer course as a new staff member or new subscriber
  • Discover best-practices and new ideas for integrating Aquifer into your course or curriculum
  • Take advantage of the many free resources included with Aquifer
  • Catch up on the latest features, Educator Resources, and assessment options available
  • Access a quick reference guide to all of the cases, resources, and features

Key Features

All Educator Guides include:

  • Course overview and pedagogy
  • Integration strategies
  • Features overview (searchable Case Library, custom courses, and more)
  • Resources included with your subscription (free courses, Aquifer Sciences Curriculum Database)
  • Support resources
  • Case details (Case Synopses, Learning Objectives, clinical locations)
  • Direct links to any course-specific additional resources and tools

Educator Guide Library

We currently offer Educator Guides for the following courses. To access the guides, please see the details below—you will need to sign in to your Aquifer account.


Additional Resources

Our Educator Guides include direct links to additional course-specific teaching and learning tools created by the Aquifer Educators Consortium. These tools are fully developed, available for download, and ready to use in your teaching. Currently, our additional resources include:

User Story Videos

Hear from top educators around the country who are using Aquifer to provide consistent clinical experiences, complete coverage of national curriculum standards, self-directed learning, and remediation opportunities for their students. User Story Videos are available for each Aquifer course.

EXPLORE USER STORY VIDEOS


Accessing Educator Guides & Resources

Sign in to your Aquifer account in Aqueduct, our learning management system.

From your Courses page, click on the green Educator Resources bar.

The Educator Resources page shows all of the resources available for your program’s subscribed courses and free interdisciplinary courses. Click on resources for your desired course to view and/or download resource files.

Searchable Content Library

Searchable Content Library

You can now search and filter the Aquifer content available to you with your program’s subscription—plus cases from Aquifer’s free interdisciplinary courses—to quickly select the content you need.

Our searchable Content Library (formerly called the Case Library), accessible from the top navigation menu for all administrative and faculty users, is home to the advanced content search.

Searchable content library

The searchable Content Library includes a series of dropdown filters which allow you to search for cases and Integrated Illness Scripts (available to Aquifer Curricular Partners) by:

  • Presenting Problem
  • Final Diagnosis
  • Additional Diagnosis
  • Aquifer Signature Content
  • Clinical Discipline
  • Clinical Focus
  • System
  • Basic Science Discipline (currently mapped to Integrated Illness Script content only)
  • Clinical Location
  • Age Group

Use a combination of the filters above to quickly find the content you need to build a custom course or select specific content to remediate students.

Content Library Filters

You can also use the free text search field to conduct a keyword search, which includes text in the case and script titles, synopses, and learning objectives.

Content Library Keyword Search

Detailed Case List Display

The detailed content list display will include the Aquifer cases and Integrated Illness Scripts which meet your search criteria which are available through your program’s subscription.   If your program does not subscribe to a course or have access to the Integrated Illness Scripts, that content will not display in the search.

From the display list you can quickly view more information about the content to determine if it fits your needs. For cases you can scan the case synopsis, learning objectives, and the detailed case summaries which are available to students on completion of the case. For Integrated Illness Scripts you can scan the synopses and Mechanism of Disease Maps for each script.

Cases and scripts in Content Library

Aquifer cases and integrated illness scripts are authored and continuously updated by the expert healthcare educators who make up the Aquifer Consortium. Content authors and the date the content was last updated are now displayed for each item—so you can be sure your students are being provided up-to-date content written by your trusted peers.

You can also access all cases and scripts directly from this page by clicking on the title. Unlike students, as an administrative user you will have ungated access to the cases, so that you can access all content at once without answering questions as you advance.


Put Your Cases to Work

Once you have selected the content you need, you can create a custom course directly from the Content Library page. You can choose content to assign to students to prepare for or review key clinical situations or concepts.

Sign In to Aqueduct

1. Go to Aquifer.org and click Sign In in the top right corner. This will take you to Aqueduct, our learning management system.

2. Enter your institutional email address in the Email box. Then click on the Register button at the bottom of the page. If you receive a prompt on the screen stating “Please ensure you are using your institutional email. If registration issue persists, please contact your clerkship coordinator.”  you may be using the wrong email address, or your email may not have been rostered in the system by the administrators at your program.   Try to register again using your official institutional email.   If you are not successful you will need to contact your course director and ask to have your email added to the system.

Note: If you have previously registered, you will receive a notification that you have already signed in and you will be re-directed to the sign-in screen.

3. You will be sent an email with a link to complete registration. Upon receipt of the registration email, click on the link “Click Here“. You will then be brought to the profile setup page.

4. You will be asked to fill in your profile information and set up a password (8 character minimum).Once you have completed your user profile and created a password, you will receive a welcome email with links to useful information and guides. You would also be logged into the Aqueduct learning management system.

After Completing Your Registration

1. Once you have completed your user profile and created a password, your sign in will be quick and easy. Go to Aquifer.org and click Sign In in the top right corner.

2. You will then be brought to the Aqueduct sign in page. Please log in with your institutional email and account password and click “Sign In”.

5. Once your profile is completed successfully, you will be brought to your institution’s Course page.

Now your sign in will be quick and easy. Go to Aquifer.org and click Sign In in the top right corner, then enter your institutional email and password.

If you experience an issue during Sign In, please allow a few minutes for it to resolve. If the issue persists, please contact Support.

Aqueduct System Requirements

Aquifer’s teaching and learning platform, Aqueduct, is built using web standards, the program runs on Windows, Mac, Linux, iOS, Android, or any other device with a modern web browser.


Supported Operating Systems include: Windows 7 and newer; Mac OSX 10.10 Yosemite and newer; Linux; ChromeOS

Mobile Operating Systems: iOS – please install our app for iOS 13 and newer; Android – Android Oreo, Oatmeal Cookie v8.1 and newer.

Computer Speed and Processor: Best experienced on a computer 5 years old or newer; 1GB of RAM; 2GHz processor

Browsers Supported: Microsoft Edge; Safari 12 and newer (Macintosh only); Chrome 81 and newer; Firefox 64 and newer

New Programs: Whitelist our Domains

This is a critical step if your program is new to using Aquifer. Whitelisting our domains and email addresses will ensure that your faculty and students will be able to gain access to our system.

Whitelisting should be done by your program’s IT department.

Web Traffic

Email from the Aqueduct learning platform

  • Domain:  delivery.meduapp.com
  • IP:  149.72.67.97

Sign in to WISE-MD, WISE-OnCall or CARE

1. Go to Aquifer.org and click the Sign In button.


2. You will be brought to the Aqueduct Sign In page. Put in your account email address and password. Then click Sign In.


3. On the top navigation bar, click on Courses.


4. You will then see blue buttons on the right to “Launch” WISE-MD, WISE-OnCall, or CARE. Click on the button for your course to access to the content in the WISE  learning platform.


5. If this is your first time accessing the WISE platform, you will be brought to a verification page which will ask you to confirm your name, institution, and to select your appropriate clerkship/group/block.

Meeting LCME Standards with Aquifer

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.

View LCME Accreditation Standards 2018-19


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.
Documentation Method

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.”

Aquifer Final Exam reports are scored and reported to schools within days.

Student FAQ’s

1. Go to Aquifer.org and click Sign In in the top right corner. This will take you to Aqueduct, our learning management system.


2. Enter your institutional email address in the Email box. Then click on the Register button at the bottom of the page. If you receive a prompt on the screen stating “Please ensure you are using your institutional email. If registration issue persists, please contact your clerkship coordinator.” you may be using the wrong email address, or your email may not have been rostered in the system by the administrators at your program. Try to register again using your official institutional email. If you are not successful you will need to contact your course director and ask to have your email added to the system.

Note: If you have previously registered, you will receive a notification that you have already signed in and you will be re-directed to the sign-in screen.


3. You will be sent an email with a link to complete registration. Upon receipt of the registration email, click on the link “Click Here“. You will then be brought to the profile setup page.


4. You will be asked to fill in your profile information and set up a password (8 character minimum).Once you have completed your user profile and created a password, you will receive a welcome email with links to useful information and guides. You would also be logged into the Aqueduct learning management system.


5. Once your profile is completed successfully, you will be brought to your institution’s Course page.


6. You will also receive a “Thank you for registering with Aquifer” email with links to tools, resources, and Aquifer news.

Now your sign in will be quick and easy. Go to Aquifer.org and click Sign In in the top right corner, then enter your institutional email and password.

1. Once you have completed your user profile and created a password, your sign in will be quick and easy. Go to Aquifer.org and click Sign In in the top right corner.


2. You will then be brought to the Aqueduct sign in page. Please log in with your institutional email and account password and click “Sign In”.

1. If you forget your password, Aquifer can help you regain access to your courses and information right away. From the Sign In page, click the Forgot Password link.


2. You will be brought to a page where you can enter your Account email address. After entering your email address, click “Send me instructions to set my password“.


4. You will then be brought to a page where you can reset your password. Please put in your new password twice to confirm and click on “Change my password”. You will then be logged in with your new password.


3. You will receive an email with instructions to reset your password. If you do not see this email, check your spam mailbox. Follow the instructions in the email to reset your password. Click the link to reset your password.

1. Go to Aquifer.org and click the Sign In button.


2. You will be brought to the Aqueduct Sign In page. Put in your account email address and password. Then click Sign In.


4. You will then see blue buttons on the right to launch WISE-MD, WISE-OnCall, and CARE. Click on the button for your course to access the content in the WISE learning platform.


3. On the top navigation bar, click on Courses.

Cases are complete when you click the Finish Case button in the Case Summary Download section at the end of each case. Completed cases show on all reporting as a green circle with a check mark.

If you have completed the case content but don’t see the Finish Case button, be sure to complete all three required feedback questions at the end of the case. After you have completed the three feedback questions, you can access the Finish Case button and the downloadable case summary.

If you do not complete the feedback questions and click the Finish Case button, your work will show as partially completed—as a yellow circle showing the percentage complete—on Aquifer reporting for both you and your instructor.

We hope that all learners will share their honest feedback. We will review this feedback and use it to help ensure that we are offering the best possible learning materials.

Adding Administrative Users & Assigning Roles


Each program has complete control over how to manage administrative users in Aqueduct. The system is designed for flexibility to best fit your program’s needs. You can choose which users view reports, add student rosters, and access student data.

Before getting started adding administrative users, be sure to review the Roles & Permissions to decide which roles each staff member in your program will fill in Aqueduct.

Administrators and educators need to be added to Aqueduct before they will be able to access it, and they need to be assigned an appropriate role in the system.

How to Add Users and Assign Roles

Once you’ve signed in, click on Users in the top navigation.


Then you’ll see the administrative user panel. At the top of the page, you’ll see a grid that provides useful counts of how many people are in each role. All users are listed at the bottom of this page and may be sorted, filtered, and exported in a variety of ways.

The Administrators tab will be activated automatically, but please note that student users are accessed separately by clicking on the “Students” tab. Click the Add Admins button in the top right-hand corner.

admin user panel overview

Enter the official institutional email addresses for the users you would like to add to the system. To batch add users, enter a list of comma-separated email addresses for users who will share the same role. Users may also be added individually.


Once you have entered your email address(es), choose the User Role that you wish to assign to this group of users from the drop-down menu and click the Add Administrators button.


You will be redirected back to the Users page. A message will be open at the top of the page indicating whether or not you have successfully added users.


The administrators you added will now appear in the administrator user list below as “Unknown Unknown”, showing their email addresses, the role you have assigned them, and a status of “Registration Pending”. When administrative users sign in and complete their registration, their status will change to “Active” and this screen will show the values that they enter for First Name, Last Name, and Clinical Discipline.

Note: Administrative users will automatically receive an email notifying them that they have been assigned a specific role in Aqueduct, and inviting them to register in the system.

Next Steps:

Exam Administration & Proctor’s Responsibilities

There are many different aspects of successful exam administration. To ensure that everyone taking an Aquifer exam is able to do so effectively, we have detailed the activities that need to happen and the responsibilities of everyone participating in the exam, including Course Administrators, Proctors, your institution’s Technical Support Staff, and Aquifer Support Staff. Aquifer has also developed several tools to enhance exam administration that are provided here in one convenient location.


Course Administrator’s Responsibilities

Course Administrators (Clerkship Administrators and/or Clerkship Directors) play a critical role in administering exams.

  • Complete our Aquifer Annual Exam Survey so we can be prepared and identify any challenges long before you need to administer the exam.
  • Secure a computer lab/testing room for each exam being administered.
  • Arrange for proctor(s) to monitor each exam. There should be one proctor for every 20-25 students, and at least one proctor in each examination room. Make sure each proctor understands his/her responsibilities and has access to the tools needed (see below).
  • Schedule technical support to be on call while each exam is taking place and make sure they are aware of their responsibilities (see below).
  • Ensure that all technology is tested in advance of administering each exam.

When planning to administer exams, please allow the following time:

  • Aquifer Pediatrics: 2.5 Hours
  • Aquifer Family Medicine: 3 Hours
  • Aquifer Internal Medicine Clinical Decision-Making Exam: 75 Minutes
  • Aquifer Radiology: 2 Hours

In addition, you may wish to plan on an additional 15-20 minutes to allow for orientation and other logistical items.

  • Schedule the exam with Aquifer by completing the Aquifer Exam Request Form. To complete the form, you will need the following information:
    • Name of the Aquifer course for which you are ordering the exam
    • School name
    • Exam start date and time (ET)
    • Request for any additional time you will need for students with academic accommodations
    • Purpose of the exam (Pre-test, Practice, Midterm, Final)
    • Primary person to contact if there’s an issue during the exam (name, email, and phone number)
    • Any special circumstances not already cited (extended length exams, special accommodations, etc.)
  • Ensure that all students taking the exam have registered to use Aquifer courses. Students who have not registered with Aquifer at least two weeks prior to the exam will not be able to take the exam.
  • Submit an Exported List of Students scheduled to take the exam from the Aquifer Reports Section.
  • Once the Exam Request Form and the Exported List of Students have been submitted, Aquifer will provide you with pre-populated student handouts that you may provide to the proctors to use for exam orientation and to disseminate logins and passwords.

Aquifer will email exam results to the Program/Course Administrator within two business days of the completion of the exam. The Program/Course Administrator will be responsible for releasing those results at his/her school.


Proctor’s Responsibilities

Aquifer requires that proctors are present during the exam to ensure that all exams are administered in a secure, proctored setting.

Please view our Video-proctoring FAQ’s for more information on video proctoring.

Ensure a standard testing room environment, including:

  • Exam workstations in a dedicated room that can be closed off from the rest of the facility to minimize noise and outside distractions during testing.
  • Exam workstations that are forward facing with adequate spacing in order to reduce students’ ability to view another’s monitor and to ensure sufficient spacing between each workstation.
  • A designated area where students can store personal items such as cell phones, iPads, tablets, media devices, papers, books, coats, purses and backpacks. These are NOT allowed in the exam space.
  • Appropriate access to the room for people with disabilities in compliance with the Americans with Disabilities Act of 1990 (in the United States) or your country-specific requirements.
  • Proctors may also want to consider designating a separate testing room for students who have been approved for extra testing time.

Proctors should be prepared to access appropriate tools and technical support staff should any issues arise, including:

  • A dedicated workstation that has been checked for exam compatibility prior to examination day.
  • Access to a telephone with an outside line for use during the test session in case the proctor needs assistance during the exam.
  • The phone number and email address for relevant technical support staff.

Access to or a print out of Exam Troubleshooting Tips the provides suggested solutions to the most common problems that may arise during the testing session.

Proctors will fulfill duties which include:

  • Arrive at least 15 minutes before the exam session.
  • Startup institution workstations (if necessary).
  • Admit students to the exam room, ensure students do not bring phones or tablets into the room, check students off the roster, and distribute student handouts.
  • Orient students to the exam and read the following statement to students:
    “The materials used in the Aquifer examinations are the copyrighted property of Aquifer. If you distribute examination materials, by any means, including reconstruction through memorization, you are in violation of the rights of the owners. You are prohibited from communicating, publishing, reproducing, or transmitting any part of your exam, in any form, or by any means, verbal or written, for any purpose. Every legal means available to protect Aquifer examination materials and secure redress against those who violate copyright law may be pursued. If you become aware of any suspicious activity related to an Aquifer exam administration, please notify the proctor or clerkship director, or submit a report.”
  • Direct students to begin the exam at the designated time using the login and password on the student handouts.
  • Monitor the progress of all students after they launch their exams and report any issues.
  • Ensure that the exam is being monitored at all times (students should never be left alone in the room).
  • Check that each student has submitted his/her exam once they have completed the test and collect each student’s handout before he/she leaves the room.

Exam Support

If an issue arises during the exam:

    1. Contact your institution’s technical support staff.
    2. Access Aquifer Exam Troubleshooting Tips.
    3. If neither of those addresses the issue, contact Aquifer’s exam support staff weekdays 8 am – 5 pm ET, except federal holidays.

Contact exams@aquifer.org or (603) 727-7002 ext. 2 with any questions about test administration activities.


Security Reminder

Please remind all faculty and students that all exam content is confidential and should not be shared with anyone, at any time, in any way.

Reporting for Students


It’s fast and easy to view your progress through Aquifer content. From your course page, students see a progress bar showing their progress through each case or Integrated Illness Script in the course, and the date the content was last accessed.

Scripts and Cases for reporting

For more detailed information—or to download and save your progress—we recommend using the Student Report for each course. The Student Report for a case includes the following information:

  • Case Number
  • Time from Case Start to Complete (Total time in hours, minutes, seconds)
  • Percent Case Completed
  • Pages Completed
  • Start Date (local time)
  • Date Last Accessed (local time)
  • Completion Date & Time (local time displayed on screen, Eastern Time displayed in exports)
  • Student-Entered Case Summary statement (if applicable)
  • Case Reset Status

If your program has access  to our Integrated Illness Scripts, you will also able to view your progress through scripts in their Student Report.  The report will provide the following information:

  • Time from Script Start to Complete
  • Percentage of Script Completed (measured by number of sections of the script opened) ..
  • Whether or not the Mechanism of Disease Map was opened within the script.
  • Student-Entered Notes in the Implications for Further Workup
  • Student-Entered Notes in the Implications for Management

How to Generate a Student Report

It’s easy to generate a student report in Aqueduct from your course page:

1. Choose the Student Report button on the right-hand side.

How to access student report

2. The generated report will appear. If both cases and scripts are included in a course there will be a separate tab in the report for each.

Case detail for student report
Student Report: Case Detail
IIS Student Report
Student Report: Integrated Illness Script

Your progress through a case is shown in real-time as:

  • Case Complete = Green Check Mark
  • Case Partially Completed = Yellow circle showing the percentage of the case complete – Note: the percentage is NOT a grade or score!
  • Case Not Started = Red Circle
  • Case Reset = Any color circle with a black outline

You Can Export a CSV File: All reports can be exported to a CSV file, which will allow you to sort and save your course progress including the work done in both cases and scripts. The export button is located on the right-hand side of all reports pages. All times will appear in Eastern Time on exports. Please note that times appear in local time on-screen.

Export Notes:

  • All times appear in Eastern Time on exports. Times display in your local time on-screen.
  • The number of times a case is reset appears in report exports only.

Completing a Case

Cases are complete when you click the Finish Case button in the Case Summary Download section at the end of each case. If you have completed the case content but don’t see the Finish Case button, be sure to answer all three required feedback questions at the end of the case. After you have completed the three feedback questions, you can access the Finish Case button and the downloadable case summary. If you do not complete the feedback questions and click the Finish Case button, your work will show as partially completed—as a yellow circle showing the percentage complete—on Aquifer reporting for both you and your instructor.

Completing a Script

Integrated Illness Scripts are marked as complete when you have opened and viewed each section of the script. Opening the Mechanism of Disease Map is reported in a separate column in your report. 

User Roles & Permissions

In Aqueduct, your program will have complete control to manage your users and assign permissions in a way that fits your structure. Our system is built to offer a range of permission options to best suit your program’s needs.

Setting Up a New Subscription

Before you begin setting up your Aquifer subscription, please review the roles and permissions for each user type and decide who will fill each role. From there, it’s easy to add users, assign permissions, and manage administrators in Aqueduct. Please note that each user may be assigned to only one role in Aqueduct.


Checking Your Aquifer Role

Your program will determine your role and permission level in Aqueduct when you are added as an administrative user. Your role is stated in your initial email invitation and is listed on your “My Profile” page in Aqueduct. If you need to create Custom Courses or access student progress reporting but do not have the appropriate role, please contact your Program Service Administrator. If you are not sure who fills that role at your institution, please contact Aquifer Support.

The Program Service Administrator is the primary subscription manager for the program and has the highest level of permissions in the system. This is a required role. There can only be one Program Service Administrator for each program. Users in this role:

  • Serve as Aquifer’s primary contact regarding subscription renewal
  • Add administrative users to the system and assign roles and permissions, including assigning a Curriculum Administrator, IT Manager, and other key administrative roles as required by your program
  • Manage (add, edit, and remove) all users—students and administrators
  • Determine who will upload student rosters. Students must be rostered in Aqueduct to gain access to Aquifer courses, and this can be done by the Program Service Administrator, a separate Student Roster Manager, or by the Curriculum Administrator. The Program Service Administrator should decide who will perform this role, and make sure they are assigned a role in the system and are prepared to upload the student roster
  • Access the searchable Content Library to easily sort and filter cases and scripts and quickly view case synopses and learning objectives
  • Full authorization for tracking and reports at the program, course, case, and student levels
  • Highest level in the permission hierarchy—the Program Service Administrator can perform any role within the system as fits your program, including creating custom courses, viewing student cases, adding/deleting other educators, and perform any other role

The Curriculum Administrator serves as the overall administrator for the educational content and has access to all courses and reports. This role is optional, and is often assigned to a Curriculum Dean and his/her Coordinator/Administrator. New programs are given permission to add up to 3 Curriculum Administrators to their program. These users may identify and oversee subscriber program standards for incorporating curricular content into courses, including use for grading and assessment. Users in this role can:

  • Manage (add, remove, and edit) most administrative users (Student Roster Managers, Course Administrators, Course Managers, and Teachers) and all student users
  • Access all program, course, case, and student reports
  • Create custom courses
  • Access the searchable Case Library to easily sort and filter cases and quickly view case synopses and learning objectives
  • View ungated case content—with the ability to see answers to embedded assessments, advance through a case, and access the case summary at the end of a case without having to click through each card or complete each answer as required in the student role

The Course Administrator is often a Course Coordinator, Site Director, or delegate. and/or their coordinator who has course-level responsibility. Course Administrators can create customized courses to assign specific cases and students to courses, and view cohort and individual performance across courses. New programs are given permission to add up to 2 Course Administrators for every paid Aquifer course they subscribe to. Users in this role can:

  • Manage (add, remove, and edit) Course Managers, Teachers, and Student users
  • Create custom courses to align with their course or block rotation, assigning specific cases and specific students to the course
  • Access course, case, and student reports for Aquifer courses as well as for specific custom courses which they created or have been granted access.
  • Create exam rosters—Course Administrators are the only role that can create exam rosters. If you need permission to add additional Course Administrators to your program to manage this role please contact us so we can help you
  • Access the searchable Content Library to easily sort and filter cases and scripts and quickly view case synopses and learning objectives
  • View ungated case content–with the ability to see answers to embedded assessments, advance through a case, and access the case summary at the end of a case without having to click through each card or complete each answer as required in the student role

The Course Manager is responsible for tracking student progress and completion within a course. This role is consistent with Clerkship or Course Director. New programs are given permission to add up to 4 Course Managers for every paid Aquifer course. Users in this role can:

  • Create custom courses to align with their course or block rotation, assigning specific cases and specific students to the course
  • Access the searchable Content Library to easily sort and filter cases and scripts, and quickly view case synopses and learning objectives
  • View ungated case content—with the ability to see answers to embedded assessments, advance through a case, and access the case summary at the end of a case without having to click through each card or complete each answer as a student needs to.

Teachers (preceptors, didactic instructors, etc.) have ungated access to Aquifer courses, meaning they can view the student cases, the answers to embedded assessments, and the case summary without having to click through each card in a case content or custom courses to which they are invited. Teachers can view all the Aquifer courses your program subscribes to. Additionally, if they are assigned to a custom course they can view that content as well. Teachers do not have access to view reporting. There is no limit to the number of Teachers that a program may add to the system. Teachers can:

  • Access the searchable Content Library to easily sort and filter cases and scripts, and quickly view case synopses and learning objectives
  • View ungated case content—with the ability to see answers to embedded assessments, advance through a case, and access the case summary at the end of a case without having to click through each card or complete each answer as required in the student role

The IT Administrator serves a supportive role, helping to whitelist your program’s specific domain to ensure users receive automated email messages and addressing firewall or other implementation issues as needed to facilitate access. New programs initially have permission to add one IT Administrative user. This is a required role. Users in this role can:

  • Reset user passwords
  • Verify user permissions
  • Resend email invitations to administrative and student users
  • View all administrative and student users

The Student Roster Manager is an optional role that can upload and manage student rosters for your program. Depending on how you chose to manage your subscription, the Program Service Administrator or Curriculum Administrator may upload student rosters, or you may assign it this role to a separate Student Roster Manager, perhaps in the Registrar’s Office. New programs initially have permission to add one Student Roster Manager user. Users in this role can:

  • Upload student rosters
  • Manage (add, remove, or edit) all student users
  • Schedule and re-send student email invitations
  • View program level reports on course and case usage

The exam proctor is the individual who supervises students using Aquifer Exams. This person can be any qualified individual who the clerkship approves to supervise test-taking students. The exam proctor is not a specific role within Aqueduct.
For Internal Medicine Key Features Exams:

This individual has the responsibility of:

  • Starting the exam for each student utilizing the exam proctor dashboard
  • Pausing the exam utilizing the exam proctor dashboard, if necessary
  • Communicating with Aquifer’s exam support stuff if any issues arise during the exam

Student Progress Reporting

Tracking Student Usage and Performance

Aqueduct provides easy access to a range of interactive report dashboards. Program Service Administrators, Curriculum Administrators, Course Administrators, and Course Managers can all access reports on student progress through Aquifer courses, cases, and Integrated Illness Scripts. (Note: users in a Teacher role do not have access to view student reports.)


The Aqueduct Reporting Experience

It’s quick and easy to find data by student, case/integrated illness script, or course. Our reports are simple to generate and easily understood. 

All reports can be viewed online in the interactive dashboard, or downloaded and exported to a CSV file. Please note that times will appear local time on screen, but all exports display in Eastern Time.


Reporting by Course Type

  • Aquifer Signature Course Reporting: Reports for Aquifer Signature courses that come standard with your subscription include student progress for:
    • Every case or Integrated Illness Script in the Signature Course
    • Every student that is registered in the system.

Note: Course reports can get large if your program has registered a lot of students and may include students who have not been assigned to work in the course. We recommend creating custom courses to access tailored reporting.

  • Custom Course Reporting: Creating a custom course is a recommended step for programs that wish to access reports tailored to a specific set of students and/or cases. Custom course reports include student progress for:
    • Just the specific cases and/or Integrated Illness Scripts that you have assigned to the students
    • Just the specific students you have assigned to the course

Optimizing your reports is just one of the many reasons to create a custom course—learn more.


The Course Report

The Course Report provides a quick view of students’ progress through each case or Integrated Illness Script in a Signature or Custom course.

To access the Course Report:

  1. Choose Courses from the main menu.
  2. Select the desired course.
  3. Click on the Course Report button on the right side of the screen.

The Course Report will appear with student progress through all content in that specific course.

Select the date range for the report. Your report will include progress in all cases and scripts started during that time period

If you are viewing a report for a custom course that includes both cases and Integrated Illness Scripts, student progress for the cases and scripts will be listed in separate tabs.

Under the Cases or Integrated Illness Scripts tab you will see:

  • List of Students Including Email Address, First Name, Last Name
    • Every student registered in the system will appear on reports for Aquifer Signature courses
    • For custom courses, only students that have been assigned to that course will appear, regardless of whether they have registered in Aqueduct. Students who have not yet registered in Aqueduct will appear as ‘Unknown Unknown’
  • All Cases or Scripts included in the Course
  • Total number of cases or scripts completed by each student
  • Progress through each case or script in the course that has been started in the given time period shown in individual columns
    • Complete = green check mark
    • Complete partially completed = yellow circle showing the percentage of the case that is complete. Note, the percentage does NOT represent a grade or score!
    • Not started = red circle
    • Any color circle with a black outline = indicates that the student reset the case
  • Search For a Specific Student: You can use the Search function to search for a specific student by entering the student’s name into the search box

The Export button for all reports is located in the upper right hand corner of the screen.

Case Completion Notes

Students must answer all three required feedback questions at the end of each case—and click the Finish Case button in the Case Summary Download section—in order for the case to appear as complete on reporting. If students have worked through the case content but haven’t completed the feedback questions or clicked Finish Case, their work will show as partially completed—a yellow circle showing the percentage complete—on all Aquifer reports.


The Case Detail Report

The Case Detail Report is a drill-down report that shows the progress that all relevant students have made within a specific case within a course.

From within your Course Report, you can access case-specific reporting in just one easy step:

  • From the Course Report: In the header row, click on the case number you need to access.
Click on Case in Student Progress Report

The Case Report includes each students’ progress through a specific case with the following information:

  • Time from Case Start to Complete
  • Percent of the Case Completed
  • Case Reset Status (indicated by a black outline around the case completion circle)
  • Pages Completed
  • Case Start Date (local time shown on-screen)
  • Date Case Last Accessed (local time shown on-screen)
  • Case Completion Date (local time shown on-screen)
  • Case Summary statement (if applicable). If the student is asked to write a summary statement as part of the case you will be able to view his/her submission here. The Summary Statement column will be blank if the student has not written a summary statement and will show N/A if there is no summary statement question within the case.
  • Expert Comment summary statement (if applicable) for easy evaluation of your students’ work. Note: Scroll to the right to view this column.
  • Note: The number of times the case was reset by each student will show in the Case and Student Report exports only.
Summary Statement for Student Progress Report

The Integrated Illness Script Detail Report

If your course includes Integrated Illness Scripts you can drill down to view details on student progress through each script.

To access the Integrated Illness Script Detail Report from the Course Report:

  1. If you are viewing a report for a course that includes cases and scripts, first click on the Integrated Illness Script Tab at the top of the report.  If your course includes only scripts you can skip this step.
  2. In the header row, click on the name of the script you need to access.

For each student, the Integrated Illness Script Detail report includes:

  • Time from Script from start to completion.
  • Percent of the Script Completed (measured as percentage of sections opened)
  • Case Reset Status (indicated by a black outline around the case completion circle)
  • A check box to indicate whether the Mechanism of Disease Map has been opened
  • Implications for Further Workup: If students record notes in this section within the script, their work appears on this report.
  • Implications for Further Management:  If students record notes in this section within the script, their work appears on this report.
Integrated Illness Script Course Report

The Student Detail Report

You can also view detailed reports on a single student, which reflect the same information found in the Case and Integrated Illness Script Detail reports, but organized with all the content completion progress in the course for a single student.

To access a Student Detail Report for a specific student:

  • From the Course Report: In the header row, click on the email address for the student you need to access
  • Use the tabs at the top of the report to toggle between the student’s progress in cases and Integrated Illness Scripts
Individual Student Report

Creating Custom Courses

Why Create a Custom Course?

Organize rotations, blocks, or academic years: Custom courses make it easy to assign specific cases and Integrated Illness Scripts to students, track class or cohort progress at a glance, and include course specific information or directions for students

Align Courses to Your Curriculum: Pick and choose content to create courses that fit your curriculum. You can create courses that align to longitudinal integrated clerkships, bootcamps, electives, or specific student’s remediation needs. You can integrate cases from our free courses, like High Value Care, with a discipline-specific course that you subscribe to, enriching an existing course.  If you have access to Integrated Illness Scripts you can create a custom course with select scripts for students to compare and contrast using one of our ready-made Integrated Learning Sessions for instance, or combine them with our cases to enable a rich learning experience.

Track and monitor progress for a specific group of students: Reports for custom courses are tailored to include just the students and just the cases or scripts assigned to that course, making it easy to track and monitor student progress in the course at a glance.

Manage Exam Rosters: Creating a custom course is a required step for subscribers using Aquifer exams, and allows for quick and easy exam roster creation.


Create a New Custom Course

Tip! Do you want to copy a set of cases or users from an existing course to a new custom course? Save time by using our new Duplicate Course feature, which allows you to copy cases and/or users to a new custom course. If not, continue with the directions below to create a new custom course.

1. Click on Content Library in the top navigation, or the Create Course button on your courses page to access the Content Library page.

Create Courses

2. Use the Searchable Content Library filters to select the cases and integrated illness scripts (available to Aquifer Curricular Partners) you would like to add to your custom course. Note: Skip this step if you want to create the custom course shell first and add cases later or create an exam roster.

Content Library Filters

After you have added your content, you can click “View Selected Items” to verify you have selected the cases and scripts that suit your course.


3. Click Create Course.

Create Course in Content Library

4. You will see a pop-up message confirming that you want to create a custom course from the selected cases. Click OK to continue.

Approve Create Course in Content Library

5. On the New Course page, enter:

Course Name: We suggest using a consistent naming convention that includes course and rotation name, such as “Family Medicine Clerkship: Block 4”.

Description: We suggest including instructor name, instructions for the course, which cases are assigned, due date, and anything else your students need to know.

Person Responsible: Select the user responsible for the course from your list of eligible administrators. The person responsible will be visible on the course page to all students and administrators associated with the course and will be notified when the course reaches its end date to either delete or extend the date of this course.

Start Date: Visible to all course users.

End Date: This date will show on the courses page for all associated users. When the end date is reached, the person responsible for the course will be notified and asked to delete or extend the date for this course.

Create new Course in Content Library

6. Click Create Course.


7. You will then see a notification of successful course creation. On your new course page, you will see your course information at the top and the content you have selected showing below.

Course Created in Content Library

Add Users to the Course

Only the users that are added to custom courses will be able to view and access it, so it is important that you complete this step. All users assigned to a custom course will receive an automated email invitation. You can add or remove users at any time.

Remember: Users must be rostered in your program before you can assign them to a custom course.

  1. From the custom course page, choose Course Users button in top right-hand corner. This will take you to the Course Users page.
Add users in Content Library

You have two options to add users:

Add by Email will allow you to batch add the students to the course, rather than adding them one by one from a list, and is recommended if you have a large group of students to add to a course.

1.Click Add By Email in the upper right-hand corner.

Add by Email in Content Library

2. Insert comma separated email addresses into the open field. It is recommended that you have list of student emails in a column list (in Excel) which you can simply copy and paste into Aqueduct.


3. Select a date to schedule an email inviting users to access this course. If you do not choose a date, the email invitation will send immediately.


4. Click Add Users button directly under the field.

Add by List allows you to select users to add to your course by selecting them from the list of current users in the system. This option is recommended if you are adding individuals or small groups of students to a course.

1.Click Add By List in the upper right-hand corner.

Add by List in Content library

2. Scroll through list to find specific users or use the Search feature to search for a user by name or email. Please note that if “Unknown Unknown” appears to the right of the student email address, they have not yet completed registration or signed in.

3. Click on a user to select them.

Search by user name content library

4. Select a date to schedule an email to your users inviting them to access the course. If no date is selected, the email will be sent immediately.

Future Date in Content library

5. Once you have completed your selection(s), click Add Members button in top right-hand corner.

Add members in content library

Confirm Your Users Were Added Successfully

1. A message will appear at the top of the course page indicates the users that were successfully added to the course.

2. If you receive a message saying “The following emails are not members of the group yet but were saved to be added to the course later ….” It means the system does not recognize those emails as having been previously rostered. Check to see that you entered the email addresses correctly. If so, contact your Program Service Administrator to ask to have the users rostered in Aqueduct. Once they have been rostered in Aqueduct they will be automatically be added to the course.

Fail to add members in content library

Click “Course Users” to view all users that have been added to the Course.

Course user list in content library

Rostering Students in Aqueduct

In Aqueduct, it’s easy for administrators to manage student access. The most important thing to know is that students need to be rostered in Aqueduct in order to have access to the Aquifer courses. Be sure to add new students to your program at the start of each academic year or semester.

Notes about Student Rosters:

  • Please inform students that you will be using their official institutional email address only. Using official institutional emails exclusively allows a consistent way for you and students to manage log-in, and for Aquifer support to assist students who need help.
  • The format for inputting a student roster is comma separated email addresses ONLY. You will want to download this list from your current system to a CSV file.

Access the Student User Panel

To access the student user panel, click on Users in the top navigation. From the program users page, click on the Students tab.


Details on the student user panel can be found in our Managing and Removing Student Users post.


Adding Students to a Program

From the student user panel, click on the Add Students button at the top of the page.

add student users button

Copy/paste your student emails in comma separated format on the screen. You can also add new students one by one throughout the year as needed by simply typing their email address into the box.

batch add students

If you would like to schedule an automated email inviting your students to access your program’s Aquifer subscription, click on the checkbox next to the “Send invite emails to students” text. If you do not want to send automated email invitations at this time, don’t check the box and click on Add Students. You will have the ability to send email invitations at any time once your students are added to your program.

batch add students and choose date for email invitation

If you wish to send an automated email invitation, a date selection field will appear after you check the send invite box. Schedule your email invitation by selecting the date on which you would like it to send. If you select the current date, your invitation will send immediately.


You will see a confirmation at the top of your User page listing the user(s) that have been added. If you have included any student emails that are already part of the program, you will see a red notification bar with that message.


The students you added will now appear in the student user list below as “Unknown Unknown”, showing their email addresses and a status of “Registration Pending”. When the students sign in and complete their registration, their status will change to “Active” and this screen will show the values that they enter for First Name, Last Name, and Anticipated Graduation Date.

student user panel

To learn more about student user management and tools, please view our Managing & Removing Student Users post.

Integrating Aquifer Cases into Your Curriculum

Effective, successful integration of Aquifer cases into the curriculum depends upon careful consideration and planning.

Proven Integration Strategies Include:

Creating clear learning objectives from the Aquifer cases that link to your course objectives
  • Articulate clearly to students how the case learning objectives fit into the overarching learning objectives for the course.
  • Discuss the use of Aquifer cases in student orientation materials.
  • Require student completion of the cases or a relevant subset of cases.
  • Fill gaps in clinical exposure with virtual patients – count completion of the case toward clinical case log entries, which assists in meeting LCME standards as well.
  • Include case content in formative or summative assessment.

Incorporating time into your curriculum for the Aquifer cases

Research has demonstrated that the most effective integration strategy is building in time for students to work on the cases.

  • Eliminate redundant teaching from didactic sessions, required reading, other course assignments or unrelated assessments.
  • Schedule time for students to work on the cases during the course.
  • Ensure sufficient access to computers and the internet, particularly during clinical assignments and away rotations.

Blending Aquifer content into clinical teaching
  • Ask clinical faculty to review case summaries for common presentations, building on the content before or after clinical encounters.
  • Compare and contrast the presentation of Aquifer cases to students’ own patients.
  • Encourage teaching residents to draw from the case resources – they likely completed the cases as students themselves!
  • Use the Aquifer clinical reasoning structure to frame and expand discussions of patient workup and management.

Building on Aquifer content in didactic sessions
  • Align required case completion to your course didactic sessions.
  • Use Aquifer cases to guide sessions on required competencies: communication skills, professionalism, cultural competency and systems-based practice.
  • Create active learning sessions––such as team-based learning or flipped classroom sessions––that require students to problem-solve and apply what they have learned.

Creating new learning experiences that elaborate on Aquifer content

Educators have reported a number of innovative methods for expanding on Aquifer content––taking clinical learning to a higher level:

  • Clinical reasoning assignments
  • Patient safety and quality improvement exercises
  • High fidelity simulation exercises
  • Standardized patient sessions
  • Reflection writing exercises

Sharing Innovations

Do you have integration strategies that have worked well for you? Do you have teaching innovations that you’d like to share? Contact us. We’d like to disseminate them!

Orienting Your Students to Aquifer

Help Maximize Student Learning

Orienting your students to Aquifer will make a big difference in their learning experience. You can help them maximize their learning by sharing some key information to help them get started and understand how Aquifer fits into your plans for your course or clerkship.

3 Steps to Successful Orientation

As always, we’re here to help! Aquifer has developed resources to make it easy for you to share key points with students in a quick, engaging way. We’ve also identified the key questions you’ll need to consider about how Aquifer is integrated into your course to be sure students clearly understand your expectations.

1

Start with Our Slides

We’ve created slides with the basics on Aquifer cases and useful tips for students, ready to drop into your course or clerkship orientation.

2

Watch Student Story Videos

Let your students hear from their peers to help them understand how Aquifer cases can help them advance their skills through complete, realistic clinical experiences. Show our two 1-minute videos in your orientation, or have your students watch them on their own by sharing this link: aquifer.org/students.

3

Share Goals & Expectations for Your Course or Clerkship

Orient students to your rationale for using the cases in your curriculum is important.

Recommended Article

We recommend reviewing the article below when planning your Aquifer use to understand key student insights.

Key Questions

Review the following questions during your course orientation or include the answers in your course materials.

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.

Many educators require students to complete all of the cases within an Aquifer course. 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 encouraged to complete the remaining cases as needed. You may also wish to make your students aware of the additional courses that Aquifer offers with each 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 document case completion to meet institutional case log or LCME requirements. Be clear with students at the beginning of your course that you will be monitoring their progress, and 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 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.

  • Completing or reviewing Aquifer cases just before or after seeing a patient with a similar presenting problem.
  • Comparing and contrasting the presenting finding from an Aquifer case with their patients’ presentation.
  • Applying the Aquifer clinical reasoning approach to their patient presentations and write-ups.
  • Using the Aquifer summary statement rubric when writing summary statements in the patient record.
  • Reviewing their questions about the cases with their preceptors or teaching residents.
  • Applying 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 assessment closes the curricular loop and demonstrates to students that you value the Aquifer content and their time spent working through the cases. We offer a variety of formative and summative assessment methods directly linked to our case content and pedagogy. An early understanding of how their Aquifer work will be assessed ensures student attention to the cases, and enhances their engagement.

Webinar: Engaging Your Students & Faculty with Aquifer

For more tips on engaging and orienting your students with Aquifer, catch our panel of educators and student contributors sharing their experiences.

Don’t Forget: Anytime, Anywhere Access

Be sure to let your students know that all cases are available via our mobile apps. Download “Aquifer Clinical Learning” for iOS and Android to complete work anytime, anywhere—including working offline.