Just-in-Time Teaching With Peer Instruction Improves Resident Involvement During Conferences

JIT  Several techniques for increasing learner engagement as compared to lecture have been described in the general education literature and are starting to replace lectures in didactic conferences for residents.  In a surgical residency program, faculty members were offered faculty development in just-in-time teaching (JiTT) during a one-hour faculty development session, or individually.  Seventy-three percent of the faculty presenting resident conferences volunteered for faculty development.  Residents were assigned readings before the class session and answered several pre-session questions addressing key concepts, as well as a question asking which concepts were most difficult.  Class sessions were structured with mixed-level resident groups.  Faculty members gave brief “mini-lectures” based on the concepts with which the residents demonstrated the most difficulty, followed by several multiple choice questions to be answered by residents individually using an audience response system.  If between 35% and 70% of residents answered the question correctly, the mixed level groups were asked to discuss the answers among themselves, utilizing peer instruction.  If very few residents answered correctly, the faculty member needed to clarify misconceptions; if the vast majority answered correctly, only brief clarification was needed.  Overall, a large majority of both residents and faculty responded positively to JiTT.  A majority of residents found the pre-readings helpful, and 90% of faculty members found the resident pre-session responses useful in their preparation.  Residents particularly enjoyed the peer instruction element.  Sessions were videotaped to objectively measure resident engagement.  Residents were actively engaged 34% of the time during JiTT sessions, vs. 11% of the time during the same faculty members’ lecture sessions.  JiTT appears to be another active-learning technique which can be successfully applied to resident conferences. — Laura Willett, MD

Schuller MC, DaRosa DA, Crandall ML. Using Just-in-Time Teaching and Peer Instruction in a Residency Program’s Core Curriculum: Enhancing Satisfaction, Engagement, and Retention. Acad Med. November 2014

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