title: Using just-in-time teaching and peer instruction in a residency program's core curriculum: enhancing satisfaction, engagement, and retention.
abstract: OBJECTIVE
  To assess use of the combined just-in-time teaching (JiTT) and peer instruction (PI) instructional strategy in a residency program's core curriculum.
  
  
  METHODS
  In 2010-2011, JiTT/PI was piloted in 31 core curriculum sessions taught by 22 faculty in the Northwestern University Feinberg School of Medicine's general surgery residency program. JiTT/PI required preliminary and categorical residents (n=31) to complete Web-based study questions before weekly specialty topic sessions. Responses were examined by faculty members "just in time" to tailor session content to residents' learning needs. In the sessions, residents answered multiple-choice questions (MCQs) using clickers and engaged in PI. Participants completed surveys assessing their perceptions of JiTT/PI. Videos were coded to assess resident engagement time in JiTT/PI sessions versus prior lecture-based sessions. Responses to topic session MCQs repeated in review sessions were evaluated to study retention.
  
  
  RESULTS
  More than 70% of resident survey respondents indicated that JiTT/PI aided in the learning of key points. At least 90% of faculty survey respondents reported positive perceptions of aspects of the JiTT/PI strategy. Resident engagement time for JiTT/PI sessions was significantly greater than for prior lecture-based sessions (z=-2.4, P=.016). Significantly more review session MCQ responses were correct for residents who had attended corresponding JiTT/PI sessions than for residents who had not (chi-square=13.7; df=1; P<.001).
  
  
  CONCLUSIONS
  JiTT/PI increased learner participation, learner retention, and the amount of learner-centered time. JiTT/PI represents an effective approach for meaningful and active learning in core curriculum sessions.
authors.affiliation: Ms. Schuller is manager, Division of Surgical Education, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Dr. DaRosa is professor and vice chair for education, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Dr. Crandall is associate professor of surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Schuller
authors.forename: Debra A
authors.initials: DA
authors.lastname: DaRosa
authors.forename: Marie L
authors.initials: ML
authors.lastname: Crandall
mesh_terms: D005180:Faculty, Medical; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D010379:Peer Group; D010549:Personal Satisfaction; D018794:Problem-Based Learning / Q000458:organization & administration*; D012153:Retention, Psychology