title: Improving education: just-in-time splinting video.
abstract: BACKGROUND
  Just-in-time training (JITT) is an emerging concept in medical procedural education, but with few studies to support its routine use. Providing a brief educational intervention in the form of a digital video immediately prior to patient care may be an effective method to reteach knowledge for procedural techniques learned previously.
  
  
  METHODS
  Paediatric resident physicians were taught to perform a volar splint in a small workshop setting. Subsequently, they were asked to demonstrate their splinting proficiency by performing a splint on another doctor. Proficiency was scored on a five-point assessment tool. After 2-12 months, participants were asked to demonstrate their splinting proficiency on one of the investigators, and were divided into the control group (no further instruction) and the intervention group, which viewed a 3-minute JITT digital video demonstrating the splinting technique prior to performing the procedure.
  
  
  RESULTS
  Thirty subjects were enrolled between August 2012 and July 2013, and 29 of 30 completed the study. The retest splinting time was not significantly different, but if the JITT group included watching the video, the total time difference was statistically significant: 3.86 minutes (control) versus 7.07 minutes (JITT) (95% confidence interval: 2.20-3.90 minutes). The average assessment score difference was 1.87 points higher for the JITT group, which was a statistically significant difference (95% confidence interval: 1.00-3.00). Just-in-time training is an emerging concept in medical procedural education
  
  
  CONCLUSIONS
  JITT seems to be an effective tool in medical education for reinforcing previously learned skills. JITT may offer other possibilities for enhancing medical education.
authors.affiliation: Pediatrics Department, Children's Hospital Los Angeles, California, USA.
authors.forename: Vincent
authors.initials: V
authors.lastname: Wang
authors.affiliation: Pediatrics Department, Rady Children's Hospital San Diego, California, USA.
authors.forename: Yu-Tsun
authors.initials: YT
authors.lastname: Cheng
authors.affiliation: Pediatrics Department, Children's Hospital Los Angeles, California, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Liu
mesh_terms: D002983:Clinical Competence; D004521:Educational Measurement; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D010372:Pediatrics / Q000193:education*; D013165:Splints; D013997:Time Factors; D014743:Videotape Recording