A Neurology Clerkship Curriculum Using Video-Based Lectures and Just-in-Time Teaching (JiTT)

Abstract

Introduction: Just-in-time teaching is an educational strategy that involves tailoring in-session learning activities based on student performance in presession assessments. We implemented this strategy in a third-year neurology clerkship. Methods: Linked to core neurology clerkship lectures, eight brief videobased lectures and knowledge assessments were developed. Students watched videos and completed multiple-choice questions, and results were provided to faculty, who were given the opportunity to adjust the in-person lecture accordingly. Feedback was obtained by surveys of students and faculty lecturers and from student focus groups and faculty. Student performance on the end-of-clerkship examination was analyzed. Results: Between October 2016 and April 2017, 135 students participated in the curriculum, and 56 students (41.5%) responded to the surveys. Most students agreed or strongly agreed that the new curriculum enhanced their learning and promoted their sense of responsibility in learning the content. Faculty agreed that this pedagogy helped prepare students for class. Most students watched the entire video-based lecture, although there was a trend toward decreased audience retention with longer lectures. There were no significant changes in performance on the end-of-clerkship examination after implementation of just-in-time teaching. In focus groups, students emphasized the importance of tying justin-time teaching activities to the lecture and providing video-based lectures well in advance of the lectures. Discussion: Just-in-time teaching using video-based lectures is an acceptable and feasible method to augment learning during a neurology clinical clerkship. We believe this method could be used in other neurology clerkships with similar success.

Analysis of Student Perceptions of Just-In-Time Teaching Pedagogy in PharmD Microbiology and Immunology Courses

“…Comparison of student performance on knowledge-based questions between JiTT vs. non-JiTT courses from major assessments indicated that JiTT was helpful in student's learning of knowledge-based concepts. This is in agreement with previously reported observation that JiTT methodology effectively enhanced knowledge-based skills required for understanding of core health-care professional curricular topics (2,(6)(7)(8)(9)(10)15). Additionally, analysis of mean KR-20 values from each assessment also showed that courses with JiTT pedagogy had consistent exam performance compared to non-JiTT courses offered to the same cohorts.…”

“…Results from assessment of JiTT approach implemented for biomechanics education indicated significantly higher learning gains and better understanding of a concept-based JiTT course, relative to a non-JiTT course (5). JiTT methodology effectively enhanced knowledge-based skills required for comprehensive understanding of topics including core health-care professional curricula (2,(6)(7)(8)(9)(10). Medical residency programs identified JiTT as an effective approach that helped residents in their interactive learning of clinical modules, increased learner participation during core sessions in the curriculum and enhanced retention of JiTT course content (7,8).…”

“…Medical residency programs identified JiTT as an effective approach that helped residents in their interactive learning of clinical modules, increased learner participation during core sessions in the curriculum and enhanced retention of JiTT course content (7,8). More recently, JiTT using videobased lectures (VBLs) was incorporated and was very wellperceived by students enrolled into a neurology clerkship program (9). Besides, it was successfully incorporated into neuroeducation study as a reinforcement-based learning tool to help establish the foundational knowledge of neuroanatomy in novice learners (10).…”

Strategic Considerations for Applying the Flipped Classroom to Neurology Education

“…Moreover, in a review of the neurology education abstracts presented at the American Academy of Neurology (AAN) annual meetings from 2016–2019 (available at: https://issuu.com/americanacademyofneurology/docs), only 2 focused on the flipped classroom format, which was used to deliver content for a specific subject within the curriculum. Similarly, explorations of neurology education resources on the MedEdPORTAL (available at: https://www.mededportal.org/) resulted in 0 of the 44 resources fitting the description of a flipped classroom; however, there is one report from Yale that describes modification of the classroom lecture based on a preclass assessment taken by the students . Overall, there is a relative dearth of reports from the medical literature regarding implementing flipped classrooms in neurology education, which flags a methodological gap that our field needs to explore further.…”

“…Similarly, explorations of neurology education resources on the MedEdPORTAL (available at: https://www.mededportal.org/) resulted in 0 of the 44 resources fitting the description of a flipped classroom; however, there is one report from Yale that describes modification of the classroom lecture based on a preclass assessment taken by the students. 26 Overall, there is a relative dearth of reports from the medical literature regarding implementing flipped classrooms in neurology education, which flags a methodological gap that our field needs to explore further.…”