‘Just in time’ learning is an ideal method to adopt in workplace based education. It is learning that is integrated and applied in real life situations to address a specific need or clinical question. In contrast, ‘just in case’ learning focuses on memorising content that may or may not be needed or even accessible to the learner at a future point in time1. It is the approach most often adopted when a learner is faced with a content heavy curriculum and limited opportunities to apply the information that is being taught.
The workplace setting provides health professional learners with a myriad of opportunities for learning clinical assessment and management, communication skills and professional behaviours. However, the environment may not be ideal for teaching and learning as it is often very fast paced, space and time limited, and both teacher and patient dependent. This can make it highly variable, sometimes unpredictable and consequently some learners may struggle.
Here are a few suggestions to optimise ‘just in time’ teaching and learning opportunities in the clinical environment:
1. Develop a Learning Plan and meet with learners coming into your area early in the placement to identify their needs and expectations. Having a negotiated and agreed plan will help you stay on track even when the plan has to change due to unforeseen circumstances.
2. Adopt an approach that is learner centred and problem-based as this will help you target individual needs, while at the same time ensuring your teaching is highly relevant, applied and stimulates interest and engagement of the learner.
3. Integrate your teaching with workplace-based activities so that learners are exposed to the various components of the system and can experience how health care teams coordinate and manage quality care.
4. Equip your learners with the ability to appropriately question their patients2, you and through reflection themselves. This will ensure they explore relevant foundation knowledge, and become independent thinkers who can clinically reason and problem-solve each clinical case that is in front of them.
5. Help your learners to make the most of the opportunities provided in the dynamic workplace setting. They often see their learning as being primarily derived from direct patient contact and structured teaching sessions. You can point out a myriad of prospects for learning that occur on a daily basis such as: discussions with peers and other team members, writing in the patients’ medical records, preparing discharge summaries, general observations and attendance at meetings.
6. Develop a number of 5-10 minute teaching scripts that you can implement on-the-spot when a particular clinical case or opportunity for ‘just in time’ teaching presents. These scripts are short teaching plans which you can prepare in advance on topics that you know are often poorly understood or not covered well in the academic curriculum.
7. Demonstrate how to be adaptable while maintaining composure, and being able to act pragmatically in your approach to your clinical work and to teaching and learning activities. Remember that being an effective role model3 is one of the most powerful teaching tools that you possess.
1. Kahn Jr CE, Ehlers MS, Wood BP. Radiologists’ preferences for just-in-time learning. J Digital Imaging 2006; 19:202-206.
2. The role of questions in teaching, thinking and learning [Internet]. [2011; cited 2012 Jan 8] Available from: http://www.criticalthinking.org/pages/the-role-of-questions-in-teaching-thinking-and-learning/524
3. Stenfors-Hayes T, Hult H, Dahlgren LO. What does it mean to be a good teacher and clinical supervisor in medical education? Adv in Health Sci Educ 2011; 16:197-210.