Regardless of your opinion on the subject, you cannot be unprepared when patients walk into the emergency department.
So, how can you quickly prepare your staff to handle a novel event that you know is coming? Just-in-time training (JITT) is the answer.
JITT provides “micro-education” on specific topics shortly before they get used. This type of training accommodates for the fact that people forget what they learn pretty quickly. The average adult’s memory is just not that great. In the late 1800s, Hermann Ebbinghaus, a German psychologist, introduced the concept of the ‘forgetting curve” — the speed at which information is lost. According to his research, adults forget almost 60 percent of the new information they have been taught within 20 minutes after instruction. Rapid memory loss continues for eight hours. Ultimately, we only retain about 20 percent of the information we are taught.
In addition to forgetting most of what we are taught soon after we are taught it, we in the Emergency Services professions usually receive our instruction in the form of lectures or textbooks — two of the most ineffective ways of learning new information. In general, people in our profession are better at learning by doing. In the words of Maria Montessori, “What the hand does, the mind remembers.” When we can actually practice doing a procedure with our hands, in addition to being told what to do, the information gets stored in our brains in a much more effective way.
Imagine that someone tells you a long grocery list. You are likely going to forget those items pretty quickly. Now compare that to sitting in a classroom, on a hard seat, listening to a lecture on the Corona Virus. How much information are you actually going to retain? Probably not much. To reduce the rapid loss of information, training sessions must be adapted to become shorter, more relevant and interactive. The faster a participant can put information to use, the more they will retain.
In addition to learning new material, JITT can be used as a brief refresher of concepts that were taught and mastered at an earlier time. People perform well on skills that they do often, but they struggle to recall concepts that they use less frequently. Take a firefighter that is typically assigned to an engine, and engine company operations will be very familiar to that firefighter. But move that firefighter to a rescue company and they may struggle to recall all the various rescue operations. That firefighter mastered all the rescue concepts during their initial firefighter training, but a lack of recent relevant experience has caused them to lose familiarity with many specific skills. Using JITT, that engine company firefighter could be quickly brought up to speed at the beginning of their rescue company shift.
Just-In-Time Training, if implemented correctly, can overcome many barriers to a learner’s ability to retain information. Here are seven steps to use JITT correctly.
Define Your Learning Objectives
This is the least sexy step, and it is commonly disregarded, but it is the most important part of doing JITT successfully. What are you trying to accomplish by holding a training session? If you don’t clearly define your objectives, you cannot ensure that your participants meet the expectations of the training. Don’t waste a training opportunity because you failed to cover the material you intended. Creating learning objectives also allows trainers to correctly plan future JITT sessions.
Cover a Single Topic
Cover a single topic per JITT session. Do not attempt to jam multiple topics into a single session. Some material or skills should be taught using other educational theories. Learning how to don and doff protective personal equipment for the novice provider should be done over a four-hour session, not JITT.
Vary Learning Environment
Don’t just rely on a classroom; change the locations of your instruction. Use the apparatus bay or go outside. You could even use a local business to hold a brief training session. For example, if you are providing JITT on a new thermal imager, meet at a warehouse and run the camera inside.
Employ Hands-On Learning
Application of information results in significantly more retention. Have participants use the equipment they are learning. Provide brief instructions and then let them practice their skills.
Give Short, Specific,
Since memory loss is so dramatic, information must be completely relevant to your learning objectives. JITT should consist of short sessions that are 15-30 minutes in length. Keep the participants focused and on-task. Provide very concise information. No stacks of handouts or lengthy PowerPoint slides. Omit information that isn’t immediately applicable. Large complex concepts should be broken down into smaller, more easily digestible sections of information. If using PowerPoint, keep the slides succinct.
Get Learners Moving
Getting students out of their chairs is a great way to keep them engaged and improve retention. Studies have shown that students have an enhanced ability to focus and remember information when they are standing. Standing also helps students burn calories while they are training.
Short training sessions go quickly, especially if you are unprepared. Throw in a casual story about the previous shift’s lack of cooking ability and half your time is gone. Create a brief educational outline to stay focused and on time. Any necessary materials should be ready long before the session begins. Ten minutes before the session starts is not the time to make copies or troubleshoot the projector.
Any large department will have problems ensuring consistency of message across multiple JITT sessions, especially if there are multiple instructors. The lead instructor should meet with all the instructors prior to training and ensure that everyone is familiar with the learning objectives and all the specifics of the session.
Just-In-Time Training is a powerful educational modality that can help you teach new concepts, provide a review of essential material, and improve retention. Following the steps listed above will help provide a successful JITT session. Go get ‘em!
Aaron Dix is the Executive Director for Prisma Health Emergency Medical Services. He has an MBA in HealthCare Management, is a Nationally Certified EMS Educator, and a Certified Healthcare Simulation Educator. Prior to working at Prisma Health, Dix was the Director of the Greenville Healthcare Simulation Center and Training Coordinator for Greenville County EMS. In addition to his responsibilities at Prisma Health he is a commissioner for Clear Spring Fire Rescue.