JIT-300x225Just in Time Training (JiTT) is an educational concept that has been easily adapted for EM. Interesting, this educational strategy originates from inventory management. To them, JiTT means: right material, right time, right place, in the exact amount. In educational terms, this means: right educational modality, given to the learner at the right time, at the right location, and exactly the amount needed.

 According to mindtools.com, the benefits of JiTT include:

  • Low Inventory
  • Low Wastage
  • High Quality Production
  • High Customer Responsiveness

To translate this to educational philosophy:

  • Not having to create a ton of educational material
  • Low wastage of your time as the educator and your learners’ time
  • High quality of delivery of educational material
  • Real time engagement of your learners!


How is this put into use?

Right Educational Modality

  • Your learner is about to do a central line on an intubated patient. Before they begin the procedure, you both pull up NEJM video vignette on IJ central placement.
  • The charge nurse gets notification of a pedestrian struck patient arriving in 15 minutes not intubated. You pull out the manikin head that is stored in the department and quickly review airway anatomy with your resident.
  • Your second year resident is about to start an ICU rotation. Prior to starting on Day 1, they are required to watch a 10 minute learning module that was created to review sepsis protocol.

Right Time

JiTT should be used sparingly.  It is not meant to replace traditional learning didactics such as lecture and board review.  But it can be used right before the start of an important procedure, or before the start of a difficult rotation as listed in the above examples.

Right Location

JiTT is perfect to be done by the computer station prior to entering a patient’s room for a procedure.  Or it can be done via internet modules from home.

Right Amount

Time and attention is valuable, and very short in supply! The goal of JiTT is to deliver hard impacting educational content in a short amount of time. Greatest amount of educational delivery in a short amount of time. Bam! Educational Gold!

As you can see from above examples, JiTT is the perfect combination of andragogy adult learning theories and asynchronous learning. It also allows educators the option of creativity. You can access great collaborative educational material to be used for your learners in the philosophy of FOAM. Or you can create your own educational material such as practice intubation carts, learning podcasts for your department, or low fidelity models for high risk procedures such as cricothyroidotomy.

Small sample listing of resources that can be used for JiTT in no particular order:

Just remember:

  • Right material
  • Right time
  • Right place
  • In the exact amount

Please share successful methods of JiTT that you have used in the past!

Nikita Joshi, MD

Nikita Joshi, MD

ALiEM Chief People Officer and Associate Editor
Clinical Instructor
Department of Emergency Medicine
Stanford University
Nikita Joshi, MD


Emergency Medicine Doctor Associate Editor of ALiEM Gun Sense Advocate #FOAMed #Docs4GunSense #MomsDemandAction Tweets represent my own views and opinions