Perceptions on the impact of a Just-in-time (JIT) room on trainees and supervising physicians in a pediatric emergency department

Abstract

Background: In just-in-time (JIT) training, education occurs immediately prior to clinical encounters or procedures. An in situ JIT room in a Pediatric Emergency Department (ED) was created for procedural education and practice. Objective: To examine trainee self-reported JIT room use, its impact on trainee self-perception of procedural competence/confidence, and the reported effect JIT room usage has on need for intervention by supervising physicians during procedures. Methods: A cross-sectional survey of residents rotating through the emergency department over one year. A separate survey was sent to supervising physicians. Outcomes included reported use of the JIT room, trainee procedural confidence, and frequency of supervisor intervention during procedures. Results: Thirty-one out of 32 (97%) supervising physicians and 122/186 (66%) resident trainees completed the survey. 71% of responding trainees reported improved procedural confidence; 68% reported improved procedural skills after JIT room use. 29% of trainees state that supervisors intervene after JIT room use; while 38% state that supervising physicians intervene in procedures when they do not use the JIT room. 90% of supervisors reported having perceived improved trainee procedural confidence; 77% reported perceived improved trainee procedural skills after JIT room use. 58% of supervisors stated they intervene in procedures without trainee JIT room use, compared to 42% intervening when trainees use the JIT room. Conclusions: Use of a dedicated just-in-time training space led to improved trainee confidence. In addition, supervisors reported they intervene less in procedures after JIT room use. A dedicated JIT room may be important in providing a medium for improving procedural competence, particularly in trainees who go on to practice pediatric medicine in low resource settings with minimal supervision.