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Techniques for Just-in-Time Teaching in a Medical School Course

In the Spring of 2014, Professors Rachel Gordon and Stephen Canfield worked with educational technologists at the Columbia Center for New Media Teaching and Learning to adopt a number of new pedagogical approaches for their Body, Health, and Disease course. These new approaches helped the College of Physician and Surgeons professors change the dynamics of their 250-student classrooms.

Gordon approached her course with the goal of increasing student engagement and learning during classroom time. To accomplish this, she relied on just-in-time teaching (JiTT) teaching approaches including an audience response system (ARS), the case study method, and peer/collaborative learning techniques. She also applied a flipped classroom model by delivering instructional content online to allow for more engaging activities during class time.

picture of r gordon

Gordon produced short video lectures for her students to review online before presenting a case study during class time. Using an ARS, she would have her students respond to a poll that challenged them to choose the best course of treatment using the concepts and content from the lecture material. This immediate feedback helped her to gauge whether or not she needed to spend more time on specific content or to move on to other topics.

Using a dashboard summary of student responses, Gordon would decide whether or not to proceed to the next case study. If the majority of the students chose correctly, Gordon would have a student representative explain the correct choice and then move on to the next case study. If 50% or less of the students chose the correct answer, she would ask her students to discuss their choices in small groups. After a brief discussion, Gordon would re-poll her students. Typically, the peer discussions led to an increase of more than 75% accuracy when students were polled a second time.

Having peer discussions helped students adjust their response, and enabled positive, collaborative learning. Gordon reported a notable increase in student engagement in spite of the many challenges with teaching in a large lecture hall setting. In her opinion, a majority of her students were listening, participating in the polls, and engaging in discussions.

Gordon wrote that, “even using JiTT for the very first time, it was apparent that it was a successful and powerful learning approach.” She posed difficult questions to her class, and was impressed by the vibrant discussions that followed. “On many levels it was more satisfying than lecturing where you don’t really know if the students are ‘getting it.’ With JiTT, that’s exactly what you find out and can teach accordingly. I hope that more educators take the plunge–it’s worth it!”

Gordon’s students also responded positively in a survey taken at the end of the course. Many indicated that the shift from lecture to case study discussion, and the use of the ARS, helped them to solidify their grasp on course material.

In the video below, created for a related grant proposal, Gordon illustrates the benefits of flipping the classroom.