A Smartphone Resource for Just-in-Time Medical Student Teaching by Emergency Medicine Residents

Objectives Previous studies have shown that residents play an important role in the education of medical students in the clinical setting, but the busy environment of the emergency department (ED) poses a challenge to the effective teaching of medical students by emergency medicine (EM) residents. To combat this, this study relies on just-in-time teaching, which refers to the application of teaching efforts specific to a particular moment, in this case, a clinical case or procedure. Building on studies showing that just-in-time teaching can improve education despite time constraints, as well as data showing that practitioners and trainees increasingly use apps for diagnosis and education, the objective of this project was to determine whether a free open-access medical education (FOAM) smartphone application (app) is feasible and improves the quality and frequency of resident teaching of medical students in the emergency department.  Methods We created a smartphone app-based teaching resource that was available to residents and students on shift. We taught residents and medical students how to integrate the app into their workflow. We performed an observational pre/post-study design by surveying residents' and students' pre- and post-teaching app introduction to determine self- and student-reported teaching frequency and quality. Outcome measures were self-reported teaching frequency and quality of teaching. Results Ten of 17 residents (59%) reported using the app at least once per shift. Among them, six of 10 (60%) reported that it increased their teaching frequency, and eight of 10 (80%) reported that it increased the quality of their teaching. There was an increase in the number of residents with positive perceptions of the availability of evidence-based teaching resources on the shift from pre-intervention (five residents) to post-intervention (14 residents, p = 0.01); however, we were otherwise unable to identify any significant differences in residents' or students' perceptions of teaching after implementation of our intervention. Conclusion Just-in-time teaching of medical students by residents using a smartphone app is feasible, as evidenced by the majority of resident respondents reporting that they used the teaching app at least once per shift. Residents reported an improvement in teaching frequency and quality. The study is limited by a small sample size and a single-site design with a pre/post design. Further studies with a focus on qualitative feedback and objective measures of learning are needed to assess whether there is an impact on medical student instruction by residents when using this app-based teaching resource.