Date of Award

January 2018

Document Type


Degree Name

Medical Doctor (MD)



First Advisor

Jeremy J. Moeller



Moises Dominguez, Daniel DiCapua, Gary Leydon, Caitlin Loomis, Kevin Becker, Kamil Detyniecki, P. Christopher Gottschalk, Erin Longbrake, Arash Salardini, Sara M. Schaefer, John Encandela and Jeremy J. Moeller. Department of Neurology, Yale University School of Medicine, New Haven, CT.


There are a number challenges medical education faces, such as the exponential

increase in medical knowledge students must learn within their four years of medical

school. Now more than ever is the time to implement evidence-based methods of

teaching while utilizing advances in technology to deliver medical content to students.

Just-In-Time Teaching is an active form of learning that uses web-based technology to

create a feedback loop between the students and instructor. Students are assigned a task,

which involves answering conceptual questions prior to the in-class session. The

instructor receives the student results to adjust their lecture “just-in-time.” Based on the

student responses, the instructor can address any common misconception amongst the

students. Our goal is to enhance the student and lecturer experience, and to assess the

effectiveness, feasibility, and acceptability of this pedagogy on student learning in third

year medical students on their neurology rotation.


8 short (~5-13 minute) video-based lectures (VBLs) were created to present the

framework and “evergreen” knowledge of 8 subspecialty didactic sessions within the

neurology clerkship. 4-8 multiple-choice questions (MCQs) were created and reflect the

learning objectives faculty members identified for their subject, which students take after

watching the VBL. We iteratively implemented the VBL/MCQ sets in order to incorporate the feedback from students and faculty member into the development of the next topic. This equated to incorporating 1-2 topics each month. Quantitative surveys

from students and faculty were obtained. End-of-clerkship knowledge assessments were

compared between the intervention and pre-intervention groups.


42.4% (56/132) of students, between October 2016 and April 2017, responded to

the surveys. Most students agreed or strongly agreed that using this pedagogy enhanced

their learning and felt more responsible for learning the material. Faculty agreed that they

enjoyed using this pedagogy and that it helped prepare students for class. Most faculty

felt that seeing how students did on the multiple-choice questions helped them better

understand which areas of knowledge need further clarification. Most students watched

the whole video-based lecture; however, there was decreased audience retention with

longer videos. There was no statistically significant difference in the end-of-clerkship

knowledge assessment scores when comparing the pre-intervention groups (traditional

lecture) and intervention groups (JiTT with VBL.)


Just-In-Time Teaching combined with Video-Based Learning is an acceptable and

feasible mode of teaching that enhances student learning and experience. Future research

will focus on improving the quality of the end-of-clerkship knowledge assessment tools

and implementing a randomized component to better evaluate the potential effectiveness

of this approach.


This thesis is restricted to Yale network users only. It will be made publicly available on 06/25/2100