Just-in-Time Teaching

Dr. Fidelma Rigby, Associate Professor of Obstetrics and Gynecology, explains how Just-in-Time Teaching can be helpful in large group settings.

Why should I use JiTT?

Many experts have forgotten what it was like to learn their field for the first time. JiTT brings the students’ confusion to the forefront so that faculty experts can directly address it.

In addition, JiTT reduces lecture time because the session does not need to cover information that the students already understand. JiTT helps students develop meta-cognitive skills, such as self-assessing learning needs, by asking them to identify what is confusing. Last, when students see that their answers were used to tailor the in-class session, they take ownership of the content to a greater degree (Novak, 2011).

How do I start?

Start by choosing a topic. Is there a session that you feel falls short, each year? Is there an especially difficult topic with which the students struggle? These sessions may be a good place to implement JiTT. Once you have identified the session and audience that you will be teaching with JiTT, the last steps are to choose a pre-class reading assignment and to write “quiz” questions.

How do I choose a good pre-class assignment?

Consider your audience, the time they have to perform the assignment, and the objectives you wish to accomplish. Avoid readings that are too dense or too long. Also, make sure the reading is written at the right level. The reading for a resident may not work for a medical student.

What are the steps I should take to ensure a successful JiTT session?

The two most important factors are writing well-constructed questions and choosing appropriate pre-reading.

How do I write good content questions for my JiTT session?

Try not to pull content questions verbatim from the text to ensure students read the chapter or assignment. Faculty should seek to develop questions that require demonstration of content understanding.  Since faculty will be scanning all responses from students in the class, they should strive to keep answers brief to make review easier. Lastly, try to relate the JiTT questions to the lesson objectives.

How long does it take to prepare a good JiTT session?

Preparation time decreases with practice.   The first time a faculty member uses JiTT, selecting appropriate readings and constructing the three questions will likely add a little pre-class preparation time, as well the time that will be needed to scan student responses after administering the survey tool.  When you set time for all student responses to be submitted to the survey tool,  allow sufficient time to do a quick review to look for themes and patterns in what students find difficult or confusing.

How do I read through hundreds of responses from students efficiently?

Constructing appropriate questions is key. You should word the question to elicit a short answer versus a paragraph. You will only be scanning the responses to your questions, which becomes easier as you see themes in the students’ answers. After the first few iterations, scanning of student responses will likely become much easier and faster.


Just in Time Teaching is an instructional strategy used to customize the in-class content, such as lecture, to the concepts that students found most confusing; this method starts with a pre-class assignment for students.

Pre-Class Assignment

In JiTT, a pre-class assignment has two parts. First, the students are given content to learn; this “content input” may be a handout. This “content input” may be a handout, a book chapter, or a website that students read prior to class.   Next, they complete three questions. The quiz consists of two content-related questions, and a third question that asks, “What part of the reading did you find most confusing?”

The quiz accomplishes two things. The first two questions ensure the students read the material and understood basic concepts. The third question identifies at least one area that confused the student during the reading/content input. Giving a small number of points for completing the quiz (not for getting the right answers) increases student participation in this quiz. After the quiz submission deadline has past, the faculty member reviews the answers and tailors the in-class instruction to the content that most confused the students.

Survey Technology

Many tools are available online that allow faculty to collect student responses to the pre-class quiz. These include RedCap, Survey Monkey, Blackboard, and Google Forms. Each of these has features that meet different needs.  The VCU SOM faculty developers are available to help you learn how to use these tools.

Concept Test

Following the tailored in-class instruction (usually lecture), faculty should verify the students’ understanding.  A concept test is a short question asked in class to ensure that the majority of students understand the concept behind the question. Asking a concept test question allows a faculty member to take the pulse of the students’ understanding. If the majority of students answer correctly, the lesson moves forward. If the students answer incorrectly, the concept is not understood and should be revisited. In this situation, Peer-Instruction is one way to quickly revisit material.


This is an in-class teaching strategy in which peers discuss confusing concepts to clarify key points. After a concept test is administered, a student explains to a neighbor why his or her answer was correct by trying to convince the peer of the alternative response.  This methodology works on the idea that the student (as a novice) can explain a concept to another student at a more appropriate level and using novice-level language, as compared with how an expert (the faculty member) would explain the same concept. After peers discuss their answers, the concept test is re-administered to make sure that the majority of students are correct in their understanding. If students still answer incorrectly, the faculty member intervenes with an additional explanation or a mini-lecture on the key point. Peer-Instruction is often paired with JiTT.

ARS / Clickers

Audience Response Systems (a.k.a. “clickers”) is an easy way to pose a concept test to a class.  This polling method is used in the classroom and allows students to respond to a question displayed on the screen. VCU SOM uses the web>clicker product. Software for this product can be downloaded from iclicker.com. Another option is Poll Everywhere, which is free and uses texting to poll the audience.