Utilization of just-in-time training for nursing education using the LA Phonospirometry asthma tool

Kathryn H. Pade, Sophia T. Seik-Ismail, Todd P. Chang, Vincent J. Wang

Research output: Contribution to journalArticle


Objective: Just-in-time training (JITT) has been used to teach and re-teach known medical techniques, but has not been used to teach novel techniques. We aimed to assess the performance retention of JITT on a novel asthma exacerbation severity assessment technique known as Los Angeles (LA) Phonospirometry. Methods: This was a prospective cohort study using a convenience sample of pediatric emergency department registered nurses (RNs) who were asked to watch a brief instructional digital video on LA Phonospirometry, and then asked to practice the technique on a research assistant (RA). A checklist was used to evaluate proficiency with the primary outcome being the number correct on the checklist. The secondary outcome included whether or not they could identify a common error demonstrated by the RA. RNs were re-tested after 4–6 months to assess skill retention. Results: Forty RNs were enrolled in the study and six were lost to follow-up. The mean time from the first to second testing was 5.4 months ± 0.5 months. The mean score of the first part of the checklist on the initial testing was 4.6 ± 0.7 and on second testing was 3.8 ± 1.5 (p = 0.008). This represented a drop in scores and thus minimal knowledge decay of 18% (from 91% to 73%). The mean values for number of errors picked up for the first test and second test were 1.3 and 1.5, respectively (p = 0.2). Conclusions: JITT demonstrated feasibility as a rapid instructional tool for RNs, with a limited decay in cognitive knowledge surrounding the LA Phonospirometry technique.

Original languageEnglish (US)
Pages (from-to)811-815
Number of pages5
JournalJournal of Asthma
Issue number7
StatePublished - Jul 3 2018
Externally publishedYes


  • Just-in-time training
  • Los Angeles technique
  • emergency department
  • learning retention
  • nurses
  • phonospirometry

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

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