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Inclusive-JITT: Training Resources for Quality Emergency Response

The Advanced Practice Center at Oregon's Multnomah County Health Departmetn developed the Inclusive Just-In-Time-Training (I-JITT) model and a suite of trainings and materials for health departments to use.

The Advanced Practice Center at Oregon's Multnomah County Health Departmetn developed the Inclusive Just-In-Time-Training (I-JITT) model and a suite of trainings and materials for health departments to use.

April 19, 2012

There’s been a large-scale emergency, and your department has to call in extra resources to respond. All staff need to be trained and comfortable with the required protocols, and fast—a tall order for a stressful situation. What’s the best way to train responders in this kind of scenario?

For the last two and a half years, the Advanced Practice Center (APC) at Oregon's Multnomah County Health Department has been researching, developing, and disseminating tools to address that very question in the context of Just-In-Time-Training (JITT). Through their work, they found that during an emergency there are often gaps between JITT methods in use and best practices of adult learning.

“In emergency training situations, health departments frequently rely heavily on either pre-produced video with little context or on didactic lectures with lots of forms,” said Beth McGinnis, MPH and program supervisor for the Multnomah APC. “Practice is the huge thing that is missing. The opportunity to physically practice the job is so critical to retention and application of the information.”

With foundational work done by Christine Cress, PhD at Portland State University, the Multnomah APC went to work developing ways to incorporate adult learning concepts into emergency trainings for health department staff. The result became Inclusive Just-In-Time-Training (I-JITT) model and a suite of trainings and materials to support it.

The I-JITT Model

The I-JITT model addresses three key factors in learning: the learning dimension (intellectual, behavioral, and emotional needs of the responder), the learning style (visual, auditory, or hands-on), and cultural context (the attitudes, beliefs and experiences of the individual or group in the emergency environment).

The principles of the I-JITT model seek to satisfy these learning needs by tailoring the training to the specific response environment, so that responders can be the best prepared.

“There is no one-size-fits all teaching technique. To convey the most information to the broadest audience, your program must employ all of the training techniques at your disposal—auditory, visual, experiential.”

—from the
Inclusive Just-In-Time
Training online course

The first steps in the Multnomah APC’s process were to develop the I-JITT whitepaper, “Enhancing Training During Public Health Emergencies: An Inclusive Just-In-Time Approach,” which provides a strong overview of the principles and arguments for why incorporating this type of training is so critical to a successful emergency response.

I-JITT Trainings and Toolkits

The Multnomah APC will complete its three-year grant in October 2012, so they are now working hard to spread the I-JITT concepts through trainings and toolkits that can live beyond the existence of the APC.

“Sustaining the model is the name of the game. We’ve created all these materials, but we have to help health departments learn to tailor and understand it, so they know appropriate use,” said McGinnis. “Otherwise the materials themselves will not be effective.”

To do this, they’ve created multiple electronic outreach vehicles—including webinars, podcasts, and an introductory video—so that health departments can integrate I-JITT toolkits and principles effectively. All of the I-JITT training materials and toolkits can be found on the Multnomah County Advanced Practice Center page.

Of these, McGinnis says she is particularly proud of the Inclusive Just-In-Time-Training Workshop video: “I think that the video training we created from an epi/investigation environment workshop was most helpful and a good resource for people to know how to begin working with the I-JITT curriculum.”

I-JITT: A Successful Model for Emergency Training and Beyond

The I-JITT concepts and toolkits have received an extremely positive response from trainers and training recipients. In fact, the I-JITT toolkit for Point of Dispensing (POD)/Mass Prophylaxis Operations remains the most viewed tool in the APC online toolbox, which contains tools from APCs all over the country.

Furthermore, while the main focus was to improve training techniques during emergencies, health department officials have also found that I-JITT concepts can be applied to any type of training.

“The inclusive part of the I-JITT is a concept in-and-of itself which I espouse and use in a lot of training.  It assures a better outcome for trainees,” commented Diana Yu, MD, Health Officer for Thurston and Mason Counties in Washington, who received I-JITT training in April 2011.

The CDC Department of the Strategic National Stockpile is also in the process of integrating the I-JITT model into part of their week-long preparatory course for trainers. This means that hundreds of state and local preparedness practitioners who attend the course each year will learn about this approach to training and the related toolkits—a big endorsement for the quality of the Multnomah APC’s work.

As of now, the future of the APCs is uncertain, due to potential changes in federal funding, so Multnomah County is making every effort to ensure that local health departments use the materials and trainings available to them.

To take advantage of these trainings and tools, you can find them all on the Multnomah County Advanced Practice Center website.

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