Development and evaluation of a just-in-time support system

OBJECTIVE: To lay the foundation for a framework of just-in-time support (JITS) for novices dealing with urgent, unfamiliar tasks, and to evaluate a JITS system. BACKGROUND: More than 350,000 people die annually of cardiac arrest in the United States. In response, automated defibrillators are advocated that, unfortunately, do not provide important respiratory support. This paper presents elements of a framework for a JITS system that instructs a lay responder to follow a treatment protocol for integrating respiratory support with the use of an automatic external defibrillator. METHOD: We simulated a medical emergency using a high-fidelity patient simulator and asked participants to care for the patient. Results: When using a paper-based NASA treatment protocol, participants made more errors and took longer to stabilize the injured person than when using the JITS system. CONCLUSION: These findings demonstrate the benefit of a JITS system to instruct novices in unfamiliar tasks. APPLICATION: The JITS system has the potential to improve the treatment outcome of victims of cardiac arrest. The JITS framework can be applied to many situations in which novices deal with urgent tasks without expertise available.