Integrating just-in-time teaching with Rain Classroom: enhancing histology learning outcomes and satisfaction in nursing students

Although just-in-time teaching (JiTT) has proven effective in Western settings, its implementation in Asian nursing curricula, within China's distinctive pedagogical landscape, remains insufficient. Rain Classroom facilitates communication between students and teachers via smartphones or computers; however, its effective application to JiTT methodologies has yet to be evaluated. Two groups were compared: the JiTT group (<i>n</i> = 63, academic year 2024), assisted by the software plug-in Rain Classroom, and the traditional classroom (TC) group (<i>n</i> = 70, academic year 2023), who received traditional lecture-based instruction. Cohorts from consecutive years showed no baseline differences, with equivalence testing confirming comparability. Students in the JiTT group achieved significantly higher final examination scores than those in the TC group [77.21 points (SD 9.27) vs. 71.97 points (SD 11.69), degree of freedom = 131, <i>P</i> = 0.006]. A moderate positive correlation was observed between final examination scores and in-class quiz performance among the JiTT participants (Spearman correlation <i>R</i> = 0.42, <i>P</i> < 0.001). Satisfaction scores, assessed per a five-point Likert scale, were significantly higher for JiTT than TC [mean 25.73 (SD 3.17) vs. mean 22.79 (SD 3.84), <i>P</i> < 0.001]. Although students generally expressed positive attitudes toward the JiTT approach, some reported heightened academic stress. Qualitative analysis identified five major stressors. Overall, JiTT assisted by Rain Classroom significantly improved histology learning outcomes and student satisfaction in Chinese nursing education, although stress mitigation strategies are warranted for sustainable implementation.<b>NEW & NOTEWORTHY</b> Although just-in-time teaching (JiTT) has been widely studied in Western educational settings, its implementation within Asian populations remains scarce. Rain Classroom, a mobile-friendly platform enabling real-time student-teacher interaction, presents a promising, though insufficiently researched, tool for applying JiTT. To address this gap, we evaluated the effectiveness of JiTT integrated with Rain Classroom in a cohort of Chinese nursing students. This method significantly outperforms traditional approaches in enhancing histology test performance, learning perception, and student satisfaction.