Generational Differences and Medical Education MAJ Sebastian R
Generational Differences and Medical Education MAJ Sebastian R. Schnellbacher, D. O. CPT Katherine Bohringer, D. O. Thomas Michels, M. D.
Disclosures The opinions expressed herein are those of the authors and are not necessarily representative of those of the U. S. Army or Department of Defense.
Objectives • List and describe differences between each generation • Demonstrate how to improve feedback given to millennials • Explain how to improve mentoring of millennials
What is a Generation? A group that shares experiences, values, and identity shaped by social factors, cultural events, and the world around them
Get Up and Move • Posterboards with generational names are spread across the room • Write down adjectives that describe the generations 5 minutes
Generational Norms
Howe and Strauss • Seven “core traits”: – Special – Sheltered – Confident – Team-oriented – Conventional – Pressured – Achieving
Twenge • Publications – Increased self-esteem – Narcissistic – Extraverted – Elevated self satisfaction – High expectations – High confidence in future performance – Desire for leisure
Twenge • Generation Me – Informal – Immediate – Idealistic – Stressed – Cynical – External locus of control
Borges • Scored higher on: – – Perfectionism Rule Consciousness Sensitivity Warmth • Scored lower on self reliance • Scored higher on the needs for: – Achievement – Affiliation • Questions confidence reflects individual personal empowerment or group confidence
Are the Differences Real? • Howe and Strauss Research – High school seniors in Fairfax County, VA – Median income is >2 x national average • Some research is anecdotal and reinforcing • Some studies shows minimal difference 1 1 Di. Lullo et al. 2011
For the Purposes of this Lecture… • Millenials: – Had overscheduled, very structured childhoods with ubiquitous praise – Were reinforced more for ability than effort – Are not practiced at facing adversity or failure – Are digital natives
For the Purposes of this Lecture… • Millenials: – Have more informal relations with authority figures – Prioritize work life balance and see work as a means to an end – Are self-focused – Desire feedback
For the Purposes of this Lecture… • Millenials: – Do not optimally learn with “traditional” teaching methods
Work expectations • Work is just work • Prioritize lifestyle – “I knew that doctors were busy but I thought I would find a job where I could work 40 hours a week. ” • Anticipate rapid progression
Expect Structure • Millennials prefer: – Structure and clear direction – Clearly define standards and ground rules • Establish expectations and consequences
Expect Team Focus • Millennials are very community oriented • Have worked in teams or groups for most of their life • Team Based learning • One trainee teaching another is a powerful tool
Feedback is Critical • Appreciate directness but don’t take criticism well • Immediate • Focus on effort instead of ability • Model receiving feedback appropriately
Focus on Why and How • Digital Age – Information is easily obtained – Half life of information is shorter – Information is easily fabricated • Utilize pro/con positions • Emphasize critical thinking • Emphasize reflection
Self Reflect • Take 1 -2 minutes and think about difficulty you have had providing feedback or receiving with a different generation. • Discuss this with a neighbor. • Think of 1 or 2 changes you can incorporate into the feedback you provide or receive.
Resilient?
Expect to Succeed • Given ubiquitous praise in the past • Strong desire and expectation to succeed (ambitious) • Highly pressured to succeed • Limited exposure to previous challenge • Might be overconfident and might not ask for help • Closely monitor
Difficulty with Failure • • Learned helplessness Blame others Might rely on authority figure for bail out Less likely to work hard or give up if ability focused • Firm boundaries • Reengage in a safer setting
Communication • Technology • Need different learning environments • Attention span
Digital Natives • Incorporate Technology – Audience response systems in lectures – Recording content online prior to lecture – Tweeting or pushing out short messages – Utilizing social media*
Digital Native • Bahner DP, Adkins E, Patel N, Donley C, Nagel R, Kman NE. How we use social media to supplement a novel curriculum in medical education. Med Teach 2012; 34(6): 439 -44. doi: 10. 3109/0142159 X. 2012. 668245. Epub 2012 Mar 27. Pub. Med PMID: 22449268. • Cook DA, Levinson. AJ, Garside S, et al. Internet-based learning in the health professions: a meta-analysis. J Am. Med. Assoc. 2008; 300(10): 1181 -1196. 26. • Chretien KC, Azar J, Kind T. Physicians on Twitter. J Am. Med. Assoc. 2011; 305(6): 566 -568. 27. • Forgie SE, Duff JP, Ross S. Twelve tips for using Twitter as a learning tool in medical education. Med Teach. 2013; 35(1): 8 -14. • Rowse PG, Ruparel RK, Al. Jamal YN, Abdelsattar JM, Heller SF, Farley DR. Catering to millennial learners: assessing and improving fine-needle aspiration performance. J Surg Educ. 2014 Nov-Dec; 71(6): e 53 -8. doi: 10. 1016/j. jsurg. 2014. 10. 014. Pub. Med PMID: 25433964.
Learning Environment • Reinvent lecture format – Incorporate case (real if possible) – 10 -15 min increments separated by active – Learn best by doing (active learning) – Focused take home points – Flip Classroom – Visual learners – ARS/Jeapordy
Consider Attention Span • Difficulty with delayed gratification • Grab the attention • Chunk material into 10 to 15 minute lectures
Mentoring • Is strongly desired • Starved for good advice on future and possible career paths • Focus on the development of self control, cultivate realistic expectations
External Locus • Won’t spoon feed themselves in a lecture environment • View it is your responsibility to train them • Lack of ownership of behaviors • Blame others • Give choices in learning experiences • Hold accountable for actions
Emotional Intelligence • Decreased skill in face to face encounters • Unaware of medical culture – need to be taught what the expectations are • Metacognition • Model
Authority Figures • See teachers as facilitators, not authority – More familiar with authority figures – Might engage in debate • Establish norms • Appropriately incorporate learner feedback
Self Reflect • Take 1 -2 minutes and think about difficulty you have had providing or receiving mentorship from a different generation. • Discuss this with a neighbor. • Think of 1 or 2 changes you can incorporate into the feedback you provide or receive
Intergenerational Conflict • • Work is just work Feelings of entitlement Informal communication External locus of control
• • Recruitment Focus on lifestyle Focus on development in the program Increase focus on team dynamics “You will work with other bright creative people”
Intergenerational Panel Discussion
Questions?
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