The Modern/Millennial Learner Darlene Metter, MD, FACR

New Orleans, LA

January 25, 2013

1. Understand WHO & WHAT

2. Describe HOW they learn

3. Apply techniques to ENHANCE

teaching

Learning Objectives

• Review generational traits

• Compare differences

• Develop teaching strategies

• Case scenarios & questions

Format

Pre-Test

• “Latch-key” kids

• “Trophy kids”

• “Work to live”

• “Live to work”

• Don’t trust institutions

• Trust institutions

Which generation?

• A. Silent

• B. Boomers

• C. Gen X

• D. Gen Y

Multi-tasking is a trait of which

generation?

• A. Silent

• B. Boomers

• C. Gen X

• D. Gen Y

Which generation expects immediate

objective, clear & simple feedback?

• Cohorts born in the same date

range with similar cultural &

historical experiences

Social/Cultural Generation

• Teachers & learners often from

different generations

• Teachers socialized in one era,

students grown up in another

• KEY: COMMUNICATION

Intergeneration Challenges

• SILENT: 1925-1945

• BABY BOOMERS (BB): 1946-1964

• GEN X: 1961-1981

• GEN Y/MILLENNIALS: 1982-2002

• GEN Z: early 2000’s

WHO

• SILENT: 1925-1945

• BABY BOOMERS (BB): 1946-1964

• GEN X: 1961-1981

• GEN Y/MILLENNIALS: 1982-2002

Who is from…..

• BABY BOOMERS (BB): 1946-1964

• GEN X: 1961-1981

• GEN Y/MILLENNIALS: 1982-2002

How many have learners from…..

….related to the politics, economy &

social events/trends of the time

WHAT: Generational Traits

• 67+ yrs; raised 1930’3, 40’s, 50’s

• POLITICS: WWII, patriotism, New Deal, McCarthyism, the Bomb, Cold War, Social Security

• ECONOMY: the Depression, “lucky to work”

Silent

• SOCIAL: low mobility, strong family &

community, segregation, women’s rights

• EDUCATION: 8th grade

• WORK ETHIC: loyal to company, willing

to “pay dues,” climb the ladder

• AUTHORITY: autocratic, follow rules

Silent

• COMMUNICATION: top-down, reluctant to disagree w/ authority

• COMM DO: formal, typed on letterhead, direct/face-to-face, correct grammar, polite

• COMM NO: use 1st name, slang, poor grammar, profanity

Silent

• PEOPLE: Joe DiMaggio, John

Wayne, Joe McCarthy, Liz Taylor,

Betty Crocker, Charles Lindberg

Silent

• 48 – 66 yr; 80 million (v competitive)

• Raised 1950’s, 60’s, 70’s

• POLITICS: Vietnam, Watergate, JFK/MLK die, Roe v Wade, civil rights

• ECONOMICS: ↑ credit, products & consumption, US dominant power

Boomers

• SOCIAL: civil rights, protests/sit-ins, the pill, drugs, communes, ↑ mobility

• EDUCATION: > women in college, Brown vs B of Education

• WORK ETHIC: “live to work”

• AUTHORITY: love-hate, anti-bureaucracy

Boomers

• COMMUNICATION: “two-way”

• COMM DO: “face-to-face,”

meetings, open

• COMM NO: unfriendly

• PEOPLE: JFK, MLK,

Beatles, Nixon

Boomers

• 30 – 51 yrs, 46 million (½ BB)

• Raised 1970’s, 80’s, 90’s

• POLITICS: Nixon resigns, Berlin Wall falls, Perestroika, Gulf War (TV), Cold War

• ECONOMICS: stock market crash, gas lines, downsize/mergers, layoffs, recession, adversity, no trust in job permanence

Gen X

• SOCIAL: ↑↑ divorce, 1 parent, 2 parents work, “latch-key” kids, TV violence, PC, diversity, AIDS, dot-com boom

• EDUCATION: grad deg, creative education

• WORK ETHIC: “work to live,” balance, quality of life, resourceful, independent, entrepreneurial, distrust institutions, work smarter, work: place to grow NOT age

Gen X

• AUTHORITY: unimpressed, not fond of rules

• COMMMUNICATION: direct, unafraid to challenge, brief, informal, facts, details, PC, cell-email-text

• COMM NO: schmoozing, complex policy, inefficient, corporate-speak

Gen X

• PEOPLE: NO heroes, exposed to

the Clinton scandal, OJ, Michael

Jordan, Madonna

Gen X

• 12 – 30 yr, 80 million

• “Eighties babies” – 1980’s +

• POLITICS: 9/11, terrorism, Columbine, Desert Storm, immigration, women leaders

• ECONOMICS: affluence, Dow Jones records, globalization

Gen Y/Millenials

• SOCIAL: “helicopter parent,” child-

focused, + outlook, trust authority,

optimistic, confident, accept clear rules

that will be enforced, multi-taskers

• EDUCATION: adv degrees, school

safety, home-schooling, mobile educ,

iPads, PC, student-led curricula, tech

Gen Y/Millennials

• WORK ETHIC: “work to live,” just a job, may have 10, determined, goal-oriented, expects to be recognized

• AUTHORITY: polite, relax, respectful, help create the rules

• COMM: all-way, open, respectful, net-working, expect opinions to be considered

Gen Y/Millenials

• COMM DO: v informal, immediate, fast,

expressive, typing, cell-email-text-IM,

blogs, Twitter, Facebook, instagram,

YouTube, Foursquare

• COMM NO: unfair, cynic, sarcasm,

script

• PEOPLE: Bill Gates, Prince

William, Mark Zuckerberg

Gen Y/Millenials

Generational Learning

Differences

• Silent & BB: linear learners

– attend class, read then do

• Gen Y: “on demand” learners, likely

“turned off” by long lectures

• BB & Gen X: may get annoyed by

Gen Y many questions & freq FB

Generational Learning

• Silent: “No news is good news”

• BB: “Once a year” with lots of

documentation

• Gen X: Now, “How am I doing”

• Gen Y: Whenever I want

Generational Views on FB*

* Silent & BB views on FB differ from what

Gen X or Y expect. Need adaptability.

So HOW do Millennials

learn?

• Center of parent attention, told

“special” & “winners”

• Close relationship w/ authority

• Expect: structure, clear

rules

Millennial: Basic

• High regard of themselves

• Optimistic, confident

• “Trophy kids” (asked “e”)

Millennial: Basic

• High regard to objective testing

• Goal-oriented, tenacious,

determined

• Short attention span

• Multi-tasker

• Fascinated by new technology

Millennial: Basic

New technology

A Generational Difference

How many like to get new phones?

Monday am: Surprise! You have a

new system in the RR. What is

your reaction?

• Excited: can’t wait to see what

it can do!

• “Oh, no”: another new system

to learn

• Millennials embrace new

technology

• Prefers structure & technology, multi-tasking, teamwork, experiential activities, expect quick responses

• Like Nintendo:

– problem solving/decision making

– “trial-n-error”

– loosing: fastest way to master a game, considered “learning”

Millennial Learning

• Case-based group learning

• Case review books

• “Trial-n-error” & “hands-on”

• Creative interactive learning

• Fun

• New technology

Millennial Prefers

• Formal lengthy lectures

• Long VTC: feel removed from

discussion, distracted

• Reading textbooks

• Boredom

Millennial “Turn Offs”

The Millennial Educator

1. Interactive teaching with

technology

2. Communication/feedback:

immediate

Millennial Educator: Tools

• ARS/cell phone w/ direct

interactive questions

– “Why did you select the

answer?” (Can be the correct or

incorrect answer)

- “What can we learn from this?”

Interactive Teaching w/ Technology

• Case-based scenarios

– Group discussion on options

– Collaborative learning with immediate feedback

– Case reviews

Interactive Teaching w/ Technology

• Standard GME lectures: try not to rely

on lectures as a 1 teaching modality

• Use multi-media presentation

• Use interactive case scenarios or

problem solving cases during lecture

Interactive Teaching w/ Technology

• Have resident write learning

objectives

– self-reflect (+/-), rotation, 6 month

• Have learner make the in-clinic (“real

time”) decisions (with graded

supervision) for ongoing NM exams

Interactive Teaching

• Involve the learner in an active

problem solving project (i.e. PBLI)

• Involve the learner in faculty

feedback/program improvement

– ARS end of lecture feedback

Interactive Teaching

• Multi-tasking may be perceived as

“rude” by the Silent generation or BB

• Cell-text-email-iPad

• Not intended

• Short attention span, need to

to know “now”

• On-line connectedness

Beware: A Misperception

• Gen Y viewpoint*: wants close

relationship to authority (like

parents), feels “special,” prefers

authority approachable, support,

communicate

• Regular feedback, attention

• Would likely start at “the top”

Communicating/Mentoring

•Silent & BB may not be comfortable with open communication w/o hierarchy

• “Trophy kids” may have problems w negative feedback/failure

– not easy, discuss defensiveness openly

– very peer conscious

• Immediate feedback on observed specific behavior made clear & simple

• Tell them what is needed & why

Communication

• Set clear expectations

– “micro-managing” – a “comfort

zone”

• Frequent & immediate feedback

– “observed behavior”

– What doing “right” & “wrong”

Communication

• Immediate (written/verbal)

• Behavior-specific, clear, simple

• Example: 360/multi-source surveys

• Involve learner in remediation plan

– Self-reflection

– Time frame goals & re-assessment

Approach to Corrective Feedback

• Consistent message

• Millennials like positive feedback

• Use praise & positive comments

in public

• Peer conscious

Approach to Positive Feedback

Now it’s your turn….

• Date: July 1

Your 1st year 28 yo NM resident is

notified that a “thyroid patient” is

ready to be seen.

• As the supervising faculty, what is

your approach to this patient with

the resident?

Scenario 1

A." See one, do one, teach one”

B. Give it to the 3rd year NM

resident

C. “Call me if you need me”

D. Explain the process of patient

evaluation

• Goal: Assess whether the pt will need a thyroid scan & uptake

• Process: Clear guidance (“step-by-step”) on basic history, lab data, physical exam, discussion with pt & family*

• Feedback

Patient Evaluation

* Future pt discussions can be more in-depth

• Date: July 14

Your 1st year 28 yo resident has

been arriving at 9 am and is “not

around” when studies are being

monitored. What is your approach

to this behavior?

Scenario 2

A. Tell the resident that work starts at

8 am

B. Address the observed behavior

C. Give a below expected

performance evaluation at the end

of the rotation

1. Timely feedback

2. Goal: resident education & pt care

3. Observed behavior: may get defensive, stress goals/outcome

4. Rules/expected behavior

5. Reassessment: ongoing

Address the observed behavior

6. Do not tell resident they are “unprofessional.”

7. Feedback needs to stress the specific inappropriate behavior & the reason(s) why.

8. Clearly state expectations & consequences if not meet.

Address the observed behavior

• Date: Oct 8

Your 1st year 28 yo resident

asks you how do you review a

VQ scan . What is your

approach?

Scenario 3

A. Pattern approach

B. A “checklist”

C. Read chapter 7

D. Prepare a mini lecture

• Explain your approach to the image, “step-by-

step” (basic, later more advanced points)

• Checklist:

1) review history/pertinent labs & studies

2) QC

3) Show* how you review the perfusion scan

How you do it.

*”show” vs “tell”

• Teaching Gen Y needs

flexibility

• Understanding Gen Y

expectations is vital to success

for the Silent/BB/Gen X faculty

• Strong educational leadership

• Rules must be clear

• Communication/feedback

immediate, objective, clear &

simple

• Define who & what are the

Silent, Boomers, Gen X & Y.

• Understand generational

differences to enhance learning

and feedback.

Summary

• Apply tools of

1) interactive learning with novel

technology and

2) immediate & frequent

feedback to optimize teaching

the Millennial learner.

Summary

Post-Test

• “Latch-key” kids

• “Trophy kids”

• “Work to live”

• “Live to work”

• Don’t trust institutions

• Trust institutions

Which generation?

• “Latch-key” kids – Gen X

• “Trophy kids”

• “Work to live”

• “Live to work”

• Don’t trust institutions

• Trust institutions

Which generation?

• “Latch-key” kids

• “Trophy kids” – Gen Y/Millennial

• “Work to live”

• “Live to work”

• Don’t trust institutions

• Trust institutions

Which generation?

• “Latch-key” kids

• “Trophy kids”

• “Work to live” - Gen X & Y

• “Live to work”

• Don’t trust institutions

• Trust institutions

Which generation?

• “Latch-key” kids

• “Trophy kids”

• “Work to live”

• “Live to work” - Boomers

• Don’t trust institutions

• Trust institutions

Which generation?

• “Latch-key” kids

• “Trophy kids”

• “Work to live”

• “Live to work”

• Don’t trust institutions – Gen X

• Trust institutions

Which generation?

• “Latch-key” kids

• “Trophy kids”

• “Work to live”

• “Live to work”

• Don’t trust institutions

• Trust institutions – Gen Y

Which generation?

Multi-tasking is a trait of which

generation?

A. Silent

B. Boomers

C. Gen X

D. Gen Y

Which generation expects

immediate objective, clear &

simple feedback?

A. Silent

B. Boomers

C. Gen X

D. Gen Y

“If you want happiness

for a lifetime, help the

next generation.”

Chinese proverb