“Look at every path closely and deliberately, then ask ourselves this crucial question: Does this path have a heart? If it does, then the path is good. If it doesn't, it is of no use.” ~Carlos Castaneda

Saturday, May 5, 2007

"Everyone's special!" ... "Which is another way of saying no one is." ... How do we educate residents with todays restrictions .... (part II)

“Every generation needs a new revolution.”
~Thomas Jefferson

Now let's look at the next generation. I had previously talked about generational differences in educating styles. I do believe it is important to first understanding where your educational style comes from as well as understand your audience. Who is our audience? The current resident probably are mostly at the end of Gen X, but are flavored with some of the upcoming generation known as the Ne(x)t generation, Gen Y, or Millennials. So, what are the educational expectations of the mellenials? Susan Heathfield, a management and organization development consultant who specializes in human resource systems, issues, and opportunities, wrote:
“Unlike the Gen-Xers and the Boomers, the Millennials have developed work characteristics and tendencies from doting parents, structured lives, and contact with diverse people. Millennials are used to working in teams and want to make friends with people at work. Millennials work well with diverse coworkers.”
They have been referred to as the most protected, watched-after, structured, achievement-driven generation in American history. Born in the late 70's to early 80's and after, their formative years saw unbridled economic prosperity. Because this generation has grown up with such a protected and technological time, we must take the time to understand what teaching styles would be the best.

There has been a lot of press on the Gen Y or Mellennials. The Mellennials have even taken it on to themselves to but the system by debunking the myths that may be proliferated through different media. Jaerid on his blog rants about being called "praise junkies". He references an article by Jeff Zaslow in the Wall Street Journal, Most-Praised Generation Craves Kudos at the Office. The first line from this article states:
You, You, You -- you really are special, you are! You've got everything going for you. You're attractive, witty, brilliant. "Gifted" is the word that comes to mind.
For many educators, they may feel this is a trend for this generation. A very "selfish" generation. I would have to agree that this is partially the case, they do like the feedback. This is opposed to my generation, Gen X, who did not want to be mentored; we knew what to do and how to do it. The Mellennials crave mentorship and guidance. Jeff Zaslow writes in another article In Praise of Less Praise which talks praising and how people know when a praise has merit. He talks about the Simon Cowell affect of debunking the praise parade. My favorite anti-praise reality Brit is Gordon Ramsey. Chef Ramsey is in a similar situation to most who are mentoring someone in a trade. He is bringing them along as Sous-chefs with his reputation on the line if they should make an error. So although his doesn't take care of patients I can see where his rage comes from at times. I do like to give praise, but try to limit the praise for occasions which warrant special praise. Mentoring can at times be taxing, but I feel it is necessary. Mentors today have to think about who they are mentoring and may require more guidance and instant feedback than in previous years.

Besides the emotional part of expecting more direct guidance or mentoring, they would also like to have more control of both their life, lifestyle, and education. There is the belief, most of which is true, that they are highly educated and ready to perform the tasks at hand. They want the scalpel soon as they enter the OR. It has been said that they have "put in their dues" already and that they "deserve" the right to operate without putting in time on menial tasks such as patient care responsibilities. Some have the opinion that they do not need to put in the foot work before getting in to complex procedures. Simple things like reading about a case beforehand, which was standard practice years ago, has some how gone by the way side. Come to the OR and expecting to be spoon fed the information without putting in the initial leg work. Mellennials value their free time and do not want to spend every hour thinking about their career or occupation. The want genuine "free time". This is something that puts a restriction in when a "lecture" can be done. Weekends are pretty much out. Late afternoons and evenings are just as problematic. For dedicated lectures, we are really restricted to somewhere between 6am-6pm. So how do we teach them with the restrictions on time?

It is easy for me to assume that I know all about this generation or to categorize everyone from this time as having these beliefs or characteristics. Most of my comments are based on recent personal experience, discussions with colleagues, and reading different articles. I think on of the important things to do is know what are the some of the right questions to ask. The first questions to ask include:
Who are our learners? It is increasingly important to have a dialogue with the learners to better understand their perspective.

How are today’s learners different from (or the same as) faculty/administrators?
Although they may be different in many ways from previous generations, some things stay the same. Learners are still socialize and obtain information but through different media. There may be more of a role for alternative media to get important information out such as Blogs, chat rooms, or Podcasts.

What learning activities are most engaging for learners? Traditionally we have done our education through lectures. There may be more of a need for expanding this to small group activities or interactive lectures.

Having an understanding of the audience is extremely important in determining what types of teaching styles will be most effective. Orthopaedics and other surgical or procedural sub-specialties have a a number of different skills or skill sets to teach. Most of the general medical conditions can be read about and leaned on line. The problem arises when teaching specific skill which require actual hands on time. Because orthopaedics is a very technically driven field, we can not just depend on lecturing and self teaching. The clinical teaching and operating becomes extremely important. So the next question is how do we, educators, teach our audience, the learners, our craft with in the restrictions of different governing bodies, while appropriately meeting the specific needs of the current generation?

“Life is no brief candle to me. It is a sort of splendid torch which I have got a hold of for the moment, and I want to make it burn as brightly as possible before handing it onto future generations.”

~George Bernard Shaw


Anonymous said...

I think this blog contains some very critical points which many educator overlook. I think for someone to effectively pass on information you must not only know how to present the material but also how the recipient will try to assimilate it. It is naive to think that education is only the educators job, as you point out, it is a dynamic exchange between both parties. The better both groups understand each other, the better the flow of information.

As a "Millennial," I think that you hit the nail on the head. Many of my classmates (and myself included) do look for positive reinforcement (aka praise) for every thing we do correctly. Many times students feel like a lack of praise is equivalent to a negative response. I do feel that as I mature, I no longer need constant feedback to let me know how I have performed. Perhaps as medical students make the transition from young third years to "old" fourth years and beyond, they will not require as much feedback and can more effectively monitor their own performances.

Midwife with a Knife said...

Residents not reading is one of my pet peeves. I think that even 15 minutes a night can make a big difference. 15 minutes is long enough to go through the steps of a hysterectomy, or the vascular supply to the pelvis or the current recommendations for managment of endometriosis. But maybe I'm just old (still too young for gout though!). Because residents expect to be 100% off when they're not at the hospital. Actually so do I, but only because I stay at the hospital until all my work is done because I don't want to bring it home.

Someonect said...

Anonymous - thanks for the comment. i think that generation differences always occur. it is important to understand that we all approach things from a different perspective due to a number of thing generation is only one of them. others include race, gender, upbringing, religion, etc. as an educator, it is important to be able to somewhat adjust to those differences.

MWWAK - hey you still haven't answered my marraige proposal ;). i do wish that everyone would expect more out of themselves and come prepared for the cases. as you probably struggle a little with now, i struggle with everyday. when do you let the free to struggle a little? when do you step in to help? are they ready? these are difficult questions when you have a patient on the table. you your case the life is truely in your hands or forceps.

Biby Cletus -thanks fot the comment

MiamiMed said...

As a Gen Y'er, I can tell you that some of us are sick of the small group thing that the educational establishment has pushed down our throats. Many med students are overachievers, and many will parrot interest in the learning styles that have defined the educational experience of the politically correct 90s. This is the sort of idealogy that is bringing things like "small group sessions" and "PBL" into current medical education. Realize that there is no exact mold, and some of us actually prefer a more traditional learning style. Switching to a model where we are allowed to sleep doesn't have to mean that we should waste time with constant evaluations and small group cry sessions. The "Press Ganey(sp?)" phenomenon has gotten me pretty close to vomiting.

I can honestly say that I have a lot of respect for your attempt to understand the generations. I've found your posts on the topic enlightening. I'd even like to discuss it more. I think that you are sometimes misunderstood in other forums, but I appreciate what you have to say.

Someonect said...


i appreciate your comment on this subject. this is a a particular interest of mine. i think that some of the problems of communicating between the educators and the learners has to do with not understanding the each others "language" well. because i work in pediatrics, i see stages of maturation from infant to rebellious teenager who things they are so different (yet they are all the same). i find it interesting. i will speak about this more as i learn more. in the near future, i will be at an educators conference that has this as one of the sessions. i am sure i will have more on this topic in the near future.

thanks for seeing that i am somewhat misunderstood on SDN. my residents actually laugh at some of the responses, 'cause i am really a "nice guy" and a resident/med student advocate. but, oh well, i just keep truckin' on. thanks for visiting the blog.