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Medical Education for the “Echo Boomer” Generation Medical Education Grand Rounds: Friday, October 31, 2008. Morton H. Levitt, MD, MHA, FCAP Clinical Professor of Biomedical Science, University of Miami Miller School of Medicine, Charles E.

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Medical Education for the “Echo Boomer” GenerationMedical Education Grand Rounds: Friday, October 31, 2008

Morton H. Levitt, MD, MHA, FCAP

Clinical Professor of Biomedical Science,

University of Miami Miller School of Medicine, Charles E.

Schmidt College of Biomedical Science, Regional Campus

at Florida Atlantic University

University, Boca Raton, FL

who are the echo boomers
Who Are the Echo Boomers?
  • A “generational cohort,” the “echo boomers,” were born between 1981 and 2000. They are <27 years old.
  • These are many of our med students.
  • Generational cohorts are groups of people, usually born in the same 20-year time span, who share common life experiences and thus share common attitudes and traits.

See Kruse, “Buckle Up; Generation Y is Here” at http://www.clomedia.com/content/templates/clo_col_elearning.asp?articleid=410&zoneid=46

four generations our workforce today arguably consists of four major generations
Four Generations: Our workforce today arguably consists of four major generations:
  • 1. Veterans/Matures: 1922-1943 (>62)
  • 2. Boomers: 1943-1960 (42-62)
  • 3. Gen X’ers: 1960-1980 (27-42)
  • 4. Gen Y’ers/Nexters/Millennials/Echo Boomers: 1980-2000 (<27)
but our medical and graduate students are genxers and genyers
But Our Medical and Graduate Students are GenXers and GenYers
  • They share many common attributes
  • They are very different than their predecessors
  • Learning methods for them must take into account their unique characteristics
genxers 1960 1980
GenXers 1960-1980

CORE VALUES

  • Diversity
  • Thinking Globally
  • Survival
  • Self reliance
genxers 1960 19806
GenXers 1960-1980

SEMINAL EVENTS

  • 1970 Women’s Liberation Protests
  • 1973 Watergate Scandal
  • 1979 Three mile Island Nuclear Meltdown
  • Massive Corporate Layoffs
  • 1987 Stock Market Plummets
  • 1991 Operation Desert Storm
genxers 1960 19807
GenXers 1960-1980

HEROES

  • None (no one famous but you can inspire Xer loyalty)
genxers 1960 19808
GenXers 1960-1980

ASSETS ON THE JOB

  • Adaptable
  • Independent
  • Unintimidated by Authority
  • Creative
genxers 1960 19809
GenXers 1960-1980

LIABILITIES

  • Impatient
  • Poor People Skills
  • Inexperienced
  • Cynical
nexters millenials y ers echo boomers 1980 2000
Nexters/Millenials/Y’ers/Echo Boomers 1980-2000

CURRENT CORE VALUES

  • Optimism
  • Civil Duty
  • Confidence
  • Achievement
  • Sociability
  • Morality
  • Street Smarts
  • Diversity
nexters millenials echo boomers 1980 2000
Nexters/Millenials/Echo Boomers 1980-2000

SEMINAL EVENTS/TRENDS

  • Violence: Oklahoma City Bombing
  • Clinton/Lewinsky
  • Columbine High School Massacre
  • Child Focus
  • Technology
  • Stress
nexters millenials echo boomers 1980 200012
Nexters/Millenials/Echo Boomers 1980-2000

HEROES

  • Michael Jordan
  • Princess Diana
  • Mother Teresa
  • Bill Gates
  • Tiger Woods
  • Christopher Reeve
nexters millenials echo boomers 1980 200013
Nexters/Millenials/Echo Boomers 1980-2000

ASSETS ON THE JOB

  • Collective Action/Teamwork
  • Optimism
  • Tenacity
  • Multitasking Capabilities
  • Technological Savvy
nexters millenials echo boomers 1980 200014
Nexters/Millenials/Echo Boomers 1980-2000

LIABILITIES

  • Need for supervision and structure
  • Inexperienced particularly when handling difficult people issues
common learning characteristics of gen x and gen y students
Common Learning Characteristics of Gen X and Gen Y Students*
  • Want to be recognized as individuals
  • Want a voice in class decisions
  • Want to establish rapport with the instructor
  • Value group interactions
  • View class time as social and educational experience
  • Need nonjudgmental sounding board

*See, e.g., Kipnis, D.G. and Childs, G.M.,

Med Ref Services Quart, Vol. 23(4), Winter 2004

common learning characteristics of gen x and gen y students16
Common Learning Characteristics of Gen X and Gen Y Students*
  • Don’t like being passive recipients of information
  • Must be engaged to retain information
  • Want a variety of learning experiences
  • Are used to being entertained
  • Need course work that must be relevant to the real world
  • Want to learn marketable skills
  • Want information to be current

*See, e.g., Kipnis, D.G. and Childs, G.M.,

Med Ref Services Quart, Vol. 23(4), Winter 2004

so here s the question
So, Here’s the Question:
  • Do Echo Boomers and Gen Xers (our current medical and graduate students) require different approaches to learning than I did?
medical education and the echo boomers a relevant quote
Medical Education and the Echo Boomers: A Relevant Quote
  • “Generation Y is much less likely to respond to the traditional command-and-control type of management still popular in much of today's workforce," says Jordan Kaplan, an associate managerial science professor at Long Island University-Brooklyn in New York. "They've grown up questioning their parents, and now they're questioning their employers. They don't know how to shut up, which is great, but that's aggravating to the 50-year-old manager who says, 'Do it and do it now.' "

Bruce Tulgan, a founder of New Haven, Conn.-based RainmakerThinking

medical education and the echo boomers
Medical Education and the Echo Boomers
  • Unlike “baby boomers” who tend to put a high priority on career, today's youngest workers are more interested in making their jobs accommodate their family and personal lives. They want jobs with flexibility, telecommuting options and the ability to go part time or leave the workforce temporarily when children are in the picture.

Cited from Stephanie Armour Generation Y: USA Today accessed Dec 12, 2006 at http://www.usatoday.com/money/workplace/2005-11-06-gen-y_x.htm

learning theories and the echo boomer
Learning Theories and the Echo Boomer
  • Technology has changed the way we deliver learning
  • Do we still teach students with an “industrial age” mentality?
  • Have we moved from the industrial era to the knowledge era?

From “Reshaping the Way We View the World, Chalofsky, N., TDNov2005.

learning theories and the echo boomer22
Learning Theories and the Echo Boomer
  • In The Fifth Discipline [New York, Doubleday, 1990), Peter Senge writes:
  • In the Industrial Era, the machine was the focus of production
  • In the Knowledge Era, the human mind is the focus
learning theories and the echo boomer23
Learning Theories and the Echo Boomer
  • In the Knowledge Era, the learning institution needs to be:
    • Transforming: continually adapting to change
    • Emphasize self-directed learning
    • Move away from internal competition to cooperation, collaboration, and networking
learning theories and the echo boomer24
Learning Theories and the Echo Boomer
  • The learning organization creates a purposeful learning environment, at the individual, group, and organizational level, for the mutual benefit of the individual and the organization
learning theories and the echo boomer25
Learning Theories and the Echo Boomer
  • Russell Ackoff, Professor Emeritus of the Wharton School talks about a “spectrum of learning:”
    • DataInformationKnowledge

UnderstandingWisdom

  • Traditional medical school education focuses on establishing a “knowledge base”

Dr. Ackoff is Professor Emeritus of the Wharton School and Chairman of Interact, the Institute for Interactive Management.

See his book Introduction to Operations Research, co-authored with C. West Churchman

learning theories and the echo boomer26
Learning Theories and the Echo Boomer
  • In the Industrial Era, there was an outcome for every cause of action (“cause-effect” principle)
  • In the Knowledge Era, as in traditional medicine, there may not be just one specific causal link for every problem
  • Multiple ways of viewing reality imply multiple ways of learning
learning theories and the echo boomer27
Learning Theories and the Echo Boomer
  • There are different ways students learn and acquire knowledge
  • One model, developed by David Kolb, with Roger Fry created his famous model out of four elements: concrete experience, observation and reflection, the formation of abstract concepts and testing in new situations. He represented these in the famous experiential learning circle (after Kurt Lewin):

*[see Kolb. D. A. and Fry, R. (1975) 'Toward an applied theory of experiential learning;, in C. Cooper (ed.) Theories of Group Process, London: John Wiley.]

learning theories and the echo boomer29
Learning Theories and the Echo Boomer
  • What if medical schools shift to a true “learning orientation,” re-examine the

traditional “performance orientation,” and develop a curriculum that is intrinsically motivating?

learning theories and the echo boomer30
Learning Theories and the Echo Boomer
  • A learning orientation focuses on the goal as a challenge that sparks a desire to learn and try new ways to do it better.
  • Those with a true learning orientation achieve higher levels of productivity, and do it with more enjoyment and satisfaction
learning theories and the echo boomer31
Learning Theories and the Echo Boomer

Today’s typical medical school curriculum: very simplified*

  • Preclinical curriculum/basic sciences
  • Clinical curriculum
  • Electives
  • Assessment of medical students

*See AAMC’s Curriculum Directory at http://services.aamc.org/currdir/about.cfm

medical school teaching methods
Medical School Teaching Methods
  • Traditional lectures
  • Small-group discussion
  • Self-instruction
  • Laboratories
  • Case studies
  • Computer assisted instruction
  • Clinical venues

*See AAMC’s Curriculum Directory at http://services.aamc.org/currdir/about.cfm

future trends that will influence medical education39
Future Trends that will Influence Medical Education

**

**Implantable cardioverter defibrillators (ICDs) and biventricular pacemakers for cardiac resynchronization therapy (CRT)

Courtesy of SG2. See www.sg2.com

so back to educating tomorrow s gen y doctor
So, back to Educating Tomorrow’s Gen Y Doctor
  • How do we align emerging and future trends in medicine with workforce needs, package the product, and make it presentable to today’s medical students?
the generation y doctor beyond knowledge
The Generation Y Doctor:Beyond Knowledge
  • Remember Ackoff’s model?
    • DataInformationKnowledgeUnder-standingWisdom
  • The Gen Y student is obsessed with garnering the minimum acceptable knowledge base, just enough to “pass the boards,” using his high-tech tools, of course (“Google it”), and then hit the ground running on Day 1
the generation y doctor beyond knowledge43
The Generation Y Doctor:Beyond Knowledge
  • How do we re-structure our medical education paradigm to ensure our students go beyond merely acquiring a knowledge base to acquiring true understanding and wisdom and develop the tools for lifelong learning?
the generation y doctor beyond knowledge44
The Generation Y Doctor:Beyond Knowledge
  • The answer: give them what they crave:
    • High tech, computer and internet-based learning tools
    • Assessment that focuses on performance outcomes (“see one, do one”)
    • Focus on lifelong learning techniques and professional development
    • Reinforce networking, collaboration, and cooperation
the generation y doctor beyond knowledge45
The Generation Y Doctor:Beyond Knowledge
  • Pedagogical techniques for the Gen Y’er:
    • Small group discussions
    • Large group interactive sessions
      • Problem-based learned
      • Team-based learning
    • Practical, hands-on experience from Day 1
    • Emphasize learning techniques that go beyond rote memorization – strive for understanding and wisdom (“can you explain it to your mother”)
teaching techniques that i use at my current school
Teaching Techniques That I Use at My Current School
  • The following are techniques, learned the “hard way,” that work at UMMSM@FAU
  • They take into account GenX/GenY common attributes
  • You know you are dealing with a GenX/Yer when, on the first day, a student approaches the podium and asks you:

“Do I really have to buy the textbook.”

educating the gen y doctor ten tips introduce yourself
Educating the Gen Y Doctor: Ten Tips: Introduce Yourself
  • “Humanize” yourself: share an anecdote so they can relate
  • They think they are more technically savvy then you are: let them know something about your experiences
  • If you can engage them at the start, you will hold their interest

*See, e.g., Kipnis, D.G. and Childs, G.M.,

Med Ref Services Quart, Vol. 23(4), Winter 2004

educating the gen y doctor ten tips keep it real
Educating the Gen Y Doctor: Ten Tips: Keep it Real
  • Tell them the goals/objectives
  • Make it relevant
  • Provide a personal incentive that will save them time in studying, etc
  • Utilize real world examples
  • Provide positive examples [“this slide always helps medical students understand the brachial plexus”]

*See, e.g., Kipnis, D.G. and Childs, G.M.,

Med Ref Services Quart, Vol. 23(4), Winter 2004

educating the gen y doctor ten tips be visual
Educating the Gen Y Doctor: Ten Tips: Be Visual
  • Students retain only10% of written materials, but 30% of what they see [Miller]
  • Text heavy slides are disadvantageous; images rule
  • Even better are short demos or screen captures

*See, e.g., Kipnis, D.G. and Childs, G.M.,

Med Ref Services Quart, Vol. 23(4), Winter 2004

educating the gen y doctor ten tips utilize humor
Educating the Gen Y Doctor: Ten Tips: Utilize Humor
  • Irony and self-deprecating humor works well
  • Corny humor works [“ET doesn’t stand for extra-terrestrial – it means Essential Thrombocythemia”]

*See, e.g., Kipnis, D.G. and Childs, G.M.,

Med Ref Services Quart, Vol. 23(4), Winter 2004

educating the gen y doctor ten tips customize
Educating the Gen Y Doctor: Ten Tips: Customize
  • GenYers know how to customize their personal Yahoo pages, create “auto alerts” on their desktops, and “push” technology on their cell phones
  • Show them how to customize their notes and other learning tools

*See, e.g., Kipnis, D.G. and Childs, G.M.,

Med Ref Services Quart, Vol. 23(4), Winter 2004

educating the gen y doctor ten tips design team assignments
Educating the Gen Y Doctor: Ten Tips: Design Team Assignments
  • They tend to work well together
  • They respect their peers more than their instructors
  • Design group exercises such as PBLs, small groups, etc. where students take the lead to teach each other

*See, e.g., Kipnis, D.G. and Childs, G.M.,

Med Ref Services Quart, Vol. 23(4), Winter 2004

educating the gen y doctor ten tips be flexible
Educating the Gen Y Doctor: Ten Tips: Be Flexible
  • They are indifferent to rules and regulations
  • Let them design or define part of the assignment
  • Positives work better [“be careful with your note taking” works better than “don’t plagiarize!”]

*See, e.g., Kipnis, D.G. and Childs, G.M.,

Med Ref Services Quart, Vol. 23(4), Winter 2004

educating the gen y doctor ten tips be honest and fair
Educating the Gen Y Doctor: Ten Tips: Be Honest and Fair
  • If you don’t know the answer, tell them; don’t “fudge it;” they can see through this
  • If you promise to do something, follow up on it
  • These students are all too familiar with corporate scandals, dirty politicians, and dishonest adults

*See, e.g., Kipnis, D.G. and Childs, G.M.,

Med Ref Services Quart, Vol. 23(4), Winter 2004

educating the gen y doctor ten tips establish authority but
Educating the Gen Y Doctor: Ten Tips: Establish Authority but…
  • Build relationships, not hierarchal structures
  • Invite participation and display empathy
  • Idle threats don’t work well [students will be IM’ing, chatting, checking e-mail, etc. – ask they to close there monitors for a while]

*See, e.g., Kipnis, D.G. and Childs, G.M.,

Med Ref Services Quart, Vol. 23(4), Winter 2004

educating the gen y doctor ten tips offer help
Educating the Gen Y Doctor: Ten Tips: Offer Help
  • Remind them where they can get help
  • Allow them to ask questions
  • Be accessible
  • They require immediate feedback and help when problems arise

*See, e.g., Kipnis, D.G. and Childs, G.M.,

Med Ref Services Quart, Vol. 23(4), Winter 2004

the echo boomer comes full circle
The Echo Boomer Comes Full Circle

See www.rahc.uthscsa.edu/Faculty/12.2.pdf