Suzanne Minor, MD, Florida International University Herbert Wertheim College of Medicine

By applying the principle of cultural competence, understanding the importance of social and cultural influences on one’s beliefs and behavior,¹ effective communication with the Millennial Generation (MG) can be achieved. Millennials, also known as Generation Y or Generation Me, were born between 1982 and 2000.² Some researchers characterize Millennials as special, sheltered, confident, team-oriented, achieving, pressured, and conventional.³ However, others take a more negative view describing them as narcissistic or entitled.⁵ Regardless, understanding the parenting culture in which many MG students were raised can help educators achieve cultural competence when working with them. They may not have heard “no” often, or they may have been consulted on major decisions. The MG student may have grown up sheltered, playing on a padded playground or reminded of deadlines, and thus may expect extra help or resources.² Also, the MG has decreased traditional academic literacy (the ability to comprehend and critically appraise traditional print media such as textbooks, journals, or newspapers) whereas their ability to understand social media and electronic communications (such as texting) is increased.⁶

How can we effectively communicate with the MG student? Explain what the student needs to learn and why this learning is important.^2,5 Let students know what is flexible and what is not, as the MG student may not understand what is up for choice, where is flexibility allowed, or where they may have input. Inform students when teamwork is OK as the MG student may not realize what is individual and what is group work. Discuss ethics and specific consequences for cheating. Students may have been told that they are special and may not have faced consequences for cheating previously or have a clear understanding of what plagiarism is with the ease of copying and pasting from the internet. Be consistent in applying consequences.² Communicate concisely—the MG student may be more accustomed to text messages than longer emails and have decreased traditional academic literacy.⁶ For longer documents, like syllabi, include an overview and bold key concepts.

Give frequent feedback.^2,5 Carol Dweck, PhD, Stanford University, recommends giving feedback on process, rather than person.⁷ Feedback enforcing innate qualities, such as telling a student she is intelligent, promotes a fixed mindset. Those with a fixed mindset have difficulty facing adversity and consider cheating more quickly. Feedback on process, such as stating the student developed a complete problem list, promotes a growth mindset. When these students face a setback, they escalate their efforts and look for new learning strategies.⁷

Outline clear, specific expectations in the syllabus, including consequences and summative assessment details such as honors criteria.2 Consider spacing assignment due dates over the course rather than setting due dates for the end of the rotation as the MG student may not understand how to pace themselves.⁴ Assigning smaller reading assignments allows for more in-depth small-group sessions.⁶

By using these tactics and keeping in mind cultural differences, we can better communicate across the generational divide to train the next generation of physicians. Indeed, they will be our colleagues one day in addition to our doctors.

References

1. Betancourt JR, Green AR, Carrillo JE, Ananeh-Firempong II O. Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public Health Rep 2003;118:293-302.
2. Moreno-Walton L, Brunett P, Akhtar S, DeBlieux PMC. Teaching across the generation gap: a consensus from the council of emergency medicine residency directors 2009 academic assembly. Acad Emerg Med 2009 Dec;16:Suppl 2:S19-S24.
3. Howe N, Strauss W. Millennials rising: the next great generation. Vintage 2000.
4. Wilson M, Gerber LE. How generation theory can improve teaching: strategies for working with the “Millennials.” Currents in Teaching and Learning 2008;1:29-44.
5. Twenge JM. Generational changes and their impact in the classroom: teaching Generation Me. Med Educ 2009;43:398-405.
6. Considine D, Horton J, Moorman G. Teaching and reading the Millennial Generation through media literacy. Journal of Adolescent & Adult Literacy 2009 Mar;52:471-81.
7. Hopkins G. How can teachers develop students' motivation—and success? Education World. www.educationworld.com/a_issues/chat/chat010.shtml. Accessed June 6, 2014.