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After the Match

After the Match: Don't be a Jerk Learn to Teach the Hip, Tech-Savvy Millennials

Cook, Thomas MD

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doi: 10.1097/01.EEM.0000451958.01175.d2
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    I was an early adopter of ultrasound in the ED, and was invited to teach it to first- and second-year medical students at the University of South Carolina School of Medicine. I thought it was pretty cool to do this, but I only lasted a month before they threw me out.

    The uncondensed version is that I showed up for my first lecture, and saw a bunch of open laptops and glowing faces looking at them. I had never encountered this before. I had lectured around the country for many years, and had never had anyone ignore me so perfectly. I asked them to close their laptops and pay attention. It seemed reasonable to me at the time.

    They thought I was a jerk.

    They were right in the end. After all, they were the customers. They are the ones paying for the service, and part of an educator's job is to figure out how to teach them. It is not their fault I didn't know how to do it.

    Millennials, those born after 1980, now make up 27 percent of the U.S. population and 100 percent of the medical students. Ask millennials how they view themselves, and they use terms such as tech-savvy, cool, innovative, and hip. Ask non-millennials to describe them, though, and lazy, entitled, selfish, and spoiled come to mind. (To be fair, this is how every older generation has described the younger generation since ancient Greece.)

    A high priority of millennials is to help others, but they are also less likely to get married, have strong religious ties, or be overtly patriotic. They also tend to be more liberal (especially on social issues), but have very little confidence that they will ever receive Social Security. Forty percent have tattoos, more than 80 percent sleep with their phones, and nearly all use social networking such as Facebook, Twitter, and the like. But what makes them a challenge to educators is that they are digital natives. They have grown up with computers of all shapes and sizes, and cannot imagine a world without them. (Pew Research; http://bit.ly/1k9rnlM.)

    This is overwhelming to older educators who grew up listening to lectures and reading textbooks. Trying to explain to millennials that I used a typewriter in college is beyond their comprehension, and the idea that they need to set aside dedicated time to read textbooks seems totally ridiculous. (“What a total waste of time. It's out of date by the time it's printed.”) Ironically, one of the most prevalent comments I see on faculty evaluations of residents is to “keep reading.” Of course, these older attendings are thinking of textbooks, not web pages.

    Millennials do read, but they do it differently from previous generations. They have grown up scanning web pages where the key content is strategically placed in an “F” pattern on the page because the dominant reading pattern for skimming text is comprised of a large horizontal component in the upper part of the page followed by a smaller horizontal component about halfway down, joined by a vertical component on the left side.

    Another thing millennials do well is watch video. The design and construction of this high-yield, time-efficient medium are almost unknown to boomers (born 1946–1964) and Generation X (born 1965–1980). But you only have to look at the two grade-school students at my house to understand its significance. Ages 12 and 14, my kids not only routinely receive their educational content via online videos, they also regularly produce edited video content to turn in for grades. They will be prepared to educate others in the future, but how about the rest of us now?

    Think about how your average 40- or 50-year-old academic physician would feel about adjusting his teaching strategy by ditching textbook reading assignments in lieu of learning how to produce educational videos and understanding web design. Asking some of the most conservative thinkers in society (older physicians) to adopt these tools is wishful at best. The world of medical education will be dominated by those who can marry the knowledge obtained from years of experience with the current educational tools needed to reach the current crop of medical students. You older teachers who cannot imagine “giving in” to the wants and desires of the younger generation will eventually end up on the outside looking in. Learning the new tools of education does not imply weakness. Rather, it displays the courage to keep learning while your peers continue to complain about the selfish and shallow younger generation that is not interested in learning the way you did 20 or 30 years ago.

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