Con ne c ti ng T e c h n o lo g y , Ed uca t i o n a n d Di s c ove ry w ith H um anis m in Me dicine
Vol. 5, Issue 3: July. 2016
Changing Education to Align with the Needs of Millennials While generational differences are nothing new, the rapid pace of development and the unprecedented number of different generations working together have made generational competency—awareness of the different perspectives, expectations, and values of co-occurring generations—an essential knowledge set. Today’s medical learners are, by and large, Millennials, born between 1981 and 2004. They are being taught by GenXers (born 1961-1980), Baby Boomers (born 1943-1960), Traditionalists (born 1900-1942)— and older Millennials. Millennials grew up in a different world than their predecessors. Their early lives were marked by burgeoning technology and a certain amount of social and political instability. Many were raised by “helicopter parents” and taught to value challenges and achievement. They expect learning to be fun and meaningful, with clear expectations and plenty of feedback. They are comfortable with diversity (they are the most diverse generation so far), but also respect hierarchy and structure. These features contribute to their comfort working in teams in which different members have different things to contribute. They are less motivated by power and money than previous generations and seek a balance of meaningful activities in their lives rather than being defined solely by their work. All of these features affect medical education. Dr. Nathan Smith, Millennial and 2016 graduate of the Department of Medicine, says that Millennials expect guidelines in medical practice
to evolve rapidly. Thus, they expect to develop a core of knowledge and strategies for solving problems and finding additional information rather than mastering all that can be known about a subject. “There is so much information out there, and more accumulates every day,” he observed. “Even subspecialties have become ‘unmasterable,’ so you get used to reaching out for additional input.” Ironically, the amount of information available to use for the patient’s well-being can interfere with connecting with the patient as a person if one does not develop good interpersonal skills. Dr. Smith says the potential to pay too much attention to a phone or computer and not enough to the patient is a real danger, but does not believe the devices have created new problems. “The doctors who are glued to their phones today were the ones glued to a paper chart or clipboard in times gone by,” he said. He is optimistic that changes in medical education will lead to more patient-centered care, noting that testing used to be exclusively on “hard facts,” but now includes topics in communication, bioethics, and medical humanities. Monday Morning Quarterback rounds, Team-Based Learning, Quiz Bowls, and use of the Sim Center are examples of teaching methods employed in the department that resonate for Millennials. They like challenges, continued on page 2
Points of View
rounds in the morning. In the afternoon, I did procedures and carried out the orders for the day, made sure patients went for their scheduled tests, and admitted new patients. In the evening, we had rounds by the Registrar (PGY4-PGY6) that typically lasted 2 to 3 hours. After a short break for dinner, I would go back to complete the notes on the patients and write orders for the next day. It was well into the night by the time my work was done, and I began my 3to 4-block walk to my hostel room. Of course, call nights were spent in the hospital covering anywhere from 45 to 70 sick patients. As I stood there and took in the scene, I resolved to go out for dinner that night with my friends, and I did. This period was one of the most exhilarating in my life. I was learning at a dizzying pace and gaining so much knowledge and clinical experience, it was as if a whole new world had opened up for me. This month laid the foundation of my career in medicine, and I am forever grateful to the dedicated physicians who worked so hard to impart their knowledge and the patients who provided me with such a valuable and diverse clinical experience.
On a Friday in late January during my medical studies, I vividly recall walking along the glass windows of the long hallway that fronted the operating rooms on the fourth floor of the hospital. It was the end of my first month as a house officer, and I was mesmerized by the scene I was witnessing on the road below me. It was a sunny day, and I stood transfixed, absorbing the movement of Rajiv Dhand, MD, Chair people, including, pedestrians, people on bicycles, rickshaws, and in cars and buses going about their “everyday lives”. It dawned on me that I had not seen the light of day for a whole month and had not left the institute’s campus during that time. My life had been overrun by a hectic daily routine of early morning blood draws, followed by pre-rounds and then attending 1
A quarterly newsletter for the Department of Medicine at the University of Tennessee Graduate School of Medicine.