VOLUME 33, ISSUE 1

In our last article, we addressed generational theory, which is the belief that individual values, motivations, and behaviors can be inferred by an individual’s date of birth.¹ Recognizing that these learning differences exist can help attending physicians improve the learning experience of their residents and medical students. The millennial generation is defined by the Pew Research Center as those individuals born between the years 1981 and 1996. In this follow up article, we will look deeper into the motivations and expectations of millennial learners and explore teaching methods that are both engaging and effective.

Millennials are motivated to do work that matters, they value working in teams, and they tend to seek mentoring more than other generations.⁵ They expect to be given meaningful assignments with clear instruction and they thrive on using technology to assimilate information.² Understanding these generational-based expectations can be used to strategically plan curriculum and develop effective tools that engage our students.

One unique characteristic of millennial learners is their desire to have immediate feedback. Compared to the baby boomer generation, who want feedback only when necessary, and generation X individuals, who want feedback weekly or daily, millennials prefer to have feedback immediately and often.² Thus, waiting to provide feedback on their progress until the end of a rotation, or even semi-annually, is not generally viewed by these residents as the most beneficial feedback method. Frequent and immediate feedback allows the resident to quickly improve their clinical and professional skills as well as have improved satisfaction at work. Ideally, this type of feedback is best provided in the operating room at a reasonable point and time that does not distract from patient care responsibilities.

Millennial learners also prefer to work in a collaborative atmosphere. They believe that hierarchy is appropriate in the medical training environment, however, these learners feel that authority figures should exert their power in a collaborative effort with others.² Although this may appear to be obvious, educators should ideally show excitement and engagement while teaching residents. Millennial residents will recognize the disconnect with faculty who appear apathetic about their teaching responsibilities.² In order to increase their connection with the residents they are instructing, educators can share their learning philosophy and describe what led them to pursue a career in academic medicine.³

The amount of information available for learners in medical education is seemingly infinite. Not only do residents have “traditional” textbooks to learn anesthesiology, they also have review texts, medical reference databases, online question banks, medical podcasts, videos on YouTube^TM and other platforms, and even smart phone applications that can assist them with their learning. This vast number of available resources can lead to a dilemma in which the learner does not know where to begin. A solution to this dilemma is to offer the learner a detailed outline and suggested resources for each block/rotation, thereby allowing learners to better prioritize their study efforts. Faculty should take care to use varying sources of learning to supplement their curriculum but, at the same time, ensure that these additional sources provide synthesis, application, analysis, and interpretation of complex material.³ For example, a faculty member may recommend that residents read a chapter about fluid resuscitation from an established textbook while also recommending that they supplement this material with a podcast about fluid responsiveness in the OR, such as what might be found in the ACCRAC podcast library.⁴

There are some learning strategies that are common to multiple generations and have been proven to markedly improve achievement. For example, self-testing and retrieval practice have been shown in hundreds of studies to improve learning and retention.⁶ The act of reconstructing knowledge requires effort and enhances learning. This learning technique’s success is amplified when the interval of time is increased between learning and retrieving the information. Self-testing is easy to implement with flashcards or question-banks.⁶ Retrieval practice, the act of recalling information, reduces test anxiety and can be supplemented with audience response systems, short answer worksheet assignments, and asking students to summarize what they learned last session.

Lastly, improving resident teaching skills has become a critical part of resident training. Residents act as teachers to a variety of learners including patients and their families, medical students, and peers. Assisting residents in improving their teaching skills not only better prepares them for future roles, it also improves the residents’ knowledge base and helps them better understand themselves as learners.⁷ Use of experiential methods such as role-playing and observation-feedback in resident-as-teacher curriculum increases student engagement and is preferred by millennial learners.

It is estimated that over 50% of our workforce are now millennials.⁵ Generational differences in teaching techniques and learning styles has become exaggerated due to the recent rapid growth of new technologies³. Understanding these differences helps medical educators become more effective teachers and improves professional relationships with their millennial colleagues.⁵

Valuing the ideals of the learners and acknowledging a job well done go a long way to helping millennials feel accepted.⁵ Age-old strategies, such as self-testing and retrieval practice, are still effective. Successful teaching requires understanding of our learners’ needs, including the need for immediate feedback and collaborative work environments. As faculty members, we must adapt to use relevant technology and create meaningful assignments to better engage our residents and ensure an optimal learning environment. Our next article will explore social media and its effects on generational learning.

1. Gillespie, Veronica. “Using the Flipped Classroom to Bridge the Gap to Generation Y.” Ochsner Journal, vol. 16, 2016, pp. 32–36.
2. Williams, Valerie N., et al. “Bridging the Millennial Generation Expectation Gap: Perspectives and Strategies for Physician and Interprofessional Faculty.” The American Journal of the Medical Sciences, vol. 353, no. 2, 2017, pp. 109–115.
3. Roberts, David H., et al. “Twelve Tips for Facilitating Millennials’ Learning.” Medical Teacher, vol. 34, no. 4, 2012, pp. 274–278., doi:10.3109/0142159x.2011.613498.
4. ACCRAC. “Episode 185: Fluid Responsiveness in the OR with Lee Goeddel.” ACCRAC Podcast, 13 Oct. 2020, accrac.com/episode-185-fluid-responsiveness-in-the-or-with-lee-goeddel/.
5. Lourenco, Ana P., et al. “Teaching and Working with Millennial Trainees: Impact of Radiological Education and Work Performance.” J Am Coll Radiol, vol. 14, 2017, pp 92-95.
6. Dunlosky, John., et al. “What Works, What Doesn’t: Some study techniques accelerate learning, whereas others are just a waste of time – but which ones are which? An unprecedented review maps out the best pathways to knowledge.” Scientific American Mind, Sept/Oct, 2013, pp. 47-53.
7. Achkar, Morhaf Al, et al. “Changing trends in residents-as-teachers across graduate medical education.” Advances in Medical Education and Practice, vol. 8, 2017, pp. 299-306.