Communicating Across Generations

By Carol Havens, MD, Regional Director of Clinical Education, The Permanente Group

National Learning Competency 5.3
Utilize effective management and communication skills when working with organizational leaders, staff, volunteers, peers and learners.

When working with colleagues from different age groups, have you ever found yourself thinking: “I just don’t understand them,” or “Why don’t they work/act/talk/think more like I do?” This is a common theme when working across generations, and the truth is that there are differences. Although these generational differences go far back into recorded history, there is now research on how different generations work, think, learn and behave. As you read this, some of you will think the descriptions don’t match you, and some of you will be right. But I encourage you to reflect on your own experiences.

These differences do not reflect right vs. wrong or good vs. bad; they reflect different approaches to life, learning and work, and they show a different definition of commitment. To a baby boomer, commitment may mean being available to your work 24/7, and baby boomers often feel they have to make a choice between work and “life,” or nonwork. It’s an “all or nothing” mindset. For a gen x-er or millennial, it’s not about choosing work or life; it’s about being able to do both a little differently. They are committed to their patients and their work, and they are committed to their families and other interests.

Generational traits are formed by early experiences in childhood and early teens. Certainly not everyone in any generation will have all the characteristics of that generation, nor will those characteristics be found only in certain generations. While there are still some individuals from the silent generation (born 1925-1945) in the workplace, they are becoming fewer in number, so I have chosen to focus on boomers (born 1946-1964), generation X (born 1965-1980) and millennials (born 1981-2000).

Baby Boomers
For the baby boomers, their formative events include the Civil Rights Movement, the Vietnam War, protest marches and general economic prosperity. Most grew up with traditional families with stay-at-home mothers and hard-working (often absent) fathers. Women grew up believing they had a number of choices – to work, to have a career, to not be defined by husband and children – and they later joined the work force in record numbers. However, baby boomers rarely saw adults actually modeling how to have a career while also being an involved parent, and they struggled to see this dynamic as anything other than an either-or. Boomers grew up optimistic that they had choices and financial security. They were also competitive because they were rewarded for success. Boomers believe in hierarchy, “paying their dues,” and loyalty to organizations. And when supervisors told them to do something, they did it without question.

Generation X
Generation X-ers grew up in a time when every institution that said “trust us” proved to be untrustworthy: schools, churches, government and even families all failed them. Divorce and dual-career families led to “latch key kids” who were left on their own or with the television as a babysitter. Personal computers became their friends, and economic prospects were more limited. Their loyalty is not to an organization but to a person who has demonstrated they are willing to partner for success. This generation has been described as the most cynical and pessimistic in history, and is it any wonder why? They also grew up self-reliant, resourceful, self-contained and entrepreneurial. They are used to figuring out how to do things themselves once they know what the goal is. When they are told to do something and they respond by asking why, it is not because they question the person; they truly want to understand the reasoning. It’s not personal.

The millennial generation has experienced widespread violence and terrorism, as well as the technology boom, which has led to multiculturalism and a globalized outlook. Their parents were the “helicopter parents” who felt a need to protect their children from real, external dangers as well as the danger of poor self-esteem. Millennials received trophies for participation, were all told they were special, and their lives were filled with play dates and structured activities. They rarely had an opportunity for spontaneous play or alone time. They are collaborative, optimistic, altruistic and idealistic, though they may be less introspective or spontaneous. They want their work and outside pursuits to be meaningful. They don’t believe in hierarchy, so they might approach the chief of staff or dean as easily as their immediate supervisor. They like to work in groups and solve real problems; they have no time for long lectures, which include what faculty have learned in their careers. They want to benefit from the wisdom of faculty in learning how to apply the information they can easily access through technology.

Designing Activities
What does this mean for us as educators? We need to meet the needs of all our learners in every generation. Consider who your learners are for any given activity (or identified need/gap). Do they include all generations (as most CE does) or just one (such as medical school, which is now mostly millennials)? If you are trying to reach several generations, the issue is more challenging and provides a great reason to use multiple different interventions to address a need or gap.

Boomers are dependent on educators. They prefer lectures and are process-oriented rather than outcome-oriented. They generally want their educational plan scripted and delivered by experts. Gen X-ers are independent learners who like learning on the job and are driven by outcomes. They prefer choices and want to know why learning something will help them. Millennials are constant learners, but they want it to be engaging (sometimes described as “edutainment”). As digital natives, millennials are constantly using technology, but they don’t like reading or listening to long lectures online. They have a low tolerance for boredom, so they want key points rather than exhaustive reviews. They like working in teams and want to analyze and solve real problems.

These differences impact both choice and introduction of faculty and planners. Often, planning committees are composed of more senior physicians, as they tend to have the time and expertise. How many of your planning committees include all generations? Having representatives of all generations increases the chance that their needs are met. Since boomers appreciate “paying their dues” and achievements, they generally prefer experts, or faculty with descriptions of their accomplishments to establish their credentials. Gen X’ers and millennials are less impressed with credentials and hierarchy. They respond better to faculty who can give them practical advice on how to apply the evidence rather than an exhaustive review of the evidence, because they can look it up faster than you can say it. And of course, they want faculty to be engaging as well.

Differences between generations can certainly lead to challenging work expectations, learning environments and personal interactions. Recognizing these differences is the first step to creating a better working and learning environment and utilizing the best of all generations. All of us learning from each other is the best outcome!

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