Participation
At the second level of the taxonomy, students have purposeful interaction with the experience. Many of the exposure strategies also are suitable for the participation level, namely, writing, case studies, and computer-based interactive programs. Teaching/learning strategies at the participation level require recurrent thinking, because previously learned foundational concepts need to be used as students build on and learn beyond the basics. Writing, for example, requires students to move beyond the basic concepts and to use or apply them to a situation. Writing at the participation level promotes student recognition that patient situations are not textbook and that they require the selection of interventions appropriate to that specific patient. In her discussion of a writing project conducted in California, Olson (1992) identified four levels or domains of writing—sensory/descriptive, imaginative/narrative, practical/informative, and analytical/expository. The domain of sensory/descriptive is writing built on concrete concepts or points. The goal at this level is to center and focus on basic information. At the next level, students construct a story by means of identifying, sequencing, and capturing significant details. At the practical/informative level, students “learn accuracy, clarity, attention to facts, appropriateness to tone, and conventional forms” (p. 23). At the last level of the domain, students are expected to use the tasks of analysis, interpretation, and persuasion. Olson noted that these domains are not completely separate, and interdependency does exist among the levels.
Case studies used at the participation level should involve more creativity and reasoning than those used at the exposure level. With more knowledge, students can be challenged to bring together concepts that have an increasing number of variables. For example, at the exposure level, students learn to identify the role of vital signs in the assessment of their patients. At the participation level, students should begin identifying the alterations in vital signs that occur when diseases affect the body and should identify needed interventions.
The Role of Health Professions Education 57
Other teaching/learning strategies appropriate for the participation level include:
1. Problem-solving team: Using groups to work as a team provides an opportunity for the students to share ideas and knowledge while working on a common goal or outcome. For this strategy to be effective, the instructor must provide clear objectives with specific instructions. Brookfield (1987) identified themes characterizing critical thinking. One of those themes related to critical thinkers is the use of imagination and exploration of alternatives. Teamwork provides ample opportunity to spark imagination and creativity for the situation presented. Typically, group discussion leads to the identification of many alternatives; the group then evaluates and selects the needed interventions. This type of teaching/learning strategy promotes a second theme identified by Brookfield: the importance of context in critical thinking. No nursing or patient care situation is identical to another.
Students must be able to assess each situation and to implement the required interventions. According to Linderman and McAthie (1999), when knowledge guides practice, it takes into consideration all other information gained through complementary means.
2. Reflective journals: Students’ use of journals is an important tool to encourage reflection on an experience and to evaluate one’s performance and/or responses to the experience. Reflection provides an opportunity to weigh, consider, and choose (Adams & Hamm, 1994). Use of a reflective journal encourages students to think about their experiences and to examine the components as well as the overall experience. To be effective, instructors need to give specific guidelines on what information to include in the journal. For example, the student first describes the patient care situation. Next, students provide an analysis of significant events in the delivery of patient care and an exploration of feelings, reactions, and responses. Critical thinking is developed further when students are asked to identify decisions made or priorities set during the clinical experience. In the last phase of journal writing, students
“examine the outcomes of the reflective process” (Bratt, 1998, p. 1).
After this examination, students often identify changes to be made in future experiences.
3. Problem-based learning: This teaching/learning strategy focuses primarily on process. A small student group works on a case study with the assistance of a faculty facilitator. This strategy links theory with clinical situations and encourages reasoning in a realistic situation using collaboration and negotiation within the group. See Chapter 9 for more information on this strategy.
58 Chapter 4 • CritiCal thinking in the health professions 4. Mind (concept) mapping: This simple but effective teaching/learning strategy requires students to develop word pictures for a specific patient problem. There are a variety of ways these maps can be constructed, but they all focus on helping students to reason, prioritize, and link the various components to a patient problem with nursing actions. Students conclude this activity with a holistic view of the situation at hand (Schuster, 2002).
See Chapter 27 or more information on this strategy.
5. Questioning: Using questioning to reinforce learning is an excellent tool in the development of critical thinking. The use of questioning as a teaching tool can be traced back to Socrates in ancient Greece. Socratic questioning examines basic concepts or points, explores deeper into these concepts, and attends to problem areas of one’s thinking (Paul, 1993). One effective way to use questioning is in a game format. It is easy to adapt popular games to the content being discussed. Gaming can be very effective because it infuses fun into learning.
Identification
At the identification level, students become more active learning partners.
Students identify with the experience at an emotional and personal level. As the experience becomes a part of the students, they desire to share the experience with others. As previously noted, teaching/learning strategies, such as writing or case studies, continue to be important learning tools in the category of identification. With each of these strategies, there needs to be increasing complexity with more variables.
Additional teaching/learning strategies at the identification level should focus on organizing and applying concepts. Instructors play an important role at this level because they must rely on teaching/learning strategies that engage students to think in complex situations with more variables. Other teaching/ learning strategies for the identification category include:
1. Defensive testing: Students at this level need to be challenged more on why they select one option over another. They need to recognize that nursing care is based on principles and know which principle matches a specific situation—in other words, matching knowledge to the appropriate context.
This strategy also provides students the opportunity to reflect on their understanding of the material being tested. Additionally, they are providing rationalization to their answers.
2. Debates and critiques: Having students critique an article or other type of work provides a means of reinforcing the six critical thinking abilities The Role of Health Professions Education 59
identified by Linderman and McAthie (1999). These abilities include identifying possibilities/innovations, formulating and analyzing arguments, constructing meaning, using knowledge as context, negotiating, and critically reflecting on one’s thoughts and actions. Seeking information and analyzing its meaning moves students beyond basic concepts and challenges traditional uses of these concepts. The strategy of debating is effective to developing critical thinking because it prepares students “to doubt, to challenge what is held to be true” (Smith, 1990, p. 104). If a student is required to debate the issue of abortion, he or she will formulate in depth critical thinking about the purpose of abortion, its impact on a woman, and how society views access to this intervention. See Chapter 11 for information on the use of debate.
3. Problem-based learning: With this teaching/learning strategy, students actively participate in problem solving. Discussion focuses on the problems presented in the case study and the identification of knowledge from previous experience with the identified problem(s).
Skill
Once students have developed an attitude of inquiry and the knowledge base needed, they need an opportunity to develop and apply knowledge in real life (clinical) situations.
The learning lab provides a tremendous opportunity for simulated learning.
Although the learning lab traditionally has been used for learning psychomotor skills, it offers students a safe, controlled environment to develop critical thinking (see Chapter 15 ). As students’ nursing knowledge increases over the span of the curriculum, instructors can use a high-fidelity patient simulator to create situations in the learning lab that promote student exploration into the various options available for nursing care (without injury to the patient). In this nonthreatening environment, students are provided the opportunity to question, explore, and experiment using a simulated patient scenario. Students can apply reasoning skills without the constraints of limited time and reflect on decisions made during the course of the experience. See Chapters 14 and 16 for more discussion of the use of high-fidelity simulators to promote student learning.
The clinical setting is identified as any setting where students provide nursing care to real patients. Today, clinical settings range from in-hospital units to homeless clinics in the community. In these clinical settings, learning opportunities to develop critical thinking abound. The challenge of all clinical instructors is to construct clinical experiences that maximize student learning. The clinical setting requires students to be familiar with their patients’ health problems, medications, 60 Chapter 4 • CritiCal thinking in the health professions procedures, and lab data. Using their knowledge of the textbook patient, students are challenged to develop skills in critical thinking in their efforts to implement appropriate care for an actual patient.
Care of patients in real life situations reinforces that critical thinking is contextual. Although the textbook lists specific interventions for patients with pneumonia, students must recognize the care needed for a specific patient at a specific time. Using a variety of mental processes, such as reasoning, prioritizing, judging, and inferring, students are able to select needed interventions. As knowledge and clinical skills develop, students’ skills in critical thinking increase.
There is no best style for instruction in the clinical setting; however, several points should be considered to increase the effectiveness of the clinical experience.
1. Questioning by the instructor is an important part of the clinical experience. This process encourages students to think about the options available and to select an intervention appropriate to a specific patient. A good technique to use when questioning students is asking the student to talk aloud while answering the instructor’s questions (Corcoran, Narayan, & Moreland, 1988). Using this technique assists instructors in evaluating students’ processing skills. Did they use appropriate reasoning skills? Was there a logical correlation between data and problem identification? Was the nursing process used appropriately, with logical sequencing of data, problem, goals, strategies or interventions, evaluation, and follow up with changes? Was there effective prioritization for the patient?
2. Students should be encouraged to test their thinking. Many healthcare alternatives are available today, and students need to explore what is best for their patients. The clinical setting provides the instructor with the opportunity to teach students on a one-on-one basis. Instructors need to verbally praise the student when the student performs correctly.
Although clinical training is stressful and challenging, students need and deserve positive reinforcement of effective problem solving using critical thinking.
3. Instructors need to empower students to think critically. Students who feel a sense of empowerment take responsibility for the process of problem solving.
4. Instructors must see the importance and impact of role modeling. Using the teaching/learning strategy of modeling includes “leading the student through thoughts and experiences to one’s own conclusions” (Reilly & Oermann, 1992, p. 331).
5. Written work related to clinical experiences is an important component in developing critical thinking. Students have the opportunity to take textbook patients and to select suitable interventions for their patients. The exercise of Evaluation of Critical Thinking 61
individualizing nursing care reinforces the conceptuality of critical thinking and the need to explore all available options for patient care.
Kurfiss (1988) discussed the elements of what she called cognitive apprenticeship, which include modeling or demonstration, coaching or assisting, guiding with gradual removal of the guidance, articulating or reasoning, reflecting or comparing, and exploring goals and options. All of these elements can be accomplished with clinical experiences. Clinical experiences expose students to the dynamic world of health care and practice with multiple concepts. Whether collecting data and relating their role to the patient’s condition or developing an argument on why one intervention is better than another, students are developing skills in critical thinking. See Chapters 25, 26, and 28 for more discussion of clinical instruction.
EVALUATION OF CRITICAL THINKING
In 1991, the National League for Nursing revised its criteria for accreditation and incorporated the need for evaluation of critical thinking in undergraduate nursing programs. The National League for Nursing Accrediting Commission (2005) recently reiterated its support of the need for critical thinking as noted in its core competencies for nursing educational programs. The American Association of Colleges of Nursing (1988) also emphasized critical thinking. Because of this notable recognition of critical thinking and its role as a competency for nursing, educators have explored, pondered, and discussed how critical thinking should be evaluated. While there is agreement on the need for critical thinking for all nurses, a consensus is absent on how critical thinking is defined and how it can be measured (Ali, Bantz, & Siktberg, 2005); however, evaluation of critical thinking is an important component of nursing education. Work within nursing education over the last few years has seen the identification of alternative options to evaluating critical thinking skills, such as concept maps and context-dependent testing (Daley, Shaw, Balistrieri, Glasenapp, & Piacentine, 1999; Oermann, Truesdell, & Ziolkowski, 2000).
Teaching and evaluation clearly go hand in hand. Nursing education is challenged to identify and/or develop tools for evaluating critical thinking that reflect the individual program’s definition and philosophy. With the use of multiple means of evaluation, nursing education gains a better understanding of teaching critical thinking and the impact of this instruction on student learning. Students should see evaluation as a learning tool; it is a positive means for determining the need for additional learning, further clarification, and/or added directions by instructors.
62 Chapter 4 • CritiCal thinking in the health professions CONCLUSION
Professional education’s challenge to produce a care provider who can think critically has never been greater. Changing health care, increased acuity of patients, and a dynamic culture offer a tremendous challenge for nurses. Nursing education must attune itself to the task of reexamining the concept of critical thinking. This reexamination includes evaluation of all components of the teaching/learning process—curriculum, teaching/learning strategies, and evaluation measures.
Critical thinking is best advanced through learner-centered teaching approaches, some of which are described in this book: service learning, learning through discussion, team-based teaching, and a structured research course. These methods aid in the development of engagement, critical thinking, clinical reasoning, and innovative practice. Outcomes from these teaching approaches are that students take more responsibility for their own learning and show more maturity as learners (Kramer et al., 2007). In selecting approaches to develop critical thinking skills, faculty can assure their students that, as the healthcare workers of tomorrow, they will possess the necessary skills needed to deliver safe and competent patient care.
REFERENCES
Adams, D. M., & Hamm, M. E. (1994). Cooperative learning: Critical thinking and col aboration across the curriculum. Springfield, IL: Charles C Thomas Publisher.
Alfaro-LeFevre, R. (2004). Critical thinking and clinical judgment: A practical approach. Philadelphia: W. B. Saunders.
Ali, N. S., Bantz, D., & Siktberg, L. (2005). Validation of critical thinking skills in online responses.
Journal of Nursing Education, 44(2), 90–96.
American Association of Colleges of Nursing. (1998). The essentials of baccalaureate education for professional nursing practice. Washington, DC: Author.
American Philosophical Association. (1990). Critical thinking: A statement of expert consensus for purposes of educational assessment and instruction. The Delphi report: Committee on pre-college philosophy (ERIC Document Reproduction Service No. ED 315–423). Millbrae, CA: The California Academic Press.
Bandman, E. L., & Bandman, D. (1995). Critical thinking in nursing. Norwalk, CT: Appleton & Lange.
Bratt, M. M. (1998). Reflective journaling: Fostering learning in clinical experiences. Dean’s Notes, 20(1), 1–3.
Brookfield, S. (1987). Developing critical thinkers: Challenging adults to explore alternative ways of thinking and acting. San Francisco: Jossey-Bass.
Candela, L., Dalley, K., & Bensel-Lindley, J. (2006). A case for learning-centered curricula. Journal of Nursing Education, 45(2), 59–66.
Corcoran, S., Narayan, S., & Moreland, H. (1988). Thinking aloud as a strategy to improve clinical decision making. Heart & Lung, The Journal of Critical Care, 17(5), 463–468.
Daley, B. J., Shaw, C. R., Balistrieri, T., Glasenapp, K., & Piacentine, L. (1999). Concept maps: A strategy to teach and evaluate critical thinking. Journal of Nursing Education, 38(1), 42–47.
References 63
Dewey, J. (1933). How we think: A restatement of the relation of reflective thinking to the educative process. Chicago: Regnery.
Ennis, R. N. (1985). A logical basis for measuring critical thinking skills. Educational Leadership, 43(2), 44–48.
Facione, N., & Facione, P. A. (1994). The California Critical Thinking Disposition Inventory (CCTDI) test administration manual. Millbrae, CA: The California Academic Press.
Facione, N., & Facione, P. A. (1996). Externalizing the critical thinking in knowledge development and clinical judgment. Nursing Outlook, 44(3), 129–136.
Klaassens, E. L. (1988). Improving teaching for thinking. Nurse Educator, 13(6), 15–19.
Kramer, P., Ideishi, R.I., Kearney, P.J., Cohen, M.E., Ames, J.O., Shea, G.B., et al. (2007). Achieving curricular themes though learner-center teaching. Occupational Therapy in Health Car e, 21(1–2), 185–198.
Kurfiss, J. G. (1988). Critical thinking: Theory, research, practice, and possibilities. College Station, TX: Association for the Study of Higher Education.
Linderman, C., & McAthie, M. (1999). Fundamentals of contemporary nursing practice. Philadelphia: W. B. Saunders.
National League for Nursing. (1991). Criteria and guidelines for evaluation of baccalaureate nursing programs. New York: Author.
National League for Nursing Accrediting Commission. (2005). Accreditation manual with interpretive guidelines. New York: Author.
Nugent, P. M., & Vitale, B. A. (2004). Test success: Test-taking techniques for beginning nursing students. Philadelphia: F. A. Davis Company.
Oermann, M., Truesdell, S., & Ziolkowski, L. (2000). Strategy to assess, develop, and evaluate critical thinking. The Journal of Continuing Education in Nursing, 31(4), 155–160.
Olson, C. B. (1992). Thinking/writing: Fostering critical thinking through writing. New York: HarperCollins.
Paul, R. W. (1993). Critical thinking: What every person needs to know to survive in a rapidly changing world. Pohnert Park, CA: Center for Critical Thinking.
Reilly, D. E., & Oermann, M. H. (1992). Clinical teaching in nursing education. New York: National League for Nursing.
Rubenfeld, M. G., & Scheffer, B. K. (2006). Critical thinking TACTICS for nurses: Tracking, assessing, and cultivating thinking to improve competency-based strategies. Sudbury, MA: Jones and Bartlett Publishers.
Scheffer, B. K., & Rubenfeld, M. G. (2000). A consensus statement on critical thinking in nursing.
Journal of Nursing Education, 38(8), 352–359.
Schuster, P. M. (2002). Concept mapping: A critical-thinking approach to care planning. Philadelphia: F. A. Davis Company.
Smith, R. (1990). To think. New York: Teachers College Press.
Steinaker, N. W., & Bell, M. R. (1979). The experiential taxonomy: A new approach to teaching and learning. New York: Academic Press.
Watson, F., & Glaser, E. M. (1980). Watson-Glaser critical thinking appraisal. Dallas: Psychological Corporation.
Youngblood, N., & Beitz, J. M. (2001). Developing critical thinking with active learning strategies.
Nurse Educator, 26(1), 39–42.
CHAPTER 5
The Teaching–Learning Experience
from a Generational Perspective
Lynda Pesta
I hear babies cry, I watch them grow,
They’ll learn much more, Than I’ll ever know,
And I think to myself, What a wonderful world.
—Sung by Louis Armstrong
INTRODUCTION
Much has been written in pedagogical and business literature about the learning differences among generations. Each generation is shaped in part by the cultural, technological, and political events that have transpired during formative years. Therefore, each generation carries its own unique imprint from specific generational influences. Most of the college classrooms are filled by Generation X and Y (Xers and Yers) students, with the minority group being Baby Boomers.
However, Boomers have heavy influence on both of the younger generations as their parents and teachers.
Projection data from the US Bureau of Labor Statistics (BLS) indicate that job growth is expected in all areas of healthcare occupations and health care will generate more than 3 million new wage and salaried positions by the year 2016.
It is estimated that more than 1 million new and replacement nurses and 200,200
physicians will be needed by 2016. Universities, colleges, and training centers that prepare people for health occupations may find several challenges in recruiting, admitting, and retaining a workforce prepared to meet the expected demand.
Tension may arise between learners and educators of differing generations who may have conflicting expectations of each other.
GENERATIONAL PERSPECTIVES OF FACULTY AND STUDENTS
Several generations are bound together for the transference of essential knowledge, skills, and attitudes for the health professions. Faculty typically consist of three generations: the Veterans/Traditionalist/Silent Generation (Veterans) who were born in the years between 1922 and 1945, the Baby Boom Generation (Boomers)
who were born between 1946 and 1964, and Generation X (Xers) who were born 65
66 CHAPTER 5 • THE TEACHING–LEARNING EXPERIENCE
between 1965 and 1981, and the Generation Y (Yers) who were born between 1982 and 2002. There is some overlap of years for each generation, depending on the source. Many healthcare programs, especially nursing, attract a wide group of students: the traditional student who enters college after high school graduation, the slightly older student who has worked after high school or perhaps has a young family, and the seasoned individual who decides to pursue a career after raising a family or deciding to change professions. To help meet future predictions for healthcare professions, recruitment efforts will remain focused on appealing to a younger demographic, fostering the idea throughout secondary educational settings that health care is an attractive career choice (Cohen et al., 2006). The majority of nursing students are either Yers or Xers. Only a minority of students today are Boomers.
The Veteran
Cultural Setting
Most Veterans experienced the effects of the Great Depression where an estimated 25 to 30% of the US population experienced unemployment or displacement. This ended when World War II broke out in 1941. The Social Security Act of 1935 was new. Medicare and Medicaid were still decades away. Credit cards had not arrived. Veterans are known for patriotism, loyalty, and duty. Many families were just beginning to afford a family car and the Interstate Highway System that linked remote areas of the nation had not been built. People listened to swing and the big band sounds of Tommy Dorsey and Glenn Miller on 78 rpm records.
The whole family sat near the radio and listened to President Roosevelt’s “Fireside Chat” or was spellbound by the “Shadow” series and other radio shows. Reel-to-reel tape recorders and televisions were new and extremely expensive. Any adult could correct a youngster and it was not considered extraordinary by a parent. The virtues of frugality, thriftiness, and self-restraint were necessary for survival.
Rapid advances in health care came about during and after World War II.
However, polio and tuberculosis killed or crippled thousands of people during this era. Many died from infection or sepsis from simple traumas. The widespread availability of penicillin during the 1940s reduced infection death rates (Smith & Bradshaw, 2008).
Despite the United States being the “melting pot” of the world, cultural diversity was not the norm or routine part of life for Veterans, especially in smaller cities, towns, or isolated rural communities. Most Americans lived in homogenous neighborhoods that were segregated by cultural practice, religious belief, race, or ethnicity. Family farms were still a way of life and Veterans were often isolated from outside influences. Life for Veterans was simpler but they grew up in a more formal Generational Perspectives of Faculty and Students 67
and ordered society where manners and decorum were prized. They were taught not to question those in authority. Information from the outside world came from movie newsreels, Life Magazine, newspapers, and postal delivery of handwritten letters. The digital age has made the world a smaller place, yet the Veterans may not be as accepting of cultural differences as are the younger generations.
Characteristics/Work Ethics/Learning Styles
Veterans are known to be disciplined, hard working, patriotic, and loyal. Veterans are known to be team players. There is an almost universal belief within this generation in the motto “All for one and one for all” to ensure that the group good surpasses individual desires. They believe that history has important lessons to follow and use them as bridges to the future. Veterans have reached retirement age but many work due to longer life expectancies and changes in retirement goals.
Workplace stability and longevity in the work environment is prized by this cohort.
This has supported the expectation of retirement security. Being raised in an environment that valued deference for established rules, Veterans will usually follow the status quo. Veterans appreciate the wisdom of experienced leaders and elders and they appreciate the mentor/mentee aspects in personal and professional relationships. Finally, Veterans prefer a hierarchical structure in the workplace where lines of authority and responsibility are well defined. Veterans spent most of their lives without the convenience (or headaches) associated with personal computers, laptops, personal digital assistants (PDA), instant messaging, email, or Facebook. In fact, they often view technology suspiciously or as an intrusion. They put a higher value on face-to-face interaction, well-written notes, and telephone conversations.
The educational system in place during a Veteran’s upbringing placed a heavy emphasis on reading, writing, and arithmetic. Most learning acquisition occurred with an emphasis on process. Knowledge was obtained through sequential, step-by-step instruction and through memorization drills. Because of this, there may be a higher comfort level among Veterans in using these strategies in teaching. There are few Veteran faculty but their influences persist in traditional healthcare curricula, policies, and teaching strategies.
The Baby Boomer
Cultural Setting
Boomers are generally classified as being born between the years of 1946 and 1964. During this time, the middle class was growing along with the economy.
68 Chapter 5 • the teaChing–Learning experienCe
Growth meant more resources to purchase goods. Automobiles, time saving appliances, electronics, and store-bought clothing became the norm. This generation learned that credit cards could provide more purchasing power and adopted a “buy now pay later” mindset with respect to homes, cars, and big ticket items (Johnson & Romanello, 2005). Advances in medicine and health care meant the average life expectancy continued to rise. Health insurance was an expected benefit when you worked for a company or corporation.
Boomers were born prior to digital technology. Because Veterans and Boomers needed to learn these digital technologies, often as a result of employer mandates, they are sometimes called digital immigrants (Prensky, 2001). Boomers needed to adapt and catch up to the rapid changes brought about by the introduction of the public Internet in the early 1990s and the ubiquitous presence of personal computing, email, distance learning, cellular telephones, and rapid information access through powerful search engines. Boomers learned that some of their previous prized skills for penmanship and spelling were now antiquated.
Predigital education had an emphasis on punctuation, writing, spelling, drills, rules, and memorization. Learners were taught in a highly structured, teacher-centered educational system that called for obedience to the rules. Computers were behemoths and, because of their large size, needed entire rooms to house them. The average person could neither afford nor use a personal computer.
Simple arithmetic could not be done on calculators. Manual typewriters created important documents. Correction fluid was considered a major time saver when correcting typed mistakes. In recent decades, learners have the distinct advantage of the delete key and can cut and paste large volumes of information into documents. Early television was not created as an educational tool but as entertainment where viewers watched on small, 9-inch screens in black and white with metal antennae. In the educational setting, challenging a teacher or parent was not expected or tolerated. Corporal punishment was not considered child abuse and was often used for a disobedient child.
Boomers used telephones to communicate when face-to-face encounters were not possible. Like learning a new language, the Boomers had to adjust to new technologies, such as email and computer networks, as a necessity of work life and not a choice (Sherman, 2006). The Boomers are not like the younger generations who are fascinated with new technology and often view these inventions as time savers and vital connections to significant others (Oblinger, 2003).
For the Boomer, Friday nights meant attending a chaperoned dance at school.
London’s Twiggy was the epitome of fashion. Boomers relied on eight-track tapes or AM/FM radios for music. Now digital MP3 players provide a wide variety of music in an instant to almost every Xer and Yer. Boomers were enthralled with a variety of musical styles, the most influential being rock. The energetic sounds from a multitude of rock and roll bands emerged. The Woodstock music festival Generational Perspectives of Faculty and Students 69
was a celebration of youth and freedom but with a downside of a culture laced with the idealization of illicit drugs, anger sparked by the Vietnam War, and the promotion of casual sex.
There were other events of the day that influenced the Boomer generation.
Following World War II, the tension between Russia and the United States esca-lated the threat of nuclear war. Other major events that shaped the attitudes of the Boomer were the mandatory draft, the Vietnam War, the Kent State massacre, the Civil Rights Movement, the assassination of Martin Luther King, the assassination of President Kennedy, the feminist movement, and President Nixon’s Watergate scandal. Protests occurred in the street and on college campuses across the nation. Boomers are seen as idealists who want to right the wrongs of an unjust world (Gardner, Deloney, & Grando, 2007). The overall discontent of the era created an upheaval in the mores of society. Unlike their parents, many Boomers came to mistrust authority figures and loudly questioned the wisdom of the institutions of organized religion, government, military, and marriage.
Characteristics/Work Ethics/Learning Styles
It is interesting that, as working adults, the Boomers became known as the generation to put in long and hard hours—often at the expense of their families.
Often referred to as the “me” generation, Boomers sought individual accomplishment over the group good (Benedict, 2008). They often equate work with self worth. In general, Boomers expect positive acknowledgment for work performed and thrive on praise for their efforts. They prefer a more casual style of dress and have an uneasy relationship with authority. The healthcare profession continues to have optimistic growth potential and many Baby Boomers dispossessed from another industry, job, or profession may find changing to health care both an attractive and challenging alternative. Boomers are known to be committed, lifelong learners and solve problems by action.
Generation X
Cultural Setting
There are differences among authors as to the exact years that define Xers.
Some authors use the years between 1960 and 1977 while other ranges exist in the literature, such as 1965 to 1976 (PEW, 2009). The most agreed upon years are in the range of 1965 to 1981. Regardless of the difference in defining age ranges, Xers comprise a much smaller group when compared to the Boomers 70 Chapter 5 • the teaChing–Learning experienCe
that preceded them and the Yers who came after them. Culturally, this group was shaped by the important events of the time including Roe v. Wade (1973), which legalized abortion.
Xers were mostly raised by Boomer parents. Demographic shifts meant many Generation X children were not raised near extended family or even by both parents. Many children were raised by single parents or parents who both worked.
Xers grew up on the experiment of the Children’s Workshop Network, known as Sesame Street. Some of these children participated in after-school programs manned by unrelated adults. The term “latchkey kid” was coined for the Xer child was left alone after school hours while a parent or both parents remained at work. Left home often without adult supervision, they entertained themselves with television shows, computer games, and videos.
Xer children were exposed to a higher level of violence in movies, music, and in video games. During this time, various musical styles emerged. Music Television (MTV) first aired in 1981. Musical influences such as grunge, heavy metal, and rap entered the mainstream American culture during the typical Xer’s formative years. These musical styles and videos contained graphic violence and obscene material that needed close monitoring from busy parents. They grew up in unprecedented economic prosperity and severe downturns in the economy. Middle class children were exposed to more marketing commercialism for brand name clothes, toiletries, and shoes than any other generation before them. Drugs such as ecstasy, heroin, and cocaine became prolific across the country. Major cities had increasing violence with gang warfare and violent initiation rites. Nationally, unwed teen pregnancy and divorce rates trended upward while marriage rates dropped (Boonstra, 2002; Stockmayer, 2004). The problems of acquired immune deficiency syndrome (AIDS) and homelessness were part of public discussions. Influential events included the Los Angeles riots of 1991, the Challenger space shuttle explosion, and the environmental disaster at Valdez.
Overseas, the Tian’anmen Square protests of 1989, the unraveling of apartheid in South Africa, the Chernobyl nuclear accident, and the fall of communism helped shape this generation. Communication was instantaneous and brought to life in living color within moments of occurring. The Internet was introduced during this time. Xers became acclimated to learning on personal computers at home, at school, and during after school hours.
Characteristics/Work Ethics/Learning Styles
There are many conflicting characteristics that are attributed to Xers. Generally they feel more comfortable working alone and are considered independent.
Due to their upbringing and isolation, it has been said that Xer have learned Generational Perspectives of Faculty and Students 71
they can only “rely on themselves.” They readily identify friends as extended family. As a learning group, Xers have come to expect instant gratification because of the advances in technology and obtaining information at the click of a button. They tend to see themselves as consumers of education and tend to mistrust authority figures, which could include faculty. Xers become bored in meetings where there is much discussion prior to making decisions (Sherman, 2006).
Leisure and time off to enjoy other interests is particularly critical to Xers.
Unlike their parents who worked long hours, only to watch them lose out on what they consider to be the fun of living, Xers jealously guard free time and view requests to work overtime as intrusions. Because of the higher value they place on personal time over the needs of their employers, they have been viewed as undependable. They highly value their individuality but, as a group, widely adopted bizarre hairstyles, tattoos, and body piercings as a sign of independence from the norm. This generation witnessed companies increasingly grow in international markets, thereby supplanting the local American worker for cheaper labor overseas. They realized that the years of loyalty their grand-parents and parents had in return for job security and a guaranteed pension no longer existed and, as a result, view government programs with skepticism and do not believe that social programs like Social Security will be available for them when they retire. Xers are described as cynical, ironic, clever, pragmatic, and resourceful (Johnson & Romanello, 2005). If there is a collective mantra that sums up the attitude of work versus leisure among Xers, it is “Work to live, not live to work.”
Generation Y
Cultural Setting
Depending on the writer, there are many names and descriptions for Generation Y. They are referred to as Nexters, Generation N, Millenials, and “Digital Natives.” Collectively, Yers are usually placed as being born between 1981 and 2001. Despite variations in date, what is certain is that most Yers have never known a time before the age of digital technology. Culturally, Yers have been shaped by such events as the 1995 Oklahoma City bombing, the 1996 Summer Olympics bombing, the mass shootings at Columbine High School in 1999, and the terrorist attacks of September 11, 2001. The War on Terror, with efforts in Iraq and Afghanistan, continues to affect the paradigm of this generation. Generation Yers show a taste in diverse music from rap, alternative, and socially conscious groups such as Coldplay, Yellow Card, or Green Day. Music and videos from Yers’
72 Chapter 5 • the teaChing–Learning experienCe
favorite bands can be instantly accessed on YouTube on wirelessly connected laptops, all while performing other tasks.
The US birthrate continued to decline in this era. Most children born in this generation were planned and “wanted.” The parents of this generation are known to be very involved in their children and are often coined “helicopter”
parents because they hover around their children. The hovering behavior is evidenced by high level of involvement with every aspect of their children’s lives and imparting on them more material goods than previous generations.
As a benefit of caring and involved parents, Yers are secure and value family relationships.
Characteristics/Work Ethics/Learning Styles
Yers, however, are thought to be more sociable than Xers. While Veterans and Boomers are referred to as “digital immigrants” because they were not exposed to the digital world until adulthood, Xers and Yers are comfortable with new technologies and are referred to as digital natives (Prensky, 2001). MP3
players, blogs, personal computers, Internet searches with Google or Yahoo, cell phones, instant messaging, text messaging, interactive gaming, video cameras, game technology such as Wii and PlayStation, Wikis, Twitter, Flickr, YouTube, and Facebook/My Space seem foreign to the “digital immigrant.” Digital natives are those who were exposed to the benefits of computer and digital technology and cannot remember a time before them. Many attributes have been assigned to Yers, including a high comfort level with computers and an insistence on being connected to family and friends technologically. There is no doubt that our world is becoming increasingly interconnected with wireless technology. Since Yers have never known a life without the presence of computers, cable, satellite radio, wireless connections, or cell phones they are comfortable “surfing” the Web, use digital music sources to download to MP3 players, and are usually experts in uploading or downloading videos through YouTube or other sources.
Using Twitter, texting, and Facebook are as essential as breathing air to the majority of Yers. Technological advances continue to grow at unprecedented rates, but Yers enjoy the latest advances. As the Xers rode the wave of MTV, the next wave brought YouTube to the Yers.
Parents of Yers have been known to involve their children in a multitude of activities: sports, music, private tutoring, and group activities. Therefore, Yers often have multiple and diverse talents. Generation Yers generally are considered more optimistic than Xers. They have lived structured, scheduled lives and generally are much closer to their parents and feel more comfortable in a structured environment than their earlier X counterparts. They are known Generational Considerations for Educators 73
to be enthusiastic learners but want to know that “what they are learning is connected to the bigger picture” (Sontag, 2009). Yers are known to be deeply committed to causes of justice, environmentalism, and volunteerism for the greater good. They are the most ethnically and racially diverse generation and readily accept persons who are different from themselves. Diversity is often celebrated and prized. Yers consider themselves to be global citizens (Johnson
& Romanello, 2005).
Yers are comfortable in group settings and feel isolated when unable to have instant access to friends through communication devices. There are similarities and differences described in the literature between the two youngest generations, Xers and Yers. Both groups have usually been exposed to a high degree of computer and digital technology in their formative years. Because of the preponderance of technology for communication, Xers and Yers may not have the verbal communication skills of their predecessors (Prensky, 2001).
There are similarities and difference among each of the generations. Although each generation is made up of individuals with unique characteristics, it is helpful to list some common characteristics that have been attributed to each generational cohort as outlined here. Table 5-1 summarizes characteristics associated with each generation.
GENERATIONAL CONSIDERATIONS FOR EDUCATORS
Changes in behavior, and thus learning, take place more readily when the student is fully engaged and can actively participate in the learning process.
Faculty should plan teaching experiences carefully in order to achieve successful outcomes. With generational considerations in mind, an educator might ask the following questions:
What factors influence each generation involved in educational settings?
What are the typical characteristics for each generation?
How do my generational preferences and characteristics merge or differ from the newer generations?
What are the best teaching strategies to engage each generation of learner?
How do generational differences affect communication?
Could generational differences simply be maturity issues?
How does technology affect the new learner?
Who are digital natives and who are digital immigrants?
Do digital natives think differently than other learners?
What strategies can engage the new generation of learners?
74 Chapter 5 • the teaChing–Learning experienCe
–
/
hnology
vic
ve;
yers
respect;
ati
tec
ven;
verse;
predecessors
aves social
easily bored;
versity; ci
oriented; self
expects
cooper
collegial.
hnology
tec
hedule dri
aces di
veati
ated into life
ve; ethnically di
ys face-to-face; cr
Instant access to desires;
integr
Asserti
optimistic; self confident in most
areas; embr
minded; consumer
reliant; enthusiastic;
idealistic; patriotic;
optimistic; friendly;
open minded; talented; less mature;
interested in others;
More respectful of rules and author
ity than Xers and Boomers
Closer to parents than
Enjo
connections via
Informal but sc
being smart is cool; team pla
collabor
Yers, 1982–2001
•
••
••
•ver
ve;
verse;
marriage
ven o
tattoos
agmatic;
expression;
relationships
tendencies
communication
hnology-dri
oriented
cings and
y pier
Confident; direct; asserti fearless; adaptable; di impatient; fun; informal; independent; pr outcome Challenges authority Bod popular forms of pessimistic Sees friends as extensions of family Hesitant to commit to and long-term Prefers tec face-to-face Xers, 1964–1981
•
••
••
•ve–
acteristics/Interpersonal Relationships/Communication Style ork
ave accused
viors; “me”
ation
authority
teristics
sacrificing
hnology as a
ac
Self-seeking
beha
gener
Inconsistent lo
hate relationship
with
Ambitious;
challenge status
quo; informal;
casual; likes fewer
rules; idealistic
Early w
of
family for w
obligations
Prefers face-to-face
communication;
Adapts to
tec
necessity
har
Attributes/Char
Boomers, 1946–1964
•
••
••
ational Cyal;
accepts
ener
proper
G
atification;
ver
al needs;
adition;
personal
communicate
authority
y gr
established
ans, 1922–1945
vidu
written
Unselfish; group
oriented; lo
patriotic; will
dela
responsible;
line authority
Prizes the group
welfare o
indi
honors tr
formal and
Prefers
or
communication; not
as comfortable with
electronic style; pre-
fers to
along
lines of
Table 5-1
Veter
•
••
Generational Considerations for Educators 75
ant to
diagnoses
ent aspect
DH
ys mentoring
D
ver reading;
y trial and error;
/AD
hool for the expec-
ic abilities; processes
D
ve learning and
acti
ork/sc
ard
osaic thinking;
ork in groups; curious;
ys inter
ultitaskers; expresses doubts
idences of A
aterials; enjoys entertainm
Parallel/m
m
about academ
quickly; prefers graphics over text;
likes to w
experiential; thrives on discovery;
shorter attention spans; higher
inc
Enjo
games with immediate response;
expects 24/7 access to learning/
faculty; learns best b
prefers more structure than Xers.
to learning; no tolerance for delays in
class beginning and endings.
Has expressed concerns regarding
academic abilities; enjo
relationships from experienced lead-
ers; likes stories that are relev
content; eager to learn new require-
ments for w
tation of rew
Prefers audio/visuals o
expresses higher reading compre-
hension than Xers
•
•• Likes creatively presented learning
m
•
•kly;
ants
ate
ent
hnology
aneous in-
ork hours;
hool flex-
ys fast pace; fo-
ployer; w
bition on their
aces tec
e over w
ay overestim
ork Styles
ork alone; needs safe
ance for extr
ork and sc
s; m
.
allel/mosaic thinking; nonlin-
vironment to participate; expe-
lues free tim
n term
Learning/W
a
Education began in student-cen-
tered settings; processes quic
multitaskers; enjo
cused; expects clear instructions;
par
ear thinking; concrete thinkers
Prefers to w
en
riential; embr
Little toler
formation; dislikes assignments—
does not view them as learning
enhancements; discounts contact
with faculty as important
Desires w
ibility; expects instant results for
efforts; self directed; entrepre-
neurial
V
little loyalty to em
success and am
ow
contributions to an organization;
expects rapid advancem
vity disorder
•
••
••
actiyper
y
ys
ver
y
ork
yal to
ards for
ements;
hiev
yer
aphics; linear
hnology
ork done; enjo
, attention deficit h
Prefers text o
gr
thinking; process
oriented; step b
step
Likes contact with
faculty
Lifelong learning
commitment; ties
learning with life
experiences; ex-
pects rew
w
titles and accolades
for ac
willing to w
long hours to get
job done
Seeks secure re-
tirement; lo
emplo
Tec
reluctant
Does not enjo
games or being put
on the spot
•
••
••
•ADHD
–
ws
ace
her
yal
chyar
hnology
ork
ery lo
yer
oriented;
alues mentorship
emplo
, attention deficit disorder;
Dependable; follo
established rules;
prefers hier
Educated in teac
centered settings
V
with established
leader or experienced
person
Less likely to embr
newer tec
than successors; more
process
expects w
security; v
to
•
••
•ADD
76 Chapter 5 • the teaChing–Learning experienCe
Educational Expectations of Teachers
Traditional teacher-centered learning has given way to a more student-centered approach (Brown, 2008). Within nursing programs, there are decades of separation from the authoritarian, quasi-military chain-of-command programs that dominated the training for most of the Veterans and Boomers, but little changes have resulted in nursing curricula (National League for Nursing [NLN], 2003).
Faculty expects students to meet learning objectives in order to successfully meet program outcomes. The hospital-based apprenticeship model of nursing education has long since moved into colleges and universities wherein students are expected to read and interpret complex written material while giving less weight to actual clinically based education with live patients. The emphasis from administration to hospital staff is to shorten lengths of stay and to provide safe, skillful, and efficient care. Providing the appropriate intensity of service according to the severity of illness is stringently applied by insurance payers.
A well-trained professional must be prepared and equipped to manage the complexities of the system or become overwhelmed by role performance demands.
Faculty, armed with the knowledge and experience of the profession’s challenges, expect students to meet the expectations set out in program curricula. Faculty expect students to attend class, remain honest when preparing assignments, meet assignment deadlines, arrive on time to class, pass exams, demonstrate appropriate communication skills, and perform psychomotor skills satisfactorily.
Students who arrive late or do not attend class, communicate poorly, or appear to be inattentive in class are viewed circumspectly. Students who text message, shop online, do not keep appointments, talk in class, or use a disrespectful tone of voice are seen as uncivil by most Boomer or Veteran faculty. To maintain a positive rapport between faculty and students of different generations, the faculty member must clearly define behaviors that are acceptable in the classroom and clinical areas (Suplee, Lachman, Siebert, & Anselmi, 2008).
Educational Expectations of Students
Parent and student expectations have undergone radical changes in primary, secondary, and postsecondary educational settings in the past decades. Advances in technology, the view that education is a commodity, developing maturity, tight schedules, previous life experiences, values, and cultural backgrounds will influence the expectations of learners. Education is no longer seen as a revered institution incapable of being criticized, as much as it is a product—the result of a consumer-oriented culture. Whereas Boomers appreciate a mentoring relationship with faculty, Xers believe they can teach themselves if given the right tools Generational Considerations for Educators 77
while Yers view experienced faculty with admiration but not awe. Generation Y
students, sheltered by doting parents, are said to be more grade conscious than earlier counterparts. They are confident and not fearful of challenging faculty over a grade disagreement. They will quite readily voice dissent and demand their consumer rights. Younger students expect respect and to be listened to when their opinions are expressed. They prefer an egalitarian approach in the learning environment (Gardner et al., 2007).
Generation Xers and Yers do expect that faculty be experts and have recent relevant experience in the subjects they teach (Oblinger, 2003). They also expect rationales as to why material is to be learned. That expectation coincides with adult learning theory and is not a foreign concept to experienced educators.
They like personal attention and expect immediate constructive criticism for their performance. Above all, students seek a connection with faculty (Gardner et al., 2007). Younger generations expect 24/7 access to their instructors (American Association of State Colleges and Universities [AASCU], 2004). One study indicated that 64% of college students indicated they would be interested in communicating with faculty outside of the class schedule in postings created in blogs (Junco & Cole-Avent, 2008). Today, schools, colleges, and universities are striving to keep pace by placing the required technological infrastructures in place to support online access for students and faculty. Communication networks supported by colleges and universities enable communication methods to support the desire for increased learning activities or faculty support outside of the classroom.
Generation Yers expect support and nurturing from faculty (Gardner et al., 2007). Both generations will adapt to a variety of teaching methods with Xers being more comfortable with computer, online, and distance learning and self-paced modules. Experiential learning is an expectation of both generations. Yers have a special penchant for hearing personal stories to illustrate points (e.g., analogies, humor, and wit) and expect an entertainment quality to teaching sessions.
Despite their apparent addiction to new technologies, some studies indicate that nursing students actually prefer a well-designed and entertaining PowerPoint with elements of multimedia imbedded into the lecture material. They also expect that a complete set of notes and slides will be provided. Younger students prefer this over other teaching methods (Paschal, 2003; Walker et al., 2006). This is especially true for difficult content topics and this traditional method is often preferred by students over group work. Undergraduate baccalaureate students younger than 25 years preferred to read about the subject first, followed by an expert’s lecture, despite self-reports of reading comprehension difficulties (Walker et al., 2007). When attempting to learn a psychomotor skill, students in these cohorts favored demonstration over a lecture covering the material. Experiential learning fits easily within all three cognitive domains of nursing and is a valued methodology among all generations. Experiential learning is described as learning through 78 Chapter 5 • the teaChing–Learning experienCe
experiences (Kolb, 1984). Xers actually value doing over knowing according to one author. Younger generation learners have been reported to prefer to perform the skill first under the direction of the faculty and then independently rather than hear a lecture over the material (Walker et al., 2007).
Barriers to the Teaching–Learning Experience
Education in a health professions program is challenging, especially for the incoming student. The sheer amount of reading and material can intimidate even the most scholarly student, yet it is inherent that, to be successful in the program, one must be able to comprehend, analyze, and write well (Arhin & Cormier, 2007).
The typical Yers will have difficulty reading and studying for long periods of time (Gardner et al., 2007). Multitasking is second nature to the Yers, but sitting and reading for long periods of time is difficult. It is estimated that by the time students reach college, they will have spent 5,000 hours reading compared to 10,000
hours playing video games and 20,000 hours watching television (Prensky, 2001).
There is no doubt that Yers have had more sensory input since childhood than earlier generations. Scientific evidence does support that environmental influences alters brain structures (Draganski et al., 2004; Sontag, 2009). It has also been supposed that the newer generations do learn differently from their predecessors because of the excessive amounts of visual stimulation they received throughout childhood.
Parallel/Mosaic Thinking Patterns
Mosaic thinking was coined by media theorist Marshall McLuhan (1978) who hypothesized that the electronic age sparked a revolutionary, or mosaic, way of processing information. Western civilization was formerly characterized by the dominance of reading and writing, which is now giving way to electronic media. Linear reasoning relies on a phonetic/alphabetical structure and its use is foundational to logical and sequential thought processes. Mosaic thinking is a consequence of visual symbols and images that are found in media today. According to McLuhan and others, this change in communication has radically altered the way information is processed and society functions. Similarly, parallel thinking is the ability to process information from a variety of sources simultaneously. These thinking/learning patterns have been ascribed especially to the newer generational cohorts who are comfortable in a fast paced, technologically connected world.
Our newest cohorts connect with various digital technologies as they become available. Digital natives are said to gather information in parallel or a mosaic Generational Considerations for Educators 79
pattern. They process quickly and have the ability to take in information simultaneously from various sources. Therefore, they do not always learn in a step-by-step sequential manner. Younger students have been exposed to endless hours of digitally enhanced games (Prensky, 2001). In gaming, trial and error methods meet with failure or reward. Quick motor reflexes, for conquering spatial barriers, and problem solving are rewarded and positively reinforced. A consequence of this is students’
reduced tolerance for quiet reading, reflection, and listening. There is evidence that, because of changes in brain activity, technologically dependent students have a shorter attention span and poorer reading abilities than digital immigrants. As a result, boredom is not conducive to active learning.
Another downside to the reliance on instant feedback is the accuracy of Internet sources. Easy distractibility due to the constant habit of multitasking is often observed in younger students. To engage today’s learner, the experienced generations will need to understand their learners’ preferred learning styles and adapt or enhance teaching strategies help them connect with the material. The new generation prefers learning strategies that encourage exploration, discovery, and trial and error. Unfortunately, trial and error problem solving takes time and resources. It is not ideal in patient scenarios where the ultimate goal is to protect the patient’s safety and comfort within limited time constraints. Current nursing education may be outdated for digital natives as well as future generations of students. Curricula in health profession programs include a large demand for reading and sequencing. There is an emphasis on step-by-step processes to achieve learning outcomes. This method does not take into account new learner’s propensity for a fast paced, parallel, and mosaic thinking patterns. Online access, virtual reality, simulation, and computer games could solve these needs. Because of this, many nursing leaders question whether current nursing curriculums are preparing a viable workforce. The American Association of College Nurses and the NLN
have published position papers calling for major changes to incorporate the technology of this younger generation (NLN, 2008). More schools are going online to adjust to the ever increasing demand from students for increasing class schedule flexibility. It is estimated that online and distance nursing programs will continue to rise and remain a viable option for many. Despite the plethora of options for students today, recent studies indicate Boomers and Yers prefer face-to-face communication over distance learning–type arrangements.
Strategies for Teaching Across the Generations
To best serve our successors, it will be necessary for faculty to understand our personal biases, learning styles, and preferred methods of teaching (Pardue & Morgan, 2008). The methods used to teach students are going through a radical 80 Chapter 5 • the teaChing–Learning experienCe
upheaval because of changes in societal expectations, technological advances, and increased access to information. Adult learning theory rests on the accepted principle that learners will retain and retrieve information when meaning is associated with it. Another important principle of adult learning theory is the idea that adults want to learn what is applicable to them at the moment (Knowles, 1973).
Knowledge of the technological advances in a digital age and methods to employ them in the classroom, lab, or clinical site will become increasingly important over time. To say that it would be a necessity to engage the students would be an understatement. Foreknowledge of general attributes of the digitally engaged student is useful for nurse educators who have been a product of a different generation. For any generation, faculty creativity, an open honest dialogue, and availability will help create a positive environment for students to thrive. From a learning perspective, Xers jealously guard their time; they prefer the bullet point version of subjects. They want to know precisely what they need to know to pass to get good grades in the shortest way possible. They enjoy the presentation of specific information through email, blogs, and instant messaging (Gibson, 2009).
Xers have little tolerance for inefficiency and do not want their time wasted. They prefer brief learning episodes followed by group interaction and, because of their independence, will research information easily online (Gibson, 2009). They enjoy online courses because it provides more flexibility in scheduling. Xers are determined to complete tasks but see it only as a means to an end, not as learning for the sake of learning.
Yers learn best in an environment where there are multiple choices for obtaining the information, especially when the subject matter is difficult; choices include detailed notes, recordings of lectures, PowerPoint lectures, and video tapes of lectures that can be reviewed later. Yers enjoy the joy of discovery more than their older counterparts. They are known to enjoy hearing experiences from teachers whom they consider mentors. This trait may be especially heartening to the educator who has a rich history and experiences to share. Yers may need to be more directed by their educators than Xers (Gardner et al., 2007). Yers appreciate being asked for their opinions and relish opportunities to be part of a discussion.
They demand respect from those who are in leadership roles. The Yer is more likely to be engaged when teaching strategies involve creative solutions (Gibson, 2009).
The Yer prefers immediate feedback and expects instructors to be available beyond the classroom schedule. The use of classroom clickers is a method to enhance classroom participation and may appeal to all generations within the classroom.
They allow anonymous responses to classroom activities and provide immediate feedback to problems. (Skiba & Barten, 2006). The risk for exposure is minimal and would appeal to a Boomer student who chooses an incorrect response.
Technology and the increasing role it plays in our lives will continue to expand, which may be sometimes intimidating and frustrating for the older generations Generational Considerations for Educators 81
but not so for the younger generations. In the workplace, the trend for increasing reliance on electronic and digital equipment and electronic medical records un-derscores the fact that technology marches forward. It will be necessary to utilize the technology already in the workplace to prepare future health professionals. The Technology Informatics Guiding Education Reform (TIGER) initiative started in 2007
is a national plan to move nursing practice and education into the digital age. Members and experts from nursing education, informational technology, practice areas, and government agencies are collaborating to meet a 10-year strategic plan. The TIGER vision is twofold. First, to “allow informatics tools, principles, theories and practices to be used by nurses to make healthcare safer, effective, efficient, patient-centered, timely and equitable” and, second, to “interweave enabling technologies transparently into nursing practice and education, making information technology the stethoscope for the 21st century” (TIGER, 2007).
There are countless ways of involving and engaging students in experiential methods with or without technology enhancements. Virtual clinical experiences and lab practice are becoming more affordable, reliable, and evidence-based.
They may be essential educator extensions as the shortage of qualified educators in the health professions continues. They blend well with the traditional methods to assist the learner in gaining psychomotor skills. The power of multisensory experiences imbedded in curricular teaching strategies cannot be overestimated because it increases the long-term memory retention and retrieval of the material for the learner. Increased networking with other faculty in distant universities through Internet listserves or blogs are viable ways for faculty to network and increase teaching method repertoires.
Computer-based video games have been part of entertainment and primary education for many years. Students are exposed to simulation experiences at increasingly younger ages. They become experts at manipulating objects in spatial environments repetitively throughout their childhoods. Applying trial and error methods in a safe environment allow the participant to practice necessary skills until perfection is achieved. Sources indicate that most of younger students, especially digital natives, expect and thrive on this type of learning. Older students may not embrace game playing as valuable, especially if they are not attuned to this particular modality. Fast-paced gaming may be threatening to an older student. There should be alternatives to this format if the class consists of multiple generations. Older students may need more time to practice or prefer a one-to-one self-paced computer experience that focuses on decision making to enhance clinical reasoning skills. Simulation games have long been used for training purposes in aviation and the military. The learner will play out scenarios repetitively and receive immediate feedback for correct or incorrect responses.
The game HotZone© was developed by Noblis for first responders during a bio-hazard terrorist scenario (Noblis, 2007).
82 Chapter 5 • the teaChing–Learning experienCe
As the technology becomes more sophisticated and realistic, it is not hard to imagine the possibilities for all areas of the healthcare professions. Learning and creative expression can also be taken into the virtual world of Second Life (Junco
& Cole-Avent, 2008; Linden Research, Inc., 2009). Second Life is a virtual reality world where “players” interact with each other locally or from across the world.
Through the combination of enhanced video games, role play, simulation, and case studies comes a potential new learning methodology using this system. The educational goals might be collaborative skill development, communication, reasoning abilities, and practicing complex psychomotor skills. An exciting dimension to simulation learning has great potential in the healthcare professions.
In 2005, Texas A&M University–Corpus Christi partnered with Breakaway Ltd., a gaming company, to launch a virtual reality simulation lab for training military and civilian emergency medical personnel in trauma care. This teaching modality immerses the learners in a high fidelity three-dimensional world that allows for multiple realistic patient scenarios to be played out in an emergency room setting. These experiential scenarios encourage critical thinking, psychomotor skill acquisition, and collaboration with other healthcare personnel—all in a low risk virtual environment (“Pulse!!,” 2005). Educators should expect virtual simulations to become more widely used as they become increasingly available and reliable (Schmidt & Stewart, 2009). It should be noted that students are more receptive when experiential learning takes place in a low stress environment.
There are many teaching strategies that can be employed to engage the younger generations of learners. Narrative pedagogy is a way of interpreting information from different perspectives; using a deconstruction (analytical) approach may work in classes that welcome and expect student participation, analysis, and dialogue (Diekelmann, 2001). Concept maps use parallel/mosaic thinking to promote clinical reasoning (Vacek, 2009). Reflection and critical thinking can be powerful and generationally relevant for promoting clinical thinking by experienced faculty. Students are guided in “examining every angle” through organized brainstorming techniques (Kenny, 2003). Another strategy that encourages clinical reasoning is engaging in Edward de Bono’s six hat game (de Bono, 1999; Kenny, 2003). This encourages parallel thinking processes by looking at a problem from six different perspectives and discussing them.
CONCLUSION
Conflicts of younger generations with their elders have been documented for millennia. It may be debated that root causes are student immaturity, undeveloped reasoning abilities, preferred learning styles, or alterations in brain structure.
References 83
On the other hand, faculty reluctance to change or generational unawareness will impact communication and learning. It will become increasingly requisite for healthcare curricula to change, modify, and adapt to strategies that coincide with technological advances and the societal expectations of the new generations (Li, 2006). Whatever the causes, these differences must be reckoned with.
The timeless determinate for true educational success will most likely remain the connections from teacher to learner and from learner to teacher that transcend generational differences.
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