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INTRODUCTION
A common pitfall among pharmacy preceptors is judging the values of their pharmacy learners based on stereotypes of the learners' generation, especially if the preceptors' generation differs from the learners. Generational similarities and differences between learners and preceptors may influence communication styles, which may inhibit meaningful interaction, hinder learning and performance improvement, and create frustration. Better understanding theses similarities and differences can facilitate better interactions and improve learning outcomes. The following article describes generational styles in the workplace including general tips for how preceptors can use this information to enhance their interactions with learners.
Review of generational differences
Generations are defined as cohorts of people who are similar in age and have shared similar experiences. A person's birth year indicates which generation he or she is a part of. Differences between generations are assumed to be the by-product of unique historical circumstances and events or shared experiences at similar ages, particularly during a time when individuals are in the process of forming opinions.1 These shared experiences create similarities among people in terms of their attitudes and behaviors, especially work-related.1 People born at the end of one generation or at the beginning of the next may have characteristics of both generations. There are currently five living generations in the workplace. The Veterans were born before 1946, the Baby Boomers born 1946-1964, Generation X born 1965 to 1980, Millennials (Generation Y) born 1981 to 1996, and Generation Z born 1997 to 2012.1 Broadly in the current pharmacy education landscape, three generations are predominant: Baby Boomers, Generation X, and Millennials (Table 1).2-4
Table 1. Key Characteristics of Baby Boomers, Generation X, and Millennials2-4
| Baby Boomers | Generation X | Millennials (Generation Y) |
|---|---|---|
| •Huge demographic | •Sandwich generation (between Boomers and Millennials) | •Largest generational cohort |
| •First generation to grow up on television | •Development of the computer | •Poor economy |
| •Civil unrest/gender revolution | •Latch key kids | •Influenced by technology |
Generations in the workplace
Sometimes older generations view younger generations negatively, most recently Millennials.5 A shift in the education mindset from relying on generational stereotypes to focus on differences in skills such as communication and technology will prevent generalizations and misconceptions, ultimately, leading to enhanced learning. Preceptors can focus on the: learning strategies, micro-learning, and instructional alignment.6-8 Preceptors can also consider modifying their communication style when engaging with individuals from different generations.
Communication with Boomers, Gen Xers, and Millennials
Recognition of communication preferences amongst the generations will allow for meaningful interactions between the preceptor and the learner, especially during an introductory pharmacy practice experience (IPPE) and advanced pharmacy practice experience (APPE). See Table 2.9,10
Table 2. Key Communication Styles of Baby Boomers, Generation X, and Millennials9,10
| Baby Boomers | Generation X | Millennials (Generation Y) |
|---|---|---|
| •Phone and talking | •Email (limit in-person meetings and calls) | •Quick sound bites of regular information (text, instant message) |
| •Be open and direct (without using controlling language) | •Be direct and use less formal communication modes | •Foster collaboration (social network generation) |
| •Be aware of body language ("show me" generation) | •Share information and strive to keep them in the loop | •Use action words and challenge them |
| •Respect that they may be guarded when communicating (do not push it) | •Be conscious of not talking down to them (or giving this perception) | |
| •Use humor and create a fun learning environment |
Engaging Millennial Pharmacy Students on IPPEs and APPEs
Multi-generational learning occurs daily in pharmacy practice. The following suggestions, the Six R's of Engagement, are offered to help pharmacy preceptors engage Millennial IPPE and APPE pharmacy students.11,12
1. Research-based Methods. Millennials prefer being taught with evidence-based active learning, otherwise interest shifts quickly. Therefore, preceptors should lecture less and use multimedia more (e.g., video, audio, images) when conducting topic discussions. Preceptors can also use peer learning activities since Millennials are good team players.13 Activities such as Team-based Learning, clickers and/or audience response systems, patient simulation exercises, and games have gained in popularity.14-18
2. Relevance. Learners now can "google" anything (e.g., doses) and may not value learning information for information's sake. Preceptors should shift from disseminating information to helping learners identify how to apply and retain information and emphasize relevance and importance of information. Relevance is an important concept related to motivation theory (attention, relevance, confidence, satisfaction).19 It is important that preceptors articulate the relevance of learning activities.
3. Rationale. Baby Boomers were raised in an authoritarian manner and readily accepted hierarchy. In contrast, Millennials were raised in a non-authoritarian manner and were offered equal say in family decision making. As a result, Millennials may want preceptors to provide rationale for policies and assignments to increase compliance but preceptors should be cautioned that this may lead to academic entitlement.20 However, there is evidence that providing rationale for post-graduate training may increase pursuit.21 Overall, preceptors should consider the pros and cons for providing a rationale for assignments so that learners do not view assignments as "busywork".
4. Relaxed. Millennials prefer a less formal, "laid-back" learning environment, and prefer informal interaction with peers and preceptors. One informal learning strategy preceptors can use is to create a Facebook group page with guest experts and peers to post on pharmacy related topics.22 However, preceptors are encouraged to make participation in the Facebook group voluntary. Another option preceptors can use to create a relaxed atmosphere is to have students call preceptors by first name. However, this may not be favored by all.
5. Rapport. Millennials are relational and are accustomed to being central to their parents' lives and having adults in their lives show interest in them. As such, this generation may want preceptors to show the same interest. Millennials may be more engaged when preceptors connect with them on a personal level. Student-faculty contact is an effective teaching principle.23 As a result, Millennials may want to be connected on social media platforms in order to build rapport; however, there are legal and ethical issues regarding social media use in pharmacy education.24 Preceptors may witness e-professionalism transgressions and questions can arise about how to uphold the school honor code. Preceptors should consider the pros and cons of "connecting" with learners on social media and perhaps explore other rapport building opportunities.
6. Responsive. Students need multiple opportunities to practice skills and receive feedback. Faculty, standardized patients, and peers are commonly used to practice techniques and provide feedback. Rubrics offer a consistent and structured way to provide feedback. For example, virtual patient activities with rubrics and feedback enhanced student performance when completed before mock clinic visits.25 Therefore, preceptors should be intentional about delivering feedback and establish with the learner the preferred frequency of feedback.
Implementation of the Six R's into IPPEs and APPEs
The following scenarios describe common communication challenges among generations during IPPEs and APPEs and offer solutions to improve the learning experience and outcomes.
Scenario 1. The preceptor receives an introductory email from an IPPE learner addressing the preceptor by first name and primarily written in "text speak".
Suggested engagement techniques: The relaxed nature of the email needs to be addressed with the learner. Consider inviting the learner to meet to build rapport and offer mentoring. This is an opportunity to teach the learner when a more relaxed versus more formal manner of communication is more acceptable; a first-time introduction to a preceptor favors formality. Use the time to coach the learner through an exercise of how to appropriately draft or reply to an email, providing feedback throughout the process (responsive). Finally, consider a patient simulation exercise whereby the learner must make the initial contact with an elderly patient to verify his/her upcoming appointment time. Reflect on the preferred method, via verbal telephone reminder or text message (research-based and relevance).
Scenario 2. On the first day of the Ambulatory Care APPE, the learner admits to not being interested in the experience as the learner already has a job arranged in the community setting. The learner states intent to do well, but only to pass because "P=PharmD".
Suggested engagement techniques: Building a rapport with the learner is key in this scenario. Try to convey the relevance and importance of each learning opportunity. While the overall goals of this rotation may not be in line with the learner's goals, the preceptor may emphasize the importance of being open-minded and finding opportunities to reinforce pharmacy practice, problem-solving, and interprofessional communication skills regardless of practice setting (rationale). The conversation should also help the learner identify opportunities for growth that can be applied to the community setting and help the preceptor tailor the rotation to the learner's professional goals. Finally, the relaxed tone and perhaps too "honest" nature of the learner's comments may be addressed. A tactful way to approach this is to state some expectations and the level of formality that is expected on the rotation, as well as how often feedback will be provided. Provide the learner with feedback (responsive) that the learner's comments may be perceived as off-putting.
CONCLUSIONS
In summary, whether working with IPPE or APPE learners, two-way communication between the preceptor and the learner (regardless of generations) is key to building the relationship. Consider these four tips when refining the experiential learning process.
Tip 1. Set the stage. Incorporate an "ice breaker" activity on the first day of the rotation whereby both the preceptor and learner share what generation they are classified as, which generation they most associate with, and which generation they find most challenging to communicate with.
Tip 2. Use technology to foster communication and reflection. Prior to the start of the rotation, email or text the e-link to a relevant professional development article (such as this one) or a YouTube video that reflects on generational differences and similarities.
Tip 3. Be proactive versus reactive. In order to prevent an awkward moment or challenging communication scenario, use the pre-reading or pre-viewing assignment as a brainstorming activity for solutions using the Six R's as a guide. Both the preceptor and the learner can share their reflections and then come to a mutually agreeable approach to improve communication.
Tip 4. Determine a mutual method of communication. Incorporating the first three tips should invite a discussion on the preferred method of communication between the preceptor and the learner. This systematic approach may increase "buy in" and promote a partnership. Both parties should hold each other accountable to agreed-upon communication practices.
Generations communicate to maintain relationships. The preceptor and the learner should be aware of their generational preferences and biases in order to promote the best learning environment for all.
