Journal of Communication in Healthcare

Strategies, Media and Engagement in Global Health

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Bridging the generation gap in the workplace: how

I learned to stop worrying and love working with
the millennial generation

Thanakorn Jirasevijinda

To cite this article: Thanakorn Jirasevijinda (2018) Bridging the generation gap in the workplace:
how I learned to stop worrying and love working with the millennial generation, Journal of
Communication in Healthcare, 11:2, 83-86, DOI: 10.1080/17538068.2018.1485830

To link to this article: https://doi.org/10.1080/17538068.2018.1485830

Published online: 31 Jul 2018.

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JOURNAL OF COMMUNICATION IN HEALTHCARE
2018, VOL. 11, NO. 2, 83–86
https://doi.org/10.1080/17538068.2018.1485830
EDITORIAL
Bridging the generation gap in the workplace: how I learned to stop worrying
and love working with the millennial generation
The millennial generation (those born between 1981
and 1996) [1]—also called ‘Gen Y’ or ‘Gen Me’—has a
bad rap. As new kids on the workforce block, millen-
nials are often blamed for conflicts in the workplace.
Over the past nearly 20 years of supervising successive
trainees in medical education, I continue to receive an
increasing number of complaints about millennial lear-
ners every year. The truth is I had not been immune to
the frustrations of supervising the millennial learners
myself–that is, until I have learned to stop worrying
and love working with the millennial generation by
reading the literature on this topic, through discussions
with other colleagues, and by learning from these new
kids. I hope these lessons are helpful to those from my
generation (Gen X) and others, and can be applied
beyond the medical education setting.
Chelsea Clinton tried to dispel misperceptions about
millennials when she stated they’re ‘often portrayed as
apathetic, disinterested, tuned out and selfish. None of
those adjectives describe the millennials I’ve been pri-
vileged to meet and work with [2].’ Nonetheless, her
statement alludes to common perceptions many
others share about this group.
How generational issues create potential conflicts in
the workplace has been observed in every field. This
issue is particularly apparent in places where different
generations share physical or employment space.
Medical education is a field in which a constant wave
of trainees come through and are supervised by older
—self-perceived as wiser—practicing physicians and
other health professionals. ‘These students/residents
appear younger and younger every year,’ and ‘they
are just so different from when I was trained’ are utter-
ances I routinely hear.
Misunderstanding and conflicts arising from genera-
tional gaps occurred long before millennials arrived on
the scene. Social scientists have observed that each
generation is defined by distinct characteristics based
on their birth years [3]. Although the line between
any two generations is at times blurred, some general-
izations have been helpful in understanding and inte-
grating co-workers from different generations in the
workplace. Influenced by myriad factors including
world events (e.g. war and similar conflicts), financial
flourishes and downturns, parenting styles, and tech-
nological advances, each generation shares unique
values, goals, and attitudes toward authority and
© 2018 Informa UK Limited, trading as Taylor & Francis Group
hierarchy. These, in turn, impact motivation, communi-
cation styles, personal and professional relationships,
ways to handle conflicts, and the concept of work-life
balance. Consequently, it is not difficult to see how a
workplace where three to four generations coexist
can be fraught with conflicts. Table 1 summarizes
characteristics of the four generations in the current
work environment [4,5].
Through my medical education career, I have been
on both ends of the generation gap. A recent experience
illustrated one end when a senior faculty member and I
failed to connect for a discussion about a new edu-
cational program because of our different preferred
modes of communication. He left messages for me on
my office voicemail, while I had been trying to contact
him via our work-based e-mail system. We finally con-
nected when he reached me on my office phone
number. Another example of a mismatch in communi-
cation on the other end relates to feedback. A couple
of years ago, in the core clinical rotation that I direct, a
medical student dropped by my office midway
through the first week of a six-week course to ask for
feedback on how she had done so far. As a Gen Xer
whose experience with feedback had been largely
summed up by ‘No news is good news’ or ‘Feedback is
for when you have done something wrong,’ I was
caught off guard by this student’s request.
Another area in which our multigenerational faculty,
who range from traditionalists to Gen Xers, complain
about millennial learners is in their commitment to
the noble profession of medicine. For example, super-
visors report that trainees frequently ask if they can
leave at five, even when patient-care responsibilities
remain. They would say, ‘When we were in training,
patient care always came before any personal commit-
ment!’ Also, millennial trainees frequently ask about
their assignments and grading rubric, seeming to
care more about what grades they will end up with
than how much they can contribute to patient care.
The role of technology in the workplace provides
another example of how millennials have frustrated
their supervisors. Many colleagues observe that stu-
dents often don’t carry their pagers, and if they do
carry them, they don’t respond to them in a timely
fashion. In subsequent discussions with students,
they tell me pagers are clunky, antiquated devices
that are difficult to use. They prefer communicating
84 EDITORIAL
Table 1. Characteristics of the four generations currently working together in the healthcare setting.
Generation (Birth Years) Core Values
Traditionalists (1922-44) Fiscal restraint
Strong work ethic
Self-sacrifice
Baby Boomers (1945-64) Ideals
Success
Generation X (1965-80) Entrepreneurship
Ambition
Self-trust
Millennials (1981–1996) Reliance on technology
Eagerness to learn
Confidence
Adapted from Mohr et al. 2011 & Elliott 2011.
through texts and other app-based platforms (our hos-
pital, for instance, is piloting ‘going pagerless’ by
directing all communication through a secure,
privacy-compliant system via a smartphone app). One
faculty member has been so frustrated with students
using their smart devices (phones, tablets, and
laptops) during her lectures that she told me she was
considering requiring students to leave all their
devices in a bucket at the door before entering her
classroom. We have since discussed ways to incorpor-
ate those devices in her session productively.
One of the valuable lessons I have learned working
with the millennial generation is that in order to maxi-
mize productivity and minimize conflicts, old-timers
(like us!) need a culture change and attitude adjust-
ment. We habitually assign blame to how the
younger generation has changed, how they do not
share our values, have the same motivation, or demon-
strate the same level of commitment. This attitude
actually shows our inflexibility and fear of change,
which ultimately does not serve anybody well. After
years of listening to millennial learners’ perspectives
—combined with reflection and reexamining my own
biases and habits—I have formulated three approaches
that I find helpful in our workplace because they not
only accommodate but also welcome the millennial
generation to work together with us toward common
goals. These strategies recognize their characteristics
as strengths rather than weaknesses.
Focus on inclusiveness
The millennial generation has been described as self-cen-
tered and entitled, characteristics that manifest them-
selves in a sense of ‘centrality despite a relative lack of
experience [6].’ Millennials have grown up in a world
driven by social media, the ultimate form of membership
and participation in social groups. They need to belong,
to share their voices and to be heard. My faculty
comment that students and residents are very vocal
and have strong opinion on everything. What has
worked with me is to listen more and without judgment
for their perspectives, then pose directed questions
Goals Strengths Challenges
To be respected Service to others Risk averse
To be valued Loyalty Conformist
Discipline Resistant to change
Lifelong learning Idealistic outlook Narcissism
Legacy Inspired to succeed Overachievement
Process over product
Independence Loyal to self Impatient
Freedom/Few rules Adaptable/Flexible Challenging authority
Creative Cynical
To be a hero Confident Reward for showing up
To make a difference Team oriented Need for structure
Digitally savvy Instant gratification
Multitasking
about their ideas for change and improvement. I also
hold them accountable for their end of the bargain.
For example, if they find supervision in clinical areas
inadequate, I probe for their suggestions about not
only how supervisors can step up but also how they
can be proactive learners themselves. Engaging millen-
nials in this way allows them to have ownership of
their education and professional development. Another
example of inclusiveness: in response to students’
feedback that our faculty talk down to them in traditional
lectures, we switched to the team-based-learning (TBL)
format, where learners have to do pre-session prep-
aration, take a quiz to ensure understanding of core con-
cepts, and work actively in a group to solve clinical cases.
This format not only satisfies students’ innate need for
participation and social interactions but also demon-
strates to faculty that they do bring something to the
table.
Despite their outward show of confidence, millen-
nials also tend to crave approval. Growing up in the
age of social media, they expect ‘Likes’ and thumbs-
ups as routine parts of any activities. Older generations
often dismiss this as the younger learners’ need for a
reward just for showing up. A more productive way
to handle this might be to think of feedback as an
ongoing process, with a beginning, middle, and end.
For example, during orientation of my six-week
course, I explicitly discuss how, when, and how often
feedback will be provided, what feedback will
include, how we will monitor progress, and how the
data will or will not count toward students’ final
grades. One could imagine that if I had done this
sooner, I might not have encountered the aforemen-
tioned scenario in which a student caught me off
guard by stopping by to ask for feedback.
Additionally, millennials appreciate honest and
open discussions even if this shows vulnerability on
either side; after all, on social media, thought processes,
attitudes, and underlying motivations are plain for all to
see. As a result, I have found myself more at ease dis-
cussing examples of how I have learned from past
errors and of efforts to improve. When I conduct inter-
disciplinary family meetings to discuss bad news,

medical errors, or family-provider conflicts, I include
students and residents at the meetings (sometimes as
observers, at others as participants) and make a point
to debrief the encounters, including how I had role-
modeled (as good or bad examples) and how they
might have done it differently.
Leverage social consciousness
As a cohort, millennials are unique in their social con-
sciousness, and they make decisions based on that
awareness. Keep them engaged at work by showcasing
a culture of paying it forward and tying the day-to-day
into the larger purpose of the organization. Kathryn
Minshew [7]
As witnesses to 9/11 and its impact on race relations, the
Black Lives Matter movement and other world-chan-
ging events, millennials have learned to appreciate
diversity. Multiple polls have shown that they are gener-
ally supportive of equal rights, same-sex marriage, and
environmental protective initiatives [8]. They have also
exercised their rights to protest against different types
of social injustice. With this sense of social conscious-
ness, millennials want to know how what they learn
and do will impact society and lead to the outcomes
they want. For a recent self-study looking at our under-
graduate medical-education curriculum, student repre-
sentatives suggested ways to strengthen their
educational experience in diversity, cultural compe-
tency, and health disparities based on race. In addition,
as at other medical colleges, our students have a track
record of delivering community service: for example,
they operate a free clinic providing uninsured, under-
served patients under the mentorship of faculty
members, and partner with Physicians for Human
Rights (http://physiciansforhumanrights.org/) to
provide medical screening for refugees seeking
asylum in the U.S.
To leverage millennials’ sense of social justice, I have
found it helpful to frame goals and objectives for edu-
cational activities throughout medical school to how
those activities shape students’ roles in ultimately
achieving quality of care and patients’ quality of life.
Discussing management of patients’ medical con-
ditions is not simply for building medical knowledge
and sharpening clinical skills, it’s also to improve
patient lives and contribute to the health of commu-
nities. Completing an evidence-based medicine assign-
ment goes beyond learning about the Ask-Acquire-
Appraise-Apply cycle [9]; rather, it is about keeping us
accountable to quality care and incorporating patient
preferences into our clinical decision making.
Incorporate technology thoughtfully
Millennials are digital natives who are facile with the
internet of things. They actively utilize smart devices
JOURNAL OF COMMUNICATION IN HEALTHCARE 85
inside and outside the classroom. Knowledge has
become something available at their fingertips.
Conflicts occur when faculty see students and residents
engaged more with their devices than with their
materials. These conflicts often occur in traditional
didactic sessions. Fortunately, in recent years, faculty
have become more open to technology in the class-
room and workplace. The challenge may be training
people to adapt to new tools on an ongoing basis, as
popular platforms may change from year to year.
I remember when I first started using an early version
of the audience-response system, in which learners
respond to questions using individual ‘clickers.’ While
most students gave their full attention by engaging
with the clickers, some responded with the device in
one hand while using the other hand to look through
their smartphones or tablets. In response, I abandoned
that system and picked up PollEverywhere©, in which
learners participate through the use of their own
devices, thus minimizing distraction. I have also found
it helpful to ask learners to work, either individually or
in groups of three to five, on worksheets they can down-
load onto their smart devices. This approach allows
everyone to focus on the same materials. In clinical set-
tings, I have started discussing explicitly expectations
for the use of smart devices during patient-care
rounds, as well as assigning different team members
to look up information that would be helpful for
patient-management decisions at the bedside. Other
formats that engage the millennials and hold their
attention include simulation and games. I have used
Jeopardy© to teach both medical content and psycho-
social aspects of care [10], and sessions utilizing team-
based learning, Jeopardy©, and simulation have
received the most positive feedback from students.
How I’ve learned to stop worrying and love working
with the millennial generation has definitely been a
journey full of trial and error. Millennials have arrived,
making their voices heard and presence felt in work-
places across all industries. Older folks, including me,
need to realize that we must change to maximize our
interactions across generations. The first step is
acknowledging the strengths of others, and the
second is leveraging those positives to reach
common goals that benefit all. It is my hope that the
three approaches described above will be helpful in
your own intergenerational journeys.
References
[1] Dimock M. Defining generations: where Millennials end
and post-Millennials begin, @pewresearch, 2018.
[2] Clinton C. Four Myths About Millennials | TIME.com, in
Time, 2013.
[3] Lancaster LC, Stillman D. When generations collide: who they
are. Why they clash. How to Solve the Generational Puzzle at
Work, HarperBusiness; Reprint edition (March 4, 2003), 2003.
86 EDITORIAL
[4] Mohr NM, Moreno-Walton L, Mills AM, et al.
Generational influences in academic emergency medi-
cine: teaching and learning, mentoring, and technology
(Part I): GENERATIONAL INFLUENCES: PART I. Academic
Emergency Med. 2011;18:190–199.
[5] Elliott S. Ties to tattoos: turning generational differences
into a competitive advantage. 2nd ed. Brown Books
Publishing Group; 2nd edition (December 15, 2011), 2011.
[6] Eckleberry-Hunt J, Tucciarone J. The challenges and
opportunities of teaching “generation y”. J Grad Med
Educ. 2011;3:458–461.
[7] Minshew K. PubTech connect: meet Kathryn Minshew,
Sage of the Millennial Workforce, @publisherswkly, 2017.
[8] Hoban B. Millennials are on the frontlines of political
and cultural change in America, @BrookingsInst,
2018.
[9] Sackett Dea. Evidence based medicine: what it is and
what it isn’t. PubMed - NCBI, MBJ. 1996;13:71–72.
[10] Jirasevijinda T, Brown LC. Jeopardy!: an innovative
approach to teach psychosocial aspects of pediatrics.
Patient Edu Counseling. 2010;80:333–336.
Thanakorn Jirasevijinda
Weill Cornell Medical College, New York, USA
jcih.editorsTF@gmail.com