Is Andy Rooney out of touch ...

“Wisdom ceases to be wisdom when it becomes too proud to weep,
too grave to laugh, and too selfish to seek other than itself.”
~Kahlil Gibran

Cell phones
Computers
IPODS
Video Games
Internet
Email
Blogs
Podcasts ...

These are things that are here that were not present at the beginning of the 20th century. This is the technology of the 21st century. These have become a part of the everyday life in todays America. Most of our college students today could not remember a time without them.

Telephone
News paper
Radio
Milk man
Great Depression
Prohibition ...

These are popular things from the time of Andy Rooney's birth. These are things from a distant past. This list resembles what may be found in a time capsule retrieved by the residents of a small town.

I watch 60 minutes every once and a while. It makes me feel really old because I always thought it was a show for "old" people. At the end of every show, Andy Rooney gives an editorial statement on some random topic. It usually starts out with some sort of list. He will go on about how he doesn't understand why people do this or that now a days. Most of his comments seem very out of date. His comments seem old and unadapted to the world today. So, is Andy Rooney out of touch with what is current? Are his ways of looking at the world dated?

Well, Andy Rooney was born 1/14/19 and is of the G.I. generation, just before the silent generation. Many of the elders of this generation and the silent generation are now retired from their orthopaedic practices. These are the elders. Many still attend annual meetings and are advisors, consultants, and emeritus professors. Are they like Andy Rooney and out of touch and out of date? Do they still believe that the arthroscope is the tool of the devil?

I refer to these people of these past generations (G.I., silent, and baby boomer) as elders because they are. In our society today unlike in the past, many of the older generations have been looked at as old, out of date, and not providing any useful input into such a technologically driven world. I would like to make it clear that in the medical community, the wisdom provided by the years of experience of the elders sometimes far out ways the technologically savvy "whipper snapper." The elders help to bring some clarity.

In orthopaedics, most of the "new techniques" have been tried in the past. Many young orthopaedic surgeons have discovered "new techniques" to realizes the they are more like Christopher Columbus than Thomas Edison. The elders bring the experience of the past and the wisdom from those previous failure. It was usually the failures that prevented any further advancement of a technique. When rediscovered by the younger generation, with fresh eyes they were willing to experiment with newer or lost techniques. It is important that these ideas are tempered by the elders. There needs to be a reminder of previous errors so that we do not repeat them.

Is the older generation out of touch and out of date? They probably are, but they provide wisdom. Many of the elders have great stories of the past. Stories of how things were when they were young; when they were "whipper snappers." These stories are past from generation to generation. It helps to keep us from repeating the past failures. The elders should be revered as in tribal society. We should listen and respect them. So, they don't know how to use this thing we call the internet. In their mind, the mouse is a rodent and the blackberry a fruit. Many elders have forgotten more than most residents and young surgeons know. The elders have put in their time. They have made their mark. Today, all they ask is that you listen.

Lost

Stand still. The trees ahead and the bushes beside you
Are not lost. Wherever you are is called Here,
And you must treat it as a powerful stranger,
Must ask permission to know it and be known.
The forest breathes. Listen. It answers,
I have made this place around you.
If you leave it, you may come back again, saying
Here.

No two trees are the same to Raven.
No two branches the same to Wren.
If what a tree or a branch does is lost on you,
You are surely lost. Stand still. The forest knows
Where you are. You must let it find you.

~ by David Whyte

“I know what I have given you.
I do not know what you have received”

~Antonio Porchia

"Everyone's special!" ... "Which is another way of saying no one is." ... How do we educate residents with todays restrictions .... (part II)

“Every generation needs a new revolution.”

~Thomas Jefferson

Now let's look at the next generation. I had previously talked about generational differences in educating styles. I do believe it is important to first understanding where your educational style comes from as well as understand your audience. Who is our audience? The current resident probably are mostly at the end of Gen X, but are flavored with some of the upcoming generation known as the Ne(x)t generation, Gen Y, or Millennials. So, what are the educational expectations of the mellenials? Susan Heathfield, a management and organization development consultant who specializes in human resource systems, issues, and opportunities, wrote:

“Unlike the Gen-Xers and the Boomers, the Millennials have developed work characteristics and tendencies from doting parents, structured lives, and contact with diverse people. Millennials are used to working in teams and want to make friends with people at work. Millennials work well with diverse coworkers.”

They have been referred to as the most protected, watched-after, structured, achievement-driven generation in American history. Born in the late 70's to early 80's and after, their formative years saw unbridled economic prosperity. Because this generation has grown up with such a protected and technological time, we must take the time to understand what teaching styles would be the best.

There has been a lot of press on the Gen Y or Mellennials. The Mellennials have even taken it on to themselves to but the system by debunking the myths that may be proliferated through different media. Jaerid on his blog rants about being called "praise junkies". He references an article by Jeff Zaslow in the Wall Street Journal, Most-Praised Generation Craves Kudos at the Office. The first line from this article states:

You, You, You -- you really are special, you are! You've got everything going for you. You're attractive, witty, brilliant. "Gifted" is the word that comes to mind.

For many educators, they may feel this is a trend for this generation. A very "selfish" generation. I would have to agree that this is partially the case, they do like the feedback. This is opposed to my generation, Gen X, who did not want to be mentored; we knew what to do and how to do it. The Mellennials crave mentorship and guidance. Jeff Zaslow writes in another article In Praise of Less Praise which talks praising and how people know when a praise has merit. He talks about the Simon Cowell affect of debunking the praise parade. My favorite anti-praise reality Brit is Gordon Ramsey. Chef Ramsey is in a similar situation to most who are mentoring someone in a trade. He is bringing them along as Sous-chefs with his reputation on the line if they should make an error. So although his doesn't take care of patients I can see where his rage comes from at times. I do like to give praise, but try to limit the praise for occasions which warrant special praise. Mentoring can at times be taxing, but I feel it is necessary. Mentors today have to think about who they are mentoring and may require more guidance and instant feedback than in previous years.



Besides the emotional part of expecting more direct guidance or mentoring, they would also like to have more control of both their life, lifestyle, and education. There is the belief, most of which is true, that they are highly educated and ready to perform the tasks at hand. They want the scalpel soon as they enter the OR. It has been said that they have "put in their dues" already and that they "deserve" the right to operate without putting in time on menial tasks such as patient care responsibilities. Some have the opinion that they do not need to put in the foot work before getting in to complex procedures. Simple things like reading about a case beforehand, which was standard practice years ago, has some how gone by the way side. Come to the OR and expecting to be spoon fed the information without putting in the initial leg work. Mellennials value their free time and do not want to spend every hour thinking about their career or occupation. The want genuine "free time". This is something that puts a restriction in when a "lecture" can be done. Weekends are pretty much out. Late afternoons and evenings are just as problematic. For dedicated lectures, we are really restricted to somewhere between 6am-6pm. So how do we teach them with the restrictions on time?

It is easy for me to assume that I know all about this generation or to categorize everyone from this time as having these beliefs or characteristics. Most of my comments are based on recent personal experience, discussions with colleagues, and reading different articles. I think on of the important things to do is know what are the some of the right questions to ask. The first questions to ask include:
Who are our learners? It is increasingly important to have a dialogue with the learners to better understand their perspective.

How are today’s learners different from (or the same as) faculty/administrators?
Although they may be different in many ways from previous generations, some things stay the same. Learners are still socialize and obtain information but through different media. There may be more of a role for alternative media to get important information out such as Blogs, chat rooms, or Podcasts.

What learning activities are most engaging for learners? Traditionally we have done our education through lectures. There may be more of a need for expanding this to small group activities or interactive lectures.


Having an understanding of the audience is extremely important in determining what types of teaching styles will be most effective. Orthopaedics and other surgical or procedural sub-specialties have a a number of different skills or skill sets to teach. Most of the general medical conditions can be read about and leaned on line. The problem arises when teaching specific skill which require actual hands on time. Because orthopaedics is a very technically driven field, we can not just depend on lecturing and self teaching. The clinical teaching and operating becomes extremely important. So the next question is how do we, educators, teach our audience, the learners, our craft with in the restrictions of different governing bodies, while appropriately meeting the specific needs of the current generation?

“Life is no brief candle to me. It is a sort of splendid torch which I have got a hold of for the moment, and I want to make it burn as brightly as possible before handing it onto future generations.”

~George Bernard Shaw