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Perspectives |
Key words: Theory X and Theory Y, millennials, Generation Y, emotional bank account, dental education
Submitted for publication 06/16/08; accepted 09/09/08
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Theory Y assumptions made by dental educators are the following:
Theory X educators generally function as the "cop." They will feel most comfortable with directive behaviors and perceive that one of their primary roles is to function as a gatekeeper to the profession. They will tell students what to do and monitor their performance closely. Theory Y educators, on the other hand, function as the "coach." They adopt a "guide on the side" approach and perceive themselves as mentors for dentists in training.1 They will generally choose supportive behaviors emphasizing encouragement and reinforcement, and see learning as a developmental process in which some students proceed at different rates than others.
This article is designed to answer two questions: How do I use this information about Theory X and Theory Y to become a more effective dental educator? How do I combine the roles of cop and coach in a way that will influence this unique generation of students? Writing as principal author (JPC), I will relate a story from my own experience that I believe will help to answer those questions.
I was, for several years, an instructor at the Army Academy of Health Sciences in San Antonio, Texas, one of the largest health care training institutions in the world. Hundreds of instructors, both military and civilian, provide training to over 17,000 individuals per year. I taught a number of leader development and management courses, and I observed a situation that I shared with students in many of these courses.
In this situation, due to security concerns, the commander directed that only supervisors would be allowed to have keys to the building, so each supervisor was asked to collect and turn in the keys from their subordinates. The task was delegated to two first-line supervisors in my department. The first supervisor reported no problems when he returned in five minutes with a handful of keys. The second supervisor did not return for more than an hour. He reported that he had had an angry encounter with some of his subordinates who made complaints like "I’ve worked here for a long time and I’ve always had a key"; "I can’t believe that you don’t trust me after all this time"; and "I deserve to be treated better than this."
When I ask dental students to explain the difference between how the subordinates reacted to the two supervisors, frequently students responded that there was some difference in the way the two supervisors asked for the keys. They make the assumption that if the supervisor asked nicely, the workers would willingly comply with the request.
In my opinion, the determining factor was the relationship between the subordinates and supervisors before they asked for the keys. The first supervisor had earned the trust of his subordinates. The workers knew that this individual would never act capriciously or in a manner that ignored their best interests. Having established trust, the subordinates were willing to cooperate even though they did not like what they were being asked to do.
In the same way, trust lays the foundation for an effective student-professor relationship. Students, of course, place high value on the technical expertise of their instructors. They also look for instructors who appear to be consistent, fair-minded, approachable, and reasonable. They may distrust instructors who appear to be inconsistent, insensitive, patronizing, or rude or those who make them feel inadequate with belittling comments.3
Once the trust has been violated, students may avoid a professor whenever it is possible to do so. They will walk to the other side of the clinic or lab to avoid a chance encounter with that instructor. They may schedule some procedures only when that instructor is gone. The professor who is not trusted loses out on opportunities to teach.
Stephen Covey uses a metaphor to describe the feeling of trust as an "emotional bank account" in The 7 Habits of Highly Effective People.4 He states that the currency in the emotional bank account is "the feeling of safeness" that a person has with another human being. A highly effective dental educator will have currency in the emotional bank account that allows him or her to make the occasional withdrawal.
Covey lists several ways in which currency is deposited in the account. He states, "The most important way is by understanding the individual and what is most significant to them." The need for understanding crosses the generation between dental instructors, most of whom were born during the baby boom from 1946 to 1963, and their students, born after 1980, who are often referred to as "Generation Y" or "millennials."5
We believe that the dental students of today are among the best and brightest of their generation. Competition for admission to dental school is keen. All dental students have been successful in college and have earned the recommendation of respected individuals in the community. Many students have returned to dental school after years of achievement in other endeavors.
Dental students share common cultural experiences with other millennials who, as a group, have earned both great praise and pointed criticism. They have been described as "The Next Great Generation."5 They have been called "technologically sophisticated, self-confident, goal-oriented, success-driven, and determined."6 They are eager to "make a difference,"7 and they will commit to goals that address the needs of society. They have also been described as "narcissistic praise hounds," who "only take yes for an answer."8
While many of these characteristics have been accepted without debate, there have been several attempts to study generational change scientifically. In 2008, Twenge et al. conducted a meta analysis of the results of a Narcissistic Personality Inventory (NPI) given to more than 16,000 college students between 1979 and 2006.9 These researchers reported a 30 percent increase above the mean 1979–85 score for narcissism among students nationwide. They defined narcissism as "a positive and inflated view of the self, especially on traits such as power, importance, and physical attractiveness." The results of the Twenge et al. study were challenged by Trzesniewski et al., who suggested that sampling errors may have affected the results and influenced the conclusions.10
Whether real or perceived, a multibillion-dollar industry has been developed to train baby boomers, many of whom are now in their fifties or sixties, how to recruit, manage, and motivate the millennials. It has been reported that "companies like Merrill Lynch, Ernst & Young, Disney, and scores of others are hiring consultants to teach them how to deal with this generation."8
Generation Yers have grown up getting constant feedback and recognition from teachers, parents, and coaches and can resent it or feel lost if communication from bosses isn’t regular.11 A book on the intergenerational puzzle says that "they are likely to mistake silence for disapproval and can be easily discouraged if they don’t receive a reasonable amount of verbal strokes."7
Although desiring continuous information about their performance, these high academic achievers also expect feedback to be positive. Based on life experience, the millennials have learned to expect that effort equals success and that hard work leads to excellent performance. There now is "a generation coming into the workplace that has grown up with the expectation that they will automatically win and they’ll always be rewarded, even for just showing up."8 These students may have a difficult time, particularly in the first years of dental school, coming to grips with the concept that only successful effort will be rewarded.
Millennials may also have little tolerance for processes that they perceive as slow or inflexible. A "one size fits all" or "do it because I said so" approach to dental education is unlikely to earn student cooperation. Millennials prefer streamlined and efficient methods and a practical "do it because it makes sense" approach. They prefer interactivity and real-time information to passive learning. Millennials place low value on what they perceive as "old ways" of doing business.6 They are eager to challenge the status quo and to redesign processes in ways that make sense to them.
The millennials expect access to professors and tend to diminish the psychological and social distance that has historically existed between the professor and the student. This is manifest in a number of ways. Millennials may require explanation of lower than expected grades, they expect an active voice in decisions, and they may expect immediate attention or feedback.7 They expect prompt responses from their instructors and immediate access when they feel a need to communicate—anytime, anywhere.12
Teaching the new generation of students requires insight, creativity, and open-mindedness. The things our students are looking for from us are not entirely different from what the baby boomers looked for from their teachers in the past. The difference is in degree. The students of today expect prompt access to professors, more feedback and explanation, transparency (openness) in decision making that influences students’ lives and academic performance, and more nurturing than students of the baby boom generation.12
"Attending to the little things" is another way to make deposits in the emotional bank account, according to Covey. The biggest "little" thing that we do is to show that we respect and approve of our students. We convey our approval when we acknowledge the difficulty of the tasks that we have given them to perform, we communicate our support and encouragement, and we become invested in their success. If students believe that they share the same goals as their instructors, they are less likely to confuse professional feedback with personal criticism.
Learning the pronunciation and preferred names of our students is another way that demonstrates we recognize them as individuals. One of our faculty colleagues who teaches lecture and clinical courses that begin in the first year reports that calling the students by name is central to his teaching style. He says it promotes active learning, even in a large lecture room. He may call on a student by name to stimulate discussion or to clarify a teaching point if it looks as if the student is confused. More importantly, he believes that calling the student by name opens lines of communication. He admits that he invests some time each week reviewing names, but he believes that his effort is well worth the time. Today’s students want education to be personalized: they don’t want to be perceived as "one in a hundred"; they want to be "the one."
Covey says that "clarifying expectations" is yet another way to make deposits. Students seem to perform better when they understand exactly what is expected of them. The professor who is able to articulate in a single sentence the overarching goal of his or her class may be surprised at how it guides the development and conduct of the course.
A professor of operative dentistry may state, for example, "Everything that we do in this course is designed to teach you to provide the highest quality patient care when preparing and restoring teeth." While the sentence may seem to leave out major topics like diagnosis, treatment planning, selection of restorative materials, and others, it sets the stage for how, when, and why critical feedback will be given to a student. It establishes high expectations for performance in a way that preserves the relationship between student and professor. It helps to draw the line between professional feedback and personal criticism.
The line that we draw allows the instructor to be both cop and coach at the same time. The professor may be absolutely unyielding in maintaining standards for performance. But, in order to remain effective, the professor needs to preserve the learning relationship by providing support and encouragement and by conveying to the student that we are invested in their success. Fisher and Ury refer to this as being "hard" on the problem but "soft" on the people.13
The last two ways to make deposits in the account are by keeping commitments and showing personal integrity. Dentistry demands that we devote ourselves to quality service even when the circumstances are difficult. Access, lighting, and the patient’s willingness and ability to cooperate are just a few of the factors that affect the quality of our treatments. Below a certain threshold, patients are unaware of the technical quality of the treatment that they receive. Professionalism is what keeps us from cutting corners or modifying our treatment when we know that doing so will adversely affect the outcome of our treatment. Keeping commitments and showing personal integrity imply that we commit to the correct choice between doing something right or taking the easy way out.
The easy way out for dental educators may be to avoid giving direct critical feedback. It is not comfortable, particularly for individuals who are strongly oriented to Theory Y (coach), to tell students that they have failed or that they have not made satisfactory progress toward competence. Neither is it honorable to give a passing grade to a student who has not earned it. It is our duty as professional dental educators to assign grades and to tell students when their work or their behavior has failed to live up to professional standards. The instructor who fails in this responsibility may confuse affection with effectiveness.
Overall, the key to an effective student-teacher relationship is finding the answer to this question: how do I provide honest critical feedback and maintain student affiliation at the same time? Cam Marston14 gives this advice to individuals who are giving negative feedback in his book, Motivating the "What’s in It for Me?" Workforce:
The highly effective dental educator should be cop and coach at the same time. Individuals who are strongly oriented to either Theory X (cop) or Theory Y (coach) should be aware of the blind spot that it creates as they evaluate their own effectiveness as instructors. Theory X individuals should be aware of the importance of the trust between student and professor and the ways in which it can be damaged. Theory Y individuals should be aware of the role and purpose of critical feedback in the development of future dentists. Trust is the element that allows these seemingly contradictory theories to exist in the same instructor at the same time.
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