Working with Students and Patients from Generation Z

Editor’s Note: This text is a transcript of the course, Working with Students and Patients from Generation Z, presented by Amanda Stead, PhD, CCC-SLP.

Learning Outcomes

After this course, participants will be able to:

1. Identify three characteristics of Generation Z students that may impact teaching and learning.
2. List three potential instructional modifications that may be necessary to optimize teaching and learning with Generation Z students.
3. Describe how to adapt models of clinical service provision to meet the needs of Generation Z.

Introduction

Today I am going to be talking about a topic that I'm actually really passionate about, and one that is perhaps becoming more of an issue for those of us who are educators or working in clinical spaces serving younger generations.

Generation Z (1997-2015)

This is Generation Z:

• AKA ‘generation connected’ or ‘dot com kids’
• 1 in 2 predicted to obtain a university degree
• By 2025, will make up 27% of the workforce
• Predicted to work 17 jobs, 5 careers, and live in 15 homes in their lifetime
• 2,000,000,000 Gen Zs globally

Figure 1. Generation chart.

Look at figure 1 and think about where you are in this generational spectrum as it compares to Gen Z specifically. These are individuals who were born between 1997 and 2015. Depending on where you look at the numbers, it can vary from one to two years. Society has typically thought of the Baby Boomer generation as the “dominant” generation.  But if you look at figure 1, you can see that Gen Z is actually the dominant generation within the country right now. They outnumber all other existing generations.

Generation Z is the youngest, then the Millennials, Gen X, Baby Boomers, and the Greatest Generation after that is the last of the current living generation and the oldest among us.

Within Generation Z, it is predicted that one in two will obtain a university degree.  That is an extraordinarily high number of students that we expect to go on to get a higher education. That is partially due to society almost necessitating an advanced degree at this point, even for entry-level positions. This is very different compared to the experience of the Baby Boomers and even Gen X.

By 2025, individuals from Gen Z will make up about 27% of the workforce. One of the things that is really different about Generation Z students compared to previous generations is they're predicted to work a number of jobs. It is projected that they will have 17 jobs, five careers and 15 homes.

If you currently examine the way the Baby Boomers have existed across their lifespan, it was more typical to start a career and have staying power within that career, or even within a particular job or place of employment. That is not the expectation nor the desire for folks within Generation Z.  Additionally, there are A LOT of Generation Z individuals globally. 

I Thought We Were Still Complaining About Millennials

I joke about this because I am technically a Millennial, although I would refer to myself as the elder Millennial. I’m on the far side of that age group. As you may know, there have been many conversations, not long ago, about how Millennials were impacting society as a whole.  The reality is that Millennials and Generation Z are really different groups of individuals.

Millennials are almost all actively engaged in upper levels of education or the workforce. In fact, they are approaching 40 years old.  Some of the major differences are included in Figur 2. 

Figure 2. Millennials versus Generation Z.

For those of you that have been in clinical practice or education for a number of years, there has been a shift in the stereotyped mentality of working with these types of different students, patients, or clients.  Millennials have often been described as being overly optimistic, interested in fantasy, and communicating through text. There is a lot of discussion about what was called “prolonged adolescence” in the millennial generation. They stayed at home longer and lived with their parents longer. They didn't “grow up” as quickly as previous generations, certainly not as quickly as Generation X ahead of them. They really liked a variety of things to come to them when they thought about their work future and their existence in society.

What is really different about Generation Z is that they are thought to be a little more pragmatic, more dystopian, more realistic in the outcomes, and interested in stability. They have this idea of “up aging” which is growing up ahead of their time. They're interested in working really hard and they like to communicate through images, media, video.

Terminology Associated with Gen Z

I want to discuss a few terms that have been associated and developed to describe the dispositions of Generation Z. Again, I want to clarify that being a member of a generation, being born in a specific set of years, is just one factor that contributes to your outcomes and your disposition as a person.  There is still a variety of dispositions within this generation. But when we are describing generations, we are talking about a common set of societal and technological contexts that heavily impact the disposition of a generation. You can imagine this when you think about who the Baby Boomers were and what their experiences were.  What were some of the defining moments within that generation? We think about things like the Vietnam war as the defining moment in the youth of a lot of that generation. Although there are different cohorts and belief styles within that, that seminal event impacted a generational disposition.

We also think about the technological aspects. For example, when we talk about the invention of the cell phone, that has had an incredible impact on the way people exist now.  I grew up with a home phone and a cord. Then when I was older, I had a cell phone.  So, I have straddled those technological inventions.  It was that pre-internet and internet era, the dial-up versus wireless era. These are the types of experiences that contribute to some of these dispositions.

If we think about terms that describe Gen Z, those terms can help us contextualize where these individuals are coming from. They can help us to relate and understand them from that basic standpoint.

Phygital

Phygital means that all aspects of the physical world have a digital equivalent such as banking, entertainment, socialization, worship, and there are ways to engage in those things that can separate you from what would have been the normal face-to-face interaction. A great example is the use of a checkbook or going to the bank. Over the past 15 years, most people can do everything digitally. Everything can be done on cell phones, there are debit cards, the reduction in the use of cash, all of those things are a very big change.  But remember, Gen Z is growing up with only that mentality whereas older folks from different generations, Millennials on up, have experienced that shift.  Gen Z individuals have only existed in a world where everything has had a digital equivalent.

Realistic

From a psychological standpoint, the way humans work is that we love people who are like ourselves. That's why you think the music that you listened to, typically between ages 15-25, is the best music ever. That's a real psychological perspective. It's easy to look at other groups and put a lot of fault on them. So, when you're from a different generation, it's easy to look at the younger cohort of citizens and think, “Ugh, why are they doing that? That's not what I would do."  It’s easy to project the negative rather than the positive onto them. 

When we think about Gen Z being the realist generation and being extraordinarily realistic, we have to remember that this group has only existed in a post-911 era, an era in which the country they reside in has always been at war. They have always existed under that heightened security. That's very different for older generations. This is all they've really known.

We also know that as these children have been growing up, they are children of the recession. The American dream has sort of been diminished for them as they watched their families and their country fall apart.  The promises of homeownership and job stability became questionable.

Again, these experiences have helped inform how they're approaching their future and the way that they trust the words of adults. They have watched the generation ahead of them become extraordinarily vulnerable and really suffer.  Many of them lived in households that went through a lot of loss during the recession. This helps explain why they can be so pragmatic about planning for the future.

When I was in college, I didn’t approach my education as, “I am paying you for a product.”  That didn’t occur to me and I think that was the norm.   But current college students really want a guarantee and an understanding of a return on their investment because they are concerned about their future. 

I meet with students applying for college that have a ten-year plan. When I started college, I wasn’t even sure what I wanted to major in. It’s very different, but it's informed by the fact that they've lived in a society that has been more dystopian, that has had more broken promises. They are concerned. They've heard about the student debt crisis. They've grown up with active shooter drills. They lived through the recession. It's not that they're sad or concerned. They're just being pragmatic about it.  They're trying to be practical and set themselves up for success.

Fear of Missing Out

The fear of missing out, or FOMO, is a term that many of you have probably heard. Partly because they have so much access to things and the increase in active social media use, there is this fear of missing out. This generation wants options. They want concurrent options. They want to be a part of many things at once. For example, they want to go to a party, be with you while they're on their cell phone, communicate with other people while they're looking at social media. They want to do all that at once because they don't want to miss anything.

They are really worried that they're not moving ahead fast enough.  For those of you who are educators in higher education, this might really resonate with you. There is this idea that they want opportunities now. They want their perfect job now. They want a certain clinical placement now. They're trying to get ahead. They're trying to set up their future. They're worried and they're anxious.

In regards to anxiety, we have to remember that over 50% of Generation Z is self-reporting that they have anxiety. The good news is that they are much more comfortable talking about it compared to previous generations.

Weconomists

Gen Z individuals have been raised in a shared economy, also known as “weconomists”.  One of my favorite qualities of Generation Z is that they want to serve their communities. While previous generations have really been characterized as egocentric or selfish, Generation Z has been noted for their desire to impact society at large, their dedication to justice and social justice issues. They want to impact the world and make a change in a more global way and community-based way. That is an incredible trait that we should harness and support, regardless of the context in which we're working with them.

DIY

This is the YouTube generation. There are so many things that you can learn how to do on the internet.  In light of that, consider the following.  Whether you're a clinician working with students who are from Generation Z or an academic who’s working with students from Generation Z, it has always been the clinician or the teacher who teaches the skill.  But when you're working with a generation who has always had a sort of skepticism and the ability to learn it from someone else, how might that impact the way we're engaging our students? We can all imagine the type of speech therapy that shows up on YouTube. We can google anything.  So, the way we are engaging with them is different because they don't need us in the way that they have previously needed us. They have access to other models or different viewpoints at the same time we are teaching and training them. Additionally, because of their fierce independence and their proclivities for self-training, that really should give us pause in the way we're teaching and training them. We should absolutely expect that they will go home and look up what you're doing, or look for alternatives, or practice in a way you may not expect from a source that may not be legitimate.

Driven

Most of our Gen Zs are raised by individuals who are from Gen X. Some Generation Z students are being raised by some of the older millennial group as well. I have two Gen Z children of my own that are quite tiny at this moment. What is important to remember regardless of the generation you're currently hailing from, is that you were raised by a different generation with a certain disposition. So, we have to stop projecting the “spoiled children” version onto Gen Z because they were raised by a different generation and the context is very different. Again, remember that they're raised during the recession. So, they're really driven to prevent the bad outcome for themselves that they witnessed.  They are competitive and they're ready to work.

Values of Gen Z

Here are some factors to consider for the education and the clinical service of citizens from Gen Z:

• Group thinkers who enjoy collaborative learning
• Process and skills-based learning (because content is online)
• Lots of technology, therefore little tolerance for delays
• Ambition in favor of more family time, travel, and less personal pressure
• Everything is "up for discussion“
• Ambitious but aimless
• Afraid to be wrong
• Attuned to mental health
• Possess critical thinking that is different because of access and use of technology – therefore…
• They have a hard time processing and analyzing complex or “big picture”
• Focus on achievement vs. learning (takes too long and is too hard)
• Uncomfortable with ambiguity
• Highly influenced by peers
• “Just tell me what to do” 

These individuals are group thinkers and enjoy collaborative learning. In the same way that we think of “the fear of missing out,” they like to socially engage.

They're also afraid of being wrong, so they like to solve problems in a group. They like to bounce ideas off of each other. Sometimes, this fear of being wrong or the proclivity towards group work can be misinterpreted as a lack of independence. But what they're really searching for is that community and that collaboration, instead of the siloing that previous generations have been really known for.

Gen Z likes skills-based learning. The old days of “Sage on the Stage” is not working. Even in therapy, the clinician-directed, clinician-driven therapy is not always as effective because they want to participate in skills and not just hear about skills all the time.

It is no surprise that they have engaged in a lot of technology all across their existence. My nine-year-old son knows more about the iPad than I do currently. The fact that they can navigate and get things on demand quickly and multitask quickly translates into not having tolerance for delays. For example, those of you who get emails from students, they're expecting you to email them back right away. We can perceive that as a professionalism issue, “I'll get to you when I get to you.”  But we need to remember that they don’t have experience with delay in a lot of ways. They're used to the “on-demand” side of things and they're used to things happening quickly. Again, when we're thinking about it from a clinician and client-based perspective, they're expecting rapidity of progress, and they may not understand why things take a long time. A lot of that is about the way we communicate with them in terms of transparency.

Gen Z individuals are ambitious in recognizing the value of having a life outside of career and school.  They are dedicated to families, travel, and less personal pressure. The pressure of achievement is very different across generations.  One of the things about Gen Z is when they're looking forward, they are thinking about if they will have balance. How can I achieve balance? What else can I put into my life?

One habit that really irritates a lot of members of the older generation, myself included, is the idea that everything is up for discussion. Again, generationally, when you are “questioned” by someone much younger than you, such as a child, a graduate student, or an undergraduate student, it can feel like a challenge in authority or a professionalism issue.

But again, generationally, because of collaborative learning and because of their experiences, this idea of “up for discussion” is rarely a challenge of your authority.  It is more of an attempt to partner with you and gain mentorship. So again, one of the things I ask you to consider when working with folks from this generation is to remember the idea of assuming good intentions. They're not often trying to challenge you, they're trying to collaborate with you. This is very different compared to previous generations that have adhered to very strict hierarchies. When someone in the upper echelon said, “Do this.” It was, “Yes, ma'am" “Yes, sir." But that isn't the baseline for Generation Z.  Again, it's not meant to be disrespectful. It's meant to approach you in a collaborative way.

There is this thought of being ambitious, but aimless.  They want to do a lot, but they're afraid to make a mistake and head in the wrong direction. So, they're looking to us as mentors.  They also have a fear of being wrong. We used to joke about the Millennials being the trophy generation. Now we are seeing now in our clinical practice and academic work that students are really afraid to get feedback. Some of you may be doing clinical supervision of graduate students and the idea of getting feedback or fear of making a mistake almost clouds the opportunity to teach.  But that helps us contextualize why they're reacting the way they're reacting, and the way we communicate about that can really change their acceptance and tolerance of that.

This generation is really attuned to their mental health. They accept that mental health is a large part of wellbeing, not only in those they serve but in the spaces they exist. They're comfortable talking about it.  Generationally, Gen X, Baby Boomers, and Millennials to a lesser degree have been a bit uncomfortable talking about their own mental health or the impacts of mental health.  But it is much more common for a member of the younger generation to say, “I have depression,” “I have anxiety,”  “I have ADHD,” “I have OCD,” “I am struggling with sadness.” They like to come out with it. That can be risky because other older generations were taught that is personal business, you don't talk about it, and it can be a sign of weakness. So, we need to make sure that those of us in positions of power, whether we're educators or clinicians of younger citizens, understand that they aren’t sharing these things to be used as excuses, but to build an alliance, to show transparency, and to have a partnership with us.

They're comfortable, more so than older generations, being their true self in front of people in power.  I, for one, think that is a wonderful trait of theirs. If anything, we should all take their model and normalize being a full person and a full human.

Critical thinking has gotten a lot of attention from different generations because we perceive this as very negative. The way that this generation processes critical thinking is different because they've had access to technology. It is really easy to say technology has ruined the ability to critically think because you can look up everything.  But the reality is that we can look everything up and for the foreseeable future, they absolutely will continue to be able to do so.

Therefore, the way that Gen Z individuals think through problems is different because they are “source inspired”.  When they say, “I don't know how to do this,” instead of thinking through the process and problem solving it internally, their process has always been to find the source. Learn the source. This is where the YouTube piece comes from: “I don't know how to implement this. I'm going to look it up.” “I don't know how to solve this problem. I'm going to ask for help.”  That has been perceived as the inability to critically think. But what they are doing is sourcing the right answer and frankly, that's not a bad thing.

What that means, then, is when we are encountering them in complex, critical thinking situations, such as clinical training, we can perceive them as not being able to think critically about the problem. However, that isn't how they've been thinking about problems. So, we need to teach them and train them how to think through problems like that.  Additionally, they're afraid to be wrong. So, sourcing makes a lot of sense from the perspective of wanting to be accurate.  And, remember, because they're dedicated to serving their community, they don't want to do poorly.  If we combine all of these factors, from the outside it can appear that they want the answer and they can't solve problems.  But their whole life has put them in this position and it's not really their fault.  It's not their fault that they grew up with Google and YouTube and email.  This is just what they grew up with. So, instead of being frustrated that their critical thinking and problem-solving skills look different than ours, remember it's not their fault because these are the tools they've had use of.  It is better to think about how we can take advantage of their sourcing and retrain the types of critical thinking we think they need at this moment.

They can have a hard time processing and analyzing the big picture because they can be solution-oriented. Because they're DIY and because they use YouTube, seeing the big picture can be more complicated. Again, that's not their fault and it's not because they don't care. It's just the context in which they grew up.

They want outcomes. There is the idea that learning can be hard or things take too long. But again, this is not their fault. When you can typically just look something up and do it, it is confusing that something takes a year or two years. It's not out of laziness. It's out of their contextual ideas about achievement and how they've grown up.

They don't like ambiguity. One of the things that I always tell my clinical students is, “There aren't answers anymore.  There are just better questions in the way we think about patients and clients.” There are a lot of approaches and a lot of answers all the time. My students are freaked out by that response because they are used to answers.   How can we be transparent about why it's okay to be comfortable with ambiguity?

Additionally, Gen Z individuals are group thinkers and are highly influenced by peers. They want to be told what to do and they want the right answer.

The most important factor for Gen Z is that they are interested in and will react better to the idea of mutual respect, guidance, and mentorship than direct hierarchical feedback.  This is true whether you are an active speech therapist working with students from Generation Z or you're an academic educator teaching undergraduate, graduate, or PhD students from Generation Z.  In your mind, you might think, “That's ridiculous. I am the professor/clinician.” But the reality is that your goal is to increase their outcomes, whether it's therapeutic goals or educational outcomes. Therefore, meeting them where they are actually benefits you and your ultimate goals for them. Being their partner and respecting why they are the way they are actually increases the likelihood of serving them and getting the outcomes you desire regardless of your context.

Gen Z and Tech

As I said earlier, Gen Z likes technology. They bring it with them everywhere. It’s no surprise that they have cell phones with them all the time.  Even I have my cell phone sitting beside me right now.  We all use them in ways that we would have never imagined. Students use them for academic work and social work and all of those things.

Figure 3. Gen Z and technology.

Smartphones and laptops and tablets are the most prevalent. So, if our students are attached to their technology, they've always grown up with these devices and they're always with them, we shouldn't be saying to them, “Put your cell phones away. They're interrupting our work.” We should, rather, ask the question, “How can I use this extension of their human form to my advantage and to their advantage to serve our mutual goals?”

So How Do We Teach Them in Higher Ed?

What Gen Z Wants

For those of you who are in higher education or for those of you who are doing clinical supervision of graduate or undergraduate students, here are some things we really need to consider. When Gen Z students are going into higher education, they want social learning environments and innovation. They want the opportunity to collaborate and engage in innovative practices. They want and expect on-demand services that are available at any time with low barriers to access. Email is an example of this.

Let’s say they're working on an assignment or lesson plan at 7:00 PM and they email you for help. Their expectation is that you're going to reply to them. They have no reason to believe you won't because we often do reply. But, we often haven't communicated with them about how we respond to on-demand things. So, for those of you who are burdened with the rapidity of email from students or clinical students, the best thing you can do is when you're working with them initially, be really clear about how you approach your own work.   For example, I mentioned earlier that Gen Z students are really interested in things outside of work and things related to balance. So, you could say, “You know, these are the other things outside of my life that I really value. And here's the process of my work.”  I tell my graduate students, “You know I love this career. I'm so dedicated to this, but I'm also a mother of two. I like to cook dinner for my family and I like to garden. I do not respond to emails after 5:00 p.m. But I will try to get back to you within 24 hours.”  You are setting up that expectation for them about 1) you've plugged into their value system of being a real-life human, and 2) you have qualified their version of on-demand from you. That's really important and being respectful of that and being transparent actually shows that you're partnering with them for mutual understanding. You respect them enough to say that you are not ignoring them but there are these other things in my life too.  That is a great opportunity. I know it sounds so simple, but it pays off in spades.

When we talk about on-demand services, there is the idea of low barriers to access. You want them to be able to get to things they need quickly and easily. This means compounding your resources and having things digitally available. Think about the cost of the materials that you're assigning to them or the materials that you want them to have. It's really important that you consider ways to reduce the cost associated higher education, which we know is already really high. So instead of making them purchase a $150 textbook can they get it through the library? Is there a different textbook available through your library system with digital access that can serve your needs just as well?

What can you do to reduce that burden and reduce those barriers? It goes without saying we have many more first-generation students and students from lower SES than we've ever had. So financial barriers can be extreme.

Gen Z is career-focused. As a higher-ed person, I meet with so many 18-year-old freshmen who are talking to me about graduate school. They've been on campus for three weeks and they're already talking about their plan for five years from now.

They're also thinking about their future in a different way. They're thinking about customizing and building a resume and CV in order to get the outcome that they want.

They really like class discussions. What is interesting is that a lot of current educators, generationally, weren’t educated with a lot of class discussion. I know I certainly didn't have a lot of “class discussion”. There were definitely opportunities to ask questions when you didn't understand the content, but active discussion was not part of my higher education experience. From that vantage point, the idea of facilitating class discussions can be a little bit intimidating and that's sort of a pedagogical issue.  But that's where they're learning.

Remember peer collaboration, social sort of forays, application of material, development of clinical and critical thinking are important. They want that interactive classroom environment. The traditional setup of students in a row, "Sage on the Stage", PowerPoint on the screen, is not working for them. And it's not working because that isn't how they've been raised and reared in their value system and their brains. That isn't how they think about information. They need to engage with the information and feel connected to really learn it and internalize it.

Again, affordability is critical for higher education.  Where can you cut costs?  If you can't cut costs, what resources can you find that can help them financially? What grants, programs or financial aid can you assist them in thinking about affordability? As children of the recession, they are much more worried about debt than previous generations. So, think about what is going to happen in higher education.

Where Are We Headed in Higher Ed?

We are really entering the era of big data. Those of you in higher education know that it has become more business-like over the last decade or two. That has really being driven by big data. We've never had so much data on students and national outcomes and trends. This is really driving the decisions that universities may or may not be making in terms of programs they're developing and/or programs they're cutting.

We're also moving towards OERs, open educational resources. We want to be thinking about what resources can we use out in the world that are free for all, that are open to everybody, that are cost-free, and that are accessible for any and all students.

Immersive learning environments are where simulations are coming from. We need to be thinking about more complex forms of learning than just didactic.
Any of you who have purchased a textbook knows the addition of the online materials, quiz banks, and PowerPoints. There are learning management systems, such as Moodle.  How you create digital course materials, what that looks like, and how it supports your course are really important.

We are using mobile technology in higher education. I have my students use a resource called Poll Everywhere when I teach. I pose questions up on a screen, and they respond by texting. The app does live polls, live word clouds, etc. The integration of mobile technology is definitely occurring in higher education.

Since COVID, we've had a lot of students on Zoom. I don't think distance learning is going away. I have students who are in their cars with Zoom on their cell phones trying to respond to something and going through slides.  We can say that's bad, but that is where they're at, and this is what they're using.  It’s better to ask how are we going to take advantage of using their mobile technology to serve our needs?

Think about learning space design. Stadium seating with straight tables and looking forward to the front of the class is really over. It's not great for their integration of learning and the development of their critical thinking. So, how can we change this space in which they are learning to serve their educational goals and needs?

Consider assessment enabled technologies. What other things can we integrate technologically to assess their learning and their clinical skills that play to their strengths?

What is On Its Way Out in Higher Education?

Here are the things that are on their way out in higher education:

• Campus Bookstores
• Textbooks
• Traditional Lectures
• Computer Labs

I am sad to say that books are headed out.  Campus bookstores are on the way out because everything exists digitally. The same is true for textbooks. Many folks are moving away from textbooks because of the cost barrier. Instead, they are putting their resources together, using digital course materials, YouTube videos, documentaries, articles, podcasts, etc.

Traditional lectures are also on the way out. It's not that they haven't worked. They've worked. But what we know about teaching and learning, especially with the generational component of active learning, discussion, and technology, is they don't work as well as they used to.  They don't work for this generation. Traditional lecturing is being replaced with more flip classrooms, hybrid classrooms, active learning, student engagement, and peer collaboration.

Computer labs are going away because of the access to technology more generally, and the increased ability for things such as cell phones to serve the purpose of what a large computer used to do.

Teaching Styles

Below is a comparison of learning styles for Baby Boomers versus Generation Z.

Figure 4. Learning styles.

I think the most significant one is Gen Z wants a facilitator and a mentor, and not the lecturer or teacher.  They're looking for flexibility. They are used to an open book world and the reality is that they live in an open book world. When they're out in their future career, they can still Google things. So, we need to think about how that contributes to their future and adjust our methods.

Gen Z in the Classroom

Gen Z is dependent on technology.  It is important that we serve them through that modality because that is the future of the world, whether we like it or not. They are active learners and want things integrated into the curriculum. They like access to information. They like to validate you. For example, sometimes I'm lecturing in class and I may throw out a percentage or statistic and my students are fact-checking me in the moment.  And that is wonderful!  I should not take that as a threat or be defensive about that because this is how they engage in the learning.  How wonderful for me that they're curious to do that.  Again, they're used to on-demand people and things.

Are You Doing These Things?

Some of the things you should be adding to your work if you're in higher education include:

• Using Simulation
• Tech-Based Projects
• Having Students Create and Demonstrate Content
• Interactive Lecture
• Activities, Activities, Activities
• Contextual Experiences
• Holistic Admissions

Simulation is the future and students are allowed to do 75 simulation hours in order to meet their clinical clock hours for graduation.

Tech-based projects - I have my students do a podcast project that involves interviewing, recording folks, and analyzing data.  The idea is to use technology to their strengths to increase their learning.

Are you having students create and demonstrate content? A great example is having them summarize your course by making an infographic that they can hang up at their clinical site.  You could watch them demonstrate treatment instead of just reciting it to you on a didactic exam. What about an interactive lecture? I have lectures where I give everybody a whiteboard and I ask questions in real-time. They have to write the answers and put them up. It’s a way to keep them with you and engaged, a way to switch materials around.  What can you put into your lecture to make it more interactive?

Activities, activities, activities - this is how Gen Z students learn.  If we want them to be excellent clinicians to serve the community, if that's our goal as educators, then this is how we teach them. We may not want to do more activities or active learning, but that is our job.  We may not be used to it, but this is how they learn.  Honestly, it is fun.  It's a great opportunity to update pedagogy.

Think about contextual experiences. Have you considered service-learning? Have you considered, in addition to doing role play, doing preclinical activities?

What about holistic admissions? Have you thought about admitting the students beyond traditional academic measures, and admitting them for their lived experience and their diverse experiences?

Clinical Opportunities

Gen Z students need more preclinical activities. They need more low-stakes opportunities before they are in clinic because they need to practice the skills.

Personality assessments and assessments of learning styles can help us understand where they're coming from and meet their needs. They really need repeated learning on Standards of Care. This is very important.

These students also need fewer silos.  Meaning, not an individual aphasia class, autism class, EI class, dysphasia class, but more integrated learning of patients with complex overlap.

They need to hear the same information in every class because you and I know that there is no such thing as a simple patient.  That holistic view is important. 

We need to consider how they use technology.  We want to close the loops and demonstrate that I, myself, am a clinician, that I can do the work, that I can model to the students.  

So How Do We Teach Them in Clinic?

Gen Z students are 21st-century learners. They have been born into technology and they understand technology.  Their attention spans are really short.  In the past, we could go 20-30 minutes in a clinical session. That is probably not the case now. These students need short bits of rapidly evolving approaches to any one goal you have for them in clinic.

They want to know things have a purpose.  It's important when serving clients and students from Gen Z that you explain the purpose of what you're doing. Once they're out of that age of play-based therapy, give them the reason they're doing the activity and give them the outcome you’re looking for. That increases the likelihood of compliance and participation.  But it also needs to be beneficial to their life. You need that buy-in from them.  We used to think that this was only a factor for adult learners, but that's really not the case, generationally.

Gen Z individuals’ circles are really global. They're connected with people all over the world and not just the people next to them in a classroom. How are we going to accommodate the fact that they're getting information from all over the place and not just from you?

This generation likes audiences. They are kind of a performative generation, the “Tik Tok generation”.  Is there something you can integrate into your clinical work where they can perform or where they can demonstrate? That can give them a lot of incentive.

Additionally, they want information in little, consumable bits and they want to be able to make and create.  Again, do you have goals for these students that you could adapt so they're demonstrating it through making, creating and performing? That can really increase their buy-in for your goals.

Create an Environment that Plays to Their Strengths

When you're working with clients from Gen Z, especially in school-based settings, they really need the opportunity for hands-on learning. This is not just for older students. This is not just for classroom learning.  This is for the benefit of your long-term goals across sessions or projects.

How many of you know about Roblox? Roblox is one of the most popular gaming sites for students from Generation Z.  If you're serving school-age children, this is something you could integrate into your work.

Use technology when possible.  Figure out how you can integrate technology and learning, demonstration, and performance. How can you incorporate it into your goals, even if you're working on articulation with a child, or working with a student who stutters, or working with a child on the autism spectrum?

Gen Z wants a connection to their world for a purpose. Meaning, can you explain that what you are doing serves them? How can you make it meaningful to them and make it meaningful for them to demonstrate to others?

These students need visuals and interactive materials. They want to form a community. Can they do this digitally through connecting with other people who stutter through an online group, for example? Can they do this personally by having a conversation with their best friend about what it means to have a hard time saying their speed sounds? Can they do it socially through a shared therapy group of other students who are managing the same sort of disorder or deference?

The one thing we really want to pull into our clinical space is fueling their curiosity. They're used to searching for what they want, so ask them what they want to integrate into therapy with you. They will tell you. They will find it and research it and bring it to you and help you integrate it. They love to have a purpose like that.

One of the things that's hard for us is letting them take responsibility and take charge. But, let them bring the work to you and give them some autonomy in that piece.

Technology Encourages Engagement

Bring technology into your space:

• Podcasts – listen or create
• Skype / zoom / telehealth
• Social media
• Game-based systems
• VR
• Roblox
• Video Games
• Apps
• Digital materials
• Digital creation

Can they listen to podcasts that talk about something they're experiencing? Can they create a podcast to talk about their experience or meet their goals?  This is great for working on fluency, speech sounds, oral fluency, etc.

Can we use Skype, Zoom, or telehealth? Can we use it to connect with students in different spaces? Can we use it to work with our patients and families in a different way?

What about social media? Can their goals be based on their participation in social media? Can they demonstrate compliance through social media?

What about game-based systems such as virtual reality, Roblox, video games, and apps? Can they demonstrate through that modality? Can they set a goal? Can you have activities through these? There are so many ways to integrate their world into ours. Using digital materials and digital creation is the way to do that. Pull their values into your work.

Transform

What can you do right now in your clinical practice to support the learning of Gen Z clients? A question we can all ask ourselves is, “What is one thing I can do that's different.”  If you're an instructor, can you change your instructional methods?  What tools do you need? Maybe you need to learn a new tool, and that's okay.  Maybe you need to learn more about creating podcasts so that you can make that an assignment or make that a project for your clients.

What old practices are you doing right now that is maybe time to let go of? It’s ok to let go and I give you permission to do that even though it's hard and you're comfortable with it. You can let go of it because it doesn't meet your goal of serving your current students or your clients.

What client goals or course goals can be transformed to support this work? It's not about doing it all at once. Pick one thing and start there.

Questions and Answers

Can you explain what dystopian means?

This is referring to the different perspectives between Millennials and Gen Zs. Dystopian is thinking about a future in a sad way instead of “sunshine and rainbows”. A good example of a dystopian future is "The Walking Dead” with the zombie apocalypse, or "Blade Runner.”  It’s referring to a future where things are not perfect, which is unlike the Millennials who thought everything would be sunshine and rainbows forever. Gen Z doesn’t assume that the future is bright. They hope it is, and they're working for it, but they assume that there's going to be some challenges.

Would you recommend using technology with pediatric patients during therapy? Should there be a limit on screen time?

This is a great question and I may give an unpopular answer. For students under the age of five or so, I think that's kind of a no-go. I think as soon as children hit elementary age, the idea of “screen time” is fundamentally different than actively engaging in technology for learning where you're playing to their strengths and playing with what they're already doing.  In a way, instead of that passive screen time we can get from children watching YouTube or just watching television, we can use that technology to their advantage. I don't think that always means using apps, but it could be in creation and design.  Think about what technology you can use with elementary-age children that helps them create something or engage in a community to meet your goal or to demonstrate your goal. That's the best way to use technology. The idea of screen time limits makes sense for our small children, but with elementary, school-aged children you can no longer avoid technology.  It's part of their world and it's part of how they're learning, so casting it as “bad” is the wrong thing to do when it is their future. Right? But we can help them develop good habits around technology.

How do 21st-century learners, especially with short attention spans, translate to the realities of therapy? Client progress is not always tangible, visual, visible, or short-term.

We all know that caseloads are a nightmare. I have a lot of empathy for the systematic barriers we have in place to making progress, especially with children. For short attention spans, can you develop your therapeutic session to approach the same goal from different directions with what feels like really different technological or actively engaged approaches? So the student can shift their attention to another activity, but it’s still meeting the same goal.  If you only have 20 minutes, that's not the worst thing because that's sort of where their attention span is. That just means we need to hook them into their active engagement sooner. Additionally, can you think of a way to get them to actively engage in your goals outside of therapy?

It would be amazing to see how these graduate students approach therapy. Can you share a little bit about what you've seen?

I have flipped a lot of my teaching methods. I think that the first thing you need to develop in graduate students is the culture of service, and the reason they're doing the work. If you do that first, everything else will follow. Everything you teach them has to be followed up with why do we care and the reason for the outcome and the model.

Part of what makes clinical education really successful is saying to your students, “I am so privileged to be on this two-year journey with you. And I'm so excited to mentor you.” Approach them as a partner in their learning, give them permission to fail, and model and play to the strengths of technology. In a way you have to get them to “drink your Kool-Aid” so to speak.  Then, you pack your class full of all of these activities. And I swear, they get it. They really do get it. They show up to clinic with those courageous spirits and with a purpose.

I just had a clinical student develop their own Roblox game for a child they have in therapy. I think the child was 9 years old.  My mind was blown away that the clinical student would have done that.  But they did it because they believe in the purpose.

I'm wondering about HIPAA implications of all this modality use?

There are a lot of HIPPA compliant platforms and there are a lot of ways that you can be anonymous in different platforms. Of course, you always want to investigate that. Also, for graduate folks with FERPA, be really thoughtful about meeting those compliance standards. But I have used a lot of anonymous platforms and anonymous group log-ins to serve that purpose.

References

Adams Becker, S., Cummins, M., Davis, A., Freeman, A., Hall, Geisinger, C., and Ananthanarayanan, V. (20107). NMC Horizon Report: 2017 Higher Education Edition. Austin, Texas. The New Media Consortium.

NMC Horizon Initiatives: The NMC Horizon Project is a global ongoing research initiative that explores the trends, challenges, and technology developments likely to have an impact on teaching, learning, and creative inquiry. https://www.nmc.org/publication-type/horizon-report/

Educause: EDUCAUSE is a nonprofit association whose mission is to advance higher education through the use of information technology. www.educause.edu

Kozinsky, S. (2017 ) How Generation Z is Shaping the Change in Education, Forbes Magazine https://www.forbes.com/sites/sievakozinsky/2017/07/24/howgeneration- z-is-shaping-the-change-in-education/#43eb773c6520

Seemiller, C. & Grace, M. (2016). Generation Z goes to college. San Francisco, CA: Jossey-Bass.

Seemiller, C. & Grace, M. (2017), Generation Z: Educating and Engaging the Next Generation of Students. About Campus, 22: 21-26. doi:10.1002/abc.21293

Sparks and Honey. (2014). Meet Gen Z: Forget everything you learned about Millennials. Retrieved from www.slideshare.net/sparksandhoney/generation-zfinal- june-17

Stillman D. & Stillman J. (2017). Gen Z @ Work: How the Next Generation is Transforming the Workplace. Harper Business.

Torpey, E. & Hogan, A. (2016). Working in a gig economy. Bureau of Labor Statistics. Retrieved from https://www.bls.gov/careeroutlook/2016/article/what-isthe- gig-economy.htm