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Review question/objective The aim of this systematic review is to present the best available evidence on teaching and learning strategies or methods preferred by ‘Generation Y’ health care professional students. The specific review question to be addressed is: What are the teaching and learning strategies or methods preferred by ‘Generation Y’ health care professional students? Objectives The quantitative objective is to identify teaching and learning approaches and activities preferred by ‘Generation Y’ students in health professional tertiary education, reported by students. The qualitative objective is to describe the meaningfulness of teaching and learning approaches and activities preferred by ‘Generation Y’ health professional students in tertiary education as reported by students. Background The goal of health professional education is to produce competent graduates who are eligible for registration with a regulatory body. Universities endeavor to provide high quality professional programs aimed at developing the knowledge, skills and professional attributes students will require to practice their health care profession. Students are an important stakeholder in the process of monitoring and evaluating the quality of programs, courses and teaching and learning1. Student perspectives can also be an integral part of quality enhancement procedures aimed at improving teaching and learning activities2. One student group, those considered ‘Generation Y’ are said to have unique teaching and learning preferences from previous generations. ‘Generation Y’ is used commonly as a stereotypical descriptor for the majority of undergraduate students in Australian Tertiary education3. In generational theory, the socio-cultural construction of society is based on distinct generations: the ‘GI generation’ born in the period 1901-1924; the ‘Silent Generation’ 1925-1942; the ‘Baby Boomers’ 1943-1960; ‘Generation X’ 1961-1982; ‘Generation Y’ (also known as the ‘Millennials’) 1983 - 2002 and ‘Generation Z’ from 2003 onwards4. The sociologist Karl Mannheim first proposed that each generation has a similar worldview, due to exposure to common historical and social events during their formative years5. Every member of a specific generation will not have experienced the same life events, but they will have a shared awareness which creates a ‘generational personality’6. Prensky (2001) argued that “today's students are no longer the people our educational systems were designed to teach” 7(p.1). The premise being that this group has different expectations and learning styles than previous generations8. This assertion is based on the arrival and rapid dissemination of technology in the formative years of ‘Generation Y’ students, with the purported consequence that this group thinks and processes information differently, as they are ‘digital natives’8, 9, 10, 11. Consequentially, it is claimed that ‘Generation Y’ has a relationship with technology that is intuitive and spontaneous, with technology use being as natural as breathing12. Technology as an overarching term includes computer games, computers, email, the internet, mobile phones and social networking13. Although all generations use technology, Prensky (2001) termed older generations ‘digital immigrants’ as they maintain traditional learning styles which are enhanced by, rather than molded by, technology7. Many authors have concluded that as ‘Generation Y’ students have assimilated technology into their daily lives new educational methods and approaches are required to accommodate their different learning preferences14, 15, 16, 17. These different methods include the inclusion of ‘fun’ learning activities within multimedia environments, reflecting the visually rich internet, gaming and other technologies which students are said to have engaged with throughout their lives15, 9, 18. Additionally, due to the immediacy of technology, authors have suggested that this group have short attention spans, are skilled multitaskers and are easily bored19, 10. Recommended teaching and learning strategies therefore include more interactive activities, providing information in shorter segments as well as creating more experiential activities which may include technologies such as gaming, blogs, wikis, on line discussions, social networking and simulation20, 21, 14, 22, 23, 16. As these methods facilitate collaboration and sharing they are collectively termed Web 2.0 technologies24. Conversely some writers have argued that these responses by education is a form of ‘moral panic’ based on little evidence that all students have been immersed in technology in their formative years or indeed have different learning preferences than other generations25. This view was supported in the findings of two surveys of health professional students, one of nursing students and one of dental hygienist students in the USA. Both reported no difference in preferred teaching methods between generations26, 27. Regardless, universities are continuing to use technology for the benefit of all generations, making courses more accessible and flexible with some courses delivered entirely on-line28. However, in some health professions there are indications that this may not meet the preferences of ‘Generation Y’ students. In the surveys mentioned above, most students did not favor completing fully on line courses but preferred blended courses, those with both traditional and online formats26, 27. Blended courses, in one comparative study of student nurses, has also been reported as being more effective than traditional formats, finding that students that participated in a blended learning course received higher grades than those who participated in the same course using traditional delivery29. Blended learning provides opportunity for face to face learning, which was also reported by nursing students as a teaching preference, describing that skill demonstration was more valued than lectures on skills27. On-line learning, which can be rich in visual and aural content, often involves participating in some way in groups. Working together in groups has also been a reported preference of ‘Generation Y’ students as a consequence of students’ communicating in groups through mobile phones, participation in on-line gaming and other technologies such as social networking connecting them to each other and to the global world14, 30, 9. Group work can be used as a learning approach as well as a method of both formative and summative assessment. Nursing students in the USA, however, reported they preferred lectures to group work and group work, inside or outside of class, was not a preferred teaching method27. Alternatively, dental hygienist students reported group work as favorable but students preferred to pick their own work groups rather than be assigned peers by faculty26. Contrary to the ‘Generation Y’ stereotype of a highly technologically competent generation, Sanders (2007) found that 1st year medical students in the UK, whilst being open to using collaborative Web 2.0 technologies, had little experience of their use prior to university31. Furthermore, one Australian inter-university study reported that students, including those in ‘professional programs’, varied in their use and skill in technology, with advanced power users in the minority32. Nevertheless, there are developments in health professional education such as simulation through virtual reality or avatars being developed and these are an extension of both Web 2.0 and computer gaming technology30. Generational theorists advocate that ‘Generation Y’ students are experienced gamers and therefore are ideally placed to learn using this technological media. However, one study of nurses in two American universities found that most ‘Generation Y’ students did not play computer games but most respondents, across generations, saw the potential for this media and were positive about its introduction into nursing education33. This may indicate that ‘Generation Y’ students have a preference for Web 2.0 technologies in education but may require suitable preparation before participating in highly technological learning environments. These studies have indicated that ‘Generation Y’ health professional students in tertiary education have a unique perspective on appropriate teaching and learning methods which contribute towards the development of graduating competence. A search of the Cochrane Library, the Joanna Briggs Institute Library, in addition to CINAHL, Medline and PROSPERO databases indicated that no systematic review exists or is underway to explore the teaching and learning preferences of ‘Generation Y’ health professional students. A systematic review will inform health professional educators of ‘Generation Y’ students preferred teaching and learning activities relevant to the development of high quality courses and curricula.
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