Журнал «Медицина неотложных состояний» Том 17, №3, 2021
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Соціально-психологічний портрет сучасного лікаря-інтерна в десятирічній динаміці
Авторы: V.V. Yekhalov, O.V. Kravets, D.A. Krishtafor
Dnipro State Medical University, Dnipro, Ukraine
Рубрики: Медицина неотложных состояний
Разделы: Клинические исследования
Версия для печати
Резюме
Проаналізовано більше 3000 анонімних анкет лікарів-інтернів, які навчалися за циклом «Невідкладні стани» у цьому році та 10 років тому. Розглянуті питання їх психологічних особливостей та соціальної поведінки в десятирічній динаміці. Визначені основні характерні риси представників покоління Y у медицині. До представників цього покоління необхідний індивідуально-особистісний підхід, що дозволить перетворювати недоліки кліпового мислення, особливості поведінки і ставлення до навчального процесу, сучасне захоплення гаджетами і манеру спілкування на позитивні якості.
We analyzed over 3,000 anonymous surveys of interns who studied the Emergency medicine course this year and 10 years ago. We were studying their psychological features and social behavior in ten-year dynamics. The main characteristics of representatives of generation Y in medicine were determined. Representatives of this generation need an individual personal approach, which would allow transforming the downsides of mosaic thinking, features of behavior and attitude to the educational process, modern passion for gadgets and manner of communication into positive qualities.
Ключевые слова
післядипломна освіта; лікарі-інтерни; психологія; соціальна поведінка
postgraduate education; medical interns; psychology; social behavior
Introduction
Over the past decade, we have faced progressive changes in public consciousness: moral and ethical norms, culture of behavior and communication, the ability to absorb information and the deviation of thinking of modern youth at the stage of postgraduate education. Studying this issue is necessary to determine the personal characteristics of mo-dern interns in order to optimize educational process at the intersection of generations.
Materials and methods
Our department staff developed a survey, which also allows highlighting the hidden socio-psychological characteristics of individuals. When the independence of the intern and the professor is acquired, the answers become quite frank, which makes it possible to analyze the positive aspects and downfalls of the educational process from within, as well as see the details of socio-psychological traits of a modern intern.
Results and discussion
In our teaching, today we are faced with a generation born in 1983–2002, which modern sociologists have termed generation Y, or millennials.
Generation is a set of individuals who have been particularly strongly influenced by certain events within a certain historical period, so their psychological and social persona-lity will never be like other generations. Spirit of the gene-ration is formed in the period of active socialization — at a young age of 15–25 years [1].
After analyzing a number of scientific publications and the results of an anonymous survey, we were able to partially describe the socio-psychological portrait of a modern young colleague, some of his psychological and social personality traits.
Based on long-term targeted observation in groups trained in the Emergency medicine course at the beginning of the last decade, we identified certain psychotypes of interns [2], and now considered the dynamics of the individual characteristics’ distribution amongst them.
Thus, the “ideal variant”, which accounted for 72 % of all respondents ten years ago, has now barely reached 64.5 %; the share of “carefree” at the same time has almost doubled (to 7.5 %); “unreasonably self-confident” — tripled (from 4 to 12.5 %); “slow-moving” increased from 4 to 9.5 %.
Both those who are now 18–20 years old, and those who are in their forties, stubbornly don’t want to say goodbye to childhood (Peter Pan syndrome). They don’t want to take responsibility, either for themselves or for others. They are reluctant to leave their parents, get married, and have children. In the last 3–4 years, there have been cases of interns’ mothers reaching the professors with a request to ease the training and production requirements for their children. Generation Y is often overly pampered by parents who themselves grew up in the years of total scarcity, which made them consciously dependent [3, 4].
Millennials have a strong sense of individuality. Probably, because they are less ideological than their predecessors, but it’s very important for them to express their point of view. Freedom of choice in everything from the subculture to the opportunity to start own business and develop it has left its mark. For them, the priority is the chance to show their ta-lents and maximize their potential, do something that will make others admire and envy them [3, 5]. The bounda-ries of the world and personal space became permeable for them, which determined their high communicability that is often characterized by frivolity and carelessness. They are characterized by a wide range of acquaintances without obligations, and fast-changing interests and hobbies. But the period of high external contact alternates with the desire for isolation, so millennials love secrets and closed communities [6]. They manage to create their ideal virtual world, with their laws. Therefore, this generation is characterized by great naivety and ignorance of the realities of the world [3, 5], and their inner emptiness and loneliness come from individualism. Lack of communication experience, inability to agree and yield are characteristic features of today’s youth [7].
Millennials are characterized by self-admiration, and even a new term has appeared — “healthy narcissism”. The democratization of the modern interns’ environment bears the difficulty of high self-esteem, defending the inalienable right to personal sovereignty, the feeling of greater freedom and greater flexibility than in the older generations [4]. The highest self-esteem was shown by 93.5 % of all respondents.
Millennials are very ambitious, devoid of a stereotyped approach to knowledge. They don’t seek to build a career in the traditional sense of the word, they don’t care about career growth and the constant pursuit of solid positions and higher salaries [3]. However, 69.2 % of the surveyed interns aspire to hold the chair of a senior manager in the future, but according to individual characteristics, only 31.2 % of them have the abilities for this.
Modern youth is characterized by fragmentary (mosaic) thinking as an increasingly progressive process. Carriers of mosaic thinking have certain optionality. Thus, 43.2 % of respondents consider it appropriate not to perform certain tasks if it doesn’t bear negative consequences for them.
Millennials are always in a hurry to do short-term work, but when it comes to long-term tasks, they lose a sense of urgency, because they don’t know how to prioritize, so many tasks remain unfinished [8]. Thus, in self-preparation for classes, more complex and extensive tasks are postponed, which was confirmed by 56.2 % of respondents. According to the survey, 69.5 % of modern respondents consider themselves procrastinators (against 78.5 % in 2011).
Representatives of generation Y are characterized by a certain energy saving in the process of studying topics, which are not very interesting for them personally. Their answers indicate that 72.2 % would not have neglected the use of fraudulent methods during the survey and testing, if not for the precautionary actions of the professor and the threat of exposure.
Multicenter studies conducted after 2000 in many countries show that IQ growth has slowed or even reversed to recession [9]. Only 7 % of young colleagues consider themselves able to reproduce the received information perfectly (previous result — 16.5 %), 35.5 % — well (against 47.5 %), 40.5 % moderately (against 32.5 %), and 17 % — unsatisfactory (against 3.5 % ten years ago). There is a natural negative dynamic associated with the thinking deviation, impo-verishment of language and social culture, reassessment of values, etc.
Millennials are a generation, which observed the blooming of digital technology, a generation of gadgets and social networks, people who interact organically with the digital world, respond to its innovations and implement them in their lives [6]. One percent of millennials are happy with the general digitalization, most of them believe that the benefits of innovative technologies outweigh the risks. Cybersecurity raises more concerns: 79 % of respondents are afraid of falling victim to online scams, and 78 % are concerned about how organizations share customers’ personal data. However, 64 % believe that reducing the time spent on social networks will help them become healthier physically, and 40 % would like to completely stop using social networks [10].
When choosing studying methods, it should be consi-dered that they prefer to receive information at a convenient time, they want a flexible and convenient schedule of classes,
which would allow secondary employment. Accordingly, they would prefer distance learning to face-to-face forms of training, and webinars to classical lectures [11]. 72.4 % of total generation Y population prefer distance learning, but among interns it amounts only to 9.2 %.
Young colleagues well understand productive dosed humor, appropriate references to quotes from scientists of the past. But the ability to draw parallels between pathological conditions and examples from the classic literature ended in almost nothing. According to the survey, the number of book lovers among interns has decreased by 21.5 % over the past decade. With such dynamics in the long run, verbal contact between people will progressively weaken, being replaced by modern technology, but the doctor’s professional competence ultimately depends on his ability to speak, the level of his language culture [12].
And despite the fact that Y-representatives don’t want to be “micro-controlled” and strive for considerable freedom in carrying out their immediate tasks, they regularly need the strong hand of an experienced leader.
The best motivation for millennials is the opportunity to realize their potential, discover their talents, do something really interesting and unusual, work in a friendly team and have fun to the fullest.
For millennials the main thing is success (92 %). The main problem is that not everyone succeeds, and this can lead to a psychological crisis. But pragmatism, individua-lism, the presence of significant intangible values, adhe-rence to life strategy, willingness to take risks and sacrifice to implement it will make this generation quite successful [5]. They are focused on the rapid professional development of their skills, but are not tied to the profession or place of work and can seriously change their lives by choosing another, more interesting direction for self-development [6]. They prefer to develop horizontally rather than vertically, gaining more experience in several areas [5].
Millennials do not like to work in teams with a rigid staff hierarchy, and also have a negative attitude to work fixed hours, avoid monotony in work [5]. They find it difficult to adapt to a well-structured subordination, the need to follow the rules, work schedule, etc. [6].
Millennials appreciate the digital communication environment through which they could interact with colleagues and superiors (social networks, instant messaging and blogging) [13]. They don’t like to do the same thing for a long time. They don’t want to work long in one place and one profession [5]. Millennials don’t perceive frequent work changes as stress [10].
The younger the doctor, the more rationally he converts his profession. 96.4 % of current interns want to receive high salaries in the future, but only 54.5 % of them agree to work hard and productively.
Generation Y has certain physical health problems [14]. Research by O.M. Yurieva (2019) proved that 42 % of medical students have a mild level of depression, 16 % — mo-derate, and 14 % — severe [15]. 57.9 % of interns surveyed reported that they were under stress all or most of the time. Millennials are very easily offended, even the requirements of the discipline often cause stress and irritation for them [16]. The mood after such excesses quickly recovers only in 18.1 % of respondents, others (49.1 %) tend to dwell on the past experiences again and again.
Because of the unwillingness to take on additional responsibilities, generation Y is reluctant to enter into a serious marital relationship. Childfree becomes the so-called “childhate”, caused by fear of childbirth, aversion to motherhood or women’s fear of losing their sexual appeal [17]. Despite relatively free views on sex and marriage, Y people have fewer sexual partners than previous generations [18].
Generation Y idols (more often cinematic or game cha-racters) have the characteristics of sociopaths who openly declare and demonstrate the priority of their own desires over the feelings and needs of others; they ignore social principles and rules of conduct, are confident in permissiveness, don’t feel shame, guilt, pity or remorse, do not realize the falsity of their actions [5, 6].
Although millennials often demonstrate a high level of knowledge and skills at a young age, they lack maturity when it comes to the concept of behavior in the workplace [8].
Thus, nowadays 71.5 % of respondents believe that it’s appropriate to leave the audience at any time (compared to 7.5 % in 2010), 46.5 % believe in their right to use mobile communications in the classroom (12 % previously).
The conflicting self-consciousness of our youth and the spirit of adventurism are only a reflection of the chaos that exists in our social life, and its confusion is a natural result of lack of experience [1]. Lack of social mobility (49.2 % of respondents) and income inequality (44.5 % of respondents) were mentioned as the main problems of our time.
Young people’s respect for the older generation is progressively declining, empathy for the patient is progressively degrading, moral principles and deontological norms are being neglected [6, 19, 20]. However, according to the results of an anonymous survey, 79.4 % of respondents show respect for the elderly, expecting nothing from them. Only 61.1 % respect the professor just because of his position, and 97.2 % — for his professional, teaching and personal qualities.
The social situation of the 1990s formed in children and adolescents who were growing up at that time a reluctance to make long-term plans, and an inclination to replace future planning with orientations to quickly achieve the goal [6]. Among the respondents, only 34.6 % have long-term plans for further life and work.
The most important feature of generation Y is optimism. At the same time, they want to achieve professionalism in several areas at once, strive to obtain comprehensive information, which is a plus. But only a few of them are truly happy, and the vast majority live with a feeling of deep inner dissatisfaction, regret for lost opportunities and the feeling that there is no person in the world who could 100 % understand and accept them as they are. The eternal pursuit of more valuable things and pleasures does not comfort, but only drives them even deeper into depression — hence the wild popularity of psychological coaches and trainings [3].
Generation Y has the desire and willingness to change life in their country. They are less ideological than previous generations, but not devoid of patriotism. In addition, they are more likely than other generations (65 %) to believe that the country is developing in the right direction [5]. According to a Deloitte Global Millennial Survey 2020 conducted in many countries around the world, almost three-quarters of respondents in Ukraine noted that the pandemic has made them more sympathetic to the needs of others and that they intend to take action to make a positive impact on their communities [13]. 84.2 % of interns recognize the leading role of medical deontology in medical practice and adhere to its principles. Only 6.9 % of respondents want to work in foreign clinics in the future, and 84.3 % are ready to make every effort to improve health care in Ukraine.
The current generation is no worse than the previous ones, they are simply not like us, and they need to be taught differently, maximally motivating the preservation of existing intellectual and moral values. Representatives of this generation need an individual personal approach, which would allow transforming the downsides of mosaic thinking, features of behavior and attitude to the educational process, modern passion for gadgets and manner of communication into positive qualities.
Received 11.02.2021
Revised 22.02.2021
Accepted 26.02.2021
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