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Keeping Pace with Communication Changes: Communicating Efficiently and Effectively with Healthcare Students from the Last Part of the Millennial Generation

Stephanie C Evans*

Harris College of Nursing and Health Sciences, Texas Christian University, TX, USA

*Corresponding Author:
Stephanie C Evans
Assistant Professor
Harris College of Nursing and Health Sciences
Texas Christian University
Fort Worth, TX, USA
Tel: (937) 830-0686, (817) 257-7498
E-mail: [email protected], [email protected]

Received Date: July 20, 2017; Accepted Date: August 04, 2017; Published Date: August 12, 2017

Citation: Evans SC (2017) Keeping Pace with Communication Changes:Communicating Efficiently and Effectively with Healthcare Students from the Last Part of the Millennial Generation. J Healthc Commun. 2:56. doi: 10.4172/2472-1654.100097

Visit for more related articles at Journal of Healthcare Communications


Communication is a key component of effective healthcare. In healthcare education, faculty to student communication lays the foundation for our students to learn to communicate with their patients. As faculty members, we must continue to embrace technology and move forward to communicate with our students in efficient and effective methods. We should consider the preferred communication methods of the students by assessing the generation and working to meet them in their comfort area of communication with technology. In the last decade, the use of text messaging has typically been limited to personal interactions between individuals. As technology has advanced so have applications and methods of using technology. There are now applications which allow individuals to text one another or groups without sharing personal phone numbers. Faculty may consider using this newer way to communicate with their healthcare students. By adapting and demonstrating flexibility in learning new methods of communication, we are leading by example for the students to be flexible and adaptable to meet the various communication methods of the patients they serve.


Communication; Text messaging; Healthcare students; Millennial generation


Communication in all areas of healthcare is paramount for improving outcomes [1]. Efficient and effective communication is a learned art that should begin with students in healthcare programs. Communication is a two-way activity and often individuals must work to develop the necessary skills for it to be effective. In addition, the context of the communication needs to be considered when selecting the method to use. There are various forms of communication, from personal (face to face), to social media, and many in between including text-messaging. One conceivable way to improve communication skills is for faculty to use varied forms of communication in the educational setting of healthcare provider students [2].

As educators, we need to develop effective communication in all forms with our students. This may include faculty learning new methods of communication which might be preferred by students. Current students entering programs of nursing, medicine, pharmacy, occupational therapy, physical therapy, and other healthcare provider programs are from a generation of digital natives, the millennial generation (born between 1981- 2001) [3]. This generation has grown up with technology as part of their daily lives. Many of the individuals in this generation do not remember a time before the internet or easy access to communicate with other individuals. They have been connected to their parents and peers digitally for most of their lives [4]. Contrast this to the prior generations, which all fall into the category of digital immigrants [5].

Those of us in the digital immigrant category have had to learn to use technology and learn to integrate new technology into our lives rather than the experience of it having always been present.


Most current faculty in healthcare education is from the digital immigrant generation and our communication styles vary from what the digital natives want. As the students continue to be more technologically advanced, faculty members need to be aware of and seek new opportunities to improve communication methods with younger generations [5,6]. One such method of communication is text messaging [2]. This is different from instant messenger or e-mail [7]. Text messaging is a form of instant communication from one digital device to another. This method does not require the internet or a computer, only that the individual have a cellular phone. A Pew Center study from 2012 noted that over 96% of individuals aged 18-29 have cell phones [8]. Of those with cell phones, 100% report using text messaging [8].

Take a step back in time and consider the days of the Pony Express, from 1890- 1891 [9]. At the time, this was the most efficient means of communication in the United States. Individuals could send a message from the East coast to the West coast in only 10 days [9]. This was considered the best way to send information until the invention and implementation of the telegraph. Moving forward to the current era, individuals have multiple ways to share information. In 1891, it took 10 days to send information coast to coast. Fast forward to 1971 and the invention of e-mail which provides the ability to send information in minutes from coast to coast directly to another person who can then respond in real time [6]. E-mail was invented almost 50 years ago and people continue to use this as a way to communicate. However, according to a 2012 Pew Center study of teenagers, only 6% of teens checked email daily yet 63% used text messaging daily [8]. Trends in phone usage indicate the rates for text messaging have increased to 100% of college age students with cell phones in using text messaging with only approximately 50% checking email daily.

Pew further reports 12% of individuals with cell phones only have internet access via their cell phone [10]. Individuals are no longer using broadband or installing internet connections into their homes [10]. This limits ability to check email or communicate with Instant Messenger (IM) programs and learning management systems (LMS). Rationales provided by Millennials as to why email is not used include that email is boring, too lengthy, takes too long to read or to open [3]. The digital native generation prefers a more direct and to the point method of communication, streamlined and fast [6]. Email and IM are considered slow and cumbersome, as it often requires one to login and an active internet connection. Text messaging is preferred as a fast, instant, on the go way to communicate.

Even the founder of Facebook, Mark Zuckerberg, was reported as saying email was outdated and this acknowledgement is what prompted Facebook to create a messaging system for individuals to communicate with each other [3]. Short, to the point, use of icons and emojis rather than words is the preferred communication of Millennials. Overall this is a reported generation of non-readers [11]. They have had access to too much information and have developed the ability skim reading material in an attempt to retrieve information faster, yet missing details in the process [12]. One interesting report did reveal that the digital generation does feel email has a place, for storage and organization of information they want to keep [7].

Future Directions

As mentioned, this generation has a desire for to-the-point immediate two-way communication. As educators, we need to use tools which will reach our students and meet them in their comfort zones to facilitate improved communication [6,7]. The question then becomes, what can we do? How can we text and not share personal phone numbers or cross the personal boundaries between personal and work time?

One suggestion is for educators to ask students what they use and be aware of advances and applications (apps) which enable improved communication, such as text messaging without sharing personal information. A search for texting apps in one of the smart phone app stores will reveal there are multiple apps which are free to use and enable instant two-way communication to use with individuals and/or groups. Having used one of these digital applications with my own students in a nursing class over the last academic year, the feedback has been overwhelmingly positive. Students have the ability to reach me and ask questions in an instant. The app allowed me to set-up specific time frames for messages to be delivered to me. If a student is attempting to text me outside of my posted times, the app tells the student it is outside of approved office hours. In addition, I can respond in real time to my student’s questions or concerns. Use of the app has not replaced other methods of communication. I do use email and the LMS system from my university with my students. However, I will send my students a quick text message reminding them to check their email or LMS system. Students have reported going into their email to look for specific emails once they receive the notice via the texting app system.

We all have come so far in communication, from the days of the Pony Express to the ability to simply touch a button to communicate or have a conversation with someone in another part of the world [11]. However, in the world of higher education, there are still lags in implementing the use of technology. Many college students report using various apps, such as text systems in their primary and secondary schools then arriving at college and having less communication with college faculty than they had with high school teachers [6]. We need to ask students their preferred method of communication and learn to improve our methods of communication with these digital native students [4].

In addition to messages, these apps will allow you to share links or documents or to just send a reminder message to an entire class at one time. There is no need for logging into a system or requirement to have internet connection. The only requirements are a cellular smart phone and the app, and to be able to send and receive messages [2]. We are the ones educating future health care providers and we need to demonstrate flexibility and adaptability to our students. When faculty can flex to meet student communication needs, faculty then can discuss the ways in which students need to meet their patients’ communication needs. Faculty need to remind students not all people are tech savvy and not all will have smart phones or access to data and internet. Faculty can teach students to think outside of the standard communication box. By demonstrating a willingness to think outside the standard communication boxes, faculty are then teaching by example.

Faculty may also consider the pedagogical aspects of technology available for usage in communicating with students [5]. It has been demonstrated student learning improves when varied teaching methodologies are employed in the learning environment. In addition, student learning is demonstrated to improve when students are comfortable in the learning environment [11]. Using apps, technology which this generation of students is adapt with, meets the students in their comfort zone. Being willing to adapt to dynamic shifts in technology expands the faculty’s repertoire of tools to use in the classroom.

One final consideration is for faculty to ask for help. If faculty are not comfortable, they may ask for help learning to use new apps and devices. Remember there is a learning curve for everyone involved when using new technology, so do not be afraid to try. Faculty may also want to include a statement in the course syllabus which states the apps to be used and methods of communication as a course policy, even including the specific hours of use. Not all students may be comfortable, so making this a course or class requirement might be difficult for some students.


Communication is a core competency for healthcare students in all programs of study. One key to communication is making certain it is efficient and effective. Faculty leading by example and implementing changes to communication from the class standpoint, such as using text messaging with students, improves the communication from a foundational level and directs the students by example [13]. We need to embrace technology, move forward, and adapt teaching methods and technology to the needs and wants of the students. Demonstrating that we, as faculty members, are able to adapt and implement new methods to communicate with students in effective and efficient methods.


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