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MyView: The four millennials you meet in dental school

December 10, 2018

By Eric Mediavilla, D.D.S. and Christian Piers, D.D.S.

Photo of Dr. Mediavilla
Eric Mediavilla, D.D.S.
Photo of Dr. Piers
Christian Piers, D.D.S. 
Do you ever feel like there are a few archetypal dental students who could represent just about everyone you met in dental school? Take a moment to imagine them. It's 10 p.m., and they're buzzing away at dentaforms. One using indirect vision and a rubber dam with full suction. One drilling a detached dentaform on a table top. One pulling the manikin's cheeks out like bat wings and comparing their work with the dentaform of a fourth, who's sitting at home watching "Game of Thrones" because they did a prep last week and they know it's an A.

We feel like we keep meeting these people, too. And we think trying to understand them could help us tailor specific educational approaches to each one. So, we're proposing some nomenclature.

We think the qualities of a dental student's learning mindset can be plotted on two axes. The first axis represents the degree to which each student invests in their education or consumes it.  Is the student an investor who dedicates resources to their learning in hopes of future gain or a consumer who approaches their education like a contract? ("I pay tuition, show up and do the work, you give me the degree.")

The second axis represents the student's focus on effort vs. outcomes. Is the student more concerned with the number of hours they spent cutting preps the night before, or are they more concerned about what happens when they sit down to cut a prep the next morning?

The answers to these questions divide dental students into four categories: the consumer with an effort mindset (Mortgaging Millennial); the consumer with an outcome mindset (Minimal Millennial); the investor with an effort mindset (Mismanaged Millennial); and the Maximizing Millennial, who is an investor with an outcome mindset.

Mortgaging Millennials are true consumers of their education. They tend to lack self-motivation and the ability to self-assess and are more focused on putting in the effort than pushing for outcomes. These students would rather take out additional mortgages with easy money rather than build educational equity. They become buried in a sort of intellectual debt — ignorance of key concepts and minimally acceptable clinical skills. Mortgagers are more likely to engage in unethical behaviors because they struggle to see the value in what they're doing. These students often define educational success as the attainment of a physical diploma and are more likely to subscribe to the mantra, "C's get degrees."

Minimal Millennials are also consumers, but they value outcomes over effort. While Minimals are better judges of their skills, they self-assess to figure out the minimum energy needed to produce an acceptable outcome (and not to reach maximum competence). This is not to say the Minimal Millennial is just an acceptable student, though. Their desired outcome may be graduating No. 1 in the class. The key is that they look to invest the minimum effort to get there. If they want to be No. 1 and a 94 percent is required to get an A, they will study only hard enough to score 94 percent — even if that means ignoring clinical takeaways. High-shooting Minimals tend to be reinforced by both peers and professors for generating their desired results while maintaining active social lives and cultivating outside interests. These individuals are actually under-achieving by definition, but they take comfort in knowing they are not overpaying for either their education or outcomes. Minimals sometimes find themselves stunned when they don't know how to handle clinical situations that their lower-ranked colleagues navigate with ease. If they engage in unethical behaviors, it's not because they don't see value in what they're doing — it's because they see this as a quicker route to the goal. An accomplishment — whether it's receiving a diploma for a low-shooting Minimal or becoming valedictorian for a high-shooting one — is as thrilling as a well-executed business deal. Minimals know they have always paid the lowest possible price for the desired product (and often far less than everybody else).

Mismanaged Millennials, on the other hand, tend to pay the most for the least. They want to invest in their education but are effort-oriented, which means they work harder as opposed to working smarter. These are the students who know they need to metaphorically save for retirement but do so by putting money into stocks without knowing how the market works.  These students never get a return on their investment because they don't seek the advice that could positively shape their outcomes. In dental school terms, they invest lots of time studying or practicing in the sim clinic but see no improvement because they don't look for feedback from faculty. Unfortunately, this group tends to lack the self-awareness that would allow them to objectively evaluate their skills, so they usually think they're much more competent than they are. When pressed in one-on-one discussions about a poor performance, Mismanageds often say they didn't seek out input because they thought they were already doing it right.  Their belief that success is dependent upon repetition hurts them when they lock the wrong movements into muscle memory.

Maximizing Millennials, you can probably guess, make a large investment in their education and expect a large return in outcomes. They have the ability to self-assess and seek out and implement feedback, and they realize the end goal is personal development — not a diploma. Because they embrace challenge, they make themselves vulnerable by asking questions. They don't mind putting in long hours because they know every hour invested increases the payoff they're delaying for a later date. For them, pumping the metaphorical 401(k) is done in hopes of graduating from dental school truly competent, with the abilities and knowledge to be immediately successful.

The diploma for these students is a formality, because they understand they've transformed into doctors long before putting on their mortar boards.

These mindsets aren't specific to millennial dental students. We've highlighted this generation because it happens to be prevalent in today's dental classes (and works well for alliterative purposes), but we believe these mindsets been around for generations. We also don't think they're fixed once assigned. Students can have different mindsets at different times, and most students likely occupy all four of these boxes at different moments in dental school. (The authors certainly have experienced all four.)

We do, however, believe most dental students exhibit a propensity towards a particular mindset. And we think it's possible to meet our students where they learn most of the time.

The next step is tailor-fitting educational approaches to each of these four mindsets — whether we're looking to pull a Minimal away from "Game of Thrones," convince a Mismanaged to mount that dentaform, get a Mortgager to stop looking at the wrong prep design or push a Maximizer to the next level.

A version of this editorial, reprinted with permission, first appeared in the June issue of the Journal of the California Dental Association. Dr. Mediavilla is the assistant dean for admissions and student affairs at the University of Colorado School of Dental Medicine and an assistant professor in the department of restorative dentistry. Dr. Piers is an orthodontic resident at the University of North Carolina-Chapel Hill.