Can Baby Boomers Teach the Current Generation? Dr Jon Bailey Chair of the Academy Trainee Doctors’ Group Academic Clinical Fellow in Emergency Medicine, Thames Valley

Somewhat undermines the concept of medical training if we don’t believe that the current generation can teach the next! But… The youngest Boomers are now 52 – average GP retirement is 59 More than half have already retired!

Does Generational Theory really stand scrutiny? Did Baby boomers have low expectations? Greatest financial and economic security in history - free education, generous pensions, early retirement and a housing boom Were they not assertive? Peace Corps, Free Speech Movement, Anti-War Protests Is loyalty not universally earned – and a function of reward? More than financial: social position, respect, treatment in the workplace, lifestyle Old age and treachery will always beat youth and exuberance but The more things change, the more they are the same.

“in my day” doesn’t help “in my day” Mean information doubling time is 9 years Approximately 64 times more information in the medical literature than there was in 1964 Annual scientific publication growth of 9%, equating to a doubling time of approximately 9 years. There are approximately 1 million times the number of scientific papers in 2016 compared to 1836. Medical training time has only increased 3 fold, so its not all bad.

In 1978, there were 55,000 hospital doctors; in 2014 there were 190,000, of which 74,859 were consultants: a rise of 345%. The UK population has increased from 56,183,000 to 64,597,000 in the same time, a rise of 14.9%.

In Emergency Medicine… Staff Grade 2010 2011 2012 2013 2014 2015 FTE Change Percentage Change Accident & Emergency Consultants (FTE) 1,013 1,100 1,230 1,320 1,425 1,483 470 46.40 A&E Registrars 2064 2166 2185 2256 2376 2359 295 14.29 A&E Senior House Officers 124 119 98 111 104 79 -45 -36.29 Foundation Year 2 1104 1086 1088 1144 1156 52 4.71 House Officer and Foundation Year 1 200 206 192 205 209 223 23 11.50

If Junior Doctors face the same problems… Do Teachers? What is good teaching? Do we optimise for good teaching? Is every consultant a teacher by default? Do we emphasise the wrong elements of intelligence? Do we spend too much time recording teaching?

How do we learn effectively? If we remember so little of what we see and hear, how much teaching really stays with us anyway?

Information is the new currency

Know less, know where to look

Know less, know where to look

Things to focus on Facilitated decision making How to interpret and synthesise evidence How to make defensible decisions How to maximise interpersonal interactions How to balance risk Difference between craft and non craft specialties Supported failure Systematic debriefs without blame Avoid humiliation Learn from outside of medicine Avoid Focus on knowledge without an evidence base Failure to update “In my day”