University of Wisconsin–Madison Medical College of Wisconsin

‘In Our Era…’: Feedback Perceptions Across Generational Cohorts

Maria Skorey, MD; Kelsey Ryan, MD; David Lambert, MD; Kris Saudek, MD

WMJ. 2026;125(1):54-61.

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ABSTRACT

Introduction: Generational differences in medical education remain unclear. In today’s multigenerational workforce, identifying whether generational differences exist in feedback practices may inform more individualized, learner-centered education. This study explored whether generational differences exist regarding feedback practices and preferences.

Methods: This qualitative study was informed by Generational Cohort Theory and Social Cognitive Theory. We interviewed third- and fourth-year medical students, house officers, and attending physicians in pediatrics, internal medicine, and surgery at the Medical College of Wisconsin between October 2020 and March 2022. A constructivist grounded theory approach was used to analyze interview transcripts and develop themes. Questions explored characteristics of helpful and unhelpful feedback, preferences for giving and receiving feedback, and opinions regarding the role of age in the feedback process. Themes were compared across generational cohorts.

Results: Thirty-eight individuals participated, with birth years spanning 1949 to 1994 (8 Baby Boomers, 9 Generation X participants, and 21 Millennials). Both generationally unique perspectives and common themes shared across cohorts were identified. Overarching themes included the influence of medical hierarchy and the importance of the relationship between the feedback giver and receiver. Most interviewees did not believe that age explicitly influences feedback practices, although perceptions of generational differences were present.

Conclusions: Different generational cohorts expressed distinct practices and preferences regarding feedback. Importantly, shared themes across generations aligned with established hallmarks of effective feedback in medical education literature. Acknowledging and thoughtfully addressing generational differences – with attention to medical hierarchy and relationships may improve feedback effectiveness and satisfaction.


Author affiliations: Medical College of Wisconsin, Milwaukee, Wisconsin (Ryan, Saudek); Washington University School of Medicine, St. Louis, Missouri (Lambert); Sanford Children’s Hospital, Sioux Falls, South Dakota (Skorey).
Corresponding author:
Kris Saudek MD; Medical College of Wisconsin; 999 N 92nd St, Suite C410, Milwaukee, WI 53226; email ksaudek@mcw.edu; ORCID ID 0000-0001-9849-7403
Funding/support: None declared.
Financial disclosures: None declared.
Acknowledgements: The authors thank Louise Arnold, PhD, Gary Beck Dallaghan, PhD, Deb Simpson, PhD, Kristina Kaljo, PhD, and Tavinder Ark, PhD, for their expertise and comments during the creation of the interview questions.
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