Beyond Surgery: The Power of Intergenerational Communication in the Operating Room

Femi Ayeni, Notch Academy Founder

Background

As an orthopedic surgeon in a leadership role, I facilitate excellent patient care within a large teaching center while leading a diverse team of 40 surgeons. Our team spans multiple generations, from first-year practitioners to late-career surgeons nearing retirement. Our role goes beyond teaching surgical skills to the next generation; it also requires managing the complexities of communication across varied generational perspectives.

In the operating room, where the difference between life and death can be determined in a matter of seconds, the stakes are extraordinarily high. Miscommunication can result in dire consequences, from surgical errors to complications that could compromise a patient's recovery - or, in the worst cases, their life. In this high-pressure environment, every action must be meticulously coordinated, with clear, effective communication serving as the team's lifeline. The operating room demands flawless coordination, with no room for misunderstandings when handling sharp instruments, navigating complex anatomy, or responding to unexpected complications.

Each member of my surgical team, from the most experienced surgeon to the newest trainee, plays a critical role in ensuring patient safety. Generational differences in communication styles can sometimes cause hesitation or errors, underscoring the need to bridge these gaps. Effective communication across all levels isn’t just important - it’s non-negotiable. In the operating room, intergenerational communication becomes more than just a soft skill - it is a critical component of survival, ensuring that everyone is aligned, every voice is heard, and every action is executed with care and precision.

The Challenge

We are witnessing a transformation in the workplace, where individuals termed “perennials” by Professor Mauro Guillen, Vice-Dean of the Wharton School of Business, continue to work and remain active beyond the traditional retirement age. In surgery, this means that team members can vary in age by up to seven decades, with a wide range of experiences. For example, an operating room team might include a 68-year-old anesthesiologist, a 60-year-old charge nurse, nurses in their early 50s, a 32-year-old surgical resident, and a medical student who is 25. And most importantly, the patient may be just 15 years old. 

With age diversity becoming more common, everyone has to communicate effectively to succeed, especially in a setting as critical as surgery. A multigenerational workplace brings both unique opportunities and challenges. For example, established hierarchies based on age and cultural norms can sometimes lead to adverse outcomes. In his book Outliers, Malcolm Gladwell described how deference to seniority contributed to fatal Korean Air crashes when junior pilots hesitated to speak up in crucial moments.

In a surgical team, each member’s communication style can significantly affect how feedback is perceived. What one may see as passive could be viewed as respectful by another, while differences in tone and cultural norms further shape communication styles and perceptions. In a high-pressure environment like surgery, these variations can lead to serious communication missteps.

So why don’t we talk more about intergenerational communication in surgery or other industries? Because it’s time-consuming, hard to measure success, and can involve tough conversations. There’s the potential to hurt feelings, affect careers, or trigger bigger reviews. In other words, ensuring effective communication across multiple generations is demanding work! It often means unlearning preferred communication styles and relearning new approaches to help the team succeed.

Opportunities For Individual & Teams

While intergenerational diversities might have some challenges, there are benefits too. I've had the privilege of not only being mentored by more experienced colleagues but also engaging in reverse mentoring, where I shared my technological expertise with older team members. Their wisdom in areas such as patient selection proved invaluable, while my contributions to emerging technologies enhanced our collective capabilities.

In a high-performing team composed of members from multiple generations, a successful leader can effectively harness the diverse skills and experiences within the group to create a dynamic and collaborative environment. This blend of seasoned expertise and fresh, innovative approaches not only enhances team performance but also fosters a culture of psychological safety and mutual respect. By encouraging active participation from all members without judgment, relationships are strengthened, often leading to valuable mentorship dynamics where knowledge flows both ways. For example, combining the skills of a tech-savvy medical trainee with those of an experienced clinician can optimize the patient experience in a hospital that is immersed in technology-based communication and also covets a more personal touch. 

One memorable example of this intergenerational collaboration involved our divisional newsletter, a critical communication tool for our activities. Despite its importance, the email open rate consistently hovered around 60%, even after trying various strategies like title changes and adjusted mailing times. By polling the division, I discovered that communication preferences varied significantly across generations - some faculty preferred faxed notices, others favoured WhatsApp groups, and the younger members leaned towards social media updates. Recognizing this diversity, I implemented a multi-pronged communication strategy that catered to these preferences. This resulted in nearly a 90% higher faculty engagement rate and the creation of new collaborative opportunities.

Solutions to Improve Intergenerational Communications

A team that establishes strong intergenerational communication will in turn build a collective trust that allows for good performance in the most stressful environments. This ability to unite a team across various age spectrums highlights the challenges and opportunities that lie within the setting of intergenerational communication. The following approaches that include introspection and action based on learned experiences have been helpful for me in my career:

1) Understand Your Team Dynamics

For Smaller Teams: Leaders can directly observe individual communication styles both in and outside of work. Informal interactions, such as between surgeries or casual chats, often reveal non-verbal cues. Use these insights to tailor communication and strengthen rapport.

For Larger Teams: Direct observation of everyone’s communication style is impractical. Instead, utilize tools like surveys or group sessions to understand generational differences. Regular team meetings with rotating facilitators can encourage inclusion, help ensure open dialogue and minimize hierarchical communication barriers. You can also create smaller discussion groups for deeper engagement.

2) Seek Feedback and Adapt Based on the Feedback

For Smaller Teams: Leaders can ask for direct feedback from team members during one-on-one meetings to understand how their communication style is perceived. Personal feedback sessions foster a deeper understanding of team dynamics and support a culture of growth.

For Larger Teams: Leaders can assign “communication champions” within smaller subgroups to collect and relay feedback during periodic check-ins. This scalable approach creates a feedback loop, providing broader insights without overwhelming leadership and supporting continuous improvement.

3) Encourage Inclusive Dialogue

For Smaller Teams: In small meetings, encourage quieter members to share their thoughts by asking, “Does anyone have additional thoughts on this issue?” This approach promotes open contribution and ensures every voice is heard.

For Larger Teams: Foster inclusivity by using polls, surveys, or collaborative tools to gather input from everyone. Offer multiple channels, like email, chat, or anonymous feedback forms, so team members can share ideas in their preferred way. These methods scale well, creating a culture that values all contributions.

4) Express Gratitude

Expressing gratitude to everyone is a simple gesture that resonates across all generations. A heartfelt “thank you” at the end of the day can have a significant impact. I make it a priority to thank everyone as much as possible after each day’s work, and I’ve found that this simple act is appreciated by people of all ages. Interestingly, this excellent article from the Harvard Business Review highlights the many benefits of expressing gratitude.

5) Keep an Open Mind

Recognize and appreciate that communication norms change over time and the only constant is a work environment that will have increased intergenerational contact. I still send handwritten notes, faxes as well as texts and emails to members of my team. Yet, I still look for ways to improve outreach and other ways to enhance communication across the newer members of the team. In my example above, the multi-media communication strategy has enabled me to reach out and communicate to as many as possible in their more accessible or comfortable medium.

Wrap Up

In a hierarchical profession like surgery, maintaining humility is invaluable. As a leader, it involves balancing decisiveness with seeking input and support from others. Even in situations of conflict, being open to all perspectives - regardless of rank or background - and fostering low-stress discussions has proven extremely beneficial. I’m often surprised by the fresh problem-solving approaches I gain from both senior and junior colleagues. Humility enables openness to new perspectives and also fosters a safer environment for others to feel heard and appreciated.

In the operating room, this ability to harness the strengths of all team members, regardless of generation, is becoming increasingly important as the workplace evolves. By investing time to include diverse perspectives and empowering everyone to contribute, we can achieve the best performance from the entire team, regardless of generational background.

As the workplace continues to evolve, understanding how to leverage the skills of all team members, regardless of their generational cohort, will become increasingly important. By investing time to include diverse perspectives and empowering all members to contribute, we can maximize the performance of the entire team.

How do you address the challenges of multigenerational team communication in high-stakes environments? I welcome comments on this topic (and stay tuned to @notchacademy for more discussions!)