The myth of “digital natives” and health IT

The purported existence of digital natives supposedly has massive implications for IT in every domain, and especially health. We are told that patients and clinicians will, more and more, be digital natives, and that their expectations of and confidence with IT will be correspondingly greater.

We hear a lot about digital natives. They are related to the similarly much-mentioned millenials; possibly they are exactly the same people (although as I am going to argue that digital natives do not exist, perhaps millenials will also disappear in a puff of logic). Born after 1980, or maybe after 1984, or maybe after 1993, or maybe after 2007, or maybe after 2010, the digital native grew up with IT, or maybe grew up with the internet, or grew up with social media, or at any rate grew up with something that the prior generation – the “digital immigrants” (born a couple of years before the first cut off above, that’s where I am too) – didn’t.

In the current edition of Teaching and Teacher Education, the educational psychologists Paul Kirschner and Pedro de Bruyckere have an excellent paper on what they call the myth of the digital native/digital immigrant divide – and the related myth of multitasking. Kirschner and de Bryckere are certainly not practitioners of the polite or punch-pulling school of academic writing. From the outset of the paper they make their position clear:

Many teachers, educational administrators, and politicians/ policy makers believe in the existence of yeti-like creatures populating present day schools namely digital natives and human multitaskers. As in the case of many fictional creatures, though there is *no credible evidence supporting their existence, the myth of the digital native (also called homo zappiens) and the myth of the multitasker are accepted and propagated by educational gurus, closely followed and reported on by the media (both traditional mass-media, Internet sites, and social media) and dutifully parroted by educational policy makers at all levels. But while the myth of the existence of a yeti or other creature is fairly innocuous, the myth of their digital variants is extremely deleterious to our educational system, our children, and teaching/learning in general.

Their abstract is also worth quoting:

Current discussions about educational policy and practice are often embedded in a mind-set that considers students who were born in an age of omnipresent digital media to be fundamentally different from previous generations of students. These students have been labelled  digital natives react-text: 153 and have been ascribed the ability to cognitively process multiple sources of information simultaneously (i.e., they can multitask ). As a result of this thinking, they are seen by teachers, educational administrators, politicians/policy makers, and the media to require an educational approach radically different from that of previous generations. This article presents scientific evidence showing that there is no such thing as a digital native who is information-skilled simply because (s)he has never known a world that was not digital. It then proceeds to present evidence that one of the alleged abilities of students in this generation, the ability to multitask, does not exist and that designing education that assumes the presence of this ability hinders rather than helps learning. The article concludes by elaborating on possible implications of this for education/educational policy.

I have some longer quotes from the paper (which is behind a paywall) on my own blog. The authors present an abundance of evidence that the digital native “phenomenon” does not exists. Commentators often mistake the enthusiasm of this generation for mobile devices and apparently fluency with visual interfaces with some kind of profound cognitive shift. There is simply no evidence for this shift. The multitasking myth is a related one; ample evidence shows that attempting to multitask invariably impairs performance.

Kirschner and de Bruyckere are also very clear that this is not a new finding of theirs. Researchers pretty much since the invention of the “digital native” concept have failed to find evidence of its existence. In their paper The ‘digital natives’ debate: A critical review of the evidence,, published in the British Journal of Educational Technology in 2008 , Sue Bennett, Karl Maton and Lisa Kervin were if anything even more trenchant:

The idea that a new generation of students is entering the education system has excited recent attention among educators and education commentators. Termed ‘digital natives’ or the ‘Net generation’, these young people are said to have been immersed in technology all their lives, imbuing them with sophisticated technical skills and learning preferences for which traditional education is unprepared. Grand claims are being made about the nature of this generational change and about the urgent necessity for educational reform in response. A sense of impending crisis pervades this debate. However, the actual situation is far from clear. In this paper, the authors draw on the fields of education and sociology to analyse the digital natives debate. The paper presents and questions the main claims made about digital natives and analyses the nature of the debate itself. We argue that rather than being empirically and theoretically informed, the debate can be likened to an academic form of a ‘moral panic’. We propose that a more measured and disinterested approach is now required to investigate ‘digital natives’ and their implications for education.

Where Kirschner and de Bruckere began their paper by comparing the digital native to the yeti, Bennett et al have an apposite quote from Proust:

The one thing that does not change is that at any and every time it appears that there have been ‘great changes’.

What are the implications of this for health IT practice? As noted above, it is often held that both staff and patients are increasingly going to be “digital natives” – sometimes this is used as an argument for urgency in delivering meaningful health IT, sometimes I have heard it used as something close to an excuse complacency – “don’t worry about usability/privacy/whatever, the kids are all right”.  Taking the yeti of the digital native out of our discourse will surely help clarity of thought and rid us of one particular illusion.

The myth of the digital native also blinds us to some real issues and risks.  An excellent summary of this issue also appeared in April 2014.  This piece points to the issue of student use of social media and the potential for reputational damage, a live issue for healthcare staff. We also read of some stark research by Northwestern University academics Estzer Hargattai and Brayden King:

But Ms. Hargittai and Mr. King, among others, say that the familiar narrative about tech-smart young people is false. Their course grew out of years of research conducted by Ms. Hargittai on the online skills of millennials. The findings paint a picture not of an army of app-building, HTML-typing twenty-somethings, but of a stratified landscape in which some, mostly privileged, young people use their skills constructively, while others lack even basic Internet knowledge.

In one multiyear study that Ms. Hargittai conducted on students’ Internet use at the University of Illinois at Chicago, about one-third of the survey respondents could not identify the correct description of the ‘bcc’ email function. More than one-quarter said they had not adjusted the privacy settings or content of social-media profiles for job-seeking purposes.

“It is problematic that there are so many assumptions about how just because a young person grew up with digital media, which in fact many have, that they are automatically savvy,” Ms. Hargittai says. “That is simply not the case. There are increasing amounts of empirical evidence to suggest the contrary.”

“Because a 2-year-old can swipe their finger on an iPad, suddenly every young person, every child, is just universally knowledgeable about digital media,” she says. “But there is so much more to using digital media than turning it on or starting an app.”

Siva Vaidhyanathan, chair of the media-studies department at the University of Virginia, describes Ms. Hargittai as a “pioneer of empirical Internet studies.” It is “absolutely untrue” that young people understand how the Internet works when they enroll in college, he says. “That myth is in the direct interest of education-technology companies and Silicon Valley itself. If we all decide that young people have some sort of savantlike talent with digital technology, than we’re easily led to policies and buying decisions and pedagogical decisions that pander to Silicon Valley.”

This is one of the other dangers of the digital native myth in health IT – that a naïve adherence to this mantra will put clinicians and policymakers in thrall to policies and buying decisions that pander to industry.

Seamus MacSuibhne

About Seamus MacSuibhne

Séamus MacSuibhne graduated in medicine from University College Dublin in 2002. Since 2011 he has been a consultant psychiatrist in Carlow/Kilkenny/South Tipperary Mental Health Services. He has a Masters in Medical Education from the University of Dundee and a MA in Philosophy and Ethics of Mental Health from the University of Warwick.

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