Introduction

Generation Z prefers communication through technology over direct contact with people. With technological development in the field of multimedia, such as tablets, smartphones, social media, young people of Generation Z have become accustomed to interaction and communication in a world that is constantly connected. Generation Z students communicate globally and receive information from around the world (Szymkowiak et al., 2021). Betz (2019) also confirms that Generation Z is accustomed to the rapid dissemination of information presented in a graphically and technologically sophisticated style. Growing up in a virtual world of technology with endless sources of information and digital interactions has changed their way of thinking, communicating, and learning.

We are inundated with a flood of emails, messages, we communicate globally, with the whole world, which creates demands for speed of decision-making, we read and perceive selectively, because the amount of information we are confronted with daily cannot be processed by our brain. We are not able, nor do we have time, to think in depth (Berg van den, 2020). Vymětal (2008) emphasizes the growing importance of communication in all areas of life. Increasingly, students, employees, professional and scientific workers, managers, and specialists are required to have communication literacy, communication competencies, soft skills, communication abilities. The author draws attention to a "communication crisis of society." One of the reasons is the information explosion characterized by an excess of information, publications, records, and the rapid development of information and communication technologies.

Generation Z is the generation of social media and the digital world. They share everything on social networks, they do not read but watch videos, they photograph everything and communicate through images more than through words. Their idols are among YouTubers who set the lifestyle. Their life is the internet. Facebook and television mean nothing to them; they are connected via WhatsApp, Instagram, Twitter. They grew up with technology: mobile phone, tablet, notebook. Generation Z has become individualistic, with a declining ability to establish relationships with others (Berg van den, 2020). Šmahaj, Kolařík & Glaser (2022) similarly characterize Generation Z. Generation Z is the first generation that does not know life without mobile phones, computers, and the internet. They are referred to as the "digital natives" generation because working with modern technologies is a matter of course for them. They are constantly exposed to a large amount of information and stimuli from online sources, they are part of the so-called "always on culture," i.e., constantly connected to the internet. For Generation Z, continuous connectivity is also a major cognitive burden and a significant psychological stressor, causing them health and ergonomic problems.

Generation Z has different communication patterns than previous generations. They are the future workforce, therefore they will significantly influence workplace communication as well. They are capable of multitasking, but have a much shorter attention span than members of other generations. Digital conversation and the use of symbols affect their written communication. They prefer instant messages over emails, use abbreviations in messages, especially English words that the older generation does not understand (Corporate English Solutions, 2024). They have their own language, abbreviations, phrases, and idioms (Bosco, 2022). Generation Z has an informal communication style and even in work communication they respond with short messages containing emojis. Generation Z prefers visual communication – videos on TikTok, Instagram. Generation Z also has gaps in soft skills and presentation skills. Sombret (2023) states that the communication style of Generation Z is brief, informal, and ideally in text format. However, this does not fully capture the communication preferences of Generation Z. They appreciate, for example, transparency and personal interaction. They have very different expectations compared to other generations when it comes to communication in a professional environment. Generation Z has difficulty reading larger blocks of text. Another characteristic of Generation Z communication is the need for regular feedback, which is a consequence of the influence of growing up with social media. They are used to receiving immediate feedback: opinions, reactions, and comments. Within work communication, they can be completely "destabilized" if their supervisor does not provide them with feedback. Generation Z's communication preferences include immediate interaction, e.g., within education via the MS Teams platform. Generation Z lives with their "smart" phones. The visual, concise, individual, personal, and transparent communication style of Generation Z differs from previous generations.

Vymětal (2008) emphasizes that the future "EuroBachelor" must be able to communicate in a team, be able to communicate in writing in at least one of the major European languages (English, German, French, Italian, or Spanish). The author states that the National Institute for Literacy in the USA considers the following key competencies in the current information age: 1. communication skills – reading with comprehension, expressing thoughts in writing, speaking so that others understand, active listening; 2. interpersonal skills – teamwork, advocating one's own opinions and interests, influencing and understanding others, ability to resolve conflicts, the art of negotiation and leadership.

Requirements for communication abilities and competencies are increasing, therefore it is important to pay attention to communication already during the educational process. When assessing communication literacy, communication competencies are required. They are defined as "a set of social, psychological, semantic, grammatical-expressive values, norms, rules that enable active participation in the communication process" (Vymětal, 2008, p.25). Communication competencies enable the speaker to communicate proportionally to the situation, characteristics of the listeners, etc. Communication skills are "the sum of the level of spoken speech, emotional competencies, healthy self-confidence, speech etiquette. Basic communication skills include listening, speaking, reading, writing, and perceiving nonverbal communication" (Vymětal, 2008, p.25). Častulínová (2021, p.6) associates communication literacy with reading and writing. She explains the concept of literacy: "literacy means mastering various types of communication for the purpose of integrating an individual into a given society, for their satisfactory action and being in their own interest, as well as in the interest of others. It is an ability that enables them to solve the changing problems of daily life." Communication literacy is linked to the growth of cognitive processes. "Being linguistically literate means knowing how to use language in a wide range of its dimensions, across the full breadth of registers and genres, depending on the situational context and communicative intent, and having conscious control over its use" (Častulínová, 2021, p.7).

Objective

To assess the communication literacy of students from the generational cohort Z preparing for healthcare professions. To identify the communication specifics of Generation Z.

Sample and Methodology

Data collection took place from September 2023 to October 2024. The sample of respondents consisted of 263 students of TnUAD in Trenčín belonging to Generation Z (born between 1996 and 2009) and studying in healthcare fields. Respondents filled out a sheet with 24 statements related to communication and assigned a score to each statement from 1 – no, I disagree to 4 – yes, I agree. We used a four-point Likert scale.

Results and Interpretation

The analysis of the communication specifics of Generation Z students in our sample of respondents yielded interesting findings, some of which are contradictory to foreign sources and studies. Thanks to the internet, Generation Z communicates with the whole world and obtains vast amounts of information without limitation. They are characterized by digital literacy, are capable of multitasking, prefer the virtual world, visual aids over text. As a result of the aforementioned factors and characteristics, they socialize in a different way, and accepting and understanding their social patterns is important not only for parents but also for educators. They represent interactional and communication challenges in teaching and learning Generation Z (Talhah Ajmain et al.,2020). The new learning environment requires creative approaches that combine social interactions and technologies: providing frequent, short, concise, constructive, and quick instructions and feedback using social media platforms and interactive activities; or online modules (e.g., collaborative projects, group assignments, case studies) to develop critical thinking, social, communication, and relational skills in Generation Z students (Shorey et al., 2021). Due to their reliance on technology, Generation Z students have underdeveloped social skills because they lack the nuances and art of conversation, and this deficiency in face-to-face communication skills hinders their skill development for social and societal interaction (Shorey et al.,2021). We investigated whether respondents have difficulty establishing interpersonal relationships: For the statement "I have difficulty establishing interpersonal relationships" (x̄ = 2.09; sd = 0.94) they were to assign a score that best characterizes them. As many as 173 Generation Z students (65.78%) have no problem establishing personal relationships and communicating, but public speaking and speaking in front of a larger number of people is problematic. After analyzing the statement "I have difficulty speaking in front of a larger number of people" (x̄ = 3.13; sd = 0.98), we note that up to 200 students out of the total number of respondents (n=263) in our sample (76%) have a problem with public speaking and presenting.

Students prefer individual learning at their own pace, engaging and visual learning environments that integrate videos, stories, powerpoint slides with sound, simulations, group projects, discussion forums, online quizzes, and case studies. Healthcare students prefer educators who are effective communicators, approachable, friendly, enthusiastic, passionate, and knowledgeable in their teaching subject, who provide students with immediate and constructive feedback and set realistic expectations (Shorey et al.,2021).

Individual communication skills are very significant for all job positions in healthcare; it is not possible to determine which one is the most important because their use overlaps: observing nonverbal signals, the art of asking questions, and the art of speaking. People in healthcare professions must know how to actively listen (Fülöpová, 2011). For this reason, in our study we focused on evaluating the communication of Generation Z students who are preparing for healthcare professions, so that we could adapt teaching and approach to them according to their communication preferences. The results are presented in the overview table no. 1. The highest average values were achieved by the statements: "I respect the privacy of other people, I am discreet" (x̄ = 3.74; sd = 0.55); "It is natural for me to ask someone for advice if they know more about the problem than I do" (x̄ = 3.58; sd = 0.77); "I think I have the right to say no to the demands of others and to negotiate a compromise" (x̄ = 3.48; sd = 0.73). Hulková (2024, p. 136) in her publication cites many authors who state that the negative characteristics of Generation Z include disrespect for the privacy of others, indiscretion, sharing their private lives on social platforms, including intimacies; they openly express their opinions, they do not understand people who guard their privacy. It is therefore an interesting finding that the respondents in our sample value discretion in communication the most. We believe this is related to preparation for healthcare professions, where we instill in students respect for patient rights, individual approach, and the duty of confidentiality. We think that many answers were influenced by the intentional selection of Generation Z individuals, i.e., students of healthcare fields. The assessed areas of Generation Z communication also included assertiveness, because as a generation they are considered to be less assertive. Assertiveness is a basic prerequisite for positive communication. It is defined as openly asserting and expressing one's own opinions, respecting the rights of others. Our findings are again in contradiction with literary sources. 79% of respondents consider themselves assertive in communication; 60% of respondents think they have the right to say no to the demands of others, and 88% of Generation Z students express their opinions honestly and in an appropriate manner. We again relate these conclusions to the preparation for a profession chosen by individuals with an affinity for people and a high degree of empathy. Humaira & Su-Hie (2021) conducted a questionnaire survey in 2020 among 243 Generation Z respondents in Malaysia regarding their communication style. The results show that they prefer face-to-face communication and the use of visuals in online communication. They like to communicate through emoticons, gifs, and abbreviations. They expect immediate feedback, appreciate transparent communication, praise, but are less assertive and can be aggressive when criticized.

Table 1 Communication of Generational Cohort Z

Another assessed area was nonverbal communication, focusing on eye contact during conversation. 141 respondents (53.61%) prefer personal, face-to-face communication and 106 respondents (40.30%) partially prefer communication via modern technologies (email, social networks, etc.). 77% of Generation Z students answered that they maintain eye contact with other people during conversation (124 respondents answered partially agree and 79 respondents answered yes, agree). The statements "I prefer personal, face-to-face communication" achieved the following values (x̄ = 3.41; sd = 0.74); "I maintain eye contact with other people during conversation" (x̄ = 3.02; sd = 0.81). Boukalová et al. (2013) state that eye contact is a significant communication channel. Within the complementing of verbal communication, eye contact has a steering function and plays an important role in handing over or "holding" the floor. Through eye contact we show the speaker interest, attention, and effectively perceive their words. The listener looks directly at the speaker about 60-75% of the time, while the speaker looks at the listener(s) and establishes eye contact 40% of the speaking time. 157 students (59.70%) in our sample have no problem maintaining eye contact during conversation, but maintaining eye contact during conversation with an authority figure is a problem for them. 66% of students stated that if they have to speak with a significant authority, it is difficult for them to maintain eye contact, to look them in the eyes. Ledrick (2020) in his study confirmed that the problem for Generation Z is personal communication, face-to-face interaction. Generation Z lacks communication skills, they live virtually thanks to technology. Talhah Ajmain et al. (2020) in their study focused on describing the impact of technology on Generation Z and on effective communication in interaction with Generation Z. The authors emphasize that if we want to get closer to Generation Z, it is necessary to communicate with them in their "technical language," because their communication, opinions, and behavior are dominated by digital technologies. Generation Z learns through visual and practical methods, such as interactive games, collaborative projects, not lectures and discussions. According to the authors, educators must be proactive in creating a new teaching and learning environment that suits the needs and characteristics of Generation Z. The authors emphasize that conventional teaching and learning is still relevant despite education through online media and the use of new technologies. Teaching using visual aids, games, experiential learning is more attractive for Generation Z students, especially if the educator possesses digital literacy. Then the subject becomes interesting for students, they achieve better results, and the educator is a respected authority for them. An interesting result of the authors' study is the finding that Generation Z does not prefer written tests, but oral examination, in order to receive immediate feedback from the educator about their weaknesses (Talhah Ajmain et al.,2020). According to Hughes (2022), communication with Generation Z must also be concise and visual. Generation Z communicates with images, they prefer videos, text messages. Similarly, Roy (2022) confirms that the academic cohort of Generation Z expects the use of technology in teaching. Szymkowiak et al. (2021) state that individuals of Generation Z have a more developed part of the brain responsible for visual abilities, therefore visual forms of learning are more effective for them. But compared to previous generations, the attention span of Generation Z is limited, which is caused by constant interaction with the multimedia environment. The average attention span of Generation Z members in the classroom can be estimated at 7-10 minutes, because young people today want to read less than 20% of the text and want to get to the core of the problem as quickly as possible. The authorial team analyzed data from 498 young people belonging to Generation Z who actively use online communication for knowledge sharing. Respondents leaned more towards education through mobile applications and video content. The questionnaire survey by Hall et al. (2019) presented the finding that university teachers consider incoming students unprepared in the area of written expression of thoughts and opinions. The subjective assessment of the written expression of Generation Z in our sample is also in contradiction with the results of the study by Hall et al. (2019). Students evaluated their own written expression. The sheet contained two statements: "There are grammatical errors in my written expression" (x̄ = 2.144; sd = 1.08). 64% of Generation Z students answered that their written expression contains no grammatical errors. "My written expression is stylistically and grammatically correct" (x̄ = 2.85; sd = 0.89). 69.2% of respondents consider their written expression to be stylistically and grammatically correct. Students use their laptops during lectures to record key information, but there is still a large percentage of students in the classrooms who take notes by hand, therefore we also included the statement "I prefer writing on a PC over taking notes by hand in a notebook" (x̄ = 2.16; sd = 1.17). By processing the data we arrived at an interesting fact: up to 65% of students in our sample of respondents prefer handwriting notes in a notebook over writing on a PC. We relate this finding causally to reduced attention and learning problems, where listening, the learning text, and their own color-highlighted notes (the visual aspect of learning) help students remember the material. Licas & Torres (2024) in their study focused on feedback provided to Generation Z nursing students. The study involved 274 full-time second-year nursing students. The authors also confirmed that Generation Z learning styles are significantly influenced by the everyday use of modern technological devices. Effective feedback must inform the student about their progress, areas for improvement, and motivate. Effective feedback is essential for students to enable them to acquire new knowledge and skills.

Recommendations for university educators: increase your digital literacy; incorporate various visual aids into teaching; online media, new technologies, games, experiential learning; provide students with immediate feedback; focus on improving the communication skills and communication literacy of university students, their verbal and written expression.

Recommendations for Generation Z students preparing for healthcare professions: participate in educational activities aimed at acquiring and expanding their communication abilities and skills; actively engage in discussions and face-to-face conversations; improve in "reading" forms of nonverbal communication, especially in interaction with patients; create your own texts for the purpose of increasing communication literacy; strive for "digital detox" – limit time spent on online platforms.

Conclusion

People need to speak, they need someone to listen to them, to understand them, they need a sense of belonging. Communication is the foundation of social interaction. Without communication, a person feels lonely, without the possibility of establishing interpersonal relationships and expressing their feelings and needs. Basic communication abilities and skills include the ability to conduct a conversation, presentation skills, media and communication literacy. Generation Z students prefer a blended learning approach that includes face-to-face interaction as well as technological learning tools. The use of social media in education as a new tool to support learning and improve the communication and social skills of Generation Z has become a necessity. The ability to communicate in written and oral form is one of the basic prerequisites for a successful working and personal life. However, what is important is not only expressing thoughts in the native and foreign language, but also the ability to advocate one's opinions, debate with others, and present oneself and one's work (Hall et al., 2019).

Limitations of the Study

The results relate only to the persons who participated in the study. Limiting factors also include the number of respondents and the implementation of the study only among Generation Z students studying in healthcare fields at TnUAD in Trenčín.

Author: doc. PhDr. Viera Hulková, PhD., MPH Department of Nursing, Faculty of Healthcare, Trenčín University of Alexander Dubček in Trenčín ORCID 0000-0003-2631-1803

List of Bibliographic References

BERG VAN DEN, M., 2020. Jak se vzájemně chápat. Generace X,Y,Z. Praha : Grada Publishing, a.s. 232s. ISBN 978-80-271-1590-7.

BETZ, CL., 2019. Generations X, Y, and Z. Journal of Pediatric Nursing. 44: A7-A8. doi.org/10.1016/j.pedn.2018.12.013

BOSCO. 2022. Messagingapplab. [online]. Available: www.boscoapp.com/single-post/2018/07/25/hi-wru-wduwta-wruw-kk-g2g

BOUKALOVÁ, H, CERHA, O, SEDLÁČEK, M & ŠÍROVÁ, E., 2013. Psychologie komunikace. Praha : Grada Publishing, a.s. 224s. ISBN 978-80-247-4971-6.

CORPORATE ENGLISH SOLUTIONS, 2024. Language transformation: Navigating Gen Z's communication style in the workplace. [online]. Available: https://corporate.britishcouncil.org/insights/language-transformation-navigating-gen-z-communication-style-workplace

ČASTULÍNOVÁ, Z.,2021. Rozvíjanie grafomotoriky dieťaťa v kontexte komunikačnej gramotnosti. Najlepšia pedagogická a odborná skúsenosť edukačnej praxe. Bratislava : Metodicko-pedagogické centrum. 55s.

FÜLÖPOVÁ, A., 2011. Význam komunikačných zručností v zdravotníctve. Verejné zdravotníctvo [online]. VIII.

HALL, R, DRÁĽ, P, FRIDRICHOVÁ, P, HAPALOVÁ, M, LUKÁČ, S, MIŠKOLCI, J & VANČÍKOVÁ, K., 2019. Jazykové a komunikačné kompetencie. Analýza zistení o stave školstva na Slovensku. Bratislava: MESA 10. [online]. https://analyza.todarozum.sk/docs/391341001ol1a/

HUGHES, J., 2022. Communicating with Generation Z: Everything You Need to Know. [online]. Available: https://www.keg.com/news/communicating-with-generation-z-everything-you-need-to-know

HULKOVÁ, V., 2024. Generačná diverzita v ošetrovateľstve - výzva pre vzdelávanie, prax a manažment. Trenčín : TnUAD. 148 s. ISBN 978-80-8295-014-7.

HUMAIRA, R & SU-HIE, T., 2021. Gen Y and Gen Z Communication Style. Estudios de Economía Aplicada. Special Issue: Trends in Business and Humanities in the Era Beyond. Monograph. 39(1):1-18.

LEDRICK, H., 2020. Gen-Z Communication Breakdown. [online]. Available: https://nashuproar.org/33721/opinion/gen-z-communication-breakdown/

LICAS, P.Z.T. & TORRES, G.C.S., 2024. Feedback preferences of generation Z nursing students: A conjoint analysis. Teaching and Learning in Nursing 19: e449 - e454. doi.org/10.1016/j.teln.2024.01.012

ROY, S. 2022. Top 10 Ways to Effectively Communicate with Generation Z. [online]. Available: https://www.leadsquared.com/industries/education/how-higher-education-communicates-with-gen-z/

SHOREY, S, CHAN, V, RAJENDRAN, P & ANG, E., 2021. Learning styles, preferences and needs of generation Z healthcare students: Scoping review. Nurse Education in Practice. 57: (1-11). 103247. doi.org/10.1016/j.nepr.2021.103247

SOMBRET, P., 2023. Gen Z communication style: how to grasp the generation with the briefest attention span. [online]. Available: www.deskbird.com/blog/generation-z-communication-preferences

SZYMKOWIAK, A, MELOVIĆ, B, DABIĆ, M, JEGANATHAN, K & SINGH KUNDI, G., 2021. Information technology and Gen Z: The role of teachers, the internet, and technology in the education of young people. Technology in Society. 65: 101565. doi.org/10.1016/j.techsoc.2021.101565

ŠMAHAJ, J, KOLAŘÍK, M. & GLASER, O., 2022). Závislostní chování na internetu. Proměny chování generací v digitální éře. Olomouc : Univerzita Palackého. 120s. ISBN 978-80-244-6289-9.

TALHAH AJMAIN, M, RAHMAN WAN IBRISAM FIK, WA, IKRAM ALIAS, M & MARZUKI, AM., 2020. Impacts and Effective Communication on Generation Z in Industrial Revolution 4.0 Era. JETAL: Journal of English teaching & Applied Linguistics. 2(1): 37-42. doi: 10.36655/jetal.v2i1.204.

VYMĚTAL, J., 2008. Průvodce úspěšnou komunikací. Efektivní komunikace v praxi. Praha : Grada Publishing, a.s. 328s. ISBN 978-80-247-6742-0.