Professionalism and Procrastination

By Loren Deutsch, LCSW, MA, MEd

Imagine the weight you feel with a looming deadline, unfinished work, self-doubt creeping in, and feeling paralyzed. Now, imagine a small room with ten graduate students; smart, capable, and among the most academically accomplished, contending with a radically delayed start (or finish) in their work. Procrastination jeopardizes grades, goals, and prospects. It is an academic problem, or is it?

Years ago, I ran a procrastination support group for graduate students who were smart but procrastinated their schoolwork, felt stuck, and experienced significant academic difficulty in school. Compounding these problems was an ennui that led to isolation and frustration, low achievement, and diminishing job prospects, often intertwined with feelings of stress, anxiety, and depression.

The students appeared stuck, stuck in their learning; stuck in their situation, and without any way of re-engaging, stuck in their delayed work. This meant the goal for the group seemed simple, get the students unstuck. However, the process wasn’t simple. It turns out that procrastination is complex and sets a tone for professionalism, eroding it by impacting reliability, time management, and the ability to meet commitments, among others.

Many of the students in the group were initially referred to a tutor. Tutoring can be an important academic support, focusing on knowledge gaps and backfilling content. However, tutoring is not designed to teach students about metacognitive processes, to learn how to learn, or to address underlying reasons for procrastination or the perfectionism that often exacerbates delayed starts. Like a mantra, each student said, “I need a win on this and once I get [it], I’ll hand it in [the assignment].” Unfortunately, this mantra becomes a gatekeeper to handing in the work, which is unattainable when “getting it” remains undefined.

The etiology of procrastination is not constrained to one classification, instead, procrastination is a psychological and emotional problem, sometimes with cognitive and/or neurological components interwoven, and manifesting in delayed or abandoned starts. It is agonizing for the student. One described it as a boulder on his chest giving just enough room to realize that with such limited breathing death would slowly arrive. Feelings such as these, appear to increase with special intensity as a student, graduates into the workforce. This is where a multifaceted coaching model, like that at LAS, helps.

Each year, students and early career physicians are referred to LAS with academic problems and underlying issues associated with procrastination and perfectionism. Though initially delayed starts might feel helpful, activating a low-level stress response that leads to task initiation, eventually competing demands increase, and time becomes the enemy. An adrenalin rush doesn’t work.

Starting with an initial consultation process, the LAS method begins with listening, to engage a new client asking for help. The consultation(s) include history taking, goal identification, discussion about expectations, and reasons for seeking academic coaching. The LAS method is system-based and highly collaborative. Before the initial meeting ends, we discuss the next steps and provide information and instructions to activate. As an example, when someone is seeking test prep support, the next steps may involve doing a pretest or error analysis. When someone is seeking support for a PIP, the next steps may involve a self-reflective assignment to assess certain competencies (e.g., patient care, professionalism, or evidence-based medicine) during the week.

Procrastination creates academic problems and feelings associated with perfectionism. It may emanate from situational matters (Zacks, S., and Hen, M., 2018) feelings of stress, or dysregulation (Sirois, Fuschia, M., 2023), or something else. In order to provide curated help, we must understand individual contexts.

This paper does not attempt to constrain the etiology of procrastination, instead, it serves to highlight the importance of integrative academic support, like the LAS method. This multi-faceted support is designed for psychological and emotional issues with possible cognitive and/or neurological components that manifest as delayed starts, perfectionism, and being stuck.

As problems go, procrastination is consistently inconsistent; sometimes it is unique to one setting, and other times, it is pervasive. It shows up at home, at work, and school. It is an experience familiar to parents, siblings, and friends, as well as colleagues, students, and teachers.

The procrastination support group provided integrative academic and psychological support. Engaging students involves a weekly process of sharing individual contexts, learning objectives, deadlines, and actionable steps. Weekly meetings provided a space for ten strangers to come together around a central theme with integrative academic support. In addition to group meetings, each student met with me for weekly one-on-one coaching, which allowed for individualized structure, support, and accountability. The one-on-one sessions supplemented group meetings and provided personal time and attention ensuring that each student started and completed their radically overdue work.

If you are a teacher, faculty, or staff in an academic setting, consider the academic and psychological resources available to your students. Ask yourself how those resources address academic goals and psychological objectives. Are they measurable, self-reflective, or perhaps, both? Then consider how the resources work in concert to address goals and objectives that are deeply intertwined. Consideration must be given to the fact that we cannot separate our emotions from learning and wonderment needs to give way to curiosity. Be curious about the quality of resources, the culture of silence and stigma that may exist in accessing resources, and the potential barriers.

Silence is one of the most limiting factors in academic difficulty. Most students and early career physicians in difficulty, assume they are alone, the only ones dealing with such issues. If you are on faculty or staff, consider how you inquire about delayed consult notes accruing from Monday to Friday or the last-minute slide decks that didn’t arrive before grand rounds or the digital Q-Bank questions and perhaps, thousands of Anki cards left untouched days before a high-stakes exam. If you see this or something similar, be curious. Procrastination may be hard to define, but the problem is easy to spot, and we need to address it if we’re going to provide resources that help.

Procrastination is a complex psychological and emotional behavior that impacts many facets of daily living, including learning and professional development. Tutoring is not designed to address procrastination, despite its impact on learning and education. Understanding individual strengths and challenges requires an understanding of context. This means asking questions and listening for answers, addressing silence, and providing resources that include system-based, integrative coaching without barriers.

Contact LAS for more information about training programs for faculty and staff and coaching for students and early career physicians.

References

Choi, J. N., & Moran, S. V. (2009). Why Not Procrastinate? Development and Validation of a New Active Procrastination Scale. The Journal of Social Psychology, 149(2), 195–212. https://doi.org/10.3200/SOCP.149.2.195-212

Sirois, Fuschia, M. (2023). Procrastination and Stress: A Conceptual Review of Why Context Matters. Department of Psychology, Durham University, Durham DH1 3LE, UK International Journal of Environmental Research and Public Health, 2023, 20(6), 5031; https://doi.org/10.3390/ijerph20065031

Zacks, S., & Hen, M. (2018). Academic interventions for academic procrastination: A review of the literature. Journal of Prevention & Intervention in the Community, 46(2), 117–130. https://doi.org/10.1080/10852352.2016.1198154