Shedding light on the causes of academic procrastination among nursing students: A qualitative descriptive study.

BACKGROUND: Academic procrastination is a complex phenomenon and a common behavior among nursing students. Due to procrastinating behaviors, students cannot show their real performances in learning processes. In order to stop this behavior, it is crucial to know the most common causes of procrastination in the first place. The aim of this study was to identify a variety of different possible factors influencing academic procrastination among nursing students. MATERIALS AND
METHOD: A qualitative study method with the content analysis approach was conducted from October 2019 to March 2020. Participants were 67 nursing students and 8 nursing educators from 3 nursing schools in Iran. Face-to-face semi-structured interviews and focus group discussions were used for data gathering. An inductive approach to content analysis was used for data analysis.
RESULTS: Five categories and 24 subcategories emerged from the data analysis: "student-related factors," "educator-related factor," "assignment characteristic-related factors," "institution-related factors," and "nursing work-related factors."
CONCLUSIONS: The present study showed that nursing students' academic procrastination can have a wide range of causes and a comprehensive effort is needed to address the problems. The result of our study will be useful to nursing students, educators, and nursing administrators in relation to what constitutes nursing students' academic procrastination, as well as how nursing education can play an effective role in decreasing tendency to procrastination. Copyright:

Introduction

Procrastination is a widespread and too familiar phenomenon to most people.[1] A common definition of procrastination is “the purposive postponement in the beginning, implementation or fulfillment of an action and usually accompanied by subjective discomfort.”[2] Academic procrastination is a complex phenomenon and the most common form of procrastination, which is a dominant, frequent tendency among learners to delay educational activities.[3] Learners need to carry out an academic task or activity, such as writing a term paper, completion of academic project, or doing weekly assignments, but, for some reasons, they failed to do an academic activity within the estimated time frame.[4]

According to the studies carried out in order to determine the causes of the academic procrastination behavior, it is concluded that low motivation to learn, lack of time management skills, negative emotions, perfectionism, and laziness were the main reasons of academic procrastination.[35] Although many studies presented the causes of the academic procrastination, the factors contributing to the formation of academic procrastination in nursing students may differ from other students. Nursing students encounter enormous stresses[6] and challenges to meet the educational process demands than other study programs.[7] Nursing students confront an extraordinarily different experience in clinical courses, overwhelming course loads,[89] standardized testing, and balancing personal, social, and scholarly demands.[10] In addition, different atmospheres of nursing schools may affect memory, concentration, problem-solving ability, and may lead to decreased learning, coping, and academic performance.[1112]

Studies on academic procrastination among Iranian nursing students are very limited, and several years’ experience of authors in nursing education showed that many students experience academic procrastination, as well as they cannot show their real performances in learning processes. Continued experiences of academic procrastination during the educational process of nursing students not only can impact their learning and academic performance but also even decrease professionalism behaviors and the quality of patient care provided by students. In order to stop academic procrastination, it is important to know the most common causes of procrastination in the first place. Hence, this study was aimed to investigate the causes of academic procrastination among nursing students.

Materials and Methods

Study design

A qualitative study with the content analysis approach was used for the data collection and analysis. Content analysis is a systematic coding and categorizing approach. The aim of this approach is to extract and organize meaning derived from interviews or textual information to catch realistic conclusions from it and to ascertain the trends and patterns of communication.[13]

Settings and participants

Data were collected from October 2019 to March 2020. Participants were 2nd -, 3rd -, and 4rd -year baccalaureate nursing students and nursing educators selected from three schools of nursing in Iran, including Ramsar School of Nursing, Babol School of Nursing, and Neyshabur School of Nursing [Table 1]. The research settings and the environments were selected based on the researchers’ access to these three faculties.

Table 1

Participant distribution in individual interviews and focus groups

School	Participant	Individual interview	Focus group
Ramsar School of Nursing	Educator	n=3 (1=18 years, 1=14 years, 1=3 years of experience in nursing educating and faculty member)
	Student	n=14 (5 in sophomore, 4 in junior, and 5 in senior level)	n=5, 2nd-year students n=6, 3rd-year students n=5, 4th-year students
Babol School of Nursing	Educator	n=3 (1=10 years, 1=6 years, 1=9 years of experience in nursing educating and faculty member)
	Student	n=9 (2 in sophomore, 4 in junior, and 3 in senior level)	n=6, 4th-year students n=5, 3rd-year students
Neyshabur School of Nursing	Educator	n=2 (1=23 years, 1=6 years of experience in nursing educating and faculty member)
	Student	n=6 (2 in sophomore, 2 in junior, and 2 in senior level)	n=6, 4th-year students n=6, 2nd-year students

The study population for individual interviews comprised 29 baccalaureate nursing students in different semesters and 8 nursing educators. Furthermore, focus groups were conducted with 38 nursing students.

Participants were chosen by purposeful sampling, to catch a wide range of perspectives, based on strongest to weakest students in the classroom and years of educators’ experience as a nursing faculty member [Table 1]. No one refused to participate or dropped out from the study.

Altogether 67 students, 19–25 years of age mean (standard deviation [SD]): 22.3 (1.5), participated in the study. The majority were female (n = 41). Eight faculty educators, 29–56 years of age mean (SD):41.8 (9.4), participated in the study. The majority were female (n = 6), n = 4 held master's degrees and n = 4 held PhD degrees, and all educators taught full time [Table 1].

Data collection

In order to attain the study's aim, face-to-face semi-structured interviews and focus groups were conducted.

Face-to-face semi-structured interviews were conducted in a private place that was convenient to the participants. Each interview lasted between 40 and 50 min.

Seven focus groups, each with 5–6 students, were conducted. Focus groups enable the researcher to collect data from a conversation between participants, as well as it is useful to achieving participants experience and exploring not only what participants think, but also how they think that way.[14] The focus group has given the students the opportunity to listen to classmates having similar experiences and created an atmosphere of openness and honesty. The heterogeneous composition of each group, in terms of academic level, assisted exploration of diverse perspectives.

In a comfortable setting convenient to the participants, the corresponding author (female and professor assistant in nursing), as the moderator, explained the aim of the study, personal goals, reasons for doing the research, and then encouraged the participants to discuss the topic, facilitated interactions among members, interjected probing comments, transitional questions, and summarized the issues. A colleague managed the audiotape recording and took notes during the interviews, as well as observing interpersonal interactions and encouraging quiet members of the groups to participate actively. The focus groups lasted between 50 and 75 min.

The researcher tried to conduct the interview without bias, prejudices, and assumptions. Some measures to reduce bias in this study were as follows: researchers constantly were confronted their opinions and prejudices during data gathering, as well as they were asked the participants who provided the data whether researchers’ interpretations seem to be representative of their beliefs.

The major explorative questions were: From your experience as a nursing student, what are the causes of academic procrastination?

From your experience as a nursing educator, what are the causes of academic procrastination in nursing students?

The questions were asked in an open-ended manner. The interviewer probed participant responses using questions, such as “Could you say something more about that?” ‘When you mention…what do you mean?

All interviews were taped, and the scripts were immediately transcribed verbatim. Iterative data collection and analysis proceeded concurrently. When the responses were repeated and no new data were added to a previous interview, data saturation was determined and interviews were concluded.[15]

Data analysis

An inductive approach to content analysis was used. In line with the qualitative content analysis approach put forth by Elo and Kyngäs,[13] data were analyzed via the following steps:

Transcribing interview verbatim

Choosing the unit of analysis

Attaining the sense of whole via the reading the unit of analysis

Taking codes out through open coding

Collecting similar codes in subthemes by comparing the codes and labeling them

Gathering similar subthemes together in one group and labeling theme (main themes).

Trustworthiness of data

The trustworthiness of this study was conducted according to Lincoln and Guba criteria such as credibility, dependability, conformability, and transferability.[16] Credibility of the data was sought using of member checking, peer debriefing and the external auditThe dependability of the data analysis was estimated. In this regard, an audit trail was maintained from the initial data collection through the determination of categories and themes. An external audit was conducted by a nursing professor assistant familiar with qualitative data analysis and checked all steps taken in the analysis process. He then reviewed the complete audit trail for this study and agreed with the findings. To achieve maximum variation, participants were selected based on different demographic variables such as age, gender and level of academic semester.

Ethical issues

Ethical issues in this study involved the assurance of confidentiality and autonomy for the participants. The Internal Review Board of Babol University of Medical Sciences approved the study before data collection began (ethical code: MUBABOL.HRI.REC.1396.132). Permission, as written informed consent, was sought from the participants for the audiotaped interviews. All the participants were asked to participate under the premise that information would be anonymized and would remain confidential. The data were stored safely where only the researcher could access it.

Results

Five categories and 24 subcategories emerged from the data analysis, including “student-related factors,” “educator-related factor,” “assignment characteristic-related factors,” “institution-related factors,” and “nursing work-related factors.” Categories and subcategories are inserted in Table 2.

Table 2

Factors affecting the emergence of academic procrastination in Iranian nursing students

Categories	Subcategories
Student-related factors	lack of interest in nursing
	Poor time management skills
	Fatigue
	Low self-confidence
	Lack sufficient knowledge
	Prefer to do fun activities and hobbies
Educator-related factors	Traditional and boring teaching methods
	Unfair evaluation
	Lack of the role model educators who guide students to do academic tasks
	Failure to introduce proper reference for assignments
	Failure of pursuit of the academic assignments
Assignment characteristic-related factors	Ambiguous assignments
	Boring and not interesting assignments
	Repetitious assignments
	Unnecessary and useless tasks
	Disharmony between tasks and course goals
Institution-related factors	Poor scheduling of courses
	Numerous exams and tasks at the end of the semester
	Numerous theoretical and clinical courses in a semester
	Lack of library facilities
Nursing work-related factors	Nursing as an undervalued profession
	Routine-centered work
	Lack of authority in nursing
	Career opportunities in nursing profession

Student-related factors

The study participants presented many examples, which indicated the main causes of academic procrastination resulting from students’ interests, personal characteristics, and their learning abilities. A large number of students frequently expressed that they have picked the wrong major in college, and their lack of interest in nursing is the main reason for their tendency to academic procrastination.

A second-year student in a focus group said that: “Like most of the classmates, when I was in high school, my dream was to be a doctor; although I studied hard, I failed in the medical entrance exam. I accepted into nursing faculty and now I’m a disappointed nursing student. Most of us didn’t choose nursing based on our interests. We have no interest in learning nursing lessons and doing academic projects.”

An educator indicated that: “it is clear that our students are not interested in nursing and this is the most important cause of their lack of attention in class and their tendency to procrastination behaviors.”

The students declared that fatigue due to long hours of presence in the classes and clinical course is one of the most important causes of their academic procrastination.

Usually we are in the hospital for clinical courses, from 7 am to 1 pm, and after 1 h of rest, our theoretical classes begin 2 pm and lasts up to 6 pm. we always exhausted at the end of the day and we have no energy to doing homework.

Findings from the participants’ interview revealed that poor time management skill is the other cause of academic procrastination. Students stated that due to many reasons such as working while studying or spending too much time on social media, they have not enough time to do academic assignments.

A junior student said that: I am a victim of social media and my lack of ability to manage time. I spend >5 h a day on aimless activities in social media. At the end of the day, I realize that all of my time wasted and I didn’t care about my homework. I know, I haven’t time management skill.

The participants’ narrations showed that lack of sufficient knowledge and low self-confidence were other causes of academic procrastination.

I have not got enough confidence and knowledge to administer my academic assignments independently (a sophomore).

I don’t trust myself to do a good job because I don’t have enough knowledge for doing course projects (a junior student).

The participants’ narrations showed that a lot of students prefer fun activities to doing course works or assignments.

I postpone the academic activities because I love fun, getting together with my friends and going to the gym…I prefer doing an attractive activity to doing boring course works (a senior student).

Within the first category, the role of students in academic procrastination was highlighted. The result of the study showed that lack of interest in nursing was the main cause of academic procrastination. Nursing administrative boards and nursing educators should create a positive and stimulating educational environment for students as well as motivate students to maintain their interest in nursing. Another result from the first category showed that many students struggle with managing their time well and avoiding procrastination, as well as they suffered from lack of organizational skills and self-confidence. There are different effective time management tips for students such as, making a project plan, setting realistic day-to-day goals, setting goals for each study session and working on one thing at a time.[1718] These solutions should be introduced to students. The authors of this study believe that the support of students from faculty members plays a pivotal role in improving the knowledge and self-regulation skill of nursing students. Promoting the confidence climate can lead to decreasing academic procrastination rate.

Educator- related factors

Findings from the participants’ interview revealed that methods and techniques of teaching play an important role in the formation of the students’ procrastination behavior.

I think the methods of teaching in classrooms play a crucial role in our academic performance. There is no doubt that when our teachers use traditional teaching methods, by reading content of lessons just from PowerPoint and when they don’t engage student in the teaching process, can lead to decreasing students’ attention to lessons and course projects (a senior).

Nursing teachers and students believed that having a guide and role model to support students to do assignments and projects successfully is the important effective masseurs to decreasing academic procrastination.

Imagine implementation of the nursing process on patient bed is our assignment. When I want to do a nursing process, I am doubtful, I don’t trust myself, I need educator to be with me and assure me that I am doing it right. I need a role model to performing the nursing process before me. I think self-confidence can contribute to decrease postponing the academic assignments.

Another factor for academic procrastination among the participants was the teachers’ approach to evaluation and pursuit of students’ coursework. The students indicated that they faced so many difficulties regarding coursework evaluation process in both theoretical and clinical courses. The majority of students employed the word “unfair and prejudgment” to portray their experiences of coursework evaluation. They talked about some kind of unfair evaluation, which led to their academic procrastination.

Students in a focus group indicated that: instructors do not care about the quality of our assignments and do not read our papers carefully. When there is no difference between the score of good or bad quality papers, why do we do assignments perfectly?

Some of my classmates did not write their coursework paper, but the same scores were given to all of us. They did not deserve the given scores (a sophomore).

A senior about the failure of pursuit of the academic assignments said that: usually our educators give us an academic project and then they don’t follow up our working process. I think continuous follow up of students’ academic work is extremely important to prevent procrastination behavior.

Moreover, the participants’ narrations showed that the students had not been clearly informed about project and coursework references. Based on the participants’ words: students should know what the coursework reference is? Or, which reference is comprehensive and better? Frequently, confusion about references leads to the loss of students’ ability to do the project.

Within the second category, the role of educators in students’ academic procrastination was highlighted. In this regard, not only teaching methods and teacher manner was the cause of academic procrastination, but also the type of evaluation was stated as the cause of academic procrastination. Educators play a key role in student's academic procrastination, and they have the opportunity to help students get a handle on academic procrastination. Participants indicated that instructors did not assess student papers carefully. Showing a careless approach in this regard was mentioned by the students as a cause of academic procrastination. The educator's behavior in evaluation of students can play an important role in academic procrastination, so instructors should modify and develop their evaluation skills.

Assignment characteristic-related factors

The participants’ narrations showed that the task characteristics such as a boring assignment or ambiguous project were the causes of their academic procrastination. Students indicated that they are interested in doing assignments that are clear, interesting, and useful in the future.

“I try not to do any repetitive and boring assignments. I leave the tasks till I am given assurance that tasks are interesting and non-repetitive (a junior student).”

“I think the assignments are very unnecessary. Emphasizing on information that we won’t use in the future, get me down. Instructors should find what is substantial and applicable for students’ future career, and then make students’ coursework accordingly (a junior).”

Moreover, students have recognized the existence of a disharmony between the type of coursework and course goals, as well as they said that this problem is one of the main causes of their academic procrastination.

Our instructors asked us to search articles and translate articles from English to Persian, because they wanted to use these in their own projects. We think it is not fair to force students to do such home works unrelated to their course goals (the seniors in focus group).

The causes of procrastination resulting from assignment characteristic were shown in this category. Students tended to procrastinate when they perceived their tasks as stressful, confusing, and when not allowing them to show their skills and create self-confidence. Furthermore, students believed that their assignments are uninteresting, unclear and unrewarded. Our findings support the need to reform the course works and assignments in order to create attractive, nonrepetitive, and applicable tasks.

Institution-related factors

Institutional conditions such as poor scheduling of courses, numerous tasks at the end of semesters, too many classes and clinical courses in one semester, as well as the lack of library facilities were the other causes of academic procrastination in the students’ view. Students believed that the poor conditions created by the institute would lead to fatigue and stress for them.

A senior student said that: “There are too many exams and tasks at the end of the semester. Sometimes we haven’t enough time to doing tasks.”

A sophomore student said that: “Course planning in our faculty is very bad, we have class 6-days a week. Always we have too many classes and tasks; we live in a stressful atmosphere with a chronic fatigue. Actually we have no energy to do course work.”

“There is a shortage of medical-surgical books in library of our faculty and we encountered a problem to complete the task (a junior).”

Within the fourth category, the role of institutional condition in students’ academic procrastination was highlighted. The participants were concerned that too many exams, tasks, and classes in a semester can lead to fatigue, stress, and postpone in doing course works. Participants noted that stressful situations impair students’ learning process. Stress affects many aspects of nursing students’ lives. Researchers believe that different atmospheres of nursing schools and high levels of stress among nursing students have been associated with poor academic performance, memory and concentration problems, and deficiencies in problem-solving ability. Hence, nurse managers need to be alert to the fact that nursing students may already be suffering from significant stress/fatigue.

Nursing work-related factors

The statements of participants reflect matching textbook descriptions of professional nurse with the reality of clinical practice; there is an ongoing problem faced by students. Participants believed that there is a difference between what nursing students had learned in the theoretical classes and what in reality was expected of students in clinical situations. According to the students, “I have no desire to do assignments about nursing holistic care or nursing process because we just do basic nursing care. We are just a simple worker with some routine-based duties, such as giving the drugs and injections, changing the sheets, and dressing wounds. We spend four years to study nursing, but we do not feel we are doing a professional job. This practice does not need hard projects and tasks about professional nursing.”

Some students said that “having no authority to practice independently was the main cause of our academic procrastination.” They considered nurses under the physicians’ orders shadow, which did not allow them to intervene, according to their own clinical judgment. Such a condition resulted in academic procrastination because the students considered the lessons and assignments useless and futile for performing routine care and doctors’ order.

“Most of the time I see experienced nurses who just follow the doctor's orders and act just as a robot without their own knowledge. I think, the main goal of nursing is to simply follow the doctor's orders and provide basic routine care, not the holistic care. So, I no need extra burden to do hard home work when I would be one nurse like this in the future.”

Furthermore, students expressed that good career opportunities in nursing profession were the other cause of academic procrastination. They believe that when there is a shortage of nurses, all nurses given the job. There is no difference between good or bad students for nursing employment, so why students should do assignments for giving well scores (a senior).

Within the last category, the role of the nature of nursing in students’ academic procrastination was highlighted. Students in our study thought that a routine-based paradigm is the dominant part of clinical education and their work is a doctor's order follower and not really professional nursing care. These conditions led to their disappointment and lack of interest in implementing educational projects. In fact, students imagine their future career when observing the nursing work in real conditions and they think doing course projects about professional nursing is a futile work. We recommend that nursing faculties and hospital administrators guide nurses to professional care rather than routine-based care. Although a good career opportunity is one of the important benefits of nursing job, students believe that this situation provokes them into academic procrastination. Students think it is not important whether they graduate with a good grade or bad grade; finally, they will find jobs anyway. About the role of nursing managers in the recruitment process, it should be noted that they should seek ways to select competent nurses and pay attention to the quality of nurse resume

Discussion

This study provided an opportunity to find the comprehension and experiences of nursing students and educators regarding the causes of academic procrastination. We obtained a multifaceted description of cause of academic procrastination from the students and educators’ perspective. After content analysis, we identified five categories.

According to the first category, lack of interest in nursing was the main cause of academic procrastination. This finding is supported by another study in Iran.[19] This is a common experience for Iranian nursing students; creating a positive and supportive learning environment can increase students interest in nursing. Furthermore, many students struggle with managing their time well. Similarly, participants of a study concerned that they did not have enough time doing assignments.[5] Having knowledge, organizational skills, and self-confidence are the essential things for doing academic project, and students of our study suffered from lack of these skills. Other studies in Iran confirmed this finding.[2021]

Data from the second category showed that not only teaching methods and teacher manner was the cause of academic procrastination, but also the type of evaluation was stated as the cause of academic procrastination. A study also reported the same results, and they founded that some factors such as teacher's approach, failure of pursuit of the project papers, and inequity of the evaluation system are the main causes of academic procrastination.[22]

The causes of procrastination resulting from assignment characteristic were shown in the third category. Similar to our results, the authors in another study[23] concluded that students tended to procrastinate when they perceived their tasks as stressful, confusing, uninteresting, unclearly instructed, as well as not associated with norms expecting the prompt completion of tasks. Their findings support the need to reform the course works and assignments in order to create attractive, nonrepetitive, and applicable tasks. Moreover, a disharmony was recognized between evaluation goals and the type of coursework. Oermann and Gaberson[24] commented that expected competencies and type of course works should be matched with those in the curriculum and course plan.

Institutional condition was the other predictor of academic procrastination. Similar to our result, Jimenez et al.[25] indicated that nursing students are under considerable pressure and stress during a long time clinical course and classes. Nurse managers need to be alert to the fact that nursing students may already be suffering from significant stress/fatigue.[26]

Factors related to the nature of nursing were the other predictor of academic procrastination. These factors were specific to nursing students. The result of our study showed that climate of hospital is not a motivator to working on professional nursing projects with students as well as routine-based paradigm led to students’ disappointment and lack of interest in implementing educational projects. This finding is supported by other studies in Iran.[272829] We recommend that nursing faculties and hospital administrators guide nurses to professional care rather than routine-based care.

Limitations of the study

This study focused on students and educators’ perspectives and experiences from three nursing faculties in Iran. The perspectives of other faculties in Iran were not collected during the data-gathering process. In order to increase the generalizability of data, it is recommended to assess the causes of academic procrastination in other nursing faculties in Iran.

Conclusions

The significance of the present study lies in the fact that enhanced awareness and increased understanding about the cause of academic procrastination can be important factors in improving nursing education and the quality of the nursing profession. Our study showed that the academic procrastination can have a wide range of causes and comprehensive effort is needed to address the problems. This study will be useful to nursing students, educators, and administrators in relation to what constitutes nursing students’ academic procrastination and how nursing education can play an effective role in decreasing tendency to academic procrastination in order to devise strategies to attract students to the nursing profession and promote their abilities to doing academic expectations.

Financial support and sponsorship

This work was supported by the Babol University of Medical Sciences under Grant (number 4509).

Conflicts of interest

There are no conflicts of interest.