Too Much Spare Time May Undermine First-Year Healthcare Students’ Leisure Skills

First-year healthcare students at Hanoi Medical University who reported having more free time actually scored worse on measures of managing that time, according to a new mixed-methods study from Vietnam. The research, published in Discover Education, surveyed 610 first-year students across all ten of the university’s majors and followed up with in-depth interviews with twelve of them. Less than half of the surveyed students—43.1 percent—met the study’s threshold for good free time management, while 56.9 percent struggled to organize their non-obligatory hours effectively.

The study, led by Nhi Tho Tran and colleagues, used a cross-sectional sequential explanatory mixed-methods design. Between July and October 2024, the team distributed a census-based questionnaire to all 1,161 first-year students, achieving a 60.21 percent response rate. After excluding invalid responses, 610 surveys remained for analysis. More than half of the participants were female (58.4 percent) and came from rural areas (59.7 percent); the largest group studied Doctor of Medicine (33.1 percent), followed by Preventive Medicine (14.6 percent) and Advanced Practice Nursing (12.1 percent). Most students lived with family (43.1 percent) or friends (44.8 percent), 61.8 percent took part in extracurricular activities, and 34.3 percent held part-time jobs. The researchers then purposively selected twelve students from the highest and lowest quartiles of the Free Time Management Scale for semi-structured interviews, reaching content saturation by the tenth interview and conducting two more to confirm consistency.

The measurement instrument was the Free Time Management Scale developed by Wang and colleagues, adapted and validated for Vietnamese use. It contains twelve items across three dimensions: free time technique, free time attitudes, and scheduling, each rated on a five-point Likert scale. The subscales showed Cronbach’s alpha values of 0.88, 0.81, and 0.72 respectively, and confirmatory factor analysis indicated satisfactory fit, with a comparative fit index of 0.93 and a root mean square error of approximation of 0.08. Students scoring at least 42 points, equivalent to 70 percent of the maximum, were classified as good free time managers.

The results revealed a telling pattern across the three constructs. Free time attitudes scored highest, with means ranging from 3.51 to 3.77, including a mean of 3.77 for the item stating that free time use is important. Free time technique fell in the moderate range, from 3.09 to 3.40, with setting priorities scoring highest at 3.40 and making a to-do list lowest at 3.09. Scheduling was the weakest dimension, with means from 2.77 to 3.42. Notably, the highest-rated scheduling item was the statement that making schedules wastes time, at 3.42, while the lowest was the belief that free time is too unpredictable, at 2.77. In short, students valued their leisure hours but were least skilled at structuring them.

The multivariable logistic regression identified two facilitators of good free time management. Students with part-time jobs had higher odds of good management than those without, with an adjusted odds ratio of 1.44 and a 95 percent confidence interval of 1.01 to 2.06. Task-managing method also mattered: compared with students who relied on self-memorization, those who recorded tasks on computers or laptops had an adjusted odds ratio of 2.09, and those using tablets had an adjusted odds ratio of 2.40. Mobile phone use, by contrast, did not maintain a statistically significant association after adjustment, and paper-based note-taking did not differ significantly from self-memorization, with an adjusted odds ratio of 1.23 and a p-value of 0.522. The Hosmer-Lemeshow goodness-of-fit test showed no evidence of poor fit for the model.

The interviews helped explain these statistical patterns. Seven of the twelve interviewees identified self-discipline as the primary driver of their time management, and several linked that discipline to the demands of juggling coursework with jobs or extracurricular commitments. One student described how good discipline helped them accomplish tasks planned in advance while guarding against distraction, and another noted that work pressure pushed them to accomplish everything well, even during time meant for rest. At the same time, half of the interviewees admitted that procrastination disrupted their schedules, with some reporting that they pushed tasks late into the night or to the next morning when motivation flagged. One participant explained that whether they managed their free time to complete a task depended on how important they perceived that task to be. External pressure emerged as a double-edged factor: deadlines and expectations initially spurred planning and urgency, but the same student who credited pressure with motivation also reported losing motivation when tired or under pressure from others, describing a slide from initial excitement into fatigue and emotional disengagement.

Perhaps the most counterintuitive finding concerned the sheer amount of unstructured time. Students reported an average of 4.73 hours of free time per weekday and 8.50 hours per weekend day, yet linear regression showed a significant negative association between available free time and management scores for both weekdays and weekends. The weekday slope was statistically significant at p = 0.010 with a 95 percent confidence interval of -0.45 to -0.06, and the weekend slope at p = 0.002 with an interval of -0.24 to -0.05. The authors interpret this through what they call the time abundance effect: when temporal constraints are loose, the perceived urgency of tasks drops, undermining the forethought and self-monitoring needed to act, and leaving students vulnerable to procrastination and behavioral drift. Exactly half of the interviewed participants explicitly said that a lack of immediate external pressure or rigid scheduling boundaries triggered procrastination, and the authors argue that without structural temporal boundaries, excessive free time can act as a behavioral trap rather than a resource.

The smartphone paradox also received attention in the discussion. Although phones possess scheduling capabilities, the authors argue that their dominant role in social media use, entertainment, and instant messaging fragments cognitive focus through constant notifications and rapid app-switching, neutralizing any organizational benefit. Larger, academically oriented devices such as tablets and computers appeared more effective, and interviewees praised digital calendars for providing clear, systematic, and eye-catching tracking. The team suggests that the effectiveness of digital tools depends on students’ self-regulatory capacity, and recommends measures such as app time limits, focus modes, and periodic digital detoxes to keep technology serving productivity rather than distraction. The discussion also points to evidence-based anti-procrastination strategies, including the Pomodoro method, breaking large tasks into smaller chunks, and setting intermediate deadlines, as approaches for maintaining momentum under heavy workloads.

The study carries several important limitations. Its cross-sectional design prevents causal inference, so the associations between part-time work, device use, and management skills cannot be interpreted as cause and effect. Voluntary participation may have introduced self-selection bias, and the authors acknowledge that students with naturally stronger organizational skills may simply be more inclined to adopt digital planning tools, rather than the technology itself driving better outcomes. The 70 percent cut-off for classifying good management is one of several possible thresholds, and alternative cut-offs could yield different categorizations; the authors suggest sensitivity analyses or treating the scale as a continuous variable in future work. Self-reported scale responses are also subject to recall bias and subjective perception. Notably, the study found no significant gender differences in free time management, a result the interview narratives corroborated, with male and female participants describing the same structural barriers of curriculum overload, digital distraction, and the need for self-discipline.

Set against the broader context of medical education, the findings carry weight. Previous research cited by the authors indicates that more than half of medical students meet criteria for academic burnout at some point during training, with severe emotional exhaustion emerging as early as the first year, and meta-analytic findings suggest nearly 30 percent of medical trainees experience clinical depressive symptoms. Prior studies in Turkey and Taiwan have linked effective free time management to greater motivation, quality of life, and well-being, and one study found that free time management accounted for 19.6 percent of the variance in students’ quality of life. The authors call for longitudinal research to track how these skills change over time and for training programs that build scheduling ability, self-discipline, and coping strategies. For students navigating one of the most demanding curricula in higher education, the message is that leisure hours are not merely a buffer against stress but a resource that, left unstructured, can quietly work against the very recovery they are meant to provide.

Subject of Research: Free time management and its associated factors among first-year healthcare students at Hanoi Medical University

Article Title: A mixed methods approach to explore free time management in first year healthcare students at Hanoi Medical University

Article References: Tran, N. T., Nguyen, H. G., Dang, C. P., Le, D. M., & Tran, H. T. (2026). A mixed methods approach to explore free time management in first year healthcare students at Hanoi Medical University. Discover Education, 5(1), Article 1229. https://doi.org/10.1007/s44217-026-02348-2

Image Credits: AI Generated

DOI: 10.1007/s44217-026-02348-2

Keywords: free time management, healthcare students, Hanoi Medical University, mixed methods, procrastination, self-discipline, digital task management, part-time work, student well-being, burnout, Vietnam, cross-sectional study