Medical professionals are busy people and exist in a constant state of “being busy.” How do we resolve chronic “busy-ness”? How do we manage our time effectively? In her recent talk at the CORD Academic Assembly 2020, Dr. Christina Shenvi, EM Physician and Associate Residency Director at UNC, provided 5 key actions to help us be productive, complete our work effectively, and strive for work-life balance. Dr. Shenvi recorded her lecture again to be shared with the ALiEM Faculty Incubator. This series of posts breaks down her talk into 3 sections in order to summarize her key points and to help us “Banish Busy” from our lives. This first post will address the importance of value-based scheduling and how to avoid self-sabotage.
0:48 Why does this matter? Maximize our time by being strategic and efficient
2:00 How can we reduce clutter and reduce distraction?
3:01 Activity A: Brain Dump! Write down all your distractions!
Key point #1: Practice value-based scheduling
3:46 How do we determine which actions are worthy of our attention?
4:27 What are our Big Values? How can we align our time to them?
8:48 Activity B: Write down your “Big Hairy Audacious Goals” and Important values
Key point #2: Avoid self-sabotage
9:09 Why do we self-sabotage?
10:01: Why do we procrastinate?
10:53 What is self-worth theory and how do we protect our self-worth?
12:42 Why are we programmed to withhold effort and make excuses?
15:46 What is defensive pessimism and why do we use it?
16:54 Why do we procrastinate?
Before we begin: remove distractors
The only way to increase productivity is to be strategic about what we do and efficient in how we do it. A jumbled, muddied, and disorganized mind prevents productivity.
“Mind trash” are key distractors that take attention away from our important and relevant work.
“Brain Dump:” When working on something of importance and “mind trash” floats to the surface, write it down but do not take action on this “trash;” remain focused on more important tasks. The goal is to move from avoidance to action but also from overwhelmed to control.
There are 5 key actions that we can take to help us take control of our time. In this section, we address the first of these actions and start to discuss the second key action.
Value-based scheduling (Attention∝Worth)
Big values are the values that truly matter to each of us. These “big values” should be the metric we utilize to evaluate if we are spending our time wisely. These values should form our “big hairy audacious goal” (BHAG) .
This approach provides clarity and maintains momentum towards accomplishing these goals.
BHAGs should be specific and not abstract, including exact numbers and dates of completion.
BHAG can pertain to multiple arenas of our life including personal and professional goals.
Once we have identified our BHAG, small changes and accomplishments will all accumulate and progress towards a BHAG. A BHAG should NOT be the role we want to be in but should represent our vision. Overall, time spent and effort used should reflect our big values!
Since time management is chiefly intertwined with emotion management, the inability to manage negative moods often leads to procrastination . This association is based on the self-worth theory (SWT). Self-worth is a critical dimension of human functioning. The theory explains many aspects of how we both assess and protect our self-worth and the effects that has on our time management:
The theory states that individuals will protect their self-worth at all costs.
When there is a fear of failure, an individual will sever the tie between ability and performance by decreasing effort.
This is a maladaptive behavior that we use to protect our self-worth in case of failure.
This concept is called self-worth protection (SWP) strategies [3-6].
SWP strategy #1: Self-sabotage and ready excuses or alibis
When we fail, there is a direct relationship between effort and shame. If we have put in high levels of effort and fail, we experience high levels of shame. Having excuses for our failures decreases our feelings of shame significantly. Along with excuses, putting in lower effort will lead to the lowest levels of shame. While low effort may increase guilt, “Shame eats guilt for breakfast.” Guilt will be tolerated to extinguish feelings of shame. Failure with low effort and built-in excuses protects self-worth. Pitfall: If success occurs, there can be inappropriate inflation of our own perceived abilities.
SWP strategy #2: Defensive pessimism
This concept is the idea of creating self-fulfilling prophecies of failure for ourselves. “This talk is going to be terrible” or “I’m going to fail this test.” This effectively lowers our self-expectations and protects ourselves from shame. Another concept, reflectivity, allows us to combat defensive pessimism. Reflectivity is considering the worst result versus the more likely consequences of a poor performance and creating perspective.
Why we procrastinate:
When thinking about procrastination, it is helpful to think of the energy needed to start a project. The “activation energy” requires overcoming fear of failure, self-preservation strategies and the avoidance of negative emotions. If we avoid starting a project, we avoid the possibility of failure. Furthermore, we use procrastination as a self-worth protection mechanism, which also raises the activation barrier to starting a project [7, 8]. Finally, we frequently procrastinate to avoid the negative emotions associated with a task. If we anticipate feeling boredom, anxiety, insecurity, or self-doubt when performing a task or working on a project, then we tend to procrastinate.
Procrastinators who avoid maximum effort do so for various reasons:
To avoid the negative emotions
To protect of self-worth
To protect the feelings of those less successful such as protecting family members that are less successful
To avoid mockery or unwanted attention such as ‘nerd’ or ‘geek’ or ‘gunner’ or ‘workaholic’
To rebel against authority
To gain revenge in a passive-aggressive nature
Coming soon in Part 2:
How often do we get in our own way when starting or finishing a project? In part 2, Dr. Shenvi discusses seven ways to help keep us from being our worst enemy by avoiding self-sabotage.
Collins, J, Porras, J. Built to last: successful habits of visionary companies. New York: Harper Business Essentials. 2004.
Cano, F., Martin, A.J., Ginns, P. et al. Students’ self-worth protection and approaches to learning in higher education: predictors and consequences. High Educ 76, 163–181 (2018). https://doi.org/10.1007/s10734-017-0215-0
Covington M. The Self-Worth Theory of Achievement Motivation: Findings and Implications. Elem Sch J. 1984;85(1):5-20. doi:10.1086/461388
Covington M. Goal Theory, Motivation, and School Achievement: An Integrative Review. Annu Rev Psychol. 2000;51(1):171-200. doi:10.1146/annurev.psych.51.1.171