Abstract
BACKGROUND: Academic cyberslacking among medical students represents a complex behavioral adaptation shaped by personal, technological, and institutional factors. This study explores its triggers, sustaining mechanisms, and long-term impacts, addressing how digital distractions evolve into entrenched patterns during medical education. METHODS: Using Straussian grounded theory, in-depth interviews were conducted with 35 medical students from two medical universities in China. The analysis followed a structured approach to identify the phased progression of academic cyberslacking behaviors. RESULTS: Findings reveal a three-phase model. In the trigger stage, students initially engage in digital distractions due to autonomy deficiency, psychological coping, and peer influences. The sustain stage is driven by algorithmic reinforcement, device dependency, and cognitive overload, making disengagement increasingly difficult. Finally, in the impact stage, prolonged cyberslacking leads to motivation decline, cognitive fragmentation, and adaptive digital integration, where students either struggle with disengagement or develop strategic coping mechanisms. CONCLUSION: Academic cyberslacking is not merely a distraction but a multifaceted adaptation process. Recognizing its structured progression informs medical education strategies, policy reforms, and wellbeing interventions. The study highlights the need for institutional responses integrating digital literacy, cognitive load management, and technology-aware curriculum design to mitigate public health risks in digitalized learning environments.