The Influence of Institutional-level Factors on Burnout Among Graduate Nursing Students

Abstract

Introduction: Burnout, stemming from chronic exposure to job-related stress, has long been recognized as a significant concern among healthcare professionals, particularly nurses. With the onset of the COVID-19 pandemic, the spotlight on healthcare workers' experiences has intensified, prompting extensive research into the phenomenon of burnout. While much attention has been directed towards practicing nurses, there has been a notable gap in understanding the impact of burnout on nursing students. A systematic literature review has synthesized existing research, revealing four main themes: the scope of the issue, risk factors, protective factors, and interventions. However, the majority of studies have focused on individual-level factors, highlighting a need for further investigation into how institutional-level factors contribute to burnout among nursing students. Methods: This study conducted a secondary analysis of cross-sectional survey data from a larger study on burnout among underrepresented minority (URM) graduate health professional students. Factor analysis was employed to streamline the campus climate variables. Descriptive statistics were computed for both the campus climate variables and the Maslach Burnout Inventory (MBI-SS) sub-scores, the dependent variables. Statistical tests, including chi-square and t-tests, were utilized to assess significant differences in score distributions between non-URM and URM, as well as non-first-generation college student (FGCS) and FGCS subgroups. Logistic regression was employed to examine the association between institutional-level variables and scores on the MBI subscales, with regression models expanded to incorporate potential interaction terms. Results: This study found that 33.3% of respondents had high-level emotional exhaustion, 15.7% of respondents had high-level depersonalization, and 54.9% of respondents had high-level reduced personal achievement. In relation to institutional-level factors, this study found that higher levels of stress related to the academic environment are correlated with increased feelings of depersonalization among nursing students and that FGCS status exacerbates this relationship. Additionally, it was found that when students perceive the program environment more negatively, their sense of professional achievement tends to decrease and that URM status exacerbates this relationship. Discussion/Conclusion: Nursing programs should prioritize the development and implementation of preventive strategies to alleviate stressors within the academic environment and enhance the environment of the nursing program. This entails fostering positive relationships among students and between students and faculty or preceptors. While the broad recommendation to improve the program environment may seem daunting, focusing on helping students cope with their feelings about the program could offer more practical benefits. Additionally, initiatives promoting diversity, inclusivity, and tailored support services for vulnerable student groups, such as URM and FGCS, should be established. Addressing these factors contributing to burnout among nursing students is pivotal for cultivating a resilient and healthier nursing workforce, thereby enhancing patient care quality and healthcare system efficiency.