The results showed that most of the participants had an average resilience scores. The mean of resilience in this study was similar to the mean of resilience in 194 Indian students, which was 26.31±6.28 . However, the mean of resilience in this study was low compared to other studies that used the same measure. For example, the mean of 240 nursing students from Australia was (37 ± 7) , the mean of 439 nursing students from Saudi Arabia was (32.26 ±5) , and over 81% of nursing students sample in Egypt were highly resilient . As a result, the findings of this study may be attributed to the stressful academic and clinical environment in Palestine, especially since the data was collected during the COVID-19 pandemic.
This study revealed that the participants had average level of burnout, whereas 21.3% of the sample had high level of burnout. The high level of burnout in this study is concerning compared with the findings in other studies. Abram & Jacobowitz  found that the mean of burnout using the same measure was 23 in 119 nursing students from the US. Lopes & Nihei  found that 6% of 284 nursing students from Brazil presented high burnout. Quina Galdino et al.,  found that 10.5% of 114 nursing students from Brazil had indicative of burnout syndrome. The burnout in this study was considered high compared with burnout in registered nurses working in Arabic and surrounding countries. Alshawish & Nairat  found that the prevalence of burnout was10.6% among 207 nurses and midwives working in the Palestinian governmental primary health care centers in the north of the West Bank. In addition, Al Barmawi et al.,  found in their study in Jordan that most nurses had low burnout. However, higher burnout compared to those in our study was found in a longitudinal survey by Rudman & Gustavsson  who revealed high burnout in Swedish nursing students (from 30% to 41%) across three years in higher education. An increase in depressive mood and less fulfillment with life, arising stress in academic, clinical, and personal life, online learning, and the consequences of the Covid-19 pandemic can be attributed to the high level of burnout.
The findings in this study revealed an inverse correlation between burnout and resilience (r= -.35). This finding is congruent with the findings in previous literature in which burnout negatively correlated to resilience (r = - 0.55, p< .01) (Rios-Risquez et al. 2016), (r = - 0·472, P < 0·001) , (r = -.486, p < .01) .
The unfortunate findings in this study revealed that almost half of the students were not satisfied when they joined the nursing program, and half of the students intend to leave nursing profession in the future. On the other hand, students who intend to stay in the nursing profession had higher resilience and lower burnout. According to Flinkman et al.,  literature review, nurses' intention to leave the profession varied from 4% to 54% across international studies. A study conducted in South Korea by Kim et al.,  revealed that 17.6% of 3rd and 4th nursing students had turnover intention within two years of career. Additional study in China revealed that half of the participants (49.1%) reported they would not choose to be on a nursing course if given a choice, 45.4% thought of not going into the nursing profession in the future, and 23.7% considered entering a healthcare industry that has zero contact with patients . Ulupınar & Aydogan  found that 42.5% (n=428) of new graduate nurses in the first years of their career had considered leaving nursing. In Sweden, 10–20% of fresh graduates have considered leaving the profession . In the Arabic counties, no studies were found regarding the intention to leave among undergraduates. The findings of this study are unfortunate, students reported a higher percentage of not viewing nursing as a lifelong career before actually starting to practice nursing than those in previous studies who intended to leave after being employed. Students are expected to have the desire to pursue their dream and study their major based on their preferences. Academic and clinical stress, poor academic performance , low satisfaction about their field of study , changes in health , low resilience , online learning , unrealistic job expectations, poor work conditions, demands exceeding resources, increased work hazards, insufficient autonomy, and control over practice [45, 46,47,48]. These all considered reasons behind nursing students' intention to leave nursing profession in Palestine.
The results also showed that male nursing students have higher resilience compared to females. The survey findings are in tandem with findings of previous research [24, 49]. Boardman et al.,  found that the heritability of resilience is higher among men than women. This implies that genetic factors play an essential role in heritable resilience to environmental stressors, as mediated by more proximate measures of psychological functioning. This study demonstrates that gender differences in resilience factors are influenced by the idea that men and women have unique personality traits that influence how they cope with adversity. For instance, in Arabic countries, men tend to communicate less and are taught to suppress their emotions during adversity as they receive less help and empathy than women who express more and earn more empathy and other forms of support. In addition, women are more likely to rely on familial and community protective factors, while men depend more on individual protective factors .
In this study, students who were working parallel to their nursing studies had higher resilience. Discussion on workers’ work-life balance has been ongoing since the 1980s. Maintaining a good work and life balance is one of the progressing issues academics face in higher education institutions . Ching & Cheung  found that having a paid job predicted resilience. Working aids in developing resilience by fostering competence in the face of, and professional growth following, workplace adversity . In addition, students who exercise/ play sports had higher resilience, and lower burnout than those who do not exercise/play sports. Many studies have found that physical activity/exercise is one frequently mentioned factor for promoting resilience [55, 56]. The healthy weight of physical activity on resilience can be attributed to that it can induce positive physiological and psychological improvements, guard against the effects of stressful events, and minimize several neurological diseases . Students who live on campus had higher resilience; this finding was consistent with the study by Dawson & Pooley , which revealed that perceived parental autonomy support in first-year university students was associated with higher resilience. Perceived parental autonomy support enables students to rely on themselves, make their own decisions, encouraging them to explore, find, and decide based on their interests, values, and goals, which develops resilience.
The results also revealed that students who did not receive support from family and friends had higher burnout. Studies have shown that individuals can redefine a problematic situation as less threatening when they perceive a high level of support from their social network and regulate emotions like mistrust, anxiety, and fear more effectively . A meta-analysis of 19 studies and 95,434 participants established that social support was negatively correlated with student burnout . Therefore, receiving support from society is crucial for university students as it affects their motivation towards study.
Students who smoke had higher burnout compared to those who did not. Similarly, Kinnunen et al.,  in their study found that daily smoking was most common among those who had a high level of school burnout, and the stress and coping model of substance use proposes that people with more stress, feelings of distress, and a lack of other coping resources (e.g., social support) may smoke cigarettes to cope with stress .
The study's findings revealed that students at higher academic levels (3rd and 4th year) have higher burnout than those in their first and second years. The results were in harmony with the longitudinal study by Rudman & Gustavsson,  which found an increase in study burnout (from 30% to 41%) across three years in higher education, and levels of both exhaustion and disengagement increased significantly across the years in education (p < 0.001). Similarly, Quina Galdino et al.  found that the more advanced the school year, the higher the exhaustion (p=0.003), depersonalization (p<0.001), and low academic effectiveness (p=0.012) scores. This finding may be correlated to the fact that students at higher educational levels have advanced subjects, higher practical workload, and are challenged to experience activities as nurses in training in the internship field. Besides, the proximity to the completion of the course brings uncertainties, doubts, and concerns regarding insertion in the labor market, approval in selective processes, and expectations regarding professional success.
The results revealed that students with lower GPAs, studying an hour or less daily, and studying a day or less before the exam, have higher burnout. In comparison, students who study a week or more before the exam have higher resilience. Rahmatpour et al.,  similarly revealed in his study on 303 students at the Guilan University of Medical Sciences that lower GPA (β = −1.17, P = 0.002), Students with less interest in their field of study (β = −0.42, P = 0.000), Students who postponed their studies to latter days of semester which are close to examinations (β = 0.22, P = 0.000) were associated with higher academic burnout. In addition, Lee et al.,  study showed that students with higher GPAs have more self-confidence and experience less academic burnout. Furthermore, postponing studying to the exam day can cause the student to become more stressed and more academic burnout.