Academic burnout refers to a syndrome characterized by three key dimensions: emotional exhaustion stemming from intense academic pressure, depersonalization manifesting as a loss of interest toward academic tasks (cynicism), and a diminished sense of personal accomplishment (inefficacy), which pose a significant threat to students [1]. Mahmoud et al. [2] defined academic burnout as the state of exhaustion and disinterest experienced by students due to the demands and expectations associated with their studies. Essentially, academic burnout reflects a sense of inadequacy and mental exhaustion in response to the stressors and lack of resources necessary to fulfill academic responsibilities [2]. Academic burnout is a widespread issue that affects students across different disciplines, including nursing. Different studies indicated a relatively high prevalence of academic burnout among nursing students, which ranged from 25–60% [3, 4, 5, 6].
Nursing students confront unique stressors beyond the inherent demands of academic learning. Studies reported that nursing students experience burnout related to the demanding curricula and increased academic workload, which can consequently lead to high levels of stress and burnout [5]. Nursing students also face challenges such as extensive and inflexible study plans, poor time management, and lack of coping mechanisms [7]. In addition to traditional academic pressures, nursing students struggle with unpleasant clinical experiences like witnessing patient mortality and suffering, facing fear of making mistakes at the bedside, and navigating complex clinical relationships [5, 8, 9]. The authors also stated that the cumulative burden of these diverse stressors, including exposure to contagious diseases, struggling for instructors’ attention, and acquiring diverse skillsets for varied nursing roles, significantly contribute to student burnout and affect their well-being.
Academic burnout leads to negative emotional, physical, and mental reactions, causing students to feel tired, frustrated, and unmotivated, which ultimately impairs their ability to effectively learn and engage in their educational pursuits [7]. Students may feel emotionally drained and fatigued, develop a disconnected, cynical, and indifferent attitude towards their academic demands and studies, and experience a sense of inadequacy and reduced feelings of competence as a student [5, 9]. The authors also stated that students with academic burnout may also experience weakness, insomnia, anxiety, depression, hostility, aggression, nervousness, and psychological withdrawal. Students with academic burnout experience disengagement, doubt of their abilities, loss of interest for academic and clinical activities, difficulties with concentration, and retain information, which adversely affect their clinical performance, patient satisfaction, and quality of care [4]. Academic burnout also affects students’ behaviors including academic performance, influences the student faculty relationship, and impacts students' enthusiasm for education [1].
Students who are struggling with academic burnout often exhibit a concerning shift in their academic behavior [5, 9]. The authors also stated that students may become disengaged, demonstrating a lack of interest in attending classes or pursuing academic activities altogether. Furthermore, their academic pursuits may lose meaning, leading to feelings of cynicism towards their studies. This internal struggle can ultimately manifest as declining academic performance, difficulty focusing on studies, which potentially lead to lower grades [5, 9]. Recognizing the symptoms of academic burnout is therefore crucial, as it allows for early intervention aimed at promoting student well-being and ensuring continued academic achievement [1]. Nowadays, people view burnout as a public health issue because it endangers people’s physical and emotional well-being in addition to having negative social and economic effects [8]. Early recognition of these symptoms is crucial for promoting students’ well-being, academic performance, professional engagement, career satisfaction and upholding excellent nursing care, while reducing absenteeism, chronic fatigue, and depression [4].
Review of Related Literature
This review presents an overview of studies conducted about the relationship between academic burnout, quality of learning experience, self-efficacy, and psychological distress. A literature search was conducted using PubMed, PsycINFO, ScienceDirect, and Goggle Scholar to find the relationships between the variables under investigation. The keywords used were academic burnout, quality of learning experience, self-efficacy, psychological distress, nursing students, and medical students. The literature review was organized into themes, where the factors that are correlated with academic burnout are presented as the following:
Quality of Learning Experience:
The quality of learning experience can be affected by several variables, which can change based on the subject matter, the educational setting, and the participants. The following are some important factors that impact the quality of learning experience, starting with the teaching methods. An instructor's methods and strategies significantly influence the student's learning process. Understanding and retention of the information can be improved by using various engaging teaching techniques. As reported by Aghajari et al. [8], learners can better understand concepts when information is presented in an orderly and understandable manner. The authors also reported that the quality of educational content affects learning experience and academic performance. Fruitful teaching involves relating information to other knowledge, critical thinking, and real-world application. The quality of communication between professors and students is crucial. Availability and support from professors alleviate stress. Positive teacher-student relationships, counseling, feedback, and reinforcement contribute to a positive attitude towards the profession.
In terms of educational setting, the learning process can positively impact the learning experience which includes a conducive physical space with comfortable seating, proper lighting, and limited distractions [10]. In addition, appropriately integrated technology can enhance the learning experience which includes providing multimedia resources, interactive simulations, and collaborative tools [11].
In general, the relationship between academic burnout and the quality of learning experience is complex and dynamic. Students may struggle to absorb and retain information efficiently, resulting in lower-quality learning experiences. Burnout can hinder students' ability to concentrate in class and interact effectively with peers and teachers. The reduction of the student performance outcomes can result from boredom, lack of motivation, and overwhelming workload. A well-designed curriculum that includes workload balance, enhances active learning, and offers opportunities for student autonomy positively influences the quality of learning experience. Excessive workloads or lack engagement with the material lead to overwhelming and increase the risk of burnout.
Quality of learning experiences, including using multiple teaching methods and information overload, play a vital role in preventing burnout [8]. Additionally, academic burnout can impede collaborative learning opportunities as students may become disengaged or fatigued during group tasks or activities. Salmela-Aro et al. [12] stated that academic burnout can hinder students from fully engaging in their schoolwork, leading to a decline in the overall quality of learning. Signs of burnout include reduced interest in learning new information, a decreased willingness to participate in class discussions, and a diminished sense of satisfaction with the educational process [12].
Academic burnout could negatively impact the quality of learning experience. When students feel burned out, they may lose interest in their studies, leading to reduced engagement, motivation, and ultimately, a lower quality of learning experience [11]. Charkhabi et al. [1] and Mahmoud et al. [2]. The authors stated that the quality of learning experience affects students' perceptions of the inputs they receive from their educational institution, influencing their academic burnout levels and highlighting the importance of improving learning conditions to reduce burnout among students.
Self-Efficacy:
The belief in one's own ability to carry out the actions required to achieve particular goals is known as self-efficacy [13]. The belief that one can influence their own motivation, actions, and social surroundings is reflected in self-efficacy [12]. Low self-efficacy is thought to be associated with sadness, disease, and poor problem-solving abilities. It is also thought to have an impact on one's drive, passion, and learning process. A person's degree of self-efficacy also affects their sense of achievement and ability to control events. High self-efficacy individuals are also more likely to be extremely devoted than low self-efficacy individuals [14].
Self-efficacy, as used in psychology, is the belief in one's own ability to carry out the necessary actions to achieve a specific goal. It is hypothesized that self-efficacy beliefs differ based on the domain of functioning and the environment in which the activity occurs [12]. Bandura [15] has distinguished three main types of experiences that are prompted by efficacy beliefs which are choice behavior, effort expenditure and persistence, and mental processes and affective responses. The first type is choice behavior, which means people choose to work on challenging and confident tasks and avoid those [16]. The second type is effort expenditure and persistence which means that individuals’ willingness to put in a lot of effort, persevering through setbacks [7]. The third type is mental processes and affective responses, which means that efficacy beliefs affect how much stress and anxiety people feel when working on a task and how much success they feel. As a result, the authors concluded that academic burnout decreased with increasing self-efficacy [16].
Self-efficacy is a vital factor in the learning experiences of nursing students. Research consistently shows that higher self-efficacy leads to improved learning outcomes. Students with strong self-beliefs engage in active learning, persist through challenges, and seek support, which consequently results in a deeper understanding of nursing concepts and higher competence. Conversely, low self-efficacy hinders learning, leading to decreased motivation and difficulties in applying knowledge. Fostering self-efficacy is crucial for creating a positive and enriching learning environment for nursing students [1].
Academic burnout can potentially impact an individual's self-efficacy, which refers to one's confidence in their capacity to thrive in particular circumstances or achieve objectives. As burnout sets in, students may start doubting their capabilities to perform well academically. This could lead to a decrease in self-efficacy, affecting their confidence in their ability to handle academic challenges effectively, leading to lower levels of stress and burnout [12, 17].
Psychological Distress:
Psychological distress refers to emotional suffering, which includes symptoms of depression (such as loss of interest, unhappiness, and desperation) and anxiety (such as restlessness and feeling tense) [18]. It is also accompanied by various physical symptoms such as insomnia, headaches, and lack of energy, which may vary in intensity depending on the context [18]. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines psychological distress as a collection of symptoms that encompass anxiety and depression symptoms, functional impairment, troubling personality traits, and behavioral issues [19].
Psychological distress is also considered as a temporary phenomenon that arises in response to specific stressors. It manifests through disruptions in sleep patterns, changes in appetite, headaches, digestive issues, chronic pain, increased irritability, excessive fatigue, difficulties with memory and concentration, and a diminished interest in sexual activities [18]. Typically, these symptoms subside or disappear when the individual either adapts to the stressor or the stressor is eliminated.
Students experiencing high levels of psychological distress may be more susceptible to academic burnout due to the additional stressors they face. For example, individuals dealing with anxiety or depression may struggle to cope with the demands of academic life, leading to feelings of exhaustion and disengagement from their studies. Conversely, academic burnout can also exacerbate feelings of psychological distress [20].
Academic burnout is often associated with various forms of psychological distress, such as anxiety, depression, or feelings of hopelessness. The chronic stress and exhaustion associated with burnout can take a toll on student's mental health, leading to increased levels of psychological distress. In turn, it can further exacerbate academic burnout and create a vicious cycle [18].
While there are research studies exist regarding academic burnout, psychoogical distress, and self-efficacy among nursing students, there is significantly lack of research that considers the relationship between academic burnout and quality of learning experience. Most studies that have been conducted were outdated. Furthermore, there was no reserch that was implemented to investigate the academic burnout especially among nursing students in Saudi Arabia.
Purpose:
This study aimed at examining the prevalence of academic burnout, self-efficacy, psychological distress, and the quality of learning experience. It will also examine the differences in the mean scores of students’ academic burnout on their demographic characteristics. It also examines the relationship between academic burnout, self-efficacy, psychological distress, and quality of learning experience among undergraduate nursing students. By investigating the potential relationship between these variables, this research aims to provide insights into the factors affecting nursing students’ academic burnout.