Rasch analysis of the professional fulfillment index burnout scale in early-career physical therapists

Burnout is prevalent in physical therapists with recent estimates reporting up to 52% of physical therapists experience burnout post-COVID-19 pandemic. Burnout is problematic because it is associated with poor mental health, poor patient care, and leaving the profession. Understanding the phenomenon and progression of burnout is a pressing need to inform examination and eventual interventions, especially among early-career physical therapists who may leave the profession within a few years. A valid and reliable measure based on current burnout theory should be able to identify physical therapists with varying degrees of burnout and inform interventions.

The study tested the dimensionality, rating-scale structure, item and person fit, item difficulty hierarchy, reliability, and separation of the Professional Fulfillment Index (PFI) burnout scale in a sample of early-career physical therapists.

A Rasch analysis with the Andrich rating scale model was conducted with survey data using a cross-sectional design. Inclusion criteria were physical therapists with 5 years or less of practice since initial United States (US) licensure.

Participants were 420 early-career physical therapists. Approximately, 68% of participants experienced burnout. Principal component analysis of residuals suggests that the PFI burnout scale is unidimensional, with no item dependency. The rating-scale structure met model criteria. One item, "physical exhaustion," misfit but met criteria for retention. The item difficulty hierarchy aligned with burnout progression theories. Only 8.5% of participants misfit the model. No floor or ceiling effect was found. The scale demonstrated high person reliability and separation, indicating it can quantify burnout in people reliably and separate persons into four distinct burnout levels.

The PFI burnout scale is appropriate for measuring burnout in early-career physical therapists. The interval scale conversion and item difficulty hierarchy may assist in detecting burnout early and testing intervention effectiveness.