Related Experiment Video
Updated: Aug 5, 2026
Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Moral distress in the PA profession
Noël E Smith1, Sean Kolhoff, Eric D Tetzlaff
1Noël E. Smith is a scholar-in-residence in the PA Leadership and Learning Academy at the University of Maryland, Baltimore in Baltimore, MD. Sean Kolhoff is a director of research for the American Academy of Physician Associates in Alexandria, VA. Eric D. Tetzlaff is an assistant professor in the Department of Hematology/Oncology at the Fox Chase Cancer Center in Philadelphia, PA. E.D. Tetzlaff discloses institutional receipt of a grant from the Association of PAs in Oncology. The authors have disclosed no other potential conflicts of interest, financial or otherwise.
Objective:
To examine the relationship among moral distress, burnout, and organizational climate, and to identify how these factors influence physician associates' (PAs') intent to leave their position.
Methods:
A total of 327 PAs completed a survey containing measures of organizational climate, moral distress, and burnout. Linear and logistic regressions were calculated to examine the relationship among moral distress, burnout, organizational climate, and intent to leave.
Results:
Burnout related to emotional exhaustion and depersonalization had a positive, statistically significant association with a PA's level of moral distress. Organizational climate, feelings of moral distress, and emotional exhaustion played a role in a PA's decision to leave a position.
Conclusions:
Understanding the interaction between moral distress and intent to leave can help improve PA well-being and reduce turnover. Future interventions aimed at addressing moral distress should target PAs who indicate they are experiencing emotional exhaustion, depersonalization, and a lack of agency in their current workplace.
Related Concept Videos
01:27Ethical Issues
Ethical Concerns in Healthcare:
01:29Professional Values
The values that are the foundation of the nursing profession are altruism, autonomy, human dignity, and social justice.
First, altruism refers to the concern for the welfare and well-being of others without personal...
01:17Ethical Dilemmas I
Let us explore some examples to understand the potentially complex moral decisions nurses face.
Take the case of caring for minors, particularly in areas related to reproductive...
01:08Obedience
01:30Ethical Dilemmas II
01:25Ethical Standards I
The Code of Ethics provisions outline the nurse's duty to the patient, the healthcare team, the profession, and society. The Code's fundamental principles include advocacy,...