Date of Award

Fall 11-12-2024

Embargo Period

11-21-2027

Document Type

Dissertation - MUSC Only

Degree Name

Doctor of Philosophy (PhD) in Nursing Science

Department

Nursing

College

College of Nursing

First Advisor

Michelle Nichols

Second Advisor

Martina Mueller

Third Advisor

Benjamin Doolittle

Abstract

Burnout and poor mental health are pervasive among clinical health professions students and are leading causes of attrition. While knowledge about burnout prevention and resilience training continue to grow, there is a significant gap in understanding how students define flourishing and what factors promote flourishing among students. This dissertation is a compendium of five manuscripts. The first is an integrative review of the drivers and barriers of clinical health profession student flourishing that was used to inform the development of an exploratory sequential mixed-methods study resulting in the remaining four manuscripts. Manuscripts two and three explore the use of a novel, self-weighted scoring approach to the Secure Flourish Index that accounts for individual values in the measurement of flourishing. The fourth manuscript explores the relationship between the social determinants of health and student flourishing. The fifth manuscript integrates interview data with the survey results to further explain student perceptions and values of the domains of flourishing accounting for the social determinants of health. The findings from manuscript two shows a difference in mean flourishing when individual values are applied to the domains to create a weighted score as compared to the traditional scoring approach. Manuscript three shows that social and economic needs as well as avoidant coping style are highly negatively correlated with student flourishing. Manuscript four shows that on average, students have at least one unmet social determinant of health need and that students with higher needs are significantly more likely to consider leaving training than those with low needs. Manuscript five shows that students define flourishing in multiple unique ways, however many of these definitions include reference to personal growth, multi-factorial thriving, and a balance between happiness and success. Additionally, students across all levels of SDOH need (no current unmet needs through three or more unmet needs) experience financial stress throughout training and depend largely on their support network for coping with both academic and personal stress. Student’s individual values, intrinsic characteristics, and social and economic needs are all intertwined with their ability to flourish through training and should be considered when developing wellness instruments for screening as well as interventions.

Rights

Copyright is held by the author. All rights reserved.

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Available for download on Sunday, November 21, 2027

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