Burnout and Turnover… the Missing Variable: Why Professional Development Matters More Than Ever

Burnout and Turnover… the Missing Variable: Why Professional Development Matters More Than Ever

By Terri Schmitt, PhD, APRN, FNP-BC, FAANP, Executive Director

It’s June again, and I find myself writing about exactly the same topic I wrote about in 2025… Burnout. Not to be redundant, but action to rectify burnout and turnover must continue at all levels, including awareness and our work at NPACE. In a closer look at this topic in recent months, a deeper dive into literature and NPACE’s own data provided new insights and an ever-developing call to action. We continue to hear the same words across healthcare: burnout, fatigue, shortage, turnover… What is becoming increasingly clear is burnout and fatigue is not simply about working too hard, but something deeper.

Burnout as Disconnection

Research concerning APP turnover and burnout debunks idea of individual resilience as the key contributor. Across published reports, burnout is recorded at an alarming rate of 25 to 37% among surveyed APPs and is strongly associated with intent to leave, making it a central driver of workforce instability and cost.^1-3 Contributing factors include clinician administrative burden, limited support, compensation and autonomy in regards to both too much and too little.^1-5,7 However, two other variables emerge in literature as contributing; weak professional connections and lack of meaningful professional development.^1-2,6-8 At the core, burnout reflects loss of meaning and connection. While focus is often on staffing or resilience training, pizza parties or ‘thank you’ days, organizations are overlooking one of the most powerful and underutilized solutions.

The Missing Variable: Professional Development

The literature provides important insight; engagement in continuing education and good professional development improves job satisfaction, reduces burnout, and strengthens retention.

But not all education is created equal. I realize ‘good’ is a subjective term, but most clinicians recognize the difference between good and not good professional development.

Poorly structured, time-burdensome CME can actually increase stress, contributing to provider frustration.^9-11 In contrast, high-quality, engaging, relevant, interactive, education aligned with real clinical practice can help restore what burnout erodes.^9-12Education directly supports three of the four domains most closely tied to burnout prevention by helping with competence, connection, and meaning. Meeting in good education, finding your people who experience what you experience and learning together, sharing experience, this is where the transformation can begin to happen.

New Evidence: The Cost of Getting This Wrong

New research presented at the 2026 AAPA conference reinforces the urgency of this issue.

APP turnover is not just a workforce concern. Turnover can become a financial and operational crisis for institutions. Noted in this recent research, the cost of replacing a single APP ranges from $150,000 to $250,000. Turnover can create a loss of over $5 million annually for mid-sized organizations. Contributing variables to turnover included underutilization of APP skills, poor onboarding, compensation inequities and lack of role clarity.¹³ I strongly propose that good professional development and connection could help mitigate these variables. These findings though, directly align with the truth that turnover is not random, being the predictable result of systems that fail to support professional growth and engagement.

What Our NPACE Community Reports

Our own needs assessment data tells a similar story. In a recent aggregated review of all of our Needs Assessment data since 2023, APPs ask for more relevant, practical education, current guidelines and medication updates, information to support navigating complex clinical care, and opportunities for connection, while desiring moments to press pause and fill their own cup. At the same time this deep dive shows growing barriers to high-quality CME as employer funding for professional development continues to erode, practice time constraints for requested days off grows (particularly for CME), and misalignment between content offered to clinicians and real-world needs. Clinicians who do engage in meaningful professional development through NPACE events report knowledge gains. In our grant funded 6-week to 3-month follow-up surveys, attendees report increased clinical confidence, improved decision-making and high satisfaction and engagement.

We gather data not just to report how great we are, but to provide a light to the profession. This data is not just feedback… It’s a roadmap.

Where NPACE Fits In

At NPACE, we are uniquely positioned to address this gap, because what we provide is not just education. Unique, engaging, relevant content and connection both live and on-demand. Information relevant to practicing APPs, whether in events or our podcast. Our goal is connection, growth, renewal of purpose, rest/wellness pauses, and confidence. In other words, NPACE works to rebuild what burnout takes away.

If healthcare is truly going to address burnout and turnover, we must start thinking differently. Burnout is not just an individual issue to manage. It is a system-level challenge that requires system-level solutions. And professional development must be viewed not as a requirement, but as a strategic investment in workforce stability, patient care, and organizational success.

I would add that the profession needs to hold itself accountable for calling clinicians to seek out their own excellent professional development and not just free access. Updated knowledge means better patient outcomes.

If you are an APP, invest in your own professional growth and seek out meaningful education and connection

If you are a leader, recognize professional development not as a cost, but a retention strategy. Support your APPs in accessing high-quality CME and advocate for them in budgeting and at all levels for time away to learn and connect.

As a professional community, we must move beyond talking about burnout and actually addressing what drives it. Because when we restore competence, connection, and meaning… We rebuild the profession.

References

1. Poghosyan, L., Liu, J., Shang, J., & D’Aunno, T. (2021). Primary care practice environment and burnout among nurse practitioners. Journal for Nurse Practitioners, 17(2), 157–162. https://doi.org/10.1016/j.nurpra.2020.11.009
2. Kennedy, L., Brom, H., Lasater, K., Albert, N. et al. the US Clinician Well-being Study Consortium (2025). Advanced Practice Registered Nurse Burnout in Magnet Hospitals: Opportunities for Organizational Intervention. JONA: The Journal of Nursing Administration 55(4):p 230-236. DOI: 10.1097/NNA.0000000000001566
3. Poghosyan, L., et al. (2024). Drivers of hospital nurse practitioner turnover: A national sample survey analysis. Nursing Outlook, 72(4), 102180. https://doi.org/10.1016/j.outlook.2024.102180
4. Kapu, A. N., Borg Card, E., Jackson, H., Kleinpell, R., Kendall, J., Lupear, B. K., et al. (2019). Assessing and addressing practitioner burnout: Results from an advanced practice registered nurse health and well-being study. Journal of the American Association of Nurse Practitioners, 33(1), 38–48. https://doi.org/10.1097/JXX.0000000000000324
5. Kim, D. K., Scott, P., Poghosyan, L., & Martsolf, G. R. (2024). Burnout, job satisfaction, and turnover intention among primary care nurse practitioners with their own patient panels. Nursing Outlook, 72(4), 102190. https://doi.org/10.1016/j.outlook.2024.102190
6. Melnyk, B. M., Strait, L. A., Beckett, C., Hsieh, A. P., Messinger, J., & Masciola, R. (2023). The state of mental health, burnout, mattering and perceived wellness culture in Doctorally prepared nursing faculty with implications for action. Worldviews on Evidence-Based Nursing, 20, 142–152. https://doi.org/10.1111/wvn.12632
7. Strobehn, P. K., Barnes, H., Bellury, L. M., & Randolph, J. J. (2024). U.S. nurse practitioner voluntary turnover: Development of a framework for analysis. Journal of the American Association of Nurse Practitioners, 36(4), 210–218.
8. Venegas, B., Benitez, E., Matthews, R., Brandt, A. et al. (2023). Factors Affecting Turnover of Advanced Practice Providers: A University Teaching Hospital Review. Journal of Healthcare Management, 68(1):p 15-24. DOI: 10.1097/JHM-D-21-00279
9. Gelaw YM, Hanoch K and Adini B (2023) Burnout and resilience at work among health professionals serving in tertiary hospitals, in Ethiopia. Front. Public Health 11:1118450. doi: 10.3389/fpubh.2023.1118450
10. Kushnir, T., Cohen, A.H. and Kitai, E. (2000), Continuing medical education and primary physicians’ job stress, burnout and dissatisfaction. Medical Education, 34: 430-436. https://doi.org/10.1046/j.1365-2923.2000.00538.x
11. Wolf, C. (2023). Fired Up or Burned Out: The Relationship Between Self-Efficacy and Burnout Among Physician Assistant Program Directors and Principal Faculty. Journal of Allied Health, 52 (4), Winter 2023, pp. 163E-170E(8)
12. Kushnir, T., Cohen, A. H., & Kitai, E. (2000). Continuing medical education and primary physicians’ job stress, burnout and dissatisfaction. Medical Education, 34(6), 430–436. https://doi.org/10.1046/j.1365-2923.2000.00538.x

Blumfeld, M. (2026). APP Turnover creates high economic and operational burdens for health systems. Research report at 2026 National AAPA conference. Reported in Clinical Advisor. Retrieved from https://www.clinicaladvisor.com/reports/app-turnover-economic-operational-burdens/