Relationship Between Educational Justice and Academic Burnout in Medical Interns

Copyright © 2021 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http:// creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 1. Background Educational justice means providing equal educational opportunities for students, which is often related to equality in the teacher’s treatment of students, especially in classes with great diversity and differences between students. This form of justice refers to interactions, behaviors, and practices based on fairness, impartiality, guidance commensurate. With students’ ability, observance in evaluating and providing points that can convey a sense of worth to students and subsequently create civic behaviors1 and this form of justice can improve students’ performance.2 Academic burnout creates fatigue in doing homework and study, having a pessimistic attitude towards education and curriculum, and a feeling of academic inadequacy. Burnout can lead to a lack of participation and a lack of energy to engage in academic activities. Students with burnout have no motivation to participate in class activities and exhibit behavioral characteristics such as absenteeism, the effect of class attendance, and early class leaving.3 Research shows that academic burnout is similar to burnout in terms of characteristics and consequences.4 Academic burnout in educational situations is characterized by fatigue due to study requirements, development of pessimistic and insensitive feelings and attitudes toward the curriculum, and feelings of inadequacy and poor academic achievement in academic matters.5 It is crucial for students’ academic burnout by university officials because academic burnout can affect students’ educational destiny. Still, its increase can damage students’ mental health and cause them various failures during or after their studies in their personal lives. Moreover, face a profession. While improving the educational conditions, including creating educational justice, it is possible to prevent students’ academic burnout and provide the ground for developing skills and maturity in their various scientific and practical fields.6 Khazaei et al believe that students’ encouragement and fair communication between the teacher and the student can reduce student burnout.7 Yousefi Maghsoudbeiki and Abstract Background: Poor teaching and lack of proper relations between teacher and student and various other causes affect students’ academic burnout. Objectives: Present study was conducted to determine the relationship between educational justice and academic burnout in medical interns of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Methods: This study was descriptive and analytical. The number of samples was equal to 300 medical interns identified and entered by the census sampling method. Data were completed by two questionnaires (researcher-made educational justice and burnout standard) whose reliability and validity were confirmed. Data were analyzed by SPSS Version 22. Results: There was no significant relationship between educational justice and academic burnout (P>0.05). Also, educational justice was below average and academic burnout was above average. There was a significant relationship between educational justice score and gender (P < 0.05), and there was no critical relationship with other demographic variables (P>0.05). There was no significant relationship between academic burnout score and all demographic variables (P>0.05). Conclusion: This study concluded that causes other than educational justice have been influential on students’ academic burnout. Hence, it suggested that studies be conducted on high academic burnout and identify influential variables. On the other hand, although the relationship between the two variables was not significant, due to the low level of educational justice, the university’s need for fair educational opportunities, especially professors, should be considered.


Background
Educational justice means providing equal educational opportunities for students, which is often related to equality in the teacher's treatment of students, especially in classes with great diversity and differences between students. This form of justice refers to interactions, behaviors, and practices based on fairness, impartiality, guidance commensurate. With students' ability, observance in evaluating and providing points that can convey a sense of worth to students and subsequently create civic behaviors 1 and this form of justice can improve students' performance. 2 Academic burnout creates fatigue in doing homework and study, having a pessimistic attitude towards education and curriculum, and a feeling of academic inadequacy. Burnout can lead to a lack of participation and a lack of energy to engage in academic activities. Students with burnout have no motivation to participate in class activities and exhibit behavioral characteristics such as absenteeism, the effect of class attendance, and early class leaving. 3 Research shows that academic burnout is similar to burnout in terms of characteristics and consequences. 4 Academic burnout in educational situations is characterized by fatigue due to study requirements, development of pessimistic and insensitive feelings and attitudes toward the curriculum, and feelings of inadequacy and poor academic achievement in academic matters. 5 It is crucial for students' academic burnout by university officials because academic burnout can affect students' educational destiny. Still, its increase can damage students' mental health and cause them various failures during or after their studies in their personal lives. Moreover, face a profession. While improving the educational conditions, including creating educational justice, it is possible to prevent students' academic burnout and provide the ground for developing skills and maturity in their various scientific and practical fields. 6 Khazaei et al believe that students' encouragement and fair communication between the teacher and the student can reduce student burnout. 7 Yousefi Maghsoudbeiki and Karimiyar Jahromy believe that educational justice can improve students' performance with individual differences in various fields such as academic performance, social class, economic and cultural. To achieve this kind of justice, the directors of educational institutions must change the structures and elements that have fueled these injustices. One of these essential factors is related to the behavior and beliefs of teachers that can be created by creating training courses and changing their views and practices to create equality and educational justice in the classroom. 8

Objectives
It is necessary to consider ways to deal with students' academic burnout, a category that can provide the basis and path to achieve the goals of educational and academic systems. Therefore, the present study was conducted to investigate the relationship between educational justice and students' academic burnout.

Methods
The present study was a descriptive-analytical and crosssectional study that was conducted in 2020. This study was performed on students who started their internship in 2019 at Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. The statistical population consisted of all medical interns of Ahvaz Jundishapur University of Medical Sciences. In this study, sampling was not done for all interns, with 300 people were included in the census. Inclusion criteria were students studying for an internship in 2019. They did not have mental health problems, and exclusion criteria were cases in which the questionnaire was incomplete or distorted. The intern was not satisfied to participate in the study.
Information about the variables under study through two questionnaires collected (researcher-made educational justice questionnaire and Maslach standard burnout questionnaire).
The Educational Justice Questionnaire had two sections: demographic information and questions related to educational justice. The questions of this questionnaire were arranged in the form of 9 5-choice questions based on library studies and existing internal and external articles and have a Likert scale. It completely agrees (5), agree (4), neither disagree nor agree (3), disagree (2), and I was completely against it (1). The minimum and maximum scores obtained from this study were 9 and 45, respectively. A score of each question got the total score of the questionnaire.
The total questionnaire got by the total score of each question was calculated. The content validity method and the opinion of university professors use to confirm the validity of this questionnaire. Cronbach's alpha test was used to calculate the reliability or scientific validity of the questionnaire, which was equal to 0.85.
The standard questionnaire of burnout (Maslach) had 15 questions and three dimensions of emotional fatigue (questions 1 to 7), doubt and pessimism (questions 8 to 9), and academic self-efficacy (questions 10 to 15). The response spectrum is of type 7 values, the score of which is related to each option. Never (0), Very Rarely (1), Relatively Low (2), Sometimes (3), Relatively High (4), Most of the Time (5), Always (6) Of course, this is a scoring method for questions 10-15 It is the opposite. To get points for each dimension, the sum of the points for that dimension is added together. The overall score of the questionnaire got the total score of all questions is added together. High scores in the dimension of emotional fatigue and the dimension of doubt and pessimism indicate academic burnout. In the case of the academic self-efficacy dimension, low scores indicate academic burnout.
To perform statistical analysis, SPSS software version 22 was used at a significance level of 0.05. Descriptive statistics, including mean and standard deviation, were used to describe qualitative data, and distribution and frequency percentages use to represent quantitative data. Inferential statistics also included t-test, chi-square, and Kolmogorov-Smirnov test to confirm the normality of the data.

Results
According to the results of the study, the average score of educational justice was 20.20. 3.18. The overall score of the questionnaire was 45, which is an average of 27, so educational justice was lower than average. Also, the mean score of academic burnout was 49.10. 5.99. The overall score of the questionnaire was 54, which is an average of 45, so academic burnout was above average.
Based on the results obtained from Table 1, there was no significant relationship between academic burnout score and its areas with educational justice (P > 0.05).
According to the results obtained from Table 2, 123 (41%) of the interns were male, and 177 (59%) were female. There was no significant relationship between academic burnout score and gender (P > 0.05). There was a significant relationship with gender in its two domains of emotional fatigue and academic self-efficacy (P < 0.05). Still, there was no significant relationship between gender and skepticism with gender (P > 0.05). There was an important relationship between educational justice score and gender (P < 0.05).
According to the results obtained from Table 3, the residence was 189 (63%) of the interns surveyed with their families, 92 (30.6%) were dormitories, and 19 (6.4%) were private homes. There was no significant relationship between academic burnout score and residence (P > 0.05). There was no significant relationship between residence in the two domains of emotional fatigue and academic selfefficacy (P > 0.05). Still, there was a significant relationship between doubt and pessimism with the location (P < 0.05). There was no significant relationship between educational justice score and residence (P > 0.05). According to the results obtained from Table 4, 235 (78.3%) of the interns were single, and 47 (21.7%) were married. There was no significant relationship between academic burnout score and marital status (P > 0.05). There was no significant relationship between marital status and marital status in its two domains: emotional fatigue, doubt, and pessimism (P > 0.05). Still, there was a significant relationship between academic self-efficacy and marital status (P < 0.05). There was no significant relationship between educational justice score and marital status (P > 0.05).
Based on the results obtained from Table 5, the mean age of medical interns was 27.09 1 1.23 years. There was no significant relationship between burnout score and age (P > 0.05). There was no significant relationship with age in its three domains: emotional fatigue, skepticism, and academic self-efficacy (P > 0.05). There was no significant relationship between educational justice score and age (P > 0.05).

Discussion
Teachers' belief as an influential variable in creating fair educational opportunities about gender has no role in creating equal educational opportunities among male and female students. Professors treat both sexes equally because both sexes have approximately the same perceptions in this area. Thus, students 'perception of unfair conditions may be due to professors' beliefs and views about some students and perhaps halo errors that play an essential role in implementing educational justice and creating fair opportunities for all students. 9 Marzooghi et al 10 studied students in Tehran Rehabilitation School. The results showed that educational justice could reduce the rate of student burnout. The results  of the two studies were not consistent with each other. The mismatch can be because the interns' burnout is due to factors other than educational justice. Jalalvandi et al 11 studied 201 students of Kermanshah University. The results showed that demographic characteristics are one of the factors affecting the status of educational justice in Kermanshah paramedical school, which was consistent with the present study results only in the gender variable. Thus, there was a significant relationship between educational justice and gender.
Heidarzadeh et al 12 in a study on students of Kerman University, showed that the average score of educational justice and academic burnout was less than the average. There was a significant relationship between educational justice and academic burnout, but no significant relationship was observed between educational justice and academic achievement. Educational justice is one of the variables that can affect the rate of academic burnout and academic achievement of students, which only in the variable of educational justice is consistent with the present study results. In both studies, educational justice was below average. The discrepancy between the two studies is that academic burnout was higher than average in the present study, and there is no significant relationship between educational justice and academic burnout. The mismatch can be because the interns' burnout is due to factors other than educational justice.
Yaghobi et al 13 selected and studied 275 people (64 boys and 177 girls) in a study. The results showed that educational justice and academic burnout, mediated by academic ethics, can predict self-management in students.
The results of this study can partly explain the lack of a significant relationship between educational justice and academic burnout. This study shows a relationship between educational justice and academic burnout mediated by academic ethics, so it is expected that in the present study, the mediating variable to establish a significant relationship between educational justice and academic burnout is examined.

Conclusion
Based on the results of this study, there was no significant relationship between educational justice and academic burnout. Also, educational justice was below average and academic burnout was above average. It can conclude that causes other than educational justice have been effective on students' academic burnout, so it is suggested that studies be conducted on the cause of high student burnout and identify effective variables. On the other hand, although the relationship between the two variables was not significant, due to the low level of educational justice, the university's need to create fair educational opportunities, especially professors, should be considered. Finally, it is suggested to identify the mediating variable to establish a significant relationship between academic burnout and educational justice.