Background Advanced Practice Providers (APPs) in emergency and urgent care settings experience high burnout rates, yet limited research examines cognitive factors influencing professional fulfillment. The Empowerment Dynamic framework suggests outcome-oriented thinking may protect against burnout compared to problem-oriented patterns.

Objective To examine relationships between cognitive mindset orientation, professional fulfillment, and burnout among APPs while providing preliminary validation of a novel cognitive assessment instrument.

Methods Cross-sectional survey of licensed APPs working in emergency departments and urgent care facilities across two health systems (July–October 2025). Professional fulfillment and burnout were measured using the Stanford Professional Fulfillment Index; cognitive orientation was assessed using a newly developed 22-item instrument.

Results Among 98 respondents (19.5% response rate), mean professional fulfillment was 5.8 and mean burnout was 4.5; 40.8% met burnout criteria. Professional fulfillment and burnout were inversely correlated (r = −0.62; P < .001). Problem orientation correlated positively with burnout (r = 0.56) and negatively with fulfillment (r = −0.36), while outcome orientation showed opposite patterns (burnout: r = −0.57; fulfillment: r = 0.44). In multivariable models, outcome orientation remained independently associated with lower burnout (β = −1.51; P = .003) and higher fulfillment (β = 1.73; P = .002).

Conclusions Cognitive mindset orientation is associated with burnout and professional fulfillment among APPs. The novel assessment instrument demonstrates acceptable psychometric properties. Future longitudinal studies are needed to establish causality and evaluate cognitive interventions for burnout prevention.

The authors have declared no competing interest.

This study did not receive any funding

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Advocate Health Wake Forest University Health Sciences Institutional Review Board waived ethical approval for this work

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