Introduction
In recent years, the phenomenon of overqualification has emerged as a growing challenge in the labor market, particularly in health-related professions. Overqualification refers to a situation in which an individual’s level of education, skills, and competencies exceeds the requirements of their current job. This issue encompasses both objective and subjective dimensions and can significantly affect individuals’ attitudes, job performance, and mental and physical health. Among healthcare professionals, nurses — as the largest group of clinical service providers — play a crucial role in care quality and patient satisfaction. The studies have shown that they have also been affected by this phenomenon. Reports from countries such as Greece and China indicate a notable prevalence of perceived overqualification among nurses with postgraduate education. Despite the importance of this issue, limited research has been conducted on nurses’ overqualification, and no comprehensive review was found. Therefore, the present study aims to provide a comprehensive review of the outcomes of overqualification and its related variables among nurses. The primary focus was on examining the psychological, occupational, and organizational consequences of overqualification among nurses. 

Methods
This is a review study. A systematic search was carried out across major international and national databases, including PubMed, Scopus, Web of Science, Google Scholar, Scientific Information Database (SID), Iranmedex, and Magiran. Keywords in both English and Persian were used combined using Boolean operators. Additionally, a manual search was performed in the articles. The quantitative studies related to the outcomes of overqualification among nurses were included, with no restrictions on language or year of publication. Studies that did not focus on nurses, lacked relevant data, or had no accessible full texts were excluded. Key information from each study, such as country, study design, sample size, study outcomes, and main findings, was extracted and recorded in a structured format. Data analysis was conducted descriptively and thematically, guided by conceptual frameworks such as the Conservation of Resources Theory and Person-Job Fit Theory. In total, 39 articles were identified. After initial screening based on titles and abstracts, 8 studies were selected for full-text review. Ultimately, 6 articles that fully met the inclusion criteria and study objectives were included in the final analysis.

Results
All included studies had a quantitative, cross-sectional design. Geographically, three studies were conducted in China, two in Greece, and one in Jordan. Among them, one article was published in Greek, while the remaining five were in English. All six studies included nurses with varying educational backgrounds (e.g., bachelor’s, master’s) and did not impose educational restrictions on their sample selection. Each study utilized the 9-item scale of perceived overqualification (SPOQ) developed by Maynard et al. [44] to assess perceived overqualification. The results demonstrated several statistically significant relationships between perceived overqualification and key occupational and psychological outcomes among nurses (P<0.05). Specifically, perceived overqualification showed a negative correlation with job engagement (r=-0.562) and job satisfaction (r=-0.674), and a positive correlation with job boredom (β=0.44) and job burnout (r=0.12). Moreover, perceived overqualification was positively associated with nurses’ silence regarding patient safety (β=0.18, P<0.01), knowledge hoarding (r=0.32), knowledge hiding (r=0.49), and obsessive passion (r=0.087). Conversely, it was negatively correlated with harmonious passion (r=-0.076) and with affective and normative commitment. Overall, these findings suggest that perceived overqualification is an occupational risk factor that can undermine nurses’ motivation, affective commitment, and job engagement, while increasing counterproductive behaviors such as organizational silence and knowledge hiding.

Conclusion
The findings highlight perceived overqualification as a risk factor in the nursing profession. Overqualification is consistently associated with negative psychological, behavioral, and organizational outcomes, including diminished job satisfaction and engagement, increased organizational silence and knowledge hoarding, and reduced service-oriented behaviors. Given nurses’ central role in healthcare delivery, addressing this issue is imperative. Nurse managers are encouraged to adopt supportive strategies that align job roles with nurses’ competencies and skills. Creating a work environment that values and utilizes nurses’ skills can mitigate the adverse effects of overqualification and promote motivation, satisfaction, and organizational commitment. Proactive interventions in workforce planning, role enrichment, and career development are essential to ensure that nurses remain engaged, empowered, and committed within the healthcare system.

Ethical Considerations
Compliance with ethical guidelines
This is a review study with no animal or human samples. Therefore, the need for ethical approval code was waived. 

Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for profit sectors.

Authors' contributions
The authors contributed equally to the preparation of this manuscript.

Conflict of interest
The authors declare no conflicts of interest. 
 

References

1. Zhao LJ, Zhao SM, Zeng H, Bai JY. To share or not to share? A moderated mediation model of the relationship between perceived overqualification and knowledge sharing. Baltic J Manag. 2021; 16(5):681-98. [Link]
2. Li Y, Wu M, Li N, Zhang M. Dual relational model of perceived overqualification: Employee's self-concept and task performance. Int J Sel Assess. 2019; 27(4):381-91. [DOI:10.1111/ijsa.12261]
3. van Dijk H, Shantz A, Alfes K. Welcome to the bright side: Why, how, and when overqualification enhances performance. Hum Resour Manag Rev. 2020; 30(2):100688. [DOI:10.1016/j.hrmr.2019.04.004]
4. Piotrowska M. Job attributes affect the relationship between perceived overqualification and retention. Future Bus J. 2022; 8(1):38. [Link]
5. Almagharbeh BKA, Ilkhanizadeh SJRdAdE. The role of overqualification, decision, and mindfulness on knowledge outcomes. Rev Adm Empresas 2022; 62(3):e2021-0471. [Link]
6. Gonçalves JM, Borges-Andrade JEJ. Perceived overqualification and job attitudes of public servants. Rev Bras Gestão Negócios. 2024; 26(1):e20230158. [Link]
7. Guo YF, Wang Y, Plummer V, Cross W, Lam L, Wang KF. Associations between perceived overqualification, organisational commitment and work passion of nurses: A multicentre cross-sectional study. J Nurs Manag. 2022; 30(5):1273-82. [DOI:10.1111/jonm.13610]
8. Li C, Shi H, Zhang Y, Zhao Y, Li T, Zhou L, et al. Association between perceived overqualification, work engagement, job satisfaction among nurses: A cross-sectional study. BMJ Open. 2024; 14(7):e081672. [Link]
9. Rahimi M, Hassani M, Ghalavandi H. The effect of job demand, role ambiguity, perceived overqualification and organizational support on employee well-being. J Organ Cult Manag. 2024; 22(3):211-27. [DOI:10.22059/jomc.2024.369963.1008625]
10. Huang YF, Hu YT. A moderated mediating model of perceived overqualification and task i-deals-roles of prove goal orientation and climate for inclusion. Chin Manag Stud. 2022; 16(2):382-96. [DOI:10.1108/cms-10-2020-0453]
11. Green F, Zhu YJOep. Overqualification, job dissatisfaction, and increasing dispersion in the returns to graduate education. Oxford Econ Pap. 2010; 62(4):740-63. [Link]
12. Wu CH, Luksyte A, Parker SK. Overqualification and subjective well-being at work: The moderating role of job autonomy and culture. Soc Indic Res. 2015; 121(3):917-37. [Link]
13. Li W, Xu A, Lu M, Lin G, Wo T, Xi X. Influence of primary health care physicians' perceived overqualification on turnover intention in China. Qual Manag Health Care. 2020; 29(3):158-63. [Link]
14. Wassermann M, Fujishiro K, Hoppe A. The effect of perceived overqualification on job satisfaction and career satisfaction among immigrants: Does host national identity matter? Int J Intercult Relat. 2017; 61:77-87. [DOI:10.1016/j.ijintrel.2017.09.001]
15. Erdogan B, Bauer TN. Perceived overqualification and its outcomes: The moderating role of empowerment. J Appl Psychol. 2009; 94(2):557-65. [Link]
16. Zhang M, Wang F, Li N. The effect of perceived overqualification on creative performance: Person-organization fit perspective. Front Psychol. 2021; 12:582367. [Link]
17. Berk U, Kahya M, Kuzu B, Bayranlık H. Effect of laborers’overqualification perception on job satisfaction and organizational commitment: An empirical study on health sector in Turkey. J Int Health Sci Manag. 2015; 1(1):70-3. [Link]
18. Berassa MS, Chiro TA, Fanta S. Assessment of job satisfaction among pharmacy professionals. J Pharm Policy Pract. 2021; 14(1):71. [Link]
19. Alomair A. Demystifying the leaking workforce pipeline: Barriers facing female professionals in the Middle East and East Asia [master thesis]. Boston: Massachusetts Institute of Technology; 2017. [Link]
20. Boniol M, Kunjumen T, Nair TS, Siyam A, Campbell J, Diallo K. The global health workforce stock and distribution in 2020 and 2030: A threat to equity and 'universal' health coverage? BMJ Glob Health. 2022; 7(6):1. [Link]
21. Koutsouraki A, Rovithis M, Kritsotakis G, Deltsidou A, Linardakis M. Relation of nursing personnel overqualification in a public general hospital of Crete to work boredom. Arch Hell Med Arheia Ellenikes Iatrikes. 2024; 41(3):1. [Link]
22. Bochoridou A, Chatziioannou A, Gkorezis P, Triantou A. Perceived overqualification and service behavior: A moderated mediation model of nurses' silence toward patient safety and praise from patients. J Health Organ Manag. 2025. [Link]
23. Dyne LV, Ang S, Botero ICJJoms. Conceptualizing employee silence and employee voice as multidimensional constructs. J Manag Stud. 2003; 40(6):1359-92. [Link]
24. Morrison EW. Employee voice and silence. Annu Rev Organ Psychol Organ Behav. 2014; 1(1):173-97. [Link]
25. Pinder CC, Harlos KP. Employee silence: Quiescence and acquiescence as responses to perceived injustice. In: Wheeler AR, Buckley R, Halsbesleben J, editors. Research in personnel and human resources management. Leeds: Emerald Group Publishing Limited; 2001. [Link]
26. Hobfoll SE. Conservation of resources theory: Its implication for stress, health, and resilience. Folkman S, editor. The Oxford handbook of stress, health, and coping. Oxford: Oxford University Press; 2011. [Link]
27. Shaukat R, Khurshid AJ. Woes of silence: The role of burnout as a mediator between silence and employee outcomes. Pers Rev. 2022; 51(5):1570-86. [Link]
28. Tangirala S, Ramanujam RJPp. Employee silence on critical work issues: The cross level effects of procedural justice climate. Pers Psychol. 2008; 61(1):37-68. [DOI:10.1111/j.1744-6570.2008.00105.x]
29. Xu AJ, Loi R, Lam LWJq. The bad boss takes it all: How abusive supervision and leader–member exchange interact to influence employee silence. Leadership. 2015; 26(5):763-74. [Link]
30. Schaufeli WB, Salanova M, González-Romá V, Bakker ABJJoHs. The measurement of engagement and burnout: A two sample confirmatory factor analytic approach. J Happiness stud. 2002; 3(1):71-92. [Link]
31. Spector PEJAjocp. Measurement of human service staff satisfaction: Development of the Job Satisfaction Survey. Am J Commun Psychol. 1985; 13(6):693. [Link]
32. Arvan ML, Pindek S, Andel SA, Spector PE. Too good for your job? Disentangling the relationships between objective overqualification, perceived overqualification, and job dissatisfaction. J Vocational Behav. 2019; 115:103323. [Link]
33. Alfes K, Shantz A, van Baalen SJHRMJ. Reducing perceptions of overqualification and its impact on job satisfaction: The dual roles of interpersonal relationships at work. Hum Res Manag J. 2016; 26(1):84-101. [Link]
34. Liu Z, Chen C, Cui H, Hu YJH. The relationship between nurses’ social network degree centrality and organizational citizenship behavior: The multiple mediating effects of job satisfaction and work engagement. Heliyon. 2023; 9(9):1. [Link]
35. Wan Q, Zhou W, Li Z, Shang S, Yu FJN, sciences h. Work engagement and its predictors in registered nurses: A cross-sectional design. Nurs Health Sci. 2018; 20(4):415-21. [DOI:10.1111/nhs.12424]
36. Santos A, Chambel MJ, Castanheira FJJoan. Relational job characteristics and nurses’ affective organizational commitment: The mediating role of work engagement. J Adv Nurs. 2016; 72(2):294-305. [DOI:10.1111/jan.12834]
37. Kim J, Park J, Sohn YW, Lim JIJJoCD. Perceived overqualification, boredom, and extra-role behaviors: Testing a moderated mediation model. J Career Dev. 2021; 48(4):400-14. [DOI:10.1177/0894845319853879]
38. Khan J, Ali A, Saeed I, Vega-Muñoz A, Contreras-Barraza NJF. Person–job misfit: Perceived overqualification and counterproductive work behavior. Front Psychol. 2022; 13:936900. [DOI:10.3389/fpsyg.2022.936900]
39. Ye X, Li L, Tan XJER. Organizational support: Mechanisms to affect perceived overqualification on turnover intentions: A study of Chinese repatriates in multinational enterprises. Employee Relat. 2017; 39(7):918-34. [Link]
40. Andel S, Pindek S, Arvan ML. Bored, angry, and overqualified? The high-and low-intensity pathways linking perceived overqualification to behavioural outcomes. Eur J Work OrganPsychol. 2022; 31(1):47-60. [DOI:10.1080/1359432X.2021.1919624]
41. Maslach C, Jackson SE, Leiter MP, Schaufeli W, Schwab RJCMG. Maslach burnout inventory manual. Menlo Park: Scarecrow Education; 2016. [Link]
42. Guo YF, Fan JY, Lam L, Plummer V, Cross W, Ma YZ, et al. Associations between perceived overqualification, transformational leadership and burnout in nurses from intensive care units: A multicentre survey. J Nurs Manag. 2022; 30(7):3330-9. [Link]
43. Kristof ALJPp. Person-organization fit: An integrative review of its conceptualizations, measurement, and implications. Pers Psychol. 1996; 49(1):1-49. [Link]
44. Maynard DC, Parfyonova NMJJoo, psychology o. Perceived overqualification and withdrawal behaviours: Examining the roles of job attitudes and work values. J Occup Organ Psychol 2013; 86(3):435-55. [Link]
45. Hobfoll SE, Halbesleben J, Neveu J-P, Westman MJAroop, behavior o. Conservation of resources in the organizational context: The reality of resources and their consequences. Annual rev Organ Psychol Organ Behav. 2018; 5(1):103-28. [DOI:10.1146/annurev-orgpsych-032117-104640]
46. Chaoyang L, Yuanhan F, Zengyuan Y, Huitao L. Study on the relationship between employee perception of overqualification, job burnout, and impulsive buying behavior. Curr Psychol. 2025. [Link]
47. Harari MB, Manapragada A, Viswesvaran CJ. Who thinks they're a big fish in a small pond and why does it matter? A meta-analysis of perceived overqualification. J Vocat Behav. 2017; 102:28-47. [Link]
48. Connelly CE, Zweig D, Webster J, Trougakos JP. Knowledge hiding in organizations. J Organ Behav. 2012; 33(1):64-88. [Link]
49. Evans JM, Hendron MG, Oldroyd JBJ. Withholding the ace: the individual-and unit-level performance effects of self-reported and perceived knowledge hoarding. Organ Sci. 2015; 26(2):494-510. [Link]
50. Li CS, Liao H, Han YJPP. I despise but also envy you: A dyadic investigation of perceived overqualification, perceived relative qualification, and knowledge hiding. Pers Psychol. 2022; 75(1):91-118. [Link]
51. Meyer JP, Allen NJJHrmr. A three-component conceptualization of organizational commitment. Hum Res Manag Rev. 1991; 1(1):61-89. [Link]
52. Fang YC, Chen JY, Zhang XD, Dai XX, Tsai FS. The impact of inclusive talent development model on turnover intention of new generation employees: The mediation of work passion. Int J Environ Res Public Health. 2020; 17(17):6054. [DOI:10.3390/ijerph17176054]
53. Vallerand R, Houlfort NJ. Passion at Work: Toward a new conceptualization. Soc Issues Manag. 2003; 35:175-204. [Link]
54. Lou T, Ye M. Studying on the Impact of Perceived Overqualification on Work Engagement: The Moderating Role of Future Work Self Salience and Mediating Role of Thriving at Work. Open J Soc Sci. 2019;7(8):24-36. [DOI:10.4236/jss.2019.78002 ]
55. Yu F, Raphael D, Mackay L, Smith M, King A. Personal and work-related factors associated with nurse resilience: A systematic review. Int J Nurs Stud. 2019; 93:129-40. [DOI:10.1016/j.ijnurstu.2019.02.014] [PMID]