Impostorism in third-year medical students: an item analysis using the Clance impostor phenomenon scale

Impostor Phenomenon Among Recently Graduated General Surgeons

BACKGROUND

Imposter phenomenon can occur in highly competitive fields causing internal feelings of fraud and self-doubt. Significant imposterism has been recently reported amongst general surgery residents.

STUDY DESIGN

We hypothesized that attending surgeons, navigating the transition into independent practice, would report a similar experience. We surveyed and collected Clance Imposter Phenomenon Scale (CIPS) scores from 24 Army general surgeons within 4 years of graduation.

RESULTS

Nearly all exhibited at least moderate imposterism, and over half reported significant or intense imposterism. Women reported statistically higher scores than men. Surgeons who engaged in off-duty employment or participated in mentorship were less likely to have significant or intense imposterism.

CONCLUSION

Transition to practice is a challenging and highly variable time for new surgeons. Identifying factors that attenuate these feelings could help with early career advancement.

Impostor Phenomenon and Advanced Practice Registered Nurse Faculty

BACKGROUND

Impostor phenomenon (IP), or syndrome, is a behavioral health phenomenon where individuals discount personal accomplishments, success, and aptitude. It negatively affects high-functioning individuals in nursing and other health care professions.

PURPOSE

This study aimed to investigate IP in advanced practice registered nurse (APRN) faculty.

METHODS

This descriptive correlational study included the Clance Impostor Phenomenon Scale (CIPS).

RESULTS

The sample included 478 APRN faculty members representing 50 states and Washington DC. The majority (n = 324) of CIPS scores were moderate (n = 198) or frequent (n = 133), indicating that scores may be clinically relevant. Moderate levels were associated with an increased likelihood of experiencing negative sequelae, including decreased job satisfaction and increased burnout. Comparing CIPS scores yielded no statistically significant differences between APRN roles. Significant predictors included age, years of teaching, and rank of associate professor.

CONCLUSIONS

Findings can inform strategies to improve retention, recruitment, and job satisfaction.

Test-reduced teaching for stimulation of intrinsic motivation (TRUST): a randomized controlled intervention study

BACKGROUND

The anatomy dissection course is a major part of the first two years of the traditional medical curriculum in Germany. The vast amount of content to be learned and the repeated examination is unanimously perceived by students and teachers as a major stress factor that contributes to the increase of psychosocial stress during the first two years of the course of study. Published interventions for specific stress reduction are scarce.

METHODS

In a randomized, controlled design two intervention groups were compared with a control group (CG) over the whole dissection course (nine measuring points before, during and after first and second semester). The 'Stress Management intervention (IVSM)' targeted at the setting of personal standards, the 'Friendly Feedback intervention (IVFF)' at the context of frequent testing. Quantitative surveys were distributed at nine measuring points. The questionnaire comprised validated instruments and self-developed items regarding stress, positive and negative affect, anxiety, intrinsic and extrinsic motivation, self-efficacy, and perceived performance.

RESULTS

Out of 195 students inscribed in the dissection course, 166 (85%) agreed to participate in the study. The experience of stress during the dissection course was significantly higher in the CG than in the IVFF. Anxiety and negative affect were lower in students of the IVFF while positive affect, intrinsic motivation, and self-efficacy were higher than in the CG. For anxiety and negative affect in the IVSM this was especially seen at the end of the second semester. The self-perceived increase in both knowledge and preparedness for the first big oral and written examination did not differ between the study groups. About three quarters of the participants would choose the intervention 'Friendly Feedback' if given the choice.

CONCLUSIONS

Replacing formal tests with friendly feedback has proven to be an effective measure to reduce stress and negative affect and foster positive affect, self-efficacy, and intrinsic motivation, while it did not impair self-perceived academic performance.

Higher degree of impostor characteristics relates to lower self-perceived teaching ability and emotional intelligence

BACKGROUND

Emotional intelligence (EI) has been previously associated with teaching ability and impostor phenomenon (IP) in medical education; however, studies have demonstrated mixed findings and have largely focused on trainees only. Therefore, we sought to explore the potential association between the degree of IP characteristics, EI and teaching ability in obstetrics and gynaecology (Ob/Gyn) faculty physicians.

METHODS

A cross-sectional, survey-based pilot study was completed at a single academic institution. Ob/Gyn attending (faculty) physicians were queried using surveys related to IP, EI and teaching ability. Resident (trainee) physicians also completed anonymous evaluations of faculty teaching ability.

FINDINGS

The degree of IP characteristics correlated negatively with self-perceived teaching ability, with no significant differences in resident assessment of faculty teaching. IP also correlated negatively with EI. Although there were no statistically significant differences in resident assessment of teaching ability based on EI, both EI and IP demonstrated inverse relationships to faculty assessment of teaching ability compared with resident assessment.

CONCLUSION

IP appears to relate to lower perceived teaching ability in Ob/Gyn faculty that does not correspond to resident evaluation of teaching performance. The demonstrated negative correlation between the degree of impostor characteristics and EI suggests that EI could potentially play a protective role in the development of IP and burnout, as well as influence teaching. This relationship may have implications for faculty willingness to continue in academic medicine.

Twelve tips for recognizing and supporting medical learners experiencing impostorism

The resurgence of studies focused on the Impostor Phenomenon (IP) demonstrates a need for greater understanding of the construct as well as strategies to limit the negative conditions that arise from it. To help address this need, the following twelve tips offer perspectives and suggested approaches for educators to assist medical learners with IP during clinical training. A review of the medical literature and the authors' experiences supplies the following information, organized first by etiology and diagnosis followed by management and special considerations. These tips provide insight into the multifaceted aspects of IP and offer suggestions for support at the individual and institutional levels. With proper monitoring and personalized guidance, educators can assist learners in breaking the cycle of negative thoughts and behaviors to achieve confidence in their professional identity and competence in their clinical skills.

Imposter Phenomenon in Pediatric Residency: An Empirical Simulation-Based Educational Study

The imposter phenomenon (IP) may have a negative impact on the ability of healthcare providers to make difficult and accurate decisions. This study presents an empirical approach, segregating the real imposters based on a simulation, and aims to investigate the prevalence and severity of IP and evaluate the attitude in the decision-making process of pediatric residents with impostorism. A simulation-based case study with the 113 pediatric residents was performed with the Clance Imposter Phenomenon Scale to identify IP scores and appropriate management skills for the case. The collected data were divided and combined into different categories based on the IP scale scores and the success of case management to further detect how real imposters were affected. Our study revealed that 24 (21.2%) of residents have moderate, 33 (25.7%) of residents have frequent, and 29 (29.2%) of residents have intense impostorism feelings. The imposter scores were found to be higher among female participants (P = .006). However, when considering the prevalence of significant impostorism (defined as both frequent and intense), there was no statistically significant difference between females and males (P = .088). The data indicated that an increase in IP scores was associated with a higher likelihood of delayed pressing the help button for both the overall and post-exclusion groups (P < .001). The analysis also revealed a significant correlation and a monotonic-linear trend between IP scores and the decision-making process, even after excluding the unsuccessful participants (P < .001). This is the first study to demonstrate the prevalence of IP among pediatric residents, potentially leading to challenges in patient care and resulting in delayed decisionmaking and self-doubt with feelings of inadequacy. The findings support the claim that higher imposter scores are associated with a greater tendency to seek help from more experienced individuals, even when fully capable of managing cases independently. This emphasizes the importance of awareness about the IP, as these factors can directly impact both the well-being of trainees and patient care outcomes.

Prevalence of Imposter Syndrome and Its Risk Factors Among University of Sharjah Medical Students

Background Imposter syndrome describes an internal experience of intellectual fraud, where individuals attribute their academic or occupational endeavors and achievements primarily to luck rather than to their diligent efforts. Additionally, the stringent standards and prerequisites set by medical institutions create an environment conducive to impostorism among medical students. This study aimed to evaluate the prevalence and severity of imposter syndrome among medical students at the University of Sharjah. Methodology This research was designed as a descriptive cross-sectional study. A total of 400 participants enrolled in the study using non-probability convenience sampling, but 399 participants, 49.4% (197) from colleges of medicine and 50.6% (202) from dentistry, successfully completed the questionnaire. Participants completed a questionnaire containing the Clance Imposter Phenomenon Scale. Statistical associations between variables were tested using the chi-square test. Individuals with chronic medical conditions or those using medications with known psychiatric side effects were excluded. Results The analyzed sample comprised 399 students, with 64.7% females and 35.3% males. Most respondents were from year 2 (21.3%, 85), while the fewest were from year 5 (18.3%, 73). The majority of students fell into the categories of moderate (46.4%, 185) and frequent (35.8%, 143) imposter experiences. Among all investigated characteristics, pure academic factors such as field of study (p = 0.001), study phases (p = 0.032), advisor's attitude (p = 0.029), and comparison with peers' performance and grades (p = 0.024 and <0.001, respectively) exhibited the highest significant association with the severity of imposter syndrome. Conclusions This study revealed a high prevalence of imposter syndrome among medical students, emphasizing the need for comprehensive strategies and interventions targeting academically associated risk factors to alleviate the burden of imposter syndrome.

Impostor phenomenon traits in radiography students: Findings from a UK pilot survey

INTRODUCTION

Impostor Phenomenon (IP) includes feelings of being a fraud, which can be associated with high anxiety levels. Research suggests healthcare students on clinical placement report high levels of anxiety. This study aimed to explore radiography students' (diagnostic and therapeutic) IP traits within the United Kingdom (UK).

METHODS

The pilot study used a mixed-method online survey, applying the Clance Impostor Phenomenon Scale (CIPS). Internal student recruitment used the university virtual learning environment (VLE), and external UK recruitment used social media with a convenience sampling method. The survey included demographic questions (gender, age, year of study, course). The statistical analysis used the Kruskal-Wallis test for the quantitative responses and content analysis of the qualitative responses.

RESULTS

The survey received n = 92 responses; 77% were found to have frequent or intense IP traits. No significant differences were identified by age (p = 0.46) or radiography programme (diagnostic or therapeutic) (p = 1.00). The year of study demonstrated a significant difference (p = 0.01), with second-year students scoring a higher CIPS score (78.56) than first and third years (72.41 and 66.17, respectively). There was also a significant difference between males and females surveyed (p = 0.001). The thematic analysis highlighted that the clinical placement environment, prior IP knowledge, feelings of not belonging, and being an older/mature student increased IP feelings.

CONCLUSION

Both therapeutic and diagnostic students returned a high CIPS score >70, demonstrating that IP traits were present in the sample of survey responses. Although being an older/mature student was a subtheme in qualitative responses, the quantitative data displayed no statistical difference amongst the CIPS scores by age. A significant difference between males and females surveyed (p = 0.001) and year of study (p = 0.01) was found with second years students scoring higher (mean CIPS score of 75.56) than first and third-year students (72.41 and 66.17, respectively). The qualitative responses further suggested as clinical placement experiences increased, feelings of IP decreased.

IMPLICATIONS FOR PRACTICE

Educational intervention methods such as workshops may assist radiography students in identifying and coping with IP traits before their first clinical placement.

Exploring Factors Affecting Impostor Syndrome among Undergraduate Clinical Medical Students at Chiang Mai University, Thailand: A Cross-Sectional Study

Impostor syndrome is a psychological condition that inhibits individuals' ability to recognize their achievements such that they fear being exposed as forgers. It is common in medical students, particularly in the early stages of clerkship training while transitioning from preclinical to clinical training. This cross-sectional study assessed the prevalence and associated factors of the imposter phenomenon among medical clinical students using the Clance Impostor Phenomenon Scale (CIPS), focusing on sociodemographic characteristics, mental health status, and occurrence of the impostor phenomenon. Out of 228 undergraduate clinical-year medical students, 108 (47.4%) reported experiencing the impostor phenomenon. The results from the multivariable analysis showed that high levels of stress (adjusted odds ratio = 2.315; 95% confidence interval = 1.105-4.853), anxiety (6.462; 1.374-30.392), and depression (4.219; 1.448-12.290) were significantly associated with an increased risk of experiencing the impostor phenomenon. We found no difference between participants in the early or later years of clerkship training. The study highlights the prevalence of impostor syndrome among medical students and its link to mental health issues. Addressing this issue through education, mentorship, systemic problem solving, normalizing failure, and monitoring and treating mental health issues could help students reach and realize their full educational and professional potential.

Impostor phenomenon and ambiguity tolerance in practicing physical therapists: an exploratory correlational study

Objectives

Investigate the prevalence and contextualize the relationship of impostor phenomenon (IP) and ambiguity tolerance (AT) in practicing physical therapists (PTs).

Methods

Online survey including demographic questions, Clance Impostor Phenomenon Scale (CIPS), and Tolerance of Ambiguity Scale (TAS).  Descriptive analyses assessed (N = 422) demographic data, CIPS, and TAS scores. Chi-square tests determined distribution across demographic variables.  Kruskal-Wallis tests assessed differences between CIPS and TAS.  Age was a proxy for career stage in Pearson product-moment correlations to assess relationships between CIPS and TAS.

Results

In practicing PTs (M age = 42.12, SD = 12.34), moderate (48.6%; n = 205) to frequent (26.8%; n = 113) IP feelings were prevalent, but only 31.5% (n = 133) were true impostors.  Significant differences exist in clinical experience for CIPS, H(7, n = 422) = 67.82, p <.001 and TAS, H(7, n = 422) = 21.79, p= .003. Most PTs tolerate ambiguity (M = 54.93, SD = 8.19).  A moderate negative correlation between age and CIPS, r = -.36, p <.001 and a small negative correlation between age and TAS, r=-.19, p <.001 exists. Age accounts for 13% of the variance per IP and 3.6% variance per TAS score.  A small positive relationship exists between CIPS and TAS, r = .10, p <.05.

Conclusions

Practicing PTs experience moderate to frequent IP and are ambiguity tolerant.  Clinical experience is inversely related to IP and AT.  Almost half of early-career PTs feel like impostors, which can lead to decreased job satisfaction, burnout, psychological distress, feelings of self-doubt, and depression.

Prevalence and Predictor of Impostor Phenomenon Among Medical Students at Jouf University, Saudi Arabia

BACKGROUND AND AIM

The impostor phenomenon (IP) was defined in 1978 as an "internal feeling of intellectual phoniness felt by people with outstanding academic and professional achievements." This study aims to estimate the prevalence and predictors of IP among medical students.

METHODS

A cross-sectional study was conducted from November 2022 to May 2023. A total of 200 medical students from years one to five participated in the survey; the response rate was 82.5% (165). A stratified random sampling technique was used to select groups of male and female Jouf University medical students from the 1st, 2nd, 3rd, 4th, and 5th batches of the 2022 to 2023 academic year. An e-mail with a self-administered questionnaire comprising the Clance IP scale and a consent form was sent to all participants. The identities of the students were kept anonymous to eliminate response bias. Participation was voluntary. Data were presented in terms of numbers and percentages; a chi-square test was used to compare categorical variables; and multivariable analysis was used to determine predictors of IP using SPSS Statistics version 20 (IBM Corp., Armonk, NY, USA).

RESULTS

A total of 165 students responded to the questionnaire, with a response rate of 82.531%; 47.30% were males, and 86 (52.10%) were females. The findings indicate that 12 (7.3%), 83 (50.30%), 59 (35.80%), and 11 (6.70%) medical students, respectively, suffered from few, moderate, frequent, and intense imposter features. Results also showed that 13 (56.50%) first-year students suffered from moderate IP experiences, and 10 (43.50%) had frequent IP experiences. It was observed that for students in the first year, the academic performance represented by a student's grade point average (GPA), monthly family income, father's educational level, mother's educational level, and marital status are predictors of impostor experience.

CONCLUSION

The study's findings show that impostor syndrome is a common problem among medical students and that being in the first year of medical school can increase the incidence of suffering from it. The problem-based learning system in medical school can contribute to impostor syndrome among medical students. Both low-achieving and high-achieving students suffer from impostorism.

Leadership and Impostor Syndrome in Surgery

BACKGROUND

Impostor syndrome is an internalized sense of incompetence and not belonging. We examined associations between impostor syndrome and holding leadership positions in medicine.

STUDY DESIGN

A cross-sectional survey was distributed to US physicians from June 2021 to December 2021 through medical schools and professional organizations. Differences were tested with the chi-square test and t -test for categorical and continuous variables, respectively. Logistic regression was used to identify factors associated with holding leadership positions and experiencing impostor syndrome.

RESULTS

A total of 2,183 attending and retired physicians were included in the analytic cohort; 1,471 (67.4%) were in leadership roles and 712 (32.6%) were not. After adjustment, male physicians were more likely than women to hold leadership positions (odds ratio 1.4; 95% CI 1.16 to 1.69; p < 0.001). Non-US citizens (permanent resident or visa holder) were less likely to hold leadership positions than US citizens (odds ratio 0.3; 95% CI 0.16 to 0.55; p < 0.001). Having a leadership position was associated with lower odds of impostor syndrome (odds ratio 0.54; 95% CI 0.43 to 0.68; p < 0.001). Female surgeons were more likely to report impostor syndrome compared to male surgeons (90.0% vs 67.7%; p < 0.001), an association that persisted even when female surgeons held leadership roles. Similar trends were appreciated for female and male nonsurgeons. Impostor syndrome rates did not differ by race and ethnicity, including among those underrepresented in medicine, even after adjustment for gender and leadership role.

CONCLUSIONS

Female physicians were more likely to experience impostor syndrome than men, regardless of specialty or leadership role. Although several identity-based gaps persist in leadership, impostor syndrome among racially minoritized groups may not be a significant contributor.

Allyship to Advance Diversity, Equity, and Inclusion in Otolaryngology: What We Can All Do

Purpose of review

To summarize the current literature on allyship, providing a historical perspective, concept analysis, and practical steps to advance equity, diversity, and inclusion. This review also provides evidence-based tools to foster allyship and identifies potential pitfalls.

Recent findings

Allies in healthcare advocate for inclusive and equitable practices that benefit patients, coworkers, and learners. Allyship requires working in solidarity with individuals from underrepresented or historically marginalized groups to promote a sense of belonging and opportunity. New technologies present possibilities and perils in paving the pathway to diversity.

Summary

Unlocking the power of allyship requires that allies confront unconscious biases, engage in self-reflection, and act as effective partners. Using an allyship toolbox, allies can foster psychological safety in personal and professional spaces while avoiding missteps. Allyship incorporates goals, metrics, and transparent data reporting to promote accountability and to sustain improvements. Implementing these allyship strategies in solidarity holds promise for increasing diversity and inclusion in the specialty.

URiMs and Imposter Syndrome: Symptoms of Inhospitable Work Environments?

BACKGROUND AND OBJECTIVES

Workforce diversity is associated with improved health outcomes. Currently, primary care physicians who are underrepresented in medicine (URiM) disproportionately work in underserved areas. Increasingly, URiM faculty describe experiencing imposter syndrome (IS), including a sense of not belonging in their work environment and a lack of recognition. Studies of IS among family medicine faculty are not prevalent nor are the factors most associated with IS among URiMs and non-URiMs. The objectives of our study were to (1) determine prevalence of IS among URiM faculty compared to non-URiM faculty; (2) determine factors associated with IS among both URiM and non-URiM faculty.

METHODS

Four hundred thirty participants completed anonymous, electronic surveys. We measured IS using a 20-item validated scale.

RESULTS

Among all respondents, 43% reported frequent/intense IS. URiMs were not more likely than non-URiMs to report IS. Factors independently associated with IS for both URiM and non-URiM respondents include inadequate mentorship (P<.05) and poor professional belonging (P<.05). However, inadequate mentorship, low professional integration and belonging, and racial/ethnic discrimination-based exclusion from professional opportunities (all P<.05) were more prevalent among URiMs than non-URiMs.

CONCLUSIONS

While URiMs are not more likely than non-URiMS to experience frequent/intense IS, they are more likely to report racial/ethnic discrimination, inadequate mentorship, and low professional integration and belonging. These factors are associated with IS and may be reflective of how institutionalized racism impedes mentorship and optimal professional integration, which may be internalized and perceived as IS among URiM faculty. Yet, URiM career success in academic medicine is crucial for achieving health equity.

Impostor phenomenon in registered dietitians: an exploratory survey

BACKGROUND

Impostor phenomenon, also referred to as imposter syndrome or impostorism, was initially identified among high achieving women who felt undeserving of their successes because they felt they were earned through luck or chance, rather than skill or experience. It's prevalence has been identified in many health professions; however, there are no known studies of Registered Dietitians' (RDs) perceptions of impostor phenomenon. This study assesses the following among RDs: [1] prevalence of impostor phenomenon and differences in impostor phenomenon levels, if any, based on [2] highest educational level achieved and [3] years of experience as an RD.

METHODS

A cross-sectional survey was sent electronically to 5,000 RDs credentialed by the Commission on Dietetic Registration in the United States. Respondents' agreement with 20 impostor phenomenon statements from the Clance Impostor Phenomenon Scale were measured. The sum score from the scale was used to classify levels of impostor phenomenon. Descriptive statistics and chi square analyses for comparison were evaluated.

RESULTS

Of the 445 (9%) who began the survey, 266 (5%) completed it and were included in analyses. Over 76% of 266 individuals reported at least moderate impostorism (score of 40 or fewer points out of 100). No difference was seen based on educational level (p = .898); however, those with less than five years' experience reported higher impostor phenomenon (p < .05). Among those with five to 39 years' experience, over 40% reported moderate impostorism.

CONCLUSION

Impostor phenomenon is prevalent among RDs. Moderate impostorism was pervasive among all those with less than 40 years' experience and could potentially negatively impact these respondents. Future research could explore ways to reduce impostor phenomenon in RDs.

Why Do We Feel Like Intellectual Frauds? A Self-Determination Theory Perspective on the Impostor Phenomenon in Medical Students

Theory: Impostor phenomenon (IP) refers to people's feelings of intellectual fraudulence and fear of being "discovered," despite contradicting evidence of success. Due to its association with burnout and distress, it is progressively being studied in medicine. While various explanations for IP have been discussed in the literature, the role of motivation has largely been neglected. Hypotheses: Using self-determination theory (SDT) as a lens, it was hypothesized that different general causality orientations (impersonal, control, autonomy), domain-specific types of motivation (autonomous vs. controlled) toward going to medical school, and levels of satisfaction of basic psychological needs (autonomy, competence, relatedness) in the medical program, would each predict severity of IP symptoms. Method: A total of 1,450 medical students from three Canadian institutions were invited to complete a survey containing the Clance Impostor Phenomenon Scale and scales derived from SDT's mini theories: basic psychological needs theory, causality orientations theory, and organismic integration theory. We explored the prevalence of IP among the students and used regression to capture variable relationships, accounting for gender effects. Results: Data from 277 (19.1%) students were assessed, 73% of whom reported moderate or worse IP symptoms. Having an impersonal general causality orientation, more controlled motivation toward going to medical school, and lower need satisfaction in the medical program, each related to increased IP severity. Together, these motivational factors accounted for 30.3%, 13.6%, and 21.8% of the variance in students' IP severity, respectively. Conclusions: Findings from this study suggest that students who are more self-determined (both in general and in medical school), and whose basic psychological needs are more supported in their medical program, will experience less frequent and severe IP symptoms. Preliminary explanations and implications of these findings are discussed within the medical education context.

Impostor syndrome among minority medical students who are underrepresented in medicine

OBJECTIVES

Impostor syndrome (IS) is prevalent in medical professionals. However, little is known about the prevalence of IS among medical trainees and those who are underrepresented in medicine (UiM). Even less is known about the experiences of UiM students at predominantly white institutions (PWIs) and historically black colleges/universities (HBCUs) relative to their non-UiM peers. The purpose of this study is to investigate differences in impostor syndrome among UiM and non-UiM medical students at a PWI and a HBCU. We additionally explored gender differences in impostor syndrome among UiM and non-UiM students at both institutions.

METHOD

Medical students (N = 278) at a PWI (N = 183, 107 (59%) women) and a HBCU (N = 95, 60 (63%) women), completed an anonymous, online two-part survey. In part one, students provided demographic information, and in part two, students completed the Clance Impostor Phenomenon Scale, a 20-item self-report questionnaire that assessed feelings of inadequacy and self-doubt surrounding intelligence, success, achievements, and one's inability to accept praise/recognition. Based on the student's score, the level of IS was measured and placed into one of two levels: few/moderate IS feelings, or frequent/intense IS feelings. We conducted a series of chi-square tests, binary logistic regression, independent sample t-tests, and analysis of variance to test the main aim of the study.

RESULTS

The response rate was 22% and 25% at the PWI and HBCU, respectively. Overall, 97% of students reported moderate to intense feelings of IS, and women were 1.7 times more likely than men to report frequent or intense feelings of IS (63.5% vs 50.5%, p = 0.03). Students at PWI were 2.7 times more likely to report frequent or intense IS than HBCU students (66.7% vs 42.1%, p< 0.01). In addition, UiM students at PWI were 3.0 times more likely to report frequent or intense IS compared to UiM students at HBCU (68.6 % vs 42.0%, p = 0.01). Computation of a three-way ANOVA with gender, minority status, and school type revealed a two-way interaction indicating that UiM women scored higher on impostor syndrome than UiM men at the PWI and HBCU. This trend was not observed among non-UiM students.

CONCLUSIONS

Impostor syndrome is informed by gender, UiM status, as well as environmental context. Efforts to provide supportive professional development for medical students should be directed towards understanding and combatting this phenomenon at this critical juncture of their medical career.

Self-doubt masked in success: Identifying the prevalence of impostor phenomenon among undergraduate dental students at Qassim University

Objective

To investigate the prevalence of impostor phenomenon (IP) among undergraduate dental students and explore its relationship with gender and academic year.

Methods

This study involved observational cross-sectional research involving undergraduate dental students (first to fifth year) at Qassim University Dental School, between February and April 2021. An electronically administered, 20-item pre-validated Clance Impostor Phenomenon Scale (CIPS) was used for data collection. Data analysis was performed using SPSS version 23. Mean IP scores of both genders were compared using t-tests, one-way ANOVA and Post-Hoc tests to establish the relationship between year-wise IP scores.

Results

The response rate was 80.59% (162 respondents). The results indicated that 8.8% of the participants had mild IP experiences, 84.1% had moderate to severe IP experiences, and 7.05% exhibited intense IP experiences. The mean IP score was highest and lowest in the third and fourth-year dental students, respectively. A statistically significant relationship was identified between year wise IP scores, while no significant difference was observed based on gender.

Conclusions

Impostor phenomenon is prevalent in substantial frequencies amongst dental students. This may have damaging physical and mental effects with negative consequences and could subsequently affect their intellectual and professional developments. The implementation of a modified curriculum and self-development plans are some of the recommended solutions.

Medical Students and the Impostor Phenomenon: A Coexistence Precipitated and Perpetuated by the Educational Environment?

People who experience the impostor phenomenon have intense thoughts of fraudulence regarding their intellect or professional activities. This perception of illegitimacy leads sufferers to believe that success in their lives is attributable to some form of error. Despite the phenomenon having been thoroughly researched in a plethora of professional and educational environments, there remains a relative lack of insight into the impostor phenomenon amongst medical students. This research aimed to better understand the relationship between medical students and the impostor phenomenon, and subsequently to investigate whether their coexistence is precipitated and perpetuated by the educational environment. A cross-sectional study of medical students was conducted using a pragmatist approach, integrating quantitative and qualitative data, via a questionnaire, focus groups and interviews. The main quantitative measure used was the validated Clance Impostor Phenomenon Scale (CIPS), where higher scores indicate more marked impostor experiences. A total of 191 questionnaire responses were received, and 19 students attended a focus group or interview. The average CIPS score for the cohort was 65.81 ± 13.72, indicating that the average student had "frequent" impostor experiences. Of note, 65.4% of students were classed as having "clinically significant" impostor experiences and females scored 9.15 points higher than males on average (p < 0.0001). Examination rankings were frequently cited as a major contributing factor to students' impostor feelings, and data revealed an increase of 1.12 points per decile that a student drops down the rankings (p < 0.05). Students' quotes were used extensively to underpin the quantitative data presented and offer an authentic insight into their experiences. This study provides new insights and contributes to our understanding of the impostor phenomenon amongst medical students, and eight recommendations for practice are presented, which are intended to provide medical schools with opportunities for pedagogical innovation.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-022-01675-x.

A study on impostor phenomenon, personality, and self-esteem of medical undergraduates and interns

Introduction

Impostor phenomenon (IP) is a psychological experience where an individual considers their achievements to be fraudulent. IP in medical professionals is of paramount importance since it affects their self-confidence and communication skills. It has been associated with burnouts, low self-esteem, and neuroticism.

Aim

This research aimed to study the prevalence of IP, personality traits, and self-esteem and to look at gender differences in medical undergraduate students and interns of an urban medical college along with the correlation of IP with personality traits and self-esteem in them.

Methodology

An online survey via Google Groups was conducted among MBBS students and interns of a medical college after informed consent and ethics approval were received. Four hundred sixteen participants completed the survey questionnaire which included demographic variables along with the the Clance Impostor Phenomenon Scale, the Big Five Inventory, and the Rosenberg Self-Esteem Scale.

Results

IP was found in 236 (56.7%) students and interns. Personality domain mean scores were extraversion (26.4 ± 5.12), agreeableness (33.5 ± 5.4), conscientiousness (29.9 ± 5.7), neuroticism (21.6 ± 5.7), and openness (35.1 ± 4.9). The self-esteem mean score was 18.37 ± 6.14; only 16.11% had high self-esteem. Interns and first-year MBBS students scored higher on IP and low on self-esteem among all groups. Significant gender differences were seen in females on agreeableness, conscientiousness, and neuroticism as compared to the males. IP negatively correlated with self-esteem, extraversion, agreeableness, and conscientiousness and positively with neuroticism.

Conclusion

This study throws some light on the IP experiences of medical undergraduates which have not been extensively researched in India.

Students' performance in clinics and self-perceived Confidence in performing Endodontic procedures: A correlation study

Objective

The study aimed to evaluate undergraduate dental students' self-perceived confidence in carrying out Endodontic procedures and correlating it with their performance in Endodontic clinics.

Methods

The correlational study was conducted on fifth year dental students at Qassim University, Saudi Arabia. The self-perceived confidence of students was assessed by using Endodontic Self-Perceived Confidence Scale (ESCS). The students' endodontic clinical performance scores were obtained from the department head. Data were analyzed by IBM SPSS-23.0. Descriptive statistics were recorded as percentages, frequencies, and mean. Chi-square test was used for gender-wise comparison of all items of ESCS, Student t-test was used for comparing means and Pearson correlation coefficient was utilized for exploring correlation.

Results

Over all response rate was 91.8%. Students exhibited the highest confidence level for achieving rubber dam isolation (4.57±0.66) while the lowest confidence level was documented for the treatment of teeth with immature apices (2.82±0.95). The mean self-confidence score of male students on ESCS was higher than the female students (P-value=0.18). However, mean endodontic clinic score of female students was significantly higher than the male students (P-value=0.02). The insignificant correlation was noted between the students' mean confidence scores and endodontic clinical performance scores (P-value=0.82).

Conclusions

The insignificant correlation between self-perceived confidence and clinic scores raises significant caveats for utilizing the self-assessment in the aforementioned group. Hence, the students should be adequately trained in self-assessment to prepare them for lifetime learning. Additionally, clinical instructors by creating a supportive learning environment should help students to deal with their shortcomings.

Impostor Phenomenon in Undergraduate and Doctor of Pharmacy Students at a Small Private University

Objective. The purpose of the study was to observe the prevalence of impostor phenomenon among students attending Ohio Northern University and to assess secondary factors that impact the severity of this phenomenon.Methods. Using the validated Clance Impostor Phenomenon Scale, the incidence of impostor phenomenon was assessed at Ohio Northern University. We hypothesized that students enrolled in the Ohio Northern University College of Pharmacy would demonstrate more intense levels of impostor phenomenon than students enrolled in other majors within the university.Results. Of the approximately 3100 students at the university, 391 students (12.6%) completed the survey and qualified for the study. Students for this study were recruited via email. This method was used for two reasons; it was the best way to reach the entirety of the student body, and, at the time of the study, students were transitioning from campus to home due to the COVID-19 pandemic. Out of a total possible score of 100, all colleges scored an average impostor phenomenon score between 68 and 75. These scores were interpreted as "frequently experiences impostor feelings." No significant differences in scores were found by college, gender, ethnicity/race, year in school, or specific major.Conclusion. Impostor phenomenon is common at Ohio Northern University and does not discriminate by college, age, gender, race/ethnicity, year in school, or academic major. There is a need for external intervention to educate students on the impact of impostor phenomenon and to reduce this impact. Interventions should be targeted to all students enrolled at the university regardless of educational program or other demographics.

Fixed mindset and imposter phenomenon: Determining the correlation and prevalence among pharmacy students

INTRODUCTION

To determine the prevalence of fixed vs. growth mindsets and imposter phenomenon (IP) scores among pharmacy students at one institution, identify variables that explained variance in fixed mindsets and IP, and determine if a correlation exists.

METHODS

A survey was developed and administered to first- to fourth-year students at the University of Kentucky College of Pharmacy. The survey included demographic questions, the Clance Imposter Phenomenon Scale (CIPS), and the Implicit Theories of Intelligence Scale (ITIS). Descriptive and inferential statistical analyses were conducted to determine the prevalence of IP and fixed vs. growth mindsets, identify variables that explained variance in CIPS and ITIS scores, and investigate if a correlation exists.

RESULTS

Pharmacy students reported a high rate of IP experiences; mean (SD) CIPS score of 67.2 (14). Thirty percent of students reported at least moderate IP experiences and 68.2% reported frequent or intense IP experiences. The majority of students (59.6%) reported a growth mindset. Gender was the only tested variable that explained variance in CIPS or ITIS scores, as male gender respondents had lower CIPS score as compared to those reporting female gender (63.27 vs 68.87, p=.006). A correlation was found between lower ITIS and higher CIPS scores (r = -0.221, P < .001).

CONCLUSIONS

Pharmacy students surveyed exhibited a high rate of IP and growth mindsets. Understanding that fixed mindsets and high rates of IP are correlated can help educators make informed decisions regarding targeted interventions, with the goal to improve overall student wellbeing.

Increasing Clinician-Scientist Workforce Diversity through the National Institute of General Medical Sciences’ Medical Scientist Training Program

The National Institute of General Medical Sciences Medical Scientist Training Program (MSTP) has been successful in producing clinician-scientists, with a majority of graduates pursuing research-related careers. However, there are a number of areas of continuing concern for the program. In particular, women and individuals from certain racial and ethnic backgrounds remain persistently underrepresented in MSTPs relative to the average college-aged U.S. population and to students receiving life sciences bachelor’s degrees. The authors, who include leaders of NIGMS, identify a number of challenges and opportunities for enhancing diversity, equity and inclusion in the MSTPs and suggest strategies for addressing them.

The Impostor Phenomenon in the Nutrition and Dietetics Profession: An Online Cross-Sectional Survey

The impostor phenomenon (IP) (also known as impostor syndrome) describes high-achieving individuals who, despite their objective successes, fail to internalize their accomplishments and have persistent self-doubt and fear of being exposed as a fraud or impostor. This study aimed to assess the prevalence and predictors of IP within a sample of nutrition and dietetics students and practitioners. An online cross-sectional survey was conducted and utilized a non-random, convenience sampling approach. A total of 1015 students, dietetic interns, and currently practicing and retired registered dietitian nutritionists and nutrition and dietetic technicians registered provided complete responses. IP was assessed with the Clance Impostor Phenomenon Scale (CIPS). Self-reported job satisfaction and well-being were assessed using validated scales. Average CIPS score was 66.0 ± 16.3 (range 22−99), and higher scores indicate more frequent or severe IP experiences. Frequent or intense IP was reported by 64% of survey respondents (n = 655). Older age, greater educational attainment and professional level, and membership in Academy of Nutrition and Dietetics groups were associated with lower IP scores. Greater social media use was associated with higher IP scores. Job satisfaction and overall well-being were inversely correlated with IP (p < 0.001). Findings suggest that IP experiences were common among a majority of nutrition and dietetics students and practitioners surveyed. Additional research and development of preventative strategies and interventions is needed.

Impostor Phenomenon and Its Relationship to Self-Esteem Among Students at an International Medical College in the Middle East: A Cross Sectional Study

The atmosphere of constant scrutiny of academic ability that prevails in medical colleges may leave some students at risk of expressing feelings of intellectual fraudulence and phoniness. Impostor phenomenon (IP) traits have been associated with anxiety, depression, job dissatisfaction, and poor professional performance. Internationally trained junior doctors exhibit stronger IP feelings than colleagues trained within their own country of citizenship. These feelings may develop during student life. International universities are diverse and complex environments where students may be emersed in a cultural milieu alien to their societies of origin, leading to feelings of isolation. Individuals with IP traits often perceive themselves as the “only one” experiencing this phenomenon, resulting in further isolation and negative self-evaluation, especially among women and underrepresented minorities. IP has also been linked to low self-esteem among students. This study assessed the prevalence of IP and its relationship to self-esteem among students at a campus of a European medical college with a large international student body situated in the Middle East. The self-administered questionnaires: Clance's Impostor Phenomenon Scale (CIPS) and Rosenberg's Self-Esteem Scale (RSES) were completed by 290 medical students (58.3% females). Participants' median (range) age was 19 years (16–35). Students were of 28 different nationalities; the largest proportions were from Gulf Corporation Council (GCC) countries. The prevalence of low self-esteem was 18.6%, while 45.2% of the students demonstrated traits suggestive of IP. There was a strongly negative correlation between CIPS and RSES (r = −0.71). No significant gender differences were found in IP. Similarly, no differences in IP were found when comparing between age groups, previous experience in higher education or year of study. Multivariate analysis showed that students from GCC countries had higher levels of self-esteem relative to students from other regions. Low self-esteem was a strong predictor of IP. Country of origin may influence students' self-esteem studying in international university settings.

Assessment of Fear of Failure Among Medical Students at King Saud University

Background

Fear of failure (FoF) is described as a “dispositional tendency to avoid failure in achievement settings.” It may potentially and adversely affect students’ ability to perform well in their educational activities.

Objectives

To measure FoF among medical students at King Saud University, FoF between men and women, academic levels, grade point average (GPA), and other factors among medical students were compared.

Method

A cross-sectional observational study was carried out using a stratified random sampling method. A total of 455 medical students completed “the Performance Failure Appraisal Inventory” during the academic year 2019–2020 at King Saud University, Riyadh, Saudi Arabia.

Results

The results showed that the mean of FoF was −0.3117. Moreover, higher levels of fear of devaluing one’s self-estimate were seen in women, and higher levels of fear of important others losing interest were seen in men. A significant relation was seen between different academic levels and fear of shame and embarrassment, fear of upsetting important others, as well as FoF. Higher levels of FoF were seen in those who had a GPA below 3.5 and a GPA greater than 4.9. Also, it was high in students who were not interested in studying medicine. The Cronbach’s α value of 0.93 of all items indicates good internal consistency, and the factor analysis confirms five items of an instrument.

Conclusion

The overall level of FoF was low among medical students at King Saud University. However, the domains and levels of FoF differed significantly according to gender, academic level, GPA, and interest in studying medicine.

Predicting Young Imposter Syndrome Using Ensemble Learning

Background. Imposter syndrome (IS), associated with self-doubt and fear despite clear accomplishments and competencies, is frequently detected in medical students and has a negative impact on their well-being. This study aimed to predict the students’ IS using the machine learning ensemble approach. Methods. This study was a cross-sectional design among medical students in Bangladesh. Data were collected from February to July 2020 through snowball sampling technique across medical colleges in Bangladesh. In this study, we employed three different machine learning techniques such as neural network, random forest, and ensemble learning to compare the accuracy of prediction of the IS. Results. In total, 500 students completed the questionnaire. We used the YIS scale to determine the presence of IS among medical students. The ensemble model has the highest accuracy of this predictive model, with 96.4%, while the individual accuracy of random forest and neural network is 93.5% and 96.3%, respectively. We used different performance matrices to compare the results of the models. Finally, we compared feature importance scores between neural network and random forest model. The top feature of the neural network model is Y7, and the top feature of the random forest model is Y2, which is second among the top features of the neural network model. Conclusions. Imposter syndrome is an emerging mental illness in Bangladesh and requires the immediate attention of researchers. For instance, in order to reduce the impact of IS, identifying key factors responsible for IS is an important step. Machine learning methods can be employed to identify the potential sources responsible for IS. Similarly, determining how each factor contributes to the IS condition among medical students could be a potential future direction.

Imposter Syndrome Relation to Gender Across Osteopathic Medical Schools

This study explores the rate of Imposter Syndrome (IS) in osteopathic medical students specifically in regard to gender. Additionally, we compare IS with previous performance on the Medical College Admission Test (MCAT) and undergraduate science GPA. IS has been described as a psychological term that refers to a pattern of behavior wherein people doubt their abilities and have a persistent fear of being exposed as a fraud regardless of adequate external evidence of success. Females in professional fields have been shown to experience IS at a significantly higher rate than their male counterparts, the cause of which is unknown. We performed an anonymous survey distributed to osteopathic medical students in the USA from the classes of 2020-2023. The final data included information from 23 classes across 9 osteopathic medical schools. Students were asked eight questions from the Young Imposter Scale questionnaire to determine if a student had IS. Students were also asked to provide MCAT scores and undergraduate science GPA information. This study confirms that female osteopathic medical students experience IS at a higher rate than their male counterparts. This phenomenon is not dependent on gender ratios in medical school classes, nor is it dependent on previous student success on the MCAT or undergraduate science GPA. This indicates that medical schools need to be aware of IS throughout the student population, not just high-achieving individuals. IS is a significant problem in medical education, which can lead to physician burnout and deteriorating well-being.

Maladaptive Perfectionism, Impostor Phenomenon, and Suicidal Ideation Among Medical Students

OBJECTIVE

Suicide is a leading cause of death for young adults, and medical students experience elevated rates of suicide and suicidal ideation. The present study uses mediation analysis to explore relationships between suicidal ideation and two dysfunctional mindsets common among medical students: maladaptive perfectionism, high standards accompanied by excessive self-criticism, and impostor phenomenon, pervasive feelings of inadequacy despite evidence of competence and success.

METHODS

Two hundred and twenty-six medical students at a single institution completed an online survey which assessed maladaptive perfectionism, impostor phenomenon, and suicidal ideation. After calculating measures of association between all study variables, linear regression was conducted to establish the relationship between maladaptive perfectionism and suicidal ideation. To evaluate whether impostor phenomenon mediated the relationship between maladaptive perfectionism and suicidal ideation as hypothesized, a series of regression models were constructed and the regression coefficients were examined. The statistical significance of the indirect effect, representing the mediated relationship, was tested using bootstrapping.

RESULTS

Significant positive associations between maladaptive perfectionism, impostor phenomenon, and suicidal ideation were observed. Impostor phenomenon score was found to mediate the relationship between maladaptive perfectionism and suicidal ideation.

CONCLUSIONS

Medical students who exhibit maladaptive perfectionism are at increased risk for feelings of impostor phenomenon, which translates into increased risk for suicide. These results suggest that an intervention targeted at reducing feelings of impostor phenomenon among maladaptive perfectionists may be effective in reducing their higher risk for suicide. However, interventions promoting individual resilience are not sufficient; systemic change is needed to address medicine's "culture of perfection."

You Are Not an Impostor: The Registered Dietitian Nutritionist and Impostor Phenomenon

Impostor phenomenon (IP) interferes with the desire for taking advantage of career opportunities and pursuing career advancement. There is robust literature describing the effects of IP in other health care professions, yet an absence of research exists on IP within the nutrition and dietetics profession. This perspective will explore why nutrition and dietetics professionals may experience IP, specify what might be done to mitigate the negative effects of IP, and describe future research directions. Impostorism is an understudied phenomenon that could have significant implications for the profession of nutrition and dietetics on an individual and systemic level.

Being an Imposter: Growing Out of Impostership

Imposter syndrome is the fear of being discovered as an intellectual fraud. It is an internal experience of believing that you are not as competent as others perceive you to be. It lowers person's inner self-confidence, self-esteem that impedes work performance and this phenomenon is more prevalent among medical students. However, talking openly about it with peers, rooting positive thoughts and building confidence helps us to appropriate reality of our situation and counter our negative self-talk.