Prevalence of Impostor Phenomenon among Medical Students in a Malaysian Private Medical School
DOI:
https://doi.org/10.5195/ijms.2018.10Keywords:
Prevalence, Stress, Psychological, Student, Medical, Depression, AnxietyAbstract
Background: Impostor phenomenon is described as an "internal experience of intellectual fraudulence" among high achievers, which include medical students who often doubt their ability to become good doctors in the future. This study sought to determine the prevalence of impostor phenomenon among medical students and how impostorism is correlated with other psychological distresses namely anxiety, depression and low self-esteem.
Methods: To conduct this cross-sectional study, various scales were distributed to all 4th-year medical students in Melaka-Manipal Medical College (MMMC), Muar campus to measure impostorism, depression, anxiety and self-esteem. Clance Impostor Phenomenon Scale (CIPS) was used to measure impostorism and a score of 62 was set as the cut off value to classify a participant as an "imposter".
Results: Out of 300, 256 (85.3%) students completed the questionnaires. 48% and 44% of male and female students respectively scored as ‘impostors’ with no significant difference between the two genders. Positive correlations were noted between impostor phenomenon with low self-esteem (rho=0.56), depression (rho=0.42) and anxiety (rho=0.41). Impostors significantly have stronger intentions of quitting medical school (p < 0.001) and felt that they were not ready to cope with challenges during housemanship (p < 0.05).
Conclusion: Impostors suffer greatly from psychological distress. They are not confident to face the future challenges of housemanship and have stronger intentions of quitting the course. It is necessary for medical colleges to acknowledge this feeling and help the students to cope with it to ensure a smooth transition from medical school to housemanship period.
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References
Clance PR, Imes SA. The imposter phenomenon in high achieving women: Dynamics and therapeutic intervention. Psychother. 1978 Jan 1;15(3):241-7.
Matthews G, Clance PR. Treatment of the impostor phenomenon in psychotherapy clients. Psychother Priv Pract. 1985 Feb 28;3(1):71-81.
Legassie J, Zibrowski EM, Goldszmidt MA. Measuring resident well-being: impostorism and burnout syndrome in residency. J Gen Intern Med. 2008 Jul 1;23(7):1090-4.
Oriel K, Plane MB, Mundt M. Family medicine residents and the impostor phenomenon. Fam Med. 2004 Apr 1;36(4):248-52.
Kumar S, Jagacinski CM. Imposters have goals too: The imposter phenomenon and its relationship to achievement goal theory. Personality and Individual Differences. 2006 Jan 31;40(1):147-57.
Jöstl G, Bergsmann E, Lüftenegger M, Schober B, Spiel C. When will they blow my cover?. Z Psychol. 2012;220(2):109-20.
Topping ME, Kimmel EB. The imposter phenomenon: Feeling phony. Academic Psychology Bulletin. 1985;7(2), 213-26.
Fried-Buchalter S. Fear of success, fear of failure, and the imposter phenomenon among male and female marketing managers. Sex Roles. 1997 Dec 1;37(11):847-59.
Castro DM, Jones RA, Mirsalimi H. Parentification and the impostor phenomenon: An empirical investigation. Am J Fam Ther. 2004 May 1;32(3):205-16.
Cokley K, McClain S, Enciso A, Martinez M. An examination of the impact of minority status stress and impostor feelings on the mental health of diverse ethnic minority college students.J Multicult Couns Devel. 2013 Apr 1;41(2):82-95.
Griffin JM, Fuhrer R, Stansfeld SA, Marmot M. The importance of low control at work and home on depression and anxiety: do these effects vary by gender and social class? Soc Sci Med. 2002 Mar 31;54(5):783-98.
Matthews S, Power C. Socio-economic gradients in psychological distress: a focus on women, social roles and work–home characteristics. Soc Sci Med. 2002 Mar 31;54(5):799-810.
Mathiesen KS, Tambs K, Dalgard OS. The influence of social class, strain and social support on symptoms of anxiety and depression in mothers of toddlers. Soc Psychiatry Psychiatr Epidemiol. 1999 Mar 24;34(2):61-72.
Mattie C, Gietzen J, Davis S, Prata J. The Imposter Phenomenon: Self-Assessment And Competency to Perform as a Physician Assistant in the United States. J Physician Assist Educ. 2008 Mar 1;19(1):5-12.
Cusack CE, Hughes JL, Nuhu N. Connecting Gender and Mental Health to Imposter Phenomenon Feelings. Psi Chi J Psychol Res. 2013 Jun 1;18(2):74-81.
Ghorbanshirodi S. The relationship between self-esteem and emotional intelligence with impostor syndrome among medical students of Guilan and Heratsi universities. J Basic Appl Sci Res. 2012;2(2):1793-802.
Holmes SW, Kertay L, Adamson LB, Holland CL, Clance PR. Measuring the impostor phenomenon: A comparison of Clance's IP Scale and Harvey's IP Scale. J Pers Assess. 1993 Feb 1;60(1):48-59.
Chrisman SM, Pieper WA, Clance PR, Holland CL, Glickauf-Hughes C. Validation of the Clance imposter phenomenon scale. J Pers Assess. 1995 Dec 1;65(3):456-67.
Henning K, Ey S, Shaw D. Perfectionism, the impostor phenomenon and psychological adjustment in medical, dental, nursing and pharmacy students. Med Educ. 1998 Sep 1;32(5):456-64.
September AN, McCarrey M, Baranowsky A, Parent C, Schindler D. The relation between well-being, impostor feelings, and gender role orientation among Canadian university students. J Soc Psychol. 2001 Apr 1;141(2):218-32.
Franck E, De Raedt R, Barbez C, Rosseel Y. Psychometric properties of the Dutch Rosenberg self-esteem scale. Psychol Belg. 2008 Jan 1;48(1):25-35.
Fydrich T, Dowdall D, Chambless DL. Reliability and validity of the Beck Anxiety Inventory. J Anxiety Disord. 1992 Jan 1;6(1):55-61.
Kroenke K, Spitzer RL, Williams JB. The PHQ-9. J Gen Intern Med. 2001 Sep 1;16(9):606-13.
Dyrbye LN, Thomas MR, Shanafelt TD. Medical student distress: causes, consequences, and proposed solutions. Mayo Clin Proc. 2005 Dec 31;80(12):1613-22.
Slonim J, Kienhuis M, Di Benedetto M, Reece J. The relationships among self-care, dispositional mindfulness, and psychological distress in medical students. Med Educ Online. 2015 Jan 1;20(1):1-13.
Smith CK, Peterson DF, Degenhardt BF, Johnson JC. Depression, anxiety, and perceived hassles among entering medical students. Psychol Health Med. 2007 Jan 1;12(1):31-9.
Moffat KJ, McConnachie A, Ross S, Morrison JM. First year medical student stress and coping in a problem‐based learning medical curriculum. Med Educ. 2004 May 1;38(5):482-91.
Shankar PR, Singh KK, Singh S. Possible impact of increase in female medical student admissions in Nepal: Findings from a qualitative study among medical undergraduates. Australas Med J. 2012;5(3):184-93.
Thompson T, Davis H, Davidson J. Attributional and affective responses of impostors to academic success and failure outcomes. Pers Individ Diff. 1998 Aug 31;25(2):381-96.
Gopalakrishnan V, Umabalan T, Affan M, Zamri AA, Kamal A, Sandheep S. Stress perceived by houseman in a hospital in northern Malaysia. Med J Malaysia. 2016 Feb;71(1):8-11.
Cozzarelli C, Major B. Exploring the validity of the impostor phenomenon. J Soc Clin Psychol. 1990 Dec;9(4):401-17.
Supe AN. A study of stress in medical students at Seth GS Medical College. J Postgrad Med. 1998 Jan 1;44(1):1-6.
Sherina MS, Kaneson N. The prevalence of depression among medical students. Malays J Psychiatry. 2003;11(1):12-7.
Zaid ZA, Chan SC, Ho JJ. Emotional disorders among medical students in a Malaysian private medical school. Singapore Med J. 2007 Oct;48(10):895-9.
Villwock JA, Sobin LB, Koester LA, Harris TM. Impostor syndrome and burnout among American medical students: a pilot study. Int J Med Educ. 2016;(7):364-9.
Martín-Albo J, Núñez JL, Navarro JG, Grijalvo F. The Rosenberg Self-Esteem Scale: translation and validation in university students. Span J Psychol. 2007 Nov;10(2):458-67.
Osman A, Hoffman J, Barrios FX, Kopper BA, Breitenstein JL, Hahn SK. Factor structure, reliability, and validity of the Beck Anxiety Inventory in adolescent psychiatric inpatients. J Clin Psychol. 2002 Apr 1;58(4):443-56.
Zhang YL, Liang W, Chen ZM, Zhang HM, Zhang JH, Weng XQ, et al. Validity and reliability of Patient Health Questionnaire‐9 and Patient Health Questionnaire‐2 to screen for depression among college students in China. Asia Pac Psychiatry. 2013 Dec 1;5(4):268-75.
Qureshi MA, Taj J, Latif MZ, Zia S, Rafique M, Chaudhry MA. Imposter Syndrome among Pakistani Medical Students. Ann King Edward Med Univ. 2017 Aug 17;23(2):106-10.
Dowd SB, Davidhizar R. Do you feel like an impostor?. Health Care Superv. 1997 Mar;15(3):51-6.
Mastenbroek NJ, van Beukelen P, Demerouti E, Scherpbier AJ, Jaarsma AD. Effects of a 1 year development programme for recently graduated veterinary professionals on personal and job resources: a combined quantitative and qualitative approach. BMC Vet Res. 2015 Dec;11(1):1-13.
Clark M, Vardeman K, Barba S. Perceived inadequacy: A study of the imposter phenomenon among college and research librarians. Coll Res Libr. 2014 May 1;75(3):255-71.
Antoine D, Hutchison M, Follman D. The undergraduate research experience as it relates to research efficacy beliefs and the imposter phenomenon. American Society for Engineering Education, 113th Annual ASEE Conference and Exposition 2006 Jun 18-21.
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