Division of General Internal Medicine, Greater Baltimore Medical Center, Baltimore, MD, USA.
Division of General Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
BMC Med Educ. 2023 Jan 24;23(1):57. doi: 10.1186/s12909-022-03982-8.
Imposter phenomenon is common among medical trainees and may influence learning and professional development. The authors sought to describe imposter phenomenon among internal medicine residents.
In 2020, using emailed invites we recruited a convenience sample of 28 internal medicine residents from a teaching hospital in Baltimore, Maryland to participate in an exploratory qualitative study. In one-on-one interviews, informants described experiences of imposter phenomenon during residency training. Using thematic analysis to identify meaningful segments of text, the authors developed a coding framework and iteratively identified and refined themes. Informants completed the Clance Imposter Phenomenon Scale.
Informants described feelings and thoughts related to imposter phenomenon, the contexts in which they developed and the impact on learning. Imposter phenomenon has profound effects on residents including: powerful and persistent feelings of inadequacy and habitual comparisons with others. Distinct contexts shaping imposter phenomenon included: changing roles with increasing responsibilities; constant scrutiny; and rigid medical hierarchy. Learning was impacted by inappropriate expectations, difficulty processing feedback, and mental energy diverted to impression management.
Internal medicine residents routinely experience imposter phenomenon; these feelings distort residents' sense of self confidence and competence and may impact learning. Modifiable aspects of the clinical learning environment exacerbate imposter phenomenon and thus can be acted upon to mitigate imposter phenomenon and promote learning among medical trainees.
冒名顶替现象在医学受训者中很常见，可能会影响学习和职业发展。作者试图描述内科住院医师中的冒名顶替现象。
2020 年，作者使用电子邮件邀请，从马里兰州巴尔的摩的一家教学医院招募了 28 名内科住院医师作为便利样本，参与一项探索性定性研究。在一对一的访谈中，告知者描述了在住院医师培训期间经历冒名顶替现象的情况。作者使用主题分析来识别文本中有意义的片段，开发了一个编码框架，并迭代地识别和精炼主题。告知者完成了 Clance 冒名顶替现象量表。
告知者描述了与冒名顶替现象相关的感受和想法、他们发展的背景以及对学习的影响。冒名顶替现象对住院医师有深远的影响，包括：强烈而持久的不足感和习惯性地与他人比较。塑造冒名顶替现象的独特背景包括：角色变化，责任增加；不断的监督；以及僵化的医疗等级制度。学习受到不适当期望、难以处理反馈以及注意力转移到印象管理的影响。
内科住院医师经常经历冒名顶替现象；这些感觉扭曲了住院医师的自信和能力感，可能会影响学习。临床学习环境中可改变的方面加剧了冒名顶替现象，因此可以采取行动来减轻冒名顶替现象，促进医学受训者的学习。
