Neufeld Adam, Malin Greg, Babenko Oksana, Orsini Cesar
Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Department of Family Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Teach Learn Med. 2024 Aug 8:1-9. doi: 10.1080/10401334.2024.2388223.
Impostor phenomenon (IP) is strongly linked to physician burnout, but the nature of this association is not well understood. A better grasp of the mechanism between these constructs could shed new light on ways to mitigate physician IP and burnout. Grounded in self-determination theory (SDT), the present study explores whether and how residents' general causality orientations at work-impersonal, controlled, and autonomous-each moderate the effect of IP on physician burnout. We theorized that the autonomous orientation would buffer the facilitative effect of IP on burnout, while the controlled and impersonal orientations would each enhance it to varying degrees. Two hundred forty-three residents from the Universities of Saskatchewan, Calgary, and Alberta, across various programs, specialties, and years of training, completed a survey containing demographic questions and three previously validated instruments: the Clance Impostor Phenomenon Scale, Causality Orientations at Work Scale, and Oldenburg Burnout Inventory. We used partial correlation analyses to test our moderation hypotheses. In line with what we expected, the autonomous causality orientation buffered the facilitative effect of IP on burnout, while the controlled and impersonal causality orientations each enhanced it. Results suggest that possessing a stronger autonomous causality orientation (and creating learning/work environments that prime it) will dampen the effect of IP on burnout, while possessing a stronger controlled or impersonal causality orientation (and creating learning/work environments that prime them) will each augment it. Findings and their implications are discussed in terms of instigating theory-informed, system-level wellness interventions in graduate medical education.
冒名顶替现象（IP）与医生职业倦怠密切相关，但这种关联的本质尚未得到充分理解。更好地掌握这些概念之间的机制，可能会为减轻医生的冒名顶替现象和职业倦怠提供新的思路。基于自我决定理论（SDT），本研究探讨住院医师在工作中的一般因果取向（即非个人取向、受控取向和自主取向）是否以及如何调节冒名顶替现象对医生职业倦怠的影响。我们推测，自主取向会缓冲冒名顶替现象对职业倦怠的促进作用，而受控取向和非个人取向则会在不同程度上增强这种作用。来自萨斯喀彻温大学、卡尔加里大学和阿尔伯塔大学的243名住院医师，涉及各个项目、专业和培训年份，完成了一项包含人口统计学问题以及三种先前经过验证的工具的调查：克兰斯冒名顶替现象量表、工作因果取向量表和奥尔登堡职业倦怠量表。我们使用偏相关分析来检验我们的调节假设。与我们的预期一致，自主因果取向缓冲了冒名顶替现象对职业倦怠的促进作用，而受控因果取向和非个人因果取向则增强了这种作用。结果表明，拥有更强的自主因果取向（并创造能激发这种取向的学习/工作环境）将减弱冒名顶替现象对职业倦怠的影响，而拥有更强的受控或非个人因果取向（并创造能激发这些取向的学习/工作环境）则会增强这种影响。我们从在研究生医学教育中推动基于理论的系统层面健康干预的角度，讨论了研究结果及其意义。
