Breaking the Cycle of Imposter Syndrome

Samantha Minnick, PharmD 

PGY2 Pharmacy Resident 

Children’s National Hospital

Have you ever felt as though you don't deserve to have your career or educational success? Potentially doubted your own knowledge or skillset; waiting for those around you to discover you're an "imposter" among the group? Like you are waiting for the shoe to drop and be "discovered" for who you really are? If you can relate to any of these concepts you may have experienced a phenomenon called imposter syndrome.

im·post·er syn·drome: (noun Psychology) 1. anxiety or self-doubt that results from persistently undervaluing one's competence and active role in achieving success, while falsely attributing one's accomplishments to luck or other external forces.¹

Pauline Rose Clance and Suzanne Imes from Georgia State University first described "imposter phenomenon" in 1978 through their work in psychotherapy with highly educated women who possessed PhD's, scholastic honors or were respected professionals in their field of work.² They discovered a trend where these women, albeit very successful, did not possess an internal sense of success. They frequently described feeling like an "imposter", being wrongfully admitted to a graduate program, strongly feeling as though they were not as intelligent as others praised them to be and that their success was from luck alone. These women were more likely to project their successes onto a temporary quality or an external factor such as "good timing" or "luck", where men were more likely own their success and experience this imposter phenomenon both less frequently and with less intensity. The authors deemed this imposter phenomenon was mostly plaguing middle class, white women who were high achieving and well accomplished when compared to men.² As the years went on Clance and other researchers acknowledged that these feelings of self-doubt and being underqualified were not unique to women and also affected men at similar rates.³  

Imposter syndrome also affects instructors, specifically higher education instructors, instructional designers and those within an academic system. Kristi Owens, an Idol Courses academy member and instructional designer, conducted an anonymous survey across LinkedIn and Facebook to determine how many other shared the feelings of Imposterism she so frequently felt despite 15 years of experience in education.⁴ The survey population included those from higher education, finance, healthcare, corporate and government job settings to name a few. Nearly 40% of the study population had functioned as an instructional designer for 5 to >10 years, another 40% had practiced for 1-5 years. The results showed that 2/3 of instructional designers who were surveyed reported feeling Imposterism at least once per month.  Those in healthcare instructional design reported feeling Imposterism once per week (30%) or every day (~40%). This group had the highest percentage of experiencing feelings of Imposterism every day.⁴ This is a pivotal statistic to consider as a group of learners actively pursuing a role in instructional design within a healthcare setting. If we ourselves are struggling with feelings of self-doubt or lack of belief in our success it could be extremely difficult to provide the confidence and support we need for our learners.

Maqsood and colleagues presented a cross sectional analysis in the International Journal of Research of Medical Sciences in 2018 to evaluate the frequency and severity of imposter syndrome experienced by medical students to assist in improving teaching and learning methodologies.⁵ The Clance Imposter Phenomenon Scale was used to assess the severity of imposter syndrome among participants. This scale helps to identify common behaviors or thoughts that are seen in imposter syndrome such as perfectionism, fear of failure, overworking and saying phrases such as "I just got lucky" to discredit their achievements. A total of 189 (94.5%) students completed the questionnaire, 38% had moderate severity and 54.5% had severe imposter syndrome. Male students accounted for a larger percentage in both the moderate and severe categories (70.8% and 68.9%) compared to women. Which is an interesting statistic when comparing the rates of imposter syndrome to the original research of Clance and Imes. Imposter syndrome in the setting of medical training can alter learning styles, student participation when compared to those unaffected and reduce the efficiency of a learners work or lead to burnout.⁵ Pharmacy students have only been explicitly described within one study from Henning et al, that surveyed a multidisciplinary school which included nursing, medical and pharmacy students. This study reported 30% of that surveyed reported experiencing imposter syndrome.⁶       

As educators and high achieving members of our fields we have the opportunity to assist our learners in identifying these feelings and providing resources for them to combat these feelings of self-doubt. Much of the recent research surrounding imposter syndrome does provide resources on how to identify and combat feelings of imposter syndrome as instructors, for ourselves and our learners. Some opportunities to overcome imposter syndrome as an educator is to change our own narrative; to tell ourselves instead of "I don't know anything" but rather "I may not know this, but I am capable of finding the answer".⁷ Another opportunity is to use the resources we all have readily available; be it literature, group forums, colleagues or past mentors. This will allow you to explore information you may already know or to find answers you knew you needed. For our learners, it will be crucial to recognize the student population we are engaging with and to recognize the possibility for feelings of imposter syndrome and to design classes or educational opportunities that directly work against behaviors we have discussed above that reinforce imposter syndrome. Examples could include; working in smaller groups to ease the fear of being incorrect, focusing on strengths of the learners to build confidence and a rapport rather than being solely critical of mistakes and to encourage discussion that will allow for a collaborative thought process between peers that can empower those with more self-doubt. By advancing the conversation surrounding imposter syndrome, it will bring with it an increased awareness and an increased acknowledgement of what changes need to occur to break the cycle of these intrusive and self-doubting thoughts.

References

1. Dictionary.com; https://www.dictionary.com/browse/impostor-syndrome

2. Clance PR, Imes S. The imposter phenomenon in high achieveing women: dynamics and therapeutic intervention. Psychotherapy Theory, Research and Practice. 15(3): 1978

3. Dalla-Camina M. The Reality of Imposter Syndrome. Psychologytoday.com. Sep 03, 2018.

4. Olivia K. Do you feel like an imposter? You're in good company. Idolcourses.com. Aug 2020 https://www.idolcourses.com/blog/Imposter

5. Maqsood H et al. The descriptive study of imposter syndrome in medical students. Int J Res Med Sci. 6(10): 3431-3434. 2018

6. Boyle JA, Bonenfant SE. The fear of being found out in pharmacy: how imposter syndrome may be holding us back. Pulses. Published: Jul 23, 2019.

7. Schock G. How imposter syndrome affects students - and instructors. Today's Learner/ Insight for Educators. https://todayslearner.cengage.com/how-imposter-syndrome-affects-students-and-instructors/