Impostor Syndrome and Burnout in Swiss Residents and Chief Residents Anaesthesiologists

Study Overview
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Brief Summary
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Surveys including a demographic chart, the Clance Impostor phenomenon scale (CIPS) and the Malash burnout inventory for medical personnel (MBI-HSS-MP) will be sent to residents and chief-residents in anesthesiology in Latin Switzerland (VD, VS, GE, Ti). A qualitative study will then explore the experiences and coping strategies of self-doubt and impostor syndrome of junior resident anesthesiologists working at Geneva University Hospital, during their transition from mandatory training in internal medicine to anesthesiology.

Detailed Description
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The Impostor syndrome (IS), as first described by Clance and Imes, is the Inability to internalize success and the tendency to attribute success to external causes such as luck, error or knowing the appropriate individuals. Failure to recognize personal or professional success may lead to a sense of fraudulence or impostorism and may have negative consequences for career advancement and well-being. IS has been described among men and women in multiple settings worldwide. A systematic review of IS found that it often co-occurs with depression and anxiety and can lead to poor job performance and burnout. A number of studies have explored IS among health professionals and its impact on professional performance. Healthcare professionals with heavy workloads and responsibility for patient care may be exposed to errors, feelings of self-doubt, anxiety and guilt. A recent scoping review of IS among physicians and physicians in training showed that low self-esteem, institutional culture and female gender were associated with higher rates of IS, which was itself associated with higher rates of burnout. Experiences of underperformance and inadequate self-assessment in physicians were also linked to self-doubt and feelings of fraudulence. Medical culture itself may encourage such individual blame and perfectionism. IS has not been well studied within the field of anesthesia. Anesthesia is a technical medical specialization characterized by its high stress level. Anesthesiologists are subject to burnout and drug dependence due to their work-related stress and facilitated access to medications. The responsibilities to care for patient lives during unstable periods brought by the surgical act or medical condition generates a particularly high tension for anesthesiologists. The purpose of our study is to assess the prevalence of IS and burnout in Swiss anesthesiology residents and chief residents and explore in depth the experiences and coping strategies of junior resident anesthesiologists in one French-speaking Swiss hospital. This will be done by first conducting a survey including two scales (one that assess Burnout (MBI-HSS MP) and one that assess Impostor Syndrome (CIPS)) and a demographic part to understand which residents and chief-residents are more prone to endure such feelings. The investigators also want to understand if those feelings are linked to a recent transition either in institutions or in role. The investigators also want to do in-depth interviews with residents in anesthesiology to understand how and in which situations those feelings arise and to uncover which coping strategies they use. The proposed study corresponds to risk category A, as participants in the study are not exposed to any direct health risk. Nonetheless, psychological support will be available to the participants taking part in the qualitative sub-study, in the event that surveys and interviews arouse difficult emotions. These results will be used to identify potential strategies to prevent IS and its negative consequences, potentially burnout, among Swiss anesthesiologists. The investigators plan to construct and implement (Test) interventions aimed at medical students and residents to increase knowledge of impostor syndrome and burnout and to give them tools to react to such feelings.

Official Title
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Prevalence and Experiences of Impostor Syndrome in Anaesthesiology Residents and Chief Residents

Conditions
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Impostor Phenomenon, Imposter Syndrome, Burnout, Professional, Burnout, Student

Intervention / Treatment
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* Diagnostic Test: Clance impostor phenomenon scale
* Diagnostic Test: Maslach Burnout Inventory for Medical Professional


Participation Criteria
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Eligibility Criteria
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Inclusion criteria for the survey: • Currently working hospitals included in the COMASUL network (COMmission Latine d'engagement pour l'Anesthésie et SUisse Latine : HUG - CHUV - Lugano - Bellinzona - Morges - Nyon - Rennaz - Payerne - Sion - Neuchâtel - Fribourg) Exclusion criteria for the survey: Working outside of the COMASUL network Specialized anaesthesiologists who are not currently chief residents. Inclusion criteria for the in-depth interviews: • Beginning anesthesiology residency at Geneva University Hospitals (HUG) in either May or November (standard residency starting times, which will be used as recruitment time) Exclusion criteria for the in-depth interviews: • Having started the anesthesiology residency at the HUG before the May or November recruitment times, or having previous work experience at the HUG in the anesthesiology department.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Residents in Anaesthesiology<br>The residents in Anaesthesiology (French-speaking part of Switzerland) will be enrolled to both: Fill a cross-sectional online survey Enter a qualitative study from the beginning of their residency at Geneva's university hospital | Diagnostic Test: Clance impostor phenomenon scale<br>* The CIPS will be used as diagnostic test in the online survey.<br>* Other names: CIPS;Diagnostic Test: Maslach Burnout Inventory for Medical Professional<br>* The MBI-HSS-MP will be used as diagnostic test in the online survey.<br>* Other names: MBI-HSS-MP;|
| Chief-Residents in Anaesthesiology<br>Chief-Residents (Board-certified anaesthesiologists after post-graduate training) in French-speaking part of Switzerland will be enrolled to fill a cross-sectional online survey | Diagnostic Test: Clance impostor phenomenon scale<br>* The CIPS will be used as diagnostic test in the online survey.<br>* Other names: CIPS;Diagnostic Test: Maslach Burnout Inventory for Medical Professional<br>* The MBI-HSS-MP will be used as diagnostic test in the online survey.<br>* Other names: MBI-HSS-MP;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Impostor syndrome | Describe the prevalence of and relationship between impostor syndrome in anaesthesiology residents and burnout (other outcome), as well as key socio-demographics. A validated score will be used: the Clance impostor phenomenon scale (CIPS) which is a 20 questions on a 5-point Likert scale that investigate feelings about self-assessment of competency, praise, and success. The higher the score, more the participant is prone to impostor syndrome. | 6 months | 
| Burnout | Describe the prevalence of and relationship between burnout in anaesthesiology residents and impostor syndrome (other outcome), as well as key socio-demographics. The MBI-HSS-MP (Maslach Burnout Inventory for medical personnel) will be used. It is a scale that captures three dimensions of burnout (emotional exhaustion, depersonalization and personal accomplishment) and uses a 7-level frequency scale on 22 questions. For the domains of depersonalization and emotional exhaustion, the higher the score, the more the participant is subject to burnout. For the domain of personal accomplishment, the lower the score, the more the participant is subject to burnout. | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Coping strategies used by residents regarding impostor syndrome and burnout | Residents in anaesthesiology will take part in a qualitative study on the experience of burnout and impostor syndrome in anesthesiology and the coping strategies they use. The qualitative interviews will assess how residents experience impostor syndrome and burnout and gather coping strategies they employ. A description of coping strategies will yield from analysis. | 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Impostor Phenomenon, Imposter Syndrome, Education, Burnout, Survey, Qualitative Research