Clinical trial NCT06097325: Impostor Syndrome and Burnout in Swiss Residents and Chief Residents Anaesthesiologists
Official title: Prevalence and Experiences of Impostor Syndrome in Anaesthesiology Residents and Chief Residents
Study type: OBSERVATIONAL
Overall status: ENROLLING_BY_INVITATION
Conditions: Impostor Phenomenon
Imposter Syndrome
Burnout, Professional
Burnout, Student
Keywords: Impostor Phenomenon
Imposter Syndrome
Education
Burnout
Survey
Qualitative Research
Lead sponsor: University Hospital, Geneva
Sponsor class: OTHER
Collaborators: name: Prof. Savoldelli Georges Louis
First posted: 2023-10-24
Enrollment: 100
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: OTHER
Time perspective: OTHER
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Residents and chief residents in anaesthesiology working in Latin Switzerland.

Residents are currently undergoing post-graduate medical training in Anaesthesiology

Chief-Residents have completed their residency and are board-certified Anaesthesiologists working in Swiss institutions.

We estimate a total population of about 140-150 residents and 100-120 chief residents.

Brief summary: 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: 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.

Eligibility criteria: 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.

Primary outcomes:
measure: Impostor syndrome
timeFrame: 6 months
measure: Burnout
timeFrame: 6 months
Secondary outcomes:
measure: Coping strategies used by residents regarding impostor syndrome and burnout
timeFrame: 2 years
Other outcomes:
Locations:
city: Geneva
country: Switzerland
facility: Geneva's university hospitals
Study officials:
affiliation: University Hospital, Geneva
name: Mia Gisselbaek, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Bravata DM, Watts SA, Keefer AL, Madhusudhan DK, Taylor KT, Clark DM, Nelson RS, Cokley KO, Hagg HK. Prevalence, Predictors, and Treatment of Impostor Syndrome: a Systematic Review. J Gen Intern Med. 2020 Apr;35(4):1252-1275. doi: 10.1007/s11606-019-05364-1. Epub 2019 Dec 17.
citation: Sirriyeh R, Lawton R, Gardner P, Armitage G. Coping with medical error: a systematic review of papers to assess the effects of involvement in medical errors on healthcare professionals' psychological well-being. Qual Saf Health Care. 2010 Dec;19(6):e43. doi: 10.1136/qshc.2009.035253. Epub 2010 May 31.
citation: Clance PR, Imes SA. The imposter phenomenon in high achieving women: Dynamics and therapeutic intervention. Psychotherapy: Theory, Research & Practice US: Division of Psychotherapy (29), American Psychological Association; 1978; 15: 241-7
citation: Rivera N, Feldman EA, Augustin DA, Caceres W, Gans HA, Blankenburg R. Do I Belong Here? Confronting Imposter Syndrome at an Individual, Peer, and Institutional Level in Health Professionals. MedEdPORTAL. 2021 Jul 6;17:11166. doi: 10.15766/mep_2374-8265.11166. eCollection 2021.
citation: Hutchins H, Rainbolt H. What triggers imposter phenomenon among academic faculty? A critical incident study exploring antecedents, coping, and development opportunities. Human Resource Development International 2016; 20: 1-21
citation: Neufeld A, Babenko O, Lai H, Svrcek C, Malin G. Why Do We Feel Like Intellectual Frauds? A Self-Determination Theory Perspective on the Impostor Phenomenon in Medical Students. Teach Learn Med. 2023 Apr-May;35(2):180-192. doi: 10.1080/10401334.2022.2056741. Epub 2022 Apr 17.
citation: Liu RQ, Davidson J, Van Hooren TA, Van Koughnett JAM, Jones S, Ott MC. Impostorism and anxiety contribute to burnout among resident physicians. Med Teach. 2022 Jul;44(7):758-764. doi: 10.1080/0142159X.2022.2028751. Epub 2022 Feb 1.
citation: Freeman KJ, Houghton S, Carr SE, Nestel D. Measuring impostor phenomenon in healthcare simulation educators: a validation of the clance impostor phenomenon scale and leary impostorism scale. BMC Med Educ. 2022 Mar 3;22(1):139. doi: 10.1186/s12909-022-03190-4.
citation: Gottlieb M, Chung A, Battaglioli N, Sebok-Syer SS, Kalantari A. Impostor syndrome among physicians and physicians in training: A scoping review. Med Educ. 2020 Feb;54(2):116-124. doi: 10.1111/medu.13956. Epub 2019 Nov 6.
citation: LaDonna KA, Ginsburg S, Watling C. "Rising to the Level of Your Incompetence": What Physicians' Self-Assessment of Their Performance Reveals About the Imposter Syndrome in Medicine. Acad Med. 2018 May;93(5):763-768. doi: 10.1097/ACM.0000000000002046.
citation: Gurman GM, Klein M, Weksler N. Professional stress in anesthesiology: a review. J Clin Monit Comput. 2012 Aug;26(4):329-35. doi: 10.1007/s10877-011-9328-7. Epub 2011 Dec 17.
citation: Maslach Burnout Inventory - Human Services Survey for Medical Personnel (MBI-HSS (MP)) - Assessments, Tests | Mind Garden - Mind Garden [Internet]. [cited 2022 Sep 28]. Available from: https://www.mindgarden.com/315-mbi-human-services-survey-medical-personne
citation: Feenstra S, Begeny CT, Ryan MK, Rink FA, Stoker JI, Jordan J. Contextualizing the Impostor "Syndrome". Front Psychol. 2020 Nov 13;11:575024. doi: 10.3389/fpsyg.2020.575024. eCollection 2020.