Not all ‘impostors’ are created equal: A dimensional, person-centered, and theory-based analysis of medical students

Abstract

Purpose

Research on the impostor phenomenon (IP) is rapidly growing in medical education due to its relationship with distress and burnout. How IP is theoretically conceptualized and analyzed has been inconsistent, however, which limits our understanding of results and how to act on them. We hypothesized that a person-centered analysis, in combination with a robust theoretical framework, would provide a more specific ‘profile’ of medical student IP and help to optimize supports for their well-being.

Materials & methods

We used exploratory factor analysis to assess the factor structure of the Clance Impostor Phenomenon Scale (CIPS) in medical students, followed by cluster analysis to identify distinct ‘impostor’ profiles, based on the identified factors. We then used self-determination theory’s (SDT) framework of motivation to explore how students in each profile differed in their general causality orientation, autonomous motivation towards going to medical school, and psychological need satisfaction in the medical program – factors that SDT identifies as predictors of engagement, performance, and well-being.

Results

Factor analysis yielded three main IP factors – feeling like a fake, attributing success to luck, and discounting achievement – in line with Clance’s original definition of IP. The cluster analysis then identified four distinct IP profiles based on individual differences in these factors, each varying in aspects of their self-determination.

Conclusions

This study sheds light on the ways that medical students may experience IP, further reinforcing the notion that not all ‘impostors’ are created equal. Findings support the three-factor structure of the CIPS among medical students, and that most students will fall into one of four IP profiles. These profiles and their implications are discussed.

Keywords:

• Impostor phenomenon
• medical students
• CIPS
• self-determination

Author contributions

All authors contributed to the study and read and approved the final version of the manuscript. Authors AN and OB contributed equally with the study’s conception and design, statistical analyses, and writing of the initial manuscript. GM edited and provided constructive feedback through several iterations of the paper.

Data availability statement

The dataset from this research is available upon reasonable request.

Disclosure statement

The authors have no conflicts of interest to declare.

Additional information

Funding

There was no funding associated with this research.

Notes on contributors

Adam Neufeld

Adam Neufeld, MSc, MD, CCFP, is a Family Physician and Faculty Member in the Department of Family Medicine at the University of Calgary. His research interests are in medical education and physician motivation and well-being.

Oksana Babenko

Oksana Babenko, PhD, is an Associate Professor in the Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta. Her research interests are motivation and well-being in health professions education.

Greg Malin

Greg Malin, MD, PhD, is a Faculty Member in the Department of Academic Family Medicine, and Academic Director for the Undergraduate Medical Education program at the University of Saskatchewan. His areas of interest are in medical education and self-determination.