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Impostorism in American medical students during early clinical training: gender differences and intercorrelating factors.

ABSTRACT: Objectives:This study examined the incidence and severity of impostorism in third-year medical students as they transitioned from the preclinical to clinical phases of training. Methods:A cross-sectional study was conducted in third-year medical students (N=215). Respondents completed a voluntary, anonymous, 60-item survey that included the Clance Impostor Phenomenon Scale and the Perceived Stress Scale. Student's-t, Mann-Whitney, and Chi-Square tests and Pearson correlation were used to determine differences between subgroups of students and relationships between instruments scores and demographic parameters. Results:Fifty-nine percent of students responded with N=112 (59% female) completing at least one instrument. The mean impostor score was 63.0 ± 14.6 (moderate-to-frequent impostor feelings) and was 9% higher in females (U=1181, p = .046). Perceived Stress scores for females were 17% higher than males (t(109)=2.87, p=.005). Females had lower United States Medical Licensing Examination (USMLE) Step 1 scores (t(107)= 3.06, p=.003). Impostor and perceived stress scores were correlated for males (r(46)=.47, p=.002) and females (r(64)=.54,p<.0001). Impostor and USMLE Step 1 scores were negatively correlated for males (r(45) =-.32, p= .034) but not females (r(63) = -.11, p=.40). Conclusions: These findings demonstrate the intercorrelation between impostorism and stress in male and female medical students and raise interesting questions regarding the contributions of gender and other factors involved with medical training.

SUBMITTER: Levant B

PROVIDER: S-EPMC7246127 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Impostorism in American medical students during early clinical training: gender differences and intercorrelating factors.

Levant Beth B Villwock Jennifer A JA Manzardo Ann M AM

International journal of medical education 20200429

<h4>Objectives</h4>This study examined the incidence and severity of impostorism in third-year medical students as they transitioned from the preclinical to clinical phases of training.<h4>Methods</h4>A cross-sectional study was conducted in third-year medical students (N=215). Respondents completed a voluntary, anonymous, 60-item survey that included the Clance Impostor Phenomenon Scale and the Perceived Stress Scale. Student's-t, Mann-Whitney, and Chi-Square tests and Pearson correlation wer ...[more]

PMID: 32356519

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Project description:Mistreatment of medical students during medical education is a widespread concern. Studies have shown that medical students report the most mistreatment compared to students of other study programs and that the prevalence of mistreatment peaks during clinical training. For this reason, a study was conducted to assess prevalence of mistreatment among medical students committed by various groups of people. The focus was to identify whether gender was associated with the experience of mistreatment. Additionally, students' perception of university climate for reporting sexual harassment was assessed.In the study 88 medical students (45 women, 43 men) participated. A modified version of the Questionnaire on Student Abuse was used to assess students' experience of various types of mistreatment and associated distress during medical education. To explore factors that could be associated with this experience the organizational climate for reporting sexual harassment was assessed with the Psychological Climate for Sexual Harassment.The most often cited perpetrators of mistreatment were strangers (79.5%), friends (75.0%) and university staff (68.2%). Strangers mostly committed psychological mistreatment and sexual harassment, whereas friends additionally engaged in physical mistreatment of medical students. The most common form of mistreatment conducted by university staff was humiliation of students. These kinds of psychological mistreatment were reported to be distressing (43%). Gender differences were found in the prevalence of mistreatment. Women experienced more sexual harassment and humiliation than did men. On the other hand, men experienced more physical mistreatment than did women. Women reported experiencing more distress from mistreatment experiences than did men and also more often reported being mistreated by university staff than did men. Women perceived a greater risk in reporting sexual harassment to the organization than did men.Mistreatment of female and male students should be focused on using a gender perspective because types of mistreatment can differ by gender. Additionally, interventions should include the societal level as there was a high prevalence of mistreatment perpetrated by strangers. Also the issue of trust in the university needs to be addressed and the organization is called on to visibly demonstrate that it represents and protects its students as well as its staff.

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Project description:BackgroundIn varied educational settings, narrative evaluations have revealed systematic and deleterious differences in language describing women and those underrepresented in their fields. In medicine, limited qualitative studies show differences in narrative language by gender and under-represented minority (URM) status.ObjectiveTo identify and enumerate text descriptors in a database of medical student evaluations using natural language processing, and identify differences by gender and URM status in descriptions.DesignAn observational study of core clerkship evaluations of third-year medical students, including data on student gender, URM status, clerkship grade, and specialty.ParticipantsA total of 87,922 clerkship evaluations from core clinical rotations at two medical schools in different geographic areas.Main measuresWe employed natural language processing to identify differences in the text of evaluations for women compared to men and for URM compared to non-URM students.Key resultsWe found that of the ten most common words, such as "energetic" and "dependable," none differed by gender or URM status. Of the 37 words that differed by gender, 62% represented personal attributes, such as "lovely" appearing more frequently in evaluations of women (p < 0.001), while 19% represented competency-related behaviors, such as "scientific" appearing more frequently in evaluations of men (p < 0.001). Of the 53 words that differed by URM status, 30% represented personal attributes, such as "pleasant" appearing more frequently in evaluations of URM students (p < 0.001), and 28% represented competency-related behaviors, such as "knowledgeable" appearing more frequently in evaluations of non-URM students (p < 0.001).ConclusionsMany words and phrases reflected students' personal attributes rather than competency-related behaviors, suggesting a gap in implementing competency-based evaluation of students. We observed a significant difference in narrative evaluations associated with gender and URM status, even among students receiving the same grade. This finding raises concern for implicit bias in narrative evaluation, consistent with prior studies, and suggests opportunities for improvement.

Dataset Information

Impostorism in American medical students during early clinical training: gender differences and intercorrelating factors.

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Impostorism in American medical students during early clinical training: gender differences and intercorrelating factors.

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