Imposter phenomenon (IP) was first described by Clance and Imes in 1978, as a psychological experience of perceived professional fraudulence and self-deception.1 There is debate whether viewing it as a ‘syndrome’ attaches further negative connotations to an experience which is not characterized as a disease or disorder.2 However, understandably it is be viewed as a syndrome due to the collective symptoms experienced on a spectrum. The collective symptoms are held despite evidence of praise and accomplishments, further impeding individuals to reach their highest potential as the symptoms are strongly associated with self-doubt regarding intellect and ability to perform to a high standard professionally.3 Interestingly, these feelings of inadequacy are not related to all aspects of their role but vary between contexts and cases.2
Predisposition to IP is multifactorial; age, gender, ethnicity, profession, co-morbidities, and parenting styles have all been linked to developing IP.4 In the past, IP was strongly linked to high achieving women, further being described as the cause for missed opportunities and lack of women in senior leadership.5 Over the years, this gender stereotype has been challenged by research comparing IP in men and women, concluding that even though the phenomenon is more common in women it does negatively impact men in varying professional settings. Regardless of gender, IP has been repeatedly conceptualized in high-achieving individuals with feelings of fear and failure centered around goal achievement and ability.6 High achieving individuals are professionals who excel in their field and respected for their expertise. This ranges from, but is not limited to, students, scholars, artists, and professionals within finance, business, and healthcare. These professionals are categorized as ambitious, self-critical, and focused on their internal desire to achieve meaningful goals. These characteristics make high achievers prime targets for IP as their achievement-orientated personalities develop a sense of ‘intellectual phoniness,’ which may be deeply rooted within parental expectations and family environment as a child.7
IP has been explored by teachers, accountants, nurses, and business professionals.4 In the past decade, this phenomenon has been reported in medical and dental students, with an increasing interest in exploring its presence within healthcare specialties. However, there is limited research in the fields of dentistry, medicine, physician associates, and even less in surgery. 8,9 IP explored in General and Neurosurgery residents reported significant levels of imposterism in most of the participants.10–12 Since IP is prevalent in high-achieving industries, it is likely that exploring the phenomenon further within healthcare sub-specialties will reap parallel results to studies already undertaken.8
Even though defining and exploring IP in a professional workplace creates an increased sense of individual and collective awareness, this is not sufficient. IP has several adverse consequences on an individual’s functioning, even more concerning the effects on mental health, leading to emotional exhaustion, work-related stress, and work-life conflict, along with perfectionism, burnout, and suicide.13–17 Lastly, the consequences of IP extend beyond the individual. Self-doubt can lead to feelings of inadequacy when reviewing positions in leadership or promotion. By refraining from such positions, individuals not only hinder their own career progression, but local or national organizations also miss out on the valuable expertise that could benefit their organization. Such systematic effects can reduce diversity. This is further perpetuated by the prevalence of IP in racial and ethnic minorities.18 Therefore, to promote diversity and inclusion with a view to further foster a supportive environment for employees of all backgrounds, it is important to understand how IP is identified and managed not only at the individual level but also by peers, institutions, and industries. It is important to identify the diagnostic tools used to identify IP in high-achieving individuals. A brief preliminary search of PubMed, Cochrane Database of Systematic Reviews, and PROSPERO identified the Clance Imposter phenomenon Scale (CIP) as the most used validated quantifiable measurement to identify IP; however, qualitative methodologies and other quantifiable scales such as the Young Impostor Scale (YIS) have also been adopted.16 It appears that most studies only identify the presence of IP in individuals without further intervention. A preliminary search specifically looking for interventions for IP demonstrated some descriptions of workshops and group discussions in the USA, with limited interventions developed in healthcare. It is therefore important to widen the search to include non-healthcare specialties; examples are but not limited to education, business, and finance.
Matthews and Clance in 1985, described their experience of managing imposter feelings in their patients through techniques of validating fears and addressing failures.19 A review of IP conducted in 2018, did not uncover any specific intervention for the phenomenon or evaluation of treatment.4 The past few years has seen more engagement in creating awareness about IP through educational interventions such as group discussions and workshops. This scoping review aims to highlight educational interventions that have been developed to equip high-achieving individuals with strategies to overcome IP. The review will evaluate all available published studies identifying interventions used to combat IP and the impact of the intervention, if described.