IMPROV-ing The Impostor Phenomenon

June 21, 2023 updated by: Esther Bui, University Health Network, Toronto
The impostor phenomenon refers to feelings of self-doubt and fraudulence in one's own abilities, despite the presence of external evidence to suggest otherwise. Symptoms of the impostor phenomenon can impede achievement of career-related goals in medical trainees and impact resilience, stress levels, and burnout. If these symptoms go unnoticed, they could progress to a severity that threatens sustained wellness among medical trainees. Our research questions are: 1) Is the time of the academic year (e.g., beginning, middle, end) associated with severity in impostor phenomenon as measured by the Clance Impostor Phenomenon Scale (CIPS) in medical trainees at the University of Toronto? 2) Is participation in improvisation workshops over the course of an academic year a feasible intervention to mitigate symptoms of impostor phenomenon in medical trainees at the University of Toronto? Combined, our two-part study will explore peak risk periods of impostor phenomenon and whether improvisation workshops are a feasible intervention to address this.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Detailed Description

Part 1 of the study:

This will be a prospective cohort study investigating the longitudinal prevalence and levels of impostor phenomenon among medical trainees over the course of one calendar year. Outcomes of interest will be measured in each participant every 3 months with rolling recruitment into the study until the end of the study. Recruitment will last for 2 years. Study investigators will offer and administer an electronic survey to measure impostor phenomenon and symptoms using validated scales. The surveys will be administered to all consenting medical trainees participating in University of Toronto-affiliated hospital rotations on the first day of the rotation. Participant recruitment will occur at University of Toronto-affiliated medical school and hospitals.

Part 2 of the study:

Among participants invited for research question 1 of our study, 10-20 participants will be recruited to further explore the feasibility of an improvisation curriculum during medical training. If volunteer numbers exceed 20, participants will be randomly chosen from the group of interested participants. This curriculum will be a uniquely designed series of flexibly-timed improvisation workshops administered during the study period. Based on within-study participant feedback, sessions will be organized to develop optimal timing and duration of improvisation sessions. Previous studies on improvisation in medical education have varied in terms of timing, frequency, and exercises. Accordingly, each improvisation workshop will involve a series of exercises derived from an improvisation game book previously developed by study investigators, followed by a reflective debrief of the experience. Although improvisation workshops can vary as described, a recently published scoping review revealed three consistent structural elements that will serve as a framework for the improvisation intervention in this study: orientation and setup, culture of safety, and debriefing. Pre-session readings will orient participants to key principles and skills in improvisation. During the exercises, facilitators foster a culture of safety by normalizing uncertainty, creating a low-stakes environment, and providing freedom for time-outs. Improvisation exercises will be followed by debrief to reflect on the session, exchange feedback, and draw connections between improvisation and the impostor phenomenon.

The workshops for this study are designed based on the recommendations established by previous studies with improvisation in medical education. Using published guidelines, workshops will have groups of approximately 10 study participants and last on average 2 hours under the instruction of an expert medical improvisation facilitator. Improvisation sessions will be initially planned to be delivered once per month for 2 hours for four consecutive months with built-in flexibility with respect to session duration and frequency based on participant feedback. Additional sessions can be subsequently offered biweekly and/or for longer than 4 months (up to 10 months) as needed.

Study Type

Interventional

Enrollment (Actual)

200

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Canada
    • Ontario
      • Toronto, Ontario, Canada, M5T 2S8
        • University Health Network

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Have official registration with the University of Toronto Undergraduate or Postgraduate Medical Education offices

Exclusion Criteria:

  • Non-fulltime student status
  • Exclusion criteria will include participating in the "Improv(ing) the Impostor Phenomenon" study as a co-investigator or concurrent participation in a structured unrelated improvisation program, workshop series, or class outside of the study (ex. The Second City Training Programs/Classes)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Non-Randomized
  • Interventional Model: Sequential Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Observational
Experimental: Improvisation Workshops
Participants will take part in an improvisation curriculum containing a uniquely designed series of flexibly-timed improvisation workshops administered during the study period. Using published guidelines, workshops will have groups of approximately 10 study participants and last on average 2 hours under the instruction of an expert medical improvisation facilitator.
Behavioral: Improvisation Workshop
Each improvisation workshop will involve a series of exercises derived from an improvisation game book previously developed by study investigators, followed by a reflective debrief of the experience.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Impostor phenomenon score
Time Frame: 3 months
Score measured by the Clance Impostor Phenomenon Scale; scores can range from 20-100, with higher scores indicating more intense symptoms of impostor phenomenon
3 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Resilience score
Time Frame: 3 months
Score measured by the Connor-Davidson Resilience Scale; scores can range from 0-100, with higher scores meaning higher resilience
3 months
Perceived stress score
Time Frame: 3 months
Score measured by the Perceived Stress Scale; scores can range from 0-40, with higher scores meaning higher perceived stress
3 months
Burnout
Time Frame: 3 months
Measured by the Maslach Burnout Inventory-Human Services Survey -2 for Medical Personnel with no quantitative score
3 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University Health Network, Toronto

Collaborators

Postgraduate Medical Education, University of Toronto

Investigators

  • Principal Investigator: Esther Bui, MD, University Health Network, Toronto

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 17, 2022

Primary Completion (Estimated)

January 31, 2024

Study Completion (Estimated)

January 31, 2024

Study Registration Dates

First Submitted

January 27, 2022

First Submitted That Met QC Criteria

January 27, 2022

First Posted (Actual)

February 8, 2022

Study Record Updates

Last Update Posted (Actual)

June 23, 2023

Last Update Submitted That Met QC Criteria

June 21, 2023

Last Verified

June 1, 2023

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 30194

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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