임포스터 신드롬: 당신 또는 당신의 멘티를 억누르고 있는가? (CHEST, 2019)

임포스터 신드롬: 당신 또는 당신의 멘티를 억누르고 있는가? (CHEST, 2019)
Impostor Syndrome Could It Be Holding You or Your Mentees Back?
Subani Chandra, MD, FCCP; Candace A. Huebert, MD, FCCP; Erin Crowley, MD; and Aneesa M. Das, MD, FCCP

 

"여기 있는 모든 사람들은 매우 성공적입니다! 그들은 매우 똑똑하고 재주가 있습니다. 나는 이 그룹에 속하지 않는다. 누군가의 실수로 여기 들어온 건 아닌지 궁금하다" 많은 이들이 직장생활 중 어느 순간 이와 비슷한 생각을 했을 것이다. 그러한 생각은 임포스터 증후군의 징후일 수 있다. 

“Everyone here is so successful! They are so smart and accomplished. I do not belong in this group. I wonder if I got invited by mistake.” Many may have had similar thoughts to this at some point in their career. Such thoughts may be a sign of impostor syndrome (IS). 

IS는 객관적인 증거에도 불구하고 자신의 업적이 부당하다고 믿는 성공한 사람들이 경험하는 사기감fraudulence입니다. IS는 교육생, 고급 진료 제공자, 제휴 의료 전문가, 의사를 포함한 모든 의료 전문가들 사이에서 널리 퍼져 있습니다. 비록 IS를 가진 사람들은 성공했지만, 그들은 스스로를 사기꾼으로 간주하고 그들의 성공을 능력보다는 운과 같은 외부 요인에 돌립니다. 자신들에게 부여된 성공과 성취를 진정으로 누릴 자격이 없거나 자격이 없다는 확신에 따라, 그들은 사기꾼으로 드러날까 두려워하며 살아간다. 
IS the feeling of fraudulence experienced by successful individuals who believe that their achievements are undeserved, despite objective evidence to the contrary. IS is prevalent among all health professionals including trainees, advanced practice providers, allied health professionals, and physicians. Although people with IS are successful, they consider themselves to be frauds and attribute their success to external factors, such as luck, rather than ability. Based on the conviction that they are not truly deserving of, or qualified for, the success and achievements attributed to them, they live in fear of being exposed as impostors. 

IS는 심리적인 고통, 특히 우울증과 불안감과 밀접한 관련이 있으며 의사와 훈련생들에게 점점 더 인식되고 있는 문제인 번아웃과 관련이 있다. IS를 가진 개인들은 일반적으로 잘 지내는 것처럼 보이지만 조용히 고군분투할 수 있는 성취도가 높은 사람들이다. IS 훈련생들은 특히 긍정적인 피드백을 내면화하지 못하고, 다른 이들이 자신의 능력에 대해 거짓으로 높은 인상을 갖고 있다는 생각에 자신이 받은 칭찬을 무시하기 때문에 취약하다. 이러한 접근 방식은 종종 능력이나 지능이 향상될 수 없다는 고정적인 사고방식과 결합되어 IS를 보유한 이들의 성장, 학습 및 신뢰에 큰 제약을 줄 수 있습니다. 실제로 IS는 학습자의 웰니스를 개선하는 데 있어 인식되지 않는 장벽이 될 수 있습니다. 또한 IS는 교육생뿐만 아니라 교수진과 리더십에서도 높은 유병률을 보이고 있으며, 시간, 경험, 성공으로 줄어들지 않습니다. IS를 관리하려면 영향을 받는 개인뿐만 아니라 학습 환경과 교육 방식도 포함하는 다각적인 접근 방식이 필요합니다. 

IS is strongly associated with psychologic distress—especially depression and anxiety—and is linked to burnout, a problem that is increasingly recognized in physicians and trainees. Individuals with IS are typically high achievers who seem to be doing well but may be struggling quietly. Trainees with IS are particularly vulnerable because they fail to internalize positive feedback, and disregard the accolades they receive, in the belief that others have a falsely high impression of their abilities. This approach, often combined with a fixed mindset of believing that ability or intelligence cannot be improved, can pose a significant constraint on the growth, learning, and confidence of those with IS. In fact, IS can be an unrecognized barrier to improving trainee wellness. Additionally, IS has a high prevalence not just in trainees but also in faculty and leadership, and it does not abate with time, experience, or success. Managing IS requires a multifaceted approach involving not only the individual affected but also the learning environment and pedagogic styles. 

정의 및 보급률
Definition and Prevalence

IS는 1970년대 후반 클랜스와 아이메스에 의해 성공을 내재화할 수 없는 성취도가 높은 사람들 사이에서 일어나는 현상이라고 처음 설명되었다. IS의 영향을 받은 이들은 자신들의 성공이 능력이 아닌 우연 때문이라고 확신하고 있으며, 그 성과가 미미하다고 보고 있다. 결과적으로 이들은 자신들이 성공률이 높은 사람들 속에서 사기꾼이고 또래들 사이에 속하지 않는다고 믿기 때문에 '발각될까 봐' 두려워하며 살아간다. 

IS was first described in the late 1970s by psychologists Clance and Imes as a phenomenon occurring among high achievers who are unable to internalize their success. Those affected by IS are convinced that their success is because of chance, rather than ability, and that their achievements are insignificant. Consequently, they believe that they are impostors amid highly successful people and do not belong among their peers, so they live with a fear of being “found out.” 

IS를 가진 사람들은 종종 성취도가 높지만, 그들은 성취도가 아니라 결코 충족되지 않는다고 인식되는 내부 기준에 의해 그들의 역량을 측정합니다. Young은 역량에 대한 자체 평가를 바탕으로 IS의 5가지 하위 유형을 설명합니다(표 1). 

Although people with IS are often high achievers, they measure their competence not by their achievements but by an internal set of standards which are never perceived to be met. Young describes 5 different subtypes of IS based on self-imposed assessments of competence (Table 1). 

 

IS를 가진 개인은 자신의 자아 회의와 사기성 감정을 IS로 인식하지 못할 수 있지만, '발각될 것'에 대한 두려움과 같은 IS의 측면과 쉽게 동일시할 수 있다. IS를 식별하고 IS의 심각성을 평가하는 데 도움이 되는 여러 도구가 개발되었습니다. 검증되고 잘 연구된 척도 중 하나는 클랜스 임포스터 현상 척도(표 2)로, 개인이 IS를 보유하고 있는지 여부와 IS의 심각성을 판단하는 데 사용할 수 있다. 
Individuals with IS may not recognize their feelings of self-doubt and fraudulence as IS, but they may readily identify with aspects of IS, such as the fear of being “found out.” Several instruments have been developed to help identify IS and assess its severity. One validated and well-studied measure is the Clance Impostor Phenomenon Scale (Table 2), which can be used to determine if an individual has IS and, if so, its severity. 

IS는 다양한 문화, 직업, 계급, 그리고 성공의 수준에 걸쳐 남성과 여성 모두에게 영향을 미칩니다. 실제로 많은 연예인들이 임포스터리즘에 대한 감정을 인정했고, 70%의 사람들이 IS를 한 번쯤 경험하게 될 것으로 추산된다. 클랜스와 아이메스는 IS가 여성에게만 일어나는 현상이라고 처음 보고했지만, 이후 연구에 따르면 남성도 IS를 경험하는 것으로 나타났다. 남성도 여성과 마찬가지로 성공에 대한 기대가 낮고 자신의 성취를 행운으로 돌릴 수 있지만, IS의 심각성은 여성에게서 더 높은 경향이 있다는 연구결과도 있다. 
IS affects both men and women across different cultures, occupations, ranks, and levels of success. In fact, many celebrities have acknowledged having feelings of impostorism, and it is estimated that 70% of people will experience IS at least once. Although Clance and Imes initially reported IS as a phenomenon occurring exclusively in women, further work has shown that men experience IS as well. Although men, just like women, can have low expectations of success and attribute their achievements to luck, some studies suggest that the severity of IS tends to be higher in women. 

훈련병 등 의료인이 IS에 특히 취약할 수 있다. 보건전문학교로의 경쟁적인 입학전형은 좋은 성적을 거두기 위해 스스로를 몰아붙이는 사람들을 선발하는 경향이 있다. 일단 선발되면, 이러한 최고의 성과자들은 종종 다른 비슷한 성취도가 높은 사람들에게 둘러싸여 있다는 것을 발견하게 되는데, 이것은 그들 자신의 성취를 비정형적이기 보다는 전형적인 것으로 정상화시킨다. 의료 훈련과 실습으로의 전환 과정에는 새로운 도전이 가득한데, 이는 자아 회의와 사칭의 감정을 고조시킬 수 있다. 헤닝 등은 한 대학의 의대생, 치과생, 간호생, 약대생 477명을 대상으로 IS 확산률을 30%로 집계했다. 빌웍 등은 의대생 138명 중 여성의 약 50%, 남성의 약 25%가 IS의 영향을 받았다고 전했다. 대부분의 연구는 임포스터리즘의 감정이 더 많은 훈련과 경험으로 누그러지지 않는다는 것을 보여준다. 실제로 빌웍 등은 의과대학 4학년이 훈련 초반과 비교해 IS의 증가와 상당한 연관성이 있다는 사실을 밝혀냈다. 대학원 의학교육 등에서도 IS의 높은 유병률이 이어지고 있다. 오리엘 등은 가정의학과 거주자 255명을 대상으로 조사한 결과 약 3분의 1이 IS(여성 41%, 남성 24%)를 보유하고 있는 것으로 나타났다. 캐나다의 48명의 내과 레지던트들을 대상으로 한 또 다른 연구에서 43.8%가 IS를 가지고 있다고 보고했다. 더군다나 외국인 유학생은 국내 졸업생에 비해 IS 보유 확률이 11배 가까이 높았다. 미국에서 수련하고 있는 대학원생과 의사들의 약 4분의 1이 국제적인 의학 졸업생들이라는 점을 고려하면, 이 연구 결과는 특히 주목할 만하다. 성취를 자신의 타고난 능력에 돌리지 못하고, 다음 번에는 운이 따르지 않을 수도 있다는 두려움은 성공이 임포스터리즘의 감정을 영속시키게 한다. 이에 따라 교수진 내 IS 유병률도 비슷하게 높은 것으로 나타났다. 

Medical professionals, including trainees, may be particularly vulnerable to IS. The competitive admissions process into health profession schools tends to select individuals who push themselves to perform well. Once selected, these top performers often find themselves surrounded by other similar high achievers, which normalizes their own achievements as typical rather than atypical. The process of medical training and transition to practice is fraught with new challenges, which can heighten feelings of self-doubt and impostorism. In 477 medical, dental, nursing, and pharmacy students at one university, Henning et al found the prevalence of IS to be 30%. Villwock et al reported that about 50% of women and 25% of men, out of 138 medical students, were affected by IS. Most studies show that impostor feelings do not abate with more years of training and experience. In fact, Villwock et al found that the fourth year of medical school was significantly associated with an increase in IS compared with earlier years in training. The high prevalence of IS continues into graduate medical education and beyond. Oriel et al surveyed 255 family medicine residents and found that about one-third had IS (41% of women and 24% of men). In another study of 48 internal medicine residents in Canada, Legassie et al reported that 43.8% had IS. Furthermore, foreign-trained residents had almost 11 times higher odds of having IS compared with local graduates. Given that approximately one-quarter of postgraduate trainees and physicians practicing in the United States are international medical graduates, this finding is particularly striking. The failure to attribute achievements to one’s inherent ability, and the fear that luck may not be so favorable next time, allows success to perpetuate the feelings of impostorism. As a result, the prevalence rate of IS among faculty also appears to be similarly high. 

영향 
Impact 

IS는 개인의 심리적, 신체적, 직업적 행복에 상당한 영향을 미칩니다(표 3). 성공을 내면화하지 못하는 것, 자기 회의감을 품는 것, 외부의 통제거점을 갖는 것, 능력의 인상을 유지하기 위한 만연한 필요성은 모두 IS를 가진 사람들의 심리적 안녕을 방해한다. IS는 훈련생들의 우울증과 불안감을 포함한 심리적 고통과 상당한 관련이 있다. 실제로 의대·치대·간호대·약대 학생들 사이에서는 IS의 중증도가 연령·성별·인종·결혼 여부·학년·정신건강치료 이력 등 평가된 모든 인구통계학적·인성적 데이터보다 일반적인 심리적 고통과 상관관계가 더 컸다. 
IS has significant impact on an individual’s psychologic, physical, and professional well-being (Table 3). The failure to internalize success, harboring feelings of self-doubt, having an external locus of control, and the pervasive need to maintain the impression of ability all interfere with the psychologic well-being of those with IS. IS is significantly associated with psychologic distress in trainees, including depression and anxiety. In fact, among students in medicine, dentistry, nursing, and pharmacy schools, the severity of IS was more strongly correlated with general psychologic distress than all of the demographic and personality data evaluated, including age, sex, race, marital status, academic year, and history of mental health treatment. 

 

IS를 가진 사람들은 실패를 피하기 위해 많은 압박을 받는 경향이 있습니다. 특히 가시성이 높을 수 있는 과제에 직면했을 때, 잠재적인 실패에 대한 불안감과 비현실적인 높은 기준이 결합되어 완벽주의나 미루는 등 부적응적인 방식으로 반응하게 된다. 과로하고, 과도하게 준비하고, 완벽을 추구하는 사람들은 그들의 성공을 업무에 투입된 일의 양으로 돌린다. 막판에 일을 미루고 집중적인 준비를 하는 사람들은 자신의 성공을 행운으로 돌립니다. IS를 가진 사람들은 어떠한 일탈이 실패의 가능성을 증가시킬 것이라는 두려움 때문에 이러한 부적응적인 업무 습관을 고칠 수 없다. 이는 신체적, 정신적 피로로 이어질 수 있으며, 이러한 사람들은 높은 수준의 성과를 유지하는 능력에 대해 불확실함을 느낄 수 있다. 결과적으로, 그들은 잠재력의 전체 규모에 도달하지 못하는 결과로 중요한 기회를 피할 수 있다. 실제로 IS를 가진 개인들은 성공에 대한 두려움으로 발전할 수 있는데, 그 이유는 거기에 따르는 추가적인 책임감과 가시성 때문이다. 이는 새로운 도전이 끊이지 않고 잦은 수행 평가가 강조되는 학업 환경에서 특히 매서운poignant 것이다. 

Individuals with IS tend to place themselves under a lot of pressure to avoid failure. In particular, when faced with a task that may have high visibility, the anxiety of potential failure combined with their unrealistic high standards causes them to react in maladaptive ways such as perfectionism and procrastination. Those who overwork, overprepare, and seek perfection (such that the input is out of proportion to the impact on the quality of their work) attribute their success to the amount of work put into the task. Those who procrastinate and do intense preparation at the last minute attribute their success to luck. Individuals with IS are unable to break these maladaptive work habits because of the fear that any deviation will increase the likelihood of failure. This can lead to physical and mental exhaustion, such that these individuals feel uncertain about their ability to maintain their high level of performance. As a result, they may avoid prominent opportunities with the consequence of failing to reach the full scale of their potential. Indeed, individuals with IS may develop a fear of success because of the additional responsibility and visibility that can come with it. This is particularly poignant in the academic setting where new challenges are continually encountered and there is an emphasis on frequent evaluations of performance. 

특히, 이러한 업무 관련 스트레스, 신체적, 정서적 피로, 그리고 IS와 겹치는 다른 심리적 동반성 또한 번아웃과 관련이 있다. 빌웍 등은 의대생들의 IS와 번아웃의 연관성을 조사한 결과 IS가 정서적 탈진, 이인화, 개인적 성취도 감소 등 번아웃 증후군의 여러 가지 요소와 유의미한 상관관계를 보였다. 레가시 등은 48명의 내과 레지던트들을 대상으로 이 관계를 연구했고 IS와 개인 성취도 사이의 부정적인 상관관계를 보고했다. IS를 가진 사람들이 그들의 성취를 받을 자격이 없다고 느낀다는 것을 고려하면 이것은 아마도 놀랍지 않을 것이다. 

Notably, these conditions of work-related stress, physical and emotional exhaustion, and other psychologic comorbidities that overlap with IS are also associated with burnout. Villwock et al examined the association between IS and burnout in medical students and found that IS was significantly correlated with multiple components of burnout syndrome, including emotional exhaustion, depersonalization, and reduced personal accomplishment. Legassie et al studied this relationship in 48 internal medicine residents and reported a negative correlation between IS and the personal accomplishment scale. This is probably not surprising given that individuals with IS feel undeserving of their accomplishments. 

IS를 가진 전문직 종사자들은 그들의 심리적인 행복에 상당한 대가를 치르고도 임상적, 학술적 업무를 효과적으로 수행하는, 전형적으로 높은 성취도가 높다. 하지만, 열심히 일해서 성취하는 것이 그들의 진정한 능력을 향상시키지 못한다고 믿는 고정된 마음가짐으로 인해 그들의 성장이 저해될 수도 있습니다. 그들은 자신의 성공이 자신의 기술이라기보다는 환경에 기인한다고 긍정적인 피드백을 무시합니다. 그 결과, 성공에 대한 객관적인 증거도, 우수한 성과에 대한 진실된 주관적 확신도 임포스터리즘의 감정을 제거하지 못한다. 프로그램 감독, 멘토, 감독 역할의 사람들은 성취도가 높고 성공한 개인들조차도 어려움을 겪을 수 있고 긍정적인 피드백이 그들을 돕는데 충분하지 않을 수 있다는 것에 주목하는 것이 중요하다. IS를 보유하고 있는 사람들에게 IS를 인식하고 관리하는 것이 필수적입니다.
Despite their self-perceived fraudulence, professionals with IS are typically high achievers who effectively fulfill their clinical and academic work, even at significant cost to their psychologic well-being. However, their growth may be impeded by having a fixed mindset with the belief that accomplishment through hard work does not improve their true ability. They disregard positive feedback by attributing their success to circumstance rather than their own skill. As a result, neither objective evidence of success nor sincere subjective assurances of superior performance remove the feelings of impostorism. It is important for program directors, mentors, and those in supervisory roles to note that even high-achieving, successful individuals may be struggling and that positive feedback may not be enough to help them. It is imperative to recognize and manage IS in those who have it. 

IS 자체 관리
Managing IS in Ourselves

임포스터리즘의 핵심이 '발각될까 봐' 하는 두려움이라는 점에서 임포스터리즘 감정을 가진 대부분의 사람들은 침묵 속에서 고통을 겪는다. IS를 상대하기 위한 필수적인 초기 단계는 IS를 인식하고, 그것이 어떤 존재인지에 대한 imposter-like feelings에 이름을 붙이는 것입니다. 이것은 적절한 맥락에서 불충분함과 사기성의 감정을 이해하는데 도움을 줄 수 있다. 문제를 명명하는 것은 또한 그것을 둘러싼 대화를 열어주기 때문에 고립되어 고통 받을 필요가 없다. 

Most people with impostor feelings suffer in silence given that the core of impostorism is a fear of being “found out.” The essential initial step in dealing with IS is recognizing it and naming the impostor-like feelings for what they are. This can help one understand the feelings of inadequacy and fraudulence in the right context. Naming the problem also opens up dialogue surrounding it, so one does not have to suffer in isolation. 

비록 약간의 자기 회의감을 갖는 것은 일반적인 일이고 바람직할 수 있지만, 이러한 감정들이 성공할 자격이 없다는 믿음으로 이어지면 안 된다. IS 개인들은 자신의 성공을 지나치게 강조하는데 겸손해 보일지 모르지만 겸손해 보이는 것은 어떻게든 자신을 속여 지금의 지위에 이르게 했다고 믿는 것과는 다르다. IS의 슈퍼스튜던트/여성/남성 아형은 그들의 단점에 집중하며 종종 그들의 많은 업적을 간과할 수 있습니다. 한 사람의 성공과 그것에 기여한 기술에 대한 객관적인 평가는 이러한 믿음과 싸우는 것을 도울 수 있다. 이를 위한 한 가지 방법은 자신의 업적과 성과를 내기 위해 사용된 핵심 기술을 나열하여 개인적인 경력 성공 목록을 작성하는 것이다. 게다가, 자신이 잘하는 것을 나열하는 것은 약점에서 강점으로 초점을 옮길 수 있습니다. 
Although some feelings of self-doubt are usual and expected, these should not lead to the belief that one does not deserve to succeed. Individuals with IS deemphasize their success, which may seem like humility, but being modest is different from believing one has somehow managed to fake one’s way to the current position. The superstudent/woman/man subtype of IS focuses on their shortcomings and can often overlook their many achievements. An objective evaluation of one’s successes and the skills that contributed to those can help combat these beliefs. One way of doing so is to conduct a personal career success inventory by listing one’s achievements and the core skills used to bring these to fruition. Additionally, listing things that one does well can shift the focus from weaknesses to strengths. 

다만 IS를 경험하는 사람에게 성공과 장점을 객관적이고 진실하게 나열하는 일은 스트레스가 될 가능성이 높다. 자신의 능력에 대한 현실적인 평가를 제공하는 또 다른 선택은 멘토와 동료들과의 강한 관계를 이용하는 것이다. 멘토들의 지지적이고 격려적인 지도는 한 사람이 사칭주의의 감정을 일반적이고 비합리적인 것으로 인식하도록 도울 수 있다. 임포스터 감정을 털어놓을 수 있는 동료들을 신뢰하면 스트레스와 긴장감이 줄어들고 고립감을 없앨 수 있다. 특히, 이 기술은 솔리스트 아형의 측면이 있는 사람들이 공동체의식을 성공의 일부로 받아들이도록 도울 수 있다. 동료들은 또한 객관적이고 현실적인 피드백을 제공할 수 있습니다. 그럼에도 IS를 이끌어낸 뿌리 깊은 신념을 바꾸는 데는 시간과 끈기가 필요하다. 
However, the task of listing successes and strengths in an objective and truthful manner for someone experiencing IS is likely to be stressful. Another option to provide a realistic assessment of one’s abilities is to use strong relationships with mentors and colleagues. The supportive and encouraging guidance of mentors can help one recognize feelings of impostorism as both common and irrational. Having trusted colleagues in whom to confide impostor feelings reduces stress and tension and can remove the sense of isolation. In particular, this technique can help those with aspects of the soloist subtype to embrace a sense of community as being part of success. Peers can also provide objective and realistic feedback. Nonetheless, changing the deep-rooted beliefs that led to IS in the first place takes time and persistence. 

IS를 극복하려면 imposter-like thinking의 고리를 끊는 것이 중요하다. Thought stopping and Shipping은 생각의 패턴을 바꾸기 위해 사용할 수 있는 두 가지 방법입니다.

• 사고중단은 타고난 천재성과 전문가 아형의 측면을 가진 사람들에게서 흔히 볼 수 있는 문제적 사고를 방해하는 것을 목표로 하는 자기실천적인 인지 개입이다. 부정적인 생각을 염두에 두고mindful, 좀 더 긍정적인 생각으로 대체하는 것이 이 기술의 기본이다. 이러한 긍정적인 생각들을 자기 연민과 자신에 대한 친절로 뿌리내리는 것은 한 사람의 능력에 대해 더 건설적이고 비판적이지 않은 관점을 만들어 낼 수 있게 한다.
• 배송은 비즈니스 문헌에서 사용되는 용어로서, 아이디어가 완벽해질 때까지 출시나 발표를 미루지 않는 개념을 나타냅니다. 배송은 누군가의 안전지대를 벗어나게 하는데, 이것은 특히 완벽주의자와 전문가 IS의 하위 유형에게 성장과 창의성에 강한 자극이 된다. 그것은 또한 자신의 실수를 용서하게 함으로써 자기 연민을 형성합니다. 전문적인 치료와 상담은 사기꾼과 같은 사고의 순환을 끊기 위해 사용되는 도구에 추가적인 깊이를 제공하는 데 도움을 줄 수 있다.

Breaking the cycle of impostor-like thinking is critical to overcoming IS. Thought stopping and shipping are two methods one can use to change patterns of thought.

• Thought stopping is a self-practiced cognitive intervention aimed at interrupting problematic thoughts that are common in those with aspects of the natural genius and expert subtypes. The basis of the technique is to be mindful of negative thoughts and replace them with something more positive. Rooting these positive thoughts in self-compassion and kindness toward oneself allows one to generate a more constructive and uncritical view of one’s abilities.
• Shipping, a term used in business literature, represents the concept of not waiting until an idea is perfect before launching or presenting it. Shipping pushes one outside one’s comfort zone, which is a strong stimulus for growth and creativity especially for the perfectionist and expert IS subtypes. It also builds self-compassion by allowing one to forgive one’s mistakes. Professional therapy and counseling can help provide additional depth to the tools used to break the cycle of impostor-like thinking. 

우리가 가르치는 분야에서의 주소 지정
Addressing IS in Those We Teach

우리가 가르치고 멘토링하는 이들에게 IS를 인식하고 대처하는 것은 우리 스스로 IS를 관리하는 것만큼 중요합니다. IS는 교육생들이 최고의 잠재력에 도달하는 것을 막을 수 있으며 의학 교육에 여러 가지 영향을 미칩니다. IS를 보유한 교육생이 많은 만큼 교육적 접근에 적응하고 후원을 받을 수 있는 학습환경을 조성하는 것이 중요하다. 실제로, 많은 기관들이 학생들의 IS를 관리하기 위해 구체적이고 구조적인 개입을 개발했습니다. 교육생들이 IS를 인지하고 관리할 수 있도록 힘을 실어주는 프로그램은 교육생들이 성과를 최적화하는 데 도움을 줄 수 있다. 

Recognizing and addressing IS in those we teach and mentor is just as important as managing IS in ourselves. IS can prevent trainees from reaching their highest potential and has several implications for medical education. Given the large number of trainees with IS, it is important to adapt pedagogic approaches and create a supportive learning environment. In fact, a number of institutions have developed specific structured interventions to manage IS in students. Programs that empower trainees to recognize and manage IS can help trainees optimize their performance. 

IS 자체를 완화하기 위해 언급된 몇 가지 기술은 교육생들의 IS를 해결하는 데에도 사용될 수 있습니다. 멘토는 멘티로 하여금 inadequacy와 fraudulence의 감정은 IS의 결과라는 것을 이해하도록 도울 수 있습니다. 이를 통해 IS 보유자들이 혼자가 아님을 알게 하는 것은 물론 멘토-멘티 관계에 대한 정직성과 신뢰도 강화할 수 있다. 이러한 신뢰는 훈련생의 능력에 대한 객관적인 평가를 그들과 공유하는 데 중요한 역할을 할 수 있습니다. 성취의 사실에 집중하고, 외적인 요인보다는 기술과 능력에 귀속시키는 것이 교육생들이 성공을 내면화하는 데 도움이 될 수 있다. 예를 들어, 만약 훈련생이 긍정적인 결과를 행운에 돌린다면, 멘토는 그들의 성공을 내적 요인으로 돌림으로써 생각을 재구성하는 것을 도울 수 있다. 
Several of the techniques mentioned, to mitigate IS in oneself, can also be used to address IS in trainees. A mentor can help a mentee understand that their feelings of inadequacy and fraudulence are in fact a result of IS. Not only does this let individuals with IS know that they are not alone, it can also strengthen honesty and trust in the mentor-mentee relationship. This trust can play a vital role in sharing an objective assessment of a trainee’s abilities with them. Focusing on the facts of accomplishments, and attributing them to skill and ability rather than external factors, can help trainees internalize their success. For example, if a trainee attributes a positive outcome to luck, a mentor can help reframe their thoughts by crediting their success to internal factors, such as being efficient or leading with authority. 

또한 멘토들은 종종 IS에 수반되는 고정된 사고방식을 성장 마인드로 전환하는 데 중요한 역할을 할 수 있습니다. 이는 IS 훈련생들이 좌절을 사칭꾼이라는 증거로 받아들이기보다는 학습과 성장의 본질적인 부분으로 바라볼 수 있도록 돕는다. 성장형 마음가짐 육성을 위한 몇 가지 팁에는 다면적인 피드백 제공, 투쟁을 기회로 보기, 지능만이 아닌 새로운 접근과 좋은 방향의 노력을 칭찬하기, 목표 설정으로 자기 성찰을 장려하기 등이 있다. 

Furthermore, mentors can play an important role in shifting a fixed mindset that often accompanies IS to a growth mindset. This helps trainees with IS to view setbacks as an inherent part of learning and growth rather than accepting them as proof that they are impostors. Some tips for nurturing a growth mindset include providing multifaceted feedback, viewing struggle as opportunity, praising an attempt at a new approach and well-directed effort instead of intelligence alone, and encouraging self-reflection with goal setting. 

자신과 다른 사람을 비교하는 것은 종종 IS 경험의 밑바탕이 되며, 특히 다른 사람들이 더 유능하다고 인식할 때 더 그렇다. 연구 결과에 따르면 교사가 만드는 환경은 학생이 공간을 배움의 기회로 보는지, 또래와 자신을 비교하고 대조하는 장으로 보는지에 상당한 영향을 미칠 수 있다. 전자는 동기 부여의 더 안정적인 형태이고, 후자는 훨씬 더 스트레스를 많이 받는다. 교육생의 부족함을 드러낼 수 있는 방식으로 가르치는 것은 당황스러움에 대한 두려움 때문에 창의력과 지적 호기심을 억누를 수 있다. IS를 가진 훈련생들은 성공을 확신하지 않는 한 대답을 주저하기 때문에 배우고 능력을 발휘할 기회를 놓친다. IS는 교육생들의 학습과 성장에 중요한 역할을 할 수 있습니다. 교육 스타일을 수정하고 사칭 감정을 관리할 수 있도록 지원과 지도를 하는 것이 교육생들의 진로와 웰빙 과정에 큰 영향을 미칠 수 있다. IS 격퇴 전략은 표 4에 요약되어 있습니다. 
Comparing oneself with others is oftentimes a cornerstone of the IS experience, especially when others are perceived as being more competent. Research suggests that the environment that teachers create can significantly affect whether a student views the space as an opportunity to learn, or as a venue to compare and contrast themselves with their peers. The former is a more stable form of motivation, and the latter is far more stressful. Teaching in a way that can expose a trainee’s inadequacies can suppress creativity and intellectual curiosity because of fear of embarrassment; these feelings are heightened in IS. Trainees with IS hesitate to answer unless certain of success, therefore missing opportunities to learn and showcase ability. IS may play a significant role in the learning and growth of trainees. Modifying teaching styles and providing support and guidance to manage feelings of impostorism can have a significant impact on the course of trainees’ careers and well-being. The strategies to combat IS are summarized in Table 4. 

결론들
Conclusions

IS는 의료계에 만연해 있으며 특히 훈련생들에게 심각한 심리적, 직업적 영향을 미칩니다. IS를 해결하기 위한 첫 번째 단계는 인식 제고입니다. 일단 확인되면, 영향을 받는 개인들과 멘토와 교육자들은 잘못된 자기 회의를 제거하고 부정적인 생각과 부적응적인 행동을 다루기 위한 조치를 취할 수 있습니다. IS를 보유한 개인은 업적과 진정한 능력을 인정함으로써 정신적, 육체적 건강을 유지하면서 가장 높은 직업 목표를 위해 노력할 수 있습니다.

IS is prevalent in the medical profession and has serious psychologic and professional implications, particularly for trainees. The first step to addressing IS is increased awareness. Once identified, affected individuals, and mentors and educators, can work to eliminate the misplaced self-doubt and take steps to address negative thoughts and maladaptive behaviors. By acknowledging achievements and true ability, individuals with IS can be empowered to strive for their highest career goals while maintaining mental and physical wellness.

 

 

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Chest. 2019 Jul;156(1):26-32.

 doi: 10.1016/j.chest.2019.02.325. Epub 2019 Mar 11.

Impostor Syndrome: Could It Be Holding You or Your Mentees Back?

Subani Chandra 1, Candace A Huebert 2, Erin Crowley 3, Aneesa M Das 4

Affiliations collapse

Affiliations

1Division of Pulmonary, Allergy and Critical Care, Columbia University Vagelos College of Physicians and Surgeons, New York, NY.

2Division of Pulmonary, Critical Care, Sleep, and Allergy, University of Nebraska Medical Center, Omaha, NE.

3Division of Pulmonary and Critical Care, Indiana University School of Medicine, Indianapolis, IN.

4Division of Pulmonary, Critical Care, and Sleep, The Ohio State University, Columbus, OH. Electronic address: aneesa.das@osumc.edu.

PMID: 30872019

DOI: 10.1016/j.chest.2019.02.325

No abstract available

Keywords: burnout; impostor syndrome; program director; trainee.