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Rethinking your CPD: Lifting the mask of self-doubt

When did you last hear that small voice at the back of your mind tell you you’re not good enough? John Castledine, Head of Learning Development and Design for NIHR, takes a look at imposter syndrome and how to overcome it. Part of the NIHR's Rethinking your Continuing Professional Development series.

When did you last hear that small voice at the back of your mind tell you you’re not good enough? That you’ve managed to fool everyone around you into believing that you are good enough? 

According to a 2019 'imposter syndrome' survey, "85 per cent of UK adults admitted to feeling inadequate or incompetent at work, and almost 70 per cent don't feel they deserve their current success. Of these, one in four said that they experience these feelings often or all the time".

For some colleagues, the more they accomplish, the more they feel like a fraud. In the short-term this may see people working harder than necessary to make sure that nobody finds out they are a fraud. Longer term this self-doubt may cause anxiety or depression.

These findings will not surprise the faculty and alumni of the NIHR Clinical Research Network’s Advanced Leadership Programme. Each year, as trust builds between the course participants, these Imposter Syndrome feelings are shared and discussed.

The participants are all experienced mid-career healthcare professionals who have successfully navigated the course application process (typically only 50 per cent of applicants get a place on the programme).  Hence we can predict that this group is just the tip of the iceberg and if we value the wellbeing of our workforce then action is needed.

The term impostor phenomenon was introduced in 1978 in the article 'The Impostor Phenomenon in High Achieving Women: Dynamics and Therapeutic Intervention' where their success was viewed as either a result of luck or by others simply overestimating their abilities. While early research focused on the prevalence among high-achieving women, impostor syndrome has been recognized to affect both men and women equally.

Perfectionism plays a significant role in imposter syndrome. Having excessively high standards, setting unachievable goals and fixating solely on our flaws or failures are huge factors in feelings of ‘not being good enough’. On the other hand, we observe our colleagues through their actual activities. Any doubts, perceived shortcomings or attributing luck are less visible to us.

In the worst cases, imposter syndrome may lead to anxiety, stress, or depression. However, what’s more common among a section of the workforce is a lack of confidence in their actual ability (which also holds them back from volunteering to mentor junior staff), and a tendency to procrastinate (feeling they need all the information to start a task for fear of looking stupid).

In rethinking our CPD and tackling Imposter Syndrome, my recommendation is to consider the following three key actions:

  1. Don't fight the fraudulent feelings. It is only when you acknowledge them that you can start to address the beliefs that are holding you back. Remember that small voice at the back of your mind saying you’re not good enough is a feeling rather than a fact. Weigh this up against the facts. Think about what would be considered ‘good enough’ rather than ‘perfection’. And most importantly, view the activity as a valuable learning exercise. If you were lucky then how has this helped you successfully practice new skills? If you didn't achieve perfection then what do you know to do differently next time?
  2. Invest the time to discuss the topic, your feelings and the impact with colleagues, friends and/or family. By talking with colleagues, mentors and family we are better able to identify our irrational beliefs.  It can be harder to hold onto the notion that we were lucky to get recruited to a role if those we admire in the team tell similar stories of doubt, luck or ‘only just making the grade’. 
  3. Give your time generously to mentoring others; overcoming any reservations that you may not be an expert in the topic. The imposter syndrome puts the spotlight firmly on us as individuals. It may be counter-intuitive but it could be beneficial for you to start by helping others. For example, if someone feels they are simply lucky in how their presentations have been received and are open to being mentored by you then take up the challenge.

To start with you may feel a fraud but the process will help give you insights into their internally held views of ideal performance.  You can contrast this with what you observe in their actual presentations. Moreover, as you see your advice impact their skills this helps reframe your own views of your ability in this area.

In short, ‘If you want to stop feeling like an imposter then you need to stop thinking like an imposter,’ says Valerie Young. Valerie's 2017 TED talk and her ‘10 steps you can use to overcome imposter syndrome are a good place to start.

John Castledine, Head of Learning Development and Design, National Institute for Health Research

The views and opinions expressed in this blog are those of the authors and do not necessarily reflect those of the NIHR or the Department of Health and Social Care.