PA School and Imposter Syndrome Vol. 3 Environmental causes of imposter syndrome

Thank you for joining me again for the Massey Martin newsletter. I continue our discussion of imposter syndrome in PA school by acknowledging how we might make imposter syndrome worse through bias in our behavior, environment, and systems.

Why environment matters

In the world of education or employment, our environments may encourage people, intentionally or not, to modify themselves to fit a certain mold. While many employers say, “We want you to be yourself,” they may unconsciously encourage a particular version of “yourself” that more closely resembles a traditional norm. 

Certainly, as we promote our DEI efforts, we don’t consciously condone forcing people into that norm. Despite earnest efforts, however, we may still unconsciously reward and encourage appearances, behaviors, and beliefs that more closely resemble that traditional viewpoint. Even if the bias is not outright or obvious, minority members will sense differentness in how they are treated.

We are almost all hardwired with a certain amount of bias. Recognizing that fact is an important first step, as is eliminating opportunities for bias to infiltrate our systems. For example, the elimination of bias from the admissions process was an important design factor in the PA school applicant ranking rubrics I helped design.

Imposterization

Whether our actions are intentional or not, when we draw attention to  “otherness,” and suggest that “others” alter toward the norm, we commit imposterization. The term means exactly what it sounds like: promoting feelings of imposter syndrome. These are seemingly harmless behaviors that nevertheless can cause people to doubt whether they belong. Some ways we might imposterize another student include:

• Mispronouncing, or asking them to alter, their name. People’s names are their first line of identity. When we mispronounce names (and make no effort to correct doing so), ask them to adopt a name that is easier to pronounce, or anglicize their name, we are pointing out that they don’t fit here. We deny their identity.
• Encouraging individual authenticity, but inadvertently discouraging it. “Patients won’t trust a PA with hair like that.” “If you use such expansive gestures, no one will take you seriously.” “Try not to be so emotional about the problem.” 
• Failure to devote our respect and attention to certain students. This is particularly true during classes and Office Hours, which time is specifically meant to be for student benefit. If students feel we disrespect their thoughts, time or questions, they begin to doubt their value in the program. When dealing with students directly, we must practice awareness of how we behave. Do we take certain students more seriously than others? Do we make assumptions about potential based on appearances or race?
• Using limited course curricula that fails to include diversity. We should aim for diversity in authors, samples, examples, and scholarship. Underrepresented groups deserve to see people like themselves succeeding in the field and being widely acknowledged for doing so.
• Assuming that all members of a cohort know the same things. This includes the knowledge of course material, as in, “You should know this already,” or “This should be obvious to everyone,” an attitude that discourages questions and clarification. However, it also includes the workings of a graduate campus. Some students may be quite new to the underpinnings of graduate school. We cannot assume every student knows “the drill,” of grad school, including what assistance or resources are available, professors’ time, tutoring services, financial aid, or even navigating the intensity of a busy study schedule. Culturally, this could be a different world, and beyond “opening the borders” to everyone, we should take care to provide a good map!

Conclusion

We must practice mindfulness about our behaviors and surroundings to eliminate environmental factors that cause feelings of exclusion, leading to imposter syndrome. A good first step is examining biases – of ourselves, our faculty, our student body, even the institution itself. Awareness of our biases can help us change the way we behave. However, “curing” bias is not actually the primary goal. Rather, we seek to eliminate bias from systems around us. When our students all feel truly welcome and accepted for who they are, the occurrence of imposter syndrome will decrease.