Workplace causality orientations moderate impostorism and burnout: New insights for wellness interventions in graduate medical education

Theory: Impostor phenomenon (IP) is strongly linked to physician burnout, but the nature of this association is not well understood. A better grasp of the mechanism between these constructs could shed new light on ways to mitigate physician IP and burnout. Grounded in self-determination theory (SDT), the present study explores whether and how residents’ general causality orientations at work—impersonal, controlled, and autonomous—each moderate the effect of IP on physician burnout. Hypotheses: We theorized that the autonomous orientation would buffer the facilitative effect of IP on burnout, while the controlled and impersonal orientations would each enhance it to varying degrees. Method: Two hundred forty-three residents from the Universities of Saskatchewan, Calgary, and Alberta, across various programs, specialties, and years of training, completed a survey containing demographic questions and three previously validated instruments: the Clance Impostor Phenomenon Scale, Causality Orientations at Work Scale, and Oldenburg Burnout Inventory. We used partial correlation analyses to test our moderation hypotheses. Results: In line with what we expected, the autonomous causality orientation buffered the facilitative effect of IP on burnout, while the controlled and impersonal causality orientations each enhanced it. Conclusions: Results suggest that possessing a stronger autonomous causality orientation (and creating learning/work environments that prime it) will dampen the effect of IP on burnout, while possessing a stronger controlled or impersonal causality orientation (and creating learning/work environments that prime them) will each augment it. Findings and their implications are discussed in terms of instigating theory-informed, system-level wellness interventions in graduate medical education.