Improv, for neurology trainee Dr. Katherine Sawicka, started as an opportunity to build community after moving to Toronto from Saskatchewan to start residency. While she was excited by the opportunity to train at the University of Toronto, she found the adjustment to living in a new city difficult. Year one of postgraduate training comes with its own set of adjustments and challenges. Katherine says, the transition from medical student to resident physician with increased responsibility, managing real patients, really brought on feelings of impostor syndrome – add in moving to a new city, far from friends, family and familiar routines – it was an understandably big transition. “I chose this place of opportunity, but I was struggling with thoughts of What am I doing here? Why did they pick me? When are they going to figure out, I don’t know what I’m doing?’,” she says, “These feelings of self-doubt led me down a path of avoiding taking on opportunities or sharing ideas for fear of being ‘found out’.”
Enter improvisation classes. To assist with making new friends and building connections outside of the hospital, Katherine decided to sign up for a seven-week improv course at The Second City. Improv is the art of spontaneous, unscripted, storytelling in a collaborative, ensemble performance. “My first few days in the program I felt similar impostor-type feelings bubbling to the surface. I wasn’t an actor or a comedian. As a resident, my work is quite serious and I didn’t really have any other avenues to be silly or test out different versions of myself.” That feeling would quickly disappear. Improv and its community in Toronto turned that initial discomfort into an amazing feeling of acceptance, that Katherine says brought out confidence and communication skills she didn’t know she had. Not only was improv personally fulfilling, but she also began to see synergies between the principles of her new hobby and the skills she was building as a medical trainee.
“Improv is all about communication and relationship building,” she says. “As I began to grow my skills as an improvisor, I also began to see how these skills were applicable in a clinical learning environment.” Improv allowed her to practice communication, find confidence in herself and her abilities and building stronger more supportive relationships with her attendings and allied health partners.
“On clinical rotation, I sometimes struggled with voicing an opinion that was new or different to someone else’s even if I had a strong rationale. I was worried about being shut down or judged for thinking differently. I would question whether my thinking was flawed or incorrect.” Improv allowed Katherine to build out of that feeling with a new set of skills, confidence and perspective. “My new perspective was much more comfortable with being ‘wrong’ and I benefitted so much more from sharing my ideas than keeping them to myself.” Katherine says not only did improv make her a more confident communicator, it made her a stronger team player. Katherine regularly uses the improv concept of “yes and” in clinical settings with her co-residents to build-upon and celebrate new ideas and perspectives.
Now, under the mentorship of Dr. Esther Bui, in partnership with her collaborators Sharon Ng, Dilshan Pieris and Hartley Jafine, Katherine is looking to quantify the effects of improv skills as a creative intervention in dealing with impostor syndrome in the clinical environment. IMPROV-ing the Impostor Phenomenon is the cleverly named title, for the group’s cohort study. Phase one of the study, surveyed postgraduate trainees at three separate points over the course of the academic year. Respondents were provided with the same question-set in all three surveys and questions probed feelings around stress, burnout and self-doubt at different points in the year.
Katherine presented the early data results in April at the Institute for Health Policy, Management and Evaluation’s Research and Impact Day. Data revealed that trainees have persistent and severe feelings of self-doubt at all points in the academic year. But what can be done to address this ever-present phenomenon of impostor syndrome? The research group hypothesizes that improv could play a role in intervening.
In the next phase of their study, survey respondents will next participate in four 90-minute sessions introducing the core tenants of improv, while providing an opportunity to learn and grow as clinicians in the improv environment. While qualitative data on the utilization of improv skills to combat feelings of self-doubt are still to come, Katherine feels that the opportunity to play, laugh and connect as co-trainees will be helpful in alleviating some feelings of stress and self-doubt.
Katherine emphasizes, that some amount of self-questioning and very critical thinking in your decision making as a physician is probably helpful but shouldn’t altogether prevent you from speaking up or expressing your thoughts and ideas. At IHMPE’s Research and Impact Day, Katherine’s presentationwas awarded the PhD CEHCR Gillian Hawker Poster Award, named for our current Chair of Medicine, Dr. Gillian Hawker. As the study progresses into its next phase, we look forward to following along and hearing more on this innovative approach to combatting impostor syndrome.
More information on the cohort study is available here.
