Imposter syndrome in doctors beyond training: a narrative review

Objective: To undertake a narrative literature review of imposter syndrome (IS) in doctors beyond training. Method: Twelve studies met inclusion criteria from a systematised search of three databases. Results: There is a paucity of literature on IS, although it has been observed across a diverse range of specialties. IS appears to be more common in female doctors but is also seen amongst male doctors. IS impacts career progression, leadership and mental health. Conclusions: IS causes professional and personal detriment. Solutions must include institutional changes to foster safer workplaces and to address systemic barriers to help-seeking and peer support. Systemic interventions are the only solution to the systemic drivers of IS.

Systematic review and narrative synthesis of suicide prevention in high-schools and universities: a research agenda for evidence-based practice

Background Youth suicide prevention in high-schools and universities is a public health priority. Our aim was to propose a research agenda to advance evidence-based suicide prevention in high-schools and universities by synthesizing and critically reviewing the research focus and methodologies used in existing intervention studies. Methods Fourteen databases were systematically searched to identify studies which evaluate suicide prevention interventions delivered on high-school or university campuses, with before and after measures. Data from included studies (n = 43) were extracted to identify what, where, how and for whom interventions have been tested. Narrative synthesis was used to critically evaluate research focus and methodology. Study quality was assessed. Results Research has focused primarily on selective interventions, with less attention on indicated and universal interventions. Most evidence comes from North America and high-income countries. The target of interventions has been: non-fatal suicidal behaviour; confidence and ability of staff/students to intervene in a suicidal crisis; suicide-related knowledge and attitudes; and suicide-related stigma. No studies included suicide deaths as an outcome, evaluated eco-systemic interventions, explored how context influences implementation, used multisite study designs, or focused explicitly on LGBTQ+ youth. Two studies evaluated digital interventions. Quality of the majority of studies was compromised by lack of methodological rigour, small samples, and moderate/high risk of bias. Interventions often assume the existence of an external well-functioning referral pathway, which may not be true in low-resource settings. Conclusion To advance evidence-based suicide prevention in educational settings we need to: conduct more high-quality clinical and pragmatic trials; promote research in low- and middle-income countries; test targeted interventions for vulnerable populations (like LGBTQ+ youth), evaluate interventions where death by suicide is the primary outcome; include translational studies and use implementation science to promote intervention uptake; evaluate the potential use of digital and eco-systemic interventions; and conduct multisite studies in diverse cultural settings.

Inconceivable! Possibilistic thinking and the sociocognitive underpinnings of entrepreneurial responses to grand challenges

Due to the radical uncertainty associated with grand challenges, prior studies have emphasized the need for robust action, which preserves future options while taking existing means and institutional constraints seriously. In this conversation on entrepreneurial futures and possibilities, we suggest that for such approaches to avoid merely reproducing or incrementally improving upon existing ideas and institutions, they must be underpinned by a set of cognitive practices that encourage the systematic interrogation of existing assumptions, the surfacing of bold systemic interventions, and efforts to discourage early dismissals of such interventions based on historically grounded feasibility judgments. To encapsulate these cognitive practices, we introduce the concept of possibilistic thinking, noting how such thinking significantly reorients entrepreneurs’ attention and reasoning processes. We conclude by discussing the tensions associated with possibilistic thinking as well as opportunities for further research.