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I högre utbildning lär sig studenter inte enbart ämnesinnehåll – de socialiseras också in i en akademisk kultur där prestation, perfektion och erkännande spelar centrala roller. Denna kultur formar studenters självbild, känsla av tillhörighet och upplevelse av vad som krävs för att lyckas. I detta bidrag lyfter vi hur akademisk prestationskultur påverkar studenters välbefinnande, särskilt de som uppfattas som högpresterande.

Vi diskuterar hur undervisningspraktiker och återkoppling från lärare bidrar till att forma studenters måttstock för prestation, ofta utan att ge dem utrymme för utveckling av egna kriterier. Detta kan leda till ökad prokrastinering, impostorkänslor (känslan av att vara en bluff som riskerar att avslöjas) och en upplevelse av otillräcklighet. Samtidigt tenderar högre utbildning att uppmärksamma underprestation, medan överprestation ofta belönas utan reflektion kring dess konsekvenser.

Vi ställer frågor om vilken kultur vi i akademin bygger kring studier och framtida yrkesliv:

• Hur påverkar akademins normer studenters upplevelse av inkludering och självständighet?
• Vilka ideal reproduceras i undervisningen – och vilka risker medför dessa för studenters långsiktiga hälsa och ett hållbart arbetsliv?

I en enkätundersökning bland läkarstudenter vid Umeå universitet framkommer att mer än varannan student skattar en förhöjd eller mycket förhöjd risk för utmattning. Kvinnorna i studien skattade en signifikant högre risk för utmattning och samtidigt signifikant lägre psykologisk trygghet, sannolikt ett uttryck för kultur, normer och klimat i utbildningen. Psykologisk trygghet var negativt korrelerat med impostorkänslor (r=0.33, p<0.001). Resultaten understryker vikten av att vidareutveckla sätt att undervisa som bidrar till en psykologiskt trygg utbildningsmiljö genom tydligt kommunicerade förväntningar, uppmuntra studenter att ställa frågor och skapa fokus på lärande och konstruktiv feedback snarare än prestation och bedömning. Att stödja lärare att utveckla dessa undervisningsfärdigheter kan spela en avgörande roll för att förändra ohälsosamma normer och föråldrade ideal. Riktade interventioner kan öka studenternas känsla av psykologisk trygghet och minska förekomsten av impostorkänslor, stress och utmattning. 

Vi argumenterar alltså för att lärare aktivt bör motverka en kultur av perfektionism, och att det är särskilt viktigt inom professionsutbildningar som leder till ett arbetsliv med höga krav och stort ansvar. Vi avslutar med att konkret diskutera hur vi kan förbereda studenter för ett hållbart arbetsliv genom:

• undervisning i egenvårdsfärdigheter
• föregå med gott exempel genom att skapa socialt trygg arbetsmiljö för våra studenter
• interventioner på individ-, grupp- och organisationsnivå som inte pekar ut individen som svag

Slutsats:För att främja hållbart lärande och välbefinnande behöver vi uppmärksamma även den som presterar – och reflektera över vilken kultur vi tillsammans skapar i högre utbildning.

Background: Psychological safety—defined as the perception that a group environment is safe for interpersonal risk-taking—could influence the development of burnout among medical students. This study, therefore, sought to investigate the prevalence of burnout, the level of psychological safety, and their association in this population.

Methods: We surveyed undergraduate medical students (n = 944) enrolled in semesters 2 to 10 at a Swedish medical school using a questionnaire containing the Burnout Assessment Tool (BAT-12), Amy Edmondson's Team Psychological Safety Survey, and socio-demographic questions. Data were analyzed using descriptive statistics, t-tests, one-way ANOVA, Pearson's correlation, and hierarchical regression analysis.

Results: A total of 457 medical students (62.6% women) completed the questionnaire (response rate: 48%). Of the participants, 51.4% scored above the cut-off for burnout risk, and among these, 25.6% were at very high risk. Women scored significantly higher on burnout and lower on psychological safety than men. A significant negative association was found between psychological safety and burnout, with psychological safety accounting for an additional 14.3% of the variance in burnout scores.

Conclusions: Our findings suggest that more than half of the surveyed medical students are at risk for burnout and that lower levels of psychological safety are associated with higher levels of burnout. Furthermore, women appear to be at higher risk for burnout and perceive medical school as less psychologically safe than male students. While longitudinal studies are needed to assess the causality between low psychological safety and burnout, our results provide impetus for developing interventions to prevent burnout and addressing an eventual lack of psychological safety in medical school.

Introduction: Psychological distress is of concern among university students worldwide, more so than in a comparable working population. The impostor phenomenon (IP) describes feelings of inadequacy often experienced by individuals struggling to internalize success despite evidence to the contrary. IP is prevalent among university students and has been identified as a significant factor in understanding psychological distress within this population. This study aimed to investigate the prevalence of IP and its association with perceived stress and anxiety in dental, law, medical, nursing and psychology university students.

Methods: A web-survey consisting of the Clance Impostor Phenomenon Scale (CIPS), the Perceived Stress Scale-4 (PSS-4), the Generalized Anxiety Disorder-2 (GAD-2), and sociodemographic questions were completed by 968 university students registered at a Swedish university during 2022 and 2023. The prevalence of IP, perceived stress, and anxiety was calculated. Pearson’s correlation coefficient and multiple linear regression were used to examine the relationship between the variables.

Results: 64.0% of the participants scored above the cut off value for experiencing IP (CIPS score ≥62). According to cut-off levels developed to categorize the intensity of IP experiences 8.4% of participants had low experiences of IP, 26.0% moderate, 42.6% frequent, and 23.0% intense experiences of IP. Of all participants, 91.6% had at least moderate experiences of IP and 65.6% had frequent to intense experiences of IP. Women scored significantly higher on CIPS than men. In contrast, neither attending semester nor age group significantly impacted CIPS scores. Finally, there was a moderate correlation between the levels of perceived stress and anxiety, respectively, and the IP scores.

Conclusion: This study suggests that the majority of dental, medical, nursing, psychology and law students experience severe IP. Moreover, this study provides valuable insights into the association of IP with perceived stress and anxiety. The results underscore the significance of exploring IP and its link to psychological distress, suggesting that interventions aimed at diminishing IP may play a crucial role in enhancing the well-being of university students.

Background: Concern over medical students' well-being is a global issue, with studies showing high psychological distress rates. Impostor Phenomenon (IP), i.e., underestimating one's abilities, attributing success to external factors, and feeling like a fraud, has been implicated as one reason behind these troubling findings. Meanwhile, resilience has been suggested to protect against psychological distress. This study aimed to investigate the prevalence of IP and its association with resilience among undergraduate medical students.

Methods: The Clance Impostor Phenomenon Scale (CIPS), the Brief Resilience Scale (BRS), and sociodemographic questions were completed by 457 medical students registered in their 2-10th semester at a Swedish university. Of the respondents, 62.6% identified as women, 36.1% as men, and 1.3% as others.

Results: The prevalence of IP was 58.4% (defined as CIPS score ≥ 62). According to the CIPS scoring guidelines, 10.3% of participants had low IP, 29.5% moderate, 41.6% frequent, and 18.6% intense IP. Of all participants, almost 90% experienced at least moderate and 60.2% frequent to intense IP. Women had significantly higher CIPS scores and lower BRS scores than men. In contrast, neither attending semester nor age group significantly impacted CIPS scores. Finally, there was a moderate inverse correlation between the level of resilience and the prevalence of IP.

Conclusions: Our findings suggest that the majority of Swedish medical students feels like an impostor, and of these students, most do so frequently. Furthermore, IP is more prevalent among female students - who also show lower levels of resilience. Moreover, our results indicated that IP could hinder achieving higher resilience. Future longitudinal studies should investigate how gender norms may contribute to IP feelings and explore the potential advantages of counteracting IP and strengthening resilience among medical students. However, targeted interventions addressing individual students' IP and resilience are insufficient. There is also a need to address structural aspects of the educational environment, such as gender stereotypes, that may contribute to IP.

Background: Primary hyperhidrosis consists of excessive focal sweating. Affected individuals camouflage the sweating on their body, avoiding stigmatisation. Hence, misrepresentation in social interactions is a common feature in patients with hyperhidrosis. The aim of this study was to investigate impostor phenomenon, perfectionism, self-compassion, stress and anxiety among individuals with primary hyperhidrosis.

Methods: A cross-sectional study was conducted at our clinic among 100 participants with axillary and palmar primary hyperhidrosis. The questionnaire contained a hyperhidrosis part and Perceived Stress Scale-4, Generalised Anxiety Disorder Scale-2, Clinical Perfectionism Questionnaire-6, Self-Compassion Scale Short form and Clance Impostor Phenomenon Scale. Descriptive statistics was used for analyses of categorical variables. As data were normally distributed independent t-test and one-way analysis of variance with post hoc Tukey test were used to compare the mean values for the questionnaires with other variables. Pearson's correlation was used, and a forward multiple linear regression model was performed to predict presence of impostor phenomenon with gender, age and other scales in this study.

Results: Impostor phenomenon occurred in almost half of our patients (48%) with hyperhidrosis. While feelings of impostor phenomenon were more common in women, there was no difference between gender regarding its intensity levels (p = 0.07). In addition, we found a significant (p < 0.001) negative correlation between impostor phenomenon and self-compassion, while feelings of impostor phenomenon increased with stress, anxiety and perfectionism (p < 0.001).

Conclusions: Feelings of impostor phenomenon was found in 48% of individuals with hyperhidrosis which indicates that it is a common feature in this patient group. Future research is warranted regarding the prevalence of impostor phenomenon in hyperhidrosis and other medical conditions, among men and women, seeking medical healthcare. Psychological interventions in hyperhidrosis may be beneficial both for the individual and in public health, by facilitating management of patients' daily lives and saving considerable resources in healthcare regarding pharmacological interventions and medical consultations.

Background. Emotional intelligence (EI), the ability to understand and regulate one’s and other’s emotions, has been linked to academic and clinical performance and stress management, making it an essential skill to develop during medical school. Nevertheless, uncertainty remains about the impact of medical education on EI, its association with sociodemographic factors, and the potential moderating role of gender. Therefore, this study aimed to explore levels of global EI among Swedish medical students based on their completed semesters while analyzing the potential moderator role of gender and identifying potential EI differences associated with age, gender, prior education, work experience, and previous experience working in a leadership position.

Methods: The participants were medical students in semesters 1, 3, 5, 7, 9, and 11 at a Swedish University. Participants answered the self-report Trait Emotional Intelligence Questionnaire - Short Form (TEIQue-SF) and demographic questions. For each participant, the mean global trait EI was calculated (range 1–7), and differences were compared based on semesters and sociodemographic factors. In addition, we investigated the relationship between semester and EI scores with gender as a moderator.

Results: Of the 663 invited medical students, 429 (65%) responded, including 269 women (62.7%), 157 men (36.6%), and 3 identifying as others (0.7%). The participants had a mean global trait EI score of 5.33. Final-year students demonstrated significantly higher global trait EI scores than first-year students, and gender did not have a moderating effect across semesters. Furthermore, students in the age group 25–29 years showed higher EI scores compared to those in the age group 21–24 years, while there were no significant differences in EI scores for older students (≥ 30 years) compared to other age groups. Higher EI scores were also positively associated with previous work-and leadership experiences. Gender and previous education did not significantly impact EI scores.

Conclusions. Our findings suggest that higher EI scores are associated with semesters of medical education, age, and previous work and leadership experience. Future longitudinal studies are needed to identify factors that could improve EI among medical students to design curricular activities aimed at supporting the EI of the next generation of physicians.

Studies have shown that psychological distress has a role in the symptomology of localized provoked vulvodynia. Therefore, psychosocial support has been presented as a valuable part of the treatment. However, little is known about which psychological variables that coincide with localized provoked vulvodynia. The purpose of this study was to identify qualities of psychological distress in patients with localized provoked vulvodynia. Patients with localized provoked vulvodynia were consecutively recruited to participate in this cross-sectional questionnaire-based study. Participants completed a self-report questionnaire measuring perfectionism, impostor phenomenon, self-compassion, anxiety and perceived stress. A sample of 30 patients were included. Questionnaire results suggestive of perfectionism was seen in 63%, impostor phenomenon in 80%, low self-compassion in 27%, anxiety in 43% and perceived stress in 23% of the participants. The level of self-compassion was higher in patients in a committed relationship. The investigated qualities appear to be more common in patients with localized provoked vulvodynia than in comparable groups. Impostor phenomenon and perfectionism were particularly common, with more than half of the study population scoring above the cutoff for clinical significance. This motivates research to investigate if interventions targeting impostor phenomenon and perfectionism, may aid in the treatment of localized provoked vulvodynia.

The aim of this study was to investigate whether Swedish swingers constitute a risk group for sexually transmitted infections (STIs). Two swinger clubs were invited to participate. At swinger meetings, members were offered an STI sampling kit and a questionnaire. Samples were analyzed for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis using a multiplex real-time polymerase chain reaction assay. In total, 235 swingers participated (118 women and 117 men). Urogenital C. trachomatis prevalence was 1.7%. Urogenital M. genitalium prevalence was 7.6% for women and 4.3% for men. No one tested positive for N. gonorrhoeae or T. vaginalis. For women, the mean number of unprotected temporary sex partners within the last 12 months was four men (range 0–35) and three women (range 0–50). Among men, the mean number of unprotected temporary sex partners within the last 12 months was five women (range 0–50) and 0 men (range 0–10). During vaginal sex, 46.6% women and 38.5% men always used protection with a temporary sex partner. Swedish swingers did not seem to have an increased prevalence of STIs. However, there was high-risk sexual behavior with unprotected sex and multiple sex partners, thereby making them a vulnerable group for acquiring STIs.

Objective: This study aimed to investigate the prevalence of sexually transmitted infections (STIs) and colonizing bacteria in relation to urogenital symptoms.

Materials and Methods: In this cross-sectional study, patients visiting the STI clinic at Umeå University Hospital were asked for symptoms and condom use. Samples from 759 patients (465 male and 294 female) were analyzed for 4 STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium) and 3 colonizing bacteria (Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum).

Results: Chlamydia trachomatis prevalence was 11% among women and 9.5% among men. Neisseria gonorrhoeae prevalence was 0.7% among women and 0.9% among men. Mycoplasma genitalium was found in 11% and 5.6% of women and men, respectively. Asymptomatic men and women had similar distribution patterns of microorganisms as those with urogenital symptoms, with the exceptions of Neisseria gonorrhoeae- and Mycoplasma genitalium-infected men who declared symptoms more frequently. Of 158 men with urogenital symptoms, 55% were test-negative. Of 129 women with urogenital symptoms, 12% were test-negative.

Conclusions: This study reveals a complex picture, where a large number of multi-positive tests made it complicated to correlate urogenital symptoms with microorganisms. A high number of test-negative but symptomatic patients indicate a need of searching for additional pathogens.