The Relationship Between Imposter Syndrome, Trapezius Myalgia and Perceived Stress in Clinical Education Rotations

Abstract

Background: The transition from preclinical education to clinical rotations is a demanding phase for healthcare students and is often accompanied by psychological pressure, performance anxiety, and increased physical strain. During this period, many students experience impostor syndrome, a psychological phenomenon characterized by persistent self-doubt despite objective competence. Chronic stress related to these perceptions may also contribute to musculoskeletal discomfort, particularly trapezius myalgia and neck disability. However, limited research has explored the combined relationship between impostor syndrome, perceived stress, and neck disability among physiotherapy students during clinical training. Objective: To determine the prevalence of impostor syndrome, neck disability, and perceived stress among physiotherapy students and to examine the relationship between these variables during clinical education rotations. Methods: A cross-sectional study was conducted among 196 undergraduate physiotherapy students at the University of Lahore using non-probability convenience sampling. Impostor syndrome was assessed using the Clance Imposter Phenomenon Scale (CIPS), neck disability was evaluated using the Neck Disability Index (NDI), and perceived stress was measured with the Perceived Stress Scale (PSS). Descriptive statistics summarized demographic characteristics and scale distributions, while Chi-square tests were used to evaluate associations between variables with statistical significance set at p < 0.05. Results: Among the participants (mean age 21.48 ± 1.39 years; 57.7% female), 38.3% exhibited mild, 43.4% moderate, 15.8% frequent, and 2.6% intense impostor characteristics. Neck disability assessment showed 21.4% had no disability, 37.2% mild disability, and 41.3% moderate disability. Perceived stress levels were categorized as low in 40.3%, moderate in 48.5%, and high in 11.2% of students. Significant associations were found between impostor syndrome and neck disability (p < 0.001) as well as perceived stress (p < 0.01). Additionally, impostor characteristics were significantly associated with gender (p = 0.033) and academic semester (p = 0.01). Conclusion: Impostor syndrome, neck disability, and perceived stress are highly prevalent among physiotherapy students during clinical rotations. Stronger impostor feelings are significantly associated with higher levels of perceived stress and greater neck disability, highlighting the importance of integrating psychological support and ergonomic interventions within clinical education programs to enhance student wellbeing and professional development.