Prevalence of the imposter phenomenon among chiropractors in South Africa: a cross-sectional survey.

BACKGROUND

The Imposter Phenomenon (IP)-doubting one's abilities despite clear achievements-is well-documented among healthcare professionals but has never been studied among practicing chiropractors, who face unique challenges including professional isolation and ambiguous healthcare identity. This study aimed to determine IP prevalence among South African chiropractors and investigate associations with age, gender, years of experience, and province.

METHODS

A cross-sectional survey using the validated Clance Imposter Phenomenon Scale (CIPS) was distributed via email to all 960 chiropractors registered with the Allied Health Professions Council of South Africa. Data were collected online from 25 March to 17 May 2024. Descriptive statistics, independent-samples t-tests, and one-way ANOVA were used; results are interpreted through effect sizes (Cohen's d) and 95% confidence intervals, with exact p-values reported as continuous evidence measures. Cronbach's alpha assessed reliability. The study followed STROBE and CHERRIES guidelines.

RESULTS

Of 159 chiropractors (16.6% response rate), mean age was 37.8 years (SD = 10.8); 61.6% were female. Mean CIPS score was 50.78 (SD = 16.82), indicating moderate IP. Severity distribution: 33.3% few, 39.0% moderate, 22.6% frequent, 5.0% intense IP (66.6% at or above moderate threshold). Females scored higher than males (55.66 vs. 42.93; t(147.69)= - 5.25, p < 0.001; d = 0.85). Chiropractors  ≤ 35 years scored higher than those  > 35 years (53.52 vs. 47.95; t(152) = 2.05, p = 0.042; d = 0.33). Chiropractors with ≤ 10 years of experience showed a non-significant trend toward higher IP scores than those with  > 10 years (52.90 vs. 47.94; two-tailed p = 0.066; d = 0.30). No provincial differences were found (F(3,155) = 0.62, p = 0.601). Cronbach's α was 0.94.

CONCLUSIONS

Moderate to intense IP affects two-thirds of chiropractors in this South African sample, particularly females and early-career practitioners. These findings highlight the need for targeted mental health interventions, mentorship, and peer support. This first study of IP among practicing chiropractors provides evidence for practitioner well-being initiatives with implications for chiropractic education, professional development, and retention.