How do medical educators discern, decode, and act upon trainees appearing to engage in impression management?

Trainees are motivated to impress clinical teachers, making impression management common. Such efforts are beneficial, but problematic when 'targets' are misled or learning opportunities missed. Guiding faculty regarding impression management is difficult because little is known about what cues yield perceptions of being managed.

A qualitative study was performed to explore faculty perspectives on: (1) recognising cues indicative of impression management; (2) interpreting cues; and (3) using them. Fifteen educators from various specialities and cultural regions of Switzerland were interviewed. Transcripts were analysed thematically following grounded theory. They were reviewed by multiple reviewers with constant comparison undertaken.

Faculty assumed trainees 'acted' whenever stakes were high. However, decoding impression management was deemed highly complex, mentally taxing, and fraught with uncertainty. Consideration of context was deemed important. Reactions to impression management were dynamic, ranging from benevolence to frustration, depending on perceptions of trainee motivations.

Findings suggest trainees should be cautious about strategies used to influence preceptors. Impression management is accepted when considered an effort to improve capacity to act as a physician; it elicits negativity when trainees seem to be endearing themselves. Valuable leads are offered that should help educators and trainees remain engaged in effective educational alliances.