Mema Briseida, Helmers Andrew, Proulx Catherine, Navne Laura E
Department of Critical Care Medicine, Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Department of Critical Care Medicine, Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Chest. 2025 Sep;168(3):737-746. doi: 10.1016/j.chest.2025.05.017. Epub 2025 May 23.
Becoming a clinician requires not only the accumulation of medical knowledge but also the development of a professional identity. The humanities may illuminate how professional and personal experiences shape identity, support meaning-making, and foster resilience through reflection and creative expression.
What transformative experiences disrupt the professional identity of critical care clinicians? How does reflection through the humanities help clinicians navigate these experiences to build meaning and support resilience?
This qualitative study used multiple data sources, including participant observation, semistructured interviews, and analysis of creative works (eg, artwork) shared by faculty and trainees engaged in a humanities program. Data were collected and analyzed inductively and iteratively until thematic sufficiency was achieved.
From March 2022 to November 2024, researchers conducted 40 hours of participant observation and analyzed > 100 creative works. Eighteen of the 60 clinicians who participated in the program were interviewed. Participants described their profession as a vocation requiring deep devotion and excellence. They turned to art frequently to process intense experiences at work. Immersed in a high-stakes clinical environment, many struggled to remain emotionally and physically present in their personal lives. Their professional identity often dominated, suppressing other facets of self. Consequently, there was a degree of separation from their social circles, contributing to loneliness and emotional isolation.
Practicing at the threshold between life and death, intensivists derive profound meaning from their work but frequently lack space to process its emotional toll. Reflection through the humanities provides a valuable opportunity to examine and articulate the impact of transformative clinical experiences. Such spaces support meaning-making, affirm nonprofessional identities, and promote resilience. Embedding humanities-based reflective practice into clinical culture may help sustain clinicians' holistic well-being.
成为一名临床医生不仅需要积累医学知识，还需要形成专业身份认同。人文学科可以阐明职业和个人经历如何塑造身份认同、支持意义建构，并通过反思和创造性表达培养复原力。
哪些变革性经历会扰乱重症监护临床医生的专业身份认同？通过人文学科进行的反思如何帮助临床医生应对这些经历以构建意义并支持复原力？
这项定性研究使用了多种数据来源，包括参与观察、半结构化访谈以及对参与人文项目的教员和学员所分享的创造性作品（如艺术作品）的分析。数据通过归纳和迭代的方式收集与分析，直至达到主题饱和。
从2022年3月到2024年11月，研究人员进行了40小时的参与观察，并分析了100多件创造性作品。参与该项目的60名临床医生中有18人接受了访谈。参与者将他们的职业描述为一项需要深度投入和卓越表现的使命。他们经常借助艺术来处理工作中的强烈情感体验。置身于高风险的临床环境中，许多人难以在个人生活中保持情感和身体上的投入。他们的专业身份常常占据主导，压抑了自我的其他方面。因此，他们与社交圈子存在一定程度的脱节，导致孤独感和情感孤立。
重症监护医生在生死边缘执业，从工作中获得深刻意义，但常常缺乏处理工作情感代价的空间。通过人文学科进行反思提供了一个宝贵的机会，来审视和阐明变革性临床经历的影响。这样的空间支持意义建构、肯定非专业身份并促进复原力。将基于人文学科的反思性实践融入临床文化可能有助于维持临床医生的整体幸福感。
