Purpose
Healer’s Art (HART), an elective typically offered in-person at over 70 medical and health professions schools for three decades, has been shown to foster Professional Identity Formation (PIF), however, no study has fully defined the emergent subthemes of PIF resultant of virtual HART instruction. We delivered the HART virtually, and have defined nine PIF dimensions students gained after engaging in virtual HART. 

PIF is a complex process guided by social construction and reflection,​​ and in medicine, includes aspects of self as a professional and self as healer.​  While most medical school instruction is focused on the professional and cognitive domains of medicine, HART is an elective course that offers non-cognitive education and validates physicians as healers. HART has been shown to decrease burnout, increase feelings of community, and foster development of intrinsic professional identity.

While previous research has shown that HART students are better able to define professionalism and incorporate community and authenticity into their framework, the research does not fully explicate the dimensions of PIF, nor does it address the validity of virtual instruction to support PIF.​​ Our research supplements this work by defining nine subthemes in HART PIF and demonstrating PIF in a virtual setting. 

Methods
Using end of course surveys from 25 schools and 570 students, we employed constant comparative analysis to define nine unique subthemes that students expressed as they discussed valuable lessons learned. Two independent coders analyzed student responses and achieved at least 85% interrater reliability.  

Results
Of the 465 student responses to the prompt of “most valuable lesson learned,” 211 (41.4%) indicated PIF. When asked the benefits of having a virtual HART experience (n=444), 114 (29.5%) students specifically identified PIF. Overall, there were 726 unique references to PIF across all student responses. The most common subtheme was Listening (n=115), followed by Humanity (n=82), and Compassion (n=76). One student recalled they gained an “understanding that silence gives another person a chance to comprehend what has just been said (e.g. when giving bad news),” thus shifting their identity as a healthcare provider from doctor to listener. Other themes include Authentic Self, Non-Judgment, Humility, Respect, Service, and Vulnerability.  

Conclusions
Our study highlights the importance and value of HART and non-cognitive emphasis in medical education and demonstrates the effectiveness of virtual HART instruction.  Further, we show nine emergent dimensions of PIF. Whether through convenience or necessity, learners can develop PIF in an online setting, thus reinforcing how virtual HART can still maintain impact.