Taru-Anneli Koivisto: The (Un)Settled Space of Music Practitioners in the Finnish Healthcare System - Building Hybrid Professionalism in and through music

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(The project has ended)

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Koivisto, Taru-Anneli. (2022). The (Un)Settled Space of Healthcare Musicians: Hybrid Music Professionalism in the Finnish Healthcare System. Sibelius Academy of the University of the Arts Helsinki. https://taju.uniarts.fi/handle/10024/7582

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Music professionalism is undergoing a period of turbulent change. Musicians are not only performing in traditional concert audiences, but also increasingly work in unconventional spaces and novel sites for and with different groups of people in a wide array of life situations. Hybrid music professionalism refers to a highly reflexive expanding professional approach. This article-based doctoral dissertation addresses the emergence of this expanding music professionalism by exploring the work of musicians in the Finnish public healthcare system. The guiding research question is: How does healthcare musicians’ relational work inform a new understanding of expanding, hybrid music professionalism in a changing society?  

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The empirical material was generated at one children’s hospital and one eldercare hospital, through observations and interviews with musicians, patients, their families, and healthcare personnel, as well as with policymakers and other arts practitioners working in healthcare settings. Through a multiple case study approach, the research builds on four sub-studies in which thematic and reflexive analyses were applied. A qualitative cross-case analysis was then used to synthesize the findings of the sub-studies. The findings have been reported in four international peer-reviewed publications: (1) a qualitative systematic review exploring healthcare musicians’ work and professional space in somatic hospital wards; (2) a descriptive case study that analyzes musicians’ interprofessional work and musicking with and for families, their relatives, and healthcare personnel in neonatal intensive care units; (3) an instrumental case study theorizing musicians’ professional work in eldercare hospitals; and (4) an in-depth case study that reflects and theorizes musicians’ emotional work in end-of-life care contexts. Additionally, a policy recommendation aimed at cross-sectoral service providers was produced.  

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The findings present healthcare musicians as socially responsible practitioners who co-construct their professionalism through reciprocal, relational practices, not only in but with the healthcare community, including patients, their families, and healthcare personnel. These relational practices are manifested in healthcare musicians’ work; for instance, through creating metaphorical thinking and language, engaging in musico-emotional interaction, and supporting gerotranscendence. Such hybrid professionalism requires interprofessional reflection and collaboration that can guide musicians towards acknowledging the limits and boundaries of their work, their own transforming expertise, and—most importantly—the necessary expertise and knowledge of others.  

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The findings imply that hybrid professionalism, realized through boundary work, incorporates emotionally sensitive, situational ethics that integrate the practice with the everyday life of healthcare communities to support the agency and integrity of potentially vulnerable patients. It is proposed that although music may serve as a clinical intervention, or maintain a performative value as entertainment, its inherent value for the participants should be better and more deeply considered in higher music education. Healthcare musicians’ socially engaged work unfolds aesthetic and existential dimensions of the whole spectrum of human interaction, and raises critical questions about what constitutes a good life for patients, their families, healthcare personnel, and the musicians themselves.  

The study suggests that expanding our understanding of music professionalism in healthcare as a salutogenic orientation to wellbeing can support not only professional self-care and patient safety, but also wider systemic change and a reorganization of professional education and working life. As part of this theoretical and practical development, music professionals may become more legitimized and significant actors in our rapidly changing societies.

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As part of the project, an In­ter­na­tional Sym­po­sium of Mu­si­cians in Health­care was organized virtually. Check more information from: https://www.uniarts.fi/en/events/international-symposium-of-musicians-in-healthcare/

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