Dr. Ashley Sandeen: On Honoring the Layers of Her Work and Purpose
Ashley Sandeen, DO, FAAP
Associate Professor of Pediatrics | Pediatric Intensivist
Associate Program Director, Pediatric Residency
Founder, Kosha Coaching for Physicians
There is a moment familiar to every pediatric intensivist—the brief pause before stepping into a room where a child’s life hangs in balance and a family waits for answers. Dr. Ashley Sandeen has built her career around honoring that moment. It is where her clinical precision, intuition, humanity, and purpose come together.
Her work spans clinical medicine, graduate medical education, quality improvement, and physician coaching, but at its core lies a single intention: to help people feel seen, supported, and empowered to become who they already are beneath the layers.
Who She Serves
Clinically: Supporting the Most Critically Ill Children
Dr. Sandeen is a pediatric intensivist caring for critically ill infants, children, and adolescents facing medical, surgical, or traumatic conditions. In the PICU, she manages complex physiology, life-threatening emergencies, and rapidly evolving clinical situations. She also provides procedural sedation services for pediatric patients requiring diagnostic studies or interventions, ensuring safe, compassionate, developmentally appropriate care.
Families often meet her during the hardest days of their lives. Her presence—steady, grounded, and deeply human—is part of what makes her work meaningful. She holds space for children and their caregivers with a balance of clinical excellence and emotional clarity.
Academically: Developing Physicians Who Lead with Skill and Purpose
As an Associate Professor and Associate Program Director for the Pediatric Residency Program at the University of South Dakota Sanford School of Medicine, Dr. Sandeen is deeply invested in education.
She teaches residents and medical students the essential principles of pediatric critical care, but her work extends far beyond the physiology of shock or mechanical ventilation. She helps trainees understand who they are as physicians—how they respond under pressure, how to navigate burnout, how to define purpose, and how to create sustainable careers in medicine.
Her curriculum work, wellness initiatives, and leadership in resident development reflect her belief that training excellent physicians requires caring for the whole person, not just the clinical mind.
Professionally: Improving Systems to Improve Lives
Dr. Sandeen is a leader in quality improvement within her health system. Her projects have shaped PICU liberation practices, delirium prevention protocols, ventilator weaning tools, rounding structures, and sepsis care pathways.
Her contributions strengthen not only patient outcomes but also the environments in which multidisciplinary teams work. She is known for bridging evidence-based practice with practical, human-centered implementation strategies—ensuring that good ideas become meaningful change.
What She’s Building This Year
Developing a PICU Follow-Up Clinic
One of Dr. Sandeen’s major current initiatives involves assessing the feasibility of establishing a PICU follow-up clinic. Many children experience lasting cognitive, emotional, or physical impacts after critical illness. This clinic would close a longstanding gap—helping families navigate recovery long after discharge.
The idea has strong support, but its full implementation requires data, structure, and cross-disciplinary planning. Dr. Sandeen is leading early development efforts as part of her ongoing commitment to ICU liberation and long-term patient wellbeing.
Strengthening Residency Recruitment & Wellness Programs
In her academic leadership role, she is working to enhance residency recruitment and expand the wellness curriculum for trainees. She strives to create an environment where residents feel valued, grounded, and prepared not only to practice medicine—but to thrive within it.
Advancing Intuition-Based Coaching
Through her business, Kosha Coaching, Dr. Sandeen helps physicians explore the koshas—the layers of self that shape identity, purpose, and connection. She is currently developing an intuition-based coaching framework that empowers physicians to strengthen the internal guidance systems often overshadowed by medical training.
Dr. Sandeen teaches that clarity comes from within, and her guiding mantra reflects this belief:
“I am already what I thought I had to seek.”
She is also engaged in collaboration around DistressRx and other innovative coaching initiatives entering graduate medical education.
Personally: Committing to Authenticity
Outside her professional work, Dr. Sandeen is navigating her own evolution—doing the “hard work” required to build a life aligned with her values, identity, and core desires. Her focus is on raising children who feel loved, safe, and supported, while also honoring her own authenticity and growth.
A Glimpse into the Human Behind the Work
Favorite colors: black, green, teal
Bucket-list destinations: Scotland, Greece, South of France, Italy, Hawaii, Costa Rica, Denmark/Sweden/Norway
Business: kosha-coaching.com | Instagram: @koshacoaching
Core motivations: helping others feel seen, easing emotional pain, supporting transformation, cultivating connection, and leading with impact and love.
Her unique blend of intensity, insight, humor, grit, and compassion shapes every aspect of her leadership, clinical care, and coaching practice.
Why She Does This Work
Across all her roles, Dr. Sandeen is driven by a deep passion for service.
She supports families in crisis.
She mentors trainees becoming the physicians they hope to be.
She improves systems that impact patient safety and provider wellbeing.
She coaches physicians who are searching for meaning, balance, and alignment.
Her mission is unified:
to create environments where people feel supported, empowered, and whole.
Her Core Beliefs
Medicine requires both intellect and intuition.
Sustainable careers depend on true wellbeing—not performative “resilience.”
Quality improvement is an act of love for patients and teams.
Recovery matters as much as survival.
Leadership is about helping others feel seen.
Healing—personal or professional—happens in layers.
IMPACT
Dr. Ashley Sandeen’s life and work reflect a powerful truth: that the most important transformations come from within. Whether at the bedside of a critically ill child, in the classroom with residents, inside a systems-level meeting, or partnering with physicians through Kosha Coaching, her purpose remains grounded in the same principles:
Impact. Love. Connection. Healing. Truth.
These values guide her through every layer of her professional and personal journey, and they continue to shape the meaningful contribution she brings to medicine, coaching, and the lives she touches.