By Michael P. McCarthy
The New Year offers a clean slate, a welcome opportunity to try something new. Given the title of the blog, Reflective MedEd, I would like to offer a way of refocusing and reorienting oneself through reflecting on the experiences of the day. As Hedy Wald described in her blog post, reflection enhances a variety of skills that are essential for continuing professional identity formation for medical students, educators, and practitioners alike. The process of the examen serves as a way to reflect by reviewing hour-by-hour the events, circumstances, and experiences of the day…
The examen begins by quieting myself, and then reviewing slowly the events of the day. I start with an objective review, what I did, and a subjective view, how I felt (positively, negatively, happy, sad, joyous, frustrated, etc.) about the day’s events. I recall experiences and feelings, and then identify one thing for which I want to be especially attentive a meeting coming-up; a difficult exam; a family crisis; etc. The context of the examen is a prayerful one that is attentive to sources of meaning and motivation. Cultivating a habit of reflecting on my daily experiences through the examen expresses a desire to become more aware of who I am and who I am becoming, two essential components of formation.
The examen was developed first by St. Ignatius Loyola in sixteenth century as a component of formation for Jesuit priests who in addition worked as educators, chaplains, even physicians. Their work flowed from their sense of meaning in “finding God in all things.” While the work was important, it also held similar challenges to the ones we face today: feelings of fatigue, disconnection, burnout, loss of empathy, etc. The examen functions as a reminder to reconnect with the meaning behind the work we do.
By rummaging backwards through one’s day we take time to pause and pay attention to the deeper meaning and motivation behind our daily responsibilities—both personal and professional. For people of faith, the goal of the examen is to find God’s presence in the midst of one’s day. For others, the examen could serve as a review of one’s day that looks for sources of meaning and motivation. Cultivating a habit of reflecting—regardless of one’s faith perspective—allows for us to be attentive to finding sources of meaning in who we are and what we do. Through reflection we might come to recognize that “all moments are key moments.”
While the purpose of entering into an examen centers on cultivating one’s relationship with God, one could also describe it as focused on integrating the personal, who I am, with the professional, what I do. In this regard, the examen stands out as a nearly 500 year-old practice that allows for people of faith to view their work as a form of prayer, and/or an opportunity to practice mindful reflection that fosters professional identity formation. Reflection on the ordinary reinforces the importance of daily choices and experiences that contribute to our becoming better persons and professionals, and isn’t that what New Year’s resolutions are all about?
Michael P. McCarthy, PhD, is an assistant professor of bioethics in the department of medical education at the Loyola University Chicago Stritch School of Medicine. He is the co-director of the innovative Physician’s Vocation Program that explores the intersection of faith and medicine in medical students’ formation.