Balint groups in undergraduate medical education: a systematic review

Objective: Though Balint groups feature increasingly in UK medical school curricula, there is no evidence-based consensus on what undergraduates might gain from participation, and how this might happen. To address this, we systematically reviewed primary research studies involving medical student Balint groups and their relationship with patient-centredness, using narrative synthesis. Data sources: Four major databases were searched from origin until 9 September 2016. The Journal of the Balint Society was hand-searched from 1971 until 9 September 2016. Study selection: English language studies reporting quantitative and/or qualitative methods examining Balint groups in medical students vs. other/no comparator. Results: Eight studies were included. Quantitative findings report statistically significant improvements to student’s empathy and intellectual interest following group participation vs. control (p = 0.03, p = 0.046, respectively). Discussion content was similar across high-income countries. There was considerable heterogeneity when students rated the efficacy of groups. All evidence had high or unclear risk of bias, or was of medium/low quality. Conclusion: Balint groups might help medical students to become more patient-centred, by increasing students’ empathic abilities and supporting their personal and professional growth. Groups are more subjectively effective when optional rather than compulsory. Discussion content is comparable to groups in continuing medical education.     

The Balint group experience for medical students: a pilot project

Loss of empathy has been reported in medical students as they move through the clinical phases of their training. Several researchers have attempted to address this issue by exploring ways of heightening students’ awareness of the emotional, non-biomedical aspects of illness and the dynamics of the doctor–patient relationship, using a variety of reflective group discussion methods. This pilot project employed the specific group method developed by Michael Balint for general practitioners working in London after the Second World War. The pilot was based on one group of six third-year graduate students, meeting weekly over six weeks. Evaluation includes pre- and post-questionnaires, a 1000-word essay and leaders’ observations. The results suggest that the traditional Balint method needs to be modified for students at a point in their training where they have not yet been exposed to patients for long enough to develop meaningful patient relationships. Nevertheless, there was some evidence of a heightened awareness of the dynamics of doctor–patient relationships and the importance of psychological/emotional factors (including their own prejudices) when interacting with a patient. Balint-style groups could be an effective way of encouraging medical students to reflect on the importance of emotions in the doctor–patient relationship.     

Zones of Maturation and Regression,and Psychoanalytic Technique

This article summarizes Balint's thoughts on the fundamental problems of psychoanalytic technique and their links with libidinal development as conceived by him.     

Understanding the dynamics of the patient-physician relationship: balancing the fiduciary and stewardship roles of physicians

There has been growing concern about the effects on the patient–physician relationship of the increasing demands on physicians to balance their fiduciary and stewardship responsibilities, what has been called double agency. Various authors have proposed ways to restore patient centeredness to the patient–physician interaction. We have previously discussed the need to establish a patient–physician alliance to achieve this aim and to facilitate achieving this balance in mutual understanding. In this essay, we examine six concepts derived by Michael Balint from research seminars with primary care physicians. These six concepts are (a) the basic fault; (b) the physician's apostolic function; (c) the mutual investment company; (d) the drug doctor; (e) the deeper diagnosis; and (f) the conspiracy of anonymity. We believe these six concepts describe basic forces that shape the patient–physician relationship and allow for the development of an alliance between patients and physicians that can help preserve the essentials of the relationship.     

The Balint movement worldwide: present state and future outlook: a brief history of Balint around the world

Michael and Enid Balint began running seminars for GPs (family physicians) in London in the late 1950s. Balint groups were soon started in other countries leading to the formation of the International Balint Federation. This paper describes the activities of the Federation and surveys the health and strength of the Balint movement in different parts of the world. While formal Balint training seems unlikely to become part of the official curriculum in more than a few countries, Balint's ideas will continue to be influential.     

借助巴林特小组培训模式提高临床护理质量

通过对巴林特小组培训模式的认识和理解,并将之运用于临床护理研究,使护理人员在处理护患关系中形成新的视角和更具分析性的思考方式,从而能够更深刻地意识到自身对于患者的影响,提高换位思考的敏感性,以便更好地理解和帮助患者;同时还能促进护理人员的心理健康和减少其工作中存在的护患矛盾。这不仅可以提高患者的治疗效果和生活质量,而且还可以提升护理人员自身的职业素养。因此,巴林特小组培训模式对于实现临床护理优质服务具有重要的现实意义。