Balint groups for medical students

Martina A. Torppa
GP, clinical lecturer

Our Student Balint groups

• An experimental course of voluntary Balint groups for 3rd -6th year medical students at the University of Helsinki, Faculty of Medicine, Department of Public Health, Section of General Practice in 2002-04 in collaboration with the Finnish Balint Society
• 15 student Balint group sessions, each 90mins, 9 medical students, experienced Balint group leader, two clinical teachers of general practice as co-leaders in each session, all participants were asked for agreement to collect data and use it for analysis

Data and analysis

• Data were the field notes by the co-leaders from each session
• Qualitative analysis; grounded theory based content and theme analysis of the transcripts
• What

1. were the contexts of the cases the students presented?
2. triggered the students to narrate the cases?
3. were the main themes discussed in the groups?

Ref.:

A Qualitative Analysis of Student Balint Groups in Medical Education:

Contexts and triggers of case presentations and discussion themes

Patient Education and Counselling 2008;72:5-11.

Findings

• What was different from traditional GP Balint groups
• How these issues that were processed in student Balint groups touch on professional growth and on future professional identity of the students as doctors.

(Contexts of the) cases

• Patients
• Confusing experiences in medical education
• Privacy and profession
• As professionals we are for the patients.
• Students got an experience of reflecting on confusing expereriences together with colleagues in a safe environment
• Students explored how to be a professional and a private person at the same time.

Triggers for presenting cases

• Wittnessing injustice
• Value conflict
• Difficult human relationships
• Incurable patient
• Role confusion
• These issues are possible sources of inner conflicts for students also as future doctors – the group discussions offered a structured way to process them.

Main themes in discussions

• Feelings related to patients
• Negative role models
• Co-operation with other medical professionals
• Building professional identity
• Students experienced a professional way to deal with emotions and feeling aroused by patients.
• Negative examples of fellow colleaques helped students to clarify their own professional identity .
• Preparation for team work as future doctors.
• Explicit discussions of professional identity were valued by the students; considered as a rare opportunity in the curriculum.

Conclusion

Student Balint groups may

• be a valuable forum to foster the development of medical students' mature professional identity.
• enhance future doctors' willingness and capability to reflect on 'difficult' issues with colleaques.

The concept of a case needs to be wider than in traditional Balint Groups (where the case is a patient).

A trained Balint group leader is important also in student groups to keep the discussion goal-oriented.