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.