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Establishing and evaluating a Balint group for fourth-year medical students at an Irish University

Published online by Cambridge University Press:  20 August 2019

Sorcha McManus*
Affiliation:
Department of Psychiatry, Smurfit Building, Beaumont Hospital, Dublin 9, Ireland Department of Psychiatry, Royal College of Surgeons, Smurfit Building, Beaumont Hospital, Dublin 9, Ireland
David Killeen
Affiliation:
St Patrick’s University Hospital, St James’s Street, Dublin 8, Ireland
Yvonne Hartnett
Affiliation:
St Patrick’s University Hospital, St James’s Street, Dublin 8, Ireland
Gearoid Fitzgerald
Affiliation:
Department of Psychiatry, Royal College of Surgeons, Smurfit Building, Beaumont Hospital, Dublin 9, Ireland UK & Ireland Balint Society, 23 Bainbridge Road, Headingley, Leeds, IS6 3AD, United Kingdom
Kieran C. Murphy
Affiliation:
Department of Psychiatry, Smurfit Building, Beaumont Hospital, Dublin 9, Ireland
*
*Address for correspondence: Sorcha McManus, Department of Psychiatry, Smurfit Building, Beaumont Hospital, Dublin 9, Ireland. (Email: [email protected])

Abstract

Objective

The study was designed to establish and evaluate the impact of a 6-week Balint group on empathy and resilience in fourth-year medical students during their psychiatry rotation.

Methodology

This prospective study used the Jefferson Scale of Empathy – Student Version and the Brief Resilience Scale before and after 6-week Balint groups. Participating students also completed a qualitative assessment of their experience.

Results

Students who participated were enthusiastic regarding the value of Balint groups in promoting self-reflection and gaining insight into self- and patient-care dynamics. There was a significant difference in empathy scores pre- and post-Balint intervention. There was no significant difference in resilience scores.

Conclusion

The establishment of a 6-week Balint group for fourth-year medical students was successful in increasing empathy. Students reported a positive view of Balint and its beneficial role in this study group.

Type
Original Research
Copyright
© College of Psychiatrists of Ireland 2019

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References

Ahern, N, Kiehl, E, Sole, M, Byers, J (2006). A review of instruments measuring resilience. Issues in Comprehensive Pediatric Nursing 29, 103125.CrossRefGoogle ScholarPubMed
Airagnes, G, Consoli, S, De Morihon, O, Galliot, A, Lemonge, C, Jaury, P (2014). Appropriate training based on Balint groups can improve the empathic abilities of medical students: a preliminary study. Journal of Psychosomatic Research 76, 426429.CrossRefGoogle ScholarPubMed
Atkinson, P, Martin, C, Rankin, J (2009). Resilience revisited. Journal of Psychiatric and Mental Health Nursing 16, 137145.Google Scholar
Balint, E (1979). The Balint group approach. Journal of the Royal Society of Medicine 72, 469471.CrossRefGoogle ScholarPubMed
Balint, E (1985). The history of training and research in Balint groups. Psyhcoanalytical Psychotherapy 1, 19.CrossRefGoogle ScholarPubMed
Balint, M (1957). The Doctor, His Patient and the Illness. Churchill Livingstone: London.CrossRefGoogle Scholar
Birden, H, Glass, N, Wilson, I (2013). Teaching professionalism in medical education: a Best Evidence Medical Education (BEME) systematic review. BEME Guide No. 25 (https://doi.org/10.3109/0142159X.2013.789132) Accessed 10 June 2018.CrossRefGoogle Scholar
Buffel du Vaure, C, Lemongne, C, Bunge, L, Catu-Pinault, A, Hoertel, N, Ghasarossian, C, Vincens, M, Galam, E, Jaury, P (2017). Promoting empathy among medical students: a two-site randomized controlled study. Journal of Psychosomatic Research 103, 102107.CrossRefGoogle Scholar
Chen, D, Kirschenbaum, D, Yan, J, Kirshenbaum, E, Aseltine, R (2012). Characterising changes in student empathy throughout medical school. Medical Teacher 34, 305311.CrossRefGoogle ScholarPubMed
Clement, N (2009). Perspectives from research and practice in values education. In Values Education and Quality Teaching (ed. Lovat, T. and Toomey, R.). Springer: Dordrect. (https://doi.org/10.1007/978-1-4020-9962-5_2). Accessed 19 June 2018.CrossRefGoogle Scholar
Connor, K, Davidson, J (2003). Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety 18, 7682.Google Scholar
Decety, J, Jackson, P (2004). The functional architecture of human empathy. Behavioural Cognitive Neuroscience Revisions 3, 71100.CrossRefGoogle Scholar
Dow, D, Leong, A, Anderson, R, Wenzel, V (2007). Theatre medicine team: using theatre to teach clinical empathy: a pilot study. Journal of General Internal Medicine 22, 11141118.CrossRefGoogle ScholarPubMed
Dyrbye, L, Thomas, M, Shanafelt, T (2006). Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Academic Medicine: Journal of the Association of American Medical Colleges 81, 354373.CrossRefGoogle Scholar
Erikson, E (1968). Youth: Identity and Crisis. New York. Norton.CrossRefGoogle ScholarPubMed
Glaser, G, Strauss, A (1967). The Discovery of Grounded Theory: Strategies for Qualitative Research. Chicago, IL: Aldine.Google Scholar
Goupy, F, Abgrall-Barbry, G, Aslangul, E, Chahwakilian, A, Delaitre, D, Girard, T, Lassauniere, J-M, Roche, N, Szwebel, T-A, Dantchev, N, Triadou, P, Le Jeunne, C (2013) L’enseignement de la medecine narrative peutil stre une reponse a l’attente de formation des etudiants a la relation medecin malade? Presse Medecine. (https://doi:10.1016/j.lpm.2012.09.012). Accessed 12 June 2018.Google Scholar
Hill, E, Bowman, K, Stalmeijer, R, Solomon, Y, Dornan, T (2014). Can I cut it? Medical students’ perceptions of surgeons and surgical careers. American Journal of Surgery 208, 860867.CrossRefGoogle Scholar
Hojat, M, Vergare, M, Maxwell, K, Brainard, G, Herrine, S, Isenberg, G, Gonnella, J (2009). The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Academic Medicine 84, 11821191.CrossRefGoogle ScholarPubMed
Iqbal, S, Gupta, S, Venkatarao, E (2015). Stress, anxiety & depression among medical undergraduate students & their socio-demographic correlates. The Indian Journal of Medical Research 141, 354367.CrossRefGoogle ScholarPubMed
Johnston, J (2012). Thinking Cradle to Grave: Developing Psychotherpaeutic Psychiatry, 4th edn., Royal College of Psychiatrists: London.Google ScholarPubMed
Jones, D, Newsome, J, Levin, K, Wilmot, A, McNulty, J, Kline, T (2018). Friends or strangers? A feasibility study of an innovative focus group methodology. The Qualitative Report 23, 98112.Google Scholar
Kjeldmand, D (2006). The Doctor, the task, and the group. Balint groups as a means of developing new understadings in the physician-patient relationship. Acta Universitatis Upsalienses. Digital Comprehensive Summaries of Uppsala Dissertations from the faculty of medicine. Upsala.Google Scholar
Lazaratou, H (2017). Interpersonal trauma: psychodynamic psychotherapy and neurobiology. European Journal of Psychotraumatology 8, 2126.Google Scholar
Loureiro, J, Goncalves-Pereira, M, Trancas, B, Caldas-de-Almeida, J, Castro-Caldas, A (2011). Empathy in the doctor-patient relationship as viewed by first year medical students: data on validity and sensibilty to change of the Jefferson Measure in Portugal. Acta Medical Portugal 2, 431442.CrossRefGoogle Scholar
Mahoney, D, Diaz, V, Thiedke, C, Mallin, K, Brock, C, Freedy, J, Johnson, A (2013). Balint Groups: The nuts and bolts of making better doctors. International Journal of Psychiatric Medicine 45, 401411.Google Scholar
Meitar, D, Karnieli-Miller, O, Eidelman, S (2009). The impact of senior medical students’ personal difficulties on their communication patterns in breaking bad news. Academic Medicine 84, 15821594.CrossRefGoogle ScholarPubMed
Montanari, C, Petrucci, C, Russo, S, Murray, I, Dimonte, V, Lancia, L (2015). Psychometric properties of the Jefferson Scale of Empathy– Health Professional Student’s Version: an Italian study with nursing students. Nursing Health Sciences 17, 483491.CrossRefGoogle ScholarPubMed
Neumann, M, Edelhäuser, F, Tauschel, D, Fischer, MR, Wirtz, M, Woopen, C, Scheiffer, C (2011). Empathy decline and its reasons: a systematic review of studies with medical students and residents. Academic Medicine 86, 9961009.CrossRefGoogle ScholarPubMed
Old, J, Malone, J (2016). The implementation and evaluation of a trial Balint group for clinical medical students. Journal of the Balint Society 2, 3140.Google Scholar
O’Neill, S, Fosterb, K, Gilbert-Obrartc, A (2016). The Balint group experience for medical students: a pilot project. Psychoanalytic Psychotherapy 30, 96108.CrossRefGoogle Scholar
Parker, S, Leggett, A (2012). Teaching the clinical encounter in psychiatry: a trial of Balint groups for medical students. Australasian Psychiatry 20, 343347.Google Scholar
Perry, ZH, Lauden, A, Arbelle, S (2013). Emotional processing—the use of Balint groups for medical students as a means for improving interpersonal and communication skills and competence. Annals of Behavioral Science and Medical Education 19, 1621.CrossRefGoogle ScholarPubMed
Pini, B (2002). Focus groups, feminist research and farm women: opportunities for empowerment in rural social research. Journal of Rural Studies 18, 339351.CrossRefGoogle Scholar
Priddis, L, Rogers, S (2017). Development of the reflective practice questionnaire: preliminary findings. Reflective Practice 19, 89104.CrossRefGoogle Scholar
Roter, D, Frankel, R, Hall, J, Sluyter, D (2006). The expression of emotion through nonverbal behavior in medical visits. Journal of General Internal Medicine 21, 2834.CrossRefGoogle Scholar
Saravanan, C, Wilks, R (2014). Medical students’ experience of and reaction to stress: the role of depression and anxiety. The Scientific World Journal 14, 18.CrossRefGoogle ScholarPubMed
Shapiro, J (2011). The Inner World of Medical Students: listening to their Voices in Poetry. Radcliff Publishing. Oxford/New York.CrossRefGoogle Scholar
Shkulaku, R (2015). Student’s stress in higher education institutions: a critical review of feigen literatures and the ones in Albania. European Scientific Journal 3, 4048.Google Scholar
Shoenberg, P (2012). Students and their patients; Evaluation of the UCL student Balint groups. Journal of the Balint Society 40, 2126.Google Scholar
Singh, G, Hankins, M, Weinman, JA (2004). Does medical school cause health anxiety and worry in medical students? Medical Education 38, 479481.Google Scholar
Spasenoska, M, Costello, S, Williams, B (2016). Investigating the psychometric properties of the Jefferson Scale of Physician Empathy in a sample of Malaysian medical students. Advances in Medical Education and Practice 7, 331339.CrossRefGoogle ScholarPubMed
Suchman, A, Markakis, K, Beckman, R, Frankel, A (1997). A model of empathic communication in the medical interview. Journal of the American Medical Association 277, 678682.Google Scholar
Sung, A, Collins, M, Smith, A, Sanders, A, Quinn, M, Block, S, Arnold, R (2008). Crying: experiences and attitudes of third-year medical students and interns. Teaching and Learning in Medicine 21, 180187.CrossRefGoogle Scholar
Tavakol, S, Dennick, R, Tavakol, M (2011). Psychometric properties and confirmatory factor analysis of the Jefferson Scale of Physician Empathy. British Medical Council Medical Education 2, 5467.CrossRefGoogle Scholar
Tempski, P, Martins, MA, Paro, HBMS (2012). Teaching and learning resilience: a new agenda in medical education. Medical Education 46, 345346.Google Scholar
Tomlin, A, Hines, E, Sturm, L (2016). Reflection in home visiting: the what, why and a beginning step toward how. Infant Mental Health Journal 37, 617627.Google Scholar
Torppa, M, Makkonen, E, Martenson, C, Pitkala, K (2007). A qualititative analysis of students Balint groups in medical education: contexts and triggers of case presentations and discussion themes. Patient Education and Counselling 72, 511.CrossRefGoogle Scholar
Weatherston, D, Barron, C (2009). What does a reflective supervisory relationship look like? In A Practical Guide to Reflective Supervision (ed. Scott Heller, S. & Gilkerson, L.), pp. 6382. Washington, DC: Zero to Three.CrossRefGoogle Scholar
Yusoff, M, Abdul Rahim, A, Baba, A, Ismail, S, Mat Pa, M, Esa, A (2013). The impact of medical education on psychological health of students: a cohort study. Psychology, Health & Medicine 18, 420430.Google Scholar