Experience of Balint Groups in the Medical Course: Impacts on the Relationship with the Patient and the Development of Empathic Skills
DOI:
https://doi.org/10.33448/rsd-v11i4.27849Keywords:
Balint Group; Empathy; Resilience; Teaching; Teaching of medicine; Medical abilities.Abstract
Introduction: It is an established fact that empathic skills are essential for building the therapeutic bond, a basic element in the doctor-patient relationship. The loss of empathic ability with a subsequent negative impact on resilience has been reported by medical students during the clinical phases of the course. Among the various interventions proposed for the development and facilitation of the empathic relationship are the Balint groups. Objective: To evaluate the participation in Balint groups in the development of an empathic attitude in the relationship established with the patient. Methods: This is an analytical, observational, cross-sectional study, in which two groups were compared: “Balint Group” and “Control Group”, to which the Wagnild & Young Resilience Scale and the Interpersonal Reactivity Index were applied. Results: Of the 36 participants, 8 were members of the Balint Group and 28 were from academic leagues. The Resilience Scale showed statistical superiority in the group of academic leagues, with a mean score of 115.6 ±19.3 obtained by participants in the Balint Group and 129.4 ±14.6 by members of academic leagues. As for the collection of the Interpersonal Reactivity Index, the Balint Group was statistically superior, with a mean score of 79±8.6 in the Balint Group and 64.4±13.6 in the academic leagues. Conclusion: The results support a more optimistic view on the issue of empathy and resilience in the medical curriculum and encourage the initiative of training aimed at helping young medical students to take into account the emotional component of the doctor-patient relationship.
References
Airagnes, G., Consoli, S. M., De Morlhon, O., Galliot, A.-M., Lemogne, 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(5), 426–429. https://doi.org/10.1016/j.jpsychores.2014.03.005
Amorim, B. B., Moraes, L., Sá, I. C. G., Silva, B. B. G., & Filho, J. W. S. C. (2018). Saúde mental do estudante de Medicina: Psicopatologia, estresse, sono e qualidade de vida. Revista Psicologia, Diversidade e Saúde, 7(2), 245–254. https://doi.org/10.17267/2317-3394rpds.v7i2.1911
Atkinson, P. A., Martin, C. R., & Rankin, J. (2009). Resilience revisited. Journal of Psychiatric and Mental Health Nursing, 16(2), 137–145. https://doi.org/10.1111/j.1365-2850.2008.01341.x
Balint, M. (1975). O Médico, seu Paciente e a Doença. Atheneu.
Buffel du Vaure, C., Lemogne, C., Bunge, L., Catu-Pinault, A., Hoertel, N., Ghasarossian, C., Vincens, M.-E., Galam, E., & Jaury, P. (2017). Promoting empathy among medical students: A two-site randomized controlled study. Journal of Psychosomatic Research, 103, 102–107. https://doi.org/10.1016/j.jpsychores.2017.10.008
Chen, D. C. R., Kirshenbaum, D. S., Yan, J., Kirshenbaum, E., & Aseltine, R. H. (2012). Characterizing changes in student empathy throughout medical school. Medical Teacher, 34(4), 305–311. https://doi.org/10.3109/0142159X.2012.644600
Connor, K. M., & Davidson, J. R. T. (2003). Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety, 18(2), 76–82. https://doi.org/10.1002/da.10113
Cuff, B. M. P., Brown, S. J., Taylor, L., & Howat, D. J. (2016). Empathy: A Review of the Concept. Emotion Review, 8(2), 144–153. https://doi.org/10.1177/1754073914558466
Dow, A. W., Leong, D., Anderson, A., & Wenzel, R. P. (2007). Using Theater to Teach Clinical Empathy: A Pilot Study. Journal of General Internal Medicine, 22(8), 1114–1118. https://doi.org/10.1007/s11606-007-0224-2
Drolet, B. C., & Rodgers, S. (2010). A comprehensive medical student wellness program—Design and implementation at Vanderbilt School of Medicine. Academic Medicine: Journal of the Association of American Medical Colleges, 85(1), 103–110. https://doi.org/10.1097/ACM.0b013e3181c46963
Dyrbye, L. N., Thomas, M. R., & Shanafelt, T. D. (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(4), 354–373. https://doi.org/10.1097/00001888-200604000-00009
Goupy, F., Abgrall-Barbry, G., Aslangul, E., Chahwakilian, A., Delaitre, D., Girard, T., Lassaunière, J.-M., Roche, N., Szwebel, T.-A., Dantchev, N., Triadou, P., & Le Jeunne, C. (2013). L’enseignement de la médecine narrative peut-il être une réponse à l’attente de formation des étudiants à la relation médecin–malade ? La Presse Médicale, 42(1), e1–e8. https://doi.org/10.1016/j.lpm.2012.09.012
Iqbal, S., Gupta, S., & Venkatarao, E. (2015). Stress, anxiety and depression among medical undergraduate students and their socio-demographic correlates. The Indian Journal of Medical Research, 141(3), 354–357. https://doi.org/10.4103/0971-5916.156571
Kind, T., Everett, V. R., & Ottolini, M. (2009). Learning to connect: Students’ reflections on doctor-patient interactions. Patient Education and Counseling, 75(2), 149–154. https://doi.org/10.1016/j.pec.2008.09.011
Ludwig, A. B., Burton, W., Weingarten, J., Milan, F., Myers, D. C., & Kligler, B. (2015). Depression and stress amongst undergraduate medical students. BMC Medical Education, 15, 141. https://doi.org/10.1186/s12909-015-0425-z
McManus, I. C., Keeling, A., & Paice, E. (2004). Stress, burnout and doctors’ attitudes to work are determined by personality and learning style: A twelve year longitudinal study of UK medical graduates. BMC Medicine, 2, 29. https://doi.org/10.1186/1741-7015-2-29
McManus, S., Killeen, D., Hartnett, Y., Fitzgerald, G., & Murphy, K. C. (2020). Establishing and evaluating a Balint group for fourth-year medical students at an Irish University. Irish Journal of Psychological Medicine, 37(2), 99–105. https://doi.org/10.1017/ipm.2019.28
Neumann, M., Edelhäuser, F., Tauschel, D., Fischer, M. R., Wirtz, M., Woopen, C., Haramati, A., & Scheffer, C. (2011). Empathy decline and its reasons: A systematic review of studies with medical students and residents. Academic Medicine: Journal of the Association of American Medical Colleges, 86(8), 996–1009. https://doi.org/10.1097/ACM.0b013e318221e615
O’Neill, S., Foster, K., & Gilbert-Obrart, A. (2016). The Balint group experience for medical students: A pilot project. Psychoanalytic Psychotherapy, 30(1), 96–108. https://doi.org/10.1080/02668734.2015.1107124
Pacheco, J. P., Giacomin, H. T., Tam, W. W., Ribeiro, T. B., Arab, C., Bezerra, I. M., Pinasco, G. C., Pacheco, J. P., Giacomin, H. T., Tam, W. W., Ribeiro, T. B., Arab, C., Bezerra, I. M., & Pinasco, G. C. (2017). Mental health problems among medical students in Brazil: A systematic review and meta-analysis. Brazilian Journal of Psychiatry, 39(4), 369–378. https://doi.org/10.1590/1516-4446-2017-2223
Pesce, R. P., Assis, S. G., Avanci, J. Q., Santos, N. C., Malaquias, J. V., & Carvalhaes, R. (2005). Cross-cultural adaptation, reliability and validity of the resilience scale. Cadernos de Saúde Pública, 21(2), 436–448. https://doi.org/10.1590/S0102-311X2005000200010
Priddis, L., & Rogers, S. L. (2018). Development of the reflective practice questionnaire: Preliminary findings. Reflective Practice, 19(1), 89–104. https://doi.org/10.1080/14623943.2017.1379384
Suchman, A. L., Markakis, K., Beckman, H. B., & Frankel, R. (1997). A model of empathic communication in the medical interview. JAMA, 277(8), 678–682.
Tempski, P., Martins, M. A., & Paro, H. B. M. S. (2012). Teaching and learning resilience: A new agenda in medical education. Medical Education, 46(4), 345–346. https://doi.org/10.1111/j.1365-2923.2011.04207.x
Tomlin, A. M., Hines, E., & Sturm, L. (2016). Reflection in Home Visiting: The What, Why, and a Beginning Step Toward How. Infant Mental Health Journal, 37(6), 617–627. https://doi.org/10.1002/imhj.21610
Turner, A. L., & Malm, R. L. (2004). A preliminary investigation of balint and non-balint behavioral medicine training. Family Medicine, 36(2), 114–122.
Van Roy, K., Vanheule, S., & Inslegers, R. (2015). Research on Balint groups: A literature review. Patient Education and Counseling, 98(6), 685–694. https://doi.org/10.1016/j.pec.2015.01.014
Unicap (2013). Projeto Pedagógico do Curso de Graduação em Medicina. P.-R. Acadêmica. Recife: p. 634.
Van Roy, K., Vanheule, S., & Inslegers, R. (2015). Research on Balint groups: A literature review. Patient Education and Counseling, 98(6), 685–694. https://doi.org/10.1016/j.pec.2015.01.014
Wagnild, G. M., & Young, H. M. (1993). Development and psychometric evaluation of the Resilience Scale. Journal of Nursing Measurement, 1(2), 165–178.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Luan Amaral Magalhães Sousa ; João Guilherme Araújo Magalhães Neiva ; Luiza Lívia Cavalcanti Morotó; Maria Cecília Amorim de Barros; Pablo Terto Magalhães Feitoza; Paulo Osório Araújo Magalhães Neiva ; Yanne Almeida Aguiar ; Déborah Karoline de Lira Sales e Silva; Eduarda Silvestre Ribeiro da Costa Gomes; José Waldo Saraiva Câmara Filho
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
