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10 Closer, wiser, stronger: setting up a peer-led reflective practice group for palliative medicine specialty registrars
  1. Robert Brodrick and
  2. Abi Ponnampalam
  1. Arthur Rank Hospice Charity, Farleigh Hospice


Background Palliative care clinicians are routinely exposed to intense distress. Maslach Burnout Inventory data suggests this is a major workforce issue and correlates with increased risk of emotional exhaustion. Interventions to increase self-awareness may reduce this risk; the GMC recommends group reflection as it can lead to improved patient care. Balint groups are an approach to reflective practice that examine the doctor-patient relationship. A recent review concluded that they should form a key component of palliative medical training.

Methods We established a confidential, co-created, peer-led reflective practice group based on Balint principles for palliative medicine specialty registrars. To our knowledge, this is a UK first. It was designed to help develop specific competencies in the current Specialty Training Curriculum such as Self Awareness (5.1), The Doctor-Patient Relationship (5.3) and Learning and Self-Development (10.1)

Whilst traditional Balint groups are facilitated by an experienced psychotherapist, we used a rotating peer facilitator to promote group work skills, with the advantage of being cost neutral. 14 specialty registrars met together for an hour-long reflective practice group each month during seven consecutive regional training days. We surveyed members’ views anonymously on the effects of group participation.

Results 100% (14/14) felt the group was an effective use of training time and were keen for the group to continue. 93% (13/14) thought it enhanced their ability to adapt to work-related challenges. 100% (14/14) valued the opportunity to learn from others’ experience, 93% found it enhanced peer support (13/14), 79% (11/14) felt less isolated as a result and 71% (10/14) thought the group helped develop self-awareness and insight. The most frequent words used to thematically describe the group were: supportive, valuable, safe, reassuring, interesting and useful.

Conclusions Starting a peer-led reflective practice group is an efficient, effective and economic method of enhancing higher specialty training in palliative medicine.

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