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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