Qualitative study of reflective practice groups for emergency medicine resident doctors.

Abstract

Aim: Resident doctors in their 3rd year of emergency medicine training in the UK face multiple challenges, leading to very high levels of burnout and exodus from the training programme. The North West School of Emergency Medicine trialled reflective practice (Balint) groups to try and help this. This involves regular small group meetings focusing on case-based reflections on the emotional aspects of practice. We aimed to explore the impact of Balint groups on emergency medicine resident doctors.

Methods: Qualitative study involving semistructured interviews with resident doctors in their 3rd year of training (ST3) in the UK. Participants included those who had undertaken Balint group sessions, ST3s who did not participate, and Balint group facilitators. Interviews were recorded, transcribed and analysed using reflexive thematic analysis.

Findings: 12 participants were included between September 2023 and May 2024. They reported Balint groups to be a hugely positive part of their training. Participants developed a psychological toolkit and a supportive community to help manage the emotional and stress-related aspects of emergency medicine. This led to improved job satisfaction, which participants believed would enhance retention. Participants felt their ability to manage the emotional needs and challenges of their patients had improved. The groups were feasible to run but required planning and communication to facilitate release from clinical work.

Conclusion: Balint groups for ST3 emergency medicine resident doctors are feasible. Clinicians report benefits for themselves and perceived benefits for their patients. This supports continuing and developing the programme locally and piloting similar programmes in other professional groups and localities.