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“……那你当时是什么感觉?”——英国本土职业培训项目中 GP 培训生对巴林特小组的看法。

'…And how did that make you feel?' - GP trainees' perceptions of Balint on a local UK vocational training scheme.

机构信息

NHS GP, Royal College of General Practitioners, London, UK.

出版信息

Educ Prim Care. 2020 Sep;31(5):281-289. doi: 10.1080/14739879.2020.1764397. Epub 2020 May 26.

DOI:10.1080/14739879.2020.1764397
PMID:32453976
Abstract

Balint allows colleagues to explore emotions generated from doctor-patient interactions, complexities sometimes overlooked within traditional curricula. With an increasing burnout rate, evidence-based strategies to support trainee general practitioners (GPs) are needed and we investigated if Balint could be one way to improve this. There are no recent studies looking at Balint in UK GP training. Our aim was to establish GP trainees' understanding of the purpose of Balint and perceived advantages and disadvantages. Qualitative methodology was used to conduct semi-structured interviews with trainees and alumni participating in Balint within a suburban London Vocational Training Scheme. Emergent coding was performed and a phenomenological approach taken to thematic analysis. Eleven participants took part in the study. Balint provided a supportive, confidential outlet to help normalise trainees' feelings after challenging doctor-patient interactions. Multiple viewpoints, the chance to vent and a sense of comradery was unanimously enjoyed. Participants could see potential benefits for delivery of care, patient safety and remaining up-to-date. There was debate over inclusion of clinical management, and variation in preferred facilitation styles. Disparity in Balint contribution was attributed to differing personalities and confidence levels. With the growing demands of general practice, a flexible approach to Balint facilitation could add value in training by providing a peer platform to help address the hidden curriculum.

摘要

巴林特小组允许同事探讨医患互动中产生的情绪,这些情绪在传统课程中有时会被忽视。由于 burnout rate(职业枯竭率)不断上升,需要采取基于证据的策略来支持实习全科医生(GP),我们研究了巴林特小组是否可以作为一种改善这一状况的方法。目前尚无研究关注英国 GP 培训中的巴林特小组。我们的目的是确定 GP 实习生对巴林特小组目的的理解以及他们认为的优势和劣势。我们采用定性方法,对参与伦敦郊区职业培训计划中巴林特小组的实习生和校友进行半结构化访谈。采用浮现编码并采用现象学方法进行主题分析。共有 11 名参与者参与了这项研究。巴林特小组提供了一个支持性的、保密的渠道,可以帮助实习生在经历具有挑战性的医患互动后,正常化他们的感受。多角度、发泄的机会和同志情谊是大家一致喜欢的。参与者可以看到在提供护理、患者安全和保持最新知识方面的潜在好处。关于纳入临床管理以及对促进方式的偏好存在争议。巴林特小组贡献的差异归因于不同的个性和信心水平。随着全科医学需求的不断增长,灵活的巴林特小组促进方式可以通过提供一个同伴平台来帮助解决隐性课程,为培训增加价值。

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