A Randomized Controlled Trial of Balint Groups to Prevent Burnout Among Residents in China

Burnout is highly prevalent among residents and is associated with negative outcomes for patients, organizations, and physicians. Balint groups have been shown to be an effective strategy to alleviate physicians' burnout. The purpose of this study was to examine the effectiveness and feasibility of Balint groups in preventing burnout among residents in training programs in China.

36 resident physicians in their first year of residency at a comprehensive hospital in China were randomly assigned to two groups. Physicians in the intervention group participated in 2 lectures and 10 Balint sessions for 6 months, while participants in the control group were placed on a waitlist for future Balint sessions. All 36 participants completed burnout and job satisfaction measures pre and post-intervention.

The mean burnout subscale scores for EE and DP decreased, and the scores for PA and job satisfaction increased after Balint group participation. However, paired t-test results revealed there were no statistically significant differences between pre and post-test scores for EE (t = -1.323, p = 0.203), DP (t = -0.727, p = 0.477), PA (t = 0.716, p = 0.484, and job satisfaction (t = 0.282, p = 0.781) for the intervention group. For the control group, the burnout subscale scores for EE (t = 2.312, p = 0.034) and DP (t = 2.898, p = 0.019) increased, and there were statistically significant differences between pre and post-test. PA (t = -0.717, p = 0.483) and job satisfaction (t = -0.241, p = 0.812) scores decreased although there were no significant differences seen between the pre and post-test. Independent t-test results demonstrated statistically significant differences in scores for EE (t = -2.662, p = 0.013) and DP (t = -2.433, p = 0.020) between intervention and control group. However, there were not statistically significant differences between groups for scores in PA (t = 1.013, p = 0.318) and job satisfaction (t = 0.367, p = 0.716). All 18 participants in the intervention group reported that Balint groups were helpful and that they would be willing to attend future sessions. Overall satisfaction with the Balint group program was over 80%.

Balint groups are an efficacious, feasible, standardized method of preventing resident burnout. Residents in China may benefit from Balint group implementation in residency training programs.