A narrative history of the American Balint Society 1990-2020.

An historical narrative tracing the inception, evolution, structure, educational focus, integration with international Balint movements and challenges to future growth of the American Balint Society (ABS) is enlivened and deepened by twelve Balint autobiographies that follow it. The ABS in choosing to create its historical narrative is confronting a vitally important project both for its members, and for many healthcare educators and clinicians. Both are deeply invested in promoting and preserving the integrity of the personal relationship between the provider and the client. The Society is striving not only to understand its past, but to educate itself through a contextual awareness of how to preserve a personal education for future healthcare providers. To truly understand how the Balint enterprise emerged in the USA, one must "hear" from the people who experienced and wanted to share the transformative insights of participation in Balint seminars. To "hear" their stories and to honor the diversity of perspectives within the organization the authors asked ABS members with long and committed involvement to write their personal "Balint Autobiographies." These authors tell a collective, personal and professional story that is truly integral with an ABS narrative history. Readers may find, amidst their narratives, gems of insight and instruction about the Balint Seminar process, its leadership and possibly indications of where the ABS could head in the future. However, the real significance of the history of the ABS lies in its potency to stimulate critical reflection on the true purpose(s) of the Society, to elicit new and stronger personal incentives in ABS members, and to initiate challenging, inquiring, and supporting reverberations in the medical-educational-insurance-business-governmental subculture in which it participates.

Teaching Medical Educators How to Teach Communication Skills: More than a Decade of Experience.

OBJECTIVES: Although opportunities exist for medical educators to gain additional training in teaching, literature that describes how to teach educators to teach communication skills to trainees is limited. The authors developed and evaluated a faculty development course that uses didactics, demonstration, drills, and role-play in a small-group format. METHODS: The course has been offered through the Institute for Clinical Research Education at the University of Pittsburgh for almost 15 years. Course effectiveness was evaluated with a survey of 62 clinicians who completed the course between 2003 and 2012. RESULTS: The response rate was 85%. A total of 98% would recommend the course to a colleague and 98% indicated the course was effective at developing teaching techniques. Their use of standardized patients, teaching in small groups, and role-play increased as a result of participation in the course. A total of 70% went on to formally teach communication skills at various medical education levels. CONCLUSIONS: This structured course effectively taught participants how to teach patient-doctor communication in both classroom and clinical settings. The majority put these techniques to use in formal settings. This course also provided educators with the skills necessary to meet the growing needs of training programs charged with teaching the next generation of providers to effectively communicate with patients. The description presented can serve as a framework for faculty development in teaching communication.

Essential characteristics of effective Balint group leadership.

OBJECTIVE: Balint work in the United States has suffered from a lack of written material on how Balint group leaders structure and guide group process. This study identified characteristics of effective Balint group leadership by gathering information from experienced Balint leaders. METHODS: We used evaluations of the leadership methods used by 21 Balint group leaders assembled at an American Balint Society workshop to pilot test the Society's credentialing process. Free text and rating data from leader evaluation forms were analyzed using qualitative text analysis and factor analysis. We also conducted focus groups. RESULTS: Convergence was seen on several characteristics across all sources of data. Effective Balint leaders operate to create a safe environment and move the group toward a new understanding of a specific doctor-patient relationship. Specific leader behaviors include protecting the presenter from interrogation, encouraging open speculation by group members, avoiding premature solutions, and tolerating silence and uncertainty. DISCUSSION: Although Balint group leaders rely on behaviors common to other small-group methods, they create a space and purpose markedly different from that seen in other small groups in medical education. Balint group leaders model and create a safe environment for shared, creative speculation and a more empathic experience of the doctor-patient relationship.