The effectiveness of Balint groups at improving empathy in medical and nursing education: a systematic review and meta-analysis of randomized controlled trials

Empathy is crucial for patient health. The Balint group is a commonly used method for empathy training. However, the impact of Balint groups on empathy remains unclear. This systematic review and meta-analysis of randomized controlled trials (RCTs) aims to assess the impact of Balint groups on empathy training among medical and nursing students, as well as doctors and nurses.

This review involved searching multiple databases for relevant articles. Rigorous eligibility criteria were applied during the screening of titles and abstracts, and during the selection of records. Following a full-text eligibility evaluation, two reviewers independently extracted data from the final selection of studies, and a meta-analysis was conducted. The standardized mean difference (SMD) was calculated to assess the systematic outcomes.

A total of 11 studies were included in this systematic review and meta-analysis. Participants in Balint groups demonstrated a significant increase in empathy than those in the control group (SMD = 1.46, 95% confidence interval [CI] 0.86–2.06; p < 0.001). Studies conducted in China (SMD = 2.13, 95% CI 1.27–2.99; p < 0.001) revealed a greater impact of Balint groups on empathy than those conducted in France (SMD = 0.24, 95% CI 0.12–0.37; p < 0.001). The impact of Balint groups was significantly greater among physicians (SMD = 2.50, 95% CI 1.79–3.21; p < 0.001) and nurses (SMD = 2.88, 95% CI 1.34–4.43; p < 0.001) compared to medical students (SMD = 0.71, 95% CI = 0.35–1.06; p < 0.001). Participants who attended ten or more sessions (SMD = 2.37, 95% CI 1.35–3.39; p < 0.001) demonstrated better outcomes compared to those who attended fewer than ten sessions (SMD = 0.79, 95% CI 0.30–1.29; p < 0.01).

Balint groups are effective for empathy training among doctors, nurses, and medical students. Future research should incorporate patient-led measurements to evaluate empathy and ascertain the long-term impact of Balint groups on empathy training.

PROSPERO registration number CRD42023488247.