This Occasional Paper sets out to explore how Michael Balint's work in the 1950s and 1960s influences general practice education today. This paper, based on the final report of a research project into small-group work in vocational training in the London area, was funded by the Scientific Foundation Board of the Royal College of General Practitioners.

This interpretive study that explores what happens when a Balint group takes place in VTS training, how it is variously read and understood by practitioners, and with what likely benefits and consequences.

" Can Balint groups that focus on the doctor-patient relationship still offer vocational training schemes something that they can ill-afford to be without or has the Balint influence been fully subsumed into the culture of general practice education?

" At a time when much work in vocational training reflects the current fashion for competency and skill-based approaches - based on that which can be demonstrated and tested - is something valuable being neglected or lost?

The research questions at the heart of this investigation are:

" What does a Balint approach to small-group work in VTS provide?
" Given the likely complexity of the learning process, how was effectiveness to be gauged? What did effectiveness mean in this context?
" What wider lessons might an intensive analysis of a Balint approach in one VTS group have for course organisers and other educators who wish to put it to work?

What emerges from the case studies illustrates both the potential of the small group and also of the method used to investigate the subject. The case studies illustrate further the potential that narrative research can contribute to our understanding of small-group learning. Because it uses ethnography, the study happily ends with more questions about small-group learning rather than offering clearly defined answers. In so doing it illustrates further the multi-faceted value of this approach.

Visit the Balint area on the RCGP website: http://tinyurl.com/rm5w8