Objective:

General practitioners (GPs) and general practice registrars report work-related stress. Balint groups may improve coping mechanisms. However, attendance at a face-to-face Balint group is difficult for rural doctors due to distance constraints. The study aim was to evaluate online Balint groups for rural doctors and determine effect size for a full-scale trial. Design:

A mixed-methods approach, including a pre–post controlled trial and thematic analysis of qualitative data. Setting:

Rural primary care. Participants:

Thirteen GPs and 8 general practice registrars completed the study. Interventions:

Balint groups were delivered over 8–9 fortnightly online sessions. GPs and GP registrars participated in separate groups. Data were collected on work-related affect, psychological medicine skills and professional isolation using the Warr's Work-Related Affect Scale, the Psychological Medicine Inventory, and a professional isolation scale. Main outcome measures:

Change scores on Warr's Work-Related Affect Scale, the Psychological Medicine Inventory, and a professional isolation scale. Results:

Balint participants' scores were significantly higher post-intervention on the Psychological Medicine Inventory (mean 6.49 (±0.20) versus 5.43 (±0.26); P < 0.01) and Warr's Work-Related Affect (mean 4.09 (±0.09) versus 3.60 (±0.12); P < 0.01) scales than control group scores. Effect size on these scales ranged from 0.46 to 0.50. The greatest challenge was technical problems related to insufficient broadband speed. Conclusions:

Online Balint groups appear to improve rural doctors' psychological medicine skills and work-related affect. New data on effect size will inform a full-scale trial. Improved national broadband infrastructure may enhance online support opportunities for rural doctors.