Background: Communication skills are not learnt innately. It is therefore necessary to both train and evaluate medical students in this area. Aim: To evaluate communication skills of fourth-year medical students with the use of a simulated patient (SP). Material and Methods: Four clinical scenarios (CS) for clinical interviews with simulated patients were designed: chronic and acute diseases, difficult and functional patients. Each student performed the four CS, and his communication skills were evaluated using our own questionnaire as agreed with the SP. The questionnaire included items on verbal and nonverbal communication, warmth, respect, specificity, assertiveness and empathy (rated from 0 to 10). The response variable was the arithmetic mean of the scores on each item. All students received a detailed evaluation report. Results: Sixty one students (32 men) performing 244 interviews, were evaluated. The overall mean score was 7.87 (4.62 to 9.03). The highest scores were for respect and specificity (7.57 and 7.15 respectively). The lowest were for empathy and nonverbal communication (6.44 and 6.84 respectively). The CS evaluations were 7.87 (chronic disease), 7.02 (difficult patient), 6.46 (acute disease) and 6.14 (functional pathology). Women had higher overall scores compared to men (7.26 and 6.51 respectively; p < 0.01) and a significantly higher score in all communication variables (p < 0.01). Conclusions: The overall assessment in clinical communication with SP is satisfactory although there is room for improvement, especially in empathy and nonverbal communication. Women had significantly higher scores than men.

Em vários países, motivos de contatos entre pacientes e a Atenção Primária (APS) são codificados pela Classificação Internacional da Atenção Primária (CIAP-2). Tal instrumento permite avaliar as razões que levam pessoas a buscarem cuidados, sendo útil no planejamento de estratégias para contemplar as necessidades de saúde da população. Objetivo: estudar os principais motivos de consulta na demanda espontânea da atenção primária em município de médio porte brasileiro. Metodologia: considerou-se todos os registros de acolhimento num mês típico de trabalho de três médicos residentes de medicina de família e comunidade. Os dados foram extraídos de banco de dados secundário, classificados com a CIAP-2 e analisados estatisticamente. Resultados: avaliou-se 1222 registros de consultas; 32 motivos representaram 50% dos contatos. As razões mais frequentes de busca por cuidados relacionavam-se ao capítulo Geral e inespecífico. Quase 20% das consultas ocorreram por motivos administrativos. Sexo feminino e aumento da idade determinaram maior número de motivos para consultar. Conclusão: conhecer os motivos de consulta por gênero e idade pode ajudar as equipes no enfrentamento dos problemas de saúde apresentados no acolhimento - ponto crítico do acesso à APS.

In various countries, motives for contact of patients with Primary Health Care (PHC) is classified by the International Classification of Primary Care (ICPC-2). This instrument enables the assessment of why people seek care, thereby assisting in planning strategies to attend the population's health needs. The scope of this study was to identify the main reasons for same-day appointments in PHC units of a medium-sized Brazilian city. The methodology used was to examine all records of a typical month of three family practice residents. Data were extracted from a secondary database of same-day appointments during the spring of 2010, classified with ICPC and then statistically analyzed. 1222 records were considered; 32 motives accounted for 50% of contacts. Most common motives were related to the General and Unspecific chapter of the ICPC. About 20% of visits occurred for administrative reasons. Female sex and greater age were determinants of greater motives for consultation. Knowing the motives for appointments by gender and age may help PHC teams in tackling health problems at the critical point of access to PHC.

Em vários países, motivos de contatos entre pacientes e a Atenção Primária (APS) são codificados pela Classificação Internacional da Atenção Primária (CIAP-2). Tal instrumento permite avaliar as razões que levam pessoas a buscarem cuidados, sendo útil no planejamento de estratégias para contemplar as necessidades de saúde da população. Objetivo: estudar os principais motivos de consulta na demanda espontânea da atenção primária em município de médio porte brasileiro. Metodologia: considerou-se todos os registros de acolhimento num mês típico de trabalho de três médicos residentes de medicina de família e comunidade. Os dados foram extraídos de banco de dados secundário, classificados com a CIAP-2 e analisados estatisticamente. Resultados: avaliou-se 1222 registros de consultas; 32 motivos representaram 50% dos contatos. As razões mais frequentes de busca por cuidados relacionavam-se ao capítulo Geral e inespecífico. Quase 20% das consultas ocorreram por motivos administrativos. Sexo feminino e aumento da idade determinaram maior número de motivos para consultar. Conclusão: conhecer os motivos de consulta por gênero e idade pode ajudar as equipes no enfrentamento dos problemas de saúde apresentados no acolhimento - ponto crítico do acesso à APS.

In various countries, motives for contact of patients with Primary Health Care (PHC) is classified by the International Classification of Primary Care (ICPC-2). This instrument enables the assessment of why people seek care, thereby assisting in planning strategies to attend the population's health needs. The scope of this study was to identify the main reasons for same-day appointments in PHC units of a medium-sized Brazilian city. The methodology used was to examine all records of a typical month of three family practice residents. Data were extracted from a secondary database of same-day appointments during the spring of 2010, classified with ICPC and then statistically analyzed. 1222 records were considered; 32 motives accounted for 50% of contacts. Most common motives were related to the General and Unspecific chapter of the ICPC. About 20% of visits occurred for administrative reasons. Female sex and greater age were determinants of greater motives for consultation. Knowing the motives for appointments by gender and age may help PHC teams in tackling health problems at the critical point of access to PHC.