MEDICAL STUDENTS LEARNING TO USE THE MCGILL ILLNESS NARRATIVE INTERVIEW TO APPROACH PATIENTS WITH MEDICALLY UNEXPLAINED SYMPTOMS IN PRIMARY CARE

Introduction Patients with medically unexplained symptoms (MUS) represent from 15 to 30% of consultations in primary care. The psychosocial approach exploring illness experience, people’s beliefs and other cultural aspects can help health professionals and patients to manage this kind of symptoms. The McGill Illness Narrative Interview (MINI) is a semistructured qualitative protocol, theoretically designed to elicit illness narratives. Students from the Family Medicine Internship in Federal University of Rio de Janeiro were trained to apply this interview, to address patients with MUS. Objective To evaluate the contributions MINI can bring training students on approaching of patients with MUS. Method Thirteen students participated. Each one conducted or observed three interviews on average. At all seventeen interviews were recorded, transcribed and examined using thematic analysis. The patients were selected by the Family Medicine team of the county of Piraí, in the State of Rio de Janeiro; Results Students criticized teaching focused in medical specialties and disease and pointed the interview as a facilitator building a dialogic relationship with the patient. The MINI allowed the students knew psychological and social determinants of illness experience. In five cases, the interns could propose a therapeutic plan, not only prescribing medications, but suggesting psychosocial interventions. Most of the students said the interview was long, but they incorporated central questions in routine consultations, out of research. Conclusion This qualitative study suggests that training students to use McGill Illness Narrative Interview can improve their communication skills, incorporating psychosocial aspects to clinical reasoning and promoting a dialogic doctor-patient relationship.