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Tutor’s role in conducting an urgency case by students in the collective health medical internship of a south Brazilian higher education institution

International Journal of Family & Community Medicine
Jessica Belei Martins,1 Fernanda Pombo Rodriguez,1  Marcelo Tsuyoshi Yamane,Vinícius Klettemberg Machado,1 Leonardo Campos TeixeiraEmile Fernandes Spinassi Teixeir2

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In-service training as a practice of medical education emerged in Brazil around the 1940s and was regulated only in 1969. Intensive, continuous, and supervised training aims to increase practical experience in the training of new doctors. In the context of active methodologies, the tutor gives the protagonist role of the medical service to the students, encouraging them “to learn how to learn”. In a Health Unit of Curitiba / PR, a student of the 10th medical period attended a patient with an acute abdomen, whose main diagnostic suspicion was acute cholecystitis. The patient had already undergone several urgent and emergency care equipment check-ups, but there was no referral to any more complex service for a definitive resolution  of  the  condition.  Through  the  electronic  health  system  and  connection  to  the  Emergency Medical Service (SAMU, in Brazil), under the direct supervision of the tutor, the student took immediate medical conduct, referring the patient to a more complex service and requesting transportation directly from the Health Unit. By combining SNAPPS and Five-Step Micro-skills tools for students and teachers in outpatient medical education, we  promoted  the  learner-tutor  meeting  for  a  clinical case  discussion,  development  of new knowledge, recognition of positive attitudes and improvement of flaws. A trained and engaged tutor is of great value in developing student’s autonomy, responsibility, and security during the learning process.


tutor, medical education, urgency, collective health, medical internship, fever, nausea, vomiting, and hyporexia