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During the recording of “Clinical Communication” episodes, before guests are asked the deep hard questions, they’re given some easier warm up questions to start with to help them feel comfortable.
These are also recorded though not released at the time,until now.
Some of this content from earlier episodes has been released on social media, but others from recent episodes have been held onto for this special episode, where you will hear:
(00:00) – Introduction
(01:26) Jo Gibson:
Which Rotator Cuff Muscle Is The Heaviest?
How To Build Rapport With Scousers?
(04:18) Nick Lividas:
Weirdest Body Parts People Have Had Steroid Injections
Weirdest Substances Being Injected
Where Are We Currently With Stem Cells?
(14:29) Ian Reilly:
What Is The Future Of Podiatry?
Orthotics in Podiatry
Original Podiatric Theories
Do In-Soles Have To Be Specially Made?
For more, find @BWhybrowPhysio across social media.
Got questions, dilemmas or stories? Send them in to [email protected]
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Many healthcare clinicians can probably identify a bunion ortoe deformity, but asked anything more than this by patients and most would get stuck.
So how do we explain what they are, why they’ve occurred and what the management options are in a way the patient can understand?
How do foot surgeons have conversations around surgicaloptions & expectations and explaining risks?
In this episode Ben is joined by Ian Reilly, Consultant PodiatricSurgeon & International Lecturer, where they discuss:
(00:00:00) – Introduction
(00:00:46) – Dad Jokes
(00:02:05) – How Romanian Christmas’s Compare To British
(00:03:50) – What Made Ian Choose Podiatry & PodiatricSurgery?
(00:07:08) – How To Explain What A Bunion Is To A Patient& Why They Have It
(00:13:00) – When Surgery Doesn’t Always Go Well
(00:17:38) – How To Discuss The Risks Of Foot Surgery
(00:21:28) – Shared Decision Making & Informed ConsentIn Foot Surgery
(00:25:20) – What To Say If They Ask “Will My Bunion ComeBack After Surgery?”
(00:28:07) – How To Manage Different Surgical Opinions
(00:30:50) – What To Say If They Ask “How Can I Prevent ThisBunion Coming Back?”
(00:33:53) – How To Explain What A Hammer Toe Is To APatient & Why They Have It
(00:35:58) – What To Say If A Toe Deformity Is Asymptomatic?
(00:39:12) – How To Discuss The Risks Of Toe DeformitySurgery
(00:41:05) – How To Discuss Toe Amputations
(00:51:28) – How Surgeon Communication Skills Have Changed Over The Years
(00:56:10) – Does Better Surgeon-Patient Rapport Lead ToBetter Outcomes?
(00:58:24) – How To Tell A Patient Surgery Isn’t Appropriate
(01:02:31) – Always Find Out What Your Patient Wants
(01:03:37) – Ian’s Hardest Conversation
(01:12:01) – Ian’s Most Rewarding Surgical Outcomes
(01:16:00) – Outro Discussion & Ian’s Courses
You can find Ian on Social Media here:
X/Twitter: @podsurgery
Instagram: @podsurgeon
YouTube: @IanReillyPodsurgeon
As well as on LinkedIn.
His website is: https://podsurgeon.co.uk/
You can find Ben across Social Media @BWhybrowPhysio
More information on Podiatric Surgery Training:
https://rcpod.org.uk/podiatric-surgery/become-a-podiatric-surgeon#:~:text=Qualified%20podiatrists%20undertake%20postgraduate%20training,Podiatric%20Surgery%20(MOPS)%20programme
“Trick or Treatment” Book Mentioned by Simon Singh &Ezard Ernst.
https://www.amazon.co.uk/Trick-Treatment-Alternative-Medicine-Trial/dp/0552157627
Have questions/situations you want help with or stories youwould like to share?
Send them into [email protected] it may well get read out and answered.
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Group programmes can be a part of the management of many long-term conditions, combining various different activities which combined can have greater outcomes than individual components.
Whilst suggestions may exist for what kind of content tocover in the specific group, the practicalities of how to run a group and ensure it is effective, have not been discussed in much depth, until now.
In this first discussion episode, Ben is joined by Conor Creedon who is a Back Pain Specialist Physiotherapist & First Contact Practitioner.Both Ben & Conor run group programmes for people with persistent pain, in this episode they cover:
(00:00:00) – Introduction
(00:02:11) – Connors Group Programme
(00:06:25) – How Should We Assess If Someone Is Ready For A Group Programme?
(00:12:00) – Is It Possible To Individualise Elements Of AGroup Programme?
(00:17:00) – What Is The Impact Of The “MechanisationParadigm” On The Thinking Of Clinicians & Patients?
(00:28:44) – How Do We Help Patients Understand The Context Nature Of Long Term Conditions?
(00:30:30) – How Using Stories Could Be The Future
(00:38:00) – How To Help Patients Understand TheMulti-Factoral Nature Of Their Condition, Without Devalidating Their Existing Beliefs.
(00:42:43) – How Do We Help Patients Understand TheseFactors, Without Feeling That It’s Their Fault?
(00:48:27) – How To Use An “Accusation Audit” In A Programme
(00:53:43) – What To Do When Participants Don’t Get On
(00:57:06) – When To Remove Someone From A Programme
(00:58:12) – Conor’s Hardest Conversation
(01:02:08 – Success Story From Conor’s Programme
You can find Connor on LinkedIn or at www.conorcreedonphysio.co.uk
You can find Ben across social media @BWhybrowPhysio
Got questions/situations you need help with or interestingstories to share?
Send it to [email protected] we’ll read it out.
Books Mentioned:
Ian McGilchrist – The Matter With Things
Chris Voss- Never Split The Difference
Donald Miller – Building A Story Brand
Alan Gordon – The Way Out
Liam Mannix – Back Up
Baaahhh
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Over the past year I've been asked to deliver some talks or webinars to various organisations and departments around clinical communication skills and difficult conversations.
One of which I was given permission to record the audio for, and so am releasing now to you.
There are interactive elements which you are welcome to play along with at home, work, in the car or wherever you listen.
It covers the topics of:
What is empathy and how to demonstrate it?
How to show you are attentively listening to the person in front of you?
How manage difficult conversations around patient expectations? (in this case of imaging)
Plus some audience questions at the end.
Want to know more?
I am @BWhybrowPhysio on X/Twitter, Instagram, TikTok, LinkedIn & YouTube.
Please follow & subscribe.
Thank you for listening and watching this year.
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Shoulder pain is a common reason for people to seekhealthcare support. Whilst many will respond well to time and rehabilitation, certain situations and beliefs make it harder to treat and manage.
This may be in relation to certain tissues being “torn”, thejoint being “out of place” and “unstable” or having to break bad news when there is no easy solution.
Jo Gibson is an Upper Limb Specialist Physiotherapist &International Lecturer for shoulder conditions. In this episode Ben & Jo discuss;
(00:00:00) – Introduction
(00:01:37) - What Influence Did Jo’s Father Have On HerPractice?
(00:06:07) - Where Did “Communication Is Your SuperPower” Come From?
(00:09:00) - Which Communication Skill Did Jo Find TheHardest To Master?
(00:16:05) - Are We Done With The Term “Shoulder Impingement”?
(00:21:00) - How To Help Someone With A Rotator Cuff TearBuy Into Rehab
(00:26:42) - How To Support Those Who Are Worried TheirShoulder Will Regularly Dislocate
(00:33:03) - How To Discuss Frozen Shoulder With A Patient
(00:37:47) - Jo’s Hardest Conversations
(00:45:48) - What Did The Upper Limb Unit Team Mean To Jo?
(00:47:57) - Jo’s Courses & Further Info
Jo is on X/Twitter: @ShoulderGeek1 & LinkedIn
Her course is “Shoulder Steps To Success” available eitherin person or online.
Ben is available across social media @BWhybrowPhysio –follow & subscribe to stay up to date.
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A cranial nerve examination can be part of a generalneurological examination for some clinicians, but often not considered by others. Whilst resources and guides now exist online on how to perform a cranial nerve examination, less guidance is available on what to say to patients before, during and after performing one.
Until now.
Alan Taylor is a Specialist Physiotherapist in Vascular FlowLimitations, especially related to Cervical Spine Risk, as well as being an Associate Professor at The University of Nottingham.
In this episode Ben & Alan Cover:
(00:00:00) – Introduction
(00:00:50) – What led to Alan Being Interested In CranialNerve Testing?
(00:03:50) – Why Are Cranial Nerve Examinations Not Taught As Much At Undergraduate Level?
(00:07:18) – How Accurate Are The Cranial Nerve Tests?
(00:08:50) – How To Prepare Patients For A Cranial NerveExamination?
(00:10:54) – What To Say During Each Part Of A Cranial NerveExamination?
(00:20:49) – Can The Torch On A Mobile Phone Replace A Pen Torch?
(00:22:57) – What Should We Say To Patients After The Cranial Nerve Examination?
(00:29:40) – What Is It Like To Be An Expert Witness &Who Should Consider Doing It?
(00:34:10) – Alan’s Hardest Clinical Conversation
(00:39:20) – What Is The Story Of Alan & Rogers NotCountry Music Band?
You can find Ben across Social Media: @BWhybrowPhysio
Alan’s Social Media:
X/Twitter: @TaylorAlanJ
Instagram: @alan_taylor_physio
YouTube: @alantaylor1068
Alan’s Cranial Nerve Examination Paper Discussed:
A Guide To Cranial Nerve Testing For MusculoskeletalClinicians
https://pmc.ncbi.nlm.nih.gov/articles/PMC8725776/
Lawrence County Band:
https://www.youtube.com/@Skiffleshow
https://linktr.ee/lawrence_county?fbclid=PAZXh0bgNhZW0CMTEAAaYxduB4Kcna3j5NI8XIulc8pDwQqlZMuXOZIOK-WIG5gz0gJ2D89APPTG0_aem_84E4Qu8lQKBU2EoDXM5AJA
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Trying to influence individual patient beliefs is tricky, but can be made even harder when someone else in their life is giving opposite information to you and having a greater influence.
This episode talks through who else could influence a patients belief and how you could try to manage it.
If you find this useful then do share & subscribe.
For more follow @BWhybrowPhysio on X, Instagram, TikTok, YouTube or LinkedIn.
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One of the hardest conversations in clinical practice is when the person in front of you holds the opposite belief to you as to how their problem should be managed, and they are not open to changing their mind.
Engrained beliefs don't change suddenly, but how these conversations play out can be made more productive and collaborative for everyone involved.
This episode discusses how to achieve this and important aspects to consider.
Find this useful?
Then please subscribe and share it with anyone you think would find it useful.
You can find Ben on X, Instagram, YouTube, TikTok & LinkedIn - @BWhybrowPhysio
Thank you for listening.
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Steroid injections have been available in healthcare forseventy years for various uses.
But how should we discuss the risks and benefits of them for musculoskeletal pain with patients?
How should we support someone who is really keen for one, but it’s not in their best interests?
On this episode Ben is joined by Nick Livadas, Advanced Physiotherapy Practitioner & Lecturer at Teeside University for which he leads the Musculoskeletal Injection Therapy module.
They discuss;
(00:00:00) – Introduction
(00:01:25) – What Made Nick Interested In Steroid Injections?
(00:04:30) – What Do Patients Usually Ask About SteroidInjections?
(00:08:50) – Shared Decision Making With Steroid Injections
(00:13:15) – How Have Patient Questions & Knowledge About Steroid Injections Changed Over Time?
(00:13:40) – Should We Still Describe Steroid Injections As A “Window Of Opportunity”?
(00:18:00) – How Should We Tell A Patient A SteroidInjection May Not Help Them?
(00:19:40) – What Should We Say To Someone When The Benefit Of The Steroid Injection Lasts Longer Than Expected?
(00:23:07) – How To Discuss The Risks Of Steroid Injections To Patients?
(00:29:55) – How To Tell The Patient When A SteroidInjection Isn’t In Their Best Interests
(00:36:10) – Are These Conversations Really The “Advanced” Part Of Being An APP?
(00:38:50) – How To Support Those Who Are Afraid Of An Injection
(00:41:48) – Nicks Hardest Conversations (And Helpful Strategies)
(00:48:50) – The Time Limit Downside To Being An Advance Practitioner
(00:54:04) – What Would Nick Change About Persistent Pain Management In Society?
(00:56:23) – How NEMS was formed & What It Is
(01:01:10) – How To Contact Nick & Further Courses
You Can Find Nick On;
X & LinkedIn – @nicklivadas
His Musculoskeletal Injection Therapy Course at TeesideUniversity is here:
https://www.tees.ac.uk/parttime_courses/sport_&_exercise/ucpce_musculoskeletal_injection_therapy.cfm
You Can Find North-East Musculoskeletal Society (NEMS) at:
X – @nemsoc16
Instagram – @nemsociety
You Can Find Ben on X, Instagram, TikTok, YouTube &LinkedIn - @BWhybrowPhysio
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The tone of voice we use to communicate is as important as the words we say, and yet much less attention is made towards it.
Until Now.
This episode covers essentials points on using different tones of voice with the patients we see, as well as giving some examples and when to use them.
For more, subscribe and follow @BWhybrowPhysio on your social media of choice.
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How should we explain spinal-related nerve pain to patients?
What should we say to those who want scans, but it’s notindicated?
How should we explain imaging results to patients?
For answers to these and a lot more, check out thisconversation with Adam Dobson, Spinal Advanced Physiotherapy Practitioner.
(00:00:00) – Introduction
(00:00:43) – Would Adam Ever Become “The Space Physio”?
(00:02:45) – How To Explain Spinal Related Nerve Pain
(00:10:33) – What To Say If They Ask “Have I Got A Trapped Nerve?”
(00:15:12) – What If They Ask “Will This Get Better?”
(00:18:40) – What To Say When It’s Not Their Nerves, It’sTheir Blood Supply
(00:24:50) – Screening vs Work-Up Imaging
(00:32:50) – What To Say When Imaging Findings Come Back “Normal”
(00:43:00) – How To Explain Relevant Imaging Findings
(0047:42) – What Does Nerve “Abutment” Mean?
(00:49:30) – What To Say When Someone Wants A Scan, But It's Not Indicated
(01:01:50) – How To Discuss Prostate Issues During A Back Pain Appointment
(01:11:35) – Difficult Conversations Around Pain
(01:18:18) – Success Stories From Adam’s “Back To Health”Programme
You can find Adam on social media @AdamDobson123
His website is: https://www.theradicularclinician.com/
You can find Ben on social media @BWhybrowPhysio
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Cauda Equina Syndrome is a rare but very serious condition that can keep many clinicians awake at night. In this episode Ben speaks with Rob Tyer all about speaking with patients about Cauda Equina Syndrome (andother important topics) as shown below.
Timeline:
00:00:00 – Introduction
00:01:14 – Was It Hard For Rob To Transition From Taekwondo to Jiu Jitsu?
00:03:32 – How Does Rob Feel Taekwondo Has Changed Over The Years?
00:08:53 – What Made Rob So Interested In Cauda Equina Syndrome?
00:12:52 – Where Is The Right Environment For Further Tests If You Suspect Cauda Equina Syndrome?
00:17:32 – When Should You Ask The Cauda Equina Syndrome Screening Questions During A History Taking?
00:20:35 – How Should We Set-Up The Cauda Equina Screening Questions?
00:23:34 – Is There Any Advantage To Asking The Questions On A Screening Tool Prior To The Appointment?
00:24:55 – Is There A Way To Make Asking The Questions Feel Less Awkward?
00:28:25 – How To Ask About Bladder & Bowel ControlSymptoms
00:32:25 – How To Ask About The Sensation Changes
00:35:08 – How To Ask About Altered Sexual Function
00:41:47 - How To Ask About Altered Gait/Balance/Drop Foot
00:45:11 – Do The Questions Need To Be Asked In An Order?
00:49:50 – How Should We “Safety-Net” Someone About Cauda Equina Syndrome?
01:03:22 – What Should You Say To Someone If You Feel They Should Go To A&E Due To Potential Cauda Equina Syndrome Symptoms?
01:12:23 – Rob’s Hardest Conversations
01:23:58 – What Did Rob Wish He Knew About Writing A Book Before He (And Tom) Wrote One?
01:29:23 – Rob’s Question For Ben
Link for Rob & Tom Jessons book, “Cauda Equina Syndrome:The MSK Clinicians Guide” –
https://shop.tomjesson.com/products/cauda-equina-syndrome-the-msk-clinicians-guide
You can find Rob on social media - @CombatSportPhys
You can find Ben on social media - @BWhybrowPhysio
Do subscribe and get in contact if you have suggestions what would make this better.
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Want to have greater influence over the people you come across in life and interact with?
“The Influential Mind” by Tali Sharot was released in 2017and is still one of the top regarded books for this topic.
This episode of “Clinical Communication” takes someimportant lessons from the book and how you can apply them to the person in front of you, to potentially have greater influence.
For more; follow @BWhybrowPhysio on X, Instagram, TikTok & YouTube.
If you’re really keen do drop me a message and send me any questions you have.
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Motivation can be a powerful tool for Behaviour Change.
But there is different types, extrinsic and intrinsic.
What do these terms mean? And how can we enhance them to lead to greater long term behaviour change with the people in front of us?
Find out in this episode of Clinical Communication.
For more follow @BWhybrowPhysio on X, Instagram, TikTok & YouTube.
Reference:
Rethorn, Z. D., Bezner, J. R. & Pettitt, C. D. (2021). Fromexpert to coach: health coaching to support behavior change within physical therapist practice. Physiotherapy Journal & Practice.
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A clinician will spend every working day explainingsomething to someone, but how much effort is put into ensuring the other person remembers what is said and interprets the information as intended?
This episode of Clinical Communication covers what you can do and say to ensure the person in front of you remembers what you have said and is able to relate to it.
If you have suggestions for what would make this resourcebetter, topics to cover or guests to suggest;
Do contact @BWhybrowPhysio on X, Instagram, TikTok and Youtube, leave a review & subscribe.
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In this episode Ben speaks with Dr Brad Neal who is aPhysiotherapist, Lecturer and Researcher at the University of Essex with a special interest in Patellofemoral Pain.
In This Episode We Discuss:
(00:00:00) - Intro
(00:01:00) – Brad’s Views On Current Cricket
(00:02:55) – Could Brad Ever Have Been A Cricket Physio?
(00:03:41) – Brad’s Experience Of Working In Elite Sport
(00:06:00) – Why Did Brad Choose Patellofemoral Pain To Work In?
(00:09:45) – How To Help Patients Understand The Multi-Factoral Nature of PFP
(00:11:10) – What To Say To The Patient When They’ve Been Told They Need To Strengthen Their VMO
(00:15:00) – Why We Should Tell Patients With Patellofemoral Pain What Isn’t Going On
(00:16:50) – Does The Patellofemoral Joint Cartilage Tear?
(00:17:10) – How To Reassure Someone With Patellofemoral Pain
(00:19:10) – How To Discuss Chromalaecia Patellae X-rayFindings
(00:20:40) – Are Normal Age Related Patellofemoral JointChanges Found In Those Who Are Asymptomatic?
(00:22:00) – Should We Still Use Term “Patella Maltracking” Or Is Their A Better Way?
(00:24:00) – Are There Any Surgical Options ForPatellofemoral Pain?
(00:25:55) – Does This Help Us With Buy-In To Rehab?
(00:27:45) – What To Say When They Ask “Will It Get Better?”
(00:29:10) – What’s Next For PFP Research
(00:33:20) – What Lessons From Academic Teaching Can We Use With The Patient In Front Of Us
(00:35:00) – Is There A Way To Assess Patient Understanding Of What We’ve Explained?
(00:37:45) – How Should Information About Conditions On Websites Be Laid Out?
(00:40:20) – Is Teaching Training Part Of HealthcareTraining Or Should It Be?
(00:46:20) – Brads Hardest Conversations
(01:01:30) – Why People Should Watch & Play Baseball
(01:04:20) – Is Baseball The American Version Of Cricket?
(01:08:45) – Where To Find Brad Online
You can find Brad here:
X/Twitter: @DrBradNeal
Instragram: @teampfp
www.teampfp.com
You can follow Ben on @BWhybrowPhysio on your social media platform of choice.
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“Messengers” is a book by Stephen Martin & Joseph Marks released in 2019. It is for anyone who wants to increase the likelihood that the messages they are giving are taken in and acted upon.
In Episode 14 of Clinical Communication we go through some of the lessons from it that can help you better manage the individual or group of patients in front of you.
(00:00) – Intro
(00:35) – You’re Not Only Judged On The Words You Say
(01:21) – Building Connections
(01:58) – Perceived Expertise
(04:29) – Warmth & Connectedness
(07:19) – Vulnerability
(09:06) – Outro
If you have suggestions for what would make this resourcebetter, topics to cover or guests to suggest;
Do contact @BWhybrowPhysio on X, Instagram, TikTok and Youtube, leave a review & subscribe.
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Osteoporosis, Osteoarthritis & Inflammatory Arthritisare conditions that many clinicians across many different specialities will see. Being able to have helpful and productive conversations with patients withthese conditions is essential for being able to provide great care for them.
Jack March is a Rheumatology Specialist Physiotherapist& Director of Operations for PhysioMatters. You can find him online by searching for “Rheumatology Physio” in whatever social media you use.
His website is here: https://rheumatology.physio/
In This Episode Ben & Jack Discuss:
(00:00:00) – Introduction
(00:00:59) – Music You Might Hear In A RheumatologyDepartment
(00:01:59) – Jack’s Top Disturbed Song
(00:03:47) – The Metal & Physio Podcast That Didn’tHappen
(00:04:30) – Jack’s New “Low Bone Density” Course
(00:05:15) – How To Explain Osteoporosis To The Patient In Front Of You
(00:09:45) – Is The “Swiss Cheese” Analogy Still Useful?
(00:13:23) – Should We Still Say “Brittle Bones”?
(00:15:55) – What To Say When They Ask “Anything I Should Avoid?”
(00:17:40) – What To Say When They Ask “Is It Curable?”
(00:20:25) – How To Explain Osteoarthritis To The Patient In Front Of You
(00:24:39) – How To Shift Patient Perspectives OnOsteoarthritis Away From Wear & Tear
(00:40:00) – What To Say If They Ask “Do I Need An X-Ray?”
(00:41:55) – What Would Trigger You To Consider AskingAdditional Inflammatory Screening Questions?
(00:49:05) - When Should We Ask The Inflammatory Screening Questions During A History Taking?
(00:54:00) – What Should We Say To Patients When Referring Them To Rheumatology?
(00:59:00) – How To Explain Inflammatory Arthritis To The Patient In Front Of You
(01:04:00) – Jack’s Hardest Clinical Conversations
(01:17:00) – The FA Cup Semi-Final Incident
(01:21:25) – Jack’s Courses & CPD Resources
(01:22:50) – Jack’s Final Thoughts
You can find Ben on social media: @BWhybrowPhysio
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Every clinician has the potential to do the perfectassessment and come up with the ideal treatment plan for the patients needs and aspirations.
However, all of that is useless if they are unable to committo it and carry out whatever has been discussed.
This episode is all about simple and practical tips you canuse with any patient you see to increase their commitment to the shared plan once they get home, so that they are more likely to carry it out, and more likely to think it will help.
If you have suggestions for what would make this resourcebetter, topics to cover or guests to suggest;
Do contact @BWhybrowPhysio on X, Instagram, TikTok and Youtube, leave a review & subscribe.
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Metaphors are an effective way to help patients easily understand complex ideas we talk about, be it diagnosis, treatment options or prognosis.
In this episode I go through three metaphors I use regularly in clinical practice that most of the patients you see can relate to and will hopefully benefit from, regardless of the speciality you are in.
They are;
The Computer Default Setting (2:04)
The Mobile Phone Analogy (4:30)
The Cocktail Analogy (7:28)
For the visuals on The Cocktail Analogy, you can find them on social media @BWhybrowPhysio or the YouTube video of this Podcast titled "Steal These Metaphors!".
Do let me know how you get on using them and tell me other metaphors you use which you feel are effective, they might just get read out.
If you have suggestions for what would make this resource better, topics to cover or guests to suggest;
Do contact @BWhybrowPhysio on X, Instagram, TikTok and Youtube, leave a review & subscribe.
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