It is interesting to note however, that the initial topics raised mainly related to the physiotherapist gathering and giving information, and did not allow the patient to engage in ‘small talk’. For example, only a minority of physiotherapists brought up topics such as the weather, parking and directions. This correlates with the finding of Roberts and Bucksey (2007) that physiotherapists make approximately twice MLN0128 order as many statements as patients, and the verbal communication used by physiotherapists comprises mostly ‘content behaviors’, such as taking

history and giving advice. Although ‘small talk’ has previously been described as a means of patients and physicians exhibiting ‘disattentiveness’ in medical interactions (Maynard and Hudak, 2008), in contrast, it has been attested that ‘small talk’ can help establish relationships because of its ability to ‘oil the social wheels’ of discourse (Holmes, 2000, p57), and thus facilitate instrumental behaviours within the consultation, such as willingness to disclose relevant health-related information (Hudak and Maynard, 2011). Professional and regulatory bodies pertinent Fluorouracil ic50 to physiotherapy, recognise the importance of developing effective communication (HCPC, 2012 and CSP, 2012). Therefore,

knowing how clinicians and patients communicate, and specifically, how clinical encounters are “best” opened, is important for teaching and feedback to assist clinicians in optimising their non-specific treatment effects. Parry and Brown (2009) recommend that teaching on communication at pre-qualification level should be based on existing empirical knowledge, but there are significant Non-specific serine/threonine protein kinase gaps in the evidence, which pose challenges for educators, students and researchers in this field. The contribution of the current study is that: i) educators in the field should consider the use of open-focused questions when advising about opening clinical encounters and; ii) clinicians could use these types of questions to facilitate patient engagement.

Although this study is novel in researching physiotherapists’ preferences on how to open clinical encounters, some limitations exist, in particular, the low response rate due to an ineffective recruitment strategy. This was hindered by being unable to put a direct link to the questionnaire on the iCSP website (due to ethical constraints). Therefore, participants had to email the researchers to request a link to the questionnaire, which subsequently may have deterred iCSP members from participating in the study. Furthermore, this study only considered verbal communication between the physiotherapist and their patient, despite the recognition that communication relies on non-verbal as well as verbal communication (Hall and Lloyd, 1990, Oliver and Redfern, 1991, Caris-Verhallen et al., 1999 and Waddell, 2004, p. 243; HCPC, 2012).