[Question] Help with presentation title

proud · 11-07-2011, 02:01 PM

I've been invited as a speaker to a regional Nurse Practitioner's conference where there will be 150+ attendee's. Given that Nurse practioner's in canada have primary access and referral authority, I felt this would be a good opportunity to promoate Physiotherapy as the subject matter experts when it comes to painful conditions.

I have one hour to present.

The conference organizer approached me two months ago and suggested I present on "clinical pearls...things not to miss" in a musckuloskeletal examination.

I'm okay with that( standard clinical tests for identifying meniscal tears, rotator cuff tears, differentiating cervical radiculopathy from shoulder problems etc).

I am sure that is what is expected of me and I think I've got to "give" what is "expected" to a degree. So a good portion will be the standard fair....

But I'm going to throw in there concepts such as fear aviodance beliefs, how primary care providers( such as NP's) play a huge role in how the patient will frame the current painful condition going forward. I'm thinking of suggesting key phrases to avoid in an initial consult( degenerative disc disease, pinched nerves, bulging discs etc etc).

I imagine at least 1/4 to 1/2 will encompass this.....as to me....it's more important.

I've been asked to submit my presentation title:

Any suggestions for a title?

joebrence9 · 11-07-2011, 02:50 PM

Quote:

I'm thinking of suggesting key phrases to avoid in an initial consult( degenerative disc disease, pinched nerves, bulging discs etc etc).

:th umbs_up

ian s · 11-07-2011, 03:27 PM

Clinical pearls ............and the shells around them ........

'sometimes its much more important to know what kind of person has a disease than the disease a person has' Osler quote..

sort of explain the nugget in the middle like you have done but how the nervous system and the communication network surrounding the 'pearl' may be the real issue ........ you could do a visual image of this.
Don't know if this metaphor would work or not . You could do some basic info on 'nerve' pain or look at the ref's that David Butler used on his 'spirituality and nerve root' re catastrophisation and pain for example?

You could put a few bullet points down as to why knowledge in this area could perhaps make 'complex' presentations more understandable and possibly prevent chronicity?

ian

**Diane** · 11-07-2011, 03:48 PM

What a great idea, proud.

I don't have a title to suggest, but if I think of one, I'll add it. The Osler quote supplied by ian is pretty good I think.

**zimney3pt** · 11-07-2011, 04:07 PM

Going along the lines of what ian suggested..."Clinical Pearl. Things not to miss and things not to add."

I like the idea of helping them understand the fear and lack of understanding that words with our "diagnosis" can bring that we all too often use in medicine..."blown or ruptured disc", "torn muscle". Adriaan Louw recently challenged people that get his ISPI newsletter to cut off the dreaded red bulge that comes on all of our spine models at L4-L5. Reducing fear and not adding to it goes a long way to recovery.

Jon Newman · 11-07-2011, 04:38 PM

Is Your Examination Iatrogenic?

The Iatrogenic Clinician and The Power of Words

Examination Fail: Avoiding Iatrogenesis

Communicating Exam Findings: What Were You Thinking?

The Examination and What the Patient Hears

Communicating Exam Findings and The Power of Words

ian s · 11-07-2011, 04:59 PM

Jon --great suggestions esp this one and here are some obvious links in support

Communicating Exam Findings and The Power of Words
http://www.cortona.ethz.ch/services/...ers/fbenedetti

http://www.ncbi.nlm.nih.gov/pubmed/17379417

**zimney3pt** · 11-07-2011, 05:47 PM

Jon, I like those...

**zimney3pt** · 11-07-2011, 06:16 PM

I submitted the full length Benedetti article "When words are paiful" in SoS. See here

Good stuff...

proud · 11-07-2011, 07:02 PM

Wow, thanks everyone for your excellent input.

Jon...I specifically like your direction: iatrogenic examination.

Keeping in mind that I am going to be spending at least half of this presentation providing the typical examination nuggets....

How could a title that utilizes the potential iatrogenic aspect of examination also reflect that they are going to get "what they also paid for"( so to speak...given I'm not gettin' paid)....

**Bas Asselbergs** · 11-07-2011, 08:12 PM

"Clinical Pearls: separating real pearls from cultured ones"

Sorry proud, have brain cramp right now - can't do better than that.

**Jason Silvernail** · 11-07-2011, 08:12 PM

I speak to and teach primary care folks often and the NPs are always an attentive audience who want to learn.
I make a lot of connections with them by pointing out the poor psychometrics on all the musculoskeletal special tests so that they feel better about not using them and memorizing their names - also so they stop according people who use them frequently (they know who they are) elevated respect.
Love Jon's suggestion and you could tie it with this advice too.
My pick is "Examination Fail..."

**nari** · 11-07-2011, 09:53 PM

Iatrogenesis is often not well recognised and practitioners believe they are being 'honest' with the patients.
Something along the lines of: How useful is a diagnosis in trhe presence of pain?

Nari

11-07-2011, 02:01 PM	#1
proud Senior Member Join Date: Sep 2006 Posts: 1,106 Thanks: 125 Thanked 336 Times in 134 Posts	Help with presentation title I've been invited as a speaker to a regional Nurse Practitioner's conference where there will be 150+ attendee's. Given that Nurse practioner's in canada have primary access and referral authority, I felt this would be a good opportunity to promoate Physiotherapy as the subject matter experts when it comes to painful conditions. I have one hour to present. The conference organizer approached me two months ago and suggested I present on "clinical pearls...things not to miss" in a musckuloskeletal examination. I'm okay with that( standard clinical tests for identifying meniscal tears, rotator cuff tears, differentiating cervical radiculopathy from shoulder problems etc). I am sure that is what is expected of me and I think I've got to "give" what is "expected" to a degree. So a good portion will be the standard fair.... But I'm going to throw in there concepts such as fear aviodance beliefs, how primary care providers( such as NP's) play a huge role in how the patient will frame the current painful condition going forward. I'm thinking of suggesting key phrases to avoid in an initial consult( degenerative disc disease, pinched nerves, bulging discs etc etc). I imagine at least 1/4 to 1/2 will encompass this.....as to me....it's more important. I've been asked to submit my presentation title: Any suggestions for a title? Last edited by proud; 11-07-2011 at 02:11 PM.

11-07-2011, 03:27 PM	#3
ian s Senior Member Join Date: Mar 2004 Location: dunblane , scotland uk Age: 50 Posts: 744 Thanks: 286 Thanked 221 Times in 99 Posts	ideas? Clinical pearls ............and the shells around them ........ 'sometimes its much more important to know what kind of person has a disease than the disease a person has' Osler quote.. sort of explain the nugget in the middle like you have done but how the nervous system and the communication network surrounding the 'pearl' may be the real issue ........ you could do a visual image of this. Don't know if this metaphor would work or not . You could do some basic info on 'nerve' pain or look at the ref's that David Butler used on his 'spirituality and nerve root' re catastrophisation and pain for example? You could put a few bullet points down as to why knowledge in this area could perhaps make 'complex' presentations more understandable and possibly prevent chronicity? ian

11-07-2011, 03:48 PM	#4
Diane Human Primate Social Groomer and Neuroelastician Join Date: Mar 2004 Location: Weyburn Sask. Posts: 19,667 Thanks: 1,486 Thanked 3,186 Times in 1,566 Posts	What a great idea, proud. I don't have a title to suggest, but if I think of one, I'll add it. The Osler quote supplied by ian is pretty good I think. __________________ Diane www.dermoneuromodulation.com SensibleSolutionsPhysiotherapy HumanAntiGravitySuit blog Neurotonics PT Teamblog Diane Jacobs.com (personal website) Canadian Physiotherapy Pain Science Division (Archived newsletters) Canadian Physiotherapy Association Pain Science Division Facebook page @PainPhysiosCan WCPT PhysiotherapyPainNetwork on Facebook @WCPTPTPN Neuroscience and Pain Science for Manual PTs Facebook page @dfjpt SomaSimple on Facebook @somasimple "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

11-07-2011, 04:07 PM	#5
zimney3pt life long learner, clinician, and instructor Join Date: Dec 2009 Location: Sioux City, IA Age: 43 Posts: 1,902 Thanks: 149 Thanked 676 Times in 265 Posts	Going along the lines of what ian suggested..."Clinical Pearl. Things not to miss and things not to add." I like the idea of helping them understand the fear and lack of understanding that words with our "diagnosis" can bring that we all too often use in medicine..."blown or ruptured disc", "torn muscle". Adriaan Louw recently challenged people that get his ISPI newsletter to cut off the dreaded red bulge that comes on all of our spine models at L4-L5. Reducing fear and not adding to it goes a long way to recovery. __________________ Kory Zimney, PT, DPT http://koryzimney.blogspot.com "Study principles not methods, a mind that can grasp principles will create its own methods." - Gill "All truths are easy to understand once they are discovered; the point is to discover them." - Galileo Galilei

11-07-2011, 04:38 PM	#6
Jon Newman Enjoy a moment of whimsy Join Date: Dec 2005 Posts: 9,024 Thanks: 5 Thanked 55 Times in 41 Posts	Some ideas Is Your Examination Iatrogenic? The Iatrogenic Clinician and The Power of Words Examination Fail: Avoiding Iatrogenesis Communicating Exam Findings: What Were You Thinking? The Examination and What the Patient Hears Communicating Exam Findings and The Power of Words

11-07-2011, 04:59 PM	#7
ian s Senior Member Join Date: Mar 2004 Location: dunblane , scotland uk Age: 50 Posts: 744 Thanks: 286 Thanked 221 Times in 99 Posts	nocebo messages......... Jon --great suggestions esp this one and here are some obvious links in support Communicating Exam Findings and The Power of Words http://www.cortona.ethz.ch/services/...ers/fbenedetti http://www.ncbi.nlm.nih.gov/pubmed/17379417

11-07-2011, 05:47 PM	#8
zimney3pt life long learner, clinician, and instructor Join Date: Dec 2009 Location: Sioux City, IA Age: 43 Posts: 1,902 Thanks: 149 Thanked 676 Times in 265 Posts	Jon, I like those... __________________ Kory Zimney, PT, DPT http://koryzimney.blogspot.com "Study principles not methods, a mind that can grasp principles will create its own methods." - Gill "All truths are easy to understand once they are discovered; the point is to discover them." - Galileo Galilei

11-07-2011, 06:16 PM	#9
zimney3pt life long learner, clinician, and instructor Join Date: Dec 2009 Location: Sioux City, IA Age: 43 Posts: 1,902 Thanks: 149 Thanked 676 Times in 265 Posts	I submitted the full length Benedetti article "When words are paiful" in SoS. See here Good stuff... __________________ Kory Zimney, PT, DPT http://koryzimney.blogspot.com "Study principles not methods, a mind that can grasp principles will create its own methods." - Gill "All truths are easy to understand once they are discovered; the point is to discover them." - Galileo Galilei

11-07-2011, 07:02 PM	#10
proud Senior Member Join Date: Sep 2006 Posts: 1,106 Thanks: 125 Thanked 336 Times in 134 Posts	Wow, thanks everyone for your excellent input. Jon...I specifically like your direction: iatrogenic examination. Keeping in mind that I am going to be spending at least half of this presentation providing the typical examination nuggets.... How could a title that utilizes the potential iatrogenic aspect of examination also reflect that they are going to get "what they also paid for"( so to speak...given I'm not gettin' paid).... Last edited by proud; 11-07-2011 at 07:05 PM.

11-07-2011, 08:12 PM	#11
Bas Asselbergs Physiotherapist Join Date: Jul 2004 Location: Canada Age: 61 Posts: 3,693 Thanks: 837 Thanked 484 Times in 233 Posts	"Clinical Pearls: separating real pearls from cultured ones" Sorry proud, have brain cramp right now - can't do better than that. __________________ We don't see things as they are, we see things as WE are - Anais Nin Pain is a conscious correlate of the implicit perception of threat to body tissue - Lorimer Moseley

11-07-2011, 08:12 PM	#12
Jason Silvernail Clinician and Researcher Join Date: Dec 2005 Location: Kandahar Province, Afghanistan Age: 39 Posts: 4,078 Thanks: 111 Thanked 536 Times in 182 Posts	I speak to and teach primary care folks often and the NPs are always an attentive audience who want to learn. I make a lot of connections with them by pointing out the poor psychometrics on all the musculoskeletal special tests so that they feel better about not using them and memorizing their names - also so they stop according people who use them frequently (they know who they are) elevated respect. Love Jon's suggestion and you could tie it with this advice too. My pick is "Examination Fail..." __________________ Jason Silvernail DPT, DSc, FAAOMPT Board-Certified in Orthopedic Physical Therapy Fellowship-Trained in Orthopedic Manual Therapy Certified Strength and Conditioning Specialist The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

11-07-2011, 09:53 PM	#13
nari NeuroNut Evangelist Join Date: Mar 2004 Location: ACT Aust Posts: 7,678 Thanks: 705 Thanked 233 Times in 167 Posts	Iatrogenesis is often not well recognised and practitioners believe they are being 'honest' with the patients. Something along the lines of: How useful is a diagnosis in trhe presence of pain? Nari

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