Signposting and metacommunication (for example, indicating what the explanation is going to be about)

Definitions and causality (using lay terminology and phrases such as ‘which is/means/what it does/it can cause …’)

Narrative structuring (logical structure to the explanation, as if ‘telling a story’, but also inviting interpretation, or expression of meaning for the patient)

Repetition (can act as a scaffolding to give a list of symptoms, but also part of the rhythm and the way speech is patterned to make it easier to listen to)

Referential cohesion (linking one area of the explanation with other areas, with words like ‘it’ or ‘that’s’, but needs to be clear what is being referred to).

Metaphor (using everyday structures to explain medical terms; for example, a plumbing system to explain vascular problems)

Convergence and dialogue with patient (constantly checking you and the patient are aligned; for example, ‘what we call’/‘you’re right that’s what I mean/which are the things I was asking you about …’). A way of showing patient centredness even if you are doing most of the talking.