Chapter 3 Communication



Effective communication is at the heart of quality health care. In radiography a considerable part of the working day is spent relating to others. Given the technical nature of radiography it is possible that practitioners may misjudge the amount of time spent in face-to-face contact and seriously underestimate the effect their own behaviours may have on the way the service users respond to and perceive the care received.

Effective communication significantly improves health outcomes by:

Department of Health policies and the National Institute for Health and Clinical Excellence (NICE) all stress the importance of empowering users and the need to achieve a ‘patient-centred focus’ in all aspects of the health service. Most patients will trust that imaging practitioners will have the correct knowledge and skills to operate the equipment and produce optimal images (unless their actions and behaviour signal otherwise!). It is often the practitioner’s interpersonal behaviours that the patient will consider when asked to assess the quality of the care received.

Learning to communicate effectively should be valued as a core clinical skill for all healthcare practitioners if service provision is to have a user orientation.

Much of the research over the past three decades suggests that when healthcare professionals use appropriate levels of eye contact, nods and gestures whilst maintaining an open posture they are regarded as more interested, empathetic and warm by their patients. Patient satisfaction, understanding and resultant concordance with the requirements of their healthcare interventions can improve when practitioners have displayed supportive, empathetic non-verbal behaviours.

Therefore, it is important that we are aware that non-verbal behaviours can serve to reinforce, regulate, qualify or replace verbal communication and show our patients and colleagues we are genuinely interested in them as individuals, however short our interactions may be.

Effective communication is essential in the interaction between staff and patients in order to maintain radiographic quality. By communicating effectively a patient’s voluntary and involuntary movements can be minimised, thus reducing the need for repeat imaging and thereby complying with the IRM(E)R regulations (2000).


Non-verbal communication displays our feelings and emotions and may demonstrate aspects of our personality and attitudes. It is often the unconscious expression of the ‘truly human’ part of us. Non-verbal signals have little or no meaning in themselves but they can acquire significance in particular contexts.

If effective communication is to occur, the non-verbal contribution to the interaction plays a critical role in the way messages are received and interpreted.

Consider the occasions you may have said something like: ‘It’s not what he said but the way he said it!’ This implies a conflict between verbal and non-verbal communications and confusion in the interpretation. This may lead to an inappropriate response and/or behaviour. On the whole, non-verbal signals tend to be spontaneous, although of course if premeditated thought is given some behaviours can be ‘stage-managed’. Non-verbal signals are often sent out and interpreted without conscious knowledge but the so-called ‘body language’ is often more representative of what the sender is trying to communicate than the spoken or written word.


Facial expressions

The face can communicate:

Facial expressions and eye contact can be used to start and sustain communication by showing interest in the individual and the conversation, but they can also be responsible for causing the cessation of an interaction.

The face can respond instantaneously, providing immediate feedback to others. This may be useful in certain situations where demonstrating empathy, concern and understanding to your patients is important. However, consider the messages that may be perceived if practitioners display uncontrolled, inappropriate facial expressions when faced with offensive body odours or unexpected, unpleasant visual information in the course of their work.

Emotional expression is under voluntary control and can be artificially manipulated, with the face demonstrating intensification or reduction of the emotion. In reality, trying to distinguish people’s emotions from their facial expressions is often more difficult than we imagine because some people are capable of masking their true emotions. Social and cultural norms may distort expression of emotion (Fig. 3.1).

It is possible people may not actually know what their facial expressions are displaying but by showing you have ‘listened to their non-verbal cues’ you have given the patient, in a supportive way, an opportunity to confirm or deny any concerns.

However, it is important to remember that it is relatively easy to lie with the face – most people can fake anger or surprise with relative ease and patients are often astute enough to sense a false, frozen smile that is not genuine in nature!

Feb 20, 2016 | Posted by in GENERAL RADIOLOGY | Comments Off on Communication
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