Effective Communication and Professionalism with Patients

Section 1 “Professional capabilities”

Domain2: Professional Communication and Collaboration

It is important and essential for health professionals to improve on communication skills with patients in daily medical settings. Diverse cultural backgrounds, various physical and mental conditions of patients also need to be considered seriously and respectfully. According to O’Daniel and Rosenstein (2008), effective communication encourages collaboration and helps prevent medical errors. 

There was a good example from my first clinical placement in 2018. The case was related to effective communication with the patient.

J.W is a 43 years old Italian woman who has been referred to the medical imaging centre for X-ray assessments. According to Dauer et al. (2013), the perceptions of patients regarding to the X-ray examination could be affected by the communication approach taken by the radiographer.  In other words. it is suggested that the responsibility of the radiographer to clearly deliver accurate information such as risks, benefits and the whole process of the X-ray examination plays an important role in effective communication with the patient.  

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Appropriate and effective communication in this case involves various aspect, for example, the respectful attitude towards patients, the display of professional conduct, giving understandable instructions, providing post examination care if necessary. The relationship between radiographers and patients can thus be strengthened if effective communication implemented.  Most patients are actually with little conceptions about the exam they are having. Thus, information given from radiographers in this stage becomes extremely critical to them. Sufficient clinical information obtained from patients assist in determining the most appropriate types of imaging approach and accurate imaging projections for better perform the exam efficiently and safely.

Since J.W. is a non-English-speaking patient, during the communication process, the barriers were encountered because of language difference. The obvious communication barrier between J.W. and us became one of the factors preventing her from cooperating with our instructions, and even ended up avoiding any eye contact with us. We’ve tried implemented multiple strategies to effectively communicate with J.W. Firstly, via simple sentences and words, which might be easier to understand; secondly, speaking every word clearly with gentle voice; thirdly, demonstrated the required positions straight away. Fortunately, the outcome turned out ideal.  The trusting relationship finally established between J.W. and us, and the X-ray examination has done successfully. 

Bal (1981) suggested that an overall understanding of the English level of the patient would help medical professionals adapt language accordingly. Aspects listed below are which would be allocable when communicating with non-native English speaking patients:

 a. Speak clearly with normal volume.

 b. Giving instructions in a clear and logical sequence

 c. Do not use medical jargon

 d. Longer explanation is usually easier to be accepted thus better not to condense the contents explanation is usually easier to be accepted.

 e. Avoid delivering too much information in one session as this may negatively affect the memory while concentrating to understand

 f. Ensure patients have full understanding of instructions and given information after each conversation

The lack of English vocabulary required to express the medical symptoms or problems is the obstacle that is very difficult for those who are non-native English speaking patients to overcome (Frank, 2000). 

In my future clinical practices, I would take account in all variations of individual patient and adapt specific techniques to achieve the goal of building appropriate interaction with patients, forming effective communications, and professionally performing X-ray examinations. In this special case, I’ve gained valuable experiences from problem solving and adapting specific communicational techniques to successfully conduct the whole examination. 

Section 2: “Lead the way” 

In medical imaging settings, the role of radiographers is evolving due to globalisation, economic recession, technological advancements, and an increase ageing population (Sithole, 2013). Based on the changing role of radiographers, the concept of leadership must to be emphasized as an essential component which professionals should have to maintain quality and excellence in diagnostic radiography practice. According to Yukl (2002), leadership is the process of facilitating individual and collective efforts to accomplish the shared objectives. ‘’Leader’’ in the medical imaging setting can be defined as the people who have direction, vision, drive and the personal skills that can motivate and lead people in an emotional intelligent manner. A high degree of self-awareness is therefore essential. The leadership of members who at particular position in the medical environments has the required knowledge and skills to lead the department in curricular activity. Furthermore, it is necessary for leaders in DR to assist radiographers to navigate the volatile and complex health care environment. Profession of radiography can thus be ensured by sustainable and effective leadership, which help to face challenges and ongoing changes from the medical environment in the future (Bloom, 2014).

Nerveless, challenges regarding to leadership still encountered in everyday practice within radiography professionals.  

An example presented below happened in one of my theatre shifts during my second clinical placement. It associated with the use of leadership power from my clinical supervisor.  In the operating theatre, there was another student who inadvertently touching the surgical equipment which has already been sterilised. The surgical nurse then yowled at the student and rebuked the clinical supervisor. The student was excluded from the whole surgery as the mistake was unacceptable for the whole nursing team. However, at the same time, the supervisor immediately tried to negotiate with the nurse and explained to her that he would take the responsibility of the mistake form the student and ensure everything was well-prepared for the surgery. After the negotiation, the student was allowed to continue the learning process in the theatre. By the end of the day, the supervisor also communicated with the student and let him know what to improve on for the next theatre experience. This example demonstrated the good use of the leadership power from the clinical supervisor to maintain good and open relationship with the student. The supervisor also took the responsibility to properly communicate with the nursing team. Equal relationship between the student, the supervisor, and the nurse was highlighted in this positive leadership example. However, some challenges might be encountered by the leader during the process of achieving successful leadership. This may include having conflicts with other health professionals, students, or patients. Although, the good practical decision-making and effective communication skills was still successfully exhibited in this case. 

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Section 3: “Reflection time” 

A reflective practice activity involves engagement of the practitioners in a continuous cycle of self-observation and self-evaluations in order to critically think and analyse about their own actions and reactions (University College Dublin, n.b.). It’s recognised as a way to learn from our experience as radiographers. The goal of improving on professional practice, observing and refining practice on an ongoing basis can also be accomplishing by participating in reflective practice activities, which allows allied health professionals to identify strengths and weakness accordingly (SARRAH, n.b.).  According to Mantzourani (2019), reflective practice has been linked to distinct characteristics that encourage stimulating evaluation process and hence empower health professionals to achieve better practice.

Keeping a daily reflecting journal can be a good reflecting practice activity for medical imaging professionals. The contents of each journal should be structured into six sections (Gibbs, 1988) :

1. Description:
2. Feelings
3. Evaluations
4. Analysis
5. Conclusion
6. Action plan

For Description and Feelings, the details of the event should be included such as locations, people involved, what activities was proceeding, reasons of happening, contexts of the event, and outcomes. Feelings relating to the process at different stage of the event also need to be specified. It seems similar between the third and fourth part of the journal, which are Evaluation and Analysis. In the section of evaluation, consider both positive and negative parts of the experience. Evaluation and judgement can be made in this section. Proper analysis can be done by breaking the event into smaller components which can be discussed separately and accurately. For conclusion part, try to integrate all the information obtained in previous sections and develop insight into ourselves and other people’s behaviour in terms of how they contributed to the outcome of the event. In the final step of the journal, which is about action plan, it is important to think forward when encounter the similar situation again and to plan what can be done differently or handle the case even better with further knowledge in the future. Reflection and ability to adapt rapid changes in workplace are necessary factors for lifelong learning to occur in medical imaging professions.

To summarise, reflective practice is an essential component in medical practice based on the previous discussion. If reflective practice is performed comprehensively and continuously throughout long term, improved performance and other associated benefits can thus be achieved. Learning from previous experiences and developing own personal skills could be factors leading to a better allied health professional. According to (CAMRT , 2014), successful and continuing professional development can be accompanied via reflective practice. The advantages of reflecting practice are numerous. Enhanced professionalism with greater autonomy and responsibility for future learning. Self-awareness are heightened with the capacity to engage in self-regulation and self-monitoring. The reflective practice activity refers to an ideal approach for medical imaging professionals to work on lifelong objectives or in the future career. The approach facilitates understand and integration of new knowledges, with opportunities to incorporate aptitudes, values, personal beliefs and local professional culture.

References

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• Dauer, L., Thornton, R., Hay, J., Balter, R., Williamson, M., & Germain, J. (2011, April).
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• Gibbs, G. (1988). Learning by doing: a guide to teaching and learning methods. London: Further Education Unit.
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• O’Daniel, M., & Alan H. Rosenstein, A. H. (2008). Professional Communication and Team Collaboration. Agency for Healthcare Research and Quality (US).
• SARRAH. (n.b.). Reflective Practice. Retrieved from Services for Australian Rural and Remote Allied Health : https://sarrah.org.au/content/reflective-practice
• University College Dublin. (n.b.). Defining Reflective Practice. Retrieved from Open Educational Resources of UCD Teaching and Learning, University College Dublin: http://www.ucdoer.ie/index.php/Defining_Reflective_Practice

• Yielder, J. (2006). Leadership and power in medical imaging. Radiography, 305-313.
• Yukl G (2002). Leadership in organisations. Upper Saddle River (NJ): Prentice-Hall.