Interpersonal Communication in Radiography Part 1: Modes and Challenges

When you enter an imaging suite, it’s easy to focus on the machine: the hum of the generator, the glow of the monitor, the rhythm of the workflow. But beneath all of this, there is a quieter current — one that powers everything you do in patient care: communication.

Interpersonal communication is more than words. It is the art of connecting science with humanity — of translating anatomy and physics into empathy and trust. As Instructor Erica Dellis explains, communication shapes every moment of interaction, from the first time you read a written order to the moment you position the patient and deliver reassurance through tone, touch, or silence. It’s how you transform a clinical encounter into an act of care.

For radiography students preparing for the ARRT® exam, mastering communication is not a “soft skill.” It’s a clinical competency — one that directly impacts image quality, patient cooperation, and professional credibility.

Modes of Communication: The Tools of Clarity

Every radiologic examination begins long before the first exposure. It begins with a message — often written, sometimes spoken, and always conveyed through presence.

Verbal and Written Communication

Radiologic technologists live in two languages: the written precision of medicine and the spoken rhythm of empathy.

Written communication comes first. Before you even greet a patient, you interpret the doctor’s requisition — that concise but critical script containing the patient’s name, date of birth, requested exam, and clinical indication. From that piece of paper (or digital order), you begin to prepare mentally: Who is this patient? A toddler? An elderly adult? Someone with limited mobility? The order is your first conversation with the case. It gives context to what’s about to unfold.

Yet written notes alone never tell the whole story. That’s where verbal communication begins. From the moment you call a patient’s name, you’re building a relationship. The way you introduce yourself, the tone of your voice, even the pace of your speech — all communicate competence and compassion.

As the Interpersonal Communication guide notes, verbal skill involves not only clear presentation of material but also *attitude, voice tone, and effective listening.*¹ Speaking clearly is important, but listening attentively is indispensable. It’s how you learn what’s not written in the chart — pain levels, fears, limitations, misunderstandings.

Always allow patients to explain their situation in their own words. A patient might reveal that the pain marked as “right arm” is actually in the shoulder, preventing a possible wrong exam. Active listening — quiet, patient, and open — protects both safety and trust.

Nonverbal Communication

Words alone are rarely enough. Nonverbal communication — facial expression, body posture, eye contact, and touch — is the language patients read first.

A calm smile, direct but gentle eye contact, and a steady presence can ease anxiety faster than any instruction. As Dellis teaches, “We have to step outside of ourselves and give the center stage to the patient — no matter how old they are.” This is empathy in motion: compassion paired with professional detachment that allows clear action.

However, nonverbal cues are deeply cultural. As the Interpersonal Communication manual reminds us, eye contact in one culture may signal honesty, but in another it may appear disrespectful or confrontational. The ethical technologist adapts — not by assuming, but by observing.

Touch, too, carries meaning. A reassuring hand can comfort one patient but startle another. Always explain before touching: “I’m going to help position your arm — you may feel my hand here.” Positive touch should convey support, not control. And always remain aware of boundaries, especially with vulnerable populations such as children or patients of different genders or cultural backgrounds.

Appearance, body language, and environment also communicate professionalism. A clean uniform, organized workspace, and focused posture tell the patient: You are safe here. You matter.

Challenges in Communication: When Connection Meets Barriers

Even the most skilled communicator will face barriers — moments when connection falters and understanding must be rebuilt. In radiography, these challenges often arise from language differences, cultural factors, sensory impairments, age, or emotional distress.

Language Barriers

When a patient cannot understand your language, they cannot understand your care. Relying on family members to interpret is both unprofessional and risky. The Interpersonal Communication text is clear: “Use a trained interpreter — in person, by phone, or via video — and always talk to the patient, not the interpreter.”

Technology has made this easier. Many facilities now provide tablets with on-demand interpreting in over 180 languages. This small act — ensuring understanding — communicates respect and inclusion more powerfully than words ever could.

Cultural and Social Factors

Culture shapes how patients perceive illness, privacy, modesty, and authority. Understanding these nuances is central to cultural competency — which includes valuing diversity, self-assessment, and adapting care to cultural needs.

For instance, some patients may avoid direct eye contact as a sign of respect; others may expect family involvement in all decisions. Cultural sensitivity doesn’t mean memorizing customs — it means approaching each person with curiosity and humility. Ask, don’t assume.

Physical, Sensory, or Cognitive Impairments

Effective communication requires flexibility. A patient with hearing loss may need you to face them when speaking, using slower, lower-pitched tones. A vision-impaired patient may rely on detailed verbal descriptions of the environment.

Patients with cognitive or emotional challenges — such as dementia, developmental disabilities, or altered consciousness — require patience, simplified language, and repetition. Always give one instruction at a time and confirm understanding before proceeding.

Age and Communication: Speaking to Every Generation

One of the most profound challenges in radiography is learning to communicate effectively across the human lifespan. Age isn’t just a number — it’s a language. Each stage of life carries its own rhythms, fears, and expectations. The radiologic technologist’s task is to listen in that language.

Neonates and Infants (Birth to 1 Year)

The infant cannot comprehend your words but feels your tone. Calmness, a soothing voice, and gentle touch are your most powerful tools. Smile. Talk softly. Involve the parent or guardian in positioning or soothing the child whenever possible. Infants sense anxiety; your serenity becomes their comfort.

Toddlers (1–2 Years)

Here, communication is about simplicity and play. Use short, concrete instructions and familiar words. Demonstrate rather than describe — “Watch me, now your turn.” A playful tone transforms fear into curiosity. Always engage parents as allies.

Preschoolers (3–5 Years)

This stage is ruled by imagination. Offer explanations that are simple but empowering: “This camera helps us take pictures of your bones.” Give praise freely and allow them small choices — “Do you want to sit on the table or stand up?” These gestures grant a sense of control that dissolves resistance.

School-Aged Children (5–10 Years)

Children in this range want to help. Be specific with your instructions and let them “assist” in the exam — holding a cassette, adjusting a sandbag, or counting down exposures. Involvement turns anxiety into pride.

Adolescents (10–25 Years)

Adolescence demands respect and privacy. Maintain modesty meticulously and engage them as adults — not children. Acknowledge their feelings and explain procedures thoroughly. Humor, when used appropriately, can bridge the gap, but never at the expense of seriousness or sensitivity.

Adults and Older Adults

With adults, clarity and professionalism matter most. Provide detailed explanations, confirm understanding, and never assume literacy or medical knowledge. For elderly patients, adjust for sensory changes: speak slowly, use low-pitched tones, and ensure proper lighting for those with visual impairments. Respect autonomy. Ask permission before assisting physically.

Most importantly, avoid stereotyping by age. Two patients of the same chronological age may differ vastly in cognitive or emotional state. Assess each person individually, with patience and empathy.

Emotional Status and the Stages of Grief

Not every patient enters the imaging suite ready to cooperate. Some arrive in shock, others in denial, fear, or grief. As Dellis emphasizes, “We must meet patients where they are emotionally before expecting cooperation physically.”

Dr. Elisabeth Kübler-Ross’s model of the five stages of grief — denial, anger, bargaining, depression, and acceptance — provides a valuable lens for understanding emotional behavior.

• Denial — The patient may resist reality. Use calm, reflective responses: “I can see this is hard to take in.”

• Anger — Avoid defensiveness. Keep your answers factual, steady, and free of judgment.

• Bargaining — Offer clear, concise directions. Avoid false reassurance.

• Depression — Listen quietly. Presence is more powerful than platitudes.

• Acceptance — Honor their trust. Allow them space to express feelings openly.

Understanding these emotional stages allows the technologist to interpret resistance not as defiance but as human adaptation. Your patience becomes part of the therapy.

Explaining Medical Terms: Clarity Over Complexity

Communication breaks down the moment patients feel confused or dismissed. In radiography, medical terminology can sound alien, even intimidating. Your job is to translate without condescension — to make science human again.

The Interpersonal Communication manual notes: *“Permitting patients to ask questions is essential.”*³ This is the cornerstone of comprehension. Avoid jargon when possible. Instead of saying “thoracic radiograph,” say “chest x-ray.” Replace “lateral decubitus” with “lying on your side for the picture.”

When technical terms must be used, define them simply:

“Contrast media is a special liquid that helps the x-ray show your organs more clearly.”

And always pause after explaining. Silence invites understanding. Encourage questions with openness, not impatience. A single phrase — “What questions do you have for me?” — transforms the power dynamic from lecture to dialogue.

Remember: explanation is not about display of knowledge; it’s about transmission of understanding. Every word should reduce fear and build trust.

Strategies to Improve Understanding

Communication is a skill — one that can be refined through self-awareness and repetition. The Interpersonal Communication text offers specific, evidence-based strategies to enhance patient understanding.

1. Use simple, everyday language.
   Replace technical descriptions with clear, relatable words. Avoid acronyms or medical shorthand.

2. Ask open-ended questions.
   Instead of “Do you understand?”, ask “Can you tell me in your own words what we’re going to do?” This not only checks comprehension but reinforces patient participation.

3. Adapt to learning styles.
   Every patient processes information differently:

   • Visual learners understand best through images or demonstrations.

   • Auditory learners retain information through listening and discussion.

   • Kinesthetic learners grasp concepts through hands-on interaction.

   • Linear learners prefer step-by-step explanations.

   • Global learners want the big picture first.

4. Use repetition and summarization.
   After instructions, restate key points in brief: “You’ll need to hold still for five seconds while I take the image.”

5. Create space for silence.
   Many patients need time to process instructions. Silence is not awkward — it’s generous.

6. Check for feedback.
   Watch facial expressions and body cues for confusion or anxiety. Adjust accordingly.

When communication becomes intentional, it transforms outcomes. Clear understanding leads to smoother exams, fewer repeats, and higher patient satisfaction.

Empathy and Assertiveness: The Twin Pillars of Effective Communication

At the heart of every successful patient interaction lies a balance — empathy and assertiveness, compassion and control. These two traits define a professional who not only connects but leads.

Empathy is not sympathy. It isn’t feeling for the patient but feeling with them — understanding their anxiety, discomfort, or confusion, and responding in a way that meets their emotional needs while maintaining professionalism. Empathy might sound like, “I understand this position is uncomfortable, but I’ll make it as quick as possible.” It acknowledges emotion without becoming consumed by it.

Assertiveness, by contrast, is calm firmness — expressing your needs, instructions, or boundaries with confidence and respect. It’s essential when working with reluctant or anxious patients. For example: “I know it’s difficult to stay still, but if you can hold still for just a few seconds, we won’t have to repeat the image.” Assertiveness prevents confusion and establishes trust through authority, not aggression.

Together, empathy and assertiveness create an environment where the patient feels both understood and guided — a delicate equilibrium every great technologist must master.

When Communication Meets Challenge

In radiography, communication is rarely linear. Patients arrive in various states — frightened, disoriented, medicated, grieving, or angry. Some refuse to speak at all. Others overshare to mask their fear. The technologist’s responsibility is to navigate these emotional landscapes with patience and professionalism.

When interacting with patients who are in distress, one of the most powerful tools you possess is tone. Speak with warmth, but maintain authority. Your voice should convey steadiness — a calm assurance that the patient is in competent hands. Avoid rushed explanations or sharp responses, even under pressure. The tempo of your communication sets the emotional temperature of the room.

If a patient is angry or uncooperative, resist the urge to mirror their emotion. Maintain composure and listen actively. Often, frustration stems from fear — fear of pain, fear of results, or fear of the unknown. By listening, you diffuse tension without confrontation. Your professionalism becomes the anchor that steadies the moment.

There will also be times when the challenge is internal — when fatigue, workload, or personal stress threaten your composure. In those moments, pause. Take a breath. Remind yourself that professionalism isn’t perfection; it’s persistence in acting with grace, even when it’s difficult.

Cultural Competence and the Modern Patient

Radiography today unfolds in a world of extraordinary cultural diversity. Each patient carries their own framework of belief, modesty, and communication style. Cultural competence is not about memorizing traditions — it’s about respecting individuality.

This requires self-awareness. Ask yourself: What assumptions am I bringing into this interaction? Perhaps you assume that direct eye contact shows respect — yet, for a patient from an Asian or Middle Eastern background, it may feel intrusive. Maybe you expect a handshake, but for others, physical contact may be considered inappropriate.

Adaptation is key. When in doubt, ask respectful questions: “Would you like me to help position your arm?” or “Is there anything I should know to make you more comfortable?” These simple inquiries communicate humility — and humility builds trust faster than any script.

Cultural competence also means recognizing non-verbal cues that transcend language: a smile, a nod, a gesture of patience. The radiographer who learns to listen beyond words transcends communication and enters connection.

Building Confidence Through Presence

A powerful, often overlooked aspect of communication is presence — the energy and focus you bring into the room. Patients sense it instantly. When you enter the imaging suite distracted, rushed, or preoccupied, they feel it. But when you are centered, calm, and attentive, the patient mirrors your steadiness.

Presence begins before the first word is spoken. It’s in the way you stand, the way you greet the patient, the care with which you prepare the equipment. It’s professionalism made visible.

To cultivate presence, slow down. Make eye contact. Acknowledge the patient by name. Explain what you’re doing as you do it. These small rituals transform a technical task into an act of human respect. They tell the patient: I see you, I’m here for you, and you are safe.

Every patient you encounter — whether in an emergency trauma bay or an outpatient imaging center — carries an invisible story. Some come in with fear, some with pain, and some simply with impatience. You will never know all their details. But through mindful communication, you can ensure one constant: that every patient leaves feeling heard, respected, and cared for.

Communication as the Core of Excellence

As you prepare for your ARRT® exam, it’s tempting to view communication as a “soft” topic beside the technical rigor of image production or radiation physics. Yet, communication is what gives meaning to your technical skill. It is the difference between a radiographer who takes x-rays and one who heals through them.

When you speak, listen, touch, and observe with intention, you create more than an image — you create an experience of safety. The quality of your communication is as critical as the quality of your exposures. It affects cooperation, positioning accuracy, repeat rates, and ultimately, diagnostic outcomes.

Mastering interpersonal communication means mastering the invisible art that defines true professionalism. It’s what patients remember long after the exam is over.

Closing Reflection

Interpersonal communication is not just about how you convey information — it’s about how you convey care. It’s the thread that binds clinical precision to human compassion. Every tone, gesture, and word you choose can either build trust or break it.

To reach your full potential as a Radiologic Technologist, speak with clarity, listen with empathy, and act with intention. Because in radiography — as in life — communication isn’t a skill to master once. It’s a craft to practice forever.