Topic: Inter professional Communication Barriers between Radiologic Technologists

and Nurses

Chapter 1

INTRODUCTION

Communication is the glue that holds a society together. The ability to

communicate enables people to form and maintain personal relationships. As mentioned

by Makanjee, Bergh, & Hoffmann (2014), it is the process of sharing ideas, information,

and messages with others. As applied in the clinical setting, it is very important given that

it entails exchanges of information between patients and health care professionals

themselves. A minor communication gap may have major effects in an organization,

when there is communication gap there is usually a breakdown in the way the

information is being sent.

The division of work, responsibilities, and scope of professional practice between

Radiologic Technologists and Nurses working in the radiology department has improved

differently. As stated by Brown (2013), the functions and capabilities of nurses working

in diagnostic imaging are of many aspects: to guarantee patient safety, comfort and

ethical care, equal patient load, and responding to emergencies. There is an everyday

need for Radiologic Technologists and Nurses because they are the medical professionals

that provide care especially in emergency cases. Provided furthermore, nurses can help

patients to understand the imaging procedures. In addition, nurses need to interact and

make collaboration with health care providers involved in the imaging procedures.
 Breaking down interprofessional communication barriers and collaboration of the

health care team improves patient outcome and satisfaction. In radiology department,

quality health care service is given to the patient by giving less radiation dosage.

Collaboration of health care professionals has shown to provide benefits to themselves,

including reducing extra work because of the good communication of the both

department, and also increasing the job satisfaction.

As indicated by Alotaibi, Al-Abdulsalam, Bakir, & Mohammed (2015), nurses

acts as the bridge between the general care services and radiology and radiography

services, there are limited studies that appear in the literature on the inter-professional

nursing domain in the radiology department. Common communication barrier between

Radiologic Technologists and Nurses may be the lack of knowledge and appreciation of

the roles of each profession. This study seeks to analyze the communication barriers

between Radiologic Technologists and Nurses. The need to establish good

communication within the clinical setting especially to Radiologic Technologists and

Nurses is important, because communication is the key element in providing high quality

health care services that leads to patient satisfaction and health.

Review of Literature

Communication is essential because it provides appropriate communication with

each other, it is important because it gives success to an organization or institution such

as hospitals, business, etc. Communicating with someone intends to voice one’s thoughts

or concerns. A lack of communication within an organization may decrease production

(Sharma, 2010).
 As eloquently stated by Keller et al. (2013), the standpoint of medical

professionals in executing successful inter professional communication in health care was

emerged for five themes. Firstly, is the support for process, wherein the data shows that

safe environment, certainty in practice, and support for the instructive procedure

influences successful communication in healthcare. According to the study, health care

professionals must be well trained to have a better understanding especially when

conveying information. Secondly, is the patient safety, where clear communication is

required to give quality care and service to the patient, and to ensure that proper treatment

is given. Getting to know with colleagues also affects inter professional communication

because it helps in understanding the pressure that is being put on the other side.

Respectful collaboration is also important in an organization because it builds strength

and respect with each other. Lastly, are the barriers to communication, levels of

communication competency may be related to the levels of confidence and experience a

professional has. The priority of every health care professional is to give quality care to

the patients. Medical professionals desire to know more about how others contribute to

patient outcome, they feel that spending more time together in a similar structure of

activities will increase confidence in communicating with other health care professionals.

Schadewaldt, McInnes, Hiller, & Gardner (2013), stated that health care professionals

have distinct views regarding collaboration and practice. Medical practitioners who have

more working experience tend to have positive work attitude especially in collaboration.

Teams (2012) analyzed that interprofessional communication barriers vary from the

structure, function, etc. that influences collaboration when it comes to patient

management.
 Collaboration in communication within health care professionals may be done by

establishing structural work methods (Uddin, Hossain, & Kelaher, 2012). Supper et al.

(2018), indicated that knowledge of each others’ role was a prerequisite for

trustworthiness. The effectiveness of collaboration within an organization had to be

apparent. Lack of clinical information and training or skills is one of the factors of having

an ineffective communication, with that, program especially for patient management and

effective communication within an organization must be built. Conformation of the

facilities and compensations of health professionals involved was for good

communication. All professionals must be aware of their role as professionals to give the

correct treatment that the patient needs. Inter professional organization and training

causes development of collaboration. The active participation is a big help going beyond

professional boundaries. According to Zainie Abd Hamid et al. (2016), the extent of the

study includes barriers and challenges in communication within the clinical setting.

Collaboration is important in an organization or industries, like hospitals because it helps

in improving the health care quality. It also develops professional network, enhance

skills, and gives contribution to the decision- making process within the department. The

data demonstrates that the relationship between professionals differs from each other; it

may be due to their culture. As contended by Bridges et al. (2011) there are factors that

are needed to achieve successful team collaboration. This will be the administrative

support, through this; there will be significant changes that may happen within an

organization and to establish programs that may improve inter professional collaboration.

J. Brown et al. (2011) analyzed that, sources on why ineffective communication is

present in an organization is because of team conflict, lack of recognition and motivation

of an individual, and fear of a professional that causes discomfort within a system. As

studied by World Health Organization (WHO) (2013), collaboration and good

communication is necessary because it delivers quality service to the patients. The study

address that health care team members must ensure to give shared understanding within

the situation and is working towards achieving the same goal.

Inter professional communication skills can be improved through training,

especially incorporating the use of simulation and standardized tools of communication.

It occurs in a synchronous and asynchronous means. Synchronous is a communication

that is happening real time such as meetings, impromptu conversation, etc., while

asynchronous is a communication which refers through the use of written progress notes.

Inter professional hierarchies had a negative effect on communication and collaboration

with other health care professionals. Several factors of having a positive relationship

were identified, the availability of manager, educator, and a number of team strategies,

also the factors that causes communication barriers were also identified, it includes the

lack of experience, lack of knowledge, and balancing of work load. Differences in terms

of job description have also differences in terms of communication styles which can lead

to ineffective communication, but through embracing differences and having an efficient

communication between other departments, the discipline and health care workforce will

advance (Foronda, Macwilliams, & Mcarthur, 2016). As indicated by Graves & Doucet

(2016), inter professional collaboration when communicating to other departments

includes training and planning, system supports, establishing good relationship and

communication patterns, synchronization and managerial challenges, patient-

centeredness, and most importantly the provision of leadership and administrative

support. Differences of the roles in healthcare, there are limited studies that shows how

inter professional communication barriers affects the collaboration in healthcare.

Advancement of understanding when it comes to communication has a really big impact

in healthcare especially in collaborative process between healthcare professional

themselves and to the patient. As studied by Tweedie, Peake, Dutta, Wasson, & Goddard

(2017), failure in communication is the most common reason on why there is a lack of

giving quality care service to the patients. The management of an institution should

promote programs that may help the employees to be able to freely communicate with

others, to share their concerns and impart knowledge. Weller, Boyd, & Cumin (2014)

mentioned that there are subjects that can help in establishing good communication in

health care system. First, is to teach effective communication technique. Second, is to

have improvement within the department by establishing training through simulation.

Third is to create protocols and procedures that will help health care professionals in

improving work techniques. Health care team members must ensure to achieve common

goal and that is to provide quality patient care.

Promoting patient-centered care has several organizational attributes and

processes, those are committed leadership, clear communication, engagement of patient

and families throughout the organization, job satisfaction, reviewing for the feedback of

the patient especially when it comes to experiences during examination, and

accountability and incentives. Institutions that have succeeded in implementing patient-

centered care have quality enhancement (Luxford, Safran, & Delbanco, 2018).

Furthermore, Van Royen, Rees, & Groenewegen (2014), stated that patient-centeredness

reflects to the improvement of the health care professionals. Van Dongen et al. (2016),
also contested that several factors were determined with regards to interprofessional

collaboration influencing patient care, those are patient-related factors, professional-

related factors, interpersonal factors, organizational factors, and external factors. To

overcome the said factors, health care professionals must collaborate and help together to

achieve common goal. As argued by Childress (2015), team collaboration and

communication is about patient safety. The study concluded that communication affects

the professionals themselves and also the quality of service that should be given to the

patient. The common goal of health care professionals is to give proper and high quality

care to the patient, the data shows that a good communication is associated with

developed job satisfaction.

As stated by Légaré & Witteman (2013), lack of decision-making process in the

clinical setting slows down process in an organization, with that, shared decision making

can make improvement and development in health care systems. Verhaegh et al. (2017)

added that health care professionals aforementioned that decision-making causes

ineffective communication due to the different perspectives of each professionals. It is

included in the data that health care professionals must consider that patients are also

involved in making decision inside the clinical setting.

 Conceptual Framework

COMMUNICATION BARRIERS
BETWEEN RADIOLOGIC
TECHNOLOGISTS AND NURSES

ORGANIZATIONAL FACTORS: INDIVIDUAL FACTORS:

 Professional Factors  Demographic Profile

 Inter professional Factors  Interpersonal Factors
 Job Related Factors
 Generational Differences

OUTCOME:
 Unified goal of health
care professionals
 Established positive
attitudes about own
profession

Figure 1

Figure 1 illustrates the relationship of the organizational and individual factors to

the communication conditions between Nurses and Radiologic Technologist. The

organizational factors pertains to the hindrances in the flow of information between

Radiologic Technologists and Nurses, it includes professional factors which refers to the

differences in language, jargons, and scope of practice, also the inter professional factors

wherein lack of knowledge and appreciation of the roles of other profession shows effect
in ineffective communication. Another cause of ineffective communication is the

individual factors which include generational differences, the demographic profile which

is incorporated with gender, culture, and ethnicity, another factor that is included in

individual’s barrier is the interpersonal factors and is related to the personal values and

personality differences of an individual. Job related factors are also enclosed with

interpersonal factors in which it relates to the multiple job responsibilities and lack of

trust in collaborative process.

The outcome of communication barriers between Radiologic Technologists and

Nurses includes unified goal in health care and that is to provide primary care to the

patient, and also to established positive attitudes about own profession.

Theoretical Framework

The theory that was used in the study is the communication theory of James

Jaccard, Jacob Jacoby (2010). According to the theory, communication is typically

defined as the process whereby a source transmits a message over a medium to one or

more receivers. For the source to communicate a thought, the source must convert it into

spoken word form, written words, or symbols to convey with the receiver. In turn, the

receiver must then decode and interpret the conveyed message. Conveying messages

especially, especially nonverbal commonly causes miscommunication because of its

different meaning and concept or thought that exist in individual’s mind. To effectively

understand the conveyed message, Jaccard and Jacoby identify several ways in which

miscommunication can occur. Firstly, is that the source intends a sense of the word, but

the receiver decodes it differently. Secondly, is when the receiver is not familiar with the
symbol that the source uses. Thirdly is the noise that might prevent the receiver from

hearing exactly what was said. Fourthly, is when the receiver considers the meaning of

the source’s symbols incorrect or inaccurate. Lastly, is when the receiver locates the

symbol in a different context.

This theory can be applied in the study on how miscommunication affects the

service being provided for the patient. There are lots of factors that hinder effective

communication in the clinical setting. The theory above explains how communication

works and how barriers affect the effective communication. Inside the hospital, medical

practitioners are all responsible in delivering information with others and how it will be

understood depending on the way the message is delivered. Having one of the factors that

hinders communication may lead to poor quality health care service and may put

patient’s health at risk. The theory explains how miscommunication can lead to a

misunderstanding of information. Communication can be express in different ways;

nonverbal (facial expressions, signs, actions, punctuations, and gestures) or verbal.

Objectives of the Study

1) To identify factors that hinders communication between Radiologic Technologists

and Nurses.
2) To know how communication barrier affects the collaboration of Radiologic
Technologists and Nurses.
3) To know the effects of communication barrier in giving quality health care to
patients.
4) To identify factors that can lessen communication barrier between Radiologic
Technologists and Nurses.
 Chapter 2

Research Methodology

This chapter discusses the research method and design employed in the study, the

correlation of the subjects and instruments used, the procedures for gathering data, and

the statistical treatment used to evaluate and interpret the data.

Research Design

This study utilized descriptive - correlational design. Broadhurst, Holt, & Doherty

(2012) define research as fundamental to the research and has added immeasurably to the

knowledge of the shape and nature of the society. A variety of designs have different

strengths and weaknesses and some were better for answering some types of questions

than others.

As stated by Broadhurst et al. (2012), correlational studies is a research method

which describes and predicts the relationship between variables. It is also used to answer

research questions that seek to link or connect. Therefore, the descriptive – correlational

design may entail control by establishing criteria for inclusion and exclusion of the study.

Research Locale

Respondent of the Study/ Sampling

Design Data Collection Tools/ Research

This study utilized a survey questionnaire to determine how communication

barriers exist between the Radiologic Technologists and Nurses. The first part of the
survey questionnaire measured the demographic profile of the respondents. This part was

constructed by the researcher to collect personal information relevant to the objectives of

the study, such as age and gender. The second part measured the communication

between Radiologic Technologists and Nurses, barriers in communication, and how can it

be solved. The frequency by which the subject experiences the items was rated from 4

Point Likert Scale: Strongly Disagree (1), Disagree (2), Agree (3), Strongly Agree (4).

Instruments Data Gathering Procedure

Ethical Consideration

Data Analysis
Part I. Demographic Profile of the Respondent

Gender:

Female

Male

Age:

20 - 30

31 - 40

41- 50

Part II. Put a check (√) on the corresponding answer.

Scale Degree of Agreement

4 Strongly Agree

3 Agree

2 Disagree

1 Strongly Disagree

Communication Between Radiologic Technologists and Nurses 4 3 2 1

1) Do you consider gender as a factor that hinders in giving

quality health care to the patient?
2) Does differences in age affects the communication system
between Radiologic Technologists and Nurses?
3) Do you think that collaboration with other health care
professionals particularly in Nurses is important?

Barriers in Communication 4 3 2 1

1) Do professional factors (language, jargons, scope of practice)

affect how you communicate with other health care
professionals especially nurses?
2) Does working environment can be considered as a factor
which hinders communication?
 3) Does lack of training mostly causes communication barrier
between Radiologic Technologists and Nurses?

How can it be solved? 4 3 2 1

1) Does getting to know with your colleagues; especially nurses

can resolve ineffective communication?
2) As a health care professional, does having adequate training
can help in executing successful inter professional
communication?
3) Does respectful collaboration important in an organization,
particularly in nurses?
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