Health Medical
SCSU Communication Between Hearing Impaired Patients in Radiologic Technology Paper

Saint Cloud State University

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This is a research paper that needs to contain 9 pages of body part, 1 page of abstract, minimum 8 references, and need to be overall 11-13 pages in total.

Format: The paper should be written using the American Institute of Physics Style Guide. This guide is available on the internet: http://kmh-lanl.hansonhub.com/AIP_Style_4thed.html

•Font: use font size 11, Times New Roman font, double-spaced with one-inch margins.

For Further information please please please refer to the attached syllabus below.

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Research Paper Important: this needs to be a high-quality final version of your paper. The paper must have good content, be grammatically correct, follow the correct format, and be free of all plagiarism and patch writing. Length: 7 to 11 full pages, not including the title page, abstract, introduction, conclusion, references, tables, or figures. Seven full pages is the absolute minimum length; it would make sense to be above the minimum not just right at the minimum. A length less than the minimum is not acceptable. If a shorter paper was acceptable, I would have given you a smaller number for the minimum. Do not add extra blank lines in order to increase the length of the paper. Keep blank lines to an absolute minimum. Keep the introduction and conclusion brief in any case. For additional information about the research paper, please see the following important information below. Content Discuss your topic. Avoid content that does not relate to your topic. Your paper will require considerable thought and planning. I recommend that you spend some time gathering ideas, doing research and finding out what references are available. Avoid being too superficial. Remember, the goal is to do some research on a specialized topic and provide an in-depth discussion. when writing the paper, write for an audience that already knows those things. If you as the author do not know them, then review as needed before you write your paper. Further Details for Research Paper Key Warnings: • This is a research paper. The goal is to learn about a topic, go into as much depth as possible, understand the topic, and write about it in your own words. • If you try to leave this paper to the last minute, it will not turn out well. You cannot write a good research paper quickly. It is important to have time to think about the topic and plan how you will approach it. • Do not copy from other sources. If you do quote from another source, you must use quote marks and reference the source. If four or more consecutive words in your paper are identical to the words used by someone else, you must use quote marks and reference the source. On the other hand, your paper cannot consist of just quotations strung together. Learn as much as you can about your topic and put things into your own words. If you use the ideas from another source (even if not the exact words), you also must reference the source. • Your paper will require considerable thought and planning. I recommend that you spend some time thinking, doing research, and finding out what references are available. Avoid being too superficial. Remember, the goal is to do some research on a specialized topic and provide an in-depth discussion. Further Details • Avoid giving the history of your topic; address it as it is today. • None of the work that you turn in should contain any patient-identifiable or other confidential information. • Font: use font size 11, Times New Roman font • The paper should be typed and double-spaced with one-inch margins. To achieve “real” one-inch margins, set all of the margins to .9 inches. The paper should have a separate title page with your name, the title of the paper, the date, the course name, and school. The paper should include references at the end of the paper. • Details on the spacing: in Microsoft Word, in the “Home” tab, choose the icon for “Line and paragraph spacing” at the top, then choose “Line Spacing Options” from the drop down menu; then select Spacing Before: 0 pt; Spacing After: 0 pt; Indentation: 0 (left and right). • All pages (except the title page) should have a page number in the upper right-hand corner of the page. References Part of the grade will be on the quality of the references. Avoid using “popular” or “superficial” web sites. Try to use peer-reviewed academic references. Avoid over-using any single reference. You can't rely on just the internet--you will need to look at other sources of information as well. Don't use only one source for your paper; if you do, then your paper is something like a book report, which is not acceptable. Similarly, don't use just a few sources. Elementary books or articles are not acceptable. Avoid using internship textbooks. If you use Google, make sure you also try Google Scholar (scholar.google.com). Google Books can often be helpful as can scitation.aip.org (a scientific publication search site). Another search engine to try is www.duckduckgo.com. There are other search engines to try also. Don’t forget to ask a librarian for help. Let the librarians help you find references. Submit the paper in Microsoft Word format. If you don't have Microsoft Word, please let me know right away. The goal is to go into depth. You will need to organize your material properly and the ideas need to be arranged in a logical order. Style The paper should be written using the American Institute of Physics Style Guide. This guide is available on the internet: http://kmh-lanl.hansonhub.com/AIP_Style_4thed.html The conclusion can be brief. Don’t use it to repeat what you already said or to summarize the paper. In any case, the conclusion won’t count towards the minimum page requirement. Each reference at the end of the paper should refer to a single page or a page range of at most two contiguous pages. What does “two contiguous pages” mean? It describes the situation where the idea or words that you are referencing started at the end of one page and finished near the top of the second page. If the idea or words that you are referencing is/are confined to one page, then just list one page for that reference. The parts of the paper need to be in this order: title page, abstract, paper, tables (with a table number and title for each table), figures (with a figure number and caption for each figure), and references. It is a requirement to follow the style manual. For example, you need section headings and also an abstract. If you have questions about the required style, use the style guide. Using the index, find the page that has that information. For example, suppose you are wondering about “section headings.” The Index tells you that it is on page 8. Look on that page and the guide will tell you how to make your section headings. Another example: if you want to know how to write your references, look in the index under “References.” The listing under “References” refers you to the section on “Footnotes and References.” Under “Footnotes and References,” there is a section called “Footnotes and References, examples of” on page 9. Thus, we want to go to page 9 in the manual. The style manual itself is written in the appropriate style, but it is be best to find the appropriate content in the manual itself. Simple Guidelines for Style Your paper needs to be divided into paragraphs. Start a new paragraph by indenting five spaces on the first line of the paragraph. Do not add extra lines. There should be no extra blank lines before or after any paragraphs, sections, section headings, or text. The abstract (one paragraph summary of the paper) goes on the title page. Refer to the references in the paper with superscripts1 like this. Here is a second example.2 In the style guide, Table II on page 9 gives examples of how to format the references at the end of the paper. Isn’t this fun?3 Notice that when the reference number occurs at the end of a sentence, the punctuation is first, and then the reference number. Here is an example for how to format an article.4 Sometimes you might need to reference the article again using a different page5 or perhaps the same page again.4 Overall always refer to a specific page. Here is a sample of how to format your reference section at the end of the paper: 1 K. S. Nelson, What I Learned from the Great Professor Ratliff, 2nd ed. (Wiley, New York, 2012), p. 126. 2 J. S. Smith, My Wonderful Life in Physics, 3rd ed. (Maritime Press, St. Paul, 2010), p. 42. 3 K. S. Nelson, p. 21. [This shows how to refer to a different page in a reference that you have already cited]. L.A. Danaher, J. Howells, P. Holmes, P. Scally, “Is it possible to eliminate patient identification errors in medical imaging?,” Journal of the American College of Radiology, volume 8, No. 8, p. 570 (2011). 4 5 L. A. Danaher et al., p. 569. If we were typing this with typewriters, we would underline the book titles, but with word processors the book titles should be in italics, such as above. Page 9 in the style guide gives you examples of how to format references to different kinds of documents (articles, for example). (syllabus continues on next page) Here is how to format an internet reference: Food and Drug Administration, Electronic Products; Performance Standard for Diagnostic XRay Systems and Their Major Components, Vol. 70, Number 111 (Federal Register Online, Rules and Regulations, June 10, 2005), p. 34036, http://www.fda.gov/ohrms/dockets/98fr/0511480.htm, accessed March 29, 2013. For internet references, the key additional ideas to keep in mind are to include the web link, the date accessed, and a page number if there are multiple pages on the web site. For information obtained from an interview or private discussion with a person, here is an example: Private communication, James S. Smith, Radiologic Technologist, Iron Range Community Hospital (Duluth, Minnesota), February 1, 2020. Organize your paper into sections, such as in the example below. Use as many subheadings as you need. Each sub-heading can have subheadings under it, as in the example below. I didn’t put in all of the subheadings, but I hope that you get the idea. The style guide attempts to describe this on page 8. The minimum requirement is to have main headings. Probably at least some first-level headings would be a good idea. I. FIRST MAIN HEADING IS BOLD AND ALL CAPITALS A. First-level subheading is bold 1. Second- level subheading is bold and italic 2. Second-level subheading is bold and italic a. Third-level subheading is underlined and in italics. This is followed immediately on the same line by text. b. Third-level subheading Same as above. B. First-level subheading 1. Here is the first subheading under I.B. 2. Here is the second subheading under I.B. Use your own text, of course. II. SECOND MAIN HEADING IS BOLD AND ALL CAPITALS A. First-level subheading 1. Here is the first subheading 2. Here is the second subheading B. First-level subheading III. THIRD MAIN HEADING IS BOLD AND ALL CAPITALS A. First-level subheading B. Second-level subheading Etc. (syllabus continues on next page) If you use a subheading under any heading, you need at least two. You should never have just one subheading under a higher-level heading. If this doesn’t make sense, please let me know. What would this style look like in an actual paper? I. THE BRITISH NAVY IN THE AGE OF SAIL A. Before Nelson 1. First-Rate Ships Paragraphs go here. 2. Smaller Ships Paragraphs go here. B. The Wars Against Spain and France Paragraphs go here. C. The Battle of Trafalgar Paragraphs go here. D. The Transition to Steam Ships Paragraphs go here. II. THE BRITISH NAVY IN WORLD WAR I A. The State of the Navy Before the War Paragraphs go here. B. The Battle of Jutland Paragraphs go here. etc. Note that there are no paragraphs that do not fit under a heading. ...
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Final Answer

Attached.

Running Head: HEARING-IMPAIRED PATIENTS AND RADIOLOGIC TECHNOLOGY

Communication between hearing-impaired patients in radiologic technology
Name
Institutional Affiliation
Date

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HEARING-IMPAIRED PATIENTS AND RADIOLOGIC TECHNOLOGY

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Abstract
Hearing-impaired patients form a significant percentage of the United States population.
The radiologic technology department is among the healthcare departments that provide care and
services to hearing-impaired patients when they seek diagnostic procedures to aid their diagnoses
and treatments. While in these departments, the front line healthcare provider that hearingimpaired patient will interact with are the radiologists who will provide consultations services,
conduct a physical examination, and finally take the patient through the diagnostic procedure.
During these interactions, the radiologist enters in a therapeutic relationship with the hearing
impaired patients, which require effective management to promote outcome.
The radiologist must explain to the patient the procedures after acknowledgment and
introduction, meaning the two must objectively converse. Some hearing-impaired patients may
communicate but cannot hear. Others may have more problems and only hears or respond with
the help of hearing aid or assistive devices. Some cannot completely talk or hear, thus use
primarily text messaging to communicate as others use lip-reading and other forms to
communicate. The radiologist must understand hearing patients' needs to avail of all the
necessary resources, including the translators, hearing aids, and any support required to promote
effective communication. Similarly, they must be skilled, knowledgeable, and empathetic
throughout communication with hearing-impaired patients1. The research below shows how

1

Erlichman, David B., Marjorie W. Stein, Amanda Weiss, and Fernanda Mazzariol.
"Radiologist, obstetric patient, and emergency department provider survey: radiologistpatient interaction in the emergency department setting." Emergency radiology 23, no. 3
(2016): 245-249.

HEARING-IMPAIRED PATIENTS AND RADIOLOGIC TECHNOLOGY

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radiologic technologists can ensure effective communication with the hearing impaired patients
to promote empathetic, equitable, and equal care and services to these patients.
DIFFICULTIES THAT HEARING IMPAIRED PATIENTS EXPERIENCE
Hearing-impaired patients exploit numerous ways to communicate2. Some use hearing
aids, others rely on sign language interpreters, written messages, assisting listening devices,
among others. There are good numbers of hearing-impaired patients who speak but cannot hear.
Often radiologic technology facility per American with Disability Act will provide a method of
communication, services, or aid based on the hearing impaired patient's ability, complexity, and
the nature of the assistive communication that such patients require.
Effective communication in every clinical setting is vital in radiologic technology
because misunderstanding may lead to misdiagnosis, improper, and delayed initiation of
treatment. Usually, the communication involves the exchange of information between the
hearing impaired persons and their healthcare provider who, in this case, is the radiology
technologist and also the caregivers. The impact of a minor communication gap may lead to
robust consequences in the radiology technology organization, necessitating effective
communication. What is effective communication? Effective communication requires efforts
from both parties involved regardless of their hearing status, mode of communication, and
setting. Usually, people with hearing problems used hearing aids and active listening strategies to

2

Cohen, Jamie M., Jan Blustein, Barbara E. Weinstein, Hannah Dischinger, Scott Sherman,
Corita Grudzen, and Joshua Chodosh. "Studies of physician‐patient communication with
older patients: How often is hearing loss considered? A systematic literature
review." Journal of the American Geriatrics Society 65, no. 8 (2017): 1642-1649.

HEARING-IMPAIRED PATIENTS AND RADIOLOGIC TECHNOLOGY

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improve their communication. However, that should not be an excuse for the other party
involved in the communication processes to assume the use of excellent communication
strategies to ensure successful communication.
HOW TO IMPROVE COMMUNICATION WITH HEARING-IMPAIRED PATIENTS
Knowledge and skills to communicate with hearing-impaired patients are crucial for all
radiological technologists3. They must be aware that people are suffering from hearing
impairment and need empathy and compassion when communicating or attending to them. The
radiologists must know that every aspect of their communication will impact communication,
including accent, verbal, and non-verbal cues. They also need to learn how to operate and fix
hearing aids and other assistive hearing devices whenever required. Few studies have been
conducted regarding the communication of hearing-impaired patients in radiographic
technology4. Among the researches on this topic, most found out that hearing-impaired patients
face a lot of difficulties and barriers in communication in the radiologic technology environment.
Most healthcare providers, including the radiologists, overestimate the number of spoken words

3

Erlichman, David B., Marjorie W. Stein, Amanda Weiss, and Fernanda Mazzariol.
"Radiologist, obstetric patient, and emergency department provider survey: radiologistpatient interaction in the emergency department setting." Emergency radiology 23, no. 3
(2016): 245-249.

4

Hayre, C. M., S. Blackman, and A. Eyden. "Do general radiographic examinations resemble a
person-centred environment?." Radiography 22, no. 4 (2016): e245-e251.

HEARING-IMPAIRED PATIENTS AND RADIOLOGIC TECHNOLOGY

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that lip-read hearing impaired patients understand5. Studies estimate that only about thirty
percent of the spoken words are read by lip-reading. This makes lip reading appear as if it can
substitute spoken communication; however, writing is unacceptable in most cases, particularly
patient who uses ASL as their language. Hence, most hearing-impaired patients in the radiologic
technology department remain with the empathetic radiology technologist as their only key to
improve communication and understanding of the same.
One of the significances of effective communication in radiographic technology setting is
that it aids in diagnosing and treating patients. The code of ethics tool, acknowledge, introduce,
duration, explain, and thanks abbreviate as AIDET is implemented in numerous radiographic
technology facilities to encourage effective communication between hearing-impaired patients
and radiographic technologists at all times6. The radiologist should conduct acknowledgment of
the patients during the first encounter through greetings using their title, first name, and
requesting to know how they are doing. Radiologic technologists must ensure patient-centered
care, and the simple acknowledgment which should display respect for the patient, make them
feel at home in the radiologist's hands, and creating a rapport is crucial to ensure this. The
hearing-impaired patient should then be led to a private room as a means of ensuring privacy and
confidentiality. The radiographer should introduce himself or herself. The introduction and the

5

Fukuzaki, Izumi, Noriko Ishigami, Terumasa Sata, and Shinichiro Nakaishi. "Initiative for
Improving Medical Instruction Communication with Elderly Hearing Impaired Patients at
an Outpatient Pharmacy Counter." In International Conference on Applied Human
Factors and Ergonomics, pp. 139-147. Springer, Cham, 2017.

6

Hinberg, Brenda. "Caring for Older Patients." Radiologic technology 90, no. 3 (2019): 278-278.

HEARING-IMPAIRED PATIENTS AND RADIOLOGIC TECHNOLOGY

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continued creation and maintenance of rapport help receive the anxiety since most hearingimpaired patients tend to be anxious as they wait for their diagnosis in the waiting room. It also
helps develop some sense of trust in the just established radiographer-patient therapeutic
relationship and urging the patient to cooperate throughout the process and feel at home to voice
their concern as necessary. The radiographer then requests for patient history, and here is where
they will learn more about the patients, including the hearing impairment.
Completion of history taking is followed with an explanation of the procedure and
assurance of taking good care of the patient throughout the procedure. It is appropriate at this
time for the radiographer to discuss with the patient the mode of communication that they will
use during the physical examination and procedure to alert the patient whenever the radiographer
wants to make contact. This will ease stress and improve patient relaxation and feeling of
empathy, which is the goal of patient-centered care. The significance of explaining the procedure
to the patient is that it may aid in management, relieve stress, diagnosis, and treatment of the
patient if they turn positive for the test or procedure. Depending on the patient's hearing
impairment, communication preference, and other vital aspects, the radiologist arranges the team
to ensure holistic care of the patient before, during, and after the procedure.
It is so unfortunate that most people in the radiology technology workplace do not
communicate, and this is the most significant problem with communication. Most people keep
communicating with themselves, thus impacting the hearing impaired patient in radiology
technology7. A lot of radiology technologists and workers either do not communicate or

7

Jama, Guled M., Shayan Shahidi, Julian Danino, and John Murphy. "Assistive communication
devices for patients with hearing loss: a cross-sectional survey of availability and staff

HEARING-IMPAIRED PATIENTS AND RADIOLOGIC TECHNOLOGY

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communicate poorly. Communication remains a vital thing for all radiology technologies and the
hearing impaired persons to improve care provision and understanding. Radiology technologists
often have front line interaction with patients and also responsible for explaining some of the
most complex procedures to types of patients, including those with hearing-impairments while
taking an accurate patient history. Communicating with hearing-impaired persons requires
excellent care, and it is better to short, sweet, and direct to the point instead of rambling, which
will not get you anywhere.
Luckily, radiology technologists and therapists, just like other healthcare providers,
already have the key to most of the hearing impaired awareness matters, which is empathy8. The
radiologist should think about how the day would be if they had to spend a day with hearing
impairment. Thus, they often strive to improve communication with hearing-impaired patients
without grand gestures. Often hearing impaired patients deal with continuous harsh reactions
from people, stereotyping, and impatience. They struggle to listen to what people say, but some
cannot hear and will often be embarrassed to request the speaker to repeat what they had said.
The secret to promoting and warranting effective communication with people with hearing
impairment is to be observant, conscious, adapt favorable communication environment, take
adequate time, repeat or rephrase as necessary the conversation and expect what might be helpful
to the patient.

awareness in outpatient clinics in England." Disability and Rehabilitation: Assistive
Technology (2019): 1-4.
8

Koth, Jana. "Diagnosis and Treatment of Oncologic Emergencies." Radiologic technology 91,
no. 2 (2019): 161-172.

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Consider the environment: Background noise will affect communication making it
difficult for hearing impaired patients to follow through a conversation9. If the radiology
technologist cannot control or minimize the noise, it is advisable to move to a different
consultation room or a quiet corner to continue with the conversation. Also, closing the doors
and windows to minimize the noise may be helpful. While hearing aids that most hearingimpaired patient uses help them understanding and following through communication, some
make it difficult for these patients to know where the sound is coming from. Most hearingimpaired patients using hearing aids will hear one speaking but will find it hard to determine the
speaker. It can be embarrassing for such patients when they respond to the wrong person. This is
why a quiet environment free from background noise is necessary for the radiologic technology
workplaces to promote effective communication between the radiologist and the hearing
impaired patients.
Moreover, radiology technologists must talk to patients while in the same room. Hearingimpaired patients failing to the speaker or the listener is a common reason for numerous
misunderstandings of the message that present in the radiology technology department. Hearingimpaired persons have not the only difficulty in hearing but also to some extent information
processing. Thus it is vital to speak clearly and distinctly but naturally. Never shout or
exaggerate mouth movement as these may confuse and lead to misunderstanding of what is said.
It also distorts the sound of the speech and makes it difficult for the hearing-impaired persons to
read the speech.

9

Mazer, Susan E. "Radiology, Noise, and the Patient Experience." Journal of Radiology
Nursing 37, no. 4 (2018): 243-246.

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Lighting: Since some of the hearing impaired patients may not hear the sounds correctly,
they tend to read the lips and body language. This may be very difficult when lighting is not
adequate. The phase of the radiologic technologist conversing with the hearing impaired patients
must be in a great light to enable patients to lip-read and learn from body language. Radiologists
should face the hearing-impaired patient directly in the eye, be on the same level as with the
patients, and ensure that there is good light when possible10. The light should be shining on the
speaker's face meaning that whenever a hearing-impaired person speaks, the light should be
directed to shine on his or her face and not in the face of the listener. The radiologist must not
stand in front of a light source or speak from another room as this may hinder the hearing
impaired patients from lip-reading. Saying the hearing-impaired person's name before beginning
to converse with them makes them focus their attention and will often reduce the possibility of
missing words when conversation commences. Sentences that are too complex or rapid talking
will likely confuse thus, encourage and practice pausing; slowing down between sentences to
warrant that the hearing-impaired person understands the previous words then proceeds.
Radiology technologists should aim to ensure that the hearing-impaired person
maximally understands their words through the conversation11. Hence, they must keep away
anything that may distract, confuse, or make understanding difficult—these including keeping

10

Nakagawa, Kei, Shinichiro Nakaishi, Takeshi Imura, Yumi Kawahara, Akira Hashizume,
Kaoru Kurisu, and Louis Yuge. "Neuromagnetic evaluation of a communication support
system for hearing-impaired patients." NeuroReport 28, no. 12 (2017): 712-719.

11

Odle, Teresa G. "Patient-Centered Care in Breast Imaging." Radiologic technology 90, no. 3
(2019): 259M-277M.

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hands away from the face while conversing, ceasing chewing, eating, or smoking. Similarly,
hearing-impaired patients will take any mouth movement and will want to analyses to get that
information out. Studies show that beards and mustaches may interfere with the hearingimpaired persons' ability to read. With that said, they should be shaved to promote maximum
understanding. Background noise interferes with hearing; thus, hearing-impaired persons will
often have difficulty in understanding speech in a place with background noise. The radiology
technologist must strive to minimize background noise.
Booking appointment: Most of the hearing impaired patients exploit devices such as the
amplifiers, text relay, and operator-assisted service, and some use smartphones. The amplifiers
are used to increase the volume of the speaker to ensure they hear what others are saying over the
phone—often hearing impaired patients will type a message in their phone and have the operator read it for them after every line. The receptionists, radiologic technologist, and the therapist
in the radiologic technology setting should be familiar with making and receiving calls in
information ways. Radiologic technology settings should accept text messaging through the
hospital line, email, or online messaging to accommodate the hearing impaired patients. Besides,
the receptionist desks should clearly show that hearing help is available and that the radiologic
technology center is ready and willing to care for hearing impaired patients compassionately and
with empathy.
Waiting room: Radiologic technology facilities should have a waiting room with a loop
system to accommodate and help hearing-impaired patients. Often, hearing impaired patients
find it stressful and tiring to wait in the consultancy room. The radiologic technologist must not
disregard the emotional energy by the hearing impaired patients who are concerned that they
might not hear their name. The chairs in the waiting of a radiologic technology facility should

HEARING-IMPAIRED PATIENTS AND RADIOLOGIC TECHNOLOGY

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