title: Voices emerging from the shadows: Radiologic practitioners' experiences of challenging conversations.
abstract: Traditionally, radiologists have practiced their profession behind the scenes. Today, radiologic practitioners face mounting expectations to communicate more directly with patients. However, their experiences with patient communication are not well understood. The aim of this study was to describe the challenges of radiologic practitioners when communicating with patients.
  
  
  
  Twelve day-long interprofessional communication skills workshops for radiologic clinicians were held at Boston Children's Hospital. Prior to each workshop, participants were asked to write narratives describing experiences with difficult radiologic conversations that they found particularly challenging or satisfying. The narratives were transcribed and analyzed through thematic content analysis by two researchers.
  
  
  
  Radiologists, radiology trainees, technologists, nurses, and medical interpreters completed 92 narratives. The most challenging aspects of healthcare conversations included: Conveying Serious News (n=44/92; 48%); Expanded Scope of Radiologic Practice (n=37/92; 40%); Inexperience and Gaps in Education (n=15/92; 16%); Clinical Uncertainty (n=14/92; 15%); and Interprofessional Teamwork (n=9/92; 10%).
  
  
  
  Radiologic clinicians face substantial communicative challenges focused on conveying serious, unexpected and uncertain diagnoses amid practical challenges and limited educational opportunities.
  
  
  
  Innovative educational curricula that address these challenges may enhance radiologic practitioners' success in adopting patient-centered communication.
authors.affiliation: Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA, USA. Electronic address: elaine.meyer@childrens.harvard.edu.
authors.forename: Elaine C
authors.initials: EC
authors.lastname: Meyer
authors.affiliation: Department of Health Sciences, Università degli Studi di Milano, San Paolo University Hospital, Via Di Rudinì 8, Milan, Italy. Electronic address: giulia.lamiani@unimi.it.
authors.forename: Giulia
authors.initials: G
authors.lastname: Lamiani
authors.affiliation: Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA, USA. Electronic address: donna.luff@childrens.harvard.edu.
authors.forename: Donna
authors.initials: D
authors.lastname: Luff
authors.affiliation: Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA, USA. Electronic address: stephen.brown@childrens.harvard.edu.
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Brown
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001900:Boston; D003142:Communication; D003479:Curriculum; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D033262:Narration; D010817:Physician-Patient Relations; D036301:Qualitative Research; D011871:Radiology / Q000193:education*
keywords: Clinician-patient communication; Narratives; Qualitative research; Radiology; US