Abdul Mueed Zafar  ( Department of Radiology, Aga Khan University, Karachi, Pakistan. )
Naila Nadeem  ( Department of Radiology, Aga Khan University, Karachi, Pakistan. )

Madam, Communication and Interpersonal Skills (CIPS) comprise an integral component of medical professionalism.^1-4 Effective CIPS augment quality health care delivery, patient satisfaction, outcomes and physician's confidence.^1-3,5 Quite understandably, regulatory bodies such as Accreditation Council for Graduate Medical Education (USA), General Medical Council (UK) and College of Physicians and Surgeons (Pakistan) have mandated their incorporation into every residency programme.

Typically, the need for CIPS is considered equivalent to the volume of direct patient interaction. Perhaps this is why CIPS are not deemed priority training areas for radiologists.³ The neglect is reflected by the fact that radiology residents perceive themselves inadequately skilled for communicating with the patients and deem such situations stressful.^1,2,6

A radiologist carries the unique responsibility of communicating with the patients, families, referring physicians and other members of the health care team; there is potential for loss of information at each interface.^2,4,5 The routine scenarios include discussing appropriateness of the requested procedure, taking informed consent for it and sharing its findings.^4,6 At times, the situation may be more complex e.g. when a patient inquires about the foetal well-being at the end of a routine ultrasound exam during which foetal anomaly/demise has been detected.⁴ A considerable proportion of this communication is verbal, especially in acute care setting. An accurate diagnosis may be rendered futile, with possible ethical implications, if not communicated effectively, in time, to the appropriate person.^4,5 Added to it is the limited duration of radiologist-patient interaction plus a lack of pre-existing rapport² and the need for training "consultants of consultants" in CIPS could not be any more obvious.^4,6

This can be achieved through CIPS curricula comprising of clearly defined objectives, effective learning strategies such as role modeling or high fidelity simulations and reliable techniques to gauge adequacy of these attributes.^1,2,5,6 The curriculum should emphasize long term inculcation of basic principles of CIPS more than the amount of knowledge attained.^5,6

Currently, CIPS training for radiology residents in Pakistan is limited to workshops organized by College of Physician and Surgeons, Pakistan. While the first two components of a curriculum exist in somewhat unsophisticated forms, the tail that wags the dog^2,5,6 i.e. methods of assessment are missing altogether.

We urge both leaders and learners in radiology to realize the critical role of CIPS in the practice of radiology and to strive for developing CIPS curricula tailored to radiology and the local needs.^1,2 Such efforts can be instrumental for excellence in radiology.^1,3,5,6

1. Avan BI, Raza SA, Afridi HR. Residents' perceptions of communication skills in postgraduate medical training programs of Pakistan. J Postgrad Med 2005; 51: 85-90.
2. Lown BA, Sasson JP, Hinrichs P. Patients as partners in radiology education: an innovative approach to teaching and assessing patient-centered communication. Acad Radiol 2008; 15: 425-32.
3. Gunderman RB. Patient communication: what to teach radiology residents. AJR Am J Roentgenol 2001; 177: 41-3.
4. Oljeski SA, Homer MJ, Krackov WS. Incorporating ethics education into the radiology residency curriculum: a model. AJR Am J Roentgenol 2004; 183: 569-72.
5. Donnelly LF, Strife JL. Establishing a program to promote professionalism and effective communication in radiology. Radiology 2006; 238: 773-9.
6. Gunderman RB. Role models in the education of radiologists. AJR Am J Roentgenol. 2002; 179: 327-9.