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Seven C's of Effective Communication

Article in American Journal of Roentgenology · May 2018

DOI: 10.2214/AJR.17.19269

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Pawan Kumar Garg Pushpinder S Khera

All India Institute of Medical Sciences Jodhpur All India Institute of Medical Sciences Jodhpur
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 Letters
Reply to “Seven C’s of Effective
Communication”
My coauthors and I appreciate the thought-
Downloaded from www.ajronline.org by 178.171.102.39 on 05/03/21 from IP address 178.171.102.39. Copyright ARRS. For personal use only; all rights reserved
ful letter by Dr. Sureka and colleagues [1],
highlighting the use of the seven C’s theory
of effective communication as applied to
crafting reports in diagnostic radiology; the
seven C’s are completeness, conciseness,
consideration, concreteness, clarity, com-
parison, and correctness. We wholeheartedly
agree that awareness of the issues they high-
light in their letter would result in a higher
quality radiology report.
For the past several years, one of my coau-
thors and I have conducted an annual report
writers workshop for our radiology residents
on improving the clarity and focus of their
reports, which includes report-writing ad-
vice basically along the same lines that Dr.
Sureka and colleagues recommend. In our
workshop, we emphasize clarity, concise-
ness, and always keeping at the forefront the
fundamental communication goals of the ra-
diology report and its intended audience or
audiences. We are convinced that writing an
effective report is a separate skill from image
interpretation and will improve only with fo-
cused effort. In our workshop, we emphasize
that the radiology report is, at its core, a com-
munication between two caregivers, although
they are now also commonly read by patients
AJR 2018; 210:W244 0361–803X/18/2105–W244 © American Roentgen Ray Society
W244
View publication stats
as well [2, 3]. Our workshop approach en-
tails several hours of “hands-on” work by the
learners, who edit and rewrite actual radiolo-
gy reports to improve their clarity and effec-
tiveness, using a familiar writers’ workshop
format in which everyone’s work is reviewed
and critiqued on the spot by their peers with
active back-and-forth discussions. Our resi-
dents have found the workshop to be helpful
to them in their training, and our assessment
of the effectiveness of this training has been
favorable as well [4].
The issue we raise in our November AJR
article [5], however, is somewhat different.
We point out that despite our best efforts as
radiologists to write clear, concise, and cor-
rect reports, our referring clinicians still do
not fully understand what we are trying to
convey to them—especially when we are try-
ing to communicate uncertainty with regard
to the meaning and significance of our find-
ings and the implications for their patients’
final diagnoses. As we explained in the ar-
ticle, there is ample evidence to suggest that
we radiologists do not fully appreciate how
poorly we are doing in this regard and also
that the clinicians who read our reports do
not fully appreciate how incomplete their
understanding of the radiologists’ intended
meaning actually is. We hope that our article
will help to increase awareness of this issue
among radiologists and the physicians whom
we serve so that more effective solutions can
be found to improve the communication of
uncertainty in radiology.
Michael A. Bruno
Penn State College of Medicine
Milton S. Hershey Medical Center
Hershey, PA
mbruno@pennstatehealth.psu.edu
doi.org/10.2214/AJR.17.19447
WEB—This is a web exclusive article.
References
1. Sureka B, Garg P, Khera PS. The seven C’s of ef-
fective communication. (letter) AJR 2018;
210:[web]W243
2. Bruno MA, Petscavage-Thomas J, Mohr MJ, Bell
SK, Brown SD. An open letter: the radiologist’s
report in the era of the patient web portal. J Am
Coll Radiol 2014; 11:863–867
3. Gefen R, Bruno MA, Abujudeh HH. Online por-
tals: gateway to patient-centered radiology. AJR
2017; 209:987–991
4. SAGE Open Medicine website. Yang C, Kasales
CJ, Ouyang T, et al. A succinct rating scale for
radiology report quality. journals.sagepub.com/
doi/10.1177/2050312114563101. Published Decem-
ber 16, 2014. Accessed December 1, 2017
5. Bruno MA, Petscavage-Thomas J, Abujudeh HH.
Communicating uncertainty in the radiology re-
port. AJR 2017; 209:1006–1008
AJR:210, May 2018