Difficult conversations with patients and carers

The target learning group of this case study was Year 1 therapeutic radiography students

In this section

In This Section

Learning Outcomes 

  • Knowledge

    • Awareness of patient responses to their diagnosis
    • Understanding a range of patient behaviours at times of stress
    • Professionalism and expected behaviours as a student radiographer
  • Skills

    • Strategies for dealing with difficult or challenging conversations  
    • De-escalating anger 
    • Developing resilience 
  • Attitudes/Behaviours

    Communication skills 
    Rationalising behaviours 
    Assuming an appropriate professional response when dealing with patients 

Scenario Environment


  • Radiotherapy Clinic Room

  • Radiotherapy department waiting area

  • Radiotherapy main reception




Immersive 3D virtual reality system-

  • Headset

  • Haptic handset

  • VR director’s laptop/interface




VR system as above


Tutor to direct VR simulation

Tutor to facilitate associated discussion / reflection 

Potential Distracters

  • Student non acceptance of VR space (e.g. cybersickness, vertigo)

  • Noise distraction from VR space (e.g. ambient noise removes VR fidelity)

Initial Simulation Set-up

  • Student dons headset and hand controllers
  • Student spends 5 minutes adjusting to VR immersion
  • Interacts with ‘virtual receptionist and gains sense of presence
  • Check student is receiving audio inputs from headset  
  • Picks up virtual clip board and reads clinical information from written treatment sheet/patient information 

Scenario Progression 

Case Introduction and Available Collateral Information

Scenario 1

  • Enter VR clinic room and introduce yourself to patient.
  • Sit with VR radiographer colleague and respond to patient questions as you would do within real world
  • Provide a professional and supportive approach to the patient- respond to the situation as it arises

Scenario 2

  • Collect patient X from the waiting room
  • ID him using the information on the patient notes/treatment sheet
  • Respond professionally to the scenario as it takes place

Instructions for Personnel

Scenario director may choose level of escalation according to how they see fit (low, medium, high).

Await student response and choose flow of scenario according to student response. 

Ensure full scenario is worked through and completed according to the scripted scenarios.

Evaluation Strategy

Post immersion student interviews to gain qualitative insights into VR immersion.

Link to Evidence Base 

Cui V., Hughes-Roberts T., White N (2022) A Design Framework for Social Virtual Reality Experiences: Exploring Social and Cultural Dimensions for Meaningful and Impactful VR. Lecture Notes in Computer Science Vol 13317 pp 395–409

The Script

Scenario Transitions

& Evolution

Effective Management

Ineffective Management


Collect patient from VR waiting area

Failure to ID patient. Poor communication exhibited


Dialogue with upset patient

Inappropriate or unprofessional dialogue


Dialogue with angry patient

Inappropriate or unprofessional dialogue