Simulated Telephone Communications

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

In this section

In This Section

Learning Outcomes 

  • Knowledge assumed to be in place

    • Recognition of the frequent use of telephones within the healthcare setting alongside other means of communication
    • GDPR regulations regarding sharing of information by telephone
    • An understanding of the importance of effective communication and inter-professional working in the healthcare setting
    • Appreciation of the role of body language and facial expression in face to face interactions
    • Basic knowledge of the organisation of healthcare services both within the hospital setting and within other healthcare sites such as GP surgeries and nursing homes, including the need for frequent liaison between them
    • Knowledge of common signs and symptoms of cancer
    • Knowledge of common side effects to radiotherapy and chemotherapy and their management strategies for a number of body sites
  • Skills

    • Correctly establish the identity and role of the other member of the conversation, regardless of whether they are the caller or recipient
    • State or establish the purpose of the call
    • Impart correct and appropriate information to the other caller
    • Maintain professional boundaries
    • Non-verbal communication
    • Active listening and responding appropriately
    • Polite and considerate communication
    • Time management
    • Ensure follow up on resultant actions
  • Attitudes/Behaviours

    • Appropriate questioning
    • Appropriate sharing of information
    • Politeness
    • Helpfulness
    • Efficiency
    • Maintenance of confidentiality
    • Empathy
    • Cultural awareness
    • Problem solving
    • Being proactive and reactive
    • Recognising the significance of tone of voice
    • Recognising the impact of absence of body language cues and facial expressions
    • Recognising own limitations

Scenario Environment


Two rooms are required, or alternatively the standardized patient

can participate via an online facility using audio but not camera


  • Two mobile telephones or an online classroom facility
  • Patient appointment list




Telephone or online audio link to a different room


Standardied patient


Potential Distracters

Incoming calls/messages to unmuted personal phones during

class when it would be usual practice to mute phones during lectures.


Script and SP briefing notes for multiple telephone call

scenarios including incoming and outgoing calls

Case Introduction

Students will work in small groups of 6-8.

Students take it in turns to use the telephone, ensuring the loud speaker function is selected so that the rest of the group can hear the conversation.

Available Collateral Information

Some students will be asked to make telephone calls whilst others will receive incoming calls.

Students making outgoing calls will be given limited information about the call, including name and role of the recipient and the nature of the enquiry that they need to make. Students receiving an incoming call will not be given any information about it in advance.

The rest of the group listen to the conversation between both participants.

After each call the participant will be asked to evaluate their own performance and the rest of the group will be asked to offer further feedback and suggestions.

The standardised patient will also give feedback at the end of the session on how they found the conversations.

Ground rules are established and include:

  • Confidential – what happens in the room stays in the room. The standardised patient will also keep conversations confidential.
  • Other members of the group must not interrupt during the telephone conversation.
  • Feedback must be constructive and supportive.
  • Any other appropriate ground rules as agreed by participants.

For outgoing calls students may request any additional information about procedures and/or the patient’s case that they feel they would usually ask before making such a call in the clinical setting.

Students may not ask for any additional information before incoming calls, in accordance with the fact that they would have no pre-warning about such calls in practice, but during the call they may ask the facilitator any questions that they might reasonably ask a radiographer during such a call in practice.

Instructions for Standardized Patient

The standardized patient is given a list of the nature of both incoming and outgoing calls in advance, along with the details of their own role as patient/staff/relative, and whether they are to place or receive the call.  A copy of the patient appointment list is also made available.

Standardized patients are encouraged to visit the MacMillan Cancer support web pages to gain a broad understanding of what radiotherapy is before participating in this activity. The following link can be used. However, conversations are designed to limit the specific radiotherapy knowledge required and to focus instead on developing appropriate conversational skills in the clinical setting.

Macmillan Cancer Support

Standardized patients are encouraged to ask questions in advance about how they might respond to anticipated questions. They may also ask any question that they feel a real patient might reasonably ask in response to information given by the other participant, e.g. If a student offers a different appointment time they might ask if that change will apply just to the one day or to every treatment.

Example of an outgoing call scenario

Patient details = Jessica Cats, registration number 098326 T

Information for student participant – Student will phone Jessica Cats to confirm her new appointment time is 2pm. She should have been contacted by a member of staff yesterday to let her know about the machine closure and new timing. The machine will be closed this morning due to routine maintenance so it is a one-off occurrence.

Information for standardized patient – Told yesterday that machine is closed in the morning today so appointment time will be moved to the 

afternoon. Had to rearrange her hair appointment but treatment is more important so she does not want to miss it.

Questions for the standardized patient to ask – Why was the machine down this morning? Is it likely to happen again as I have important appointments next week that I would need to work around?

Example of an incoming call scenario

Standardized patient role – Doctor Felicity Hoffman, from clinic

Enquiring about patient  – Immanuel Mahtoombe 804536 T

Student given appointment list in advance – Mr Mahtoombe’s appointment is listed as 1pm.

Standardized patient to ask –Hello, this is Doctor Hoffman. I need to confirm an appointment time for a patient of mine.

Desired response from student – Student should ask for clarification on who is calling and where they are calling from.

SP response – I’m calling from the chemotherapy clinic. I’m with Mr Mahtoombe now and need to know when his appointment time is this afternoon.

Desired response from student – Student should recognize that it is okay to release this information under these circumstances and should disclose the relevant appointment time from the list.

Additional questions for the standardized patient to ask –  Can I ask how long his appointment will be? He is concerned about being on time to pick his children up from school.

Desired response from student –Student should already be aware that appointments typically take around 20 minutes but that delays can sometimes happen. Ideally the student should ask the doctor to instruct the patient to speak up if he finds that his treatment is delayed and his school pick up time is approaching.

Evaluation Strategy

Each conversation will be informally evaluated by the facilitator against key information that should have been transmitted between giver and receiver, and whether each participant’s needs were met. E.g. In the case of a change of appointment change did the patient receive the new appointment time and did the student explain why it had changed? The facilitator will offer feedback on whether these basic elements of the conversation have been achieved before inviting debrief.

Debrief after Simulated Activity

The participating student is encouraged to evaluate their own performance, focusing on how they felt about the experience, what went well/not so well in their opinion, and what, if anything, they might do differently next time.

The remaining members of the group are then encouraged to share further ideas about how they might have handled the conversation differently. Discussion is monitored by the facilitator to ensure that all feedback is constructive and that comments are fair. The facilitator may add further tips/advice and clarify areas of good practice.

The SP is encouraged to add any feedback about how the conversation was perceived from the patient’s/staff member’s point of view.

A short debrief will take place after each conversation so that the remainder of the group can draw on the resultant feedback before attempting the next conversation. Although simple scenarios are initially used in this first year simulation exercise, if feedback is well received and student performance appears to be improving as the class progresses, increasing levels of difficulty can be added at the facilitator’s discretion, e.g. asking the standardized patient to be a little more impatient in their responses.


  • Andrea Maggs

    Name: Mrs Andrea Maggs

    Job title: Senior Lecturer in Radiotherapy and Oncology

    Department: Department of Allied Health, College of Health, Science and Society, University of the West of England

    Simulation experience / simulation research:Module lead for year 1 Radiotherapy simulation week, including design and implementation of telephone conversation simulations and Radiotherapy set up simulations. Co-authorship of online branched learning scenarios in years 1 and 2 to simulate communication experiences, including evaluation and publication of year 2 branched learning scenarios. Currently co-designing online escape rooms to simulate treatment set ups for all 3 years of the programme, with plans to evaluate this innovative approach.