“Lig asseblief u linker skouer terwyl u, u regter skouer plat teen die bed hou.” says Noluthando to an elderly Afrikaans lady presenting with dementia. Noluthando has a limited Afrikaans vocabulary, and her patient in the X-ray room only understands Afrikaans. She knows from the waiting patient log that some of her following patients might be Setswana and an immigrant from Mozambique. Noluthando would usually be apprehensive about how she would communicate with these patients. However, she uses an innovative application to guide her patients into the correct radiographic position, irrespective of her current linguistic capabilities. South Africa has a unique demographic of citizens, with a cultural and ethnic diversity that truly makes us a rainbow nation. With such a diverse populace and a myriad of different languages spoken within the borders of our country, it is hardly strange to hear at least five different languages in a day. Currently recognising twelve official languages, Mzansi truly is a cultural hotspot of diversity. Most South Africans have at least a basic understanding of English, and conversing often occurs in English as a second language. Yet, for many residents, English remains a foreign language seldom spoken, especially in rural areas. South Africa also hosts many foreign residents and immigrants from Francophone and Lusophone backgrounds. This means that patients in South African radiology departments may speak various languages. A radiology department provides various medical imaging services, and diagnostic radiographers are responsible for positioning patients to obtain images according to international standards. As a result, the instructions given to a patient for positioning a specific anatomical area are standardised globally. For diagnostic radiographers, navigating the challenging linguistic landscape can be difficult. When guiding a patient during a radiographic examination, it is vitally important that the patient understands what will be happening and works together with the radiographer to ensure that required imaging is optimal – thus ensuring optimal diagnostic imaging and better patient outcomes. If linguistic challenges hamper communication between the radiographer and the patient, this may result in sub-optimal imaging, exposing patients to higher ionising radiation due to repeated imaging. The patient may feel that they have no say in their imaging process, while the diagnostic radiographer may feel frustrated by the challenge of positioning the patient correctly. This linguistic challenge is echoed by UJ’s Department of Medical Imaging and Radiation Sciences (MIRS) diagnostic radiography students undertaking work-based learning. They often rely on peers and other staff members to assist them in communicating with patients, which is time-consuming. Using existing translation applications is also time-consuming. Searching for a solution, Dr Shantel Lewis, from the MIRS department, thought to develop an application that could assist diagnostic radiography students in communicating standard radiographic positioning instructions at the touch of a button (Figure 1). Effective communication enhances patient experiences and care and improves student learning outcomes in the clinical setting. Since the initial ideation, the MIRS Department and the Metaverse Research Unit have partnered to create an application specifically for diagnostic radiography students to guide patients in the language that they feel most comfortable with. This application, which is currently undergoing alpha testing, seeks to equip diagnostic radiography students with the most common radiographic phrases in many of the languages that one could hear in South Africa. The application provides patient positioning instructions for 82 radiographic projections and 36 phrases commonly used to interact with patients in the radiology department (Figure 2). Using a combination of artificial intelligence (AI) neural voices and recordings made by first-language speakers, the application provides an innovative way for communication to occur in a radiographic practice. The first languages included in the application are English, Afrikaans, isiZulu, Portuguese, French, and Gujarati, all generated by AI voices. Since there are currently no AI neural voices available for other South African languages, students and staff of the MIRS Department shared their voices for the recordings of instructions in all official South African verbal languages. These recordings were done at the UJ Library Podcast Studio, a service that provides researchers and students with high-quality recording facilities for all their projects’ needs. The recordings are currently being cleaned and standardised for inclusion in the application. “Lig asseblief u linker skouer terwyl u, u regter skouer plat teen die bed hou.” says Noluthando to an elderly Afrikaans lady presenting with dementia. Noluthando has a limited Afrikaans vocabulary, and her patient in the X-ray room only understands Afrikaans. Noluthando would usually be apprehensive about how she would communicate with these patients. However, she uses an innovative application to guide her patients into the correct radiographic position, irrespective of her current linguistic capabilities. Teaching Innovation for the 21st Century | Showcasing UJ Teaching Innovation Projects 2024 75
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