DR News: Understanding Multicultural Obstacles in a Radiography Program
By Jacqueline K. Peccerillo, BS, RT(R)(CT)(BD)(PET)
Radiology Today
Vol. 23 No. 1 P. 6

The term “multicultural” can be understood in a variety of contexts, and health care professions abound with cultural diversity. Some examples of cultural diversity include race, gender, religion, age, and educational background.1 Because of these cultural differences, many radiography students and instructors have endured roadblocks in the learning process. Radiography programs are unique in that they address students not only within a classroom setting but also in a clinical environment. Instructors must understand their own culture as well as the cultures of their students to develop instructional strategies that overcome the challenges of a dynamic and multicultural classroom.

A person’s culture and upbringing have a profound effect on how he or she sees the world and processes information.2 Low academic achievement, difficulty adjusting to a new culture, and trust issues are all serious problems that have been identified as impacting academic success in a multicultural classroom.3 There are five behavioral areas affected by an individual’s cultural identity: eye contact, asking questions, smiling during an intense discussion, inattentiveness, and refusal to engage in debates.4

These behaviors are inherent to working with patients in a radiology department. A radiographer must be able to look a patient in the eyes when speaking with them, physically position them for examinations, and challenge an ordering physician, should they feel an examination has been ordered incorrectly. Poorly understood cultural differences interfere with student-instructor relationships as well as student-technologist and student-physician relationships. These relationships are crucial for building a solid foundation when moving forward into the field of radiography and must be well maintained.

Students’ Cultural Identity Experiences
Using personal communication strategies, data were collected from seven radiography students to examine the role of cultural differences in a radiography program. The graduation dates from the accredited radiography program ranged from 1998 to May 2020. The communications took place between April 10 and 13, 2020.

The ages of the students ranged from 21 to 50 years old. Six people identified as white (non-Hispanic) and one identified as Hispanic. Three individuals identified as immigrants: one from Russia, one from Hungary, and one from Colombia.

The individuals from Russia and Colombia shared that their learning experience during the radiography program was negatively impacted by this part of their identity. Their obstacles included communication both in class and in the clinical environment, as well as their intelligence being questioned because English was not their first language. One example of cultural miscommunication involved the emotional differences between the Russian culture and culture within the United States. According to the Russian student, Russians are not outwardly emotional. They speak with a direct communication style that has low context, meaning that the receiver can clearly understand the speaker’s true intentions.1 Many times, the direct style was misunderstood as being confrontational. The same could be said for the native Colombian student. She expressed that she was afraid to ask any questions during class because she felt her accent would cause an issue in understanding what she was trying to say.

Religion was identified as another obstacle. A student who identified as being Jewish felt that her religion isolated her from her fellow classmates, causing her to forego participation in any bonding experiences that concerned religion. Making friendships within a radiography program serves as a support system to help a student through the rigors of the program requirements. This is an area that requires further research.

Disabilities, both physical and psychological, can be included in a person’s identity. One student identified as being dyslexic. She felt she was assumed to be a slow learner because of the dyslexia. Despite her high academic performance, she was still treated as though she did not fully understand concepts presented to her.

Psychological disabilities and mental illness, including depression and anxiety, were listed in two of the students’ identities. These students shared how their anxiety caused them to fear the clinical setting. Their behaviors were often misconstrued as shyness and/or laziness and, in some instances, their lack of aggression gave the impression they did not possess the knowledge to perform an examination. To avoid incidents such as this moving forward, instructors should pursue professional development opportunities addressing psychological disorders to better understand that some students are not simply ”shy” but suffering from a psychological disability.

Becoming a Culturally Sensitive Instructor
Teachers need to undergo training programs that prepare them for teaching in a multicultural classroom. The use of action research and data collection tools will help strengthen the instructional skills of the teacher. By constructing curricula—both internal and external activities—and various instructional approaches that work harmoniously with the students and teacher, a safe and effective multicultural learning environment will emerge.3 There are many ways in which teachers can cultivate a culturally responsive curriculum.5 A teacher who expresses an interest in the cultural backgrounds of his or her students creates a bond among the students rather than a cultural divide. Also, by making the classroom more student centered, a teacher empowers students to share their cultural values and beliefs and create connections between what they are learning in class and their experiences at home. Providing ancillary materials in a student’s native language to help them with an assignment can help strengthen their English fluency and build confidence when performing an assignment. Teachers should also maintain high expectations for every member in the class, regardless of cultural differences. Incorporating nongraded testing is also a highly effective method of allowing students to demonstrate progress within the class without creating unnecessary stress. Finally, curricula should be both inclusive and respectful of the cultural differences found within a class.5 By staying true to these concepts, radiography program instructors, like all other instructors, can help students discover their identities and maintain a positive outlook on their learning within a new culture.

Radiography programs face many multicultural obstacles. Faculty and clinical instructors need to work together to develop culturally sensitive curricula and instructional strategies. It is clear there is a need for multicultural training and instructional development. Instructors need to reflect on their own cultural identity and how it impacts their style of instruction. They should also make every effort to get to know their students’ cultural backgrounds so they can create a safe and effective learning environment both in the classroom and in the clinical setting.

— Jacqueline K. Peccerillo, BS, RT(R)(CT)(BD)(PET), works and teaches at St. Vincent’s College-Sacred Heart University in Fairfield, Connecticut. Correspondence can be addressed to peccerilloj@sacredheart.edu or Jacqueline K. Peccerillo, Department of Radiography, Sacred Heart University, 5151 Park Avenue, Fairfield, Connecticut 06825.

1. Martin JN, Nakayama TK. Experiencing Intercultural Communication: An Introduction. 6th ed. New York, NY: McGraw-Hill Education; 2018.

2. Lynch M. How cultural differences can make school tougher for students. The Edvocate website. https://www.theedadvocate.org/how-cultural-differences-can-make-school-tougher-for-students/. Published October 18, 2018. Accessed January 14, 2022.

3. Alsubaie MA. Examples of current issues in the multicultural classroom. J Educ Pract. 2015;6(10):86-89.

4. Alrubail R. Being mindful of cultural differences. Edutopia website. https://www.edutopia.org/discussion/being-mindful-cultural-differences. Published January 14, 2016. Accessed January 14, 2022.

5. Lynch M. 6 ways teachers can foster cultural awareness in the classroom. https://www.theedadvocate.org/6-ways-teachers-can-foster-cultural-awareness-in-the-classroom/. Published August 22, 2015. Accessed January 14, 2022.