Medical imaging; X-rays, ultrasound, CT, MRI shapes modern diagnosis and treatment. But access to imaging isn’t the same as understanding it. This article explains how a telephone survey uncovers public perceptions, why gaps in understanding persist, and what practical steps health teams and policymakers can take to close the gap.

1) Why this question matters

• Informed consent and trust. Patients who understand why a scan is ordered and what it will show are more likely to give informed consent and follow up on recommendations.

• Reduced anxiety. Clear explanations reduce fear and unnecessary worry about radiation, claustrophobia, or the meaning of results.

• Better outcomes and adherence. When people know the purpose and limitations of imaging, they make better decisions about follow-up, screening and treatment.

• Equity. Understanding gaps helps target education to populations who are least likely to benefit from diagnostic advances.

2) How a telephone survey reveals what patients know (the “how”)

Telephone surveys using CATI (Computer-Assisted Telephone Interviewing) are particularly useful for measuring public knowledge and attitudes about medical imaging. Their practical strengths and limits:

How CATI telephone surveys work (brief):

1. A structured questionnaire is programmed into CATI software.

2. Interviewers call respondents and follow scripts with prompts and built-in validation.

3. Responses are recorded in real time, enabling fast, standardized data capture and immediate quality checks.

4. Data are exported for analysis and segmentation by age, gender, urban/rural, or other variables.

Why telephone surveys are chosen for this topic:

• Reach: They can access respondents who lack internet access but have phone service.

• Speed and quality control: CATI's guided scripts reduce interviewer error and standardize phrasing (important when asking technical questions).

• Anonymity and comfort: Some respondents disclose misunderstandings more openly by phone than face-to-face.

• Cost-effectiveness: Compared with household visits in dispersed geographies, CATI is faster and less expensive.

Limitations to note:

• No visual aids (cannot show images of an MRI or CT during the interview).

• Responses are self-reported and subject to recall bias.

• Sampling frames that rely on phone ownership can underrepresent some demographics.

3) What telephone surveys commonly reveal about patient understanding (the “what”)

Even without naming specific numbers, telephone surveys often surface consistent themes:

A. Familiarity vs understanding

Many people recognize common terms (X-ray, scan, MRI) but cannot accurately describe:

• Differences between CT and MRI (radiation vs magnetic fields).

• Why contrast agents are used.

• What a “false positive” or “incidental finding” means.

B. Fear, myths and partial facts

Common misconceptions include:

• “All scans are dangerous” (overstated fear of radiation).

• MRI causes implants to ‘explode’ (exaggerated fear about metal and MRI).

• One scan will always ‘find everything’ (overconfidence in sensitivity).

C. Communication gaps at the point of care

Patients report:

• Explanations that are rushed or overly technical.

• Little or no pre-scan counselling about what to expect.

• Results delivered without plain-language summaries.

D. Social and structural barriers

Language differences, low health literacy, cultural beliefs, and cost/access concern all shape what patients learn and remember.

4) Why telephone survey findings should change practice (practical implications)

Telephone survey findings are not academic they point to concrete actions:

For clinicians and radiology departments

• Use plain-language one-page preparatory notes that explain: purpose, process, risks, and next steps.

• Train staff in brief teach-back techniques (“What will this scan show?” have patient repeat in their own words).

• Offer call-back lines or SMS summaries of results in accessible language.

For hospitals and health systems

• Integrate short patient education modules before imaging (via phone, SMS, or waiting-room video).

• Track patient understanding as a quality indicator use periodic telephone surveys to measure progress.

• Translate consent materials and result summaries into local languages/dialects.

For policymakers and funders

• Invest in community education campaigns that demystify imaging (radio spots, community health workers, phone hotlines).

• Fund research to test which communication channels work best in different contexts.

5) How telephone surveys can be used to measure impact (closing the loop)

A telephone survey is not only diagnostic it’s a monitoring tool. Use repeated CATI telephone surveys to:

• Baseline patient understanding before an education intervention.

• Measure short-term changes (1–3 months) in knowledge and attitudes.

• Capture long-term effects on care-seeking behavior and adherence to follow-up imaging.

A simple evaluation cycle:

1. Baseline CATI survey → identify top misconceptions.

2. Implement targeted education (clinic counselling + SMS).

3. Post-intervention CATI survey → compare knowledge and reported behavior.

4. Refine messages and scale what works.

6) Practical, tested communication tips clinicians can use today

• Lead with purpose: “This CT scan will help us check for X; it cannot show Y.”

• Use analogies: “MRI uses magnets to read tissue, like how a radio picks up signals.” (Keep analogies local and simple.)

• Address common worries early: Briefly explain radiation risk in context (when relevant) and safety checks used.

• Teach-back: Ask the patient to explain, in their words, what they expect from the scan.

• Follow-up in writing or SMS: A single plain-language message after the appointment reinforces understanding.

7) A short telephone survey module you can adapt (example questions)

(Use simple, non-leading wording; program Into CATI and test with local respondents.)

1. Have you ever had a medical scan (X-ray, ultrasound, CT, MRI)? (Yes/No)

2. In your own words, what do you think an MRI does? (Open text)

3. Which do you think uses radiation: X-ray, CT, ultrasound, MRI? (Multiple choice)

4. How clear was the explanation you received before your most recent scan? (Very clear / Somewhat / Not clear / Didn’t get one)

5. Would you like to receive a short follow-up message (SMS/call) explaining your scan results in plain language? (Yes/No)

6. What worries do you have about medical scans? (Open text)

8) Conclusion-the “so what”

Telephone surveys using CATI are a powerful way to map what people understand about medical imaging and to measure the effect of communication improvements. The takeaway for clinicians, hospital managers and policymakers is straightforward: technology without understanding limits benefit. Investing a small amount of time in plain-language communication checked by teach-back and reinforced by phone or SMS multiplies the value of every scan.

To access the full CATI Africa survey instrument, commission a tailored telephone survey on imaging literacy, or get help designing patient education tested by CATI methods, contact CATI Africa