Before
Resume normal activity as tolerated.
Project Artifact
Before/After Communication Example
A portfolio-safe example showing how clinical wording can be redesigned for clearer patient understanding, plain language, cultural meaning, and teach-back.
In development
Language Access | Plain Language | Health Literacy | Clinical Communication | Instructional Design
Artifact Overview
This artifact is part of the Khmer Clinical Communication Gap Analysis project. It demonstrates how clinical wording can be reviewed and redesigned so that patient-facing communication is easier to understand, remember, and act on.
The examples are fictional and generalized. They are not copied from real patient records, institutional forms, confidential encounters, or official clinical documents.
Why Before/After Examples Matter
In healthcare, unclear wording can create hidden understanding gaps. A phrase may be medically familiar to staff but confusing for patients, especially when it includes abstract wording, technical terms, legal language, or assumptions about health literacy. For Khmer-speaking LEP patients, a direct interpretation or translation may preserve the words but still fail to explain the meaning.
Before/after examples help show how communication can be redesigned as a learning experience.
Example 1: Activity After a Procedure
Communication gap
The patient may not know what "normal activity" means, what "as tolerated" means, or which activities should be avoided.
After
Start with light activity, such as walking around your home. Rest if you feel tired. Do not lift heavy objects or do strenuous activity until your care team says it is safe. Call the clinic if pain gets worse or you are unsure what you can do.
Design support
- Use icons for walking, resting, lifting, and calling the clinic.
- Add a teach-back prompt: "What activities will you avoid today?"
- Provide interpreter-supported explanation when needed.
Example 2: Sedation and Transportation
Before
You cannot drive after sedation.
Communication gap
The patient may not understand sedation, may confuse it with anesthesia, or may not plan transportation.
After
The medicine used during your procedure may make you sleepy or slow your reaction time. For your safety, do not drive after the procedure. Please arrange for a responsible adult to take you home if your clinic requires it.
Design support
- Use a ride-home icon.
- Add a reminder card before the appointment.
- Add a teach-back prompt: "Who will take you home after the procedure?"
Example 3: Clear Liquid Instructions
Before
Clear liquids only.
Communication gap
The patient may not know what counts as a clear liquid or may assume any light-colored drink is allowed.
After
Drink only liquids you can see through, such as water, clear broth, or certain clear juices if your clinic allows them. Do not drink milk, smoothies, or drinks with pulp. Follow your clinic's exact instructions.
Design support
- Use a yes/no visual chart.
- Include culturally familiar examples when possible.
- Provide a large-print version and audio explanation.
Example 4: Biopsy Explanation
Before
A biopsy may be taken.
Communication gap
The patient may think biopsy means cancer has already been found.
After
The doctor may take a very small tissue sample during the procedure. The sample may be sent to a lab for testing. This does not always mean cancer. Your care team will explain the results when they are ready.
Design support
- Use a simple visual of a small sample being tested.
- Add a "What happens next?" section.
- Encourage questions through the interpreter.
Example 5: Patient Rights Form
Before
By signing, you acknowledge receipt of the patient rights and responsibilities notice.
Communication gap
The patient may sign because it feels required, without understanding that the document explains rights, responsibilities, interpreter access, privacy, and complaint options.
After
This form says you received information about your rights as a patient. These rights include asking questions, getting language help, understanding your care, and knowing how to share concerns. Signing means you received the information, but you can still ask for help understanding it.
Design support
- Provide a plain-language rights summary.
- Add icons for interpreter, questions, privacy, and concerns.
- Allow patients to ask for explanation before signing.
Design Pattern
Across these examples, the communication design pattern is consistent: identify the clinical meaning, remove vague or abstract wording, explain the patient action, add visual or audio support, and confirm understanding through teach-back.
- Preserve the clinical intent.
- Replace vague wording with specific actions.
- Explain unfamiliar terms.
- Separate normal, concerning, and urgent symptoms when relevant.
- Use visual, audio, or interpreter-supported formats.
- Confirm understanding without blaming the patient.
Relationship to Instructional Design
This artifact treats clinical communication as instructional design. The goal is not only to translate words, but to help patients understand what is happening, what choices they have, what they need to do, and when to ask for help.
Relationship to the Clinical Communication Project
This before/after example supports the Khmer Clinical Communication Gap Analysis project by showing how communication gaps can be translated into practical design decisions, plain-language explanations, teach-back prompts, and patient education supports.
Relationship to the Flagship Toolkit
The same before/after method can support the Khmer GI Patient Education Design Framework & Learning Toolkit by helping refine procedure instructions, post-care handouts, video scripts, form explanations, and interpreter-supported education tools.