Clinical Communication Review Checklist

Artifact Overview

This checklist is part of the Khmer Clinical Communication Gap Analysis project. It is designed as a professional practice artifact for reviewing patient-facing clinical communication through the lens of language access, cultural validation, health literacy, and patient usability.

The checklist is not a clinical approval tool, legal review tool, or substitute for qualified medical translation, professional interpretation, provider explanation, or organizational compliance review. It is a portfolio-safe concept that demonstrates how clinical communication can be reviewed for whether patients are likely to understand, remember, and act on the information.

Why This Checklist Matters

In healthcare communication, accurate wording does not always guarantee patient understanding. A phrase may be technically translated but still unclear, culturally awkward, too abstract, too literal, or difficult for patients to act on. For Khmer-speaking LEP patients, these gaps may affect informed consent, screening questions, procedure preparation, medication instructions, discharge understanding, and follow-up care.

This checklist helps identify where communication may need plain-language support, cultural adaptation, visual explanation, interpreter-supported clarification, or teach-back.

Recommended Use

• Reviewing Khmer patient education materials
• Reviewing translated clinical instructions
• Preparing interpreter-supported patient education
• Identifying phrases that may need plain-language explanation
• Supporting culturally responsive health literacy design
• Flagging wording that may require expert, clinical, or compliance review
• Supporting future patient education toolkit development

Review Area 1: Clinical Meaning

• Does the wording preserve the clinical intent?
• Is the meaning clear enough for the patient to understand the action needed?
• Could the phrase be interpreted too broadly or too narrowly?
• Does the wording explain what the patient should do next?
• Does the phrase require provider clarification?
• Does the phrase require interpreter-supported explanation?

Prompt: "What does the patient need to understand or do because of this sentence?"

Review Area 2: Plain Language and Health Literacy

• Are medical terms explained in everyday language?
• Are instructions broken into clear steps?
• Is the reading level appropriate for the patient audience?
• Are abstract terms explained with examples?
• Are time, dosage, diet, or preparation steps specific?
• Would a low-literacy patient be able to act on the instruction?

Prompt: "Could the patient explain this instruction in their own words?"

Review Area 3: Cultural Meaning and Communication Norms

• Could the wording sound harsh, shameful, confusing, or culturally awkward?
• Does the phrase assume Western health beliefs or communication norms?
• Does the material support respectful question-asking?
• Does it avoid blaming the patient?
• Does it account for patients who may nod politely even when they are unsure?
• Does it leave room for interpreter-supported clarification?

Prompt: "How might this phrase be heard by a Khmer-speaking patient?"

Review Area 4: Actionability

• Is the patient told exactly what to do?
• Is the timing clear?
• Is the location or contact pathway clear?
• Does the instruction distinguish between normal, concerning, and urgent symptoms?
• Does it explain when to call the clinic?
• Does it explain when to call 911 or local emergency services when appropriate?
• Does it reduce the chance of missed preparation, rescheduling, or unsafe recovery decisions?

Prompt: "Can the patient safely act on this information after leaving the encounter?"

Review Area 5: Accessibility and Format

• Is the information available in more than one format?
• Could audio narration support patients who do not read confidently?
• Could icons, timelines, or images make the instruction clearer?
• Are captions or transcripts available for video/audio content?
• Is the layout readable with large text and high contrast?
• Is the material usable on paper, tablet, or screen?
• Can staff or interpreters use the material during education?

Prompt: "What barrier might stop the patient from accessing this information?"

Review Area 6: Teach-Back and Confirmation

• Does the material include teach-back prompts?
• Does it avoid only asking "Do you understand?"
• Does it normalize confusion or questions?
• Does it give staff/interpreters a way to confirm understanding?
• Does it identify when the patient may need additional support?
• Does it allow the patient to say what is still unclear?

Prompt: "How will we know the patient understood?"

Red-Flag Communication Patterns

These examples are framed generally and are not real patient cases.

• Literal translation that keeps the words but loses patient meaning
• Clinical jargon with no explanation
• Vague instructions such as "as tolerated" or "if needed"
• Consent language that sounds like a formality instead of a choice
• Screening questions that may sound shameful, frightening, or unclear
• Discharge instructions that do not explain when to call for help
• Materials that assume the patient can read comfortably
• Instructions that rely only on English-language portals or paperwork

Relationship to Instructional Design

This checklist connects clinical communication review to instructional design. It treats patient communication as a learning experience, not only a translation task. The goal is to help identify where patients may need clearer structure, visual support, plain language, repeated key points, interpreter-supported discussion, or teach-back.

Relationship to the Flagship Toolkit

The Clinical Communication Review Checklist can support the Khmer GI Patient Education Design Framework & Learning Toolkit by helping review handouts, video scripts, teach-back prompts, and patient-facing instructions before they are developed into final learning materials.