When researchers at the H. Lee Moffitt Cancer Center set out to improve the way they collected patient data for their Breast Cancer Lymphatic Mapping Database, they discovered something simple but powerful: better design makes a real difference.

In a study comparing two versions of a clinical questionnaire—one created by a systems analyst and another crafted using information design principles and usability testing—they found that the thoughtfully designed form gathered significantly more complete data.

But the story isn’t just about better forms. It’s about the real-world challenges that information designers face, including navigating software limitations, balancing user needs with design best practices, and often having to explain the value of their work to people who don’t fully understand it. This study highlights those tensions, especially in complex fields like medicine, where the impact of poor design can ripple far beyond usability. The authors candidly note that they often had to:

“compromise among the needs of the users, the general design guidelines, and the constraints of the software” (p. 183).

That's familiar to every designer. We should keep in mind that even the most thoughtful design choices can sometimes seem futile or even irrelevant to clients who don’t share our lens. And that’s a challenge worth unpacking.

Why Clients Don’t Always “Get” Design

One of the most valuable takeaways from this study was the reminder that our clients may see our work as pedantic or unnecessary. And it's often not because they don’t care, but because they’re coming from a different perspective. That tension is common, especially when we try to apply information design principles in industries where those practices aren’t the norm.

But instead of feeling frustrated or dismissed, we can shift our approach. Rather than defending our choices based on personal preference, we should aim to explain how these design principles actually serve the client’s goals and their users.

As technical communicators, we’re often “cursed” with expert knowledge. It becomes hard to imagine how someone wouldn’t see the value in clean, user-centered documentation. But for many clients, especially in highly specialized fields, that value isn’t self-evident. And sometimes, design decisions come up against deeply ingrained norms or regulatory systems that weren’t built with usability in mind.

The High Stakes of Design in Unfamiliar Fields

Clinical research is one such field. Zimmerman and Schultz’s article focuses on how poorly designed questionnaires impact the accuracy of medical data. That’s a pretty high-stakes issue—far beyond a frustrating user interface or a confusing form field.

Anyone who’s filled out a medical questionnaire knows how frustrating (and often overwhelming) they can be. And yet, this difficulty is so common that many patients accept it as just another part of navigating healthcare. But as technical communicators, we should be asking: Why aren’t these designed better?

The authors point to a deeper problem:

“There is a gap between research and practice in document design… much of the research is conducted in widely disparate fields” (p. 178).

In other words, the people who create these forms often lack training in information design. And it’s not just a matter of making forms easier to fill out—these design issues have real ethical consequences.

Design as an Ethical Responsibility

As Zimmerman and Schultz emphasize, design decisions in this context go beyond usability:

“The success of the design used in this study should be considered in terms of its potential to add to patients’ overall personal healthcare and raises an ethical question about the practice of making broad generalizations regarding healthcare based on incomplete data” (p. 192).

That statement really hit home. Not every designer will be confronted with ethical stakes this high. But it’s a powerful reminder that how we structure information can have real-world consequences—especially when others are relying on that information to make decisions that affect people’s health and wellbeing.

Becoming Empathetic Advocates for Design

At the end of the day, our role isn’t just about making things look good or work better, it’s about advocating for clear, human-centered communication, even when the value isn’t immediately obvious to others.

We may not have medical expertise or the same professional lens as our clients, but we do bring something valuable to the table. It’s our job to bridge that gap—to explain, with empathy and clarity, how good design can benefit users, clients, and in some cases, entire systems.

The work can be hard, and the compromises are real. But when we center our practice on collaboration and understanding, we help build a world where thoughtful communication design is appreciated and expected.

Works Cited

Zimmerman, B. & Schultz, J. (2000). A Study of the effectiveness of information design principles applied to clinical research questionnaires. Technical Communication, (Second Quarter, 2000). 177-194.