Skier et al.；An
Investigation
the Safe Useof Foreign
Languages
for theSales of OTC
Japanese
Journal of into
Community
Pharmacy
Vol.7,
No.2, 36-45(2019)《 Original Article 》

An Investigation into the Safe Use of Foreign Languages
for the Sales of OTC Medicines by Registered Salesclerks:
Survey Results of Registered Salesclerks after Seminars on Using
English with Non-Japanese Customers in OTC Environments
Eric
AkikoTomizawa
Tomizawa22,, Katsuei
KatsueiWatanabe
Watanabe33,, Koji
Koji Narui
Narui22
Eric M.
M. Skier
Skier11*,,Akiko
In the summer of 2019, three days of training seminars were held to help
improve the ability of registered salesclerks to communicate with non-Japanesepatients in English when selling OTC medicines. After each seminar, a survey was
given and a total of 583 registered salesclerks responded to it. The purpose of ourstudy is to investigate the ability of registered salesclerks to provide information in
a foreign language so non-Japanese customers can use OTC medicines properly andsafely.
While 202 (34.6%) of the 583 seminar participants had no experience using aforeign language with a non-Japanese customer in a work environment, theremaining 49.9% had. Next, we asked about the content of the seminars and while
180 participants (30.9%) said the level of the presented English content wasdifficult, the remaining 67% of the participants found the content to be a little
difficult (57.8%), pretty simple (8.1%), or simple (8.1%). We next asked if they felt
the seminar content would be useful for them in communicating with non-Japanesecustomers and 472 of the participants (80.9%) replied that the English presented
would be useful or might be useful. In comments from the participants, they often
mentioned that the need for greetings “May I help you?” or “Get well soon.” wasnew to them. As was the need for polite English, e.g. using please, thank you, andexcuse me.
Our results showed that a majority of registered salesclerks are already using
foreign languages with non-Japanese customers. Having said this, the responses tothe level of the English presented in the seminars also show that many of theregistered salesclerks may not be doing an appropriate job when communicatingwith non-Japanese customers leading to fears of safety. Furthermore, generalcomments shared on the survey showed that many of the salesclerks wish to
improve their ability to communicate on the job in a foreign language and as such
we look forward to helping registered salesclerks in the future with more seminars.
Key words; registered salesclerks, foreign languages, OTC drugs, English education
Received November 14, 2019; Accepted December 14, 20191English 2 Laboratory, School of Pharmacy, Nihon University

2Department of Self-Medication and OTC, School of

Pharmacy, Tokyo University of Pharmacy and Life Sciences 3Tokyo Metropolitan Druggist Association*Corresponding author: Eric M. Skier Narashinodai, Funabashi-shi, Chiba, 274-8555 Japan.

Phone: 047-465-7976

E-mail address: eric.m.skier@nihon-u.ac.jp
3636

Journal of Community
Pharmacy
Vol.7,
No.2, 36-45
Skier et Japaneseal.；An Investigation
into the Safe Useof Foreign
Languages
for the(2019)
Sales of OTC

focus on topics such as greeting customers, talking
about patient symptoms, giving simple directions

1. Introduction

on how to take a medication, giving precautions,
The latest government figures on visitors toand asking for a simple patient history. The

Japan show that in the first half of 2019, over 16.6

instructor also presented examples of polite English

million people had visited Japan for an increase ofand other strategies for communicating in an

4.6% from the same period in 2018. 1). In addition,

appropriate manner in English with a non-Japanese

the number of foreign visitors is expected tocustomer. The purpose of our study is to investigate

continue to grow as people from around the world

the ability of registered salesclerks to provide

will come to Japan to attend the Tokyo Olympic

information in a foreign language so non-JapaneseGames that will be held in the summer of 2020.

customers can use OTC medicines properly andsafely.

In 2018, a survey of registered salesclerks was
carried out by Ujiie, et al2) and it was found that 337

2. Methods

participants of their study (51.9%) had experience
responding to non-Japanese customers in a foreign

2. 1. Seminars and Survey

language. The foreign languages varied fromEnglish (86.4%) to Chinese (70.0%) to Korean

In the summer of 2019, three days of seminars(25.8%) to others (26.7%). Ujiie, et al then further

were held at Akabane Hall on July 5, 13, and 14,

questioned those 337 participants and found that

respectively. In this study, all participants had themany of them, 228 (67.7%) were somewhat able tofreedom to participate by filling out the survey orcomprehend what the customer was saying, but

not and this was explained to them prior to thewere unable to express what they wanted to say andbeginning of the seminars. The present study was

this led to some issues. The next question of theirapproved by the Institutional Review Board forsurvey asked, “What sort of preparation/tools do

Utilization of Human Tissue, Etc. for Research of

you think would be useful to respond to questions

Tokyo University of Pharmacy and Life Sciences

or consultations in a foreign language?” and 253 of(2019-011).

the 649 participants (39.0%) responded that they
2. 2. Seminar Content

would like to learn how to better communicate with

Each seminar was three hours long andnon-Japanese customers in a seminar environment.

consisted of the following:With these responses in mind, the Tokyo
Metropolitan Druggist Association decided to offer

 An introduction to natural English with afocus on pronunciation.

English language seminars to its members in thesummer of 2019 as English was the language that

 An introduction to using English in an
appropriate manner.

the registered salesclerks in the study by Ujiie, et al
had used the most. Between the instructor, the head Simple gestures and other ways toof the Druggist Association, and others, it wascommunicate with non-Japanese customers.

decided that the material of the seminars would

 Example dialogs (in Japanese and English)
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Skier et al.；An
Investigation
the Safe Useof Foreign
Languages
for theSales of OTC
Japanese
Journal of into
Community
Pharmacy
Vol.7,
No.2, 36-45(2019)

not ask questions that could be used to identify

in drugstore settings.
 Lastly, participants were given 20-30

individual respondents. Moreover, at the beginning

minutes to complete an English quiz of 10

of the questionnaire, we explained that the results ofcomprehension questions based on thethe survey would be published in an academic

seminar.

journal, individuals would not be identified, andsubjects could respond only after giving consent.

The instructor used both English and Japanese

The questionnaire style allowed for thethroughout the seminar and made the seminar

participants to circle their response or write a freeinteractive

method,response (Fig. 2). The first question was, “Howparticipants would try to repeat what the instructor

often have you used a foreign language when

said to help the participants improve both theirspeaking with a customer?” (Question A) Next welistening comprehension and pronunciation skills.

asked them to evaluate the content of the seminar

An example of a dialog presented can be found in(Question B), in particular we asked them theFig. 1.

following five questions: Was the content of the

by

using

a

shadowing

seminar difficult or not? Was the content of theseminar enough or too little? Did the purpose of the

2. 3. Overview of the questionnaire content
We first asked the participants to provide someseminar meet your needs? Do you think the content

personal information, i.e. work history, sex, age. To

presented will be useful to you soon? In general,

protect the participants’ private information, we did

how satisfied were you with the seminar? Questions

Fig. 1

Example Dialog Presented in the Seminar
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Journal of Community
Pharmacy
Vol.7,
No.2, 36-45
Skier et Japaneseal.；An Investigation
into the Safe Useof Foreign
Languages
for the(2019)
Sales of OTC

Fig. 2-1

Questionnaire

39
39

Skier et al.；An
Investigation
the Safe Useof Foreign
Languages
for theSales of OTC
Japanese
Journal of into
Community
Pharmacy
Vol.7,
No.2, 36-45(2019)

Fig. 2-2

Questionnaire
40
40Journal of Community
Pharmacy
Vol.7,
No.2, 36-45
Skier et Japaneseal.；An Investigation
into the Safe Useof Foreign
Languages
for the(2019)
Sales of OTC

C, D, E, and F were, “What tools have you preparedpeople (4.6%) responded "every day," 50 people

for communicating with non-Japanese customers?”(8.6%) responded "several times per week," 72“What tool(s) were useful?” “What issues did you

people (12.3%) responded "several times per

encounter with the tools you used?” “In the future,month," 142 people (24.4%) responded "several

what tools would you like to use to help

times per year," 83 people (14.2%) responded

communicate in a foreign language?” We finished"several times during my career," 202 people

the questionnaire with, “Write freely about using a(34.6%) responded "never," and 7 people (1.2%) did

foreign language to communicate with non-not respond. Thus, it was found that 291 people

Japanese customers.”(49.9%) had experience in using a foreign language
when selling an OTC drug. The participants who
replied "several times during my career," in “Had3. Results

experience in responding to foreign language
inquiries when selling an OTC drug.” were not

3. 1. Background of the participants
Of the 672 questionnaires that were distributed,

included as we considered the possibility that some

607 surveys were returned (response rate: 90.3%),of the participants had careers of over a decade

however not all of the questionnaires were returned

while others had been working for only a few years.

with responses or some were returned but without
3. 3. Evaluation of the seminar content

the sufficient profile information of the respondent.
As such, there were 583 valid responses (valid

Next, we asked the participants to evaluate theresponse rate: 96.0%). The work history of theseminar content. For the sake of comparing eachsurveyasurvey result, we are providing averages. Answers

registered

to the first question, “Was the content of the seminarsalesclerk) was an average of 10.9 years. The

difficult or not?” on a scale of 1-4 had an average

participants were mostly female 417 (71.5%) withscore of 1.79. With one being “difficult” and four

the remaining 156 male (26.8%) and 10 no answers

being “easy” (Fig. 3). As for the amount of material(1.7%). The breakdown of the participants by age

presented, there was an average score of 2.77 on a

was as follows: in their 20s, 11 people (1.9%); 30s,

scale of 1-4 with one being “too little” and four

104 people (17.8%); 40s, 164 people (28.1%); 50s,

being “too much”. Responses to “Did the purpose

171 people (29.3%); 60s, 89 people (15.3%); 70s,of the seminar meet your needs?” had an average of

23 people (3.9%); 80s, 5 people (0.9%); and no3.18 on a scale of 1-4 with one being “not at all” andresponse, 16 people (2.7%).

four being “yes”. In regards to the usefulness of theparticipants

pharmaceutical(totalproduct

experience

sellerorasEnglish presented in the seminar, there was an
3. 2. Frequency of using a foreign language when

average score of 3.12 on a scale of 1-4 with one

selling OTC drugs

being “not at all” and four being “I agree”. As for

In response to Question A, “How often

satisfaction with the seminar, the average was also

have you used a foreign language when speaking

3.12 on a scale of 1-4 with one being “not at all” andwith a customer?” we received 583 responses: 27

four being “satisfied”.
41
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Skier et al.；An
Investigation
the Safe Useof Foreign
Languages
for theSales of OTC
Japanese
Journal of into
Community
Pharmacy
Vol.7,
No.2, 36-45(2019)

Fig. 3. Results on the Difficulty, Amount, Applicability, Usefulness,and Satisfaction with the Seminar Content
Table

Breakdown of Communication Tools Used in Drugstores,
Their Usefulness, and Future Plans

Questions
In your pharmacy, what tools do you presently have to help you communicate in a foreign language?
In regards to Question C, what tools do you think are useful? More than one answer is acceptable.
In regards to Question C, what tools do you think were not useful? More than one answer is acceptable.
In the future, what tools would you like to use to help communicate in foreign languages?
Breakdown of Responses
ChoicesCDE
1 None.
51.6
2 We have had seminars on how to use foreign languages with customers.
2.2
4.9
9.5
3 We have signs in the drugstore in foreign langauges.
2.4
8.9
9.5
4 Medicines are described in foreign languages.
2.2
9.8
9.5
5 We have directions on how to take meds in foreign languages.
7.5
21.1
11.9
6 We have smartphones and tablets to help communicate in foregin language
15.3
48.8
14.3
7 We have patient surveys in foreign languages.
13.2
39.8
14.3
8 We have drug explanations in foreign languages.
10.8
30.9
35.7
9 We have a translation machine.
8.6
22.0
26.2
10 Other.
2.7
3.3
2.4
11 Not applicable.
11.5
Number of Responses
747
233
56
Number of Respondents
583
123
42

C
D
E
F

3. 4. Communication tools used in drugstores

F
17.5
20.6
19.4
19.4
19.6
28.1
13.7
16.5
18.9
0.7
16.0
1109
583

Having said that, the top three responses for toolsforprepared were: smartphone/tablet, 89 (15.3%),

communicating with non-Japanese customers?” Of

patient questionnaire in a foreign language, 77

the 583 responses, 301 (51.6%) replied that they had(13.2%), and drug explanation sheets in a foreign

no tools prepared to help with communication.

language, 63 (10.8%) (Table).

“What

tools

have

you

prepared42
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Journal of Community
Pharmacy
Vol.7,
No.2, 36-45
Skier et Japaneseal.；An Investigation
into the Safe Useof Foreign
Languages
for the(2019)
Sales of OTC

We next asked about which tools they used and“May I help you?” Many commented that they

thought were useful (more than one answer waslearned the need to avoid using impolite English. To

allowed) and the same top three as above were

do so, this included learning to use “please, thankmentioned: smartphone/tablet, 60 (10.3%), patientyou,questionnaire in a foreign language, 49 (8.4%), andcommunicating in English. Another aspect of the

drug explanation sheets in a foreign language, 38

seminar content mentioned was the focus on(6.5%) (Table).

naturally spoken English where “Nice to meet you”

andexcuse

me”

more

often

when

On the other hand, when asked what was notis actually pronounced “Nicetameetcha” by many

useful as a tool for communication (more than one

native speakers. Another comment frequently

answer was allowed), the number one answer was

shared was about using the pain chart presented in

drug explanation sheets in a foreign language, 15

the seminar materials to ask customers about their(2.6%). The next most common answer was

pain. In this pain chart, English is not actuallytranslation machine with 11 answers (1.9%) andrequired to communicate, but customers can point

there was a tie between smartphone/tablet andto a variety of faces with differing expressions topatient questionnaire in a foreign language with six

show how bad their own pain is or is not.
On the other hand, not all comments werementions each (1.0%) (Table).
The last question was about tools, “In the future,

positive. Participants shared many issues they had

what tools would you like to use to help

with the seminar. The main one being the level ofcommunicate in a foreign language?” The mostthe English presented. Even though the dialogs also

common response was smartphone/tablet, 164

had Japanese translations and the instructor used(28.1%), followed by seminars, 120 (20.6%), andJapanese to explain the English content, there weredirections on how to take a medicine in foreign

still times when participants were unable tolanguages, 114 (19.6%) Directions on how to takeunderstand what was being shared. Comments

medicine in foreign languages was closely followed

included: “I am very poor at English and could notby signs in foreign languages in the drugstore andunderstand anything.” “I wish there had been more

medicines described in foreign languages with 113

katakana to help with the pronunciation.” “Just one

responses (19.4%) each (Table).

seminar won’t be enough to help me improve myEnglish. I want to study more.” “There was toomuch content. There should be less content in the

3.5. Comments about the seminar

future.” “The speed of the presentation was too fast.”

We finished the survey with two questions:“What did you learn today that would help you

4. Discussion

immediately?” and “Please comment on why youwere or were not content with today’s seminar.”
The first question had many replies that

Over the three days of seminars, there wereparticipants were looking forward to using theclose to 700 participants and we received feedback

polite English that had been presented to them. This

from 607 of them. Of the 607 respondents, there wasincluded greetings, such as “Good morning.” andlittle difference in terms of gender, age, and43
43

Skier et al.；An
Investigation
the Safe Useof Foreign
Languages
for theSales of OTC
Japanese
Journal of into
Community
Pharmacy
Vol.7,
No.2, 36-45(2019)

experience using a foreign language with customers

about communicating in English with non-Japanesefrom abroad as found in a previous study in similarcustomers when selling OTC medicines.

settings by Ujiie, et al.2 In the study by Ujiie, many

We

also

asked

about

what

tools

for

of the registered salesclerks expressed a desire tocommunication with customers from abroad thestudy English in a seminar and thus we held thisregistered salesclerks were using and we received

series of them. Comments from the participants of

mixed results. First, 51.6% of the salesclerks replied

our study included ones such as: I enjoyed myself, I

on the survey that they were not using any tools forlearned a lot, and I will be able to use some of thecommunication in their work environment. On the

English presented in the seminar upon my return toother hand, the registered salesclerks who used tools

work.

for communication used three main types of them:

Having said this, not all of the feedback on ourtranslation machines, tablets/smartphones, and drug

survey was positive. We also learned that the

explanations on paper. Smartphones were the mostEnglish knowledge of the registered salesclerks wascommonly used tool for communication and were

not as high as we expected and many of thementioned to be the most useful of the tools forparticipants commented that they could not follow

communication shared.

the English presented – even with Japanese

One of the most common comments was thattranslations to help them. Participants also shared

not all of the customers from other countries arethat the content of the seminar was too much and theable to understand English. Many participants

speed too fast. With a focus on shadowing of theexpressed a need for communication tools fornatural English pronunciation presented, it was

languages other than English. Furthermore, asapparent to the instructor that many of the

English used for describing medicines can beparticipants had little experience speaking English

technical at times, there are limits to their use andand various comments on the survey support this. In

they may not be useful when helping with the salefact, this seminar included a quiz of 10

of OTC medicines. Respondents also shared theircomprehension questions (in English) and evenworries about the translations from the machines orwith 20 minutes to answer them, many participants

smartphones they were using as they lacked thecommented that there was not enough time and that

English ability to confirm whether the English

they could not answer the questions because they

produced was correct or not leading to fears about

had been written entirely in English. As such, in thethe safe usage of the medicines sold. As such, thesecond and third seminars that were held, theregistered salesclerks mentioned that the least

comprehension questions were translated orally by

useful tools for communication with customers

the instructor into Japanese and the participants

were drug explanation sheets in English andwere given 30 minutes instead of 20 to answer them.

translation machines.

Even with the negative comments, many of the

In conclusion, we found that registeredrespondents included positive feedback that whilesalesclerks were interested in improving their

the content was too difficult, they still enjoyed

English skills in a seminar setting as more and morethemselves and learned some important things

foreigners are visiting and deciding to live in Japan
44
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Journal of Community
Pharmacy
Vol.7,
No.2, 36-45
Skier et Japaneseal.；An Investigation
into the Safe Useof Foreign
Languages
for the(2019)
Sales of OTC

and going to drugstores for OTC medicines, etc….
References

While there are some tools available to help
communicate with customers, the registeredsalesclerks in our study accepted a need to improve1） Japan National Tourism Organization (JNTO):

their own English communications skills for fear

Numberthator

https://asset.japan.travel/image/upload/v1563

translations on paper are not helping meet the needs

437857/pdf/Number_of_visitor_arrivals_to_Jof customers in a safe manner. As such, we feelapan_up_6.5__YoY_to_2.88_million_in_June

there is a need to continue to hold English_2019.pdf (as of July 17, 2019)

smartphones,

translation

machines,ofvisitorarrivalstoJapan,

communication seminars to further help improve2） Ujiie N., Narui K., Watanabe K., and Watanabe

the skills of registered salesclerks in Japan. Lastly,K., Status of Responses to Foreign Language

we look forward to seeing whether the English

Inquiries When Selling OTC Drug, Jpn. J. ofpresented in these seminars was actually useful or

Drug Information, 2018; 20(2): 129-135.

not and this will be the theme of our next
investigation.
Conflict of Interest: There are no conflicts ofinterest.

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