Japanese
JournalVol.9,
No.1,
1-12(2021)
Japanese
JournalofofCommunity
Community Pharmacy
Pharmacy Vol.9,
No.1,
1-12
(2021)《 Original Article 》

A Follow-up Survey of Registered Salesclerks after Seminars
on Using English with Non-Japanese Customers in OTC Environments
Eric M. Skier1*, Akiko Tomizawa2, Katsuei Watanabe3, Koji Narui2
Based on the findings of a report on registered salesclerks in Tokyo in 2018, training seminars
were planned and held in July 2019 to help improve the ability of registered salesclerks tocommunicate with non-Japanese customers in English when selling OTC medicines. After theseminars, the participants were surveyed about what they learned and their use of foreign
languages when counseling non-Japanese customers on the buying and use of OTC medicines.
Three months after these English seminars, a follow-up survey was conducted and theparticipants were almost the same as the those who took the English seminars (86.5%). Our
objective was fourfold. Did the participants find the English seminars meaningful? What
influence did the English seminars have on the participants in terms of their language studies
and/or usage, and if so, how? We also wanted to learn if there were any changes made in work
environments to better communicate with non-Japanese customers. And lastly, did theparticipants want to continue to study English in a seminar format?
Key findings of the follow-up survey showed that 80% of the participants found the English
seminars meaningful to one extent or another. Second, there was a positive effect in terms of
motivating a majority of the registered salesclerks to think about their English skills tocommunicate with non-Japanese customers. Furthermore, there were also actual changes madeby some of the participants in their workplaces. Finally, many participants (71.9%) responded
that they wanted to participate in more English seminars to help them sell OTC medicines to
non-Japanese customers.
Key words; registered salesclerks, foreign languages, OTC drugs, English education
Received November 13, 2020; Accepted February 17, 2021
English 2 Laboratory, School of Pharmacy, Nihon University
Department of Self-Medication and OTC, School of Pharmacy,
Tokyo University of Pharmacy and Life Sciences
3
Tokyo Metropolitan Druggist Association*Corresponding author: Eric M. Skier, English 2 Laboratory, School of Pharmacy, Nihon University,
7-7-1, Narashinodai, Funabashi-shi, Chiba, 274-8555 Japan.
Phone : 047-465-7976 E-mail : eric.m.skier@nihon-u.ac.jp
1
2

1
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Skieretetal.；Follow-upal.；Follow-upSurvey
Surveyonon Using
Using English with
E. E.
M.M.
Skier
withNon-Japanese
Non-JapaneseCustomers
Customers

tools to help communicate with non-Japanese
1．
． Introduction

customers or if the registered salesclerks had been
motivated to study English. Lastly, we asked themwhether they wanted to participate in future English

In recent years, the number of non-Japaneseseminars to further improve their skills.

visitors to Japan has increased steadily. Government
figures on visitors to Japan show that in the first six

In the end, the purpose of this study, as well asmonths of 2019, over 16.6 million people had

the previous one, is to investigate the ability ofvisited Japan for an increase of 4.6% from the sameregistered salesclerks to provide information in aperiod in 2018 1).

foreign language so non-Japanese customers canuse OTC medicines properly and safely.

In 2018, a survey of registered salesclerks inTokyo by Ujiie, et al. showed that a majority of them2.

(51.9%), had experience responding to non-

Methods

Japanese customers in a foreign language and a vast
majority of the clerks, 86.4%, were trying to use
English 2).

1. Seminars and Survey

Further results of the same survey also

Three months after the English seminars, inshowed that only 67.7% of the clerks were

October of 2019, the Tokyo Metropolitan Druggist

somewhat able to follow what customers were

Association held a series of seminars unrelated tosaying in English but were often unable to express

the English ones. These seminars presented us thethemselves well, i.e. speak English.

opportunity to conduct a follow-up survey of theBased on those results, a series of three seminars

registered salesclerks. All of the participants had thewere then planned by the Tokyo Metropolitan

freedom to participate by filling out the survey or

Druggist Association and held in July of 2019 to

not and this was explained to them prior to thehelp the registered salesclerks to improve their

beginning of the seminars. The present study was

English skills – the language that was most often

approved by the Institutional Review Board forbeing used by the previously surveyed druggists. At

Utilization of Human Tissue, Etc. for Research of

the end of each seminar, the participants were asked

Tokyo University of Pharmacy and Life Sciences

to fill out a questionnaire and the results were(2019-019).

3)

published in a report by Skier, et al .
2. Overview of the questionnaire content

Therefore, in this study, three months after the
English seminars, we conducted this follow-up

We first asked the participants to provide somesurvey to investigate what effect, if any, thepersonal information, i.e. work history, sex, and age.

seminars had on the registered salesclerks. In

To protect the participants’ private information, we

particular, we wanted to see whether our English

did not ask questions that could be used to identify

seminars had been meaningful or not. Next, we

individual respondents. We explained that thewanted to see if their thoughts on communicating inresults of the survey would be published in an

English had changed. Thirdly, we wanted to learn if

academic journal, individuals would not be

there had been actions taken, i.e. implementation ofidentified, and the subjects could respond only after22Japanese
JournalVol.9,
No.1,
1-12(2021)
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JournalofofCommunity
Community Pharmacy
Pharmacy Vol.9,
No.1,
1-12
(2021)

giving consent.
3.

The follow-up questionnaire style allowed for the

Results

participants to circle their response or write a free
1. Background of the participants

response. Question C is novel to this report, “Do
you think it is necessary to use a foreign language

In the follow-up survey, 689 questionnaires werewhen selling OTC drugs?” but Question D is the

distributed. We collected 668 responses with two ofsame as Question A of our previous report 3) (Fig.

them being returned blank for a total of 666 valid1). Questions E and F were directly related to the

responses for a response rate of 96.7%. When asked

previous English seminars of July 2019. They were,

if they had participated in the English seminars in“Do you think the previous series of English

July 2019, 576 (86.5%) replied, “yes.” The work

seminars had meaning?” And “After the English

history of the participants (total experience as aseminars, on a personal level or at work, was there

pharmaceuticalan increase in your thoughts about how tosalesclerk) was an average of 11.9 years. The

communicate in English?” Questions G-J thenparticipants were mostly female 422 (73.3%) withasked about what changes were made, if any, at thethe remaining 148 male (25.7%) and six no answers

participants’was,(1.0%). The breakdown of the participants by age“Presently, what skills development seminars or

was as follows: in their 20s, 9 people (1.6%); 30s,

tools is your drugstore or pharmacy offering to help

92 people (16.0%); 40s, 158 people (27.4%); 50s,

you learn how to communicate with non-Japanese

170 people (29.5%); 60s, 96 people (16.7%); 70s,

patients?” Question H was, “After the English

35 people (6.1%); 80s, 2 people (0.3%); and noseminars,

response, 14 people (2.4%). These results were

workplaces.

have

you

Question

introducedGanyskillsproduct

sellerorregisteredsimilar to those of our first survey3).

development seminars or tools?” Question I was,
“In the future, what preparations or tools are you
planning to introduce?” And Question J was, “In the

2. Necessity of using a foreign language when

future, do you want your drugstore or pharmacy toselling OTC drugs

hold a seminar on OTC medicine sales in foreign

In response to Question C, “Do you think it islanguages?” There was one last question (K) thatnecessary to use a foreign language when selling

was partially related to the previous seminars and it

OTC drugs?” we received 576 responses: 15

was, “In the future, what kind of content do you

participants (2.6%) responded "It is not necessary."

want in your OTC medicine sales seminars?” As in

Thirty-six (6.3%) responded "It is a little

the first questionnaire, we also allowed for theunnecessary." After that, the rest of the respondents

participants to write freely on two occasions. The

replied that it was necessary to some degree orfirst was in response to Question E and the second

another with 253 responses (43.9%) saying, “It is a

was at the end of the survey where we allowed thelittle necessary.” And 264 responses (45.8%) saying,participants to, “Write freely about using a foreign“It is necessary.” Only eight participants (1.4%) had

language to communicate with non-Japanese

no answer.

customers.”33Skieretetal.；Follow-upal.；Follow-upSurvey
Surveyonon Using
Using English with
E. E.
M.M.
Skier
withNon-Japanese
Non-JapaneseCustomers
Customers

Fig. 1

Follow-up Survey of Registered Salesclerks (1/3)

44Japanese
JournalVol.9,
No.1,
1-12(2021)
Japanese
JournalofofCommunity
Community Pharmacy
Pharmacy Vol.9,
No.1,
1-12
(2021)

Fig. 1

Follow-up Survey of Registered Salesclerks (2/3)

55

Skieretetal.；Follow-upal.；Follow-upSurvey
Surveyonon Using
Using English with
E. E.
M.M.
Skier
withNon-Japanese
Non-JapaneseCustomers
Customers

Fig. 1

Follow-up Survey of Registered Salesclerks (3/3)

3. Frequency of using a foreign language when

After that, the frequency of foreign language use

selling OTC drugs

declined to “A few times a month” with 81

Our next question, D, was, “Do you have

responses (14.1%) to “A few times a year.” with 146

experience using a foreign language when selling

responses (25.3%) to 100 responses (17.4%) with

OTC drugs?” Here, too, we received 576 responses.

“In my work experience, only a few times.” And theThirty-eight participants (6.6%) responded "Everylargest group had 163 responses (28.3%) withday." 42 (7.3%) responded "A few times a week."“Never”.
66

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(2021)

Fig. 2 Results of Question E: Do You Think the Previous Series of English Seminars Had Meaning?

who come to our drugstore/pharmacy.” and “The4. Reflections on the English seminars
Three months after the English seminars, we

content of the English seminars was too difficult.”

wanted to know what the participants thought about

In regards to the 77 replies “There was not muchthem in retrospect and asked Question E, “Do you

meaning.” many were comments the same as those

think the previous series of English seminars had

above, i.e. they have no non-Japanese customers or

meaning?” The results were positive with 80% of

the content was too difficult.

the participants saying they were meaningful ofComments to the more positive replies “There

somewhat meaningful. The exact numbers were 242

was some meaning.” and “There was meaning.”

participants (42.0%) saying, “There was meaning.”

centered on two themes, too. Many participants

And another 219 (38.0%) saying, “There was some

replied that they met non-Japanese customers on ameaning.” The remaining responded either, “Thereregular basis and that the English that was presented

was not much meaning.” with 77 replies (13.4%)

to them helped them learn many things. The

and 20 participants (3.5%) saying, “There was no

feedback in regards to “There was meaning.” alsomeaning.” There were 18 no answers (3.1%). (Fig.

mentions non-Japanese customers coming to their2)drugstore or pharmacy and that the English
As stated previously, participants were alsopresentation and the communication strategies

allowed to write freely about their responses to(using polite English and tools for communication

Question E. The comments for the 20 participants

such a patient survey in English) were very useful.

who responded, “There was no meaning.” could be

When asked Question F, “After the English

divided into two groups: “There are no foreigners

seminars, on a personal level or at work, was there
7
7

Skieretetal.；Follow-upal.；Follow-upSurvey
Surveyonon Using
Using English with
E. E.
M.M.
Skier
withNon-Japanese
Non-JapaneseCustomers
Customers

Fig. 3Results of Question F: After the English seminars, on a Personal Levelor at Work,

Was There an Increase in Your Thoughts about How toCommunicate in English?

an increase in your thoughts about how toseminars had in fact motivated any change. We

communicate in English?” the answers could bestarted with Question G, “Presently, what skills

divided into four groups with a majority of thedevelopment seminars or tools is your drugstore or

participants (54%) saying that they had thought

pharmacy offering to help you learn how tomore about how to use English to communicate.

communicate

Two hundred and seven participants (35.9%)

Multiple answers were allowed and so the

responded, “On a personal level there was an

breakdown is based on the following: from the 576

increase but not at work.” Another 104 (18.1%)

responses we received 829 answers and we thenreplied, “There was an increase.” The remaining

calculated our percentage of responses based on the

responses

increase.”

total answers received minus the 278 participants

mentioned by 247 participants (42.9%) and another(48.3%) who replied, “None.” As there were 25 “No

18 (3.1%) responded, “No answer.” (Fig. 3)

answers,” we also deducted these for a total of 525

were,“There

was

no

with

non-Japanesepatients?”

answers from 273 responses about tools in theworkplace.

5. Communication tools used in drugstores andThepharmacies

mostcommonly

used

tool

for

Next, we asked about tools for helping

communication with non-Japanese customers was,communicate in foreign languages with non-“We have smartphones or tablets to help

Japanese customers, but this time we asked in thecommunicate in foreign languages.” with 123

present tense. We did this to see if the English

replies (45.1%). This was followed by “We have
88

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1-12(2021)
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JournalofofCommunity
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Pharmacy Vol.9,
No.1,
1-12
(2021)

patient surveys in foreign languages.” with 96

responded “No answer” with 517 (89.8%) replies.

replies (35.2%), “We have drug explanations in

As we had 623 answers from the 576 total responses,

foreign languages.” with 73 replies (26.7%), andwe subtracted the 517 from the number of responses“We have cards with various languages forand answers in addition to the seven participants

customers to point at to confirm the purpose of their(1.2%) that replied “None” in response to thisvisit, their symptoms, etc and to counsel them onquestion. This left us with a total of 99 answers fromtaking medicines.” with 69 replies (25.3%). There

52 responses. As in the responses to Question G, thewas one other response, “We have a translation

most common one was, “We have smartphones ordevice.” with over 20% and that had a response

tablets to help communicate in foreign languages.”

total of 59 (21.6%). The remaining replies werewith 24 (46.2%). The next most common responses

under 20% and they consisted of: “On the shelves,

were more or less the same with between 11-13

we have signs in foreign languages on drug efficacy

responses. “We have cards with various languages

and products for sale.” with 43 replies (15.8%), “Onfor customers to point at to confirm the purpose of

the products, we have pictures or symbols in foreign

their visit, their symptoms, etc and to counsel themlanguages on drug efficacy.” with 34 replies

on taking medicines.” had 13 responses (25%). This

(12.5%), and “Others” with 18 replies (6.6%). The

was followed by the responses “On the shelves, weleast common response was “We have English

have signs in foreign languages on drug efficacy

seminars or classes to learn how to simply

and products for sale.” and “We have patientcommunicate in a foreign language.” with 11

surveys in foreign languages.” both with 12

responses (4.0%).

responses (23.1%), respectively.

The next two

also had the same number of responses at 11
6. Implementations after the English seminars and(21.2%): “On the products, we have pictures or

future plans (if any)

symbols in foreign languages on drug efficacy.” andAfter having participated in the English seminars,“We have a translation device.” Eight responses

we wanted to know whether the participants had(15.4%) were “We have English seminars or classes

been

their

to learn how to simply communicate in a foreigncommunication skills in foreign languages. In orderlanguage.” This was followed by six responses

to learn so, we asked two questions in particular.

(11.5%) of “We have drug explanations in foreign

Question H was written to see whether there had

languages.” The final two responses (3.8%) werebeen workplace changes made over the previous“Other.”motivatedtofurther

improvethree months, while Question I was about hitherto

In Question I we asked the participants, “In the

future plans. As in Question G, multiple answers

future, what preparations or tools are you planningwere allowed and we calculated for this in the same

to introduce? We received 622 answers from 576

manner as above.

responses. As mentioned above, we subtracted theQuestion H was, “After the English seminars,“No answers” which had a total of 503 (87.3%)

have you introduced any skills developmentfrom the number of responses and answers,

seminars or tools?” The vast majority of participants

respectively. There were also four answers, “None.”9
9

Skieretetal.；Follow-upal.；Follow-upSurvey
Surveyonon Using
Using English with
E. E.
M.M.
Skier
withNon-Japanese
Non-JapaneseCustomers
Customers

Fig. 4 Results of Question J: In the Future, Do You Want Your Drugstore or Pharmacy
to Hold a Seminar on OTC Medicine Sales in Foreign Languages?

7. Future plans for seminar content

and these were also subtracted. This left us with a
total of 115 answers from 69 responses. The mostThe last two questions of our survey (related tocommon response was, “We have smartphones orthis study) were J and K, “In the future, do you want

tablets to help communicate in foreign languages.”

your drugstore or pharmacy to hold a seminar onwith 25 (36.2%) followed by “We have a translation

OTC medicine sales in foreign languages?” and “In

device.” with 18 (26.1%). The next four responses

the future, what kind of content do you want in yourwere between 14 and 16 in number. “On the

OTC medicine sales seminars?”, respectively.
For Question J, we received 576 responses for a

products, we have pictures or symbols in foreign
languages on drug efficacy.” had 16 responses

100% response rate.

A large majority of the(23.2%) followed by “We have patient surveys in

responses (71.9%) were positive and fell into two

foreign languages.” with 15 (21.7%). Both “Wecategories: 235 (40.8%) who replied, “I kind of

have cards with various languages for customers tothink so.” and 179 (31.1%) who answered, “I think

point at to confirm the purpose of their visit, theirso.” Fifty-five (9.5%) of the participants replied,

symptoms, etc and to counsel them on taking“No answer.” And 49 (8.5%) replied, “No.” Lastly

medicines.” and “We have drug explanations inwas “I kind of don’t think so.” which received 58

foreign languages.” had 14 responses (20.3%),

responses (10.1%). (Fig. 4)

respectively. “On the shelves, we have signs in

For Question K, we received 414 responses

foreign languages on drug efficacy and products for(71.9%) and of these 314 (75.8%) responded, “Thesale.” had eight responses (11.6%) and thesame as was held before (English).” Eighty-two

remaining five responses (7.2%) were, “We have

(19.8%) responded, “Any kind of seminar (like one

English seminars or classes to learn how to simply

on Chinese herbal medicines)” with the remaining

communicate in a foreign language.”18 (4.3%) saying, “No answer.”
1010Japanese
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responded they had never done so3). So, it seems

8. Comments in general
The last part of the survey allowed for thethat over 5% of the participants, after the English

participants to write freely about their experience.

seminars, attempted to use English at work for the

Many comments shared that English was not thefirst time.

only foreign language they needed to study to meet

The responses to Question E showed that 80% of

the needs of their customers as some customers

the participants had positive feelings about thefrom Asia were unable to understand either

usefulness of the English seminars three months

Japanese or English. Languages mentioned were:later. When planning the July 2019 English

Chinese, Thai, and Korean. Other feedback specificseminars with the Tokyo Metropolitan Druggist

to the English seminars was that participants hoped

Association, we purposely made the seminars

the seminars would be held again or on a yearlybilingual (English and Japanese) and focused on thebasis and that the seminars were fun and interesting.

sales of OTC medications and tools (patient surveys

Other comments mentioned that the materials fromin English, charts with body parts, flowcharts with

the English seminars were very useful. And lastly,

yes/no questions, etc…) that would help thethere were even a few comments that mentioned theregistered salesclerks in their workplaces. The

seminars were a little too easy and that the content

feedback in the comments section showed that theshould be a little more difficult to better meet theparticipants appreciated these aspects of theneeds of the non-Japanese customers.

seminars though there were some who mentionedthat the English was too high-level or the Japanese

4.

Discussionof the instructor was not easy to understand. Twopoints that we will keep in mind in planning any

Thisfollow-up

surveyofthefuture English seminars.

registeredsalesclerks three months after the English seminars

The feedback to Question F also showed that aallowed us to see what if any effect our English

majority of the participants (54%) had thought more,seminars had on them personally or in terms of their

to one extent or another, about their use of English

work. As our results show, we had access to more oreither in the workplace or in their everyday lives.

less the same participants and that they cooperated

We feel this is a positive effect from the English

by answering this second survey.

seminars. A minority of the participants (42.9%)

Some of the notable results were the responses to

had no increase in their thoughts of using English

Question C with almost 90% of the registeredafter the seminars and this is something we will

salesclerks saying that there is some need or a needkeep in mind in planning future English seminars.

to use foreign languages when selling OTC drugs.

In regards to the implementation or use of tools

Yet many of the participants (28.3%) responded toto communicate with non-Japanese customers,

Question D of this report that they had never used a

Question G, there was still a large minority (48.3%)

foreign language when selling them. However, this

who replied that their workplaces had done nothing.

was a decline from the results of the same question

As we did not further investigate as to why this wasin our previous report, Question A, where 34.6%

the case, it is hard to tell, but reasons could be that
11
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Skieretetal.；Follow-upal.；Follow-upSurvey
Surveyonon Using
Using English with
E. E.
M.M.
Skier
withNon-Japanese
Non-JapaneseCustomers
Customers

the drugstore or pharmacy rarely has non-Japanesemeaningful. Second, they were motivated to thinkcustomers or that the registered salesclerk, not being

more about their English communication skills bothan owner of the place he or she works at, is unable

personally and/or at work. Next, there were actual

to implement new policies. In contrast, thechanges made by some of the participants andremaining 50% of the responses showed there was

efforts to use English. And lastly, the participantsa high reliance on smartphones or tablets (45.1%).

look forward to studying more English and this

These technologies were mentioned in our previous

means there is a need for more English seminars in3)

report and were thus expected. Furthermore, being

the future. As such, we look forward to using thesesmall and portable, it makes sense for smartphones

findings to continue and improve our future English

and tablets to be used with non-Japanese customers.

seminars.

We also feel it is a positive sign that other responses
Conflict of Interest

showed foreign languages being used on patient
surveys, on signs on shelves, and with cards forpatients to point to to help communicate with the

There are no conflicts of interest.

registered salesclerk.
References

But not everything was positive. Responses to
Question H showed that almost 90% of theparticipants had not implemented any skills

1） Japan National Tourism Organization (JNTO):

development seminars or tools in the three months

Numberafter the English seminars had been held. And thishttps://asset.japan.travel/image/upload/v1563

applied equally to the responses to Question I about

437857/pdf/Number_of_visitor_arrivals_to_J

future plans with 87.3% of the participants saying

apan_up_6.5__YoY_to_2.88_million_in_June

they had none. On the other hand, the positive_2019.pdf (as of July 17, 2019)

ofvisitorarrivalstoJapan,

feedback highlighted the desire to use technology,2） Status of Responses to Foreign Language

e.g. smartphones, tablets, or translation devices toInquiries When Selling OTC Drug, Ujiie N.,

help communicate with non-Japanese customers.

Narui K., Watanabe K., and Watanabe K, Jpn.

Lastly, the responses to Questions J and K and theJ. Drug Information, 2018; 20(2): 129-135.

comments written in the general feedback showed

3） An Investigation into the Safe Use of Foreignthat many of the registered salesclerks look forward

Languages for the Sales of OTC Medicines by

to more English seminars in the future—a result we

Registered Salesclerks: Survey Results ofwill keep in mind when planning future seminars for

Registered Salesclerks after Seminars on

registered salesclerks.

Using English with Non-Japanese Customers

In conclusion, the results of this follow-up study

in OTC Environments, Skier, E., Tomizawa A.,

show that the English seminars held in July 2019

Watanabe K., and Narui, K, Jpn J. of

had various positive influences on the participants.

Community Pharmacy, 2019; 7(2): 36-45.

First, they found our English seminars had been

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