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HCP: Hi there! My name is Emily and I am the nurse working with Dr. Chorney today. I am going to go over some of the post op education for ear tubes before you speak to the scheduler. Parent: Ok HCP: Has your child had ear tubes before? Parent: No, they have not. HCP: Ok! It is usually a pretty easily tolerated procedure. Most children notice more effects from the anesthesia than the ear tubes themselves, like nausea or tiredness for maybe 24 hours after surgery. You may notice drainage from either ear, which is normal and the reason for placing the ear tubes – to let the fluid out from behind the ear drum. Bloody drainage is also normal, although I know that can look concerning. We will give you ear drops to use twice a day for one week after surgery that will help dry up any drainage and clean up the ears. Please hold on to these drops. If your child has ear drainage in the future, you can use them in the same way (twice a day for a week); they do not need to be seen or take oral antibiotics. If you feel the drops are not working, please call us for further advice. The ear tubes should not be painful, but you’re welcome to give your child Tylenol or motrin for comfort if they seem fussy after surgery. Parent: Great! HCP: I know this was quite a bit of information. To make sure I did a good job explaining the care you will need to provide, can you please confirm how you will use the ear drops after surgery? Parent: Twice a day for a week. HCP: Yes! And how will you treat ear drainage moving forward? Parent: I will use those same drops, in the same way. HCP: Great! You will receive a printed copy of these instructions to reference, but please call us if any questions or concerns arise! Parent: Thank you!

1. Was the doctor welcoming? Why? Yes, the nurse (HCP) was welcoming. She introduced herself by name, explained her role, and proceeded to provide post-operative education in a friendly manner.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

1. Was the doctor welcoming? Why?

HCP: Hi there! My name is Emily and I am the nurse working with Dr. Chorney today. I am going to go over some of the post op education for ear tubes before you speak to the scheduler. Parent: Ok HCP: Has your child had ear tubes before? Parent: No, they have not. HCP: Ok! It is usually a pretty easily tolerated procedure. Most children notice more effects from the anesthesia than the ear tubes themselves, like nausea or tiredness for maybe 24 hours after surgery. You may notice drainage from either ear, which is normal and the reason for placing the ear tubes – to let the fluid out from behind the ear drum. Bloody drainage is also normal, although I know that can look concerning. We will give you ear drops to use twice a day for one week after surgery that will help dry up any drainage and clean up the ears. Please hold on to these drops. If your child has ear drainage in the future, you can use them in the same way (twice a day for a week); they do not need to be seen or take oral antibiotics. If you feel the drops are not working, please call us for further advice. The ear tubes should not be painful, but you’re welcome to give your child Tylenol or motrin for comfort if they seem fussy after surgery. Parent: Great! HCP: I know this was quite a bit of information. To make sure I did a good job explaining the care you will need to provide, can you please confirm how you will use the ear drops after surgery? Parent: Twice a day for a week. HCP: Yes! And how will you treat ear drainage moving forward? Parent: I will use those same drops, in the same way. HCP: Great! You will receive a printed copy of these instructions to reference, but please call us if any questions or concerns arise! Parent: Thank you!

2. Did the doctor use medical jargon that is hard to understand for the general audience? If so, what are they? And replace them with layman language. The nurse used some medical terms, but they were relatively simple and she explained them well. Terms like "anesthesia," "nausea," "drainage," "ear drum," and "oral antibiotics" are medical terms, but the context in which they were used made them understandable. However, here are simpler explanations: - Anesthesia: medicine to make your child sleep during surgery - Nausea: feeling sick to the stomach - Drainage: fluid coming out of the ear - Ear drum: the thin part inside the ear that vibrates when sound hits it - Oral antibiotics: medicine taken by mouth to fight infection

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

2. Did the doctor use medical jargon that is hard to understand for the general audience? If so, what are they? And replace them with layman language.

HCP: Hi there! My name is Emily and I am the nurse working with Dr. Chorney today. I am going to go over some of the post op education for ear tubes before you speak to the scheduler. Parent: Ok HCP: Has your child had ear tubes before? Parent: No, they have not. HCP: Ok! It is usually a pretty easily tolerated procedure. Most children notice more effects from the anesthesia than the ear tubes themselves, like nausea or tiredness for maybe 24 hours after surgery. You may notice drainage from either ear, which is normal and the reason for placing the ear tubes – to let the fluid out from behind the ear drum. Bloody drainage is also normal, although I know that can look concerning. We will give you ear drops to use twice a day for one week after surgery that will help dry up any drainage and clean up the ears. Please hold on to these drops. If your child has ear drainage in the future, you can use them in the same way (twice a day for a week); they do not need to be seen or take oral antibiotics. If you feel the drops are not working, please call us for further advice. The ear tubes should not be painful, but you’re welcome to give your child Tylenol or motrin for comfort if they seem fussy after surgery. Parent: Great! HCP: I know this was quite a bit of information. To make sure I did a good job explaining the care you will need to provide, can you please confirm how you will use the ear drops after surgery? Parent: Twice a day for a week. HCP: Yes! And how will you treat ear drainage moving forward? Parent: I will use those same drops, in the same way. HCP: Great! You will receive a printed copy of these instructions to reference, but please call us if any questions or concerns arise! Parent: Thank you!

3. Count the number of key points that the doctor made. Did the doctor have to re-teach some of the points? If only 3 points were to keep, which 3 points should be kept? The nurse made several key points: - The procedure is usually well tolerated. - Post-surgery effects are mostly from anesthesia. - Drainage from the ears is normal. - Bloody drainage can occur and is normal. - Ear drops will be provided for use after surgery. - Ear tubes should not be painful, but pain relief can be given if needed. - Use ear drops for future drainage without needing to see a doctor or take oral antibiotics. - Call for advice if drops don't seem to work. The nurse did not have to re-teach any points but confirmed understanding through teach-back questions. If only 3 points were to be kept, they should be: - How and when to use the ear drops after surgery. - Drainage is normal, and bloody drainage can occur. - Use ear drops for future drainage without needing to see a doctor or take oral antibiotics.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

3. Count the number of key points that the nurse made. Did the nurse have to re-teach some of the points? If only 3 points were to keep, which 3 points should be kept?

HCP: Hi there! My name is Emily and I am the nurse working with Dr. Chorney today. I am going to go over some of the post op education for ear tubes before you speak to the scheduler. Parent: Ok HCP: Has your child had ear tubes before? Parent: No, they have not. HCP: Ok! It is usually a pretty easily tolerated procedure. Most children notice more effects from the anesthesia than the ear tubes themselves, like nausea or tiredness for maybe 24 hours after surgery. You may notice drainage from either ear, which is normal and the reason for placing the ear tubes – to let the fluid out from behind the ear drum. Bloody drainage is also normal, although I know that can look concerning. We will give you ear drops to use twice a day for one week after surgery that will help dry up any drainage and clean up the ears. Please hold on to these drops. If your child has ear drainage in the future, you can use them in the same way (twice a day for a week); they do not need to be seen or take oral antibiotics. If you feel the drops are not working, please call us for further advice. The ear tubes should not be painful, but you’re welcome to give your child Tylenol or motrin for comfort if they seem fussy after surgery. Parent: Great! HCP: I know this was quite a bit of information. To make sure I did a good job explaining the care you will need to provide, can you please confirm how you will use the ear drops after surgery? Parent: Twice a day for a week. HCP: Yes! And how will you treat ear drainage moving forward? Parent: I will use those same drops, in the same way. HCP: Great! You will receive a printed copy of these instructions to reference, but please call us if any questions or concerns arise! Parent: Thank you!

4. Did the doctor ask teach-back questions? If so, list those questions. Yes, the nurse asked teach-back questions: - "Can you please confirm how you will use the ear drops after surgery?" - "And how will you treat ear drainage moving forward?"

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

4. Did the doctor ask teach-back questions? If so, list those questions.

HCP: Hi there! My name is Emily and I am the nurse working with Dr. Chorney today. I am going to go over some of the post op education for ear tubes before you speak to the scheduler. Parent: Ok HCP: Has your child had ear tubes before? Parent: No, they have not. HCP: Ok! It is usually a pretty easily tolerated procedure. Most children notice more effects from the anesthesia than the ear tubes themselves, like nausea or tiredness for maybe 24 hours after surgery. You may notice drainage from either ear, which is normal and the reason for placing the ear tubes – to let the fluid out from behind the ear drum. Bloody drainage is also normal, although I know that can look concerning. We will give you ear drops to use twice a day for one week after surgery that will help dry up any drainage and clean up the ears. Please hold on to these drops. If your child has ear drainage in the future, you can use them in the same way (twice a day for a week); they do not need to be seen or take oral antibiotics. If you feel the drops are not working, please call us for further advice. The ear tubes should not be painful, but you’re welcome to give your child Tylenol or motrin for comfort if they seem fussy after surgery. Parent: Great! HCP: I know this was quite a bit of information. To make sure I did a good job explaining the care you will need to provide, can you please confirm how you will use the ear drops after surgery? Parent: Twice a day for a week. HCP: Yes! And how will you treat ear drainage moving forward? Parent: I will use those same drops, in the same way. HCP: Great! You will receive a printed copy of these instructions to reference, but please call us if any questions or concerns arise! Parent: Thank you!

5. Did the doctor conduct the conversation overall in a manner that solicits the patient's response with the aim to repeat back important information? Yes, the nurse conducted the conversation in a manner that encouraged the parent to repeat back the important information, ensuring they understood the post-operative care instructions.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

5. Did the doctor conduct the conversation overall in a manner that solicits the patient's response with the aim to repeat back important information?

HCP: Hi there, my name is Emily and I am the nurse working with Dr. Ulualp today. I am going to go over some of the post op care information with you prior to scheduling the tonsil and adenoid removal surgery. Parent: Ok HCP: This surgery does have a bit of a rough recovery, and your child will need to be out of school for at least one week. The biggest thing is going to be staying on top of their pain and hydration. We will let you know on the day of surgery exactly how much Tylenol and ibuprofen they can have, based on their weight, so we give them the highest dose that is safe for them. We will have you switch off between the medications every 3 hours, including overnight the first few nights. For example, they would get Tylenol at 12 o’clock, ibuprofen at 3 o’clock, Tylenol again at 6 o’clock, ibuprofen at 9 o’clock and so on. The other big thing will be staying on top of their hydration. Your child may not want to each much food, which is ok, as long as they stay drinking lots of fluids. I recommend a variety of things like juice, Gatorade, or Pedialyte, so they’re still getting sugar and salt. If they do want to eat, that is fine, just nothing crunchy or scratch for two weeks after surgery. We recommend soft things like mac n cheese, mashed potatoes, spaghetti, pudding, ice cream. Cold things usually feel better on their throat. Bleeding is the biggest risk after surgery. A little blood in their spit is normal, but if they have more than two tablespoons of blood we would want to see them in the emergency department right away. A few other things: They can brush their teeth like normal, just no mouthwash. They will need to stay out of PE for 2 weeks, again to prevent bleeding. We recommend “couch activities” to keep them calmer and allow their body to heal. I know this was a lot of information. It will all be printed for you to have at home to resource, as well as a video version that your child may want to watch before surgery. Is there anything I can go back over and review for you? Parent: Not at this time. HCP: Great! In order to make sure I did a good job reviewing the information, could you tell me how often you are going to switch off the pain medications? Parent: Every 3 hours. HCP: Yep! And what would be a reason to bring your child to the emergency department? Parent: Bleeding more than two tablespoons. HCP: Correct! Those are two key pieces of information for a successful recovery! If you think of any questions before or after surgery, please call us as there is always somebody available for you to discuss concerns with. Parent: Thank you!

1. Yes, the nurse was welcoming. She introduced herself and her role, and she explained the post-operative care information in a friendly and informative manner.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

1. Was the doctor welcoming? Why?

HCP: Hi there, my name is Emily and I am the nurse working with Dr. Ulualp today. I am going to go over some of the post op care information with you prior to scheduling the tonsil and adenoid removal surgery. Parent: Ok HCP: This surgery does have a bit of a rough recovery, and your child will need to be out of school for at least one week. The biggest thing is going to be staying on top of their pain and hydration. We will let you know on the day of surgery exactly how much Tylenol and ibuprofen they can have, based on their weight, so we give them the highest dose that is safe for them. We will have you switch off between the medications every 3 hours, including overnight the first few nights. For example, they would get Tylenol at 12 o’clock, ibuprofen at 3 o’clock, Tylenol again at 6 o’clock, ibuprofen at 9 o’clock and so on. The other big thing will be staying on top of their hydration. Your child may not want to each much food, which is ok, as long as they stay drinking lots of fluids. I recommend a variety of things like juice, Gatorade, or Pedialyte, so they’re still getting sugar and salt. If they do want to eat, that is fine, just nothing crunchy or scratch for two weeks after surgery. We recommend soft things like mac n cheese, mashed potatoes, spaghetti, pudding, ice cream. Cold things usually feel better on their throat. Bleeding is the biggest risk after surgery. A little blood in their spit is normal, but if they have more than two tablespoons of blood we would want to see them in the emergency department right away. A few other things: They can brush their teeth like normal, just no mouthwash. They will need to stay out of PE for 2 weeks, again to prevent bleeding. We recommend “couch activities” to keep them calmer and allow their body to heal. I know this was a lot of information. It will all be printed for you to have at home to resource, as well as a video version that your child may want to watch before surgery. Is there anything I can go back over and review for you? Parent: Not at this time. HCP: Great! In order to make sure I did a good job reviewing the information, could you tell me how often you are going to switch off the pain medications? Parent: Every 3 hours. HCP: Yep! And what would be a reason to bring your child to the emergency department? Parent: Bleeding more than two tablespoons. HCP: Correct! Those are two key pieces of information for a successful recovery! If you think of any questions before or after surgery, please call us as there is always somebody available for you to discuss concerns with. Parent: Thank you!

2. The nurse did not use medical jargon that is hard to understand for the general audience. The language used was appropriate for laypersons.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

2. Did the doctor use medical jargon that is hard to understand for the general audience? If so, what are they? And replace them with layman language.

HCP: Hi there, my name is Emily and I am the nurse working with Dr. Ulualp today. I am going to go over some of the post op care information with you prior to scheduling the tonsil and adenoid removal surgery. Parent: Ok HCP: This surgery does have a bit of a rough recovery, and your child will need to be out of school for at least one week. The biggest thing is going to be staying on top of their pain and hydration. We will let you know on the day of surgery exactly how much Tylenol and ibuprofen they can have, based on their weight, so we give them the highest dose that is safe for them. We will have you switch off between the medications every 3 hours, including overnight the first few nights. For example, they would get Tylenol at 12 o’clock, ibuprofen at 3 o’clock, Tylenol again at 6 o’clock, ibuprofen at 9 o’clock and so on. The other big thing will be staying on top of their hydration. Your child may not want to each much food, which is ok, as long as they stay drinking lots of fluids. I recommend a variety of things like juice, Gatorade, or Pedialyte, so they’re still getting sugar and salt. If they do want to eat, that is fine, just nothing crunchy or scratch for two weeks after surgery. We recommend soft things like mac n cheese, mashed potatoes, spaghetti, pudding, ice cream. Cold things usually feel better on their throat. Bleeding is the biggest risk after surgery. A little blood in their spit is normal, but if they have more than two tablespoons of blood we would want to see them in the emergency department right away. A few other things: They can brush their teeth like normal, just no mouthwash. They will need to stay out of PE for 2 weeks, again to prevent bleeding. We recommend “couch activities” to keep them calmer and allow their body to heal. I know this was a lot of information. It will all be printed for you to have at home to resource, as well as a video version that your child may want to watch before surgery. Is there anything I can go back over and review for you? Parent: Not at this time. HCP: Great! In order to make sure I did a good job reviewing the information, could you tell me how often you are going to switch off the pain medications? Parent: Every 3 hours. HCP: Yep! And what would be a reason to bring your child to the emergency department? Parent: Bleeding more than two tablespoons. HCP: Correct! Those are two key pieces of information for a successful recovery! If you think of any questions before or after surgery, please call us as there is always somebody available for you to discuss concerns with. Parent: Thank you!

3. The nurse made several key points: - Child needs to be out of school for at least one week. - Importance of managing pain and hydration. - Specific instructions on alternating Tylenol and ibuprofen. - Recommendations for fluid intake and suitable foods. - Warning about the risk of bleeding and when to go to the emergency department. - Guidance on oral hygiene and physical activity restrictions. The nurse did not have to re-teach any points during this conversation. If only 3 points were to keep, they should be: - Instructions on how to manage pain with medication. - The importance of hydration and dietary recommendations. - Warning signs of bleeding and when to seek emergency care.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

3. Count the number of key points that the nurse made. Did the nurse have to re-teach some of the points? If only 3 points were to keep, which 3 points should be kept?

HCP: Hi there, my name is Emily and I am the nurse working with Dr. Ulualp today. I am going to go over some of the post op care information with you prior to scheduling the tonsil and adenoid removal surgery. Parent: Ok HCP: This surgery does have a bit of a rough recovery, and your child will need to be out of school for at least one week. The biggest thing is going to be staying on top of their pain and hydration. We will let you know on the day of surgery exactly how much Tylenol and ibuprofen they can have, based on their weight, so we give them the highest dose that is safe for them. We will have you switch off between the medications every 3 hours, including overnight the first few nights. For example, they would get Tylenol at 12 o’clock, ibuprofen at 3 o’clock, Tylenol again at 6 o’clock, ibuprofen at 9 o’clock and so on. The other big thing will be staying on top of their hydration. Your child may not want to each much food, which is ok, as long as they stay drinking lots of fluids. I recommend a variety of things like juice, Gatorade, or Pedialyte, so they’re still getting sugar and salt. If they do want to eat, that is fine, just nothing crunchy or scratch for two weeks after surgery. We recommend soft things like mac n cheese, mashed potatoes, spaghetti, pudding, ice cream. Cold things usually feel better on their throat. Bleeding is the biggest risk after surgery. A little blood in their spit is normal, but if they have more than two tablespoons of blood we would want to see them in the emergency department right away. A few other things: They can brush their teeth like normal, just no mouthwash. They will need to stay out of PE for 2 weeks, again to prevent bleeding. We recommend “couch activities” to keep them calmer and allow their body to heal. I know this was a lot of information. It will all be printed for you to have at home to resource, as well as a video version that your child may want to watch before surgery. Is there anything I can go back over and review for you? Parent: Not at this time. HCP: Great! In order to make sure I did a good job reviewing the information, could you tell me how often you are going to switch off the pain medications? Parent: Every 3 hours. HCP: Yep! And what would be a reason to bring your child to the emergency department? Parent: Bleeding more than two tablespoons. HCP: Correct! Those are two key pieces of information for a successful recovery! If you think of any questions before or after surgery, please call us as there is always somebody available for you to discuss concerns with. Parent: Thank you!

4. Yes, the nurse asked teach-back questions: - "Could you tell me how often you are going to switch off the pain medications?" - "And what would be a reason to bring your child to the emergency department?"

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

4. Did the doctor ask teach-back questions? If so, list those questions.

HCP: Hi there, my name is Emily and I am the nurse working with Dr. Ulualp today. I am going to go over some of the post op care information with you prior to scheduling the tonsil and adenoid removal surgery. Parent: Ok HCP: This surgery does have a bit of a rough recovery, and your child will need to be out of school for at least one week. The biggest thing is going to be staying on top of their pain and hydration. We will let you know on the day of surgery exactly how much Tylenol and ibuprofen they can have, based on their weight, so we give them the highest dose that is safe for them. We will have you switch off between the medications every 3 hours, including overnight the first few nights. For example, they would get Tylenol at 12 o’clock, ibuprofen at 3 o’clock, Tylenol again at 6 o’clock, ibuprofen at 9 o’clock and so on. The other big thing will be staying on top of their hydration. Your child may not want to each much food, which is ok, as long as they stay drinking lots of fluids. I recommend a variety of things like juice, Gatorade, or Pedialyte, so they’re still getting sugar and salt. If they do want to eat, that is fine, just nothing crunchy or scratch for two weeks after surgery. We recommend soft things like mac n cheese, mashed potatoes, spaghetti, pudding, ice cream. Cold things usually feel better on their throat. Bleeding is the biggest risk after surgery. A little blood in their spit is normal, but if they have more than two tablespoons of blood we would want to see them in the emergency department right away. A few other things: They can brush their teeth like normal, just no mouthwash. They will need to stay out of PE for 2 weeks, again to prevent bleeding. We recommend “couch activities” to keep them calmer and allow their body to heal. I know this was a lot of information. It will all be printed for you to have at home to resource, as well as a video version that your child may want to watch before surgery. Is there anything I can go back over and review for you? Parent: Not at this time. HCP: Great! In order to make sure I did a good job reviewing the information, could you tell me how often you are going to switch off the pain medications? Parent: Every 3 hours. HCP: Yep! And what would be a reason to bring your child to the emergency department? Parent: Bleeding more than two tablespoons. HCP: Correct! Those are two key pieces of information for a successful recovery! If you think of any questions before or after surgery, please call us as there is always somebody available for you to discuss concerns with. Parent: Thank you!

5. Yes, the nurse conducted the conversation in a manner that solicits the patient's response with the aim to repeat back important information. She asked direct questions to ensure the parent understood the key points of post-operative care.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

5. Did the doctor conduct the conversation overall in a manner that solicits the patient's response with the aim to repeat back important information?

HCP: Hi there! My name is Emily and I am the nurse working with Dr. Chorney today. I am going to go over some of the post op education for ear tubes before you speak to the scheduler. Parent: Ok HCP: Has your child had ear tubes before? Parent: No, they have not. HCP: Ok! It is usually a pretty easily tolerated procedure. Most children notice more effects from the anesthesia than the ear tubes themselves, like nausea or tiredness for maybe 24 hours after surgery. You may notice drainage from either ear, which is normal and the reason for placing the ear tubes – to let the fluid out from behind the ear drum. Bloody drainage is also normal, although I know that can look concerning. We will give you ear drops to use twice a day for one week after surgery that will help dry up any drainage and clean up the ears. Please hold on to these drops. If your child has ear drainage in the future, you can use them in the same way (twice a day for a week); they do not need to be seen or take oral antibiotics. If you feel the drops are not working, please call us for further advice. The ear tubes should not be painful, but you’re welcome to give your child Tylenol or motrin for comfort if they seem fussy after surgery. Parent: Great! HCP: I know this was quite a bit of information. To make sure I did a good job explaining the care you will need to provide, can you please confirm how you will use the ear drops after surgery? Parent: Once a day for a couple of days after surgery. HCP: We will actually want you to use the drops twice a day, so in the morning and in the evening, for 7 days after surgery. Parent: Got it. I will use the drops twice a day for a week. HCP: Great! And how will you treat ear drainage in the future? Parent: I will have my child see their pediatrician for antibiotics. HCP: We can actually treat any ear drainage moving forward with just the ear drops! Having the tube in place makes it much easier for us to treat any ear infections, and your child typically will not need to take anything by mouth (or even be seen for an appointment!). Just let us know if you need a refill or the drainage is not improving with the drops! Parent: Oh that is great to hear, they have been on a lot of antibiotics. So in the future I will restart ear drops if I notice drainage from their ears. HCP: Perfect! You will receive a printed copy of these instructions to reference, but please call us if any questions or concerns arise! Parent: Thank you!

1. Was the doctor welcoming? Why? Yes, the nurse (HCP) was welcoming. She introduced herself by name, explained her role, and proceeded to provide post-operative education in a friendly and informative manner.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

1. Was the doctor welcoming? Why?

HCP: Hi there! My name is Emily and I am the nurse working with Dr. Chorney today. I am going to go over some of the post op education for ear tubes before you speak to the scheduler. Parent: Ok HCP: Has your child had ear tubes before? Parent: No, they have not. HCP: Ok! It is usually a pretty easily tolerated procedure. Most children notice more effects from the anesthesia than the ear tubes themselves, like nausea or tiredness for maybe 24 hours after surgery. You may notice drainage from either ear, which is normal and the reason for placing the ear tubes – to let the fluid out from behind the ear drum. Bloody drainage is also normal, although I know that can look concerning. We will give you ear drops to use twice a day for one week after surgery that will help dry up any drainage and clean up the ears. Please hold on to these drops. If your child has ear drainage in the future, you can use them in the same way (twice a day for a week); they do not need to be seen or take oral antibiotics. If you feel the drops are not working, please call us for further advice. The ear tubes should not be painful, but you’re welcome to give your child Tylenol or motrin for comfort if they seem fussy after surgery. Parent: Great! HCP: I know this was quite a bit of information. To make sure I did a good job explaining the care you will need to provide, can you please confirm how you will use the ear drops after surgery? Parent: Once a day for a couple of days after surgery. HCP: We will actually want you to use the drops twice a day, so in the morning and in the evening, for 7 days after surgery. Parent: Got it. I will use the drops twice a day for a week. HCP: Great! And how will you treat ear drainage in the future? Parent: I will have my child see their pediatrician for antibiotics. HCP: We can actually treat any ear drainage moving forward with just the ear drops! Having the tube in place makes it much easier for us to treat any ear infections, and your child typically will not need to take anything by mouth (or even be seen for an appointment!). Just let us know if you need a refill or the drainage is not improving with the drops! Parent: Oh that is great to hear, they have been on a lot of antibiotics. So in the future I will restart ear drops if I notice drainage from their ears. HCP: Perfect! You will receive a printed copy of these instructions to reference, but please call us if any questions or concerns arise! Parent: Thank you!

2. Did the doctor use medical jargon that is hard to understand for the general audience? If so, what are they? And replace them with layman language. The nurse used some medical terms, but they were relatively straightforward and she explained them well. Terms like "anesthesia," "nausea," "drainage," "ear drum," and "oral antibiotics" are medical terms, but the nurse provided context making them understandable. For example, "anesthesia" could be replaced with "sleeping medicine used during surgery," and "oral antibiotics" with "antibiotics taken by mouth."

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

2. Did the doctor use medical jargon that is hard to understand for the general audience? If so, what are they? And replace them with layman language.

HCP: Hi there! My name is Emily and I am the nurse working with Dr. Chorney today. I am going to go over some of the post op education for ear tubes before you speak to the scheduler. Parent: Ok HCP: Has your child had ear tubes before? Parent: No, they have not. HCP: Ok! It is usually a pretty easily tolerated procedure. Most children notice more effects from the anesthesia than the ear tubes themselves, like nausea or tiredness for maybe 24 hours after surgery. You may notice drainage from either ear, which is normal and the reason for placing the ear tubes – to let the fluid out from behind the ear drum. Bloody drainage is also normal, although I know that can look concerning. We will give you ear drops to use twice a day for one week after surgery that will help dry up any drainage and clean up the ears. Please hold on to these drops. If your child has ear drainage in the future, you can use them in the same way (twice a day for a week); they do not need to be seen or take oral antibiotics. If you feel the drops are not working, please call us for further advice. The ear tubes should not be painful, but you’re welcome to give your child Tylenol or motrin for comfort if they seem fussy after surgery. Parent: Great! HCP: I know this was quite a bit of information. To make sure I did a good job explaining the care you will need to provide, can you please confirm how you will use the ear drops after surgery? Parent: Once a day for a couple of days after surgery. HCP: We will actually want you to use the drops twice a day, so in the morning and in the evening, for 7 days after surgery. Parent: Got it. I will use the drops twice a day for a week. HCP: Great! And how will you treat ear drainage in the future? Parent: I will have my child see their pediatrician for antibiotics. HCP: We can actually treat any ear drainage moving forward with just the ear drops! Having the tube in place makes it much easier for us to treat any ear infections, and your child typically will not need to take anything by mouth (or even be seen for an appointment!). Just let us know if you need a refill or the drainage is not improving with the drops! Parent: Oh that is great to hear, they have been on a lot of antibiotics. So in the future I will restart ear drops if I notice drainage from their ears. HCP: Perfect! You will receive a printed copy of these instructions to reference, but please call us if any questions or concerns arise! Parent: Thank you!

3. Count the number of key points that the doctor made. Did the doctor have to re-teach some of the points? If only 3 points were to keep, which 3 points should be kept? The nurse made several key points: - The procedure is usually well tolerated, with more effects from anesthesia. - Drainage from the ears is normal, and bloody drainage can occur. - Ear drops are to be used twice a day for a week after surgery. - The ear tubes should not be painful, but Tylenol or Motrin can be used for comfort. - In the future, ear drainage can be treated with ear drops instead of oral antibiotics. The nurse had to re-teach the frequency and duration of using the ear drops after surgery. If only 3 points were to be kept, they should be: - Use ear drops twice a day for a week after surgery. - Treat future ear drainage with ear drops, not oral antibiotics. - Call the office if the drops are not working or if there are any questions or concerns.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

3. Count the number of key points that the nurse made. Did the nurse have to re-teach some of the points? If only 3 points were to keep, which 3 points should be kept?

HCP: Hi there! My name is Emily and I am the nurse working with Dr. Chorney today. I am going to go over some of the post op education for ear tubes before you speak to the scheduler. Parent: Ok HCP: Has your child had ear tubes before? Parent: No, they have not. HCP: Ok! It is usually a pretty easily tolerated procedure. Most children notice more effects from the anesthesia than the ear tubes themselves, like nausea or tiredness for maybe 24 hours after surgery. You may notice drainage from either ear, which is normal and the reason for placing the ear tubes – to let the fluid out from behind the ear drum. Bloody drainage is also normal, although I know that can look concerning. We will give you ear drops to use twice a day for one week after surgery that will help dry up any drainage and clean up the ears. Please hold on to these drops. If your child has ear drainage in the future, you can use them in the same way (twice a day for a week); they do not need to be seen or take oral antibiotics. If you feel the drops are not working, please call us for further advice. The ear tubes should not be painful, but you’re welcome to give your child Tylenol or motrin for comfort if they seem fussy after surgery. Parent: Great! HCP: I know this was quite a bit of information. To make sure I did a good job explaining the care you will need to provide, can you please confirm how you will use the ear drops after surgery? Parent: Once a day for a couple of days after surgery. HCP: We will actually want you to use the drops twice a day, so in the morning and in the evening, for 7 days after surgery. Parent: Got it. I will use the drops twice a day for a week. HCP: Great! And how will you treat ear drainage in the future? Parent: I will have my child see their pediatrician for antibiotics. HCP: We can actually treat any ear drainage moving forward with just the ear drops! Having the tube in place makes it much easier for us to treat any ear infections, and your child typically will not need to take anything by mouth (or even be seen for an appointment!). Just let us know if you need a refill or the drainage is not improving with the drops! Parent: Oh that is great to hear, they have been on a lot of antibiotics. So in the future I will restart ear drops if I notice drainage from their ears. HCP: Perfect! You will receive a printed copy of these instructions to reference, but please call us if any questions or concerns arise! Parent: Thank you!

4. Did the doctor ask teach-back questions? If so, list those questions. Yes, the nurse asked teach-back questions: - "Can you please confirm how you will use the ear drops after surgery?" - "And how will you treat ear drainage in the future?"

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

4. Did the doctor ask teach-back questions? If so, list those questions.

HCP: Hi there! My name is Emily and I am the nurse working with Dr. Chorney today. I am going to go over some of the post op education for ear tubes before you speak to the scheduler. Parent: Ok HCP: Has your child had ear tubes before? Parent: No, they have not. HCP: Ok! It is usually a pretty easily tolerated procedure. Most children notice more effects from the anesthesia than the ear tubes themselves, like nausea or tiredness for maybe 24 hours after surgery. You may notice drainage from either ear, which is normal and the reason for placing the ear tubes – to let the fluid out from behind the ear drum. Bloody drainage is also normal, although I know that can look concerning. We will give you ear drops to use twice a day for one week after surgery that will help dry up any drainage and clean up the ears. Please hold on to these drops. If your child has ear drainage in the future, you can use them in the same way (twice a day for a week); they do not need to be seen or take oral antibiotics. If you feel the drops are not working, please call us for further advice. The ear tubes should not be painful, but you’re welcome to give your child Tylenol or motrin for comfort if they seem fussy after surgery. Parent: Great! HCP: I know this was quite a bit of information. To make sure I did a good job explaining the care you will need to provide, can you please confirm how you will use the ear drops after surgery? Parent: Once a day for a couple of days after surgery. HCP: We will actually want you to use the drops twice a day, so in the morning and in the evening, for 7 days after surgery. Parent: Got it. I will use the drops twice a day for a week. HCP: Great! And how will you treat ear drainage in the future? Parent: I will have my child see their pediatrician for antibiotics. HCP: We can actually treat any ear drainage moving forward with just the ear drops! Having the tube in place makes it much easier for us to treat any ear infections, and your child typically will not need to take anything by mouth (or even be seen for an appointment!). Just let us know if you need a refill or the drainage is not improving with the drops! Parent: Oh that is great to hear, they have been on a lot of antibiotics. So in the future I will restart ear drops if I notice drainage from their ears. HCP: Perfect! You will receive a printed copy of these instructions to reference, but please call us if any questions or concerns arise! Parent: Thank you!

5. Did the doctor conduct the conversation overall in a manner that solicits the patient's response with the aim to repeat back important information? Yes, the nurse conducted the conversation in a way that encouraged the parent to repeat back the instructions, ensuring understanding. She corrected misunderstandings and confirmed the correct information with the parent.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

5. Did the doctor conduct the conversation overall in a manner that solicits the patient's response with the aim to repeat back important information?

HCP: Hi there, my name is Emily and I am the nurse working with Dr. Ulualp today. I am going to go over some of the post op care information with you prior to scheduling the tonsil and adenoid removal surgery. Parent: Ok HCP: This surgery does have a bit of a rough recovery, and your child will need to be out of school for at least one week. The biggest thing is going to be staying on top of their pain and hydration. We will let you know on the day of surgery exactly how much Tylenol and motrin they can have, based on their weight, so we give them the highest dose that is safe for them. We will have you switch off between the medications every 3 hours, including overnight the first few nights. For example, they would get tylneol at 12 o’clock, ibuprofen at 3 o’clock, tylneol again at 6 o’clock, ibuprofen at 9 o’clock and so on. The other big thing will be staying on top of their hydration. Your child may not want to each much food, which is ok, as long as they stay drinking lots of fluids. I recommend a variety of things like juice, Gatorade, or Pedialyte, so they’re still getting sugar and salt. If they do want to eat, that is fine, just nothing crunchy or scratch for two weeks after surgery. We recommend soft things like mac n cheese, mashed potatoes, spaghetti, pudding, ice cream. Cold things usually feel better on their throat. Bleeding is the biggest risk after surgery. A little blood in their spit is normal, but if they have more than two tablespoons of blood we would want to see them in the emergency department right away. A few other things: They can brush their teeth like normal, just no mouthwash. They will need to stay out of PE for 2 weeks, again to prevent bleeding. We recommend “couch activities” to keep them calmer and allow their body to heal. I know this was a lot of information. It will all be printed for you to have at home to resource, as well as a video version that your child may want to watch before surgery. Is there anything I can go back over and review for you? Parent: Not at this time. HCP: Great! In order to make sure I did a good job reviewing the information, could you tell me how often you are going to switch off the pain medications? Parent: Every 6 hours? HCP: You will actually want to switch off every 3 hours. You are correct that each dose of the same medication will be every 6 hours, but we want to stagger them so your child has medicine available to them every 3 hours. For example, they would get tylneol at 12 o’clock, ibuprofen at 3 o’clock, tylneol again at 6 o’clock, ibuprofen at 9 o’clock and so on. Does that make sense? Parent: Yes, I will switch off the medicines every 3 hours. HCP: Perfect! And what would be a reason to bring your child to the emergency department? Parent: If my child has any amount of bleeding. HCP: We are actually ok with some bleeding or blood-tinged spit; this is normal. Reasons we would want to see them in the emergency room include more than two tablespoons of blood. Parent: Understood. If my child has more than two tablespoons of blood I will bring them to the closest emergency department. HCP: Correct! Those are two key pieces of information for a successful recovery! If you think of any questions before or after surgery, please call us as there is always somebody available for you to discuss concerns with. Parent: Thank you!

1. Was the doctor welcoming? Why? Yes, the nurse (HCP) was welcoming. She introduced herself, explained her role, and clearly stated the purpose of the conversation, which is to go over post-op care information.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

1. Was the doctor welcoming? Why?

HCP: Hi there, my name is Emily and I am the nurse working with Dr. Ulualp today. I am going to go over some of the post op care information with you prior to scheduling the tonsil and adenoid removal surgery. Parent: Ok HCP: This surgery does have a bit of a rough recovery, and your child will need to be out of school for at least one week. The biggest thing is going to be staying on top of their pain and hydration. We will let you know on the day of surgery exactly how much Tylenol and motrin they can have, based on their weight, so we give them the highest dose that is safe for them. We will have you switch off between the medications every 3 hours, including overnight the first few nights. For example, they would get tylneol at 12 o’clock, ibuprofen at 3 o’clock, tylneol again at 6 o’clock, ibuprofen at 9 o’clock and so on. The other big thing will be staying on top of their hydration. Your child may not want to each much food, which is ok, as long as they stay drinking lots of fluids. I recommend a variety of things like juice, Gatorade, or Pedialyte, so they’re still getting sugar and salt. If they do want to eat, that is fine, just nothing crunchy or scratch for two weeks after surgery. We recommend soft things like mac n cheese, mashed potatoes, spaghetti, pudding, ice cream. Cold things usually feel better on their throat. Bleeding is the biggest risk after surgery. A little blood in their spit is normal, but if they have more than two tablespoons of blood we would want to see them in the emergency department right away. A few other things: They can brush their teeth like normal, just no mouthwash. They will need to stay out of PE for 2 weeks, again to prevent bleeding. We recommend “couch activities” to keep them calmer and allow their body to heal. I know this was a lot of information. It will all be printed for you to have at home to resource, as well as a video version that your child may want to watch before surgery. Is there anything I can go back over and review for you? Parent: Not at this time. HCP: Great! In order to make sure I did a good job reviewing the information, could you tell me how often you are going to switch off the pain medications? Parent: Every 6 hours? HCP: You will actually want to switch off every 3 hours. You are correct that each dose of the same medication will be every 6 hours, but we want to stagger them so your child has medicine available to them every 3 hours. For example, they would get tylneol at 12 o’clock, ibuprofen at 3 o’clock, tylneol again at 6 o’clock, ibuprofen at 9 o’clock and so on. Does that make sense? Parent: Yes, I will switch off the medicines every 3 hours. HCP: Perfect! And what would be a reason to bring your child to the emergency department? Parent: If my child has any amount of bleeding. HCP: We are actually ok with some bleeding or blood-tinged spit; this is normal. Reasons we would want to see them in the emergency room include more than two tablespoons of blood. Parent: Understood. If my child has more than two tablespoons of blood I will bring them to the closest emergency department. HCP: Correct! Those are two key pieces of information for a successful recovery! If you think of any questions before or after surgery, please call us as there is always somebody available for you to discuss concerns with. Parent: Thank you!

2. Did the doctor use medical jargon that is hard to understand for general audience? If so, what are they? And replace them with layman language. The nurse used some medical terms, but they were relatively straightforward and commonly understood: - "Post op" could be replaced with "after surgery." - "Tonsil and adenoid removal" could be replaced with "surgery to remove the tonsils and adenoids." - "Hydration" means "drinking enough fluids." - "Emergency department" could be replaced with "emergency room."

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

2. Did the doctor use medical jargon that is hard to understand for the general audience? If so, what are they? And replace them with layman language.

HCP: Hi there, my name is Emily and I am the nurse working with Dr. Ulualp today. I am going to go over some of the post op care information with you prior to scheduling the tonsil and adenoid removal surgery. Parent: Ok HCP: This surgery does have a bit of a rough recovery, and your child will need to be out of school for at least one week. The biggest thing is going to be staying on top of their pain and hydration. We will let you know on the day of surgery exactly how much Tylenol and motrin they can have, based on their weight, so we give them the highest dose that is safe for them. We will have you switch off between the medications every 3 hours, including overnight the first few nights. For example, they would get tylneol at 12 o’clock, ibuprofen at 3 o’clock, tylneol again at 6 o’clock, ibuprofen at 9 o’clock and so on. The other big thing will be staying on top of their hydration. Your child may not want to each much food, which is ok, as long as they stay drinking lots of fluids. I recommend a variety of things like juice, Gatorade, or Pedialyte, so they’re still getting sugar and salt. If they do want to eat, that is fine, just nothing crunchy or scratch for two weeks after surgery. We recommend soft things like mac n cheese, mashed potatoes, spaghetti, pudding, ice cream. Cold things usually feel better on their throat. Bleeding is the biggest risk after surgery. A little blood in their spit is normal, but if they have more than two tablespoons of blood we would want to see them in the emergency department right away. A few other things: They can brush their teeth like normal, just no mouthwash. They will need to stay out of PE for 2 weeks, again to prevent bleeding. We recommend “couch activities” to keep them calmer and allow their body to heal. I know this was a lot of information. It will all be printed for you to have at home to resource, as well as a video version that your child may want to watch before surgery. Is there anything I can go back over and review for you? Parent: Not at this time. HCP: Great! In order to make sure I did a good job reviewing the information, could you tell me how often you are going to switch off the pain medications? Parent: Every 6 hours? HCP: You will actually want to switch off every 3 hours. You are correct that each dose of the same medication will be every 6 hours, but we want to stagger them so your child has medicine available to them every 3 hours. For example, they would get tylneol at 12 o’clock, ibuprofen at 3 o’clock, tylneol again at 6 o’clock, ibuprofen at 9 o’clock and so on. Does that make sense? Parent: Yes, I will switch off the medicines every 3 hours. HCP: Perfect! And what would be a reason to bring your child to the emergency department? Parent: If my child has any amount of bleeding. HCP: We are actually ok with some bleeding or blood-tinged spit; this is normal. Reasons we would want to see them in the emergency room include more than two tablespoons of blood. Parent: Understood. If my child has more than two tablespoons of blood I will bring them to the closest emergency department. HCP: Correct! Those are two key pieces of information for a successful recovery! If you think of any questions before or after surgery, please call us as there is always somebody available for you to discuss concerns with. Parent: Thank you!

3. Count the number of key points that the doctor made. Did the doctor have to re-teach some of the points? If only 3 points were to keep, which 3 points should be kept? The nurse made several key points: - Child needs to be out of school for at least one week. - Importance of managing pain and hydration. - Specific instructions on how to alternate Tylenol and Motrin. - Dietary recommendations post-surgery. - What to do in case of bleeding. - Oral hygiene and physical activity guidelines post-surgery. - Availability of printed and video resources. The nurse had to re-teach the point about alternating pain medications every 3 hours, as the parent initially misunderstood and thought it was every 6 hours. If only 3 points were to keep, the following should be kept: - Instructions on alternating pain medications every 3 hours. - Importance of staying hydrated and dietary recommendations. - What to do in case of bleeding (more than two tablespoons of blood).

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

3. Count the number of key points that the nurse made. Did the nurse have to re-teach some of the points? If only 3 points were to keep, which 3 points should be kept?

HCP: Hi there, my name is Emily and I am the nurse working with Dr. Ulualp today. I am going to go over some of the post op care information with you prior to scheduling the tonsil and adenoid removal surgery. Parent: Ok HCP: This surgery does have a bit of a rough recovery, and your child will need to be out of school for at least one week. The biggest thing is going to be staying on top of their pain and hydration. We will let you know on the day of surgery exactly how much Tylenol and motrin they can have, based on their weight, so we give them the highest dose that is safe for them. We will have you switch off between the medications every 3 hours, including overnight the first few nights. For example, they would get tylneol at 12 o’clock, ibuprofen at 3 o’clock, tylneol again at 6 o’clock, ibuprofen at 9 o’clock and so on. The other big thing will be staying on top of their hydration. Your child may not want to each much food, which is ok, as long as they stay drinking lots of fluids. I recommend a variety of things like juice, Gatorade, or Pedialyte, so they’re still getting sugar and salt. If they do want to eat, that is fine, just nothing crunchy or scratch for two weeks after surgery. We recommend soft things like mac n cheese, mashed potatoes, spaghetti, pudding, ice cream. Cold things usually feel better on their throat. Bleeding is the biggest risk after surgery. A little blood in their spit is normal, but if they have more than two tablespoons of blood we would want to see them in the emergency department right away. A few other things: They can brush their teeth like normal, just no mouthwash. They will need to stay out of PE for 2 weeks, again to prevent bleeding. We recommend “couch activities” to keep them calmer and allow their body to heal. I know this was a lot of information. It will all be printed for you to have at home to resource, as well as a video version that your child may want to watch before surgery. Is there anything I can go back over and review for you? Parent: Not at this time. HCP: Great! In order to make sure I did a good job reviewing the information, could you tell me how often you are going to switch off the pain medications? Parent: Every 6 hours? HCP: You will actually want to switch off every 3 hours. You are correct that each dose of the same medication will be every 6 hours, but we want to stagger them so your child has medicine available to them every 3 hours. For example, they would get tylneol at 12 o’clock, ibuprofen at 3 o’clock, tylneol again at 6 o’clock, ibuprofen at 9 o’clock and so on. Does that make sense? Parent: Yes, I will switch off the medicines every 3 hours. HCP: Perfect! And what would be a reason to bring your child to the emergency department? Parent: If my child has any amount of bleeding. HCP: We are actually ok with some bleeding or blood-tinged spit; this is normal. Reasons we would want to see them in the emergency room include more than two tablespoons of blood. Parent: Understood. If my child has more than two tablespoons of blood I will bring them to the closest emergency department. HCP: Correct! Those are two key pieces of information for a successful recovery! If you think of any questions before or after surgery, please call us as there is always somebody available for you to discuss concerns with. Parent: Thank you!

4. Did the doctor ask teach-back questions? If so, list those questions. Yes, the nurse asked teach-back questions: - "Could you tell me how often you are going to switch off the pain medications?" - "And what would be a reason to bring your child to the emergency department?"

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

4. Did the doctor ask teach-back questions? If so, list those questions.

HCP: Hi there, my name is Emily and I am the nurse working with Dr. Ulualp today. I am going to go over some of the post op care information with you prior to scheduling the tonsil and adenoid removal surgery. Parent: Ok HCP: This surgery does have a bit of a rough recovery, and your child will need to be out of school for at least one week. The biggest thing is going to be staying on top of their pain and hydration. We will let you know on the day of surgery exactly how much Tylenol and motrin they can have, based on their weight, so we give them the highest dose that is safe for them. We will have you switch off between the medications every 3 hours, including overnight the first few nights. For example, they would get tylneol at 12 o’clock, ibuprofen at 3 o’clock, tylneol again at 6 o’clock, ibuprofen at 9 o’clock and so on. The other big thing will be staying on top of their hydration. Your child may not want to each much food, which is ok, as long as they stay drinking lots of fluids. I recommend a variety of things like juice, Gatorade, or Pedialyte, so they’re still getting sugar and salt. If they do want to eat, that is fine, just nothing crunchy or scratch for two weeks after surgery. We recommend soft things like mac n cheese, mashed potatoes, spaghetti, pudding, ice cream. Cold things usually feel better on their throat. Bleeding is the biggest risk after surgery. A little blood in their spit is normal, but if they have more than two tablespoons of blood we would want to see them in the emergency department right away. A few other things: They can brush their teeth like normal, just no mouthwash. They will need to stay out of PE for 2 weeks, again to prevent bleeding. We recommend “couch activities” to keep them calmer and allow their body to heal. I know this was a lot of information. It will all be printed for you to have at home to resource, as well as a video version that your child may want to watch before surgery. Is there anything I can go back over and review for you? Parent: Not at this time. HCP: Great! In order to make sure I did a good job reviewing the information, could you tell me how often you are going to switch off the pain medications? Parent: Every 6 hours? HCP: You will actually want to switch off every 3 hours. You are correct that each dose of the same medication will be every 6 hours, but we want to stagger them so your child has medicine available to them every 3 hours. For example, they would get tylneol at 12 o’clock, ibuprofen at 3 o’clock, tylneol again at 6 o’clock, ibuprofen at 9 o’clock and so on. Does that make sense? Parent: Yes, I will switch off the medicines every 3 hours. HCP: Perfect! And what would be a reason to bring your child to the emergency department? Parent: If my child has any amount of bleeding. HCP: We are actually ok with some bleeding or blood-tinged spit; this is normal. Reasons we would want to see them in the emergency room include more than two tablespoons of blood. Parent: Understood. If my child has more than two tablespoons of blood I will bring them to the closest emergency department. HCP: Correct! Those are two key pieces of information for a successful recovery! If you think of any questions before or after surgery, please call us as there is always somebody available for you to discuss concerns with. Parent: Thank you!

5. Did the doctor conduct the conversation overall in a manner that solicits patient's response with the aim to repeat back important information. Yes, the nurse conducted the conversation in a way that encouraged the parent to repeat back important information, ensuring understanding of the post-op care instructions.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

5. Did the doctor conduct the conversation overall in a manner that solicits the patient's response with the aim to repeat back important information?

Nurse: Hello, my name is Jordan and I’m the nurse working with Dr. Ulualp. Dr. Ulualp let me know the plan, that we are scheduling your son for a tonsillectomy and adenoidectomy. Does that sound right? Parent: Yes, that’s correct. Nurse: Great, I’ll go over the post-operative care instructions with you. Once I finish explaining everything, I’ll ask a couple of questions to make sure that I explained every clearly. Parent: Okay, I understand. Nurse: Okay, so the recovery time for this surgery is typically about 2 weeks. During the 2 weeks, we will have your son started on a schedule of Acetaminophen/Tylenol and Ibuprofen/Motrin. He will take these medications q3h, alternating between the two medications. We do request that you give the medication overnight for the first 3-5 days after surgery. After that, you may begin to space out how often you give the medication. Now to discuss the post-operative restrictions, after the tonsillectomy and adenoidectomy, we will require your son to be absent from school for 1 week at the minimum, but he may need to be out of school for up to the full 2 weeks. In addition, he will also need to eat only soft foods for 2 weeks, and not participate in any sports or PE for 2 weeks as well. It is also imperative that your son receive adequate hydration, so please provide him with a variety of fluids to ensure this. We also want you to watch out for any post-surgical complications, such as hemorrhage or dehydration. Some symptoms of dehydration include limited voids, urine that is darker than normal, or dry oral mucosa. If you notice any of these, this means that your son needs to increase fluid intake. It is important to also watch out for hemorrhage. A small amount of blood is normal, but any amount of hemorrhage greater than or equal to one ounce would require emergent care. This blood may come from the nasopharynx, the mouth, or be present in emesis. Please bring your son to the emergency room for any hemorrhage larger than two tablespoons. We also recommend avoiding any red liquids, to avoid confusion with blood. Okay, that’s everything that you need to know, now I will ask you to state in your own words what you need to do after surgery. In your own words, when should you bring your child to the emergency room and how often you’ll give the medication after surgery? Parent: I will alternate acetaminophen and Tylenol every 3 hours. I should bring him to the emergency room for any amount of bleeding or too much urine. Nurse: I can see that I may have not explained this as clearly as I should have. Let me start again. First, I will talk about the medicine that he will take after surgery. Acetaminophen and Tylenol are actually the same medicine. Motrin and Ibuprofen are also the same medicine. What do you call them in your house? Parent: I see! We call them Tylenol and Motrin in our house. Nurse: Perfect, after the surgery you will alternate Tylenol and Motrin every 3 hours. For example, you would give Tylenol at 9am, and then 3 hours later, you would give Motrin. 3 hours after that, it would be time for Tylenol again. We recommend continuing this schedule at night as well. Can you tell me now in your own words how you’ll give the medicine after surgery? Parent: Yes, I will rotate Tylenol and Motrin back and forth every three hours, including waking up at night to take the medicine. Nurse: Yes exactly, thank you! I also want to make clear when you should bring your child to the emergency room. You will bring your son to the emergency room if he has any bleeding from his mouth, nose, or throws up 2 tablespoons or more of blood. A small amount of blood is okay, but anything two tablespoons or more is not normal. Now, would you be able to tell me in your own words when you need to bring your son to the emergency room? Parent: Yes, I need to bring my son to the emergency room for any bleeding that is 2 tablespoons or more. Nurse: That’s exactly correct, thank you so much for your time!

1. Was the nurse welcoming? Why? Yes, the nurse was welcoming. She introduced herself, confirmed the procedure with the parent, and expressed her intention to ensure the parent understood the post-operative care instructions.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

1. Was the doctor welcoming? Why?

Nurse: Hello, my name is Jordan and I’m the nurse working with Dr. Ulualp. Dr. Ulualp let me know the plan, that we are scheduling your son for a tonsillectomy and adenoidectomy. Does that sound right? Parent: Yes, that’s correct. Nurse: Great, I’ll go over the post-operative care instructions with you. Once I finish explaining everything, I’ll ask a couple of questions to make sure that I explained every clearly. Parent: Okay, I understand. Nurse: Okay, so the recovery time for this surgery is typically about 2 weeks. During the 2 weeks, we will have your son started on a schedule of Acetaminophen/Tylenol and Ibuprofen/Motrin. He will take these medications q3h, alternating between the two medications. We do request that you give the medication overnight for the first 3-5 days after surgery. After that, you may begin to space out how often you give the medication. Now to discuss the post-operative restrictions, after the tonsillectomy and adenoidectomy, we will require your son to be absent from school for 1 week at the minimum, but he may need to be out of school for up to the full 2 weeks. In addition, he will also need to eat only soft foods for 2 weeks, and not participate in any sports or PE for 2 weeks as well. It is also imperative that your son receive adequate hydration, so please provide him with a variety of fluids to ensure this. We also want you to watch out for any post-surgical complications, such as hemorrhage or dehydration. Some symptoms of dehydration include limited voids, urine that is darker than normal, or dry oral mucosa. If you notice any of these, this means that your son needs to increase fluid intake. It is important to also watch out for hemorrhage. A small amount of blood is normal, but any amount of hemorrhage greater than or equal to one ounce would require emergent care. This blood may come from the nasopharynx, the mouth, or be present in emesis. Please bring your son to the emergency room for any hemorrhage larger than two tablespoons. We also recommend avoiding any red liquids, to avoid confusion with blood. Okay, that’s everything that you need to know, now I will ask you to state in your own words what you need to do after surgery. In your own words, when should you bring your child to the emergency room and how often you’ll give the medication after surgery? Parent: I will alternate acetaminophen and Tylenol every 3 hours. I should bring him to the emergency room for any amount of bleeding or too much urine. Nurse: I can see that I may have not explained this as clearly as I should have. Let me start again. First, I will talk about the medicine that he will take after surgery. Acetaminophen and Tylenol are actually the same medicine. Motrin and Ibuprofen are also the same medicine. What do you call them in your house? Parent: I see! We call them Tylenol and Motrin in our house. Nurse: Perfect, after the surgery you will alternate Tylenol and Motrin every 3 hours. For example, you would give Tylenol at 9am, and then 3 hours later, you would give Motrin. 3 hours after that, it would be time for Tylenol again. We recommend continuing this schedule at night as well. Can you tell me now in your own words how you’ll give the medicine after surgery? Parent: Yes, I will rotate Tylenol and Motrin back and forth every three hours, including waking up at night to take the medicine. Nurse: Yes exactly, thank you! I also want to make clear when you should bring your child to the emergency room. You will bring your son to the emergency room if he has any bleeding from his mouth, nose, or throws up 2 tablespoons or more of blood. A small amount of blood is okay, but anything two tablespoons or more is not normal. Now, would you be able to tell me in your own words when you need to bring your son to the emergency room? Parent: Yes, I need to bring my son to the emergency room for any bleeding that is 2 tablespoons or more. Nurse: That’s exactly correct, thank you so much for your time!

2. Did the nurse use medical jargon that is hard to understand for the general audience? If so, what are they? And replace them with layman language. - Tonsillectomy and adenoidectomy: Surgery to remove the tonsils and adenoids. - q3h: Every three hours. - Post-operative: After surgery. - Hemorrhage: Severe bleeding. - Dehydration: Not having enough water in the body. - Limited voids: Not urinating often. - Urine that is darker than normal: Dark yellow or brown urine. - Dry oral mucosa: Dry mouth. - Nasopharynx: The upper part of the throat behind the nose. - Emesis: Vomiting.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

2. Did the doctor use medical jargon that is hard to understand for the general audience? If so, what are they? And replace them with layman language.

Nurse: Hello, my name is Jordan and I’m the nurse working with Dr. Ulualp. Dr. Ulualp let me know the plan, that we are scheduling your son for a tonsillectomy and adenoidectomy. Does that sound right? Parent: Yes, that’s correct. Nurse: Great, I’ll go over the post-operative care instructions with you. Once I finish explaining everything, I’ll ask a couple of questions to make sure that I explained every clearly. Parent: Okay, I understand. Nurse: Okay, so the recovery time for this surgery is typically about 2 weeks. During the 2 weeks, we will have your son started on a schedule of Acetaminophen/Tylenol and Ibuprofen/Motrin. He will take these medications q3h, alternating between the two medications. We do request that you give the medication overnight for the first 3-5 days after surgery. After that, you may begin to space out how often you give the medication. Now to discuss the post-operative restrictions, after the tonsillectomy and adenoidectomy, we will require your son to be absent from school for 1 week at the minimum, but he may need to be out of school for up to the full 2 weeks. In addition, he will also need to eat only soft foods for 2 weeks, and not participate in any sports or PE for 2 weeks as well. It is also imperative that your son receive adequate hydration, so please provide him with a variety of fluids to ensure this. We also want you to watch out for any post-surgical complications, such as hemorrhage or dehydration. Some symptoms of dehydration include limited voids, urine that is darker than normal, or dry oral mucosa. If you notice any of these, this means that your son needs to increase fluid intake. It is important to also watch out for hemorrhage. A small amount of blood is normal, but any amount of hemorrhage greater than or equal to one ounce would require emergent care. This blood may come from the nasopharynx, the mouth, or be present in emesis. Please bring your son to the emergency room for any hemorrhage larger than two tablespoons. We also recommend avoiding any red liquids, to avoid confusion with blood. Okay, that’s everything that you need to know, now I will ask you to state in your own words what you need to do after surgery. In your own words, when should you bring your child to the emergency room and how often you’ll give the medication after surgery? Parent: I will alternate acetaminophen and Tylenol every 3 hours. I should bring him to the emergency room for any amount of bleeding or too much urine. Nurse: I can see that I may have not explained this as clearly as I should have. Let me start again. First, I will talk about the medicine that he will take after surgery. Acetaminophen and Tylenol are actually the same medicine. Motrin and Ibuprofen are also the same medicine. What do you call them in your house? Parent: I see! We call them Tylenol and Motrin in our house. Nurse: Perfect, after the surgery you will alternate Tylenol and Motrin every 3 hours. For example, you would give Tylenol at 9am, and then 3 hours later, you would give Motrin. 3 hours after that, it would be time for Tylenol again. We recommend continuing this schedule at night as well. Can you tell me now in your own words how you’ll give the medicine after surgery? Parent: Yes, I will rotate Tylenol and Motrin back and forth every three hours, including waking up at night to take the medicine. Nurse: Yes exactly, thank you! I also want to make clear when you should bring your child to the emergency room. You will bring your son to the emergency room if he has any bleeding from his mouth, nose, or throws up 2 tablespoons or more of blood. A small amount of blood is okay, but anything two tablespoons or more is not normal. Now, would you be able to tell me in your own words when you need to bring your son to the emergency room? Parent: Yes, I need to bring my son to the emergency room for any bleeding that is 2 tablespoons or more. Nurse: That’s exactly correct, thank you so much for your time!

3. Count the number of key points that the nurse made. Did the nurse have to re-teach some of the points? If only 3 points were to keep, which 3 points should be kept? The nurse made several key points: - Recovery time is about 2 weeks. - Medication schedule for pain relief. - Give medication overnight for the first 3-5 days. - Absence from school for 1-2 weeks. - Soft food diet for 2 weeks. - No sports or PE for 2 weeks. - Ensure adequate hydration. - Watch for signs of dehydration. - Watch for signs of hemorrhage. - Avoid red liquids to prevent confusion with blood. The nurse had to re-teach the medication schedule and the conditions for taking the child to the emergency room.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

3. Count the number of key points that the nurse made. Did the nurse have to re-teach some of the points? If only 3 points were to keep, which 3 points should be kept?

Nurse: Hello, my name is Jordan and I’m the nurse working with Dr. Ulualp. Dr. Ulualp let me know the plan, that we are scheduling your son for a tonsillectomy and adenoidectomy. Does that sound right? Parent: Yes, that’s correct. Nurse: Great, I’ll go over the post-operative care instructions with you. Once I finish explaining everything, I’ll ask a couple of questions to make sure that I explained every clearly. Parent: Okay, I understand. Nurse: Okay, so the recovery time for this surgery is typically about 2 weeks. During the 2 weeks, we will have your son started on a schedule of Acetaminophen/Tylenol and Ibuprofen/Motrin. He will take these medications q3h, alternating between the two medications. We do request that you give the medication overnight for the first 3-5 days after surgery. After that, you may begin to space out how often you give the medication. Now to discuss the post-operative restrictions, after the tonsillectomy and adenoidectomy, we will require your son to be absent from school for 1 week at the minimum, but he may need to be out of school for up to the full 2 weeks. In addition, he will also need to eat only soft foods for 2 weeks, and not participate in any sports or PE for 2 weeks as well. It is also imperative that your son receive adequate hydration, so please provide him with a variety of fluids to ensure this. We also want you to watch out for any post-surgical complications, such as hemorrhage or dehydration. Some symptoms of dehydration include limited voids, urine that is darker than normal, or dry oral mucosa. If you notice any of these, this means that your son needs to increase fluid intake. It is important to also watch out for hemorrhage. A small amount of blood is normal, but any amount of hemorrhage greater than or equal to one ounce would require emergent care. This blood may come from the nasopharynx, the mouth, or be present in emesis. Please bring your son to the emergency room for any hemorrhage larger than two tablespoons. We also recommend avoiding any red liquids, to avoid confusion with blood. Okay, that’s everything that you need to know, now I will ask you to state in your own words what you need to do after surgery. In your own words, when should you bring your child to the emergency room and how often you’ll give the medication after surgery? Parent: I will alternate acetaminophen and Tylenol every 3 hours. I should bring him to the emergency room for any amount of bleeding or too much urine. Nurse: I can see that I may have not explained this as clearly as I should have. Let me start again. First, I will talk about the medicine that he will take after surgery. Acetaminophen and Tylenol are actually the same medicine. Motrin and Ibuprofen are also the same medicine. What do you call them in your house? Parent: I see! We call them Tylenol and Motrin in our house. Nurse: Perfect, after the surgery you will alternate Tylenol and Motrin every 3 hours. For example, you would give Tylenol at 9am, and then 3 hours later, you would give Motrin. 3 hours after that, it would be time for Tylenol again. We recommend continuing this schedule at night as well. Can you tell me now in your own words how you’ll give the medicine after surgery? Parent: Yes, I will rotate Tylenol and Motrin back and forth every three hours, including waking up at night to take the medicine. Nurse: Yes exactly, thank you! I also want to make clear when you should bring your child to the emergency room. You will bring your son to the emergency room if he has any bleeding from his mouth, nose, or throws up 2 tablespoons or more of blood. A small amount of blood is okay, but anything two tablespoons or more is not normal. Now, would you be able to tell me in your own words when you need to bring your son to the emergency room? Parent: Yes, I need to bring my son to the emergency room for any bleeding that is 2 tablespoons or more. Nurse: That’s exactly correct, thank you so much for your time!

4. Did the nurse ask teach-back questions? If so, list those questions. Yes, the nurse asked teach-back questions: - "In your own words, when should you bring your child to the emergency room and how often you’ll give the medication after surgery?" - "Can you tell me now in your own words how you’ll give the medicine after surgery?" - "Now, would you be able to tell me in your own words when you need to bring your son to the emergency room?"

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

4. Did the doctor ask teach-back questions? If so, list those questions.

Nurse: Hello, my name is Jordan and I’m the nurse working with Dr. Ulualp. Dr. Ulualp let me know the plan, that we are scheduling your son for a tonsillectomy and adenoidectomy. Does that sound right? Parent: Yes, that’s correct. Nurse: Great, I’ll go over the post-operative care instructions with you. Once I finish explaining everything, I’ll ask a couple of questions to make sure that I explained every clearly. Parent: Okay, I understand. Nurse: Okay, so the recovery time for this surgery is typically about 2 weeks. During the 2 weeks, we will have your son started on a schedule of Acetaminophen/Tylenol and Ibuprofen/Motrin. He will take these medications q3h, alternating between the two medications. We do request that you give the medication overnight for the first 3-5 days after surgery. After that, you may begin to space out how often you give the medication. Now to discuss the post-operative restrictions, after the tonsillectomy and adenoidectomy, we will require your son to be absent from school for 1 week at the minimum, but he may need to be out of school for up to the full 2 weeks. In addition, he will also need to eat only soft foods for 2 weeks, and not participate in any sports or PE for 2 weeks as well. It is also imperative that your son receive adequate hydration, so please provide him with a variety of fluids to ensure this. We also want you to watch out for any post-surgical complications, such as hemorrhage or dehydration. Some symptoms of dehydration include limited voids, urine that is darker than normal, or dry oral mucosa. If you notice any of these, this means that your son needs to increase fluid intake. It is important to also watch out for hemorrhage. A small amount of blood is normal, but any amount of hemorrhage greater than or equal to one ounce would require emergent care. This blood may come from the nasopharynx, the mouth, or be present in emesis. Please bring your son to the emergency room for any hemorrhage larger than two tablespoons. We also recommend avoiding any red liquids, to avoid confusion with blood. Okay, that’s everything that you need to know, now I will ask you to state in your own words what you need to do after surgery. In your own words, when should you bring your child to the emergency room and how often you’ll give the medication after surgery? Parent: I will alternate acetaminophen and Tylenol every 3 hours. I should bring him to the emergency room for any amount of bleeding or too much urine. Nurse: I can see that I may have not explained this as clearly as I should have. Let me start again. First, I will talk about the medicine that he will take after surgery. Acetaminophen and Tylenol are actually the same medicine. Motrin and Ibuprofen are also the same medicine. What do you call them in your house? Parent: I see! We call them Tylenol and Motrin in our house. Nurse: Perfect, after the surgery you will alternate Tylenol and Motrin every 3 hours. For example, you would give Tylenol at 9am, and then 3 hours later, you would give Motrin. 3 hours after that, it would be time for Tylenol again. We recommend continuing this schedule at night as well. Can you tell me now in your own words how you’ll give the medicine after surgery? Parent: Yes, I will rotate Tylenol and Motrin back and forth every three hours, including waking up at night to take the medicine. Nurse: Yes exactly, thank you! I also want to make clear when you should bring your child to the emergency room. You will bring your son to the emergency room if he has any bleeding from his mouth, nose, or throws up 2 tablespoons or more of blood. A small amount of blood is okay, but anything two tablespoons or more is not normal. Now, would you be able to tell me in your own words when you need to bring your son to the emergency room? Parent: Yes, I need to bring my son to the emergency room for any bleeding that is 2 tablespoons or more. Nurse: That’s exactly correct, thank you so much for your time!

5. Did the nurse conduct the conversation overall in a manner that solicits the patient's response with the aim to repeat back important information? Yes, the nurse conducted the conversation in a manner that encouraged the parent to repeat back the important information, ensuring understanding of the post-operative care instructions.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

5. Did the doctor conduct the conversation overall in a manner that solicits the patient's response with the aim to repeat back important information?

HCP: Hi! I am going to go over postoperative care instructions with you prior to scheduling your child’s adenotonsillectomy surgery. Parent: Ok HCP: This surgery has a rough recovery, and your child will need to be out of school for at least one week. Some kids need up to two weeks out of school, and most feel better around 10 days. We will provide a school note for up to two weeks, and can complete paperwork or FMLA for whoever needs to stay home with them as well. We will let you know on the day of surgery exactly how much Tylenol and ibuprofen they can have, based on their weight, so we give them the highest dose that is safe for them. We will have you switch off between the medications every 3 hours, including overnight the first few nights. They will still have throat pain, regardless of the medication, but this should keep them comfortable. You may also try chloraseptic throat numbing spray that is available over the counter, and can help with localized numbing. Ear pain is common after surgery and is caused by a nerve in the back of the throat causing referred pain to the ears. The Tylenol and motrin should help with this, but you can also use a warm washcloth for comfort. The other big thing will be staying on top of their hydration. Your child may not want to each much food, which is ok, as long as they stay drinking lots of fluids. I recommend a variety of things like juice, Gatorade, or Pedialyte, so they’re still getting electrolytes. If they do want to eat, that is fine, just nothing crunchy or scratchy for two weeks after surgery. We recommend soft things like mac n cheese, mashed potatoes, spaghetti, pudding, ice cream. Cold things usually feel better on their throat. We want to stay away from foods with sharp edges like pizza crust, chips, taco shells – as these may scratch the throat and cause bleeding. Bleeding is the biggest risk after surgery. A little blood in their spit is normal, but if they have more than two tablespoons of blood we would want to see them in the emergency department right away. They can brush their teeth like normal, just no mouthwash. They will need to stay out of PE for 2 weeks, again to prevent bleeding. We recommend “couch activities” to keep them calmer and allow their body to heal. We will print all of this out for you to review. Do you have any questions? Parent: No HCP: Great! So how often will you give the pain medicine? Parent: Every 4 hours? HCP: You will actually want to give the pain medicine every 3 hours, switching off between the Tylenol and the motrin. For example, they would get Tylenol at 12 o’clock, ibuprofen at 3 o’clock, Tylenol again at 6 o’clock, ibuprofen at 9 o’clock and so on. We will let you know exactly how much they can get when they are discharged home. Parent: Ok that makes sense. I will give the medicines alternating every 3 hours. HCP: Correct! And you will bring them to the ER when? Parent: If they have any bleeding? HCP: We are actually ok with some bleeding or blood-tinged spit; this is normal. Reasons we would want to see them in the emergency room include more than two tablespoons of blood (demonstrating with hand the size of a tablespoon). If they cough up or spit out this amount of blood, we would want you to bring them in right away. Susie, you are old enough to watch for this. If you are back at school and have bleeding more than two spoonfuls, please let your teacher know right away and they can call your mom. Parent: Got it! If there is only a little blood in the spit, that is ok. If the bleeding is more than two tablespoons I will bring Susie to the ER right away.

1. Was the doctor welcoming? Why? The doctor was welcoming in the sense that they initiated the conversation with a friendly greeting and immediately informed the parents about the purpose of the discussion, which was to go over postoperative care instructions. However, the conversation is quite brief and focused on information delivery, so there isn't much personal warmth conveyed.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

1. Was the doctor welcoming? Why?

HCP: Hi! I am going to go over postoperative care instructions with you prior to scheduling your child’s adenotonsillectomy surgery. Parent: Ok HCP: This surgery has a rough recovery, and your child will need to be out of school for at least one week. Some kids need up to two weeks out of school, and most feel better around 10 days. We will provide a school note for up to two weeks, and can complete paperwork or FMLA for whoever needs to stay home with them as well. We will let you know on the day of surgery exactly how much Tylenol and ibuprofen they can have, based on their weight, so we give them the highest dose that is safe for them. We will have you switch off between the medications every 3 hours, including overnight the first few nights. They will still have throat pain, regardless of the medication, but this should keep them comfortable. You may also try chloraseptic throat numbing spray that is available over the counter, and can help with localized numbing. Ear pain is common after surgery and is caused by a nerve in the back of the throat causing referred pain to the ears. The Tylenol and motrin should help with this, but you can also use a warm washcloth for comfort. The other big thing will be staying on top of their hydration. Your child may not want to each much food, which is ok, as long as they stay drinking lots of fluids. I recommend a variety of things like juice, Gatorade, or Pedialyte, so they’re still getting electrolytes. If they do want to eat, that is fine, just nothing crunchy or scratchy for two weeks after surgery. We recommend soft things like mac n cheese, mashed potatoes, spaghetti, pudding, ice cream. Cold things usually feel better on their throat. We want to stay away from foods with sharp edges like pizza crust, chips, taco shells – as these may scratch the throat and cause bleeding. Bleeding is the biggest risk after surgery. A little blood in their spit is normal, but if they have more than two tablespoons of blood we would want to see them in the emergency department right away. They can brush their teeth like normal, just no mouthwash. They will need to stay out of PE for 2 weeks, again to prevent bleeding. We recommend “couch activities” to keep them calmer and allow their body to heal. We will print all of this out for you to review. Do you have any questions? Parent: No HCP: Great! So how often will you give the pain medicine? Parent: Every 4 hours? HCP: You will actually want to give the pain medicine every 3 hours, switching off between the Tylenol and the motrin. For example, they would get Tylenol at 12 o’clock, ibuprofen at 3 o’clock, Tylenol again at 6 o’clock, ibuprofen at 9 o’clock and so on. We will let you know exactly how much they can get when they are discharged home. Parent: Ok that makes sense. I will give the medicines alternating every 3 hours. HCP: Correct! And you will bring them to the ER when? Parent: If they have any bleeding? HCP: We are actually ok with some bleeding or blood-tinged spit; this is normal. Reasons we would want to see them in the emergency room include more than two tablespoons of blood (demonstrating with hand the size of a tablespoon). If they cough up or spit out this amount of blood, we would want you to bring them in right away. Susie, you are old enough to watch for this. If you are back at school and have bleeding more than two spoonfuls, please let your teacher know right away and they can call your mom. Parent: Got it! If there is only a little blood in the spit, that is ok. If the bleeding is more than two tablespoons I will bring Susie to the ER right away.

2. Did the doctor use medical jargon that is hard to understand for the general audience? If so, what are they? And replace them with layman language. The doctor used some medical terms that might be considered jargon: - "Adenotonsillectomy" could be replaced with "surgery to remove the tonsils and adenoids." - "FMLA" stands for the Family and Medical Leave Act, which could be explained as "a law that allows you to take time off work to care for your child without losing your job." - "Chloraseptic" is a brand name for a throat numbing spray, which could be described as "a spray you can buy without a prescription that numbs the throat." - "Referred pain" could be explained as "pain that shows up in a different part of the body than where the problem is." - "Electrolytes" could be described as "important minerals in your body fluids that are necessary for the body to function properly."

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

2. Did the doctor use medical jargon that is hard to understand for the general audience? If so, what are they? And replace them with layman language.

HCP: Hi! I am going to go over postoperative care instructions with you prior to scheduling your child’s adenotonsillectomy surgery. Parent: Ok HCP: This surgery has a rough recovery, and your child will need to be out of school for at least one week. Some kids need up to two weeks out of school, and most feel better around 10 days. We will provide a school note for up to two weeks, and can complete paperwork or FMLA for whoever needs to stay home with them as well. We will let you know on the day of surgery exactly how much Tylenol and ibuprofen they can have, based on their weight, so we give them the highest dose that is safe for them. We will have you switch off between the medications every 3 hours, including overnight the first few nights. They will still have throat pain, regardless of the medication, but this should keep them comfortable. You may also try chloraseptic throat numbing spray that is available over the counter, and can help with localized numbing. Ear pain is common after surgery and is caused by a nerve in the back of the throat causing referred pain to the ears. The Tylenol and motrin should help with this, but you can also use a warm washcloth for comfort. The other big thing will be staying on top of their hydration. Your child may not want to each much food, which is ok, as long as they stay drinking lots of fluids. I recommend a variety of things like juice, Gatorade, or Pedialyte, so they’re still getting electrolytes. If they do want to eat, that is fine, just nothing crunchy or scratchy for two weeks after surgery. We recommend soft things like mac n cheese, mashed potatoes, spaghetti, pudding, ice cream. Cold things usually feel better on their throat. We want to stay away from foods with sharp edges like pizza crust, chips, taco shells – as these may scratch the throat and cause bleeding. Bleeding is the biggest risk after surgery. A little blood in their spit is normal, but if they have more than two tablespoons of blood we would want to see them in the emergency department right away. They can brush their teeth like normal, just no mouthwash. They will need to stay out of PE for 2 weeks, again to prevent bleeding. We recommend “couch activities” to keep them calmer and allow their body to heal. We will print all of this out for you to review. Do you have any questions? Parent: No HCP: Great! So how often will you give the pain medicine? Parent: Every 4 hours? HCP: You will actually want to give the pain medicine every 3 hours, switching off between the Tylenol and the motrin. For example, they would get Tylenol at 12 o’clock, ibuprofen at 3 o’clock, Tylenol again at 6 o’clock, ibuprofen at 9 o’clock and so on. We will let you know exactly how much they can get when they are discharged home. Parent: Ok that makes sense. I will give the medicines alternating every 3 hours. HCP: Correct! And you will bring them to the ER when? Parent: If they have any bleeding? HCP: We are actually ok with some bleeding or blood-tinged spit; this is normal. Reasons we would want to see them in the emergency room include more than two tablespoons of blood (demonstrating with hand the size of a tablespoon). If they cough up or spit out this amount of blood, we would want you to bring them in right away. Susie, you are old enough to watch for this. If you are back at school and have bleeding more than two spoonfuls, please let your teacher know right away and they can call your mom. Parent: Got it! If there is only a little blood in the spit, that is ok. If the bleeding is more than two tablespoons I will bring Susie to the ER right away.

3. Count the number of key points that the doctor made. Did the doctor have to re-teach some of the points? If only 3 points were to keep, which 3 points should be kept? The doctor made several key points: - Recovery time and school absence - Pain management with Tylenol and ibuprofen - Use of throat numbing spray - Ear pain and its management - Importance of hydration and dietary recommendations - Avoiding crunchy or sharp foods - Normalcy of some bleeding, but excessive bleeding as an emergency - Oral hygiene and activity restrictions The doctor had to re-teach the point about the frequency of administering pain medication. The parent initially thought it was every 4 hours, but the doctor corrected them to every 3 hours. If only 3 points were to keep, the most critical ones would be: - Pain management with Tylenol and ibuprofen, including the correct frequency of administration. - The importance of hydration and dietary recommendations to avoid complications. - The guidance on when to seek emergency care for bleeding.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

3. Count the number of key points that the nurse made. Did the nurse have to re-teach some of the points? If only 3 points were to keep, which 3 points should be kept?

HCP: Hi! I am going to go over postoperative care instructions with you prior to scheduling your child’s adenotonsillectomy surgery. Parent: Ok HCP: This surgery has a rough recovery, and your child will need to be out of school for at least one week. Some kids need up to two weeks out of school, and most feel better around 10 days. We will provide a school note for up to two weeks, and can complete paperwork or FMLA for whoever needs to stay home with them as well. We will let you know on the day of surgery exactly how much Tylenol and ibuprofen they can have, based on their weight, so we give them the highest dose that is safe for them. We will have you switch off between the medications every 3 hours, including overnight the first few nights. They will still have throat pain, regardless of the medication, but this should keep them comfortable. You may also try chloraseptic throat numbing spray that is available over the counter, and can help with localized numbing. Ear pain is common after surgery and is caused by a nerve in the back of the throat causing referred pain to the ears. The Tylenol and motrin should help with this, but you can also use a warm washcloth for comfort. The other big thing will be staying on top of their hydration. Your child may not want to each much food, which is ok, as long as they stay drinking lots of fluids. I recommend a variety of things like juice, Gatorade, or Pedialyte, so they’re still getting electrolytes. If they do want to eat, that is fine, just nothing crunchy or scratchy for two weeks after surgery. We recommend soft things like mac n cheese, mashed potatoes, spaghetti, pudding, ice cream. Cold things usually feel better on their throat. We want to stay away from foods with sharp edges like pizza crust, chips, taco shells – as these may scratch the throat and cause bleeding. Bleeding is the biggest risk after surgery. A little blood in their spit is normal, but if they have more than two tablespoons of blood we would want to see them in the emergency department right away. They can brush their teeth like normal, just no mouthwash. They will need to stay out of PE for 2 weeks, again to prevent bleeding. We recommend “couch activities” to keep them calmer and allow their body to heal. We will print all of this out for you to review. Do you have any questions? Parent: No HCP: Great! So how often will you give the pain medicine? Parent: Every 4 hours? HCP: You will actually want to give the pain medicine every 3 hours, switching off between the Tylenol and the motrin. For example, they would get Tylenol at 12 o’clock, ibuprofen at 3 o’clock, Tylenol again at 6 o’clock, ibuprofen at 9 o’clock and so on. We will let you know exactly how much they can get when they are discharged home. Parent: Ok that makes sense. I will give the medicines alternating every 3 hours. HCP: Correct! And you will bring them to the ER when? Parent: If they have any bleeding? HCP: We are actually ok with some bleeding or blood-tinged spit; this is normal. Reasons we would want to see them in the emergency room include more than two tablespoons of blood (demonstrating with hand the size of a tablespoon). If they cough up or spit out this amount of blood, we would want you to bring them in right away. Susie, you are old enough to watch for this. If you are back at school and have bleeding more than two spoonfuls, please let your teacher know right away and they can call your mom. Parent: Got it! If there is only a little blood in the spit, that is ok. If the bleeding is more than two tablespoons I will bring Susie to the ER right away.

4. Did the doctor ask teach-back questions? If so, list those questions. Yes, the doctor asked teach-back questions: - "Great! So how often will you give the pain medicine?" - "Correct! And you will bring them to the ER when?"

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

4. Did the doctor ask teach-back questions? If so, list those questions.

HCP: Hi! I am going to go over postoperative care instructions with you prior to scheduling your child’s adenotonsillectomy surgery. Parent: Ok HCP: This surgery has a rough recovery, and your child will need to be out of school for at least one week. Some kids need up to two weeks out of school, and most feel better around 10 days. We will provide a school note for up to two weeks, and can complete paperwork or FMLA for whoever needs to stay home with them as well. We will let you know on the day of surgery exactly how much Tylenol and ibuprofen they can have, based on their weight, so we give them the highest dose that is safe for them. We will have you switch off between the medications every 3 hours, including overnight the first few nights. They will still have throat pain, regardless of the medication, but this should keep them comfortable. You may also try chloraseptic throat numbing spray that is available over the counter, and can help with localized numbing. Ear pain is common after surgery and is caused by a nerve in the back of the throat causing referred pain to the ears. The Tylenol and motrin should help with this, but you can also use a warm washcloth for comfort. The other big thing will be staying on top of their hydration. Your child may not want to each much food, which is ok, as long as they stay drinking lots of fluids. I recommend a variety of things like juice, Gatorade, or Pedialyte, so they’re still getting electrolytes. If they do want to eat, that is fine, just nothing crunchy or scratchy for two weeks after surgery. We recommend soft things like mac n cheese, mashed potatoes, spaghetti, pudding, ice cream. Cold things usually feel better on their throat. We want to stay away from foods with sharp edges like pizza crust, chips, taco shells – as these may scratch the throat and cause bleeding. Bleeding is the biggest risk after surgery. A little blood in their spit is normal, but if they have more than two tablespoons of blood we would want to see them in the emergency department right away. They can brush their teeth like normal, just no mouthwash. They will need to stay out of PE for 2 weeks, again to prevent bleeding. We recommend “couch activities” to keep them calmer and allow their body to heal. We will print all of this out for you to review. Do you have any questions? Parent: No HCP: Great! So how often will you give the pain medicine? Parent: Every 4 hours? HCP: You will actually want to give the pain medicine every 3 hours, switching off between the Tylenol and the motrin. For example, they would get Tylenol at 12 o’clock, ibuprofen at 3 o’clock, Tylenol again at 6 o’clock, ibuprofen at 9 o’clock and so on. We will let you know exactly how much they can get when they are discharged home. Parent: Ok that makes sense. I will give the medicines alternating every 3 hours. HCP: Correct! And you will bring them to the ER when? Parent: If they have any bleeding? HCP: We are actually ok with some bleeding or blood-tinged spit; this is normal. Reasons we would want to see them in the emergency room include more than two tablespoons of blood (demonstrating with hand the size of a tablespoon). If they cough up or spit out this amount of blood, we would want you to bring them in right away. Susie, you are old enough to watch for this. If you are back at school and have bleeding more than two spoonfuls, please let your teacher know right away and they can call your mom. Parent: Got it! If there is only a little blood in the spit, that is ok. If the bleeding is more than two tablespoons I will bring Susie to the ER right away.

5. Did the doctor conduct the conversation overall in a manner that solicits the patient's response with the aim to repeat back important information? Yes, the doctor conducted the conversation in a way that encouraged the parent to repeat back the information, particularly regarding the administration of pain medication and the circumstances under which to seek emergency care. This was done through the use of teach-back questions.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

5. Did the doctor conduct the conversation overall in a manner that solicits the patient's response with the aim to repeat back important information?

Nurse: Hello, I am Jordan, the nurse working with Dr. Ulualp. Dr. Ulualp let me know that your daughter will be scheduled for ear tube surgery for her ear infections. Does that sound right? Parent: Yes that is correct. Nurse: Great, I’ll go over what you need to know to take care of your child after the surgery. After this surgery, your child may feel a bit sleepy or cranky from the medicine used during surgery. This is normal and will get better as the medicine wears off. Your daughter may also have some liquid come out of her ears after the surgery. This liquid is called drainage, and it may be green, yellow, or even bloody. This is all normal. We will give you some ear drops after the surgery that you will use for one week to clean up this ear drainage. You will put 4 drops into both ears two times per day for the full week. Your child can go back to taking baths like normal and eating their regular foods after the surgery. The only restriction with the ear tubes is that we ask that your daughter use waterproof ear plugs in both of her ears to protect them when swimming in “dirty” water. Examples of “dirty” water are oceans, lakes, or ponds. The last thing I want to tell you is that if your daughter develops any drainage or liquid from her ears at any time in the future after the ear tube surgery, please call our office so we can send a prescription for more ear drops. That’s everything I wanted to tell you! Do you have any questions! Parent: Nope, thank you so much!

1. Was the nurse welcoming? Why? Yes, the nurse was welcoming. They introduced themselves, confirmed the patient's procedure, and expressed readiness to provide information about post-surgery care.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

1. Was the doctor welcoming? Why?

Nurse: Hello, I am Jordan, the nurse working with Dr. Ulualp. Dr. Ulualp let me know that your daughter will be scheduled for ear tube surgery for her ear infections. Does that sound right? Parent: Yes that is correct. Nurse: Great, I’ll go over what you need to know to take care of your child after the surgery. After this surgery, your child may feel a bit sleepy or cranky from the medicine used during surgery. This is normal and will get better as the medicine wears off. Your daughter may also have some liquid come out of her ears after the surgery. This liquid is called drainage, and it may be green, yellow, or even bloody. This is all normal. We will give you some ear drops after the surgery that you will use for one week to clean up this ear drainage. You will put 4 drops into both ears two times per day for the full week. Your child can go back to taking baths like normal and eating their regular foods after the surgery. The only restriction with the ear tubes is that we ask that your daughter use waterproof ear plugs in both of her ears to protect them when swimming in “dirty” water. Examples of “dirty” water are oceans, lakes, or ponds. The last thing I want to tell you is that if your daughter develops any drainage or liquid from her ears at any time in the future after the ear tube surgery, please call our office so we can send a prescription for more ear drops. That’s everything I wanted to tell you! Do you have any questions! Parent: Nope, thank you so much!

2. Did the nurse use medical jargon that is hard to understand for a general audience? If so, what are they? And replace them with layman language. The nurse used the term "drainage," which might be considered medical jargon. However, they explained it as "liquid coming out of the ears," which is understandable for a general audience. The term "medicine" could also be considered jargon, but it is commonly understood to mean "medication" or "drugs."

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

2. Did the doctor use medical jargon that is hard to understand for the general audience? If so, what are they? And replace them with layman language.

Nurse: Hello, I am Jordan, the nurse working with Dr. Ulualp. Dr. Ulualp let me know that your daughter will be scheduled for ear tube surgery for her ear infections. Does that sound right? Parent: Yes that is correct. Nurse: Great, I’ll go over what you need to know to take care of your child after the surgery. After this surgery, your child may feel a bit sleepy or cranky from the medicine used during surgery. This is normal and will get better as the medicine wears off. Your daughter may also have some liquid come out of her ears after the surgery. This liquid is called drainage, and it may be green, yellow, or even bloody. This is all normal. We will give you some ear drops after the surgery that you will use for one week to clean up this ear drainage. You will put 4 drops into both ears two times per day for the full week. Your child can go back to taking baths like normal and eating their regular foods after the surgery. The only restriction with the ear tubes is that we ask that your daughter use waterproof ear plugs in both of her ears to protect them when swimming in “dirty” water. Examples of “dirty” water are oceans, lakes, or ponds. The last thing I want to tell you is that if your daughter develops any drainage or liquid from her ears at any time in the future after the ear tube surgery, please call our office so we can send a prescription for more ear drops. That’s everything I wanted to tell you! Do you have any questions! Parent: Nope, thank you so much!

3. Count the number of key points that the nurse made. Did the nurse have to re-teach some of the points? If only 3 points were to keep, which 3 points should be kept? The nurse made several key points: - The child may feel sleepy or cranky from the anesthesia. - Expect ear drainage after surgery, which may be various colors. - Use prescribed ear drops for one week. - The child can bathe and eat normally after surgery. - Use waterproof ear plugs when swimming in natural bodies of water. - Contact the office for a prescription if ear drainage occurs in the future. The nurse did not have to re-teach any points. If only three points were to be kept, they should be: - Use prescribed ear drops for one week. - Use waterproof ear plugs when swimming in natural bodies of water. - Contact the office for a prescription if ear drainage occurs in the future.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

3. Count the number of key points that the nurse made. Did the nurse have to re-teach some of the points? If only 3 points were to keep, which 3 points should be kept?

Nurse: Hello, I am Jordan, the nurse working with Dr. Ulualp. Dr. Ulualp let me know that your daughter will be scheduled for ear tube surgery for her ear infections. Does that sound right? Parent: Yes that is correct. Nurse: Great, I’ll go over what you need to know to take care of your child after the surgery. After this surgery, your child may feel a bit sleepy or cranky from the medicine used during surgery. This is normal and will get better as the medicine wears off. Your daughter may also have some liquid come out of her ears after the surgery. This liquid is called drainage, and it may be green, yellow, or even bloody. This is all normal. We will give you some ear drops after the surgery that you will use for one week to clean up this ear drainage. You will put 4 drops into both ears two times per day for the full week. Your child can go back to taking baths like normal and eating their regular foods after the surgery. The only restriction with the ear tubes is that we ask that your daughter use waterproof ear plugs in both of her ears to protect them when swimming in “dirty” water. Examples of “dirty” water are oceans, lakes, or ponds. The last thing I want to tell you is that if your daughter develops any drainage or liquid from her ears at any time in the future after the ear tube surgery, please call our office so we can send a prescription for more ear drops. That’s everything I wanted to tell you! Do you have any questions! Parent: Nope, thank you so much!

4. Did the nurse ask teach-back questions? If so, list those questions. No, the nurse did not ask any teach-back questions.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

4. Did the doctor ask teach-back questions? If so, list those questions.

Nurse: Hello, I am Jordan, the nurse working with Dr. Ulualp. Dr. Ulualp let me know that your daughter will be scheduled for ear tube surgery for her ear infections. Does that sound right? Parent: Yes that is correct. Nurse: Great, I’ll go over what you need to know to take care of your child after the surgery. After this surgery, your child may feel a bit sleepy or cranky from the medicine used during surgery. This is normal and will get better as the medicine wears off. Your daughter may also have some liquid come out of her ears after the surgery. This liquid is called drainage, and it may be green, yellow, or even bloody. This is all normal. We will give you some ear drops after the surgery that you will use for one week to clean up this ear drainage. You will put 4 drops into both ears two times per day for the full week. Your child can go back to taking baths like normal and eating their regular foods after the surgery. The only restriction with the ear tubes is that we ask that your daughter use waterproof ear plugs in both of her ears to protect them when swimming in “dirty” water. Examples of “dirty” water are oceans, lakes, or ponds. The last thing I want to tell you is that if your daughter develops any drainage or liquid from her ears at any time in the future after the ear tube surgery, please call our office so we can send a prescription for more ear drops. That’s everything I wanted to tell you! Do you have any questions! Parent: Nope, thank you so much!

5. Did the nurse conduct the conversation overall in a manner that solicits the patient's response with the aim to repeat back important information? No, the nurse provided information but did not solicit the patient's response to confirm understanding through teach-back or other methods that would have the patient repeat the information.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

5. Did the doctor conduct the conversation overall in a manner that solicits the patient's response with the aim to repeat back important information?

HCP: Hi! I am going to go over postoperative care instructions with you prior to scheduling your child’s adenotonsillectomy surgery. Parent: Ok HCP: This surgery has a rough recovery, and your child will need to be out of school for at least one week. Some kids need up to two weeks out of school, and most feel better around 10 days. We will provide a school note for up to two weeks, and can complete paperwork or FMLA for whoever needs to stay home with them as well. We will let you know on the day of surgery exactly how much Tylenol and ibuprofen they can have, based on their weight, so we give them the highest dose that is safe for them. We will have you switch off between the medications every 3 hours, including overnight the first few nights. They will still have throat pain, regardless of the medication, but this should keep them comfortable. You may also try chloraseptic throat numbing spray that is available over the counter, and can help with localized numbing. Ear pain is common after surgery and is caused by a nerve in the back of the throat causing referred pain to the ears. The Tylenol and motrin should help with this, but you can also use a warm washcloth for comfort. The other big thing will be staying on top of their hydration. Your child may not want to each much food, which is ok, as long as they stay drinking lots of fluids. I recommend a variety of things like juice, Gatorade, or Pedialyte, so they’re still getting electrolytes. If they do want to eat, that is fine, just nothing crunchy or scratchy for two weeks after surgery. We recommend soft things like mac n cheese, mashed potatoes, spaghetti, pudding, ice cream. Cold things usually feel better on their throat. We want to stay away from foods with sharp edges like pizza crust, chips, taco shells – as these may scratch the throat and cause bleeding. Bleeding is the biggest risk after surgery. A little blood in their spit is normal, but if they have more than two tablespoons of blood we would want to see them in the emergency department right away. They can brush their teeth like normal, just no mouthwash. They will need to stay out of PE for 2 weeks, again to prevent bleeding. We recommend “couch activities” to keep them calmer and allow their body to heal. We will print all of this out for you to review. Do you have any questions? Parent: No HCP: Great! Let’s get you scheduled!

1. The doctor was welcoming as they initiated the conversation with a friendly greeting and immediately explained the purpose of the discussion, which was to go over postoperative care instructions for the child's upcoming surgery.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

1. Was the doctor welcoming? Why?

HCP: Hi! I am going to go over postoperative care instructions with you prior to scheduling your child’s adenotonsillectomy surgery. Parent: Ok HCP: This surgery has a rough recovery, and your child will need to be out of school for at least one week. Some kids need up to two weeks out of school, and most feel better around 10 days. We will provide a school note for up to two weeks, and can complete paperwork or FMLA for whoever needs to stay home with them as well. We will let you know on the day of surgery exactly how much Tylenol and ibuprofen they can have, based on their weight, so we give them the highest dose that is safe for them. We will have you switch off between the medications every 3 hours, including overnight the first few nights. They will still have throat pain, regardless of the medication, but this should keep them comfortable. You may also try chloraseptic throat numbing spray that is available over the counter, and can help with localized numbing. Ear pain is common after surgery and is caused by a nerve in the back of the throat causing referred pain to the ears. The Tylenol and motrin should help with this, but you can also use a warm washcloth for comfort. The other big thing will be staying on top of their hydration. Your child may not want to each much food, which is ok, as long as they stay drinking lots of fluids. I recommend a variety of things like juice, Gatorade, or Pedialyte, so they’re still getting electrolytes. If they do want to eat, that is fine, just nothing crunchy or scratchy for two weeks after surgery. We recommend soft things like mac n cheese, mashed potatoes, spaghetti, pudding, ice cream. Cold things usually feel better on their throat. We want to stay away from foods with sharp edges like pizza crust, chips, taco shells – as these may scratch the throat and cause bleeding. Bleeding is the biggest risk after surgery. A little blood in their spit is normal, but if they have more than two tablespoons of blood we would want to see them in the emergency department right away. They can brush their teeth like normal, just no mouthwash. They will need to stay out of PE for 2 weeks, again to prevent bleeding. We recommend “couch activities” to keep them calmer and allow their body to heal. We will print all of this out for you to review. Do you have any questions? Parent: No HCP: Great! Let’s get you scheduled!

2. The doctor used some medical terms that might be unfamiliar to a general audience: - Adenotonsillectomy: This is the surgical removal of the adenoids and tonsils. - FMLA: The Family and Medical Leave Act, a U.S. labor law requiring covered employers to provide employees with job-protected and unpaid leave for qualified medical and family reasons. - Chloraseptic: A brand of throat numbing spray. - Referred pain: Pain perceived at a location other than the site of the painful stimulus. - Electrolytes: Minerals in body fluids that carry an electric charge and are essential for bodily functions. - PE: Physical Education, a school subject that involves physical exercise and games.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

2. Did the doctor use medical jargon that is hard to understand for the general audience? If so, what are they? And replace them with layman language.

HCP: Hi! I am going to go over postoperative care instructions with you prior to scheduling your child’s adenotonsillectomy surgery. Parent: Ok HCP: This surgery has a rough recovery, and your child will need to be out of school for at least one week. Some kids need up to two weeks out of school, and most feel better around 10 days. We will provide a school note for up to two weeks, and can complete paperwork or FMLA for whoever needs to stay home with them as well. We will let you know on the day of surgery exactly how much Tylenol and ibuprofen they can have, based on their weight, so we give them the highest dose that is safe for them. We will have you switch off between the medications every 3 hours, including overnight the first few nights. They will still have throat pain, regardless of the medication, but this should keep them comfortable. You may also try chloraseptic throat numbing spray that is available over the counter, and can help with localized numbing. Ear pain is common after surgery and is caused by a nerve in the back of the throat causing referred pain to the ears. The Tylenol and motrin should help with this, but you can also use a warm washcloth for comfort. The other big thing will be staying on top of their hydration. Your child may not want to each much food, which is ok, as long as they stay drinking lots of fluids. I recommend a variety of things like juice, Gatorade, or Pedialyte, so they’re still getting electrolytes. If they do want to eat, that is fine, just nothing crunchy or scratchy for two weeks after surgery. We recommend soft things like mac n cheese, mashed potatoes, spaghetti, pudding, ice cream. Cold things usually feel better on their throat. We want to stay away from foods with sharp edges like pizza crust, chips, taco shells – as these may scratch the throat and cause bleeding. Bleeding is the biggest risk after surgery. A little blood in their spit is normal, but if they have more than two tablespoons of blood we would want to see them in the emergency department right away. They can brush their teeth like normal, just no mouthwash. They will need to stay out of PE for 2 weeks, again to prevent bleeding. We recommend “couch activities” to keep them calmer and allow their body to heal. We will print all of this out for you to review. Do you have any questions? Parent: No HCP: Great! Let’s get you scheduled!

3. The doctor made several key points: - The child will need to be out of school for 1-2 weeks. - Medication dosages will be provided based on the child's weight. - The importance of alternating Tylenol and ibuprofen every 3 hours. - The use of throat numbing spray and warm washcloth for comfort. - The necessity of hydration and the types of fluids recommended. - Dietary restrictions post-surgery. - The risk of bleeding and what to do if it occurs. - Oral hygiene instructions and activity restrictions post-surgery. If only 3 points were to be kept, they should be: - The importance of pain management and medication schedule. - The necessity of hydration and dietary restrictions to prevent complications. - The risk of bleeding and the immediate actions to take if it occurs.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

3. Count the number of key points that the nurse made. Did the nurse have to re-teach some of the points? If only 3 points were to keep, which 3 points should be kept?

HCP: Hi! I am going to go over postoperative care instructions with you prior to scheduling your child’s adenotonsillectomy surgery. Parent: Ok HCP: This surgery has a rough recovery, and your child will need to be out of school for at least one week. Some kids need up to two weeks out of school, and most feel better around 10 days. We will provide a school note for up to two weeks, and can complete paperwork or FMLA for whoever needs to stay home with them as well. We will let you know on the day of surgery exactly how much Tylenol and ibuprofen they can have, based on their weight, so we give them the highest dose that is safe for them. We will have you switch off between the medications every 3 hours, including overnight the first few nights. They will still have throat pain, regardless of the medication, but this should keep them comfortable. You may also try chloraseptic throat numbing spray that is available over the counter, and can help with localized numbing. Ear pain is common after surgery and is caused by a nerve in the back of the throat causing referred pain to the ears. The Tylenol and motrin should help with this, but you can also use a warm washcloth for comfort. The other big thing will be staying on top of their hydration. Your child may not want to each much food, which is ok, as long as they stay drinking lots of fluids. I recommend a variety of things like juice, Gatorade, or Pedialyte, so they’re still getting electrolytes. If they do want to eat, that is fine, just nothing crunchy or scratchy for two weeks after surgery. We recommend soft things like mac n cheese, mashed potatoes, spaghetti, pudding, ice cream. Cold things usually feel better on their throat. We want to stay away from foods with sharp edges like pizza crust, chips, taco shells – as these may scratch the throat and cause bleeding. Bleeding is the biggest risk after surgery. A little blood in their spit is normal, but if they have more than two tablespoons of blood we would want to see them in the emergency department right away. They can brush their teeth like normal, just no mouthwash. They will need to stay out of PE for 2 weeks, again to prevent bleeding. We recommend “couch activities” to keep them calmer and allow their body to heal. We will print all of this out for you to review. Do you have any questions? Parent: No HCP: Great! Let’s get you scheduled!

4. The doctor did not ask teach-back questions directly. They provided information and ended with an open-ended question asking if the parents had any questions.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

4. Did the doctor ask teach-back questions? If so, list those questions.

HCP: Hi! I am going to go over postoperative care instructions with you prior to scheduling your child’s adenotonsillectomy surgery. Parent: Ok HCP: This surgery has a rough recovery, and your child will need to be out of school for at least one week. Some kids need up to two weeks out of school, and most feel better around 10 days. We will provide a school note for up to two weeks, and can complete paperwork or FMLA for whoever needs to stay home with them as well. We will let you know on the day of surgery exactly how much Tylenol and ibuprofen they can have, based on their weight, so we give them the highest dose that is safe for them. We will have you switch off between the medications every 3 hours, including overnight the first few nights. They will still have throat pain, regardless of the medication, but this should keep them comfortable. You may also try chloraseptic throat numbing spray that is available over the counter, and can help with localized numbing. Ear pain is common after surgery and is caused by a nerve in the back of the throat causing referred pain to the ears. The Tylenol and motrin should help with this, but you can also use a warm washcloth for comfort. The other big thing will be staying on top of their hydration. Your child may not want to each much food, which is ok, as long as they stay drinking lots of fluids. I recommend a variety of things like juice, Gatorade, or Pedialyte, so they’re still getting electrolytes. If they do want to eat, that is fine, just nothing crunchy or scratchy for two weeks after surgery. We recommend soft things like mac n cheese, mashed potatoes, spaghetti, pudding, ice cream. Cold things usually feel better on their throat. We want to stay away from foods with sharp edges like pizza crust, chips, taco shells – as these may scratch the throat and cause bleeding. Bleeding is the biggest risk after surgery. A little blood in their spit is normal, but if they have more than two tablespoons of blood we would want to see them in the emergency department right away. They can brush their teeth like normal, just no mouthwash. They will need to stay out of PE for 2 weeks, again to prevent bleeding. We recommend “couch activities” to keep them calmer and allow their body to heal. We will print all of this out for you to review. Do you have any questions? Parent: No HCP: Great! Let’s get you scheduled!

5. The doctor conducted the conversation in a manner that was informative and directive, but they did not explicitly solicit the patient's response with the aim to have them repeat back important information. The doctor did provide an opportunity for questions at the end, but there was no specific request for the parent to confirm understanding through teach-back.

You will be provided with the texts of conversations between a doctor/nurse and the patient's parents. Act like a healthcare professor to evalute the conversations based on provided numbered prompts. Your response should be detailed, concise, and clear. Use as few words as necessary without sacrificing quality.

5. Did the doctor conduct the conversation overall in a manner that solicits the patient's response with the aim to repeat back important information?