We often think of visual tools, like icons, emojis and pictograms, as a form of communication that is understood everywhere. A pill icon means medicine. A heart icon means love. A red circle with a diagonal bar through it means some kind of prohibition.

Wouldn’t you agree?

Not quite.

While many visuals can be intuitively understood, others require learning, context and  repeated exposure to be understood correctly. This is especially so in healthcare, where accuracy and clarity can impact real outcomes.

This article looks at the spectrum of learnability across different kinds of visuals and how this has an impact on how effective they are. We also consider how designers, clinicians and communicators can better match the visual tool to the context, especially when patients need to understand, trust and act on the information.

The Spectrum of Visual Learnability

Visual tools do not all ‘land’ with users in the same way. Some are understood instantly, while others are ambiguous or culturally dependent until they are explained. We can see them on a ‘learnability spectrum’ from intuitive to dependent on instruction.

Category 1: Instantly Intuitive

These are visuals that are universally or near-universally understood, regardless of age, language or culture.

For example:

• 🛑 Red stop sign

• 💊 Pill = medicine

• 🚫 Circle slash = "no" or “do not”

• 😷 Face mask emoji = illness or health protection

• 🔥 = hot or danger

However, a great deal of these still rely on deep cultural learning or metaphor. All of them have been learnt. We think that we do not need to be told what a stop sign means if you have seen roads. A red X instinctively means “wrong” or “danger” in Western cultures, but this is not universal. There would have been a time, even in Western societies, where the first contact the circle clash or the stop sign caused us to stop and think ‘what does THAT mean?’. Now, we see them as intuitive because of repeated exposure. This means that we understand them instantly when we encounter them because there is no doubt or ambiguity as to their intended meaning.

Category 2: Familiar but Ambiguous

These are visuals that are widely seen but can be interpreted in multiple ways, especially outside of their original context.

For example:

• 🍽️ = meal? restaurant? dining?

• 🧪 = lab work? chemicals? science class?

• ❤️ = love? heart health? favourite?

• 🤒 = sick? tired? not feeling well?

• 🔋 = battery? energy? tiredness?

These are familiar visuals, but not always precise. Their meaning depends on context, whether cultural, emotional or situational.

In health communication, these icons need to be used with supporting text or icon sequences. Category 2 visuals should not be used to carry medical meaning on their own, especially in critical instructions or forms.

Category 3: Learned or Technical

This category involves visuals that require explanation or exposure to understand. They are often abstract, specialised or based on conventions unfamiliar to the average user.

Examples:

• 🩺 Stethoscope icon as "consult a doctor”.

• 🕒 ➝ 💊 = timed dose

• 🧬 = genetics or hereditary condition

• 🚻 = toilet (not recognized globally)

• ISO safety pictograms (e.g., skull and crossbones for toxicity).

Many medical icons fall into this category: they are clear to clinicians or people ‘in the know’ such as system designers, but not necessarily to lay people or their caregivers.

In health communication, this category of visuals needs to be used with labels. This is ideal in digital systems where functions like hover text, info bubbles, mouseover pop-ups are possible. However, they can be confusing in static printed materials if the visuals are not explained. In that case, they could be paired with a label, as well as including a glossary.

Applying This to Written Health Communication

In written health materials, visuals have to work in harmony with the text, not as decoration, but as tools that enhance comprehension.

Patient Information Leaflets and Medication Guides

These documents explain medication use, safety and doing. They are often the first place where patients encounter medical visuals.

In this context, designers need to think about:

-            Using intuitive pictograms, e.g. ⚠️

-            Not overloading text with abstract icons, such as 🧬, unless they are clearly defined with accompanying text.

-            Reinforcing the visual with bold text and minimal clutter.

-            If an icon must be learnt, e.g. virus shapes or lab test icons, make the learning part of the campaign. Learning happens with repetition.

Consent Forms and Instructions

Informed consent forms are legal and procedural documents, often dense, intimidating and vital for ethical and safe practice. Visuals also have a role here, where familiar icons could be used to guide navigation through otherwise dense walls of text. For example:

📄 = “read this section”
✅ = “sign here”
📞 = “call if you have questions”

Designers should be cautious with emojis, as they can undermine the perceived seriousness of the document. Less intuitive symbols, such as technical procedure icons, should include a visual glossary or inline definitions.

Digital Interfaces and Health Apps

Unlike paper-based static materials, apps allow for progressive learning. This makes them perfect for introducing more complex icon systems over time.

Designers could:

-            Start with intuitive or well-known visuals to build trust and confidence.

-            Introduce abstract or advanced icons, such as symptoms, actions, outcomes, through onboarding, tooltips or repetition.

Digital tools are the best forum to build up icon sequences and, therefore, visual literacy, such as 🕖 ➝ 💊 ➝ 🥛 = “Take your pill with water at 7am.” This can support long-term understanding and user autonomy.

Towards a Visual Literacy

Visual Literacy is both a skill and a design responsibility. It cannot be assumed that all patients, regardless of different cultural, linguistic or educational backgrounds, will instantly recognise every visual that are used in health communication or in wider life contexts.

By developing visuals with learnability in mind, designers need to:

-            Prioritise clarity over creativity.

-            Use redundancy, i.e. icon + text, when comprehension is critical.

-            Repeat icons consistently across documents and platforms.

-            Be transparent about meaning.

-            Make visuals teachable.

We need to consider visual literacy as a learnable skill, just like any other forms of literacy. By implementing visuals in communication that support learning, we turn icons, emojis and pictograms into tools of empowerment.

Thank you for reading,

Mark Gibson

Leeds, United Kingdom, April 2025