I lived in San Juan, Puerto Rico in the winter of 2019 working full time as a designer for Fresenius Medical Care while learning Spanish, with the goal of conducting user research in Spanish with patients and immersing myself in the culture and context of Puerto Rico.

An immersive experience project


Fresenius Medical Care has more than 30 dialysis clinics in Puerto Rico, and according to the National Kidney Foundation, there were 83,691 Hispanics or Latinos on dialysis in the 50 US states in 2013. I therefore felt it was important to explore, how might the experience of our non-English speaking patients and care partners be impacted by their cultural context and native language?

I sought to better understand our Spanish-speaking patient population and immerse myself in a culture outside of my own to develop further as a human-centered designer.

  • Spanish language improvement to conduct user research now and in the future
  • Spanish language audit of patient portal
  • Informal portal investigation in Puerto Rico
  • Disaster response application investigation
  • Cultural immersion and exploration

I moved from Boston, MA to San Juan, Puerto Rico from January 27th - April 27th, 2019.

User research in Spanish

My normal tasks as a senior UX designer for the patient Portal team did not change – I continued to work remotely for the Portal team, conducting remote research with patients, providing and iterating designs for various new features and improvements, and attending daily scrum calls with my team. The foundational goal of being in Puerto Rico was to achieve conversational fluency in Spanish in order to conduct user research now and in the future.

I studied Spanish in a one-on-one setting for fourteen hours a week, for twelve weeks, including a two week homestay immersion experience.

By the end of my three months on the island, I was able to travel to ten different dialysis clinics and have informal conversations in Spanish with eighteen patients, ten clinical staff, and members of my company's distribution and operations team in Puerto Rico.

In addition to making improvements to the Spanish-language version of the patient Portal, patient and care giver interviews were aimed at understanding a population of users that we haven’t talked to yet.

A few anecdotal observations from these conversations included:

Cross cultural design and the role of UX

My time in Puerto Rico intensified my curiosity around the crossroads of culture and design. As a product and experience designer, I value the ability to empathize, work with, understand, and hold many different communities, perspectives, and points of view at the same time. I researched and presented on the topic of cross cultural design and the role of UX for the Fresenius Department of User Experience after returning home in the Spring of 2019.

“It is no longer enough to simply offer a product translated in ten to twenty different languages. Users also want a product that acknowledges their unique cultural characteristics and business practices.”

- Elisa M. del Galdo and Jakob Nielsen, International User Interfaces

Hofstede Cultural Country Comparison

Around the world, people move through the world and interact differently based on the culture in which they belong. Dutch social psychologist Geert Hofstede identified six aspects of cultural differences in his Cultural Dimensions Theory:

Learn more about Geert Hofstede's Cultural Dimensions Theory here.

GEERT HOFSTEDE'S cultural comparison: puerto rico and the united states
So what?

It’s easy to assume that some countries (such as Puerto Rico and and U.S.) are culturally similar—and in many ways that’s true. But when it comes to cross-cultural user experience design, understanding the differences between cultures is essential in creating an acceptable product and meeting user needs.

My trip was not a systematic evaluation of the cultural differences between the US and Puerto Rico, and therefore my findings cannot be definitively representative in regards to how these differences impact our user's experience. However, my immersive experience in Puerto Rican culture and language has shaped my mindset as a designer and user experience researcher.

Outcome & reflection

What's next?

I am currently working on a capstone video project to capture the narrative of my time and experience in Puerto Rico. I continue to work on my Spanish skills to conduct user research in Spanish now and in the future. I am extremely passionate about continuing this project and work in exploring the intersection of design thinking, language, culture, and social impact.

final thoughts

This immersive experience project was fueled by the belief that the people who face problems every day are the ones who hold the key to their answer. I feel incredibly lucky to have had the chance to spend even a small amount of time in Puerto Rico, as it illustrated the importance of designing with communities, of understanding deeply the people we look to serve, and of creating solutions rooted in people’s actual needs.