This article investigates the contribution visual rhetoric and rhetorical genre studies (RGS) can make to health care education and communication genres. Through a visual rhetorical analysis of a patient record used in an optometry teaching clinic, this article illustrates that a genre's visual representations provide significant insights into the social action of that genre. These insights are deepened by an insider analysis of the patient record that highlights how content analyses of visual designs need to be elaborated by contextual considerations. A combined visual rhetoric and RGS analysis shows that clinical novices learn to interpret the record's visual cues to safely traverse the complex requirements of this apprenticeship genre. The article demonstrates that visual rhetoric research can meaningfully contribute to the understanding of genres by presenting an enriched contextual analysis achieved by consulting with context insiders.