The importance of teaching clinicians when and how to work with interpreters

John H. Stroger, Jr Hospital of Cook County, USA.
Patient Education and Counseling (Impact Factor: 2.2). 02/2010; 78(2):149-53. DOI: 10.1016/j.pec.2009.12.001
Source: PubMed


To describe the importance of teaching clinicians when and how to overcome language barriers in clinical practice, provide an example of a curriculum for teaching on this topic, and outline the critical issues that must be addressed in this type of teaching.
We describe a 1.5h educational program for students in a large urban medical school as an example curriculum and how it impacted student responses on a 28-item questionnaire measuring their knowledge, attitudes and likelihood of future behaviour before and after the course. The course components are described and highlight the essential components that should be included in teaching about overcoming language barriers in clinical practice.
There were significant improvments in knowledge, attitudes, and reported likelihood of future behaviors after the educational program. Recommendations for essetential curricular components are made.
Teaching clinicians about language barriers in health care and how to overcome them should be essential to all clinical curricula. Brief educational interventions can meet this need and should include a core set of essential teaching points as outlined.
Teaching clinicians when and how to overcome language barriers in health care will help to reduce the impact of this barrier, make clinicians and interpreters' jobs easier and more transparent, and improve patient care and satisfaction.

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    • "However, these studies also acknowledge issues related to this blurring of boundaries and the tensions between the provider's medical expertise and the interpreter's cultural expertise. Jacobs et al. (2010) argued against the use of ad hoc interpreters such as family and friends and advocated education of clinicians in the use of trained medical interpreters. Valero Garc es' (2005) institutional discourse analysis conducted in Spain and the USA contrasted three types of exchange: doctor/foreign-language patient; doctor/ foreign-language patient/ad hoc interpreter (husband); doctor/ foreign-language patient/trained interpreter and made similar recommendations viz the preferred use of trained hospital interpreters and education for clinicians in working effectively with interpreters. "
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    ABSTRACT: The global movements of healthcare professionals and patient populations have increased the complexities of medical interactions at the point of service. This study examines interpreter mediated talk in cross-cultural general dentistry in Hong Kong where assisting para-professionals, in this case bilingual or multilingual Dental Surgery Assistants (DSAs), perform the dual capabilities of clinical assistant and interpreter. An initial language use survey was conducted with Polyclinic DSAs (n = 41) using a logbook approach to provide self-report data on language use in clinics. Frequencies of mean scores using a 10-point visual analogue scale (VAS) indicated that the majority of DSAs spoke mainly Cantonese in clinics and interpreted for postgraduates and professors. Conversation Analysis (CA) examined recipient design across a corpus (n = 23) of video-recorded review consultations between non-Cantonese speaking expatriate dentists and their Cantonese L1 patients. Three patterns of mediated interpreting indicated were: dentist designated expansions; dentist initiated interpretations; and assistant initiated interpretations to both the dentist and patient. The third, rather than being perceived as negative, was found to be framed either in response to patient difficulties or within the specific task routines of general dentistry. The findings illustrate trends in dentistry towards personalized care and patient empowerment as a reaction to product delivery approaches to patient management. Implications are indicated for both treatment adherence and the education of dental professionals. Copyright © 2015 Elsevier Ltd. All rights reserved.
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    • "Unfortunately, in many contexts practices remain suboptimal. Not all physicians receive training in how to work with an interpreter, and many may overestimate their skills [40-42]. In a study in Geneva, we found that while physicians and medical students considered themselves highly skilled, most were unable to name basic elements of effective collaboration with an interpreter [42]. "
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    ABSTRACT: Patient-provider communication, in particular physicians' ability to listen to their patients, and support them in making difficult lifestyle changes, is an essential component of effective diabetes care. Clinical communication around diabetes can be especially challenging when language barriers are present, and may contribute to poor diabetes management and outcomes. Clinicians need to be aware of and address potential communication difficulties associated with interpreter-mediated consultations. The purpose of our study was to explore how physicians communicate in interpreter-mediated consultations with diabetic patients, and how their communication behaviors may impact diabetes communication and care. We analyzed transcripts from 8 audio recorded, outpatient consultations at the Basel University Hospital general medicine outpatient clinic involving Turkish-speaking patients, German-speaking physicians, and Turkish-German interpreters (both community interpreters and family members). Clinicians used closed questions when asking about symptoms and glucose control. When providing information and explanation, they spoke in long and complex speech turns. They often directed their speech to interpreters or became sidetracked by family members' questions or requests for information. Patients' participation in the consultation was minimal, and limited to brief answers to clinicians' questions. Clinicians need to be aware of common pitfalls that diminish patient-centeredness during interpreter-mediated consultations, and learn strategies to avoid them. Attention to established guidelines on triadic communication is recommended, as is hands-on training with interpreters.
    Full-text · Article · Oct 2013 · BMC Family Practice
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    • "There appears to be a paucity of academic literature on the subject of learning and teaching through an interpreter. Research has uncovered publications about the use of interpreters in social work (Baker, 1981) and medicine (Jacobs et al, 2009; Smith et al, 2006), and references to these works have been provided in the bibliography. There is some information on the issues faced by deaf students who require the services of interpreters in mainstream education; for example, Foster et al (1999). "

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