Week 2 – Discussion Board 1

[Art Liebl]

In at least 250 words, discuss the benefits of doing a pre-session with Yourself, the provider and the patient? What are possible scenarios that might be avoided by doing a pre-session? Do you think it is always necessary to do a pre-session with providers? Reply to two fellow students by Monday.

[Leonisa Avelino]

I believe a pre-session between the interpreter, provider, and patient is a very important step in ensuring effective communication in medical settings. This meeting allows the interpreter to clarify expectations, understand the medical context, and establish guidelines for a smooth interaction.

One key benefit of a pre-session is ensuring that all parties understand the interpreter’s role. Medical professionals may not always be familiar with best practices for working with interpreters, so a pre-session helps set expectations, such as speaking directly to the patient rather than the interpreter. Additionally, it allows the interpreter to learn any complex medical terminology that may arise during the session, reducing confusion and improving accuracy.

A pre-session can also help prevent misunderstandings. For example, if a provider is unaware of cultural sensitivities, they may phrase a question in a way that could offend the patient. An interpreter who is familiar with the patient’s cultural background can help the provider navigate these differences. Another scenario that could be avoided is misinterpretation due to lack of context. If an interpreter enters a session without understanding the patient’s medical history or reason for the visit, they may struggle with terminology or miss subtle nuances in meaning.

While a pre-session is beneficial, and highly encouraged, it may not always be necessary. In emergency situations where immediate interpretation is needed, there may not be time for a pre-session. Also, when an interpreter is familiar with a particular department p\or physician a pre-session is not necessary. Another unnecessary case would be when an interpreter has many years of experience working in an office setting.

[Lesly Betancur]

Leonisa, you bought up a great benefit of a pre-session, ensuring the interpreter is familiar with medical terminology and the patient’s cultural background is also crucial. It’s an essential step to ensure effective communication and to prevent potential errors or misunderstandings during medical consultations, and from our own personal experience cultural sensitivities unfortunately can occur.

[Alexandra Cumplido]

Hi Leonisa, you make a great point when you say the pre-session allows the interpreter to clarify any expectations and establish guidelines. However, a pre-session will not give you any medical context, it is solely an introduction for yourself to the provider and to the patient. Also, you mentioned that the pre-session would help navigate cultural differences but in actuality the pre-session will not do that, that instead is part of your role as cultural broker. Providers are not in any obligation to give you a summary of the patients medical history, I know you may be wondering so how will I know what to say? well, this is where the medical terminology comes to play. The more you study different terms and you get exposure to different scenarios that more your medical terminology expands. This is the beauty of this career, you are always learning. That being said, it is crucial for the interpreter to do their pre-session on every single encounter. It doesn’t have to be a long speech, it is as a short as an elevator speech per say. Just because your provider knows the rules it doesn’t mean the patients do. So by setting those expectations right away you set yourself up for a successful encounter each time.

[Leonisa Avelino]

Thank you so much Alexandra for your detailed feedback. I really appreciate the clarification regarding the purpose of the pre-session. I now better understand that it is meant as a brief introduction to establish roles and expectations, rather than an opportunity to gain medical context. Your explanation helped me see the distinction between the pre-session and the interpreter’s role as a cultural broker, and I’ll be more mindful of that moving forward.

• This reply was modified 1 month ago by Leonisa Avelino.

[Milleny Arantess]

Leonisa, I agree that a pre-session with yourself, a patient, and the provider will reduce the risk of miscommunication, inaccuracy, and offense. It’s very important to have a pre-session when possible so that everything can flow perfectly and so that you can be more prepared and ready for anything that could occur.

[Yona Souza]

Leonisa, I like the way you mention that pre-sessions prevent any misunderstandings which I agree with as well. It definitely sets all parties for success because like you said, interpreters guide both patients and providers throughout the whole talk.

[Milleny Arantess]

The benefits of doing a pre-session with yourself are:
1. You mentally prepared yourself for a day of work and for an appointment that could be mentally draining
2. You looked up the details of the appointment and prepared yourself for the vocab that you will have to use for that specific appointment topic.
3 You prepared your pre-session speech for both the patient and the provider making it easier to introduce yourself so you didn’t have to think on the spot.

The benefits of doing a pre-session with a patient are:
1. You introduced yourself and now the patient knows the organization you work with, your name, and are probably more comfortable with sharing personal information in your midst.
2. The patient feels assured and now has knowledge that they should be speaking to the provider and they shouldn’t ask you for help or advice.
3. The patient knows to talk in a way that will be easy for you, the interpreter, to control the flow and interpret.

The benefits of doing a pre-session with the provider are harder to list because you have less time to talk to them but a few are that they would know your name, the organization your with, and the best way to use you and your services.

Possible scenarios that could be avoidied by doing a pre-session are:
1. You not knowing what you’re getting into and what type of language your most likey going to use
2. You having to make up a pre-session on the spot and forgetting to mention important things
3. The patient/provider not knowing your name
4. The patient wanting you to interfer in their’s and the provider’s discussion
5. The patient asking you for advice

Although very important and helpful, I don’t think a pre-session is always necessary because if it were an emergency situation instead of a regular check-up or appointment you wouldn’t waste time telling the patient or provider about yourself you should go straight into interpreting. I also think that it would be unescessay when the interpreter is familiar with the patient and/or the provider.

[Lesly Betancur]

Milleny, I completely agree with your points about the benefits of a pre-session. By mentally preparing, reviewing vocabulary, and having a clear introduction ready, you set yourself up for success. It helps the patient feels more comfortable knowing your role, and the provider gains clarity on how to best utilize your services, which makes it easier for the medical interpreter to control the flow and interpret.

[Milleny Arantess]

Thank you, Lesly!
An interpreter should always make every situation as easy as possible for everyone involved because it’s not an easy job so simplifying where we can will help everyone in the long run.

[Alexandra Cumplido]

Hi Milleny, I really like how you broke it up in 3 parts. I agree with your points and it shows me you know why this is so crucial. I will say the pre-session isn’t an evaluation of a patient’s register. Since it is supposed to be a fast yet informative introduction it will be very difficult to gauge the patients level of education. Never assume, as a trained interpreter you should always start with a high register and lower it as deemed necessary for the patient’s understanding needs. Just because they are LEP doesn’t mean they aren’t educated, always remember that. I have interpreted for patients who are Doctors in their country and are here visiting and suddenly became ill. It would have been not only embarrassing but also rude on my end if I assumed and started with a low register because during my pre-session they were in so much pain they could barely introduce themselves. Once the pain was controlled I realized he kept up with my register and also had a high register on his end to ask the provider questions.
I will disagree where in an emergency situation it is crucial to do a pre-session of some sort. Think of a trauma room, the patient is there and often times the patient isn’t alone. Then, there’s a medical team in the room. If you don’t do an efficient pre-session you will be stuck saying “he,she,they,her, the mom, the dad, the sister, the neighbor, the nurse, the xray tech, the doctor, the phlebotomist” instead of “I”. It will be a recipe for chaos because everyone will talk at once and now you will lose control of flow, direct first person communication and efficacy. So always make time for it, even if its 5 seconds, remember you are in control of the communication within both parties.

[Milleny Arantess]

Hi Alexandra!

Thank you for your comment and for correcting me! I see how starting off talking in a very common and easy way can be offense and how it is important to do a pre-session even in an emergency situation.

[Cristina Restrepo]

Alexandra, thank you for pointing out the importance of doing a short but effective pre-session even in an emergency situation to obtain and maintain control of the communication in the room. I was assuming that being an emergency and time being of essence the pre-session was not necessary but I now see what could happen if that one step is omitted.

[Leonisa Avelino]

I really liked the way you broke down your strategies and listed the benefits of doing a pre-session. You made some great points about how preparing ahead of time can help avoid awkward or challenging situations. I especially liked how you included the mental preparation—it’s so true that some appointments can be emotionally draining, and being ready makes a big difference.

[Lesly Betancur]

A pre-session involving the medical interpreter, the provider, and the patient can offer many benefits, and it can be an important practice for ensuring that all parties involved are aligned and prepared for the session. Establishing clear lines of communication between all parties can help to ensure that expectations are set correctly, questions are answered, and any concerns are addressed before the actual session begins. It reduces misunderstandings during the session and ensures that everyone is on the same page. In the pre-session you are setting the expectation to the patient and the provider so they will know what to expect from a medical interpreter. An example is that you have to advise the patient to speak directly to the provider, and as a medical interpreter I cannot answer any questions or give medical advice. It is imperative that the patient and provider knows that everything said will be interpreted and this protocol applies to anything that is said in the waiting room as well. By addressing any logistical or procedural questions before the session, a pre-session can ensure that the actual session is more focused and time efficient. This can help avoid wasting time on clarifying basic information or managing misunderstandings that could otherwise occur during the session itself. A pre-session can minimize interruptions and ensure that everyone is prepared.

Without a pre-session, a patient and provider may have different expectations for the session. For example, a patient may want to address a specific issue, but the provider may be prepared to focus on something else. A pre-session can ensure alignment on objectives especially if a patient is unfamiliar with the process or procedure, they may feel more anxious or uncomfortable during the session. A pre-session allows the provider to walk the patient through what to expect, reducing surprises and potentially uncomfortable moments. Because of the language barrier, lack of preparation does happen. A patient or provider may not be fully prepared for the session but with a pre-session we can avoid that scenario by clarifying what the patient needs to bring or prepare such as medical records, lab testing, results, forms, etc. ensuring that both parties are ready, and no time is wasted.

While a pre-session can be beneficial, it may not always be necessary in every case. Whether a pre-session is required depends on the type of service or interaction, and the needs of the patient and provider as well. Each scenario should be assessed individually to determine whether a pre-session will enhance the experience and outcomes for both the patient and the provider.

[Milleny Arantess]

Lesly, you talked about a point that I didn’t think about, that going into an appointment, the patient and provider may have different objectives. A pre-session truly can help the patient and provider know what they each want to talk about and figure out how to navigate that. It makes it easier for the patient and provider to talk and have a flow of communication when they know each other’s objectives and can think about how to talk about both.

[Alexandra Cumplido]

Hi Lesly, so I want you to not confuse a pre-session with a pre-appointment prep. Providers are not required to tell us anything about what we are about to interpret. It is always helpful if they did so we can mentally prepare. In an out-pt appointment that is easier because you know what department you are going to GI, Imaging, Cardiologist etc. Within the hospital it is challenging as you can be in the ER and no one knows anything about this patient that just walked in, or in the ICU a patient is coding and you get called in STAT and have to talk to the family. Those are situations where there is no time to get a background but instead you introduce yourself (pre-session) and carry-on with your role. It is best that we don’t talk more than the necessary with pts pre-appointment in the waiting room or in the room without a provider present. Not because you are being anti-social but because pre-sessions and encounters are done in front of the provider so that everyone is aware of the rules. If you sit next to the patient in the waiting room while you wait you run the risk of the patient telling you to lie for them. Eg. I am going to go for a smoke, but when the doctor asks tell him i quit 5 months ago. Now you are stuck in the middle because you have to interpret what she says you are her voice and ethically you told that patient everything you say will be confidential but now you are lying to the provider. So its great to be prepared with your own research and department but no need to be familiarized with the patients medical history. Remember, you are not a mediator you are their voice how they want to use their appt time thats on them.

[Cristina Restrepo]

Thank you Alexandra for explaining why it is so important to keep interaction with the patient to a minimum before the encounter as it can allow room for ethical issues to occur. You having so many years of experience in the field must have seen a lot and it really gives us an opportunity to learn from your experience and prevent the same scenarios to happen to us when interpreting.

[Yona Souza]

Lesly, I love that you mention how a pre-session sets clear expectations for both parties during the interpreting process. I also agree that this factor is extremely important and useful because it allows them to better understand when to wait for their turn to talk, and what to ask during their apointment.

[Yona Souza]

The benefits of doing a pre-session with yourself: it allows you to envision your approach before the appointment starts, by preparing yourself with the right tools and information that you’re supposed to know beforehand. This not only helps you mentally prepare for the encounter but also ensures the whole process is successful.

The benefits of doing a pre-session with the patient and provider: allows you to set the ground between personal and professional roles since speaking the same language as the patient might seem as if you can answer any questions they ask when instead, the interpreter’s role is to convey the information from the patient to the provider and vice-versa.

Some possible scenarios that might be avoided by doing a pre-session are: doing a pre-session avoids many problems if the interpreter makes the right use of the CEFF protocols which stand for: confidentiality; everything; flow; and first-person. The interpreter can go over the mechanics of the encounter by explaining how it works, highlighting that confidential information will always be kept, and ensuring that everything the patient mentions will be conveyed to the provider and vice-versa. Doing a pre-session also helps both ends of the encounter understand how long they can talk for the interpreter to retain all the information and convey it.

I believe that it’s always necessary to do a pre-session with providers in regular daily scenarios when the appointment is running smoothly. Even if it’s a short introduction, a pre-session is a way to professionally introduce yourself and allows the provider to better understand your role as an interpreter and your approaches during the appointment. Pre-sessions are appreciated by patients and providers, making the encounter less awkward and more comfortable during the meeting time. However, each scenario has its particular circumstances and in emergency cases, a pre-session isn’t necessary because it wouldn’t be useful to spend time doing it.

[Leonisa Avelino]

Hi Yona. I really liked what you wrote about the importance of setting the ground between personal and professional roles during the pre-session. That stood out to me because it’s so true—when you speak the same language as the patient, they can easily become too comfortable and start asking personal questions or trying to have side conversations.

[Cristina Restrepo]

The benefits of a pre-session are valuable as it levels the playing field for all parties involved by explaining to the patient and provider what they can expect from you, how to best use your services, and to clarify your role as the interpreter, you also place yourself as the one responsible for the flow of communication in the encounter.

The benefit of a pre-session with yourself is to prepare yourself for the encounter that is about to take place. It allows you to be more comfortable with the process while maintaining professionalism and a high standard of service. For example a pre-session with yourself could include asking yourself what kind of appointment it is, familiarizing yourself with medical vocabulary that pertains to that particular appointment, procedures that will occur at that particular appointment and what part of the body is going to be talked about.

The benefit of a pre-session with the patient and provider as previously stated is to level the playing field for everyone involved, by explaining what they can expect from you, how the interaction between interpreter, provider and patient works, as well as going over the pre-session protocol CEFF to avoid misunderstandings and prevent possible issues from arising.

Possible scenarios that could be prevented by doing a pre-session are confusion by not knowing the roles of each party, people talking simultaneously, patient asking you to omit information or lie to the provider, not being clear what the appointment is for etc.

As far as the necessity of always doing a pre-session with the provider I would say is highly recommended for most instances, however, if an interpreter has been working with that provider for a while or has been working with that office and everyone knows their role then it may be omitted.

[Yona Souza]

Thank you so much for your feedback! And yes, I have noticed all the things you said because I once did it myself when I used to need an interpreter. Being an interpreter doesn’t mean we can answer all medical-related questions, rather we’re supposed to conduct any questions to the provider so that they can correctly address any questions or concerns.

[Joseph Matthews]

There are solid benefits of conducting a pre-session among patient, provider and the interpreter. Being adequately prepared, before the formal session begins, is a good step towards a successful outcome for all involved.
It is key that the interpreter should first perform a quick inventory of his/her key deliverables in the session such as scope, specific body parts to be addressed, which overall vocabulary will be most applicable and how to interact with the provider before the session begins.
As pertains to the patient you want to make sure he/she has a clear understanding of what your role as interpreter is, which should include such things as your name, the organization you represent and that the patient can speak directly and candidly with the provider. There are a cadre of potential surprises that can be avoided by the interpreter first doing a quick environment scan of the patient, his / her cultural origin and the specific medical issue to be addressed.
The above will also help lessen the risk of miscommunications about expectations (such as medical advice for example) that may jeopardize the outcome and / or create potential issues concerning ethics.
A brief pre-session with the provider is helpful, when possible, especially in the case when the provider has not had prior experience with interpreters present.
It has been my personal experience that anticipating the key events of an upcoming commitment is always much more preferable than reacting to same as this is an earmark of what it means to be a professional. With the interpreter carrying out key preparations beforehand – this will aid in paving the way for a successful medical encounter between patient and provider.

[Joseph Matthews]

Good point you make Milleny about when a pre-seesion with the provider is not necessary – in fact not possible – as in the case of an emergency treatment. This points out the reality that a medical interpreter does not always have the luxury of the “time factor” to plan out everything ahead and that he / she must be able to stay focused and on point in a rapidly evolving situation.

[Joseph Matthews]

Leonisa – you cite a most valid point about when the provider is not aware of certain cultural idiosyncrasies / sensitivities that could confuse and possibly even offend the patient. The “trust factor” suffers here along with the many pitfalls it entails. Therefore, it is key that the interpreter identifies and conveys this beforehand, in the pre-session with the provider, to help avoid any such occurrence.

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