Week 2 – Discussion Board 2

Welcome To Interpreters Associates, Inc. Forums Week 2 – Discussion Board 2

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    • #52498
      Avatar photoArt Liebl

      In at least 250 words, outline the four chief roles of a medical interpreter, citing examples of each. Reply to two fellow students by Monday.

    • #52699
      Betty Oliver-Pinto

      CONFIDENTIALITY- Confidentiality if not only the LAW but it is unethical to speak about a patients diagnoses out side of the practice or with people in the practice who do not render care to the patient,

      i.e Mr. Jones comes into the office today to see Dr. Smith patient has a diagnosed of rectal cancer. Mr. Jones has just received his pathology results with Mrs. Jones and their older son. As Mr. Jones comes out of the patient room he and his family are crying, housekeeping ask me the interpreter why is he crying and I proceed to tell her his diagnosis and I rant on how sorry I feel for the patient and his family. (In this example I have just broken confidentiality even though I did not mention the patients name I just told his story to someone who does not render care to the patient.)
      Correct action would have been to say to the housekeeper I am sorry I am not at a place where I can discuss his situation that is briefing his confidentiality and breaking the law.

      Everything- Interpret everything in the dialogue between patient and provider,

      i.e. Mrs. Smith was in the waiting room I was sitting next to her helping her fill out her distress question sheet she was having trouble seeing one of the question she said that she was concerned with treatment decisions because she did not have enough money to pay for her care, but she ask me not to mark it because her niece is an employee at this office. When we are in the room and I am to interpret I tell her and the doctor what happened in the waiting room so he knows this as he is going to give her, her treatment plan. I say interpret says that when helping pt fill out paper work she stated has concern regarding treatment decision due to not having enough money for her care.

      Flow- you have to choose which method you will use while you are in the middle of translating
      Consecutive Mode- most common mode that is used this is where the conversation is held a pace where the speaker says a couple sentences and the interpreter is able to interpret what was said and giving the other party time to grasp the concept and gives them adequate time to respond.

      i.e. Doctor Mr. Smith you are here today for a follow up on you wound. How are you feeling?
      interpreter interprets
      Mr. Smith replies with a short senctece
      interpreter interprets

      Simultaneous mode mostly used in a conferences the interpreter is almost at the same pace as the speaker he/she is only staying a few words behind.

      i.e. While at a school conference or church conference you will see the speaker speaking and as soon as the speaker speaks so does the interpreter. It is a very fast for of interpretating.

      Sight Translation orally translating written text.

      i.e. Interpret what is written on the paper a good example of this is a consent to treat you would interpret what you are reading in the target language. It is important to sight translate just as you would read the paper in English out loud using punctuation and having knowledge of proper legal terms. There should be no long pauses it is best if the interpreter is familiar with the forms prior to translating.

    • #52702
      Betty Oliver-Pinto

      Please excuse this post I misunderstood the question. Please see new post.

      • #52725
        Miriam Kelly

        Sometimes people think they are not revealing private health information because they didn’t mention the name. If you mention details about a person’s personal business, you are revealing private info that you are not allowed to. This is why people have problems trusting people, even professionals who sign their names on the dotted line saying they understand and will abide by the law.

    • #52709
      Betty Oliver-Pinto

      Message conveyor or conduit, conduit is a means of transporting something from one location to another. As a message conduit you will use the verbal and nonverbal message from both the provider and the people in the room. When one interprets, they take the whole message from the person speaking and convey it to the other in their language; they do this without adding or subtracting what is actually being said. The interpreter will observe the body language of both parties and gives the message as it is being said not add or subtract the interpreter must be able manage the flow of the conversation and intervene if one party is speaking to fast or if does not give the interpreter allotted time to interpret what is being said. The interpreter needs to set boundaries so each party may finish speaking and the interpreter interprets what is being said without interruption.

      EXAMPLE A water conduit transports water from one place to another. A conduit does not leak and does not let anything get in the water.

      The CHIA has standards for the message clarifier. Their role is to be aware and focus on possible words or concepts that the receiver may not understand or lead to a mis understating this may apply to the interpreter as well. If anyone is involved in the conversation whether it be verbal or nonverbal and there may be some type of confusion by a work phrase or body language or a motion.

      If or when this occurs the interpreter may need to interrupt the communication with a word comment or gesture to the party who is speaking.

      The interpreter should alert all parties that there is a sign of confusion between one or more individuals and the interpreter needs to be able to identify the word or concept.

      The speaker may need to break down the word or concept and put it in a way the listener may understand or the speaker may understand.

      When there is some confusion, the speaker can explore ways to describe the concept using analogies or pictures. This should be done when there is not a word or a concept that is equal to the linguist in both languages. When the interpreter speaks using their own voice it is very important that the interpreter states what the interpreter would like to say and then continue. It is valuable that the interpreter lets the provider and the patient communicate with our interpreter. When bother parties are able to communicate the interpreter can wait until one of the parties’ requests for interpretation for the words or concepts that either party does not understand.

      When a message clarifier is being a message clarifier the interpreter will pay attention to the educational background of the patient and keep the same level of linguistics and formality which they speak and their grammar and familiar vocabulary.

      EXAMPLE the word pee as we become older, one may no longer use the word pee one may use the word urinate and when one has higher education such as a doctor, they may use void.

      Culture broker/clarifier as the CHIA states culture determines how people behave, make decisions, communicate and interact with each other. Culter and language are inseparable. Concepts and words sometimes exist in one language but not another. It may be hard to find equivalent expressions, this is the reasoning for the verbiage to be so long in a second language. There are many different culture beliefs about health and illnesses the are very different from all bio-metric perspectives all over the world. Many traditional heath beliefs, practices, and healers lack the terms that may be used in the language that is being interpreted. As an interpreter we have to have the fundamental role in being ble to assist both parties understand the other explanation of health and illnesses. As a cultural clarifier your role is more than being able to clarify a word or concept you have to facilitate communication between both parties who do not share common culture, this may lead to misunderstandings. If at any time there is confusion due to cultural difference the interpreter needs to interrupt the conversation with a work gesture or a comment, however appropriate. The interpreter needs to let both parties that is a potential for misunderstanding or miscommunication The interpreter may say for an EXAMPLE As an interpreter I think that there may be potential danger for miscommunication/misunderstanding. The interpreter should express cultural concerns that can be misunderstood or miscommunication. The interpreter can assist by explaining the culture beliefs to the provider and the provider can explain the bio-metric concept. There are times that the interpreter may need to express culture customs, heal. beliefs, or practice from the patient to the provider and the educate the patient on bio-metrics.

      Patient Advocate It is not the responsibility of the interpreter for everything that everyone does or does not do. The interpreter should bring a problem that is starting to arise to the attention of someone before it becomes a serious problem. People who have limited English skills have numerous of cultural and linguistic problems especially in health care EXAMPLE eligibility and enrollment, making appointments, clinician visits, billing, understanding prescriptions. A lot of the time immigrants are unaware what is available to them. It is hard for them to advocate for themselves due to their language barriers. The interpreter notices the problem and advocates for the patient. However, being a patient advocate is an optional role for each interpreter.

      • #52715
        Soila Morales

        Always good to remember CHIA and its standards. Good to know educational backgrounds to be of more help to the patient.

      • #52734

        Great pist Betty, I am more familiar with IMIA but being familiar with both is great! I also appreciated your first post all great examples of becoming a great interpreter!

    • #52710
      Miriam Kelly

      We were given the acronym CEFF, which stands for confidentiality, everything, flow, and first person. I am going to start backwards with my explanations and examples.

      First person means that we translate using the first person, i.e., using I or me. The book tells us that we should always using the first person even though we are obviously not talking about ourselves because it saves time. It can get confusing and time consuming to keep adding he said and she said, so to eliminate those issues, we just use the first person.

      An example of first person, would be
      Doctor: Why did they bring you?
      Me: Por que eles te trouxeram?
      Cleosandra (patient): Tenho dor no pâncreas.
      Me: I have pain in my pancreas.

      I translate it properly and use the first person.

      Flow- The book emphasizes that we (the interpreters) are in control of the flow of the conversation, so we need to use cues and gestures so we don’t get overwhelmed by the output, i.e., the messages that the doctor/nurse and the patient are conveying. Sometimes medical professionals or patients talk too fast or don’t wait for one another to finish. There may be a family member there speaking, so those things (among many others) can get in the way of interpreting the message properly and/or in an orderly fashion.

      An example of this would be a husband and wife are in a hospital setting both trying to explain what happened to him. The translator could use the gesture in the book to signal them to stop in order to take control of the situation and direct the person who needs to be speaking at the moment to speak.

      Everything- We must interpret everything. We cannot omit anything, add anything, or provide inappropriate translations. Under regular circumstances, we may think that certain information doesn’t matter or that the person is giving too much information, but as medical interpreters we must ignore this urge and interpret everything that was said, and even nonverbal “speaking.”

      Ex. Let’s imagine Adam said he had pain starting two days ago. It occurred early in the morning. He reached to move the pasta sauce out of the way, and he pulled his upper back. It was at 6:33 AM because he was in front of the clock. Now, I would interpret that in the first person. In nonprofessional situations, an interpreter might leave out in font of the clock or even the precise time, but as a medical interpreter, I must interpret everything.

      Confidentiality- The protected health information interpreters experience in the field is not to be shared with unauthorized persons. We are in a position of trust, so we cannot break that trust by illegally sharing confidential information.

      Ex. The interpreter could start describing a patient she dealt with at her job to her husband. Describing her would give identifiable markers, and if she were describing the patient, she would probably be giving details about the interaction or the person’s medical problem, which is illegal and unethical. While I hope most people trust their partners, we can’t share confidential information with them about the job.

      • #52716
        Betty Oliver-Pinto

        I agree with what the book states about it making the conversation lengthy when using he said she said.

      • #52732

        Great examples Miriam! Its important to know and understand the roles and apply them into different scenarios that we as intwrpreters may face on the day to day. Nice work!

      • #52737
        Sara Abbasova

        I love how you mentioned that we must interpret everything the patient said including specific details because it’s the patient speaking to the doctor, not us, we are simply relaying what they are saying in the provider’s language

      • #52745
        Cynthia Rodriguez

        Great examples! Confidentiality is really important, yes! and I agree that medical professionals can talk to fast which can lead to errors in part of the interpreter . Which is why it is important to be aware of those potential misunderstandings.

    • #52712
      Soila Morales

      As Message Conveyor or Conduit, you are responsible for transporting verbal and non-verbal messages from the provider to patient or vice versa patient to provider, this makes you responsible of carrying the message from one party to the other without adding or taking from what is to be interpreted, for example Mr. Gonzales asks if a clear liquid diet is necessary? That should be all that is asked in that instance. In this role you also are who manages the flow of the communication technically you are in charge of the conversation you will be who pauses, in between to ask them to slow down if they are speaking too fast for you to be able to acquire all that is being said. You also are responsible for indicating who speaks or taking turns to speak.

      Message Clarifier In this role, interpreters have to pay close attention to words or key phrases that can be misunderstood, you will also identify and help with clarifying any type of confusions or misunderstandings the patient or Provider may have. These misunderstandings sometimes can be expressed verbally, by face gestures, or hand signs. Also, as a clarifier you have to remember how the levels of formality will be different with Provider and patient because of the levels of education and cultural background.

      When performing the role as a cultural broker/Clarifier you learn that with someone’s behavior they can communicate and interact with another person. With time you will learn that sometimes some words or expressions exist in one language but not in another, the hard task in this situation is finding a good way to understand terms in another language and for it to make sense. In this role you will be put against many difficult moments because remember this is when you will realize that many cultures have different ways of healing and dealing with medical situations, not only do they sometimes use natural medicine but sometimes find it hard to follow Providers Medical advice. We must always keep in mind that if at any given moment we feel confused or lost with what the patient is trying to communicate we must stop and explain that you are not understanding and try to comprehend what the party is trying to communicate.

      Interpreters are responsible for being advocates to the patients and to assure that many things that could go wrong don’t, interpreters are not fully responsible for everything and everyone’s ways of communication but can make things function in a better way with interfering when something is not going well. While being an advocate you find yourself being of a bit more help to the patient because you can offer certain help that might be something very simple to you, but of great help to them such as handing them information to contact the proper number to certain situations or even communicating to the provider the patient will also need Interpret assistance to his follow up visit. Like in every other role there are things to keep in mind, according CHIA you have potential risks that may put you or the Patient in an uncomfortable situation.

      • #52717
        Betty Oliver-Pinto

        It is very important to know when to step in as an interpreter if you identify that the conversation may be misunderstood.

      • #52726
        Miriam Kelly

        The cultural broker/ clarifier is a particularly difficult role. Interpreting what the person says, doesn’t mean that cultural concerns will be addressed. That is something the interpreter has to look out for and be aware of. After that, the interpreter has to be active in addressing cultural issues. Even if the interpret can operate well between cultural understandings, the doctor and patient may never see eye to eye on certain things (and those things could be critical).

      • #52736

        Soila, those are all great explanations and examples. Though on the last point on being advocates I must say that itsis a role but not a responsibility. We have the resources to help and advocate for LEPs though it is not a responsibility. Also, we do not interfere as we are their voice, but we can be a liason if and when an issue arise to help them resolve tthem. Although it is hard because I know we like to help and more often can anticipate what is going to be said or whats going to happen we do not speak over them or interrupt to prevent something from being said. Our role is to listen and help with the communication between two parties.

      • #52738
        Sara Abbasova

        Sometimes idioms or certain phrases have no translation into another language so it’s important for us to interpret what is being said as best as we can without changing any details.

      • #52742
        Angela Mayfield

        Great job explaining the 4 principles of interpreting. Princliples that many of us interpreters go by.

      • #52746
        Cynthia Rodriguez

        Really great job clarifying they roles and sharing your examples. I really like how you stated that it is good to keep in mind that whenever we feel lost to stop and get clarity. As misunderstandings can lead to upset and untrusting patients, who look for us to help get clear understandings of what is going on.

    • #52735
      Sara Abbasova

      The medical interpreter has four chief roles.

      Message Conveyor: As a medical interpreter, you transmit verbal and nonverbal messages from one person to the other, whether it’s the patient or the provider. We must observe the person who is speaking, what they are saying, their body language, take all of that, and explain it to the other person without changing the meaning or adding anything unnecessary in their language. Interpreters manage the flow of the conversation. An example would be speaking in the first person when interpreting as if you were the patient or the provider.

      Message Clarifier: If there is any chance that one party gets confused, the interpreter’s job is to clarify what is being said and the overall message being conveyed. For example, if the interpreter sees the patient looking confused, they must politely interrupt the provider, explain their concern and kindly explain to the patient in other words what is being said and make sure that they understand. One may also use pictures to help express what is being said.

      Cultural Broker/Clarifier: Many cultures have different belief systems and that can play an important role when discussing medical treatment. The interpreter must be aware of these cultural differences and be able to ensure that both parties are aware of them and help them proceed forward finding common ground. Another thing, different cultures or religions may have mannerisms that can be considered rude, and a patient may perceive their doctor as rude or vice versa.

      Patient Advocate: If the interpreter notices something going wrong or that the patient may need additional help, for example – insurance problems, they must say something to the appropriate party, instead of sitting back and watching a disaster unfold. As interpreters, we must do our best to help the situation and everyone involved.

      • #52743
        Angela Mayfield

        Being the patient advocate is so very important and knowing when tpo step in.

    • #52740
      Angela Mayfield

      I feel that a role as interpreter should be equipped with a wide range of linguistic and interpersonal skills. Language education and experience lay a strong foundation for interpreters, but the ability to be an empathetic listener is just as important. I would feel more comfortable with someone I know is listening to what I am saying and cares than one that doesn’t. I feel it is important to put yourself in their shoes and ask yourself how you would feel, if this was a situation you were put in.

      Interpreters should not only be very familiar with more than one language, but they should also have a cultural understanding of the languages they interpret for. This is the ability to detect certain nonverbal cues or customs that are specific to a particular group of people or Having a strong grasp on cultural norms will help an interpreter better convey what a non-native speaker is trying to get across. I know I wouldn’t want someone translating for me that did not have an understanding of my culture.
      Another huge role is being the patient advocate and being there for the patient as they cant be their own advocate because of linguistics.

      I do feel a pre-session is a better way to convey a message and ensure clear and proper communication. he or she is someone who is willing and able to be a good, compassionate listener. Interpretation situations can be intimidating for non-native speakers, and an interpreter should try to make the experience as comfortable as possible.

    • #52744
      Cynthia Rodriguez

      1)Message Conveyer or Conduit-transport verbal and nonverbal messages from providers or patients to each other and without out adding or deleting or changing any meaning to the language.

      Ex) Doctor Jay tells Ms. Ross that it is very important she takes her vitamins with food. Ms. Hex her interpreter, conveys the message to her with out adding or deleting or changing any meaning to the language.
      2)Message Clarifier—CHIA sets the standards of message clarifier. In the role of message clarifier, one must be alert for possible words or concepts that might lead to a misunderstanding.
      Ex) an example of this would be when the interpreter does not know the meaning of one of the words or the word has a double meaning. It could be the patient does not understand the terminology so as the interpreter you must figure out another term that has the same meaning.

      3)Cultural Broker/Clarifier-Culture determines how people behave, make decisions, communicate, and interact with each other. Culture and language are inseparable. Concepts and words sometimes exist in one language but no the another.
      Ex) When culture is involved the interpreter must be aware of their clients needs and be able to work with the patient on making sure both parties understand each other’s explanations.
      4)Patient Advocate-a individual patient health and well-being is at the heart of the patient advocate role. Healthcare interpreters enter the patient advocate role when they actively support change in the interest of the patient health and well-being.
      Ex) Makin g sure the patient understands what is being told, and if they agree with everything that was said, and if they have a different viewpoint making sure that gets across is very important. If a patient doe does not agree on a course of treatment or they which to change or add something that their message is getting across to their provider. At the end of the day what we do is for the patient and what they need and want.

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