[Cristina Restrepo]

Lesly, I really like how well you explained the many ways Rhode Island is implementing and adhering to order 13166 which calls to improve access to services for individuals with limited English proficiency. You really showed how compromised the state is with its LEP community, however, I also agree with you in that there is still many challenges to be addressed such as limited funding, technological tools needed, as well as diverse language interpretation among others. I hope our state representatives act to resolve these issues to better serve our LEP community.

[Cristina Restrepo]

I believe present day legislation is not enough as current laws still face some challenges some of them being the lack of universal certification standards for medical interpreters, reimbursement of services and ongoing need for accessible qualified interpreters in various languages. While order 13166, Massachusetts Emergency Room Interpreter Bill and ClAS Standards provide a good foundation, they do not fully address the challenges and gaps that LEP individuals face today.

The most outstanding challenges are the reimbursement of services as it can be a significant barrier especially for Medicaid/Medicare recipients. Also, there are no universal federal standards for certifying medical interpreters, which raises concerns about the quality and consistency of interpreter services. Another issue that needs to be addressed is the lack of medical interpretation in languages other than the most commonly spoken. Despite the legal requirements in place today, there is insufficient access to qualified interpreters, particularly in regions with diverse language population.

When it comes to order 13166, it is already being implemented in the state of Rhode Island to ensure access to federal programs and services for individuals with limited English proficiency. This means that any health facility that receives federal funding must provide competent and qualified interpreter services to those who need it. Also, the state of Rhode Island has developed a Limited English Proficiency Plan to ensure accessible transportation planning and public notification. This plan focuses on the provision of multilingual publications, translation, and interpretation services to meet the needs of limited English proficiency individuals.

[Cristina Restrepo]

Hi Milleny, I absolutely agree with you when it comes to making sure patients are being treated fairly and if we as future medical interpreters see something that might compromise the patient’s wellbeing or health we should definitely speak up and advocate for them.

[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.

[Cristina Restrepo]

Hi Leonisa, I am glad you found my examples helpful when it comes to understanding each role of the medical interpreter. I really liked how you highlighted the importance of stating to both patient and provider when the message is coming from the interpreter and when you have stepped out of the message conveyor role, as you said. As it makes it clear to both parties that the message being conveyed is not coming from either the provider nor the patient but from the interpreter itself.

• This reply was modified 3 months, 3 weeks ago by Cristina Restrepo.

[Cristina Restrepo]

The chief roles of the medical interpreter are message conveyor, message clarifier, cultural broker and lastly patient advocate.

To further explore what each roles entails let’s start with the message conveyor which transports the verbal and non verbal messages from provider to patient and vice versa. As a message conveyor the interpreter listens to both parties, observe body language, and convert the meaning of all messages from the source language tío the target language, without unnecessary additions, deletions or changes in meaning. In order for this to happen interpreters need to be in charge of the flow of communication, meaning deciding who and for how long each party needs to speak. An example of this would be the doctor asking the patient if they take any medications and the interpreter saying exactly the same thing in the target language without adding or changing anything such as what medications you take for instance.

The message clarifier role alert for possible words or concepts that might lead to a misunderstanding. When there is evidence of confusion the interpreter needs to address the issue before moving on with the encounter. Also, it is important for the interpreter to let patient and provider know when the message being spoken is coming from themselves personally and not being converted through interpretation. The message clarifier role also takes into account the educational background of the patient and maintains the same register as the patient and provider. An example of this would be the interpreter asking the provider for clarification after noticing a confused facial expression from the patient after a procedure was explained.

In the cultural broker role the interpreter acts as a bridge between patients and providers with different cultural backgrounds, facilitating communication, understanding, and potentially resolving conflicts. An example of this would be the interpreter finding a similar expression or word to convey a message that has no literal translation from one language to another. Another example could be when the patient refuses to have eye contact with a male doctor because her culture does not allow it.

In the patient advocate role the interpreter ensures that the patient’s voice is heard and their needs are met, particularly when language barriers exist, by facilitating communication, clarifying messages, and acting as a cultural broker, with the ultimate purpose of promoting patient-centered care as well as patient health and wellbeing. It is important to mention that this role of the medical interpreter is optional in light of the high skill level required and the potential risks to both patient and interpreter. An example would be the interpreter asking the front desk person to make a morning follow up appointment after the patient had disclosed during the encounter that this is the only time the patient has transportation available.

[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.

[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.

[Cristina Restrepo]

Leonisa, I am right there with you as I am now learning how deep and important the role of a medical interpreter is in ensuring effective communications between patients and medical providers. Really looking forward to learning everything that is needed to be a successful medical interpreter!

[Cristina Restrepo]

Hi again Lesly. I’m glad to hear that we share many things in common such as being neighbors and both coming from a Colombian background, having two beautiful daughters and also sharing similar experiences growing up in a household with English as a second language. I hope the transition from being a stay at home mom to student and future medical professional is a smooth one. I am sure this new career opportunity will help you grow even more professionally and personally.

[Cristina Restrepo]

Art, if you have the opportunity to visit Colombia please do as you will not regret it. Colombia is such a beautiful country with so much to offer that I am sure you will love it there. From the people to the food, the scenery, the weather, the experiences you get to live there are definitely one of a kind. I am from the city of Medellin and most tourists usually go during La feria de las Flores in early August or in December to celebrate the holidays as there are many activities going on throughout the city during those times.

[Cristina Restrepo]

Hi Lesly, thank you for explaining so well why it is important to understand that a translator is not the same as an interpreter, and as you said it, it’s to make sure the right professional is employed to ultimately ensure the job is done correctly.
You also pointed out the high level of focus an interpreter needs to have to accurately convey messages, and that is spot on considering the distractions they can face while working in certain environments such as hospitals, court rooms, etc.

[Cristina Restrepo]

The most important difference between a translator and an interpreter is the type of language each of them works with because translators work with written language and interpreters work with spoken or signed language.

Other important differences between a translator and an interpreter are the skills needed to perform each job. For example, translators need to have great grammar, strong writing skills as well as an understanding of the subtle differences between the languages being translated. Also since translators work with written language they normally have time to research and revise their work for accuracy. They also work in one direction meaning that they translate from the source language to the target language, being the target language their native language.
On the other hand, interpreters work with spoken or signed language so the skills needed to perform the job are great listening skills, good memory and the ability to translate or convey meaning in real time. They also work in two directions meaning they go back and forth between the source and target language.

When it comes to the challenges, interpreters can encounter cultural differences in style of communication, also specialized knowledge of terminology that is used in a particular area such as law or medicine. Another challenge is the speed of speech and accents as it could make it difficult for the interpreter to understand what is being said. Also cultural expressions or sayings that have no translation. Being neutral and accurate is also a challenge as interpreters need to avoid adding their own opinions when interpreting.

While translators can face similar challenges as interpreters there are some challenges that only apply to translators such as avoiding literal word for word translation as it can affect the accuracy of the message being conveyed. Also keeping up with new words and expressions as languages are constantly evolving. Another interesting challenge is the competition with machine translators as they are becoming increasingly popular. Lastly, as translators work with written language they might need to collaborate with other professionals to ensure accuracy of translation.

To conclude, it is important to understand that an interpreter is not the same as a translator because they work with completely different formats of language. While the translator works with written language, the interpreter works with spoken or signed language. This key difference gives each career its own unique challenges and rewards.

[Cristina Restrepo]

Hi Leonisa, I am glad to be working with someone that shares the same experience of interpreting for parents and relatives from a young age. Also happy to hear that you want to use your knowledge in both languages to help the Cape Verdean community where you live. I’m sure you will make a difference anywhere you decide to work.

[Cristina Restrepo]

Hello Art, thank you for sharing your journey in the medical interpreting career. It gives us encouragement and insight as to what to expect after obtaining this certification. I am really excited to see what is in store for us for the following 10 weeks. Looking forward to working with you.

• This reply was modified 4 months ago by Cristina Restrepo.

[Author]

Posts