[Joseph Matthews]

First Interpreting Encounter
Scene # 1
Errors:
• Interpreter used the 3rd person and not the 1st person
• No (clear) evidence of a pre-session as the patient (P) did not maintain eye contact with Healthcare Provider (HP)
Positive Points:
• Interpreter maintained relatively sound eye contact with both (P) and (HP) and also followed the triadic positioning.
Scene # 2
Errors:
• The interpreter sat right next to the (P) and outside of the required triadic positioning
Positive Points:
• This time the interpreter employed the required / correct 1st person

Scene # 3
Errors:
• The interpreter, once again, as in scene #2, did not employ the triadic positioning
Positive Points:
• This conveyed quite accurately the (HP’s) diagnosis and prognosis
Scene # 4
Errors:
• In this scene – the (P) nods her head concerning (HP’s) comment about the digestive system however, the (P) did not clarify it with a clear “yes” which the interpreter should have reinforced to ensure the (P) clearly understood.
• (P) said she had experienced 2 to 3 episodes of stomach pain in the past while the interpreter only conveyed to the (HP) two episodes.
Positive Points:
• Interpreter maintained clear eye contact with both (P) and (HP), spoke in the 1st person and maintained triadic positioning

Scene # 5
Errors:
• The interpreter inserted the additional point to the (HP) that the (P’s) father and mother had “problems” which was not part of the original answer of the (P) to the (HP)
Positive Points:
• Positive points same as that of scene # 4.

Scene # 6 (in my video – starting at 4:36 – is incorrectly depicted as Scene # 5)
Errors:
• I did not pick up any specific error on the part of the interpreter other than the (P) – once again – nodded her head and the interpreter did not reinforce this by having the (P) confirm with a clear yes – that she understood.
Positive Points:
• The interpreter handled the “beeper interruption” at the beginning of this scene quite well by maintaining the “flow” aspect of the encounter that is given via the CEEF orientation in the manual.

Scene # 7
Errors:
• When the (HP) provider has to exit the encounter to attend another matter – the interpreter lets her guard down when the (P) uses this time to discuss day-to-day personal banalities and the interpreter shifts from a professional encounter to a “coffee break” style of conversation which detracts from the professionalism of the encounter. This takes away from the focus and discipline on the part of the interpreter which, unfortunately, the interpreter allowed to slip by the wayside here.
Positive Points:
• I did not see any specific positive points here in this scene.
Scene # 8
Errors:
• In the continuation of this “beeper interruption” break – where the (HP) is still absent for the encounter – the (P) informs the interpreter of an additional and quite serious symptom she is experiencing but asks the interpreter not to inform the (HP) to which the interpreter, in an unhesitant manner, agrees to do so.
• This is totally unacceptable as it will impede the (HP) to make the correct diagnosis which will wind up endangering the health and well-being of the (P).
• The interpreter should have declined this request in a polite, professional yet polite manner.
Positive Points:
• I did not see any specific positive points in this scene.
Scene # 9
Errors:
• Not so much an error on the interpreter’s part as she conveyed accurately what the (HP) said but, via the facial expression of the (P), it is evident there is a problem brewing.
• Possibly because the (P) does not want the (HP) to know the entire extent of her symptoms and (possibly), based on the interpreter’s error in the previous scene, the (P) was under the impression that the interpreter would have said something to the (HP) – possibly to avoid this request of having to have an endoscopy performed.
•
Positive Points:
• Again – I see no positive points in this scene

Scene # 10
Errors:
• Major errors and problem noted here.
• Due to the lengthy explanation fon the part of the (HP), the interpreter should have politely interrupted his explanation after about 20 seconds – however she did not, and the explanation dragged on way too long.
• The interpreter should have started taking notes but waited too long and her notes were too short.
• What the interpreter passed onto the (P) was only partial – at best – overlooking a cadre of important logistical and technical details – and adding a few “improvisions” of her own- which were not accurate and also misleading for the (P)
• As the (P) is already uncertain and nervous – the above lays the framework for additional problems going forward.
Positive Points:
• Again – I see no positive points in this scene

Scene # 11
Errors:
• Here the interpreter has simply delegated her mission and responsibility of interpreting to the (HP) and has virtually exited the encounter altogether turning the process from a professional encounter into an amateurish affair
• The interpreter was totally passive and absent in this scene
•
Positive Points:
• Again – I see no positive points in this scene

Second Interpreting Encounter
In this second encounter the interpreter, for the most part, performed much better than in the first one. My main takeaways are as follows:
• The interpreter held a pre-session with the (P) which was brief, informative for the (P) and it was professionally done.
• The interpreter did not accept the gift offered by the (P) and was polite and professional in the demeanor in the way she did this
• The pre-session with the doctor was OK however it as not as well done as was the pre-session with the (P)
• The interpreter accurately conveyed the cadre of symptoms concerning the urinary problems to the (HP) to start out the encounter
• When the (HP) asked for additional details – the interpreter accurately conveyed those as well
• At the end of the session – the interpreter took on the role of facilitator by offering the (HP) to assist the (P) in setting up the next appointment in 30 days’ time
• Finally, the interpreter acted correctly by informing the (P) that offering a ride to patients is not permitted, by the rules, but she kindly offered to call a third-party service to provide the patient with a ride home that was greatly appreciated on the part of the (P)

[Joseph Matthews]

Overview
As stated previously, I am a layperson when it comes to the subject of medicine, in general. Therefore, to enter into the field medical interpreting, this can be a daunting, at times, even an overwhelming challenge and task to embrace. However, with focused strategies and an organized approach, interpreters can gradually build the knowledge and confidence needed to perform their role effectively and ethically in the areas where they will most commonly be used – as follows:
(1) Some Key Strategies For Learning Medicine As A Medical Interpreter
One key strategy is to start with foundational medical terminology such as prefixes, suffixes and root words – because this knowledge helps break down complex terms into understandable parts. For example, knowing that “-itis” refers to inflammation or that “cardio-” relates to the heart makes it easier to understand terms like “arthritis” or “cardiology.” Another strategy is to use visual aids, such as anatomy charts, idea maps, interactive apps and role plays to connect words with body systems and processes. Flashcards, medical dictionaries and online glossaries which are tailored for interpreters are also valuable tools.
Furthermore, listening to or watching real medical interactions (with permission or using training simulations) helps interpreters understand the flow and tone of clinical conversations. Regular review and repetition are essential, especially when it comes to high-frequency terms or procedures.
(2) Areas That Are Most Common For Medical Interpreters
Medical interpreters are most frequently involved in the areas of primary care, OB/GYN, emergency medicine, pediatrics and orthopedics. These areas represent routine and urgent medical needs for patients and therefore require consistent interpreting support. Mental health, oncology, and surgical specialties are also becoming increasingly common, depending on the healthcare setting.
(3) Adapting The Medical Interpreter’s Study Approach To Different Areas
Each area of medicine has its own vocabulary, pace, and emotional tone. For example, emergency medicine demands quick thinking and familiarity with urgent terminology, while, on the other hand, mental health requires sensitivity to emotional nuances and confidentiality. As such, it behooves the medical interpreter to adapt his / her study methods – focusing on the terminology, procedures and patient communication styles that are unique to each field.
In sum, by approaching the general study of medicine with curiosity, structure, patience, determination and a good dose of practical immersion, even those without a medical background can become, over time, skilled and trusted interpreters in such healthcare settings.

[Joseph Matthews]

Introductory Overview
As I have mentioned previously – my ultimate goal, in this profession of interpreting, as I am a retired business executive is to interpret in the various spectrums of the business arena. As the port-of-entry into this field is through the medical area, I find every aspect of this certification course to be extremely challenging due to my lack of medical knowledge. With that said, and to address the above question at hand – I have chosen one area for general reasons and the other for personal reasons, as follows:
Critical Care and Hospital Emergency Room Medicine (General Reason)
The medical interpreter plays a critical role in ensuring accurate communication between healthcare professionals and patients with limited English proficiency especially in the high stakes setting of Critical Care and Hospital Emergency Room settings. The interpreter has to be alert, very focused, have an acute sense of attention for detail and while keeping emotionally cool, calm and collected in a venue where the pace is rapid, it is constantly evolving and decisions must be made instantly. Interpreters must work under extreme pressure, often with patients who are in pain, frightened, or semi-conscious.

They must be able to translate a complex cadre of medical terms, on the spot, such as throat, hemorrhage, intubation, blurred vision, lower abdomen, right lung area, upper right thigh, lower left groin or even anaphylaxis — without hesitation or error. Moreover, the interpreter must not only use the correct terms but also choose the right tone, sense of urgency, and non-verbal cues all while remaining neutral and calm posture knowing full well that any errors could lead misdiagnosis, mistreatment and the serious consequences they entail.

Hand, Wrist and Forearm Surgery Medicine (Personal Reason)
I have chosen this as I have experienced many problems in this area for the last 20 years and I am most interested (and challenged) to discover, if possible, why this is happening and how best to “prevent such problems” rather than “reacting” to them. In this area of medicine, the challenge lies in the precision of anatomical and procedural terminology such as carpal tunnel release, radius fracture, trigger finger syndrome, tendon tears, tendon repair, acute tendonitis, compartment syndrome, osteoarthritis, wrist fracture and ulnar nerve decompression – all which require exact knowledge to ensure the patient fully understands the diagnosis, procedure, and risks.

[Joseph Matthews]

Leonisa – I liked the way that you succinctly concluded your text in one well-drated informative sentence – once again – placing emphasis on conveying the message with focus on being concise.

[Joseph Matthews]

Cristina – in your text, you pointed out two additional (and interesting) characteristics pertaining to the dermis which I did not pick up in my research, namely:
(1) It composes 90% of the thickness of all three layers. As per the diagram in the manual – I did not think it was that much but your statistic clarified that doubt.
(2) It also plays a key role in maintaining the smooth texture of the epidermis above.

[Joseph Matthews]

The human body’s largest organ, covering an area of about 18 sq. ft., is the integumentary system which chief component is the skin but also includes hair, nails, glands and nerve receptors. The skin serves as a critical barrier between the body’s internal organs and the external environment. It is composed primarily of three key layers what are the epidermis, dermis, and hypodermis (or the subcutaneous layer). Each layer has its distinct structures and functions which are essential to maintaining overall health. Herewith a breakdown of the three:
Layer 1 – The Epidermis:
This is this outermost layer, only about 0.1 millimeter thick, and is primarily made up of keratinized stratified squamous cells that provide a waterproof barrier and is responsible for creating new skin cells. It contains melanocytes, that produce melanin, which is the dark pigment that gives the skin its color. The epidermis also plays a key role in the body’s immune defense by fighting antigens (i.e., foreign bodies) from entering the body. This layer is avascular, meaning it lacks blood vessels, and receives its nutrients via diffusion from the underlying dermis.
Layer 2 – The Dermis:
This middle layer lies immediately beneath the epidermis. The dermis is a thicker layer which is composed of connective tissues that provide structural support and elasticity. It contains blood vessels, lymph vessels, hair follicles, sweat glands, oil glands and nerve endings. The dermis is also responsible for thermoregulation, sensation, and nutrient delivery to the epidermis. The dermis itself is divided into two key sub-layers: (1) the papillary layer, which contains capillaries and sensory neurons, and (2) the reticular layer, which contains collagen and elastin fibers that give the skin strength, flexibility and helps ward off wrinkling and sagging.
Layer 3 – The Hypodermis:
This is the deepest layer which consists mainly of adipose (fat) tissue and connective tissue. This layer acts as insulation, helping to regulate body temperature as well as cushion internal organs against trauma. The hypodermis also stores excess energy, in the form of fat, and aids in the attachment of the skin to underlying structures such as muscles and bones.

[Joseph Matthews]

Lesly, I have a similar take on your write-up and in line with that of Leonisa. I would add that you employ powerful impact statements that keep the reader focused to the message – with emphasis in your tie-off paragraph – addressing the absolute importance of the alveoli to the overall (life-sustaining) process of breathing.

[Joseph Matthews]

Leonisa – once again – in a very technical subject, for we laypersons, such as the importance of the alveoli, you aptly addressed the matter in three paragraphs while I needed three. Elaborating a concise text, without missing the key elements is not only a science – it is also an art. Well done.

[Joseph Matthews]

The alveoli are extremely tiny spongy sac-like structures located at the ends of the bronchioles in the lungs and are essential for the respiratory system’s primary function: that of gas exchange (specifically speaking; oxygen and carbon dioxide). There are approximately 300 million alveoli in the human lungs which provide a very expansive surface area of over 750 sq. ft. This large surface area is essential for the efficient gas exchange between the air and the bloodstream. These microscopic air sacs are critical in order to sustain life as they allow oxygen to enter the blood, while, at the same time, carbon dioxide to be expelled from the body.

The walls of the alveoli are extremely thin as well. They are only 0.2 micrometers in width and are surrounded by a dense network of capillaries which are thin barriers that are known as the respiratory membrane which allows for the rapid diffusion of gases. This process works as follows: Oxygen that comes from inhaled air passes through the alveolar wall, then enters the capillaries and binds to hemoglobin in the red blood cells for transport throughout the body. Concurrent with this, carbon dioxide, which is a waste product of cellular metabolism, diffuses from the blood back into the alveoli and is then exhaled.

Alveoli are also lined with a substance called surfactant, made up of proteins and lipids, that reduces surface tension and prevents the alveolar walls from collapsing during exhalation. Surfactant is an essential substance within the respiratory system, especially as pertains to newborns, because their lungs may not yet possess sufficient levels of surfactant which can lead to respiratory distress.

The importance of the alveoli is not limited to the process of gas exchange only. Healthy alveoli also go a long way in efficient respiration. Diseases such as emphysema, which is part of chronic obstructive pulmonary disease (COPD), can destroy alveolar walls, reduce surface area and can acutely limit the intake of oxygen. Ancillary conditions, such as pneumonia fill the alveoli with fluid, impairing their function.

In sum, the alveoli are crucial for oxygenating the blood and removing carbon dioxide. These processes are absolutely essential to all cellular functions in the body. Without properly functioning alveoli, the body cannot receive the oxygen it needs, nor can it rid itself of carbon dioxide, which consequences can be life-threatening.

[Joseph Matthews]

Yona, you creatively posted in your concluding paragraph the sometimes overlooked, but very important aspects of how the pituitary gland impacts key things such as proper sleep, exercise and overall hormonal balance in the body.

[Joseph Matthews]

I also like how Lesly inserted an additional element to this very complex and technical subject of the pituitary gland by commenting on the importance of an accurate understanding of this subject and how it affects the medical interpreter’s overall performance is such cases.

[Joseph Matthews]

The pituitary gland is one of the key components of the human body’s endocrine system. This gland, which is also termed as being the “master gland,” is small in size and is located just below the hypothalamus region of the brain. Its tiny size notwithstanding, the pituitary gland plays a key role in regulating many essential bodily functions by producing and then releasing a cadre of hormones that influence growth, metabolism and reproduction.
The pituitary gland is divided into two main parts: (1) The anterior lobe (adenohypophysis) and (2) the posterior lobe (neurohypophysis). Each lobe releases different hormones however, both are under the control of the hypothalamus, which sends signals to regulate their activity. Herewith is a brief breakdown and the importance of each:
The anterior pituitary produces several important body hormones:
• Growth hormone (GH) which stimulates growth and development of bones and tissues
• Thyroid-stimulating hormone (TSH) – regulates the thyroid gland which controls metabolism
• Adrenocorticotropic hormone (ACTH) – this stimulates the adrenal glands to produce cortisol which is key for stress response and energy regulation
• Prolactin (PRL) promotes milk production in breastfeeding women
• Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) – these control sexual development and reproductive functions in both males and females
The posterior pituitary stores and releases:
• Antidiuretic hormone (ADH) – which helps control the water balance in the body by regulating the amount of water that is reabsorbed by the kidneys.
• Oxytocin – which is involved in childbirth and lactation as well as emotional bonding and general social behaviors.
Because of its widespread hormonal influence, any dysfunction in the pituitary gland can lead to serious conditions, which include growth disorders, infertility, thyroid imbalances as well as adrenal insufficiency.
Finally, the pituitary gland is vital for maintaining homeostasis which is the state of balance among all body systems needed for the body to function properly. In this role, it acts as a type of central command center, helping the body to effectively and efficiently respond to internal and external changes through its hormonal output.

[Joseph Matthews]

Cristina, I liked the way you addressed the introduction to this issue in the form of a general “environmemnt scan-overview” to inform the reader of the main points that will follow in sequence. Both an interesting and effective communication technique. Well dome!

[Joseph Matthews]

Leonisa, you are able to address and sumarize a complex and an important subject such as this in half the words than it took me and I do applaud this. Congrats!

[Joseph Matthews]

The male and female reproductive systems are both essential for human reproduction and, together, form one of the human body’s most important systems. However, they each differ significantly in terms of anatomy, function and roles within the reproductive process as is addressed in the synopsized format below.
The female reproductive system is designed to produce eggs, called ova, support fertilization and nurture a developing fetus throughout pregnancy. The principal female organs include the ovaries, fallopian tubes, uterus, cervix, vagina, and external genitalia. The ovaries release one egg each month during the menstrual cycle and also produce the hormones estrogen and progesterone, which regulate menstruation and pregnancy, amongst other functions. When the fertilization process occurs in the fallopian tube, the egg becomes implanted into the lining of the uterus (called embryogenesis) where the embryo forms which is then followed by the process of morphogenesis in which the fetus begins to take shape. When the fetus reaches sufficient maturity, the cervix dilates and contractions of the uterus propel it through the birth canal.
The male reproductive system is primarily responsible for producing, storing, and delivering sperm. Key external components include the penis and scrotum, while important internal organs include the testes (which produce sperm cells), epididymis, vas deferens, seminal vesicles, prostate gland, and the urethra. The sperm cells mature in the epididymis, travel through the vas deferens, mix with fluids from the seminal vesicles and prostate gland to form semen, which is expelled through the urethra during ejaculation.
The male system continuously produces sperm, while the female system follows a cyclical process and is capable of supporting and sustaining new life. Both systems are hormonally regulated and work together to make reproduction possible.
Also worth noting are the diseases that affect both the female and male reproductive systems. The key disease for both is cancer. In the case of the female reproductive system – it affects the ovaries, uterus, cervix and breast. Ovarian cancer tends to be the most impacting one as there is no standard screening test for it and it is usually diagnosed only when the cancer has reached an advanced stage. In the case of the male reproductive system – the most common is prostate cancer but there are also forms of penile and testicular cancer as well.
Finally – there is the subject of infertility which affects both sexes. In the case of the female, it arises from the inability to ovulate, conceive and give birth to an infant. In the case of the male – it is chiefly the inability to produce sperm cells.

[Author]

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