Interpreting in Health Care Progress Made & Challenges Ahead
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Interpreting in Health Care Progress Made & Challenges Ahead
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Interpreting in Health Care Progress Made & Challenges Ahead
- 1. Interpreting in Health Care Progress Made & Challenges Ahead Gem P. Daus, M.A. Executive Director, NCHIC May 9, 2011 PICC Language Access Conference 1
- 2. Healthcare Interpreters’ Role Code of Ethics Standards of Practice Standards for Training Certification 2
- 3. 3 2001-2010 Published 13 working papers Open calls/Webinars: Mental Health Interpreting Vicarious Trauma/Interpreter Self-Care Best Practices Certification State policies (March 18, 2011, 1:00 p.m. EST)
- 4. 2004 National Code of Ethics for Interpreters in Health Care – guiding principles and values governing conduct; shoulds 2005 National Standards of Practice for Interpreters in Health Care – what and how a competent interpreter does (accuracy, confidentiality, impartiality, respect, cultural awareness, role boundaries, professionalism, professional development, advocacy) 4
- 5. Objective ◦ To acknowledge the inherent dignity of all parties in the interpreted encounter Code of Ethics ◦ The interpreter treats all parties with respect. Standards of Practice ◦ The interpreter promotes direct communication among all parties in the encounter. ◦ For example, the interpreter may tell the patient and provider to address each other, rather than the interpreter.
- 6. Provide consistency in performance of role Make health care providers and interpreters aware of the clinical and financial ramifications from using unqualified interpreters Provide guidance when addressing ethical dilemmas during an interpreting encounter 6
- 7. 2011 National Standards for Healthcare Interpreter Training Programs Collaborate with the Certification Commission for Healthcare Interpreters (CCHI) on a national certification http://www.healthcareinterpretercertification.org/ 7
- 8. National Standards for Healthcare Interpreter Training Programs
- 9. Why Standards for Interpreter Training Programs? Curriculum developers/trainers Interpreters Employers
- 10. Steps to Developing National Standards for Training
- 11. Challenges OR
- 12. After careful analysis, these are some of the reactions we expect to the Standards:
- 16. The Standards
- 17. The Standards Content Standards A. Knowledge B. Interpreting Skills
- 18. Program of Study Content Standards A. Knowledge:
- 19. Knowledge A.1. The profession of healthcare interpreting
- 20. Knowledge A.2. Language and communication:
- 21. Knowledge A.3. Ethical principles and standards of practice:
- 25. Program of Study Content Standards B. Interpreting Skills:
- 26. Interpreting Skills B.1 Message conversion:
- 27. Interpreting Skills B.2 Modes of interpreting
- 28. Interpreting Skills B.3 Interpreting Protocols:
- 29. Interpreting Skills B.4 Cultural competency / brokering:
- 31. Interpreting Skills B.6 Translation in the interpreting context:
- 34. For more information, contact The Standards, Training and Certification Committee of the NCIHC stc@ncihc.org gdaus@ncihc.org
Editor's Notes
- What sort of program are the Standards for? Standards for academic programs? Community-based trainings? Longer programs? 40-hour programs?How do programs measure if they’ve met the Standards? On what basis would we set benchmarks?
- See which one you relate to:
- …. trainers who through they were done
- …. interpreters who thought they were done
- for people who appreciate that this is a long process and these standards will improve quality
- As you can see, the Standards are divided into three sections. Today we are going to focus on the Content Standards………..
- As you can see, the Standards are divided into three sections. Today we are going to focus on the Content Standards………..
- The definition of interpreting as contrasted with bilingualism and translationFields of interpreting (e.g. diplomatic interpreting, liaison interpreting, business interpreting, community interpreting [including judicial, healthcare, social service, forensic , and educational interpreting) Ways in which interpreters are employed (dedicated vs. dual role, staff, contract or freelance interpreter)Overview of the history of healthcare interpreting in the U.S. The purpose and functions/responsibilities of the healthcare interpreterModes of interpreting in health careMedia of interpreting (e.g. face-to-face, remote [telephonic, video])Laws, standards and regulations relevant to healthcare interpreting (e.g. Title VI of the 1964 Civil Rights Act, Department of Health and Human Services [DHHS] Standards for Culturally and Linguistically Appropriate Services [CLAS], The Health Insurance Portability and Accountability Act of 1996 [HIPAA], The Joint Commission [TJC], and local policy), American’s with Disability Act )Liability insurancePurpose and limitations of certification
- Language elements (e.g. regional and social dialects, style, register, discourse; literal and figurative language; idiomatic and frozen language ; meaning and sense; literalness vs. meaning accuracy; paraphrasing; conversation vs. interviewing)Communication elements (e.g., power dynamics; negotiation of meaning)Cultural elements of language (e.g. forms of address; politeness markers; turn-taking and interruptions; body language)
- The general concept of ethics and its application to interpreting in health care.Ethical principles and standards of practice consistent with the National Code of Ethics and Standards of Practice for Interpreters in Health CareProfessional behavior and development (e.g., self-care both physical safety and emotional well-being; case conferencing and supervision; preparing for high stress situations)
- Overview of the U.S. healthcare system (e.g., venues, insurance, primary and specialty care, types of hospital services, categories of healthcare workers, legal concepts and terms)Concepts and relevant terminology in biomedicine (e.g., anatomy and physiology, symptoms, common diseases, diagnostic procedures, common medications, treatments, apparatus, general understanding of biomedicine)Overview of common healthcare interview routines and medical decision-making (e.g., the medical interview, the process of diagnosis, referral process, physical exam)
- Overview of culture – what it is and how it impacts health and health careConcepts and relevant terminology from the patient’s perspecti ve (e.g., understanding of the human body and its functioning, description of symptoms, common diseases and treatments, expectations around insurance, origin of illness, complementary and alternative medicine.The culture of biomedicine (e.g., the biomedical view of origins of illness, doctor- patient relationships, hierarchies, decision-making) Cultural competence , awareness, and sensitivity
- Active listeningMessage (discourse) analysisTarget language equivalence (e.g. figurative language, expletives, idiomatic speech, colloquialisms)Managing regional dialectsMaintaining / changing registerMemory skills (e.g., chunking, prediction, visualization, note-taking)Self-monitoring and self-assessment
- 1. Consecutive (default mode)2. Simultaneous (exposure to)3. Sight translation
- Introducing and explaining the role of the interpreterUse of the first personPositioning , including the dynamics of different positionsConducting a pre and post-sessionIntervention techniques (e.g. speaking as the interpreter in the third person, maintaining transparency)Managing the flow of communicationMonitoring comprehension among listenersInterpreting for groups (e.g., team and family conferences , teaching sessions)Interpersonal skills (e.g., how to work with healthcare professionals; dealing with disrespectful providers or difficult patients; de-escalating conflict) Footnote Positioning paper
- Recognition and management of cultural misunderstandingsAbility to recognize own cultural biases and maintain objectivity in the interpreting encounter.
- Ethical decision-making – Ability to think through an ethical dilemma and make an informed choice based on the National Code of Ethics for Interpreters in Health Care.Critical thinking - Ability to think through a situation and make an informed choice about the best course of action to take and be able to justify this action.
- 1. Ability to decide when on-the-spot translation or transcription is appropriate2. Ability to respond to requests for translations/transcriptions ethically and professionally
- So, how does your program measure up?.... Intro next activity