1. Elizabeth González Soto

2. Introduction:
A brief history of phone interpreting
 Telephone interpreting is a relatively new field. With
advances in communication technology, we have witnessed
how the humble telephone made more services available to
those that need it the most
 Telephone interpreting started in Australia in 1973 as a free
service in response to a wave of immigrants, which resulted
in an increase for the need to communicate in different
languages
 Originally, the service was used mostly for emergencies and
was only available in the cities of Sydney and Melbourne. It
was later expanded to become a program with a more
general scope and national availability (Department of
Immigration and Multicultural and Indigenous Affairs,
2005).

3.  In the United States, telephone interpreting was first
offered in 1981, when a police officer noticed the need
for language assistance when dealing with immigrants
in the state of California.
 This need helped create a charity-based organization
that offered interpreting services. That company
transitioned from charity-based to for profit and by
the 1990’s, there were more for-profit companies in the
horizon
 The name of that first company is what is now known
as Language Line Solutions

4.  Today, there are many companies that offer telephone
interpreting to a number of different industries, such
as finance, insurance, communications, legal and
healthcare.
 In the case of healthcare, hospitals sometimes have
their own phone interpreting department.
 The focus of my research is on healthcare interpreting.
I have investigated the tools of the pre-session and
clarification and how they are vital to provide
excellent service to both healthcare providers and
patients when interpreting over the phone.

5. What is the Pre-Session?
 When we talk about the pre-session, we refer to the
time before the interpreter formally starts an
encounter. It can be referred to as pre-interview or
pre-encounter.
 The interpreter has the responsibility to inform both
the provider and the patient of certain parameters that
will guide the encounter.
 The pre-session should start with interpreters
identifying themselves, their language and
organization if it’s different than the clinic or hospital

6.  The interpreter will also explain to both patient and
provider that the confidentiality of the encounter will
be maintained. If needed, the interpreter will explain
the concept of confidentiality as it applies on a
healthcare setting.
 Interpreters will indicate that everything spoken by
both parties will be interpreted, something that it is
required by the standards of practice of the healthcare
interpreting profession. (National Standards for
Interpreters in Healthcare*)

7.  The last two steps in the pre-session are the following: To
make sure that both parties know that the interpreter shall
intervene if there’s a need for clarification and, that the
interpreter will ask the provider if there’s something that
she/he needs to brief the interpreter on.
 Interpreters will emphasize how important it is for each
party to address each other directly. They will also make
sure that both parties know that they need to pause
frequently to allow for interpretation.
 As you have seen, the pre-session is a multi-step process. So
how can we adapt it to the immediacy and urgency that
sometimes precludes phone interpreting? Before we do
that, let’s talk about our other tool: Clarification

8. What does Clarification means in an
interpreting context?
 The medical encounter is a highly interactive process
in which the provider uses language (the provider’s
and the patient’s) as a powerful tool to understand,
evaluate and diagnose symptoms (Woloshin et al.,
1995)
 It is no surprise then that when we are interpreting, we
need to make sure that the message being transmitted
is understood.
 Clarification means that when there’s a risk of
miscommunication, the interpreter must step out of
her main role as a conduit

9.  The National Standards of Practice for Interpreters in
Healthcare say the following about clarification*: “The
interpreter maintains transparency. For example, when
asking for clarification, an interpreter says to all parties, "I,
the interpreter, did not understand, so I am going to ask for
an explanation”
 When the interpreter assumes this role or uses this tool,
he/she is either verifying for comprehension or requesting
an explanation when necessary. An example of this would
be if there’s a word that the patient has used in a way the
interpreter not used to hearing or when a doctor uses an
acronym that the interpreter is not familiar with.

10.  When the interpreter verifies for comprehension is
usually because there has been a nonverbal cue from
the patient that denotes that he/she might have issues
understanding what is being said.
 So how does clarifying and the pre-session aid the
interpreting telephonic encounter? Why are they so
vital?

11. Why is the pre-session so important in
over the phone interpreting?
 It helps maintain situational control for the interpreter. If
all parties are aware of what is needed to achieve a
successful encounter, it is likely that everyone will
cooperate
 Situational control is very important in healthcare phone
interpreting as the interpreter depends completely on what
she can hear; whether pauses, hesitations, inflexion or
tone.
 For example, if the doctor or patient is not informed that
they need to pause frequently or speak in first person, the
interpreter can miss auditory cues that are vital to
understanding what is happening in the medical
encounter.

12. A Successful Phone Pre-Session
 Because of the time constraints in phone interpreting, the
interpreter can not be as thorough as a face-to-face
counterpart when doing a pre-session
 However, the interpreter can summarize a phone pre-
session as follows: “The interpreter will repeat everything
you say, everything you say will remain confidential, please
speak in the first person and pause frequently to allow for
interpretation”
 Even if the interpreter ends up dealing with a long-winded
doctor or patient, a polite reminder to pause for
interpretation usually brings the monologue to a halt

13. Why Do We Ask Them To Speak in
1st person?
 “ Healthcare interpreters are aware of patient-centered
care , enabling the primary parties to communicate and
build rapport. Therefore, they encourage speakers to
address each other directly” (AUSIT,2012)*
 The constant “Please tell the doctor/patient” proves to
be distracting to the interpreter and it’s best avoided
 When both parties do NOT address each other directly,
it makes for a longer and more cumbersome encounter,
especially over the phone when we cannot direct our
gaze to the other party to help direct the conversation.

14. Why is it so important to use the
clarification tool in phone interpreting?
 Phone interpreting comes with unique challenges. There
are no visual cues, so interpreters depend solely on what
they can hear.
 Because phone interpreters depends only on auditory cues,
it is imperative they use the clarification tool and if
possible, in a continuous manner to check for
comprehension.
 A good rule of thumb : When there are instructions to be
given, such as directions on how to take a medicine, post-
op or discharge instructions, the phone interpreter should
check for comprehension to make sure the patient
understands this vital information.

15.  Healthcare phone interpreters like their counter-parts
on-site, deal with information that is incredibly
important tot he patient.
 It is vital they use whatever tools available to make sure
the patient has all the information that was conveyed
by the health care provider.
 That is the main reason why the clarification tool is so
necessary. It empowers phone interpreters to do the
best job that they can

16. Phone Versus On-Site Interpreting:
The Importance of Providing Great Service
 Something that distinguishes telephone interpreting from
many other types of interpreting is the focus on customer
service
 Because telephone interpreting is, at the end of the day,
provided by companies that are all competing for business,
customer service skills are required for employment with
most telephone interpreting companies (Kelly, 2007 p.38)
 Although the opportunity to actually provide customer
service is very limited, it is still important that the health
care phone interpreter has some knowledge or training in
this area.

17.  Whereas in on-site interpreting the hospital or clinic may
simply choose not to work with a certain interpreter, in
phone interpreting, sometimes the doctor or nurse may be
directly connected with the interpreter and have no other
interaction with another representative of the interpreting
company.
 This is the main reason why the phone interpreter needs to
use every single tool available to provide excellent service.
 From a polite, professional tone of voice to taking
advantage of the pre-session and clarification tools, the
health care phone interpreter not only provides a valuable
service, but it is also representing a for-profit business.
Therefore, every effort must be made to provide excellent
service.

18. Phone Versus On-Site Interpreting:
Focus on Customer Service
Interpreting
Services
Company
Healthcare
Provider &
Patient
Interpreter

19. Conclusion
 Phone interpreting comes with unique challenges
(dependency on auditory cues, technical difficulties)
 The Pre-session and clarification tools aid the interpreter
when navigating these challenges
 The phone interpreter has an obligation to provide excellent
service, as it is representing a for profit business.
 Situational control is vital to the phone interpreter and the
pre-session and clarification tools directly contribute to create
a better session/encounter.
 The pre-session and clarification tools directly impact in a
positive manner the quality of service that phone interpreters
provide.

20. Reference List
 National Standards of Practice for Interpreters in
Healthcare (September,2005)
 National Council of Interpreting in Healthcare
www.ncihc.org
 Telephone Interpreting: A Comprehensive Guide to the
Profession by Nataly Kelly (2007) Trafford Publishing
 Language Service Associates Training Department
www.lsaweb.com
 New South Wales Healthcare Interpreter Service,
Professional Development Committee (2014) Interpreting
in Healthcare: Guidelines for Interpreters Retrieved from:
www.wslhd.health.nsw.gov.au/ArticleDocuments/518/HCI
SBrochure.pdf.aspx