NCIHC.HFT.45.Missing.the.plot.02-17-2021_vslideshare

NATIONAL
COUNCIL
ON
INTERPRETING
IN
HEALTH
CARE
WWW.NCIHC.ORG

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NATIONAL
COUNCIL
ON
INTERPRETING
IN
HEALTH
CARE
Housekeeping
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Homefor Trainers Interpreter Trainers Webinars Workgroup
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NATIONAL
COUNCIL
ON
INTERPRETING
IN
HEALTH
CARE
Welcome to our guest presenter!
Ineke H. M. Crezee, PhD, ONZM, MA (Tr), MA,
BA, RN, NAATI Cert Tr, Cert Health Int

Missing the Plot: Preparing Trainee
Interpreters for the Use of Informal
Idiomatic Language in the Health
Setting
Ineke Crezee, PhD, Professorof Interpretingand Translation
Auckland UniversityofTechnology

Historical
background
How it all started
Research
Implementation in the
mixed language
classroom
Implementation in
other course settings

‘the unfortunate experiment’
• 1970s-1980s: cervical cancer research:
• No interpreters
• No Informed Consent
• Women died
• Two journalists wrote about this > shock waves
• (Bunkle & Coney, 1987)
• Cartwright commission of inquiry appointed
• (Cartwright, 1988; Coney, 2009; Bryder, 2009; Bunkle, 2010)
• Recommendations: use of trained healthcare interpreter where
practicable
• Informed Consent always used
• Recommendations enshrined in the 1996 Health and Disability
Act: the right to effective communication
• Photo: NationalWomen’sHospital, Auckland,New Zealand

Briefhistory of interpretingin New Zealand
• Auckland Technical Institute:
first health interpreting course
1990 – 90 hours – borrowing
from Australians in terms of
AUSIT code of ethics etc.
• Mixed language classroom
cohorts from the outset
• ATI> Auckland University of
Technology (AUT) in 2000
• Ineke involved from 1991 to
the present time: many
changes, from short certificate
to Grad Cert (4 papers), Grad
Dip (in Arts) Interpreting, and
BA Interpreting

Healthinterpretingcourses
• Part of overarching
qualifications: consisting of 4
courses (Graduate Certificate), 8
courses (Graduate Diploma), or
3-year BA Interpreting
• Interpreter role, ethics and
practice course is always a co-
requisite or pre-requisite
• Health interpreting courses used
to have 3 assessments,now only
two, due to university-wide
changes implemented due to
Covid-19 pandemic//teaching
wholly online in most of 2020

Reflectionsas partof course
• Semester One: Introduction to organ
systems and commonconditions,
lots of dialogue practice: only 2
assessments (since Covid-19):
dialogue interpreting test, reflections
on own interpreting and on language
peer feedback
• Semester Two: specialist healthcare
areas, including oncology, NICU,
working with speech language
therapists: only 2 assessments:
simultaneous interpreting (300
words), long consecutive interpreting
(300 words), reflective journal
Photo: SLT clinic at University of Auckland

Why idiomatic language?
• Student cohorts mainly consistof skilled migrants
• Learning English as an additional language usually involves
learning formal English: “How do you do?”
• Informal idiomatic language is learned in context:learners
learn to understand (and use) informal expressions – when
and when not to use them
• Over the years studentsalways came up to ask meaning of
informal expressions in practice dialogues – NOT medical
terms, since they would learn those in class and discuss
them with their same language peers
• In other words, they did not struggle with medical terms so
much, as they did with informal language

Why is idiomatic language important in
interpreter education?
• Crezee and Grant (2020, p. 44) argued that when student
interpreters interpret idiomatic language,
• “they would quite possibly give a literal rendition of the
idiomatic language, thereby potentially misinterpreting the
meaning. This assumption was born out by a subsequent
study (Crezee & Grant, 2016) where student interpreters
incorrectly interpreted idiomatic language used by
paramedics featured in authentic audiovisual interpreting
practice material. Hence, studentinterpreters’ inability to
correctly distinguish literal from idiomatic language may not
only affect the accuracy of their input monitoring (cf. Liu,
2008), but also prevent them from considering pragmatic
and culturally appropriate equivalences.”

Why is interpreting idiomatic language
verbatim of concern?
• “This is of concern, as interpreting such language verbatim
may result in inaccurate or culturally and pragmatically
inappropriate outputs (cf. Darwish, 2006; Hale, 2014; Issa,
2018; Crezee, Teng & Burn, 2017), as demonstratedin these
examples cited by Mikkelson (2017, p. 69):
• “When a Colombian says ‘¿que más?’ is it ‘what else?’ or
‘how you doin’?’ When a Dominican says ‘dímelo, tigraso,’ is
he actually talking to someone called ‘tigraso’ [big tiger], or
is he saying something more akin to ‘talk to me, big guy’?
• (Palma, 2004, as cited in Valero-Garces, 2014, p. 163)”
• (Crezee & Grant, 2020, p. 44).

Excerpt from interview with Ineke Crezee
(Source: https://fb.watch/3F-XZ_BuYX/)

Study: An Achilles Heel?
• In 1999 Lynn Grant (originally from Canada) and her
colleague Gay Devlin published In other words: A dictionary
of expressions used in New Zealand

Teaching idiomatic expressions?
• From 1999 to 2005 Ineke taught student interpreters 10
different commonly used idiomatic expressions per week,
and working them into practice dialogues.
• Students:never heard this expression
• After learning: I hear this expression all the time now
• Maybe we don’t hear expressions if we don’t know what
they mean
• Or perhaps we “interpret” them literally? Sometimes that
can work. “She left that job with her head held high.”

First study
• Do studentsrecognize idiomatic expressionsfor what they
are?
• Recognition is the first step.
• Translating literature: important to recognize fresh new
expressions from tired old cliches.
• (my problem as a student of literary translation)
• Even with an MA in English, I was not familiar with NZ
expressions:
• “Where is our guest going to sleep?”
• “Oh, he can just crash on the floor!”
• “Crash??!!”

Results published in 2020
• Participants: 12 student interpreters (Mandarin, Russian,
Farsi, Samoan, Tongan, Spanish, Thai, Korean) – aged 20-50
• Phase One: The importance and awareness of idiomatic
language (first semester
• Pre- and post-survey re perceived importance of knowing
idiomatic language from literal language
• Phase Two: ability to identify phrases as being literal,
idiomatic or both
• idioms randomly taken from the Cambridge International Dictionary
of Idioms
• Idioms taken from television interviews and dialogues

Expressions consistently incorrectly
explained (or failed to explain)
• It’s a doosey
• It goes both ways
• I thought I’d died and gone to heaven
• You are a train wreck
• I am giving you an out
• You have your work cut out for you
• He’s always there for me
• I haven’t the foggiest
• All these are commonlyused in NZ

Implications for teaching (Crezee &
Grant, 2020, pp. 55-56)
• teachers working with interpreting, translation or other
non-native English-speaking students:
• • Raise students’awareness from the early stages of
language learning:
• that manyEnglish phrases can have a literal meaning, a non-literal
meaning, or sometimes both.
• that these meanings can be deceptively transparent (Martinez &
Murphy, 2011).

More recommendations
(Crezee & Grant, 2020, p. 55)
• • Choose a variety of sources of idioms:
• names of shops, written and spoken advertisements, clips from
soap operas (e.g. Grant, 1996)and TV sitcoms, newspaper
headlines, radio and television interviews, talkback radio, political
texts.
• dictionaries of idioms, especially those with pictures and
etymology, (cf, Szczepaniak & Lew, 2011).
• English speakers (e.g. neighbors, shopkeepers, friends).
• corpora conversations (e.g. BNC2 , COCA3 ).
• corpora lectures – (e.g. MICASE4 , BASE5 ).
• comparison with idioms used in their native languages, to increase
their intercultural awareness.

Final recommendations (Crezee & Grant,
2020, p. 56)
• Show students how translation of some idioms may
preserve the meaning only by changing the image, or ‘spirit
of the original’ (Horodecka & Osadnik, 1989-90).
• Encourage studentsto develop strategies:
• to notice idioms they hear and see around them.
• to paraphrase the meaning of idiomatic language including socio-
pragmatics and register.
• to practice using idioms in their conversations with classmates,
monitored by their teacher or an English speaker who can give
feedback on the appropriateness of their use.

Students like authentic practice!
• Next study: studentswere shown clips from NZ television
programmes where professionals were interacting with
members of the public
• Funding used to transcribe, pay assessors to give feedback,
and funding for technical assistance:
• Funding to manipulate clips: utterances interspersed with
silences/blank screens to give students time to interpret
• Ethics approval (student-teacherrelationship)
• Crezee & Grant (2013), Missing the plot? Investigating the
role of idiomatic language in interpreting pedagogies.

What came before the study
• From 1999 to 2005, students in liaison interpreting (Gentile,
Ozolins, & Vasalikakos, 1996) courses were taught 120
idiomatic expressions taken from Grant and Devlin (1999).
• Students would initially express surprise at the existence of
expressions such as up in the air, mixed bag, box of
birds, and bright-eyed and bushy-tailed, often saying that
they had never heard these used. However, once they
learned the expressions, students would almost invariably
tell the lecturer that they now heard them used “all the
time.” This experience demonstrates the importance of
raising awareness of such expressions among student
interpreters (Crezee & Grant, 2013).

definition
• “idioms have been traditionally defined as expressions
whose meanings are not the functions of the meanings
of their individual parts (Chomsky, 1980; Fernando,
1996; Fraser, 1970).
• Usage of idiomatic language is common, not just in
general English (Grant & Nation, 2006) but also in the
language use of professionals, who may use idiomatic
language in an attempt to put patients or members of
the public at ease. Interpreting students thus must
develop awareness and reflectiveness in relation to
their ability to choose appropriate approaches to
interpreting idiomatic language (cf. Baker, 2011).”
• (Crezee & Grant, 2013, p.

Corpus
• The corpus consists of the written transcripts of language
used in 80 recorded reality television programs shown on
New Zealand television between 2003 and 2011, with most
of them dating from 2009 to 2011. All documentaries
featured “real-life drama” showing paramedics and
immigration, customs, prison, and police officers interacting
with members of the public. Approximately half of them
showed these professionals at work in New Zealand; the
other half were in settings in Australia (Australian and New
Zealand English are considerably similar in terms of
expressions used and also in terms of the ways speakers
interact with each other).

Participants
• Participants
• students from four different undergraduate interpreting
courses: liaison interpreting, advanced interpreting health,
advanced interpreting legal, and telephone interpreting and
videoconferencing.
• broad range of sociolinguistic backgrounds
• large majority (96%) had English as an additional language
(EAL).
• Applicants for interpreting programs at the university are
always asked about the extent of their exposure to both of
their working languages, in particular about the number of
years spent working with colleagues speaking the
applicants’ second language (L2). This is done to ensure that
student interpreters can comprehend natural and idiomatic
language used in everyday contexts.

Missing the plot?
Three distinct parts
• 1. Testing student interpreters’ ability to recognize idiomatic
expressions in transcripts of natural language as well as their
ability to identify the correct meaning of such expressions: 53
students Week 2 pre-test and Week 10 post-test (12-week
semester):
• Results showed that students varied considerably in their
ability to recognize the correct meaning of the language
excerpts given. It is interesting to note that whereas some
students seemed to have become more familiar with the
idioms, others appeared to have become more confused,
scoring lower on the posttest than on the pretest.
• Crezee, I., & Grant,L. (2013). Missingthe plot?Idiomaticlanguage in interpreter education.
International Journal of Interpreter Education, 7(1),

Post-test survey results
• The posttest: also few questions asking how interpreting students
perceived the importance of gaining familiarity with idiomatic
expressions.
• Answers showed that 61% of respondents thought it extremely
important for interpreting students to be familiar with this
language, whereas 32% thought it was very important, and 7%
thought it was quite important (moderately important).
• When asked how best to learn idioms (various options given)
• interacting with colleagues at work – selected as the best way to
learn such expressions,
• closely followed by watching ordinary television programs and
watching reality television programs showing professionals at work.
• One student commented, “I think that sometimes I miss some
form of idiomatic expressions; for instance, I recently learned
that ‘with his head held high’ means ‘with confidence,’ but I take
it literally [sic].”

Prior to Part 2 of the study
• a small group of students (n = 6) were presented with audiovisual material
taken from one of the documentary programs for interpreting in the
computer laboratory.
• This material showed a corrections dog handler searching the car of a
prison visitor and finding some contraband. After the female visitor had
given the dog handler increasingly different responses as to whether she
knew the contraband was there and why she had this in her car, the dog
handler ended up telling her, “Your story doesn’t wash.”
• Students reported that without the transcripts they would have found it
more difficult to pick up on the meaning and said that they used the
audiovisual context and perceived information about the relationship
between the speakers on the screen to surmise the meaning of the
idiomatic expressions used.
• Context-related information also provided clues of a sociopragmatic nature
that assisted student interpreters in paraphrasing the idiomatic expressions
appropriately in the target language (TL).
• This supported our decision to present interpreting students with a
combination of excerpts from written transcripts and audiovisual material.

Guessing the meaning of idiomatic
expressions
• 2. Over a 10-week period, students(n=36) watched excerpts
from the transcriptions of the documentaries - were asked
to paraphrase the meaning of idiomatic expressionsused by
the speakers – in writing.
• The most familiar expression in the transcript proved to
be “he should buy a Lotto ticket,” meaning that he was
very lucky (88% correct).
• [image is from Road Cops, a NZ television doco]

Idiomatic expressions
• He might be clean (87% correct)
• He is quickly on their tails (83% correct)
• These guys are just digging a bigger hole for themselves
(53% correct)
• It’s Tony’s turn to bat (50%)
• Classic, man! (33% correct)
• He has rolled pretty quickly (20%)
• This street is Hoon Central (10%)
• He gets bolshy (6%)
• Two boy racers light up (3%)

Part 3 of the study
• 3. Students practiced dialogues based on the transcripts of the
reality television programs and were asked what approach they
had taken to interpret these
• The health interpreting students’ practice files were based
on a transcript taken from an Australian reality television
program showing Australian paramedics and emergency
department staff interacting with patients. The liaison
interpreting practice files were taken from a New Zealand
reality television program showing customs officers at work.
After they practiced with the dialogues, students received
the accompanying transcripts in which the idiomatic
language items had been highlighted. They were asked to
put a check next to those they were familiar with and a cross
next to expressions they had found unfamiliar. They were
also asked some brief questions about their approach to
interpreting such expressions.

Part 3 findings
• Students found it difficult to interpret some “on the
spot” and admitted that they had sometimes chosen a
verbatim interpretation due to time constraints.
• A majority stated they would have chosen to
paraphrase such expressions given more time.
• A small minority admitted they had not recognized the
idiomatic expressions for what they were when played
the mp3 files and had therefore chosen a literal
interpretation.

Paraphrasing as the best strategy?
• “Morris (1999, as cited in Hale, 2008, p. 115) asserted that
interpreting involves “gaining an understanding of the intentions
of the original-languagespeaker and attempting to convey the
illocutionary force of the original utterance,” adding that this
“understanding will be to some extent a personal, i.e., a subjective
one.” Hale stated that “the interpreter’s very difficult role is to
understand the intention of the utterance and portray it as
faithfully as possible in the other language” (Hale, 2008, p. 115).
Although it may not be possible to ever be sure about the
intention behind other people’s utterances, interpreters can “be
faithful to their own interpretation of the original utterance,” as
that is the best they can be expected to do (Hale, 2008, p. 115).
For this study, we feel that paraphrasing may be the most “risk-
averse” approach to recommend to student interpreters in this
context.”
• (Crezee & Grant, 2013, p. )
• However,paraphrasing requires 1)recognizing idiom; 2)
understanding its intended meaning in the context

Recommendations for
interpreter trainers
• Try to ascertain how much exposure course applicants have
had to natural language (L1 and L2) in a range of settings:
have they worked in the L1 and L2 setting? In which
country/countries?
• Encourage optimal exposure to idiomatic language
• Ensure trainee interpreters recognize idiomatic language for
what it is. Recognition is a crucial first step – checking with
speaker if they sense they don’t “get” the intended meaning
• Encourage trainee interpreters to develop strategies for
paraphrasing idiomatic language

More recommdations
• Explore including natural idiomatic language in the
‘classroom’, as this will encourage students’ awareness
of such items and will enable students to reflect on
appropriate sociopragmatic interpreting strategies.
• A good way of doing this might be to get students to
watch clips of natural language use and ask them to
write down and paraphrase five idioms.
• Following this, the students should be exposed to a
practice dialogue (in either audio or audiovisual mode)
that includes idiomatic expressions taken from the
same video clip.

Thrownin the deepend (Crezee& Grant,
2016)
• My favourite study:
• Students were asked
to interpret after the
speakers in some
excerpts from the
Australian
documentary Recruit
Paramedics

Thrown in the deep end
Focus on:
• Naturally occurring idiomatic language used by paramedics
interacting with the public. Audiovisual clips showing
paramedics at work chosen: language used in the different
clips referred to common healthcare conditions, which meant
terminology was relatively easy to interpret for studentswho
had already completed an introductory health interpreting
course.
• Students’ awareness of the same, and their ability to recognize
and interpret it at first attempt.
• Classroom discussionswith healthcare interpreting students
over the past two decades: they encounter 2 main types of
problems
• 1) relating to medical terminology (as one would expect)
• 2) use of everyday idiomatic language.

Method
• Participants: L2 English student interpreters representing a range
of different languages including Mandarin, Cantonese, Russian,
Samoan, Portuguese, Thai and Korean.
• All student interpreters in an advanced healthcare interpreting
classroom.
• Students interpreted clips – received feedback from language
assessors
• Idiomatic expressions from the scripts were inserted into an Excel
spreadsheet and for each expression on each clip, a comment
was made as to how the student had interpreted the expression
in question (correct paraphrase, omission or incorrect
interpretation).
• Pre- and post-study survey
• Analysis of language use

Findings re language use
• Three types of use of informal idiomatic language:
• 1) Eliciting information from either patient or
relatives/bystanders
• What has our young lady done? (speaking to an 85-year old
female),
• 2) Giving instructions
• You reckon you can give us a hand to get on the bed?
• 3) Softened Representations of Medical Reality (SRMRs)
• You need to go into the hospital, get a bit of a chest x-ray
• I just need you to hang in there alright?

Sometimes all three categories
within the same utterance
• I’m just going to pop this on your face, cause your breathing is
pretty ordinary, isn’t it doll?
• We are just pulling up okay. Just keep coughing it up, you are
doing really well okay?
• Going to try and clean you up here a bit, alright?
• [said to a patient with a serious episode of pneumonia
complicated by Mexican flu.]
• Another utterance aimed at both instructing and reassuring
included: Okay, just straighten that leg up for me. You’re alright,
you don’t move at all, you let me move you.
• You look like you might have done that other hip darling. That’s
how it’s sort of looking [said to an elderly woman who had broken
her other hip the previous year]

Examples of
incorrectly interpreted phrases
• you reckon you can giveus a hand to getonto the bed? - give us your arm; give us one of
your hands. …
• she’s a bit worked up… -should be able to recover with a good night’srest; so it broughther
to the current
• she was rearendedwhen the car in front of her stopped suddenly - she hit a car in front;
she went into a car; she hit the front; she lost her direction; her car spin out as it been hit …
• my legs just went out from under me… - I think this side has no feelings; legs stayed/went
on; something went not quite well; everything was blurry’.
• probably stillhasn’t sunk in - too much happened today I think I will slowly accept them;
now startsslowly realizing; have to slowly experience it
• I will just pop that on you - Do you have any problems?; I'll take this off; I'll just take out
this thing into this way; I'll take that out
• thrown in the deep end - has experienced death; was right about his job; has done a lot of
good things in a week; was put onto a day shift; has been involved as much as possible; ‘has
been thrown in day team.

It still hasn’t sunk in…..
• With regard to the expression
• it still hasn’t sunk in,
• two students seemed to have mistaken the word ‘sunk’ for
‘sun’.
• Another one said I will slowly accept them
• It should be noted that in spoken Chinese language, the
verb ‘accept’ can also mean ‘to understand’.

Concluding remarks on ‘thrown in the
deep end’
• “It is sometimes jokingly said that informality is the default
mode of communicationin Australia and New Zealand and
the discourse of the paramedics certainly fell into this
category, as they tried to establish rapport with their
patients and get them to relax” (Crezee & Grant, 2016, p.
10).
• “The findings demonstrated students’apparent lack of
familiarity with idiomatic and colloquial language, both in
terms of recognizing it as such, and being able to accurately
guess its meaning, as well as cross-cultural issues relating to
the acceptability of such language in the patient's culture”
(Crezee & Grant, 2016, p. 10).

Cross-cultural considerations
• “Several students commented afterwardsthat it would be
unacceptable in their culture to address patients as doll,
sweetie, mate, buddy or by their first name (as in the case
of 85-year-old Gwen). Some said they considered them
culturally inappropriate and had felt omission was the best
approach. While such terms of address can easily be left out
without changing the meaning of the utterance, the same
cannot be said for the omission of colloquialisms used to
help make patients feel more relaxed about their situation.
It might be that interpreting trainers need to make room in
their training to cover this aspect of the language with
trainees and its purpose, especially with those trainees
aiming to become medical interpreters” (Crezee & Grant,
2016, p. 10).

Whereto find
Paramedics
• Recruit paramedics
• https://youtu.be/nAdw8jqaVIQ
• “if you haven’t got a sense of humor,
you’ve got 8 weeks to develop one”
• Paramedics
• https://youtu.be/gQQk9cuj8BE?list=PL
LPhP7srang8Ae1The6HmpRXzfXtO6kR
D
• https://www.youtube.com/watch?v=xg
ohGiwVPkM&ab_channel=AmbulanceV
ic
• Rapid ResponseNew Zealand
• https://youtu.be/a3fpQ3tQG0s

Other real life television programs for
interpreting practice
• UK: 24 hours in Emergency
• New Zealand: LifeFlight
• New Zealand: Rapid Response (unscripted); ShortlandStreet
(scripted)
• Australia: RPA/Royal Prince Alfred Hospital (Sydney)
• US: (on Netflix):
• Lenox Hill (https://www.netflix.com/nz/title/80201728)
• https://www.prevention.com/life/g25737172/netflix-health-
documentaries/

Informal language in bad news
interview
• I get my students in their second health interpreting
course (special settings such as oncology, mental
health) to reflect on pretending to be the interpreter in a
bad news conversation involving an Australian GI
surgeon called Dr Storey who is giving an Australian
man called Doug bad news about his inoperable
stomach cancer.
• Students play, interpret and record their renditions in
VoiceThread – then replay and reflect on their
renditions immediately after – they also reflect on
interpreting such bad news interview in a reflective
writing assignment

Bad news interview: Doug and Dr Storey
– what happened first
Dr Storey has told Doug that he will operate on his stomachcancer,but first Doug has a
PET scan and that shows two suspicious looking areas in the lymph nodes below
Doug’s stomach. Dr Storey tells Doug this and carries out a gastrotomy:Two specimens
(biopsies) are sent to the Pathology Lab.
• Dr St: It’s got some areas with tumour in it. It’s like it’s invading fibrous
tissue I think.
• [the phone rings. Theater Nurse answers the phone]
• Dr McK: Hello it’s Dr McKenzie in Pathology. I’ve got a frozen section report for
Dr Storey. There were two, two specimens sent up, both labelled para-aortic lymph
node and both of them contained metastatic carcinoma.
• Nurse: Both contain metastatic carcinoma. Okay thank you very much. Bye,
bye.
• Dr St: So it’s metastatic carcinoma. So it’s not so good. Okay. We’ve got all
the information we need now. So just to reinforce it for him because it’s almost
certainly from his stomach. Scissors thanks.And that’s about the worst news we could
have got. I’ll go back and see him tonight and tell him that and we’ll talk more about
the implications of it tomorrow. Okay, well, that’s one for the PET scan I guess.

Dr Storey reports back to Doug
– Doug’s wife is sitting next to him
• DR: … and I took a sample of that off and sent it to the pathologist.
Now the pathologist can’t give an absolute answer on what’s gone
up, but I guess the important thing is that the bit I did remove is
cancer and it’s not lymphoma, they can tell me that much, so the
only options really that are left are to use chemotherapy for it.
• Doug: Right. But surgery wouldn’t clean it, you couldn’t take those out
plus the bit of stomach?
• DR: I could do it, but it wouldn’t cure you. You’ve got to use the fact
that it’s spread to those glands as an index that it might well have
spread to places that even the PET scan didn’t see.
• Doug Oh I see what you mean. So that is not the be all and end all.
• DR: Look it might be, but you’ve just got to go on the odds, and the fact
is that it’s not really in anyone’s experience that removing nodes in
that area involved with cancer is likely to result in you being cured.

Doug and Dr Storey
- continued
• Doug: Oh right. So does that mean that the only alternative then is
chemo?
• DR: Is chemotherapy. Yeah, I mean that’s not a simple decision
either in that chemotherapy for stomach cancers, it’s not
fantastic. It can be very good in some people, but you’ve got to
say there’s a few people that have it and get no benefit at all
from it. I mean ultimately it will come down to your decision
once we’ve sort of told you all the pros and cons.
• Doug: Yeah, well I’d be a layman so I’d only be able to absorb what
you said and I still want you to be nodding.

Doug and Dr Storey
- continued
• Dr: Sure, sure. But the other thing that you’ve got to remember is that you
yourself aren’t feeling too bad. There’s an argument in this circumstance that
says that you’re feeling pretty fit and well, that you’re strong at the moment,
and you know that sort of indicates to me that the cancer is not overwhelming
your system. That can be taken both ways. You might say well now is the
time to have the chemotherapy and give its best effect. On the other hand, you
might want to take what some might refer to as the South of France option
and sort of grab the fact that you are feeling well and living well and eating
well now, and not have that upset by the fact of chemotherapy.
• _____
• Doug: That’s dead true, you know like if I can go through like this and
you can get out and do a bit of gardening and have visits from the kids and
that, then that would mean a hell of a lot then if you were propped up in a
chair and you had to be moved here and moved there to feel comfortable.
Yeah.

Student reflections on issues
interpreting the clip
• Informal expressions - non-English speaking student
interpreters were either unable to hear them (incorrect
transcriptions) or unable to understand them
• Go on the odds
• I still want you to be nodding
• The South of France option
• Students don't get that these are part of an existing
relationship between the surgeon and the patient.
• Chinese-speaking interpreters often say they are used to
Chinese-speaking doctors (in Mainland China) being very
curt and very authoritative, and certainly not asking the
patient how they would feel about certain options.
(Taiwanese doctors are very kind, very patient oriented and
consultative, so there is quite a contrast there.)
• Other culture-specific reflections: 'death’ is not usually
discussed with the patients themselves

Implications for Healthcare Interpreter
Trainers
• Ensure trainees are aware of
• - informal language use by patients
• may not make sense when translated (Cindy Roat’s example)
• Euphemisms
• - Informal language use by doctors – combined with
establishing rapport and a consultative approach (Calgary
Cambridge Framework – Kurz et al., 1996)
• Providers may use informal language for a range of reasons, not
aware that this mayprovide a problem for interpreters and patients
• This is not a deal breaker, but we have to be on the same page here
(Crezee, telephone interpretingbetween Fertility specialist and
potentialsperm donorwho smoked at the time of donation)
• Softened Representations of Medical Reality

How to incorporate findings into teaching a
40-hour training course
• Sensitization is key - what kinds of classroom exercises
are good for sensitization?
• Scripted dialogues with idioms
• Real-life documentaries with idioms for interpreting
practice e.g.
• https://depression.org.nz/
• https://www.mentalhealth.org.nz/get-
help/stories/story/6/lance-elliot
• Feedback on renditions by same-language peers
• Reflections on renditions: intercultural (appropriateness;
how to convey pragmatic intent in a culturally sensitive
way, e.g. in Thai you would not talk about dying in a few
weeks, but about living for another few weeks)
• In pairs
• In writing

Semester long courses
at college
• Practice dialogues with idiomatic expressions
• Authentic practice from real life ‘fly on the wall’
documentaries involving paramedics and patients –
identify informal idiomatic expressions
• Reflections on own and others’ renditions
• One-off workshops
• If dedicating the entire workshop to the topic:
• Ask participants if they have ever encountered informal language
use by either health providers or patients that was hard to interpret
• - ask them why it was hard to interpret
• - what intercultural considerations come up
• - how they keep up with the manyregional variants for a particular
language (Spanish, Chinese, Arabic)

Things to remember
• The use of idiomatic language may be considered to be
inappropriate OR the interpreter may not be familiar with it
(Crezee & Grant, 2013)
• Many expressionsin Chinese go back to Chinese classics
such as ‘the Monkey King’ or ‘The Journey West’ or ‘Dreams
of the Red Mansions’
• See this interview with Dr Jing Han, head of subtitling at SBS
Australia
• https://www.youtube.com/watch?v=5zgx4-
WjhPA&ab_channel=AUSIT
• https://www.westernsydney.edu.au/newscentre/news_centre/stor
y_archive/2017/if_you_are_the_one_and_the_art_of_translating

Commonly asked questions
• how you would help students to learn to identify issues, give
each other peer feedback?
• Step 1: sensitization to the issue
• Step 2: recognizing, identifying idiomatic language
• Step 3: identifying its pragmatic intent
• Step 4: how to convey this in the TL in a culturally
appropriate manner
• Step 5: reflecting on own renditions
• Step 6: reflecting on others’ renditions
• Step 7: developing strategies
• Step 8: ongoing professional development by watching
reality TV shows and interpreting in preparation for real life
scenarios

References
• Bryder, L. (2009). Researchinto the Cartwright Inquiry. The New Zealand
Medical Journal (Online), 122(1288).
• Bunkle, P. (2010). Patient-centred ethics, the Cartwright Inquiry and feminism:
Identifying the central fallacy in Linda Bryder, A History of the'Unfortunate
Experiment at National Women's Hospital (2009, 2010). Women's Studies
Journal, 24(2).
• Cartwright, S. (1988). The report of the committee of inquiry into allegations
concerning the treatment of cervical cancer at National Women's Hospital and
into other related matters. The Committee.
• Coney, S., & Bunkle, P. (1988).An Unfortunate Experiment at National
Women's. Bioethics News (Monash University), 8(1), 3-30.
• Crezee, I. (2013) Introduction to healthcare for interpreters and translators.
Amsterdam, the Netherlands & Philadelphia, PA: John Benjamins.
• Crezee, I., & Grant, L. (2013a). Missing the plot? Idiomatic language in
interpreter education. International Journal of Interpreter Education, 5(1), 17-
33. Retrieved from http://www.cit-asl.org/
• Crezee, I., & Grant, L. (2016). Thrown in the deep end: Challenges of
interpreting informal paramedic language. Translation and Interpreting, 8(1),
1-15.
• Crezee, I. H. M., Teng, W., & Burn, J. A. (2017). Teething problems? Chinese
student interpreters’ performance when interpreting authentic (cross-)
examination questions in the legal interpreting classroom. The Interpreter and
Translator Trainer, 11(4), 337-356.

References continued
• Darwish, A. (2006). Translating the news, reframing constructed realities.
Translation Watch Quarterly 2(1), 52- 77.
• Grant, L.E. (1996). Teaching conversation using a television soap. Prospect,
11(3), 60-71.
• Grant, L., & Nation, P. (2006). How many idioms are there in English?
International Journal of Applied Linguistics, 151(1), 1–14.
• Hale, S. (2014). Interpreting culture. Dealing with cross-cultural issues in court
interpreting. Perspectives. Studies in Translatology 22(3), 321-331.
• Horodecka, E. & Osadnik, W. (1989-90). The problem of translation of
idiomatic expressions from English into Polish. New Zealand Slavonic
Journal, 167-173.
• Issa, S. (2018). Challenges facing conference and television interpreters.
(Unpublished Master of Philosophy thesis, Auckland University of
Technology).
• Liu, M. (2008). How do experts interpret? Implications from researchin
Interpreting studies and cognitive science. In: Hansen, G., Chesterman, A., &
Gerzymisch-Arbogast, H. (Eds.), (2009), Efforts and models in interpreting
and translation research: a tribute to Daniel Gile (pp. 159-178).Amsterdam,
the Netherlands: John Benjamins.
• Valero-Garces, C. (2014). Transcription and translation. In H. Mikkelson and
R. Jourdenais (Eds.), The Routledge handbook of interpreting (pp. 154-168).
London and New York: Routledge.

NATIONAL
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Q&A
Ineke H. M. Crezee, PhD, ONZM,
MA (Tr), MA, BA, RN, NAATI Cert
Tr, Cert Health Int

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