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Overview of Role and Practice
Issues
Standards of Practice
Medical interpreting has been practiced for generations, although not
as a formally organized profession. In the past two decades, more individuals
in the United States and other countries have been hired or used as "medical
interpreters," but without commonly understood expectations and standards.
This lack of professional standards can frequently compromise the quality
of interpretation services, and therefore of the entire medical encounter.
In order to create a structure or foundation for interpreter expertise,
it is necessary for people in the field of interpreting to share experiences
and begin to select the skills that interpreters need to provide the most
basic, accurate type of service, skills without which an interpreter could
not function. These skills form the basis for "standards of practice"
for the interpreting profession. Standards of practice, then, define the
role, responsibilities, expectations, and behaviors that identify the professional,
qualified medical interpreter.
It is important for medical interpreters to come together to develop
universal standards of practice - standards that don't change from setting
to setting. The Massachusetts Medical Interpreters Association (MMIA) offers
an example of one organization that has undertaken the development of standards of practice with great enthusiasm and thoroughness.
MMIA has defined three basic categories of skills to consider in developing
standards of practice: interpreting, cultural interface, and ethical behavior.
The beauty of these standards is that they allow for different levels of
competency among language groups. For newer immigrant groups with few experienced
interpreters available, specific training in how to let health care providers
know their limits and ask for assistance could make novice interpreters
dynamic and "safe" members of the health care team.
While national standards are essential, the special needs of individual
communities must not be overlooked. Without disconnecting from the larger
picture, communities can examine their own needs and develop standards that
are achievable both from a short-term and long-term perspective. For example,
if an area has a large population needing a specific language service but
does not have qualified interpreters available for that language, then an
approach that provides training in basic skills will meet short-term needs,
and should go hand-in-hand with a long term plan to develop a higher level
of competency.
Role Definition
Lack of interpreter role definition has caused much confusion among providers,
clients, interpreters and administrators. Even in communities and organizations
where role has been defined, not everyone agrees on that role. This subject
continues to provoke discussion, debate, and controversy. Until a uniform
role definition is agreed upon, it is of paramount importance for individual
organizations to expound clear role definitions that are understood and
accepted by all within their walls - providers, interpreters, patients,
and administrators alike. One perspective on interpreter role is provided
in the training developed by the Cross-Cultural Health Care Program in Seattle.
This program views role as a continuum with the interpreter taking on different
roles depending on the particular circumstances at any given moment within
a patient-provider-interpreter encounter. See Choosing
a Role for more information on this perspective.
Certification, licensing, accreditation, role of national/state boards
Various organizations have developed or are in the process of developing
certification processes and tests for medical interpreters. One example
is the certification process developed by the Washington
State Department of Social Services. An article
written by Cindy Roat of the Cross Cultural Healthcare Program further
discusses the Washington State process, raising concerns and questions for
further consideration.
At least in some cases, the processes for certification have gotten ahead
of the profession. That is, they have been developed in the absence of standards
of practice, which are necessary to know what is being testing; and in the
absence of training programs, which provide a foundation for the skills
being tested. To have value and significance, certification programs should
be the result of extensive networking with experts within the field of interpreting,
analysis of information, and a connection to standards of practice. Discussions
are underway for the formation of a national league of medical interpreters
which could then develop and administer a nationally recognized certification
process.
Two models of such national interpreter associations can be found within
the United States and one in Great Britain. The American Translators Association
(ATA) has developed an Accreditation Program to evaluate the competence
of translators (written rendition of information only) according to established
guidelines. Among other functions, the ATA Accreditation Committee prepares
and grades examinations for translator accreditation from a number of languages
(mostly European) into English, and from English into these same languages,
and issues a certificate of accreditation to each successful candidate.
More information on ATA can be found at www.atanet.org.
Another example of a US-based professional interpreter organization is the
Registry of Interpreters for the Deaf (RID), www.rid.org.
RID is widely recognized as a national organization which tests and certifies
professional sign language interpreters.
In the United Kingdom, the National Register of Public Service Interpreters
provides a directory of public service interpreters available by subscription
to social service agencies throughout the U.K. with the assurance that listed
interpreters have achieved certain standards. Administered by the Institute
of Linguists, applicants to the National Register must demonstrate evidence
of public service interpreting experience, references, and educational background,
with two levels of registration available.
For more information on this organization, contact Institute of Linguists,
48 Southward Street, London SE1 1UN, Great Britain, tel: 0171-940 3100,
fax: 0171-940-3101
Questions for our Readers:
- Are you able to determine how qualified your interpreters are? How
would you describe an interpreter who is qualified?
- What is your view of the role of interpreter in your institution? Please
describe in as much detail as you care to.
- Are there any groups in your area that are working on role defintion
or standards of practice?
- Are there any certification tests in your area?
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