|
|
The Certification Blues:
Pitfalls and Peaks Along the Road to Certifying Medical Interpreters
by Cindy Roat,
reprinted with permission from the April 1997 issue of "Across Cultures,"
Cross Cultural Health Care Program
In 1991, the Department of Social and Health Services of Washington State
(DSHS) embarked on a pioneering endeavor: certification of medical and social
service interpreters. While legal interpreters are certified in several
states, no other state has a program to certify interpreters in the medical
and social service arenas.
Both DSHS and the interpreting community have struggled with this unfolding
process and have learned along the way. The first test, developed and administered
by the LIST (Language Interpretive Services and Translation) office within
DSHS, had no study materials attached, so interpreters had no way to prepare
for it. After a year and numerous interpreter complaints, study materials
were developed and are now routinely distributed. The test included an evaluation
of an interpreter's skill at simultaneous interpretation in a legal setting,
an advanced skill that most medical and social service interpreters use
rarely. After many interpreters failed the test partly due to this section,
DSHS created a dual level of certification, one of which did not require
the simultaneous skills. The test itself focused exclusively on the social
service setting, and many medical interpreters felt it did not measure the
knowledge and skills needed in their work. DSHS responded to this concern
by developing a second test focused specifically on medical interpreting.
In response to a concern about the quality of interpretation in other than
the 7 certifiable languages, DSHS also developed a non-language-specific
test for use with other language interpreters.
In developing this pioneering certification system, LIST has had to meet
innumerable challenges, both logistical and with respect to content, in
order to provide some standard in interpretation in multiple settings, multiple
languages and multiple localities around the state. However, now that the
system is in place is not the time to rest on any proverbial laurels. but
the time to seriously evaluate how appropriate and effective testing system
is.
For example, a look at the percentage of candidates passing the written
and oral medical tests in different languages raises some questions. As
of the end of January 1997, LIST reported that Spanish-speaking candidates
were passing the written test at a rate of 97%, while only 48% of Laotian
interpreters were passing. What does this mean? Are Spanish-speaking candidates
coming to the test better prepared? Is medical vocabulary easier in Spanish
than in Lao? Is the written test more appropriate in its form for Spanish
speakers than for Lao speakers? If preparation is the key, then why are
these same Spanish language interpreters passing the oral test at a rate
of only 61%, below the average for all languages?
Another area of concern is the raw number of interpreters coming to take
the test. Although certification is now required in 7 languages, the state-wide
number of candidates presenting for the test is very low in some of those
languages 62 for Cambodian; 80 for Korean, and only 21 for Lao (as of 1/30/97).
In the non-certified languages, whose interpreters take the non-language-specific
qualification test, only 4 Hmong interpreters have taken the test, and only
1 Mien interpreter. When the rates of passing are applied, we see that very
few interpreters are being certified or qualified in some language communities,
making the provision of services difficult.
At this point in the process a serious evaluation is needed to determine
what is going on. The first series of questions, of course, focuses on the
test itself. Is the test geared to an appropriate level? Is the form of
the test appropriate? For example. the reading level on the written test
is college-level English. Did we mean to be testing reading comprehension
at that level? Is it necessary for the job of medical interpreter? Is it
realistic to expect from all language groups? But then, has the test even
been validated for all language groups? If not, can we adequately use only
one test for all languages? The second series of questions looks at candidate
preparation. If we determine that the test is fair. then how can we help
interpreters better prepare for it? What pan of the test is posing a problem?
Do we need to be teaching more ethics, more medical vocabulary, or better
reading comprehension? The third area of inquiry is about outreach. Why
are so few interpreters taking the test in certain language groups? What
are the barriers in their eyes? What could we do to make the certification
process more accessible to them?
These are questions that need to be looked at, if not by LIST, then by
community organizations concerned with interpreter issues. Around the country,
medical centers and health departments are becoming more aware of the need
for quality interpretation for patients who speak limited English. Certification
requirements for medical interpreters are being considered at this very
moment in Oregon and California, as well as in other states, and they are
looking at Washington State for a model to follow. We need to assure that
model they are offered is effective and appropriate, and won't leave them
singing the blues.
|
