|
|
1.3 Medical Interpreter Training
and Provider Education on Working with Interpreters
1.3.1 Medical Interpreter Training
Despite the slow progress in the development of national
standards and testing for medical interpretation, the field of training
has advanced considerably. In fact, we could say that little further development
of training programs and curricula is needed, as thousands of hours have
resulted in a wide variety of approaches and resources. Linda Okahara
of Asian Health Services and Cindy Roat of the Cross
Cultural Health Care Program, have developed a comprehensive compilation
and review of some key training programs in United States and Canada
(Appendix 5).
The dissemination of this kind of information is highly
desirable, as each new interpreter services program is frequently compelled
to develop its own training program, especially if they use previously
untrained in-house or community volunteers as interpreters. It is likely
that the vast majority of interpreter "training" is conducted in-house,
and varies wildly with respect to content and comprehensiveness. The continuum
of cursory interpreter orientation to formal medical interpreter certificate
programs (Bentley College and Northern Essex Community College,
both in Massachusetts) can involve anything from a few hours to several
semesters of instruction. Several recently developed programs that were
based on a review of other available curricula converge on 40 hours of
training as the minimum (Asian Health Services and the Cross
Cultural Health Care Program). This lack of uniformity reflects, of
course, the lack of universally accepted definitions of role and practices,
and no uniform agreement on competency. Again, there is a strong need
to synthesize the critical elements of interpreter education from previously
developed curricula and to define minimum training requirements. Publicizing
these criteria and standards would help health care providers and interpreter
service managers select an appropriate curriculum for training programs
and to evaluate the abilities of prospective interpreters.
A related concern in most parts of the country (outside
Massachusetts, Illinois, Minnesota, Washington, New York City, and the
San Francisco Bay Area) is the lack of qualified individuals who can serve
as trainers. Having access to a curriculum is often insufficient to conduct
training, especially if the instructors have not been trained as a medical
interpreter themselves. A few train-the-medical interpreter trainer programs
have been recently developed (the New York Task Force For Immigrant
Health and Cross Cultural Health Care Program), but they are
either only conducted regionally or can be expensive to export where they
are needed.
1.3.2 Provider Education on Working
with Interpreters
In order for interpreters to function well in medical
and social services environments, providers must understand the interpreter
role and how to interact with them. Expectations about how information
is communicated, whose responsibility it is to clarify complicated subjects
or patient cultural concerns, etc., must be understood. Ideally, clinical
and administrative staff should be instructed or briefed on these issues
in advance of the encounter. At the University of Massachusetts Medical
Center, this topic is part of each new employee's orientation, and
is included in orientation for medical students and residents. However,
many settings introduce interpreters into the clinical or patient services
environment without staff preparation, and resentment and low utilization
result.
With funding from the HHS Office of Minority Health,
Asian Health Services of Oakland developed and distributes a training
packet for provider education on medical interpretation that incorporates
lecture, role play, supplementary readings, and a pre- and post-training
test. The content of provider training for working with interpreters may
include the following functional issues: understanding of provider responsibilities
for communication, ethics, liability, triadic relationship, interpreter
role and skills, and negotiation of basic cultural issues. It should also
include raising awareness around the impact of language barriers on patient
care, and the factors involved in adequate communication, such as knowing
when to call for an interpreter and not using family members. It could
be incorporated into overall cultural competence training for professionals
and staff, either in-house or in continuing education, and optimally should
be part of the health professions education process. This education and
awareness could be critical to widespread implementation of and respect
for interpreter programs.
Summary Recommendations for 1.3
- Support dissemination of information about interpreter training
programs to providers and provider organizations.
- Support development of critical interpreter training elements and
minimum training requirements.
- Support train-the-trainer programs and interpreter training activities,
especially for community based interpreters from small language groups
- Disseminate information about provider education programs and promote
provider education with providers, provider organizations, cultural
competence trainers, health professions associations, and health professions
training programs.
Contacts, Resources, Reference
1.3
Asian Health Services
The Language Coop.
818 Webster St. #115
Oakland, CA 94607-4277
510-986-6830
Cindy Roat
Pacific Medical Center
Cross Cultural Health Care Program
1200 12th Ave. South
Seattle, WA 98144
206-621-4472
training@pacmed.org
John Nickrosz
Massachusetts-based programs
34 Longfellow Street
Dorchester, MA 02122
617-636-5212
JDNICKROSZ@AOL.COM
Francesca Gany
New York Task Force on Immigrant Health
NYU School of Medicine
New York, NY 10016
212-263-8783
GANY@IS.NYU.EDU
Monica Escobar Lowell
University of Massachusetts Medical Center
55 Lake Avenue
Worcester, MA 01655
508-856-3255
mlowell@banyan.ummed.edu
next >
|
