Interpreting in Medical Settings:

Synthesis of Effective Practices Focus Group Discussions

Developed by Marty Taylor, Ph.D., Project Consultant
CATIE, College of St. Catherine/NCIEC
DRAFT ~ 2007

---

Background | Data Collection/Process | (1) Requisite Skills | (2) Advocacy/Support | (3) Cultural Differences | (4) Diversity | (5) Deaf Interpreters | (6) Sight Translations | (7) Patient Charts | (8) Conveying Meaning | (9) Crossover to Legal | (10) Job Description | Summary/Implications | Appendices | Download PDF of Report | Download PDF of Focus Group Survey Results

---

Diversity

4. What is your experience with diversity in medical settings?  What have you noticed? (For facilitator only if needed -- e.g. Language, socioeconomics, age, educational background).

 The more interpreters know related to diversity in advance of the appointment the more prepared interpreters will be.  Having the goal of providing communication access that allows for each party to maintain their dignity requires interpreters to notice cues, overt and subtle, from the people involved in the interaction. It is important that interpreters have “a range and ability to try different approaches through trial and error.  Flexibility and sensitivity can not be over emphasized.”

Deaf people’s prior experience in seeing medical professionals with interpreters significantly affected interpreters’ work.  For example, if deaf people were accustomed to working with interpreters AND were familiar with medical settings then interpreters felt that the expectations related to role and function of interpreters were already well understood. 

It was reported that generally speaking older deaf individuals had less experience working with interpreters and often were used to writing notes back and forth with health care professionals.  Depending on deaf people’s English literacy skills, they were unaware of the amount of information they may have missed during this process.  On the other hand, younger deaf people often had more experience with interpreters, but certainly not always the case, and were also more familiar with their rights, possibly through their education, access to closed captions from a young age and advertising on television.  It was felt that younger deaf individuals who have grown up with closed caption have more experience with societal norms of the majority culture than older deaf people who may have limited exposure.  

Language use among deaf individuals is diverse, ranging from ASL to the use of various sign systems and at times lipreading. There are differences among and between younger signers and older signers, males and females, and persons from different geographic locations.  These differences among deaf individuals can be observed while chatting and waiting for the appointment to begin.  During this waiting time, observations can be made on how the deaf person communicates, his/her educational level, his/her familiarity with the medical setting and whether or not a CDI is required.  It is during this time that interpreters must compare their schemas with that of the deaf individual.  A word of caution was mentioned, “Don’t assume that just because they’re highly educated they know what’s happening in the setting.”

Working with deaf individuals who have additional disabilities or with those who have minimal language skills (MLS) is extremely challenging.  Determining how they were raised, what signs they know, what are references that will work in the interpretation process and what won’t are all crucial elements in establishing communication.  Trying to find mutual understanding and a foundation on which to build is extremely important before proceeding with the actual interpretation. 

Interpreting for health care professionals who had strong accents presented challenges for interpreters. Interpreters had to focus their time and energy on deciphering accents, thereby requiring interpreters to multi-task on both the linguistic understanding of the source message and the content health care professionals were conveying to deaf patients. 

Gender plays an important part in the interpreting process.  For example, “an older deaf woman assumes you, a female interpreter, understands and can explain better because you have that problem too.”  One “male interpreter feels out of place with women.”  It was noted that women can’t empathize with male situations on one hand, but on the other hand, women appear more comforting and open.  “The deaf community sees women interpreters more often, so they seem more indifferent” to the female gender of interpreters.

There was uncertainty expressed as to whether or not health care professionals received specific training on diversity.  If health care professionals and staff receive training on diversity it would be very useful for interpreters to participate in this training as well, particularly as it pertains to medical settings.