Medical Interpreting: A Review of the Literature

Developed by J. Moore and L. Swabey
CATIE, College of St. Catherine/NCIEC
DRAFT ~ 2007

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Introduction | Deaf Patient Perspectives | NonDeaf Patient Perspectives | Settings and Types | Challenges and Issues | Interpreting Role | Preparing to Interpret | Summary and Implications | References | Bibliography | Download PDF

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Summary and Implications

This review of literature, though not exhaustive, offers useful insights into the practice of interpreting in medical settings. Many articles both on sign and spoken language interpreting have not been included; there are also video resources, including instructional materials, which are not reviewed here. However, by identifying apparent gaps and needs in the field, this brief survey provides a salient background for further research and study.

Within health care settings, second-language patient experiences appear similar in many respects for both Deaf and non-deaf individuals. Despite the parallels, however, differences rooted in a history of oppression produce a unique Deaf community experience. 

 A discussion of the variety of medical interpreting types and settings reinforces the complexity of this interpreting specialty. Ongoing challenges to effective practice include both legal issues and logistical concerns. Despite the existence of laws mandating language accommodations for second-language users, communication access remains elusive or sporadic in many instances. Logistical complications include timely scheduling of interpreters for emergencies, service provision to remote locations, and the need to bolster interpreter numbers to meet service demand. Emerging innovations, such as on-call dispatch systems for medical emergencies, offer some practical solutions, and new technology promises further gains, especially in the area of video remote interpreting.

A number of studies have described the benefits of using educated, professional interpreters in medical settings, and promoted their exclusive use with both Deaf and non-deaf second-language populations. In reality, however, quality assurance remains a concern. Health care providers hire professional interpreters inconsistently, a problem that indicates a need for further education and awareness.

Examination of the interpreter’s role has included a look at both traditional and more recent interpreting models, and reveals active participation to be a necessary function of working in health care. Given the unique needs of the setting, an interpreter cannot operate strictly as a conduit, nor be completely impartial.

Although professional and ethical standards are available to guide the general practice of interpreters, standards and guidelines specific to signed language interpreters in the medical settings are still evolving. Neither interpreter assessment tools nor certification for medical settings are widely available, although strides are being made. This is an area to be further developed.

For both spoken and sign language interpreting, studies show that cultural and linguistic differences within the interpreted medical event can influence interpersonal dynamics and shape the outcome of the encounter. Problems arising are often due to differing cultural norms, and the onus falls to the interpreter to make the adjustments required for accurate communication. 

As emphasized throughout the review, adequate education and preparation are necessary for effective interpreter performance, and learning opportunities tailored specifically to medical interpreting offer the greatest benefits. Interpreters need to be equipped with not only a basic medical background and an awareness of medical procedures, but also a thorough understanding of the emotional and safety issues inherent to health care settings. Additional needs in this area include the development of comprehensive curricula, and identification of best practices for medical interpreting.

Overall, this survey of the literature on medical interpreting both in ASL and in spoken languages confirms that interpreting in the medical setting is a complex, challenging and crucial task, and one the requires intensive preparation and education. There is a great deal of research, curriculum development, and learning still to be done. Further exploration of this subject is essential to expanding the knowledge base, developing quality learning opportunities for medical interpreters, and ensuring more effective communication access for Deaf citizens within the health care system.

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