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Techniques for Effectively Using Interpreters

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					Techniques for Effectively Using Interpreters
Read over these proven strategies for efficiently getting the most out of an interpreted patient
visit. It takes awhile to become truly adept, but you’ll find that these techniques really work, and
you’ll soon be able to implement them quickly and automatically.

Have a Quick Pre-Encounter Discussion with Interpreter

Tell the interpreter what you hope to accomplish, what the encounter is about. As you and your
interpreters consistently work together and develop a mutually workable style, this “discussion”
may simply be a sentence or two.
     Ask interpreter if he/she is familiar with the concepts involved in the visit that is about to
     occur
     Agree with interpreter on interpretation techniques, e.g., how to signal you to pause,
        signal that they need to explain something the patient has said
     When working with non-staff interpreters, point out importance of accuracy,
        completeness, impartiality and confidentiality
     Agree with interpreter on interpretation techniques, e.g., how to signal you to pause,
        signal that they need to explain something the patient has said
     Encourage interpreters to ask questions when they are uncertain
     Encourage interpreters to make pertinent comments when they notice there is a
        conceptual, cultural or linguistic misunderstanding. Frequently either clinician or patient
        assumes background information, which is actually lacking
     In many cases, patients will prefer an interpreter of their same gender, particularly if a
        physical examination is to take place

In the Encounter

      Be sure to introduce the interpreter to the patient. Emphasize that the interpreter is bound
       to confidentiality, just as you are
      Place the interpreter slightly to one side and behind the patient, so that it is easy to look
       directly at the patient when the interpreter is speaking
      Look at patient just as if you were conversing with an English-speaking person. The
       interpreter is only a conduit. Observe non-verbal signs that will give you an indication of
       their emotional effect; this will provide you with important information as to what your
       response to the individual patient should be
      Use the first person when talking to the patient: “Mr. Quesada, I am wondering if...”
       Encourage the interpreter to use the first person as well instead of “The doctor says she is
       wondering if…”
      Express one concept at a time
      Pace your speech so interpreter and patient can understand and follow
      Make sure the complexity of the language is not beyond the interpreter's medical
       knowledge and familiarity with institutional protocols and procedures
      When the interpreter finishes explaining a point to the patient, occasionally ask the
       interpreter to tell you in English exactly what she just told the patient. This "re-telling"

Developed by M. Jean Gilbert, Ph.D.— General Guidelines for Effective Use of Interpreters in
a Health care Setting
       will give you the feedback you need to feel confident about the quality of the translation
       or to identify and catch mistakes
      Give complete information on diagnosis, tests and treatment. Then ask for feedback if
       there is any doubt that the patient understands. For example, if the question "How do you
       feel about that?" elicits a nervous and bewildered reaction, you will conclude that the
       patient doesn't entirely understand and needs you to elaborate more fully
      Patients of varied ethnic backgrounds will not follow your orders unless they made to feel
       that you really care enough to provide a full explanation and are therefore trustworthy.
       They have a need to clearly understand why it is in their best interest to comply
      Encourage interpreters to make pertinent comments when they notice there is a
       conceptual, cultural or linguistic misunderstanding

After The Visit

Ask for feedback from the interpreter. If possible after the interview, speak privately with the
interpreter. Be open to comments. Interpreters may perceive cultural and emotional subtleties
more clearly than you. Take advantage of their unique bi-cultural perspective.

Non-verbal Communication in the Interpreted Encounter

Body language and non-verbal behavior are important links. They can make an important
difference in those situations where you have no language and no cultural background in
common with your international patient. Sixty percent of rapport is the result of non-verbal
language. It is therefore important to be aware of signs, which may be misunderstood.
For example:
     Eye contact and a calm, intent attitude will take you a long way with Latin American
        patients
     Lack of eye contact while listening by Asian patients can mean respect and concentration
        and not disrespect, as it does in Western cultures
     When Asian patients are preoccupied, they may seem tense and concentrated. The
        impenetrable features should prompt the clinician to ask the patient for more detail about
        their concerns
     When Limited English Proficiency (LEP) patients repeatedly nod with a subtle
        nervousness it sometimes means they are listening intently but don’t understand
     A warm empathetic smile at the right time creates a link with Asian as well as Latin
        American patients. However, a smile while a patient is talking or acting out his/her
        problem is considered sarcastic by both these cultures and is often misunderstood
     Warm and polite physical touch is considered a sign of empathy by most international
        patients. However some Muslim and Orthodox Jews do not want any male/female
        physical contact, no matter how friendly




Developed by M. Jean Gilbert, Ph.D.— General Guidelines for Effective Use of Interpreters in
a Health care Setting

				
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