How to Avoid Mistakes in Medical Interpreting
As families and populations become more mobile, and as immigration levels rise dramatically in many countries, healthcare providers worldwide are increasingly drawing on the skills of medical interpreters to help them communicate with their patients. There are a variety of classes and trainings that offer practice and instruction, but when it comes down to preparing to walk into an appointment it can be helpful for interpreters to review a basic list of common mistakes medical interpreters make. An interpreter can have a wealth of trainings and vocabulary memorization, but often it's the small things that pop up in a consultation that can have the potential to throw the interpreter off his or her course for the rest of the session. The following is a list of the most common mistakes that are made, and how to avoid them.
Mistake #1: Being too shy to change the seating/standing arrangement. Most trained interpreters learn from the beginning to avoid the "triangle" seating or standing arrangement (in which the parties are arranged like three points in a triangle), because this arrangement prevents the provider and patient from looking at each other, since they are constantly turning to speak to you. As most interpreters learn, it is more effective for the interpreter to seat themselves or stand to the side and slightly behind the patient, so that patient and provider are forced to look at each other. However strong your conviction on the importance of seating or standing arrangement, though, it can be a challenge to actually enforce this. I have found that this is relatively easy in a quiet and low-key consultation room, since you can calmly explain to provider and patient why you are awkwardly scraping your chair across the floor to get beside/slightly behind the patient. However, in situations that might be more chaotic, like an emergency room or a mobile clinic, it is difficult to interrupt the urgent flow of things in order to arrange seating, and a mistake interpreters sometimes make is to just follow along with the triangle or other seating/standing position that is initiated.
How to Avoid It: Be bold! Remind yourself that though others might look at you strangely or act annoyed, it really only takes a few moments to change into ideal interpreting position, and maybe also some quick thinking if you are in a cramped, free-clinic type situation. Then it's done and patient and provider will thank you at the end for an interpreting job well done.
Mistake #2 - Focusing so hard on exact translation of every word that you forget the general idea of what is being expressed. Certainly in medical situations it is especially important for us to focus a lot of effort on translating every word as exactly as possible, since a word left out or added to the original can have harmful consequences when a patient's diagnosis and treatment are on the line. However, you are not a machine, so when you focus so intently on "computing" translation for every word in your head, you can actually lose the whole of the idea and stop listening and following what they are saying, which can impair your interpreting and leave everyone confused.
How to Avoid It: Practice with youtube clips or other audio/video that you can play and pause. Interpret segments of speech, or interpret "consecutively," whichever method you use, and practice listening on two levels:
Listening Level # 1 - Follow the "story" of the patient's or provider's speech as if you were a friend interested in getting the general idea.
Listening Level # 2- Translate words and segments in your mind and then speak them.
Focusing solely on level #1 makes your interpreting too general and therefore full of errors, while focusing solely on level #2 makes it forced and fragmented. Practice incorporating both levels of listening at the same time.
Mistake #3 - Choosing not to interpret side remarks or extraneous speech. Trained medical interpreters are generally taught to let patient and provider know ahead of time that all speech will be interpreted, even if it is a side remark to the interpreter or a conversation with another person in the room. However, once you're in the consultation it can be tempting to let the doctor's small talk with you slip by un-interpreted to the patient, or to let the patient's casual side remark to you about their tiredness from the bus ride go under the radar. But these remarks, though they take extra energy to interpret, are just as crucial to interpret as any other. A side remark a doctor makes about the weather, when interpreted to a patient, can help the patient relax and feel more connected, which can affect the flow of a treatment. A brief comment the patient makes to you in conversation while the nurse is distractedly preparing for a treatment can still, when interpreted, affect the outcome of a consultation. Missing interpretation of these can block some potential connections.
How to Avoid it: Stick to your guns with giving some sort of notice beforehand in both languages that you will be interpreting everything, so if they don't want it interpreted, they should not say it. Sometimes this doesn't sink in, so provide an example if necessary. An instructor from a Bridging the Gap Medical Interpreting Training, put on by the Blue Ridge Area Health Education Center, shared the insight that when he interprets a side comment or a side conversation and the speaker is shocked to find it relayed to the other party, it can serve as a good reminder of your rules and he will be more careful next time he speaks! Even discussion happens between one healthcare provider and another about the patient's treatment, interpreting as much as you can understand of their interaction can keep the patient in the loop and keep him a respected, participating party. Clear and open communication of all speech is crucial to an honest and effective consultation.
Conquering your shyness about seating arrangements, learning to listen on two levels, and persistently interpreting all speech from all parties are three goals to set for yourself in order to avoid the common mistakes made in medical interpreting.