28 Lost in Translation: Canadian Paediatric Resident Education and Practice of Clinical Translation Services

Abstract

Abstract Background Canadian paediatric residents provide care to many families with non-English or French language preferences (NEFLP). Lack of communication in a family’s preferred language is inequitable and results in inferior care. Professional medical interpreters offer a route to enhanced understanding and safety. There is no data available about Canadian paediatric residents’ use of interpreters, making it difficult to identify gaps in practice or develop targeted interventions to improve patient experience. Objectives An anonymous, 19-item survey (REDCap) was designed to evaluate: (1) interpreter services available in paediatric training centers; (2) resident perception of their ease of access, utility, and value; and (3) barriers and drivers to interpreter use. This survey represents the first collection of data from Canadian paediatric residents about translator services. Design/Methods Eligible participants included all paediatric residents enrolled in an accredited Canadian paediatric training program. The survey was distributed by email and available for a three-month period. This project was reviewed and considered within the category of quality improvement and thus exempt from formal review by the hospital ethics committee. Descriptive statistics were performed in STATA v15.1. Results 122 residents (approximately 19% of eligible participants) responded. Approximately 40% reported no previous training in interpreter use, and 60% desired more training. Interpreter services are widely available but remain underused in a variety of clinical situations: interpreters are most often used during informed consent (98% ‘mostly’ or ‘always’), family meetings (97%), and history-taking (86%), and least often during physical examinations (41%) and bedside rounds (38%). Residents are more likely to use an interpreter if access is easy (97% ‘more likely’ or ‘likely’) or if there is extra time for the encounter (78%). Most residents (85%) felt they provide better care to patients who share their primary language (English or French), compared with families who prefer other languages. Conclusion Residents are more confident in their clinical and communication skills when working with families who share their primary language compared with NEFLP families, even when an interpreter is present. Our findings suggest that residents lack the training and confidence to provide equal care to families with varying language preferences. Paediatric training programs should develop curriculum content that not only targets safe and effective interpreter use, but also reviews non-spoken aspects of cultural awareness and safety.