Preventing the Lost-in-Translation Phenomenon: Piloting a Curriculum for Health Care Interpreters in End-of-Life Conversations (319-B)

Abstract

1.Describe the need for professionally-trained interpreters in hospice and palliative care.2.Name two strategies to promote high-quality communication with patients with limited English proficiency.3.Identify current and future training opportunities for professional interpreters in palliative and end-of-life care. Although studies suggest that using professional healthcare interpreters improves care quality and satisfaction for patients with limited English proficiency (LEP), significant communication errors may still occur during crucial discussions between language-discordant patients and providers. One potential explanation for the observed high rates of communication errors may be that healthcare interpreters lack appropriate training in end-of-life discussions. Although interpreters have access to general training in healthcare interpretation, there are no standardized curricula or training programs for healthcare interpreters in palliative care. We developed an innovative training program, Interpreting in Palliative Care, to prepare healthcare interpreters for the linguistic, cultural, and personal challenges of interpreting for palliative and end-of-life (EOL) discussions. A group of palliative care physicians and interpreter trainers developed the curriculum by reviewing relevant literature and then performing a needs assessment of palliative care programs in California public hospitals, which serve a high percentage of LEP patients (average 36%). The core elements of the eight-hour in-person/online training program include: (a) a conceptual introduction to palliative care; (b) three videos of EOL interpreter-mediated encounters modeling best practices in palliative care interpreting; (c) an introduction to palliative care vocabulary terms and exercises enabling practice interpreting from English to seven other languages, and (d) exercises on managing the emotional impact of interpreting for EOL conversations. The curriculum was pilot tested in a group of 15 experienced interpreters. Pre- and posttesting of participants in the pilot group demonstrated that the curriculum was effective in improving interpreter understanding of palliative care and the specific techniques and vocabulary used to interpret these conversations. Preliminary data suggest that an innovative training program in palliative care interpreting can increase interpreters’ knowledge and understanding, specific to end-of-life interpreting. We will incorporate lessons learned from the pilot group to revise and disseminate the curriculum nationally.