Professional Interpreters Research Articles

Assessing and Improving Medical-Spanish Language Proficiency Among Nursing Students.

Introduction: Language discordance among health care providers and patients has been shown to result in poor patient outcomes. Health care providers who identify as being proficient in the native language of their patients may decline the use of professional interpreters due to their self assessment of language proficiency. More information is needed about whether providers who speak Spanish are proficient in medical Spanish. This study measured medical-Spanish language proficiency among nursing students. Methods: A quantitative pretest posttest evaluation (N = 30) at a large private university in the northeastern U.S. compared student and faculty assessment of student language proficiency after taking a medical-Spanish course using the Interagency Language Roundtable (ILR). T-tests compared student's final, self-assessed ILR scores with faculty's final ILR scores. Results: A significant difference was noted between students' self assessments and faculty assessments of student language proficiency (Rater 1: t(29) = -2.660, p = 0.013; Rater 2: t(29) = -2.693, p = 0.012) with high interrater reliability (kappa = 0.875). There was a significant difference between students' self-assessment of language abilities before and after the course (t(29) = -3.694; p < 0.001). Conclusion: Objective assessment of medical-Spanish language proficiency following a medical Spanish course may more accurately measure proficiency than self-assessment alone.

Teaming in Translation: training interpreting, medical, and midwifery students in simulated birth settings

This paper reports on the TeamTra – Teaming in Translation project, conceived in response to calls for improved training of both professional interpreters and healthcare providers. TeamTra is a cooperation among the Medical Faculty, the University Hospital, the Institute for Applied Linguistics and Translation Studies (IALT), and the Oriental Institute (OIL) at Leipzig University. The program is aimed at medical, midwifery, and interpreting students and draws upon interprofessional and simulation education models to provide students with a hands-on experience for different professions using simulated patient-physician/midwife encounters in maternal health. Special attention is devoted to cultural differences, varying degrees of health literacy and challenges of triadic communication. The course was carried out for approximately 80 students in the 2022/2023 winter semester and in the 2023 summer semester. This paper reports on the first year of the project, which included a pre-kick-off survey, a satisfaction survey, and feedback sessions.

Examining the association between professional language interpreter services and intensive care unit utilization among patients with non-English language preference: Evidence from a large U.S. hospital

ObjectiveTo examine the healthcare utilization of patients with non-English language preference (NELP) who utilized a professional language interpreter (PLI) in the intensive care unit (ICU) compared to similar patients with NELP who did not utilize a PLI in the ICU. MethodsSingle center cohort study of patients with NELP with at least one ICU admission a large academic medical center in the U.S. Midwest (1/1/2008-12/31/2022). The first model examined ICU length-of-stay (LOS) using a negative binomial and the second model examined whether a patient was readmitted to the ICU using a logistic regression with each model controlling for PLI utilization and covariates. ResultsPatients with NELP who utilized a PLI in the ICU had 0.87-days longer in the ICU (p<0.01) and had a 46% decreased odds of being readmitted to the ICU (p<0.01) than a comparable patient with NELP who did not utilize a PLI in the ICU. ConclusionProviding patients with NELP with access to a PLI in the ICU can improve patient outcomes and reduce language barriers. Practice implicationsThese results can provide the justification to potentially increase PLI staffing levels or increase the access to existing PLIs for more patients with NELP in ICUs.

Enhancing nursing students' communication skills with deaf patients: Workshop impact on nursing education programs

BackgroundNursing students require education on effective communication with patients to fulfill their roles as future healthcare providers. Ensuring inclusive patient care requires addressing this educational gap. PurposeThis study assesses the impact of workshops on nursing students' communication strategies with Deaf and hard-of-hearing patients. MethodA cross-sectional survey was conducted among nursing students before and after participating in workshops conducted by Deaf instructors from the non-profit association Maagalei Shema. Data was collected from January 2023 to March 2024 and analyzed using SPSS software. FindingsResults indicate that the workshops significantly improved participants' communication strategies, with 82.48% reporting enhanced abilities post-workshop. The use of communication tools, including professional interpreters, increased following the workshops. DiscussionWorkshops offer an effective approach to enhancing healthcare workers' communication with Deaf and hard-of-hearing patients. These findings underscore the importance of incorporating experiential learning opportunities into nursing education to optimize patient interactions and improve healthcare outcomes.

Workshops: Enhancing communication for nursing students with patients with hearing disabilities

Abstract Background Nursing students need guidance on effective communication strategies for interacting with patients with hearing disabilities, emphasizing the importance of addressing this gap in their education as future healthcare professionals. Methods A cross-sectional survey was conducted among nursing students at seven institutions before and after workshops led by guides with hearing disabilities from a non-profit organization Ma’agalei Shema and funded by the National Insurance Institute. Data was collected from 2023 to March 2024 and analyzed using SPSS software. Results 279 participants completed the survey before the workshops. and 136 responding afterward. Almost 80% were female. Before the workshops, 68.46% of students expected to gain communication tools for patients with hearing disabilities. About one-third believed the healthcare system offers accessible treatment to these patients, while only 22.22% foresaw no barriers. One-third reported no clinical contact with such patients. Among those who did, lip-reading (25.53%), writing (17.73%), assistance from family members (15.6%), and sign language (9.22%) were commonly used. Only 2.84% used professional sign language interpreters, and 20.57% reported never meeting a patient with hearing disabilities (8% reported “other”). Post-workshop surveys showed that around 82.48% of participants felt the workshops would significantly enhance their communication skills with such patients, with only 5.11% reporting a lack of practical tools received. Conclusions Practical workshops can significantly enhance communication skills and improve patient care. This study underscores the potential impact of minor adjustments in communication strategies on patient care, such as increasing the use of professional interpreters. Main messages: Providing training to nursing students in effective communication with these patients can streamline interactions, diminish reliance on family intermediaries, and enhance medical care. Key messages • Nursing students need guidance on communicating with patients with hearing disabilities to improve future healthcare interactions. • Practical workshops enhance communication skills, stressing the importance of minor adjustments for better patient care.

34 Improving language concordant care in the paediatric emergency department

Abstract Background Paediatric patients and families with limited English proficiency (LEP) experience worse health outcomes. Use of professional medical interpreter services (IS) helps ensure that all patients receive high quality care, regardless of their preferred language of communication. Objectives The aim of this quality improvement (QI) study was to improve language concordant care within a paediatric emergency department (ED) in downtown Toronto by increasing the rate of over-the-phone interpreter use by 50% by July 2024 and to understand common reasons for interpreter non-use. Design/Methods Using the model for improvement, we assembled an interdisciplinary team that included physicians, ED registration clerks, triage nurses, and language services staff to understand current workflow and develop targeted interventions aimed at addressing key drivers through multiple plan-do-study-act (PDSA) cycles. Interventions included introduction of a standardized script to capture language preference at ED registration, EMR-integrated preferred language notification and smart text template in provider notes for standardized IS use or non-use documentation, and departmental education. Our primary outcome measure was rate of over-the-phone IS use for all ED visits. Process measures were rate of EMR documentation of patients and caregivers with non-English language preference (NELP) and rate of provider documentation of IS use or non-use. Balancing measures included time to provider initial assessment (PIA) and ED length of stay. Results The baseline period (November 2022-April 2023) revealed an over-the-phone IS rate of 5.2% for all ED visits. The initial results from the first 6 months of the intervention period demonstrated an increase in physician documentation of IS use or non-use in patients with NELP, from 10% to 76%. Additionally, 18.6% of patients or caregivers with NELP had IS use per provider notes. Over the next 9 months of the intervention period, special cause variation is anticipated in the rate of IS use and rate of EMR documentation of NELP. The most common reasons for IS non-use were: ‘deemed unnecessary by provider’, ‘declined by family’ and ‘use of family member/friend as interpreter’. There was no change in PIA or ED length of stay for patients with NELP. Conclusion This QI initiative increased consistent provider documentation of IS use in ED patient records in one of the most linguistically diverse cities in the world. Future efforts will focus on exploring additional ways to capture language preference beyond registration, facilitating IS use in the ED, and addressing top reasons for non-use of IS in patients and caregivers with NELP.

Oscillatory features of German–English sentence processing: Evidence from an EEG study

Aims and objectives: In this study, we investigated the neural oscillatory patterns occurring during sentence-level overt bilingual processing tasks on 46 German–English bilinguals with the intention of finding out if there were task-specific oscillations for this language pair. Methodology: Four tasks, including Language 2 (L2) listening, Language 1 (L1) speaking, L2 shadowing (i.e., repeating a segment of an utterance), and backward interpreting (i.e., orally translating L2 sentences to L1), were implemented with the technique of electroencephalography (EEG). Data and analysis: Data included demographic indices, neural oscillation metrics, and oral production scores from participants. Static spectral analysis, time–frequency analysis, principal components analysis, cross-frequency coupling, and inferential statistics were applied to the data. Findings: The sensory task and articulatory tasks differed greatly in the delta–theta band and the beta–gamma band in terms of time–frequency dynamics. Analyses also revealed variations in a frontal/prefrontal theta component and a distinct gamma component across the four tasks. Moreover, we found a right fronto-temporal theta–gamma coupling unique to backward interpreting. Originality: The task-wise comparison experiment paradigm has rarely been implemented in neuroimaging research on language, especially so in EEG research on bilingualism. Significance: The findings provide novel insights for the understanding of language conversion mechanism and may benefit the training of professional interpreters.

Strategies and sacrifices of family caregiving in the Somali-American community: a qualitative study

BackgroundAmong the many pressing concerns of the Somali-American community, and other similar immigrant and refugee communities as they grow in the United States, is the provision of care for older adults and adults with disabilities. The implications of effective caregiving range from the facilitation of community building and place-making to the delivery and management of healthcare on a systemic level. However, little is currently known about Somali-American family caregivers, including their duties and responsibilities, primary concerns, and the impacts of surrounding influences on their ability to fulfill their role.MethodsSemi-structured interviews were conducted with 10 Somali-American family caregivers in Somali language. The resulting transcripts were translated into English by a professional interpreter and analyzed using an inductive thematic analysis approach. A key informant from the community was additionally consulted for insights regarding cultural nuances and interpretations of idiomatic expressions and concepts.ResultsThematic analysis of the reports revealed the principal themes of visitation, patient accompaniment, and self-sacrifice through acceptance and God-consciousness as pervasive and salient concerns across participants. Furthermore, the heightened stresses of the COVID-19 pandemic revealed just how severe the consequences can be when access to culturally habituated navigational tools and coping mechanisms are restricted.ConclusionsIn light of our findings, the growing concern for discrimination and sociocultural discord in the Somali-American community presents a particularly prescient threat to the well-being and sustainability of family caregivers. Their experiences must be understood and used to promote education and partnership between the healthcare system and the community in order to build trust and ensure a healthy future for this indispensable population.

The Bright and Dark Sides of Sports Interpreting in Iraq: Football Interpreting as an Example

With the rapid increase in international matches, such as the Olympic Games, World Cup by FIFA, Arab or Gulf Cup events the demand for interpreting becomes very necessary, as through this activity players can connect with viewers around the world, this is on the one hand, and on the other, through which they can instantly obtain their instructions. After the war in 2003, the participation of Iraqi athletes in international competitions and the recruitment of foreign coaches flourish. This new situation urges policy designers to strategically plan to offer qualified interpreters to ensure ideal communication between the players and their coaches and between them and the international audience. The status quo, however, is very frustrating: the number of Iraqi qualified interpreters can relatively be visible (for the ordinary observers) as there are no specialized academic or non-academic institutions that offer the requirements. This lack has opened the door for non-professional interpreters to carry the task leading not only to fragmented communication but also to deform the perception of this profession. This study sheds light on this particular area. It solely adopts the participant-oriented method offered by Saldanha and O’brein (2013). The research instrument is a carefully-designed questionnaire which is presented to a sample of thirty professional interpreters. The study findings emphasize that the status quo of sports interpreting in Iraq is discouraging because of some obstacles, such as the absence of specialized interpreting training facilities and monitoring institutions.

The impact of language discordance on pediatric cancer care outcomes: A systematic review.

Language discordance between clinicians and families in pediatrics has been associated with adverse events and lower quality of care. We aimed to summarize the existing literature evaluating the impact of language discordance among healthcare professionals and families within pediatric oncology by conducting a systematic review. Of 8364 studies, 43 studies met eligibility for inclusion in this review. These studies highlight the impact of language discordance on pediatric cancer care outcomes, including communication challenges, obstacles to research participation, and potentially higher risk disease features at presentation. Healthcare professionals endorsed inconsistent professional interpreter use and lack of formal training on communicating via interpreters. Interventions to address barriers to language-appropriate care are sparse. Further research is warranted to design and implement interventions promoting language justice and provision of high-quality, equitable pediatric cancer care for all families.

Automatic subtitles increase accuracy and decrease cognitive load in simultaneous interpreting

Abstract This study examines the effect of real-time subtitles generated by automatic speech recognition (ASR) technology on interpreting accuracy and interpreters’ cognitive load. Multiple measurements — including interpreting accuracy, the NASA-TLX for subjective ratings of cognitive load, eye-tracking and theta power as indicated by EEG recordings — were applied. Twenty-three professional simultaneous interpreters worked with a video recording of a speech presented in five conditions: a baseline without subtitles and then with subtitles of varying levels of precision (100%, 95%, 90% and 80%). The results reveal that the presence of subtitles significantly improved interpreting accuracy, with a suggested optimal precision rate of 90% or higher. The interpreters looked more at the subtitles, regardless of their level of precision, than the speaker. Contrary to our predictions, the presence of subtitles decreased, rather than increased, the cognitive load (although this outcome was shown by the EEG data only and not by the self-reported data). We conclude that the cognitive cost of processing subtitles as an additional information channel is offset by the cognitive gain achieved through visual prompting. The study highlights a complex effect of subtitles on interpreting, with such factors as subtitle presence and precision modulating the interpreters’ cognitive load in such a workflow.

Characterizing Spanish-speaking patients' patient-centered care experiences in the emergency department.

Patient-centered care (PCC) is an essential component of high-quality health, yet patients with non-English language preferences (NELP) experience worse PCC outcomes. Additionally, there are likely unique aspects to PCC for patients with NELP in the emergency department (ED). To inform the development of strategies to improve PCC for NELP in the ED, we sought to understand how Spanish-speaking ED patients experience care and the factors that influenced their perceptions of the patient-centeredness of that care. We conducted a single-center qualitative study using semistructured interviews with adult, Spanish-speaking patients who had been discharged home from the ED. Interviews were conducted using an interview guide, recorded, transcribed, and analyzed iteratively in Spanish using inductive and deductive thematic analysis. We conducted 19 interviews with participants from 24 to 72 years old. Participants were born in seven different Spanish-speaking countries. Participants identified three domains of PCC: patient, medical team's skills, and system. Several of the identified themes such as shared decision making, open communication, compassionate care, and coordination of follow-up care are often incorporated into PCC definitions. However, other themes, including uncertainty leading to fear, use of professional interpreters to promote understanding, receiving equitable care, technical proficiency, and efficiency of care expand upon existing domains in PCC definitions. We now have a more nuanced understanding of how Spanish-speaking patients with NELP experience PCC in the ED and what matters to them. Several of the themes identified in this analysis add details about what matters to patients within the domains of previous PCC definitions. This suggests that the conceptualization of PCC may vary based on the setting where care is provided and the population who is receiving this care. Future work should consider patient population and setting when conceptualizing PCC.

Early use of professional interpreters improves trauma outcomes: Results of a single-center retrospective study

Patients with limited English proficiency (LEP) experience reduced pain assessment and treatment, less comprehensive physical exams, and fewer explanations of the next steps in care. These disparities persist in hospitals with staffed professional interpreters, raising questions about interpreter access and the impact on outcomes. A retrospective review of 1133 trauma activations at a single center Level 1 Trauma Center in 2021–2022 was conducted. Demographic, injury, and outcome data were drawn from the institutional trauma registry, and patient-preferred language was pulled from EMR data. Early interpreter use was defined as documentation of professional interpreter use within 24 h of arrival. LOS and ICU LOS were compared between language groups using Cox regression, and mortality was compared using Fischer's exact test. 1114 patients had data available on initial injury severity and preferred language. Of the 70 LEP patients, 62 (88.6 %) required an interpreter, and 41 of those (66.1 %) had evidence of professional interpreter use within 24 h of arrival. LEP patients who lacked early interpreter use had longer hospital stays than both English proficient (EP) patients (HR 0.59, p < 0.05) and LEP patients with early interpreter use (HR 0.51, p < 0.05) when stratified by ISS and controlling for GCS and patient age. There is no difference in LOS between LEP trauma patients who used an interpreter and EP patients, suggesting that early use of an interpreter may improve the length of stay in LEP trauma patients.

Communication Practices for Families With Languages Other Than English in US Neonatal Care Units.

The lack of provision of culturally and linguistically appropriate services (CLAS) to families with languages other than English (LOE) is a highly modifiable driver of health care inequities. In a nationally representative sample of level 2 to 4 US NICUs, we examined patterns and predictors of communication practices for families with LOE and ascertained clinical leaders' beliefs about barriers to CLAS provision. We surveyed clinical leaders from 500 randomly selected US NICUs. Responses were weighted by the number of eligible NICUs per region and nonresponse rates. Outcomes included: consistent parental language documentation (≥75% of the time versus <75%) and consistent professional interpreter use (in-person or remote interpretation ≥75% of the time versus <75%). We used logistic regression to examine the associations of predictors (region, hospital characteristics, and the proportion of racial and ethnic minority and families with LOE served) with outcomes. The overall response rate was 34%. A total of 63% of NICUs collected parental language data consistently, and 41% used interpreters consistently. Patterns of interpreter use varied by service hours and type of communication event. Teaching status, highest level of neonatal care, and larger NICU size were associated with consistent language documentation. Only a larger NICU size was associated with consistent interpreter use. Barriers to CLAS provision included untimely access to interpreter services and suboptimal quality of certain interpretation modalities. Implementation guidance, accountability for compliance with existing mandates, and interventions tailored to the NICU context are needed to reduce linguistic disparities.

Leveraging AI technology for professional interpretation education: With an emphasis on ChatGPT.

Leveraging AI technology for professional interpretation education: With an emphasis on ChatGPT.

Charting the landscape of remote medical interpreting: an international survey of interpreters working in remote modalities in healthcare services

ABSTRACT The COVID-19 pandemic has accelerated the growth of remote interpreting, yet research on several aspects of remote medical interpreting (RMI) remains limited. Against this backdrop, this study reports key findings from a survey of professional healthcare interpreters with experience in RMI (N=47), addressing various gaps in RMI research, including interlocutor distribution and technology use, factors affecting interpreters' perceived impact of RMI on their performance, medical settings in which RMI is used, and working conditions. Results indicate that most interpreters have experience with both telephone interpreting (TI) and video interpreting (VI) in the healthcare context, encountering various medical settings, distribution patterns and technological configurations. Quantitative findings reveal four similar normative configurations of interlocutor distribution in both TI and VI, each with slightly different normative technologies. TI is perceived to have a more negative impact on overall performance than VI, which receives more positive evaluations regarding source text comprehension, target text production, rapport between interlocutors, concentration, stress, and fatigue. Qualitative results reveal common challenges shared by TI and VI, with COVID-19 exacerbating some of them. This study contributes to establishing a systematic understanding of the complexity of RMI across multiple dimensions and provides a nuanced perspective on both TI and VI.

Maternal birthplace and experiences of perinatal healthcare in Belgium: Evidence from a cross-sectional survey

BackgroundPatient experience is an important part of perinatal care quality. Migrant women in high-income countries often report more negative experiences than non-migrants, but evidence in Europe is patchy. In this study, we compared the experiences of two migrant populations with non-migrants, taking into account socioeconomic characteristics. MethodsWe surveyed mothers born in Belgium, North-Africa, and Sub-Saharan Africa (n = 877) using an adapted version of the Migrant-Friendly Maternity Care Questionnaire. Two patient experience scores were created using multiple correspondence analyses: a) information and communication with healthcare professionals and overall satisfaction with pregnancy care, and b) patient-centred aspects and satisfaction with delivery care. Through descriptive analyses and multivariable logistic regressions we estimated the associations of maternal characteristics with each score. ResultsOverall, positive experiences were reported in terms of communication (83 %) and patient-centred care (86 %). North African immigrants with low language proficiency had higher odds of negative communication experience (especially problems understanding information) (ORa: 2.30, 95 %CI 1.17–4.50), regardless of socioeconomic position. Among women with language barriers, 88 % were never offered a professional interpreter, relying on family members for translation. Patient-centred care was not associated with maternal birth region but was rated more negatively by older mothers, those with longer residence in Belgium, and higher majority-language proficiency. ConclusionIn Belgium, perinatal care experiences were generally positive, although communication with immigrants was suboptimal. Language barriers, single motherhood, and unstable housing increased communication issues. Our findings underline the necessity to improve information-exchange with immigrants and socioeconomically vulnerable women.

Labor, gender, and intercultural diplomacy: the emergence of Madame Montour as a professional interpreter in colonial North America

ABSTRACT Madame Montour, the child of a union forged by an Algonquin woman and French settler, leveraged her fluency in multiple indigenous and European languages to emerge as one of the most prominent interpreters in colonial New York and Pennsylvania. As the fur trade developed and new material culture was introduced in colonial North America, the labor of intercultural interpreters was invaluable as the interactions of diverse peoples, both settler and indigenous, intensified. This paper examines the distinguished career of Madame Montour as an interpreter engaged in intercultural diplomacy during an increasingly tumultuous and violent time that was marked by shifts in the relationship between gender and labor identity. I consider how payments in the form of cash, cloth, and clothing were entwined in the negotiation of an emerging colonial identity and how Madame Montour advocated to be recognized for her labor and to receive timely compensation for her skilled work.

Brokering understanding: Canadian deaf interpreters’ role and practice

ABSTRACT This article reports findings from semi-structured interviews with twelve Canadian deaf interpreter (DI) participants as part of a three-year study of language ideologies related to DIs. DIs are professional or amateur sign language interpreters and translators who are deaf and who may often but not always work as part of a team with hearing interpreters. When working with a hearing interpreter who uses the same national sign language, the DI’s role is often seen as meeting the needs of deaf clients who are viewed as lacking proficiency in a named language and/or who are viewed as monolingual in a named national sign language. This reflects normative language ideologies and conceptions of interpreting and translation. DI participants described their role in terms of their enhanced powers of understanding that elicited greater information from other deaf individuals than was apparent to a hearing interpreter. In addition, DI participants characterized their work as primarily translation, in a manner that accords with translation as the creation of meaning and as translanguaging that extends beyond named languages and deploys the individual’s full semiotic repertoire.

Re-conceptualising communicative expertise in professional practice through the lens of sign language intercultural mediation

The Candlin Lecture When we consider language, communication and the professions, we know that talk (speech or signs) is critical to professional practice and to relationships between professionals and service users. In a multilingual and multicultural world where people do not share the same languages or language repertoires, they must either adapt the way they talk to others (intercultural communication) or, if they cannot communicate directly, allow others to mediate communication on their behalf – a process labelled intercultural mediation. The latter occurs through professional or non-professional interpreting or language brokering. Current theories in interpreting studies consider (professional) interpreters as co-constructors of meaning and co-participants in any interaction. Communicative expertise is usually conceptualized in direct, monolingual communication. Using an explorative illustrative case study, this paper extends this theoretical framework to examine how communicative expertise manifests in interpreter-mediated communication, and particularly in relational aspects of intercultural mediation between a signed language and a spoken language and how professional interpreters and non-professional interpreters (brokers) draw on and apply their expert or lay knowledge about communication in a mediated interaction.