Transcript Interpreting: Serving our Neighbors

Professionalizing the
Interpreter Profession
University Center Rochester
Workshop: Overview and Application of
Interpreter Roles, Ethics and Skills
Presented by Nicki Ugalde
June 22, 2005
1
Hola
Choum reap
suor
Nabat
Xin chao
Ni hao
Hello
Zdravo
Namaste
Ahalan
Sabaai-dii
Kon-nichiwa
2
Workshop Goals (4 contact hours)
Session I (1:00-2:50)
• Identify appropriate
interpreter roles
• Identify types of
ethical situations
• Elaborate techniques
to analyze and
resolve selected
ethical dilemmas
Session II (3:00-5:00)
• List interpreter skills
for consecutive and
simultaneous modes
• Identify types of
interpreter errors
• Assess and apply skill
improvement
techniques to
minimize errors
3
Tentative Workshop Itinerary
•
1:00-1:10
–
–
•
Orientation and Introductions
sign in with name, languages and
emails of participants
Interpreter Roles
Ethical Codes
Types Ethical Situations + Video
–
–
•
Whole group: share one ethical
dilemma /solution per room
•
Skills for Consecutive and
Simultaneous Interpreters
Interpreter Errors
Video + critique
3:45-4:15
–
Breakout: mixed cultures/3 rooms
(by name tag color) -groups of 4-5
ID spokesperson
•
Group evaluates and resolves
listed and/or personal interpreter
ethical dilemmas
2:35-2:50
•
–
–
2:15-2:35
–
3:00- 3:45
–
1:10-2:15
–
–
–
•
•
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Breakout (groups of 3 same/related
cultures/languages): 3 scripts, +
assessment
interpreter takes notes– prepare 1-2
minute role play for whole group
discussion
4:15-4:55
–
Whole group: present 1-2 role plays
per room
4:55-5:00
–
Workshop evaluation + Certificate of
Attendance (to be mailed)
2:50-3:00
–
Snack break
4
Who needs interpreters?
• About 32 million people in the United States,
13.8 % of the population, speak a language
other than English at home. A recent study of
public and private teaching hospitals found
that more than 11% of patients required the
use of interpreter services.
• In some cities, residents speak more than
one hundred separate languages and
dialects. According to the 2000 Census, the
most common foreign languages spoken in
the U.S. are: Spanish, Chinese, French,
German, Tagalog, Italian, and Vietnamese.
5
Interpreters are VIP
• U.S. health care providers have a legal
obligation to offer interpreting services to nonEnglish-speaking patients under a variety of
federal, state, and local laws. These laws are
available on the following internet sites:
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–
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Title VI of the Civil Rights Act of 1964 (p. 50)
Medicaid law and related regulations
The Hill-Burton Act
Miscellaneous Federal programs
The Emergency Medical Treatment and Labor Act
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Community Interpreters
FIELD
• Legal
• Medical
• Education
• Social
Services
• Political
• Corporate
• Technical
LOCALES
Law enforcement, lawyer onsult,
courtroom
MD/DDS office, clinic, mental
health, migrant outreach, CPR
Classroom, IEP, PTA
WIC, Welfare, Social Security
Rallies, public hearings
Job interviews
Training: job related
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What are ethical codes?
• A text document of a framework of
standards with universal principles
acknowledged and accepted by all
practitioners within a field. These
codes (or canons) are professional
guidelines to standardize the norms
and behaviors expected in a field.
8
Medical Roles and Codes
• As medical interpretation has grown around the country
so too have ethical guidelines. Although codes for
medical interpreters have often emerged independently
in various institutions and locales, they express similar
core values. These core values include: confidentiality,
accuracy, and professionalism. Most codes give
interpreters the responsibility and right to turn down or
leave assignments they feel unable to handle in a
professional manner, including interpreting for close
friends or relatives, interpreting in situations which
pose a conflict with the interpreter's own internal
values, and interpreting in situations for which they feel
untrained or unqualified.
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Roles and Codes
• Elements that do vary among different codes
of ethics usually result from the definition of
the interpreter's role. While most guidelines
acknowledge that interpreters should be
neutral and not impart personal opinions or
advice, there are varying views on the
interpreters' responsibility to add information
on culture or to act as advocate for the clients.
An institution's particular code of ethics will
reflect these views.
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Roles and Codes
•
Interpreters and providers alike must have a
clear and common understanding of the role
and ethical guidelines in order to avoid conflict
and confusion. At the same time, it is important
to seek feedback from interpreters on their
ability to follow through on these expectations.
What makes sense for one cultural group may
not make sense for another. Asking
interpreters what a particular rule means for
them individually and within their culture will
help to clarify the code, support the interpreters
in their efforts to comply, and adapt the code
when it doesn't work.
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Minnesota Code of Professional
Responsibility
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•
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•
•
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•
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Canon 1: Accuracy and Completeness
Canon 2: Qualifications
Canon 3: Impartiality
Canon 4: Professional Demeanor
Canon 5: Confidentiality
Canon 6: Restriction of Public Comment
Canon 7: Scope of Practice
Canon 8: Reporting Impediments
Canon 9: Reporting Ethical Violations
Canon 10: Professional Development
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Basic principles of the Code of Ethics
(legal and medical)
1. Confidentiality
2. Impartiality
3. Integrity
4. Fidelity
(Accuracy)
1. Respecting the privacy of
others
2. Not taking sides in a
transaction
3. Being honest about one’s
own skill level and
qualifications for a job
4. Ensuring that the message
is faithful to the original
utterance, appropriate to
the original context
13
Differences in Codes
Legal interpreting considerations:
1. Representation of qualifications
2. Impartiality and avoidance of conflict of
interests
3. Assessing and reporting impediments to
performance
4. Duty to report ethical violations
5. Considerable knowledge of legal systems,
laws and legal procedures in the societies
concerned
(Mayo Clinic Interpreter Code of Ethics-p. 31)
14
Four basic roles of the medical interpreter
(see next slide) A pyramid with Advocate at
the top of the point, followed by Culture Broker,
Clarifier, and Conduit at the bottom represents
the amount of time that medical interpreters
routinely spend in any one role. As you go up
the pyramid, the roles become increasingly
intrusive, but the role is used relatively less
often. For example, interpreters always act as
Conduits; however, because of the complexity
of medical terminology, medical interpreters are
routinely called to be Clarifiers. Some patients
and encounters require culture brokering or
advocacy as well.
15
Medical Interpreter
Role
Pyramid
Advocate
Culture Broker
Clarifier
Conduit
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Definitions of roles:
• I. Conduit: This is the most basic of the
roles and involves rendering in one
language the meaning of what has been
said in the other: no additions, no
omissions, no editing or polishing, This is
the "default" role of the interpreter, which
you should adopt unless you perceive a
clear potential for misunderstanding.
17
Definitions of roles:
• II. Clarifier: In this role, the interpreter
adjusts register, explains or makes word
pictures of terms that have no linguistic
equivalent (or whose linguistic
equivalent will not be understood by the
patient) and checks for understanding.
You should take this role when you
believe it is necessary to facilitate
understanding.
18
Definitions of roles
• III. Culture Broker: In this role, the
interpreter provides a necessary cultural
framework for understanding the
message being interpreted. You should
take this role when cultural differences
are leading to a misunderstanding on
the part of either provider or patient.
19
Definitions of roles:
• IV. Advocate: Advocacy is any action an
interpreter takes on behalf of the patient
outside the bounds of an interpreted
interview. The advocate is concerned with
quality of care in addition to quality of
communication. An on-site interpreter would
appropriately become an advocate when the
needs of the patient are not being met due to
a systemic barrier such as the complexity of
the health care system or racism.
20
What is the appropriate role for
the interpreter?
• The more invasive a role you take, the
greater the risk of "getting in the way" of
the patient-provider relationship.
However, if you limit yourself to an
inappropriately limited role, fundamental
misunderstandings may occur that not
only undermine the patient's relationship
with the provider, but may endanger the
patient's life.
21
What is the appropriate role for
the interpreter?
• In a given session, you may have to
switch between different roles because
every patient will have different needs.
The "appropriate role" for the interpreter
is the least invasive role that will assure
effective communication and care.
22
Roles: What is the most effective
response in these situations?
1.
•
The nurse asks you to take the patient’s
history while s/he sees another patient.
Or s/he asks you to explain to the
patient how to collect a urine sample.
The mother asks you to watch her
children while she makes a phone call
and/or assumes you will give her a ride
home.
23
Video: Role play of ethics topics
• As you watch the
short role play
vignettes, identify the
ethical problem and
how the interpreter
handled it. Would you
have done or said
anything differently?
24
Breakout I:
ethics discussion groups
First, choose a group spokesperson/
leader. Then, discuss the 5 situations
in the following slides as each
participant suggests how the
interpreter should manage the
situation. Answer the following
questions to guide your decision.
1. What is the interpreter’s role?
2. What is the use of good judgment and common
sense?
3. What are the interpreter’s options and
consequences of each?
4. Choose the best response and discuss effective
ways of communicating your response.
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Breakout I:
•
•
•
ethics discussion groups
What has been your experience in
interpreting situations that provoke
ethical dilemmas? Can each of
you give us one specific example,
including what/who provoked the
situations (provider, interpreter,
patient, other) and how it was
resolved?
Does your organization have a
designated staff person available
to help deal with ethical issues?
Name (s): _________________
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Ethical Situation 1
• A provider gives a non-Englishspeaking patient a prescription,
explaining that it is for some
suppositories. The interpreter is too
embarrassed to admit that he does
not know the equivalent word for
"suppository" in the patient’s
language, so s/he uses the word for
"pill" instead. The patient takes the
medication orally and ends up in the
emergency room.
27
Ethical Situation 2
• After her appointment, a patient's
husband asks the interpreter what
the doctor said to his wife. Trying to
be helpful, the interpreter discloses
the happy news that the patient is
pregnant. This is not happy news to
the husband, as his wife has just
arrived from their home country, after
being apart from him for 6 months.
The couple leaves the clinic with the
husband angrily muttering thinly
veiled threats of violence.
28
Ethical Situation 3
• The doctor asks the patient a
question. The interpreter and the
patient get into a long discussion,
while the doctor sits and waits,
completely left out. Finally the
interpreter turns to the doctor and
says "She said no." When the
doctor asks exactly what the patient
said, the interpreter smiles and
says, "Oh, it wasn’t important. She
just means no."
29
Ethical Situations 4 (choose one)
Case 1: The patient becomes very
angry with the doctor when the doctor
tells him he is ready to go back to
work. The patient uses profanity and
insults the doctor.
Case 2: During a physical exam, the
doctor asks the patient if she is
sexually active. Since the patient is
not married, she is embarrassed and
uncomfortable to be asked such a
question and does not respond.
30
Ethical Situation 5
The hospital asks you, the staff
interpreter, to assist. The patient has
brought her own untrained interpreter
and no longer requires your services.
The physician asks you to stay anyway.
Before long you realize that the
untrained interpreter has made major
linguistic errors, omitted crucial
information and added unnecessary
information during the encounter. If
these errors are not addressed, you
know the outcome may be detrimental
for the patient as well as the hospital.
31
Ethical Situation 5
• Discussion:
• Does the interpreter have an
ethical obligation to say
something or would this be
interfering with the patient’s
right to conduct her own
business? What factors would
influence your decision to
“interfere” with the errors
committed by the untrained
interpreter?
32
Session II: Workshop Goals
Session I (1:00-2:50)
• Identify appropriate
interpreter roles
• Identify types of
ethical situations
• Elaborate techniques
to analyze and
resolve selected
ethical dilemmas
Session II (3:00-5:00)
• List interpreter skills
for consecutive and
simultaneous modes
• Identify types of
interpreter errors
• Assess and apply skill
improvement
techniques to
minimize errors
33
Court: Consecutive or Simultaneous?
•
Consecutive interpretation, in which the
interpreter waits until a complete statement has
been spoken and then begins interpreting is
used primarily to interpret witness testimony, a
situation in which everyone in the courtroom
needs to hear the interpretation. Simultaneous
interpretation is generally considered
inappropriate for witness testimony because
hearing two voices at once is too distracting. In
your work as a court interpreter, you will find
that simultaneous interpretation is called for
much more often than consecutive, because
most cases are settled without a trial.
34
Medical: Consecutive or Simultaneous?
•
The three stages of a consecutive
interpreter's work are the understanding of the
speaker's original message, the immediate
analysis of its content and the re-expression of
the same content in another language, with the
help of some notes the interpreter writes down
upon hearing the original message.
• In most medical encounters, the consecutive
mode is preferred. Are there any medical
situations where the simultaneous mode might
be more appropriate? What would the
considerations be?
35
What skills/knowledge do interpreters need?
• language fluency in source and target
languages
• interpreting skills: shadowing, chunking, main
idea, paraphrase, attending/focusing, sight
translation, etc.
• wide general knowledge
• knowledge of specialized terminology
• cultural knowledge
• Ethics (Ethics Exam, Federal Exam info–pp. 36-42)
• Professionalism (includes proper attire and
responsible behavior such as respect and promptness)
36
Specific Tips On Preparation for
Consecutive Interpretation
• 1. Strengthen your retention skills. The
administrative hearing interpreter exam requires the
interpreter to retain speech up to 40 words in length.
If given, the medical interpreter exam requires the
interpreter to retain speech up to 30 words in length.
• 2. To enhance your retention skills, develop a notetaking technique that works for you. Note taking is
an aid to the interpreter when it is second nature. It
is very hard to improvise abbreviations and symbols
on the spur of the moment.
• 3. Always be ready with pencil and notepad in hand.
37
Specific Tips On Preparation for
Consecutive Interpretation
• 4. Stay focused - concentrate; it is
imperative that you not let your mind
wander. It takes time to develop this
discipline.
• 5. Speak clearly and audibly; people
requiring the services of an interpreter
need and deserve clarity.
• 6. Ask for a repeat if you are concerned you
may make an error. It is better to ask for a
repeat than to be inaccurate.
(additional skill-enhancing exercises – pp. 33-34)
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Core Competencies
1. Introduces self and explains role
2. Positions self to facilitate communication
3. Reflects the style and vocabulary of the
speaker
4. Uses consecutive interpretation mode and
speaks in first person when appropriate
5. Accurately and completely relays the
message between patient and provider
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Core Competencies
6. Show of dignity and respect
7. Remains neutral
8. Identifies and separates personal beliefs
from those of the other parties.
9. Identifies and corrects own mistakes.
10. Addresses culturally-based
miscommunication when necessary.
40
Categories of Interpreter Error
1. Literal Translation
2. Inadequate Language Proficiency
3. Grammatical Errors
4. Lexical Errors
5. Register Conservation
6. Distortion, Substitution, Condensation
7. Omission
8. Addition
9. Protocol, Procedure and Ethics
10. Conservation of Paralinguistic Elements,
Hedges, Fillers
41
1. Literal Translation
• The languagedeficient
interpreter
focuses on the
exchange of
words, rather
than the essential
ideas, conserving
the source
language
message.
42
2. Inadequate Language Proficiency
• Lack of proficiency and language fluency
• Predicting skills absent
• Cognitive and linguistic association for
processing is restricted by wrong choices
• Limited attention span in least developed
language
• Interference present from one language to
another at all levels
• Speed and accuracy compromised
43
3. Grammatical Errors
• Grammar errors
include verb
tenses, gender and
number agreement,
syntax, etc.
Ouch!
44
4. Lexical Errors
• Lack of generalized
and specialized
vocabulary
• Language-deficient
interpreters rely on
false cognates, and
tend to paraphrase,
define, invent, omit,
guess. . . .
45
5. Register Conservation
• Interpreters have trouble preserving the
frozen, formal register of court and the
informal, casual register of idioms and
slang.
46
6. Distortion: Substitution, Condensation
• Mistranslation errors distort the overall or partial
meaning of the original message.
– Substitution: the tendency to replace concepts
– Condensation: the tendency to simplify and explain
• Causes include deficient language skills,
memory or interpreting skills
• Lack of understanding of the interpreter’s role
which includes preservation of profanity and
sexually explicit language
47
6. Distortion: Substitution, Condensation
• Lengthy (more than
35 words in one
response) and short
discourse (less than
15 words) can cause
problems.
• False starts,
emotional intensity,
hedges, unfinished
sentences and
incoherent language
may be involved.
48
7. Omission
• The interpreter
partially or completely
deletes a message
sent by the speaker
• Omits words from
articles to portions of
discourse because of
fatigue, little
knowledge of technical
terms, regional
variants, and
information overload.
49
8. Addition
• Includes information not expressed by
the speaker
• The unskilled interpreter cannot retain
the contextual ideas of the source
message so s/he uses synonyms and
“thinks aloud”.
50
9. Protocol, Procedures and Ethics
• Interpreters do not understand their role as
an objective medium of communication:
– Role exchange: the interpreter assumes the role
of the interviewer
– Lack of self-correction
– Initiates conversations with witnesses or uses
inappropriate tone, summarizes, guesses and
does not take notes when necessary
51
10. Non-conservation of Paralinguistic
Elements, Hedgers, Fillers
• Interpreters do not
conserve hesitation
words, fillers,
interrupted and
incomplete
sentences, etc.
• English: um, ah,
you know, like
• Your examples in
your other working
language: ????
52
Video: The Professional Interpreter
1. Who is the interpreter?
2. How are the parties addressed?
3. Is the interpreter prepared?
4. Were introductions made?
5. Where is the interpreter
positioned?
6. Which interpreting mode was
used?
7. Which inappropriate roles were
noted?
8. Was there awareness of cultural
dimensions?
9. Did the interpreter ask for
clarification and pauses when
needed?
10. Was the interpreter aware of
his/her own limitations/biases?
1. Family member, untrained person,
professional
2. I, you, he/she
3. Yes
No
4. Yes
No
5. Beside, behind, hidden from client
6. Simultaneous, consecutive,
summary
7. Editing, giving advice, adding
information
8. Yes
No
9. Yes
No
10. Yes
No
53
Video: The Professional Interpreter
11. Did the interpreter use eye
contact and the first person in
addressing the parties?
11. Yes No
12. Does the interpreter treat all
parties with respect?
12. Yes No
13. Is the interpreter sensitive to
ethical issues as they arise?
Explain.
13. Yes No
14. Was the interpreting done
accurately and completely?
14. Yes No
54
Breakout 2A: Medical role-play
(consecutive mode - bidirectional)
• 1) If possible, form groups of 3 people who speak
the same other working language. All use the
dialogue script “The Eye“. The “patient” will sight
translate to the other working language. The
Spanish language interpreters may use dialogue
scripts “Getting a Prescription“, “Child Medical”
and “Pediatrician”.
• 2) Each participant will take turns acting as the
interpreter for the script provided in your packet
(one page per interpreter). The interpreter
assumes all parties have never met each other
and have never before worked with an
interpreter. Be prepared to take notes.
• 3) After your role playing, discuss together the
5 self-assessment questions that follow.
55
Breakout 2B: Legal role-play
(consecutive mode - bidirectional)
• 1) If possible, form groups of 3 people who
speak the same other working language.
Spanish language interpreters may use
“Firearm Testimony” script.
• 2) Each participant will take turns acting as
the interpreter for the “Witness Testimony:
Burglary” script provided in your packet (one
page per interpreter). The witness (A) will
sight translate script into other working
language.The interpreter assumes all parties
have never met each other and have never
before worked with an interpreter.
Be prepared to take notes.
• 3) After your role playing, discuss together
the 5 self-assessment questions that follow.
56
Breakout 2C: Legal role-play
(simultaneous mode - monodirectional)
• 1) If possible, form a pair who speak
the same other working language. Use
the “Closing Argument” script.
• 2) Each participant will take turns
acting as the interpreter for the script
provided in your packet (one page per
interpreter).
• 3) After your role play, discuss
together the 5 self-assessment
questions that follow.
57
Self-assessment
(5+ questions)
• 1. Overall, how do you assess your
interpretation of the dialogue or
monologue? Were you able to convey
the overall meaning and information? If
not, what types of information caused
you the most difficulty? How effective
were your note-taking skills?
• 2. Did you ask the speakers for
repetition or clarification? How did this
work for you? How does it seem to
affect the speakers’ ability to convey
what they wanted to say?
58
Self-assessment continued
• 3. What was the most difficult part
of this interpretation? What are the
factors that make this the most
difficult part (vocabulary, speed,
speech concerns)?
• 4. How would you rate yourself in
terms of vocabulary usage, grammar
and accuracy of the interpretation?
• 5. What do you consider to be the
skill area (strong and weak) you would
want to focus on based on your
interpretation of the dialogue or
monologue?
59
General Preparation
1. READ, READ, READ!
2. Attend courses, workshops, training
3. Make yourself available to listen to and
observe health providers as they discuss
patient care; ask to accompany the health
providers during rounds; attend courtroom
proceedings or shadow legal counsel/paralegals.
4. Build a resource manual of Web glossaries,
field specific bilingual dictionaries, court/legal
documents, translated patient education
materials from CDC, etc.
5. Build a network of interpreter colleagues for
consultation and support.
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Additional reading materials in your packet:
Mayo Medical Interpreter Code of Ethics
Suggested Skills-Enhancing Exercises
How to Practice for the Federal Exam
Suggestions for Independent Study
Interpreter Standards
Mayo Clinic Code of Ethics
Your questions, comments and suggestions regarding
the interpreting profession are welcome.
[email protected]
[email protected]
507-285-7534 (office)
507-282-9441 (home)
Please respond to the questions on the workshop
evaluation form and return it to the facilitator.
61
Let us go forth and interpret
accurately, confidentially,
completely, with integrity
and professionalism.
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