The Impact of Medical Interpretation Method on Time and Errors
Twenty-two million Americans have limited English proficiency. Interpreting for limited English proficient patients is intended to enhance communication and delivery of quality medical care.
Little is known about the impact of various interpreting methods on interpreting speed and errors. This investigation addresses this important gap.
Four scripted clinical encounters were used to enable the comparison of equivalent clinical content. These scripts were run across four interpreting methods, including remote simultaneous, remote consecutive, proximate consecutive, and proximate ad hoc interpreting. The first 3 methods utilized professional, trained interpreters, whereas the ad hoc method utilized untrained staff.
Audiotaped transcripts of the encounters were coded, using a prespecified algorithm to determine medical error and linguistic error, by coders blinded to the interpreting method. Encounters were also timed.
Remote simultaneous medical interpreting (RSMI) encounters averaged 12.72 vs 18.24 minutes for the next fastest mode (proximate ad hoc) (p = 0.002). There were 12 times more medical errors of moderate or greater clinical significance among utterances in non-RSMI encounters compared to RSMI encounters (p = 0.0002).
Whereas limited by the small number of interpreters involved, our study found that RSMI resulted in fewer medical errors and was faster than non-RSMI methods of interpreting.
- Larsen LJ, U.S. Census Bureau. The foreign-born population in the United States: 2003. Washington, DC: U.S. Census Bureau; 2004; Current Population Reports, P20-551:1–9. Available at: http://www.census.gov/prod/2004pubs/p20-551.pdf. Accessed May 20, 2005.
- Shin BH, Bruno R. Language use and English speaking ability: census 2000 brief. Washington, DC: US Census Bureau; 2003. Available at: http://www.census.gov/prod/2003pubs/c2kbr-29.pdf. Accessed May 20, 2005.
- Kwang K, Collins M, McArthur E. Participation of adults in English as a second language classes: 1994–1995. Washington, DC: National Center for Education Statistics; 1997. Available at: http://nces.ed.gov/pubs97/97319.pdf. Accessed August 5, 2000.
- Lobo AP, Salvo JJ; New York Department of City Planning, Population Division. The newest New Yorkers, 2000 immigrant New York in the new millennium. New York: New York City Department of Planning, Population Division; January 2005.
- Downing B, Roat C. Models for the provision of language access in health care settings. Albany, NY: National Council on Interpreting in Health Care; 2002. Available at: http://www.ncihc.org/NCIHC_PDF/ModelsfortheProvisionofLanguageAccessinHealthCareSettings.pdf. Accessed March 2006.
- Baker DW, Hayes R, Fortier JP. Interpreter use and satisfaction with interpersonal aspects of care for Spanish-speaking patients. Med Care. 1998;36(10):1461–70. CrossRef
- Elderkin-Thompson V, Silver RC, Waitzkin H. When nurses double as interpreters: a study of Spanish-speaking patients in a US primary care setting. Soc Sci Med. 2001;52(9):1343–58. CrossRef
- Ku L, Flores G. Pay now or pay later: providing interpreter services in health care. Health Aff (Millwood) 2005;24:435–44. CrossRef
- Woloshin S, Bickell N, Schwartz L, Gany F, Welch G. Language barriers in medicine in the United States. JAMA. 1995;273:724–8. CrossRef
- Timmins CL. The impact of language barriers on the health care of Latinos in the United States: a review of the literature and guidelines for practice. J Midwifery Womens Health. 2002;47:80–96. CrossRef
- Gandhi TK, Burstin HR, Cook EF, Puopolo AL, Haas JS, Brennan TA, Bates DW. Drug complications in outpatients. J Gen Intern Med. 2000;15:149–54. CrossRef
- Hampers LC, Cha S, Gutglass DJ, Binns JH, Krug SE. Language barriers and resource utilization in a pediatric emergency department. Pediatrics. 1999;103:1253–6. CrossRef
- Jacobs EA, Shepard DS, Suaya JA, Stone EL. Overcoming language barriers in health care: costs and benefits of interpreter services. Am J Public Health. 2004;94(5):866–9. CrossRef
- Karliner LS, Jacobs EA, Chen AH, Mutha S. Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health Serv Res. 2007;42(2):727–54. CrossRef
- U.S. Environmental Protection Agency, Office of Civil Rights. Title VI of the Civil Rights Act of 1964, as amended (42 U.S.C. §§2000d to 2000d-7)
- Chang PH, Fortier JP. Language barriers to health care: an overview. J Health Care Poor Underserved. 1998;9(supp/1):S5–20.
- Hornberger JC. Eliminating language barriers for non-English-speaking patients. Med Care. 1996;34(8):845–56. CrossRef
- Mouzourakis P. Remote interpreting: a technical perspective on recent experiments. Interpreting. 2006;8(1):45–66. CrossRef
- Telephone interpreting: a long-distance success in saving money. Available at http://www.uscourts.gov/newsroom/tip.htm. Accessed on May 16, 2007
- Altman J. Error analysis in the teaching of simultaneous interpreting: a pilot study. In Lambert S, Moser-Mercer B, eds. Bridging the Gap. Empirical Research in Simultaneous Interpretation. Philadelphia, PA: John Benjamins, 1994.
- Barik H. A description of various types of omissions, additions and errors of translation encountered in simultaneous interpretation. In Lambert S, Moser-Mercer B, eds. Bridging the Gap. Empirical Research in Simultaneous Interpretation. Philadelphia, PA: John Benjamins, 1994.
- Bugel-Shunra D. Proofreading translations: a checklist, not a blank check. ATA Chronicle. 2000;29(October):12.
- Kussmaul P. Training the Translator. Chapter 6: Evaluation and errors. Philadelphia, PA: John Benjamins, 1995.
- MacCulloch CE, Searle SR. Generalized, Linear, and Mixed Models. Hoboken, NJ: Wiley, 2001.
- The Impact of Medical Interpretation Method on Time and Errors
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Journal of General Internal Medicine
Volume 22, Issue 2 Supplement, pp 319-323
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- medical errors
- access to care
- immigrant health
- Industry Sectors
- Author Affiliations
- 5. Center for Immigrant Health, New York University School of Medicine, New York, NY, USA
- 2. Harvard Medical School, Boston, USA
- 3. Cambridge Health Alliance, Windsor Street Health Center, Cambridge, USA
- 4. Mount Sinai School of Medicine, New York, USA
- 1. New York University School of Medicine, New York, USA