Journal of General Internal Medicine

, Volume 28, Issue 12, pp 1589–1595

Revolutionizing Volunteer Interpreter Services: An Evaluation of an Innovative Medical Interpreter Education Program

  • Oswaldo Hasbún Avalos
  • Kaylin Pennington
  • Lars Osterberg
Original Research

ABSTRACT

BACKGROUND

In our ever-increasingly multicultural, multilingual society, medical interpreters serve an important role in the provision of care. Though it is known that using untrained interpreters leads to decreased quality of care for limited English proficiency patients, because of a short supply of professionals and a lack of formalized, feasible education programs for volunteers, community health centers and internal medicine practices continue to rely on untrained interpreters.

OBJECTIVE

To develop and formally evaluate a novel medical interpreter education program that encompasses major tenets of interpretation, tailored to the needs of volunteer medical interpreters.

DESIGN

One-armed, quasi-experimental retro-pre–post study using survey ratings and feedback correlated by assessment scores to determine educational intervention effects.

PARTICIPANTS

Thirty-eight students; 24 Spanish, nine Mandarin, and five Vietnamese. The majority had prior interpreting experience but no formal medical interpreter training.

OUTCOME MEASURES

Students completed retrospective pre-test and post-test surveys measuring confidence in and perceived knowledge of key skills of interpretation. Primary outcome measures were a 10-point Likert scale for survey questions of knowledge, skills, and confidence, written and oral assessments of interpreter skills, and qualitative evidence of newfound knowledge in written reflections.

RESULTS

Analyses showed a statistically significant (P <0.001) change of about two points in mean self-ratings on knowledge, skills, and confidence, with large effect sizes (d > 0.8). The second half of the program was also quantitatively and qualitatively shown to be a vital learning experience, resulting in 18 % more students passing the oral assessments; a 19 % increase in mean scores for written assessments; and a newfound understanding of interpreter roles and ways to navigate them.

CONCLUSIONS

This innovative program was successful in increasing volunteer interpreters’ skills and knowledge of interpretation, as well as confidence in own abilities. Additionally, the program effectively taught how to navigate the roles of the interpreter to maintain clear communication.

KEY WORDS

interpreter community health minority health quality improvement underserved populations 

Supplementary material

11606_2013_2502_MOESM1_ESM.docx (131 kb)
ESM 1(DOCX 131 kb)

REFERENCES

  1. 1.
    Smedley BD, Stith AY, Nelson AR, eds. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academy Press; 2002.Google Scholar
  2. 2.
    Flores G, Abreu M, Barone CP, Bachur R, Lin H. Errors of medical interpretation and their potential clinical consequences: a comparison of professional versus ad hoc versus no interpreters. Ann Emerg Med. 2012;20(10):1–8.Google Scholar
  3. 3.
    Jacobs EA, Lauderdale DS, Meltzer D, Shorey JM, Levinson W, Thisted RA. Impact of interpreter services on delivery of health care to limited–english-proficient patients. J Gen Intern Med. 2001;16(7):468–474.PubMedCrossRefGoogle Scholar
  4. 4.
    National Council on Interpreting in Health Care. National standards for healthcare interpreter training programs. 2011. Available at: http://www.ncihc.org/assets/documents/National_Standards_5-09-11.pdf. Accessibility verified May 1,2013.
  5. 5.
    Hwa-Froelich DA, Westby CE. Considerations when working with interpreters. Commun Disord Q. 2003;24(2):78–85.CrossRefGoogle Scholar
  6. 6.
    Casey M. Providing health care to latino immigrants: community-based efforts in the rural midwest. Am J Public Health. 2004;94(10):1709–1711.PubMedCrossRefGoogle Scholar
  7. 7.
    Vandervort E. Linguistic services in ambulatory clinics. J Transcult Nurs. 2003;14(4):358–366.PubMedCrossRefGoogle Scholar
  8. 8.
    “Volunteer Health Interpreters Organization.” Volunteer Health Interpreters Organization. Volunteer Health Interpreters Organization at UC Berkeley, n.d. Web. Available at: http://calhbc.wordpress.com/decal-class/. Accessibility verified May 1, 2013.
  9. 9.
    Lacorte M, Canabal E. Interaction with heritage language learners in foreign language classrooms. In: Blyth C, ed. The Sociolinguistics of Foreign-Language Classrooms: Contributions of the Native, the near Native, and the Non-Native Speaker. Boston: Heinle and Heinle; 2002:107–129.Google Scholar
  10. 10.
    Larrison CR, Velez-Ortiz D, Hernandez PM, Piedra LM, Goldberg A. Brokering language and culture: can ad hoc interpreters fill the language service gap at community health centers? Soc Work Public Health. 2010;25(3):387–407.PubMedCrossRefGoogle Scholar
  11. 11.
    Long R, Roy NG, eds. Bridging the Gap: An Interactive Textbook for Medical Interpreters. 1st ed. Seattle: Cross Cultural Health Care Program; 2002.Google Scholar
  12. 12.
    Butow PN, Lobb E, Jefford M, Goldstein D, Eisenbruch M. A bridge between cultures: interpreters' perspectives of consultations with migrant oncology patients. Support Care Canc. 2012;20(2):235–244.CrossRefGoogle Scholar
  13. 13.
    Langdon HW, Cheng L-RL. Collaborating with interpreters and translators: A guide for communication disorders professionals. Thinking Publications, 2002.Google Scholar
  14. 14.
    Smirnov S. An overview of liaison interpreting. Perspect Stud Transl. 1997;5(2):211–226.CrossRefGoogle Scholar
  15. 15.
    Cross Cultural Healthcare Program. Bridging the Gap Training Programs. The Cross Cultural Healthcare Program. July 25, 2012. Available at http://xculture.org/medical-interpreter-training/bridging-the-gap-training-program. Accessibility verified May 1, 2013.
  16. 16.
    Howard G. Internal invalidity in pretest–posttest self-report evaluations and a re-evaluation of retrospective pretests. Appl Psychol Meas. 1979;3(1):1–23.Google Scholar
  17. 17.
    Hill L. Revisiting the retrospective pretest. Am J Eval. 2005;26(4):501–517.CrossRefGoogle Scholar
  18. 18.
    Fan X. Statistical significance and effect size in education research: two sides of a coin. J Educ Res. 2001;94(5):275–282.CrossRefGoogle Scholar
  19. 19.
    Cohen J. Statistical power analysis for the behavioral sciences. Lawrence Erlbaum, 1988.Google Scholar
  20. 20.
    McCartney K, Rosenthal R. Effect size, practical importance, and social policy for children. Child Dev. 2003;71(1):173–180.CrossRefGoogle Scholar
  21. 21.
    Cohen J. Things I have learned (so far). Am Psychol. 1990;45(12):1304.CrossRefGoogle Scholar
  22. 22.
    Flores G, Laws MB, Mayo SJ. Errors in pediatric medical interpretation and their potential clinical consequences in encounters. Pediatrics. 2003;111(1):6–14.PubMedCrossRefGoogle Scholar
  23. 23.
    Jacobs E. The impact of an enhanced interpreter service intervention on hospital costs and patient satisfaction. J Gen Intern Med. 2001;22(2):306–311.Google Scholar
  24. 24.
    Baker D, Parker R, Williams M, Coates WPK. Use and effectiveness of interpreters in an emergency department. JAMA. 1996;275(10):783–788.PubMedCrossRefGoogle Scholar
  25. 25.
    Falk GA, Robb WB, Khan WH, Hill AD. Student-selected components in surgery: providing practical experience and increasing student confidence. Ir J Med Sci. 2009;178:267–272.PubMedCrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2013

Authors and Affiliations

  • Oswaldo Hasbún Avalos
    • 1
  • Kaylin Pennington
    • 1
  • Lars Osterberg
    • 1
    • 2
    • 3
  1. 1.Stanford UniversityStanfordUSA
  2. 2.Stanford University School of MedicineStanfordUSA
  3. 3.VA Palo Alto Health Care SystemPalo AltoUSA

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