Include pre- and post-sessions
When health care professionals work with interpreters to educate non-English-speaking patients, it is a team effort. While it is important that interpreters have the skills they need to convey the teaching to the patient correctly, health care professionals also need training to effectively work with interpreters.
"Often providers think they have a magic telephone where they speak English and it comes out the other end in the target language. That is not a helpful way to look at it. The interpreter is really the provider’s partner in communicating," says Bria Chakofsky-Lewy, RN, supervisor of caseworker/cultural mediators and interpreters for Community House Calls Interpreter Services at Harborview Medical Center in Seattle.
As a partner, providers need to know that the interpretation is not always word-for-word because sometimes an English word does not exist in the patient’s language; therefore, it must be described or explained.
In addition, the clinician doing the teaching should divide the session into three parts. The first is a pre-teaching session where the goals for the encounter are discussed. At this time, the interpreter can share some of the barriers to accomplishing the goals so the provider is prepared to address them, says Chakofsky-Lewy.
During the teaching session, the provider speaks directly to the patient in the first person as if a third party were not in the room.
When the teaching is completed, a post-session meeting should take place between the interpreter and the provider. At this time, both parties give each other feedback on the session. Also, the provider can ask questions about the patient’s culture or traditions that he or she became aware of during the teaching session. This is an opportunity for health care professionals to increase their cultural knowledge.
The No. 1 skill practitioners need when working with an interpreter is patience, says Andrea Henry, coordinator of Multi-Cultural Translation Services at Children’s Healthcare of Atlanta. During a teaching session, educators must pause quite a bit to allow the interpreter to interpret. In addition, they may need to phrase things differently than they would when speaking to someone who speaks English for it to be understood by the patient.
It’s OK to ask interpreters how to phrase information, says Erika Shell Castro, manager of Interpretive Services at Grant/Riverside Hospitals in Columbus, OH. Interpreters are not just linguistic bridges, they are cultural bridges, she explains. When scheduling a teaching session, it’s important to allow more time when working with an interpreter, says Shell Castro. It is not uncommon for a teaching session to take twice as long.
Good teaching strategies should be followed as well. For example, patients should be asked to repeat information and instructions to determine if they understood the teaching, says Shell Castro.
The use of an interpreter needs to be documented in the medical chart. The documentation of the encounter should include the language spoken, arrival and departure time of the interpreter, and the interpreter’s name. People need to document how they got the information from the patient. For example, they need to write "per the bedside interpreter, the patient reports" if the information was gleaned with the aid of an interpreter, says Shell Castro.
When health care professionals work with interpreters to educate non-English-speaking patients, it is a team effort.
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