Working with interpreters

Working with interpreters in healthcare is integral to providing culturally competent and accessible services for CALD clients/patients. It is essential to engage trained interpreters when necessary and to facilitate the process according to protocol and guidelines. It can be a challenging process; below are some pointers for how to work with interpreters in practice. The eCALD course on Working with Interpreters [provide link here] provides a more comprehensive learning experience and includes learning material, video scenarios and exercises.

When working with an interpreter it is necessary to make time for a short pre-briefing session, and also for a de-briefing session after the appointment. This is important for both the quality of service to the client, and for the benefit of the practitioner and interpreter relationship. Structuring sessions to accommodate the needs of the interpreting process can greatly enhance the outcome.

  • Introduce yourself and check ID and confirm Job Number of interpreter (if necessary)
  • Arrange seating appropriately to facilitate communication (trained interpreters can guide you on this)
  • Brief interpreter on purpose and objectives of the session
  • Obtain relevant cultural background information from the interpreter if necessary, and any cultural etiquette required
  • Establish mode of interpreting - consecutive or simultaneous
  • Brief on confidentiality protocol (this also includes not discussing client in the session or talking in front of client without including letting them know what is being discussed).
  • Introduce interpreter and explain respective roles to client (include fact that everything said in the session will be interpreted i.e. no private discussions between parties)
  • Ensure client of confidentiality with all parties (interpreter also bound by a Code of Ethics)
  • Establish ground rules of speaking through the interpreter, not to (i.e. use 1st person singular)
  • Expect the interpreter to use the 1st person singular when interpreting
  • Maintain eye contact with your client (if appropriate), not the interpreter
  • Direct questions / statements to the client or family, not directly to the interpreter
  • Do not enter into direct conversation with the interpreter during the session, unless it is to clarify
  • Do not ask the interpreter for their opinion (only for cultural clarification)
  • Pause at regular intervals for the interpreter to assimilate and interpret
  • Allow interpreter to interpret after every 3-5 sentences
  • Allow enough time for the interpreter to convey information (it may only take you 3 words to explain but it may take more time for the interpreter to convey the information in another language)
  • Use short sentences
  • Check with interpreter about any cultural contexts for information provided by patient (if necessary).
  • Summarize session and discuss whether objectives were met (there may be language or cultural reasons if objectives were not met)
  • Clarify diagnostic/treatment issues where necessary
  • Clarify any cultural issues, interpretation of words or concepts
  • If the session involved traumatic material, check whether the interpreter has been emotionally triggered (considering that many interpreters may have come through similar experiences/cultural context as the client for whom they are interpreting). If so, offer some de-briefing or make an appropriate referral
  • Confirm follow-up procedure/appointments as appropriate
  • Complete interpreter Job Information Forms if required.

Accuracy in interpreting is vital since inaccurate interpreting and information can result in misdiagnoses, and unsafe and ineffective health care. It is useful to be aware of the 7 most commonly committed errors in interpreting:

  • Omission (e.g. leaving out part of the sentence/explanation)
  • Addition (adding their own words to those of the client’s)
  • Substitution (e.g. because the interpreter cannot think what is meant; or does not know an exact synonym, or concept does not exist in Target language or culture
  • Role exchange (interpreter takes over the session)
  • Condensation (interpreter summarizes what is said)
  • Closed/open Statements (interpreter changes closed into open statements and vice versa)
  • Normalization (strange statements ‘normalized’ for benefit of practitioner which increases possibility of misdiagnoses)

If you think one of the above errors have occurred, address this directly with the interpreter.

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