Interpreting in Medical Settings:
Synthesis of Effective Practices Focus Group Discussions
Developed by Marty Taylor, Ph.D., Project Consultant
Background | Data Collection/Process | (1) Requisite Skills | (2) Advocacy/Support | (3) Cultural Differences | (4) Diversity | (5) Deaf Interpreters | (6) Sight Translations | (7) Patient Charts | (8) Conveying Meaning | (9) Crossover to Legal | (10) Job Description | Summary/Implications | Appendices | Download PDF of Report | Download PDF of Focus Group Survey Results
Some participants from each group reported that when asked by deaf people to interpret a variety of standard forms (e.g., medical history forms, intake forms) the interpreters would interpret them without assistance from health care professionals. One person felt that it was “providing access to health care”. However, if there were questions that interpreters were not certain about, then they only interpreted those items on the form with a health care professional present. There were also individuals in the focus groups who handled it differently, for example asking the receptionist how they would like the questions completed, either leave the form blank or come back up to the front desk for assistance. Usually the receptionist responded by saying leave it blank until the health care professional could ask and obtain the answers. It was also noted that nurses might hand the forms to the interpreters asking them to interpret the form to the deaf patient. However, it was felt that if patients were non-deaf, nurses would ask the questions aurally and complete the forms themselves. One group suggested that perhaps the standard should be the same and the nurse should ask the questions rather than the interpreter interpreting them to the deaf patient without a health care professional present.
The possibility was raised in one group that it could become a best practice to only interpret the forms when health care professionals are present. Supporting this latter comment, several participants stated that they used to interpret the forms but don’t interpret them any more and don’t allow the health care professionals to even hand the forms to the interpreters. Thus, interpreters never have control of the forms, either the health care professionals or the deaf patients maintain control of the forms at all times.
It was further discussed that some forms, such as consent for surgery forms, are not interpreted without a health care professional asking the questions and explaining the form. The risk and legal implications related to some forms (e.g., HIPPA) were an important factor when deciding whether or not to interpret a form without a health care professional present. In contrast, the risks are minimal when interpreting the content of a health history form because health care professionals will review the content of the form with the patients. Some of the focus group participants felt comfortable with interpreting these forms. Still others felt comfortable interpreting DNR forms “for compassionate purposes wanting to make sure patients understand DNR.” Other interpreters wanted health care professionals present for the DNR forms but warned them that it might take a long time because of its complexity and the need to be extremely clear so that deaf patients are making informed consent one way or the other. It was noted that when interpreters behave in divergent ways it makes it difficult for the next interpreter. Health care professionals are unsure of interpreters’ roles and boundaries when one interpreter interprets forms, one doesn’t, and yet another interprets some forms but not other forms.There was a concern noted that sometimes health care professionals watch deaf people’s responses, particularly their head nodding. Health care professionals complete forms based on the nodding of the head, rather than the interpretation which may be different due to the linguistic differences in English and ASL.