Sharing Best Practices for Effective Multilingual Communication in Healthcare
Oftentimes, healthcare interpreters are asked to read a document in one language and say it out loud in another right on the spot. This is known as sight translation. Interpreters can perform sight translation of medical documents to a certain extent, but there are some important caveats to consider. In fact, the National Council of Interpreting in Health Care has specific guidelines for sight translation.
Asking an interpreter to sight translate a medical document is like asking a heart surgeon to perform a cataract removal and lens replacement. In the professional language world, there are interpreters and there are translators. They both are fluent in at least two languages, but each have unique training and use completely different language skills.
Interpreters deal only with oral communication and their primary role is to facilitate a conversation between parties that speak different languages. Medical interpreters have the amazing ability to go back and forth between both languages right on the spot. This requires having listening and speaking skills in both languages, and an exceptional working memory, so much so that neuroscientists study interpreting output in relation to the development of specific regions of the brain.
On the other hand, translators only handle written communication. They convert a written text into a comparable written version in another language. This requires having reading and writing skills. Translators typically only translate into their native language, which is professionally defined as the language in which they received their education, and not the language their family speaks at home. This wouldn’t sound remotely exciting to most people, and they certainly don’t look as cool as Nicole Kidman in the movie “The Interpreter.” Even so, professional translators do have impeccable grammar and an impressive vocabulary repertoire in their language pair. Medical translators are known for being obsessed with language nuances. After all, patient safety and compliance often depends on the quality of a medical translation.
There are several things to consider when deciding whether or not it is adequate to have an interpreter sight translate a medical document. Sight translating long and complex medical documents such as applications, consent forms, and patient instructions is mentally draining and has time constrictions which leave a lot of room for error. Sight translation is a complex cognitive process that requires analyzing the text and coming up with an oral version that makes sense and has proper syntax in another language. In essence, sight translation is multitasking. As with texting and driving, doing more than one thing at a time compromises our ability to successfully complete either task and might even be disastrous. Language researchers have found that interpreters performing sight translation even experience dysfluency, or lack of fluency, in their preferred language.
Beyond considering interpreter fatigue and dysfluency, there is also the question of how much information a patient can understand and retain during a sight translation session. There are always risks associated with a patient’s lack of adherence to instructions, either by lack of information because it was left out, or their inability to comprehend it. Another point is considering the guidelines of the US Department of Health and Human Services (HHS). According to HHS, vital documents referring to patient’s rights, such as confidentiality agreements and information pertaining to the healthcare institution, should be handled by a professional medical translation service. Financial agreements, informed consents, living wills and advanced directives, discharge instructions and any other information the patient needs to consult at a later time, must be put in writing by a professional medical translator as well.
The question remains as to whether sight translation has a role to play in medical care and if so, how to use it appropriately. Short documents with specific instructions might be appropriate for sight translation, but whenever sight translation is used, the provider must remain present, so that he or she can address any questions the patient might have.