Dimensions of Culture

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When it comes to providing an interpreter for patients with limited English proficiency, the most basic requirement is that you have access to an experienced and skilled interpreter who can truly aid communication rather than getting in the way or distorting the messages that you and the patient want to communicate. Following this section we provide some specific guidelines to use when working with interpreters.

Who is Qualified to Act As An Interpreter?

• The term “interpret” generally refers to spoken language and “translate” to written language. The skills required for these two disciplines are obviously different, though many interpreters can translate as well.
• Professional interpretation requires a minimum level of proficiency in two languages and the demonstrated ability to convey a complex message using words and grammar that are appropriate to both the provider and the patient.
• Professional interpreters are trained to convey messages without the distortion that can result from interjecting their own opinions, beliefs, or prejudices. A qualified interpreter knows her role, her limitations, and her responsibilities as an interpreter for others.
• Relying in family members, friends, and “informal” interpreters is problematic. They are more likely to modify what the patient has actually said in their effort to be helpful. Children should not be used as interpreters.
• Being bilingual in English and another language does not qualify an individual as an interpreter (just as speaking English competently does not qualify an individual to teach the language).

Qualified Medical Interpreter Skills

• Qualified medical interpreters have additional skills that enable them to work effectively in health settings. They have studied the basics of anatomy and physiology. They may know the meanings of medical terms, diseases, and procedures in specialty areas and should be able to quickly make complex medical terminology understandable in the everyday language of the patients.
  
• They know the words that may be “taboo” in the language or culture of the patient and the euphemisms that may be used instead.
  
• They are familiar with the common health beliefs and practices of the cultures whose languages they speak. They understand and have been taught to handle the “triadic” relationship—the dynamics introduced by the introduction of a third person into a medical encounter.
  
• They “must know how to engage both provider and patient effectively and efficiently in accessing the nuances and hidden socio-cultural assumptions embedded in each other’s language, which could lead to dangerous consequences if left unexplored.” (Massachusetts Medical Interpreters Association and Educational Development Center, Inc. 1995)
  
  
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