building health care interpreter capacity in the community: a national strategy health care &...
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Building Health Care Interpreter Capacity In The Community:
A National Strategy
Health Care & Community College Partnership
Gayle Tang, Director
National Linguistic & Cultural Programs
National Diversity Department
http://kpnet.kp.org/national/diversityhttp://kpnet.kp.org/national/diversity
A partnership in improving the health status of our diverse communities
Objectives
To introduction the KP/Community College Health Care Interpreter Certificate Program - A proven approach to increasing linguistic & cultural capacity
Building Capacity
Outline:
What are the core competencies?
Features, advantages, and benefits of the Program
Current Partnerships & successes
What does it take to create a Partnership?
Instructor / Coach requirements
Highlights of Instructor Training Intensive
What are the next steps?
Definition of Terms
Interpreter
Translator
Bilingualism Biculturalism
Goal
• To develop linguistically and culturally competent interpreters who can function effectively and efficiently in health care settings
Cultural Competence
ActionActionBeyond sensitivity & awareness
Skills knowledge
A specific set of skills and a particular knowledge base to operate in a multicultural setting
Cultural Competence the Nexus to Eliminating Health Disparities
Core Competencies
• To develop linguistically and culturally competent interpreters who can function effectively and efficiently in health care settings
Conversational proficiency (pre-requisite)
Slang / idiomatic expressions
Health care terms and concepts
Basic medical knowledge
Listening and memory
Core Competencies
• To develop linguistically and culturally competent interpreters who can function effectively and efficiently in health care settings
Self-awareness (Learning model)
Diversity and cultural awareness
US biomedical system & other’s
Characteristics of specific cultures
Health beliefs, values and traditions
Effective communication: cross-cultural, intercultural, and intra-cultural
Core Competencies
• To develop linguistically and culturally competent interpreters who can function effectively and efficiently in health care settings
Roles & responsibilities
Interpreting skills
Types of interpreting
Code of ethics
Standard of Practice
Core Competencies
• To develop linguistically and culturally competent interpreters who can function effectively and efficiently in health care settings
Problem solving / conflict management
Teamwork / Group dynamics
Time management
Giving & receiving of feedback
Legal & regulatory requirements
Systems & resources
Interpretation Errors of Untrained Interpreters
Translated the target word as
“Womb” “Stool”“Bowel Movement”
Not interpreted
“Liver” “Vagina”Not interpreted
“Neck” “Hip”“Cervical Vertebrate”
Not interpreted
Target WordTarget Word
BowelBowel
BladderBladder
CervixCervix
From assessments of candidates for interpreter training and candidates for interpreter positionsFrom assessments of candidates for interpreter training and candidates for interpreter positions
Margarita Battle, Massachusetts General Hospital, 1990 - 1996Margarita Battle, Massachusetts General Hospital, 1990 - 1996
Interpretation Errors of Untrained Interpreters
Translated the target word as
“Beard/chin” “Push”“Bend down/sit down”
“Carry a weight”“Get undressed from the waist down”
Not interpreted
“Cramp” “Pull”“Radiate” “Pierce”
Not interpreted
Target WordTarget Word
Bear DownBear Down
TinglingTingling
From assessments of candidates for interpreter training and candidates for interpreter positionsFrom assessments of candidates for interpreter training and candidates for interpreter positions
Margarita Battle, Massachusetts General Hospital, 1990 - 1996Margarita Battle, Massachusetts General Hospital, 1990 - 1996
• No community standards for health care interpreters
• No accountability• No training available in
the service area• Curriculum
development originated from SFO
Why?
Profile of a Model ProgramProfile of a Model Program
C. Vargas, D. Kwan, S. Do, A. Yee - Language Coaches
Center: R. Lee, MD - Presenter and medical expert consultant
G. Tang - Instructor
• Proposed partnership with community college to institutionalize the curriculum
• Solidified curriculum • National search for
programs to benchmark• Received training from
Cross-Cultural Health Care Program
• Support and sponsorship from Tony Gately, NCAL RMGA, and Ronald Knox, VP, National Diversity
How?
Profile of a Model ProgramProfile of a Model Program
• City College of San Francisco formally institutionalized the Health Care Interpreter Certificate Program in 1997
When?
Profile of a Model ProgramProfile of a Model Program
• The curriculum for the Health Care Interpreter Certificate Program is designed to train bilingual and bicultural students to develop the awareness, knowledge and skills necessary for effective linguistic & cultural interpretation in health care settings
What?
Profile of a Model ProgramProfile of a Model Program
Graduation 1999
• 3 Courses: – Health 80 Health 81
Health 82• 378+ Hours• Lecture• Language Lab• Internship Field work
What?
Features
Profile of a Model ProgramProfile of a Model Program
Integrative Approach...
Health 80 - 6 units• Develop awareness, knowledge, and skills necessary for effective
interpretation in health care settings• Roles and responsibilities• Basic knowledge of common medical conditions, treatments and procedures• Insight on language and cultural nuances of specific communities
What?
Features
Profile of a Model ProgramProfile of a Model Program
Another great experience…
Health 81 - 6 units• Further skills building in being an
integral member of the health care team in bridging linguistic and cultural gaps
• Specialized health care service areas such as genetics, mental health, death and dying, etc.
• Development of cultural competency in the community and workplace
What?
Features
Profile of a Model ProgramProfile of a Model Program
LGBT Community Panel
Health 82 - 3 units• Field work experience• Application of knowledge and skills learned in Health 80 and 81
What?
Features
Profile of a Model ProgramProfile of a Model Program
What?
Advantages
Profile of a Model ProgramProfile of a Model Program
Convenience - Times & Location
Featured Speakers Expert CoachesDiversity in ClassQuality ProgramCollege Credit - 15 UnitsLow CostSustainability
Spanish Lab
Cantonese Lab
Mandarin Lab
Russian Lab
Japanese Lab
Korean Lab
Why?
Benefits
Profile of a Model ProgramProfile of a Model Program
Setting community standardsKP practitioners gaining cultural competence through teaching Increasing work force diversity in the health sector & improving KP’s imageLeveraging program to recruit for the very best Satisfying KP’s mission & meeting organizational business objectives
Setting community standardsKP practitioners gaining cultural competence through teaching Increasing work force diversity in the health sector & improving KP’s imageLeveraging program to recruit for the very best Satisfying KP’s mission & meeting organizational business objectives
Kaiser PermanenteKaiser Permanente
Source of revenue
Key to future partnerships
Increasing reputation
Linking with other programs
Leveraging health care expertise
Satisfying community colleges mission
Source of revenue
Key to future partnerships
Increasing reputation
Linking with other programs
Leveraging health care expertise
Satisfying community colleges mission
Community CollegesCommunity Colleges
Benefits
Challenges
KP People & SystemsKP People & Systems
Coordination for field work can be a challenge if no systems in place
Coordination for field work can be a challenge if no systems in place
ChallengesChallenges
Enhance skills
View training as an incentive
Tuition reimbursement
Enhance skills
View training as an incentive
Tuition reimbursement
BenefitsBenefits
Next?
Experience
Dissemination & ReplicationDissemination & Replication
SK I
L L S
Disseminated curriculum to 6 community colleges in California
Conducted Summer Institute 2001 - Health Care Interpreter Instructor Training
Additional KP / community college partnerships identified
Developed & disseminated training manuals
Balancing demand & supply
Replicating Model
Language & Culture
The work of an interpreter is invaluable and has a direct impact on the patient’s
health outcome. They hold a very important key that helps unlock those
cultural and linguistic barriers.Quality
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AccessAccess
Quality & Quality & OutcomesOutcomes
Cost
Risk Factors
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Risk Risk ManagementManagement
AccreditationAccreditation
State & Federal Requirements
Implications
Educational Educational Institutions & Health Institutions & Health Care Organizations Care Organizations Partnership Structure
Initial Sponsorship of the HCI Certificate Program:
Interest
7 Days of Intensive Instructor Training and curriculum dissemination offered to HC liaison and College Instructors (April / May 2004)
Minimal Partnership Requirements for HC Organizations:
Liaison with college
Provide site for field work
Provide expert speakers if college is interested
Use of classroom & equipment,
Use printed material, e.g., health education material, etc..
Initial Sponsorship of the HCI Certificate Program:
Interest
7 Days of Intensive Instructor Training and curriculum dissemination offered to HC liaison and College Instructors (April / May 2004)
Minimal Partnership Requirements for HC Organizations:
Liaison with college
Provide site for field work
Provide expert speakers if college is interested
Use of classroom & equipment,
Use printed material, e.g., health education material, etc..
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Timeline
Interest
5/03 - 6/03
Present and identify interested Regions
Sponsorship
6/03 - 8/03
Decision & designate Regional
Champion & Liaison
College
9/03 - 10/03
Present and identify
interested Colleges
Instructor Training
April / May 2004
Disseminate Curriculum
5 - 7 Days Intensive Instructor Training
Program Start Fall 2004 or Spring 2005
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Timeline
Interest
5/03 - 6/03
Present and identify interested Regions
Sponsorship
6/03 - 8/03
Decision & designate Regional
Champion & Liaison
College
9/03 - 10/03
Present and identify
interested Colleges
Instructor Training
April / May 2004
Disseminate Curriculum
5 - 7 Days Intensive Instructor Training
Program Start Fall 2004 or Spring 2005
Agreement
Finalize Coaches & Instructors
KP & College
ID Coaches & Instructors
KP & College
Instructor Training
Objective highlights:• Overview of curriculum• Integrating all essential components of health care interpreting with trainer’s tips• The role of the instructor and of the language coach• Assessment and testing of students• Operationalizing from marketing to instructions
Instructor Training
Logistics:
Travel - arrive at least day before Networking evening night before Sessions - consecutive days with 8 - 10 hr days Partners join on 1st and part of last day
Agreement Provisions
• Institutional specific for contract• See specifics for field work experience
General Coach & Instructor Requirements
Minimum Requirements:Fluency in pair language: Oral and written communication skills (except instructor if not able to find)Educational level: BAKnowledge and experience in the health care systemOrganized, professional, flexible, commitment, interpersonal skills & empathyTeam player, ability to give and receive feedbackAbility to work under pressureTeachable, with learning attitude and works effectively with diversityLeadership skills and possible Masters required, especially instructorSee college specific requirements for the primary instructor
General Coach & Instructor Requirements
Required Competencies:Minimum two (2) years of interpreting experience.Certified Health care Interpreter or experience in teaching HC interpretersGood facilitation skillsCross-cultural / Intercultural communication techniquesExperience in working with diversity and a clear understanding and respect of various culturesGood knowledge of medical terminologyTeaching experience - Presentation skillsSee College requirements for the primary instructorSee Language Coach job description
Bridging Languages and Cultures
“Access with dignity”