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Working with an Interpreter

Tips for pHC researCHers

Working with an InterpreterFace-to-Face

Why use interpreters?Language barriers

• Putinformedconsentanddecision-makingatrisk,underminingtheethicalprinciplesofjustice,respectforpersons,andconcernforthewelfareofparticipants.

• Candelayresearchorresultinflaweddata,duetothereceiptofinaccurateorpoorlyunderstoodinformationbyresearcherorpar-ticipant.

• Decreaseeasyaccesstoandawarenessofresearchactivities,under-miningtheprinciplesoffairnessandequityinresearchparticipa-tion.

Why you should use qualified interpretersThe use of unqualified interpreters may invalidate consent

Qualified interpreters need to meet the following criteria:

Unqualified interpreters are more likely to:

•Demonstrateproofoflanguagepro-ficiencyintheinterpreter’sworkinglanguages•Havecompletedspecializedprofession-altrainingthatincludesethics,profes-sionalskills(e.g.,useoffirstperson),andknowledge(e.g.,terminology)•Followaprofessionalcodeofethicsandstandardsofpractice•Passaprofessionalinterpretingskillstest•Abidebytheethicalprinciplesof

» Accuracyandfidelity» Confidentiality» Impartiality» Respectforpersons» Maintainingroleboundaries» Accountability» Professionalism» Continuedcompetence

•Makemoreerrorsthanqualifiedinter-preters•Omitpertinentinformation•Addinformationthattheparticipantdidnotinclude•Substituteinformation•Condensesummariesthatomitdetails•Breachconfidentiality•Makemoreerrorsinexplainingmedi-calterminology.

NOTE - never use minors for interpretation

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Did you know?• Wheneventsareencodedinonelanguage,tryingtotalkaboutthateventinanotherlanguagemayaffectrecall.Thelanguageofaconversation,inotherwords,mayinfluencethequalityandquantityofinformationelicited.

• ‘Abstract’words–suchasjusticeortruth,and‘emotion’words–suchasfearorsadness–varyacrosslanguages,andvarymorethanthewordsusedforconcreteobjects.Whenabstractconceptsareusedinaconversation,apersonmightonlybeabletogiveanapproxima-tionofwhattheywishtosayiftheyarenotspeakingintheirfirstlanguage.

• Languageandcultureareverycloselylinked.

Key DefinitionsInterpretation-therenderingofspo-kenorsignedcommunicationfromonelanguageintoanother.Interpret-erssupportbi-directionalconversa-tions–thatis,fromlanguage1intolanguage2andfromlanguage2intolanguage1.

Whentheinterpreter,researcher,andparticipantaretogetherinonespace,thisisreferredtoasface-to-face inter-pretation.

Whenaninterpreterwaitsforaspeak-ertofinishanutterancebeforeheorsheinterprets,thisisreferredtoasconsecutive interpreting(asopposedtosimultaneous interpreting).

Consecutive interpreting and simulta-neous interpreting require very differ-ent skill sets and qualifications.

AVLIC-AssociationofVisualLan-guageInterpretersofCanada(www.avlic.ca).

Bilingual Person-Anindividualwhohassomedegreeofproficiencyintwolanguages.Ahighlevelofbilingual-ismistheminimumqualificationforacompetentinterpreterbut by itself does not ensure the ability to interpret.

Working with an interpreterBefore the interpretation session

Note - Interpreters should only interpret what has been stated by either researcher or participant. It is generally not profes-sionally acceptable for them to initiate conversation or answer participants’ questions on their own.

TheresearchermustpresenttheinformationontheEnglishversionoftheconsentform.Theinterpretertheninterpretsthisinformationfortheparticipant,intheparticipant’slanguage.Interpreters should NOT be asked to sight read,e.g.,tosilentlyreadaconsentforminonelan-guage-andwhilereading-interpretthecontentintoasecondlan-guageoutloud.Thisskillrequiresadditionalqualificationsthatmanygeneralinterpretersdonothave.

Note - Even if an interpreter is qualified to sight read, a lengthy or complex informed consent form greatly reduces the likeli-hood that the participant will be able to retain the information in a way that promotes genuine informed consent, and is there-fore a highly discouraged practice.

• Meetafewminutesinadvanceofthesessiontobrieftheinterpreteroncontentandwhatyouwishtoaccomplish.AlwaysinformtheInterpretingServiceProvider(agencyorinterpreter)ofanyknownrisks.Provideinterpreterswiththeneededadvice,protectionandsafetymeasuresgenerallyavailabletoparticipants.Theinterpretershouldneverbeforcedintoasituationthatposesarisktotheirhealthandwell-being.

• Explainanycomplexorspecializedresearchormedicaltermsinadvanceofthesession,toensuretheinterpreterisabletoconveythisinformationinthetargetlanguage.

• Asktheinterpretertostopandaskforclarificationimmediatelyifheorshedoesnotunderstandwhatyouortheparticipantsaid.

• Cometoanagreementabouthoweachofyouwillrespondifeitherfeelsthattheparticipantisuncomfortableordoesnotunderstandsomething.

• Discusshowyouwillregulatethepaceoftheconversation,topreventtheconversationfrommovingtooquicklyorslowly.Avoidaskingtheinterpreterforhis/heropinionduringthesession.

• Ensurethattheinterpreterisappropriate,i.e.,speaksthecorrectlanguageordialect.

• Arrangetheseatingtofacilitateeaseofcommunication.Atriangu-lararrangementisusuallyrecommended.

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Key DefinitionsLimited English Proficiency (LEP)-LEPreferstoalevelofEnglishlanguageproficiencythatisnotsufficientforensuringequalaccesstopublicserviceswithoutaninterpreter.Thisincludestheinabilitytospeak,read,write,orunderstandEnglishatalevelthatpermitsanindividualtointeracteffectivelywithhealthcareprovidersorsocialserviceagencies.

Remote Interpreting-interpretationprovidedbyaninterpreterwhoisnotinthepresenceofthespeakers,e.g.,heorsheisinterpretingviatelephoneorvideoconferencing.Intelephoneinterpreting,there-searcherandparticipantaretypicallyinthesameroom,althoughsome-timesthethreeparties(researcher,participantandinterpreter)canallbeatdifferentsites.

What exactly does nodding or saying “Yes” mean? Non-verbalaspectsofcommunica-tionmaybedifficultorevenimpossi-bleforsomeonefromadifferentlan-guageorculturalgrouptoaccurately‘read’.Forexample,noddingmaymeaneither“yes”or“no”indifferentcultures.Cross-culturally,noddingorsaying“yes”mightactuallymeananyofthefollowing–

• Iunderstand,agree,orapprove

• Iheardwhatyousaid

• Iheard,butmayormaynotagree

• Iunderstandbutdon’tagree

• Iseethatthisisimportantforyou,butImaynotagree

• Idonotunderstand,butoutofrespecttoyou,Iwillnotletyouknowthatyouhaveexplainedthispoorly

• Iagreeandwilldo

Note - Instead of asking questions that require a “yes” or “no” response from participants, ask them to summarize - or teach back to you - what they heard or understood, in their own words.

During the interpretation session

Note - interpreters are professionally bound to confidentiality.

• Introducetheinterpreterandparticipant(s)toeachother,andem-phasizethatinterpretersareprofessionallyboundtoconfidentiality.Ensuretheparticipantknowsyouareconductingthesessionandunderstandstheinterpreter’srole.

• Confirmwiththeparticipantthatheorsheiscomfortableworkingwiththeinterpreter.

Members of some religious or cultural groups may have a strong preference for an interpreter of the same gender.

Some individuals might prefer not to work with an interpreter from their local community - especially if that community is small or tightly knit - for fear of loss of confidentiality.

Members of some religious or cultural groups will have strong beliefs about acceptable levels of physical closeness to oth-ers. Be attentive to how the session is physically arranged, and watch for cues that indicate discomfort.

• Alwaysdirectyourconversationtotheparticipant,nottheinter-preter.Explainthepurposeofthesession,howitwillproceed,andallowtimeforparticipants’questionsorconcerns.

Be aware that members of some religious or cultural communi-ties may find direct eye contact disrespectful.

• Useplainlanguage.Avoidtechnicalterms,abbreviations,slang,metaphors,orprofessionaljargon.

• Avoidexpressingmorethanoneortwoconceptsorpiecesofinfor-mationatatimebeforegivingtheinterpretertimetointerpret.

• Regularlypausetoasktheparticipantto‘teachback’orrestatewhattheyheardorunderstood,usingtheirownwords.

• Encourageparticipantstoaskquestions.Givethemampletimetoprocessinformation.

Finishing the interpretation session

• Debrieftheinterpreter,especiallyifthesessionwasemotionallytaxingoriftheconversationwasdifficult.Clarifyanyissuesyoumayhavefromthesession.Askfortheinterpreter’sfeedbackaboutthesession’ssuccess(pace,clarity,plainnessoflanguageused,etc.)Makesureyouhavethisconversationinaprivatespace.

• Recordtheuse(orrefusal)ofaninterpreteronallrelevantdocu-ments.

• Informed consent is an ongoing process.Theparticipants’continu-ingabilitytoprovideinformedconsentneedstobeconsideredthroughoutthestudy–notjustatthetimeofinitialconsent.Interpretersshouldbeavailableatregularintervalstoensurethatparticipantshaveopportunitiestoaskquestionsthroughouttheresearchactivity.

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Participants who have spoken English for many years may revert back to a language they feel more comfortable with during times of stress, injury, or illness.

Key DefinitionsSign Language-avisual-spatiallan-guagewhereinformationisexpressedbyfacialexpressions,andthroughcombinationsofhand-shapes,palmorientations,movementsofthehands,armsandbody,locatedinrelationtothebody.AmericanSignLanguageor(ASL)isthemostcommonsignlanguageusedbyEnglishsignersinCanada,withLanguedessignesquébécoise(LSQ)mostcommonlyusedbyFrench-deafcommunitymembers.On October 9, 1997, in a unanimous decision, the Supreme Court of Canada ordered the Govern-ment of British Columbia to pay for sign language interpreters when Deaf people access health care services.El-dridgev.BritishColumbia(AttorneyGeneral)(1997),46CRR(2nd)189(SCC).InDominionLawReports,151D.L.R.(4th).

Sight Translation-translationofawrittendocumentintospokenorsignedlanguage.Aninterpreterreadsadocumentwritteninonelanguageandsimultaneouslyinterpretsit(intooralorsignedcommunication)intoasecondlanguage.Interpretation and sight translation require different skill sets and qualifications.

Simultaneous Interpreting-theprac-ticeofhavingtheinterpreterinterpretutterancesfromonelanguageintoanotherwhilesimultaneouslylisten-ingtoandcomprehendingthenextsentence.Thisformofinterpretingistypicallyusedwhencommunicat-ingwithagroupofpeoplewhosharethesamelanguage,anddonotspeakorunderstandthelanguageofthepresenter.Simultaneousinterpretingrequiresuseofelectronictransmittingandlisteningequipmentandahighlyqualifiedpersontrainedandexperi-encedinsimultaneousinterpretation.

STIBC-SocietyofTranslatorsandInterpretersofBritishColumbia(STIBC)(www.stibc.org).

Teach-Back-thepracticeofaskingparticipantstorepeatorsummarize,intheirownwords,whattheyneedtoknowordo.Thisisatestofhowwellyoucommunicated.Itprovidesacrucialopportunityforyoutocheckforparticipantunderstanding,andifnecessary,tore-teachyourinforma-tion.

Translation-therenderingofawrittentextinonelanguage,intoawrittentextinanotherlanguage.Interpreta-tion and translation require different skill sets and qualifications.

Booking an Interpreter

Note - You will need to book additional time - beyond that required in a non-interpreted encounter.

Tips

• Ifthecontentismedicalinnature,requestaninterpreterwithmedical interpreterqualificationsandexperience.

• Givetheagencyprovidingtheinterpreterservicesasmuchadvancenoticeaspossible.Thisusuallymeansputtingyourrequestinmorethan48hoursinadvanceofthesession.

• Givethedispatcherdetailsabouttheinterview,especiallyifyouan-ticipatethatsensitive,technical,orcomplexissueswillbecovered.

Information you will be asked for by the Interpreting Service Provider

Timeanddateinterpreterisrequired;expectedlengthofsession;par-ticipant’sname;languageofparticipant;purposeofsession;topics;keycontactinformation,andpaymentdetails.

To book an interpreter,contactoneofthefollowingagencies:

MOSAIC Interpretation ServicesTelephone–604-254-8022Email–interpretationservices@mosaicbc.comOnlinebooking–http://www.mosaicbc.com/mosaic-language-services/

translation-and-interpretation/interpretation-0

Lower Mainland Interpreting Services (LMIS)Telephone–604-675-4099;toll-free–1-877-228-2557Onlinebooking–https://plscustomer.phsa.ca/

Note - an account must be first set up with LMIS. Visit the LMIS website for more information.

Formoreinformation,contact:AnnVanderbijlConsultant,Diversity-CulturalandLinguisticCompetence604-806-9312

June2011