19 February, 2013

The "CIFE"

One of the first things one learns when they are training as an interpreter is the CIFE. This acronym is an important part of the interpretation process. It is the first opportunity for an interpreter to establish his or her role in the triadic relationship.

When a interpreter walks into a patients room with a provider the first thing he or she must do is to set the stage.  A brief introduction of himself to the patient and provider.  The following is what it should sound like.

Hello,  my name is____________ I'm a medical interpreter and will be interpreting for you and Dr.__________.  Let me take a moment to review some important information prior to starting.  This will only take a minute or two.

Every thing that is said will "CONFIDENTIAL".
In order to control the "flow" I will use the T sign if I or the patient have a question or need clarification
I will be speaking in 'First person"
"Everything" will be interpreted
"This Previously stated has not been wrtten in it usual sequence"

This is repeated to the provider as well. The the session can begin.  This is how to properly set the stage.  When the interpretation ends check in with both parties to see if they require something else from you prior to departing. Thank both provider and patient alike.

If you are an interpreter and use this you will see that it has great benefit in establishing yourself in the Triadic Relationship and controlling the flow of the dialogue between patient and provider.

TRY IT!!

07 February, 2013

Preparing for National Certification Oral Exam

It is now time to prepare for the National Certification Exam, part II, Oral Exam.  The strategy that I will use is not a proven one, but one that I believe will prove to serve me well.  If successful, and I'm almost certain it will, then maybe others will benefit from it. 

Now lets review the steps.  First I will review each of the body systems medical terminology making sure to say each word in English then in Spanish. Afterward, a review of medical terminology only in the target language using YouTube Video presentations in medical terminology. Furthermore, I will take several hospital documents, located via internet search and attempt to perform a visual translation of the documents. Moreover, I will make certain that these documents include discharge instructions, admission questions,  insurance payment authorizations, etc. Lastly, practice sessions of oral interpretation with a partner reading dialogue that I will then interpret. This should suffice.

The materials will be divided into segments as follows;

15 min = terminology
15 min = oral translation
15 min = simultaneous interpretation
15  min = consecutive interpretation

The purpose of the aforementioned is to make sure that a review of as many of the possible topics, that will be covered on the oral exam, are included in my practice sessions.  In addition, the use of actual hospital documents will insure that the practice is as close to real life as possible. Lastly, equal time segments will insure that a balance amount of materials is covered.

Thus, when I pass the National Certification Exam Oral Section I will post whether or not I passed.

WISH ME LUCK!!!




01 February, 2013

Interpreter Team Cohesiveness

Interpreters must multitask throughout the work day while interacting with colleagues and assisting oneanother daily.  Many times they work in close and cramped quarters.  Also, they face a whole host of stressors both in and out of work.  Despite the many challenges they may face one thing is certain, they must have a cohesive team and enjoy their job in order to perform at their best.  There are factors that can damage the cohesiveness of your interpreter team.

The cohesion of the interpreter team can be damaged when individuals in the team lack consideration for other team members.  This can manifest itself in some very simple yet not so obvious ways.  For instance, one team member does not have the same sense of urgency as others. Furthermore, one member may have a sense of entitlement and not respect their team members.  Moreover, one member may have too much on their plate and not be able to fullfill the requirements of their position, and other team members must pick up the slack.  Yet they continue to be merited with completion of the work they did not perform.  This team member may ignore work that needs to be done so that team members must fill the void by taking on the added work. The team member may me arrogant in some mannarisms,  or even moody.  He or she may think that what is assigned for he or she to do is more important than what other team members have to do.  Or the team member in question may simply be lazy.  All of these scenarios can hurt the team cohesion and the trust that goes with it.  Ultimately, your hard work to build a strong team may go down the tubes.

The aforementioned can be complicated by a manager who tends to overlook these issues for the sake of not creating friction or simply avoiding having to have the difficult conversation to correct matters before they get too far gone.  Or simply a manager may lack the wisdom to be able to acknowledge the fact that one team member may be taking advantage of the rest of the team.

How can we as managers embark on a process to keep our interpreter team working harmoniously toward the ultimate goal of the organization, to provide interpretation and support to medical staff and patients alike?  How do we insure that the team we organized continue to work well together?

The answer to these two questions is very simple.  Managers must create an environment where interpreters can freely voice their opinions, provide suggestions, be creative, and even express their grievances.  Use the tool of assigment and accountability to insure that all members of the team are performing and completing duties that have been assigned to them.  Create opportiunities for your team to share some time together outside or inside of work.  Do not allow any member who may be tired due to extracurricular activities to affect the team negatively. Hold all team members accountable.  Don't forget that a manager must hold everyone to the same standards.  Don't use your team members to perform anothers' duties, while not holding the deficient member accoutable. Do not favor one team member over another. Do not exploit those who work hard and allow those that don't to underperform.  This sends the wrong messsage to your team and they may lose their confidence and respect for your abilities as a leader.  If you make allowances for one, remember you must do the same for the others.  Remember to reward hard work appropriately and in direct correlation to the work performed.  Hold meetings that include the whole team when possible and always provide all members  with the results and decisions reached at meetings.

We can continue to make suggestions regarding how to properly address situations that destrroy team cohesiveness.  The simple truth is that we must be proactive and not reactive when something disrupts team dynamics. In other words level the playing field for all. Finally, live by these three words; fair, firm, consistent, they will almost insure your success in maintaining team cohesivenes and team member retention.

I will write more on this topic later

05 December, 2012

Training Interpreters The Training Manual

One of the most valuable components of a well defined training strategy is the training manual.  Managers in industries across the board have used this instrument as part of a multipronged approach to training employees.  However, there seems to be a lack of such an instrument in preparing interpreters for their roles in the health care setting. 

Yes, Interpreters are trained in the role they play as part of a service being provided to patients as a matter of their rights to access Health Care Services.  We learn the terminology, the applicable laws,  code of ethics, must be certified, and more.  However, the one missing link is a manual that defines the particular functions that the interpreter will have to perform once on the job.  Please keep in mind that interpreters are required to track and record their activities.  In addition, they are required to place certain types of calls that require they follow a prescribed script and vernacular.  Furthermore, there are a whole host of office functions they must familiarize themselves with and perform, among these is the use of certain software.

In many interpreter offices there is usually a person or two who have a great handle on the particular tasks performed on a daily basis.  They are usually charged with the specific task of imparting that knowledge to the novice.  This works well most of the time.  However, imagine if a training manual existed for a professional interpreter to walk into a training situation and it complement their learning.

The challenge is in the varying responsibilities of intrepreters in this industry.  Apart from the actual function of how to perform an interpretation, the onsite functions actually differ. This is because not all hospitals are using the same methods for capturing data and performing specific functions.  There is a difference in software, remote video, equipment, and more.  Thus, a generic manual would be impractical.

The only way to resolve this issue is to impart to every hospital Interpreter Services Coordinator or Manager the responsibility to write a training manual specific to their environment.  This will provide a framework for training and reference not currently in existence.  Moreover, it formalizes the inhouse training process and provides management at all levels with a tool that can be referred to and revised when needed.  Finally, it addresses the lack of inhouse training materials for interpreters to refer to when in doubt about how a particular function should be performed.

Hopefully our industry and profession will have the foresight to see the value in such an instrument and begin to take some action.  Healthcare organizations need not look too far for someone among their ranks that has the experience and knowledge necessary to write a training manual.  The benefits of a well written revisable training manual are many.  Look for the benefits in future post.

Technology and the Medical Interpreter

Technology is changing rapidly all over the world.  In the industrialized nations the change is even greater.  This of course has an effect on all of society.  Businesses must subscribe to and upgrade their technologies almost as rapidly as the changes take place.  The healthcare industry is no different. Furthermore, individuals within the  industry must consistently upgrade their knowledge and skills if they are to compete and remain competitive as employees.

The same is true of the medical interpreter.  We must rise to the challenges of increased demand for our time and creativity.  If we do not subscribe to the idea of constant learning we will eventually be left behind.  As technological changes take place in our workplaces we must demonstrate to our employers that we are up to the challenge of learning and creating new methods for performing our responsibilities while adapting to and creating new ways to use technologies to produce qualitative outcomes that provide a great benefit to both the employer and employee.

In short, the medical interpreter today is much more than just a medical interpreter. He is an administrative support staff member that must manage many aspects of the daily functions of the interpreter services office. however, in order to participate in this environment one must learn the new technologies and its different uses.  Furthermore, he/she must combine this knowledge and determine what changes can be instituted that would make there jobs more flexible, productive, and necessary. In other words the medical interpreter of today must constantly be looking for ways to quantify and track performance through the use of technologies.

So if you want to be part of the changes taking place in the healthcare industry make sure that you are willing to learn and use the newly acquired skills to produce for your employer in a way that is second to none.  Only the knowledgeable and creative will be able to compete in this new environment of rapid technological change in healthcare.

18 November, 2012

The Digestive System

Medical Interpreters must constantly test their knowledge.  Also, they must gain additional knowledge in order to improve the quality of their performance on the job.  Many medical interpreters utilize already published and existing materials in order to achieve this goal. This requires time, effort and lots of reading. In addition, one must always quiz and test ones' knowledge in order to keep it banked in ones' memory.

Here is a short quiz regarding the digestive system. Take the quiz, see how you do,  and review areas that you don't quite know.   This method of learning will help you to retain and reinforce your newly gained knowledge.    Have Fun!!


If you do well then you are well on your way to becoming a proficient medical interpreter.  I will post these quizzes from time to time.

03 November, 2012

National Certification Exam for Interpreters

So, you have been thinking of taking the national certification exam  for interpreters.  However, you fear failing the exam?  Don't worry yourself. If you have been interpreting for at least one year, have a good handle on the meanings of medical terms, are familiar with the Code of Ethics and the National Standards of Practice, you will do well.

Here's some advise.  When preparing for the written portion of the exam make sure that you understand your responsibilities as an interpreter.  In addition, have someone create situations that can arise in the context of interpreting and ask you how you would handle these in reference to the Standards of Practice. The more complex the scenario the better.

When it comes to the vocabulary you might want to familiarize yourself with the body systems and what each system does.  Also, focus on what some of the functions of the major organs and glands.  Know the meanings of medical terms commonly used in the medical setting.  

You may have already taken exams where you were asked ' what is the function of the pancreas?" or a similar question.  These are the types of questions that you will be asked on the National Certification Written Exam.  There are no trick questions.

Finally, register, pay the fee, schedule the exam, and go for it.  Before you know it, it will be over and you will be one step closer to being Nationally Certified as an Interpreter.

30 September, 2012

Preparation for National CertificationIn A

So you want to prepare for the National Certification Exam.  Well, there are some things you want to know. First, you should make sure that you know as much medical terminology as possible. However, you must not know the translation of a word but the meaning of a word.  Secondly, try to know your body systems and their function. Thirdly, read your CHIA Standards of practice and know how to use these in an interpretation scenario.  in Addition, you must know the Interpreter Code of Ethics and how it relates to your day to day activities as a interpreter.

Now Sign up for the exam.  And try to take the practice test that are offered.   Review your interpreter 60 hour training materials and do the quizzes at the end of each chapter.  If there is anything you don't remember review it.  Also, there are some very good review materials on You Tube.  Search for Body Systems, select the ones you feel you are least knowledgeable with.   After this you should be well prepared for the exam.

I will inform you regarding how well I do after November 3rd.  Wish me luck.

26 August, 2012

Medical Interpreters Are Needed To Assist With Discharge Instructions

Medical Interpreters are needed in the healthcare industry primarily to increase positve treatment outcomes (access) for LEP (limited English proficiency) patients.  However, treatment is never complete unless the outcomes of said treatment is a positve one.  LEP patient understanding of discharge instructions is pivotal in completing the treatment process.

Healthcare providers are constantly revisiting this topic in order to increase the positve outcomes when treating LEP patients. The Medical Interpreter is the key to increasing the treatment outcomes for LEP patients after discharge from a healthcare facility.  However, hospital staff and interpreters must work together to insure that discharge instructions are understood.  In addition,  both parties must work together to followup with patients after being discharged from the healthcare facility.

Studies point to the need for continued work where discharge instructions is concerned.  Patient understanding and follow through is extremely important and related to increasing positive treatment outcomes.  Healthcare providers must do more and involve the Medical Interpreter in the process of developing new strategies for addressing this issue.

The following is the outcome of a study related to the understanding of discharge instructions by LEP patients. Please review it and share the data. I'm certain you will agree that new strategies are needed.


Language barriers and understanding of hospital discharge instructions.

Source

Department of Medicine, Medical Effectiveness Research Center for Diverse Populations, Division of General Internal Medicine, USA.

Abstract

BACKGROUND:

Effective communication at hospital discharge is necessary for an optimal transition and to avoid adverse events. We investigated the association of a language barrier with patient understanding of discharge instructions.

METHODS:

Spanish-speaking, Chinese-speaking, and English-speaking patients admitted to 2 urban hospitals between 2005 and 2008, comparing patient understanding of follow-up appointment type, and medication category and purpose between limited English-proficient (LEP) and English-proficient patients.

RESULTS:

Of the 308 patients, 203 were LEP. Rates of understanding were low overall for follow-up appointment type (56%) and the 3 medication outcomes (category 48%, purpose 55%, both 41%). In unadjusted analysis, LEP patients were less likely than English-proficient patients to know appointment type (50% vs. 66%; P=0.01), medication category (45% vs. 54%; P=0.05), and medication category and purpose combined (38% vs. 47%; P=0.04), but equally likely to know medication purpose alone. These results persisted in the adjusted models for medication outcomes: LEP patients had lower odds of understanding medication category (odds ratio 0.63; 95% confidence interval, 0.42-0.95); and category/purpose (odds ratio 0.59; 95% confidence interval, 0.39-0.89).

CONCLUSIONS:

Understanding of appointment type and medications after discharge was low, with LEP patients demonstrating worse understanding of medications. System interventions to improve communication at hospital discharge for all patients, and especially those with LEP, are needed.
PMID:
 
22411441
 
[PubMed - indexed for MEDLINE] 
PMCID:
 
PMC3311126
 [Available on 2013/4/1]


15 August, 2012

Translations

Interpreters are often requested to translate written documents from one language to another. This is not a task for those without experience. It is very difficult and requires a knowledge of both the written and target language at at least a college level.  However, not just in one language but in both.  This comes only through formal study and lots of practice.

Even when one is a very good interpreter one can still be a very bad translator.  So it is recommended that before one embarks on this type of endeavor that one take several courses prior.  Or you can train with a professional who can teach a guide you through the development phase.

Now if you are currently employed as an interpreter and there is a person who has that skill in your office.  They can mentor you so that you can develop this skill slowly.  They can assign you small translation assignments and review it with you once completed to discuss how the translation can be improved and correct any errors.  Another approach would be to assign more than one person to translate a document and review it with both parties. These are just a few practical ways to develop this skill.  However, be forewarned, it takes many years to become a proficient translator.