Community Ambassador Program
Culture and Language Training
Maria Servin, MSW
Service Director
Marketing/Diversity
The Role of the Interpreter
Learning Objectives
• Learn from the field of interpreting to learn
how to effectively use language skills to
assist community members
• Increase understanding of the role of an
interpreter
• Become familiar with tips and techniques
when acting as an interpreter
Slide 3
The Right to be understood
“ A community interpreter has a very different
role and responsibility from a commercial or
conference interpreter. She/he is responsible
for enabling professional and client, with
very different backgrounds and perceptions
and in an unequal relationship of power and
knowledge, to communicate to their mutual
satisfaction.”
Shackman, Jan. The Right to Be Understood, A handbook on working with, empoying and training
community interpreters. Cambridge, UK; National Extension College.
Slide 4
Building Bridges
Interpreters build a bridge over the language
gap that allows people who do not speak
the same language to communicate with
each other.
The interpreter therefore must be prepared
to adjust his/her role depending on the
need of the patient and provider.
Slide 5
Purpose of the Interpreter
The basic purpose of the interpreter is to
facilitate understanding in communication
between people who are speaking different
languages.
Communication is the interpreter’s main
function, and anything an interpreter does
should relate to that.
Slide 6
Barriers to Communication
Four types of communication
barriers:
 LINGUISTIC BARRIERS
 BARRIERS OF REGISTER
AND EXPERIENCE WITH
U.S. CONCEPTS AND
PROCEDURES
 CULTURAL BARRIERS
 SYSTEMIC BARRIERS
Slide 7
Roles of an Interpreter
To overcome these barriers an interpreter develops
skills and takes on four principle roles:
 Conduit
 Clarifier
 Cultural Broker
 Advocate
Slide 8
Which role to choose?
Interpreters flow from role to role
Advocate
Cultural Broker
Clarifier
Conduit
Slide 9
Three relationships are established:
• Provider - Client
• Interpreter - Client
• Provider – Community Ambassador
Which is more important?
The only reason the interpreter is involved is to
support the “provider - client” relationship.
Slide 10
Interpreter vs Translator????
What’s the difference?
• An interpreter is one who hears
information from one language and
converts it orally into another language.
• A translator is one who takes written
information from one language (source
language) and writes it into another
language (target language).
• We will be dealing with the modes for an
INTERPRETER not a translator.
Slide 11
The Interpreter Code of Ethics
Interpreter Code of Ethics
• What are Codes of Ethics?
• Why do we need them?
• How do we use them?
Slide 13
Code of Ethics
 The skills of a community
ambassador requires cultural
competence, respect,
mastery of colloquial
terminology which makes it
possible for the trust and
accurate communication to
take place.
 A Code of Ethics sets trained
and untrained interpreters
apart.
 Provide guidelines and rules
for interpreters to abide by.
Slide 14
Modes of Interpreting
Modes of Interpreting
• Interpreters use different modes of interpreting
under different circumstances. The four modes
used include:
• CONSECUTIVE INTERPRETING
• SIMULTANEOUS INTERPRETING
• SUMMARIZATION
• SIGHT TRANSLATION
Slide 16
SIMULTANEOUS INTERPRETING
 The interpreter interprets at the
same time that the speaker is
speaking, just a few words
behind.
 This technique is useful when
an interpreter is interpreting for
a single person in a large
group.
 It is also useful when patients
launch into an emotional
speech that cannot be
interrupted or in times of
emergency.
Slide 17
CONSECUTIVE INTERPRETING
• This is the most common mode used by
interpreters.
• It involves a relay, in which one speaker says a
few sentences, the interpreter interprets, the
other speaker responds, the interpreter
interprets, etc.
• It closely resembles the way people talk to each
other.
Slide 18
SIGHT TRANSLATION
 This involves taking a
document written in one
language and reading it
aloud in another language.
 This is also common when
interpreting consent forms,
patient education materials,
instructions or anything that
is written.
Slide 19
SUMMARIZATION
• When one person speaks at length and the interpreter
summarizes the important points at the end.
• Summarization is not recommended in medical
settings because of the potential for errors and
omissions.
• If the interpreter is going to summarize, he/she should
take careful notes while the person is speaking.
Slide 20
Being a Conduit
Being a Conduit
• The most basic role of the interpreter is that of the
Conduit, whose rule is to:
Interpret everything that is said, exactly as it is
said: add nothing, omit nothing, change
nothing.
Slide 22
CONDUIT
• The least evasive role. Being a conduit
involves rendering in one language exactly
what has been said in another language.
• Interpret everything that is said, exactly as it is
said: add nothing, omit nothing, change
nothing.
Slide 23
How to be a good Conduit?
 Use the first person. If the patient
says “My stomach hurts.” The
interpreter says “My stomach hurts.”
 Interpreting in the first person
reinforces the primary relationships.
 Interpreting in the first person helps
the interpreter focus on repeating
exactly what is said.
 Interpreting in the first person
shortens the communication and
avoids confusion as to who is
speaking.
Slide 24
How to be a good Conduit? (continued)
• Interpret pauses, “ums”, sighs, everything or
anything that adds meaning to the communication.
• Interpreter gives an accurate interpretation not a
literal interpretation.
• Interpreter also reflects tone, inflection and volume.
Include all the information that carries meaning in the
message.
Slide 25
Being a Clarifier
CLARIFIER
The interpreter takes this role when he or she
believes it necessary to facilitate
understanding. In this role the interpreter
adjusts register, makes word pictures of
terms that have no linguistic equivalent and
checks for understanding.
Slide 27
Clarifier
“Well, your thyroid gland is overactive, causing a
hormonal imbalance in your system that
accounts for many of your symptoms. We
suspect that cancer in the thyroid is causing this
overproduction. This is a hard one to call. We’ll
have to do a radioactive uptake exam followed
by a fine needle aspiration to ascertain exactly
whether the tumor is benign or malignant.”
Slide 28
Basic Interpreter Skills
Being a Clarifier
The clarifier may have to change the form of the message significantly in order to be faithful to the
meaning of the message. This includes:
• Lowering the register: “Register” refers to the level of formal or complex language a person
chooses to use. High register speech is very formal and complex. Low register is used in
everyday speech. If the provider uses high register the interpreter could:
 use high register if he/she thinks the patient will understand
 lower the register but not change the meaning, the meaning must stay the same
 ask the provider to speak in simpler language
•
•
•
Create Word pictures: Sometimes there are no words with the same meaning.
Symbolic meaning: Symbols have meaning in only one language.
Check for comprehension: Be aware of clues that suggest that either the patient or provider is
not understanding. “The interpreter would like to ask if the patient understood.” If the patient is
really confused the interpreter should communicate this to the provider so that the provider can
explain, not the interpreter.
Slide 30
Clarifier Guideline
Interpret what is said faithfully but in such
a way that the listener can understand;
check for understanding.
Slide 31
Managing the flow of the
Interpreted Session
• In an interpreted session, the interpreter is the best
person to facilitate the flow of the communication.
• Interpreters do this by using a number of techniques:
 Introduction and pre-session (with both provider
and patient)
 use of first person
 appropriate intervening
 transparent communication
 positioning
Slide 32
Introduction and Pre-Session
The pre-session helps to set the ground rules for the interpreted session.
Example: “Buenas Tardes mi nombre es Maria, voy a servir como su interprete.
Para asegurar la mejor comunicacion le voy a pedir que hable directamente
con la enfermera, voy a interpretar todo lo que usted diga, palabra por palabra,
use frases chicas, digale lo que usted guste, todo se mantenera con
confianza.”
Example for Provider: “Hello this is Maria Servin, I will serve as your Spanish
interpreter. There are a few things to help me do a better job of interpreting.
First, please speak directly to the patient, I will interpret everything you say
exactly as you say it. If there is something you do not want the patient to hear
please do not say it. Use short sentences and pause often so I can interpret
accurately. If I need you to clarify I will ask you to do so.”
Slide 33
Sight Translation
 Oral rendering of one
language of a document
written in another
language.
 Sight Translation is a
high level skill for an
interpreter.
Slide 34
 Interpreters are asked to
sight translate any
number of documents:





scripts and protocols
consent forms
registration forms
financial aid forms
patient education
materials
 instructions, etc.
CULTURAL BROKER
In this role, the interpreter provides a necessary
cultural framework for understanding the
message being interpreted. The interpreter
takes this role when cultural differences are
leading to a misunderstanding on the part of
either provider or patient.
Slide 35
Cultural Broker
• “People who speak different languages live in different worlds, not the
same world with different labels.” Edward Sapir, Noted Linguist
• Culture is a shared set of belief systems, values, practices and
assumptions which determine how we interact with and interpret the
world.
• Culturally competent means that we must educate ourselves further
about other cultures, the role culture plays in health care and the
differences these can generate in the health care setting. WE need to
learn specific information about a community and simultaneously treat
each person as a unique individual.
• We must understand basic cultural frameworks and point out that there
are many differences between individuals who come from the same
community.
• We run the risk of stereotyping if we do not maintain this delicate
balance.
Slide 36
How to be a Cultural Broker?
The first step to intervening is to be aware that a culture-based
misunderstanding may be occurring.
Interpreter should intervene in a “transparent” way, letting the patient know
what he/she is going to do, then offer key information to provider. The goal
is to get back to interpreting as fast as possible.
Use the following steps:
Be alert to potential cultural barriers
 Tell the patient briefly what you intend to tell the provider.
 Briefly tell the provider the appropriate information. Don’t give the
impression that this is necessarily true for this particular patient,
above all avoid stereotyping.
 Let the doctor decide what to do with the information.
 Go back to interpreting.
Make sure you are: respectful, make no assumptions, not creating or
reinforcing stereotypes, get back to interpreting.
Slide 37
The Role of Advocate
The Role of the Advocate
“Washing one’s hands of the conflict between the powerful and the powerless means to
side with the powerful, not to remain neutral”
Paulo Freire
What is advocacy?
 Advocacy is the most controversial of the interpreter
roles.
 Guidelines must be established to help interpreters
know when they are advocating appropriately and
when they are invading the patient/provider
prerogative.
 Interpreter must be taught skills necessary to advocate
well so as to increase trust rather than undermine it.
Slide 39
The Role of Advocate
There are times when advocacy is not appropriate.
These include:
 when the contested decision is based on medical expertise,
and there does not appear to be a misunderstanding or
oversight
 when the patient does not want to continue
 when the patient needs a service not provided for by anybody
else
 when the request is of primary benefit to the interpreter and not
the patient
 when advocacy would involve breaking confidentiality
Slide 40
ADVOCATE
• Advocacy is any action an interpreter takes on behalf of the
patient outside the bounds of an interpreted interview.
• The advocate is concerned with quality of care in addition to
quality of communication.
• Interpreters appropriately become advocates when the
needs of the patient are not being met due to a systemic
barrier such as the complexity of the health care system or
racism.
• Advocacy most often takes the form of giving information or
connecting the patient to other clinic staff whose job it is to
resolve the patient’s problem.
Slide 41