Interpreter Training and Education
Training and education in interpreting are what distinguish a bilingual individual from a skilled health care interpreter. Bilingual language skills serve as a foundation. Currently, interpreters in health care settings come from a variety of language backgrounds such as being a heritage (native) speaker or learning in school. The majority of people serving as interpreters in hospitals have not had their language skills evaluated, have not been trained in basic interpreting skills or ethics, and are not familiar with medical content and medical terminology critical to interpreting in clinical encounters. Some may have skills that are adequate for an administrative encounter such as registration, where conversational language skills will suffice. However, untrained interpreters not formally introduced to the legal and ethical issues involved in health care interpreting are not appropriate for use in patient-provider interactions.
Many health care providers and other organizations are now recognizing the dangers and costs of untrained interpreters, and as a result, a variety of approaches to training and testing have been developed. Less well understood is the importance of assessing the degree of difficulty of different types of encounters and the content knowledge that may be needed to effectively interpret what a given health provider is saying. Assessing the required language proficiency, content knowledge, and interpreting skills for different types of encounters is an effective approach to language services. On this page, we will describe several of the major considerations involved in the training of health care interpreters. Please note that training staff to work with interpreters is critical to the success of these trained interpreters. Training for staff is a topic that will be covered in the Hablamos Juntos Resource Guide.
Training in the following areas is generally considered the foundation of skilled interpreting training and education.
- Basic clinical orientation—overview of anatomy and different body systems; the way they work and some of the common illnesses, conditions and medical procedures likely to be encountered.
- Integrated interpreting skills—asking for pauses and clarification, using mnemonic devices to remember key information, attention to details and sequences, and managing communication flow.
- Interpreting role and skills—different methods of interpreting, the skills associated with capturing meaning and the practice of clarifying roles and intent throughout the process.
- Language and terminology—general language ability as well as medical terminology and the language nuances of medical care and health.
- Legal and ethical issues—the practice of discerning the risks and possibilities of trying to work cross culturally, understanding legal implications from a medical perspective and managing or resolving value conflicts that will occur.
- Cultural competence training—awareness of different world views and processes for learning and validating assumptions.
- Reading comprehension and the ability to sight translate documents like consent forms.
Health interpreter training programs may be developed within the context of a single hospital or health care system. A more cost effective strategy is to develop locally or regionally with the collaboration of multiple health care entities and educational institutions. Though internal training programs may seem more manageable and may better suit some organizations that are new to the formal provision of language services, collaborations not only draw on a larger pool of existing resources, but also are more stable and enduring. Nonetheless, internal programs to train staff who are not interpreters can be useful in meeting federal requirements to inform all staff of language services that are available and to teach staff how best to work with interpreters. Hablamos Juntos grantees have created several types of interpreter training programs, which primarily fall into three types:
Internal training programs provide abbreviated or customized training in all of the content areas described above, and may be comparable to classroom programs in terms of the number of hours required. Yet instead of resulting in a degree or certificate, internal programs result in a job, and often the trainee may begin the job before having fully completed the training. Because health systems are not in the business of training interpreters, these programs are often difficult to replicate for new hires or to sustain for continued growth and development of interpreters. Generally speaking, these programs are not designed to run long-term, but instead serve as a way of getting a critical mass of interpreters trained at start-up. Temple University Health System, an Hablamos Juntos grantee, started up an internal training program based on accepted programs like Bridging the Gap and the Kaiser Permanente curriculum. Temple’s program requires 100 basic training hours over four weeks, testing, and then 1.5 hours of weekly classroom instruction, a minimum of 1 hour of weekly field observation, and various relevant clinical training over the following 6 months.
Classroom-based training programs typically require collaboration with local educational partners. Among Hablamos Juntos grantees, classroom-based training programs have ranged from certificate programs of 12 semester credit hours to diploma programs, to associate degrees, to a full master of public health (M.P.H.) degree requiring 45 semester credit hours and a master’s thesis. Minimum requirements usually include proven ability in English and another language, as well as language and interpreting skills assessment; further requirements are more variable. For more information on collaborations between Hablamos Juntos grantees and educational organizations, please see the Community Solutions page of this site.
In rural areas where people wanting to train as interpreters may be spread out geographically, online approaches to training may prove more viable than classroom instruction. Central Nebraska AHEC, one of the Hablamos Juntos grantees, is currently in the process of finalizing a 4 DVD health care interpreter training program.
Like any skill, health care interpreting can be improved over time through experience, monitoring, and continued training. Many of our grantees have developed ongoing training opportunities for interpreters working in their systems. These training opportunities—on topics like cultural competence and medical terminology—often cover topics that are taught in initial trainings and serve as a reminder and refresher course on those topics. Continuing education may also take the form of shadowing other interpreters and learning from/critiquing their work, the use of individual improvement plans, shared learning programs in which groups of interpreters are brought together, and mentoring programs.