Effective interpreter use
Baker et al (1996) showed that, without the use of an interpreter in medical contexts, patients reported nearly 30% poorer understanding of their condition and treatment. We know that understanding of these aspects has an incredibly strong influence on outcome of an injury. Therefore, adequate and efficient use of interpreters is vital to ensuring the successful recovery of a Culturally and Linguistically Diverse (CALD) patient.
Assessing how well a person can understand and communicate in English is the first step in identifying the need for an interpreter. Engaging an interpreter is recommended when the client:
- requests it
- speaks English as a second language and is in a stressful, complex or unfamiliar situation
- is difficult to understand
- responds only in a limited way
- relies on family or friends to interpret
- wishes to communicate in his or her preferred language
- cannot grasp or respond to questions in English.
Remember, an interpreter serves not only the client. An interpreter can be requested if needed. To determine a client’s level of English language proficiency, ask open-ended questions that require more than a ‘yes’ or ‘no’ answer, such as, “Why are you here today?”
A client’s language cannot be determined reliably from their country of birth as many countries have multiple languages and dialects. Furthermore, a person such as an asylum seeker may not have spent much time in their country of birth.
If unknown, a client’s language can be determined by:
- asking the client or person accompanying them (such as a family member, friend or support worker)
- using a visual aid that lists languages, although be aware that this method assumes the client can read their own language (and note that some languages do not exist in written form)
- contacting an interpreter agency, which may be able to assist you by engaging telephone interpreters.
How you offer a client an interpreter will affect the response you get.
Poor: “You (or the client) won’t need an interpreter, will you?”
Asking the question this way discourages the client, or the person who is making the appointment, from asking for the language assistance that he or she may need
Better: “Will an interpreter be needed? In what language?”
This question may generate information on the need for an interpreter. On the other hand, many clients may reply ‘no’, believing that they have to either bring their own interpreter or a family member
Basic: “What language do you (or the client) speak at home?”
This question will give you information about the client’s home language, but ignores the possibility that the client may be bilingual in English as well.
Best: “In what language do you (or the person for whom you are making the appointment) prefer we offer our service?”
Asking the question this way will provide you information on the language the client feels he or she needs to speak in a health or other service related conversation.
If a client refuses the offer of an interpreter, it is important to clarify and address the reasons. Below are some reasons for refusing an interpreter and some possible remedial actions.
- Unaware they exist
- Preference for family or friends
- Pride or embarrassment
- Don’t want to be understood
- Confidentiality or privacy
- Brief the interpreter by providing general background information, such as the reason for the session, specific terms to be used and what needs to be achieved.
- Consider incorporating a break for long sessions.
- As with all interpreting, it is important to be patient and allow time for communication due to the delay between a message being spoken or signed and the interpretation.
Ensure the room is set up appropriately. Consideration should be given to appropriate lighting, avoiding glare from windows, and seating arrangements. Ideally, seats will be arranged in a triangle with the service provider facing the client and the interpreter next to the client. Avoid leaving the interpreter alone with the client, either in the room where the interview will take place or a waiting room.
Telephone and Video Remote
Ensure you have access to the appropriate technology and understand how to work the telephone/IT system. Telephone interpreting is more effective when a landline is used rather than a mobile phone. It is also recommended that a telephone with a speakerphone (or two handsets) be used where possible.
At the start of the interview:
- Introduce yourself and the interpreter to the client
- Explain the interpreter’s role, noting that the interpreter’s role is not to add to the communication, but only to interpret what is being said
- Explain the purpose of the session and what you hope to achieve
- Do not assume that the client knows what the interview is about. Explain to the client that questions or concerns can be raised at any time during the interview.
During the interview:
- Talk directly to the client, not the interpreter, and maintain eye contact with the client
- Use the first person when speaking to your client. For example, say ‘What time did you arrive today?’ instead of ‘What time did she arrive today?’
- Use clear language and avoid using slang, jargon, acronyms, colloquialisms and metaphors.
- Make one point at a time. Pause until the end of a full sentence. Keep questions, statements and comments short. This allows the interpreter to understand and remember what is being said and to interpret in stages
- Allow the interpreter to clarify information with you. If there is a need to clarify, ask the interpreter to explain this to the client first
- Allow the client to ask questions or raise issues at any time in the interview
- If you have any questions about the client’s cultural background, ask the client directly and not the interpreter
- Summarise the discussion occasionally to ensure the client understands the information do not ask the interpreter to edit your information to suit the client’s background.
At the end of the interview:
- Summarise key points for the client
- Check that the client understands any information you have conveyed and if there are any final questions
- Allow the interpreter to leave separately to the client.
- Debrief the interpreter and discuss any issues experienced in the interview related to the role of the interviewer or the interpreter
- Do not ask for or allow the interpreter to express an opinion about the client or what they have said.