Using professional interpreters in undergraduate medical consultation skills teaching

Figures & data

Table 1 Skills for consulting through interpreters

Existing transferable consultation skills	Additional consultation skills
Picking up on nonverbal cues	Positioning of interpreter
Using jargon-free language	Briefing interpreter
Chunking and checking information given to patient	Checking language/dialect and literacy
Awareness of ideas, concerns, and expectations	Observing patient–interpreter interaction and keeping control of the consultation

Table 2 Feedback sheet guide for observing students in interpreted consultations

This handout is to be used alongside the Calgary–Cambridge observation guide

• The student introduced themselves to the patient

• The student explained the interpreter’s role to the patient at the beginning

• The student maintained direct eye contact with the patient

• The student addressed the patient directly in the second person: eg, “How are you Mrs Ali?” and not “How is Mrs Ali?” through the interpreter

• The student asked the patient one question at a time

• The student presented information at a pace that was easy to follow for both patient and interpreter, that is, information was given in “digestible chunks”

• The student listened to the patient without unnecessary interruption

• The student asked questions to clarify his/her understanding of the patient’s answers

• The student acknowledged and responded to the patient’s beliefs, concerns, and expectations

• The student appropriately closed the encounter, giving the patient a chance to ask questions

• The student kept the interpreter on track with his/her assigned role

Figure 1 Student self-rated change in confidence in consulting through interpreters before and after the teaching session.

Table 3 Student free-text themes on factors influencing change in confidence

Applicable to future clinical practice	Really useful experience. Will definitely come in handy in the future.
Improved understanding and skills	The session made me think about the dynamics of a three-way consultation. Good tips. Great session. Discussion of pitfalls to avoid. Aware of practical issues: Patient/Dr positioning, eye contact, and sentence structure.
Value of professional interpreters	Great opportunity to talk to interpreters about their good/bad experiences in practice.
Experiential learning environment	To be able to practice in a fake situation was really helpful as I am now much less intimidated by doing it in a real situation. Constructive feedback was provided for every scenario, highlighting good areas and suggesting improvements. Good to have a practise in a safe small-group environment.
Quality of scenarios	Scenarios very realistic and prepare you for real-life consultations. All of the major common issues/problems have been brought up and addressed during the scenarios.

Table

Not at all confident	Not very confident	Somewhat confident	Quite confident	Very confident
1	2	3	4	5

Table

	Not at all useful	Not very useful	Quite useful	Very useful
Accuracy
Friendliness
Neutrality
Confidentiality
Known to the patient
Professional training

Table

	Not at all useful	Not very useful	Quite useful	Very useful
Positioning of patient and interpreter
Using simple jargon-free language
Speaking loudly
Using a phrase book
Largely maintaining eye contact with the patient
Largely maintaining eye contact with the interpreter
Addressing the patient directly
Using one sentence at a time
Awareness of cultural influences on the consultation

Table

Not at all confident	Not very confident	Somewhat confident	Quite confident	Very confident
1	2	3	4	5

Table

	Not at all useful	Not very useful	Quite useful	Very useful
Accuracy	0% (0)	0% (0)	11% (26)	89% (217)
Friendliness	0% (1)	15% (36)	57% (139)	28% (67)
Neutrality	0% (0)	0%(0)	21% (50)	79% (193)
Confidentiality	0% (0)	0% (1)	2% (4)	98% (238)
Known to the patient	35% (86)	49% (118)	14% (33)	2% (6)
Professional training	1% (3)	6% (15)	44% (106)	49% (119)

Table

	Not at all useful	Not very useful	Quite useful	Very useful
Positioning of patient and interpreter	0% (0)	3% (7)	65% (158)	32% (78)
Using simple jargon-free language	0% (0)	0% (0)	20% (48)	80% (195)
Speaking loudly	19% (46)	49% (120)	26% (63)	6% (14)
Using a phrase book	26% (62)	62% (149)	11% (26)	1% (3)
Largely maintaining eye contact with the patient	0% (0)	1% (2)	25% (61)	74% (180)
Largely maintaining eye contact with the interpreter	27% (66)	55% (133)	16% (39)	2% (5)
Addressing the patient directly	0% (0)	0% (1)	19% (45)	81% (197)
Using one sentence at a time	0% (0)	3% (7)	36% (88)	61% (148)
Awareness of cultural influences on the consultation	0% (0)	3% (7)	42% (101)	55% (135)