Working with interpreters: how student behavior affects quality of patient interaction when using interpreters

Figures & data

Fig. 1.  Summary of guidelines proposed by Wiener and Rivera 17.

Table 1. Combined SI and SP ‘Working with Interpreters’ OSCE checklist

Overall satisfaction
	6	5	4	3	2	1
1. How satisfied was the interpreter with how the student involved you in the encounter?
2. How satisfied was the patient with how the student involved the Interpreter in the encounter?
History (Hx)
The student:					Yes	No
Standardized interpreter perspective
3. Ascertained the interpreter's background/experience/relationship to the patient (at least one)
4. Discussed with the interpreter how she/he would like the interpreter to participate in the encounter (exact translation of questions and answers, no paraphrasing, no extraneous conversation, etc.)
5. Rearranged the chairs to facilitate the interview (ideally, interpreter sitting next to interviewer or behind interviewer's shoulder, so patient can look at both simultaneously)
6. Gave the interpreter time to speak (did not try to rush the interpreter, did not interrupt or overlap, i.e., did not attempt or expect simultaneous translation)
7. Corrected the interpreter/refocused the interview in an appropriate manner
Standardized patient perspective
8. Posed questions to the patient rather than to the interpreter (i.e., ‘did you…’ rather than ‘ask him/her if…’)
9. Focused on/maintained eye contact with the patient rather than the interpreter
10. Spoke in a voice of normal volume
11. Ascertained the patient's understanding of what was discussed and/or asked the patient if she/he had any questions
12. Discussed confidentiality
13. Asked what the patient thought might be going on OR what she/he thought might be causing the problem OR what she/he is most concerned about or afraid of
14. Asked how the patient has been coping with the problem and/or how it has affected his/her day-to-day activities
Patient/physician interaction (PPI)
The student:	6	5	4	3	2	1
Standardized interpreter perspective
15. Was respectful of the interpreter's efforts regardless of his/her ability/inability
Standardized patient perspective
16. Made the patient feel supported and taken care of
17. Used open-ended questions
18. Was respectful/not condescending over the patient's lack of English language skills
Standardized interpreter and patient perspective
19. Explained things in a manner that could be understood

Note: 1 = Unacceptable, 2 = Marginal, 3 = Needs improvement, 4 = Good, 5 = Very good, 6 = Outstanding.

Table 2. History items within subcategories of ‘Working with Interpreters’ checklist

Subcategory	Item nos.
Setting the stage	3, 4, 5, 12
Management	6, 7, 8, 9, 10
Patient-centeredness	11, 13, 14

Wiener ES, Rivera MI. Bridging language barriers: how to work with an interpreter. Clin Pediatr Emerg Med. 2004; 5: 93–101.

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