All health care providers must learn how to work efficiently with interpreters and respect patients’ values and preferences

Dear Sir,

We read with great interest the article by Marion et al. (2008), and we fully support introducing a ‘working effectively with interpreters’ curriculum to Physician Assistant Students (PAS). We would like to stress on few issues. Cultural awareness should be emphasized more and included in the standardized patient checklist during assessment. The Health Care Provider (HCP) should be able to respond to the cultural and religious preferences exhibited by patients as an essential part of the encounter. A patient's demand of being seen, or interpreted, by different gender personnel should be granted instead of trying to convince the patient otherwise. The student should be taught that all efforts should be done to accommodate the patients’ values and preferences and modify the clinical encounter accordingly.

While paraphrasing or omitting words during interpretation was not favoured, it might have been the ideal thing to deliver the right information to the patient, needless to say, who is the centre of the whole process. Exploring different languages may reveal that some words/phrases do not exist in other languages. Interpreters may use different phrases with similar meanings in the quest of delivering the information based on additional diversity among speakers of a common language. Ideally, students’ evaluation of such process should be done by a bilingual medical professional who is able to assess the pros and cons of such paraphrasing. We applaud the authors for pointing out that a difference in evaluation exists between a native and non-native bilingual interpreter.

Declaring our awareness of some draw backs, we would like to suggest training PAS to use an over-the-phone interpreter. By using this service, we may: (1) avoid side conversations between patients and interpreters, (2) the interpreter being an obstacle between the patient and HCP and (3) maintain direct interaction between patients and HCP.

This teaching model should be recommended to all health care students, especially medical students.