Interpreter Accuracy and Informed Consent Among Spanish-speaking Families with Cancer

ABSTRACT

Language interpreters mediate a growing number of health care communication events, including the informed consent process, which underlies the ethical conduct of clinical research. This article explores a key interpretive outcome, accuracy, in 21 Spanish/English informed consent consultations. Discussions were transcribed, translated, and coded according to established techniques. Most (74%) discussion was accurately interpreted (range: 47%–98%; std. deviation: .137). Accuracy was lower in the more technical portions of the discussion when compared with nontechnical portions such as discussion of coping and quality-of-life issues (p = .024). The concept of “randomization” often was poorly communicated and interpreted. These differences may be due in part to the use of long, uninterrupted, and jargon-filled sentences by clinicians explaining research, among other factors. The article concludes that accuracy may be promoted if clinicians used less technical language and shorter sentences, and are more “process driven.” Interpreters may need to be better informed about research-related concepts such as randomization. Further research is needed to determine the effects of interpretive accuracy on the informed consent process, the decision to participate in research, and other outcomes.

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Acknowledgments

This research was support by an RO3 grant from the National Cancer Institute of the National Institutes of Health (CA 099453). We thank the participating research sites, clinicians, interpreters, and families for their cooperation over the course of this study and the parent study, the Project on Informed Consent. The hard work and support of Dr. Anne Angiolillo and Dr. Kathy Ruccione and their research staff are gratefully acknowledged. Nori Maldonado, Elizabeth Sharp, Fatoumata Traore, and Dr. Michelle Eder all provided excellent support and input. The names of the participating medical institutions have been omitted to help protect the identity of the interpreters, clinicians, and families who participated in this study.