1. ON THE SAME PAGE Holding All Medical Interpreters to the Same Standards Marjory Bancroft, MA

2. THE IDEAL WORLD Staff interpreters, contract interpreters, bilingual staff who interpret (dual role) and volunteers are ALL: 1.Screen and assessed. 2.Tested for language proficiency 3.Professionally trained in medical interpreting. 4.Tested for interpreting skills and medical terminology. 5.Certified…

3. THE REALITY…

5. FORMER “STANDARD” PROCEDURE DOES ANYONE OUT THERE SPEAK SPANISH!!!!!

6. On the Bright Side! Ten Years Ago Outside MA, WA and CA, there was almost no awareness of medical interpreting standards. Family, friends and children were the primary interpreters. National certification was a distant dream. Today Many health care organizations: -Have staff interpreters -Contract w/telephone/VMI interpreters -Train some bilingual staff to interpret -Have interpreter policies, procedures and services -Use certified ASL interpreters

7. But What Do Standards MEAN? Are we talking about… Standards for medical interpreting (as a profession—i.e., standards of practice) Standards for training of interpreters Standards for language proficiency testing Standards for testing of interpreters (skills, terminology) Standards for interpreter services Standards for accreditation Confusion reigns.

8. Standards for Medical Interpreting National standards: USA (NCIHC), Canada (HIN), Australia (NATI:general interpreting, not medical) U.S. Government standards: Federal standards (ILR interpreting standards); a few states have legislation on medical interpreting or cultural competence Industry and business standards: ASTM and individual interpreter services (small/large, for-profit/nonprofit) Regional standards: MMIA (IMIA), CHIA (impact of both extends far beyond the two states) State and local standards: some local interpreting associations, interpreting state/regional networks, ATA chapters

9. Standards for Training of Healthcare Interpreters… NONE

10. Oops. Let’s Try Again… NCIHC has launched a project to establish national standards for training of healthcare interpreters IMIA has commissioned a guide on interpreter education More community colleges and four-year programs are addressing medical interpreting, though currently national standards for the education of interpreters appear to exist only for ASL (through the Conference of Interpreter Trainers)

11. De facto standards in the field (NOT universal) –40 hours minimum training (IMIA recommendation) –Training should include focus on ethics/standards, modes, skills, interpreter roles, intervention/mediation skills –Skills-based vs terminology-based programs –Many hospitals, health departments, etc sending bilingual employees to be trained; interpreter services also and contract interpreters doing so on their own –Many more agencies are requiring that contract interpreters show proof of professional training

12. Standards for Language Proficiency Testing Two national scales exist: ILR and ACTFL ILR (Interagency Language Roundtable), the federal government scale, is used to assess language skills in any federal agency ACTFL (American Council on Teaching of Foreign Languages) is widely used elsewhere Validated tests exist that use these two scales have existed for decades Most language proficiency tests still do not test to these national scales and ARE NOT VALIDATED

13. A Sad Reality Most language and interpreter skills tests used for medical interpreters are “homegrown” They are not based on recognized language or interpreting standards They are not validated tests They were not developed by testing experts (psychometricians) Experts suggest they should not be used Using them as a basis for hiring, promoting or using interpreters raises legal questions of discrimination, liability, risk management

14. Examples of Validated Tests (Not an Endorsement!) Language Proficiency Testing LTI: Language Testing International (ACTFL) LLU: Language Line University Medical Interpreter Skills Testing Fluency, Inc, MITI (Medical Interpreter Test on the Internet) LLU medical interpreter skills testing University of AZ, MICE (Medical Interpreter Competency Examination)

15. Standards for Interpreter Services No national standards except for ASTM (American Standards for Testing and Materials) currently exist Reality is a hodge-podge Some interpreter services, esp. in hospitals, are keenly aware of NCIHC, IMIA, CHIA standards etc, while others seem unaware that standards exist ALC (Association of Language Companies) is raising awareness

16. THE FUTURE BECKONS The good news…. Standards are raised each and every time a health care organization uses a screened, trained, tested professional interpreter. To get everyone on the same page means holding anyone who interprets in health care to THE SAME STANDARDS.

17. One Final Plea Much energy is spent exhorting health care agencies to use contract or staff interpreters. The simple fact: bilingual staff and volunteers will continue to be used. The solution: develop specialized training for every type of medical interpreter and hold all to the same standards. One page for all: and all on the same page. Support national standards for training and certification!

18. Questions? Marjory Bancroft, MA, Director Cross-Cultural Communications, LLC 4725 Dorsey Hall Drive, A-610 Ellicott City, MD 21042 410-750-0365 (voice) 410-750-0332 (fax) URL: www.cultureandlanguage.net Email: mbancroft@cultureandlanguage.net