1. How to use an Interpreter IMPROVING HEALTH OUTCOMES FOR EXPATRIATES IN AZUAY

2. Why use a medical interpreter?  Interpreters are not routinely provided at medical visits in local hospitals and clinics.  Trained medical interpreters ensure effective communication between patients and health care providers.  Effective, culturally competent communication improves health care received and patient outcomes.  Even foreign residents that are able to speak Spanish, may not possess the fluency with medical terminology needed depending on the situation.

3. Interpreters vs. Translators  An interpreter is specially trained to convert ORAL messages from one language to another  A translator is specially trained to covert WRITTEN text from one language to another  The National Code of Ethics for Healthcare Interpreters states that “interpreters strive to render the message accurately, conveying the content and spirit of the original message, taking into consideration the cultural context.” Thus, interpretation and translation are approached as “meaning for meaning” rather than “word for word.”

4. Selecting an Interpreter  Review the education and experience of the interpreter  Contact references  Assess fluency in English and Spanish  Be aware of communication style of the interpreter  Try to use the interpreter for multiple appointments so a working relationship can be established  Establish a confidentiality agreement

5. Before the Appointment  Prepare the interpreter regarding tests, procedures, treatments, and goals relevant to your care  Educate the interpreter about not adding any wording that is not said  Review that the interpreter may have to educate providers about not speaking too fast, allowing breaks for interpretation, and communicating directly to the patient as if the interpreter was not present  Remind the interpreter to have paper available to take notes  Remind the interpreter to interpret everything into first person (to avoid “he said”, “she said”)  Encourage the interpreter to ask questions and alert you to possible cultural misunderstandings

6. During the Appointment  Talk directly to the person, not to the interpreter  Speak at and even pace, slowly, and in short segments  Make sure you are not talking too fast  Allow time for interpretation  Understand that feelings, emotions, and attitudes may not have the same meaning when translated  Ask for clarification when needed and restate what was communicated in order to ensure full understanding  Make sure the provider is giving you a sufficient explanation, not speaking Spanish is not a reflection of intelligence or education  Ask for written materials and information

7. After the Appointment  Review how things went in appointment  Discuss difficulties in process

8. References: American Speech-Language-Hearing Association. (2015). Tips for working with interpreters. Retrieved from http://www.asha.org National Council on Interpreting in Healthcare. (2004). Code of Ethics for Healthcare Interpreters. Retrieved from http://www.ncihc.org National Council on Interpreting in Health Care. (2011). Interpreters vs. translators. Retrieved from http://www.refugeehealthta.org