Standardized Interpreting Protocols PDF
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This document outlines standardized interpreting protocols for hypothetical healthcare encounters. It discusses various aspects like preamble, positioning, direct speech, and managing the flow essential for effective communication during a session. It emphasizes the importance of unobtrusive presence and factors to consider while selecting a position. It also highlights the importance of direct communication and avoiding unnecessary attention.
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SMIP I F24 Standardized Interpreting Protocols Learning objectives learn the four standardized interpreting protocols Begin to apply your knowledge of protocols to hypo...
SMIP I F24 Standardized Interpreting Protocols Learning objectives learn the four standardized interpreting protocols Begin to apply your knowledge of protocols to hypothetical healthcare encounters What is a protocol? A protocol is a detailed description showing how something is to be done. A protocol is more specific than an ethical principle. Ethical principles describe a “big idea” that interpreters adhere to - the protocol shows what this ideal looks like in practice through a series of specific steps. Protocols are what interpreters follow in their day-to-day work, which helps them adhere to the ethical principles. Four Interpreting Protocols 1. Preamble (professional introduction) 2. Positioning 3. Direct Speech 4. Managing the encounter (managing the flow) 1. Preamble A preamble is a short professional introduction which helps us to set expectations and guidelines for the encounter. See the Preamble handout for more information. 1 SMIP I F24 2. Positioning Our goal during the session is to promote direct communication between the provider and the LEP. We want the parties to form a strong patient / provider relationship and communicate well with each other, therefore we do not want to be the center of attention, we want to be in the background. Ideally, the other parties should forget that we are even there! After your preamble, you should try to find an unobtrusive position that promotes direct communication. An exception to this is for sign language interpreters, as they need to maintain a sightline between themself and the Deaf/Hard-of-hearing individual. Factors to consider when selecting your position: you should be unobtrusive (in the background) you need to be able to hear the patient and provider the patient and provider need to be able to hear you you must not be in the provider’s way if they are moving around the room Other factors that may influence your decision: What is the nature of the session? How many speakers are in the room? How big is the exam room? What is the emotional state of the patient? Could they be violent? Does the patient have a contagious disease? Is it a potential COVID patient? Should the interpreter sit or stand? There is no one specific “correct” position, each situation and encounter is different. With experience you will learn which positioning most favors direct communication. 2 SMIP I F24 There are four positions to consider: Position # 1 – a position away from everyone Position # 2 – the triangle position Position # 3 – near the provider Position # 4 – next to, but slightly behind, the patient Sketch out these four positions from an aerial point of view: 1 2 3 4 3 SMIP I F24 Always try to keep health, safety and privacy in mind when you decide where to stand or sit. All of these things may impact your decision: patients who may act erratically (mental health crisis, substance use) patients with contagious diseases patients that have to disrobe medical equipment in the room diagnostic tests being carried out very small exam rooms a lot of external noise Your position during the session can be fluid, as you move to adapt to the circumstances or to improve patient-provider communication. If you feel that the position that you decided on did NOT promote direct communication, use your judgment and be ready and quick on your feet to change during the session, OR try a different position the next time you have a similar type of session. If the position is truly not working (for example, it’s very hard for you to hear the patient, and you have to keep asking for repetitions), then you absolutely should choose another position if possible. What can go wrong with positioning? Even though there is no one correct or perfect position for every single session, the position that you decide on does make a difference and can impact the dynamics of the session. An inadvisable position in the wrong situation can end up with you being the center of attention and it can lead to everyone speaking to you, instead of speaking to each other. So as to offer the patient privacy, during certain sessions you may end up having to interpret from behind a curtain for part of the session, or the entire time. If the room has no curtain, you may find yourself with your back to the patient, looking at the wall. 4 SMIP I F24 In summary: As soon as you enter the room, try to find a position where you: are unobtrusive can promote direct communication can maintain your own physical safety and the patient’s visual privacy be ready to quickly change your position if needed Eye contact / positioning of the interpreter’s gaze It is generally recommended not to make eye contact with the service users while they are speaking. If the service users are making eye contact with the interpreter, that means they are not speaking directly to each other. It can also make the interpreter feel like they are watching a tennis match. You might struggle with not making eye contact - it might feel awkward to you, since it’s so different from what we normally do when conversing with someone. You can look at your notepad as a way to “escape” eye contact. Try not to look at the floor, though. You can watch for people’s facial expressions, body language, etc. from your peripheral vision. You can demonstrate active listening by turning your ear toward the speaker and nodding your head as you listen & take notes. When you are doing an intervention (like asking for clarification) you should make eye contact! This helps to show the difference between speaking as yourself, and interpreting for the service users. 5 SMIP I F24 Remember that eye contact and smiling is encouraged when you do your preamble with each party. That is a good chance to make a connection and help each service user feel comfortable with your presence. Conclusion: if the interpreter went largely unnoticed, the positioning was effective in meeting the objective of direct communication! 6 SMIP I F24 3. Direct Speech Most specializations of interpreting use direct speech when interpreting. Another term for direct speech is speaking in the “first person”. For example, if someone says “I have a pain in my side”, you repeat those words in the other language. You do not say “He says he has a pain in his side” or “He has a pain in his side.” These would be indirect speech (the third person). Why do we use direct speech? Direct speech - uses the 1st person Indirect speech - uses the 3rd person ➔ focuses more on the message ➔ makes communication less direct ➔ takes the interpreter “out of the ➔ focus is on the interpreter picture” ➔ adds words to indicate who the ➔ promotes direct communication speaker is ➔ more accurate - says EXACTLY what ➔ takes longer to interpret (more words) the speaker says ➔ is harder to interpret (more ➔ simpler sentence structures complicated grammar) ➔ faster and easier to interpret! ➔ more complicated for the listener to ➔ reduces risk of errors understand - can lead to confusing messages ➔ increased risk for error (adding words, editing message) 7 SMIP I F24 Exceptions to the direct speech protocol There are certain situations where we might need to use indirect speech to interpret, for example: ➔ elderly patients that are confused by the use of direct speech (for example dementia) ➔ with young children ➔ in an emergency situation ➔ when you are interpreting for several people or family members at the same time ➔ for certain indigenous languages, as direct speech is not understood If you interpret in the third person for the patient, remember to use the first person (direct speech) with the other parties in the session, for example the provider. 8 SMIP I F24 4. Managing the Flow You have to manage the flow and take control of the situation when you are unable to interpret accurately. For example: ➔ more than one person speaking at once ➔ the person speaking is speaking too fast ➔ the person speaking is speaking for too long, without pausing to allow you to interpret ➔ your note-taking skills are not strong enough to keep up ➔ the person speaking is not speaking loudly or clearly enough (for example covering their lips with their hand or mumbling) The patient and provider may NOT remember to allow you time to interpret, or to pause often. Do you think you can interrupt an authority figure? Don’t be afraid to do this! Remember to be concise and polite. Managing the flow is all about making sure that you are able to interpret accurately and reminding everyone to pause to allow you to interpret. How to interrupt to manage the flow / the encounter? There is no universal signal, and each interpreter may have a signal preference and a different way that they manage the flow. You can use the gesture that you showed the parties in your preamble. Here are some other ideas: ➔ raise your hand in a gentle slicing motion ➔ raise your palm ➔ raise your hand and make a “time-out” / T shape ➔ just lean forward and make eye contact ➔ alternatively, when the speaker pauses to breathe, jump in and interpret, this may be enough for them to realize that they have forgotten to pause for you 9 SMIP I F24 If despite making your signal the person speaking does not pause, try the last suggestion above, and you can also make a statement to remind everyone that you need them to pause, for example: “the interpreter would like to remind everyone to pause frequently to allow them to interpret accurately”. Remember that we use the third person or clearly indicate that it is the interpreter speaking, when speaking our own words. Alternatives to the third person when intervening: Excuse me, as the interpreter, could I ask you to…. Excuse me, interpreter speaking, could I ask you to…. The rule is to identify that it is the interpreter speaking. For managing other issues during the encounter, have a brief and clear script to say, for example: “The interpreter can only interpret for one person at a time.” “The interpreter requests that you speak louder / slower / more clearly.” Let’s review: ➔ our preamble is to let the parties know who you are, what you do and how you will do it ➔ our positioning should facilitate direct communication o avoid eye contact while interpreting to promote direct communication ➔ use direct speech (first person) (except in exceptional circumstances) ➔ to ensure accuracy, use a gesture or a verbal reminder to manage the flow of the session when needed 10