New Certification Tool Developed for Medical Interpreters

A visit to the doctor can produce anxiety and confusion under the best of circumstances; when doctor and patient don’t speak the same language, misunderstandings can be dangerous. In a recent article in the American Translators Association (ATA) Chronicle, EDC researcher Maria-Paz Avery and her co-author Eduardo Berinstein describe recent efforts to develop a certification tool for medical interpreters in Massachusetts.

Medical interpretation, Avery stresses, is much more than merely substituting words from one language to another. Instead, it requires creating an equivalent message in a second language that captures the meaning of the original utterance. For languages that do not share linguistic origins and/or cultural frameworks, generating equivalent messages are especially challenging. Often, there are "untranslatable words"—words that represent concepts that are alien to the other society. In such situations, medical interpreters have to help both providers and patients find appropriate metaphors that will convey the essential information underlying the concept.

EDC’s involvement in the field of medical interpretation began in 1992, when it received funding from the U.S. Department of Education, Fund for the Improvement of Secondary Education, to develop the first college-level certificate program in medical interpreting in the nation. Developed in collaboration with the Massachusetts Medical Interpreters Association (MMIA), a community college, and a hospital in the area, this project led to the creation and publication of Standards of Practice for medical interpreters. These standards have since been endorsed as the best available in the nation by the National Council on Interpretation in Health Care. They are currently used by training programs for interpreters and health care providers and by local interpreter associations as a guiding framework for the competent practice of medical interpretation. They have also been informally translated into Dutch and French.

Today, as the proportion of foreign-born Americans approaches 10% and the diversity of languages spoken in the U.S. grows—one Boston hospital provided interpreters in 24 languages last year—demand for skilled medical interpreters runs high. But as the demand increases, the complexities of assessing the competence and qualifications of interpreters in many different languages becomes a daunting task. To address this pressing need, Avery and her MMIA colleagues have used the Standards of Practice as the basis for a certification tool. This tool relies on "authentic assessment," which measures the actual skills critical to the task of medical interpretation, such as cultural knowledge and knowledge of both the technical and lay terms used to describe symptoms.

Intended for interpreters in a variety of languages, with diverse educational backgrounds, the certification tool relies primarily on oral demonstrations of skill to evaluate interpreters’ language proficiency, knowledge of health-related terms, familiarity with relevant ethical and cultural factors, and skills in interpretation. As of today, the MMIA has piloted a prototype in Spanish that will serve as the model for the development of other versions in other languages.

Avery observes, "Who would have thought that the work we started in 1992 would take a life of its own and have such a tremendous impact on the development of the field in the national and international arena? I still keep getting phone calls on a regular basis from across the country asking for copies of the Standards of Practice. People are now looking to Massachusetts as leaders in developing a certification process that is inclusive, equitable, and culturally and linguistically sensitive."