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VOL. 129 | NO. 52 | Monday, March 17, 2014

Interpreting Health

U of M program reaches lofty status with accreditation

By Don Wade

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Probably, you’ve seen this scene on a television show or in a movie. Some English-speaking authority figure – say, a doctor – can’t communicate with a middle-aged or older person from Mexico.

Espi Ralson, left, an instructor in the University of Memphis’ Health Care Interpreter Program, and Dr. Marian Levy, associate professor and assistant dean of students and public health practice at the university.

(Daily News/Andrew J. Breig)

So the doctor turns to the child or grandchild raised in the United States and who is bilingual. The child may not even be out of elementary school yet, but suddenly he or she is thrust into the position of medical interpreter.

“That has happened,” said Dr. Marian Levy, associate professor and assistant dean of students and public health practice at the University of Memphis. “There’s a problem with children having to tell a parent they have a dire illness. Ethically, it’s really not a good situation.”

Recently, the Health Care Interpreter Program in the School of Public Health at the University of Memphis became the first such program in the country to receive accreditation from the International Association of Medical Interpreters, the only international body that accredits medical interpreter educational programs.

For Levy and Espi Ralston, who is the only instructor the U of M program has had, it was an achievement a long time coming. The two women began working on providing medical interpreters for the Memphis area’s Latino community more than a decade ago. At that time, Levy said, there were an estimated 100,000 Spanish-speaking people in Shelby County who could potentially have need for a medical interpreter.

Since 2007, the U of M’s program has provided training for around 150 interpreters. It was established as part of a Robert Wood Johnson Foundation (RWJF) initiative (Hablamos Juntos). RWJF provided about $10 million for 10 national demonstration sites, one of which was The Regional Medical Center at Memphis. The university then received a small “sub-contract,” Levy said, to start its program.

From 2002 to 2006 the Regional Medical Center increased its number of medical interpreters as part of the RWJF project. According to a RWJF report, this reduced complication rates among Spanish-speaking obstetric patients from 33 percent to just more than 5 percent during the course of the project.

Today, hospitals and medical centers in the area employ full-time medical interpreters that in many cases received their training through the U of M’s program, which is administered in collaboration with the Interpreter Program of St. Jude Children’s Research Hospital and Methodist Health Systems. The curriculum was developed by Kaiser Permanente, which is where Ralston received her training as an instructor.

Much goes into the training, as medical interpreters not only need to have a strong grasp of anatomy and medical terminology, Ralston says, but be effective “cultural brokers,” understand ethics and confidentiality, and have an innate sense for when information is not being fully understood by either the patient or the medical professional.

“We stress the importance of being culturally competent,” Ralston said. “We are facilitators for two people of different languages and backgrounds. When we notice misunderstanding, we say, `the interpreter would like to intervene for clarification.’ But we try to be invisible.”

Yet, the interpreter’s very presence can change a patient’s attitude and mindset from the beginning.

“The interpreter puts the patient at ease,” Levy said. “There is a lot of intimidation in a medical setting.”

This is especially true for patients who may not even count Spanish as their first language, such as people who have come from a small village in Guatemala or Nicaragua.

“Sometimes we have to contact an interpreter in that dialect or language by phone,” Ralston said.

Interpreting by phone is not ideal, but years ago that was yet another common practice with Spanish-speaking patients before hospitals employed interpreters. In those situations, the nearest able-to-speak-some Spanish or nearest able-to-speak-some-English person became the default medical interpreter.

Having trained medical interpreters increases safety and accuracy of communication and makes the process more efficient. Which is why upon completion of the training program at U of M, students have to pass an oral exam that proves they are ready for real-world settings.

“We can’t slow down the time doctors have to see patients to look up something in our dictionary,” Ralston said.

The Health Care Interpreter Program offering at the University of Memphis is geared toward bilingual individuals and the next session will run from May 3 through May 18, with classes being held over three weekends in Robison Hall. Tuition is $760; some employers may pay some or all of the tuition.

There will be a pre-requisite oral proficiency evaluation; this is neither an English language nor Spanish language class.

A minimum of 10 students is required for the course to be offered. For more information, visit http://www.memphis.edu/sph/mph/interpreter.php. Or contact Espi Ralston: espiralston@gmail.com or at 218-4691.

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