In Through the Looking Glass: The Discord Between Practice and Education

Introduction

The role of the interpreter in healthcare settings has been in a constant state of evolution from the moment of its ad-hoc advent to current day. The establishment of designated titles (healthcare interpreter, medical interpreter, etc.), ensuing standards of practice and certification programs existing in some countries have not prevented this ongoing transformation. This is not to say that the role is lacking robust qualifications, clearly defined duties or expected performance outcomes, instead that continual states of ambiguity and redefinitions of practice and purpose have resulted in a distorted mirror image of the original, and where the role is experienced “through the looking glass.” Interpreters who work in healthcare settings regularly face challenges, often unanticipated, that cause a dissonance between role definition and situational pull that brings into question the presentation of their role. Traditional interpreter education programs designed for the conference interpreter in mind, and a linear conduit model of message transmission, require assessment and transformation if they are to equip the interpreter to work in healthcare settings. For example, the demand for collaborative intermediation or the need for intervention is a common occurrence in healthcare settings (Angelelli, 2004b, Bischoff, Kurth, & Henley, 2012, Leanz, 2005, Katan, 2012). All interpreter-mediated settings have their dynamics and challenges. Intercultural and interpersonal communication are amplified in medical settings, as a result of factors that influence the encounter and that are not often found in other interpreter-involved settings, or at least not found to the same level of intensity. The context of healthcare interpreting may quickly transform what interpreters were taught in class to little more than guidelines for best-case scenarios. These ambiguous spaces, while the concern of ongoing research, also leave the role open to subjective revisionism, facilitating a definition or redefinition of the function of the interpreter’s role to a host of characters.

While advances have taken place in recent years with five certification schemas worldwide, and an upcoming ISO standard on Interpreting in Healthcare Settings (ISO TC37/SC5), along with several other standards of practice that touch upon specialized settings, there is still a very large chasm between these significant improvements and educational programs for interpreters, where the focus is still primarily on teaching the most basic interpreting skills and terminology, and have not expanded to other core competencies (Tryuk, 2015, Albl-Mikasa, Glatz, Hofer, & Sleptsova, 2015). Moreover, the fundamental conceptualization of the healthcare interpreter still models that of language conduit engaged in the act of linear message transmission. This is evidenced by the current interpreter education courses that “tend to be structured around modes of interpreting (consecutive – only sometimes dialogue – then simultaneous) where the ultimate aim is becoming proficient in conference interpreting. There is little room on these programs for variety in kinds of professional interpreting” (Kelly, 2017, p.28). This lack of alignment between classroom content and real-world requirements, along with a lack of consensus on role and purpose has resulted in a myriad of interpreter education programs that span the range from 40-hour community-based training to undergraduate programs that provide modules on interpreting in healthcare settings within their Translation and Interpreting programs. In many cases, programs that continue to perpetuate the traditional archetype of the interpreter, seem more like ad-hoc responses to the practice needs of interpreters in healthcare settings, rather than an authentic and deliberate approach to the role. Fundamentally, it’s because such methods continue to ignore the underlying need for a paradigmatic shift in pedagogy in relation to the specialized setting of healthcare interpreting.

This chapter will address how the primary role of the interpreter as a communication facilitator has deviated from a strict adherence to the conduit model in healthcare settings, and the implications of this transformation for interpreter education. The chapter will also explore how the application of the role in such settings is determined by a progression of factors and conditions that contextualize the communication process as well as the relationships between the participants. Finally, this chapter examines how the current pedagogical framework lacks critical real-life underpinnings for interpreting in the specialized setting of healthcare. It concludes by recommending the implementation of a multipronged schema for both the interim and long-term timeline. This chapter is limited to Canadian experience.