Healthy House Within A MATCH Coalition

For the past five years, Healthy House --a California non-profit organization known for its innovative approaches to interpreter training-- has convened internationally renowned researchers, academicians, and interpreter trainers to discuss recent research, interpreting pedagogy, and teaching methodologies. The convening reunites close to thirty participants from across the nation for two-days of presentations and intense discussions. They meet to share lessons from current and innovative projects and to learn from each other. The convening showcases a dozen professional presentations on various topics. Some have been delivered in English and Spanish. Other languages represented include Chinese, French, Hmong, Italian, Khmer, (Cambodian), Lao, Mixteco, Portuguese, Quiche, Spanish, Thai and Vietnamese.

The convening strives to learn from empirical research and integrate it into the education and training of interpreters with the ultimate goal to advance the health care interpreting field. Past convening sessions introduced trainers to the cognitive dimension of interpreting. Trainers have continued to learn about teaching actual interpreting skills such as anticipation, active listening, paraphrasing, text (oral) analysis, memory, note-taking, re-expression, and other cognitive processes.

This year the convening garnered additional support from The California Endowment, the UC Merced Chancellor’s Task Force on Community Engaged Scholarship and the Center of Excellence for the Study of Health Disparities in Rural and Ethnic Underserved Populations. It also generated remarkable attention from local legislators and physicians. The Honorable Senator Leland Yee from San Francisco spoke at a pre-convening reception about the challenges he faced fighting for the notable legislation (AB 292) he authored in 2004 to prohibit the use of children as medical interpreters.  Senator Yee, who is also a clinical psychologist and who learned English as a second language, praised interpreter trainers for their efforts in advancing the healthcare interpreting field. He offered to continue educating his colleagues in the legislature about the importance of quality communication in healthcare and language access issues.

Thirty-six interpreter trainers, scholars and researchers across the world met for two intensive days to learn from current research, innovative projects, certification efforts, and from each other. The 2010 convening featured seven presentations by researchers, interpreter trainers, academicians, and one physician researcher. The academician presenters this year were Elaine Hsieh, Ph.D. and Andrew Clifford, Ph.D. who are actively researching the work of interpreters in health.  Lisa Diamond, M.D. MPH was the first physician researcher to present at the convening.

Professor Hsieh is an Associate Professor at the Communications Department at the University of Oklahoma. Her presentation was entitled: Challenges to Provider-Interpreter Collaboration: Co-Constructing Meanings, Identities, and Goals in Bilingual Health Care. Dr. Hsieh presentation generated multiple questions and ample discussions. Participants were impressed with Professor Hsieh’s scholarship and her ability to talk about complex research studies in an interesting and engaging way.  In addition to a Doctorate degree on Health Communication, she holds a Master’s degree in Translation and Interpretation from the Monterey Institute of International Studies and has previous experience as a Chinese Interpreter. Her research interests focus on the communicative process between various individuals during an illness event. She has been involved in research on bilingual health communication for the past 10 years. The three aspects that she has investigated are:  (a) the discrepancies between the beliefs and the practice of medical interpreters, (b) interpreters' influence on the quality of health care services, and (c) interpreters' mediation of conversational partners' identities and communicative goals. For additional information about her research interests and scholarship visit http://faculty-staff.ou.edu/H/I-Ling.Hsieh-1/vitae/publications.htm

Professor Andrew Clifford, Ph.D. is the Chair of the School of Translation at York University in Toronto, Canada. His presentation, entitled What Interpreters’ Experiences Tell Us about Moving Forward in Healthcare: Three Stories that Point the Way, was, in the words of one participant, “highly entertaining, brainy, and thought-provoking.”  Professor Clifford is an excellent story-teller. His presentation was full of anecdotes, cross-cultural examples, and multilingual references. Participants were impressed by the relevance of his research for day to day interpreting practice.  Professor Clifford holds an MA in conference interpretation, is an accredited conference interpreter with the Government of Canada, and is an Active Member of the International Association of Conference Interpreters (AIIC). To pursue his research interests, Andrew completed a Ph.D. in Translation Studies at the University of Ottawa in 2003. His dissertation was a psychometric analysis of interpreter certification exams. Since that time, he has gone on to publish a number of peer-reviewed articles using theoretical frameworks from evaluation and measurement, ethics, and pragmatics to examine conference interpreting, community interpreting, scientific translation, and other topics. For additional information about his research interests and scholarship visit: http://www.yorku.ca/rgttc/index.php?p_id=28

The presentation by Lisa Diamond, MD, MPH was entitled Language Access and Quality of Care for Linguistically Diverse Populations: One Physician's Perspective. Interpreter trainers had an opportunity to learn and comment about research occurring in their field and examine one influential physician’s perspective.  The presentation that Dr. Diamond provided was very candid. Participants were particularly interested in a recent study she led---Getting By: Under-Use of Interpreters by Resident Physicians--the first to closely examine how resident physicians arrive at the decision of whether or not to use an interpreter. The study involved resident physicians taking part in advanced training at a hospital under the supervision of its medical staff. The study found that these residents often underuse interpreter services and, instead, rely on hand gestures or a limited number of words in the patient’s native language to convey critical medical information. Dr. Diamond explained that residents are part of an overall hospital culture that is struggling to adapt to the care of patients with limited English proficiency. Her presentation emphasized the importance of hospitals offering clear guidelines for interpreter use and framing such guidelines as an issue of patient safety and quality improvement. The study findings suggest that increasing interpreter use will require interventions at both the level of the individual physician and the practice environment. The study is published in the February 2009 issue of the Journal of General Internal Medicine and is available online at http://www.springerlink.com/content/g935m81354731116/fulltext.html.

Dr. Diamond is a Research Physician at Palo Alto Medical Foundation (PAMF) Research Institute, Department of Health Policy Research. Before joining PAMF, Dr. Diamond completed a two-year fellowship in the Robert Wood Johnson Clinical Scholars Program at Yale University. She has an undergraduate degree in Policy Studies from Syracuse University and a master’s degree in Public Health (MPH) from the Johns Hopkins School of Public Health. She also attended the George Washington School of Medicine in Washington, DC, and then completed her internship and residency in Internal Medicine at New York Presbyterian/Columbia University Medical Center in New York.

Other out-of-state presenters included Cindy Roat, M.P.H, who conducted a focus group activity to contribute to the National Council in Interpreting in Healthcare (NCIHC) National Standards for Healthcare Interpreter Training Programs, and Amy Wilson-Stronks, MPP from the Joint Commission who spoke about new patient and family-centered care standards for hospitals, current research, and promising practices to advance effective communication and cultural competence. Professor Jaime Fatás, Assistant Professor of the Practice, Director of Translation and Interpretation, University of Arizona/Tucson presented an on-line editorial initiative for convening participants in order to publish on-line articles about their own practice and research.  

From California, Elizabeth Nguyen, MA discussed Testing Considerations for Languages of Lesser Dissemination and Rosanna Balistreri, MA and CHIA President, provided a report about the 1^st North American Summit on Interpreting held recently in Washington D.C.  Steve Roussos, Ph.D., a Merced-based researcher representing the Center of Excellence on Health Disparities at UC Merced, conducted the closing evaluation of the convening. The Center is a federally funded research and training program designed to understand and make a positive impact on gaps in health and health services that exist due to differences in factors such as race, income, social status, and education. 

Healthy House staff will continue following research in interpreting ethics and bilingual communication in health care. They look forward to new partnership to continue convening and to strengthen the alliances between physician-providers, renowned researchers, and UC Merced scholars to conduct additional studies. Moreover, Healthy House, in conjunction with Merced’s new community hospital and the proposed UC Merced Medical School, is committed to being part of a “best practices” model of medical interpretation to reduce medical disparities in a multi-ethnic population.