Jucelei Pereira, M.A., Medical Interpreter, Certified Translator
Maria Anna Calamia, Ph.D., Medical Interpreter and Translator
Marta C. Oliveira Sousa, B.A. Medical Interpreter
University Health Network
Abstract:
1.
UNIVERSITY HEALTH NETWORK - UHN
The University Health Network (www.uhn.on.ca) is a
multi-site teaching hospital affiliated with the University of Toronto
The department of Interpretation and Translation
Services (ITS) provides tested and trained interpreters for all three tertiary
care facilities. The team consists of eight staff interpreters and over 160
contract interpreters who facilitate communication between healthcare providers
and patients with limited English proficiency (LEP) and patients who are Deaf,
deafened or hard of hearing, in more than 55 spoken and sign languages. In
addition to interpretation, ITS provides multilingual translation services to
departments at UHN.
The University Health Network’s Interpretation and
Translation Services strives to provide its patients as well as its health care
providers with optimal language support through the provision of professionally
tested and trained medical interpreters.
2. INTERPRETER’S QUALIFICATIONS
3. THE NATIONAL STANDARD GUIDE FOR COMMUNITY INTERPRETING SERVICES
In the past, interpreters were considered to be
“cultural brokers” with the expectation that they would provide information
regarding “cultural differences” between service providers and non-English or
LEP speakers. Without a national body regulating the profession there were no
consistent definitions of what was expected from community interpreters thus
competencies varied, creating great disparity in the way medical interpreters
were practicing. The first National Standard Guide for Community Interpreting
Services was finally published by the Healthcare Interpretation Network (HIN)
in November 2007, following several years of hard work on the part of many
stakeholders. HIN felt that the experience in Canada
was different than in the United
States
As a result, today, interpreters are expected to
comply with the professional standards of practice and ethical principles
according to the National Standard Guide for Community Interpreting Services,
where the role of the interpreter focuses on the delivery of the message rather
than playing “cultural broker” for individuals who do not share a common
language. Ethical principles and standards of practice protect non-English
speakers or LEP patients, service providers and also interpreters.
In order to deliver consistency in their practice
interpreters must adhere to the standards of practice which state:
4. IMPROVING INTERPRETATION AT UHN – OCTOBER 2008
Interpreting is an isolated profession where
interpreters rarely have the opportunity to talk about their experiences,
standards of practice, ethical issues, practice strategies, vicarious trauma
and emotional exhaustion. For external providers working for many
organizations, few of which adhere to the National Standards of Practice, the
work is particularly challenging because these providers lack a sense of belonging
to the organization, and by extension, feel disengaged. Furthermore, although
all interpreters are qualified to provide services in a medical setting,
performance is not monitored formally. Feedback on performance is ad hoc, based
on compliments or complaints from care providers. A lack of consistency of
performance quality among the large team of interpreters can compromise patient
care.
There was a growing awareness that not all contract
interpreters were adhering to the Interpreter’s Code of Ethics and to the National
Standards of Practice. For example, there was inconsistency in the
interpreter’s introduction: while some interpreters felt that their name and
language was enough of an introduction, given to either or both parties, others
gave an explanation of their role, and others still gave no introduction at
all. Some interpreters sat next to the patients (and at times the patient’s
family member/s) in the waiting room and engaged in conversation. While some
may have refrained from giving medical or spiritual advice, or from comforting
the patient and or family members, others did not.
Furthermore, there were variations on the length of
the assignment, which was an additional cost to the department. Sometimes an
interpreter would wait one hour in the waiting room until the health care
provider was free, then interpret for only a quarter of an hour. The time was
not well used and did not serve the patients well, as demand has always
exceeded the supply of interpreters available. Protocols were therefore put
into place in order to ensure that only 15 or 30 minutes was spent in the
waiting room, after which the interpreter would call the ITS office for
direction.
Any lack of professionalism on the
part of the interpreters reflected poorly on the department, which made it
challenging for interpretation to be regarded as a profession, especially by
health care providers. If we wanted to raise our vocation from cultural brokers
to full-fledged professionals we had to exceed the expectations of health care
providers and at the same time train our interpreters to conduct themselves in
such a way as to become respected members of the health care team.
Once the issues were identified,
staff interpreters wanted to remedy the situation at UHN. Inspired by protocol for new hires at best
practice hospitals in the U.S.
5. MENTORSHIP PROGRAM
9. CONCLUSION
What started off as a fairly straight-forward program
with clear guidelines has turned out to be far more complex and time consuming
then what we had anticipated. However, our team believes that it has been a
worthwhile investment.
As a result of the mentorship program, staff members
and contract interpreters have more opportunities to interact, thus
acknowledging contract interpreters as members of the ITS team and are
increasingly recognized as members of the UHN health care team. More
interpreters are motivated to participate in professional
development/educational activities and feel more confident when in it comes to
clarifying issues/reporting irregularities. This confidence has enabled
interpreters to better explain their role as interpreters. In turn, more health
care providers are aware of the interpreter’s role and are more willing to
request interpreters instead of using family members, as well as to work with
the interpreter to ensure that LEP and Deaf patients receive the best quality
of care that UHN has to offer.
On the down side, we have noticed that some
interpreters refuse to change bad behaviour and that more interpreters need
additional training than previously anticipated, which increases the costs of
shadowing and training. This also means that we have to establish measures to
enforce “professional behaviour,” such as addressing poor performance with a
warning letter, identifying the breach of contract, which requires adherence to
the National Standards of Practice.
Moving forward any interpreter who does not comply
with protocol and does not follow the standards of practice will not have their
contracts renewed. Given that we provide
interpretation services in a health care setting, it is imperative that all our
interpreters conduct themselves according to.
By ensuring consistent quality of service through best practices and
standardized practices, interpreters are aiding in improved patient outcomes,
increasing visibility and connection to care providers, reducing frustration
for patients and staff and increasing awareness of patient diversity and
unique, individual needs.
 |
- Introducing myself to the reception staff, including my name, the patient’s name and MRN, and the care provider’s name
- Making sure my cell phone and pager are off, even in the waiting room.
- Politely reminding staff of my booked time when kept waiting for 15 minutes, and offering to call the patient. Calling ITS after 30 minutes.
REFERENCES
Conceived and implemented by staff
interpreters at the University Health Network’s (UHN) Interpretation and
Translation Services (ITS), the Mentorship Program has been designed to ensure
quality control among contract (freelance) interpreters in the delivery of
language services across UHN. In doing
so, the authors hope to reduce disparities in the way that contract
interpreters are practicing. The program consists of an orientation, two-way shadowing, monthly brown bag lunches, bi-monthly
bioethics rounds, professional development series, medical terminology lexicon
for UHN’s areas of specialization, and e-Forums. By improving quality of
service through consistent application of standards, and applying quality
assurance measures of interpreter performance, ultimately the patients will
benefit from a cohesive and engaged interpreter team. It is documented in the
literature that the use of professionally tested and trained medical
interpreters reduces overall healthcare costs, misdiagnosis, unnecessary
diagnostic tests, inappropriate admissions, fewer re-admissions, extended
length of stay and adverse drug errors.
In order to be considered for hire as a UHN interpreter, applicants
must have the following credentials. First and foremost is the successful completion
of a language proficiency test such as the CILISAT (Cultural Interpreter and
Language Interpreting Skills Assessment Tool) or the ILSAT (Interpreter
Language and Skills Assessment Tool), as this ascertains a high level of
fluency in the language/s that the interpreter wishes to work in. In addition,
the interpreter must have completed a core
competency training course offered by a designated interpreter service provider
for the Ontario Ministry of Citizenship and Immigration (e.g. Multilingual Community
Interpreter Services www.mcis.on.ca offers a 100-hour program) or
must have obtained a Certificate from the Language Interpreter Training Program
(e.g. Seneca College and Niagara College which offer a 180-hour program).
“Standards of practice serve in
all areas where criteria for professional performance are needed in making
decisions and may be used in making determinations regarding professional
misconduct, incompetence or incapacity. Standards of Practice enable service
providers, employers and non/limited English speakers requiring the services of
an interpreter to recognize what standards of performance can be expected by a
competent interpreter (Ref. 1).”
The
mentorship program was created as a means to control quality, to foster
professional development, to create loyalty and promote a sense of belonging to
the organization, and to improve retention. Furthermore, it was conceived as a
way to foster the involvement of, and
support for, contract interpreters in the delivery of standardized best
practices in providing interpreting services throughout the UHN for limited
English Proficiency patients, and patients who are Deaf, deafened and hard of
hearing.
Staff envisaged a program where
mentors and mentees could work cohesively to ensure that health care providers
and patients receive the highest level of services that can be offered. This
long-term, multi-faceted program contains the following components: an
orientation, two-way shadowing, monthly brown bag lunches, bi-monthly bioethics
rounds, professional development series, medical terminology lexicon for UHN’s
areas of specialization, e-Forums for language groups and a recognition program
for outstanding performance.
Prior to
the official launch of the project, a meeting was held for all contract
interpreters in order to explain the mentorship program. Interpreters were
informed that they would be evaluated during an encounter and that it would
also be possible for them to evaluate themselves in that particular encounter
which was shadowed. In this way, with two feedback forms, a clearer picture of
the encounter could be obtained. It was important to know not only what staff
members thought of the mentee’s performance, but also what the mentee thought of
his/her own performance. In part this was to see how aware they were of their
actual way of practicing. At the same time, the self-evaluation would give us
an insight into how to go about re-training our contract interpreters all the
while presenting them with a new way of practicing consistent with the new
Standards.
Once the
areas of improvement were clearly identified, our vision of offering support
and training for the mentees became clearer.
However, initially, this was met by great diffidence by the veteran
interpreters, who seemed to be offended by the idea of being
"observed" and were afraid of being "policed.” In response to the protests, we reassured
them that this was not about penalizing them in any way, but the contract
interpreters felt that their job security was at stake. We quickly realized
that with time and patience we would achieve the desired "buy-in", as
interpreters would eventually comprehend that this was an opportunity for
personal and professional growth. Interpreters were also informed that the main
objective of the mentorship project was to ensure that all interpreters across
UHN were following the National Standards of Practice.
Since the program was put into place, our hiring
practices have changed to reflect the new policy. Once an interpreter has been
interviewed and deemed a suitable match for our department, he/she must attend
a mandatory orientation. At the orientation session interpreters are informed
of departmental protocol with a keen emphasis on introducing themselves
(letting the patient and the provider know about their role) and limiting their
contact with the patients to when the health care provider is present.
Interpreters are also required to sign a document called "Rules to
Interpret By" (see Appendix A), which clearly states guidelines for best
practices. The purpose of this document is to ensure that all interpreters are
familiar with, and clearly understand, the guidelines for best practices. Following the orientation, interpreters must
begin the shadowing program.
The shadowing program was originally launched as a
pilot program with 40-50 interpreters.
Mentees were assigned mentors according to language, where
applicable. Staff interpreters were
trained on the shadowing process and on how to give mentees constructive
feedback as to avoid discouraging them, and to help them recognize their
potential and to be the best interpreters that they could be.
The shadowing program consists of two phases, both
of which are paid at the normal UHN rate for contract interpreters. During
Phase I the mentee shadows a mentor two to three times. The mentee is to
observe how the mentor performs the introduction, adheres to the interpreter’s
Code of Ethics and follows the National Standards of Practice. This is also an opportunity
for both mentee and mentor to exchange valuable knowledge. Once the mentee has
completed Phase I, he/ she is made "active" in our dispatch system
and can start accepting assignments.
Next begins Phase II of the shadowing program, where mentors schedule
themselves to shadow the mentee.
It is important to note that our goal was to
identify key competencies that needed to be developed and then train the
interpreters as required. This is emphasized during a post-shadowing meeting.
Both mentor and mentee review the evaluation forms and discuss what was
observed during the encounter. This is also a coaching opportunity, where the
mentor provides the mentee with helpful tips and encourages the mentee to
improve his or her performance.
Mentees are then shadowed a second time by mentors
to see if improvements were made. If the mentee demonstrates willingness and
commitment to professional development, they are recognized as having completed
the shadowing program and will not be shadowed until further notice. However if
the mentee shows no improvement, they will be required to attend a mandatory
workshop with the purpose of providing mentees with further training. If
mentees fail to comply with departmental protocol and opt not to follow the National
Standards of Practice, they are removed from our roster.
One year into the shadowing program, we
acknowledged that there was a backlog. In part this was due to lack of staff
availability to shadow mentees, and in part it was because of the way the
mentees were assigned (by language).
This has prompted us to change the shadowing process. Our staff has come
up with a unique way to expedite the process which will ensure that all
interpreters will have completed Phase I and Phase II (shadowing the staff interpreters)
by the end of this calendar year. This new process involves the creation of a
virtual and interactive Phase I, where current interpreters can access
digitally recorded vignettes demonstrating common issues that interpreters face
during an encounter and instructions on how to overcome these. Once the virtual
Phase I has been completed interpreters must complete an online quiz which will
demonstrate their knowledge of best practices. Then they will be shadowed by a
mentor. Since this is done with the aim to ensure that everyone catches up, new
interpreters will still follow the old format.
As previously stated, the mentorship program is
multi-faceted with a focus on creating a platform for interpreters to enhance
their professional skills and to give them a chance to take care of their
emotional and psychological wellbeing.
On June 10, 2010 we launched our first Brown Bag Lunch and eight
contract interpreters attended. Facilitated by trained staff interpreters, we
discussed vicarious trauma. Our second Brown Bag lunch was held on July 21,
2010 and nine contract interpreters attended. The focus was twofold, as we
discussed ethical and practice issues. Regarding ethics, the discussion focused
on if, when and how an interpreter should advocate for a patient, and as for the practice issue, whether or not interpreters should accept gifts from
patients. The feedback for both events was astounding. Those who attended felt
that this was very worthwhile, even though attendance is voluntary.
To further promote training for all interpreters,
ITS invites health care providers from across UHN to provide interpreters with
clinical education in areas such as transplant, cardiology, palliative care,
mental health and addictions, surgical oncology, and rehabilitation. ITS has
also developed a Medical Terminology Manual for interpreters for the various
areas of specialization to ensure that all interpreters are familiar with
common terminology and are able to prepare for an encounter.
Bi-monthly bioethics rounds will commence in
September of 2010 and will be led by a UHN bioethicist. The goal of these
meetings is to provide interpreters with an opportunity to discuss difficult
encounters that they have had and to develop constructive and beneficial ways
to navigate challenging situations.
The e-Forums for language groups is currently in
its pilot stage and the purpose is to offer interpreters of the same language
groups a platform in which they can engage in linguistic discussions. Currently
there is a system in place in Google docs, where a medical terminology lexicon
has been posted for the Portuguese speaking interpreters.
The recognition program for outstanding performance
distinguishes those individuals who demonstrate professionalism, commitment and
dedication to the organization. Interpreters are acknowledged and presented
with a certificate of outstanding service during our Annual General Meeting.
Interpreters also receive sponsored membership to the Healthcare Interpretation
Network conference and opportunities to cover staff interpreters during
vacation.
6. ITS
INTERPRETERS
ITS currently has 169 permanent and contract
interpreters. Eight are considered
permanent, working either full time (5 days/37.5 hours a week) or part time
(from 2 to 3 days a week /7.5 hours/day). Out of these, 72% (121) are
professionally tested to interpret in English and one other language, while 13%
(22) are tested in two other languages, 10% (17) in three languages and 5% (9)
in four other languages. This does not mean that the 72% are only
bilingual. They may be polyglots. The figure demonstrates only that they have
not obtained the certificate/s that the ITS department requires in order for
them to work as an interpreter in a particular language. Where the interpreters
are professionally tested in two or more languages, the languages seem to be
paired, such as Cantonese and Mandarin, Hindi and Punjabi, Spanish and
Portuguese, but there are some other instances where the languages are
linguistically unrelated such as Russian and Armenian, or Ukrainian and
Italian.
It is interesting to note that nine of the 169
interpreters (or 5%) were professionally tested in languages that were
sometimes totally unrelated. A permanent staff interpreter practices in
Cantonese, Mandarin, Toishan and Portuguese, while a contract interpreter is
fluent in French, Kiswahili, Kirundi and Kinyarwanda. Other more linguistically
coherent combinations include Cantonese, Mandarin, Shanghinese and Ningbo
Within the 72% who work in English and only one
language, there are several sub-languages that they actually understand and can
interpret from or into. Such is the case of Portuguese and the difference
between the language spoken on the mainland and that spoken in Angola , Brazil ,
Cape Verde , Guinea-Bissau , Mozambique ,
and São Tomé and Príncipe and East Timor .
Although still considered the same language, there are slight variations and
nuances that the interpreter must be aware of. In the non-contiguous areas of
the world where Portuguese is spoken, there are significant differences in
pronunciation, grammar, vocabulary and the use of idiomatic expressions.
Although these differences are often profound, they are not sufficient to
challenge the fundamentally basic structure of the language. Despite its
history, diffusion and diversity, Portuguese continues to maintain considerable
cohesion around the world.
The same is true of Italian, where the copious
dialects still flourish among the patients at UHN. In fact, very few patients
actually speak Italian, although they all understand Italian. Most of the time
the patients speak a mixture of Italian, their local dialect, and Italiese (Ref.
2). The interpreter interprets from English into Italian, but actually
interprets from a mixture of the languages stated above, into English. As was
previously indicated, ITS interpreters are not cultural brokers; however, it
would be incorrect to assume that interpreters should be without any cultural
know-how. In fact, in many cases it would be impossible to interpret without
this extra-linguistic knowledge.
As we can easily appreciate from the bar graph
below, Mandarin, Spanish and Portuguese interpreters are the most numerous,
followed by ASL, Cantonese, Farsi/Persian, Russian and Urdu. On the other end
of the spectrum are languages such as Albanian, Armenian, Croatian, Czech,
Hebrew, Japanese and others, where we only have one interpreter fluent in that
language. This rarity makes it challenging if not impossible for ITS to ensure
that a patient who speaks that language has an interpreter present when
necessary. Often we will outsource interpreters from other local agencies in
order to fill the demand.
Language is not the only consideration when booking
an interpreter. Sometimes gender can play a very important role. As a rule, ITS
does not send male interpreters to areas such as the Gynaecology, Breast and Colposcopy clinics. The same is
true of the Prostate Clinic, where male interpreters are favoured; whereas who
to send to clinics such as Cystoscopy is determined by the gender of the
patient whenever possible (Ref. 3). Given that only 22% of interpreters are
male, sometimes it is not possible to find a male interpreter for all
appointments, even when the request is made in advance. As was indicated
before, many of our staff and contract interpreters work for different
agencies/hospitals and therefore the language pool of qualified interpreters is
surprising low.
7. SHADOWING PROGRAM RESULTS
Since the Shadowing Program was first introduced,
several changes have been made, including changes to the questionnaires
completed by the mentors and mentees. Initially, the mentees (contract
interpreters) were assigned to mentors (staff interpreters) who interpreted the
same language/s. However, it soon became apparent that this was not always
possible due to scheduling issues and the fact that language congruence
requirements would exclude those interpreters who did not interpret the same
language/s as the staff interpreters. After several Phase II shadowing
sessions, it also became apparent that not all interpreters were following
correct ITS protocols. Therefore, additions were made to the questionnaire in
order to ensure that both the Code of Ethics and ITS protocols were evaluated.
Mentors were no longer asked to check for linguistic competence (as this should
have been established by the credentials needed in order to become an ITS
interpreter) and instead focused on how the mentee performed in his/her role as
an interpreter. The questionnaires were therefore modified to reflect this
renewed focus
(see Appendices B and C).
ITS protocols are twofold and include
administrative procedures (when to call the office, how long to wait in the
waiting room, what to do post encounter, see Appendices B and C), and following
standards of practice and the Code of Ethics (confidentiality, impartiality,
respect for all involved). We asked both the mentor and the mentee if the
mentee introduced him/herself and the results were surprising. While only 52%
of mentors said that the mentees introduced themselves, nearly all of the
mentees said they introduced themselves and listed the points they covered (or
hoped to have covered).
ITS expects interpreters to adhere to the following
points (Ref. 4).
Mandatory
First name
Role (Hospital
Interpreter)
I will interpret
everything said as faithfully/accurately as possible
I will hold
everything seen and heard confidential
(In mental health
settings) if I take notes, it is to aid my memory. The notes will be destroyed
at the end of the session
Optional
Please speak
directly to each other (e.g. Discourage
“Ask her”, “Tell him”)
Note taking (in
settings outside of mental health)
I may need to
interrupt if I need to clarify something
I will remain
impartial
8. OVERALL RATING
Out of all the mentees shadowed to date, 32% were
rated as excellent by the mentors, compared with 38% of mentees who declared
themselves excellent. A further 38% were rated as effective, while 56% rated
themselves as effective; 11% were rated as competent compared with 6% who
declared themselves competent; and 19% were rated unacceptable or required
further training, while no one declared themselves as such (Ref. 5).
APPENDIX A
UHN
Interpretation
and
Translation Services
Rules to Interpret By
for all UHN Interpreters
The undersigned fully understands, and
agrees to abide by, the following protocols when working at University Health
Network:
1.
To call the department 416 603 5800 ext 3248 at the end of my booked
assignments and when an assignment is cancelled.
If I cannot reach
an ITS staff member, I will page 416 715
8423.
2.
To call the department 416 603 5800 ext 3248 if I cannot find a patient or a
department.
If I cannot reach
an ITS staff member, I will page 416 715
8423.
3.
To not be in the presence of
the patient/client unless a care
provider is also present. This includes
in the waiting room and during intervals when a care provider leaves the exam
room, however briefly.
4.
As a representative of UHN
Interpretation and Translation Services, to exercise outstanding customer service skills throughout the encounter, that
is, from the time I enter the clinical area until I leave. This includes but is not limited to:
5.
To politely and respectfully inform the care provider of the
limitations of your role (e.g., if asked to stay with a patient to keep them
company).
The phrase
“That’s not my role” is not acceptable.
An example of an
appropriate response: “I appreciate your concern for the patient, but
unfortunately, there is a liability issue should the patient disclose something
and ask me to keep it confidential, or the patient claims to have disclosed
something that doesn’t get into her chart. It’s best for the organization if I
wait for you to come back.”
Always offer solutions and show that I am willing to support the care provider’s objective
in a way that is fitting with an interpreter’s standards and ethics, e.g.,
“I’ll be happy to interpret if you’d like to address the patient’s anxiety when
you come back.”
6.
Never allowing a difference of opinion
to escalate with a UHN staff member, patient or family member, but de-escalating
the conflict and reporting the matter to ITS: 416 603 5800 ext 3248.
If I cannot reach
an ITS staff member, I will page 416 715
8423.
Practice Issues
7.
Not answering questions
directed to me, but interpreting them instead.
8.
Avoiding contact with the patient/client
before, during and after the encounter, including if I happen to see them in
the Food Court
9.
Avoiding eye contact with the speakers
during the encounter, to encourage the parties to address each other directly.
10. Not altering the message of
either speaker in any way whatsoever, such as simplifying, softening “bad
words,” correcting grammar, editing redundancy.
11. Interrupting for clarification
in two languages, in order to ensure transparency.
12. Not offering “cultural
brokering” or “cultural mediation,” which would require making assumptions
about a patient’s values or belief system based on their country of
origin. Such assumptions may be inaccurate
and dangerous.
13. Reporting all incidents to
ITS: 416 603 5800 ext 3248.
If I cannot reach
an ITS staff member, I will page 416 715
8423.
______________________________ ___________________________
UHN Interpreter (Name) Signature
__________________
Date
APPENDIX B
Encounter number: ________________________________
Mentee’s name: ________________________________
Language interpreted: ________________________________
Location of encounter: ________________________________
Date and time of shadowed assignment: ________________________________
Pre Encounter:
1. Is the mentee sitting with or near enough to the patient as
to allow interaction? Y N N/A
Comments:_______________________________________________________________________________________________________________________________________________________________
1a. If the patient insists on interacting with the mentee, how does s/he
conduct her/himself to clarify his/her role?
__________________________________________________________________________________________________________________________________________________________________________
2. If applicable, did the mentee Y N check in, Y N remind the staff after 15 min, Y N after 30 min and Y
N call the
office after 30 min of waiting?
3. If applicable, did the mentee call the office after the
assignment finished? Y
N N/A
4. If applicable, did the mentee ask the Health Care provider
for a brief description of the case?
Y N N/A
5. During the encounter:
a) Y N N/A The mentee introduced himself/herself to the
Service Provider
b) Y N N/A The mentee introduced himself/herself to the
Patient
c) Y N N/A The mentee used the first person
d) Y N N/A The mentee used correct positioning
e) Y N N/A The mentee interpreted everything that was
said
f) Y N N/A The mentee was able to control the flow of
conversation
g) Y N N/A The mentee was respectful of all parties
involved
h) Y N N/A The mentee maintained boundaries
i) Y N N/A The mentee interrupted for clarification
j) Y N N/A The mentee took notes
k) Y N N/A The mentee destroyed notes at the end of the
encounter
l) Y N N/A The mentee left the room with the provider
Post encounter:
6. Did the mentee leave the
encounter site in such a way as to actively avoid interaction with the patient? Y N N/A
Comments:__________________________________________________________________________
___________________________________________________________________________________
7. Please provide your
thoughts on the mentee’s performance during this session:
_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
8. Identify key strengths
about this encounter: ______________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________
9. Identify key
competencies about this encounter that could have been better:
______________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________
10. Additional Comments:
______________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
11. Is further training required?
Y N N/A
___________________________________________________________________________________
12. How effective was this
mentee’s performance within this encounter?
unacceptable competent effective excellent
APPENDIX C
MENTEE’S
SELF EVALUATION
TO BE COMPLETED ON THE
SAME DAY AS THE ENCOUNTER AND BROUGHT TO MED
WEST, room 227 or to TGH, first floor, room 402, East Wing
Encounter number: ________________________________
Interpreter’s Name: ________________________________
Language interpreted: ________________________________
Location of encounter: ________________________________
Date and time of assignment: ________________________________
1. Please check
all that apply:
a) I introduced myself to the service provider
b) I introduced myself to the patient
c) I used the first person during the encounter?
d) Was I positioned in such a way as to
facilitate interpretation?
e) I interpreted everything that was said
accurately,
using the same inflection
tone
register
and vocabulary as the speaker
f) I took control of the flow of conversation
g) I was respectful of all parties involved
h) I took notes
i)
I maintained boundaries
j)
I interrupted for clarification if applicable
k) I destroyed notes at the end of the encounter
l)
I left the encounter site in such a way as to
actively avoid interaction with the patient.
2. What points did I cover during the introduction to
the patient and service provider?
____________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________
3. Identify key strengths about this encounter: ____________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________
4. Identify key competencies about this encounter that
could have been better:
____________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________
5. Additional Comments and opinion of how the encounter
evolved:
____________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________
How effective was my
performance?
unacceptable
competent
effective excellent
Thank you very much! J
1. Healthcare Interpretation Network. "National
Standard Guide for Community Interpreting Services," Toronto , Canada
2. A Term coined by Gianrenzo P. Clivio (University of Toronto )
referring to the language spoken by Italian immigrants who lived in Canada
3. We rely on the requestor to provide this
information.
4.
As introductions seem to be an issue, this point has been addressed at
every Annual General Meeting, however, not all contract interpreters provide a
complete introduction.
5. These statistics refer to protocol only,
not linguistic competence.