Interpreter Standards of Practice

Question 1

IMIA Standards: What is the Goal of the Standards?

Answer 1

Standards of practice provide:

• A defining baseline of expectations for consumers and practitioners.
• A measure against which individual interpreters can monitor the quality of their own performance.

Standards establish:

• criteria for certification and/or entry into the profession, ensuring quality and consistency of performance.

Question 2

IMIA Standards: What is the First Duty of the Interpreter?

Answer 2

Duty A: Interpretation

Convert a message uttered in a source language into an equivalent message in the target language so that the intended recipient of the message responds to it as if he or she had heard it in the original.

The primary test of a competent interpreter, therefore, is the accuracy and **completeness **of the interpretation.

Complementary skills of the interpreter:

• Setting the stage
• Interpreting
• Managing the flow of communication
• Managing the triadic relationship
• Assisting in closure activities

Question 3

IMIA Standards: What is the Second Duty of the Interpreter?

Answer 3

Duty B: Cultural Interface

• Language is not the only element at work in the interaction between providers and patients who speak different languages.
• The meaning inherent in the messages conveyed is rooted in culturally based beliefs, values, and assumptions.
• Interpreting in the health care arena requires the interpreter to understand the ways in which culturally based beliefs affect the presentation, course, and outcomes of illness as well as perceptions of wellness and treatment.

Question 4

IMIA Standards: What is the Third Duty of the Interpreter?

Answer 4

Duty C: Ethical Behavior

In a very significant way, the interpreter holds tremendous power, often being the only one present in the encounter who understands both languages involved.

Both the patient and the provider have to be able to trust that the interpreter
will not abuse this power. They need to trust that the interpreter:

• will transmit faithfully what it is they have to convey to each other and not the interpreter’s own thoughts.
• will uphold the private and confidential nature of the clinician-patient relationship.

A code of ethics provides guidelines and standards to follow, **creating consistency and lessening arbitrariness in the choices **interpreters make in solving the dilemmas they face.

Question 5

NCIHC Standards: “Accuracy” Objective and Standards

Answer 5

Objective: To enable other parties to know precisely what each speaker has said.

Standards:

1. The interpreter renders all messages accurately and completely, without adding, omitting, or substituting.
2. The interpreter replicates the register, style, and tone of the speaker.
3. The interpreter advises parties that everything said will be interpreted.
4. The interpreter manages the flow of communication.
5. The interpreter corrects errors in interpretation.
6. The interpreter maintains transparency.

Question 6

NCIHC Standards: “Confidentiality” Objective and Standards

Answer 6

Objective: To honor the private and personal nature of the health care interaction and maintain trust among all parties.

Standards:

7. The interpreter maintains confidentiality and does not disclose information outside the treating team, except with the patient’s consent or if required by law.
8. The interpreter protects written patient information in his or her possession.

Question 7

NCIHC Standards: “Impartiality” Objective and Standards

Answer 7

Objective: To eliminate the effect of interpreter bias or preference.

**Standards: **

9. The interpreter does not allow personal judgments or cultural values to influence objectivity.
10. The interpreter discloses potential conflicts of interest, withdrawing from assignments if necessary.

Question 8

NCIHC Standards: “Respect” Objective and Standards

Answer 8

Objective: To acknowledge the inherent dignity of all parties in the interpreted encounter.

Standards:

11. The interpreter uses professional, culturally appropriate ways of showing respect.
12. The interpreter promotes direct communication among all parties in the encounter.
13. The interpreter promotes patient autonomy.

Question 9

NCIHC Standards: “Cultural Awareness” Objective and Standards

Answer 9

Objective: To facilitate communication across cultural differences.

**Standards: **

14. The interpreter strives to understand the cultures associated with the languages he or she interprets, including biomedical culture.
15. The interpreter alerts all parties to any significant cultural misunderstanding that arises.

Question 10

NCIHC Standards: “Role Boundaries” Objective and Standards

Answer 10

Objective: To clarify the scope and limits of the interpreting role, in order to avoid conflicts of interest.

**Standards: **

16. The interpreter limits personal involvement with all parties during the interpreting assignment.
17. The interpreter limits his or her professional activity to interpreting
    within an encounter.
18. The interpreter with an additional role adheres to all interpreting
    standards of practice while interpreting.

Question 11

NCIHC Standards: “Professionalism” Objective and Standards

Answer 11

Objective: To uphold the public’s trust in the interpreting profession.

**Standards: **

19. The interpreter is honest and ethical in all business practices.
20. The interpreter is prepared for all assignments.
21. The interpreter discloses skill limitations with respect to particular assignments.
22. The interpreter avoids sight translation, especially of complex or critical documents, if he or she lacks sight translation skills.
23. The interpreter is accountable for professional performance.

24 The interpreter advocates for working conditions that support quality interpreting.

25. The interpreter shows respect for professionals with whom he or she works.
26. The interpreter acts in a manner befitting the dignity of the profession and appropriate to the setting.

Question 12

NCIHC Standards: “Professional Development” Objective and Standards

Answer 12

Objective: To attain the highest possible level of competence and service.

**Standards: **

27. The interpreter continues to develop language and cultural knowledge and interpreting skills.
28. The interpreter seeks feedback to improve his or her performance.
29. The interpreter supports the professional development of fellow interpreters.
30. The interpreter participates in organizations and activities that contribute to the development of the profession.

Question 13

NCIHC Standards: “Advocacy” Objective and Standards

Answer 13

Objective: To prevent harm to parties that the interpreter serves.

**Standards: **

31. The interpreter may speak out to protect an individual from serious harm.
32. The interpreter may advocate on behalf of a party or group to correct mistreatment or abuse.

Question 14

CHIA Standards: What is the Goal of the Standards?

Answer 14

CHIA = California Healthcare Interpreters Association

To standardize healthcare interpreting practices by providing:

• a set of ethical principles
• interpreting protocols
• guidance on roles particular to the specialty of healthcare interpreting.

We hope that increased availability of quality interpreting will result in **better access to **healthcare for limited English proficient (LEP) patients.

Question 15

CHIA Standards: What is Discussed in Section 1?

Answer 15

Ethical Principles:

1. Confidentiality
2. Impartiality
3. Respect for Individuals and their Communities
4. Professionalism and Integrity
5. Accuracy and Completeness
6. Cultural Responsiveness

Question 16

CHIA Standards: What is Discussed in Section 2?

Answer 16

Protocols specifying interpreter actions:

Protocol 1: Pre-Encounter, Pre-Session, or Pre-Interview

• Assure confidentiality
• Gain cooperation

Protocol 2: During the Encounter, Session, or Interview

• Positioning
• Reminders/gesturing for patient/providers to address each other directly
• Use of first person interpreting.
• Manage the flow of communication
• Facilitate or seek clarification of messages
• How to conduct more active interventions when necessary
• How to clearly identify when interpreters intervene

Protocol 3: Post-Encounter, Post-Session or Post-Interview

• Provide closure to the interpreted session
• Ensure that no other questions or concerns are outstanding
• Facilitate follow-up appointments and scheduling of interpreter services
• Debrief with the provider or interpreter’s supervisor as needed

Question 17

CHIA Standards: What is Discussed in Section 3?

Answer 17

Roles of the Medical interpreter

This section defines these multiple roles and describes performance strategies to facilitate communication and assist the interpreter to set appropriate boundaries for the benefit of all parties in an encounter.

1. Message Converter
2. Message Clarifier
3. Cultural Clarifier
4. Patient Advocate