Text Box 1.

Major Themes in Reflections on Shadowing Experience and Its Impact

Serving the Role of Patient Advocate

• “[The interpreter] actually did step into the role of the advocate when she felt that the nurse didn’t understand that the patient’s co-pay might be too large at a certain pharmacy. That was really helpful to see, and I think it’s important for the interpreter to know when such an intervention is appropriate. I also really liked how the interpreter explained carefully to the patient when the nurse was [talking] to another nurse. It clearly comforted the patient.”

Serving the Role of Cultural Broker

• “A few months beforehand, [the patient] had gone back to her homeland to visit family. While there…[she was] diagnosed her with some form of calcification in her tissue. She came back to America and wanted to see what was wrong but did not have the words to describe it … what the patient had been trying to explain to the secretary for 20 minutes took seconds to get across through a trained medical interpreter. It was a great educational experience to see the balance and catching of social cues required to be an effective interpreter.”

• “The patient [was] an old Vietnamese lady, her knowledge about medical terminology [was] limited … The interpreter also noticed [a] cultural gap … When the doctor said that he hasn’t yet been able to explain her condition, the patient seemed to be very disappointed and questioned his reliability, perhaps because the Vietnamese culture is very sensitive and very dependent on doctors. Thus, the interpreter was able to explain to the patient that it was not because the doctor didn’t look at her case closely, but it was because her condition was rare and needed further consultant from specialists and radiologists from the field.”

Managing the Encounter: Family Members in Room

• “This interpreting session was difficult to navigate due to the daughter’s presence in the room. [The daughter] wanted the doctor to withhold information from the patient… [she] usually served as his interpreter; it was obvious. At times, she would interject and interpret for the patient, but the interpreter always handled those situations with ease.”

Managing the Encounter: Intervening & Working with Providers

• “The physical therapist told the interpreter that she spoke relatively fluent Spanish and would likely not need his help. As we quickly learned, however, the therapist did not speak very good Spanish at all. Although some of what she said could be understood, it was clearly creating a barrier of understanding. The interpreter was able to step in to facilitate communication between the wife and the physical therapist.”

Navigating Limitations of Interpretation Theory: Simultaneous Interpretation

• “The interpreter used simultaneous interpretation to interpret the directions of provider… Even though the interpreter did her simultaneous interpretation very well, [it] delayed several seconds so that the patient delayed to respond to the provider’s directions. Then the interpreter told the patient the meaning of each English direction, then asked the patient to follow the provider’s English directions to breathe without simultaneous interpretation. Finally, the patient successfully produced an eligible breath.”

Navigating Limitations of Interpretation Theory: Use of First Person

• “Even in the strange set up with all the family members, the interpreter did an excellent job of ensuring that everyone was included in the discussions … While talking to the patient, he couldn’t always use the first person because she became confused. This is something we had talked about during the course, and seeing it in action, it made sense when it was appropriate to use and not to use first-person.”