Sight Translation: Healthcare Interpreters’ Cinderella

Not long ago the Certification Commission for Healthcare Interpreters (CCHI) hosted a webinar on the subject of Sight Translation in medical settings: “When Interpreter Meets Translator: Sight Translation of Healthcare Documents”, which was presented by Natalya Mytareva (M.A., CoreCHITM, CCHI Managing Director) on Sunday, Feb 1, 2015. Revising several concepts discussed during the webinar, some thoughts sprouted on this particular chapter of our regular duties as healthcare interpreters. Let us here comment on some of them.

SIGHT TRANSLATION is the oral rendition of text written in one language into another language and is usually done in the moment (NCIHC, 2010). Traditionally, instead of an activity on its own, sight translation has mostly been considered as a supportive interpretation method for simultaneous and consecutive interpretation, a type of simultaneous interpreting, or just a pedagogical exercise for getting started in the techniques of consecutive and simultaneous interpreting (Ersozlu, 2005). However, sight translation is neither proper INTERPRETATION (oral rendering of spoken or signed communication from one language into another; NCIHC, 2010) nor proper TRANSLATION (rendering of a written text in one language in a comparable written text in another language; NCIHC, 2010), although a tension with this latter activity is clearly apparent: both translation and sight translation share the intended communicative purpose, require knowledge of similar specific documents, and start their journey on a written text.

sight v written translation graphic

Their particular outcomes, though, as well as the problem solving routes that can be undertaken in a given difficult situation are different in each case. While in translation the linguistic form is always preserved, in sight translation simplification is considered acceptable due to the need for immediate delivery.

Sight translation is an exercise half way in between interpretation and translation that requires its own particular set of skills:

  • Knowledge of TERMINOLOGY (the system of terms belonging to any science or subject, nomenclature; OED) specific to healthcare documents.
  • Understanding the REGISTER (a variety or level of usage, especially as determined by social context and characterized by the range of vocabulary, pronunciation, syntax, etc., used by a speaker or writer in particular circumstances; OED) to have the ability to adjust it to neutral if needed.
  • Understanding the SYNTAX (the set of rules and principles in a language according to which words, phrases, and clauses are arranged to create well-formed sentences – the ways in which a particular word or part of speech can be arranged with other words or parts of speech; OED) and, if required, be able to SIMPLIFY it without sacrificing accuracy of meaning.

natalya mytareva

(Graph by Natalya Mytareva)

Sight translation requires different skills than oral interpreting, and sight translating long documents can consume quite a lot of time, fatigue the interpreter and increase the risk for error (NCIHC, 2010). Thus, we come with the dilemma of:

Sight Translate versus DO NOT Sight Translate

From the pool of documents that we, healthcare interpreters, might handle while performing our duties, there are those ones (institutional forms and some informational documents) that we may sight translate (green in the table below), those ones (legal documents) that should practically never be sight translated but translated (red in the table below), and those ones (some informational documents) that depending on their length and level of complexity might or might not be sight translated (yellow in the table below).

chart 3.2015

Once it has been decided that a given written document is suitable for sight translation, here are some tips to prepare for it as they were suggested by Natalya Mytareva:

  • Beforehand:
    • Collect and study (translate and become familiar with) healthcare documents; even better if they are from the institution/s you are working for).
    • Prepare yourself by:
      • Analyzing the peculiarities of healthcare documents.
      • Analyzing sentences and identifying their subjects and predicates.
      • Studying specific vocabulary (legal, insurance, etc.)
      • Practicing paraphrasing sentences without changing the original meaning.
      • Creating your own sight translation glossaries (including formulaic phrases, sentences, paraphrases, and expressions without standard equivalents in other languages).
    • On site:
      • Identify the intent of the document & focus on preserving the intended meaning.
      • Review the whole document.
      • Simplify the written form as you go (idea by idea, not word by word).
      • While sight translating a sentence, read ahead to the next one to ensure an even pace.
      • Try sight translate at a moderate, even pace with a non-monotonous intonation.

Along with sight translation, TRANSLATION “ON THE SPOT” (written source to written target, on site), probably a performance less frequently done than sight translation, is also something that we are requested to do. Therefore, hinted here are types of texts that might be considered suitable for translation on the spot:

  • Notes on documents; not the whole document
  • Only from English to patient’s language
  • Only short, specific portions
  • Non-Technical” language

On-the-spot translations by interpreters, aside from documents such as those mentioned above, are unnecessary if materials have been translated in advance and are available for use in patient encounters (NCIHC, 2010).

It would be grand for those few comments if they manage to spark discussion among your fellow interpreters, especially among those ones working for your same department/agency, so when approaching a particular situation where sight translation might be required, by your professional response you can undisputedly be identified as a member of your institution.

References:

Medical Interpreting for Spanish Speakers – Spring 2015

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MISS Spring 2015 Flyer

Medical Terminology & Body Systems – Spring 2015

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MTBS Spring 2015 Flyer

Bridging the Gap – Spring 2015

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BTG Spring 2015 Flyer

Summary from a CCHI Webinar: “Infection Control and Industrial Safety for Medical Interpreters”

Presented December 19, 2014 by Linda Golley (Interpreter Services Manager, University of Washington Medical Center)

Medical interpreters, as any other health care worker, must be aware of what infection control means and know the measures that should be taken to prevent infection to and from a hospital setting as well as where to go to familiarize with health safety standards. INFECTION CONTROL is known as those measures taken to minimize the risk of becoming vectors of diseases to patients, family members, themselves, and any person the interpreter comes in contact with.

vector of infection

VECTORS OF INFECTION (carriers that transfer an infective agent from one host to another) can potentially be dangerous when vectors are not aware of the disease or infection they might be carrying. This could be due to the fact that they are merely mechanical carriers (they carry the infectious agent in their clothes, etc.), or when being biological carriers (they carry the infectious agent within their bodies), which in those cases is strongly related to the INCUBATION PERIOD (the symptoms of the disease are not yet manifested in them). Therefore, to prevent becoming a RESERVOIR OF INFECTION is recommended to get vaccinated when vaccines are available, and pay attention to each VACCINE EFFECTIVENESS TIME-LAPSE (vaccines are not immediately effective upon reception). The recommended vaccines for any healthcare worker are: MMR (Measles, Mumps, and Rubella); Chicken pox (Varicella); TDAP (Tetanus, Diphtheria, and Pertussis); Flu, annual; Hepatitis B; and TB (Tuberculosis) monitoring exposure, annual.

There are two types of Health Associated Infections (HAI), which sometimes are considered almost synonymous: Iatrogenic infections (originated during treatment) and Nosocomial infections (contracted in the hospital). In the USA, 2 million patients yearly get hospital related infections, with approximately 90,000 dying from them; and with most of those infections being transmitted on the hands of health care personnel. As might be expected, the most vulnerable populations to those infections are found within those very sick patients admitted in NICUs and ICUs, within those patients with depressed or suppressed immunologic systems (cancer patients, transplant patients, HIV/AIDS patients, and any other immune-suppressed – i.e., on steroids), or non-vaccinated patients.

In any situation, though, the best precaution is to assume that every patient/health worker is infected with a life-threatening blood-borne disease and with droplet-borne disease, and to act accordingly. Therefore, a self-conscious interpreter should always refuse assignments if he/she feels ill or experiences any disease symptoms.

Very important MEASURES/safety points to consider while on an assignment are:

  • Take STANDARD PRECAUTIONS as peremptory with all patients.
  • HAND HYGIENE, through; specific instructions are available at cdc.gov/handhygiene/

hand washing

  • ALWAYS FOLLOW POSTED signs as PRECAUTIONS outside the patients’ room; use always personal protective equipment (PPE) when prompted and/or advised to. And when remove PPE, leave it in the patient’s room; DO NOT take it into hallways.
  • Use BARRIERS: physical – Positioning!!!
  • DO NOT take food or drinks where patients are.
  • AVOID SHAKING HANDS; you can always politely refuse by saying things in the style of: “You don’t want to shake hands with me; you don’t know where my hands have been!”.

TRANSMISSION-BASED PRECAUTIONS are especial extended precautions taken on top of standard precautions, not instead of. They are specific for every particular infectious organism.

Keep in mind that at ANYTIME the best measures to protect your patients are always to:

  • Take nothing to their environments (room, etc.).
  • Remove outer street clothing.
  • Gel in and gel out (soap and water, if used continuously it dries up the skin and may cause skin cracks); to prevent that, it is advised to use gel provided by the facilities instead of interpreter’s own (composition is known, precludes handling personal stuff, and limits the number of surfaces touched before gelling).
  • Touch nothing.

INDUSTRIAL SAFETY deals with vulnerability AND responsibility. It refers to all those actions taken by health care workers, medical interpreters among them, in all those areas within a health care setting where their own safety, due to vulnerability, might be compromised during the exercise of their profession: infection control, radiation safety, mechanical safety, chemical safety (spills), patient’s fall, cold/heat weight (tolerance), physical danger (behavior), safety in a disaster while on the job, mental health (vulnerability in a locked Psychiatric Unit). Therefore, it is strongly recommended at anytime for the interpreter to increase self-protection to minimize vulnerability. The interpreter should always be vigilant and take the appropriate responsibilities by BEING PROACTIVE:

  • Dress properly for each given situation
  • Follow Department of Health (DOH) rules
  • Be alert to special precautions
  • Be alert regarding to protective equipment
  • Pay proper attention to standard precautions

It goes without saying that in cases with patients in psychiatric units or in prisoner environments the interpreter should never be alone with the patient, both for general safety and to prevent any putative interference from the interpreter into the therapy.

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 During the presentation the presenter posed four true or false questions to the audience:

  1. Is important for the interpreter to know what are the patients’ infections/diseases so interpreters can refuse an assignment?
  2. Medical interpreters are not dangerous to patients if they are careful to not shake hands with the patient.
  3. Medical interpreters are not dangerous to patients if they wear a surgical mask when they go to appointments while having a cough.
  4. Medical interpreters are not dangerous to patients if they put on a gown and a hair cover no matter what precautions are posted.

And these are the responses, in percentage, elicited by over 150 participants (being 66-74 % of them, Certified Interpreters):

Graph 3

The most controversial one among the four questions was doubtless the first one. I think that is very important for the interpreter to know the patient’s disease, and especially if it is infectious, but as the presenter pointed out, not to withdraw from the appointment, an action that should be prevented by the interpreters’ code of ethics, but to minimize the role of the interpreter as a vector of infection into and from the patient’s environment.

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