Training healthcare professionals to work with interpreters

I was encouraged to see articles published on interpreted consultations in the February 2013 issue of the BJGP. Seale et al observed significant differences in the content of interpreted consultations as opposed to same-language consultations, including, fewer questions from the patient, less questioning of the patient agenda, less patient involvement in management, and a lack of humour.1 However, as the majority of the fluent English consultations were with white patients rather than with ethnic-minority patients fluent in English, it does not necessarily follow that the differences observed were as a direct result of the consultation being interpreted. Although we can assume that proficiency in English also points to a level of acculturation in ethnic-minority patients, some of the observed differences may be explained by cultural distance between the patient and provider rather than a language barrier. Cultural distance between patient and provider has been shown to challenge the delivery of patient-centred care, even where there is no language barrier.2,3 Any training on working with interpreters, therefore, also needs to incorporate diversity training that encourages examination of unconscious biases/stereotypes and enables providers to deal with the uncertainty created by cultural distance.4

In his editorial on the subject, Joe Kai points to many excellent areas of research to help improve interpreted consultations.5 These suggestions are very welcome. However, perhaps as a first step, we should prioritise implementing research linking the use of professional interpreters with patient safety. We already know that professional interpreters improve clinical care to patients with limited English to approach that of English-speaking patients.6 Additionally, there are fewer problems with accuracy, confidentiality, and control when using professional interpreters as opposed to family or bilingual workers.7 Despite this, and even when interpreting services are available, healthcare professionals under-use the services of professional interpreters, tending instead to use family interpreters, bilingual workers, or ‘getting by’ without services.8 Furthermore, training healthcare professionals on how to consult effectively through interpreters not only improves skills with all kinds of interpreted consultations but more importantly increases the likelihood of using professional interpreters in the future.9

Our responsibility for patient safety demands that we address the inadequate provision of training for healthcare professionals on consulting through interpreters at both undergraduate and postgraduate level.

• © British Journal of General Practice 2013