eLetters to:

ARTICLE: Glenn Flores, M. Barton Laws, Sandra J. Mayo, Barry Zuckerman, Milagros Abreu, Leonardo Medina, and Eric J. Hardt Errors in Medical Interpretation and Their Potential Clinical Consequences in Pediatric Encounters Pediatrics 2003; 111: 6-14 [Abstract] [Full text] [PDF]

eLetters: Submit a response to this article

eLetters published:

Ad Hoc Translators Not That Bad!

Norman M. Jensen   (28 May 2003)

First Person Interpretation Techniques

Richard Jafrate   (31 July 2009)

Ad Hoc Translators Not That Bad! 28 May 2003
Norman M. Jensen, Professor of Medicine University of Wisconsin, Madison, Wi Send letter to journal: Re: Ad Hoc Translators Not That Bad! nmj{at}medicine.wisc.edu Norman M. Jensen	When I read this article closely, I come to a different conclusion than the authors seem to. Of the 13 interpreted visits studied, 6 were with "qualified" and 7 were with "ad-hoc" interpreters. "Qualified" interpreters averaged 39 errors / visit (14-60, "ad hoc" interpreters 24 (10-58), with no statistical difference between the two. Of "errors of potential medical significance", "qualified" interpreters ageraged 20 / visit (5-34), "ad hoc" interpreters 18 / visit (8-49), with the difference probably not significant statistically or clinically. Statistical significance in group differences in percent all errors that were medically significant, but this statistic is likely flawed by an inflated denominator, i.e., the fact that when a "qualified interpreter" was used, the clinicians made a lot more "fluency errors". And, in this analysis, I see little or no clinical significance. Both groups made too many errors. Clinicians must be on guard for interpretation erros with both types to minimize the adverse medical care consequences.
First Person Interpretation Techniques 31 July 2009
Richard Jafrate, Electrical Engineer N/A Send letter to journal: Re: First Person Interpretation Techniques rjafrate{at}gmail.com Richard Jafrate	My wife is a medical interpreter and I'm an electrical engineer. I have worked on a number of overseas industrial projects where communication was through an interpreter. We present a 1 hour talk, "Working Through an Interpreter", to groups of nurses participating in a continuing education program at SHMC, a hospital in Spokane Washington. We advocate the use of "first person" techniques which are very effective and I believe could eliminate many of the errors identified in this study. Using first person techniques, the provider and patient make eye contact and talk directly to each other, pausing after each phrase or sentence, allowing the interpreter to repeat the phrase or sentence in the other language. When done in this way the interpreter does not have a chance to editorialize, make omissions, or to otherwise control the conversation. In addition the provider and patient are able to non- verbally communicate directly with each other. Anecdotal examples given in the article seem to use a third person technique (i.e. "Tell her that ...", "What did he say..", etc). I am curious if any of the interpretation sessions were conducted using the "first person" technique and if so, did it have any effect on the error rate or potential clinical consequences. I think it would be interesting to take into account the interpretation techniques used (i.e. fist-person vs third-person) in a future study of this type. I offer the above comments in the hope that someone will find them interesting or useful. ;) Conflict of Interest: Spouse works as a medical interpreter.