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Article published In: Revista Española de Lingüística Aplicada/Spanish Journal of Applied Linguistics
Vol. 37:2 (2024) ► pp.682–719

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Transcending medical consultations

Entering the in-between zone to study the role of healthcare interpreters

ORCiD logo with link | University of Alcalá (FITISPos-UAH Research Group)
Published online: 5 April 2024
DOI logo with link
https://doi.org/10.1075/resla.22043.cri
Abstract
The role of healthcare interpreters has attracted much interest over the years, with particular emphasis on the distance between an invisible, uninvolved prescribed behaviour that contrasts with the interpreters’ behaviour in practice as active participants. However, much of the existing literature focuses on unfolding medical consultations where providers, patients and interpreters are simultaneously present, often overlooking situations when interpreters are left alone with patients. This involves areas of special role complexity in which interpreters must choose whether or not to become visible to the patient in what has been defined as the in-between (Shaffer, L. (2020). In-between: An exploration of visibility in healthcare interpreting. In de V. Souza, I. E. T., & Fragkou, E. (Eds.), Handbook of research on medical interpreting (pp. 188–208). IGI GLOBAL. Google Scholar logo with link to Google Scholar). This contribution aims to observe the healthcare interpreter’s role beyond the very act of the medical interview. Inspired by Shaffer, L. (2020). In-between: An exploration of visibility in healthcare interpreting. In de V. Souza, I. E. T., & Fragkou, E. (Eds.), Handbook of research on medical interpreting (pp. 188–208). IGI GLOBAL. Google Scholar logo with link to Google Scholar, we examine 66 moments “in-between” involving a sample of six interpreters (including four student interns) that took place prior, mid and end of consultations in a Spanish hospital. Rather than staying invisible, our analysis reveals that interpreters of the sample often participate in moments in-between (89.39%) to enact different roles (i.e., companion/confidant, advocate for the profession, mediator, institutional navigator, and healthcare ambassador). Among other aspects, triggers for role adoption in the in-between space include preventing conflict and deploying empathy. In this study, the behaviour of interpreters has demonstrated to influence the subsequent development of medical consultations (e.g., saving time or facilitating history taking). In light of preliminary findings that must be interpreted considering our research context, the next step is to examine how the healthcare interpreter’s behaviour in the in-between zone can facilitate interprofessional collaboration to provide patients with quality-care.
Resumen
Más allá de las consultas médicas: un estudio sobre la in-between zone para estudiar el papel de los intérpretes sanitarios
A lo largo de los años, el papel de los intérpretes sanitarios ha generado un gran interés, prestándose especial atención a la distancia entre la invisibilidad que se les prescribe y su comportamiento en la práctica como agentes activos. Sin embargo, buena parte de la bibliografía existente se centra en el desarrollo de consultas médicas en las que están presentes proveedores sanitarios, pacientes e intérpretes al mismo tiempo, lo que implica que a menudo se obvian situaciones donde los intérpretes se quedan a solas con los pacientes. Esto da lugar a áreas de especial complejidad en lo que a su(s) papel(es) se refiere, ya que los intérpretes deben elegir si mostrarse o no visibles ante el paciente en lo que se ha definido como in-between zone (Shaffer, L. (2020). In-between: An exploration of visibility in healthcare interpreting. In de V. Souza, I. E. T., & Fragkou, E. (Eds.), Handbook of research on medical interpreting (pp. 188–208). IGI GLOBAL. Google Scholar logo with link to Google Scholar). Este trabajo pretende observar el papel del intérprete sanitario más allá de la consulta médica en sí. Siguiendo a Shaffer, L. (2020). In-between: An exploration of visibility in healthcare interpreting. In de V. Souza, I. E. T., & Fragkou, E. (Eds.), Handbook of research on medical interpreting (pp. 188–208). IGI GLOBAL. Google Scholar logo with link to Google Scholar, se examinan 66 interacciones en la in-between zone en una muestra de seis intérpretes (que incluye cuatro estudiantes en prácticas) que tuvieron lugar antes, a mitad y al final de distintas consultas médicas en un hospital español. En lugar de permanecer invisibles, el análisis revela que los intérpretes de la muestra suelen participar activamente en estas situaciones (89,39%) para desempeñar diferentes papeles (por ejemplo, acompañante/confidente, defensor de la profesión, mediador, navegador institucional y embajador de la atención sanitaria). Entre otros aspectos, los factores que desencadenan asumir distintos papeles en la in-between zone incluyen prevenir conflictos o mostrar empatía. En este estudio, se ha demostrado que el comportamiento de los intérpretes en el espacio social descrito influye en el desarrollo posterior de las consultas médicas (por ejemplo, permite ahorrar tiempo o facilita la anamnesis). Según estos resultados preliminares, que deben interpretarse teniendo en cuenta el contexto de la investigación, el siguiente paso consiste en examinar cómo el comportamiento del intérprete sanitario en la in-between zone puede facilitar la colaboración interprofesional, para así proporcionar a los pacientes una atención sanitaria de calidad.
Article outline
  • 1.Introduction
  • 2.The healthcare interpreter’s role
  • 3.Introducing the in-between area
  • 4.Methods
    • 4.1Data collection
    • 4.2Situational context
    • 4.3Study participants
    • 4.4Procedure for analysis
  • 5.Analysis and results
    • 5.1When interpreters enter the in-between zone
      • 5.1.1Medical information/instructions: The interpreter as a healthcare ambassador
      • 5.1.2Institutional procedures: The interpreter as an institutional navigator
      • 5.1.3Conflict prevention: The interpreter as mediator
      • 5.1.4Dynamics of interpreter-mediated consultations: The interpreter as an advocate for the profession
      • 5.1.5Empathy: The interpreter as a confidant and/or companion
      • 5.1.6Rapport building: The interpreter as a confidant and/or companion
    • 5.2When interpreters refuse to enter the in-between zone
      • 5.2.1Flirtatious advances
      • 5.2.2Requests for medical information
      • 5.2.3Requests for the interpreter’s personal opinion
  • 6.Discussion and final remarks
  • Notes
  • References
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