Community Interpreting Best Practices Corner
- Filling out forms -
in a nutshell...
interpreters should not fill out a client/patient's form
interpreters support discussions of others, interpreters' work is spoken, interpreters should never be asked to be alone with a client/patient
INTERPRETERS: How do I tell the customer that I can't fill out a form?
OCCI: Explain to the customer that an interpreter's scope and skills sets are focused on rendering a message in spoken form only. You should also the customer that an interpreter is supposed to be present only when a discussion between other parties is taking place, and that is why you are not to be alone with the client.
For your own professional protection, you should not perform a task that is outside your role as interpreter and most definitely not one for which your skills have not yet been assessed. (Neither the ILSAT nor the CILISAT assess your written skills.)
Suggest the following best practice to the customer or refer the customer to the ISP.
CONSUMERS: Can the interpreter sit with my client and help them fill out a form?
OCCI: You should not be asking the interpreter to (1) be alone with your client or (2) to help your client to fill out a form.
While the National Standard Guide on Community Interpreting Services does not explicitly state that an interpreter may not render anything in a written form, interpreting is defined as specific to "spoken communication", meaning that the source message may be delivered in the target language only in spoken form. (see pages 11 and 12)
Please see the following best practice for this situation. Consider what you would do if your client were English speaking but not literate or could not physically fill out the form.
Welcome to the OCCI Community Interpreting Best Practices Corner, where we weigh in on various aspects of community interpreting - considering the perspectives of interpreters, consumers, and interpreting service agencies.
The topics here are based on questions sent to OCCI. If you have a question about interpreting best practices,
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ISPs: How do I tell the customer that the interpreter cannot fill out a form for their client/patient?
OCCI: Explain to the customer that interpreters are trained and tested based on their spoken skills, not their written skills. Written vs spoken performance is not a matter of a hierarchy of skills - just different, like writers vs singers.
Be ready to hear that previous interpreters have not objected. Reiterate that you will follow up with those interpreters and review best practices with them.
Consider that Errors & Omissions insurance coverage for your interpreters may not cover written renderings.
Refer to the following best practices:
Recommended best practice when a form must be completed by/for a client/patient with limited English proficiency with an interpreter present:
A person from the customer's organization (service provider, staff, volunteer, student) must be present along with the client and interpreter. (Please note, that this applies to all interpreting assignments unless specifically requested and designated as escort/accompaniment interpreter which must be indicated at the time of booking.)
The interpreter provides sight translation and interpreting, the client/patient provides their information, the agency person clarifies any questions or issues related to the form being filled out and captures responses on behalf of the client.
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- Signing as Witness on Consent Forms -
in a nutshell...
interpreters should not sign as witness on consent forms
the interpreter is a participant in, not a witness to, the process
Recommended best practice when obtaining consent across a language barrier:
If any documents are to be reviewed during the consent discussion, these documents should be provided to the interpreter in advance with appropriate time for the interpreter to review and prepare, particularly if the interpreter may be asked to provide a sight translation of any part(s) of the document(s).
The interpreter should not be asked to sign as witness or to make any assertions or attestations as to the patient's understanding or willingness to give consent.
The interpreter's participation in the discussion should be documented by the clinician obtaining consent.
If the interpreter is asked to sign a consent document, it should be limited to a section that (1) is specific and unique to participation as interpreter, and (2) is aligned with the interpreter's role as defined in the NSGCIS.
ISPs: How do I tell the customer that the interpreter should not be signing as witness?
OCCI: Explain to the customer that interpreters have a participatory role, i.e. facilitating the discussion about informed consent between the patient and clinician, and therefore cannot also serve as a witness to the process.
It might be helpful to ask to see the consent form document. In many cases, the witness section includes a statement about confirming the patient's comprehension and having given consent freely. This will make the case even more clear because an interpreter should not be asked to confirm a patient/client's comprehension, and the interpreter should most certainly not be asked to make any claims about whether consent was given freely or not.
CONSUMERS: I need someone to sign as witness on the consent form. Can I ask the interpreter to be the witness?
OCCI: Since the interpreter is an active participant in the process, he/she would be in conflict if asked to serve as witness. In addition, it is not appropriate to ask the interpreter to perform the duties of witness, i.e. to attest to the patient's comprehension and to confirm that the patient has given consent freely.
From the National Standard Guide: "The healthcare provider is responsible for obtaining informed consent. The interpreter cannot be asked to obtain informed consent and should not be asked to serve as witness to the actual signed document. When consent is obtained with the assistance of an
interpreter, the participation of the interpreter should be documented." (page 36)
INTERPRETERS: How do I tell the customer that I can't sign as witness?
OCCI: Explain to the customer that your role is to interpret the discussion, and that since you are actively participating, you are not also able to serve as witness.
Just as it would be a conflict of interest for the patient or clinician to sign also as witness, it would similarly be a conflict of interest should the interpreter be asked to perform a dual role in this process.
Pay particular attention to the wording of any section you are asked to sign. The participation of the interpreter should be documented, however it is outside your role to be attesting to a patient's understanding or to the conditions under which the patient gave consent (e.g., freely, not under duress, etc.)
If needed, refer to the NSGCIS, page 36.
- Confirming the patient/client's comprehension -
in a nutshell...
the interpreter should not be asked if they think the client understands
the interpreter is not there to make sure, or even to comment on whether or not, a client/patient understands, but rather to provide the language support so that parties may participate in an exchange as if they shared a language
Recommended best practice for confirming comprehension:
Everyone working with an interpreter should receive orientation/training on working effectively with interpreters so that they know; (1) they should never ask an interpreter for her/his opinion; and (2) it is the responsibility of the English-speaking service provider to check in with the client/patient for comprehension.
Interpreters must refrain from commenting on the comprehension of any of the parties.
Interpreters must advise the parties of, and correct, any errors made in the performance of the interpretation.
ISPs: How do I tell the customer that the interpreter should not be asked to comment on the client's comprehension?
OCCI: Explain to the consumer that interpreter's role is to interpret the discussion and to ensure that she/he understands what is being said. The interpreter is responsible for accurately interpreting, but cannot be accountable, or comment on, how any to of the parties is perceiving or understanding the disussion.
Remember that the NSGCIS places the reponsibility on consumers to ensure their client/patient's comprehension. Using an interpreter is a first step - a great first step toward the goal of effective communication. Next, consumers still need to apply techniques, like teach back, to confirm comprehension. It should always be the responsibility of the ISP to make sure that consumers understand this and this should be included in all new customer on-boarding and training on how to work effectively with interpreters.
CONSUMERS: I want to be sure that my client/patient understands what I'm saying. Can I ask the interpreter if they think the client is understanding or not?
OCCI: The interpreter should never be asked for her/his opinion on any matter relating to the encounter. Commenting on one's perception of another person's understanding would be expressing an opinion.
As a service provider, it is up to you to check in with your client to see if they are understanding. When an interpreter is present you have the language support you need to be able to apply the same techniques that you would with an English-speaking client to ensure comprehension: ask the client to repeat back information; ask the client if they have some questions;
From the National Standard Guide: "The interpreter does not enter into the discussion, give advice or express personal opinions about the matter of the encounter, or show reactions to any of the parties." Standard of Practice #22.
INTERPRETERS: How do I tell the customer that I can't comment on whether or not I think the client understands?
OCCI: Explain to the customer that your role is to interpret the discussion, and you can't know whether or not the client is understanding; that you know only what you've heard and that is what you've interpreted - as accurately as possible.
Offer to interpret for the service provider if they want to ask the client what they have understood of key aspects of the discussion.
Remember, it is the responsibility of the English-speaking service provider to check in with the client for comprehension. If you observe what you believe/think to be a misunderstanding by any of the parties, the only situation in which you should intervene is when you believe/think that the misunderstanding may be a result of your work as interpreter (e.g., you may have misunderstood, misheard, or rendered an utterance incorrectly). It is always your responsibiilty to advise the parties of, and to correct, your errors.