Emotion work in interpreter-mediated consultations: a systematic literature review. , Patient education and counseling xxx (2019)."The published version of the manuscript is available on the Patient Education and Counseling (PEC) website.

EmpathicCare4All. Study protocol for the development of an educational intervention for medical and interpreting students on empathic communication in interpreter-mediated medical consultations. A study based on the Medical Research Council (MRC) framework phases 0-2.

Empathic communication (EC) in healthcare occurs when patients express empathic opportunities, such as emotions, to which doctors respond empathically. This interactional process during which participants try to achieve specific communicative goals (e.g., seeking and displaying empathy) serves as a context in which doctors and patients perform verbal and nonverbal actions and collaboratively co-construct meaning. This applies to interpreter-mediated consultations (IMCs) too, where interpreters perform additional actions of a similar kind. However, there is a dearth of research on the ways in which participants perform these actions in the context of EC, and how these actions in turn help (re)shape the context of EC in IMCs (Theys et al., 2020). To date, any tools for studying EC investigate participants’ actions in isolation, without studying them in the context of EC or in relation to the participants’ awareness of their own and others’ ongoing interactions. In this article, we present the Empathic Communication Analytical Framework (ECAF). The tool draws on valid, complementary analytical tools that allow for a fine-grained, three-level multimodal analysis of interactions. The first level of analysis allows for instances of EC in spoken language IMCs to be identified and for participants’ verbal actions in the context of EC to be studied. The second level allows analysts to investigate participants’ verbal and nonverbal actions in the previously identified context of EC. The third level of analysis links the participants’ concurrent verbal and nonverbal (inter)actions to their levels of attention and awareness and shows how participants’ actions are shaped and in turn help to reshape the context of EC in IMCs. In this article, we present the various levels of the ECAF framework, discuss its application to real-life data, and adopt a critical stance towards its affordances and limitations by looking into one excerpt of EC in IMCs. It is shown that the three distinct yet interconnected levels of analysis in the ECAF framework allow participants’ concurrent multimodal interactions in the context of EC to be studied.

Doctors and patients rely on verbal and nonverbal resources to co-construct clinical empathy. In language-discordant consultations, interpreters’ communicative actions might compromise this process. We aim to explore doctors, patients, and professional interpreters’ perspectives on their own and others’ actions during their empathic interaction in interpreter-mediated consultations (IMCs). We analyzed 20 video stimulated recall interviews with doctors, patients, and interpreters using qualitative content analysis. Doctors and patients found ways to connect with each other on the level of empathic communication (EC) that is not limited by interpreters’ alterations or disengaged demeanor. Some aspects of doctors and interpreters’ professional practices might jeopardize the co-construction of EC in IMCs. The co-construction of EC in IMCs is not only subject to participants’ communicative (inter)actions, but also to organizational and subjective factors. These results provide evidence of the transactional process between the behavioral, cognitive, and affective components of clinical empathy in the context of IMCs.

Current interpreter training programs pay increasingly more attention to the intricacies of the clinical context, such as doctors and patients’ communicative goals. However, to date, the conduit model remains influential when it comes to interpreters dealing with other participants’ emotions and their own emotions in interpreter-mediated consultations (IMCs). Consequently, establishing a good doctor-patient relationship by means of empathic communication (EC) might be jeopardized in IMCs. During EC, patients express their emotional or illness experiences to which doctors convey their empathic understanding. This study aimed to assess how doctors, patients, and interpreters verbally co-construct EC and the interpreter’s effect on this process. We analyzed 7 authentic IMCs using the Empathic Communication Coding System, as previously adapted for IMCs. We identified empathic opportunities (EOs) and empathic responses (ERs) as expressed by patients/doctors, and as rendered by interpreters. Our results showed that EC is the result of an interactive and collaborative process among all participants in IMCs. That is, the interplay between participants’ communicative actions determines how patients’ expressed lived experiences are addressed in IMCs. Our findings suggest that interpreters hold a central position in this process as they initiated EC about the patient’s illness experience and exerted control over the ways in which statements were rendered (e.g., interpreters omitted and altered original statements). In addition, our results indicated that EC in IMCs might be compromised by doctors and interpreters’ communicative actions.