Enhancing Medical Student-Interpreter Collaboration in an Urban Free Clinic

Abstract

Background and Objectives: Cultural barriers and patient-provider language discordance exert deleterious effects on patient care. One solution has been the integration of medical interpreters into the care of patients with limited English proficiency. While medical schools and residency programs have started developing training programs on how to work with medical interpreters, no similar endeavor has been reported by student-run free clinics. Methods: Over 1 year, 76 third-year medical students (MS3s) were enrolled in control and intervention groups, and evaluated by in-person interpreters during interpreted real-patient encounters. MS3s in the intervention group received a lesson- and reminder-based training program on how to work with in-person interpreters. Results: MS3s who received the intervention were more likely to ask the patient one question at a time (odds ratio [OR] 3.54, P=.0079), listen to the interpreter without unnecessary interruption (OR 3.30, P=.022), and speak in short, simple sentences with pauses for interpretation (OR 3.08, P=.017). Conclusions: Our lesson- and reminder-based training program on provider-interpreter collaboration can improve the performance of MS3s within a select skill set with minimal cost and time investment.

The Use of Interpreters in Medical Education: A Narrative Literature Review

“…This section is centrally relevant to the research aim of this study because it focuses on the use of interpreters during undergraduate medical/health care curricula. Interestingly, only five papers discussed the actual use of interpreters in medical or health care education as part of the curriculum [13,[18][19][20][21]. More specifically, Itaya et al 2009 [18] conducted a survey with students and faculty members to understand how the limited English patients (LEP) were managed in dental education and what was the perceived impact on the quality of education.…”

“…Moreover, Kalet, Gany, and Senter's [22] and Kalet et al's [23] studies indicated that students greatly appreciated the training paradigms they used and expressed a strong interest in learning to collaborate with interpreters. In addition to the use of professional interpreters, two studies focused on the use of medical students as interpreters [21,34]. The results revealed that these students improved their skills and enhanced their cultural competency, but were challenged when attempting to separate the two roles in educational settings.…”

“…Some of the articles employed cross-sectional designs and surveys and used questionnaires to measure perceived effectiveness of training paradigms [5,19,35]. Many articles used pre-post scoring scales or tests [22][23][24]27,30,31], while only very few articles relied on control trials with control or intervention/control groups [20,21,29]. In general, all articles answered their research aim and presented useful results which could inform decisions and open new directions in research.…”

“…The fifth relevant study by Mazori et al [21] evaluated a program of working with interpreters at a free clinic. Of the 76 medical students, 40 were allocated to the intervention group and 36 were allocated to the control group.…”

“…These papers provided some insights into the use of interpreters in medical education in the USA, but we still do not know the extent of the use of interpreters in medical education globally; what patients think about the services; and how students and interpreters feel about it. Although Omoruyi et al's [20] and Mazori et al's [21] studies discussed the impact of using interpreters on students' skills, there is no study included in this review which presents information about long-term educational outcomes, student satisfaction, and the impact of interpreting services in medical education on patients and their health outcomes. Such lack of evidence highlights a huge gap in improving medical education in multicultural environments and the need to empirically explore the impact of interpreting services on educational and health outcomes.…”