Interpreters’ perceptions of culture bumps in genetic counseling

Abstract

Culture bump theory provides a practical and goal‐oriented framework for addressing cultural differences that can impact communication and patient care. Differences in language and culture, coupled with a lack of knowledge or competency regarding these differences, often contribute to ‘culture bumps’ between healthcare providers and patients. Interpreters serve the unique role of ‘cultural brokers’, going beyond bridging the linguistic divide to close cultural gaps. Research from the perspective of interpreters focused on culture bumps and cultural competency within genetic counseling sessions is lacking. We aimed to assess interpreters’ experiences with significant ‘culture bumps’ in genetic counseling sessions, obtain interpreters’ perspectives regarding genetic counselors’ gaps in cultural competency, and explore interpreters’ perceptions of the impact of cultural competency on the genetic counseling sessions. Spanish and Polish interpreters experienced in working in person with genetic counselors were recruited through interpreter supervisors at medical centers, hospitals, and interpreter training and service agencies in the Chicagoland area. Using a semi‐structured interview guide, phone interviews were conducted with eligible participants and transcribed verbatim. A codebook was developed between two coders, and inter‐rater reliability was assessed (κ = 0.82). Grounded theory was used as a guiding principle to code data. The results of this study revealed significant culture bumps identified by interpreters in genetic counseling sessions in the areas of exchange of information, gender and family dynamics, and incorporation of religious and faith beliefs. Interpreters identified the impact on rapport, both negative and positive, due to gaps and strengths in cultural competency, respectively. These responses offer useful insight for training and providing practicing genetic counselors with tools to promote cultural competency, in order to provide optimal care for patients with limited English proficiency (LEP). Further research is necessary to explore these concepts within other languages and cultures, as well as to determine the most appropriate methods for implementing these suggestions for improvement.

“I Don’t Know, I’m Just the Interpreter”: A first approach to the role of healthcare interpreters beyond bilingual medical encounters

“…More interestingly, the proposed categories also apply to research focusing on the interpreter's role in the course of medical consultations. For instance, the role of mediator encompasses both moral (Seale et al, 2013) and intercultural mediation (Rosenbaum et al, 2020;Sleptsova et al, 2014). On the other hand, examples of patient advocacy as understood in the present paper are equally reported in Hsieh (2013) and Krystallidou et al (2017), whereas the role of healthcare ambassador covers strategies also observed by Espinoza Suarez et al (2020).…”

Spanish language concordance in genetic counseling sessions in the United States: Counselor experiences and perceptions of its effects on processes and outcomes

“…Three recent genetic counseling studies highlight common barriers posed by language discordance. Rosenbaum et al, (2020) studied Spanish and Polish interpreters' perceptions of 'culture bumps' in genetic counseling conducted in Chicago, Illinois. Culture bumps are divergent expectations about behavior when two people of different cultures interact.…”

“…When the genetic counselor does not directly communicate in an LEP patient's preferred language, it may be difficult to achieve desired genetic counseling outcomes. Barriers to communication may include the variable skill level of medical interpreters (Cheng et al, 2018;Joseph & Guerra, 2015;Kamara et al, 2018;Rosenbaum et al, 2020), patient embarrassment about not understanding (Joseph & Guerra, 2015;Kinney et al, 2010), and patient misinterpretation of key information needed to make informed decisions (Cheng et al, 2018;Luksic et al, 2020).…”

Genomic Sequencing Results Disclosure in Diverse and Medically Underserved Populations: Themes, Challenges, and Strategies from the CSER Consortium

“…Recent work reported that a genetic counselor's cultural competency level could positively or negatively impact rapport [25]. In this case set, providers did not report challenges related to the objective "Apply genetic counseling skills in a culturally responsive and respectful manner to all clients."…”