The Role of Interpreter Services and Cultural Competence in Reducing Language Barrier

Language barriers between nurses and patients is a challenge that has increasingly affected nursing practice (Andreae et al., 2016). For instance, it has led to miscommunication in the healthcare sector, a situation that can be life-threatening (Meuter, Gallois, Segalowitz, Ryder, & Hocking, 2015). The problem is partly attributed to the growing number of migrant patients as well as foreign-trained staff (Li, Abdulkerim, Jordan, & Son, 2017). The challenge has also been associated with globalisation, an aspect that has necessitated the need for people to move around the world in search for work and educational opportunities (Andreae et al., 2016). Several studies have been conducted to address the issue systematically. This research paper seeks to examine some of the proposed strategies for minimising the language barrier when communicating with clients. The reasons for undertaking this research is to compare different findings on how to reduce language barrier and to identify trends in evidence.

Research Questions

            Many studies have focused on interpreter services as a means through which language barrier can be minimised in a healthcare setting (Anazawa, Ishikawa, & Kiuchi, 2012). According to such studies, the availability of professional interpreters has been linked to increased patient satisfaction, communication, and access to medical services (Anazawa et al., 2012). However, experts also admit that it is not only the presence of specialised interpreters that can help in reducing language barriers but also individual care practitioner's cultural competence could play a crucial role in addressing the problem (Meuter et al., 2015). For instance, as much as there might be an interpreter, the practitioner might miss vital communication components such as body language. Additionally, there is an assertion that cultural competence could provide an opportunity through which the health provider can connect with the patient on a level beyond the spoken words (Anazawa et al., 2012). As such, this leads to the research question: can interpreter services coupled with cultural training programs minimise the language barrier when communicating with clients?

Research Objective

            The primary objective of this paper is to analyse the extent through professional translators, and cultural competency can minimise the language barrier in a healthcare setting. The goal of this research paper is also to compare and contrast two sources of information on the effectiveness of interpreters and cultural training in reducing miscommunication in the healthcare sector.

The discipline that could be connected to this Research Activity

One discipline that could be related to this research initiative is social science. Social science is a branch of knowledge that is concerned with human behaviour in the context of social and cultural aspects.  There is no doubt that the problem identified in this paper mostly relates to human action, though in the healthcare setting, where culture also plays an essential role.

Data Collection Methods

            The data to be analysed will be gathered mainly through literature review. The process will include collecting evidence and from past studies and scientific articles that have examined the relationship between the key variables. Reviewing literature would be appropriate because data gathered from the review may have already been used in the past study, thereby making it easier to carry out more research. Additionally, collecting information through literature review saves time and is cost-effective, hence making it useful in this case. Other data will be gathered through search engines. Using a search engine is also appropriate because it is cost-effective and easy to use.

Data Evaluation

            Appraising data, in this case, involves checking the suitability of sources in addressing the research problem. A total of four sources were selected to aid in answering the research question. The inclusion criteria were mainly based on the applicability and practicality of the author’s message in the real world. The decision to include the articles in this analysis was also founded on the suitability of the research methods utilized as well as the relevance of the study hypothesis or topic of study. For instance, a review by Li et al. (2017) was chosen to inform the findings because the subject of the investigation is relevant to the research question. Additionally, a cross-sectional analysis by Andreae et al. (2016) was appropriate for the study because of the diverse population sample use, which makes the inferences relevant for other comparable settings with the impoverished populace. At the same time, the authors measured the exposure validly and reliably.

A pilot study examining the accuracy of medical interpretations by Anazawa et al. (2012) was also included because the research topic is relevant to the hypothesis under investigation. At the same time, despite the pilot study having few limitations, the outcomes were evaluated in a standard, valid and reliable way for cases controls. Finally, an explorative and descriptive study examining the use of interpreter and healthcare by Emina (2011) was chosen to contribute to the discussion due to congruity between research methods and hypothesis as well its relevance to the topic of study. Mostly, all the selected articles are relevant according to this research paper’s objectives and workplace requirements. In particular, the report by Anazawa et al. (2012) not only acknowledges the effectiveness of using translators in minimizing language barriers but also provides considerable evidence that necessitates the need for cultural competence among interpreters in the healthcare setting.

Summary of Findings

Interpreters play a significant role in the healthcare setting, a fact that is evident in the Japanese medical set-up. According to the article by Anazawa et al. (2012), the Japanese health scenery is defined by multiple, and cultural barriers as most patients are from foreign nations. As such, different health centres have hired English interpreters to aid minimise the language barriers experienced when communicating with patients (Anazawa et al., 2012). However, to determine the efficiency and accuracy of interpretation, the researchers analysed the errors associated with understanding. The researchers identified substitution, false fluency and omission-type errors as the major types of errors that occurred during interpretation (Anazawa et al., 2012). The findings highlighted the need to implement an integrated training programme in healthcare settings to minimise interpretation errors and consequently reduce language and cultural barriers in healthcare practice (Anazawa et al., 2012). Furthermore, the fact that interpreters with over one year experience made fewer errors emphasizes the need to prioritise the training and certification of interpreters and translators in medical contexts.          

            Emina (2011) also recognizes the importance of interpretation in the delivery of holistic healthcare services. Emina, however, approaches the subject from a different perspective as the researcher seeks to analyse the individual views and experiences of family, health providers and clients on interpretation in the Swedish medical context (2011). The perspectives are significant because practitioners are responsible for providing care to the patient, family and the entire community and may require interpretation services in the event of cultural and language barriers. The results of the descriptive research reveal that every stakeholder was interested in the services of a qualified interpreter to ease the communication process between physicians, patients, and families (Emina 2011). Overall, understanding the individual perspectives and experiences on the acquisition of interpretation services is essential to enhancing information delivery and reducing language barriers.

            With the aim to further understand the interplay between interpretation and reduction in language barriers, Li et al. (2017) advocate for the training and certification of interpreters. The authors recognize not only the need for more interpreters but also the importance of improving the translators' proficiency in the healthcare setting. As part of the certification, the researchers suggest that the interpreters should receive training on both the non-verbal, verbal and cross-cultural communication (Li et al., 2017). Additionally, translation aids such as apps and dictionaries should be made available and accessible to any medical practitioners. The researchers also emphasize the need to inform all the limited English proficiency clients of the resources available to them, such as the interpretation aides, to minimise language and cultural barriers, thereby improving service delivery (Li et al., 2017).

The retrospective research by Andreae et al. (2016) sought to determine the benefit of adopting comprehensive strategies to minimize language barriers to enhance client adherence to scheduled clinic appointments. The essential role of interpretation in overcoming language barriers became evident in the study. To improve clinic attendance, the study population was constantly reminded of their appointments (Andreae et al., 2016). However, to overcome the language barriers, the reminders were translated into the client's preferred language. The health center hired and certified more Spanish and English interpreters to increase efficiency (Andreae et al., 2016). The results of the study indicate an increased rate of clinical attendance upon implementation of language-sensitive appointment reminders (Andreae et al., 2016). As such, it can be inferred that interpretation and translation are essential to minimizing language barriers and improving healthcare delivery. Overall the findings of these four studies emphasise the significant role that interpretation and cultural training play in overcoming cultural and language obstacles between health providers and clients.

Conclusion

In conclusion, based on the above analysis, it can be deduced that interpretation or translation services can be useful in minimising language barrier when communicating with clients in a healthcare setting. Additionally, the verdicts support the view that interpreter services should be accompanied by training programs in a bid to increase awareness on cultural aspects associated with language barriers. As such, the findings support the premise that interpreter services coupled with cultural training programs minimise language barrier when communicating with clients.

The inference made in this paper might have a significant impact on the duty of care requirements. For instance, healthcare facilities approach to language barriers would involve recognizing linguistic challenges, offering language services, and ensuring cultural competence among translators as well as healthcare providers (Anazawa et al., 2012). In other words, regarding the duty of care requirements, quality medical care would entail the provision of interpreter services by every healthcare facility whenever necessary. Additionally, the conclusion necessitates elimination of complexity during the translation process by creating social training programs within healthcare settings, an initiative that would see interpreters also serve as cultural brokers.

Use of Information in Practice

            Different aspects of the above information might be used in any work setting. For instance, when it comes to my workplace, a large number of clients are unable to speak fluent English. At the same time, workers find it difficult to communicate with patients. One way in which the different aspects of information can be applied is by putting in place a policy related to language access, limited English proficiency, as well as cultural competence (Li et al., 2017). The plan would ensure that health workers provide quality medical services to clients regardless of their language and ethnic background. At the same time, it would facilitate the creation of cultural competence training programs, which might increase awareness among medical service providers and enable quality care for clients from all upbringings (Li et al., 2017).

            Additionally, most scholars identify language barrier as one of the significant obstacles in offering adequate, fitting, effective, and timely medical services to patients with limited English proficiency (Li et al., 2017). Based on what I have learned from this research, acknowledging that the patient population is diverse in term of language and culture is one area that needs to be earmarked for change in my workplace and the current practice as a whole. Communication and cultural competence is a vital aspect of care and a crucial element of a health worker's professional role irrespective of the clinical area or specialty (Emina, 2011). Therefore, it is essential to initiate change in that particular area.

            Finally, there is no doubt that some issues require further research and evaluation. For instance, using interpreter services might be associated with some limitations such as arrangement hitches, availability, and accessibility of translator services, convenience, and privacy-related issues as well as the effect on the client's comfort. There is a likelihood that such problems could hinder the implementation of research proposals. As such, further research and evaluation need to be conducted to ascertain their impacts.   

References

Anazawa, R., Ishikawa, H., & Kiuchi, T. (2012). The accuracy of medical interpretations: A pilot study of errors in Japanese-English interpreters during a simulated medical scenario. The International Journal for Translation & Interpreting Research, 4(1), 1-20. Retrieved from trans-int.org/index.php/transint/article/download/159/96

Andreae, M. H., White, R. S., Chen, K. Y., Nair, S., Hall, C., & Shaparin, N. (2016). The effect of initiatives to overcome language barriers and improve attendance: A cross-sectional analysis of adherence in an inner city chronic pain clinic. Pain Medicine, 18(2), 265-274. doi:10.1093/pm/pnw161

Emina, H. (2011). The use of an interpreter in healthcare. Perspectives of individuals, healthcare staff and families. Linnaeus University, 1-68. Retrieved from https://www.diva-portal.org/smash/get/diva2:444194/FULLTEXT01.pdf

Li, C., Abdulkerim, N., Jordan, C. A., & Son, C. G. (2017). Overcoming communication barriers to healthcare for culturally and linguistically diverse patients. North American Journal of Medicine and Science, 10(3), 103-109. doi:10.7156/najms.2017.1003103

Meuter, R. F., Gallois, C., Segalowitz, N. S., Ryder, A. G., & Hocking, J. (2015). Overcoming language barriers in healthcare: A protocol for investigating safe and effective communication when patients or clinicians use a second language. BMC Health Services Research, 15(1), 1-5. doi:10.1186/s12913-015-1024-8

Appendix

Article 1:  Li, C., Abdulkerim, N., Jordan, C. A., & Son, C. G. (2017). Overcoming communication barriers to healthcare for culturally and linguistically diverse patients. North American Journal of Medicine and Science, 10(3), 103-109. doi:10.7156/najms.2017.1003103

Article 2:  Anazawa, R., Ishikawa, H., & Kiuchi, T. (2012). The accuracy of medical interpretations: A pilot study of errors in Japanese-English interpreters during a simulated medical scenario. The International Journal for Translation & Interpreting Research, 4(1), 1-20. Retrieved from trans-int.org/index.php/transint/article/download/159/96

Currency

2017

2012

Study findings

The training and certification of interpreters is essential to minimizing language barriers.

There is need for integrated training to minimize interpretation errors and overcome language barriers.

Strength of study

Numerous secondary data.

It fills the gap in knowledge concerning the types of errors made by Japanese–English providing grounds for future research.

Relevance to objectives

The article precisely answers the research question as it directly addresses the interplay between interpretation and overcoming language barriers.

The article does not precisely relate to the objectives but provides information that can be inferred to answer the research question. 

Reliability

High reliability due to systematic synthesis of review articles.

Low level of intercoder reliability.

Validity

Internal validity: Reliance on reliable secondary data improves internal validity

External validity:  The findings are generalisable to the entire population.

Internal validity: A greater objectivity could not be achieved.

External validity: The results are not generalisable to the entire population due to the use of a small sample size.

Benefits

The findings can inform evidence-based medical practice more so among limited English proficiency clients.

The information provide basis for further research.

Risks

Risks associated with ambiguity of information

The findings are not representative of the entire population.

Feasibility associated with information

Applying the information to the workplace will be quite costly and, thus challenging.

Implementing integrated training programs will be costly.

Conclusions

It is essential to consider the significant role that interpretation and cultural training play in overcoming cultural and language barriers between health providers and clients.