Spanish Interpreter Apprenticeship Program II (SIAP II) ENRH-141

Spanish Interpreter Apprenticeship Program II (SIAP II) ENRH-141

Elective Description

Spanish Interpreter Apprenticeship Program II (SIAP II) ENRH-141

SIAP Course Directors:

2017-2018: Caleb Ashbrook ; Jennifer Gueler ; Jacob Khoury ; Benjamin Tomelleri-Galichia

Coordinators in the Office of Talent Management:

Hugo Castellanos

Patient interpreting, Language Services Manager

Office of Talent Management

Deyanira Wood

Supervisor

Language Services Department

Office of Talent Management

Meredith Stegall

Director

Language Services Department

Office of Talent Management

Faculty Sponsor: James Wagner, M.D.

Rationale

Throughout hospitals and clinics in the United States, Spanish has become an essential tool for communicating with patients. Studies show that Spanish-speaking patients are more satisfied with their care when their provider either speaks Spanish or has an accompanying, appropriately trained interpreter (1, 2). On the other hand, many medical students and physicians lack adequate training in the Spanish language and in the appropriate use of interpretation services, despite the motivation to improve their skills (3). These points resonate at UT Southwestern, with students working at the Parkland Hospital System and volunteering in outside clinics such as the student-run Monday Clinic. Many UT Southwestern students speak Spanish at an advanced level but recognize the need to expand their Spanish-language medical vocabulary and to develop bilingual communication skills unique to clinical settings. The SIAP I class in the Fall semester class works to prepare students for effective communication with Limited English Proficiency (LEP) patients through developing basic skills in medical interpreting in Spanish. The SIAP II course directors will work closely with the Language Services Department of Parkland to coordinate shadowing experiences between medical students and professional Spanish-language interpreters. In this way, students will garner a deep understanding of the inherent challenges and intrinsic importance of medical interpreting.

Objectives

  • To shadow medical interpreters in order to learn directly from professional interpreters about the profession of medical interpreting and to foster an understanding of the training, skills, ethics, and cultural competencies needed to provide adequate interpreting services
  • To practice medical interpretation for patients and providers at Parkland under the supervision of an interpreter mentor, and to receive feedback from the mentor
  • To further students’ knowledge through opportunities to participate in training activities designed by Parkland Language Support Services for its interpreters
  • To expose students to novel Spanish vocabulary, both medical and colloquial
  • To strengthen students’ ease and comfort in working with medical interpreters

Format

SIAP II revolves around at least 15 hours of one-on-one shadowing with Parkland Spanish language medical interpreters providing in-person, consecutive interpreting for patients and providers. The course directors will work alongside the Language Services Department at Parkland Hospital to set-up shadowing experiences over the spring 2018 semester. This course will run the semester after SIAP I, and either participation in SIAP I or Spanish fluency is a prerequisite for SIAP II. Students must complete at least 15 hours of shadowing throughout the semester and write a short reflection essay. We will also require that students provide feedback through a REDCap survey at completion of the course to receive credit.

Eligibility

The Spanish Interpreter Apprenticeship Program II is designed as a pre-clinical elective for medical students with advanced Spanish proficiency. Graduates of the SIAP I elective and fluent Spanish speakers will be eligible to enroll. A requirement to enroll in SIAP I is to take the Cambridge Institute Spanish Level Test (4) and at minimum place at level B2. I.

Orientation Session and Tour

Two orientation meetings will be held. The first meeting is also the first day of class for SIAP I. This session will be jointly taught by student SIAP course directors and mentors from the Language Services Department. The session will use material from the SIAP I elective, as well as the Parkland interpreter’s training module, to review the following important concepts:

  • The legal foundations for medical language services
  • Ethics of medical interpreting
  • Standards of Practice for medical interpreters (as defined by CHIA)
  • What providers need to know about using an interpreter
  • The structure of SIAP I and SIAP II

Students who are interested in SIAP II will be invited to the second orientation meeting, which is a short tour of the Office of Patient Relations and Language Support Services on the 1st floor of New Parkland Hospital. This meeting will familiarize students with the area where they will meet their interpreter mentors.

Scheduling Shadowing Hours

Students may schedule their own shadowing experiences as suits their schedule, on weekdays or weekends, with the following limitations:

  • Students must notify the course directors at least 2 weeks in advance of the experience. Students must then email the Office of Talent Management (and cc the SIAP II student leaders) to schedule a time to shadow an interpreter
  • Students should notify the Office of Talent Management of their preference for a particular service or clinic. A complete list of available services will be added at a later date, but may include:
  • Emergency Department
  • Laboratories and Diagnostic Procedures
  • OB/GYN clinic
  • Outpatient clinic
  • OR/Special procedures
  • Inpatient – the majority of interpreters are not assigned to a particular service
  • After 5PM, there may be limited availability for certain services or clinics, as fewer interpreters staff these areas after business hours. Course directors will notify students if there are any conflicts so that they may reschedule. A First-come-first-serve policy will apply in these situations
  • The number of hours spent shadowing will total at least 15

Logging Shadowing Hours

Two records will be kept of shadowing experiences, one by the individual student and one by the SIAP II student course directors. Students participating in the elective will receive a chart to document their experiences. The student reports the date and time, and the interpreter mentor will sign their chart after each experience. It is the student’s responsibility to request a signature from the interpreter mentor after the experience. SIAP course directors will also be copied on requests for experiences that students send to the Office of Talent Management and will use these emails as well to keep a record. The SIAP course directors will follow up with students on a weekly basis to confirm that experiences occurred, and signed charts will be collected.

During Shadowing

On these rotations, medical students will effectively be held to the same expectations as Parkland interpreters-in-training.

  • Patient, family, and provider consent must be obtained for the student to be present for the encounter.
  • The student and interpreter mentor may agree to allow the student to interpret during a patient encounter, with the supervision of the mentor. When a student is interpreting, the mentor will make corrections or clarifications as he or she feels necessary. The mentor may also resume the role of interpreter if he or she feels it is necessary.
  • The student is expected to respect the privacy and autonomy of patients in accordance with hospital and state policy.
  • The mentor will provide feedback to the student on his or her performance through a scored rubric based on national Interpreter Standards of Practice. These evaluations will help students identify areas for improvement in their interpreting skills, and may be points of discussion during the didactic portion of SIAP I. The rubric is the same one that the Office of Talent Management uses to train its new interpreters, and it will be provided to students at a later date.

Training Workshops

Students may voluntarily participate in classes and workshops designed by the Office of Talent Management for interpreters to improve its language services. These include a workshop on interpreting for psychiatric patients and a workshop on the implications of EMTALA for interpreters. Information about these workshops will be provided at a later date.

Student Evaluation

Grading will be Pass/Fail. Students must complete 15 hours of shadowing and a short reflection essay to be reviewed by the Course Directors. For the reflection essay, students will write a 3-page reflection essay (in English) followed by as a list of vocabulary (with definitions and/or descriptions) new to the student. Students must also fill out the end-of-course evaluation.

Course Evaluation

Students will receive an evaluation on the last day of the course. The evaluation will ask the students to reflect on their interpreter mentors and their mentorship strategies, and evaluate the content and presentation of each didactic and practical portion of the course on a scale of 1 (poor) to 5 (excellent). Questions concerning mentors and mentorship will be submitted to the survey by the Office of Talent Management. The Office of Talent Management will also review the anonymous results of this survey in order to identify areas for improvement in its own training program.

References

1. Fernandez A, Schillinger D, Grumbach K, Rosenthal A, Stewart AL, Wang F, Perez-

Stable EJ. Physician language ability and cultural competence. An exploratory study of communication with Spanish-speaking patients. J Gen Intern Med. 2004 Feb;19(2):167-74.

2. Lee LJ, Batal HA, Maselli JH, Kutner JS. Effect of Spanish interpretation method

on patient satisfaction in an urban walk-in clinic. J Gen Intern Med. 2002

Aug;17(8):641-5.

3. Yawman D, McIntosh S, Fernandez D, Auinger P, Allan M, Weitzman M. The use of

Spanish by medical students and residents at one university hospital. Acad Med.

2006 May;81(5):468-73.

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