A new method for evaluating the quality of medical interpretation.
OBJECTIVE
To develop and implement a method to evaluate the quality of medical interpretation in a pediatric outpatient setting and explore the patterns and correlates of errors and failures in translation.


METHODS
Observational study of a convenience sample of 13 Spanish-speaking families attending pediatric outpatient clinics at an urban teaching hospital, their English-speaking providers, and interpreters. Visits were audiotaped and transcribed. The transcripts were divided into segments consisting of continuous sections of dialogue in a single language, plus any translation of that dialogue, and segments were coded for characteristics of the translation, word count, and the identity of the speakers.


METHODS
Translation quality on an ordinal scale derived from a set of nominal codes.


RESULTS
We found that 66.1% of segments in which translation should have occurred were translated with substantial errors or omissions or not translated at all. In 29.8% of segments, the interpreter engaged in speech unrelated to interpretation. Quality of interpretation was inversely associated with the word count per segment and, independently, whether the interpreter engaged in speech acts which did not consist of interpretation, which we call "role exchange." We give several examples and qualitative discussion of "role exchange" and show that it not necessarily associated with mistranslation but may have egregious consequences.


CONCLUSIONS
Interpreters who lack appropriate training fail to interpret accurately. Engaging in speech behaviors other than interpreting is associated with a higher rate of errors.
Laws
M Barton
MB
Latin American Health Institute, Boston, MA 02116, USA. Bart@LHI.org
Heckscher
Rachel
R
Mayo
Sandra J
SJ
Li
Wenjun
W
Wilson
Ira B
IB
D000328:Adult; D002648:Child; D002675:Child, Preschool; D003144:Communication Barriers; D005260:Female; D006302:Health Services Research; D006630:Hispanic or Latino; D006784:Hospitals, Teaching / Q000592:standards; D006786:Hospitals, Urban / Q000592:standards; D006801:Humans; D007223:Infant; D008297:Male; D009511:New England; D010044:Outpatient Clinics, Hospital / Q000592:standards*; D010372:Pediatrics / Q000379:methods / Q000592:standards; D010817:Physician-Patient Relations; D024382:Professional Role; D011368:Professional-Family Relations; D011785:Quality Assurance, Health Care / Q000379:methods*; D012044:Regression Analysis; D014175:Translating