title: Conveying information in the interpreter-mediated medical visit: the case of epistemic brokering.
abstract: OBJECTIVE
  This study introduces the concept of epistemic brokering in interpreter-mediated medical visits and illustrates how it can be used to effectively convey information between providers and patients/parents.
  
  
  METHODS
  Conversation analysis is used to analyze 24 pediatric genetics consultations (=17.75 h) involving 16 Spanish-speaking families, their various English-speaking healthcare providers, and four on-staff bilingual interpreters.
  
  
  RESULTS
  Interpreters-as-epistemic-brokers can aid in the transfer of information between clinicians and patients/parents (i) by (re)designing content to be appropriately fitted to a specific recipient's understanding, and (ii) by monitoring the ongoing medical visit for moments in which one or more interactants may be in a relatively unknowledgeable position and taking steps to secure common ground.
  
  
  CONCLUSIONS
  It is posited that epistemically brokering interaction can serve to promote the development of positive relationships with potentially hard-to-reach patients/parents. Although seemingly minor, these moments in interaction contribute to these individuals' overall experience with and understanding of the institution of medicine. Future research is needed to identify the particular strategies associated with effective epistemic brokering.
  
  
  CONCLUSIONS
  Interpreters and clinicians should be aware of the role that discursive practices play in conveying information in the medical visit, and reconceptualize interpreters as collaborators in this process.
authors.affiliation: Department of Sociology & Department of Spanish and Portuguese, University of California, Los Angeles, USA. Electronic address: craymond@ucla.edu.
authors.forename: Chase Wesley
authors.initials: CW
authors.lastname: Raymond
mesh_terms: D002648:Child; D003144:Communication Barriers; D005260:Female; D005817:Genetic Counseling; D006630:Hispanic or Latino; D006801:Humans; D007802:Language; D008297:Male; D019303:Multilingualism; D010372:Pediatrics; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D014175:Translating
keywords: Conversation analysis; Genetic counseling; Information delivery; Knowledge; Pediatrics; Translation/interpreting