• Liz Essary

SimLab: Healthcare Interpreters Go Off Script

Updated: Feb 13, 2020

In my experience, we train healthcare interpreters with scripted dialogues. I've used some great dialogues, and written a lot of them. They're important in many training contexts, but they're limited. Not everyone can read their part in a natural way, and if the interpreter needs to ask the "doctor" for clarification or to explain a term in a different way, the interpreter playing the part of the doctor will struggle and it falls apart.They also don't always provide for natural problem solving. If someone has to go off script for any reason, it can easily go off the rails.

Interpreters don't work with scripts in real life (if only!), and with that in mind my training partner Laura Holcomb developed unscripted sessions for the Virtual Healthcare Interpreting Practicum (VHIP) at Glendon College. These sessions, in which healthcare providers play the role of themselves and interpreters prepare a patient persona to play, allow for spontaneous dilemmas to arise that the interpreter must resolve. With the help of our friends in Mexico, we took this model and offered it as a 3-day onsite interpreting intensive at the Lenguas 2020 event in Cuernavaca. We call it SimLab.

SimLab is named for the simulation labs used by medical professionals in training. We wanted to create a similar model, where interpreters could experiment with problem solving and see how other interpreters solve problems, in a safe setting. As a bonus, the interpreters got feedback about their work from the providers' point of view.

So, how exactly did this all work?

The Players

The physicians provided brief medical cases to us that the students used to build their patient persona (more on that in a second). They also showed up ready to simulate a patient encounter--They all brought their white coats, stethoscopes, and charts. The physicians were also instructed to add two elements of difficulty for the interpreters. We divided those elements into categories that included linguistic, emotional and managing the flow.

The patients were played by interpreters who used the information provided by the doctors. We used a worksheet to guide them so they could research adequate information to respond to the physician in a logical way, according to their assigned medical condition. The patients were also instructed to plan two elements of difficulty for the interpreters, using the same categories above.

Some patients expressed anger at the doctor or the interpreter, addressed the interpreter directly, or responded to the doctor before the interpretation was finished (all classics!). Some used really colloquial language that can be tough to interpret, or that the interpreter may not understand. Many of the interpreters playing the part of the patient certainly had a flair for drama!

The interpreters received the medical condition they would work with in advance so they could prepare for the session. We wanted the exercises to be challenging, but also wanted to focus on protocol and problem solving for interpreters that went beyond terminology. And even with the medical condition, there was no way they could know in advance everything that would be said or done during their simulation.

The Interpreting

The consecutive interpreting activities were straightforward: The simulations ran for 20 minutes, then the interpreters changed roles for another 20 minutes, and in the final 20 minutes the interpreters had a chance to ask medical questions of the doctors, and the doctors gave the interpreters feedback on what worked and what didn't work about the interpreting. Those hour sessions were followed by 30 minutes of peer support, which is feedback that is interpreter-driven (the interpreter names their goals for the session and gets to self evaluate before getting feedback) and recorded on forms so they can look at it later.

The second day we practiced whispered simultaneous interpreting. We asked the physicians to prepare a patient education session that would be delivered in a group setting. For the simultaneous sessions, it was more one-sided, but the "patients" were encouraged to ask the interpreter questions or make comments to them directly while the physician was presenting, and then ask questions at the end of the presentation. In this way, we got some practice with mode switching between consecutive and simultaneous.

Participants got to see how other interpreters work, play around with positioning, eye contact and body language, and different strategies for managing the flow of the session.

We closed the final day with relay and remote interpreting practice, which did require scripts. For these sessions, we wanted to focus to be entirely on the protocol for relay and remote work, so we gave the participants the scripts ahead of time so they could prepare the sight translations where required, and prepare the vocabulary. It worked brilliantly. They were prepared and could focus on the relay and remote interpreting protocols and overcoming difficulties.

The Fellowship

We also planned some non-interpreting activities on the final afternoon. We facilitated small group discussions on culture and communication in medicine, discrimination in interpreting, and professional development for interpreters. These discussions brought forth so many earnest comments on tabu subjects, and the participants handled some very delicate discussions with care. We wrapped it all up by sharing next steps, and a just-for-fun closing activity with idioms.

Our group was small but mighty. None of us had ever participated in an event like this, and just like in healthcare interpreting, it truly was a group effort to make it work.

The Next SimLab

We're bringing our next SimLab to Marian University at Indianapolis from July 8th to 10th, 2020. It'll be two and a half full days of back-to-back interpreting practice in their simulation lab, with a half day for small group discussions and a whole-group debrief at the end. All spoken and signed languages are welcome, and our CEU applications are in the works for certified interpreters! Would you like to join us? We'd love to meet you there.

SimLab registration is open! Attend all three days for just $400.00 when you register by April 30th. Have a friend who wants to come, too? When you both sign up, you'll each get an extra $25.00 off the registration fee, bringing it down to $375.00 if you sign up by April 30th!

You can find the registration form here.