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The language divide

The importance of training in the use of interpreters for outpatient practice

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Abstract

PURPOSE: Provision of interpreter services for non-English-speaking patients is a federal requirement. We surveyed clinicians to describe their experience using interpreters.

SUBJECTS AND METHODS: In this cross-sectional study we surveyed clinicians in three academic outpatient settings in San Francisco (N=194) regarding their most recent patient encounter which involved an interpreter. Questions about the visit included type of interpreter, satisfaction with content of clinical encounter, potential problems, and frequency of need. Previous training in interpreter use, languages spoken, and demographics were also asked. Questionnaires were self-administered in approximately 10 minutes.

RESULTS: Of 194 questionnaires mailed, 158 were completed (81% response rate) and 67% were from resident physicians. Most respondents (78%) were very satisfied or satisfied with the medical care they provided, 85% felt satisfied with their ability to diagnose a disease and treat a disease, but only 45% were satisfied with their ability to empower the patient with knowledge about their disease, treatment, or medication. Even though 71% felt they were able to make a personal connection with their patient, only 33% felt they had learned about another culture as a result of the encounter. Clinicians reported difficulties eliciting exact symptoms (70%), explaining treatments (44%), and eliciting treatment preferences (51%). Clinicians perceived that lack of knowledge of a patient’s culture hindered their ability to provide quality medical care and only 18% felt they were unable to establish trust or rapport. Previous training in interpreter use was associated with increased use of professional interpreters (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.4 to 7.5) and increased satisfaction with medical care provided (OR, 2.6; 95% CI, 1.1 to 6.6).

CONCLUSIONS: Clinicians reported communication difficulties affecting their ability to understand symptoms and treat disease, as well as their ability to empower patients regarding their healthcare. Training in the use of interpreters may improve communication and clinical care, and thus health outcomes.

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Authors and Affiliations

  1. Received from the Division of General Internal Medicine, Department of Medicine, Medical Effectiveness Research Center for Diverse Populations, Center for Aging in Diverse Communities, University of California, San Francisco, San Francisco, Calif

    Leah S. Karliner MD, Eliseo J. Pérez-Stable MD & Ginny Gildengorin PhD

Authors
  1. Leah S. Karliner MD
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  2. Eliseo J. Pérez-Stable MD
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  3. Ginny Gildengorin PhD
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Corresponding author

Correspondence to Eliseo J. Pérez-Stable MD.

Additional information

Research was supported by grant no. P30 AG 15272 awarded by the National Institute on Aging, National Institute of Nursing Research, and Office of Research on Minority Health, grant no. D22HP00349 by the HRSA Residency Training Grant in General Internal Medicine, and a grant from The California Endowment to the University of California, San Francisco.

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Karliner, L.S., Pérez-Stable, E.J. & Gildengorin, G. The language divide. J GEN INTERN MED 19, 175–183 (2004). https://doi.org/10.1111/j.1525-1497.2004.30268.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2004.30268.x

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