medical students train with interpreters to improve minority
By Susie Shutts
Feb. 25, 2008
“In Mexico, my
grandmother delivered the kids,” said Anabella Sanchez,
program manager at Nationwide Children’s
Hospital in Columbus.
When Sanchez moved
to Texas from Mexico at 21 she was pregnant, and she
prepared for childbirth not through prenatal checkups, but
by drinking cumin tea, a natural labor inductor used by
Hispanic midwives. During her delivery – her first U.S.
hospital visit – Sanchez did not understand a word; she
spoke no English.
a growing minority. The most recent U.S. Census figures,
from 2000, estimate that 21.4 million Americans (8.1 percent
of the population) speak English less than “very well.”
And, like Sanchez, these individuals often take different
approaches to wellness – for example, through the use of
traditional home remedies.
To help future
doctors serve such patients, Sanchez visited the Ohio
University College of Osteopathic Medicine (OU-COM) on Jan.
22 and Jan. 31. There she led the college’s third annual
medical interpreter simulation lab. All second-year medical
students attended one of four sessions. In May, all
first-year students will participate.
“The state of Ohio
isn’t homogenous,” said lab coordinator Pat Burnett, Ph.D.,
OU-COM’s director of student affairs and multicultural
programs. “We want to train student physicians for the
future, and the future includes a diverse population.”
professionals, miscommunication can have dire consequences.
In 1984, a 22-year-old man told his girlfriend he felt
‘intoxicado’ and collapsed. When she repeated the term, non
Spanish-speaking paramedics took it to mean intoxicated,
though the intended meaning was nauseated. His brain clot
was misdiagnosed as a drug overdose, and he later won a $71
million malpractice settlement against the South Florida
tiene?” –What seems to be the problem?
herself English through books and daily conversation
(supplemented, she says, by English-language soap operas).
She mastered her second language, and years later after
moving to Ohio, Sanchez started a medical interpreter
program at Children’s. She now oversees 28 interpreters – 20
for Spanish and eight for Somali – who facilitate more than
6,000 encounters a month. Sanchez keeps a contingent staff
for 12 other languages, including French, Cantonese, Swahili
Sanchez requires 60 training hours and a verbal language
proficiency test, but there are no hard and fast state or
federal rules concerning medical interpreter training.
The Civil Rights Act
of 1964 and the U.S. Department of Health and Human Services
mandate that physicians accepting federal financial
assistance such as Medicaid must provide free interpreter
services. But the obligation can be met in a variety of
ways, including community volunteer services.
Although the Office
for Civil Rights guidelines suggest that a patient “may feel
more comfortable when a trusted family member or friend acts
as an interpreter,” untrained individuals are more likely to
err. The provider must inform patients of their right to a
provided professional translator without charge.
– Do you have any questions?
During the OU-COM
simulation labs, Spanish-speaking simulation patients were
assigned either hypertension or diabetes, and they spoke
solely in Spanish, aided by one of six interpreters from
With five people
crammed in the examination room, student Jess Nordin was
forced to stand. It made her uncomfortable to look down at a
patient, but “the interpreter made a big difference.”
instructed to direct all speech and eye contact to the
patient and treat the interpreter as “a floating voice.”
“Even if I don’t
understand, it’s uncomfortable if you aren’t paying
attention to me, because I’m sick,” said Rocio Perez, a
simulation patient, during a debriefing following the lab.
Sanchez later taught
Spanish medical terminology basics at a workshop sponsored
by OU-COM’s Student National Medical Association chapter.
She showed slides on body parts, illnesses and greetings,
noting that a doctor’s use of Spanish greetings, even with
an interpreter present, helps build trust and rapport with
The golden rule:
while being mindful of cultural differences, “treat
patients the same as if they are speaking English,” Sanchez