F.I.T. : Final Written Exam Review (The Medical Interpreter Textbook) with Complete Solutions

Communicative Autonomy - ANSWER-The capacity of each party in an encounter to be responsible for and in control of his or her own communication Medical Interpreting - ANSWER-Interpreting for patients, their families and service providers in healthcare What are the general credentials needed for Medical Interpreters? - ANSWER-They should be: 18 years or older, have education, pass a language proficiency test, Literacy, experience, certificate for medical interpreting training, and have certification through a validated test. (18 years or older; Hold a high school diploma or equivalent; demonstrate adequate oral proficiency in their working languages; Have literacy in their working languages; Have had life experiences in countries or communities where they communicated regularly in their working languages. Hold a certificate for professional training in medical interpreting of at least 40 hours. Demonstrate professional interpreting skills, preferably through a validated test such as certification) What is NCIHC? - ANSWER-National Council in Interpreting in Health Care (NCIHC), is one of many training and professional associations for medical interpreters. What are the NCIHC Code of Ethics? - ANSWER-Confidentiality Accuracy Impartiality Role Boundaries Cultural Awareness Respect Advocacy Professional Development Professionalism How does NCIHC define "Ethics"? - ANSWER-Strict set of principles or values that govern the conduct of members of a profession. While they are engaged in the enactment of that profession How does NCIHC define "Standards of Practice"? - ANSWER-Set of guidelines that define what an interpreter does in the performance of his or her role, that is, the tasks and skills the Interpreter should be able to perform in the course of fulfilling the duties of the profession. They are considered "Best Practice". What is the difference between Certificate and Certification? - ANSWER-Certificate is what is generally received after taking a medical interpreting training course. Certification is received after passing an exam given by a professional body such as NBCMI (National Board of Certification for Medical Interpreters) and CCHI (Certification Commission for Healthcare Interpreters). Define CONFIDENTIALITY (NCIHC Code of Ethics) - ANSWER-The interpreter treats as confidential, within the treating team, all information learned in the performance of their professional duties, while observing relevant requirements regarding disclosure. Define ACCURACY (NCIHC Code of Ethics) - ANSWER-The interpreter strives to render the message accurately, conveying the content and spirit of the original message, taking into consideration its cultural context. Define IMPARTIALITY (NCIHC Code of Ethics) - ANSWER-The interpreter strives to maintain impartiality and refrains from counseling, advising or projecting personal biases or beliefs. Define ROLE BOUNDARIES (NCIHC Code of Ethics) - ANSWER-The interpreter maintains the boundaries of the professional role, refraining from personal involvement. Define CULTURAL AWARENESS (NCIHC Code of Ethics) - ANSWER-The interpreter continuously strives to develop awareness of his/her own and other (including biomedical) cultures encountered int he performance of their professional duties. Define RESPECT (NCIHC Code of Ethics) - ANSWER-The interpreter treats all parties with respect Define ADVOCACY (NCIHC Code of Ethics) - ANSWER-When the Patient's health, well-being, or dignity is at risk, the interpreter may be justified in acting as an advocate. Advocacy is understood as an action taken on behalf of an individual that goes beyond facilitating communication, with the intention of supporting good health outcomes. Advocacy must only be undertaken after careful and thoughtful analysis of the situation and if other less intrusive actions have not resolved the problem. Define PROFESSIONAL DEVELOPMENT (NCIHC Code of Ethics) - ANSWER-The interpreter strives to continually further his/her knowledge and skills. Define PROFESSIONALISM (NCIHC Code of Ethics) - ANSWER-The interpreter must at all times act in a professional and ethical manner. Explain the concept of "CONFIDENTIALITY"? (NCIHC Code of Ethics) - ANSWER-The interpreter must be careful of sharing any information or details that can identify a patient. You might be required to break confidentiality for some instances such as: - If you are required by law (e.g. you get a subpoena to testify in court) - If there is "imminent danger" such as a risk of homicide or suicide (required in many or most states) - If there is suspicion of child or vulnerable adult abuse (may not be required in every state for interpreters) (Note: Domestic violence is not considered "imminent danger" unless the victim's life is in danger. So you usually would not report it. ) Explain the concept of "ACCURACY"? (NCIHC Code of Ethics) - ANSWER-Interpret EVERYTHING, including: "Bad words" side conversations Information you didn't catch (ask for repetition) Long answers that seem irrelevant or go on and on. Offensive language, upsetting remarks and insults. (Note: Remember there is No accuracy without transparency; If you can't hear it, you can't interpret it. ; Lack of transparency can lead to side conversations which is the most common complaint from providers and can lead to mistrust of interpreters;) What are some obstacles for Accuracy (NCIHC Code of Ethics)? - ANSWER-- A situation spirals out of control - Patient is incoherent (intoxication, or other reason) - Several people talking all at once (Too much noise) (If you note a serious problem, you could say "Excuse me, as the interpreter, one of my goals is to provide accurate interpretation, and I am concerned _____________ (potentially offer to work with the provider to come up with a solution?)".) Explain the concept of "IMPARTIALITY" (NCIHC Code of Ethics) - ANSWER-Interpreter must remain unbiased and neutral, however patients and providers may misunderstand your role and pressure you to do something that violates this ethical requirement. It is important to clarify your role. (Ex: Patient might ask for your opinion of the provider, Nurse or Social Worker may leave you alone with a patient with a long consent form or advanced directives form that you are expected to fill out and explain with no one present to ask questions.) Avoid conflicts of interest such as interpreting for people you know. Define Conflicts of Interest - ANSWER-Any situation that might compromise your impartiality What are the 3 steps for managing conflicts of interest? - ANSWER-(1) Always disclose the relationship and the conflict of interest (2) Offer to Withdraw (3) If all Parties ask you to stay, self Evaluate to see whether you should or shouldn't stay (really reconsider this last step, ALWAYS consider what is best for the patient, and how it will affect you if you do choose to stay) Explain the concept of "ROLE BOUNDARIES" (NCIHC Code of Ethics) - ANSWER-It is important to know your role and stay in your role as a medical interpreter. Educate providers, patients and clients about your role. (Ex: Clarify that you cannot answer questions while you interpret, unless they are questions about your interpreting or what you just said) What are some special considerations for "Role Boundaries"? - ANSWER-- When you know the patient and it is hard to avoid people you know - Dual Role interpreters (bilingual staff) must clarify with provider if they are needed as medical interpreter or as their other role. - When the provider leaves the Interpreter must leave to avoid being left alone with the patient, however this is not always realistic, so interpreter must avoid speaking alone with the patient. (and can clarify if necessary the need to maintain professional boundaries and provider can answer any question patient has, this is why it is best to avoid this all together and not be alone with the patient.) Explain the concept of "CULTURAL AWARENESS" (NCIHC Code of Ethics) - ANSWER-Interpreters should strive to develop awareness of their and others cultures in the performance of their professional duties. However Interpreters are NEVER to be considered Cultural experts. The only cultural expert is the patient. It is the Interpreters duty (if absolutely necessary) to alert the provider there may be a possible cultural misunderstanding, however not to assume what that may be and allow the provider and patient to resolve it._______ What is the CHIA Ethical Decision making Process? - ANSWER-1) Ask questions to determine whether there is a problem. 2) Identify and clearly state the problem, considering the ethical principles that may apply and ranking them in applicability. 3) Clarify personal values as they relate to the problem. 4) Consider alternative actions, including benefits and risks. 5) Decide to carry out the action chosen.