1. National Standards for Healthcare Interpreter Training Programs

2. Building a Profession Working group discussions (1994-2000)
Agreement on Healthcare Interpreters’ Role (2000)
National Code of Ethics (2004)
National Standards of Practice (2005)
National Standards for Training (2011)
National Certification (2011)
Code of Ethics and Standards of Practice – consensus-building process
Served not only to create the standards, but to stimulate discussion and thought throughout the field. 2

3. Why Standards for Interpreter Training Programs?
Curriculum developers/trainers will know what content is essential and what methodologies are most effective.
Interpreters will know how to evaluate potential trainings.
Employers will know what to expect from interpreters who have completed different levels of training.

4. Steps to Developing National Standards for Training
Conduct core research / literature review
Conduct Body-of-Knowledge / Interpreter Task Analysis
Form Advisory Committee
Draft standards (April 2010)
Solicit feedback (October – November 2010)
Revise (December 2010 – March 2011)
Copy edit and proofread (April 2011)
Publish and disseminate (May 2011)

5. Challenges OR
What sort of program are the Standards for? Standards for academic programs? Community-based trainings? Longer programs? 40-hour programs?
How do programs measure if they’ve met the Standards? On what basis would we set benchmarks?

6. After careful analysis, these are some of the reactions
we expect to the Standards:
See which one you relate to:

7. …. trainers who through they were done

8. …. interpreters who thought they were done

9. for people who appreciate that this is a long process and these standards will improve quality

10. Program of Study Content Standards Instructional Methods Standards
The Standards
Program of Study Content Standards
Instructional Methods Standards
Programmatic Standards
As you can see, the Standards are divided into three sections. Today we are going to focus on the Content Standards………..

11. Content Standards Knowledge Interpreting Skills
The Content Standard are divided into 2 sections: knowledge and skills…

12. Program of Study Content Standards
Knowledge:
A basic program of study exposes the student to the essential body of knowledge that serves as the context of the profession of healthcare interpreting.

13. Knowledge A.1. The profession of healthcare interpreting:
A basic program of study provides the student with an introduction of healthcare interpreting as a profession.
The definition of interpreting as contrasted with bilingualism and translation
Fields of interpreting (e.g. diplomatic interpreting, liaison interpreting, business interpreting, community interpreting [including judicial, healthcare, social service, forensic , and educational interpreting)
Ways in which interpreters are employed (dedicated vs. dual role, staff, contract or freelance interpreter)
Overview of the history of healthcare interpreting in the U.S.
The purpose and functions/responsibilities of the healthcare interpreter
Modes of interpreting in health care
Media of interpreting (e.g. face-to-face, remote [telephonic, video])
Laws, standards and regulations relevant to healthcare interpreting (e.g. Title VI of the 1964 Civil Rights Act, Department of Health and Human Services [DHHS] Standards for Culturally and Linguistically Appropriate Services [CLAS], The Health Insurance Portability and Accountability Act of 1996 [HIPAA], The Joint Commission [TJC], and local policy), American’s with Disability Act )
Liability insurance
Purpose and limitations of certification

14. Knowledge A.2. Language and communication:
A basic program of study provides the student with an introduction to different aspects of language and communication dynamics as they impact interpreting.
Language elements (e.g. regional and social dialects, style, register, discourse; literal and figurative language; idiomatic and frozen language ; meaning and sense; literalness vs. meaning accuracy; paraphrasing; conversation vs. interviewing)
Communication elements (e.g., power dynamics; negotiation of meaning)
Cultural elements of language (e.g. forms of address; politeness markers; turn-taking and interruptions; body language)

15. Knowledge A.3. Ethical principles and standards of practice:
A basic program of study provides the student with an introduction to ethics in the healthcare profession and the ethical principles and standards of practice of interpreter professional practice.
The general concept of ethics and its application to interpreting in health care.
Ethical principles and standards of practice consistent with the National Code of Ethics and Standards of Practice for Interpreters in Health Care
Professional behavior and development (e.g., self-care both physical safety and emotional well-being; case conferencing and supervision; preparing for high stress situations)  

16. Knowledge A.4 Health system:
A basic program of study provides the student with an introduction to  the key concepts, beliefs, and common terms relevant to the U.S. health care system.
Overview of the U.S. healthcare system (e.g., venues, insurance, primary and specialty care, types of hospital services, categories of healthcare workers, legal concepts and terms)
Concepts and relevant terminology in biomedicine (e.g., anatomy and physiology, symptoms, common diseases, diagnostic procedures, common medications, treatments, apparatus, general understanding of biomedicine)
Overview of common healthcare interview routines and medical decision-making (e.g., the medical interview, the process of diagnosis, referral process, physical exam)

17. Knowledge
A.5 Culture: A basic program of study provides the student with an introduction to culture and its impact on health and health care.
Overview of culture – what it is and how it impacts health and health care
Concepts and relevant terminology from the patient’s perspecti ve (e.g., understanding of the human body and its functioning, description of symptoms, common diseases and treatments, expectations around insurance, origin of illness, complementary and alternative medicine.
The culture of biomedicine (e.g., the biomedical view of origins of illness, doctor- patient relationships, hierarchies, decision-making)
Cultural competence , awareness, and sensitivity

18. Knowledge A.6 Resources:
A basic program of study provides the student with knowledge of where to find and how to manage resources for further study for both knowledge and skill areas.

19. Program of Study Content Standards
B. Interpreting Skills:
A basic program of study provides the student with models of and opportunities for practice in the foundational skills of healthcare interpreting.

20. Interpreting Skills
B.1 Message conversion: A basic program of study provides models of and opportunities for practice in converting messages accurately and completely from a source language to a target language, and includes the following components.
Active listening
Message (discourse) analysis
Target language equivalence (e.g. figurative language, expletives, idiomatic speech, colloquialisms)
Managing regional dialects
Maintaining / changing register
Memory skills (e.g., chunking, prediction, visualization, note-taking)
Self-monitoring and self-assessment

21. Interpreting Skills
B.2 Modes of interpreting: A basic program of study provides the student with an understanding and demonstrations of the different modes of interpreting with a focus on the development of consecutive interpreting skills as the default mode used in healthcare interpreting.
1. Consecutive (default mode)
2. Simultaneous (exposure to)
3. Sight translation

22. Interpreting Skills B.3 Interpreting Protocols:
A basic program of study provides the student with demonstrations of and practice in interpreting protocols based on an understanding of the rationale for these protocols and their appropriate use.
Introducing and explaining the role of the interpreter
Use of the first person
Positioning , including the dynamics of different positions
Conducting a pre and post-session
Intervention techniques (e.g. speaking as the interpreter in the third person, maintaining transparency)
Managing the flow of communication
Monitoring comprehension among listeners
Interpreting for groups (e.g., team and family conferences , teaching sessions)
Interpersonal skills (e.g., how to work with healthcare professionals; dealing with disrespectful providers or difficult patients; de-escalating conflict)
 Footnote Positioning paper

23. Interpreting Skills B.4 Cultural competency / brokering:
A basic program of study provides the student with demonstrations and opportunities to develop cultural competency skills.
Recognition and management of cultural misunderstandings
Ability to recognize own cultural biases and maintain objectivity in the interpreting encounter.

24. Interpreting Skills B.5 Decision-making:
A basic program of study provides the student with opportunities to explore ethical and other professional dilemmas and situations.
Ethical decision-making – Ability to think through an ethical dilemma and make an informed choice based on the National Code of Ethics for Interpreters in Health Care.
Critical thinking - Ability to think through a situation and make an informed choice about the best course of action to take and be able to justify this action.

25. Interpreting Skills B.6 Translation in the interpreting context:
A basic program of study provides the student with basic skills in on-the-spot translation and transcription of simple oral and written instructions.
1. Ability to decide when on-the-spot translation or transcription is appropriate
2. Ability to  respond to requests for translations/transcriptions ethically and professionally

26. Expected Impact

28. So, how does your program measure up?.... Intro next activity

29. For more information, contact stc@ncihc.org.
The Standards, Training and Certification Committee of the National Council on Interpreting in Health Care