Mahdavi, Mojdeh (2020) The Role of Interpreters in Healthcare in Australia. PhD thesis, Victoria University.

Abstract

Interpreters play a pivotal role in facilitating communication between healthcare professionals and their patients when there is a lack of a common language which inhibits direct communication. This thesis examines the roles and practices of interpreters in healthcare settings in tertiary teaching hospitals with a high proportion of patients from culturally and linguistically diverse backgrounds in Melbourne, Australia. On the surface, the process of interpreter-mediated communication may seem straightforward, and the interpreter’s role is characteristically presented as being that of a neutral ‘language conduit’, seamlessly transferring meaning between two languages. However, this research explores the argument that conceptualising and understanding the role in this way is too simplistic, and devalues a range of contributions expected and made by interpreters in facilitating patient--health professional communication in Australian hospitals. The study was designed to investigate qualitatively the expectations and experiences of each group of participants in interpreter-mediated health communication concerning the role/s of the interpreter and factors that impact these role/s. To provide a complementary lens, the qualitative investigation of interpreters’ practices includes analysis of recordings of actual interpreted health encounters. Thirty-one individuals across three groups of participants (i.e. health professionals, patients and interpreters), across two large hospitals participated in semi- structured in-depth interviews. For the contrasting perspective, three interpreter-mediated outpatient healthcare interactions (in Dari, Arabic and Italian) were recorded and analysed enabling examination of similarities and differences between reported experiences and interpreter practice. The overall findings highlighted the interpreters’ awareness of the code of ethics and code of conduct that AUSIT (Australian Institute of Interpreters and Translators) promotes as professional standards. Interpreters seek to adhere to the neutral language conduit role as best they can. However, factors impacted the effectiveness of interpreters in relation to this role in the hospital interpreting setting, in particular, patients’ limited educational level and understanding of health terminology, dialect and gender compatibility between patient and interpreter, and institutional constraints, such as time and scheduling of consultations. On average interpreters engaged solely in direct message transfer in about 60% of their interpretations. However, they demonstrated a willingness and ability to move beyond their direct language conduit role when required, to facilitate more meaningful and expeditious HP- -patient exchange. Three core non-conduit roles (conversational facilitator, cultural facilitator, and experience facilitator) were also identified. Each of these roles is discussed in detail. Most importantly, whilst interpreters adopted these three non-conduit roles on an ‘as needs basis’, they felt in control and able to manage their professional boundaries when challenged. To conclude, recommendations about enhancing communication and training for health professionals, interpreters and patients were presented.

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