Laurie Swabey and
Karen Malcolm, Editors

Introduction

laurie swabey and karen malcolm

Given the importance of healthcare interpreting, both in terms of the high stakes involved and the fact that it affects almost all deaf individuals and their family members, it is time for our field to seriously expand the number of evidence-based publications that are accessible and available to educators, consumers, and students. As a contribution to that effort, this volume seeks to engage educators in building stronger courses in healthcare interpreting and to further engage the profession in the important work of preparing interpreters to facilitate full access to healthcare communication for Deaf people around the world.

Deaf Americans have identified healthcare as the most difficult setting in which to obtain a qualified interpreter (NCIEC, 2008). Despite the importance of healthcare interpreting services to the Deaf community, relatively little attention has been given to developing evidence-based curricula, textbooks, case studies, and other resources for educating healthcare interpreters. An equally glaring lack in the field of signed language interpreting is an agreed-upon standardized body of knowledge that all interpreters who work in healthcare settings should master before working unsupervised in these settings. Additionally, there is a lack of professional standards related to decision latitude, particularly in regard to the minute-by-minute decisions regarding boundaries and involvement that interpreters face during every healthcare encounter. Further, the field is in need of additional research on which to base curricula for teaching healthcare interpreters. As an example, relatively little research has been conducted on interpreted interactions between deaf patients and hearing healthcare professionals that are mediated by interpreters and even less empirical work on healthcare interactions in which Deaf interpreters are members of the healthcare team.

Our field has made many advances in the education of interpreters, from 6-week programs in the 1970s, to AA programs in the 1980s and the proliferation of BA programs in the 1990s and early 2000s. The latter period also saw the establishment of accreditation for interpreter education programs in postsecondary institutions, the requirement of a degree to apply for RID certification, an MA in teaching interpreting and a PhD in interpreting. Although a few institutions offer sequences of courses in healthcare interpreting, our field has yet to agree on standards of practice for healthcare interpreting and interpreting education. The domains and competencies for healthcare interpreters (chapter 1) is a step in the right direction, but further work needs to be done. Focus groups (CATIE center, 2007) indicate that experienced, certified interpreters still do not have agreed-upon standards for making decisions related to the highly personal and high-risk situations that full-time staff interpreters and freelance interpreters find themselves involved with in their daily work. As educators, we play a role in implementing changes in education and policy so that deaf patients can focus on their healthcare without the fear of having to make decisions based on information that was incorrectly communicated due to the interpreter’s lack of competence.

One of the first records regarding the need for interpreting education, which was written in 1965 (Quigley & Youngs), recognized that haphazard approaches to training interpreters were not sufficient for interpreters either to attain certification or to meet the needs of consumers. Forty-five years after this initial book on interpreting was published, our field has made only incremental progress toward establishing healthcare interpreting as a specialty area based on education of significant scope and sequence.

An early notable effort in this direction occurred in 1983, when the first program specifically designed to educate healthcare interpreters was established in Minnesota on the St. Mary’s Campus of the College of St. Catherine (now St. Catherine University).^[1] Marty Barnum was instrumental in the development of the program, guiding it from a certificate program to a 3-year AAS program and finally a bachelor’s degree. In 1985 Barnum was awarded a FIPSE grant to develop the first textbooks and video materials in signed language healthcare interpreting. With this funding, Sandra Gish, Beth Siebert, and Barnum published instructional manuals that changed the way educators and students approached healthcare interpreting and healthcare interpreting education. Central to their approach was that the interpreter was a member of the healthcare team and was in fact a thoughtful decision maker. The goal was not invisibility but involvement in providing the best communication access for the patient and providers. This was a radical move away from the conduit approach, which was commonly practiced at that time.