'Subject To Interpretation' is a weekly podcast that deep dives into the topics that matter to interpreters.🎙 Hosted by Maria Ceballos Wallis
This week we speak with Natalya Mytareva on CCHI's Critical Incident Reports and Channels for Interpreter Discourse
Natalya Mytareva, M.A., CoreCHI™, is Executive Director and one of the founding Commissioners of the Certification Commission for Healthcare Interpreters (CCHI), a U.S. 501(c)6 organization whose mission is to develop and administer national certification programs for healthcare interpreters. Her duties at CCHI include coordination of the Commission’s business operations, public relations, and communication with stakeholders as well as test development and content management of CCHI exams. CCHI is a virtually operated organization since its inception in 2009, with legal HQ in Washington, DC, and staff telecommuting from across the U.S.
Natalya also serves as Administrative Commissioner of the National Commission for Certifying Agencies (NCCA), the authority on accreditation standards for professional certification programs in the U.S.
In 2000-2013, Natalya was Communications Director and Refugee Services Director at the International Institute of Akron, a non-profit refugee resettlement agency in Ohio. At the local and state levels, she engaged in advocating for and ensuring that immigrant and refugee populations receive culturally appropriate services from healthcare, law enforcement, and social services agencies. Additionally, she developed and taught several academic, workforce development and continuing education courses for healthcare and court interpreters, including being an adjunct faculty at Kent State University (OH).
Prior to moving to the U.S., Natalya was a senior, tenured instructor at Volgograd State University (VSU, Russia) teaching interpretation, translation, and linguistics courses in 1991-1996. She earned her combined BA/MA degree in Philology and Teaching English as a Foreign Language from VSU.
Natalya works from her home office in Green, OH.
To subject, welcome to subject to interpretation podcast, which takes us deep into the topics that matter to professional interpreters. I'm your host by Wallace interpreters encounter multiple instances of ethical and professional dilemmas during their day to day practice. Today, we're going to talk about these experiences in the medical setting. They are known as critical incidents to learn about this subject and a recently launched tool intended to help interpreters learn from the experience of others. We've invited Natalia Mitra Reva to subject to interpretation. Natalia's the executive director and one of the founding commissioners of the certification commission for healthcare interpreters, CCH HHI CCH HHI is a nonprofit organization whose mission is to develop and administer national certification programs for healthcare interpreters. Natalia is also a core C H I working in Russian and English and previously an instructor of interpretation, translation and linguistics at vulgar grad state university in Russia, and also at Kent state university in the United States. Welcome Natalia.Speaker 2:
Well, Maria, thank you very much for inviting me to discuss this important topic. I'm truly, uh, grateful and excited.Speaker 1:
Well, we're happy to have you here. Let's start by asking you what is a critical incident and why is this important?Speaker 2:
Well, a critical incident in a concept taken OB from the healthcare, uh, settings where doctors, nurses, all allied professions are required to report any incident when the patient suffers harm and there are different degrees of harm and criticality of those incidents. So what, uh, we thought that CCH is important because we are an equal member of the team that treats the patient and it communicates with their family that we need to be mindful of the situations when we interpreters feel that there was something in the communication, uh, that didn't go quite well or that caused us some distress. It's one of those moments. Uh, when I think of it as, uh, you know, your gut feeling like, Hmm, did I do it right? Did I really say it? How, so those are the moments that we want to capture so that we can then collectively ponder, discuss and come up with solutions in terms of either pointing them out, like in these situations, if you're a novice interpreter, even if you're experienced interpreter, you may experience some discomfort and this is what you should do, or maybe even provide special trainings and special, you know, scripts on how to deal with those moments that we encounter. But first we need to collect them to, you know, figure out what are those moments, incidents in communication, where we feel either doubt, frustration, anxiety, or maybe satisfaction and thinking like, oh, that went so well. I need to tell for the world about this. So that's put in a nutshell, what we think of when we say critical incidentsSpeaker 1:
Now, how do interpreters generally deal with critical incidents? What are some of the ways that either a staff medical interpreter or a freelance medical interpreter might deal with either one of these incidents of satisfaction or dissatisfaction?Speaker 2:
Well, as you know, in the field, uh, they're usually, you know, two broad options. One option is you come to the supervisor to debrief, or you come to, uh, you know, uh, a meeting. If it is a staff interpreters, they usually have staff meetings where you bring something up. But I think the most common one is what we've done for decades, uh, which is discussed with your peers, discuss with the, uh, fellow interpreters, uh, because I do believe that interpreters do not discuss this with their family or members, friends, et cetera. So I think we are beyond that professionally, that we understand that, uh, we, uh, should seek advice and we do it within our fellow interpreters. However, we believe that these discussions are often not captured or not captured appropriately. Like in the past, before pandemic, majority of us were interacting face to face. So we discussed it at conferences or get togethers. Now we tend to discuss the situations in social media groups, uh, and, uh, all the richness of the discussions sometimes is lost for being a learning lesson to others.Speaker 1:
So let's talk about Facebook, for example, because there are a lot of forums on Facebook and these can be very useful and they can be very supportive for interpreters. Sometimes the questions are, Hey, I, I need help in interpreting this phrase and this context. And that's always very interesting because no matter where you're from, it's always nice to hear different options and different versions that other interpreters come up with. But when an interpreter has one of these critical situations happen, then, and they post it on Facebook, what risk do they run?Speaker 2:
Well, there's several things. Uh, one is, uh, because this is Facebook. Sometimes we feel very comfortable and we forget about the privacy of our patients and providers and your own, right? So you are exposing on Facebook because you have your identity there. Uh, you're exposing already, maybe too much of the context of your question, uh, and your employer, or both, either a facility, hospital, or a language company, maybe monitoring Facebook. And they may see that you have overstated, uh, uh, the, uh, identifiable personal information that you should not disclose. In other words, you violate a he, so that's the number one, uh, kind of legal and professional challenge with sharing things on Facebook. Now, the second, uh, aspect of why I think sometimes these conversations may be not quite satisfying is that anybody could comment, right? And including individuals who call themselves interpreters, but have not invested in the professions through going through the training through certification. In other words, you may get an advi advice that has not been vetted and is not correct. Uh, and because it's face such groups or social media usually closed and, uh, they're monitored for, you know, normal things like, you know, um, decency of the conversation, respect, but they're not monitored for the actual content. Uh, how would you know that you're getting good advice, right? It's similar to, um, we still have interpret to say I've been doing it for 20 years, and then they fail a certification exam that may mean that you may have been doing it wrong for 20 years.<laugh> so same challenge. And, um, is I feel exists with the, uh, social media posts like that because we simply, they're simply not meant to be a professional, um, for, uh, you know, uh, mediation or arbitrage. They're still just social media.Speaker 1:
Now I find that the comments and the responses that are most useful to me are those that are grounded in a clear understanding of the code of ethics that underpins the question that the person is asking. Uh, obviously many people are responding, you know, while they have five minutes at the supermarket or they might be giving an opinion. So there's really no way to curate these quest, these answers and these responses in a way that prioritizes those answers that are grounded in, in the code of ethics and professional responsibility until you create a program like the one that C H I is trying to create, right.Speaker 2:
Well, that's the intent. We really like, you know, curating and providing the input that is grounded in the code of ethics in the practice and in the emerging best practices, right? That's the challenge when you deal with the, uh, changing world and with communication, uh, before COVID 19, we didn't dream that we would do certain things, right? Our main challenge was leave the room, don't be alone with a patient, and now it is what do I do with my webcam, right. Do I turn it off? Do I turn it on? Right. So, uh, how do you, so the different, uh, types and they evolve. So we cannot have it once. And for all decided that this is the right thing to do. Um, and what we should, uh, as a profession embrace is the tool that exists for medical professionals, which is Browns, right, when they discuss cases. And they learn during the treatment of a specific case, how this could be applied to future cases. And because this cases sometimes are not already yet for peer reviewed medical publications, but in the facility they're discussed, especially when you do Schwartz rounds and you have multidisciplinary discussions from social workers, the, you know, clinical team and interpreters could come in at that moment. So if we have this virtual rounds and, uh, you know, now that we're all virtual, it's actual perfect time, uh, when, uh, we have, uh, critical incidents that are submitted to us for review, and we publish them on our website, and then we can invite a panel of experts, represe presenting, different, uh, stakeholders, which would be your practicing interpreters, who are experienced, uh, who, uh, have, uh, you know, shown their, um, dedication to the profession who are certified, uh, interpreter trainers, maybe medical healthcare providers, uh, of different kinds like doctors, nurses, social workers, and discuss that incident from all these three perspectives. Uh, and eventually I hope we could also invite somebody to represent patients or the public so that they could also chime in because sometimes we need to, uh, uh, deal with communication issues, not just from, within interpreting, but know all the other perspectives while applying our professional standards and code of ethics. So that's the idea when we have a good enough sample of incidents, we'll have the first virtual rounds. And I already talked to, uh, several, uh, experts in the field who are eager and willing and are on standby to get, to get ready, which we just need to, uh, to, uh, get this project off the ground and have more people contribute to it.Speaker 1:
So walk us through the process of contributing to this new initiative.Speaker 2:
Well, um, you know, you go to our website, CCH I certification.org, and on the bottom of the homepage, uh, there is a link that takes you to that process. It's a report, it's an online form. And in the fall, we try to kill so many birds with one stone that it is, uh, really, you know, robust. So we ask for some demographic information, uh, that would be, uh, eventually analyzed and, uh, reported in an aggregate manner in terms of, uh, who are the interpreters practicing, uh, who are the ones who contribute with languages, where they work, that kind of stuff, because we don't know whether these reports will come from staff interpreters or freelancers, or whether they'll all be from Spanish interpreters or we'll have the richness of different cultures and languages. So, but we will keep track of it. And we hope that, uh, annual will be publishing reports that will show us how active our profession is because we need to keep a record online record of our profession. And this is one of this kind of byproduct of that, uh, uh, initiative. But the bulk of that online form is, uh, the actual description of the critical incident. And then your reflection, yours, the interpreter reflection on that incident and your suggestions, your assessments, whether it was good, whether it was, um, whether you applied all you wanted, or if you needed to think through it in the future, make some changes to your behave in similar situations. So those are the kind of, um, the intent. So we hope, and we know from a couple of people who submitted the repo, it takes about 50 to 60 minutes to complete that online form, because we truly need you to think through, to look up the codes of ethics so that you can back up your decisions either in that moment or your proposed solutions with the actual existing, uh, recommendations, or if you cannot find anything in the code of ethics or the standard of practice, then propose the solution of what, how we should address that. Uh, and, uh, the form has several parts. And, uh, before, uh, submitting the form, we encourage everyone to read on our website, the, um, critical incident report guidelines, because that's the documents, it's a short, it's a short document, and it defines for you, um, the five elements of the report and especially confidentiality, uh, when you submit your scenario, because ultimately when you describe your incident, it's important that you keep it very specific. So we don't have to, so we can give specific feedback, but it also, it should not disclose any identifiable health information, uh, or, uh, business information about the facility that is engaged in it, because we anticipate reports could be about different things, including, uh, one of the parties mishandling the situation, and we don't want, uh, anybody including CCH I, or the panelists who will do the virtual end to get in trouble by discussing something. So we, that's why we have those, uh, you know, guidelines about confidentiality, how you can blur some elements. For example, if the real incident involved a two year old boy from hospital X, Y, Z, which you will tell us, it'll be a three and a half year old girl from a rural hospital. And then nobody will know what you're talking about. Especially when we publish these reports, we de further de-identified by removing your name, obviously. And, uh, if the language is mentioned in the report, if it's important, then we keep it. Uh, and if it is not, and we also like they preliminary review of our staff includes the fact that if we see something that we think may be too close to identifying something, then we also would blur it even more before we publish it on our website.Speaker 1:
Now, I find it very interesting that this tool, that the process that one follows can actually be a process that we as interpreters can adopt in our own self-evaluation and reflection of incidents, perhaps not necessarily a critical incident, but those of us who routinely review our work re review, the situations that we encounter ourselves in this really presents a very, very useful framework, especially the section in which you have to match and identify the conflict together with a code of ethics that you think, um, is being infringed upon.Speaker 2:
Yes, absolutely. And, uh, uh, right now we only have two reports published and in one of those, uh, the first one, uh, I appreciate the actual self-reflection moment that the interpreter took when chief, or he filled out that, uh, and in that moment, where was she, uh, in that moment, like we asked the question specific questions, like, um, what were your thoughts and assumption during and after the incident, right? Or what were your feelings during, and after an incident because assumptions and feelings, right. Uh, different things, right. Uh, what did you do in connection with that incident? And, uh, why is it critical to you? Right. Because what we're looking for, it could be something very simple. I did not interpret part of the statement, but why, and why did you feel that you want to go through this process and fill out this paper, because hopefully you are trying to either teach somebody something or you yourself discovered that, you know what I need to, I, this is one of my weaknesses, uh, and I need to, uh, you know, overcome it. And by filling out the report, when we put things in writing, right, they words start living their different, uh, life, their different reality. And then you re you know, review it before you click submit. And something happens in you that next time you are in the same situation, you most likely will pause and act in a different way than in the first time when you did it. So that self reflecting moment answering those questions. And that's another, um, you know, benefit of going with, uh, through this process rather than just posting online online will usually throw things like, oh, this happened, what do you think? Well, here we ask you, like, what do you think first? Right.<laugh>. And that is like, because, uh, we reach the point, especially when we do have so many years of experience that we best learn by thinking and evaluating ourselves than actually just listening to a lecture, uh, because, uh, we already have a lot to draw on internal, and I want interpreters to be empowered and understand that there is a learning moment in just filling out this self-reflection, uh, part of the critical incident report.Speaker 1:
Now let's take a look at some of the, or let's talk about some of the reports that you have already online, obviously, where this is an initial stage. So there isn't an actual, um, I guess, analysis of this, this hasn't been done by a group of experts, but it's sufficient to give us food for thought, isn't it? I think one of the interpreters who submitted a report, um, was concerned that she omitted information on wittingly. Can we talk about that case?Speaker 2:
Yes. I, uh, really appreciated that report because that is so easy, especially if we get comfortable and we get experience to start, uh, thinking that, well, this was a long segment of the patient, and we know the patient wants this kind of assuming. And in this specific situation is, uh, uh, our listeners will read it's situation where a patient tells that she wants, uh, the provider to schedule a blood count test today. And the reason is so that she could see if there was continuous bleeding in the kidneys of her daughter. And so the interpreter, because she hears the urgency of the scheduling, the appointment with the, for the test scheduling the test today feels that that's the most important information and forgets to mention about the reason why the reason is that this continuous possible continuous kidney bleeding, uh, and, uh, that's after, you know, the mother, luckily in this case, understands some English. And so she hears that the interpreter omitted that information and, uh, she very graciously then reiterates. And could you please explain that? The reason I'm asking for this test is because I want to check if there is bleeding and then the interpreter catches, oh, she actually had two important key things. And I interpreted only one. Uh, and, uh, because, uh, of my not being very familiar with that specific case with that specific patient. So I assumed that one thing was more important than the other. Uh, so it's, and the interpreter then proceeds through self-reflection and answering question is like, I really need not to assume, take notes of everything, because when you see on the notes that you had, uh, complete, you know, CBC, and then, uh, continuous bleeding, you have to interpret those things because you see them in your notes. And that's the lesson that this interpreter learns. So not assuming things it's also could happen and does happen to many novice interpreters because they, especially, if they follow the same patient, they sometimes think that they can answer the questions for the patient, but they get into the same trap sometimes because we cannot know what is important for the patient in this particular utterance. And it's not our job to figure out what's important for them. Our job is to listen, identify key elements of the meaning and interpret key elements. And if you like it all the other elements too, but the key elements all have to be interpreted of the meeting. So, uh, this, you know, um, if we're looking at the mastery of accuracy, it's a continuum and the minimum you start is with key elements. And then you add, you know, other important elements, then you add secondary elements of that, me of that utterance. And so when you're a master, you interpret actually everything accurately, completely without changing or substituting anything. But before you get to that master, at least the key elements, and, uh, it's hard to figure out how do we force ourselves to do it every single time, every single utterance without assuming.Speaker 1:
And I now in,Speaker 2:
Uh, you know, interested to, uh, you know, there's some suggestions that this interpreter makes in the report, I'll be interested to hear what the panelists decide of. Like, what, how do we train that, right? How do we, what do we, how do we help people to remember about not assuming? SoSpeaker 1:
Now, Natalia, I also found it very interesting that this particular interpreter included background information on his or her work situation. And this particular interpreter was a telephonic interpreter who is working full time and who averaged about 20 calls of medical interpreting a day. Um, I think it's very important that, um, our listeners realize that critical incidents can happen in any scenario. Mm-hmm,<affirmative>Speaker 2:
Exactly, that's kind of the richness, right. Of this, collecting all this information in a standardized manner, because we would capture that this is not just novice interpreter working the first week or the person who does medical interpreting once in a life, uh, well, sorry, once a year. Right? So it is something that happens and we need to figure out why does it happen to this person? Uh, and would it happen to the other person? So maybe we'll have similar situation from a novice interpreter and we'll discover that this happens for different reasons, right?Speaker 1:
Absolutely. Now there's also a second, um, report that has already been published. And this one has to do with an in person encounter where an interpreter was told not to interpret something. And they were conflicted because they had not done a Prees and they felt that they had compromised the situation and themselves, by not having stated the guidelines in advance, which they felt, I think they were judging themselves pretty harshly mm-hmm<affirmative>, but they felt that they had opened the door for the situation to occur. Can you talk about that one?Speaker 2:
Yes. That was also a very, uh, thoughtful moment, uh, in the past and clearly, uh, giving us an example that, uh, you know, we will make mistakes and mistakes or, uh, we will behave in a way that we will then feel sad about and guilty about. And that's what I felt about that report. That the person actually didn't interpret what the provider said. Uh, least the way I understood that report, that, uh, the interpreter didn't do the procession. And when the provider said, well, don't interpret that part. Uh, the interpreter felt very uncomfortable, but followed the provider's lead. And then now looking back on it, uh, the interpreter realizes, well, both things were wrong and I should have followed, done the procession and I should have still probably handled it in a different way. And, uh, the, I like the, um, recommendation is to realize that providers will not, or other parties, maybe patients too obviously will not always act the way we are used to them acting. They will make their own mistakes. They will not follow the rules, even if you do state things, because even if this let's say, uh, interpreter had done the procession, the provider still could have made that comment because it was a culturally, it was a reflection of that. Provider's cultural competence and cultural sensitivity. And that's not something you can fix with one Prees, but the way how you would handle that, uh, obviously is, uh, critical and different. And, uh, it's important to see. And I think by having this, this kind of reports in one place and interpreters, both, uh, novice students, uh, of interpreting, uh, programs, uh, and experience interpreters, reading it, they will see that, you know, uh, we have all these, you know, critical incidents on a daily basis and a variety of scenarios, and we need to, uh, you know, be cognizant of them and address them even so that, you know, we cannot change yesterday, but we can do better next time. SoSpeaker 1:
In addition, in that particular scenario, the interpreter also assessed what she could do in the future. She identified one of her techniques, which she clearly, um, labeled as not a standard way of handling. And this was where the interpreter was talking about how she might say to the provider or that person give them the opportunity to, uh, to, to, to rephrase what they had said. If the interpreter, I guess, felt that it was inappropriate the way it had been said now, independently of judging her, whether she's right in her manner of solving this in her solution. I think that these rounds and these critical incidents reports are so valuable because just as language is not static, it's not frozen. It changes. I believe that interpreting as we move forward and we encounter all these different situations, the way that we do something today is perhaps not how we did it 20 years ago. And by having this interpreter being honest and said, you know, this could be a way of resolving it. It may not be the accepted way or the best practice, but it puts it in the general continuum of possibilities that the experts can discuss in the upcoming panels. What do you think about that?Speaker 2:
Oh, absolutely. Absolutely. Because, uh, you know, uh, it's the hardest part is to prepare for the unknown, right? And by, uh, seeing how some people handle and struggle and figure out how would they handle it. Uh, we could find some good solutions, uh, for that we could apply in unknown situations. Right. And then the other thing is that in this particular case, uh, you know, I like her vulnerability of saying that I realize that this method is not, uh, an approved and accepted method, but, you know, we cannot predict and approve every method for every possible situation, right? If, uh, especially with last year, taught us with COVID, uh, 19 pandemic. Uh, there are situations if doctors where in some facilities at the point of dis discussing of, uh, who would get a ventilator and who would not right. And while it was, you know, against all the other ethical norms of theirs to figure out, well, you all just may have to disconnect that ventilator from that patient and give it to the other patient. So that is nobody prepared them. No school will have. And each, you know, after reading this discussion, you'll see that different facility had different priorities. And then, you know, the different advocacy groups conflicting with them. So I think what we would achieve with the rounds is discussing these very difficult moments where right now they're not accepted and approved, but they could be a good moment to handle an unknown situation that you handle it that way in that moment. And then you bring it back to the rounds and we'll figure out what will be a better way, because it's always best to do something about it, then wing it and ignore it because ignoring it makes it always worse, but addressing it in a way that shows that you noticed it and you care about it, and you do something about it, at least that gives you the, uh, you know, the satisfaction of sleeping at night, right?<laugh>, you know, I may not have done the best of the jobs, but I recognize there's a moment as a critical incident. And I addressed it in that moment that way. Uh, and then I'm going to think about it then I'll do better next time, so, or differently, whatever I find the peers, uh, would recommend. So that I think is a very important, um, opportunity for us to, as a profession, to ponder this, uh, situations and, uh, dilemmasSpeaker 1:
Now, not all critical incidents are created equal. There may be some incidents which actually are at the cusp of having somebody be harmed by something that is done or not done. And yet we have others, like the example we had earlier of the parent who just added the information that the interpreter had emitted. I think it's really critical for us using the word critical here. I think it's critical for interpreters, um, to be able to distinguish the difference, but also to not, um, set aside those things that they think are trivial because mm-hmm,<affirmative>, they really may not be trivial in the long run and by reviewing them and incorporating them into their thought process, that's another way that they can, um, ensure that they're doing best practices. What do you think?Speaker 2:
Oh, absolutely. Uh, uh, you know, uh, and I hope we'll get a lot of, um, no harm reports because we really don't want to get harm. Right? Our whole purpose is to facilitate communication, to make the life of the two parties easier. So, uh, that's why my prediction as the majority of our reports will be no harm. Uh, and, uh, the value would be in, uh, showing your critical thinking process, your actions in the moment, your assessment, and that would lay the foundation for newcomers to our profession to, you know, see how it's done, because, you know, in a way where a lot, we are kind of an apprentice type profession, when you learn interpreting translation, right. You're shown the model. You do it, you're given feedback. These are errors like linguistic ones wise, right. Uh, so, and the same thing is about critical, uh, thinking and applying ethics. Uh, yes, we have the, uh, webinars, we have online training courses, but there's never enough because, you know, it's, um, uh, living, uh, profession. So, uh, I think the, the actual, uh, discussion and showing of the no harm incident is more important because that'll prepare you for an incident when there could be potentially harm and you prevented it. And so that's the other type of incidents I hope will, uh, reports, I hope we will see is the ones where the interpreter did the right thing, because we want to have both the ones where you feel you didn't do something, but also when you did do something, uh, and, uh, it, uh, especially would be interesting to see in the areas where there is this intersection of medical interpreting healthcare interpreting in other fields, uh, that I think is where we would need a lot of that critical thinking, uh, practice before we could, you know, really do a good job there. So, because those are the, um, there's gray areas that are always hard.Speaker 1:
So let's talk about some of those gray areas. I believe that one of those is workers compensation.Speaker 2:
Absolutely. Absolutely. And, you know, uh, uh, among our certified interpreters, we have a pretty large cohort of interpreters who work mostly in worker's compensation. They not, they don't work staff, staff, interpreter at hospitals, and they are freelancers, but in a sense that, uh, a majority of their work is done in worker's comp cases. Uh, and, uh, they could be different things, including administrative hearings, but also, uh, evaluation, uh, you know, uh, appointments or sometimes even follow up appointments, right? Physical therapy, et cetera. So it's a whole spectrum, which is, uh, very, you know, clearly intersects with medical interpreting and healthcare interpreting. And here, I hope we will see incident reports from those interpreters as well, because, uh, it's one thing when you're interpreting for a person's physical therapy, which was, uh, you know, is paid by worker's compensation, you know, uh, proceedings, but then the same interpreter may step in for the same patient to the administrative hearing, which is court interpreting, uh, most of, you know, in, especially with the speed they talking and, uh, you know, you have to resort to a lot of simultaneous interpreting and nobody really wants to clarify anything there, and they want you to do it so fast and leave it. And here you are getting into the area, which code of ethics am I following? Right. Medical interpreter, who will say, wait a minute, they, you know, need to do all my proper things here, or do I follow the court, interpret ethics? And, uh, when is that, you know, what is the trigger of switching? Because to me, the cold point is like, you know, I know you do both, right. I did court interpreting two appointments. And then I was done for a reasons that, you know, I realized that well, being neutral in court interpreting is much harder than in the medical interpreting. So adversarial setting is not for me, but, but I think of it as, at some point, there is a trigger that, you know, that tells you, okay, now it has to be the court interpreter hat. Uh, and what is that trigger? And I think through critical incident reports, we can identify the incidents which become those triggers. Uh, a similar situation could be, for example, in interpreting an emergency room when the police, uh, officer comes in. Oh, and I also need to ask this person because they're victim of blah, blah, blah, some questions, right. And the different parameters of if you're a staff interpreter, or you're a freelancer, but ultimately as medical interpreters, we definitely have, uh, you know, different sets of rules. And, uh, if a special, you never even did any interpretation for the police, which becomes a beginning of a case, or is a part of the case that will be tried in court potentially. So you are getting into the legal area. So I hope with hear a lot from, uh, interpreters who get into those practices like workers comp or into cases that have both to tell us what helps them identify those challenges and also, uh, pose questions, uh, so that we could create policies because wouldn't it be nice if there would be a clear policy that is somewhere stored, where it says medical interpreters do not interpret for police ever in the United States, right? Wouldn't that be nice then you don't have to have anything ethical, ethical dilemmas. You just show to the police officer here.<laugh>, that's what it says everywhere. And you won't even need to say tell it to the police officer that the police officer will know that because it's everywhere. But until we get to that policy change and acceptance of the standard, we need to discuss it through the critical incidence reports and bring in experts, especially when we, uh, when we'll get those cases, the experts on the panels will be, uh, from, you know, court interpreting world, obviously, and from workers compensation area, so that we find the solution that works for that particular setting for that particular gray area. And not just, um, judge everything from one side, the medical interpreting ethics code of ethics.Speaker 1:
Now, as far as workers' compensation is concerned, there are some states which are creating some parameters for this.Speaker 2:
Yes. Uh, like the state of California, right. Leading the way they have very, you know, specific requirements. Of course, they also, uh, uh, they have the association of interpreters who work in workers' compensation. Uh, but at the same time, there's still not, um, a document that says, you know, the code of ethics for interpreters and workers compensation. And I don't know if we need it, but maybe we do. And maybe the fact that we don't have it, and we have court interpreters and medical, but not for workers comp that maybe the weakness that we could address. Right. There's also the state of Colorado that, uh, is adopting the legislation. They're requiring interpreters to be certified who work for workers' compensation cases. And obviously the state is doing it to protect, uh, the injured workers because they deserve, they have the highest quality of interpretation. And, uh, so, um, as we, uh, see, and of course in the state of Washington, there is a social services certification and exists, and they do have the state of Washington code of ethics that, uh, you know, they are applying. So we have all this initiatives at the state level that it would be, uh, important for us nationally to know about and inform them and be informed by those initiatives as well.Speaker 1:
Now, from the perspective of a legal interpreter, they often encounter situations which are quasi medical, quasi-legal depositions often include, um, topics that are healthcare related, independent medical examinations, mental health evaluations. So it's, it really cuts both ways.Speaker 2:
Absolutely. And, uh, you know, I've, uh, heard the stories when, uh, attorneys would use certified medical interpreters for depositions, because it kind of is a medical case or injury case. Right. But if that medical interpreter has never gotten any legal interpreter training, that's not quite right from my opinion, right. Because medical interpreters do not know what the deposition is. They don't, they're not, they don't have to know about that. Right. So it's important because we, again, always both in the medical field, in the legal field, in the education field, struggle with, um, consumers of our services, not understanding our role, uh, we need to, you know, educate them better and educate ourselves better, uh, because, uh, there's nothing precluding medical interpreter for doing deposition. Uh, but, um, and I know if they took the training, then they could definitely do it, but that's kind of will be, that would be the trigger I'm called to, I'm a freelance medical certified medical interpreter. I'm called to interpret for a deposition. Oops. I need to get online training about interpreting depositions before I can accept that appointment. And that could be, you know, the situations. And if there's a legal interpreter who is doing a deposition, they know what they're doing, but if that same legal interpreter steps into, uh, uh, doctor's appointment, uh, where they may need to apply more medical interpreting, um, code of ethics, uh, rather than the legal one, they also need to get training. So those critical incidents maybe show, will show us that, uh, the, some of them are because individuals are crossing settings without proper training. Uh, cuz I know, I mean, of course we're doing this podcast for Delmar Institute and I know there was a training crossover training for medical and legal interpreters a couple of years ago started. And I really appreciated that because, uh, without, uh, you know, when you're ignorant, uh, you making worse errors than when you know things, but then you can catch, Ooh, something went wrong and I can report it.<laugh>Speaker 1:
Absolutely. So N Natalia, um, you know, this is your opportunity to, to speak directly to our listeners at interpreters out there from all sectors and get them to participate in this program.Speaker 2:
Well, and I appreciate this opportunity. I really want, would like to encourage all interpreters, especially the ones who are certified to truly, uh, submit at least one reporting here, because I know you have more than one incidence a year. You know, when I, I used to interpret, uh, more often I would, uh, I, you know, almost every day they would be like, mm there's something in my, the back of my mind, like, oh, I wish I did it differently. Uh, so call next time I will. That's the teaching moment for somebody and it's a learning moment for you. So, uh, we at CCH HHI, if you're certified through CC HHI, we award one continuing education unit for you just for submitting this report, uh, in of course, complete report. Uh, and then if your report is chosen for, uh, being discussed by panelists during the interpreter rounds, then you get an additional continuing education interpreter unit. Because what I think we, uh, sometimes don't, uh, uh, we forget that continuing education is not just online training, listening, being passive consumer of knowledge, it's sharing your knowledge, right? Instructors do it when they teach something and everyone can do it when they submit this critical incident report. So go to our website, TCCs certification.org and on the homepage at the bottom, click the link and, uh, fill out a report. There are about over 4,500 certified interpreters in the United States by CCH I alone, right? If one submits one report by the end of this year, we will have 4,500<laugh> reports. We'll have so much, uh, rich material that trainers could use that we could use. That would be amazing. So let's at least shoot 4,000 this year. How's that<laugh>.Speaker 1:
And by all means it doesn't have to be limited to CCH. I interpreters it could be CMI interpreters, it could be legal interpreters, anybody who's ever had a question or an in critical incident, um, that has left them thinking about these types of situation and would like to either think about it some more or have, uh, their peers give them some feedback. So this isn't restricted to just CCH I,Speaker 2:
And it's not restricted to spoken languages either, you know, or sign language interpreters. Uh, I know, uh, you know, you have your own mechanism of discussing this, but we want to learn from you too. Uh, you know, so that's why this is open for anybody and for interpreters who are not certified yet because, uh, you know what we want to see, we want to actually, you know, as if you think in the medical field, the joint commission collects those critical incident reports from every accredited hospital, right? And then they run analysis and then they create different policies. Like for example, uh, you know, ask several times whether it's, uh, left kidney, right kidney, we're going to take out today, right? So they established all these policies based on the analysis of their critical incident reports. And they find this simple solutions as asking three times or whatever many times, uh, to confirm what they're supposed to do. Same thing with us. If we will run an analysis at the end every year of every year, we'll see that the majority of incidents reports are about ethics and X, Y, Z, right? Then we will throw we'll reach out, throw all things out, all our resources added. We'll reach out to trainers. We'll reach out to associations, to national council to create some guidances for that. Because right now we don't know what are the most, uh, frequent incidents that we experience. We're a very intimate profession, right? One on one with people. And this is our opportunity in a safe, professional, and thorough manner and systematic manner to discuss this and come up with solutions.Speaker 1:
Natalia MI Reva. Thank you so much for joining us here on subject to interpretation. It's been a pleasure.Speaker 2:
Well, Maria, thank you very much. And, uh, also thank you for, uh, subject to interpretation to invite me.Speaker 1:
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