CLAS Standard 7: Competence of interpreters – Use of untrained individuals and/or minors as interpreters should be avoided

The use of clinical and nonclinical staff who speak a non-English language but who are untrained in medical interpretation can pose potential safety risks (Regenstein et al., in press). Research has shown that when clinicians speak a non-English language, or when untrained bilingual staff is available, an important set of potential barriers can arise and hinder the effective and appropriate use of trained interpreters (Maul, Regenstein, Andres, Wright, & Wynia, 2012).

All those who provide language services should be held to the same standards, regardless of their place of employment.

In other words, based on their needs, organizations should use a combination of bilingual employees, contract interpreters and staff interpreters, but they should all be held to the same standards:

  • Have the necessary language skills to understand and speak the languages in question.
  • Have the necessary skills to transfer meaning from one language to another accurately.
  • Have the necessary training in terminology, protocols, ethics and standards of practice to provide appropriate services in the setting.

As an interpreter, I have seen medical practitioners try to apply their Spanish skills a few times. In some cases, their Spanish was truly not sufficient to communicate effectively. As an interpreter, I established my role promptly and professionally, and provided my services so communication was accurate and effective.

The desire to have direct communication is commendable, and it is appropriate for some levels of communication. As I traveled in foreign countries as an interpreter, I have certainly observed that people who made an effort to introduce themselves in the language of the other person were more effective in making a personal connection. However, when it comes down to the medical interview, when a diagnosis is at risk, a professional interpreter must be allowed to use their professional skills to avoid the risks of misdiagnosis. This risk can happen early on in a conversation!

See “Foreign Language for Doctors?

I recommend that bilingual staff who intend to use their foreign language professionally be tested by LTI for the skills they are expected to use. If they are expected to speak the language, they should take the oral proficiency test. If they are expected to write the language, they should take the writing proficiency test. The industry standard for professional proficiency is Advanced High on the ACTFL scale or ILR 3. Not everyone who graduates with a Bachelors in a foreign language achieves these levels. See this post for more information.