Certified Medical Interpreters’ Perspectives on Relationship-Centered Communication in Safety-Net Care
- Author(s): Ratanawongsa, Neda;
- Cardenas, Angelica;
- Occeña, Bruce;
- Critchfield, Jeff;
- Mercer, Mary;
- Myers, Kara
- et al.
Published Web Locationhttps://www.mededpublish.org/manuscripts/2031
This article was migrated. The article was marked as recommended. Background: Interpreters may offer valuable perspectives on ways clinicians could improve communication skills. Relationship-centered communication (RCC) curricula are based on a framework for promoting effective communication both with patients and within health care teams. Methods: We conducted a 90-minute workshop with certified interpreters at an academically-affiliated safety-net system to solicit feedback to optimize RCC skills trainings for clinicians at a U.S. academically-affiliated safety-net system. We applied an editing analysis style to transcribed quotes to reveal opportunities to optimize RCC skills trainings to improve safety-net care for diverse populations. Results: Twenty-two Spanish-, Cantonese-, Mandarin-, Vietnamese-, and Russian-speaking interpreters participated. Overall, interpreters emphasized the importance of creating a supportive environment for safety-net patients. One Spanish-speaking interpreter added: "When they get up in the morning and go to work, they may get deported. So, that's important to create an atmosphere to help them open up. And they may tell you stuff that's directly pertinent to patient care." Thematic analysis revealed opportunities to tailor and reinforce each RCC stage. On agenda-setting and rapport-building: "We need a little background on the phone, and we don't know how many people are in the room ... Sometimes you're talking to the mom, but the doctor didn't even bother to say it.. [If] we're lost, we're bound to make mistakes." On eliciting the patient's perspective: "Start with this information so they know you're still going to give them your advice: "I'm going to let you know what I think is going on, but what do you think is going on?" On negotiating a shared plan: "[Teachback] is really important. Otherwise it puts an incredible burden on the interpreter ... I'm not sure that the patient really understood." Conclusions: Teaching RCC in partnership with medical interpreters could provide opportunities to deepen clinician RCC skills for more effective patient-interpreter-clinician interactions.