Responses to question 3 from Wed. morning

the panel on examining discourse in healthcare that was presented on Wed. morning ran out of time for panelists to offer their response to the final question, so we will post some of those responses here.

The question: What is one recommendation you have that practitioners or educators could immediately apply?

Karen’s response:
I think role plays of medical interaction, with Deaf participants, are extremely beneficial. It’s even more helpful if the “healthcare practitioner” in the role play is actually a hearing HCP who doesn’t know ASL but my experience is that it’s been difficult to find people to fill this role. Deaf people understand the importance of developing interpreters’ skills, and are more willing to give of their time. (By the time, I think they should always be offered some kind of honorarium or payment in compensation.)

Having both a Deaf and hearing interpreter observe the role play, to offer their feedback and suggestions, is very useful. It’s also helpful to have developed some talking points for the discussion to counteract the artificiality of the situation. So the “doctor” should know whether they’ve met the patient before, and what the issue is they’ll be presenting, while the Deaf patient should have some points of what they want to cover. There should also be a card for the interpreter, giving them some basic information, and then let them have the opportunity to meet the Deaf patient prior to the appointment with the doctor, and ask whatever questions they think would be useful.

For people who are working in an academic institution, you may be able to partner with a health sciences or nursing program at the institution, so that students in the program role play the healthcare practitioner. It increases the authenticity of the interaction, as well as providing some exposure and education for the students.

I attended Kathy Miraglia’s presentation on the new Certificate in Healthcare Interpreting that NTID has established. there is a wonderful opportunity there to observe real interactions, between hearing participants (healthcare provider and patient), with no Deaf person or interpreter involved, and then between Deaf HCP and Deaf patients, with no interpreter, before viewing interpreted interactions. This seems like an excellent way to learn. However, given that many of us don’t have access to these kinds of resources…yet?….role plays do offer a rich opportunity for learning and reflection.

1 reply
  1. Anna Witter-Merithew says:

    The question: What is one recommendation you have that practitioners or educators could immediately apply?

    My recommendation is that practitioners and educators begin learning to think from a systems-perspective. Being a systems thinker allows us to see the inter-relationship between the various parts of the healthcare system. It encourages us to better understand how we fit within the healthcare system, and to appreciate how the consequences of our professional practices and acts impact the system as a whole. Being a system thinker requires us to approach our work more holistically. This can be a challenge, given our practice in analyzing messages and processes towards the goal of understanding individual parts and meaning. Approaching our work more holistically means we will think of it from a big picture orientation and that we will work to understand the perspectives of others (their world views, their goals, how what they do relates to the goals and objectives of the healthcare system at large) who are engaged in the exchanges we are interpreting. Becoming system-oriented means becoming less interpreter-centric.

    There are a number of ways to gain more appreciation for systems thinking. One is to read more about it. There are a lot of good resources on the internet and you can put the term systems thinking into your favorite search engine and find examples of publications that provide an overview and examples of how systems thinking works. Another good starting place is through observation. Seek out and arrange for opportunities to shadow a healthcare professional for a day (or several days if possible) without the pressure of having to interpret what transpires to learn more about the system in which they work, the decisions they make, and the factors that influence the decisions they make. Healthcare systems with experience in serving deaf and hard of hearing individuals are a great place to start.
    This observation approach parallels what Karen discussed in her post. Another option is case conferencing with peers–discussing actual scenarios that occur as part of the our work as interpreters, discussing what occurred and our reflections on the implications, and looking for ways to improve or enhance outcomes by assessing our success based on the goals of the system. Use these discussions with peers to determine whether our performance and interactions were effective from a system perspective.

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