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Interpreting a Visit to an Emergency Department

by Doug Bowen-Bailey

The following reflections come from my attempts at creating video resources which will support interpreters and educators in developing the competencies necessary for interpreting interactive discourse. As this is new for me (and for our profession) they are ideas undergoing evolution, and are designed to prompt your thinking about the relationships between Consecutive (CI) and Simultaneous (SI) interpreting. For a more in-depth introduction to CI, Carol Patrie (2004) offers an excellent one in her Teacher’s Guide for: Consecutive Interpreting from English.


In our profession, the majority of resources created have been monologic in nature. One person on camera delivering a talk in either ASL or English. This emphasis comes from several sources. Cokely (2003) explains three of these influences. First of all, it was a response to the RID Certification test which initially consisted solely of monologues. Second, interpreter education was influenced by professional dialogues with programs that prepared spoken language interpreters for working in conference settings where simultaneous interpreting of monologues was the principal task. Third, in the absence of commercially produced materials, the ease of creating monologues meant that programs could produce their own relatively inexpensively. This primary emphasis on simultaneous interpretation of monologic discourse led to a teaching sequence which moves from students having more control over time to less control over time. (Translation > Consecutive Interpretation > Simultaneous Interpretation.)

The result is that in many programs, the message taught is that CI is primarily a stepping stone to interpretation, rather than a viable option in its own right. Debra Russell (2002) challenged interpreter educators at the 2002 CIT conference to “reconstruct our views” and recognize the ways that our perceptions of CI might be negatively shaping the way it is used in practice. This section represents the reconstruction of my own views.

A Continuum of Approaches

In April 2005, I gave my first workshop focused on the relationship between CI and SI. As with any time I am presenting on something for the first time, I learned much more than the workshop participants. (Not necessarily because they didn’t learn anything, but because I gained such a great deal of new insight.) In my explanation of the choice of whether to use CI or SI, and the ensuing questions from participants, I tried to talk about CI and SI as a “both/and,” rather than an “either/or” proposition. The point being that interpreters need to see both approaches as viable options. In the midst of this discussion, however, I became aware that discussing it in this way gave the false impression that there are only two choices: one either chooses the simultaneous or consecutive approach. Such a description doesn’t give any way to talk about the changes in approach an interpreter can make as discourse changes within a given situation.

What struck me is that just as our profession talks about a continuum of language use, so too do we need to think about the approach to interpreting in terms of a continuum. Based on the interplay of factors related to both the language and the context in which it is created, interpreters move along a continuum employing more or less processing time and exerting more or less control over turn-taking. At the CI end of the continuum, turns in communication are discreet. The speaker and signers agree to defer their natural turn-taking to the needs of the interpreting process. Humphrey & Alcorn (1995) define it as “the process of interpreting after the speaker/signer has completed one or more ideas in the source language and pauses while the interpreter transmits the information.” On the other end of the continuum, the process of interpretation exerts no control over the pacing and pausing of the participants. An interpreter uses minimal processing time and produces ideas in the target language at the same time as receiving more ideas from the speakers.

Approaches to interpreting are not, however, an all or nothing affair. We do not have to come to a doctor’s appointment, for instance, and decide in advance that we are going to do consecutive or simultaneous interpreting. Rather, interpreters have options to move along a continuum based on the nature of the interaction. In the beginning of the appointment, when a doctor is establishing rapport and asking about how a patient has been since they last saw each other, a more simultaneous approach might be more effective. As the interaction begins focusing more on the technical nature of a condition or procedure, an interpreter might choose a more consecutive approach.

What I am proposing here is a model for thinking about how we make those choices as an alternative to either/or thinking. An interplay between text and context shape the nature of interactive discourse. It is not just what is said, but where it is said, how it is said, and what the implications are for the participants that needs to taken into account in determining an approach. The diagram seeks to show this multi-faceted relationship in only two dimensions. On one axis, text is shown between simple and complex. Text that is complex is more likely to be effectively interpreted (or translated) consecutively. Text can also be shared or not, meaning that all the participants in the situation are familiar with the terminology being used or not. If all participants know the terms, then it is more likely an interpreter can work with less processing time. When the vocabulary is not shared, an interpreter will need more processing time to do their work.

Working on this one axis, however, ignores that there is more than language at issue. The dynamics of the context and the relationship of the participants is also affected by the approach of the interpreter. And so, the second axis shows a context moving from simple to complex and shared to not shared. So, as the context becomes more complex or if certain perspectives and values are not shared, it may pull an interpreter closer to the CI end of the continuum, even if the language is simple.

On Shared/Not Shared and Simple/Complex

While I am not totally satisfied with the descriptors with this model, they are the best I have come up with yet and will have to do until new ones are suggested. Many factors affect the choices that interpreters make related to the amount of processing time to use, and what is more important than adjectives are some descriptions of the features associated with each category.

The table on the next page provides an initial working list of features, and situations will have a combination of all of these. What I think is helpful about having a matrix such as this is that it gives us a way of thinking about how as the nature of texts or contexts shift, our position along the CI-SI continuum needs to adjust accordingly.

Russell’s research in the courtroom settings gives some examples of how these features can affect the choices that interpreters make. She gives the example of three different discourse frames: direct evidence offered by a Deaf witness, cross-examination of that same Deaf witness, and testimony by an expert witness.

Shared Text

• Simple linguistic structures
• Conveys concrete ideas
• What is being talked about and how it is talked about is familiar to both interpreter and participants
• Standard use of language

Complex/Not Shared Text

• Complicated linguistic structures (embedded clauses, etc.)
• Technical information
• Conveys abstract ideas
• Unfamiliar to participants or to the interpreter
• Non-standard usage of language by one or more participants

Simple/Shared Context

• Setting is familiar to all involved
• Shared cultures and values
• Participants uncomfortable with pausing for interpretation. Note: This is not necessarily related to being simple or shared but it contributes to the use of less processing time.
• Focus on the dynamic of relationship between participants

Complex/Not Shared Context

• More formal constraints on interaction
• Setting allows for more natural chunking of information (such as one-on-one interaction)
• More severe consequences for error
• Participants more accepting of pausing for interpretation
• Setting is not familiar to all involved
• Participants (or interpreters) come from different cultural backgrounds

In the first discourse frame, her evidence suggests that “consecutive interpreting allows the greatest degree of accuracy and the full telling of the narrative.” Let’s look at the features of the text and context which contribute to this choice. In a courtroom setting, there are formal constraints on interaction regulated by the judicial process, which makes all involved more likely to be accepting of the pausing required for a consecutive approach. In addition, the consequences of error are grave – so even if the language is more relatively simple, the complexity of the context guides the choice.

In the situation of direct examination, this covers material already introduced to the record, which means the text would be something with which the interpreter and all the participants are familiar. More significantly, however, the dynamic of the relationship between participants takes precedence over the concern for accuracy. In cross-examination, the goal of the attorney is to “pressure the witnesses into revealing information that may be contradictory to previous testimony.” Simultaneous interpreting more effectively helps cross-examining attorneys meet their goal. While CI might allow interpreters to create a more linguistically and technically accurate interpretation, it also affords the witnesses the time to compose their responses in a way that avoids some of the pressure of cross-examination. So, while accuracy is obviously still a concern, the other factors of the context guide interpreters to a more simultaneous approach.

In the third situation, testimony by an expert witness, Russell suggests that a combination of CI and SI is the most effective option. For portions in which the testimony is familiar and predictable, SI can lead to an accurate interpretation. However, at points where the “text was rich with technical data and contextually or culturally bound information,” CI provided the greater processing time required to accurately convey the information.

These examples in the courtroom settings show that interpreters must use the interplay of text and context to guide their choices. The same is true in the medical settings. In the different segments of the visit shown on this DVD, there is distinct evidence of this. As you approach working with the video, keep the interplay of text and context in mind. Look for examples of how things are simple or complex – shared or not – and what impact that has on the choices you would make in your approach.

Putting Theory Into Practice

All of this provides a theoretical framework for working with this resource. In some ways, this DVD still maintains a “stepping-stone” model of CI because it was filmed using a more simultaneous approach and then edited to allow for the use of CI. Regardless, it is an opportunity for you to both use CI as a tool for developing more effective SI skills, and to evaluate the effectiveness of CI in its own right. That said, it is time for you to move on and begin working with the interactions that are on the Hurry Up & Wait DVD.

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