Diversity of Interpreter Education Nancy K. Esparza, M.Ed, CHES Central MA Area Health Education Center, Inc.

1. Diversity of Interpreter EducationNancy K. Esparza, M.Ed, CHESCentral MA Area Health Education Center, Inc. First National Symposium for Medical Interpreter TrainersJune 12, 2010 Rutgers University

2. Medical Interpreter Training ProgramPresentation Overview • History and Goals • Statewide Initiative • Funders • Curriculum • Course Overview • Prerequisites • Course Objectives • Training Modules • Instructors • Teaching Methodologies • Customized Trainings • Assessment 2010 First National Symposium for Medical Interpreter Trainers

3. History and Goals • The Medical Interpreter Training Program was created 11 years ago by UMASS Medical School, Office of Community Programs and the Area Health Education Centers • Addresses several issues facing health care institutions with respect to communicating with the limited English proficient (LEP) patients. • Anticipates/ Responds to shifting demographics and Refugee Resettlement in MA. • Committed to offering job skills and opportunities for members of underserved communities. 2010 First National Symposium for Medical Interpreter Trainers

4. History and Goals • Overarching Program Goal: To improve the supply and distribution of health care professionals placing emphasis on providing primary health care services for underserved populations. 2010 First National Symposium for Medical Interpreter Trainers

5. Statewide Initiative • Offered in all 6 state regions • Total number of graduates since 1999: 3,488 • Languages include: • Spanish, Portuguese, Russian, Chinese (Cantonese, Mandarin), Korean, Vietnamese, Arabic, Khmer, Polish, Nepali, Somali, French, Albanian, Haitian Creole, Portuguese Creole, Twi, Khran, Swahili, Burmese, Karen, Kirundi, Albanian, Bosnian, Italian • Selected as one of the training curricula to be reviewed by the National Council on Interpreting in Healthcare Standards of Training & Certification 2010 First National Symposium for Medical Interpreter Trainers

6. Funders • Executive Office of Health and Human Services, Office of Medicaid, to support the MassHealth provider network and meet the needs of MassHealth Members. • Executive Office of Health and Human Services: has been committed to sponsoring the medical interpreter training program over the last several years to improve language access to health care for all of its participants. 2010 First National Symposium for Medical Interpreter Trainers

7. Curriculum • Course Title: Fundamentals of Medical Interpreting • Course Hours: 60 classroom hours (3 hour weekly sessions for 20 weeks). Plus optional 15 hours supervised, documented practicum experience. • College Credit Bearing 2010 First National Symposium for Medical Interpreter Trainers

8. Languages of Most Recent Refugee Arrivals in Massachusetts CountryLanguage(s)

9. Curriculum • Course Description: The goal of this course is to provide students with an understanding of the importance of Medical Interpreters and their role in promoting and ensuring access to quality health care. The course: • incorporates awareness of and respect for cultural perspectives; • explores the therapeutic relationship between patient and provider; • teaches effective communication skills to ensure understanding and enhance meaning during the health care encounter. 2010 First National Symposium for Medical Interpreter Trainers

10. Curriculum • Course Prerequisites: • Proficiency and fluency in written and oral English; • Proficiency and fluency in English and at least one other language; • High School diploma or the equivalency; • Pass a Written and Oral Language Proficiency Examination created by UMASS in partnership with the AHEC Centers. 2010 First National Symposium for Medical Interpreter Trainers

11. Curriculum • Course Objectives: • Describe and demonstrate adherence to the Standards of Practice and Code of Ethics of the International Medical Interpreters Association (IMIA) and the National Council on Interpreting in Health Care (NCIHC); • Explain and apply each of the four main roles of the medical interpreter (conduit, clarifier, culture broker, patient advocate); 2010 First National Symposium for Medical Interpreter Trainers

12. Curriculum • Course Objectives (continued): • Acquire and use essential medical terminology and vocabulary in English and the target language; • Function effectively in the triadic encounter across multiple settings; and • Function effectively as an integral member of the health care team. 2010 First National Symposium for Medical Interpreter Trainers

13. Curriculum • Training Modules: • Role of the Interpreter • MMIA Standards of Practice • Code of Ethics • The Triadic Encounter • Cultural Responsiveness • U.S. Medical System 2010 First National Symposium for Medical Interpreter Trainers

14. Curriculum • Medical Terminology by Systems: 2010 First National Symposium for Medical Interpreter Trainers

15. Curriculum • Instructors Lead instructors include a medical interpreter and a clinical presenter. Clinical presenters: • Medical Doctors • Nurse Practitioners • Physician Assistants In addition, Language Coaches for each language represented in the training are used in the practice component of specific sessions. U.S. Licensed 2010 First National Symposium for Medical Interpreter Trainers

16. Curriculum • Teaching Methodologies • Lecture • Demonstration • Class discussion • Role play of triadic/quad encounters • Reading assignments • Supervised field-based practicum 2010 First National Symposium for Medical Interpreter Trainers

17. Assessment: Methodology Observation and Feedback • Instructors • Language Coaches • Peers/ Other Students • Written Home Assignments • Quizzes • In Class Final Examination • Written Components • Oral Components • Case Simulation 2010 First National Symposium for Medical Interpreter Trainers

18. Customized Trainings • Additional training curricula has been developed for graduates of Fundamentals of Interpreting: • Mental Health Medical Interpreter Curriculum • Fundamentals of Interpreting: Train the Trainer • Fundamentals of Interpreting: Skill Building for Language Coaches 2010 First National Symposium for Medical Interpreter Trainers

19. Continuing Education OfferingsBased Upon the Belief in the Importance of Ongoing Learning and Professional GrowthHighlights Emergency Preparedness Mindfulness Oral Health • HIV/AIDS • End of Life Issues • Diabetes 2010 First National Symposium for Medical Interpreter Trainers

20. Our Participants… • Diverse Educational Backgrounds • Median Educational Level: Bachelor’s Degree • Range: High School Diploma M.D. • Diverse Professional Backgrounds • Dual Role Employees (e.g., MAs, CNAs, lab technicians) • Foreign Educated Professionals 2010 First National Symposium for Medical Interpreter Trainers

21. Central MA AHEC, Inc. Mission is dedicated to enhancing access to quality health care, promoting workforce development, and eliminating health disparities. A Member of the MassAHEC Network. 2010 First National Symposium for Medical Interpreter Trainers

22. Central MA AHEC, Inc. Highlights of CM AHEC Initiatives: • Medical Interpreter Training • Language Link Interpreter Services • Translation Bureau • Outreach Worker Training Institute (OWTI) • Community Health Worker Training Programs • Patient Navigator Training Programs • Community Based Training for Medical Professionals • Community Based Participatory Research • Specialized Health Disparities Initiatives 2010 First National Symposium for Medical Interpreter Trainers

23. Contact InformationNancy K. Esparza, M.Ed, CHESCentral MA Area Health Education Center, Inc.nkesparza@cmahec.orgwww.cmahec.org First National Symposium for Medical Interpreter TrainersJune 12, 2010 Rutgers University