information and resources: translation and interpretation
This section provides detailed information and advice about translation and interpretation; information appears under the following headings:
- translation defined
- choosing a translator
- working with a translator
- preparing text for translation
- NHS consent forms
- non-written languages
- interpretation defined
- choosing an interpreter
- working with an interpreter
- during the meeting
- non-written patient consent
- Emergency Multilingual Phrasebook
- NHS language requirements of healthcare workers
- some online public-service translation and interpretation services
Translation is the written conversion of one language to another.
Languages are complex and translation is very rarely word for word. Some meanings are intrinsic to the language, whereas other meanings have to be captured and expressed using linguistic devices. A translation is therefore an individual's view of the meaning of the source text. Any worthwhile translation should be written specifically for a target audience to ensure it is meaningful to the reader.
choosing a translator
When arranging to have a document translated, extra care must be taken to select the best person for the job because it is very likely that you are 'buying blind', and are unable to evaluate the finished product yourself. It may help to consider the following points:
- Check their qualifications. The main qualification, requiring linguistic skills in the source language at least equivalent to degree level, is the Diploma in Translation (DipTrans IOL) issued by the Institute of Linguists. Affiliation to one of the professional organisations – the Institute of Linguists (IOL) or the Institute of Translation and Interpreting (ITI) – is usual for professional translators. Other IOL qualifications indicate skills in various languages at various levels.
- Choose someone who will be translating into their mother tongue. This is the best way to ensure that the text will read well to its target audience and should minimise any cultural void. However, remember that bilingualism alone is not a guarantee of translation ability.
- Evaluate samples of their previous work. Ideally, arrange for a native speaker to check some recent translations. At the very least, speak to their previous clients.
- Choose someone who understands the context of the material that is to be translated. This obviously becomes more important as the technical content increases.
- Evaluate their experience of working in the public sector in relation to your particular field.
- Ask how they keep up to date with changes in their own language;
- Ask how they check their work.
- Clarify their pricing policy. If they charge per word, is it the source or target language that counts? The number of words used can vary considerably between languages. You may consider this to be the fairest way to charge, but it is easy to pad out text with extra words. If the charge is made on a time basis, you may be tempted to ask for the job to be rushed through, which is unlikely to produce the best results in terms of both the translated text and your relationship with the translator.
- Check that they carry professional indemnity insurance.
- Ask them what they would do if the target audience did not understand the translated material.
Using a reputable translation agency is likely to make your job a lot easier!
working with a translator
It is important to realise that a translator needs to be given far more than the source document in order to produce good work. Your relationship with them should be ongoing and you should be prepared to provide them with the following information:
- Details of the target language, for example the Castilian variant of Spanish.
- A description of the target audience, for example 7–11 year olds, visiting junior doctors.
- The purpose of the document, for example a leaflet to be handed out by GPs, a position paper to be presented at an international conference of medical specialists.
- The required level of translation. Accurate but unpolished work is known as 'for information' translation and is cheaper and quicker to produce than 'for publication' translation.
- The media on which you require the completed work. If this involves computers, ensure that your software is compatible.
- Deadlines for any drafts and completion of the work, which may require your own commitment for the timely return of drafts.
- Whether their work will be credited in the translated document. This may help to ensure a high standard of work.
During the translation process, try to follow these guidelines:
- Allow plenty of time for any translation project – it can be a lengthy process and the best results will not be produced if it is rushed.
- Do not finalise any changes by telephone.
- Ask a native speaker to proof-read the translation if possible.
- Do not be tempted to alter typographical conventions which vary between languages. These include not only accents but also the use of capitals and different quotation marks. A missing accent can change the whole meaning of something.
- Produce and continually update an in-house glossary of terms. As translators produce various documents, this can become a multi-lingual resource and help to ensure consistency of content.
preparing text for translation
The need to have something translated can provide an opportunity to improve existing documentation in terms of content and consistency of house-style. The translation process puts the document under scrutiny, and a translator who works with you regularly may suggest changes that might improve consistency over, for example, a series of leaflets. Try to take into account the following points before submitting a document for translation:
- Be direct and write simply and clearly. Existing documents may be edited so that only relevant sections are translated, or new, shorter documents may be produced specifically to be translated. A translator may find it easier to work from notes – unlike full text, a set of essential points will not have to be unravelled first.
- Be consistent, particularly in the use of terminology and abbreviations.
- The target document will not be the same length as the source document, so allow extra time to accommodate this difference when preparing leaflets, etc. This may also have implications for the costing of the project.
- Specify the required style, including the type of vocabulary and complexity of sentences. The style will vary according to your target audience and what you wish to achieve.
- Avoid using idioms and colloquialisms. However, if these are part of the style you wish to achieve, discuss them in detail with the translator.
- Substitute images for text wherever possible. Photographs and diagrams can be far more effective, and the same ones can be used for different languages, providing that any cultural content is compatible.
- Finalise the content of the document before sending it for translation. Accommodating changes once the translation process has begun can be costly, time-consuming and frustrating for the translator.
NHS consent forms
The Department of Health website has a section on translation that includes consent forms in a range of languages, which can be downloaded (search for 'consent + form + translations').
Some spoken languages that remain unwritten are still in existence today. Speakers of such languages often speak a second language that does have a written version, but for the few that do not, the translation of their language is very difficult.
Recordings of translated phrases may be useful, and diagrams, cartoons and photos may be used to communicate with patients who do not read or write, including those who do speak English. Visual images are particularly versatile because they can be used with speakers of any language, and also patients with learning disabilities. Many libraries of photographic images are available on the internet.
Interpretation is the conversion of one spoken language into another, enabling communication between people who do not share a common language. Interpreters interact directly with the different parties involved. It is clearly a much quicker and less scrutinised process than translation, and it is therefore essential to have an experienced, impartial interpreter who is totally trustworthy.
There are two types of interpreting – simultaneous, where the interpreter speaks while the foreign-language speaker is speaking, and consecutive, where the interpreter waits for appropriate pauses before speaking. Interpreters tend to specialise in one type, but some are able to do both. Simultaneous interpreting is often whispered and is particularly useful during a lengthy speech that is best not interrupted. A conversation or interview is usually best served by consecutive interpretation.
choosing an interpreter
Great care should be taken when choosing an interpreter, and the following points should be taken into consideration:
- Check their qualifications. The Institute of Linguists in London is an awarding body offering vocationally related qualifications in a wide variety of languages from A-level to postgraduate level. These include a Diploma in Public Service Interpreting (DPSI) and a Certificate of Bilingual Skills. Many relevant graduate and postgraduate qualifications also exist (for further information, see the Department for Education and Skills website). An interpreter should have a relevant language degree but this alone is not a qualification for interpretation ability.
- Check the National Register of Public Service Interpreters (NRPSI), a not-for-profit subsidiary of the Institute of Linguists, listing 1500 public-service interpreters working in 83 languages.
- Check that they are experienced in the type of interpretation – simultaneous or consecutive – that you require.
- Evaluate their work. Ask another fluent speaker of that language to assess their work using oral tests or role-play, or speak to their previous clients.
- Find out about their particular field of experience – have they worked not just in the public service but specifically in the NHS or a medical context? Although you are the person responsible for ensuring the explanation of professional matters (as you would be with any patient who speaks British English), the interpreter will need to have at least a basic understanding of what you are talking about in order to do their job properly.
- Ensure that they are confident, responsible and have a good attention span. Meet them in person if possible because they will be part of the public face of your department.
- Ask about their experiences in other countries in order to assess their feel for the culture of the foreign-language speakers they work with and how they keep abreast of changes.
- Find out their terms and conditions of work and, of course, their charges. Seek assurance that they can be flexible enough to accommodate appointments running late, and can be available at short notice if necessary. Expect to be charged a fee if you cancel at short notice.
- Ask to see a copy of their code of conduct.
- Re-evaluate their work from time to time. A good interpreter will not mind occasional recording and checking of their work.
working with an interpreter
Once you have found a suitable interpreter, it is important to build up a good working relationship with them. Book their services as far in advance as possible, and give them as much information as you can before the meeting including:
- The name of the person necessitating their services, so that they can declare if they are known to them. They may also be able to advise you on the pronunciation of the name.
- Full details of when, where and to whom they must report on arrival, and whether you require them to convey similar details to the person(s) necessitating their services.
- The respective roles of the people involved in the meeting.
- Any relevant background information, including foreseeable problems or conflicts.
- The actual purpose of the meeting; that is what information you want to glean from the patient and what information you want to convey to them.
- Details of any confidentiality issues.
- Details of any technical terms or specialist vocabulary that may be used.
during the meeting
When an interpreter is present during a meeting, it is important to remember the following points:
- Expect the meeting to take much longer than usual. The interpretation process and cultural differences must be accommodated. The interpreter may need to clarify what is said, comment on the patient's reaction to or understanding of what they are told, and identify and resolve cultural differences. It is likely that the patient will view this meeting as an opportunity to ask lots of questions that they have previously been unable to ask. It may even be necessary to take a short break if the meeting is very long.
- Ensure that you will not be disturbed. All parties need to concentrate, particularly the interpreter.
- Sit facing the patient and direct your speech at them, not to the interpreter, who should be seated to one side, halfway between the patient and yourself. In this way, the interpreter should be perceived as impartial, and their presence may eventually be forgotten.
- Establish for the understanding of everyone, the names and roles of all those who are present.
- Explain that the interpreter is there to give a full, unbiased interpretation of everything that is said by those present, and will respect full confidentiality. Ensure that any notes that they make to assist their work are destroyed at the end of the meeting.
- Try to speak as you would normally without the presence of an interpreter, in terms of addressing the patient directly rather than asking the interpreter to address them for you. If the interpreter identifies cultural differences, discuss them with the patient so that it is their view and not that of the interpreter that you establish.
- Try to avoid speaking too quickly and using incomplete sentences. Do not be offended if the interpreter picks you up on this – it is a very common habit! In fact, working with an interpreter may help you to improve your communication skills in general.
It is useful to have a debriefing session, during which the interpreter may be able to give you additional feedback. You will also have the chance to clarify any aspects of your respective roles in order to improve performance in future meetings. The interpreter may ask you to sign a time-sheet in respect of their services.
non-written patient consent
One reason for working with an interpreter is to seek consent from a patient who speaks a language without a written version. Non-written patient consent has validity issues, and the following points must be considered:
- It is vital that the patient fully understands what they are being asked to do, and all the issues pertaining to the consent.
- The patient's understanding of what they have agreed to must be checked by reiteration.
- Their decision must be recorded fully in writing.
- The act of giving consent must be formally witnessed.
Emergency Multilingual Phrasebook
The British Red Cross, with advice and funding from the Department of Health, has produced a user friendly phrasebook that contains 62 common medical questions and statements in 36 languages, to enable basic communication in emergency situations.
This 'Emergency Multilingual Phrasebook' has been sent to all accident and emergency departments. Copies are available from the British Red Cross; alternatively, sections in individual languages can be downloaded as PDF versions from the Department of Health website (search for 'emergency + multilingual + phrasebook').
NHS language requirements of healthcare workers
Doctors who have full registration with the General Medical Council (GMC) are not required to take any language tests. Those who are eligible for full registration must have obtained their primary medical qualification in the UK, European Economic Area (EEA) or certain other countries including Australia, Hong Kong, Malaysia, New Zealand, Singapore, South Africa and the West Indies. Doctors who are not eligible for full GMC registration may apply for limited registration if they have a primary medical qualification that is recognised by the World Health Organization (WHO), and have passed two language tests:
- a linguistic ability assessment, for example the International English Language Testing Service (IELTS);
- the Professional and Linguistic Assessment Board (PLAB) test of clinical and language skills.
Nursing staff must be registered with the Nursing and Midwifery Council (NMC) and may have to take an English language test (IELTS) if English is not their first language.
some online public-service translation and interpretation services:
- Cambridgeshire Interpreting and Translation Service (CINTRA)
- Herts Interpreting and Translation Service
- Liverpool Translation and Interpreting Service
- Translation and Interpretation Service for Telford and Shropshire
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