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|Posted on June 2, 2011 at 7:46 AM|
Years ago, when Rodney Ramos came to the U.S. from Puerto Rico he was the first one in his family to learn English. So when he was 11 years old and his grandmother became ill, it fell to him to try interpret the doctor's diagnosis that his grandmother had a detached uterus and possibly cancer.
It was an experience he never forgot.
"A child can't be asked to do that," he said, adding that he often served as his family's interpreter.
Out of his experience as a child and then as an adult interpreter at a hospital in Racine, Ramos said he continued to be dissatisfied with the training and outcomes of interpreters trying to communicate between Spanish-speaking patients and doctors.
So after doing a lot of research and consultation, he developed a yearlong medical interpreter technician program that he has taught for the last seven years at Milwaukee Area Technical College.
Earlier this month, 18 students completed the two-semester program that teaches not just language fluency, but also medical terminology, cultural sensitivity, dialectical differences among various Spanish-speaking countries, ethics, values and nonverbal communication skills.
With the growth of the Latino community and changing demographics, health care providers are challenged by the demand to provide professional health care interpreters, said Ramos, 45, who has a bachelor's degree in Spanish with concentrations in English and philosophy.
"There's an incredible need for medical interpreters," he said.
Kristin Neitzel, the patient amenities and family services manager at Children's Hospital of Wisconsin, agrees.
"The need has been around for a long time," she said. "We want to provide interpreters because civil rights law dictates that we do. But more than that, there's a lot of research that shows that service and outcomes are better when an interpreter is used."
Skilled medical interpreters are sometimes also good for a medical facility's bottom line, because if a health issue is well understood and identified early, it can keep the number and cost of diagnostic tests down, she said.Cultural comfort
It's also important that patients and families feel comfortable culturally, so that they can accurately communicate with doctors and nurses, she said.
"A lot of times families will nod or say 'yes' and that's not what they mean. Or they don't understand and don't want you to know that they don't understand," Neitzel said.
Years ago, people used to say that if you live in this country you should speak English, she said. "But imagine if you were in another country with a sick child or family member and didn't speak the language and couldn't communicate."
In 2000, the U. S. Census Bureau estimated that more than 21 million are of limited English proficiency, she added.
Children's Hospital has five full-time and four part-time interpreters and 29 other interpreters that it brings in through a local company, Neitzel said. All but two of the interpreters speak Spanish; one speaks Hmong and one is a sign language interpreter.
"We don't have the ability to hire all the interpreters we need because it's a cost to the organization and there's no reimbursement for it," she said.
Neitzel, who is a member of the advisory board of health care professionals that Ramos has assembled to provide feedback on the curriculum, said some of the interpreters who work at Children's have gone through the MATC program.
"Rodney has really taken his program to a new level," she said.
Before a student begins the program, Ramos gives a Spanish proficiency assessment, both written and oral, to test comprehension, fluency and limitations. He also conducts a conversation in Spanish and English with the student for additional input.
Ramos then develops an individual educational language plan for each student to elevate a person's language skills. Together the students work in classes in medical terms, culture, ethics and techniques of interpretation.
"The size of the class is kept at 18 because beyond that it's not manageable to produce the level of quality we want," he said. "I think the success of the curriculum is the individualized plan."
He claims a 100% graduation rate from his program.
Most of the students in his classes are Latino but "culturally broader," he said. "They're not polarized, like I'm Puerto Rican. They need to understand the wonderful variations, regionalisms, and that there's no one right way. He who knows the most ways of saying something can cater to the most patients."Interpreter's role
The role and importance of an interpreter, he said, is to be "a conduit, clarifier and cultural broker."
His goal at MATC is "to lead the state and the Midwest in the quality of medical interpretation."
Every hospital administers its own interpreter test, even if the person has completed the MATC program, he said.
Only in the last year have efforts begun for a national certification program for medical interpreters, and that's still evolving, said Ramos and Neitzel. She said she would like to see Wisconsin have a licensure program for interpreters, but there is none now.
Medical interpreters can earn from $16 to $25 an hour, said Ramos.
"Mr. Ramos is a great teacher who tells you how it is with patients," said Rigoberto Valle, 25, who said he had firsthand experience with interpreters when his mom suffered a stroke. "There were misinterpretations and what I call 'false fluency,'" he said.
Yvette Martinez, 25, who was born in Mexico and is a native Spanish speaker, said she walked into the class thinking she knew what she was doing but soon learned differently.
"I went through a one-week interpreter training course, but I quickly found out I needed more training," she said after completing the MATC program.
"It's so important to be accurate and complete and to convey what the patient is feeling and saying to the doctor," said Manal Rivera, 32. "You see what your family and others go through. That's why I want to do this professionally."
Categories: Medical Interpretation