Hyorin, Great Songs Never Die, At night like this, words translated into English

Hyorin who is a member of the emerging Hallyu girl group sista is being recognized by her competing and winning against other Hallyu idols at the popular Korean program, Great Songs Never Die.
See the Video for her appearance on June 25, 2011.

Want to hear words of Hyorin’s song? Here it is:

You wouldn’t know how much I miss you
I cannot bear the loneliness anymore
Whenever the evening comes
I used to call out your name.
Although you get tired from the long long wait,
please don’t shed tears of loneliness my love.
Someday I will hold the two hands of yours
and walk with you.
At night like today’s oh baby
I want to hold you tight in my arms
and forever stay with you
as the time stops for us.

courtesy of https://latranslation.com/

A Guide To Interpreters And Translators

Posted on 06/21/2011 by Steve Petrovich

Originally posted on <a href=http://businessnewsexpress.com/a-guide-to-interpreters-and-translators/8776148/>BusinessNews Express</a>

Interpreters and translators facilitate the cross-cultural communication necessary in today’s society by converting one language into another. However, these language specialists do more than simply translate words-they relay concepts and ideas between languages. They must thoroughly understand the subject matter in which they work in order to accurately convey information from one language into another. In addition, they must be sensitive to the cultures associated with their languages of expertise.

Although some people do both, interpreting and translation are different professions. Interpreting Services deal with spoken words, translators with written words. Each task requires a distinct set of skills and aptitudes, and most people are better suited for one or the other. While interpreters often interpret into and from both languages, translators generally translate only into their native language.

Interpreters convert one spoken language into another-or, in the case of sign-language interpreters, between spoken communication and sign language. Interpreting requires that one pay attention carefully, understand what is communicated in both languages, and express thoughts and ideas clearly. Strong research and analytical skills, mental dexterity, and an exceptional memory also are important.

Sign-language interpreters facilitate communication between people who are deaf or hard of hearing and people who can hear. Sign-language interpreters must be fluent in English and in American Sign Language (ASL), which combines signing, finger spelling, and specific body language. Most sign-language interpreters either interpret, aiding communication between English and ASL, or transliterate, facilitating communication between English and contact signing-a form of signing that uses a more English language-based word order. Some interpreters specialize in oral interpreting for people who are deaf or hard of hearing and lip-read instead of sign. Other specialties include tactile signing, which is interpreting for people who are blind as well as deaf by making manual signs into their hands, using cued speech, and signing exact English.

In contrast to the immediacy of simultaneous interpreting, consecutive interpreting begins only after the speaker has verbalized a group of words or sentences. Consecutive interpreters often take notes while listening to the speakers, so they must develop some type of note-taking or shorthand system. This form of interpreting is used most often for person-to-person communication, during which the interpreter is positioned near both parties.

Translators convert written materials from one language into another. They must have excellent writing and analytical ability, and because the translations that they produce must be accurate, they also need good editing skills.

Not Lost in Translation

  • Thursday, November 16, 2006
  • By Stephen Ornes
  • Originally posted on Technology Review

As computer programmers develop new techniques for translating texts between languages with different alphabets, they are increasingly turning to a science that seems to have little in common with the conventions of grammar: statistics.

Last week, the National Institute of Standards and Technology (NIST) released the results of its yearly evaluation of computer algorithms that translate Arabic and Mandarin Chinese texts into English. Topping the charts was Google, whose translations in both languages received higher marks than 39 other entries. A machine-calculated metric called BLEU (BiLingual Evaluation Understudy) used scores from professional human translators to assign a single, final score between zero and one. The higher the score, the more the machine translation approximated a human effort.

“If you get a good score, you’re doing well,” says Peter Norvig, Google’s head of research. “If you get a bad score, then either you did poorly or you did something so novel that the translator didn’t see it.”

The Google team, led by Franz Och, designed an algorithm that first isolates short sequences of words in the text to be translated and then searches current translations to see how those word sequences have been translated before. The program looks for the most likely correct interpretation, regardless of syntax.

“We look for matches between texts and find several different translations,” Norvig says. “You take all these possibilities and ask, What is the most probable in terms of what’s been done in the past?”

By comparing the same document (a newspaper article, for example) in two languages, the software builds an active memory that correlates words and phrases. Google’s statistical approach, Norvig says, reflects an organic approach to language learning. Rather than checking every translated word against the rules and exceptions of the English language, the program begins with a blank slate and accumulates a more accurate view of the language as a whole. It “learns” the language as the language is used, not as the language is prescribed. (Google’s program is still in development, but other publicly available webpage translators use a similar method.)

“This is a more natural way to approach language,” Norvig says. “We’re not saying we don’t like rules, or there’s something wrong with them, but right now we don’t have the right data … We’re getting most of the benefit of having grammatical rules without actually formally naming them.”

Lost in translation

Stewart Lee
Originally from The Guardian, Tuesday 23 May 2006

In 1873, the British scholar and traveller Professor Basil Hall Chamberlain visited Japan. He recorded his views of the nation’s music in his subsequent book, Japanese Things: Being Notes On Various Subjects Connected With Japan. “Music,” he wrote, “if that beautiful word must be allowed to fall so low as to denote the strummings and squealings of Orientals, is supposed to have existed in Japan since mythological times … but (its) effect is not to soothe, but to exasperate beyond all endurance the European breast.”

Today this view seems shameful; we can see that it was not, as Chamberlain assumed, that Japan had no musical ability, but that it had no musical tradition that a Victorian professor could recognise. The Japanese musical vocabulary was simply utterly alien to him.

Similarly, a commonly held contemporary British view is that the Germans have no sense of humour. But can this be possible? Can there genuinely be a nation incapable of laughter, or is it just that the German language of laughter differs so greatly from our own, that it appears non-existent?

Our attitude to the Germans and their supposed lack of a sense of humour is best understood through the example of the joke known to comedy professionals such as myself as The German Child. It goes like this. An English couple have a child. After the birth, medical tests reveal that the child is normal, apart from the fact that it is German. This, however, should not be a problem. There is nothing to worry about. As the child grows older, it dresses in lederhosen and has a pudding bowl haircut, but all its basic functions develop normally. It can walk, eat, sleep, read and so on, but for some reason the German child never speaks. The concerned parents take it to the doctor, who reassures them that as the German child is perfectly developed in all other areas, there is nothing to worry about and that he is sure the speech faculty will eventually blossom. Years pass. The German child enters its teens, and still it is not speaking, though in all other respects it is fully functional. The German child’s mother is especially distressed by this, but attempts to conceal her sadness. One day she makes the German child, who is now 17 years old and still silent, a bowl of tomato soup, and takes it through to him in the parlour where he is listening to a wind-up gramophone record player. Soon, the German child appears in the kitchen and suddenly declares, “Mother. This soup is a little tepid.” The German child’s mother is astonished. “All these years,” she exclaims, “we assumed you could not speak. And yet all along it appears you could. Why? Why did you never say anything before?” “Because, mother,” answers the German child, “up until now, everything has been satisfactory.”

The implication of this fabulous joke is that the Germans are ruthlessly rational, and this assumption leaves us little room to imagine them finding time to be playful. But be assured, the German sense of humour not only exists, it actually flourishes, albeit in a form we are ill-equipped to recognise.

In December 2004 I accompanied Richard Thomas, the composer of the popular stage hit Jerry Springer The Opera, to Hanover, where he had gained a commission to develop an opera about a night in a British stand-up comedy club. We wrote the words in English and Richard then collaborated on a translation with a talented German comedy writer called Hermann Bräuer. There were two initial problems with this comedically, one cultural and one linguistic. First, the idea of stand-up is somewhat alien to the Germans. They have a cabaret tradition of sophisticated satire, cross-dressing and mildly amusing songs, and there are also recognisable mainstream, low-brow comedy tropes in the form of vulgar popular entertainers. But the idea of the conversational, casual, middle-ground of English speaking stand-up comedy is unknown to the Germans. Indeed, initial attempts by the Hannover Schauspielhaus set designers to render a typical British comedy club floundered as they attempted to formalise the idea of a stand-up venue, and it was a struggle to explain that we needed to reduce the room to a bare black box rather than attempt to give it a cabaret stage vibe.

Second, this instinct to formalise a genre of comedy we accept as inherently informal is not indivisible from the limitations the German language imposes on conventional British comedy structures. The flexibility of the English language allows us to imagine that we are an inherently witty nation, when in fact we just have a vocabulary and a grammar that allow for endlessly amusing confusions of meanings.

At a rough estimate, half of what we find amusing involves using little linguistic tricks to conceal the subject of our sentences until the last possible moment, so that it appears we are talking about something else. For example, it is possible to imagine any number of British stand-ups concluding a bit with something structurally similar to the following, “I was sitting there, minding my own business, naked, smeared with salad dressing and lowing like an ox … and then I got off the bus.” We laugh, hopefully, because the behaviour described would be inappropriate on a bus, but we had assumed it was taking place either in private or perhaps at some kind of sex club, because the word “bus” was withheld from us. Other suitable punchlines for this set-up would be, “And that was just the teachers”, “I was 28-years-old” and “That’s the last time I attempt to find work as a research chemist in Paraguay.”

There is even a technical term used by those who direct comedy on camera to describe this one-size-fits-all mechanism. Eddie Large is gasping for air as a hot dog falls into the end of his snorkel. The shot widens to reveal Sid Little, whose sausages are flying into the air out of his hot-dog buns because he is using too much ketchup. Pull back and reveal. But German will not always allow you to shunt the key word to the end of the sentence to achieve this failsafe laugh. After spending weeks struggling with the rigours of the German language’s far less flexible sentence structures to achieve the endless succession of “pull back and reveals” that constitute much English language humour, the idea of our comedic superiority soon begins to fade. It is a mansion built on sand.

The German phenomenon of compound words also serves to confound the English sense of humour. In English there are many words that have double or even triple meanings, and whole sitcom plot structures have been built on the confusion that arises from deploying these words at choice moments. Once again, German denies us this easy option. There is less room for doubt in German because of the language’s infinitely extendable compound words. In English we surround a noun with adjectives to try to clarify it. In German, they merely bolt more words on to an existing word. Thus a federal constitutional court, which in English exists as three weak fragments, becomes Bundesverfassungsgericht, a vast impregnable structure that is difficult to penetrate linguistically, like that Nazi castle in Where Eagles Dare. The German language provides fully functional clarity. English humour thrives on confusion.

Third, for the smutty British comic writers, it seemed difficult to find a middle-ground between scientifically precise language describing sexual and bodily functions, and outright obscenity. There seemed to be no nuanced, nudge-nudge no-man’s land, where English comic sensibilities and German logic could meet on Christmas Day and kick around a few dirty jokes in a cheeky, Carry On-style way. A German theatre director explained that this was because the Germans did not find the human body smutty or funny, due to all attending mixed saunas from an early age.

Later on in my stay I found myself explaining to the dramaturg of Hannover Schauspielhaus why English was a great language for comedy, with its possibility for confusion of meaning and the flexibility of its sentences. “There is no need for you to be so proud of yourself,” she explained in precise and accurate English, “it is not as if you personally invented the English language. You merely inherited it by the geographical accident of your birth.” I laughed, and everything finally fell into place.

The geographical accident of Germany has denied Germans the fun we have with language, and it seemed to me that their sense of humour was built on blunt, seemingly serious statements, which became funny simply because of their context. I looked back over the time I had spent in Hannover and suddenly found situations that had seemed inexplicable, even offensive at the time, hilarious in retrospect. On my first night in Hannover I had gone out drinking with some young German actors. “You will notice there are no old buildings in Hannover,” one of them said. “That is because you bombed them all.” At the time I found this shocking and embarrassing. Now it seems like the funniest thing you could possibly say to a nervous English visitor. Since watching jokes I co-wrote for our German production withering in the translation process, all their contrived weaknesses exposed, I have stopped writing jokes as such, and feel I am a better stand-up because of it. I try now to write about ideas, that would be funny in any language, and don’t rely on pull- back and reveals and confusion of meaning. Germany kicked away my comedy crutches and taught me to walk unaided. I am hugely grateful to the Germans. Since you asked, the stand-up opera went OK, and sooner or later we’ll stage it in Britain, in English, where it will make a lot more sense. To paraphrase Simon Munnery, a British comedian so rigorous in his intellect he is almost German, there is much we can learn from watching the Germans. Not as much, however, as they can learn from watching us.

Are you kidding?
Some Germans tell us their jokes …

Andrea Foss, 46, Schleswig Holstein

“What is romantic?” “I don’t know.” “When a man strokes a woman tenderly with a feather.”

“What is perverse?” “I don’t know.” “When the chicken is still attached.”

Tabea Rudolph, 26, Stuttgart

There are problems in the woods. The animals of the forest are always drunk, so the fox decides to ban alcohol. The following day, the fox spies a rabbit hanging out of a tree, clearly wasted. The fox ticks him off, and carries on his way. But the next day he sees the rabbit drunk again, and gives him a final warning. The next day, the fox does his rounds and there’s no sign of the rabbit, but he notices a straw sticking out of a stream. Wondering what it is, the fox scoops it out, only to find a very drunk rabbit on the other end of it. “How many times do I have to tell you that animals of the forest aren’t allowed alcohol?” says the Fox. “We fishes don’t give a toss what the animals of the forest aren’t allowed to do,” says the rabbit

Gerhard Bischof, Bad Toelz, 57

A man jumps out of a plane for the first time. At 3,000m he tries to undo his parachute, but the cord fails. At 2,000m he tries to open the emergency chute but that doesn’t work either. At 1,000m he bumps into a man wearing blue overalls, carrying a spanner. “Can you repair parachutes?” asks the first man. “‘Fraid not,” says the other. “I only do boilers.”

Wolfgang Voges, 56, from lower Saxon

Three priests hold a meeting to discuss where life begins. The evangelical priest says, “No question about it, life begins when the child is born.” “No, no,” says the Catholic priest, “it all starts when the sperm meets the egg.” “You’re both wrong,” says the Rabbi. “Life begins when the children have left home and the dog is dead.”

UN Interpreters Make Sure Nothing is Lost in Translation

Think you’re good at languages? Try applying for one of the toughest translation jobs on earth — working as a language specialist for the United Nations. RFE/RL takes a behind-the-scenes look at the world of interpreters.

UNITED NATIONS — When Libyan leader Muammar Qaddafi delivered his notorious 96-minute speech before the UN General Assembly last autumn, no one may have been more aware of each passing minute than his personal translator, Fouad Zlitni, whom he had brought along for the occasion.

Nearly three-quarters of the way into Qaddafi’s address, Zlitni collapsed, undone by the effort of translating the Libyan leader’s rambling, at times angry speech from Arabic into English for nearly 75 minutes straight.

Hossam Fahr, the Egyptian-born head of the UN’s interpretation service, says Qaddafi’s translator went far beyond the normal limits of what an interpreter can reasonably be expected to do.

“It was a very unusual situation, because every member state has the right to bring its own interpreter. [Qaddafi] had his own interpreters; they were already installed in the booths. So we let them do the work, and then unfortunately, one of them just collapsed a good 75 minutes into the statement,” Fahr said.

“I take my hat off to him — he did a very good job under the circumstances.”

The incident served to highlight the grueling nature of simultaneous interpretation, a profession which few ordinary people have occasion to observe.

But at the United Nations, which brings together 192 member states and a profusion of mother tongues in its day-to-day pursuit of international diplomacy, interpretation is at the very core of its operations.

The annual General Assembly — which every autumn brings together the entire UN membership for a massive two-week series of speeches and policy reviews — may represent the World Cup of professional interpretation.

But even on a day-to-day basis, the UN’s councils, committees, and publications produce enough work to keep its language staff of nearly 460 people busy on a full-time basis.

Barry Olsen, who heads the conference interpretation program at California’s highly respected Monterey Institute of International Studies — from which a number of UN translators have graduated — says UN language specialists are generally considered the best in the business.

“A translator or interpreter who works for the United Nations has reached what is very much one of the pinnacles of the profession. It is an organization that is respected and the linguistic work that goes on with the United Nations is of the highest order,” Olsen says.

Iron Nerves And A Sense Of Style

Although the official working languages at the United Nations are English and French, the UN has six official languages into which the bulk of its official documents and publications are automatically translated — English and French, plus Arabic, Chinese, Russian, and Spanish. (In instances where other languages are needed, the UN will hire freelance interpreters or country delegations will bring in their own translators.)

UN interpreters, most typically, translate from their acquired languages into their native tongue. With language like Chinese and Arabic — where accomplished translators are more difficult to find — interpreters will translate both into their native language as well as their adopted ones.

It’s an intense experience that can drain even the most accomplished interpreters — to avoid a Qaddafi-like marathon, in fact, the UN abides by a strict timetable in which interpreters work in teams of two, with one typically working no more than 20 minutes at a time before switching to his or her partner. (General Assembly speeches, moreover, are usually kept to 15 minutes or less.)

Mastering a language is only the start to being a good interpreter. In a UN guide for would-be language specialists, the job appears to be equal parts diplomat, rocket scientist, and traffic cop. “A good translator,” it reads, “knows techniques for coping with a huge variety of difficult situations, has iron nerves, does not panic, has a sense of style, and can keep up with a rapid speakers.”

Igor Shpiniov of the UN Training Section, Hossam Fahr, the chief of the UN Interpretation Service, and Stephen Sekel, the former chief of the UN English Translation Service.

Stiff Competition

Such people, it appears, are hard to find. Despite salaries that are among the highest in the profession — top-rank UN interpreters can earn $76,000 a year — the United Nations is suffering a severe shortage of qualified language personnel.

“We’re looking for people with good comprehension skills. Sometimes people who translate from French or English into Russian do not necessarily speak fluently in English or French,” says  Igor Shpiniov, a Russian-born translator who runs the UN’s language training division.

“Sometimes, paradoxically, they can translate a text about atomic energy, but if you ask them to buy milk at a French supermarket, they’ll be at a loss.”

Competition for the jobs is stiff. Out of 1,800 applicants looking to work as Chinese interpreters last year, only 10 passed the UN examination. For Arabic, only two out of 400 made the cut.

Many UN language experts work as translators for the vast numbers of publications and documents that pass through the international body each year. But the most prestigious position is that of the simultaneous interpreters when language experts sit in soundproof booths and provide a running translation of often highly technical or politically charged speeches.

The Comma Affair

The profession was first developed during the Nuremberg trials of Nazi war criminals in 1946. Now both the General Assembly and Security Council have eight translation booths — one for each of the UN’s official languages, and two for alternate language translations. (According to UN rules, the media is barred from sitting in on live interpretation sessions.)

When working at important events like Security Council meetings, interpreters are often allowed to prepare with advance information about the proceedings, allowing them to familiarize themselves with the concepts and terminology of the debate. The agenda for the General Assembly is often planned months in advance, allowing the translation team ample time to estimate how many interpreters will be needed for scheduled talks.

Still, no amount of advance planning can completely protect interpreters from anxiety when the time has come for them to translate. Some studies have shown that during intense debates, interpreters often experience an increase in blood pressure and heart rate as they struggle to translate different terms, nuances, and arguments into smooth, comprehensible phrases.

Movies like “The Interpreter,” starring Nicole Kidman as a UN translator and filmed inside the United Nations compound, brought an aura of Hollywood glamour and intrigue to the role of interpreters. In reality, the job can be far more prosaic, although constant worries about involuntary bloopers and misinterpretations can keep tensions high.

In one instance, a firestorm was raised when a single comma was removed from the text of a UN resolution involving two unnamed former Soviet republics in the thick of a border dispute. One of the countries, angered by the omission, demanded it be replaced. But the UN translators, undaunted, said the comma had distorted the meaning of the text. Not everyone was happy, but in the end, the comma stayed out.

Mistakes And Applause

Interpretation head Fahr also recalls a mistake he made as an Arabic-English interpreter when the Egyptian diplomat Boutros Boutros-Ghali was sworn in as UN secretary-general in 1992.

“What comes out of my mouth is, ‘I congratulate you upon your election as secretary-general of the United States.’ And everybody in the General Assembly laughed,” Fahr said.

“So the president of the General Assembly asked the then-secretary-general, [Peru’s Javier] Perez de Cuellar why are they laughing, and he said ‘The English interpreter made a mistake.'”

In the end, Fahr says, he received a forgiving round of applause.

Stephen Sekel, former chief of the UN’s English translation service, says such mistakes are quite common and that UN staff only occasionally demand an interpreter be sanctioned for making a mistake. Overall, he says, the skill and professionalism of the UN translation team ensures any they remain an indispensible, behind-the-scenes asset — and that their errors will be few.

“We expect our language staff to bring a great deal of general knowledge to the job, a high level of education and a lot of intellectual curiosity,” Sekel said.

“They are expected to be continuous learners. They wouldn’t survive otherwise. Perhaps that explains why we don’t have too many examples of terrible mistakes that brought us to the brink of a major international crisis.”


Demand for Interpreter Grows

Demand for interpreters grows


Ask Sarah Shannon how many court cases she’s worked on recently and she’ll tell you, “Oh my word, too many!”

As the only state-certified Spanish language interpreter in the Panhandle’s 12th Judicial District, the Mitchell, Neb., woman’s “part-time” job has her working with at least 30 clients each month.

Interpreting accounts for a growing share of the state court budget – an expense that’s increased dramatically over the past five years.

On a busy day, four interpreters will be working in Douglas County courtrooms, handling trials in district court, traffic cases, and civil and juvenile court cases, said Adriana Hinojosa, the county’s coordinator for interpreter services. She said demand has jumped in the past year.

Last year, the Nebraska courts paid more than $1 million for interpreting services, hiring 160 interpreters speaking 21 languages.

It’s a trend that results from Nebraska’s increasingly diverse population. The state’s Hispanic population has grown by 49 percent since 2000, according to 2008 U.S. Census information. An estimated 9 percent of Nebraska’s population speaks a language other than English in their homes, according to the Census.

Court officials are looking for ways to cut costs so they can free up money to recruit and train more interpreters.

One strategy, using laptop computers, Web cameras and Internet conferencing technology for remote interpretation, is being adopted by more than a dozen county courts in rural areas, said Sheryl Connolly, who spends part of her time coordinating interpreter services for the state court system.

The new state budget includes a 10 percent increase, or $105,000, for next year’s court interpreter budget.

But it provides no funds for a full-time state coordinator as requested by court officials, nor would it allow the program to grow in 2010-11, the second year of the two-year budget cycle.

In his state of the judiciary address earlier this year, Supreme Court Chief Justice Michael Heavican said it “isn’t unusual in Grand Island, for example, to need interpreters in languages such as Nuer, Dinka and Nubian in court cases.”

In other states, cases have been overturned because of poor interpretation, said Supreme Court Judge John Gerrard, who heads the court system’s Interpreter Advisory Committee.

“It’s a due process issue,” he said. “If you’re not being interpreted correctly, you’re not having your opportunity to be heard.”

In an effort to assure quality, the state offers a certification program that includes training workshops and testing. Interpreters generally need the equivalent of a college-level education in both English and a foreign language to pass the tests.

Judges must use certified interpreters when they are available. Although Nebraska now has 17 certified interpreters, all of them speak Spanish.

That means those who speak other languages often must rely on less-skilled interpreters.

Court interpreters are paid $50 an hour for their part-time work. The state has no full-time interpreters on staff.

Most interpreters live in population centers like Lincoln and Omaha, where they have better access to college-level language courses. Meanwhile, interpretation services often are needed hours away, in towns like Lexington, Schuyler and Dakota City, where the meatpacking industry has attracted many Spanish-speaking workers.

To help save on travel costs, some counties are looking to remote interpreting.

With the technology, an interpreter can participate without traveling to the courtroom. The interpreter can see and hear those in the courtroom, and those in the courtroom can see and hear the interpreter.

The effort started with Colfax County in east-central Nebraska and now includes five counties in the Panhandle and 10 counties in south-central Nebraska.

Connolly, with the state court system, said another county, Lincoln, where North Platte is located, recently notified her that court officials there want to begin using a Web camera and laptop computers to bolster interpreting.

Hinojosa said remote interpreting is not being used in the Omaha metro area, which doesn’t face the same obstacles with distance and travel expenses.

Colfax County Judge Patrick McDermott of Schuyler studied remote interpreting for his master’s degree project while studying at the University of Nebraska at Omaha.

He concluded the state could save up to $450,000 per year.

But Shannon, an interpreter who serves the Panhandle, said she’s uncomfortable with remote interpreting.

“An interpreter has to see and hear the attorneys, the judges, the client and everyone in the courtroom to be effective,” Shannon said.

Connolly agreed that remote interpreting probably would not be appropriate for complex hearings and trials with many witnesses and multiple days of testimony. She said the effort thus far is focusing on county courts in part because the technology is best suited for simple proceedings.

Level Playing Field: Court Interpreters Help Speed the Process, Meet Growing Demand

WORCESTER- But for Marisol Arzeno-McGill’s linguistic skills, Santos A. Delgado would probably not have understood a word Assistant District Attorney Timothy M. Farrell was saying as the prosecutor explained his predicament to the judge.

He could not go forward with the scheduled hearing on Mr. Delgado’s motion to suppressmotion to suppress n. a motion (usually on behalf of a criminal defendant) to disallow certain evidence in an up-coming trial. Example: a confession which the defendant alleges was signed while he was drunk or without the reading of his Miranda rights.
….. Click the link for more information. the drug evidence against him because a key police witness had inexplicably not shown up to testify, Mr. Farrell told Judge James R. Lemire during a recent Worcester Superior Court session.

Held on $50,000 cash bail and facing a minimum mandatory 10-year prison sentence if convicted, the 22-year-old defendant listened intently as Ms. Arzeno-McGill, the Spanish-speaking interpreter at his side, communicated Mr. Farrell’s comments in Mr. Delgado’s native tongue.

Citing the court’s heavy docket and the likelihood that Mr. Delgado’s case would not be reached anyway, Judge Lemire continued the matter to another date. Mr. Delgado, a Jamaica Plain man also known as James Pena-Guerro, was returned to the lockupSee hang and abend.

Ms. Arzeno-McGill rushed off to another courtroom where her services were needed.

It was one of more than a dozen times Ms. Arzeno-McGill would be called upon this particular day to assist Spanish-speaking parties to cases in the five court departments that make up the Worcester Trial Court at 225 Main St. She and Larry Smith

For other people named Larry Smith, see Larry Smith (disambiguation).

Larry W. Smith (born 1951 in Hudson, Quebec) is a Canadian athlete and businessperson. He is currently the president of the Montreal Alouettes. , the other Spanish-speaking interpreter assigned permanently to the Worcester courthouse, are among 28 certified language interpreters employed full time by the state Office of Court Interpreter Services.

They include 19 Spanish interpreters, five Portuguese and one each who speak Vietnamese, Khmer, Cape Verdean and Haitian Creole Haitian Creole
A language spoken by the majority of Haitians, based on French and various African languages.

Noun 1. Haitian Creole , according to according to
1. As stated or indicated by; on the authority of: according to historians.

2. In keeping with: according to instructions.

3. Gaye Gentes gen·tes
Plural of gens. , manager of the office. Court interpreters are required to pass a test and undergo a tightly structured training program before becoming certified.

Ms. Gentes also uses the services of 188 per diem per diem adj. or n. Latin for “per day,” it is short for payment of daily expenses and/or fees of an employee or an agent.  interpreters, independent contractors who speak both English and a combined total of 51 other languages, from Albanian to Vietnamese. A recent recruitment program added court interpreters in Hmong and several African languages African languages, geographic rather than linguistic classification of languages spoken on the African continent. Historically the term refers to the languages of sub-Saharan Africa, which do not belong to a single family, but are divided among several distinct , including Twi, Ibo, Dinka and Luganda, Ms. Gentes said.

State law mandates that non-English speaking and deaf or hearing-impaired parties or witnesses in legal proceedings All actions that are authorized or sanctioned by law and instituted in a court or a tribunal for the acquisition of rights or the enforcement of remedies. be provided the aid of an interpreter. In fiscal year 2008, the Office of Court Interpreter Services filled 96,737 requests for interpreters in about 140 courts statewide, up from 56,000 seven years earlier, according to Ms. Gentes.

The annual cost to the taxpayers is $1.5 million for the staff interpreters and $4.4 million for the per diems, according to Trial Court spokeswoman Joan Kenney.

Court interpreters have their own code of professional conduct covering such topics as accuracy, impartiality, confidentiality, proficiency, demeanor, case preparation, conflicts of interest, public comments and legal advice.

The code describes the role of the interpreter as that of a “communication facilitator” who helps protect the rights of non-English speaking people involved in the legal process.

Mr. Smith, a Michigan native, said he learned Spanish while attending Western Michigan University Western Michigan University, at Kalamazoo, Mich.; coeducational; founded in 1903 as Western State Normal School, became accredited in 1927 as a college, gained university status in 1957.  and later became more fluent in the language while working in the tourism industry in California. A graduate of the University of Michigan Law School The University of Michigan Law School, located in Ann Arbor, is a unit of the University of Michigan. The Law School, founded in 1859, currently has an enrollment of approximately 1,200 students, most of whom are earning the degrees of Juris Doctor (J.D.) or Master of Laws (LLM).  and a member of the California bar, Mr. Smith moved to North Carolina North Carolina, state in the SE United States. It is bordered by the Atlantic Ocean (E), South Carolina and Georgia (S), Tennessee (W), and Virginia (N). Facts and Figures

Area, 52,586 sq mi (136,198 sq km). Pop. in the late 1990s, started doing

court interpreting part time there, then received his certification as a court interpreter.

He and his wife moved to Worcester “sight unseen” in 2001, after he accepted his current job here.

“I love it,” Mr. Smith said of his work.

“For me, it’s a natural. It’s a coming together of law and Spanish after all these years. It brings together what I like about both. I’m a people person. I think you have to be in this business. And I love language,” he said.

There’s more to court interpreting than the ability to speak English and another language, according to Mr. Smith.

There are two basic modes of court interpretation, simultaneous and consecutive, and each has its own set of challenges, said Mr. Smith. The former requires the interpreter to speak contemporaneously with the person whose statements are to be heard. In the latter, the interpreter allows the speaker to finish his or her statement before attempting its interpretation.

Mr. Smith likened simultaneous interpretation to a splitting of the brain’s lobes that enables the interpreter to listen and speak at the same time.

“You’ve got to develop that ability of incoming and outgoing, in two different languages. And it’s in real time,” he said “It takes practice. It doesn’t come naturally. You just have to learn.”

Surprisingly, Mr. Smith said he and most of his colleagues find consecutive interpreting more difficult because it is so taxing on the memory.

Spanish is Ms. Arzeno-McGill’s first language. Born in San Juan, Puerto Rico San Juan (IPA: [saŋ hwaŋ]) (from the Spanish San Juan Bautista, “Saint John the Baptist”) is the capital and largest municipality on Puerto Rico. , she studied English in grade school.

A former bilingual elementary school elementary school: see school.  teacher with a master’s degree in communications from Boston University, Ms. Arzeno-McGill worked as an account executive in

public relations public relations, activities and policies used to create public interest in a person, idea, product, institution, or business establishment. By its nature, public relations is devoted to serving particular interests by presenting them to the public in the most

before becoming a medical interpreter at Brigham and Women’s Hospital Brigham and Women’s Hospital (BWH) is a hospital in the Longwood Area of the Boston, Massachusetts neighborhood of Mission Hill. With Massachusetts General Hospital, it is one of the two founding members of Partners HealthCare.  in Boston, a position she held four years.

She has been a court interpreter for 20 years, the last seven on a full-time basis, and said she has enjoyed every minute of it.

“I think I have the best job in the world,” she said.

Being assigned to five different courts – superior, district, juvenile, probate and housing – exposes her to a wide range of legal issues and keeps the job interesting, according to Ms. Arzeno-McGill.

“Each court has its own style, its own way of doing things. I never know when I walk through the door what’s waiting for me that day,” she said. Ms. Gentes said the system developed by Ms. Arzeno-McGill and Mr. Smith to cover the Worcester Trial Court is used as a model for court interpreters statewide.

“What I enjoy the most is that what I do, it’s an instrument to the limited-English speaker to have a voice and have full understanding, participation and access to our legal system,” Ms. Arzeno-McGill said.

Contact Gary Murray by e-mail at gmurray@telegram.com.


CUTLINE: Spanish-speaking court interpreters Larry Smith and Marisol Arzeno-McGill are assigned permanently to the Worcester Trial Court. They are among 28 certified language interpreters employed full time by the state Office of Court Interpreter Services.

Errors in Medical Interpretation and Their Potential Clinical Consequences

Background. About 19 million people in the United States are limited in English proficiency, but little is known about the frequency and potential clinical consequences of errors in medical interpretation.

Objectives. To determine the frequency, categories, and potential clinical consequences of errors in medical interpretation.

Methods. During a 7-month period, we audiotaped and transcribed pediatric encounters in a hospital outpatient clinic in which a Spanish interpreter was used. For each transcript, we categorized each error in medical interpretation and determined whether errors had a potential clinical consequence.

Results. Thirteen encounters yielded 474 pages of transcripts. Professional hospital interpreters were present for 6 encounters; ad hoc interpreters included nurses, social workers, and an 11-year-old sibling. Three hundred ninety-six interpreter errors were noted, with a mean of 31 per encounter. The most common error type was omission (52%), followed by false fluency (16%), substitution (13%), editorialization (10%), and addition (8%). Sixty-three percent of all errors had potential clinical consequences, with a mean of 19 per encounter. Errors committed by ad hoc interpreters were significantly more likely to be errors of potential clinical consequence than those committed by hospital interpreters (77% vs 53%). Errors of clinical consequence included: 1) omitting questions about drug allergies; 2) omitting instructions on the dose, frequency, and duration of antibiotics and rehydration fluids; 3) adding that hydrocortisone cream must be applied to the entire body, instead of only to facial rash; 4) instructing a mother not to answer personal questions; 5) omitting that a child was already swabbed for a stool culture; and 6) instructing a mother to put amoxicillin in both ears for treatment of otitis media.

Conclusions. Errors in medical interpretation are common, averaging 31 per clinical encounter, and omissions are the most frequent type. Most errors have potential clinical consequences, and those committed by ad hoc interpreters are significantly more likely to have potential clinical consequences than those committed by hospital interpreters. Because errors by ad hoc interpreters are more likely to have potential clinical consequences, third-party reimbursement for trained interpreter services should be considered for patients with limited English proficiency.

Key Words: language • interpreters • medical errors • children • pediatrics • Hispanic Americans • quality

Abbreviations: LEP, limited in English proficiency • SD, standard deviation


We audiotaped pediatric encounters in which a Spanish interpreter was used in the pediatric outpatient clinic of an urban Massachusetts hospital over a 7-month period. All study parents had identified themselves as LEP. A bilingual research assistant was present during the encounter only to record the interaction, and did not act as an interpreter, nor take part in subsequent production of transcripts or data analysis. A bilingual verbatim transcript was prepared from the audiotape of each encounter by a professional transcriptionist fluent in both English and Spanish. To ensure accuracy and reliability of the transcripts, each transcript was reviewed 3 times for errors, once by a bilingual physician whose first language is English (G.F.), a second time by a bilingual sociologist whose first language is English (M.B.L.), and a third time by a bilingual physician whose first language is Spanish (M.A.).

The encounters analyzed for this study represent all pediatric visits with Spanish interpreters that occurred in a larger study of patient-physician communication, which consisted of a convenience sample of 153 audiotaped visits in the pediatric outpatient clinics of an urban Massachusetts hospital. Of the 153 participants in this larger study, 110 of the children and their families were Latino. Among these 110 Latino participants, there were 74 mothers/adult caregivers who were LEP, for which 38 visits occurred in Spanish with Spanish-speaking clinicians, 13 visits included a Spanish interpreter, and 25 occurred in English without an interpreter. Although this larger study used a convenience sample, the sample was obtained to reflect a reasonable spectrum of outpatient pediatric visits experienced by Latino families, and has no obvious selection biases other than respondent refusal, which was rare (only 2 potential subjects refused to participate). Participants from the larger study were sampled to capture visits from the full range of daily office hours and all 5 clinic days (Monday-Friday) during the work week. Pediatric encounters included walk-in, sick, and routine health care maintenance visits at the pediatric primary care clinic, and initial and follow-up visits at the outpatient lead and failure-to-thrive clinics. Both pediatricians and pediatric nurse practitioners provided care to study patients, and patient care was in no way altered by the study, except for the presence of the research assistant and tape recorder. The patients and their families, clinicians, and interpreters were told only that this was a study of patient-physician communication, and they were not aware that errors of medical interpretation would be analyzed.

Personnel who provided medical interpretation were classified as: 1) hospital interpreters, professional interpreters (ie, those receiving financial compensation) employed by the study hospital’s department of interpreter services; and 2) ad hoc interpreters, who could include family members, friends, nonclinical hospital employees, strangers from waiting rooms, and hospital clinical staff (including nurses and social workers) who had received no formal medical interpreter training or screening. During the period when the study was conducted, all Spanish hospital interpreters who had been hired had undergone some level of screening and evaluation for language proficiency in Spanish and English. There was, however, no ongoing training or formal performance evaluation in the hospital for interpreters. Low-intensity, voluntary formal interpreter training was sporadically available at various community sites, but it was not known what proportion of interpreters took advantage of these voluntary community opportunities.

For each audiotaped encounter, analysis consisted of identification of the frequency and categories of interpreter errors. An “interpreter error” was defined as any misinterpretation of an utterance that occurred in the clinical encounter, including those committed by the designated medical interpreter, as well as those made by health care providers (such as when a physician with limited Spanish proficiency made errors in Spanish while talking to the mother after the designated interpreter had departed). Errors by health care providers were classified as interpreter errors because the study focus was on errors of interpretation made by any staff member acting as a medical interpreter during a clinical encounter, and we found that certain providers often would attempt to interpret when the designated medical interpreter departed or was temporarily unavailable.

Five categories were used to classify interpreter errors, based on 4 categories used in previous work,10,11 supplemented by an additional category (false fluency). These categories are as follows:

Omission: The interpreter did not interpret a word/phrase uttered by the clinician, parent, or child.

Addition: The interpreter added a word/phrase to the interpretation that was not uttered by the clinician, parent, or child.

Substitution: The interpreter substituted a word/phrase for a different word/phrase uttered by the clinician, parent, or child.

Editorialization: The interpreter provided his or her own personal views as the interpretation of a word/phrase uttered by the clinician, parent, or child.

False Fluency: The interpreter used an incorrect word/phrase, or word/phrase that does not exist in that particular language.

In addition to being classified into 1 of these 5 categories, an interpreter error was also considered to have potential clinical consequences if it altered or potentially altered 1 or more of the following: 1) the history of present illness; 2) the past medical history; 3) diagnostic or therapeutic interventions; 4) parental understanding of the child’s medical condition; or 5) plans for future medical visits (including follow-up visits and specialty referrals).

Medical jargon, idiomatic expressions, and contextual clarifications may occasionally require medical interpreters to not interpret a phrase word-for-word. Thus, any deviations from word-for-word interpretation in transcripts that were attributable to jargon, idioms, or contextual clarifications were not classified as interpreter errors. Because medical interpreters may also act as a cultural broker or advocate, any utterances that could be interpreted as cultural explanations or patient or family advocacy were not classified as interpreter errors. A separate analysis of the relationship of the number of verbal exchanges, the interlocutor, and the quality of the interpretation will be reported elsewhere in a separate paper.

The validity of the analytic method for identification and classification of interpreter errors was assessed as follows: 2 transcripts (cases 26 and 153) were first subjected to preliminary error analysis using simple definitions of each error type and category. The 2 transcripts were scored by 3 observers, a bilingual physician whose first language is English (G.F.) and 2 bilingual physicians (M.A. and L.M.) whose first language is Spanish. To avoid the introduction of bias, the latter 2 observers were blinded to the study goals and hypotheses. Each of the observers was assessed as being highly fluent in their second language based on years of experience providing primary care to Spanish-speaking patients in a Pediatric Latino Clinic (G.F.), 7 years as a research associate on studies of English-speaking populations in the United States (M.A.), and years of teaching high school to English-speaking students in the Massachusetts school system (L.M.). Interobserver variability for the 3 observers was assessed using agreement matrices and by calculating the percentage of agreement in 2 separate analyses, 1 for overall interpreter errors, and the second only for errors of potential clinical consequence. The Kappa Index was also determined for errors of clinical consequence. It was not possible to derive a Kappa Index for overall errors, as transcripts could not be accurately scored for 1 of the 4 cells (cell d): when neither observer identified an error, there was no reliable way to determine whether one should count by words, phrases, transcript lines, or utterances.

The preliminary error analysis of the 2 test transcripts revealed a mean percentage of agreement (± standard deviation [SD]) among the 3 observers on the overall errors of 60% ± 19, with a range of 31% to 82%. Disagreements were primarily attributable to either overlooked errors or unintended differences in the line numbering of the transcripts analyzed by different observers. After line numbering corrections, refinements, and meeting for consensus purposes, there was complete agreement among the 3 observers on the number and type of overall interpreter errors. The mean percentage of agreement (± SD) among the 3 observers on errors of potential clinical consequence in the preliminary analysis was 83% ± 12, with a range of 72% to 97%. The mean {kappa} (± SD) for errors of potential clinical consequence in the preliminary analysis was 0.57 ± 0.3 (considered a moderate strength of agreement by the guidelines of Landis and Koch12), with a range of 0.21 to 0.97 (from fair to almost perfect agreement by the Landis and Koch guidelines12). Because the mean percentage of agreement and {kappa} were considered unacceptably low, the error categories and types were further refined. After refinement, there was mean agreement of 99% ± 1.7 (range: 97%–100%) and a mean {kappa} of 0.99 ± 0.03 (range: 0.94–1.0 [almost perfect by the Landis and Koch guidelines12 for both the mean and range]) regarding interpreter errors of potential clinical consequence on the 2 test transcripts. The remaining 11 transcripts were analyzed by the first author, using the refined error categories, types, and analytic approaches.

To analyze the statistical significance of differences between hospital and ad hoc interpreters in the proportion of errors made, the Yates-corrected {chi}2 test was used, with P < .05 considered statistically significant.

Institutional review board approval was obtained from the participating institution to conduct this study, and written informed consent was obtained from each participating parent.


Thirteen clinical encounters with Spanish interpreters present were audiotaped, yielding 6 hours of audiotapes, 474 pages of transcripts, and 49 513 words that were exchanged. Hospital interpreters were present in 6 of 13 encounters; in the remaining 7 encounters, the ad hoc interpreters included a nurse for 3 encounters, a social worker for 3 encounters, and an 11-year-old sibling for 1 encounter. The number of words uttered per encounter averaged 3781, and there was no statistically significant difference in the mean number of words uttered per encounter by interpreter type (mean words uttered = 3919 when hospital interpreters were present vs 3663 when ad hoc interpreters were present, with P > .5 by the 2-tailed Student t test). The visit type, clinician present, patient age, and number of interpreter errors in each clinical encounter are summarized in Table 1.

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TABLE 1. Selected Features of Study Encounters

There were 396 interpreter errors noted in the 13 clinical encounters (Table 2). The mean number (± standard error) of interpreter errors per clinical encounter was 30.5 ± 3.6, with a range of 10 to 60. There was no statistically significant difference between hospital and ad hoc interpreters in the mean number of errors committed per clinical encounter.

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TABLE 2. Summary of Errors of Medical Interpretation Observed in Clinical Encounters in the Study

The proportions of interpreter errors by category were: omission, 52%; false fluency, 16%; substitution, 13%; editorialization, 10%; and addition, 8%. There were no statistically significant differences between hospital and ad hoc interpreters in the proportion of errors by specific category (Table 2), except for false fluency errors, which occurred more often during encounters with hospital than ad hoc interpreters (22% vs 9%, P = .001). Additional analysis of false fluency errors occurring in encounters with hospital interpreters revealed that health care providers made 76% of the false fluency errors, and 58% of these errors occurred while the interpreter was out of the room or on the phone, whereas the remaining 42% of errors were made by the provider without any correction by the interpreter. Health care providers were >11 times more likely (relative risk: 11.4; 95% confidence interval: 1.7–76.2) to make false fluency errors when a hospital interpreter was involved, committing 76% of the false fluency errors with trained interpreters, compared with only 7% of false fluency errors when untrained interpreters were involved (P < .001). Nevertheless, health care providers committed only ~10% of all errors observed in this study. About three quarters (73%) of the false fluency errors committed by hospital interpreters involved medical terminology, including not knowing the correct Spanish words for “level,” “results,” and “medicine,” and using the Puerto Rican colloquialism for mumps, which could not be understood by a Central American mother.

There were 250 errors (63% of all errors) that had potential clinical consequences (Table 2). The mean number (± standard error) of errors with potential clinical consequences per encounter was 19 ± 3.2, with a range of 5 to 49. Errors made by ad hoc interpreters were significantly more likely to have potential clinical consequences than those made by hospital interpreters, at 77% vs 53% (P < .0001). When an 11-year-old sibling was used as an interpreter, for example, 84% of the 58 errors she committed had potential clinical consequences, and when an untrained staff nurse interpreted, 90% of his 10 errors had potential clinical consequences. Indeed, the lowest proportion of errors of potential clinical consequence committed by an ad hoc interpreter was 62%.

Interpreter errors of potential clinical consequence included: 1) omitting questions about drug allergies; 2) omitting key information about the past medical history (a mother’s statement that her child had been hospitalized at birth for a renal infection); 3) omitting crucial information about the chief complaint and other important symptoms (Fig 1); 4) omitting instructions about antibiotic dose, frequency, and duration; 5) instructing a mother to give an antibiotic for 2 instead of 10 days (Fig 2); 6) erroneously adding that hydrocortisone cream must be applied to an infant’s entire body, instead of solely to a facial rash (Fig 3); 7) telling a mother to give soy formula to her infant, instead of a physician’s instructions to breastfeed only; 8) omitting instructions on the amount, frequency, and type of rehydration fluids for gastroenteritis; 9) editorializing to a mother that she should not answer personal questions asked by her physician about sexually transmitted diseases and drug use; 10) explaining that an antibiotic was being prescribed for the flu; 11) omitting a mother’s clear explanation that a child had already been swabbed rectally for a stool culture; 12) omitting and substituting for a mother’s description of her child’s abnormal behavioral symptoms (Fig 4); and 13) instructing a mother to put oral amoxicillin into her child’s ears to treat otitis media (Fig 5).

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Fig 1. Multiple omission errors of potential clinical consequence committed by an ad hoc interpreter (the patient’s 11-year-old sister) during a sick visit to a pediatrician by a 2-year-old child for vomiting and dehydration (case 26). Note that the pediatrician never receives a response about how many times the child has vomited before the visit, and the interpreter omits the mother’s statements about the child’s ear pain and oral lesion.

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Fig 2. Substitution, addition, and omission errors of potential clinical consequence committed by an ad hoc interpreter during a sick visit to a pediatrician by a 9-month-old child for fever, vomiting, and a rash (case 19).

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Fig 3. Multiple errors of omission and substitution of potential clinical consequence committed by a hospital interpreter during a sick visit to a pediatric nurse practitioner by a 1-month-old male infant for seborrhea and an upper respiratory illness.

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Fig 4. Omission and substitution errors of clinical consequence committed by an ad hoc interpreter during an 18-month-old boy’s visit to a pediatrician in the lead clinic (case 176).

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Fig 5. Addition and omission errors of clinical consequence made by an ad hoc interpreter during a visit to a pediatric nurse practitioner by a 7-year-old-girl diagnosed with otitis media (case 165).


Implications for Practice, Training, and Research
Errors in medical interpretation were found to be alarmingly common in this study, averaging ~31 per clinical encounter. In addition, there was no statistically significant difference between hospital and ad hoc interpreters in the mean number of errors committed per encounter. Although errors made by hospital interpreters were significantly less likely to be of potential clinical consequence than those made by ad hoc interpreters, over half of hospital interpreter errors had potential clinical consequences. These findings support the conclusion that most hospital interpreters do not receive adequate training at their institution.13 Fewer than one fourth of hospitals nationwide provide any training for medical interpreters.13 Only 14% of US hospitals provide training for volunteer interpreters, and in half of these hospitals, the training programs are not mandatory.13 Even when hospitals provide training to medical interpreters, the training may be limited to short orientation sessions or shadowing more seasoned interpreters.13 Our study findings and these national data suggest that additional research and policy work is needed to determine what type of medical interpreter training is most effective in reducing interpreter errors. Specific issues that need to be addressed include whether training of medical interpreters should be mandatory, and which training approaches are most effective in eliminating common errors of potential clinical consequence and in improving accuracy and understanding medical terminology.

The categories of interpreter errors noted in this study indicate areas where more training is needed for medical interpreters. Omissions by far were the most common type of interpreter error, accounting for more than half of all errors. This finding suggests that a principal focus of interpreter training should be the faithful transmission of each and every utterance by clinicians, patients, and patients’ families. Simultaneous remote or on-site interpretation (as is done in the United Nations) has the potential to increase the number of utterances and reduce the number of errors,11 but concerns can be raised about the costs of training and implementation, and difficulties with acceptance by interpreters. Most false fluency errors committed by hospital interpreters (73%) involved medical terminology. This finding indicates that medical interpreter training should include a detailed review of medical terms, with attention to linguistic issues such as variation among cultural subsets of a single linguistic group. In addition, periodic performance evaluation, including monitoring of false fluency errors, may be an important means of quality improvement for medical interpreter services, indicating when additional training in medical terminology is needed.

The categories of interpreter errors noted in this study also indicate that more training is needed for clinicians in the use of medical interpreters. Clinicians commit most false fluency errors when the interpreter leaves the room or is taking a telephone call, and clinicians are 11 times more likely to make false fluency errors when hospital interpreters participate in the clinical encounter. These findings are consistent with studies that show that most hospital staff receive no training on working with interpreters,13 and most medical schools do not provide adequate instruction on linguistic and cultural issues in clinical care.14 For example, only 23% of US hospitals provide any training for their staff on the use of medical interpreters, and such training may consist of nothing more than policies and procedures for requesting interpreters.13 These studies and our results suggest that clinicians should receive skills training on the proper technique for working with medical interpreters, especially the risk of false fluency errors associated with clinicians with limited foreign language fluency. It is recommended that interchanges between such clinicians and patients (and their families) in a foreign language should be limited to when the medical interpreter is present and not distracted; if such interchanges occur without an interpreter, the clinician should consider repeating the interchange when the interpreter is available once again. The limited foreign language skills of a clinician can prove to be an asset, however, in that they can provide a means of verifying the quality of medical interpretation. For example, if the clinician hears a patient utter a word or phrase that was not translated by the interpreter, the clinician could bring this to the interpreter’s attention, and reemphasize the importance of faithful message transmission of each and every utterance. Conversely, because 42% of false fluency errors committed by clinicians occurred in the presence of an interpreter and went uncorrected, medical interpreters probably should be taught that it is reasonable and appropriate to correct clinician false fluency errors.

Medical Errors and Quality of Care
The study findings suggest that interpreter errors of potential clinical consequence could be a previously unrecognized possible root cause of medical errors. Although a recent Institute of Medicine report15 has drawn much attention to medical errors, errors of medical interpretation have not generally been included in the discussion of sources of medical errors. In this study, several documented common mechanisms for medical errors16,17 were observed among the interpreter errors of clinical consequence, including being told to use the wrong dose, frequency, duration or mode of administration of drugs and other therapeutic interventions, and omitting relevant clinical information on drug allergies and the past medical history. These findings suggest that for LEP patients, providing qualified, trained medical interpreters may be an important means of reducing medical errors and improving the quality of medical care. It also seems reasonable that as part of ongoing quality improvement efforts, medical institutions might consider periodically audiotaping or videotaping a representative subsample of clinical encounters where medical interpreters are used, to identify and monitor the overall number and categories of interpreter errors, the number of interpreter errors of potential clinical consequence, and medical errors that result from interpreter errors.

Study Limitations
Several limitations of this study should be noted, along with their implications for future research. Our sample size was relatively small; studies of errors of medical interpretation on a larger scale are needed. Only 1 observer analyzed 11 of the transcripts, so interpreter errors potentially may have been missed that could have been identified had multiple observers analyzed these transcripts. Single-observer transcript analysis was performed, however, only after refinements of the analytic technique were instituted as a result of multiple-observer testing and validation. It also seems unlikely that identification and inclusion of potentially overlooked errors would have substantially altered the principal study findings, but additional study of this interpreter error analytic tool is warranted. This study was limited to pediatric encounters; similar studies of adult LEP populations need to be conducted, particularly given that interpreter errors may have an even greater effect on adults because of their generally greater morbidity, comorbidity, and mortality. Similarly, we examined only outpatient encounters with Spanish interpreters, and studies are needed of interpreter errors and their clinical consequences in other languages and in the emergency department and inpatient settings. The hospital interpreters in this study had little to no training (although the study institution has subsequently initiated extensive training of their hospital interpreters). Replication of this study with hospital interpreters who have received extensive, consistent training compared with ad hoc interpreters may reveal more substantial differences in the number and categories of errors. Because LEP patients who need interpreters sometimes obtain medical care without interpreters, more research is needed comparing health care quality and satisfaction with care when LEP patients have trained hospital versus ad hoc versus no interpreters.

Policy Implications
The study finding that errors made by ad hoc interpreters are significantly more likely to have potential clinical consequences—coupled with a fairly extensive literature documenting that LEP patients tend to receive poorer quality medical care—would seem to constitute a strong argument for third-party reimbursement for trained medical interpreter services. Studies demonstrate a wide range of adverse effects that limited English proficiency can have on health and use of health services, including impaired health status,6,18 a lower likelihood of having a usual source of medical care,6,18,19 lower rates of mammograms, pap smears, and other preventive services,20,21 nonadherence with medications,7 a greater likelihood of a diagnosis of more severe psychopathology and leaving the hospital against medical advice among psychiatric patients,5,22 a lower likelihood of being given a follow-up appointment after an emergency department visit,23 an increased risk of intubation among children with asthma,24 a greater risk of hospital admissions among adults,25 an increased risk of drug complications,26 longer medical visits,27,28 higher resource utilization for diagnostic testing,28 lower patient satisfaction,18,29,30 and impaired patient understanding of diagnoses, medications, and follow-up.31,32 Latino parents consider the lack of interpreters and Spanish-speaking staff to be the greatest barriers to health care for their children, and 1 out of every 17 parents in one study reported not bringing their child in for needed medical care because of these language issues.4 On the other hand, recent studies indicate that trained professional medical interpreter services are associated with improvements in the delivery of health care services to LEP patients,33 but do not increase the mean duration of medical visits.34

The lack of trained hospital interpreters is not uncommon for the millions of LEP patients in the United States: one study found that no interpreter was used for 46% of LEP patients, and when an interpreter was used, 39% had no training.31 In a guidance memorandum, the Office of Civil Rights stated that the denial or delay of medical care for LEP patients because of language barriers constitutes a form of discrimination, and requires that any recipient of Medicaid or Medicare must provide adequate language assistance to LEP patients.35 A Presidential Executive Order also has been issued on improving access to services for persons with Limited English Proficiency.36 Concerns have been raised by medical associations about physicians having to cover the costs of complying with the Office of Civil Rights guidance memorandum,37 but the issue could be resolved by having third-party reimbursement for interpreter services. Although additional research on the cost effectiveness of third-party reimbursement for interpreter services would be helpful, mounting evidence suggests that additional studies of the issue may not be needed, including a successful $71 million lawsuit over a misinterpreted word in the emergency department,38 a report of a prolonged hospitalization for perforated appendicitis that might have been avoided if an interpreter had been called,39 and a report of children placed in state custody for mistaken child abuse because of a misinterpreted word and failure to initially call an interpreter.39 Legal liability and medical errors may be important factors in considering whether investment in third-party reimbursement of interpreter services is a reasonable strategy for assuring that LEP patients receive high-quality, equitable care.


This study was supported in part by the Generalist Physician Faculty Scholars Program (to Dr Flores), the Minority Medical Faculty Development Program (to Dr Flores), and the Opening Doors Program (to Dr Laws) of the Robert Wood Johnson Foundation. Dr Flores is a recipient of an Independent Scientist (K02) Award from the Agency for Healthcare Research and Quality.

We thank Howard Bauchner and Paul Wise for their comments on earlier manuscript drafts.


Received for publication Jan 29, 2002; Accepted May 24, 2002.

Reprint requests to (G.F.) Center for the Advancement of Urban Children, Department of Pediatrics, 8701 Watertown Plank Road, Milwaukee, WI 53226. E-mail: gflores@mail.mcw.edu

Presented in part at the annual meeting of the Pediatric Academic Societies; May 2, 1999; San Francisco, CA.


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