(1094) "How Do You Say..." PICU Provider Perspectives of Interpreted Medical Encounters​

Introduction: Children of parents whose primary language is not English are at increased risk for poor health outcomes. Increased complexity of communication using medical language interpreters may account for this outcome disparity. We sought to understand provider perspectives of interpreted medical encounters (IME) with the long-term goal of improving the provider-interpreter dyad.

Methods: We developed and conducted a cross-sectional, mixed-methods study of Pediatric Intensive Care Unit (PICU) providers at a Midwest tertiary care academic children’s hospital. A survey of PICU providers obtained baseline demographic data, training for IME, and comfort working with language services. In-depth, semi-structed interviews with a sub-set of survey respondents further explored participants’ experiences working with medical language interpreters. An interdisciplinary research team (physician, interpreter) performed qualitative coding using an inductive thematic analysis approach and compared codes.

Results: Thirty-nine providers completed the survey for a response rate of 21%. 38% (n=15) of providers stated that they received formal training working with medical language interpreters, but training was variable. Eighty percent (n=31) of respondents reported being “extremely comfortable” working with in-person interpreters but only 20% reported being “extremely comfortable” working with video or telephonic interpreters. Twenty-four qualitative interviews were conducted. Based on interviews, facilitators of IME included pre-huddle, interpreter practices such as clarifications, and provider practices such as spatial positioning. Barriers to IME included technological challenges with remote interpretation, impersonal encounters, and concern for incorrect interpretation. All interviewed providers were interested in formal IME training.

Conclusions: Providers generally report being comfortable working with interpreters, but less so with video or telephonic interpretation. Many were interested in formal training to improve IME skills. Educational initiatives should consider including virtual modalities in training. Further study might evaluate the feasibility and impact of provider education around the identified facilitators of an IME.