Professional Interpreters in ER Need Training More Than Experience

Professional interpreters who received more than 100 hours of training in medical interpreting had nearly two-thirds fewer errors than those with fewer than 100 hours of training and significantly fewer errors with medical consequences than ad hoc interpreters, according to a study published on March 16 in Annals of Emergency Medicine (“Errors of Medical Interpretation and Their Potential Clinical Consequences: A Comparison of Professional vs. Ad Hoc vs. No Interpreters”).

“One hundred hours of training seemed to be the tipping point for professional medical interpreters,” said lead study author Glenn Flores, MD, FAAP, of the University of Texas Southwestern Medical Center in Dallas, Texas. “Professional interpreters who received that much training on average had 12 errors while those with less training had 33.  Patient encounters that relied on ad hoc interpreters or no interpreters had significantly more errors, including some with potential clinical significance, such as mistaking tablespoons for teaspoons of medicine.”

Researchers studied 57 encounters for pediatric patients for whom Spanish was the primary language spoken at home and English proficiency was limited. In 20 of the encounters, a professional, paid interpreter translated. In 27 of the encounters, an ad hoc interpreter, such as a family member, friend or hospital staff, provided interpretation. No interpreter was involved in 10 of the encounters.

The proportion of errors with potential clinical consequences for professional interpreters with 100 or more hours of training was 2 percent, while the proportion of errors with potential clinical consequences for those interpreters with less than 100 hours of training was 12 percent. Years of experience were not significantly associated with the overall number of errors.

The proportion of errors with potential clinical consequences was 22 percent in encounters with ad hoc interpreters and 20 percent of encounters for no interpreters.

“More than 25 million Americans have limited English proficiency and federal policy requires that hospitals provide adequate language assistance to these patients,” said Dr. Flores. “Our findings add to the growing body of evidence that paid, professional interpreters are essential for delivering high-quality health care to our patients.”

About ACEP
Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, the national medical society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information visit www.acep.org.