Laura Gavioli

Are close renditions the golden standard? Some thoughts on translating accurately in healthcare interpreter-mediated interaction

‘Close renditions’ – renditions that are very close, if not identical, in form and meaning, to the original utterances – are often considered fundamental in dialogue interpreting. It has been suggested that interpreters should address exhaustively and accurately all pieces of information, including those conveyed with minimal responses. This perspective seems to reflect the ‘golden standard’ that normatively guides interpreters’ training. Drawing from research over a long period, we look here at the work of ‘intercultural mediators’ providing interpreting service in healthcare. The analysis described in this article shows that closeness in the meaning and function of single utterances does not necessarily coincide with closeness in their function in the interaction. In order for renditions to be ‘close’, in their interactional function, to those in the other language, interpreting mediators need to achieve ‘accurate’ coordination work. So ‘accuracy’ in coordination should be looked at as a fundamental activity in dialogue interpreting to achieve translational closeness. Expanded dyadic sequences addressing what is going on and pursued in the interaction, for instance, are often necessary to achieve ‘close’ rendition, but their accurate management can be a very complex accomplishment. It is suggested that learning accurate coordination may be a major achievement in healthcare interpreter training.

On professional and non-professional interpreting in healthcare services: the case of intercultural mediators

Abstract A debate that has revolved around the organisation of Italian healthcare interpreting services concerns the choice adopted by most institutions to employ intercultural mediators rather than professional interpreters. Intercultural mediators do not necessarily have a professional training in interpreting, they are, however, preferred to professional interpreters in that they are considered more competent in mediating the possibly different perspectives of healthcare providers and migrant patients. This preference provides food for thought for reflections on professionalism in interpreter-mediated interaction in healthcare. Drawing form a 10-year research on mediator-interpreted interactions in healthcare and a set of data comprising around 250 consultations, our contribution sets out as an attempt to clarify what is involved in this mediating work. Our analysis shows that mediators’ agency is relevant both in providing renditions of participants’ utterances and in promoting their active participation in the interaction. We describe the different ways in which mediators’ agency is displayed in interactions and the interactional constraints on mediators’ choices of action. Suggestions derived from our analysis may have an impact on the improvement of both mediators’ and interpreters’ professionalism with particular reference to facilitating communication with migrant patients, an aspect that has been recognized as highly problematic in the literature.

The relevance of interactions in functionally differentiated society: The contribution of conversation analysis to the theory of social systems

Zusammenfassung Während die Funktionssysteme der modernen Gesellschaft kulturelle Voraussetzungen schaffen und zur Geltung bringen, die sich in Form von strukturierten Erwartungen in Interaktionen widerspiegeln, können im Gegenzug Interaktionen kulturelle Voraussetzungen beeinflussen, indem sie Beiträge fördern, die zuweilen neu definieren, was jeweils erwartet wird. Die Konversationsanalyse als eine Methode zur Untersuchung von Interaktionen scheint ein besonders interessanter Kandidat für die Ergänzung der Theorie der Gesellschaft zu sein, indem sie reziproke Einflüsse zwischen Interaktionen und Funktionssystemen zu erklären versucht. Der Artikel erörtert die Verbindungen zwischen der soziologischen Systemtheorie und der Konversationsanalyse. Unsere These ist, dass die Integration von soziologischer Systemtheorie und Konversationsanalyse dazu beitragen kann, die Wechselbeziehung zwischen unterschiedlichen Typen von sozialen Systemen zu erklären. In unserem Beitrag analysieren wir die komplementären Aspekte der soziologischen Systemtheorie und Konversationsanalyse, indem wir Interaktion als ein soziales System verstehen; wir konzentrieren uns auf die Art und Weise, in der die Strukturen der Interaktion in die Funktionssysteme der Gesellschaft eingebettet sind und wir behaupten, dass die Möglichkeit der Interaktion, durch ihre Teilnehmer neue Beiträge einzuführen, es potentiell erlaubt, soziale Veränderungen zu bewirken.

L’entretien clinique en présence d’un interprète : la traduction comme activité de coordination

Le recours a un interprete est une des solutions adoptees par les institutions de sante en Europe pour faciliter la communication entre des participants de langues differentes. Dans l’interaction medicale, rendre le sens des contributions des participants et leurs fonctions peut impliquer bien plus que traduire le contenu des tours successifs : differents doutes, problemes, difficultes peuvent necessiter une elaboration plus complexe dans les deux langues. Cet article presente certains des resultats d’un vaste projet dans lequel des interactions dans plusieurs services medicaux italiens ont ete enregistrees, transcrites et analysees. Nous illustrons trois types de restitutions qui sont recurrentes dans nos donnees, et qui visent l’accomplissement des objectifs de la rencontre medicale : traiter les questions delicates, encourager la participation des patients et creer un contact direct entre les medecins et les patients. En conclusion, nous montrons que l’interpretation efficace implique un travail attentif de coordination des discours, non seulement en explicitant les types de restitutions pour les interlocuteurs, mais aussi en facilitant leur participation dans l’interaction bilingue.

Mediating patient-centred interaction: the case of doctors’ questions

This paper analyses interactions in Italian healthcare services, involving Italian speaking doctors, migrant patients with little or no knowledge of Italian and a bilingual mediator. The mediator participates in the interaction with the double function of assuring linguistic understanding and dealing with cultural differences, which may emerge in talk between doctors and migrant patients. In this study, we look at doctors’ question-patients’ answer sequences and their interactional renditions. In our data, a doctor’s question is often rendered by mediators with a series of questions expanding that initial question. The analysis shows that provision of a series of questions, rather than a single rendition, allows the mediators to re-design the doctor’s question in a patient-mediator dyadic interaction. In (provisionally monolingual) dyadic talk, patients are encouraged to deal with their diseases and tell about their worries and concerns. Mediators’ expansions of doctors’ questions seem thus functional to the achievement of patients’ narratives, which can afterwards be rendered to the doctors. Our study suggests that such expanded renditions may achieve patient-centred communication in triadic bilingual interactions.

La mediazione nell’interazione centrata sul paziente: il caso delle domande del medico

This paper analyses interactions in Italian healthcare services, involving Italian speaking doctors, migrant patients with little or no knowledge of Italian and a bilingual mediator. The mediator participates in the interaction with the double function of assuring linguistic understanding and dealing with cultural differences, which may emerge in talk between doctors and migrant patients. In this study, we look at doctors’ question-patients’ answer sequences and their interactional renditions. In our data, a doctor’s question is often rendered by mediators with a series of questions expanding that initial question. The analysis shows that provision of a series of questions, rather than a single rendition, allows the mediators to re-design the doctor’s question in a patient-mediator dyadic interaction. In (provisionally monolingual) dyadic talk, patients are encouraged to deal with their diseases and tell about their worries and concerns. Mediators’ expansions of doctors’ questions seem thus functional to the achievement of patients’ narratives, which can afterwards be rendered to the doctors. Our study suggests that such expanded renditions may achieve patient-centred communication in triadic bilingual interactions.