5 Ways Simultaneous Mode is a Medical Interpreting Game-Changer

As medical interpreters, we’re told that consecutive interpretation is our default mode of interpreting. Simultaneous interpretation is some sort of mythical unicorn that we’re taught to rely on only in a few vaguely outlined situations. Furthermore, only the Certification Commission for Healthcare Interpreters (CCHI) includes simultaneous interpreting in their certification exam. All signs point to simultaneous interpreting as an “extra” skill for medical interpreters to possess.

That being said, as an on-site Spanish medical interpreter in Richmond, Virginia, I engage in simultaneous interpreting more than you’d think! I’d argue that practicing medical simultaneous interpreting is something all medical interpreters should be doing. The following scenarios are some common situations where simultaneous mode is not only a game-changer, but I’d also argue is essential.

1. Physical & Occupational Therapy

Interpreting consecutively in physical therapy (PT) and occupational therapy (OT) settings can sometimes throw a wrench in the process. Many times, providers are actively giving time-sensitive instructions to a patient while they’re already doing an exercise, and waiting for the provider to finish the utterance in order to interpret it may result in the exercise being done incorrectly. At best, this may only be a minor inconvenience. At worst, this could result in injury to the patient!

This point is best illustrated with an example: the physical therapist asks the patient, “Now, you’re going to hold this position for 15 seconds.” If you’re interpreting consecutively, it may take you 5 seconds to interpret this utterance, so in all reality the patient will have been holding that position for 20 seconds. It may seem like a small difference, but the goal of interpretation is to do your best to provide that patient with the same quality of care an English-speaking patient would receive, and all those extra seconds add up.

If you’re interpreting for PT or OT and you’re not planning on engaging in simultaneous if needed, it may be worthwhile to discuss with the provider the fact that there will be a delay in the relaying of instructions to the patient. Ideally, a provider should have experience and training working with interpreters and should be able to accommodate for this. But it’s always best to make sure everyone is on the same page!

2. Fall Risk Patients

This can also be applicable to PT/OT, but if a patient is likely to lose their footing if you engage in consecutive interpreting, simultaneous interpreting is your best bet. I most commonly encounter this in inpatient physical rehabilitation for patients who are recovering from a stroke, joint replacement, or other major surgery or condition.

Bed-to-commode, wheelchair-to-bed, bed-to-wheelchair, wheelchair-to-commode, or any combination of those transfers can be tricky, and waiting to consecutively interpret instructions from a provider or nurse can actually be a danger to the patient. Again, in an ideal world, providers will be aware of this and do their best to prevent issues from arising, but unexpected situations can always arise. Practicing simultaneous interpreting is the medical interpreter’s best way to ensure patient safety.

3. The PACU

The PACU or Post-Anesthesia Care Unit is one of those places where providers tend to think interpreters don’t need to be present. I wholeheartedly disagree with this for a number of reasons that I could write an entire post about on its own! This is the place where patients who have just come out of surgery wake up. It’s a gradual process and many times patients don’t remember being here once they’ve gone home.

Even if you think a patient isn’t lucid enough to necessitate having things interpreted, my rule is: if they’re conscious, interpret. Imagine how scary it is to wake up from surgery and not understand a thing being said around you! Many times nurses will speak directly to the patient, asking them how they feel, telling them everything is okay, which can all be interpreted consecutively. However, there will be at least a few instances in which they’ll rattle off a bunch of vital signs and information to their colleagues, and simultaneous mode is perfect for this.

Once, I had a patient become hysterical while they were doing this because they didn’t understand these rapid-fire utterances. They assumed that because the nurse was speaking so quickly, that something was wrong. They should have had me in the PACU, but I was in the waiting room expecting them to let me back into the secured area. Who knows if the patient would have been less agitated if I had been there to interpret what they said, but at the very least they would have been given the same experience as an English speaker in the PACU.

4. Non-Stop Utterances

There are those patients and providers who will not stop to give you an opportunity to interpret. Even if you give a robust pre-session, even if you switch into third person and remind all parties to allow you a chance to interpret, sometimes they just don’t heed your advice. Simultaneous is a good tool to have in your toolbox for these sorts of situations.

I always say: simultaneous begins where note-taking ends. There’s a limit on even the best interpreters’ capacity for note-taking. If you encounter a patient or provider who just barrels over your interpretations despite multiple attempts to direct the encounter, simultaneous interpreting may be your best bet.

5. Emergency Situations

While I’ve never interpreted in the emergency room, I have interpreted for situations in which a patient is at a primary care facility and an ambulance has been called. In emergency situations like these, time is of the essence, and simultaneous interpreting enables you to do your job while allowing providers and EMTs alike to get the patient to the hospital as soon as possible.

Bonus: Mental Health Interpreting

Medical interpreters are often called in for mental health interpreting assignments, but mental health interpreting often requires simultaneous interpreting skills. Emotionally-charged utterances can be long and fast-paced, with unpredictable twists and turns, making simultaneous interpreting ideal. But the surprising truth is that these emotionally-charged utterances don’t just occur in mental health settings; they can occur anywhere, at any time. Being able to engage in simultaneous gives medical interpreters that extra edge in these sorts of situations.

Practice Simultaneous Interpreting

Simultaneous interpreting for the medical interpreter is a sort of catch-22: many of us don’t get a lot of experience with it, but you have to use it or lose it! Practice makes perfect, and the fact of the matter is that we as medical interpreters can’t rely on our day-to-day interpretations to “work out” our simultaneous interpreting muscles. So how can you get better at simultaneous interpreting as a medical interpreter?

InterpreMed is a learning community created for medical interpreting professionals and students interested in acquiring and honing their skills through hands-on activities, training materials and resources. Nanyi, the founder of InterpreMed, and I have been hard at work producing medical simultaneous interpreting practice exercises. These practice scenarios involve many different medical specialties and we’ve made sure to include different speeds for different skill levels. Join InterpreMed today to take your medical interpreting skills to the next level!

What are some other situations in which medical interpreters may be better-suited to use simultaneous interpreting mode? Be sure to comment with your responses below!