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Beverly Johnson, MD, Medicine, New York Presbyterian Hospital, 435 E. 70th St Apt 32E, New York, NY 10021, William Kirkpatrick, LICSW, Director, Department of Clinical Social Work, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903, and Edward Feller, MD, Community Health, Brown Medical School, BioMed, Providence, RI 02912, (401) 863-6149, Edward_Feller@brown.edu.

Introduction : Limited English Proficiency (LEP) patients often have decreased access to care, increased miscommunication, fewer preventive services and follow-up visits, and poorer health outcomes than English-speaking individuals. National legislation mandates that all patients have the right to an interpreter, but this is not widely enforced. Untrained interpreters may have a conflict of interest, lack of medical terminology and high likelihood of interpretation errors. We describe a model student-run volunteer program, the Interpreter's Aide Program (IAP), which was started to enhance the quality and availability of medical interpretation.

Methods : The Interpreter's Aide Program (IAP) is a collaboration between Brown Medical School and Rhode Island Hospital. Bilingual Brown medical and undergraduate students train primarily in Spanish. Training consists of shadowing professional interpreters and attending seminars on interpretation techniques and cultural competency. Certification is contingent on passing rigorous oral and written examinations.

Results : From 2000-2002, an average of 34 student volunteers translated 1333 hours a year ( average per student = 40 hours/year and 80 patients/year). The total number of patients seen averaged 2,720 per year. The cost-benefit is estimated at $60,000/year. Patient and staff feedback, assessment of observed interviews, and students' self-assessments were positive.

Discussion: In spite of legislation mandating interpreter services, often LEP patients are unaware of their right to such services. Without interpreter services, LEP patients have poorer health outcomes than non-LEP patients. A collaborative program to train students in medical interpretation can help alleviate system gridlock, enhance patient care, and sensitize students to cultural issues.

Learning Objectives:

• Identify current US legislation mandating the right to interpreter services in a health-care setting.
• Discuss the barriers to implementing this legislation in the face of a growing limited-English proficient population.
• Understand the negative consequences of no or inadequate interpreter services for patients with limited English proficiency.
• Recognize the limitations and negative consequences of using untrained interpreters, such as ancillary staff or family members.
• Describe a hospital-based model using trained bilingual undergraduate and medical students to supplement professional interpreters.

Keywords: Access to Health Care, Interpreters

Related Web page: bms.brown.edu/omma/omma_iap.htm

Presenting author's disclosure statement:

Not Answered