6. Cultural Competence

Principle: Healthcare interpreters develop and apply their knowledge, skills, and understanding of culture, the relationship between culture and language, and how one's cultural affiliations influence one's beliefs and behaviors.

Objective: To support effective intra-cultural communication and interpersonal interactions between parties who do not share the same language and culture.

Description: Cultural competence is the ability to interact respectfully and effectively across cultures. Cultural competence requires both cultural awareness and cultural humility. Cultural competence means interacting and communicating effectively across cultures. Providers rely on interpreters to fulfill their responsibility to provide culturally-competent, and responsive patient-centered care.

Standards of Practice

6.1 Alert all parties to any significant cultural misunderstandings that may arise, including both linguistic and interpersonal misunderstandings.

Prompt: Does this term have a meaning the listener may not know (such as a culturally specific "untranslatable" term) that needs to be conveyed in another way to maintain understanding?

Example: Interpreters may provide relevant contextual information, such as cultural or linguistic nuances, to support informed consent, as long as it does not alter the speaker's message.

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6.2 Ask for clarification to allow the speakers to explain untranslatable words or culturally specific ideas.

Prompts:

  • When I (described)/(made a word picture of)/(used scaffolding to express) a culturally specific term, did I let the speaker know how I expressed it so they are aware of exactly what was said?
  • Does this term have meaning beyond the word itself that needs to be conveyed in another way to maintain understanding?
  • Does this idea have cultural meaning that needs to be conveyed in another way to maintain understanding?

Example: A patient uses a culturally specific phrase to describe a symptom, and the interpreter pauses to ask the patient to explain its meaning so they can convey it accurately to the provider. A doctor uses a medical term that has no equivalent term in the patient's language so the interpreter asks for clarification.

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6.3 Alert participants to cultural expectations and behaviors that might not be shared or understood and assist them in managing their interactions across these differences.

Prompts:

  1. Is the cultural information relevant to the goals of the participants in the current encounter?
  2. Is the information objective and verifiable (not just my own opinion)?
  3. What is the best way to ensure the participants are aware of the information? Can I ask one of them to share the information with the other?
  4. If no participants can share the information, interpreters share it with them politely and succinctly.
  5. Return to interpreting so they can discuss and decide what to do with the information.

Example: Healthcare interpreters may share relevant cultural information if needed to help clarify the issue for both parties.

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6.4 Transparently alert all parties to cultural differences that could be affecting how messages are being understood and received.

Prompt: Are there cultural factors influencing how the message is being received that I should bring to the participants' attention?

Example: Interpreters notice when cultural differences may be causing misunderstanding and tactfully alert participants to these differences.

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6.5 Request an explanation/clarification of "untranslatable" words used by a speaker and create a conversational space between the speaker and the listeners to arrive at a shared understanding.

Prompt: How can I help the participants work together to understand this culturally specific concept?

Example: Interpreters facilitate discussion between participants to ensure mutual understanding of culturally specific terms or concepts.

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6.6 Continue to develop their understanding and awareness of how cultural practices and world views influence communication, meaning, and behavior.

Prompt: How am I staying informed about the cultural contexts that affect my interpreting work?

Example: Interpreters actively monitor their interpretation to ensure that ideas and messages are represented within the appropriate cultural context.

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6.7 Continue to build their understanding of the cultures associated with the language they interpret, including that of the provider, and of biomedicine/of the medical professions.

Prompt: What aspects of medical culture or the cultures I serve do I need to better understand?

Example: Interpreters engage in ongoing learning about both the cultures of the communities they serve and the culture of healthcare providers.

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