Corresponding Author:
David Galbis-Reig, M.D.
Medical Director
Commonwealth Health Benefits Management, Inc.
P.O. Box 70219
Richmond, VA 23255-0219
W - (804) 673-4234
H - (804) 673-0726
Cell - (804) 305-5515
E-Fax: (501) 423-1588
E-Mail: DGalbis834@POL.NET

INTRODUCTION

Language, as defined by the Webster’s II New Riverside Pocket Dictionary, is “any system of signs, symbols, etc. used for communication.₁“ Interestingly enough, the “etc.” in the definition of the term language opens the door to a myriad of different interpretations of the true meaning of the word “language”. To some, for example, language merely represents “pure” communication, both written and spoken, but does not encompass much more than these “pure” forms of communication. For others, however, language represents much more than written and/or spoken communication; it represents an expression of emotion, art, and most importantly, culture. To be proficient in a language, then, an individual must not only be capable of producing literal translations of the source language, but must also be capable of translating and interpreting the subtle cultural nuances that are left unspoken and/or unwritten within the body of the text or speech.₂ This represents the art of translation and interpretation.

In today’s rapidly shrinking world in which individuals with one language and culture are increasingly coming into contact with other individuals from very different cultural and language backgrounds, the skill of culturally competent translators and interpreters is becoming an invaluable commodity. Even as advances in technology continue to blur the boundaries between countries and cultures through globalization of information via high-speed communication portals now available through the internet, language and cultural barriers continue to stand in the way of a full globalization of the human family. As the world continues to become a smaller place, the demand for culturally competent, (specialized and non-specialized), translators and interpreters will continue to rise.

This having been said, in no other field, (except perhaps where international politics is concerned), is the need for culturally competent translators/ interpreters more evident than in the health care arena.₃ Over the past two decades, several articles have demonstrated that when a language barrier is present between health care providers and their patients, the effect on the quality of health care can be significantly impacted.₄,₅,₆ Other articles have stressed the importance of incorporating culturally competent medical translators and interpreters as crucial members of the health care team.₇,₈,₉ Yet others have dealt with the complexity involved with translating different health assessment questionnaires from one language to another.₁₀,₁₁,₁₂,₁₃ Despite their different orientation, all of these articles have one thing in common: they all speak to the increasing importance of having access to culturally competent medical translators and interpreters in today’s rapidly shrinking world.

At this point, it is important to clarify some terminology. While many people use the term translator and interpreter interchangeably, the two terms describe technically different, yet related, services. The term translator has broader connotations than the term interpreter does in that it refers to any person who expresses or renders the meaning of a text and/or verbal material from the source language into a language different from that of the source language. An interpreter is a translator who accomplishes the same goal in “real” time either through verbal or written means, (e.g. a person translating for a live speaker or an individual transcribing for a live speaker into a different target language at a conference or seminar). While the goal for both is the same, (to produce an accurate and meaningful translation from the source language to the target language), the skills required for the two service-types are very different. While both translators and interpreters are important within the health care field, the remainder of this article will focus on assessment of translation services (e.g. non-real time translations) using the internet as a resource.

Why the internet? As the internet becomes an increasingly important resource for disseminating medical and non-medical information to patients and their health care providers, both patient and provider will utilize these resources with increasing frequency to obtain information regarding available health care services and resources - medical translation services included. For this reason, it is important for health care providers to understand how to search for, and evaluate the competence of, medical translators or translation services by using resources available through internet.

WHERE TO LOOK

Searching for medical translation services on the internet requires the appropriate use of available Internet search tools. While the use of search engines (e.g. http://www.yahoo.com, http://www.altavista.com, http://www.lycos.com, etc.) and/or meta-search engines (e.g. http://www.google.com, http://www.dogpile.com, etc.) remains the most common technique for finding medical translation services on the Internet, other less commonly used resources, including the use of translation-specific web directories and professional translation organization web directories such as those provided by the American Translators Association (ATA) at http://www.atanet.org and the National Association of Judiciary Interpreters (NAJIT) at http://www.najit.org are also available. In addition, Glenn’s Guide to Translation Agencies and Glenn’s Guide International, two of the most important guides for translation and interpretation agencies and professionals currently in print, are available as free directory downloads in acrobat format from the web site http://www.etranslate.net/en/career/glennsguide.html.

WHAT TO LOOK FOR

After locating a medical translator or translation agency on the Internet (or listed in a web-based directory), the next step in the evaluation process involves assessing the quality and content of the information presented on the web site of interest. The process of evaluating web-sites, whether the site be the personal home page of an individual freelance translator, the home page of a large translation agency, or the web-site for a web-based directory of translation services, should always begin with a general assessment of a number of important criteria as delineated by the University of Wisconsin on their web site at http://www.uwec.edu/admin/library/guides/tencs.html.₁₄ According to this web site, the “Ten C’s for evaluating internet resources” includes the following:

CONTENT

Evaluation requires asking a series of questions to determine the intent of the web page, the author of the web page, the nature of the content displayed on the web page, and the time interval by which the material presented on the web page is updated.

CREDIBILITY

The credibility of a web site is determined by determining the author of the site, the credentials of the author, evaluating the purpose of the information presented on the web site, and assessing the meaning of the URL extension used to register the site.

CRITICAL THINKING

The primary purpose of this criteria is to remind the internet user to use critical thinking skills to evaluate the information presented on the web site as he/she would evaluate similar information in traditional publications.

COPYRIGHT

It is important to remember that the creation of a document, graphic, sound, or image falls under copyright law. For this reason, proper credit must be given to the author of all site material.

CITATION

A credible web site will provide readers with citations for source information published by other individuals in order to give credit to the appropriate individual while providing the reader with access to new resources for further research.

CONTINUITY

The term continuity primarily refers to the timeliness by which the internet site is updated to reflect new information.

CENSORSHIP

The degree to which the content of discussion lists is regulated and monitored, the limitations of web page utilization, and privacy issues fall under the jurisdiction of this topic.

CONNECTIVITY

This term refers to the speed, accessibility, tools, and applications available on or through the web site.

COMPARABILITY

The degree to which the data presented on the web site is available in comparable forms in printed materials, CD-ROM, or other form of hard copy.

CONTEXT

The context criterion refers to the reasons for which the viewer initiated the internet search in the first place.

One of the primary methods available for assessing the credibility of any registered business is to contact the Better Business Bureau (online at http://www.BBBonline.org) and request information regarding the company in question. Because the Better Business Bureau (BBB) only opens files on those agencies that have registered, or have had a complaint filed against them, with the Bureau, the usefulness of this resource is normally limited to larger translation agencies, (and then only those that have registered themselves with the bureau). Freelance translators and/or smaller translation agencies may not have registered themselves with the bureau, in which case, the requested information will not be available. In addition, a full information request from the bureau may take some time to process; time that may not be available.

In addition to performing a quick, general analysis of the content contained on the company’s web site and utilizing the resources available through the BBB, health care providers “shopping” for medical translation services on the Internet should also consider checking the company’s reputation by searching the files of several web-based consumer advocacy companies that provide ratings of the services, web-page content, and quality of web based (and non-web based) businesses. Examples of such web sites include, but are not limited to, sites such as http://www.bizrate.com and http://www.bizbuyercategories.com. Of particular interest to health care providers wanting to assess the quality of different medical translators and/or translation agencies is the site at http://www.bizbuyercategories.com/c_guides/v3_trn_at_a_glance.htm.

WHO TO LOOK FOR

While locating and being able to assess the general content of a web site for a freelance translator and/ or translation agency on the internet is an important beginning, even more important is the ability to understand the unique experience and expertise of individual freelance translators and translation agencies. In order to be able to assess the quality and competence of freelance translators and translation agencies, it is important for health care providers to have a basic understanding of the art of providing translation services. After all, an educated consumer makes more appropriate choices regarding the products he/she purchases. This concept holds true regardless of whether the assessment is for the purchase of merchandise or a service to be rendered. For this reason, it is important for health care workers to keep the following criteria in mind when assessing the competence of a freelance medical translator or translation agency.

Experience in the Subject Matter

All translators are not created equal. As occurs in the health care profession, translators are divided into generalists and specialists. The term generalist is utilized to describe a translator who has either received formal training (e.g. a degree) as a generalist translator or whose experience, though maybe extensive, is not focused within a specific area of specialization. Specialized translators are those translators who have acquired specific training within a specialty area that gives them an increased familiarity with the terminology and language that is unique to the specialty field, either through professional studies leading to a degree within the field (e.g. an RN, Pharm.D., or MD who provides medical translation services), through acquisition of significant translation experience in one of the specialty fields, or via formal training in the art of translation in one of the specialty fields (e.g. a translation degree involving focused study within the specialty area of interest). Current specialty areas include, but are not limited to, the following: technical/ scientific, medical/ biologic, literary, legal, and business/ commercial.

In addition to specializing within specific areas, it is important to remember that many translators also specialize within complimentary language pairs. A complimentary language pair represents the language pair of interest (e.g. Spanish®English) plus its “complimentary” pair (e.g. English®Spanish). An example of a complimentary language pair, then, is the combination of Spanish®English and English®Spanish. Not all translators will translate between both complimentary language pairs, (e.g. from Spanish into English and vice versa, also written “Spanish(English”). In fact, many translators limit themselves to providing translations within one language pair (e.g. from Spanish to English but not the other way around). Before deciding on a translator it is important to determine whether the individual (or agency) provides translation services within the specific language pair of interest. (For example, a translator that provides only Spanish®English translation services is not the appropriate candidate for providing translation services from English®Spanish.)

TABLE 1 provides a list of questions that should be asked of all potential medical translators to assess the experience, competence, and expertise of the translator with respect to the subject matter. It is important to interview all potential candidates either in person, via telephone conversation, or e-mail regarding the answer to these questions.

TABLE 1: Questions For All Potential Freelance Medical Translators and/ or Translation Agencies

Native Versus Non-Native Speakers: Does it Matter?

What does it mean to be a native speaker and what advantage, if any, do native speakers have over non-native speakers in terms of providing translation services? The term native speaker implies just what it describes – an individual who acquires the ability to speak in the language of interest at a very young age, and therefore has no appreciable accent as judged by other native speakers from the same geographic region. In general, a native speaker has the distinct advantage of being able to decipher subtle nuances in speech, language, and culture that may bestow a very different meaning upon the underlying message of the text. While a well-studied non-native speaker may also be able to pick up these subtle language variations, the probability that a native speaker will correctly interpret the subtle nuance is much greater. In other words, native speakers trained in the art of translation have a tendency towards greater cultural competence than equally trained non-native speakers. It is important for health care providers to keep this fact in mind when assessing the cultural competency of a translator becomes essential.

Freelance Translator versus Translation Agency

TABLE 2 lists the strengths and weaknesses associated with the choice of utilizing a freelance translator versus a translation agency.

Figure 1

TABLE 2: Freelance Translator versus Translation Agency

As a general rule, freelance translators are more likely to provide the client with personal attention and to tailor the services rendered to specific client needs. Oftentimes, freelance translators tend to provide better service for projects that require greater attention to detail, are most often specialized within a specific language pair or set of language pairs, and may be generalists or specialize specifically in providing medical translations. On a less positive note, however, freelance translators tend to be more costly than using a translation agency and they are less likely to have quality assurance checks.

In contrast, the strengths of a translation agency tend to be the weaknesses of the freelance translator and vice versa. As a general rule, translation agencies excel in providing their clients with superior quality assurance checks by having multiple experienced translators on-site to able to check the initial translation for accuracy and correctness. Translation agencies tend to be less costly, to provide translations to and from a variety of language pairs, may be specialized or provide a number of different specialty translations, but tend to provide much less client-specific attention to detail than freelance translators.

As a general rule, then, freelance translators tend to provide superior service for longer, more labor-intensive projects that require greater attention to detail whereas translation agencies tend to provide superior service for short-notice translations or for translations with a deadline.

Membership in Professional Organizations

As is the case in the health care profession, numerous professional organizations are available for professional translators. While membership in any of these organizations does not necessarily imply competence in the art of translation, it does imply a certain amount of commitment to the profession as well as a commitment to continuing education in the field. The largest professional organization available to translators from around the world is the American Translators Association (ATA) whose home page can be found at http://www.atanet.org. The ATA provides professional development seminars and workshops, continuing education, accreditation for members that pass a rigorous accreditation exam, and a meeting place for translators from around the world. Members who have passed the accreditation exam (see below), and are therefore accredited in at least one language pair, are upgraded from associate membership status to active membership status within the ATA.

In addition to the ATA, other, more specialized, professional organizations include the American Literary Translators Association (ALTA), The Translators and Interpreters Guild, and the National Association of Judiciary Interpreters and Translators (NAJIT) at http://www.najit.org. The latter organization is notable in that it is the professional organization for court-certified translators and interpreters.

Apart from the above-mentioned national (and international) organizations, a number of local and regional ATA Chapter and Affiliate organizations are also available for interested translators, a list of which can be found in TABLE 3.

TABLE 3: REGIONAL ATA CHAPTERS AND AFFILIATED ORGANIZATIONS

Atlanta Association of Interpreters and Translators (AAIT)

Carolina Association of Translators and Interpreters (CATI)

Florida Chapter of the ATA (FLATA)

Mid-America Chapter of the ATA (MICATA)

National Capitol Area Chapter of the ATA (NCATA)

New York Circle of Translators (NYCT)

Northeast Ohio Translators Association (NOTA)

Northern California Translators Association (NCTA)

Northwest Translators and Interpreters Society (NOTIS)

Southern California Area Translators and Interpreters Association (SCATIA)

Michigan Translators/ Interpreters Network (MiTiN)

Utah Translators and Interpreters Association (UTIA)

Accreditation

The only currently available accreditation program for translators is offered through the ATA. Interested translators are encouraged to take a three-hour accreditation exam in the desired language pair. The exam consists of five 250-300-word passages, one each in the following categories: general topic, medical/ biologic, technical/ scientific, literary, and business/ legal. The candidate can use a dictionary (or multiple dictionaries) to translate a maximum of three passages. Only complete passages are evaluated. In order to pass the exam, the candidate must successfully translate two of the five passages as determined by two independent graders (both active members of the ATA themselves) who do not know the identity of the candidate and are considered experts within the field with respect to the language pair of interest. If the candidate successfully passes the exam, he/she receives an accreditation certificate for the specific language pair and the candidates ATA membership is upgraded from associate to active membership. Accreditation within the specific language pair does not expire once the member passes the accreditation exam, and follow-up examinations are not required for continued accreditation.

CONCLUSION

As technology continues to unite the world, the skill of competent translators capable of facilitating communication among and between different cultures is becoming an increasingly important commodity. Nowhere is the need for competent translators and interpreters more evident than within the health care system. From immigrant medical records and journal articles to hospital interpreters capable of translating between patient and physician, the need for competent medical translators continues to rise. In order to make educated decisions regarding the choice of medical translator, health care professionals and administrators must be aware of certain basic criteria that should be assessed prior to hiring. These criteria are the three W’s of finding a competent translator; WHERE to look, WHAT to look for, and WHO to look for. By understanding these criteria, a health care professional is better equipped to make an educated decision regarding the competence (or lack thereof) of medical translators prior to hiring.