Remote interpreting in health-care settings

As the cover blurb notes, remote interpreting is increasingly becoming the modus operandi in interpreting practice. The book therefore offers a welcome contribution and overview of remote interpreting, and explores differences in quality of interpreting between the “traditional” mode of face-to-face and remote (telephone, video) interpreting in a health-care setting. Judging from the style and structure, this work clearly originated in the form of a thesis.

Chapter 1 sets out the context of the study and follows the typical structure found in most academic theses, where the research questions are contextualised and an outline of the methodology is given. No adaptation from the thesis version was attempted, and so the reader is first introduced to the structure of the chapter, and then most of the rest of the chapter is devoted to defining what is remote interpreting and its various categories. It is only on page 10 that the reader is introduced to the research design (three interpreters engaged through three different modes—face-to-face, telephone, and video—during three simulated medical consultations: The “doctor” role was played by a Dutch-speaking gynaecologist, and the “patient” role by French-speaking professional actors. Transcripts of the interpreting events are analysed in terms of quality, defined (primarily by the researcher although ostensibly from a literature review) in terms of errors of equivalence on one hand, and the quality of doctor–patient interaction on the other. Surprisingly, the research questions and study objectives are not mentioned in Chapter 1, but only in Chapter 4 (p. 74), leaving the reader to plough through the interim pages with only a vague notion of how the information relates to the current study.

The comprehensive literature review (Chapter 2) gives an overview of the field of remote interpreting to date. Key previous studies on remote conference interpreting (RCI) are discussed. These identify issues in terms of video quality, increased psychological stress, and social interaction/alienation. The author then turns her attention to remote dialogue interpreting (RDI), and usefully points out that while standards have been developed for RCI, no such standards have been developed for RDI. This of course emphasises the contribution of the current work. The rest of the chapter is devoted to exploring a few key research studies in the field of medical, business, legal, and sign language interpretation. De Boe identifies language barriers as the primary focus of studies by medical practitioners, with less focus given to technological and interaction quality. Turning her attention to research conducted within the field of Interpreting Studies (including detailed discussion on studies related to telephone interpreting, video interpreting, business interpreting, legal interpreting, health-care interpreting, and sign language interpreting), De Boe notes that while a wide range of topics have been explored, as yet there still has been no replication of studies and testing of the various hypotheses proposed, and that findings are still very much tentative and even contradictory. While the attention to detail on each different setting is interesting and potentially useful, the thesis style of writing, coupled with the lack of an overarching structure (synopses, tables of comparison, etc.) means that the reader is quickly lost in the vortex of individual details. While the chapter serves as a useful overview of the state and challenges of remote interpreting, it makes for difficult reading. A summary paragraph at the end of the chapter, drawing the many lines of thought together, would be useful. Similarly, a table or two comparing the different findings across the different studies and settings would assist the reader in comprehending the information in a coherent manner. In addition, the brevity of the index makes it difficult for readers to check a particular issue addressed in the chapter, should they so wish.

In Chapter 3, the author discusses the concept of interpreting quality, focusing on notions of equivalence and interpreters’ management of interactions between parties. What looks like a divergence from the topic, however, becomes appreciated when the reader arrives at Chapter 4 and understands that equivalence constitutes a core aspect of the data analysis. However, the narrow focus on only two issues of interpreting quality of course means that other aspects of interpreting quality are neglected (see, e.g., Grbić, 2008). The chapter closes with a relook at what is meant by health-care interpreting. This information, as well as the careful definitions of what is meant by dialogue interpreting, could have been more suitably placed in Chapter 1.

Chapter 4 gives a more detailed explanation of method and procedure: three professional interpreters are engaged in consecutively interpreting a simulated dialogue between doctor and patient. Each interpreter is exposed to each of the three modes under investigation, namely face-to-face interpreting, telephone interpreting, and video interpreting. The transcripts are then analysed in terms of the quality constructs explained in Chapter 3. Both are briefed in terms of a script which the doctor provides concerning three typical gynaecological problems. A simulation is conducted to avoid the ethical difficulty of breaching confidentiality were a real patient to be used. Two weeks after the interpreting event, participants’ perceptions of the interpreted experience are gleaned by means of interviews. Readers will find the detailed tables of interpreting strategies (pp. 92–95) useful. The research questions for the study are finally introduced (pp. 74–75), and thus it is only by Chapter 4 that the reader gains a comprehensive understanding of what the study entails. Should a second edition be envisaged, moving the research questions to the first chapter, and providing a better general organisational structure for the book is organised would greatly help readers to process the mass of information.

Chapters 5 and 6 give the results of the microanalysis of the transcripts. Chapter 5 focuses on issues of equivalence, whereas Chapter 6 deals with patient–doctor interactions. Chapter 6 also explores technical issues and how the interpreter deals with overlapping utterances. The analysis is detailed, and the author presents both qualitative analysis of various omissions, additions, and reformulations in the interpretations, as well as quantitative data in the form of frequency statistics. I found the qualitative analysis interesting, as the examples presented are well chosen and give the reader a holistic impression of each interpreter’s style of interpreting. However, it seems that the categorisation of the translation strategies was done only by the researcher, as there is no mention whether someone independently checked them. In addition, the segment-by-segment analysis of differences between source and target transcripts clearly indicates an underlying descriptive translation studies (DTS) theoretical framework (Toury, 2012), which the author neglects to mention. The author finds that error frequencies seem to reflect (what she considers) individual interpreter competence, as well as interpreting mode. These findings would have been enhanced had the author conducted rigorous factor and correlation statistical analysis to explore the relationship between variables. Moreover, in both chapters, the reader is bombarded with data, and the bigger picture remains obscure until the final chapter of the study. It would have been useful to conclude each chapter with a synopsis of the main findings presented in the chapter, and by reminding the reader which research questions are being addressed by which findings.

Chapter 7 discusses the perceptions of the role players (doctor, actor–patient, interpreter) in each interpreting scenario. The findings for each interpreter are presented individually across the three modes of interpreting, and again, while interesting, without a synopsis at the end of the chapter, the bigger picture is missing.

Chapter 8 is still very much in thesis form, but is essentially the crucial and most important chapter of the book in that the author finally relates her findings to research questions. To my mind, it is in this chapter that the author makes a contribution to the field by her careful assessment and evaluation of interpreting quality across the three different modes, comparing and contrasting differences between face-to-face and remote interpreting. Hasty readers could well skip the rest of the book and read only this final chapter, should they specifically want to know the findings of this particular study. It is therefore in a sense a pity that the results are based on simulations. Although the difficulties in obtaining authentic data are understandable, it would be of interest and value to follow through with a study on authentic doctor–patient interactions (on less sensitive topics) to explore how the variables identified in the current study play out in a real situation: One wonders whether knowing that the interpreting event was staged might have influenced the interpreters’ performance, especially in regard to accuracy.

Despite the obvious weaknesses in style and structure, this work adds value to the field in its detailed assessment of remote interpreting as applied to health-care settings. The comprehensive literature review of the field is helpful to students and others wishing to know more about remote interpreting, and would contribute to teaching remote interpreting at senior university levels. The findings certainly show both the strengths and weaknesses of telephonic and video remote approaches compared with normal face-to-face interpreting. Notably, they reveal that doctor–patient interaction in the telephone approach is unsatisfactory for all role-players. Differences between face-to-face and video interpreting seem to be less, and largely dependent on the video quality, as well as on individual interpreters’ level of competence and comfortableness in dealing with remote interpreting. The findings therefore corroborate the usefulness of video interpreting as an alternative to face-to-face interpreting.

The book is a useful reference to other researchers, not only in its comprehensive handling of the topic, but also in terms of further avenues for research. However, the dense thesis-like style of writing and the lack of chapter synopses do detract from the work, and if a second edition is envisaged, it would be useful for the author to reconsider the style and structure to make the book more readable. Notwithstanding, this is a useful and comprehensive exposition on the pros and cons of remote interpreting, something that is definitely here to stay in the interpreting profession.


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