From concern for patients to a quest for information
How medical socialization shapes family physicians’ representations of interpreters
This study of social representations about interpreted medical consultations examines the discourse of French language focus groups (FGs), conducted in Quebec, with 22 third year medical students (4 FGs), 29 family medicine residents (4 FGs) and 47 experienced family physicians (5 FGs). The audio-recorded FGs were transcribed. Each discussed two video vignettes of interpreted consultations. Statistical textual analysis showed that the students’ discourse patterns differed by FG. Residents prioritized access to the patient’s culture via the interpreter, though recognizing the need to respect the patient-physician relationship. Senior physicians organized their discourse differently for each vignette, associating it with a ‘standard’ response: for them, the two main issues were the quest for information, which we relate to the medical socialization process; and the interpreter’s stances, in terms of how s/he is perceived by physicians and the role(s) s/he is seen to play in the consultation. Physicians tend to represent the interpreter as a controllable ‘object’, not a full-fledged healthcare professional.
Article outline
- 1.Introduction
- 2.Materials and methods
- 2.1Participants and study context
- 2.2Material
- 2.3Procedure
- 2.4Data analysis by textometry: Rationale and procedure
- 2.5Variables and operationalization of research aim
- 3.Results
- 3.1Discourse organization in the corpus as a whole
- 3.2Discourse organization according to status
- 3.2.1Students
- 3.2.2Residents
- 3.2.3Senior physicians
- 3.3Significant co-occurrences in the status subcorpora
- 3.3.1Students
- 3.3.2Residents
- 3.3.3Senior physicians
- 4.Summary and discussion
- Disclosure
- Notes
-
References
References
Angelelli, C. V.
(
2004)
Medical interpreting and cross-cultural communication. Cambridge: Cambridge University Press.
Bauer, A. M. & Alegria, M.
(
2010)
Impact of patient language proficiency and interpreter service use on the quality of psychiatric care: A systematic review.
Psychiatric Services 61 (8), 765–773.
Beagan, B. L.
(
2000)
Neutralizing differences: Producing neutral doctors for (almost) neutral patients.
Social Science & Medicine 51 (8), 1253–1265.
Beagan, B. L. & Kumas-Tan, Z.
(
2009)
Approaches to diversity in family medicine: “I have always tried to be colour blind”.
Canadian Family Physician 55 (8), e21–e28.
Beaud, J.-P.
(
2009)
L'échantillonnage. In
B. Gauthier (Ed.),
Recherche sociale. De la problématique à la collecte des données. Québec: Presses de l'Université du Québec, 251–283.
Betancourt, J. R., Green, A. R., Carrillo, J. E. & Ananeh-Firempong, O.
(
2003)
Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care.
Public Health Reports 118 (4), 293–302.
Bezuidenhout, L. & Borry, P.
(
2009)
Examining the role of informal interpretation in medical interviews.
Journal of Medical Ethics 35 (3), 159–162.
Bjorn, G. J.
(
2005)
Ethics and interpreting in psychotherapy with refugee children and families.
Nordic Journal of Psychiatry 59 (6), 516–521.
Brady, D. W., Corbie-Smith, G. & Branch, W. T.
(
2002)
What's important to you?: The use of narratives to promote self-reflection and to understand the experiences of medical residents.
Annals of Internal Medicine 137 (3), 220–223.
Brisset, C., Leanza, Y. & Laforest, K.
(
2013)
Working with interpreters in health care. A systematic review and a meta-ethnography of qualitative studies.
Patient Education and Counseling 911, 131–140.
Brisset, C., Leanza, Y., Rosenberg, E., Vissandjée, B., Kirmayer, L., Muckle, G., Xenocostas, S. & Laforce, H.
(
2014)
Language barriers in mental health care: A survey of primary care practitioners.
Journal of Immigrant and Minority Health 161, 1238–1246.
Burbano O'Leary, S. C., Federico, S. & Hampers, L. C.
(
2003)
The truth about language barriers: one residency program's experience.
Pediatrics 111 (5 Pt 1), e569–e573.
Caillaud, S. & Kalampalikis, N.
(
2013)
Focus groups and ecological practices: A psychosocial approach.
Qualitative Research in Psychology 10 (4), 382–401.
Chapman, E., Kaatz, A. & Carnes, M.
(
2013)
Physicians and implicit bias: How doctors may unwittingly perpetuate health care disparities.
Journal of General and Internal Medicine 28 (11), 1504–1510.
Cole, M.
(
1996)
Cultural psychology: A once and future discipline. Cambridge, MA: Belknap Press of Harvard University Press.
Cox, A.
(
2015)
Do you get the message? Defining the interpreter’s role in medical interpreting in Belgium.
Monographs in Translation and Interpreting, Special Issue 21, 161–184.
Drennan, G.
(
1999)
Psychiatry, post-Apartheid integration and the neglected role of language in South African institutional contexts.
Transcultural Psychiatry 36 (1), 5–22.
Greenhalgh, T., Robb, N. & Scambler, G.
(
2006)
Communicative and strategic action in interpreted consultations in primary health care: A Habermasian perspective.
Social Science and Medicine 63 (5), 1170–1187.
Grize, J.-B.
(
1993)
Logique naturelle et représentations sociales.
Papers on Social Representations 21, 151–159.
Hadziabdic, E., Heikkila, K., Albin, B. & Hjelm, K.
(
2009)
Migrants' perceptions of using interpreters in health care.
International Nursing Review 56 (4), 461–469.
Hatton, D. C. & Webb, T.
(
1993)
Information transmission in bilingual, bicultural contexts: a field study of community health nurses and interpreters.
Journal of Community Health Nursing 10 (3), 137–147.
Hilfinger Messias, D. K., McDowell, L. & Estrada, R. D.
(
2009)
Language interpreting as social justice work: Perspectives of formal and informal healthcare interpreters.
Advances in Nursing Science 32 (2), 128–143.
Hsieh, E.
(
2006)
Conflicts in how interpreters manage their roles in provider-patient interactions.
Social Science and Medicine 621, 721–730.
Hsieh, E.
(
2007)
Interpreters as co-diagnosticians: overlapping roles and services between providers and interpreters.
Social Science and Medicine 641, 924–937.
Hsieh, E.
(
2008)
"I am not a robot!" Interpreters' views of their roles in health care settings.
Qualitative Health Research 181, 1367–1383.
Hsieh, E.
(
2010)
Provider-interpreter collaboration in bilingual health care: Competitions of control over interpreter-mediated interactions.
Patient Education and Counseling 781, 154–159.
Hsieh, E. & Kramer, E.
(
2012)
Medical interpreters as tools: Dangers and challenges in the utilitarian approach to interpreters’ roles and functions.
Patient Education and Counseling 891, 158–162.
Hsieh, E. & Terui, S.
(
2015)
Inherent tensions and challenges of oncologist–patient communication: Implications for interpreter training in health-care settings.
Journal of Applied Communication Research 43 (2), 141–162.
Hudon, R.
(
2009)
Le pouvoir médical au Québec. Tensions autour du statut professionnel des médecins.
Recherches sociographiques 50 (2), 245–253.
Hudon, R., Martin, É. & Perreault, M.
(
2009)
Le pouvoir médical et le défi de la collaboration interprofessionnelle. Trois cas de figure.
Recherches sociographiques 50 (2), 321–344.
Hudon, R., Mathieu, R. & Martin, É.
(
2009)
Pouvoir médical et interventions législatives au Québec, 2001–2008.
Recherches sociographiques 50 (2), 255–281.
Immigration et Communautés culturelles Québec
(
2011)
Portraits régionaux 2000–2009: Caractéristiques des immigrants établis au Québec et dans les régions en 2011. Québec: Gouvernement du Québec.
Jefferson, G.
(
1984)
Transcription Notation. In
J. Atkinson &
J. Heritage (Eds.),
Structures of social action: Studies in conversation analysis. Cambridge/New York/Paris: Cambridge University Press; Editions de la Maison des Sciences de l’homme, 346–369.
Jodelet, D.
(
1991)
Les représentations sociales (2nd ed.). Paris: Presse Universitaires de France.
Kai, J., Bridgewater, R. & Spencer, J.
(
2001)
"'Just think of TB and Asians', that's all I ever hear": medical learners' views about training to work in an ethnically diverse society.
Medical Education 35 (3), 250–256.
Kalet, A. L., Mukherjee, D., Felix, K., Steinberg, S. E., Nachbar, M., Lee, A., Changrani, J. & Gany, F.
(
2005)
Can a web-based curriculum improve students' knowledge of, and attitudes about, the interpreted medical interview? Journal of General Internal Medicine 20 (10), 929–934.
Karliner, L. S., Jacobs, E. A., Chen, A. H. & Mutha, S.
(
2007)
Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature.
Health Service Research 42 (2), 727–754.
Kaufert, J. M. & Koolage, W. W.
(
1984)
Role conflict among 'culture brokers': The experience of native Canadian medical interpreters.
Social Science and Medicine 18 (3), 283–286.
Lafon, P.
(
1980)
Sur la variabilité de la fréquence des formes dans un corpus.
Mots 1 (1), 127–165.
Leanza, Y.
(
2008)
Community interpreter's power. The hazards of a disturbing attribute.
Curare 31 (2+3), 211–220.
Leanza, Y.
(
2011)
Exercer la pédiatrie en contexte multiculturel: Une approche complémentariste du rapport institutionnalisé à l’Autre. Genève: Georg Éditeur.
Leanza, Y., Boivin, I., Moro, M. R., Rousseau, C., Brisset, C., Rosenberg, E. & Hassan, G.
(
2015)
Integration of interpreters in mental health interventions with children and adolescents: The need for a framework.
Transcultural Psychiatry 52 (3), 353–375.
Leanza, Y., Boivin, I. & Rosenberg, E.
(
2010)
Interruptions and resistance: A comparison of medical consultations with family and trained interpreters.
Social Science and Medicine 70 (12), 1888–1895.
Leanza, Y., Boivin, I. & Rosenberg, E.
(
2013)
Patients' Lifeworld: Building meaningful clinical encounters between patients, physicians and interpreters.
Communication and Medicine 10 (1), 81–93.
Leanza, Y., Rizkallah, É. & Michaud Labonté, T.
(
2014)
Intégrer un interprète dans les consultations de médecine familiale : une analyse de discours assistée par ordinateur.
Monografías de Çédille, 41, 9–30.
Lebart, L.
(
1989)
Stratégies du traitement des données d'enquètes.
La revue de Modulad 31, 21–29.
Lebart, L., Salem, A. & Berry, L.
(
1998)
Exploring textual data. Dordrecht ; Boston: Springer.
Lie, D., Bereknyei, S., Kalet, A. & Braddock, C.
, 3rd (
2009)
Learning outcomes of a web module for teaching interpreter interaction skills to pre-clerkship students.
Family Medicine 41 (4), 234–235.
Lie, D., Bereknyei, S. & Vega, C. P.
(
2010)
Longitudinal development of medical students' communication skills in interpreted encounters.
Education for Health 23 (3), 466.
Maingueneau, D. & Angermüller, J.
(
2007)
Discourse analysis in France: A conversation.
Forum Qualitative Sozialforschung / Forum: Qualitative Social Research 8 (2). Retrieved from
[URL]
Marcus, E. R.
(
2003)
Medical student dreams about medical school: The unconscious developmental process of becoming a physician.
International Journal of Psychoanalysis 84 (Pt 2), 367–386.
Martinez, W.
(
2003)
Contribution à une méthodologie de l'analyse des cooccurrences lexicales multiples dans les corpus textuels. Paris: Paris III – Sorbonne nouvelle.
McEvoy, M., Santos, M. T., Marzan, M., Green, E. H. & Milan, F. B.
(
2009)
Teaching medical students how to use interpreters: a three year experience.
Medical Education Online 14, 12.
National Physician Survey
(
2010)
2010 National Physician Survey. Retrieved
February 1st 2013, from
[URL]
Papic, O., Malak, Z. & Rosenberg, E.
(
2012)
Survey of family physicians' perspectives on management of immigrant patients: Attitudes, barriers, strategies, and training needs.
Patient Education and Counselling 86 (2), 205–209.
Pöchhacker, F.
(
2008)
Interpreting as mediation. In
C. Valero Garcés &
A. Martin (Eds.),
Crossing borders in community interpreting: Definitions and dilemmas. Amsterdam: John Benjamins, 9–26.
Pottie, K., Ng, E., Spitzer, D., Mohammed, A. & Glazier, R.
(
2008)
Language proficiency, gender and self-reported health: An analysis of the first two waves of the longitudinal survey of immigrants to Canada.
Canadian Journal of Public Health 99 (6), 505–510.
Rastier, F.
(
2001)
Arts et sciences du texte. Paris: Presses universitaires de France.
Ratinaud, P. & Marchand, P.
(
2015)
Des mondes lexicaux aux représentations sociales. Une première approche des thématiques dans les débats à l’assemblée nationale (1998-2014).
Mots 21, 57–77.
Reinert, M.
(
1993)
Les ‘mondes lexicaux’ et leur ‘logique' à travers l’analyse statistique d'un corpus de récits de cauchemars.
Langage et société 66 (1), 5–39.
Rosenberg, E., Leanza, Y. & Seller, R.
(
2007)
Doctor-patient communication in primary care with an interpreter: Physician perceptions of professional and family interpreters.
Patient Education and Counseling 67 (3), 286–292.
Rouanet, H., Bernard, J.-M. & Lecoutre, B.
(
1986)
Nonprobabilistic statistical inference: A set-theoretic approach.
The American Statistician 40 (1), 60–65.
Rouanet, H. & Bert, M.-C.
(
1998)
Introduction to combinatorial inference. In
H. Rouanet,
J.-M. Bernard,
M.-C. Bert,
B. Lecoutre,
M.-P. Lecoutre &
B. Le Roux (Eds.),
New ways in statistical methodology: From significance tests to Bayesian inference. Bern; New York: Peter Lang, 97–122.
Ryan, G. & Bernard, R.
(
2000)
Data management and analysis methods. In
N. Denzin &
Y. Lincoln (Eds.),
Handbook of qualitative research (2nd ed.). Thousand Oaks: Sage, 769–802.
Ministère de la Santé et des Services sociaux du Québec
(
2011)
Info-Méd. Bulletin d'information concernant la répartition des médecins selon le sexe et l'âge, au Québec. Québec: Ministère de la Santé et des Services sociaux.
Sleed, M., Durrheim, K., Kriel, A., Solomon, V. & Baxter, V.
(
2002)
The effectiveness of the vignette methodology: A comparison of written and video vignettes in eliciting responses about date rape.
South African Journal of Psychology 32 (3), 21–28.
Street, R. L.
(
2002)
Gender differences in health care provider-patient communication: Are they due to style, stereotypes, or accommodation? Patient Education and Counseling 48 (3), 201–206.
Sullivan, M.
(
2003)
The new subjective medicine: Taking the patient's point of view on health care and health.
Social Science and Medicine 56 (7), 1595–1604.
ten Have, P.
(
2001)
Sequential structure and categorical implications in doctor-patient interaction: Ethnomethodology and history. Paper presented at the Structure and emergence of professionalized "Praxis". Retrieved from
[URL].
Wagner, W., Duveen, G., Farr, R., Jovchelovitch, S., Lorenzi-Cioldi, F. & Marková, I.
(
1999)
Theory and method of social representations.
Asian Journal of Social Psychology 21, 95–125.
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2023.
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New Trends in Healthcare Interpreting Studies [
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Tiselius, Elisabet, Elisabet Hägglund & Pernilla Pergert
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