Career Ladder Options Supplements to Community-Based Health Worker Training: Healthcare Interpreters

1. Career Ladder Options & Supplements to Community-Based Health Worker Training: Healthcare Interpreters Jesus Oliva, MD: Mt. SAC RHORC Patty Perkins, MS, MPH: CCSF RHORC

2. Healthcare Interpreter (HCI): Background In Nov. 2003, The California Endowment, a large healthcare foundation headquartered in Los Angeles, commissioned a Letter of Intent from the CCSF and Mt. SAC RHORCs for curriculum revision and multimedia development for a jointly developed HCI curriculum program

3. Healthcare Interpreter: Background, cont. Final grants submitted Spring 2004 Grants of $150K each awarded to CCSF and Mt. SAC RHORCs in September 2004 Program funding includes evaluation, job analysis, and scan of employers in Bay Area counties and greater LA & Southland region

4. Developing a Curriculum (DACUM)Health Care Interpreter A panel of experts guided by a trained facilitator Task: complete a job analysis Duties Tasks Knowledge Skills Traits Attitudes Tools and equipment

5. HCI Curriculum DevelopmentMt. San Antonio College

6. JOB ANALYSIS FOR HCI: Conducted Jan. 31/Feb. 1, 2005 Focus statement Duties Tasks Knowledge Skills Traits Attitudes Tools and equipment

7. Focus Statement The goal of the Health Care Interpreter Training Program is to increase the pool of trained interpreters to meet the growing needs of ethnically-diverse communities in California. The United States Civil Rights Act, and the Office of Civil Rights mandates that patients with limited English skills have equal access to health care as those who are English speakers ( Title VI of the Civil Rights Act of 1964) . Interpreter services are key to the realization of this mandate.

8. Duties of a HCI Provide effective interpretation. Facilitate linguistic and cultural communication between patients and health care providers in English and Language of Service.

9. Tasks of a HCI Interpret. On line, over the phone, simultaneous, consecutive, site translation. Translate documents. Medical lectures, brochures, flyers, consent forms, medical notes, prescriptions, discharge instructions, medical procedures and instructions.

10. Knowledge of a HCI Medical terminology Anatomy and Physiology Pathophysiology Surgical Procedures Diagnostic Procedures Consent forms Cultural backgrounds Legal and Medical aspects in the Health Care settings

11. Skills of a HCI Ability to communicate clearly and fluently in English/Language of Service Ability to convey the message to different levels of education Ability to interpret different cultural beliefs Conduit Clarifier

12. Skills of a HCI cont. Cultural Broker Advocate Interpret without own cultural beliefs interfering with the session Good listener No prejudice feelings

13. Traits of a HCI Knowledgeable in Medical Terminology. Skill to convey message in proper way. Professionalism. Experience and Education in the Field. Love for the career.

14. Attitudes of a HCI Professional behavior Dress Professionally Understanding Confidentiality Respectful

15. Tools and equipment of a HCI Medical dictionary Medical books Computer Beeper Cell

16. Early Evaluation Finding:PHASE II DACUM FOR HCI The panel of curriculum experts take the tasks, knowledge and skills from the DACUM chart and arrange them into instructional units. Our 10 panelists came from 6 hospital or healthcare systems in LA, Orange, Santa Clara, Alameda, and San Francisco counties A substantial finding from our February 2005 DACUM was the extent that translation services were provided by HCIs in a variety of hospital-based settings, in both Nor & SoCal

17. Health Care Interpreting First Semester: Voc. English for Health Care. MEDI 90 (Medical terminology) ANATOMY 50 (Basic Anatomy and Physiology) Health Science Skills Lab 05 (Clinical Lab) Second Semester: Voc Health 13 Voc Health 14 Voc Health 15

18. VOC. English for Health Care Requirement for ESL students- may be waived for native English speakers. Recommended by ESL staff during Orientation.

19. MEDICAL TERMINOLOGYMEDI 90 Course description: This is a credit by examination (CBE) course that includes the use and meaning of medical terminology as used in various allied health fields. Students who pass the final exam with a score of 70 % or higher may petition for and receive 3 college units at Mt. SAC.

20. Medical Terminology This is a credit by examination (CBE) course. Course Objectives: Identify root words, prefixes, suffixes and combining forms of English health /medical terms. Learn the correct spelling, definition, usage, pronunciation and abbreviations of health/medical terms in English. Build confidence in using English medical terms.

21. Basic Anatomy and Physiology Course Description: This course is designed to familiarize the student with the gross anatomy and physiology of the Human Body. Introduction to the Human Body Chemical Aspects of Life The Cell, Tissues and Membranes All of the Body Systems (Nervous, Muscular, Skeletal, Urinary, Digestive etc.)

22. Health Science Skills Lab 05 This is self-directed with assignments to encourage and reinforce topics covered in both VOC ANAT 50 and VOC HLTH 12 Suggested Video-listings to watch. Interactive Computer programs. Internet Sites. Audio and Video Recordings to enhance interpreting skills.

23. Second Semester Classes VOC HEALTH 13: 108 Hours Purpose: To develop awareness, knowledge and skills necessary for effective language interpreting in health care settings emphasis on the rule and responsibilities of a health care interpreter, basic knowledge of common medical conditions; treatments and procedures, insight in language and cultural nuances for specific communities necessary in the art of interpretation.

24. MODULE 1Introduction to Health Care Interpreting (40 hrs) Roles of Interpreter The Interpreter Code of Ethics Health Care in the US Standards of Care Culture & Interpreting

25. MODULE 2Basic Interpreting Skills (18 hours) Modes of Interpreting Pre-Sessions Being a conduit Being a clarifier Intervening Managing the Flow of the Session Memory Development Sight Translation

26. MODULE 3Body systems & Their Problems (36 hours) Medical Terminology-Anatomy & Physiology, Pathophysiology �Diagnosis-Procedures for: + Respiratory System + Circulatory System + Nervous System + Musculoskeletal System + Digestive System + Integumentary System + Endocrine System + Urinary System + Reproductive System

27. MODULE 4Nutrition and Public Health (14 hours) Nutrition + Maintaining a balance + Common problems + Nutrition diagrams Public Health + HIV + Childhood diseases + Immunizations + Other infectious diseases

28. VOC Health 14 (108 hours) Enhancement of interpreting skills learned in VOC Health 13 covering specialized health care service areas such as genetics, mental health, and death and dying. Emphasis also on the development of cultural competency in the community and workplace and careers in interpreting.

29. MODULE 5 Culture and It�s Impact on Interpreting (27 hrs) An introduction to Culture Spotting Cultural �Bumps� Recognizing Diversity Traditional Health Care in Specific Communities Application to the Culture Broker Role The Role of the Advocate Effective Communication Appropriate Advocacy

30. MODULE 6 Interpreting for Examinations and Procedures (27 hours) Physical Exam Neurological Exam Mental Status Role Plays for Interpreting for Exams Interpreting Consents Translation of Consents Assesses level of understanding for consents

31. MODULE 7Mental Health/Death and Dying (27 hours) Substance Abuse Mental Health Domestic Violence Self-Care Death and Dying

32. MODULE 8 Professional Development (27 hours) Critical Incidents Office of Civil Rights Confidentiality Ethics Preparing for Internship Writing a Resume Professional Conduct

33. VOC HEALTH 1554 Hours Arranged Facilitating linguistic, cultural and communication between client and health care providers/hospital field experience. Seminar (20 hours, 4 hours/day X 5 Saturdays). Role Playing Video Testing Internship Preparation

34. Health Care Interpreting Course Work

35. ACKNOWLEDGEMENTS The California Endowment: Ignatius Bau Funder of this project Gayle Tang, RN,MSN Health Care Interpreting Instructor, SFCC, KP of Northern California Jose Ramon Fernandez Pena, MD-MPA Associate Professor, SFSU; Director Welcome Back Initiative Bonnie Adams, RN, MSN, Ed.D Curriculum Coordinator Mt. San Antonio College RHORC staff CCSF RHORC Staff & Dept. of Health Sciences Curriculum writers; our advisory groups; DACUM panelists

36. STATEWIDE DISSEMINATION Currently in process is a Grant with The California Endowment to take this model curriculum as a statewide project. Evaluation data will be shared. Community Colleges or Organizations interested? Contact: RHORC � John Cordova Mt. San Antonio College 1100 N. Grand Ave. � Bldg. 35 Walnut CA 91789 Office: (909) 594-5611 x 6101 Fax: (909) 468-4093 Email: ihwac@mtsac.edu36