Conveying information in the interpreter-mediated medical visit: The case of epistemic brokering

作者：Raymond Chase Wesley^*

来源：Patient Education and Counseling, 2014, 97(1): 38-46.

DOI：10.1016/j.pec.2014.05.020

• Knowledge
• Information delivery
• Translation/interpreting
• Conversation analysis
• Genetic counseling
• Pediatrics

Objective: This study introduces the concept of epistemic brokering in interpreter-mediated medical visits and illustrates how it an be used to effectively convey information between providers and patients/parents.
Methods: Conversation analysis is used to analyze 24 pediatric genetics consultations (=17.75 h) involving 16 Spanish-speaking families, their various English-speaking healthcare providers, and four on-staff bilingual interpreters.
Results: Interpreters-as-epistemic-brokers can aid in the transfer of information between clinicians and patients/parents (i) by (re)designing content to be appropriately fitted to a specific recipient's understanding, and (ii) by monitoring the ongoing medical visit for moments in which one or more interactants may be in a relatively unknowledgeable position and taking steps to secure common ground.
Conclusion: It is posited that epistemically brokering interaction can serve to promote the development of positive relationships with potentially hard-to-reach patients/parents. Although seemingly minor, these moments in interaction contribute to these individuals' overall experience with and understanding of the institution of medicine. Future research is needed to identify the particular strategies associated with effective epistemic brokering.
Practice implications: Interpreters and clinicians should be aware of the role that discursive practices play in conveying information in the medical visit, and reconceptualize interpreters as collaborators in this process.

• 出版日期2014-10