Assessing Linguistic and Cultural Mediation In Healthcare Services

This paper deals with the assessment of interpreter-mediated interactions in healthcare settings, that is interactions between migrants and healthcare providers, speaking different languages and talking to each other with the help of a third party, who acts as a linguistic interpreter and a cultural mediator.In this paper, we are interested in assessing practices of mediation/interpreting. There are different possible types of evaluative research on “good” practices: analysis of customer satisfaction, self-reports, analysis of interactions, analysis of contexts. Here we look at interaction, on the basis of four assumptions: (1) practices are achieved in social interactions, (2) reports do not inform directly on practices, rather they are their “social representations”, (3) context can be observed only through practices, in interactions that reproduce it, (4) level of satisfaction does not necessarily correspond to quality of practices. Therefore, first-hand observation of practices achieved in interactions may throw light on those interactional mechanisms that make them effective. Analyses of customer satisfaction and reports may though provide useful enrichments and suggestionsMediation/interpreting in the interaction is achieved through a series of coordinated actions and is effective when action and understanding are coordinated in a way as to produce information for the participants. Information and knowledge as achieved through sequences of actions are then visible (observable and analysable) in turn-taking.Interpreting can thus be observed as an interactional activity and, as such, it is an activity of mediating.. Interpreting projects different opportunities for interlocutors’ active participation in the interaction, as it assures common understanding and facilitates direct communication between the parties. Interpreting is the result of coordinated actions of the mediator’s and the other participants’ (doctor and patient) and a look at the achievement of this coordination may be indicative of the practices adopted to construct it.Mediation/interpreting has the function to facilitate successful doctor-patient intercultural communication. It presupposes the cultural forms of the healthcare system, i.e. expectations concerning the meaning and importance of patients’ illness and therapy, roles of doctors and patients, expectations of medical expertise and patients’ adaptation. Different forms of medicine (e.g. doctor-centred vs. patient-centred) too, rely on different presuppositions and affect mediation. Mediation/interpreting can, in its turn, introduce novel presuppositions which may affect forms of mediation, facilitating (or inhibiting) doctor-patient communication. Novel presuppositions may characterize cultural diversity and be indicators of intercultural communication achievements. So the mediation/interpreting function of facilitating (or inhibiting) either reproduction of specific cultural forms or cross-cultural adaptation between different forms can also be observed through interactional dynamics.. On these basis, we can assess: (1) interpreting as mediation; (2) the function of mediation/interpreting as facilitation/inhibition in the healthcare system, (3) the function of mediation/interpreting as facilitation/inhibition of intercultural communication.Interpreting and facilitation (of doctor-patient intercultural communication) are clearly intertwined. Their analytical distinction is useful because it permits the evaluative analysis of differentiated components of mediation/interpreting. The paper identifies the most important variables for assessing the success of mediation as interpreting, its facilitation of doctor-patient communication and cross-cultural adaptation. This enhances the opportunities both to observe different aspects of mediation/interpreting and to assess its different aspects separately. The combination of these aspects permits analysis and assessment of mediation/interpreting in its complexity.