Proprietary Culture Advantage Curriculum, designed by Marlene Obermeyer, RN

As an RN, with hands-on experience in bedside nursing, charge nurse and advocate experience, I have worked with patients with limited proficiency in the front-lines of healthcare. I have worked with both adhoc and "trained" interpreters. I came to experience the general medical knowledge deficit of training programs, and the inadequate preparation of interpreters to work in the acute care setting, where their knowledge of medical concepts in BOTH languages is critical.

I. Interpreter Needs Survey for Nurses.

In 2009, I conducted an online survey of over 750 nurses working in different areas of healthcare.

The results showed that at least 40% of the respondents were concerned about the clinical accuracy of medical interpreters.

Question: What is your major concern about working with interpreters?

Total: 785 respondents.

Accuracy (Misinterpretation, saying the correct thing, wrong treatment, etc.)
Specific Medical Knowledge/Ability to explain terminology (Can they convey complex medical information, etc.)
Training and Skills (Lack of training)
Ethics/Confidentiality (HIPAA, privacy, use of family, etc.)
Access and Availability (Can't get hold of interpreter, not available, etc.)
Technical Challenges (Telephonic vs. Face-to-Face)
Communication (Communication and Understanding of Information, but not accuracy)
Professionalism of Interpreters (punctuality, accommodating, giving feedback,)
Language and Cultural Issues (Understanding and conveying dialect/idioms)
Time and Cost
Language and Communication: Interpreter's inability to speak English well, unable to understand interpreter, etc.
Other: Nurse-patient relationship, trust in interpreter, no concerns (Working with good interpreters, no problems, etc.)
Other (No category): (I don't know, no experience with interpreters, etc.)

The Culture Advantage Program is focused on ensuring clinical accuracy of interpretation by training and evaluating students in BOTH languages.

II. Informal interviews with other healthcare professionals and literature review.

The survey, the interviews, and the literature review formed the basis of the Core Curriculum.
The Core Curriculum is the foundation of clinical knowledge base for interpreters.
The Core Curriculum prepares the interpreter for the most common diagnoses, procedures, treatments and patient education in the acute care and primary care setting.
The Core Curriculum is the medical knowledge base that entry level and experienced interpreters should have at a minimum level of competency.

III. Validated by healthcare professionals.

The curriculum was validated by international medical graduates and international nurses, pharmacists, respiratory and physical therapists who took the program to enhance their skills as dual-role provider/interpreters.

IV. Analysis of current state of medical interpreting field.

As a CMIE commissioner and chairperson, I reviewed medical interpreter training programs and identified gaps in their curriculum.
I advocated for a minimum of 60-Hour of training.
In addition, I advocated for language-specific training, which means, that interpreters should be trained and evaluated in both languages.
Culture Advantage has always offered language-specific 60-hour training since 2009.
As an approved provider of Healthcare Interpreter Training by the Oregon State Authority, we continue to offer 60-hour professional training.
The Culture Advantage 60-Hour Professional Medical Interpreter Program (PMI) prepares the interpreter with the critical skills in BOTH languages to interpret in acute care, medical centers, medical specialties (for example, oncology, orthopedics), in addition to ambulatory care/community health (primary care and outpatient).
The 40-Hour General Healthcare Interpreter Program was designed to meet the needs of interpreters who are not ready to interpret in acute care, but would like to gain general skills for interpreting in clinics and community health centers. The 40-Hour program is designed for native speakers of non-English languages who plan to start in community interpreting, before working in acute care/hospitals/medical centers.
The Culture Advantage 60-Hour Program has been successful in preparing our graduates with hands-on skills and readiness to work in hospitals, in addition to preparing graduates for national certification.
An 80-Hour Training Option is available for interpreter who value more advanced medical concepts and interpreter skills as an entry level interpreter or experienced interpreter with no formal training in medical concepts.

V. We define medical interpreting as Provider-managed, Patient-centered, Interpreter-faciliated Communication.

In interpreter-facilitated communication, the quality of medical care provided depends on quality medical interpreting.

The Culture Advantage Medical Interpreter Training Program was developed to address the training deficits in the state of medical interpreter training.

Based on our study and consensus of healthcare professionals, the Culture Advantage Program provides:

A strong foundation in medical knowledge, from general to specific diseases and a comprehensive understanding of the disease process instead of just memorizing medical terminology.
Training in medical concepts in BOTH languages and assessment in both languages, instead of the current state of the field of providing interpreters with basic medical terminology training in one language only (English).
Coaching and feedback by healthcare professionals who know what and how they want interpreters to be able to do for optimal patient decision-making and patient safety.
Live performance evaluation, using clinically accurate medical scenarios, by a healthcare provider with a professional medical interpreter AND in both languages.
Integrating the medical perspective with the interpreting standards, ethics, and role boundaries so they conceptualize the implications of interpreting in the actual clinical setting.
Analyzing and understanding the actual or potential clinical significance of interpreting errors.