Bringing together researchers, practitioners and policy makers working with migrants, refugees and asylum seekers in Scotland
By Dr Ima Jackson, Project Co-investigator*
New GRAMNet research on Interpreter mediated health encounters provides a practical online free education tool to support and increase learning for those who participate.
20 years ago, a nurse might spend their whole career without ever needing an interpreter. But in some areas in Scotland, interpreting is now a daily requirement. As one colleague said, “It can be difficult to know if you are saying the right thing”. Clinicians generally aren’t taught about interpreting; migrants often don’t know what to expect, and interpreters themselves may be language-proficient, but they are not necessarily trained in health or ethics. They might be doing health one day, legal work the next.
The issue involves complex, three-way relationships, and there has been some progress, such as Greater Glasgow and Clyde setting up its own “bank “ of interpreters, but we still have some work to do. We think that the complexity of interpretation is one area where everyone benefits from some formal training, rather than a kind of well-intentioned but ill-informed muddling through. Similar views were reflected by a range of health professionals, migrants and interpreters at the end of project dissemination event at Glasgow Caledonian University School of Health in December 2013.
This event promoted a new resource for health and social care interpreting which has been developed by the Project Team through an SFC AHRC Healthier Scotland knowledge exchange research grant and The British Council for a project which investigated the experience and skills of those involved in interpreter mediated health encounters in Glasgow.
In Scotland, as in many other healthcare systems, there are limited opportunities for migrants, interpreters and health professionals to learn about interpreting in health as they are experienced by all three participants. Historically, and the literature and policy changes reflects this, one or two of the key participants’ experience has been investigated but rarely all three participants at the same time.
This study reviewed the academic and policy literature from each perspective and then participants from each of those perspectives were interviewed individually or in focus groups. The results from analysis of their recounting of the experience were reconfigured into filmed scenarios. The films don’t represent any individuals’ experience but emerge from the total analysis.
Unlike other research projects, whose findings can sometimes be inaccessible for its targeted audience, the films can be viewed by any individual by accessing them on a computer or in public places such as hospital or GP waiting rooms, or more formally within facilitated tutorial and lecture groups.
Why films to spread the results?
Why did we film the output of our research? For a few reasons: because these encounters are dramatic; because we are learning from the participants; because we wanted to make our work available to everyone with an interest in this process- and also because there are no simple answers. The films allow people to experience the issues, and draw their own conclusions.
The films also helped our drive to make the outcome of the research immediately useful. They work politically and demonstrate through film, the seriousness of these issues in modern healthcare. A maxim of film-making is “show not tell”. We applied that principle to our filming… “when you watch it, you really feel it”, and the politics and the potential for inertia fades away. Producing a film based learning tool out of academic research is a mechanism which directly interacts with current health policy as well as migration and health politics. Through dramatising the interactions in health interpreting it highlights the potential effect of shifting from face to face interpreting to telephone interpreters.
We really hope these films will help people to make better use of the potential for interpreting to transform rather than limit health and social care encounters. We hope the films offer practical help to colleagues who may increasingly have found themselves needing interpreters, even though this was never part of their practice before.
By examining and then dramatising the dynamics of the experience of interpreting, we hope that everyone can gain: community interpreters may gain increased respect as they demonstrate their professionalism; patients benefit from the pitfalls of interpreting being recognised and managed (rather than being blamed on them); and care providers gain a sense of the potential for interpreting to empower understanding, rather than be a drain on resources and in doing so support the learning of our future health and social care providers, educators and interpreters.
*Ima Jackson is an experienced clinician, lecturer, researcher and project manager and has spent most of her career working with marginalised groups: initially pregnant women in the poorest parts of London and Glasgow, and in more recent years with refugees, asylum seekers and other migrants in Scotland. Her research interest is in migration, in particular transnational workforce issues, ethical recruitment processes, migrant health and healthcare infrastructure needs and gendered migration policy
The Project Team
Principal Investigator: Prof Alison Phipps
Post Doctoral Research Associate: Dr Teresa Piacentini
Co-investigators: Dr Ima Jackson, Dr Niamh Stack, Prof Kate O’Donnell
Non-HEI Partner: Tanveer Parnez (BEMIS)