Introduction
Communication is a cornerstone to the safety and quality of medical care
delivery.1 Effective communication facilitates the
formation of trustful patient-healthcare provider relationships, thereby
enabling better understanding of patients’ perspectives, concerns, and
expectations. 2, 3 On the other hand, unresolved
linguistic and cultural barriers can lead to the misunderstanding of
symptoms, incorrect diagnosis, reduced patient compliance and
satisfaction, and poor health outcomes.4-7
Communication barriers disproportionally affect populations with limited
language proficiency (LLP) which include official language minorities,
Indigenous people, and migrants8-10 Medical
interpretation services have been shown to be effective in bridging
cultural and linguistic gaps for LLP patients.11 The
use of professional medical interpreters is considered the highest
standard in medical interpretation. Studies have shown that when caring
for patients with language barriers, the quality of clinical care is
improved and the number of medical errors is reduced if professional
medical interpreters are used.7 However, several
studies have reported relatively low rates of use of face-to-face
professional interpretation services (i.e., 33% - 42%), which could be
related to limited service availability, cost, and time
inefficiency.12-17
When professional interpreters are not available, ad hoc interpreters,
or friends and family members accompanying the patient, are often asked
for translational support.8 There are several
disadvantages to this. Ad hoc interpreters include people recruited
through hospital-wide intercom announcements, other patients in the
waiting rooms, or hospital employees. Both ad hoc interpreters and
friends or family members are often untrained individuals whose language
proficiency and dialect remain unverified prior to recruitment. There is
evidence to suggest that when compared to no interpretation service, the
use of untrained interpreters leads to greater miscommunication, an
increased number of medical errors, and reduced quality of
care.8, 18, 19 There is also a major issue of
confidentiality and lack of ethical training associated with using
untrained interpreters.8
Interestingly, studies from multiple countries have reported an increase
in the diversity of incoming trainees across medical
programs.20-23 For example, at McGill University
(Montreal, Canada), 22 to 36% of students admitted to medical school in
the last three years declared their mother tongue to be a language other
than English or French (the national languages of
Canada).24 Such a heterogenous population of
multilingual students with medical training are a valuable resource and
could potentially bridge the gap in medical interpretation. Recruitment
of medical student interpreters could mitigate the challenges associated
with accessing professional interpretation services or relying on
untrained native speakers. Medical students are proficient in medical
terminologies, are familiar with the structure of healthcare
institutions, are available on-site, and are trained in ethics and the
intricacies of medical communication. As some healthcare institutions
are exploring the role of medical students as medical
interpreters,15, 25 more knowledge of the current
evidence regarding the use of medical student interpreters is required
to address these issues, specifically the current landscape of medical
student interpretation, the existing interpretation training programs,
as well as the benefits and risks associated with this practice. To
address these knowledge gaps, a scoping review was conducted.