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Facilitating legitimate peripheral participation in medical settings

by Christopher Stone & Thaïsa Hughes


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In the presentation the authors explore the professional development function of roleplays that take place in clinical-skills labs with hearing clinicians, student sign-language interpreters and deaf patients.

Within their university, the authors work with a senior nurse practitioner to base roleplays within the nursing clinical-skills lab used to train student nurses and other healthcare professionals, to more closely resemble the experience of interpreting in a real-world clinical setting. They also work with key members of the local deaf community to ensure their participation in the roleplays. Experienced interpreters, i.e. the senior lecturers, run the roleplays and discuss in debriefing sessions involving all stakeholders the decisions the student interpreters make, demonstrating ways of managing language and interaction (Roy, 2000; Wadensjö, 1998). The engagement of these participants is representative of the medical ‘community of practice’ (Lave & Wenger, 1991) of which the sign-language interpreting students will become a part, i.e. the professionals and deaf people with whom they will work when undertaking medical interpreting assignments.

The topics covered within the roleplays are either based upon the health experiences of the deaf participants, to expose students to authentic responses of deaf patients receiving care for conditions they have experienced; or on common medical conditions that give rise to consultations in primary healthcare, for which interpreters will be expected to interpret, and which might be novel for the deaf participants. Emulating the patient’s reactions to novel situations also facilitates deaf participants asking genuine questions. The widely reported limited access of deaf people to health information (SignHealth, 2014) supports exposing students in this setting to the type of questions that deaf community members may well ask.

The student interpreters must understand that when interpreting, several strategies are available to them. Linguistically, the student can ‘tell’ the participants what was said; linguistically encode via depicting language (Dudis, 2011) what is being shown; or interactionally point to the language or gestures of the participants to draw the interlocutor’s attention to communicative behaviours being used. This telling, showing and pointing must also be supplemented by ‘doing nothing’, i.e. letting the nurse and the patient interact directly so that clinical rapport is established, with the nurse taking clinical responsibility for the patient.

The involvement of the medical interpreting community of practice within the clinical-skills lab ensures that the talk, co- and no-speech gestures, and use of tools simulate real-world practices within an ‘authentic’ medical appointment. The students experience the talk of nurses from a nurse and the use of tools (termed ‘realia’ by Crezee, 2015), such as the blood-pressure cuff, oxygen mask and physiotherapy table, as a nurse would use them. They witness the ways a deaf patient would interact with them, the amount of space available to professionals within the hospital and clinical settings, the interaction of the nurse with the patient while engaging in tool use and diagnostic and medical procedures. This shifts the focus away from ‘talk as text’ to talk as action and talk while acting.

Participants will be able to:

  • describe what is meant by the term ‘legitimate peripheral participation’ in the context of training interpreters in healthcare settings.
  • explain the impact of using realia within healthcare settings for student interpreters.
  • identify the occurrences of co-speech and pro-speech/sign gestures that facilitate therapeutic rapport between healthcare professional and patient without needing interpreter mediation.

A white man with black hair pulled back  wearing a blue button-down shirt in front of a bright blue wall looks directly at cameraChristopher Stone earned his PhD from the University of Bristol in 2006. His book, Towards a Deaf Translation Norm was published by Gallaudet University Press in 2009. His research interests are broad, exploring both deaf and hearing translators and interpreters from historical, linguistic, social, pragmatic, andragogical and institutional perspectives. His interpreting practice is primarily academic conference interpreting. He is an active member of AIIC, an accredited WFD-WASLI IS interpreter and maintains UK (NRPCD) and US (RID) certification. He has published and presented about Deaf interpreters, educational interpreting, interpreter aptitude (in the journal of Translation & Interpreting vol 9), and indexing multimodal resources in translation television dews by deaf sign interpreters (in the Routledge Handbook on Translation and Pragmatics).

A white woman with long blond hair and dark-rimmed glasses in front of a window smiles at the cameraThaïsa Hughes is currently a PhD student and Senior Lecturer at the University of Wolverhampton. Her research interests at interpreting andragogy, situated learning, and cognitive apprenticeship within sign language interpreter education. She is also a practising interpreter within the UK with UK (NRCPD) accreditation, undertaking freelance interpreting, interpreting assessment, and mentoring work outside her university commitments. She has published and presented about situated healthcare interpreter training in the UK and Europe.