NBCMI Written Exam

Code of Ethics

Set of principles or values that govern the conduct of members of a profession while they are engaged in the enactment of that profession. Guidelines for making judgments about what is acceptable and desirable behavior in a given context or particular relationship. (NCIHC, 6)

Core Duty

To make possible the communication between two parties - patient & provider - who do not speak the same language in order to achieve the goal of the encounter - the health and well-being of the patient. (NCIHC, 8)

Ethos

Moral custom

Ethic

Principle of good conduct

6 Tenets of Code of Ethics

Confidentiality, Accuracy, Professionalism, Impartiality, Use Advocacy and Cultural Interface Roles Appropriately, Professional Development

Confidentiality, Confidencialidad

The interpreter treats as confidential, within the treating team, all information learned in the performance of their professional duties, while observing relevant requirements regarding disclosure. (NCIHC, 10)

Confidentiality, Confidencialidad

Interpreters will maintain confidentiality of all assignment-related information. Do not disclose assignment-related information unless with the expressed permission of all parties or if required by law. (IMIA, 1)

"Right to Know"

The norms of the U.S. medical system value and protect the autonomy of the individual. It is with the individual that the right to know rests unless the patient has explicitly or implicitly indicated otherwise.

When is it justifiable to break the Code of Confidentiality?

(1) The patient has communicated the desire to hurt self or others. (2) There are statements of child, domestic, or elderly abuse.

HIPAA, year?

Health Insurance Portability and Accountability Act of 1996.

What Colleagues are doing to Ensure Confidentiality?

(1) Avoid discussing sensitive medical information in hallways, elevators, etc. (2) Shred medical notes after assignment or shift. (3) Disclose to both parties that you are bound by a Code of Ethics to maintain information confidential. (4) Do not volunteer health information about a patient to family members. (5) Do not share the name of the patient or other identifying information when discussing case studies. (6) Do not leave any document with the patient's name in a public area.

The 3 Core Values of the Code of Ethics for HCIs

(1) Beneficence (2) Fidelity (3) Respect for the importance of culture and cultural differences

Beneficence

Core value that is shared with other health care professions. Essential obligation and duty to support the health and well-being of the patient and their system of support and to do no harm.

Fidelity

Interpreters vow to remain faithful to the original message as they convert utterances from one language into another without adding to, omitting from, or distorting the original message.

Respect for the importance of culture and cultural differences

Understanding speaker's cultural frame of reference and being aware that cultural differences in perspectives and alternative views of the world can lead to critical misunderstandings and miscommunication.

Sapir-Whorf Hypothesis

Language serves as an expression of the ways that a culture organizes reality.

The 9 Principles of the National Code of Ethics for Interpreters in Health Care (NCIHC)

1. Confidentiality 2. Fidelity 3. Impartiality 4. Boundaries (Transparency, Conflicts of Interest) 5. Scope of Practice 6. Professional Courtesy 7. Advocacy 8. Professional Development 9. Professional & Ethical Manner (NCIHC, 21)

Accuracy & Completeness

Precisión & Completud

The principle of fidelity. The interpreter strives to render the message accurately, conveying the content and spirit of the original message, taking into consideration its cultural context.

Impartiality

Imparcialidad

The interpreter strives to maintain impartiality and refrains from counseling, advising, or projecting personal biases or beliefs.

Conflict of Interest

Conflicto de intereses

The interpreter maintains the boundaries of the professional role, refraining from personal involvement.

Scope of Practice

Àmbito de práctica

The interpreter continually strives to develop awareness of their own and other (ex. biomedical) cultures encountered in the performance of their professional duties. Cultural Competency.

Disqualification/Impediments to Performance

Descalificación/impedimentos al desempeño

Interpreters will refrain from accepting assignments beyond their professional skills, language fluency, or level of training.

Responsibility to withdraw from assignment if language or content keeps interpreter from enacting role in accordance with the principle of fidelity.

Responsibility Toward Ensuring Adequate Working Conditions (ex. interpreter fatigue, 20 minute rule, requesting complex materials ahead of time.)

Professional Courtesy

Cortesía profesional

The interpreter treats all parties with respect

Professional Development

Desarrollo profesional

The interpreter strives to continually further his/her knowledge and skills.

Interpreters will

Guidelines to the Conduit Role

- interprets in the first person

- interprets pauses, sighs, meaningful gestures, etc

- interpreter gives an accurate interpretation, not a literal interpretation

- the interpreter reflects tone, inflection, and volume

Clarifying: when intervention is necessary

- the interpreter needs to have the speaker repeat what they said

- the interpreter needs to ask the speaker to use shorter sentences

- the speaker is not pausing enough to allow for interpretation

- use of language that the interpreter does not understand

- the interpreter suspects, due to non-verbal clues, that the patient does not understand

- anyone uses a term that must be explained or put in a cultural context to be understood

- a cultural difference is causing a misunderstanding

Exceptions to using first person interpreting

- if the patient is disoriented, mentally ill, etc.

- if the patient speaks a language whose grammatical structure makes it inappropriate to use first person

IMIA (International Medical Interpreters Association) Standards

Guideposts in the development of educational and training programs.

Evaluation tool for training, practicums or self-assessments.

Preparation of health care providers to work with interpreters

Foundation for the IMIA certification examination (provided by the National Board)

A defining baseline of expectations for consumers and practitioners.

A measure against which individual interpreters can monitor the quality of their own performance.

NCIHC (National Council on Interpreting in Healthcare) Standards

To acknowledge the inherent dignity of all parties in the interpreted encounter.

The NCIHC's National Standards of Practice are designed to help improve the quality and consistency of interpreting in health care. Just like clinical protocols for physicians, these new standards will provide guidance as to what is expected of health care interpreters and what constitutes good practice.

These standards provide a common base of understanding of our profession and foster consistency in its practice, thus improving the quality of interpreter services across the United States

CHIA (California Healthcare Interpreters Association) Standards

It was released in 2002, the goal of this document is to standardize healthcare interpreting practices by providing a set of ethical principles, interpreting protocols, and guidance on roles particular to the specialty of healthcare interpreting. We hope that increased availability of quality interpreting will result in better access to healthcare for limited English proficient (LEP) patients."

IMIA-The Standards of Practice

1. Interpretation

2. Cultural Interface

3.Ethical Behavior

Ethical Principles for CHIA

Confidentiality

Impartiality

Respect for Individuals and their Communities

Professionalism and Integrity

Accuracy and Completeness

Cultural Responsiveness

Ethical Behavior for IMIA

1 Maintain confidentiality.

2 Interpret accurately and completely

3 Maintain impartiality.

4 Respect patient's privacy.

5 Maintain professional distance.

6 Maintain professional integrity.

7 Deal with discrimination.

STANDARDS OF PRACTICE for NCIHC

Accuracy

Confidentiality

Impartiality

Respect

Cultural Awareness

Role Boundaries Professionalism

Professional Development

Advocacy

CODE OF ETHICS for NCIHC

-The interpreter treats as confidential, within the treating team, all information learned in the performance of their professional duties, while observing relevant requirements regarding disclosure.

-The interpreter strives to render the message accurately, conveying the content and spirit of the original message, taking into consideration its cultural context.

-The interpreter strives to maintain impartiality and refrains from counseling, advising or projecting personal biases or beliefs.

-The interpreter maintains the boundaries of the professional role, refraining from personal involvement.

-The interpreter continuously strives to develop awareness of his/her own and other (including biomedical) cultures encountered in the performance of their professional duties.

-The interpreter treats all parties with respect.

-When the patient's health, well-being, or dignity is at risk, the interpreter may be justified in acting as an advocate. Advocacy is understood as an action taken on behalf of an individual that goes beyond facilitating communication, with the intention of supporting good health outcomes. Advocacy must only be undertaken after careful and thoughtful analysis of the situation and if other less intrusive actions have not resolved the problem.

-The interpreter strives to continually further his/her knowledge and skills.

-The interpreter must at all times act in a professional and ethical manner.

aparato digestivo

digestive system

esófago

esophagus

estómago

stomach

glándulas

glands

intestinos

intestines

boca

mouth

dientes

teeth

sistema sensorial

senses

ojos

eyes

visión

vision

aparato respiratorio

respiratory system

pulmones

lungs

vías respiratorias

airways

aparato locomotor

musculoskeletal system

huesos

bones

articulaciones

joints

tendones

tendons

músculos

muscles

sistema nervioso

nervous sistem

cerebro

brain

nervios

nerves

oído

ear

nariz

nose

sistema integumentario

integumentary system

piel

skin

cabello

hair

uñas

nails

sistema cardiovascular

cardiovascular system

corazón

heart

arterias

artery

vena

vein

capilares

capillaries

sangre

blood

sistema endocrino

endocrine system

glándulas endocrinas productoras de hormonas

hormone producing endocrine glands

sistema reproductor feminino

female reproductive system

sistema reproductor masculino

male reproductive system

órganos sexuales femininos

female sex organs

órganos sexuales masculinos

male sex organs

aparato excretor

excretory system

riñones

kidney

sistema urinario

urinary system

el uréter

ureter

la uretra

urethra

la vejiga

bladder

encía

gum

esmalte

enamel

canal de la raíz

root canal

nervio

nerve

dentina

dentin

nervio óptico

optic nerve

párpado

eye lid

lente cristalino

lens

pupila

pupil

iris

iris

córnea

cornea

retina

retina

esclerótica

sclera

vasos sanguíneos

blood vessels

lágrimas

tears

necesito un doctor que sea especialista en alergias

subjunctive clause 1

quiero un medicamento que pueda aliviar mi dolor de cabeza

subjunctive clause 2

busco una clínica que esté cerca de mi casa

subjunctive clause 3

Un ataque cerebral es cuando hay una alteración del flujo sanguíneo en el cerebro

que es un ataque cerebral

hay dos tipos: el accidente cerebrovascular isquémico y el accidente cerebrovascular hemorrágico

cuantos tipos hay