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This short article in an issue of JAMA addresses the issue of clinicians who are not fluent in the language of their patients working without an interpreter. It provides a practical list of situations where the clinician should be sure to have a skilled interpreter. 


JAMA, January 9, 2013—Vol 309, No. 2, from

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To compare interpreter errors and their potential consequences in encounters with professional versus ad hoc versus no interpreters.


This was a cross-sectional error analysis of audiotaped emergency department (ED) visits during 30 months in the 2 largest pediatric EDs in Massachusetts. Participants were Spanish-speaking limited-English-proficient patients, caregivers, and their interpreters. Outcome measures included interpreter error numbers, types, and potential consequences.


The 57 encounters included 20 with professional interpreters, 27 with ad hoc interpreters, and 10 with no interpreters; 1,884 interpreter errors were noted, and 18% had potential clinical consequences. The proportion of errors of potential consequence was significantly lower for professional (12%) versus ad hoc (22%) versus no interpreters (20%). Among professional interpreters, previous hours of interpreter training, but not years of experience, were significantly associated with error numbers, types, and potential consequences. The median errors by professional interpreters with greater than or equal to 100 hours of training was significantly lower, at 12, versus 33 for those with fewer than 100 hours of training. Those with greater than or equal to 100 hours of training committed significantly lower proportions of errors of potential consequence overall (2% versus 12%) and in every error category.


Professional interpreters result in a significantly lower likelihood of errors of potential consequence than ad hoc and no interpreters. Among professional interpreters, hours of previous training, but not years of experience, are associated with error numbers, types, and consequences. These findings suggest that requiring at least 100 hours of training for interpreters might have a major impact on reducing interpreter errors and their consequences in health care while improving quality and patient safety.

Copyright © 2012. Published by Mosby, Inc.

Patient-Centered, Provider-Managed, Interpreter-Facilitated Human Communication ©We prepare professional medical interpreters for the clinical setting - hospitals and clinics, where your knowledge of medical terminology and professional interpreting skills are critical.We teach three categories of professional online training programs to ensure that our students are comfortably placed in an appropriate e-learning environment with regard to their skills and experience.Our regular Professional Medical Interpreter Training Program, our Fast Track Program for Bilingual Healthcare Professionals, and our Comprehensive Language Neutral Program with Language Pack are designed to build a strong understanding of medical terminology and and of the ethical role, standards, techniques, and principles of accurate professional medical interpreting.

 OVERVIEW OF NATIONAL BOARDThe mission of the National Board is to foster improved healthcare outcomes, patient safety and patient/provider communication, by elevating the standards for and quality of medical interpreting through a nationally recognized and accredited certification for medical interpreters.The CMI certification program is governed by the National Board of Certification for Medical Interpreters (National Board), an independent division of the International Medical Interpreters Association (IMIA). The purposes of the National Board are to:·         Develop, organize, oversee and promote a national medical interpreter certification program in all languages.·         Promote patients and providers working with credentialed medical interpreters who have met minimal national standards to provide accurate and safe interpretation.·         Ensure credibility of national certification by striving to comply with national accreditation standards including transparency, inclusion, and access. The Board of Directors of the National Board consists of 12 voting members that include medical interpreters, a health care provider, industry representatives, and a public member. Initial Board members were selected by a public process and independent selection committee. Subsequently, Board members are recruited through a Nominating Committee process and are elected by the members of the National Board. To see the National Board click here. 

The aim of this paper is to describe various approaches that have been taken or could be taken to avoid the linguistic incompatibility that impedes full and equal access to health care on the part of health care providers and their patients when they do not speak the same language.

From Health Reources and Services Administration this resource is available in Spanish and english. In an accessible, easy-to-read format, the Seasonal Flu guide provides: flu facts; every day prevention steps; and ways that community leaders can contribute to the flu prevention effort. This guide is an important fight the flu resource for our Spanish-speaking community and faith-based partners.

Order printed copies of the Seasonal Flu guide (in English or in Spanish) from the HHS Partnership Center by emailing Please include # of copies requested, mailing address (or interoffice mail stop) and person of contact in the email. Please specify if you are ordering the English or the Spanish version.

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A Spanish language public service announcement for patients on how to register for healthcare services while avoiding errors and confusion in registration information. Specifically, consistency in name and date of birth.

PSA by LATCH (Local Access to Community Healthcare), a program of the Division of Community Health - Duke University Medical Center Community & Family Medicine ... (more i

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Este recurso del CDC ofrece una visión general de la tos ferina , también conocida como Whooping Cough. Los temas incluyen síntomas , propagación, la tos ferina en los EE.UU. y las medidas de prevención.

This resources provides an overview of Pertussis, also known as the Whooping Cough. Topics include symptoms, how its spread, Pertussis in the US and prevention measures.

This site holds many medical Spanish material, including a comprehensive medical Spanish dictionary, complete with audio.

This website offers some free online lessons which teach basic Spanish concepts. More detailed and advanced lessons can be purchased on CDs from the website.
The goal of this project is to create awareness about less common languages. This website offers a database of less commonly taught language classes, instructional materials, and other resources for teaching these languages. There are some resources for Zapoteco, Nahuatl, and Mayan indigenous languages.
The town of Greenfield, CA has a high population of indigenous immigrants from Oaxaca, Mexico, many of whom speak little Spanish and/or English. This website is a compilation of work done by students from the UC,Berkeley Graduate School of Journalism and reports on what the town of Greenfield is doing to improve communications and relations with these indigenous peoples

M E J Personal Business Services, Inc. is an interpreting, translation, and financial service based in New York City.  They provide Foreign Language Interpreting, Telephone interpreting, video remote Interpreting, and Financial and Translation Services.  Their website specifies that they provide document translations in Mixteco.  

General information or a free quote:  866-557-5336

Language Line is a company which provides a number of interpretation services. One of their services is over-the-phone interpretation in Mixteco for $3.95 per minute. General information or questions:  1-877-886-3885

The MICOP is an organization of English,Spanish,and indigenous language speakers who are working to aid Oaxacan immigrants in Ventura County California.They mostly provide direct services.The“Necessities of Life” program distributes clothing, diapers, blankets, and other items to those in need.The organization also has programs which provide food, resources for medical care,education and literacy classes for adults, and weekly community meetings.Contact info:325 W. ChannelIslands Blvd. Oxnard, California 93033805) 385-8662

The CDI is an organization that was created in 2003 to ensure that indigenous communities and people in Mexico have the rights guaranteed to them by the Mexican Constitution. It collaborates with state governments and federal dependencies to evaluate current strategies and works to form new programs that will ensure equality and fight against indigenous discrimination. It also works to help indigenous peoples to improve their quality of life. Their website includes a number of resources on indigenous areas of Mexico including news stories (some of which are written in an indigenous language), music, and research information on the indigenous populations. There is also a section of basic information on the indigenous languages of Mexico.

Radio Bilingüe is a Spanish language network on public radio.  Although it is mostly California based, there are affiliate stations in Carrboro, Asheville, and Greenville, North Carolina.  There is also a radio program broadcast in Mixteco called La Hora Mixteca.


Contact: Filemón López, Coordinator of La Hora Mixteca

(559) 455-5784

The Oaxacan Indigenous Binational Front (FIOB) is a non-profit organization based in California. It is a coalition of indigenous organizations, communities, and individuals from Oaxaca, Baja California and in the State of California. This organization works to empower the indigenous peoples of Oaxaca and make sure that human rights are upheld for these communities in both Mexico and the United States.

The Language Materials Project works to provide a variety of materials, such as dictionaries, phrasebooks,grammars, and cultural materials.Currently, thewebsite only provides materials in one indigenous language (Nahuatl), but the project continually updates the language profiles, so additional languages may be added at a later date.
Rosetta Stone is a software company which markets a variety of language learning software.This company also has an Endangered Languages Division, which creates software to preserve less prevalent languages. The company currently does not have any software available in theIndigenous Languages of Latin America but is possibly interested in developing software with ECMHSP and its parents who speak indigenous languages.Contact Marion

This faith-based organization works to document and study lesser-known languages.  It has developed a number of materials, ranging from dictionaries to literature sources, in a wide variety of languages. 

The Native Literacy Center in Oaxaca, Mexico was founded by a group of professionals and native educators from Oaxaca to support literacy projects for indigenous peoples.  This center is involved with preservation, helping indigenous peoples to write their languages, print and publish individual works, write their histories, and record their knowledge for future generations.  People come from Central and South America to this Center, where they learn how to produce their own works.  The center also works with education, teaching indigenous peoples how to write their languages so that they are able to produce their own works. 

This digital archive features a number of recordings and texts in the indigenous languages of Latin America. Materials are available in Mixteco, Mam, Nahuatl, Otomi, Triqui, Zapoteco, and many other indigenous languages. These materials give information about the cultures of these indigenous groups. Original works of literature in indigenous languages are also published on this site. AILLA works to preserve written forms of these languages, but it also collects grammars, dictionaries, ethnographies, and research notes that can be used as teaching materials. Most of the archive is free and available to the public.

  1.  Online dicitionary in a variety of languages available under the "Foreign Language Aides for Latin America and Iberia" section, including Mixteco, Nahuatl, and Zapoteco.
  2.  Mixtec-Spanish Online Dictionary                 
  3.  Mixtec dictionary created by the SIL:
  4.  Mam-Spanish Dictionary


This website, owned by SIL International, provides detailed background information about less common languages.  Many of the indigenous languages have profiles. 

Note: Wikipedia also contains a variety of sites describing the basic characteristics of each of the indigenous languages. 

Western NC Workers Center:  Located in Morganton, North Carolina, the Western NC Workers Center is a non-profit group of community organizers.  This organization currently has a number of outreach and education projects which work to uphold the rights of immigrant and low wage employees in Western North Carolina.  They also work with high levels of Guatemalan immigrants who speak indigenous languages.  One of their projects designed to reach indigenous language speakers is their Promotora Education project, which uses scenario picture books without words to educate low literacy populations about health and work safety. 


Francisco Risso                                                                                                                (828) 432-5080                                                                                                   

Mayan Ministries:  Organized through the Diocese of Palm Beach in Florida, Maya Ministries works to address the needs of Mayan immigrants to the area.  These Mayan workers speak up to 25 different dialects of Mayan indigenous languages, but most can speak Spanish as well.  The organization’s main services are literacy programs for families, adult education programs, and early childhood education programs for children who have English as a second language.  They also offer a variety of social services referrals and translating specifically for Mayan immigrants.  They have a Literacy Program funded by the Department of Education that was written in the Mayan indigenous language Canjobal. 


Contact Information:

1615 Lake Ave.
P.O. Box 209 
Lake Worth, Fl 33460-0209

General information:

Translating Health Care is a video by the New York Times. It illustrates how Minneapolis has taken in waves of immigrants with distinctive patterns of beliefs about health. Other topics covered include: cultural competency, health translation, interpreters, immigrant health care, culturaly sensitive healthcare, and challenges for the healthcare worker.

Free tutorial for medical Spanish, including recorded dialogues.

This site is presented as a free medical Spanish immersion, with vocabulary including greetings, history, examination, and everyday speech, all with translation and audio. It is designed to be helpful for a variety of medical personnel. In addition to introducing Spanish medical terms, this site will hopefully improve fluency and even cultural competency.

Each dialogue consists of a few statements from the patient, the patient's family, and healthcare providers. Click to hear my voice and pronunciation. Then, repeat aloud everything you hear. When listening to Spanish medical phrases, feel free to use the pause button, and, of course, replay the recordings when needed.