It is recommended that parameters be established for emergency service requests to ensure the quality of services provided and interpreters’ well-being. Ad2(F,30) stressed the importance of prioritizing the urgency of service requests more efficiently in order to better meet users’ actual needs: “The problem doesn’t have to do with processing urgent requests. The problem occurs when people make emergency requests when no actual emergency exists.” Interpreting services can also be requested without notice—from a police station or hospital, for example.

The information included with the service request varies depending on the source of the request. Direct requests from a hospital department provide more information than those from an appointment centre, explained Ad1(F,40). The reason for the consultation and the name of the department making the request are examples of the type of information that could help banks of interpreters be more efficient, enabling them to contact the best interpreter for a given job based on individual skills and preferences. As the participant cited above explained, “There are interpreters who don’t want to work in certain situations—abortions, for example—but since we aren’t provided with any information on the type of consultation, we don’t have much leeway.”

Similarly, it would also be helpful if interpreters were given some basic information about the service request when the appointment is being set up. If they knew more about the context of the interview, interpreters could better prepare by reviewing any specialized terminology, for example, as explained by In8(F,60), who always makes a point of finding out the context of an interview beforehand.

With respect to the logistics of setting up appointments, several interpreters complained that when interpreted interviews are set up by telephone, practitioners are more casual about cancelled or changed appointments. In2(F,30) said that she was often not informed when interviews were moved forward, postponed or cancelled:

Another thing we’ve noticed is that they sometimes don’t respect appointment times for remote interpreting. For example, if we’re supported to be ready to interpret from 1:00 pm until such-and-such a time, they’ll either be late or ahead of schedule. […] They sometimes forget that they’ve reserved an interpreter or, when the user arrives, they decide their French is good enough and forget to notify us. When that happens, you just have to wait. And when you call the bank of interpreters to find out what’s happening, they’ll tell you that the practitioner completely forgot to inform you.

In the case of face-to-face interviews, it is rare that practitioners forget to cancel because, if they do, they are required to pay the interpreter the equivalent of two hours’ work to compensate for travel time and lost income. Quebec interpreter banks have no such rules, however, for telephone interpreting.

According to a majority of participants, the practice of briefing interpreters is a rare occurrence. In fact, several participating practitioners had never even heard of it. In2(F,30) told us that interviews interpreted over the telephone generally start as soon as she picks up, with no preliminary remarks at all:

The doctor is familiar with the case because he has already spoken several times with the user through an interpreter, but we just got there. It’s like day 1. We have no idea what has happened before or what will happen after. We’re just dropped right into the middle of things. We can’t interpret properly under those conditions.

This impression that interpreters can have of being “thrown into the deep end” is particularly disquieting in the case of RI. Unlike interpreting in person, V-RI or T-RI requires additional support to compensate for the interpreter’s virtual presence. This point is discussed in the following sub-section.

According to participants, it is rare that the practitioner and the interpreter will take a few minutes after a remote interview to talk about how it went. Aware of the importance of debriefing, Pr6(F,30) explained why she found it harder to debrief at a distance than face-to-face:

It’s not always easy to say to an interpreter, “I don’t like it when you do such-and-such a thing.” Especially if you want to maintain a good working relationship with that person. […] I think it would be a good idea [if debriefings were required] because, in general, it’s a step that’s neglected.

Pr6(F,30) also mentioned that having someone act as an intermediary between practitioners and interpreters greatly facilitates the debriefing process:

It was made clear that we could send an email to [the administrator] if there were technical problems or if we had told the interpreter about an aspect of their behaviour that we didn’t like and the situation hadn’t been corrected, or simply if we weren’t comfortable talking directly to the interpreter about a more sensitive issue. That’s something I’ve done in the past. It’s a lot easier to do through an intermediary.

This practitioner also pointed out that this type of procedure could also protect practitioners’ working alliance with their interpreters.

Another practitioner, Pr8(F,30), explained that it was simply impossible for her to do a debriefing in the context of her practice because she met users in their homes where she then conducted a conference call with the interpreter. She suggested an alternative, saying that it could be the responsibility of the administrator to initiate the dialogue separately with practitioners and interpreters. This would encourage practitioners to express any problems experienced during the interview, even if they did not initially consider them to be particularly important.

Clarifying the availability of interpreters, practitioners and administrators would facilitate the appointment-making procedure and help service operations run more smoothly.

The majority of interpreters are self-employed, working part-time on call, juggling other activities at the same time. As Ad2(F,30) explained, they are usually available in the late afternoon or evening to deal with last-minute requests for interpretation services. Practitioners’ schedules often require that the interpreted interview take place on the same day the request was made, however, and their standard hours are from 8:00 am to 4:00 pm.

Practitioners often go through a bank of interpreters to send an urgent message to a user. The remotely interpreted interview therefore involves two other people: the interpreter and the user. As Ad2(F,30) explains, however, it can be difficult to meet such requests—the user might not be home when the interpreter calls or may have questions that the interpreter cannot answer without the practitioner’s input.

The service request may also be made directly to the interpreter, which makes it difficult for the interpreter to refuse an urgent request, even if their immediate situation is not ideal for RI—for example, if they are driving or in a location where confidentiality may be compromised.

From the point of view of the banks of interpreters, their business hours may conflict with the time of requests. As Ad1(F,40) explained, if a request is made at 3:00 pm, it may not be picked up as staff usually stop work at that time. Pr1(F,50) said that the bank of interpreters she works with closes at 4:00 pm, which makes it difficult to arrange follow-up appointments with users who go to school and are generally only available between 3:30 and 5:30 pm.

Pr3(F,50) mentioned that it would be a good idea for hospitals to better publicize the availability of telephone interpretation services, as most practitioners are still unaware of this option. She also suggested that banks of interpreters offer training in accessing the service and that a concise information document be widely distributed.

For example, when she started using RI services, Pr2(F,30) didn’t know that it was up to her to initiate the conference call:

I soon understood that the interpreter and the parent would be on the line at the same time, and that it was my responsibility to make the call. So I had to learn how to do that very quickly.

In9(F,30) also mentioned that her establishment would sometimes omit to unlock the conference call function, which could result in the interview being cancelled.

Finally, Pr6(F,30), the only practitioner who mentioned having received training in all types of interpreted interviews, emphasized how useful that training had been.

Pr8(F,30) told us that she would soon be leaving her current position and was worried that the expertise she had developed in the area of interpreted interviews would be lost when she left the unit. Although she felt it was important that the other members of the team be able to benefit from her experience, no one in a management position had approached her on this subject.

The race against the clock that characterizes so much of our daily lives—the medical profession being no exception—conflicts with the short pauses recommended in the literature on PSI and supported by all the participants in our study, practitioners and interpreters alike.

Pr6(F,30), who has access to face-to-face interpreting services, explains that she does not recommend interpretation by telephone for interviews that will be longer than 30 minutes.

When describing an interview he interpreted over the telephone that lasted several hours, In1(M,40) told us how exhausted he was and how he had to find ways to avoid falling asleep during the interview:

[They] told me, “I don’t know how you’re going to have time to breathe today!” There were 12 people who were all sick. I started at 8:00 in the morning and went until 2:00 in the afternoon. The patients were talking to different doctors, but I was the only interpreter. […] I was absolutely exhausted. I was so tired that I had to jump up and down in the room where I had shut myself in with the telephone just to keep myself awake.

The challenge of limiting remote interviews is made even more difficult by the fact that they generally require more time, as In10(F,30) explained:

Sometimes we need more time because the practitioners aren’t able to reassure the client over the telephone, whereas when they are present in person, they introduce themselves and reassure the user. […] Sometimes you ask [the practitioner] questions and you can tell that the answer is completely beside the point; it’s like they’re not there or don’t understand. It’s difficult for me to take time with them.

It is more difficult to build a working alliance in the context of remote exchanges, which tend to generate relationships that are more utilitarian, brief and impersonal. When Pr6(F,30) mentioned these problems, she also suggested that the first contact with the user be in person before moving on to RI.

Even though V-RI allows participants to read facial expressions and provides a more complete social presence than T-RI, it is still harder to establish a good working alliance on-screen than face-to-face. In fact, many practitioners are reluctant to use V-RI for sensitive psychosocial interventions. However, the COVID-19 pandemic is forcing a significant number of practitioners to use this modality on a regular basis and thus to become accustomed to it.

Pr1(F,50) raised the issue of equality underlying the choice of interpreting method. She stated that it is important to offer allophone users the same service as other users: “In my opinion, if we wouldn’t do it in French, we shouldn’t do it in translation. First appointments are not done over the telephone.”

Several practitioners and interpreters spoke about the communication challenges involved in talking about medication during medical consultations. When dealing with people who do not speak the language of use, it seems to be easier to talk about medications, side effects and dosages in person, as interpreters can ask users to bring their medications with them to the consultation. Barriers created by language and the poor literacy skills of certain clients make it more difficult to obtain information on medication from a distance.

Pr4(F,40) explained that she tries to remedy this situation by obtaining a list of the patient’s medications from the pharmacy ahead of time in order to simplify discussions during the interpreted interview and reduce the risk of medical error.

Several participants raised the importance of the user being alone in a quiet space with no distractions during the interpreted interview. It appears that this is not always the case: the user may be surrounded by family members or in some other very noisy environment. Both of those factors can affect the interpreter’s concentration and even affect the quality of the interpretation.

If the user is in an inappropriate space, family members can get involved in the conversation with the interpreter and interfere with the intervention, potentially affecting the quality of the consultation, as In6(F,50) explains:

I was doing a video conference with a doctor, a nurse [and a user] to discuss surgery scheduled for the next day. Whenever the doctor asked a question, it was the patient’s husband who answered. I asked to speak to the woman directly, but the phone was on speaker. While I was speaking, I could hear someone whispering to the patient. The next day, when I came in for the operation, the lady hadn’t received the same information I had given her; her husband had given her the wrong instructions by talking in her place. As a result, she was not prepared for the surgery, even though I had provided the correct instructions.

RI tends to be more expeditious, with less attention paid to introducing the interpreter (i.e., explaining the process and confidentiality). Practitioners are inclined to cut to the chase:

Over the telephone, it’s like doctors are in a hurry, even though the user is right beside them. They want you to interpret what they’re saying, but they don’t give you the time to express yourself. All they say is, “I’m with someone whose name is Mr. X. I am Dr. Y.” And then you introduce yourself: “I’m the interpreter. My name is Mr. Z.” And you start interpreting. But when everyone is in the same room, you have more time… maybe two minutes or five minutes: you introduce yourself, they introduce themselves, and you have a chance to talk about prescriptions, confidentiality and all the rest.

In1(M,40)

Skipping over these introductions does little to foster users’ trust. They might be more reluctant to divulge certain important information for fear, for example, that the interpreter will pass the information on to other members of their community.

Comments made by In1(M,40) illustrate the kind of confusion that can arise when everyone talks at the same time during interviews that are being remotely interpreted:

[This goes on] until I say, “No. You need to do this in an organized way. First one talks, then the other. If you talk at the same time, I can’t interpret what you’re saying.” But when you’re in the same room, it’s easy to say to everyone present, “Ok, everyone has to take turns speaking.” When you’re on the phone, you can’t see anyone; you don’t know what’s going on at the other end. You have to try to integrate yourself into the… situation they’re creating. That’s a lot harder.

This feeling of being overwhelmed and not being able to find their own place is particularly acute in a legal/courtroom context, when everyone’s words overlap or when there is a delay caused by the camera (when the hearing is being held in two separate rooms or when the interpreting is gesturing to take a turn but the camera is focused on another interlocutor).

Practitioners can also find it difficult to interrupt one of the other participants in the interview in order to intervene. Such interjections may be perceived as abrupt, rude or aggressive, as Pr6(F,30) explained:

When everyone is there in person, it is easier to stop the interpreter and say, “Just a second… there’s something I want to reformulate.” Since the client sees what we’re doing, it maybe seems less aggressive than on the phone. […] But since there’s no visual or non-verbal feedback during a conference call, I don’t take a chance. I let the interpreter translate what I said, even if it takes some time before I can provide feedback, and then I re-explain or say what I wanted to.

Sometimes the people involved in a remote interview forget the predetermined signals, or there is confusion about how to know when someone has finished speaking (unlike during face-to-face conversations). Pr6(F,30) explained how the use of communication signals differs in both contexts:

In person, we have visual contact, so feedback is easier. We don’t have to stop the interpreter, say something, and start again. We can often see at a glance that the speaker hasn’t finished. Being able to see each other makes everything so much easier, more natural, more fluid than over the telephone. So it’s important that we use artificial methods to indicate that we have finished speaking during a telephone interview.

Although it is generally recommended that practitioners break up their remarks into segments (called “chunking”), the experience of Pr6(F,30) has proved otherwise. She has noticed that during remote interviews, if she slows down her rate of speech to give the interpreter time to assimilate the information she is communicating, the user will generally not wait for her to continue. Instead, they will take advantage of a strategic pause to ask questions or make remarks. She has therefore, somewhat paradoxically, gotten into the habit of segmenting her speech less in order to make things easier for the interpreter and keep the conversation on track:

I realized that segmenting my remarks over the telephone made things a bit more difficult, in that it encouraged users to provide lots of feedback, like “Yes, but I have a question…,” or “Yes, but what about…” That happens in person as well, of course, but it’s easier to handle. You can use non-verbal cues to say, “Yes, I know, but I haven’t finished.” They can see by your body language that you have more to say, so they don’t ask as many questions.