Anatomy of a conversation: Voices of dual-role medical interpreters

Interpreted communication in the medical domain is inherently complex, but due to the cost of professional interpretation in outpatient settings, qualified bilingual speakers or even untrained interpreters are common in the United States. With its focus on the use of language, conveyed meanings, and construction of social relationships, linguistic pragmatics provides a useful framework to analyze interpreted communication. The data comprised 57 video-recorded encounters between Spanish-speaking patients and family medicine clinicians, mediated by Spanish-speaking medical personnel who also served as interpreters. This study applied the framework of voices (forms of talk) to examine the roles of untrained, dual-role interpreters with Spanish-speaking patients in medical conversations. A grounded qualitative analysis revealed communicative functions and discourse strategies within four different voices. The analysis further identified recurring ways that speakers frame meaning to align with both doctors and patients. The findings elucidate the language mediators' dynamic medical, linguistic, and interpersonal roles, highlighting the importance of context in health communication practice. The excerpts from selected interactions illustrate the complex collaborative work that these language mediators accomplish, including professional teamwork, explaining medical facts, creating natural conversation, and fostering human connection. The findings can be applied to training dual-role interpreters for specific contexts in outpatient settings.