PhD, defended 2020

Title: Remote interpreting in healthcare settings: A comparative study on the influence of telephone and video link use on the quality of interpreter-mediated communication‚Äč


In a relatively short span of time, technological developments have greatly impacted the ways in which we communicate. In interpreting, the introduction of technologies enabling Remote Interpreting (RI) has profoundly changed, and continues to change how interpreting services are being delivered. Whereas dialogue interpreting was traditionally carried out face-to-face (F2F), contemporary communication channels allow for different types of distance interpreting by means of telephone (Telephone Interpreting, TI) or video link (Video Interpreting, VI). At the same time, in response to the increasing immigration flows, RI is increasingly being welcomed to meet the growing demand of interpreting services. Especially in medical settings, RI enables access to healthcare and improves cost efficiency. Whereas clinical research on remote healthcare interpreting has reported predominantly positive results concerning its use, empirical research on RI in conference and business settings, as well as in legal contexts, has demonstrated that the conditions in which interpreting takes place can affect the quality of interpreter-mediated communication. However, so far, in healthcare settings, no qualitative comparison of different interpreting methods together (F2F, TI and VI) has been carried out.

This thesis aimed at bridging this gap by investigating the effects of the remote conditions on the quality of interpreter-mediated healthcare communication. Central to the research design was a corpus of three series of simulations, each consisting of three simulated interpreter-mediated doctor–patient encounters. In each series, three different interpreting methods were used: F2F, TI and VI. The simulations (nine in total) involved three different interpreters, a gynaecologist and a simulation patient. The sessions were video recorded, transcribed and annotated. First, quantitative analyses of miscommunication (message equivalence issues and interactional issues) and of interaction management were performed. The quantitative analyses served two purposes: (1) to identify potential relationships between message equivalence issues and interactional issues and (2) to establish the influence of environmental and technological factors. Subsequently, the quantitative data were submitted to comparative, qualitative analyses. The results of the quantitative and qualitative analyses were triangulated by the findings from the participants’ quality assessment, collected by means of thirty post-simulation interviews.

The quantitative analyses show a large variance in frequency of the occurrence of miscommunication at the levels of message equivalence and interaction, as a result of which, no direct influence of the use of the remote interpreting methods on the quality of communication could be demonstrated. Despite this variance, the qualitative analyses indicate that, across the three series of simulations, there were salient differences between the RI methods and the F2F method, in the ways in which miscommunication occurred and interaction was managed by the participants. Since the frequency of miscommunication seemed to be more closely linked to average turn duration than to use of the remote interpreting methods, the impact of the remote conditions on the quality of interpreter-mediated communication can be considered primarily indirect. Nevertheless, a direct influence of technological factors in the form of sound quality issues and loss of internet connection was observed. However, the impact of technology was largely determined by the interaction management of all participants, in particular the interpreter. Therefore, apart from the appropriate technological and environmental conditions, the successfulness of the interpreter-mediated communication depended greatly on the competences of the individual interpreters, as well as on the interactional behaviour displayed by the primary participants (i.e., the doctor and the patient).

Notwithstanding the challenges that RI may impose on the quality of interpreter-mediated communication, many of the quality-related factors can be manipulated. The insights in the potential threats of RI methods on communication quality offered in this thesis, are highly relevant for all users (interpreters, healthcare providers and patients) to anticipate and overcome potential communication problems. Moreover, these insights are extremely useful for interpreter trainers preparing their students for today’s labour market, in which the use of RI methods will continue to increase. Finally, gaining knowledge of the potential challenges that RI methods pose for ensuring communication quality is of considerable interest for other stakeholders involved, such as dedicated platforms providing RI services and healthcare policy makers.


Remote interpreting, Telephone interpreting, Video interpreting, Community interpreting, Healthcare interpreting


PhD supervisors: 

Dr. Aline Remael, University of Antwerp

Dr. Jim Ureel, University of Antwerp

Dr. Sabine Braun, University of Surrey