Accuracy and Communication Styles - How can healthcare interpreters navigate between the two safely?


Connecting Cultures would like to thank Rosanna Balistreri for contributing this article!

As part of this year’s annual educational conference by the California Healthcare Interpreting Association (CHIA), Rosanna Balistreri, former CHIA Board President and current owner of REACH-reaching diversity, will be presenting a topic that can be fairly complex and controversial – Interpreting Across Communication Styles, Paralanguage and Body Language

Miss Balistreri frames her presentation on a study conducted in 2003 by the Geneva University Hospital named “Improving Patient-Provider Communication: insights from interpreters”.  The study evaluates interpreters’ point of view and experiences in relation to misunderstandings and communication breakdowns between patients and providers.

The Geneva University study uses the experience of nine professional medical interpreters working at the University Hospital’s general medicine outpatient clinic, Policlinique, to identify potential patient-provider cross-cultural communication barriers and the importance of trained interpreters to ensure effective communication.

The study’s findings, given the feedback received from the nine interpreters, highlights three main areas where patient and providers are likely to differ:

  1. Ideas about patient’s health problem
  2. Expectations on the actual clinical encounter
  3. Verbal and non-verbal communication styles

Based on the premise of this study, Miss Balistreri centers her presentation on verbal and non-verbal communication styles, offering an overview of communication differences across cultures.  She further challenges the audience by juxtaposing principles that are traditionally introduced in healthcare interpreting training, such as accuracy and fidelity to register, to the linguistic adaptations that interpreters may make to align providers’ message with patients’ communication style.

In a nutshell, Miss Balistreri’s presentation lends itself as a dynamic forum where participants can discuss and debate:

  1. The unique position that interpreters hold in the eyes of providers as “experts of communication differences”.
  2. Interpreter’s dilemma between accuracy, completeness and mediation of cross-cultural communication differences to support the patient-provider alliance.


Improving patient–provider communication: insights from interpreters, Patricia Hudelson, Oxford University Press, 2005

Improving communication between physicians and patients who speak a foreign language, Alexander Bischoff, Thomas V Perneger, Patrick A Bovier, Louis Loutan, and Hans Stalder, British Journal of General Practice, July 2003 541 

ABOUT THE AUTHOR: Miss Balistreri is a linguist and a trilingual speaker of Spanish, Italian & English.  She has dedicated most of her professional and academic background to translation studies, applied linguistics, and second language learning/acquisition.  She has lived in Italy, Argentina, England and Spain.

In 2010 & 2011, Miss Balistreri served as President of the California Healthcare Interpreting Association, a not-for-profit organization that advocates for the professional advancement of healthcare interpreting and language access.  She is a Subject Matter Expert (SME) for the Certification Commission for Healthcare Interpreters (CCHI), a member of the National Council on Interpreting in Health Care (NCIHC) Standards & Training Committee, and she co-chairs the NCIHC’s Language of Lesser Diffusion (LLD) Workgroup.

Currently, Miss Balistreri teaches at Cal State University Fullerton in the Translation and Interpreting Certificate Program where she also serves as a member of the Translation & Interpreting Education Advisory Board.

She is the owner of REACH-reaching diversity, a consulting business that she founded in 2008 to provide cultural & linguistic services targeted to healthcare and mental health to enhance quality of patient and client-centered service delivery, increase patient safety and maximize customer satisfaction.