12
Texas Association of Healthcare Interpreters and Translators
A
round 300 million years ago, the Earth
was a simple place. The fragmented
continents that span the planet today
did not exist. Pangaea, a single super continent
reigned supreme, its borders bound by the cool
waters of a global ocean. 200 million years ago
Pangaea began to split into many continents,
each riding atop massive tectonic plates. Over
the millennia, each of these continents developed
independently, forming unique ecosystems,
weather patterns, flora and fauna, and eventually
hosting populations of humans who multiplied
and diversified, spreading across our little oasis
in space. Now, in an age of globalization
and massive cultural integration, countries like
the United States are feeling rumblings along
communication fault lines much like those
generated by the strained movements of the
Earth’s crust. When communication strains under
cultural pressures in health care, the results can
be tragic; however, when interpreters and health
care providers appreciate one simple contrasting
factor in cross cultural communication, disaster
can be avoided.
The culture of the American health care system,
otherwise known as biomedical culture, is quite
unique in that its cultural style of communication
is fundamentally incompatible with that used by
95% of Limited English Proficient (LEP) patients
in the United States. And while patients and
health care providers come together with the
shared goal of addressing illness, a fault line
in communication occurs as the cultural forces
on both sides clash, at times with quite volatile
results. Professionals recognizing the contrasts
between these styles can thus be prepared
to reduce the impact of their coming together
and dramatically improve the quality of each
interpreted encounter.
Every person on the planet has the ability to
communicate using two primary communication
styles: high context and low context. Cultural
groups tend to show a strong preference for
one or the other when interacting with others in
the community.
Understanding derived from
high context
communication
is dependent on how, what, why,
when, and where something was said and who
the conversation was between. The vast majority
of Earth’s non-English-speaking population
is made up of high context communicators.
Have you ever communicated to a close friend
with nothing but a look? Yes? Then you have
experienced high context communication. Your
friend understood the meaning of the look from
the context of the situation in which it was given.
Understanding
low context communication
on
the other hand, is dependent on the actual words
used and the logical progression of the dialogue
in the conversation. While Germans are famous
low context communicators, it is the dominant
style for most English speakers, especially in
important situations. The courtroom is the home of
the lowest context dialogue typically seen. Those
who speak must answer only the question being
asked and must avoid adding contextual details if
not specifically invited to do so.
When a doctor is logically working through
a diagnosis, she is following a process built
around low context communication and can
By RYAN FOLEY, MANAGER OF TRAINING AND ASSESSMENTS DIVISION, MASTERWORD SERVICES
THE
RUMBLING
OF
COMMUNICATION FAULT LINES
