National Certification of Health Care Interpreters   

What has the NCIHC done so far?

In 2004, with the support of the US Office of Minority Health, the NCIHC developed and published the National Code of Ethics for Interpreters in Health Care.  

In this document, the NCIHC identified three steps that needed to occur at the national level in order to standardize expectations and raise the quality of health care interpreting.  These steps were: 1) to create and build support for a national Code of Ethics; 2) to develop nationally accepted Standards of Practice; and 3) to create a national certification process.

Immediately following the work on the Code of Ethics, funding was secured from The California Endowment and The Commonwealth Fund to complete the second step in standardizing the health care interpreter profession – the development of national standards of practice. 

In 2005, after extensive public input from stakeholders around the country, the National Standards of Practice for Interpreters in Health Care were published. These documents have been endorsed or supported by over 140 stakeholder groups, including interpreter associations, governmental agencies, language companies, accreditation organizations, professional medical associations, and health care institutions.

As the NCIHC engaged in the development of the National Code of Ethics and Standards of Practice, it became evident that in order to create a level playing field for national certification the quality of interpreter training and education had to be addressed.  Consequently, the NCIHC added an additional step prior to national certification – the development of national standards for health care interpreter training.

Acknowledging the increasing pressure at the state and national level for certification, the NCIHC began to seek funding to simultaneously address the development of standards for interpreter training and certification.

Building on initial conversations held at the 2005 MMIA conference, the NCIHC took the following actions:

•  organized forums to initiate a dialogue on the complexities of a national certification process at conferences in Seattle, Boston and San Jose;

•  sought funding to organize additional open forums as well as expert panels to be held around the country to identify the key questions and next steps for national certification. Several funders have expressed great interest in this work and we expect to be able to secure funding in the next few months;

•  began to seek funding to simultaneously develop national standards for interpreter training, a step that we believe is a critical pre-requisite to any national certification process.

What are the principles that guide the development of national certification?

The following principles outline the spirit in which all the work of the NCIHC, including discussions around certification, has and should be grounded. They ensure that such discussions and any resulting certification will be conducted in a fair, equitable, inclusive, and transparent manner.

• Certification as a complex undertaking. The NCIHC believes that the development of a national certification process goes beyond the creation of a test. We believe that certification is a complex process in any field but especially so in a field in which the content is steeped in difficult linguistic and cultural issues. While we wholeheartedly agree to the need for scientifically rigorous assessment methodologies, we still have much to learn about creating an equitable and fair process that will allow all competent interpreters, regardless of background, to be able to demonstrate the knowledge and skills they possess as interpreters, and that will not result in high numbers of good interpreters failing simply because of a certification tool’s inability to adequately assess knowledge and skills across cultural and linguistic differences.
• Inclusiveness and consensus building.The NCIHC believes that any effort to develop national standards or assessment must be a collaborative, consensus-driven process in which all stakeholders have the opportunity to participate. In order to address the complexities of certification in a respectful manner and to ensure the transparency of the development process, we will need to find a variety of ways to include the voices of as many stakeholders as possible, especially those who do not have the opportunity to participate in large national meetings
• Neutral leadership. The emerging health care interpreting field incorporates many stakeholders: patients, interpreters, health care institutions, advocates, interpreter associations, language companies, non-profits and for-profits. It is imperative that the national dialogue be led by a neutral party whose primary interest is the well-being of those in need of interpreting services. Each entity involved must make known the nature of its interest in certification, including potential conflicts of interest and/or benefits that it may accrue as a result of the work. In order for a national certification process to be credible, care must be taken to avoid even the appearance that any vested interest has unduly influenced the development process.

What questions need to be answered?

The NCIHC feels that a national dialogue to build consensus around national certification must address the following key questions:

• What have we learned from health care interpreter assessment/certification efforts undertaken at local levels in the US as well as in other countries
• What have we learned from existing certification processes such as for sign language and court interpreters?
• Is there a research agenda in which we need to engage prior to developing national certification?
• What are the potential benefits as well as downsides of national certification?
• Who would potentially benefit from national certification and how?
• What conditions and resources need to be in place nationally?
• Where would be a logical “home” for a national certification for healthcare interpreters?
• What are the challenges in developing a reliable and valid certification process, including a methodologically sound instrument and grader reliability?

By addressing these questions and others that will continue to arise, the NCIHC intends to provide leadership in creating a national roadmap for certification with the involvement and buy-in of stakeholders in the field. 

It is our ultimate goal to arrive at a well-conceived certification process that is research-based, valid and reliable while remaining respectful of the many cultural and linguistic groups represented in this profession.

To read the latest updates and developments, visit our certification updates page.