Introduction

Communication is a cornerstone to the safety and quality of medical care delivery.1 Effective communication facilitates the formation of trustful patient-healthcare provider relationships, thereby enabling better understanding of patients’ perspectives, concerns, and expectations. 2, 3 On the other hand, unresolved linguistic and cultural barriers can lead to the misunderstanding of symptoms, incorrect diagnosis, reduced patient compliance and satisfaction, and poor health outcomes.4-7
Communication barriers disproportionally affect populations with limited language proficiency (LLP) which include official language minorities, Indigenous people, and migrants8-10 Medical interpretation services have been shown to be effective in bridging cultural and linguistic gaps for LLP patients.11 The use of professional medical interpreters is considered the highest standard in medical interpretation. Studies have shown that when caring for patients with language barriers, the quality of clinical care is improved and the number of medical errors is reduced if professional medical interpreters are used.7 However, several studies have reported relatively low rates of use of face-to-face professional interpretation services (i.e., 33% - 42%), which could be related to limited service availability, cost, and time inefficiency.12-17
When professional interpreters are not available, ad hoc interpreters, or friends and family members accompanying the patient, are often asked for translational support.8 There are several disadvantages to this. Ad hoc interpreters include people recruited through hospital-wide intercom announcements, other patients in the waiting rooms, or hospital employees. Both ad hoc interpreters and friends or family members are often untrained individuals whose language proficiency and dialect remain unverified prior to recruitment. There is evidence to suggest that when compared to no interpretation service, the use of untrained interpreters leads to greater miscommunication, an increased number of medical errors, and reduced quality of care.8, 18, 19 There is also a major issue of confidentiality and lack of ethical training associated with using untrained interpreters.8
Interestingly, studies from multiple countries have reported an increase in the diversity of incoming trainees across medical programs.20-23 For example, at McGill University (Montreal, Canada), 22 to 36% of students admitted to medical school in the last three years declared their mother tongue to be a language other than English or French (the national languages of Canada).24 Such a heterogenous population of multilingual students with medical training are a valuable resource and could potentially bridge the gap in medical interpretation. Recruitment of medical student interpreters could mitigate the challenges associated with accessing professional interpretation services or relying on untrained native speakers. Medical students are proficient in medical terminologies, are familiar with the structure of healthcare institutions, are available on-site, and are trained in ethics and the intricacies of medical communication. As some healthcare institutions are exploring the role of medical students as medical interpreters,15, 25 more knowledge of the current evidence regarding the use of medical student interpreters is required to address these issues, specifically the current landscape of medical student interpretation, the existing interpretation training programs, as well as the benefits and risks associated with this practice. To address these knowledge gaps, a scoping review was conducted.