CMI Cultural Competency and Health Literacy 2 — Questions and Answers
Question 1: When a provider uses the phrase 'take this medication twice a day,' a culturally competent interpreter should be alert to:
- Whether the provider means morning and night or another schedule (Correct answer)
- Whether the medication is available in the patient's home country
- Whether the patient has insurance to cover the medication
- Whether the medication requires refrigeration
Correct answer: Whether the provider means morning and night or another schedule
Cultural and practical interpretation of 'twice a day' may vary; interpreters should ensure the instruction is unambiguous and culturally understood.
Question 2: A patient appears to be withholding symptoms because discussing certain body parts is taboo in their culture. The interpreter should:
- Report this observation to the provider as a cultural communication barrier (Correct answer)
- Urge the patient to speak freely regardless of cultural norms
- Pretend not to notice and continue interpreting
- Interpret for the patient's family member instead
Correct answer: Report this observation to the provider as a cultural communication barrier
Flagging cultural communication barriers to the provider helps ensure comprehensive clinical history-taking.
Question 3: Which of the following is an example of a low health literacy indicator that a medical interpreter should recognize?
- A patient who asks many detailed questions about their diagnosis
- A patient who nods repeatedly but cannot correctly repeat back instructions (Correct answer)
- A patient who brings a written list of symptoms
- A patient who requests a second opinion
Correct answer: A patient who nods repeatedly but cannot correctly repeat back instructions
Appearing to agree without demonstrating understanding is a common low health literacy indicator that may lead to non-adherence.
Question 4: A provider uses a highly technical explanation for a diagnosis. The interpreter should:
- Simplify the provider's explanation independently before interpreting
- Interpret accurately and, if needed, suggest the provider use simpler language (Correct answer)
- Ask the provider to use a different interpreter more familiar with the topic
- Summarize the key points only
Correct answer: Interpret accurately and, if needed, suggest the provider use simpler language
The interpreter renders the message accurately and may professionally suggest plain language if patient comprehension is at risk.
Question 5: In US healthcare settings, which federal law most directly mandates language access services for patients with limited English proficiency?
- HIPAA
- Title VI of the Civil Rights Act of 1964 (Correct answer)
- The Americans with Disabilities Act
- The Affordable Care Act
Correct answer: Title VI of the Civil Rights Act of 1964
Title VI prohibits discrimination based on national origin, which courts have interpreted to require language access in federally funded programs.
Question 6: A culturally competent medical interpreter recognizes that eye contact norms vary across cultures. The interpreter should:
- Maintain direct eye contact with the provider at all times
- Adapt personal eye contact to avoid discomfort while ensuring all parties communicate effectively (Correct answer)
- Instruct the patient to maintain eye contact with the provider
- Avoid eye contact with all parties to appear neutral
Correct answer: Adapt personal eye contact to avoid discomfort while ensuring all parties communicate effectively
Being aware of cultural eye contact norms and adapting accordingly supports respectful and effective communication.
CMI Cultural Competency and Health Literacy 2
When a provider uses the phrase 'take this medication twice a day,' a culturally competent interpreter should be alert to: