Testing, Testing…

The interpreters in my department are scheduled to take their written exam for national certification next week, and over the last several weeks I’ve been holding test prep sessions for them.  (You can see our original prep plan here.) By far, what they liked the most (besides the stickers and candy prizes, of course) were sets of multiple choice test questions for the categories Manage an Interpreting Encounter and Interact with Other Healthcare Professionals.  There are some sample questions in the official CCHI Handbook, and after we went through those, I decided to write up some of my own, based on my experience writing official exam questions a couple years ago.  They haven’t undergone the rigor that real test questions are subjected to, but they can be the start to a conversation about how we apply ethics and standards to decision making.  Some of you might be thinking of putting together a study group, so I put together some very basic tips for making up practice questions, since they were so popular with my team.

• Start with a scenario that poses a problem, or something that seems like a problem.  Someone yells obscenities.  Someone uses terminology the interpreter doesn’t understand.  A patient asks for your advice.  Two people are having a side conversation.  Someone says something disrespectful to the doctor.  Someone uses terminology the patient doesn’t understand.  Someone asks you to do something that’s part of a nursing role.  You can throw in something to elicit an emotional reaction, and this helps us remember to focus on the issue at hand, so we can resolve it with our ethical principles and standards of practice, rather than reacting to emotion.
• When you write answers, there can be only one right answer.  No trick questions.  In my experience writing test questions, you have to make sure that there is just one right answer, and you have to defend it.  In our prep sessions with my made-up questions, I most enjoyed the interpreters picking apart each possible answer, and defending why each was right or wrong.  Sometimes that means going back to the original scenario and adding a detail so that only one answer can be right.
• When you write answers, there is usually at least one obviously wrong answer.  This is what we now call the “Excuse yourself to the bathroom” answer.  It’s so obviously wrong, you can rule it out from the beginning, and it can be fun to come up with the one obviously wrong answer.  It also provides some laughs during test prep, which we don’t usually think of as fun.

Here’s a practice test question I wrote, with the multiple choice answers:

A patient on the unit is going to have to administer IV antibiotics to himself after he goes home. You just finished interpreting the pharmacist’s instructions to the patient, and after leaving the patient’s room, the pharmacist asks you if you think the patient understood all of the instructions. What is the best way to resolve this?

a) Tell the pharmacist that the patient would be able to let her know, and offer to go interpret that question for her

b) Tell the pharmacist that you feel confident that the patient understood, since nobody has ever misunderstood your interpretations in the past

c) Tell the pharmacist that it’s not your job to give your opinion

d) Tell the pharmacist that since the patient didn’t ask any questions, that must mean that she understood everything.

When you’re working through these, make sure you have a clear idea if there is a problem to be resolved, and what that problem is.  When we think about a problem, remember that usually we’re looking for something that makes us concerned about clear communication, or role boundaries.  Sometimes there is no problem, even though it might seem like there is:

You are interpreting for a patient and his medical care team. The patient shouts, “Get me an interpreter who knows what he’s doing!” What is the best action to take?

a) Interpret exactly what the patient says to his medical care team.

b) Tell the patient that you know what you’re doing, and don’t interpret what he said, since it doesn’t have anything to do with his medical care.

c) Tell the medical care team that the patient isn’t making any sense and doesn’t know what he’s talking about.

d) Excuse yourself to the restroom.

There is nothing in this scenario that makes me concerned for clear communication or  my role boundaries.  It’s uncomfortable, sure.  But that’s what our ethical principles and standards of practice are there for: To help us decide what to do when we’re in a jam.

You can take these kinds of scenarios and switch up the details to make more questions.  Not gonna lie–they take a while to write.  I probably spent a total of two workdays coming up with 16 questions.  But after the first 8, the next set was much easier to write.  And you don’t have to write 16 exam questions.  How about trying to write just one?  You’re welcome to use mine to get you started!

Of course, there are official practice tests that you can buy online, and making up your own questions is not a substitute for that.  I also made up some practice materials for healthcare terminology, which I can share in a future post if you guys want, but they were nothing fancy, just some timed matching games, and some Jeopardy-like games based on the material in our Medical Terminology for Interpreters workbook.

When you’re deciding how to prep for your exam, you’ll want to start by looking at the test content outline and doing some self reflection: What’s your weakness? Medical terminology? Answering multiple choice questions? Using ethics and standards to resolve problems?  Then move from there, and dig in.

Oh, and the right answers to the questions above?  I’ll leave that for your homework, and you can always feel free to add your thoughts in the comments.  Happy test taking, and good luck, y’all!