Identity and Coping: Deaf Sign Language Interpreters and Secondary Traumatic Stress

This article describes the results of a mixed methods study with 47 Deaf sign language interpreters (D-SLIs) and their experiences with secondary traumatic stress (STS). By replicating AUTHOR AND AUTHOR (2020) research, this study contributes data based on the unique experiences of Canadian and American Deaf interpreters and allows us to contrast the findings to the original study with non-Deaf interpreters (ND-SLIs). The findings reveal that the majority of D-SLIs did not experience clinical levels of STS, compassion satisfaction, anxiety, or burnout. In looking at the results, one-third of the D-SLIs showed comparable levels of STS and compassion satisfaction but less burnout than the ND-SLIs. Recommendations are identified, including the need to offer secondary traumatic stress specific training for all SLIs. The study has implications for all sign language interpreters and interpreter educators in designing educational programs and professional development

From Interpreting Student to Deaf Interpreter: A Case Study of Vocational Identity Development

Research indicates that the development of a vocational identity is critical to the process of adult maturation and for creating a sense of purpose in one’s life. Deaf individuals in the United States are increasingly interested in establishing a vocation in signed language interpreting, despite workplace obstacles experienced by other oppressed and marginalized populations. Career identity has been examined in several professions, but little is known about the factors underlying the vocational identity development of Deaf interpreters. To address this gap, the researchers adopted a case study approach to explore the experiences of two Deaf students during their first semester in an undergraduate interpreting program. We analyzed video recordings of interaction between the students and a Deaf instructor, the students’ responses during an end-of-semester interview, and the students’ biographical information. Taken together, the data reveal factors that shaped their paths as interpreters including: (a) educational background, (b) professional experience, (c) bilingual and bicultural fluency, (d) personal identity, and (e) guidance from a Deaf instructor. This paper illuminates how two Deaf students who engaged in separate but interlocking paths developed a vocational identity as interpreters – or changed course – in their career trajectories

Driving Without Directions? Modifying Assignments for Deaf Students in an Interpreter Education Class

In the U.S. and other countries, deaf interpreters are increasingly providing professional interpreting and translation services between one or more languages. One outcome of this trend is that deaf individuals are enrolling in educational degree programs in pursuit of training and credentials for signed language interpreters. Interpreter educators whose experience may have only been with teaching non-deaf students are now seeking to create meaningful learning experiences for their deaf students. In this article, we discuss two course assignments modified for deaf students who were enrolled in a beginning translation course at Gallaudet University and we provide the students’ perspectives about the efficacy of the assignments. The aim of this article is to share ideas about creating or altering tasks to better address the needs of deaf students enrolled in interpreter education programs

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit:prospective analysis of data from 27 countries

Purpose: As global initiatives increase patient access to surgical treatments, there is a need to define optimal levels of perioperative care. Our aim was to describe the relationship between the provision and use of critical care resources and postoperative mortality. Methods: Planned analysis of data collected during an international 7-day cohort study of adults undergoing elective in-patient surgery. We used risk-adjusted mixed-effects logistic regression models to evaluate the association between admission to critical care immediately after surgery and in-hospital mortality. We evaluated hospital-level associations between mortality and critical care admission immediately after surgery, critical care admission to treat life-threatening complications, and hospital provision of critical care beds. We evaluated the effect of national income using interaction tests. Results: 44,814 patients from 474 hospitals in 27 countries were available for analysis. Death was more frequent amongst patients admitted directly to critical care after surgery (critical care: 103/4317 patients [2%], standard ward: 99/39,566 patients [0.3%]; adjusted OR 3.01 [2.10–5.21]; p < 0.001). This association may differ with national income (high income countries OR 2.50 vs. low and middle income countries OR 4.68; p = 0.07). At hospital level, there was no association between mortality and critical care admission directly after surgery (p = 0.26), critical care admission to treat complications (p = 0.33), or provision of critical care beds (p = 0.70). Findings of the hospital-level analyses were not affected by national income status. A sensitivity analysis including only high-risk patients yielded similar findings. Conclusions: We did not identify any survival benefit from critical care admission following surgery