Cornelia Wermuth

In recent years, the field of media accessibility (MA) has undergone profound changes and paradigm shifts. Key aspects in these shifts include: a move from particularist accounts to universalist accounts of accessibility (Greco, 2018, 2022; Greco & Jankowska, 2020); others are a move from maker-centred approaches to user-centred approaches, including greater participation of people with the lived experience of disability (Greco, 2018; Romero-Fresco, 2020) and a move away from the post hoc addition of access services after the creative process is finished, to an ab ovo attention to accessibility from the very first design stages of that process. In this paper, we report on the application of these principles in creating an animation video that is as broadly accessible as possible. The video was developed in the context of a research project on inclusive crisis communication. For the development of the video, we adopted a participatory methodology with an iterative feedback loop, in which experts and end-users were asked to provide their feedback during every design phase, which was evaluated and taken into account during the subsequent phases. The results showed that including users in the development process and considering accessibility from the start is feasible and has considerable advantages. On the other hand, using a universalist approach that considers different access modalities at the same time in one single product poses considerable challenges. Lay summary The field of media accessibility (MA) is currently undergoing various fundamental changes. People working in the field have started to realise that MA services should no longer exclusively target one specific target group but should actually serve the entire population. At the same time, there is a growing awareness that accessibility should not merely be an initiative taken by the maker, but that end users should be included in the creative process to guarantee the end product serves their concrete needs. Finally, both experts in MA and users of MA services advocate that accessibility should be considered from the very first design stage rather than being added as an afterthought once the (audiovisual) product is completely finished. However, to date, very little research has been done to study how these essential shifts play out in practice. In the present paper, we report on the application of these new principles in the creation of a fully accessible animation video that was developed in the context of a research project on inclusive crisis communication. We made sure that accessibility was taken into account from the very beginning, and we included end-users of the various access services (including easy language, audio description, subtitling and sign language interpreting), gathering and implementing their feedback in every stage of the design process. The results showed that considering access from the start and including end-users in the development process is definitely feasible and offers various advantages. On the other hand, combining various access services in a single product to make it fully accessible poses clear challenges, and the solutions implemented to solve them are sometimes conflicting or even mutually exclusive.

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The co-construction of empathic communication in interpreter-mediated medical consultations: A qualitative analysis of interaction

This article provides insight into the collaborative translation of medical ontologies and how translators' needs, commitment and desire to learn and share knowledge can be the seeds of a community of practice to support this type of translation. It is based on the experience of a project to translate 7,500 respiratory system concepts from SNOMED CT® into French. The project was guided by the following principles: (1) translators are bilingual medical experts in the field in which the terms to be translated are used; (2) linguistic advice is available during translation; (3) translating experts accept, correct or replace terms already translated by a web-based translation tool using a prepared lexicon. The project results were characterised by low acceptance of computer-assisted pre-translations due to inadequate lexicon preparation and insufficient alignment of the concepts to be translated with the expertise of the translating expert. These issues were solved to a considerable extent by web-based communication between translators, suggesting the need for well-structured collaboration between highly specialised field experts. Based on this observation, we discuss how a community of practice built on the motivation and needs of the translating experts could significantly support the quality and efficiency of medical ontology translation.

Empathic communication (EC) in healthcare occurs when patients express empathic opportunities, such as emotions, to which doctors respond empathically. This interactional process during which participants try to achieve specific communicative goals (e.g., seeking and displaying empathy) serves as a context in which doctors and patients perform verbal and nonverbal actions and collaboratively co-construct meaning. This applies to interpreter-mediated consultations (IMCs) too, where interpreters perform additional actions of a similar kind. However, there is a dearth of research on the ways in which participants perform these actions in the context of EC, and how these actions in turn help (re)shape the context of EC in IMCs (Theys et al., 2020). To date, any tools for studying EC investigate participants’ actions in isolation, without studying them in the context of EC or in relation to the participants’ awareness of their own and others’ ongoing interactions. In this article, we present the Empathic Communication Analytical Framework (ECAF). The tool draws on valid, complementary analytical tools that allow for a fine-grained, three-level multimodal analysis of interactions. The first level of analysis allows for instances of EC in spoken language IMCs to be identified and for participants’ verbal actions in the context of EC to be studied. The second level allows analysts to investigate participants’ verbal and nonverbal actions in the previously identified context of EC. The third level of analysis links the participants’ concurrent verbal and nonverbal (inter)actions to their levels of attention and awareness and shows how participants’ actions are shaped and in turn help to reshape the context of EC in IMCs. In this article, we present the various levels of the ECAF framework, discuss its application to real-life data, and adopt a critical stance towards its affordances and limitations by looking into one excerpt of EC in IMCs. It is shown that the three distinct yet interconnected levels of analysis in the ECAF framework allow participants’ concurrent multimodal interactions in the context of EC to be studied.

This paper deals with collaborative terminological activities in the biomedical field. Efficient communication based on uniform language use is a prerequisite for safe and cost-efficient patient care. Terminological consistency and standardization are therefore central issues in healthcare with high societal relevance. The objectives of this contribution are (1) to show how actors from different disciplines and institutions are involved in the standardization of medical terminology and electronic terminology systems; (2) to describe how translation-oriented terminological principles affect the translation of the Systematic Nomenclature of Medicine – Clinical Terms (SNOMED CT). The challenges of this approach will be discussed and some suggestions for its further development will be made.

UNSTRUCTURED Doctors express empathy infrequently and they do not respond sufficiently to patients’ emotional statements. Empathy is compromised even more in cross-cultural and linguistically diverse healthcare settings where doctor-patient communication is mediated by interpreters. Empathy in interpreter-mediated clinical communication has received insufficient attention in medical education and even less in interpreter education. This project aims to develop a research-based educational intervention for undergraduate medical- and interpreting students on empathic communication in interpreter-mediated consultations. The project relies on the Medical Research Council (MRC) framework for the development and evaluation of complex interventions (phases 0-2). Phase 0: 1. Systematic literature reviews on i) complex interventions on clinical communication training between medical students and students from a different field of study, ii) on cross-cultural and interlingual clinical communication training, iii) emotion management in interpreter-mediated consultations. 2. Analysis of video recorded interpreter-mediated consultations by means of the Empathic Communication Coding System (ECCS) and multimodal interaction analysis. 3. Verification of findings by means of video-stimulated recall interviews with doctors, patients and interpreters. Phase 1: Development of training intervention and validation. Phase 2: Feasibility testing and proof-of-concept study/ event. The transfer of the findings into the curricula of both faculties will pave the way for better trained professionals who will be able to co-construct and manage empathic communication more effectively in linguistically and culturally diverse contexts. Both groups of professionals will help improve the health and well-being of patients with linguistically and culturally diverse backgrounds, who might often experience a bias and inequality in the provision of healthcare. Interpreters trained to perform in specialized clinical settings and doctors trained to work in linguistically and culturally diverse settings will enhance the effectiveness and sustainability of hospitals and other healthcare centers and public services in which they operate, contributing, in this way, to better social welfare and social cohesion.

This paper explores the linguistic patterns of instrumentality in the titles of English medical research papers, at the interface between conceptual and linguistic structure, and offers a contribution to the little studied interrelationships between static and dynamic conceptual relations in medical ontology and LSP terminology. It is demonstrated how causal cues constitute the conceptual background against which instrumentals are profiled in the causal chain of the medical model. Taking inspiration from Talmy, frame semantics and construction grammar, the linguistic patterns in which causal and instrumental frame elements are co-activated are transcribed as complex patterns with partial morphological, syntactic and lexical marking of the conceptual relations under study. The paper offers an exploratory typology of causal cues for instrumentals and describes how multiple instruments can appear in medical LSP. The findings are relevant for those interested in the nexus between ontology, constructional aspects of expert language and frame semantics