Table 1 Overview of consultation characteristics

Professional interpreter, no family present

Female doctor

Female professional interpreter D1

Male patient, 60 yrs

Diabetes check-up, and chest/arm pain. Much of the discussion centers on understanding the patient’s chest and arm pain symptoms.

Patient speaks no German

Clinician always addresses interpreter

The interpreter frequently asks the patient additional questions or for clarification before interpreting back to the clinician, in an attempt to provide the doctor with coherent answers to her questions.

Female doctor (same as E)

Female professional interpreter D1

Female patient, 50 yrs

Diabetes check-up. The discussion centers on when and how she measures her glucose, and on adjusting her insulin.

Patient speaks a little German

Doctor most addresses the patient directly.

Patient and doctor speak to each other in German; the interpreter only intervenes occasionally to interpret when the patient switched to Turkish or if the patient seemed not to understand the doctor.

Female doctor (same as D)

Female professional interpreter D1

Female patient, 33 yrs

Diabetes check-up. The discussion centers on her glucose measurements and how to calculate and adjust her insulin.

Patient speaks a little German

Doctor mostly addresses patient directly, and is quite empathetic and encouraging. She speaks in lengthy turns, with a lot of numbers.

Patient appears to understand at least some German because the interpreter doesn’t bother to translate everything, and sometimes the patient answers (in Turkish) the doctor’s question before it has been translated. The interpreter does a lot of paraphrasing of doctor’s speech.

Female doctor, and female nurse diabetic educator

Female professional interpreter D2

Female patient, 58 yrs

Diabetes check-up. The discussion centers on review of her glucose measurements, how to adjust her insulin, and the importance of seeing the dietary counsellor.

Patient speaks no German

Clinician mostly addresses interpreter

Interpreter often uses first person translation for the patient and direct or reported speech for the clinicians.

The clinician speaks in lengthy turns

This is the only consultation where the interpreter intervenes to suggest that the patient may not understand the doctor’s explanations.

Family as interpreter

Female doctor

Adult son

Husband and wife together, 70 yrs

Diabetes check-up. The doctor sees husband and wife together to go over various lab results.

Husband and wife both speak a little German

Doctor almost exclusively addresses patients directly, but is frustrated by the son who doesn’t translate much.

Son answers for parents, rarely translates, and asks his own questions.

Male doctor

Adult daughter

Female patient, 60 yrs

Results from lung x-ray; diabetes check-up. The discussion centers on the patient’s x-ray results, as well as her diabetes and blood pressure management.

Patient speaks a little German

Doctor addresses patient directly, but is drawn into conversation with the daughter.

Daughter answers for mother, translates only when she cannot answer the doctor’s question herself. She also asks her own questions.

Professional interpreter and family

Female nurse/diabetic educator

Female professional interpreter D1

Female patient, 40 yrs, accompanied by her adult daughter

Gestational diabetes. The discussion centers on the importance of the patient following her diet plan more closely in order to determine whether or not she needs insulin.

Patient speaks no German

The clinician starts by addressing the interpreter, but when the daughter jumps in to answer a question for her mother, the clinician then talks only to the daughter.

At first the interpreter attempts to translate for the patient what is being said between the clinician and daughter, but is not given the time and eventually becomes silent while clinician and daughter speak for the rest of the consultation.

Female dietician

Female professional interpreter D1

Female patient, 40 yrs, accompanied by her adult daughter (same as in B)

Gestational diabetes. The discussion focuses on her dietary plan.

Patient speaks no German

Clinician speaks directly to the patient, never the interpreter

The interpreter tends to summarize the clinician’s lengthy turns. The daughter says nothing during the consultation, and only responds to a question about a next appointment.

The clinician speaks in lengthy turns