The Macy Project
As a Macy Faculty Scholar (2026–2028), I am leading a two-year program of research and curriculum design on one of the most common and least-taught problems in clinical care: communication across language difference.
Medical education usually treats communication across a language barrier as an individual clinician skill, and treats the interpreter as a neutral conduit, a tool for converting words. In practice, the interpreted encounter is distributed clinical work. It is carried by clinicians, nurses, social workers, and interpreters together, and it breaks down in patterned, teachable ways. Interpreters, positioned at the seam of the encounter, see pressures and failures that clinicians often do not. My project takes that vantage seriously as a source of knowledge for teaching, while studying it critically. Interpreters vary in skill, interpretation is itself a site of judgment and error, and the very model of what an interpreter is for remains contested. The aim is to learn from interpreters without idealizing them, and to prepare clinicians to reason about the conditions of understanding rather than simply defer to the interpreter as an authority.
The work has two halves that feed each other. The first is a multi-site interview study of medical interpreters, recruited through national professional networks across institutions with different language-access models, so that variation in training, setting, and modality becomes something the study examines rather than averages away. The second is a simulation curriculum, co-designed with interpreters and clinicians for emergency medicine residents and built as moral rehearsal: low-stakes practice of the distributed work at the points where it most often breaks, including discharge teach-back through an interpreter, family-member interpreting, and care delivered under the shadow of immigration enforcement.
Language-discordant care is a large and under-recognized source of preventable harm, and the field still lacks shared, transportable resources for teaching it well. By grounding new teaching materials in close study of how interpreted care actually works, breaks, and is repaired, the project aims to produce resources that other programs can use, not only my own. It also extends commitments that run throughout my scholarship: that health is shaped by social and structural conditions, that the people closest to a problem hold knowledge the curriculum needs, and that medical education carries an ethical obligation to prepare clinicians for the patients they will actually meet. The interpreter stands at the intersection of immigration, equity, and trust that defines much of my work, and this project is the next movement in that larger arc.