Hacettepe University Graduate School of Social Sciences Department of Translation and Interpreting English Translation and Interpreting Programme VIDEO REMOTE INTERPRETING (VRI): A NEW DIMENSION FOR TURKISH HEALTHCARE SYSTEM Sıla Saadet TOKER Ph.D. Dissertation Ankara, 2025 VIDEO REMOTE INTERPRETING (VRI): A NEW DIMENSION FOR TURKISH HEALTHCARE SYSTEM Sıla Saadet TOKER Hacettepe University Graduate School of Social Sciences Department of Translation and Interpreting English Translation and Interpreting Programme Ph.D. Dissertation Ankara, 2025 ACCEPTANCE AND APPROVAL The jury finds that Sıla Saadet TOKER has on the date of 11.06.2025 successfully passed the defense examination and approves his/her Ph.D. Thesis titled “Video Remote Interpreting (VRI): A New Dimension for Turkish Healthcare System”. Prof. Dr. Alev BULUT (Jury President) Prof. Dr. Aymil DOĞAN (Main Adviser) Doç. Dr. Hilal ERKAZANCI DURMUŞ Doç. Dr. Sinem SANCAKTAROĞLU BOZKURT Dr. Öğretim Üyesi Dr. Korkut Uluç İŞİSAĞ I agree that the signatures above belong to the faculty members listed. Prof.Dr.Uğur ÖMÜRGÖNÜLŞEN Graduate School Director YAYIMLAMA VE FİKRİ MÜLKİYET HAKLARI BEYANI Enstitü tarafından onaylanan lisansüstü tezimin tamamını veya herhangi bir kısmını, basılı (kağıt) ve elektronik formatta arşivleme ve aşağıda verilen koşullarla kullanıma açma iznini Hacettepe Üniversitesine verdiğimi bildiririm. Bu izinle Üniversiteye verilen kullanım hakları dışındaki tüm fikri mülkiyet haklarım bende kalacak, tezimin tamamının ya da bir bölümünün gelecekteki çalışmalarda (makale, kitap, lisans ve patent vb.) kullanım hakları bana ait olacaktır. Tezin kendi orijinal çalışmam olduğunu, başkalarının haklarını ihlal etmediğimi ve tezimin tek yetkili sahibi olduğumu beyan ve taahhüt ederim. Tezimde yer alan telif hakkı bulunan ve sahiplerinden yazılı izin alınarak kullanılması zorunlu metinleri yazılı izin alınarak kullandığımı ve istenildiğinde suretlerini Üniversiteye teslim etmeyi taahhüt ederim. Yükseköğretim Kurulu tarafından yayınlanan “Lisansüstü Tezlerin Elektronik Ortamda Toplanması, Düzenlenmesi ve Erişime Açılmasına İlişkin Yönerge” kapsamında tezim aşağıda belirtilen koşullar haricince YÖK Ulusal Tez Merkezi / H.Ü. Kütüphaneleri Açık Erişim Sisteminde erişime açılır. o Enstitü / Fakülte yönetim kurulu kararı ile tezimin erişime açılması mezuniyet tarihimden itibaren 2 yıl ertelenmiştir. (1) o Enstitü / Fakülte yönetim kurulunun gerekçeli kararı ile tezimin erişime açılması mezuniyet tarihimden itibaren ….. ay ertelenmiştir. (2) o Tezimle ilgili gizlilik kararı verilmiştir. (3) ……/………/…… [İmza] [SILA SAADET TOKER] 1“Lisansüstü Tezlerin Elektronik Ortamda Toplanması, Düzenlenmesi ve Erişime Açılmasına İlişkin Yönerge” (1) Madde 6. 1. Lisansüstü tezle ilgili patent başvurusu yapılması veya patent alma sürecinin devam etmesi durumunda, tez danışmanının önerisi ve enstitü anabilim dalının uygun görüşü üzerine enstitü veya fakülte yönetim kurulu iki yıl süre ile tezin erişime açılmasının ertelenmesine karar verebilir. (2) Madde 6. 2. Yeni teknik, materyal ve metotların kullanıldığı, henüz makaleye dönüşmemiş veya patent gibi yöntemlerle korunmamış ve internetten paylaşılması durumunda 3. şahıslara veya kurumlara haksız kazanç imkanı oluşturabilecek bilgi ve bulguları içeren tezler hakkında tez danışmanının önerisi ve enstitü anabilim dalının uygun görüşü üzerine enstitü veya fakülte yönetim kurulunun gerekçeli kararı ile altı ayı aşmamak üzere tezin erişime açılması engellenebilir. (3) Madde 7. 1. Ulusal çıkarları veya güvenliği ilgilendiren, emniyet, istihbarat, savunma ve güvenlik, sağlık vb. konulara ilişkin lisansüstü tezlerle ilgili gizlilik kararı, tezin yapıldığı kurum tarafından verilir *. Kurum ve kuruluşlarla yapılan işbirliği protokolü çerçevesinde hazırlanan lisansüstü tezlere ilişkin gizlilik kararı ise, ilgili kurum ve kuruluşun önerisi ile enstitü veya fakültenin uygun görüşü üzerine üniversite yönetim kurulu tarafından verilir. Gizlilik kararı verilen tezler Yükseköğretim Kuruluna bildirilir. Madde 7.2. Gizlilik kararı verilen tezler gizlilik süresince enstitü veya fakülte tarafından gizlilik kuralları çerçevesinde muhafaza edilir, gizlilik kararının kaldırılması halinde Tez Otomasyon Sistemine yüklenir. * Tez danışmanının önerisi ve enstitü anabilim dalının uygun görüşü üzerine enstitü veya fakülte yönetim kurulu tarafından karar verilir. ETİK BEYAN Bu çalışmadaki bütün bilgi ve belgeleri akademik kurallar çerçevesinde elde ettiğimi, görsel, işitsel ve yazılı tüm bilgi ve sonuçları bilimsel ahlak kurallarına uygun olarak sunduğumu, kullandığım verilerde herhangi bir tahrifat yapmadığımı, yararlandığım kaynaklara bilimsel normlara uygun olarak atıfta bulunduğumu, tezimin kaynak gösterilen durumlar dışında özgün olduğunu, Prof. Dr. Aymil DOĞAN danışmanlığında tarafımdan üretildiğini ve Hacettepe Üniversitesi Sosyal Bilimler Enstitüsü Tez Yazım Yönergesine göre yazıldığını beyan ederim. [İmza] [SILA SAADET TOKER] iv ACKNOWLEDGEMENTS My deepest and most heartfelt thanks go to my thesis advisor, dearest Prof. Dr. Aymil Doğan. The completion of this thesis would not have been possible without her enlightening guidance, unwavering support, and inspiring mentorship. Throughout this long journey, she not only provided invaluable academic insight but also shared with me her remarkable life energy, which uplifted me in both scholarly and personal moments. It was with her belief in me that my dreams began to take shape—and ultimately came true. I will always carry her wisdom and warmth with deep gratitude. I am also grateful to Prof. Dr. Alev Bulut and Assoc. Prof. Dr. Hilal Erkazancı Durmuş, who have always been constructive, kind-hearted, and encouraging in every interaction throughout this journey, for their invaluable support as members of my Thesis Monitoring Committee. I would like to extend my sincere thanks to Assoc. Prof. Dr. Sinem Sancaktaroğlu Bozkurt and Dr. Korkut İşisağ for their insightful feedback and thought-provoking contributions. I also wish to express my heartfelt appreciation to all the esteemed faculty members of the Department of Translation and Interpretation at Hacettepe University. It has been both an honour and an emotional journey to be part of this department for thirteen years—from my undergraduate beginnings to the completion of my PhD—and I will always remember this academic home with deep appreciation and affection. My deepest gratitude is also extended to Prof. Dr. Toker Ergüder, who has been a constant source of motivation since the beginning of my academic journey. His unwavering support and belief in my potential— from the very beginning of my master’s studies to the final stages of this doctoral research—have been instrumental in encouraging me to pursue a PhD and in shaping the path of my academic and professional development. I would also like to thank Prof. Dr. Alper Tolga Kumtepe, Dr. Özge Bayraktar Özer, and Dr. Cansu Ayan Ürek for their academic guidance and the inspiring ideas they shared, which have opened new perspectives throughout my journey. Additionally, my thanks go to Dr. Kattal Fatih Aydıner for his invaluable guidance during the course of this study as his insights at critical moments illuminated my path and contributed to shaping a new direction for my research. v I would also like to express my sincere gratitude to Dr. Şanal Tosun and Mehmet Karakaya for their kind and endless support throughout this process. Furthermore, I would like to sincerely thank all the participants—physicians, healthcare interpreters, and foreign patients—who generously contributed their time and insights to this study. Their dedication and openness were essential, and this research would not have been possible without their valuable involvement. Above all, I would like to express my deepest gratitude to my family—my mother Süheda, my father Aziz, and my sister Selin—for their unconditional love, patience, and continuous support throughout this journey. Their presence in my life has been a constant source of strength and comfort. My heartfelt thanks also go to my fiancé Yusuf, who has stood by me through every step of my academic journey. His steady belief in me, his calming presence in difficult times, and his endless support—both emotionally and intellectually—have been invaluable. This accomplishment would not have been possible without my family’s constant encouragement and belief in me. vi ABSTRACT TOKER, Sıla Saadet. Video Remote Interpreting (VRI): A New Dimension for Turkish Healthcare System, Ph.D. Thesis, Ankara, 2025. Recent technological advancements lead people to find technology-mediated solutions to respond to the increasing needs for public services, including healthcare. Therefore, video remote interpreting emerges as an evolving mode which has gradually gained prominence throughout the world, allowing people with linguistic and cultural differences to make use of such services available from remote locations, which is deemed to fulfil the principle of equity in access to healthcare. To this end, this research seeks to provide an overview regarding the video remote interpreting (VRI) mode and its current practices in the exemplary countries where this system has successfully been integrated through reviewing available regulations and legislative frameworks, as this system is yet to be available in Türkiye. Additionally, this research aims to investigate the expectations of interpreters, physicians, and foreign patients from the potential future implementation of video remote interpreting services in the Turkish healthcare system. To this end, the data for this research was first generated through a document analysis. In this vein, administrative documents such as legislation and other related documents of the countries performing good practices of video remote interpreting services having been provided in their healthcare system have been studied. Secondly, semi- structured in-depth interviews were conducted with the participation of three interlocutor groups: interpreters, physicians, and foreign patients as potential users so as to investigate their expectations from video remote interpreting services, which may hopefully provide relevant information just in case such services may be planned to be integrated into the Turkish healthcare system in the future. Additionally, the research diaries kept by the researcher also facilitated a deeper insight into the situation. Consequently, this research is expected to contribute to the possible integration of video remote interpreting services within the Turkish healthcare system. Keywords Video remote interpreting, remote interpreting, healthcare services, health, Information and Communications Technology (ICT). vii ÖZET TOKER, Sıla Saadet. Video Yoluyla Uzaktan Çeviri: Türk Sağlık Sistemi için Yeni Bir Boyut, Doktora Tezi, Ankara, 2025. Son zamanlarda ortaya çıkan teknolojik gelişmeler, insanları sağlık hizmetlerinin de dahil olduğu kamu hizmetlerine yönelik artan ihtiyaçlara cevap vermesi için teknoloji aracılı çözümler bulmaya yönlendirmektedir. Bu doğrultuda, video yoluyla çeviri hizmetleri dünya çapında giderek adını duyuran ve gelişmekte olan bir tür olarak ortaya çıkmaktadır. Ayrıca, sağlık hizmetlerine erişimde eşitlik ilkesini yerine getirmek gayesiyle bu tür hizmetlerin, dilsel ve kültürel farklılıkları bulunan nüfusa yönelik uzaktan sağlanmasına da olanak sağlamaktadır. Bu kapsamda, bu araştırma, ilk olarak video yoluyla çeviri hizmetlerini genel bir bakış açısı ile açıklamayı, daha sonra ise bu çeviri türünün Türkiye’de uygulanmadığı göz önüne alınarak bu hizmeti sağlık sistemlerinde başarılı bir şekilde sunan örnek ülkelerin uygulamalarını, mevcut düzenleme ve yasal çerçevelerini gözden geçirerek ortaya koymayı amaçlamaktadır. Ek olarak, bu çalışma Türk sağlık sisteminde video yoluyla çeviri hizmetinin gelecekte uygulanması halinde tercümanlar, doktorlar ve yabancı hastaların beklentilerini ve düşüncelerini araştırmayı amaçlamaktadır. Bu doğrultuda, araştırmanın ilk veri seti doküman analizi yoluyla elde edilmiştir ve bu çeviri türünü kendi sağlık sağlık sistemlerinde iyi örneklerle uygulayan ülkelerin yasal ve diğer ilgili dokümanları ortaya konmuştur. İkinci veri setini elde etmek için gelecekte Türk sağlık sistemine entegre edilmesi ihtimalinde video yoluyla çeviri hizmetlerine yönelik beklentilerini ve düşüncelerini öğrenmek amacıyla tercümanlar, doktorlar ve yabancı hastalardan oluşan üç farklı potensiyel kullanıcı grubuyla yarı yapılandırılmış derinlemesine görüşmeler gerçekleştirilmiştir. Son olarak, araştırmacı tarafından veri toplama aşamasında tutulan araştırmacı günlükleri ise durumun daha derinden gözlemlenmesine katkıda bulunmuştur. Sonuç olarak, bu araştırma video yoluyla çeviri hizmetlerinin Türk sağlık sistemine olası entegrasyonuna katkı sunmayı amaçlamaktadır. Anahtar Sözcükler Video yoluyla uzaktan çeviri, uzaktan çeviri , sağlık hizmetleri , sağlık, bilgi ve iletişim teknolojileri. viii TABLE OF CONTENTS ACCEPTANCE AND APPROVAL……………………….……………………….………........i YAYIMLAMA VE FİKRİ MÜLKİYET HAKLARI BEYANI………………………………ii ETİK BEYAN ………………………………..………………………………………….…...…iii ACKNOWLEDGEMENTS…………….………………………………………..…..................iv ABSTRACT……………………………………………………………………………………...vi ÖZET……... ..……………………………………………………………………......................vii TABLE OF CONTENTS…………………………………………………………...................viii ABBREVIATIONS ……...………………………….………………….....................................xii FIGURES ………... ………… ………..…………………………………….............................xiv INTRODUCTION……………………………………………………………………………….1 CHAPTER 1……………………………………………………………………………………...4 1.1. PROBLEM SITUATION………………………………………………………………...4 1.2. AIM OF THE STUDY…………………………………………………….……………...6 1.3. IMPORTANCE OF THE STUDY………………………………………………………6 1.4. RESEARCH QUESTIONS ………………………….…………………………………..7 1.5. DEFINITIONS…………………………………………………………….………...........7 1.6. ASSUMPTION...………………….………………………………………………………8 1.7. LIMITATIONS…………………………………………………………………………...8 CHAPTER 2: LITERATURE REVIEW……..………………………………..........................9 2.1. REMOTE INTERPRETING…………………………………………………………….9 2.1.1. Telephone Interpreting (TI)………………………………………………………….22 ix 2.1.2. Video Remote Interpreting (VRI) …..…………………………………………..…...24 2.1.2.1. Video Remote Interpreting (VRI) in the World…………………..…………......25 2.1.2.2. Video Remote Interpreting (VRI) in Türkiye …………………..………………28 2.1.2.3. Relevant Studies on Video Remote Interpreting…………………..……………31 2.2. VIDEO REMOTE INTERPRETING (VRI) IN HEALTHCARE SERVICES..........38 2.2.1. General Overview……………………………………………………………………38 2.2.2. Exemplary Countries for Video Remote Interpreting in Healthcare Services…….....47 2.2.2.1. The USA………………………………….…………………………….……….47 2.2.2.2. Australia ………………………………….……………………………………..52 2.2.2.3. The UK ………………………………….……………….……...………………60 2.2.2.4. Canada …………………………………. ……….……….…......………………64 CHAPTER 3: THEORETICAL FRAMEWORK……………………………………………67 3.1. GENERAL OVERVIEW OF ACTOR-NETWORK THEORY……………………..67 3.2. ACTOR-NETWORK THEORY AND TRANSLATION & INTERPRETING STUDIES……………………………………………………………………………..............69 CHAPTER 4: METHODOLOGY…………….……………………………………………...77 4.1. DESIGN OF THE STUDY…………………………………………………………..….77 4.1.1. Data Sources………………………………………………………………………….78 4.1.2. Participants and Sampling Method………………………………………...................80 4.2. PROCEDURE …………………………………………………………………………...83 4.3. DATA COLLECTION TOOL……………………………….……….………………...85 4.3.1. Validation of the Data Collection Tool……………………………………………….88 x 4.4 DATA ANALYSIS ……………………………………………………………………….89 CHAPTER 5: FINDINGS AND DISCUSSION ……………………………………………...93 5.1. PARTICIPANTS PROFILE ……………………………………………………...........93 5.1.1 Physicians ………………………………………………………………………….94 5.1.2. Interpreters………………………………………………………………...............95 5.1.3. Foreign Patients……………………………………………………………………97 5.2. THE AVAILABLE FACE TO FACE INTERPRETING SYSTEM …………………98 5.3. THE ANALYSIS OF CATEGORIES AND THEMES……………………………....102 5.3.1. Perceived Ease of Use…………………………………………………………….104 5.3.1.1. Scheduling and Time Management………………………………………….105 5.3.1.2. Situational Factors…………………………………………….......................107 5.3.1.3. Human Interaction…………………………………………….......................111 5.3.1.4. Technical Convenience……………………………………….......................114 5.3.2. Perceived Usefulness……………………………………………………………..116 5.3.2.1. Healthcare Service Quality ………………………………………………….116 5.3.2.2. Suitability for Elderly and Persons with Disabilities…………………………118 5.3.2.3. Time Efficiency……………………………………………….......................119 5.3.2.4. Health Policy and Technological Integration……………………………….121 5.3.3. Perceived Affordances…………………………………………………………...122 5.3.3.1. Task Assignment and Planning………………………………………………122 xi 5.3.3.2. Confidentiality and Data Security Concerns…………………………………124 5.3.3.3. Communication Quality……………………………………..………………126 5.3.3.4. Workload Efficiency………………………………………...………………128 5.3.4. Intention to Use…………………………………………………………………..130 5.3.4.1. Positive Intention…………………………………………………………….131 5.3.4.2. Negative Intention………………………………...…………………………134 5.4. VRI AS A NEW NON-HUMAN ACTOR IN HEALTHCARE NETWORK.............136 CONCLUSION ………………………………….…………………………………..………...143 BIBLIOGRAPHY.…………………………………………………………………………..…149 APPENDIX 1. ENGLISH SEMI-STRUCTURED IN-DEPTH INTERVIEW QUESTIONS.. ……………….………………….………………….………………….………………….…….160 APPENDIX 2. TURKISH SEMI-STRUCTURED IN-DEPTH INTERVIEW QUESTIONS ……………….………………….………………….………………….………………….…….169 APPENDIX 3. VOLUNTEER CONSENT FORM – TURKISH VERSION ……………..177 APPENDIX 4. RESEARCHER’S DIARY – TURKISH VERSION……………………….179 APPENDIX 5. RESEARCHER’S DIARY – ENGLISH VERSION……………………….185 APPENDIX 6. HACETTEPE UNIVERSITY SOCIAL SCIENCES AND HUMANITIES RESEARCH ETHICS BOARD CLEARANCE LETTER ………………………………...191 APPENDIX 7. ORIGINALITY REPORT ………………………………………………….192 APPENDIX 8. GLOSSARY ………………………………….………………………………194 APPENDIX 9. CODE MATRICES FOR COLLECTED QUALITATIVE DATA ……...195 xii ABBREVIATIONS ACA :Affordable Care Act ADA :Americans with Disabilities Act AIIC :International Association of Conference Interpreters ALC :Association of Language Companies ANT :Actor-Network Theory ATA :American Translators Association AUSIT :Australian Institute of Interpreters and Translators AVIDICUS:Assessment of Video-Mediated Interpreting in the Criminal Justice System Projects BSL :British Sign Language CALD :Culturally and Linguistically Diverse CCHI :Certification Commission for Healthcare Interpreters CHIA :California Healthcare Interpreting Association CLAS :Culturally and Linguistically Appropriate Services DDA :Disability Discrimination Act DHH :Deaf or hard of hearing DI :Distance Interpreting EP :European Parliament EU :European Union ICT :Information and Communications Technology ISDN :Integrated Services Digital Network ISO :International Organization for Standardization ITTS :Implementing Transnational Telemedicine Solutions xiii ITU :International Telecommunication Union LEP :Limited English Proficiency LOTE :Language Other than English MISS :Medical Interview Satisfaction Scale NAATI :National Accreditation Authority for Translators and Interpreters NCIHC:National Council on Interpreting in Health Care NDIS :National Disability Insurance Scheme NHS :National Health Service NHSGGC: National Health Service Greater Glasgow and Clyde PAHO :The Pan American Health Organization PEI :Patient Enablement Instrument PHSA :Provincial Health Services Authority PWD :Persons with Disabilities RC :Research Committee RI :Remote Interpreting TA :Thematic Analysis TFDI :Taskforce on Distance Interpreting THC :Technical and Health Committee TI :Telephone Interpreting TIS :Translation and Interpreting Service National VCI :Videoconference Interpreting VITS :Victorian Interpreting and Translating Service VRI :Video Remote Interpreting WHA :World Health Assembly WHO :World Health Organization xiv FIGURES Figure 1: Braun and Taylor’s initial terminology use in their study titled “Video-mediated interpreting: an overview of current practice and research: Videoconference and remote interpreting in criminal proceedings” published in 2012………………………………………...12 Figure 2 : Braun’s classification for remote interpreting and different terminology use in her study published in 2015 …………………………………………………………………………13 Figure 3: Participant distribution of location for teleconference interpreting and remote interpreting ………………………………………………………………………………………13 Figure 4: Braun’s finalized (improved) categorization on the modalities of distance /technology mediated interpreting…………………………………………………………………………….14 Figure 5: The up-to-date classification presented in the official website of AVIDICUS projects ……………………………………………………………………………………………………15 Figure 6: The classification presented by AIIC in the official website, accepted AIIC 2015 Assembly during the Debate on Remote Interpreting ………………………………………………...16 Figure 7: Types of Remote Interpreting (RI) ……………………………………………………21 Figure 8: Types of Video Remote Interpreting (VRI) …………………………………………..25 Figure 9: General case of a web VRI system in a case where both healthcare professionals and patients are in the same location and connecting online to a virtual interpreter …………………..39 Figure 10: An example from a virtual interpreting session during the healthcare service provision ………………………………………………………………………………………………………………..40 Figure 11: All interlocutors are in different locations (e.g. telemedicine, tele-education) ………………………………………………………………………………………………………………..41 Figure 121: Simplified representation of types of health services provided through information communication technology (ICT) ………………………………………………………………………41 Figure 13: An example showing how interpreter information appears in the waiting area before a video remote interpreting session is initiated …………………………………………………………55 Figure 14: The content page of “Language Services Policy” Document which provides tremendous information for language services provided in the Victorian State Government ………………………………………………………………………………………………………………..57 Figure 15: The representation of National Interpreters Symbol and Victorian Interpreter Card to help reducing the stress of people with limited language proficiency seeking for public services support ………………………………………………………………………………………………………58 xv Figure 16: The scope and content of the official guidance released by NHS England in 2018 ………………………………………………………………………………………………………………..62 Figure 17: Steps followed in the thematic analysis of the collected data ………………………….90 Figure 18: Themes and respective categories in the content analysis of in-depth interviews ………………………………………………………………………………………………………………103 Figure 19: Thematic coding generated upon qualitative data analysis ……………………………104 1 INTRODUCTION The digitalization era leads people to find technology-mediated solutions to respond to the increasing needs for public services for all people in particular vulnerable populations with linguistic and cultural differences. This tendency results in a shift from in-person to remote service provision, including public service settings. As an open and constantly evolving area, remote interpreting incorporates new technological advancements and responds to the changing needs to overcome disparities in access to public services. Remote interpreting (RI) generally refers to the type of interpreting services provided in situations where an interpreter is not physically present in the service setting, yet can communicate from different locations. The utilization of this type of interpreting significantly evolved thanks to the technological advances in recent years; moreover, its adoption has accelerated after COVID-19 hit the whole world. This technology-aided type of interpreting is generally provided either over the phone or via a video system and can be used as an alternative to face-to-face interpreting when it is not feasible due to cost or time constraints. As a recently growing practice, remote interpreting services are used in various settings such as healthcare, legal, education, and business. Especially in the field of healthcare, where linguistic and cultural differences have become a distinctive and vital challenge in service provision (WHO, 2010, p.8-9), remote interpreting enables an efficient and low-cost opportunity for instant deployment of professional interpreters (Havelka, 2020, p.1). The language barriers can be addressed through remote interpreting services in healthcare settings since it provides services for patients who can’t speak the language of the healthcare providers, especially in areas where an on- site interpreter is not available. As one of the modalities of remote interpreting, video remote interpreting (VRI) has emerged as a particularly promising option due to its ability to incorporate visual and auditory cues and it provides more information for efficient communication such as facial expressions and voice effects. The use of video remote interpreting in healthcare settings and thereby the ongoing research are gradually increasing worldwide; however, its practice is yet to be available in the Turkish healthcare system. In this respect, a survey which was administered to healthcare interpreters in Türkiye after COVID-19 by Şan and Duru (2020) demonstrated that there was a demand stated by the interpreters for the endorsement of technological tools – in other words telephone and video 2 conferencing - in service provision, which would allow them to serve remotely. This study highlights that integrating the internet and video remote interpreting systems driven by advancing technologies into this country’s healthcare system would lead to different achievements, also noting that the framework of professional competencies might need to be revisited, considering the requirements of these new tools. Thus, the non-availability of video remote interpreting services in the Turkish healthcare system brings about the need for relevant research to present the current national context with respect to the potential implementation of such a service that might be integrated into the system in the future. Thus, the purpose of this research is first to find how video remote interpreting for different languages is provided in the top four exemplary countries where this type of interpreting is efficiently provided. Second, this study aims to investigate the expectations of interpreters, physicians, and foreign patients from the potential future implementation of video remote interpreting services in the Turkish healthcare system. To this end, the data for this research will first be generated through a document analysis. In this vein, administrative documents such as legislation and other related documents of the countries performing good practices of video remote interpreting services having been provided in their healthcare system were reviewed and studied. Secondly, semi-structured in-depth interview questions have been directed to the physicians, foreign patients, and interpreters so as to investigate their expectations from video remote interpreting services, which may hopefully provide relevant information just in case such services may be planned to be integrated into the Turkish healthcare system in the future. Additionally, the research diaries to be kept by the researcher are also intended to facilitate a deeper insight into the situation, considering that "qualitative methods take the researcher's communication with the field and its members as an explicit part of knowledge instead of deeming it an intervening variable, unlike quantitative research" (Flick, 2009, p.16). The collected data has been analysed to inquire about current insights of the above- mentioned three group interlocutors on video remote interpreting services and their expectations from the potential implementation of such services in Türkiye in terms of their perceived ease of use, perceived usefulness, perceived affordances and intention to use. As a result, the suggestions to be drawn at the end of the research are expected to contribute to the possible establishment and 3 development of video-mediated remote interpreting services within the scope of the Turkish healthcare system. In this vein, the content of the thesis is given chapter by chapter below. Chapter 1 of this study provides a general introduction and brief information on what this thesis aims to investigate. Related information will be presented in a more detailed way in the subsequent parts, namely problem situation, aim of the study, importance of the study, research questions, assumptions, limitations, and definitions of some important terms. Chapter 2 is devoted to the literature review, which presents the current situation of remote interpreting and its sub-modality, video remote interpreting, on both the national and international levels. It also explains the relevant studies on video remote interpreting services. Lastly, it provides a general overview of video remote interpreting in healthcare services and how it is currently practised in the top four exemplary countries. Chapter 3 sheds light on the theoretical framework of the study, focusing on Actor-Network Theory (ANT). First, it provides a general overview of ANT, outlining its key principles. Then, it explores the relevance and applicability of ANT within the field of Translation and Interpreting Studies, highlighting how this theory frames the methodology of this thesis. Chapter 4 presents the methodology used in the study. The design of the study, participants, procedure, data collection instruments, and information on data analysis methods are provided. Chapter 5 demonstrates the findings and discussion of the results of the data collected from the field, analysed through thematic analysis as a qualitative data analysis method. Chapter 6 presents the conclusion of the study. Based on these conclusions, suggestions for further research are provided. 4 CHAPTER 1 This chapter provides a foundational framework for the study by outlining the problem situation, research aim and significance, research questions, and key conceptual definition. It also clarifies the study’s assumptions and limitations, offering a comprehensive overview of the scope and direction of the research. 1.1 PROBLEM SITUATION Developing technology, especially after the pandemic, is constantly observed to lead humankind to digital solutions while responding to their needs in recent years. In this regard, community services provided in different settings began to shift from in-person to remote in the era of digitalization. With its vital importance for human life, especially health services are highly affected by this shift, which was first taken as a temporary measure, but is becoming permanent day by day. Since health professionals and policymakers are recently searching for innovative service delivery models to ensure uninterrupted access to essential health services, especially for vulnerable groups, some countries have introduced remote interpreting practices at varying stages of implementation and development. This practice also aims to help vulnerable population groups as target user, including linguistically and culturally diverse migrants and refugee populations to get access to healthcare services in an equitable manner; thus, avoiding the exacerbation of health inequalities. Remote interpreting has been used in medical settings for those people with linguistic and cultural differences to meet their needs in seeking healthcare services. While this service traditionally was offered as telephone interpreting which relies on telephone connection between the interlocutors without no participant view, remote interpreting (RI) with an interpreter’s virtual presence, named as video remote interpreting (VRI) recently gained prominence and emerged as a growing practice in the light of new digital solutions in health settings. This mode of interpreting in healthcare settings is available to provide solutions for doctor-patient interaction in hospitals and other healthcare settings (Braun, 2011, p.37). 5 In the past decade—particularly over the last four years with the impact of the COVID-19 pandemic—the use of remote interpreting, especially via video conferencing, has gained increasing attention in healthcare settings. While academic interest has predominantly emerged within medical studies focusing on disease management and the delivery of high-quality healthcare services, the interpreting dimension remains relatively underexplored. This study, therefore, addresses this gap by taking into account the interpreting dimension and contributing to the respective field in the utilization of technology-aided services in healthcare provision. To better understand how such services could be integrated into the Turkish healthcare system, this research was designed to identify international good practices and to observe the needs and expectations within the local context through direct engagement with the potential users of such a system. Considering that video remote interpreting services are not described in the Turkish healthcare system and no available implementation exists, a document analysis, as the first data source of this research has been carried out to outline the good practices in the countries where remote interpreting services in their healthcare system are available. Afterwards, a user expectation survey was administered to physicians, foreign patients, and interpreters as potential users to investigate their expectations from video remote interpreting services that might be integrated into the Turkish healthcare system in the future. In addition to conducting the interviews with the above-mentioned three groups of interlocutors, the research diaries were also recorded for deeper insight into the situation. The collected data was analyzed to inquire about those three groups of interlocutors' current opinions on the concept of video remote interpreting services and their expectations from the potential implementation of the video remote interpreting services in Türkiye in terms of their perceived ease of use, perceived usefulness, perceived affordances, intention to use. The four key themes—perceived ease of use, perceived usefulness, perceived affordances, and intention to use—were initially inspired by the framework of Lazard et al. (2021) and served as the foundation for formulating the research questions; further details on their adaptation can be found under the 'Data Collection Tool' section. As a result, the suggestions to be drawn at the end of the research are expected to contribute to the possible establishment and development of video-mediated remote interpreting services within the scope of the Turkish healthcare system. 6 1.2 AIM OF THE STUDY This study, owing to its interdisciplinary nature, aims to review how remote interpreting for different languages in healthcare services is provided in the countries where this type of interpreting is efficiently provided. The study also aims to inquire into the expectations of physicians, interpreters, and foreign patients from the potential implementation of remote interpreting services in Türkiye in the future, where no such practice is available yet for a linguistically and culturally diverse population in its healthcare system. All related data would form a basis for some suggestions to be made at the end of the thesis to be proposed for the possible integration of VRI system into the healthcare system in Türkiye. 1.3 IMPORTANCE OF THE STUDY Türkiye does not currently have any available video remote interpreting services in its capacity. Considering that excellent and efficient remote interpreting services are available in foreign countries in their healthcare systems, this study were carried out to develop an understanding of how the most appropriate systems have been established in the concerned countries and also the vision that will pave the way to a possible decision to establish a VRI system. Considering that a video remote interpreting service is not described in the Turkish healthcare system and that no available implementation exists, this research will provide a platform for the potential users (physicians, interpreters, and foreign patients) to offer feedback and opinions about the possible integration of such services into the Turkish healthcare system. It reveals the current opinions on the concept of video remote interpreting services and their expectations from the potential implementation of video remote interpreting services in Türkiye regarding their perceived ease of use, perceived usefulness, perceived affordances, and intention to use. Ultimately, the findings of this research are expected to play a pivotal role in the possible establishment and development of video-mediated remote interpreting services, potentially improving the healthcare services provided in Türkiye. 7 1.4. RESEARCH QUESTIONS The research questions of this research are presented below: 1. How do the exemplary countries perform video remote interpreting services in their healthcare system in light of their available administrative documents? a- Legislation and regulations b- Practice 2. What are the expectations of interpreters, physicians, and foreign patients from the potential implementation of the video remote interpreting services in the Turkish healthcare system in terms of the following factors: a- perceived ease of use b- perceived usefulness c- perceived affordances d- intention to use 3. What sort of a systematic structure can be the best possible example to provide a VRI service in the Turkish healthcare context? 1.5. DEFINITIONS The definitions presented below were used to designate the framework of concepts adhered to in the study for the purposes of this research, to avoid confusion. (1) Ease of use (Kullanım kolaylığı): The degree to which a new video remote interpreting tool/system which resulted in adopting a process into the existing healthcare system can be utilized effortlessly and intuitively without requiring extensive effort. (2) Usefulness (Yararlılık): The extent to which a new video remote interpreting tool/system effectively enables users to achieve their goals or fulfill specific needs. (3) Perceived affordances (Uygunluk): The qualities or features of a new video remote interpreting tool/system that suggest or enable specific actions, as interpreted by users based on their prior experience and expectations. 8 (4) Intention to use (Kullanma isteği): The possible user’s deliberate willingness to adopt and engage with a new video remote interpreting tool/system as a new technology in the future while providing or receiving health care services. 1.6. ASSUMPTION  The respondents are assumed to respond to the questions raised during the interviews sincerely. 1.7. LIMITATIONS  The conclusion drawn from this research is limited first to the data gathered from publicly accessible institutional information extracted from the respective legislation and regulation and secondly to the results of the user expectation survey administered to physicians, interpreters and foreign patients along with the research diaries recorded by the researcher.  Findings are based on data collected from physicians and interpreters working in a single private hospital, as well as patients who received services there. The responses may have been shaped by the specific service conditions and working environment of the hospital, which could limit the generalizability of the results to other healthcare settings.  Target users: This research sample only includes people with limited language proficiency. The services provided for the deaf and hard of hearing or people with speech impairments are not included within the scope of this research data collection process. 9 CHAPTER 2 LITERATURE REVIEW This chapter focuses on the literature review of the study. Basic information on remote interpreting is presented along with its modalities which are telephone interpreting and video remote interpreting in the first part. This section also addresses the practices and research on video remote interpreting at both international and national levels along with its relevant studies in the related literature. The second part provides a general overview of video remote interpreting services and sheds light on the video remote interpreting services provided in the healthcare systems of the top four exemplary countries, along with their respective administrative and legislative documents. 2.1. REMOTE INTERPRETING Technological developments and societal changes lead people to find alternative solutions to overcome the language barriers experienced in communication. To keep pace with those developments, distance interpreting emerged and was defined as information and communication technology (ICT) enabled interpreting of a distant speaker at a certain event by the International Association of Conference Interpreters (AIIC, n.d). Remote Interpreting is used to ``gain access to an interpreter in another site in virtual settings at which the primary participants themselves are distributed across different sites`` (Braun, 2015, p.364). The practice of remote interpreting can be carried out in different forms, such as simultaneous, consecutive, and dialogue interpreting, as well as in the form of spoken or sign language interpreting. Paneth (1957, as cited in Braun, 2015) noted the first reference to remote interpreting in 1957 and described the practice “as a neat and obvious use of interpreters”. Despite the fact that remote interpreting practice was considered controversial at first mainly due to the reduced sensory input available to interpreters working in this modality (AIIC, n.d), its practice gradually increased, especially after the restrictions imposed after COVID-19 which is an ongoing global pandemic which keeps this ICT-enabled interpreting type as an attractive option for service delivery and a growth area in the market. 10 The varied use of ICT-based solutions under the general category of distance interpreting has led to the emergence of different interpreting modalities in response to evolving market demands in recent years. Previously, distance interpreting was considered an umbrella term encompassing various technology-mediated interpreting types, including remote interpreting. For instance, ISO Standard 20108 (2017) defined distance interpreting as “interpreting of a speaker in a different location from that of the interpreter, enabled by information and communications technology,” positioning remote interpreting as a subcategory. However, with the publication of the updated ISO 2024 standard, this distinction has been revised, and remote interpreting is now considered synonymous with distance interpreting, reflecting the increasing convergence of terminology in professional practice. In the revised version (2024), it is defined as “interpreting of a speaker or signer in a different location from that of the interpreter enabled by information and communications technology,” thereby explicitly including sign language users in the definition. This terminological shift signals a broader recognition of remote interpreting as a fundamental component of modern language access services, inclusive of both spoken and signed language modalities. Previously, the terminology used in the field of distance interpreting exhibited considerable variation, largely due to the existence of numerous categories and modalities within the domain. This lack of uniformity often led to inconsistencies in both academic and professional discourse. For example, Krasnopeyeva (2021) analyzed the taxonomy and terminology associated with distance interpreting and its sub-modalities, revealing that in both her working language (Russian) and in English, the terminology was highly diverse and lacked conceptual stability (p. 143). This finding reflects the broader challenges the field faced in achieving terminological clarity prior to more recent standardization efforts. As this form of interpreting has evolved alongside technological advancements, it has often been referred to as technology-mediated interpreting. In parallel with the development of the field, the categorization and terminology used to describe such practices have also undergone significant changes over time. This ongoing evolution has resulted in the use of varied terms across academic and professional literature, reflecting efforts to capture the expanding scope and complexity of the practice. A range of examples drawn from existing publications can illustrate how this 11 terminological diversity has emerged and shifted throughout the years. As a remarkable scholar, Sabine Braun has studied remote interpreting for nearly two decades. Her work has significantly contributed to the development of this area as she has conducted many studies and published relevant articles, research papers, and a book that sheds light on this field, mainly focusing on remote interpreting in criminal proceedings. Braun and Taylor (2011), in their article where they present an overview of practices and research on this type of interpreting in legal proceedings, utilize two different terms with a distinction of the interpreters being positioned in different locations as “Videoconference Interpreting (VCI)” and “Remote Interpreting” (RI) were explained; moreover, they introduced the term “video-mediated interpreting” as an umbrella term to cover all those varying forms of interpreting. According to their definition, - the first term – videoconference interpreting refers to the form of interpreting in which the interaction takes place at two video-linked locations with the interpreter being situated at either end of this video link, while the latter – remote interpreting, refers to the form of interpreting in which the interaction takes place at a single location, like a courtroom; however, the interpreter provides interpretation via video link from a remote location such as another courthouse (ibid, p.34). In line with this distinction, videoconference interpreting involves the use of a video link to facilitate communication between geographically separated parties, whereas remote interpreting refers specifically to the use of technology for “the sole purpose of linking a legal interpreter to the proceedings” (ibid., p. 41). 12 Figure 1: Braun and Taylor’s initial terminology use in their study titled “Video-mediated interpreting: an overview of current practice and research: Videoconference and remote interpreting in criminal proceedings” published in 2012 In 2015, Braun explains key terms and concepts, specifically related to remote interpreting in her related article. In her work, she defines remote interpreting as below (2015, p.364): “...remote interpreting (RI), refers to the use of communication technologies to gain access to an interpreter in another room, building, town, city or country. In this setting, a telephone line or videoconference link is used to connect the interpreter to the primary participants, who are together at one site. Braun classifies remote interpreting into two primary modalities: telephone-based and videoconference-based interpreting. In both cases, the main objective is to connect the interpreter with the primary interlocutors, who are typically co-located at a single site (ibid). In this work, Braun also acknowledges the ongoing ambiguity in the terminology used within the field. To address this, she proposes the use of two cover terms: telephone-based interpreting, referring to remote interpreting conducted via telephone or interpreter-mediated phone calls; and videoconference-based interpreting, referring to remote interpreting delivered through videoconferencing platforms or interpreter-mediated video interactions. The figure below presents alternative terminology that is often used interchangeably with these two overarching categories. Video-mediated Interpreting either a- interpreter is located with the other participants in the main room or b- interpreter is co-located with other language speaker Interpreter is located in a different place 13 Figure 2 : Braun’s classification for remote interpreting and different terminology use in her study published in 2015 Braun further distinguishes teleconference interpreting as a separate modality from remote interpreting, defining it as a three-way (multi-point) communication setup in which each participant—including the interpreter—connects from a different location via telephone or videoconference link. What sets teleconference interpreting apart from remote interpreting is the spatial distribution of the participants. Unlike remote interpreting, where the primary interlocutors are typically co-located and only the interpreter is remote, in teleconference interpreting all parties are geographically dispersed. As Braun emphasizes, the two modalities are not interchangeable due to this key structural difference (see the below figure). Figure 3: Participant distribution of location for teleconference interpreting and remote interpreting Remote Interpreting (RI) Telephone-based Interpreting (cover term) Remote Interpreting by telephone Interpreter mediated phone calls Telephone Interpreting Over-the-phone Interpreting Videoconference-based Interpreting (cover term) Remote Interpreting by videoconference Video-conference Interpreting Interpreter mediated videoconferencing Teleconference interpreting (clients at two or more sites) Remote interpreting (clients at one site; interpreter(s) at separete site(s)) 14 Further elaborating on terminology use, Braun (2019, p. 272), in her contribution to the Handbook of Translation and Technology, presents an updated framework illustrating the various terms applied to different technological configurations and participant location settings in interpreting. She notes that while the modalities of technology-mediated interpreting—also referred to as distance interpreting—are not yet standardized, the term distance interpreting continues to function as an umbrella concept encompassing all such modalities. In her classification, Braun organizes these modalities based on the communication technology employed (e.g., telephone, videoconference) as well as the physical distribution of participants and interpreters (ibid). This approach aligns with her earlier work and reinforces the idea that spatial configuration remains a primary factor in the categorization of technology-mediated interpreting practices (see below figure). Figure 4: Braun’s finalized (improved) categorization on the modalities of distance /technology mediated interpreting published in 2019 Building on her theoretical contributions to the field, Braun has also played a pivotal role in applied research and implementation. She notably served as a lead researcher in the Assessment of Video- Mediated Interpreting in the Criminal Justice System (AVIDICUS) projects, which were completed in three phases in 2008-2016 and tremendously contributed to video-mediated interpreting services provided in the legal settings and a more detailed and the most up-to-date classification (see below figure) is presented in Project’s official website (AVIDICUS, n.d). 15 Figure 5: The up-to-date classification presented in the official website of AVIDICUS projects (currently available in 2025) In addition to the typologies discussed above, the International Association of Conference Interpreters (AIIC) presents a classification of interpreting modalities that was formally adopted at the AIIC Assembly in 2015. The figure below has been extracted from AIIC’s official website and illustrates this classification. The typology is structured according to two main criteria: whether the participants are in direct or indirect visual contact, and the physical location of the interpreter or interpreting team. 16 Figure 6: The classification presented by AIIC in the official website, accepted AIIC 2015 Assembly during the Debate on Remote Interpreting In addition to the historical development of terminology—which simultaneously offers insight into the evolution of the remote interpreting field—English definitions and their corresponding English–Turkish translations are provided in Appendix 8: Glossary to further clarify the terminology discussed throughout this chapter. Additionally, this study adopts the classification proposed by the International Association of Conference Interpreters (AIIC), a leading professional body in the field, which presents an up-to-date typology aligned with current market trends and service demands. Accordingly, all headings and subheadings in this chapter have been structured based on this classification. To better understand the origins and institutional authority behind the adopted classification, it is essential to briefly introduce the role and structure of the International Association of Conference Interpreters (AIIC). The International Association of Conference Interpreters (AIIC) was founded in 1953 as a global association of conference interpreters to ensure service quality, professional ethics, and working conditions protecting the interpreter's health and well-being. The Association comprises numerous 17 committees and working groups focusing on various topics, from technical and health issues to research and training, all of which are administered by volunteer members. According to AIIC, Remote Interpreting, which is classified under ICT-enabled interpreting services, can be distinguished from other modalities by the lack of direct visual contact between the interlocutors involved in the interpreting process. AIIC had committed itself to the developments in this field and raised its concerns about remote interpreting solutions to protect the particular interests of the interpreters, like working conditions and well-being at a certain level, and promote high standards of quality before the pandemic, which hit the whole world at the end of 2019 and made humankind locked to their homes. To this end, AIIC published "AIIC Position on Distance Interpreting (DI)" in 2018 to emphasize that Information and Communications Technology (ICT) leads to the emergence of new interpreting modalities and its intertwining with conference interpreting might have negative implications on the multilingual communicative process as a whole (AIIC, 2018a, p.1). This position paper also refers to the importance of all ISO standards relating to conference interpreting, interpreting equipment, and sound and image input to interpreters, indicating the requirement of all Distance Interpreting modalities to meet not only the applicable requirements of those standards but also the Association's technical specifications (ibid, p.2). This paper is of great value in presenting the Association's rigorous stance towards Distance interpreting modalities since it also refers to AIIC Task Force on Distance Interpreting (n.d.), which conducted AIIC's first Distance Interpreting Survey in January 2018. This first AIIC survey on the use of 4 types of DI, namely Videoconference, Audioconference, Video Remote, and Audio Remote Interpreting, aimed to map the landscape and have a better understanding of the types and frequency of distance interpreting modalities used by members Report on Survey concludes above-listed four distance interpreting modalities under scrutiny are somewhat different not only from a technical point of view but also their frequency of use and their implementation channels are not same; therefore, these differences need to be acknowledged, and the discussion should take place on working conditions governing different distance Interpreting modalities (AIIC, 2018b, p.43). At the end of the report, the survey calls for additional systematic research into the cognitive ergonomics of distance interpreting modalities to establish 18 minimum standards and best practices, keeping in mind the increase in the frequency of use across all modalities inquired under Distance Interpreting in this survey. Upon changing realities, the association has released a new position paper dated 15 April 2020 referring to DI from home, which had to be welcomed by the whole world due to contamination risk for holding in-person meetings due to COVID-19. In this position paper, AIIC presented recommendations specific to the COVID-19 scenario regarding new working conditions, remuneration, and the use of remote simultaneous interpreting equipment. The difference in AIIC’s stance towards distance interpreting modalities can be clearly observed in two different position papers released by AIIC, respectively, in 2018 and 2020. While the first states that “AIIC has always supported face-to-face interpreting scenarios (technology, mode, and working conditions) that underpin interpretation quality and interpreter well-being” (AIIC, 2018a, p.1), the latter indicates “modalities of work with interpreters located together should always be preferred over work from home” (AIIC, 2020a, p.2) as a result of association’s acknowledgment of evolving conditions, especially after COVID-19 which leaves no other alternative scenario. Acknowledging the seismic shift to technology-mediated interpreting modalities, AIIC has set up the Taskforce on Distance Interpreting (TFDI) as a focal point for the association on all matters about the communication solutions provided by distance, with its consultative and coordinating functions. TFDI leads AIIC’s response to the new paradigm in collaboration with other AIIC groups, while its primary responsibilities include gathering evidence-based information for the practice of various distance interpreting forms, articulating the association’s position, and providing guidance and guidelines for its members in their efforts in various DI modalities for keeping pace with the developments in the field (AIIC, n.d). The Taskforce presents itself as a consultative, coordinating, research, awareness-raising, and outreach body of the association. In its consultative capacity, the TFDI equips its members and groups with related advice and assistance and feeds AIIC’s Executive Committee on policy decisions concerning technical, physiological, psychological, and practical aspects of distance interpreting modalities (ibid). 19 As to its coordination role, the TFDI is made up of representatives of different groups, which include all interpreters (freelance, consultant, staff), its working group on the International Organization for Standardization, the Training and Professional Development Committee, the Sign Language Network, the Advisory Board, its Executive Committee, the Research Committee (RC) and the Technical and Health Committee (THC). TFDI aims to coordinate DI activities with those groups, mainly hand in hand with the last two indicated groups (ibid). In its research capacity, the TFDI has carried out innovative research in the field of DI, which was an association-wide online survey on the frequency of use of different distance interpreting modalities in early 2018. The results of the survey are explained in the related chapter of this research, in which all relevant studies are presented in the field of video remote interpreting. The force also expresses that further research is also needed into its impacts in real-life situations, mainly with a focus on the service quality, health, and well-being of interpreters (ibid). Lastly, the TFDI is responsible for raising awareness and advocating for its members at DI- interpreting-related workshops, conferences, and other international activities. It is of the essence for the TFDI to engage with members on DI issues to provide them with the necessary toolkit just before they accept the offers or negotiate with employer organizations. It adheres to AIIC’s core values of teamwork, interpretation service quality, interpreter well-being, and a consolidated commitment to promoting multilingualism (ibid). Despite the fact that AIIC acknowledges, through its research component, further guidelines and recommendations are to be developed after carrying out further research on the field, the AIIC Taskforce on Distance Interpreting published “AIIC Guidelines for Distance Interpreting” in 2019. It updated it in March 2020 to reflect the new impacts of COVID-19 on the field. The guideline clearly states its primary purpose: to define “minimum standards and best practice recommendations applicable to working conditions for video remote conference interpreting in simultaneous mode” (AIIC, 2020b, p.2). Therefore, it should be noted that this guideline does not provide any information for any technology-mediated interpreting modality if there is no transmission of images of speakers and/or audience to the interpreter, such as telephone calls or audio conferences. AIIC aims to take a position to accompany the development of Distance 20 Interpreting on the world markets by providing input in shaping up-to-date requirements and recommendations in the provision of conference interpreting services in remote settings through these guidelines (ibid, p.1). The guidelines give detailed coverage of the topics related to working conditions and minimum standards such as location, presence of technician, interpreter access to software along with the relevant documents, confidentiality, data protection, briefing, the requirement of a language disclaimer added to the web streamed and/or archived recording, intercommunication, screens and microphone management and technical requirements, image quality and latency. Distance interpreting modalities can be used for different underlying motivations, with their advantages and disadvantages. On the upside, first and foremost, it helps to provide low-cost remote interpreting services since all parties are not required to be physically in attendance, which puts budgetary constraints out of the way, such as accommodation and transportation expenses for the interpreter. It also speeds up the process due to the fact that professional interpreters’ instant deployment is possible, and more to the point whenever they are needed urgently (Havelka, 2020; Devaux, 2017). Devaux (2017, p. ix), in her dissertation on technology-mediated interpreting in criminal court hearings, highlights that these remote solutions also enhance the security of interpreter-mediated communication. On the downside, the use of remote interpreting raises questions about interpreting quality, communication dynamics, training, and skills required for remote interpreters compared to onsite/face-to-face interpreting. Additionally, deterioration of working conditions along with remuneration is among the debatable issues. As a form of interpreting practiced in the encounters where public services are provided, remote interpreting also leaves a question mark on minds regarding equal access to public services such as healthcare and justice (Russo et al., 2020, p.235). Interpreters mediate communication in various settings which also requires remote interpreting modalities. Remote interpreters are also in great demand across public services, which results in them mainly providing community interpreting services, in other words. Typical settings they provide services are healthcare (medical consultation, hospitals, medical centers, any setting where a health consultation is needed), legal (law-enforcement agencies, police stations, detention centers, courts, hotspots for refugees), social and education (social service centers, schools, online 21 training sessions) and other settings (operations connected to emergency hotlines, administrative and public sector offices, tourism and entertainment, insurance companies, banks) (Russo, 2018, p.50). That all-inclusive range for work settings makes remote interpreting an overarching interpreting modality used across all fields, such as dialogue, conference, media, and especially health and legal. Moreover, it should be acknowledged that there is a growing demand for remote interpreting in legal, healthcare, business, and educational settings, and both methods are used to deliver spoken and sign-language interpreting alike (Braun, 2015, p.2). As explained in detail in the above paragraphs, focusing on classification and terminology used, Remote Interpreting (RI), as an ICT-enabled interpreting of a distant speaker, has two types of interpreting - audio (telephone) and video remote interpreting. While their similarity is the remote location of the interpreter, the difference between them is the availability of a video-mediated view of the speaker for the interpreter in the latter one, while the interpreter does not have a view of the speaker or any other participants (AIIC, n.d). Figure 7: Types of Remote Interpreting (RI) Based on this classification, the following sections will provide a more detailed examination of each mode of remote interpreting, exploring their specific characteristics, use cases, and implications within healthcare settings, beginning with an analysis of telephone interpreting. Remote Interpreting (RI) Telephone Interpreting (Audio Remote Interpreting) Video Remote Interpreting (VRI) 22 2.1.1. Telephone Interpreting (TI) As a basic definition, telephone interpreting is the modality of remote interpreting whereby the interpreters are connected to some or all participants by an audio link/telephone (Russo et al., 2020, p.235). Telephone interpreting was first introduced in 1973 as free of charge by the Immigration Department in Australia to respond to the increasing need for communication in other languages due to waves of immigrants coming to the country (Kelly, 2008, p.5). In the USA, telephone interpreting was first initiated in 1981 by a young police officer in collaboration with his colleague from the Defense Language Institute to establish an organization -Language Line Services- to overcome language barriers, only as a charity organization. However, it quickly expanded beyond police clients into other markets, like health care, and was transformed into a for-profit organization. (ibid, p.5). For decades, telephone interpreting brought people with different language backgrounds the ability to communicate with each other; therefore, the services reached an even larger group. However, phone call costs were high in some countries, and long-distance calls were expensive, which resulted in relatively slow growth and innovation in TI until the mid- 1990s, when people shifted to using mobile telephony rather than landlines. As a result of this big revolution, this led to a price decrease particular in fixed-line telephony, with the effect of greater capacity of new technologies, as well. This shift has liberated telephone interpreting from its obligatorily local and expensive use, and it lifted the confines of local networks and opened a new door for the practice of TI (Ozolins, 2011, p.34). Looking at the relevant research on telephone interpreting, Fernández and Russo (2020) draw a multidisciplinary theoretical and methodological framework for the study of telephone interpreting in their article published in 2020. The authors discuss the relevance of telephone interpreting components with, respectively, Ethnography of Communication, Conversation Analysis, Prosody, and Phonetics, with the aim of their contribution to a more comprehensive approach to the study and training of telephone interpreting. The Handbook of Remote Interpreting allocates a chapter focused on telephone interpreting and presents descriptive articles on telephone interpreting and its comparison with traditional methods. The first study published by Rodriguez (2018) explains the essential components of telephone 23 interpreting and the differences between telephone and face-to-face interaction, the classification of telephone interactions, the cultural aspects of phone calls, and the impacts of information and communication technologies on telephone interaction. The second study explains the figurations for participants’ location in telephone interpreting, sound quality, equipment, and system design, and communication management. It guides readers about the steps to be taken pre-/during/post telephone interpreting sessions. In the last study presented under this TI-specific interpreting section, Amato (2018) introduces the challenges and solutions through some paradigmatic examples. A comparative study conducted by Wang and Fang (2019) aims to compare the accuracy of interpreting performance in telephone and on-site interpreting through 3 simulated tasks; one is on-site while the others are telephone interpreting. According to the results, interpreters’ performance was found to be accurate in all three tasks, and the study identified the potential reasons behind the accurate and inaccurate interpretations. Another study (Wang, 2018) investigates the interpreter’s perspective on the suitability, remuneration, and quality of telephone interpreting and reports the findings from a survey conducted with 465 telephone interpreters. The study does not reveal optimistic results for the use of telephone interpreting. The interpreters reported serious problems, such as its use in inappropriate situations, and dissatisfaction resulting from the low remuneration for telephone interpreting; therefore, many interpreters declared a higher interest in providing on-site interpreting services, not telephone interpreting. In addition, the interpreters contributed to the study with their opinions regarding how the quality of telephone interpreting can be enhanced and highlighted that those interpreters, service receivers, and interpreter employers must work together to improve the service. With a solid foundation of academic research in place, it is essential to consider the results and perspectives if any policy development is at stake. However, recent technological advancements led to a tremendous transformation in the modality of remote interpreting, and the power of video communication also revolutionized the field. Integration of video technology into remote 24 interpreting opened a new era and provided real-time interpretation services from a distance; however, sustaining the essence of face-to-face interaction. 2.1.2. Video Remote Interpreting (VRI) The International Telecommunication Union (ITU) defines video remote interpreting (VRI) in a technical paper published in 2020 as follows (ITU, 2020, p. 3): “A system or service that provides a remote sign language interpretation between a sign language user and a hearing person using a telecommunication means” ISO Standard 20108 defines VRI as “(a type of) interpreting delivered from a different location than that of the speaker and the audience, enabled by information and communications technology (ICT), with sound and image from speakers being transmitted to interpreters”. It has unique main characteristics that differ from other modalities of distance interpreting. First of all, the interpreter has no in-person view of the speaker and the audience; in the same vein, the location of the interpreter is different from the other interlocutors engaged in interpreter-mediated communication. Furthermore, such visual input as the view of the speaker, audience, and visual material available for the audience is shown to interpreters on one or several screens (ISO, 2017). This provides an advantage to see the facial expressions, which is one of the fundamental elements of effective communication, contrary to telephone interpreting. According to the AIIC definitions and diagram released on its website, if the interpreter has only a video-mediated view of the speaker but not the view of other participants, this type is called single-screen video remote interpreting, while it is called multiscreen video remote interpreting if s/he has not only the view of the speaker but also some or all of the other speakers. 25 Figure 8: Types of Video Remote Interpreting (VRI) Video remote interpreting has gained prominence since it offers many advantages over traditional on-site interpreting methods to overcome its limitations. It provides substantial flexibility and overcomes the limitations of service provision as a qualified interpreter can be accessed from various locations, reduces costs such as travel and logistics, and enhance accessibility through a range of devices such as tablets, computer, or even phone. 2.1.2.1. Video Remote Interpreting (VRI) in the World Keeping pace with technological advancements, the number of VRI practices increases to address language barriers and facilitate effective communication between interlocutors in those settings worldwide. The earliest documented experiment on video remote interpreting was carried out by UNESCO in 1976 to test the use of the Symphonie satellite. The experiment linked the UNESCO headquarters in Paris with a conference hub in Nairobi, with the interpreters in Paris. Similar experiments were also carried out by the United Nations in the 1970s-1980s (University of Surrey, n.d). As ISDN-based (Integrated Services Digital Network) video conferencing was first in place in the 1990s, a video telephony experiment by the European Telecommunications Standards Institute was carried out in 1993, and the International Telecommunications Union organized a collaborative study with École de Traduction et Interprétation in 1999 to asses human factors such as psychological aspects. The latter study found that the interpreters’ performance in video remote interpreting was reduced faster than their on-site performance. Moreover, the European Parliament Video Remote Interpreting Multiscreen VRI Single Screen VRI 26 (EP) conducted a similar study in 2004, and its results presented no significant differences between video remote interpreting practice and on-site performance (ibid. and Şengel, 2022, p.175). Remote interpreting was introduced in the 1980s; however, this has gradually been replaced by video remote interpreting since it ensures that interpreters have more visually supportive inputs, such as the screen of other interlocutors and any additional materials. Video remote interpreting (VRI) has begun to be widely practiced in various public service settings, including healthcare, legal, and business, along with meetings held by international organizations. Looking at the practices in the legal settings, the first well-known example of VRI in legal settings was a central video interpreting hub introduced by the 9th Judicial Circuit Court of Florida in 2007 (the University of Surrey, n.d). The location of the interpreters working in the hub is configured to allow a combination of consecutive and simultaneous interpreting. The Florida courts (n.d.) define themselves as a leader in applying this technology and state that the courts were able to bridge the geographical divide between people in need of access to services and qualified interpreters. Similarly, the Metropolitan Police Service in London introduced the practice of video remote interpreting in 2011. It established centralized hubs linked to London police stations and consisted of interpreters working in consecutive mode (the University of Surrey, n.d). More importantly, the Article 7.6 under the European “Directive on the right to interpretation and translation in criminal proceedings (2010/64/EU)” released in 2010 explicitly states that: “Where appropriate, communication technology such as videoconferencing, telephone or the Internet may be used, unless the physical presence of the interpreter is required in order to safeguard the fairness of the proceedings.” The first academic studies on VRI in the legal settings were conducted under the scope of AVIDICUS (Assessment of Video-Mediated Interpreting in the Criminal Justice System) Projects, 2008-2016, with the financial support provided from the European Commission’s Directorate- General for Justice (see Relevant Studies section for detailed information). Those projects formed the basis for adopting the related legislation on video remote interpreting practice in legal settings. 27 Remote Interpreting Guide for Courts and Court Staff was released in 2014 by the National Center for State Courts in the USA, and it presents basic information on definitions, how it works, minimum technology requirements such as video screen, video camera, endpoint bandwidth, computer, software, quality of service, etc. Moreover, the California Federation of Interpreters released the “Video Remote Interpreting Position Statement” in 2013 on the grounds of the notification of the United States Department of Justice to all state courts about their obligation to provide meaningful access to all court users regardless of their language abilities. Considering California state courts provide service to the largest number of people with limited English proficiency nationwide, it is reasonable to conclude that VRI, when used appropriately, can expand language access in the courts despite the Federation’s concerns. Video remote interpreting practices play an essential role in ensuring equal access to justice when a person accused or suspected of a crime is engaged in criminal proceedings in which a foreign language is spoken and needs to get informed about their rights. By the same token, its practice in healthcare settings is of vital importance to deliver quality care and address the health inequalities resulting from linguistic and cultural diversities. Masland et al. (2010) state that poor communication resulting from limited language proficiency might cause lower patient use of preventive care, misdiagnosis, increased testing, low medication adherence, and increased hospital and emergency room admissions. They present relevant data in their publication to document the use of telephone and video interpretation solutions to improve healthcare communication with persons with limited English proficiency. It is unfortunate that there is no EU directive or legislative reference in EU resources regarding access to remote language services provided in healthcare settings, as it is available for those provided in legal settings. In the USA, even though (video) remote interpreting had been practiced even before, the sudden rise of technology-mediated interpreting solutions with COVID-19 was inevitable, especially in healthcare settings. To this end, numerous civil society organizations put an intensive effort in place and began to present several resources for language access during COVID-19. National Council on Interpreting in Health Care (NCIHC, n.d.) explicitly indicates its effort to ensure healthcare interpreters’ safety during the pandemic and presents a list on its official 28 website. The best practice guidelines provided step-by-step guidance on connecting qualified interpreters during healthcare access through a remote channel. All those resources and guidelines have built a solid foundation for video remote interpreting practices. For example, “Providing Interpreting Services During COVID-19” was collectively prepared by the National Council on Interpreting in Health Care (NCIHC), Association of Language Companies (ALC), American Translators Association (ATA), Certification Commission for Healthcare Interpreters (CCHI), California Healthcare Interpreting Association (CHIA), CoPTIC America (an advocacy organization), and Interpret America. Moreover, some countries have their country-specific legislative documents for video remote interpreting practice, and the details can be found in the relevant section on exemplary countries. Even though it is not widely practiced, video remote interpreting is also used in business and education settings purposes, such as training staff and capacity building. It eliminates language barriers, resulting in practical learning skills. In summary, there is an increase in the use of video remote interpreting in various settings where people need access to public services worldwide. As further research is conducted on the practice of video remote interpreting, the continued improvement will help to shape more country-specific guidelines and result in the adoption of respective legislations. 2.1.2.2. Video Remote Interpreting (VRI) in Türkiye Despite the growing significance of healthcare interpreting services in Türkiye, driven by the increasing number of international patients seeking treatments such as organ transplantation, infertility procedures, or wellness-related care (Toker, 2019, p. 23), video remote interpreting has not yet been integrated into the national healthcare system. Research on the use of VRI in the Turkish healthcare context also remains scarce, limiting the available knowledge on its potential implementation and impact. In light of this gap, the following section reviews the limited academic studies that have addressed related themes within the Turkish context. Okuyan and Şahin (2019) conducted a survey-based study on remote interpreting technologies. This study aims to reveal the perspectives and expectations of interpreting market representatives 29 on remote interpreting practice through the administration of a questionnaire to 34 companies, members of the Turkish Association of Translation Companies. According to the survey results, the representatives stated that their lowest level workload belongs to remote interpreting, with the respective percentages of 18% for simultaneous interpreting and 10% for consecutive interpreting. However, the representatives highlighted that it is a promising modality in light of the technological developments, and they would be better prepared for the required setup to respond to this need. To this end, integrating remote interpreting modalities into the training curriculum was seen as a must, considering its high potential to be improved and exponentially increase practices. Referring to the above study, Şahin (2022) published a script to explain her experiences with remote interpreting as a freelance interpreter. She recommends that Skype provides more advantages than Zoom since the user is not limited to 40 minutes. She adds that the lack of physical presence of the interpreter may cause the concurrence of speeches, blinking the fact that an interpreter is putting a cognitive effort behind. As another advantage, she states that note-taking during an online meeting requires less effort since the speakers constantly repeat themselves due to the lack of affirmative facial expressions such as nodding. The author also highlights the requirement to download up-to-date versions of relevant applications such as Zoom and Skype Lite, indicating that the availability of a high-speed internet connection is a must. In conclusion, she recommends the integration of lectures on remote interpreting into the current curriculum, as it has been done for the 2021-2022 academic year at the Sakarya University Department of Translation and Interpreting. Şan and Duru (2020) focus on how healthcare & community interpreting services are provided under COVID-19 conditions by administering a questionnaire to the interpreters to get their perspectives as healthcare interpreters working during the pandemic. Although this study does not directly investigate the remote interpreting practice, the results imply that the integration of remote interpreting services can help to enhance our health system and there is an obvious demand stated by the healthcare interpreters themselves during the interviews. The authors recommend that the integration of technological tools into the interpreting process in the ‘new structure’ should be 30 reflected in the professional standards in line with requirements for those new tools, so that quality remote interpretation services can be ensured. Şengel (2022) investigates the usability of the Zoom platform from the perspective of professional conference interpreters and focuses on the ergonomics of remote simultaneous interpreting practices. The USE (Usefulness, Satisfaction and Ease of Use) questionnaire developed by Lund was administered to 16 conference interpreters, although 75 were contacted. It aims to examine the usability of the platform by conference interpreters. Results found that the usability of the Zoom platform is of high scores, and interpreters welcome the improvement of the platform, which shows interpreters have the desire to improve the available remote simultaneous interpreting ergonomics. In conclusion, the practice of video remote interpreting in Türkiye preserves its significant potential to strengthen accessibility to public services, especially healthcare services and facilitate communication in different sectors between service providers and culturally and linguistically diverse people. Given that Türkiye occupies a unique geographic position and a large area situated as a bridge between Asia and Europe continents, the video remote interpreting solutions offer several advantages, such as the elimination of the constraints of distance (especially between rural and urban), enabling the equal public services regardless of the location, even for underserved areas where on-site interpretation opportunities may not be available, addressing the logistical challenges and reducing the travel duration and expenses. Responding to different emergencies (refugee flow after the Syrian War, earthquake in the Southeast region), Türkiye can benefit from the flexibility of this practice so that immediate access to qualified interpreters can be provided in urgent situations or in case of unexpected language needs through quick on-demand remote language support. Integration of video remote interpreting practice in Türkiye would foster inclusivity and empower individuals with limited language proficiency who need public services. However, the necessity of availability of respective software and applications along with a robust internet infrastructure must be borne in mind. The training of interpreters on technology-mediated interpretation practices can further optimize the quality of the services. 31 2.1.2.3. Relevant Studies on Video Remote Interpreting Despite the scarcity of research in this field in Türkiye, there are not only quite a number of studies but also a few doctoral dissertations published on the international platform. In addition to the research, several projects implemented by international and supra-national organizations shed light on the current practice of remote interpreting. The field has started to gain prominence in recent years, keeping in step with the development of technology worldwide. Even though the practice was controversial among interpreters, the last several years have seen an increase in this practice, especially after COVID-19, which left no other solution other than remote communication between people; therefore, the relevant research field caught the attention of scholars who began to carry out many field studies. This section will provide a generic insight into research and initiatives conducted in the related field. Several projects have been implemented in the last two decades, mainly focusing on training remote interpreters. Interpreting in Virtual Reality (IVY) Project, as an EU-funded Lifelong Learning Programme, was carried out in 2011-2013. The IVY project utilized the features of three- dimensional technology to ensure an adaptive 3D virtual environment that provides “the acquisition and application of skills” required in interpreter-mediated encounters. The rationale behind the implementation of this project is the consideration for the difficulty of achieving an ever-broadening range of interpreting scenarios in light of the increasing level of multilingualism in Europe with traditional teaching methods; therefore, it aims to adapt interpreters to the 3D virtual environment so that they can be adaptive to the virtual environment and exploit the potential of the virtual reality products. The project's deliverables include but are not limited to the review of best practices, 3D environment, and interpreting scenarios for interpreters, pedagogical evaluation report, and guidelines (IVY, n.d). Another European project, Evaluating the Education of Interpreters and their Clients through Virtual Learning Activities, aims to evaluate the virtual learning environments not only for the interpreters' training but also to educate the professionals/clients who can work with the interpreters in their daily lives. The rationale behind this project is that information and communication technologies can offer an opportunity to simulate real-life practice; therefore, 32 learners can gain a similar experience of situatedness and authenticity. Likewise, its use in interpreter training also ensures the same opportunities for interpreting students and the people who may work with them. In addition, using such technologies during the training will support students in acquiring digital competence (EVIVA, n.d). Interpreting students, users of interpreting services (clients), trainers of interpreters, and virtual learning tool developers were the target groups of this project. The document outputs of this project include, but are not limited to, a report on evaluation methods, videoconferencing environments, a report accompanying role play material, evaluation studies, and a best practice guide (ibid). Both above-explained EU-funded projects were conducted under EU Lifelong Learning Programme in coordination with the University of Surrey, and they pave the way for future research in the field of remote interpreting since they have many content-rich deliverables/reports and provide a fair amount of food for thought for scholars in the field. Assessment of Video-Mediated Interpreting in the Criminal Justice System (AVIDICUS) Projects package, with its quite comprehensive nature in video-mediated interpreting, has been carried out from 2008 to 2016 in coordination with the University of Surrey as three subsequent projects. All three successive projects focus on video-mediated interpreting practices, specifically in legal settings. The AVIDICUS 1 project was carried out in 2008-2011, and its primary aim was to investigate whether the quality of video-mediated interpreting (VMI) is good enough for criminal proceedings so that a significant step towards improving judicial cooperation across Europe would be taken. The specific objectives of the project were to identify the baseline situation where video-mediated interpreting would be most helpful with its different configurations from a criminal proceedings point of view, to assess the reliability of video-mediated interpreting from an interpreting point of view by conducting a series of comparative case studies (face-to-face interpreting vs. VMI) in order to formulate a set of recommendations for EU criminal justice services regarding the use of video-mediated interpreting in criminal proceedings, and to develop training modules on those new forms of interpreting to equip interpreter students, practicing legal interpreters and legal practitioners with the knowledge extracted based on the findings of those surveys. Implementation 33 of AVIDICUS 1 was successfully completed, and awe-inspiring outcomes are of outstanding contribution to the field, which is a set of recommendations for video-mediated interpreting practice in criminal proceedings such as benefits, risks, guidelines for best practice documents along with a set of training modules to equip legal practitioners, practicing interpreters and interpreting students with the relevant knowledge. On the other hand, it reveals that “further research was required to investigate how the combination of technological mediation through videoconference technology and linguistic-cultural mediation through an interpreter affects the specific goals of legal communication and to elicit adaptive strategies to mitigate such effects” (AVIDICUS, n.d.). Last but not least, the outcomes of this project served Criminal Justice Systems across Europe to develop common regulations on video-mediated interpreting practice in criminal proceedings. AVIDICUS 1 was a cooperative project involving partners in several European countries implemented in coordination with the University of Surrey (the UK) and partnership with Lessius Hogeschool Antwerp (Belgium), Local Police Antwerp (Belgium), Ministry of Justice (the Netherlands) and Legal Aid Board (the Netherlands), TEPIS Polish Society of Sworn and Specialised Translators (Poland) and one internal evaluator (AVIDICUS 1, n.d) AVIDICUS 2 was implemented in 2011-2013, and its objectives are listed below in line with the findings of its previous phase (AVIDICUS 2, n.d.): - To equip the national authorities, legal practitioners, interpreters and European citizens with the gained knowledge about the use of video-mediated interpreting (VMI) for criminal proceedings - To develop current insights further into remote forms of interpreting and reveal the best practice through research into the behavioural and communicative aspects of video-mediated interpreting services provided in criminal proceedings. - To advance training opportunities for video-mediated interpreting not only for interpreters but also for legal practitioners. In the scope of this second phase, the outcomes include but are not confined to a series of European workshops were held to train nearly 300 legal practitioners and interpreters on video-mediated interpreting, a set of recommendations and guidelines were revised regarding the use of VMI, its 34 benefits and challenges in criminal proceedings, three mini guidelines (for legal practitioners, interpreters, and European citizens) were published about the video-mediated interpreting practice in criminal proceedings and they were designed to be integrated in the European e-Justice portal. AVIDICUS 2 was a cooperative project involving partners in several European countries implemented in coordination with the University of Surrey (the UK) and in partnership with Lessius Hogeschool Antwerp (Belgium), Institut Télécom (France), Ministry of Justice (the Netherlands) and Legal Aid Board (the Netherlands) and one internal evaluator. While the findings of the AVIDICUS 1 and AVIDICUS 2 projects assessed the viability and quality of video-mediated interpreting practices carried out in criminal proceedings, AVIDICUS 3 (n.d), implemented as the last phase in 2014-2016, turned its focus on the design and implementation of bilingual video-mediated communication solutions. The primary aim of this project was to carry out a comprehensive assessment of the videoconference system as a communication tool in legal institutions across Europe to understand its suitability for bilingual communication. The project also aims to reveal the individual and institutional needs for training regarding bilingual videoconferencing and provide this training set using videoconferencing methods if needed. Under the scope of the research conducted in AVIDICUS 3, a “combination of over 100 stakeholder interviews, fieldwork in videoconferencing facilities and observations and qualitative analysis of over 300 videoconferencing-based proceedings” was used to examine the existing bilingual videoconferencing practices in different legal institutions located in 12 European countries. The project points out that legal and institutional stakeholders might underestimate the complexities of communication provided through the interpreter and bilingual videoconferencing and that a more comprehensive understanding of the specific requirements of that combination must be acquired in legal settings. AVIDICUS 3 was also a cooperative project involving partners in several European countries implemented in coordination with the University of Surrey (the UK) and in partnership with the Ministry of Security and Justice of the Netherlands, KU Leuven University, and Institut Mines Télécom, University of Trieste and one internal evaluator. 35 In conclusion, these three projects contributed quite a lot to the video remote interpreting field but were limited to legal settings. Several reports, one book, many articles, and chapters, along with one comprehensive book, were published as the outcomes of the subsequent projects. The methodology, survey tools, and re