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Table 2 Summary of the literature

From: Challenges, coping responses and supportive interventions for international and migrant students in academic nursing programs in major host countries: a scoping review with a gender lens

# 1st Author (year) Objective Methodologya/Discussion paper/Review typeb Countryc Foreign-born Students’ descriptiond Methodse (or N/A) Educational contextf
Research
1 Abu-Arab (2015) [50] To present and discuss the challenges faced by a group of clinical educators in teaching and assessing nursing students from culturally-and-linguistically diverse (CALD) backgrounds in Australian English-speaking hospitals. Qualitative descriptive Australia International students
Migrants
Creole, Mandarin, Khmer, Malay, French, Korean, Cantonese, Vietnamese, Swahili, Malayalam speaking
8 clinical educators
19 students
Questionnaire
Bachelor
Clinical
2 Abu-Saad (1981) [51] To assess the difficulties foreign nursing students encounter in their adjustment to university nursing programs and to evaluate the mechanisms that facilitate their adaptation to university nursing programs. Quantitative survey with open-ended questions United States Foreign-born
Asia, Latin America, North America, Middle East, Africa, Western Europe, Scandinavia, South Pacific
82 students
Questionnaire
Bachelor
Graduate (Masters)
Graduate (Doctorate)
Clinical
3 Abu-Saad (1982) [52] To examine actual and potential factors that help Asian students adjust to the nursing program and to describe difficulties encountered. Quantitative survey with open-ended questions United States Foreign-born
Asian
Students
(sample not specified)
Questionnaire
College/vocational
Bachelor
Graduate (Masters)
Graduate (Doctorate)
Clinical
4 Abu-Saad (1982) [53] To examine actual and potential factors that help Middle Eastern students adjust to the nursing program and to describe difficulties encountered. Quantitative survey with open-ended questions United States Foreign-born
Iran, Egypt, Lebanon, Jordan, Syria, Israel (Arab only)
LOT: average of 4 years
Students
(sample not specified)
Questionnaire
Not specified
5 Abu-Saad (1982) [54] To examine whether academic nursing programs in the United States meet foreign nursing students’ and their countries’ needs and expectations. Quantitative survey with open-ended questions United States Foreign-born
Asia, Latin America, North America, Middle East, Africa, Western Europe, Scandinavia, South Pacific
LOT: 64% < 6 years
82 students
Questionnaire
Bachelor
Graduate (Masters)
Graduate (Doctorate)
Clinical
6 Alexander (1991) [55] To examine the concerns of international students as they face life in a new culture and struggle with a second language, to examine their coping methods and to identify ways that can facilitate their learning. Ethnography United States International students
Africa, others not specified
16 students
Interviews
Bachelor
7 Ali Zeilani (2011) [56] To explore the doctoral study experiences of Jordanian students who completed their nursing doctoral degree in the United Kingdom. Qualitative descriptive United Kingdom International students
Jordan
16 students
Interviews
Graduate (Doctorate)
8 Bosher (2002) [57] To report the findings of a needs analysis conducted to determine why many English-as-a-second language (ESL) students enrolled in the Associate of Science degree nursing program were not succeeding academically and to report on the development, implementation and evaluation of a course created to respond to students’ challenges. Descriptive (qualitative and quantitative data) United States Migrants
Needs assessment: West Africa, East Africa, South East Asia, Caribbean, Former Soviet Union
LOT: an average of 5 years
Course participants: Liberia, Somalia, Ethiopia, Cameroon, Vietnam, Cambodia, Laos (Hmong), Nepal (Tibetan), China, Haiti, Cuba, Russia, Ukraine, India, Morocco
LOT: an average of 5 years; two students 20 or more years
1 program director
5 faculty members
28 students
(participated in the needs assessment)
18 students (participated in and evaluated the course)
Interviews
Questionnaires
Observations
College/vocational
Clinical
9 Bosher (2008) [58] To determine the effects of linguistic modification on ESL students’ comprehension of nursing course test items. Qualitative descriptive United States Migrants
India (Tibetan), Malaysia (Malay), Laos (Hmong), Ethiopia (Amharic)
LOT: 3–10 years
5 students
Interviews
Group discussions
Bachelor
10 Boughton (2010) [59] To describe and report findings from an evaluation of a support program for CALD nursing students enrolled in a two-year accelerated Master of Nursing program in Sydney, Australia. Qualitative descriptive Australia Foreign-born
Korea, Philippines, Tanzania, United States, Singapore, China, Laos, Romania, Nigeria, Kenya, Zimbabwe
LOT: 1 week to 29 years
13 students
Interviews
Graduate (Masters)
Clinical
11 Brown (2008) [60] To describe the development, implementation and outcomes of a program to increase the retention and success of foreign-born students challenged with English as a second language at a historically Black university located in Virginia, United States. Descriptive (qualitative and quantitative data) United States Migrants
Ghana, Ethiopia, Nigeria, Kenya; Philippines, Vietnam, Mexico, Panama, Caribbean
LOT: most > 10 years, two students < 2 years
22 students (provided input for program development)
Faculty members (sample not specified)
26 students
(outcome data)
Focus group
Questionnaire
Group meetings
Interviews
Informal discussions
University data
College/vocational
Bachelor
Clinical
12 Cameron (1998) [61] To report results from an extensive needs analysis for ESL-speaking graduate nursing students with a focus on skills required for school, clinical practice and interaction with a multicultural, socially stratified patient population. Descriptive/Ethnographic United States International students
Taiwan, Japan, Thailand, Jordan
16 students
(completed tests)
4 division chairpersons in the School of Nursing
Clinical preceptors, educators and students (participated in interviews and/or observations, sample not specified)
Speaking proficiency test
Observations
Interviews
Graduate (Masters)
Clinical
13 Campbell (2008) [62] To test the effects of using enhanced language instructions to improve oral and written communication skills for students with limited language proficiency and standard form of instructions. Pre-test post test United States Migrants
Chinese, Korean, Haitian, East Indian, Hispanic, Russian
20 students
Tests on oral and written performance
College/vocational
Clinical
14 Caputi (2006) [63] To describe how faculty members explored the learning needs of their student population with English-as-an-additional- language (EAL) and offer practical suggestions to help other faculty members. Qualitative descriptive United States Migrants
Poland, Romania, Mexico, China, Philippines
LOT: 6–18 years
7 students
Conversation circles
Observations
College/vocational
Clinical
15 Carty (1998) [64] To describe the challenges and support strategies used for Saudi international students in an intensive bachelor of nursing program in Virginia, United States. Qualitative descriptive United States International students
Saudi Arabia
12 students
Faculty members (sample not specified)
Discussions
Observations
Bachelor
Clinical
16 Carty (2002) [65] To identify challenges and positive points regarding international nurses’ doctoral education experiences in American schools of nursing. Descriptive (qualitative and quantitative data) United States International students
Survey: Taiwan, Thailand, Zimbabwe, Cameroon, Colombia, Iceland, Netherlands, Lebanon, Brazil, Gambia, Greece, Kenya, India, Liberia, Germany, Puerto Rico, Hong Kong, Switzerland, South Korea, China, Japan, Jordan, Canada, Saudi Arabia, Egypt, Jamaica
Focus group: Thailand, Egypt, Saudi Arabia
24 universities (presumably administrators and/or faculty completed surveys)
5 students
Survey
Focus group
Graduate (Doctorate)
17 Carty (2007) [66] To identify predictors of success of Saudi Arabian students enrolled in an accelerated baccalaureate program leading to a bachelor of science in nursing degree. Descriptive correlational United States International students
Saudi Arabia
34 students
Student records
Application forms
Bachelor
18 Chiang (2009) [67] To offer additional knowledge and insights regarding teaching and learning barriers encountered by international nursing students and those training them and to describe and report on the evaluation of a transition course developed to support international students at an Australian university’s school of nursing. Qualitative descriptive Australia International students Students
(sample not specified)
Educators
(sample not specified)
Interviews
Bachelor
Clinical
19 Colling (1995) [68] To describe the experiences of international students including how they learn about various nursing schools in the United States, the type of programs in which they enroll, and the barriers they encounter when they come to study and to identify strategies that schools of nursing use to manage the educational and cultural challenges that students face. Quantitative descriptive United States International students
Across the schools of nursing: 49 different countries, 50% from Asia
83 students: Asia, western Europe, Canada, Australia, Middle East, Africa, Hispanic countries
83 students
45 schools of nursing
Questionnaires
Bachelor
Graduate (Masters)
Graduate (Doctorate)
20 Crawford (2013) [69] To report findings from the initial round of interviews of an action research study, in which the project intended to evaluate the English language support program; identify the needs/ perceptions of students in terms of learning needs; and develop appropriate teaching/learning strategies to be implemented. Qualitative descriptive Australia International students
Migrants
Philippines, Zimbabwe, China, Japan, Egypt, Bangladesh
8 students
Interviews
Bachelor
Clinical
21 DeBrew (2014) [70] To describe nurse educators’ experiences where they struggled in their decision to fail or pass a student in clinical, including foreign students and other students with non-traditional backgrounds. Qualitative descriptive United States Foreign-born 24 educators
Interviews
College/vocational
Bachelor
Clinical
22 DeLuca (2005) [71] To describe what it is like to be a Jordanian graduate student in nursing in the contexts of a new culture, university and realm of professional nursing. Phenomenology United States International students
Jordan
7 students
Interviews
Journals
Graduate (Masters)
23 Donnell (2014) [72] To examine the associations between English language ability, participation in a reading comprehension program and attrition rates of nursing students in Texas. Correlational, secondary analysis United States ESL students
Black, Hispanic/Latino
3258 students (529 were ESL students)
Questionnaires
College/vocational
Bachelor
24 Donnelly (2009) [73] To identify factors that influence EAL students’ academic performance from the perspectives of the instructors. Qualitative descriptive Canada Migrants 9 instructors
Focus groups
Bachelor
Clinical
25 Donnelly (2009) [74] To gain a greater understanding of how EAL nursing students cope with language barriers and cultural differences and to identify the factors that help or hinder them to succeed. Mini-ethnography Canada Migrants
China, Korea, Japan, Romania, Ukraine, Hong Kong
LOT: 2.5–10 years
14 students
Interviews
Bachelor
Clinical
26 Doutrich (2001) [75] To describe the international educational experiences of Japanese nurses completing a masters’ or doctoral degree in the United States. Phenomenology United States International students
Japan
22 students
Interviews
Graduate (Masters)
Graduate (Doctorate)
Clinical
27 Dudas (2018) [76] To study EAL students’ experience in an accelerated second-degree baccalaureate nursing program. Phenomenology United States International students
Migrants
Korea, others unknown
12 students
Interviews
Field-notes
Bachelor
28 Dyson (2005) [77] To understand the lived experiences of Zimbabwean nursing students and to suggest strategies for improving their educational management. Life history study United
Kingdom
International students
Zimbabwe
9 students
1 nurse
Interviews/narratives
College/vocational
Clinical
29 Englund (2019) [78] To investigate the relationship between marginality and nontraditional student status in nursing students enrolled in a baccalaureate nursing program in Texas. Correlational United States ESL students 192 students (32 were ESL)
Questionnaire
Bachelor
30 Evans (2007) [79] To investigate the educational experiences of international doctoral nursing students and their research supervisors. Qualitative descriptive United Kingdom International students
East Asia, Middle East
5 students
11 supervisors
Questionnaire (open-ended questions)
Graduate (Doctorate)
31 Evans (2011) [80] To explore the international doctoral student journey; specifically, to investigate the learning experiences of international doctoral nursing students at different points in their journey and to identify best practice in supporting effective learning in this student group. Qualitative descriptive United Kingdom International students
European Union, Middle East, East Asia, South Asia, Sub-Saharan Africa
17 students
Interviews
Graduate (Doctorate)
32 Fettig (2014) [81] To explore the role of peer-group interactions in the socialization of non-traditional nursing students in a licensed practical nurses –to-associate registered nurse program in the Midwest, United States. Qualitative descriptive United States International students
African countries
10 students
Interviews
College/vocational
Clinical
33 Gardner (2005) [82] To gain a greater understanding of the factors that influence foreign-born students’ success in nursing school. Case study United States Foreign-born
East Indian
LOT: 5 years
3 students
Interviews
Observations
Bachelor
34 Gardner (2005) [83] To describe ethnic and racial minority nursing students’ experiences while enrolled in a predominantly White nursing program. Phenomenology United States Foreign-born
East Indian, Hispanic, Hmong (Laotian), Nigerian, Filipino, Nepalese, Vietnamese, Chinese
LOT: at least 4 years
15 students
Interviews
Bachelor
35 Gay (1993) [84] To describe the international students attending a large school of nursing in the United States, their challenges (from the perspective of faculty members) and the strategies used for dealing with problems. Case study United States International students
Finland, Iceland, Japan, Jordan, Korea, China, Taiwan, Saudi Arabia, Thailand
42 students
Observations
(by faculty)
Graduate (Masters)
Graduate (Doctorate)
36 Gilligan (2012) [85] To: [1] discover the specific needs of CALD students in the Master of Pharmacy, Joint Medical Program and Bachelor of Nursing programs in relation to language and cultural considerations and [2] delineate the attitudes of domestic students to the cultural issues experienced by their peers and patients. Qualitative descriptive Australia International students
China, Taiwan, Saudi Arabia, Philippines
35 students
(10 nursing students)
Focus groups
Bachelor
37 Gorman (1999) [86] To describe the views and experiences of non-English speaking background nursing students and the faculty members who teach them at two Australian universities. Qualitative descriptive Australia Foreign-born
Italy, Russia, Poland, Malawi, China, Iran, Romania, Hong Kong, Singapore, Malta, Vietnam
17 students
14 faculty members
Interviews
Bachelor
Clinical
38 Greenberg (2013) [87] To evaluate the effectiveness of a faculty development program on faculty’s self-reported feelings of comfort when acting as an ESL support person, ability to identify their own cultural biases and assumptions, knowledge of barriers and challenges faced by ESL nursing students, and ability to apply the knowledge gained from the project to ESL group sessions. Pre-test-post-test United States ESL students 10 faculty members
Questionnaires
Observations
College/vocational
Clinical
39 Guhde (2003) [88] To describe and present the evaluation of a tutoring program meant to help ESL students master the English language. Case study United States Foreign-born
China
1 student
Observations
Discussions
An evaluation of the student’s ability to understand clinical information
Bachelor
Clinical
40 Harvey (2017) [89] To explore adult international students’ experiences of leaving spouse and children for further education overseas. Descriptive phenomenology Australia International students
India, Indonesia, Vietnam, Brunei, the Philippines, Taiwan, China
LOT: 2 months- 6 years
10 students
Interviews
Graduate
(not specified)
41 Havery (2019) [90] To investigate how clinical facilitators’ pedagogic practices in hospital settings enabled or constrained the learning of students for whom English was an additional language. Ethnography Australia International students
Korea, Japan, Cambodia, Taiwan, China, India, Hong Kong, Nepal, Vietnam, Indonesia, Malaysia
21 students
3 clinical facilitators
Observations
Field-notes
Bachelor
Clinical
42 He (2012) [91] To investigate Chinese international undergraduate nursing students’ acculturative stress and sense of coherence at an Australian university in Sydney. Quantitative descriptive and correlational Australia International students
China
119 students
Questionnaires
Bachelor
43 Jalili-Grenier (1997) [92] To 1- determine nursing students’ perceptions of the learning activities which contribute the most to their knowledge and skills; 2- determine students’ perceptions of their learning difficulties; 3- compare the perceptions of ESL and non-ESL students; 4- determine nursing faculty perceptions of ESL students’ learning difficulties; 5- compare the perceptions of ESL students and faculty; and 6- identify needs for educational and/or supportive programs for faculty and students. Quantitative descriptive Canada International students
Migrants
21 countries
LOT: ages on arrival 1 to 29 years old
179 students
24 faculty
Questionnaires
Bachelor
Clinical
44 James (2018) [93] To explore the lived experience of one ethnically diverse nursing student who speaks English as a second language. Narrative inquiry United States Immigrant
India
LOT: immigrated when she was 11 years old
1 student
Informal discussions
Bachelor
Graduate (Masters)
Clinical
45 Jeong (2011) [94] To explore the factors that impede or enhance the learning and teaching experiences of CALD students and academic and clinical staff respectively and to identify support structures/systems for students and staff. Qualitative descriptive Australia International students
Students enrolled in program: China, South Korea, other countries
Participants: China, Philippines, Botswana
11 students
3 clinical facilitators
4 academic staff
Focus groups interviews
Bachelor
Clinical
46 Junious (2010) [95] To describe the essence of stress and perceived faculty support as identified by foreign-born students enrolled in a generic baccalaureate degree nursing program. Interpretive phenomenology with a quantitative component United States International students
Migrants
Nigeria, Cameroon, China, India, Vietnam
LOT: <  10 years
10 students
Focus groups
Interviews
Questionnaires
Bachelor
Clinical
47 Kayser-Jones (1982) [96] To identify the facilitating factors that help European and Canadian nursing students’ adjustment to American culture and the university and to describe their learning experiences and difficulties encountered. Quantitative survey with open-ended questions
(qualitative data from open-ended questions were the focus in this paper)
United States Foreign-born
Canada, Norway, Denmark, England, Germany
Students
(sample not specified)
Questionnaire
Bachelor
Graduate (Masters)
Graduate (Doctorate)
Clinical
48 Kayser-Jones (1982) [97] To discuss the concept of loneliness and its relationship to the education of foreign nursing students who study in the United States. Quantitative survey with open-ended questions United States International students
Asian, Latin American, Canadian, Middle Eastern, African, European, Australian
82 students.
Questionnaire
Bachelor
Graduate (Masters)
Graduate (Doctorate)
49 Keane (1993) [98] To examine learning styles, learning and study strategies, and specific background variables (primary language, ethnic background and length of time in the United States) in a multicultural and linguistically diverse baccalaureate nursing student population. Correlational United States Foreign-born
Nigeria, Ghana, Sierra Leone, Liberia,Dominican Republic, Jamaica, Haiti, Barbados, Nicaragua, Philippines, Hong Kong, Taiwan, China, Europe, Columbia, Peru
LOT: 1 to > 10 years
112 students
Questionnaires
Bachelor
50 Kelton (2014) [99] To describe the clinical coach role and present data collected including outcomes achieved when a clinical coach role was implemented to support and develop nursing practice for the marginal performer or ‘at risk’ student. Quantitative descriptive Australia International students
ESL students
188 students
University student data (outcomes of coaching)
Bachelor
Clinical
51 Khawaja (2017) [100] To examine the relationship between second language anxiety and international nursing student stress. Correlational Australia International students
LOT: majority 1–3 years, some < 1 year, others > 3 years
152 students
Questionnaires
Bachelor
Clinical
52 King (2017) [101] To explore the perceived effectiveness of standardized patients as a means to achieve academic success among EAL nursing students. Qualitative descriptive Canada ESL students
Arabic, Tagalog, Malayalam, Bengali, Afrikaans, other languages- speaking
35 students
Focus groups
Bachelor
Clinical
53 Leki (2003) [102] To describe a Chinese undergraduate student’s literacy experiences in her nursing major. Case study United States International students
Migrants (participant seems to be an immigrant but paper overall pertains to immigrants and international students)
China
LOT: 5 years
1 student
Students’ professors (sample not specified)
Interviews
Observations
Journals
Students’ school documents (e.g., assignments)
Bachelor
Clinical
54 Lu (2012) [103] To elicit clinical tutors’ views on the ways in which EAL nursing students had developed appropriate spoken English for the workplace. Qualitative descriptive New Zealand International students
Migrants
4 clinical tutors
Interviews
Bachelor
Clinical
55 Malu (1998) [104] To uncover the problems that impeded success for immigrant ESL nursing students. Case study United States Migrants
Latin America (region of origin was only mentioned for one student)
Students
(sample not specified)
Interviews
University admission data
Observations
College/vocational
Clinical
56 Markey (2019) [105] To explore international student experiences while undertaking Master of Science postgraduate education far from home. Qualitative descriptive Ireland International students
Asian
11 students
Interviews
Graduate (Masters)
57 Mattila (2010) [106] To describe international student nurses’ experiences of their clinical practice in the Finnish health care system. Qualitative descriptive Finland International students
African, Asian
14 students
Interviews
Bachelor
Clinical
58 McDermott-Levy (2011) [107] To describe the experience of female Omani nurses who came to the United States to earn their baccalaureate degree in nursing. Descriptive phenomenology United States International students
Oman
12 students
Interviews
Bachelor
Clinical
59 Memmer (1991) [108] To identify and describe the various approaches used in baccalaureate nursing programs in California to retain their ESL students. Descriptive (included qualitative and quantitative data) United States Migrants 21 nursing programs (data collected from directors or designees of the programs)
Questionnaire
Bachelor
Clinical
60 Mikkonen (2017) [109] To describe international and national students’ perceptions of their clinical learning environment and supervision, and explain the related background factors. Cross-sectional Finland International students
Africa, Europe, Asia, North America, South America
LOT: 1–33 years
329 students (231 were international students)
Questionnaire
Bachelor
Clinical
61 Mitchell (2017) [18] To explore the learning and acculturating experiences of international nursing students studying within a school of nursing and midwifery at one Australian university. Qualitative Australia International students
Chinese, others unknown
17 students
Interviews
Field-notes
Bachelor
Graduate (not specified)
Clinical
62 Muller (2015) [110] To present a case study, including an evaluation of a school-based language development and support program for EAL students. Case study Australia International students
Asian, others unknown
Students
(sample not specified)
Faculty and staff
(sample not specified)
Student data (e.g., number who participated in program, number who accessed resources, fail rates)
Faculty and staff feedback through various methods
Bachelor
Graduate (not specified)
Clinical
63 Mulready-Shick (2013) [111] To explore the experiences of students who identified as English language learners. Interpretive phenomenology United States Migrants
Central America, South America, Africa
LOT: came to reside in United States in adolescence or early adulthood
14 students
Interviews
College/vocational
64 Newton (2018) [112] To examine the experiences of registered nurses who supervise undergraduate international nursing students in the clinical setting. Case study Australia International students 6 clinical supervisors
Interviews
Bachelor
Clinical
65 Oikarainen (2018) [113] To describe mentors’ competence in mentoring CALD nursing students during clinical placement and identify the factors that affect mentoring. Cross-sectional Finland Migrants 576 clinical mentors
Questionnaire
Bachelor
Clinical
66 Ooms (2013) [114] To identify and describe available supports at two universities for non-traditional background students and to measure the students’ perceptions regarding the use and usefulness of these supports. Cross-sectional with a qualitative component United
Kingdom
ESL students 812 students
Questionnaire
Bachelor
Clinical
67 Palmer (2019) [115] To explore the lived experiences of graduate international nursing students enrolled in a graduate nursing program. Descriptive phenomenology United States International students
Saudi Arabia, India
12 students
Interviews
Graduate (Masters)
68 Rogan (2013) [116] To describe and evaluate an innovation to assist ESL nursing students at an Australian university develop their clinical communication skills and practice readiness by providing online learning resources, using podcast and vodcast technology, that blend with classroom activities and facilitate flexible and independent learning. Cross-sectional with a qualitative component Australia ESL students
Chinese, Korean, Nepalese, Vietnamese, Other
558 students
(254 were ESL students)
Questionnaire
Bachelor
Clinical
69 Sailsman (2018) [117] To explore the lived experience of ESL nursing students who are engaged in learning online in a Bachelor of nursing program. Interpretive phenomenology United States ESL students
Spanish, African, Russian, French, Filipino (Tagalog) speaking countries
10 students
Interviews
Bachelor
70 Salamonson (2010) [118] To evaluate a brief, embedded academic support workshop as a strategy for improving academic writing skills in first-year nursing students with low-to-medium English language proficiency. Randomized controlled design Australia International students
Migrants
106 students
Student assignment scores
Bachelor
71 San Miguel (2006) [119] To report on the design, delivery and evaluation of an innovative oral communication skills program (the ‘clinically speaking program’) for first year students from non-English speaking backgrounds in a Bachelor or nursing degree at an Australian university. Descriptive (included qualitative and quantitative data) United States Foreign-born
China, Hong Kong, Korea, Vietnam
LOT: arrived within the previous 4 years
15 Students
3 clinical facilitators
Survey
Students’ clinical grades
Focus groups
Students’ and facilitators’ comments
Bachelor
Clinical
72 San Miguel (2009) [120] To report on an evaluation of the long-term effects of a language program that aimed to improve students’ spoken communication on clinical placements. Qualitative descriptive interpretive United States International students
China, Vietnam, Taiwan, Hong Kong
10 students
Interviews
Bachelor
Clinical
73 Sanner (2002) [121] To explore the perceptions and experiences of international students in a baccalaureate nursing program. Qualitative descriptive United States International students
Nigeria
LOT: 5–20 years
8 students
Interviews
Bachelor
Clinical
74 Sanner (2008) [122] To describe the experiences of ESL students in a baccalaureate nursing program to develop a better understanding of the reasons for their course failures. Qualitative descriptive United States Migrants
Liberia, Philippines
LOT: 13–24 years
3 students
Interviews
Bachelor
Clinical
75 Shakya (2000) [123] To explore the experiences of a small number of ESL/international nursing students during one year of their studies at a large Australian university. Hermeneutic phenomenology Australia International students
Migrants
Vietnam, Ethiopia, Iran, Nepal, Philippines, South Africa
LOT: 4 months to 10 years
9 students
Interviews
Bachelor
Clinical
76 Shaw (2015) [124] To identify key learning and teaching issues and to implement and evaluate ‘group work’ as a teaching strategy to facilitate international nursing student learning. Participatory action research (descriptive with quantitative and qualitative data) Australia International students
Middle-East, South East Asia, Europe, Canada, North America, South America
12 students
(planning phase)
14 teaching staff (planning phase)
108 students (31 were international students; evaluation survey)
Interviews Questionnaire (also included open-ended questions)
Bachelor
77 Starkey (2015) [125] To explore the critical factors that influence faculty attitudes and perceptions of teaching ESL students. Grounded theory United States ESL students 16 educators
Interviews
Focus group
College/vocational
Bachelor
Graduate (Masters)
Clinical
78 Valen-Sendstad Skisland (2018) [126] To shed light on practice supervisors’ experiences of supervising minority language nursing students in a hospital context. Qualitative descriptive Norway Foreign-born 10 Clinical supervisors
Interviews
Bachelor
Clinical
79 Vardaman (2016) [127] To describe the transitions and lived experiences of international nursing students in the United States. Descriptive phenomenology United States International students
Vietnam, China, Nepal, South Korea, Colombia, St. Lucia, Rwanda, Nigeria
LOT: 9 months to 5 years, average of 4.3 years
10 students
Interviews
College/vocational
Bachelor
Clinical
80 Wang (1995) [128] To describe the experience of Chinese nurses studying abroad. Phenomenology United
States
International students
Taiwan
23 students
Interviews
Bachelor
Graduate (Masters)
Graduate (Doctorate)
Clinical
81 Wang (2008) [129] To describe the experiences of Taiwanese baccalaureate and graduate nursing students studying at Australian universities. Qualitative descriptive Australia International students
Taiwan
LOT: <  1 year to > 2 years
21 students
Interviews
Bachelor
Graduate (Masters)
Clinical
82 Wolf (2019) [130] To explore the experiences of Chinese nurses when completing a graduate nursing degree taught in English (as a second language) in the United States. Case study (included qualitative and quantitative data) United States International students
China
8 students
Survey
Interviews
Graduate (Masters)
Clinical
Discussion papers
83 Abriam-Yago (1999) [131] To discuss and present the Cummins Model as a framework for nursing faculty to develop educational support that meets the learning needs of ESL students. Discussion paper United States Migrants N/A Any program
Clinical
84 Choi (2016) [132] To provide an overview of the establishment and implementation of a proactive nursing support program purposely designed to address the challenges faced by EAL students. Discussion paper Canada ESL students N/A Bachelor
Clinical
85 Coffey (2006) [133] To describe a bachelor of Science in Nursing Bridging Program which aims to address barriers and provide access to employment for internationally educated nurses who are residents in Ontario, Canada. Discussion paper Canada Migrants N/A Bachelor
Clinical
86 Colosimo (2006) [134] To discuss how shame affects the learning and experiences of ESL students and present the implications for nursing education. Discussion paper United States International students
Migrants
N/A College/vocational
Bachelor
87 Genovese (2015) [135] To describe the current complexities associated with the process of admitting international students to graduate nursing programs and how to avoid some pitfalls. Discussion paper United States International students N/A Graduate (Masters)
Graduate (Doctorate)
Clinical
88 Henderson (2016) [136] To provide tips on how to support international students to overcome challenges while studying nursing in Australia. Discussion paper Australia International students N/A Bachelor
89 Malu (2001) [137] To propose six active learning-based teaching tips for faculty teaching ESL students. Discussion paper United States Migrants N/A College/vocational
Bachelor
Clinical
90 Robinson (2006) [138] To describe the development and implementation of a partnership and program at an American university for foreign nurses from India to obtain graduate education. Discussion paper United States International students
India
N/A Graduate (Masters)
Clinical
91 Ryan (1998) [139] To describe the challenges and strategies used in a program at an American university that provides nurses from Taiwan to obtain a bachelor of science degree in nursing. Discussion paper United States International students
Taiwan
N/A Bachelor
Clinical
92 Shearer (1989) [140] To provide suggestions for teachers who are presented with the challenge of teaching students that use English as a second language. Discussion paper United States International students N/A College/vocational
Bachelor
93 Terada (2012) [9] To describe the requirements for admission and the challenges that international and ESL students face while studying in advanced practice nursing programs in the United States. Discussion paper United States International students N/A Graduate (Masters)
Clinical
94 Thompson (2012) [141] To explore cultural differences in communication and to identify strategies to improve the experience of international and ESL students studying in advanced practice nursing programs in the United States. Discussion paper United States International students N/A Graduate (Masters)
Clinical
Reviews
95 Burnard (2005) [142] To review and discuss some of the research on problems associated with studying overseas and in a different culture and to provide suggestions on how teachers in universities might address these challenges. Literature review United Kingdom Foreign-born 17 sources (books, dissertation, chapters, online material)
Medline, library searches and ‘serendipitous findings’
Any program
96 Choi (2005) [143] To examine the challenges faced by ESL nursing students, and identify strategies and explore the utility of the Cummins model of English language acquisition in educating these students. Recommendations for educating ESL nurses are also made. Literature review Canada ESL students 12 articles
Search strategy not specified
College/vocational
Bachelor
Clinical
97 Crawford (2013) [19] To discuss the challenges ESL nursing students face in adjusting to Western culture, their difficulties using academic English and technical language of healthcare, and the support programs for these students. Literature review Australia ESL/international students 33 sources (articles and books)
Search strategy not specified
Bachelor
Graduate (Masters)
Clinical
98 Davison (2013) [144] To investigate the application of mobile technologies to support learning in a specific context, namely nursing education for ‘English as a foreign language’ learners. Qualitative meta-synthesis Canada ESL students 66 sources (articles and dissertations)
Databases (ERIC, Education Research Complete, CINAHL)
Not specified
Clinical
99 Edgecombe (2013) [145] To identify factors that may impact international nursing students’ clinical learning with a view to initiating further research on how to work with these students to enhance their learning. Literature review Australia International students 36 articles
Databases (CINAHL, ERIC, PubMed, Medline, ProQuest Central, Biomed Central, Joanna Briggs, Cochrane databases, Google Scholar, Sci-Verse-Hub)
Bachelor
Clinical
100 Evans (2010) [146] To review the literature on international doctoral students’ experiences, with specific reference to nursing. Literature review United Kingdom International students 19 sources (book chapter, research report, conference paper, journal articles)
Databases (ERIC, CINAHL, PubMed, ASSIA)
Graduate (Doctorate)
101 Gilchrist (2007) [37] To discuss strategies for attracting and retaining students from diverse backgrounds, including ESL students in nursing education. Literature review United States ESL students 13 articles (other literature related to other student groups who face barriers in nursing education was also included)
Search strategy not specified
Bachelor
Clinical
102 Greene (2012) [33] To discuss the barriers to educational success among internationally born students and to propose practical, evidence-based strategies that nursing faculty can implement to help international students succeed in nursing school. Literature review United States International students
Migrants
31 sources (articles, books)
Search strategy not specified
College/vocational
Bachelor
Graduate (Masters)
Graduate (Doctoral)
Clinical
103 Hansen (2012) [147] To discuss areas of difficulty for ESL nursing students and to recommend strategies that can be employed by supportive faculty to assist these students. Literature review United States ESL students 35 sources (book chapters, articles)
Search strategy not specified
College/vocational
Clinical
104 Koch (2015) [42] To identify studies which describe the clinical placement experiences of nursing students who have a broad range of diversity characteristics. Literature review Australia International students
Migrants
6 articles (other literature related to other student groups who face barriers in nursing education was also included)
Databases (CINAHL, PubMed, Academic Search Complete, Medline, Education Search Complete, Health Source: Nursing/Academic Edition, Science Direct, Scopus, Google Scholar) and reference lists of potentially relevant studies
Bachelor
Clinical
105 Kraenzle Schneider (2019) [148] To discuss the challenges of international doctoral nursing students and recommend strategies to support them. Literature review United States International students 17 articles
Databases (CINAHL, Medline, PsychInfo, PubMed, Scopus) and ‘other search methods’
Graduate (Doctorate)
106 Lee (2019) [149] To examine the effectiveness of programs to improve (clinical) placement outcomes of international students and to collate recommendations made by international students and/or placement supervisors that they felt might improve placement outcomes. Systematic review Australia International students 10 articles (other literature related to other disciplines was also included)
Databases (PsychInfo, CINAHL Plus, ProQuest Central, ERIC, Informit A+ Education, Informit MAIS) and reference lists of included articles
Bachelor
Graduate (Masters)
Clinical
107 Malecha (2012) [17] To identify and summarize what have been reported as stressors to foreign-born nursing students living and studying in the United States. Literature review United States International students
Migrants
11 articles
Databases (ERIC, CINAHL, MEDLINE, PsychInfo, Web of Science) and reference lists
College/vocational
Bachelor
Clinical
108 Mikkonen (2016) [20] To describe the experiences of CALD healthcare students’ in a clinical environment. Systematic review of qualitative studies Finland International students
Migrants
12 articles
Databases (CINAHL, Medline, Scopus, Web of Science, Academic Search Premiere, ERIC, Cochrane library) and reference lists of included studies
Bachelor
Clinical
109 Newton (2016) [150] To review the literature reporting on the experiences and perceptions of registered nurses who supervise international nursing students in the clinical and classroom setting. Integrative literature review Australia International students 10 articles
Databases (CINAHL, Informit, PubMed, Medline, Journals@Ovid, Findit@flinders)
Bachelor
Clinical
110 Olson (2012) [34] To identify the barriers and discover bridges to ESL nursing student success. Literature review United States International students
Migrants
25 articles
Databases (Academic Search Premier, CINAHL, PubMed, DAI, ERIC) and reference lists from the first database run
College/vocational
Bachelor
Clinical
111 Scheele (2011) [151] To synthesize the existing literature on Asian ESL nursing students including their challenges encountered and academic strategies to help these students. Systematic review United States International students
Migrants
Asian
15 articles
Databases (CINAHL, LexisNexis, Expanded Academic ASAP plus, Medline, Cochrane Database of Systematic Reviews, PsychInfo)
Bachelor
Clinical
112 Starr (2009) [152] To synthesize the current qualitative literature on challenges faced in nursing education for students with EAL. Meta-ethnographic synthesis of qualitative literature United States Migrants 10 articles
Databases (CINAHL, ERIC, PubMed, EbscoHost, Medline)
Bachelor
Clinical
113 Terwijn (2012) [153] To synthesize the existing literature on the experiences of international students in undergraduate nursing programs in English-speaking universities. Systematic review Australia International students 19 articles
Databases (CINAHL, Medline, EBSCOHost, ERIC, PsychInfo, MedNar, ProQuest Dissertations and Theses, Google Scholar + several others (n = 37 total)) and reference lists of suitable articles collected during the search process
Bachelor
Clinical
114 Wang (2015) [154] To report the current knowledge on the Chinese nursing students’ learning at Australian universities. Narrative literature review Australia International students
Chinese
15 articles
Databases (A+ Education, Australian Bureau of Statistics, CINAHL, ERIC, Medline, ProQuest), table of contents of 14 journals and reference lists of relevant articles
Bachelor
Graduate (Masters)
Graduate (Doctorate)
Clinical
  1. a The methodology is based on what was reported in the paper. If a general qualitative methodology was used, it is described as ‘Qualitative descriptive’
  2. b The review type is based on what was reported in the paper. If no specific type of review was named, it is described as a ‘Literature review’
  3. c For discussion papers, the country is based on the location that was the focus of interest in the discussion. For reviews, the country is based on the country where the first author is based (since almost all reviews included literature from multiple countries and did not focus on a specific country)
  4. d For research papers that included student participants, the description of students indicates whether participants included international students and/or migrants; ‘foreign-born’ is indicated if it’s clear that foreign-born students were included but it’s unclear whether they were international students and/or migrants; ‘ESL students’ is indicated if it was not explicitly stated that foreign-born students were included in the study (and there was no explicit mention of international students and/or immigrant students). Country/region of origin or ethnic/language background and LOT (length of time) in country are indicated if information was available for these indicators. For research papers that included only educators and/or administrators as participants, discussion papers and reviews, the description of students is based on the focus of the paper – i.e., international students and/or migrants or foreign-born or ESL students; country/ethnic background is indicated if a specific group was examined
  5. e For research papers, the methods include the sample (the number of student and/or educator/administrator participants) and the methods used to gather data. For reviews, the methods include the number and type of sources included in the review and the process used for identifying sources
  6. f For research papers, the educational context is based on the degree level of the student participants and/or the degree level of the students who were supervised and educated by the educator participants. ‘College/vocational’ refers to a level of qualification that is between a high school diploma and a bachelor’s degree. For discussion papers and reviews, the educational context is based on the degree level that was the focus of interest in the paper or the degree level that the results pertain to. In all instances, ‘Clinical’ is indicated if the clinical context was examined or discussed in the paper