International nursing students' perceptions and experiences of transition to the nursing workforce - A cross-sectional survey.

OBJECTIVE: To investigate international nursing students' perceptions about their preparedness and experiences of transition from the educational settings to the host country's nursing workforce. BACKGROUND: Transition from a student to a registered nurse is a challenging phase for undergraduate nursing students. Undergraduate nursing students have reported concerns about their clinical preparedness and felt inadequately prepared as new graduates. One under-researched area is international nursing students' preparedness and experiences of transition from their undergraduate nursing program to the host country's nursing workforce. DESIGN: A descriptive cross-sectional study. SETTING: Online survey active from 26 October 2020-31 January 2021 in Australia. PARTICIPANTS: 110 eligible international nursing students (Mean age = 25.10 ± 3.32; 57.8% female) in the final year of their undergraduate nursing program Australian universities took part in the survey in 2020. METHODS: The survey used the Casey-Fink Readiness for Practice Survey as well as newly added questions to measure transition preparedness, clinical preparedness, facilitators and barriers that may affect transition and the impact of Coronavirus disease of 2019 on transition. Both descriptive and inferential statistics were used for data analysis. RESULTS: Over 90% of the respondents planned to transition to the Australian nursing workforce, with over 50% feeling prepared to transition as registered nurses. However, over 50% of the respondents did not feel ready to find nursing employment in Australia. When assessing clinical preparedness, participants reported their discomfort and lack of confidence in dealing with dying patients, delegating tasks to nursing assistants and communicating and interacting with physicians and interdisciplinary team members in the clinical area. They also reported clinical simulation activities helpful in clinical preparation, being comfortable in taking actions to solve problems and being confident in identifying actual or potential safety risks for patients. The major barriers for transition included temporary visa status, financial challenges, duration of clinical placements during the nursing program, inability to comprehend local colloquialism and knowledge of the Australian healthcare system. The main facilitators were clinical simulation experiences, the ability to speak languages other than English and interactions with people from diverse cultures. CONCLUSIONS: International nursing students had unique challenges related to their temporary visa status, knowledge of the Australian healthcare system and comprehension of colloquialism. Clinical simulation experiences, the ability to interact with diverse cultures and speak different languages contributed positively to their transition preparedness. They expressed their desire to have extended clinical placements in more acute care settings to improve their clinical experiences.

International nursing students' and international nursing graduates' experiences of transition to the nursing workforce: A systematic review of qualitative evidence.

OBJECTIVE: The objective of this systematic review was to identify and synthesise existing evidence on the experiences of international nursing students' and international nursing graduates' transition to the host country's nursing workforce. BACKGROUND: International students' experiences of transition to the host country has been extensively explored by researchers. International students experience unique challenges related to communication and language, socialisation, finance, and temporary student visa. One under-researched area is the experiences of transition for international nursing students and international nursing graduates. This systematic review examined the existing evidence on international nursing students' and international nursing graduates' experiences of transition to the host country's nursing workforce. INCLUSION CRITERIA: This review considered published and unpublished studies-qualitative, quantitative, mixed methods, evidence syntheses, and grey literature-that included international nursing students enrolled in an undergraduate nursing programme outside their home country and international nursing graduates, either employed or not yet employed in nursing and within their first year of completing an undergraduate nursing programme outside their home country. METHODS: A three-step search strategy was utilised in this review. The search strategy aimed to find published and unpublished literature in English from January 2000 to April 2020. The databases searched were Ovid Medline, Scopus, Emcare, ERIC, PsycINFO, ProQuest Central, ProQuest Dissertations and Theses Global, JBI Evidence-based Practice Database, and ScienceDirect. Two reviewers independently screened the titles/abstracts and full texts of studies for inclusion and appraised the methodological quality of the included studies. Findings and accompanying illustrations were extracted by one reviewer, assigned a level of credibility, and checked by the others. Results were analysed using JBI's approach to qualitative meta-aggregation. RESULTS: This review included three qualitative papers published between 2011 and 2018. All included studies were appraised as of moderate quality. Sixty-five study findings and nineteen categories were aggregated into the following six synthesised findings: international nursing graduates developed confidence and satisfaction through challenges; personal challenges; clinical challenges; discrimination and justice; academic barriers to success; and what international nursing students liked and wanted. CONCLUSION: The synthesised findings revealed ongoing anxiety, lack of preparedness and role uncertainty that was experienced by international nursing students and international nursing graduates as they transition to the host country's nursing workforce. They expressed the need for information about professional role expectations, guidance, and support to transition. University transition programmes and services could provide support to address the workforce transition challenges faced by international nursing students and international nursing graduates. TWEETABLE ABSTRACT: Systematic review shows international nursing students and international nursing graduates experience anxiety, limited preparedness and role uncertainty when transitioning to the host country's nursing workforce.

International nursing students' and new graduates' experiences of transition to the nursing workforce: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to identify and examine the available evidence of domestically trained international nursing students' and new graduates' experiences of transition to the nursing workforce. INTRODUCTION: International students' workforce transition experiences are attracting researchers globally. One under-researched area relates to the workforce transition experiences of domestically trained international nursing students and new graduates. This scoping review will focus on identifying studies that examine factors that can directly or indirectly affect experiences of workforce transition. INCLUSION CRITERIA: This review will consider studies that include domestically trained international nursing students enrolled in an undergraduate/baccalaureate nursing program (outside their country of origin) and new graduates within their first year of completing an undergraduate/baccalaureate nursing program (outside their country of origin). Participants may be either employed or not employed in the host country's nursing workforce. Studies that include participants from any other nursing programs will be excluded. METHODS: The JBI approach for conducting and reporting scoping reviews will be followed. The review will include both published and unpublished literature. Research from 2000 onward that is available in English will be included. Searches will be conducted in MEDLINE, Scopus, Emcare, ERIC, PsycINFO, ProQuest Central, ProQuest Dissertations and Theses Global, and ScienceDirect. An assessment of methodological quality will be included, with results presented in the final report. One reviewer will carry out the data extraction process independently, which will be checked by another reviewer. Data will be presented in tabular form accompanied by a narrative summary that aligns with the objective of this scoping review.