Factors influencing job satisfaction and professional competencies in clinical practice among internationally educated nurses during the migration journey: A mixed-methods systematic review.

ABSTRACT

BACKGROUND: The increasing migration of internationally educated nurses (IENs) from developing to developed countries highlights the importance of implementing integration strategies that facilitate their workplace transition, leading to improved job satisfaction and professional competence. AIM: The mixed-methods systematic review aimed to synthesise the current literature on factors influencing job satisfaction and professional competencies among IENs throughout their transition process, including the pre-migration, migration, and post-migration periods. METHODS: This study conducted a mixed-methods systematic review from 2013 to 2023, using the CINAHL, Scopus, and PubMed databases and employing a Population, Interventions, Comparisons, Outcomes (PICO) framework. Quality assessment employed the Mixed Methods Appraisal Tool (MMAT), and data analysis followed a convergent parallel design. Data synthesis was presented narratively, and the literature review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: Out of 565 articles, eleven studies (eight qualitative, two quantitative, and one mixed-method) met the inclusion criteria. Three key themes that influenced job satisfaction and professional competencies among IENs were identified pre-migration and pre-deployment demands, challenges in workplace integration, and post-migration career challenges and retention strategies. LIMITATIONS: The study primarily focused on IENs recruited from developing countries, potentially limiting the generalisability of the findings to IENs from other regions or countries. Furthermore, the inclusion of nurses from developed countries who also migrated was limited in the available studies, which further restricts the applicability of the research findings. CONCLUSIONS: It is essential to reconsider the pre-migration language requirements and evaluate the feasibility of completing them during the integration period to enhance the job satisfaction and professional competencies of IENs. Additionally, key factors for improving job satisfaction among IENs include providing personalised support, addressing managerial barriers, facilitating career advancement, efficiently managing workloads, and promoting effective communication within the healthcare team.