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Supporting Students with English as a Second Language to Succeed in Pre-Registration Nursing Programmes: A Realist Review

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Mowat, Rebecca
Mearns, Gael

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Dissertation

Degree name

Master of Health Science

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Publisher

Auckland University of Technology

Abstract

Background: Nurses who have English as a second language add to a diverse nursing workforce and match the population demographic that now resides in many Western countries. t is often the case that catering to the requirements of nursing students who speak English as a second language (ESL) is not available.. ESL students are expected to keep up with the nursing curriculum and succeed, yet often more understanding and support from education providers to make their journey more successful is needed. The aim of this realist evaluation is threefold: first, to identify teaching and learning programs that provide optimal support for the successful completion of a pre-registration nursing program. Second, to propose changes to the program that will enhance the likelihood of successful completion. Last, to make recommendations for modifying programs to cultivate practice-ready ESL nurses who can seamlessly transition from the pre-registration phase to the role of a registered nurse. Method: A systematic literature review was undertaken using inclusion and exclusion criteria to identify research articles to answer the research aims. These articles were screened using the mixed methods assessment tool to check for validity, Braun and Clarke’s thematic analysis was used to develop themes whilst simultaneously using Pawson’s methodology for realist synthesis to identify critical context, mechanism, and outcome (CMO) configurations. These configurations are then utilised to develop a midrange theory. Findings: Ten research articles were identified and three broad CMO configurations; communication complexity, cultural development, and self-efficacy, were identified, and a midrange theory was created highlighting key factors to best support ESL students to succeed in their nursing studies. All factors are interconnected and related for success, these include enhancing English skill development, acknowledging the symbiotic relationship between clinical facilitators and ESL students, using the Cummins Language theory and transcultural teaching models to help guide linguistic and culturally safe support. Also significant is the importance of providing leadership opportunities for ESL students and embracing whanaungatanga (close connection between people), which will ultimately enhance self-efficacy for both students and clinical facilitators. Conclusion: Many vital factors can be used to assist nursing students with English as a second language to succeed. Offering professional development days to clinical educators and ESL students to share these factors and then implementing these practices into daily business with ESL is recommended. If these strategies can be implemented into nursing programmes, success for ESL undergraduate nursing programmes can be enhanced.

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