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Mannes MM, Thornley DJ, Wilkinson TJ. Cross-cultural code-switching - the impact on international medical graduates in New Zealand. BMC MEDICAL EDUCATION 2023; 23:920. [PMID: 38053141 DOI: 10.1186/s12909-023-04900-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/24/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND New Zealand relies on International Medical Graduates (IMGs); however, the retention of IMGs is not optimal. This research uses a lens of cross-cultural code-switching to explore how professional and cultural differences impact on International Medical Graduates' (IMGs') journeys to practise effectively and remain in New Zealand. METHODS Utilising theory-informing inductive analysis within a constructivist approach, framework analysis was conducted following 14 face-to-face interviews with IMGs. The analysis then explored the degree to which their experiences could be explained by cross-cultural code-switching's psychological challenges (authenticity, competence, and resentment). RESULTS Analysis showed there was an expectation for IMGs to code-switch. The greater the cultural and professional difference of IMGs (compared to New Zealand), the greater the intensity of psychological challenges experienced when switching. Moreover, IMGs received minimal support, making it difficult to overcome psychological challenges, especially the competence challenge. This led to feelings of frustration and vulnerability. Code-switching could also explain why complaints about IMGs were more likely when IMGs were stressed or tired. CONCLUSION Cross-cultural code-switching can be used to explain and identify how cultural differences cause psychological challenges. These findings inform how programmes can better support IMGs in orientation and ongoing training. Additionally, establishing, and allocating IMG cultural mentors would assist in addressing IMGs' vulnerability and isolation. With this support, the journey may prove more manageable and encourage IMGs to continue practising in their adopted country.
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Affiliation(s)
- Mariska M Mannes
- School of Social Sciences, University of Otago Dunedin, PO Box 56, Dunedin, 9054, New Zealand.
| | - Davinia J Thornley
- School of Social Sciences - Media, Film and Communication, University of Otago Dunedin, Dunedin, New Zealand
| | - Tim J Wilkinson
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
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Eriksson E, Högstedt D, Engström M, Jansson I. Preceptors' experiences of supervising internationally educated nurses attending a bridging program: An interview study. NURSE EDUCATION TODAY 2023; 131:105975. [PMID: 37729862 DOI: 10.1016/j.nedt.2023.105975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/28/2023] [Accepted: 09/12/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Internationally educated nurses attending a bridging program must demonstrate clinical competence and meet requirements to apply for a nursing license in Sweden. OBJECTIVES To describe preceptors' experiences of supervising internationally educated nurses undergoing clinical practice education during a bridging program. DESIGN A qualitative descriptive study. SETTINGS Two universities offering the 1-year bridging program for nurses with a nursing degree from outside European Union/European Economic Area and Switzerland. PARTICIPANTS Fifteen preceptors, all registered nurses, who supervised internationally educated nurses were included. METHODS Semi-structured interviews were performed, and data were analyzed using qualitative content analysis. RESULTS Supervising internationally educated nurses was not the same as supervising nursing students and raised feelings of both joy and frustration. Preceptors had to adapt supervision to the student's nursing knowledge and skills. They had to help students communicate in Swedish and form good relationships with other students, patients, and other professionals. Most preceptors requested more information about the student's nurse education, country of education/cultural background, and previous work experiences. Mixed experiences of support from the university, first-line managers, and colleagues were reported. CONCLUSIONS Being a preceptor for internationally educated nurses is a challenge, and supervision training is important for managing preceptorship. To supervise students based on their level of knowledge and skills, more information must be shared with the preceptor. Encounters with others are of importance in the training, where teamwork and person-centered care must be in focus, both in prior theoretical education and in clinical practice education.
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Affiliation(s)
- E Eriksson
- Faculty of Health and Occupational Studies, University of Gävle, 801 76 Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
| | - D Högstedt
- Faculty of Health and Occupational Studies, University of Gävle, 801 76 Gävle, Sweden.
| | - M Engström
- Faculty of Health and Occupational Studies, University of Gävle, 801 76 Gävle, Sweden; Medicine College, Lishui University, No. 1 Xueyuan Road, Lishui 323000, China.
| | - I Jansson
- Institute of Health and Care Sciences, University of Gothenburg, 405 30 Göteborg, Sweden.
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Zulfiqar SH, Ryan N, Berkery E, Odonnell C, Purtil H, O’Malley B. Talent management of international nurses in healthcare settings: A systematic review. PLoS One 2023; 18:e0293828. [PMID: 37930991 PMCID: PMC10627454 DOI: 10.1371/journal.pone.0293828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/20/2023] [Indexed: 11/08/2023] Open
Abstract
AIM To identify and systematically review current scholarship on talent management of international nurses in healthcare organizations. BACKGROUND As nurse shortages persistently pose challenges for healthcare organizations globally, one of the primary strategies employed to address these shortages is employment of international nurses. To date little has been done to systematically review and collate contemporary research on talent management of this strategically important cohort. Talent management is a holistic construct that can support healthcare organizations to attract, develop, motivate, and retain talented employees to drive organizational performance. This systematic review isolates, appraises and collates available evidence on talent management practices for international nurses. STUDY DESIGN Systematic literature review. DATA SOURCES Searches of PubMed, EBSCO and Scopus were made covering literature from 2012-2022. REVIEW METHODS This study followed Cochrane protocol for Systematic Reviews and key search terms were developed in consultation with University of Limerick library. As a key aim of the review was to provide evidence for the development of effective talent management practices, only peer-reviewed academic papers and empirical studies were included. Initial articles screening was conducted by two reviewers and full articles review was conducted by the entire research team. Findings were combined in a data extraction template for further analysis. RESULTS This review includes 62 articles thematically analysed under the headings recruitment and selection, retention and turnover, career progression, professional development, discrimination and racism, culture and communication. CONCLUSION No articles were found that directly address talent management for international nurses. Although there are studies that address aspects of talent management independently, more research is required on talent management as a holistic process for international nurses to inform evidence-based practice. IMPACT This research emphasizes the importance of talent management for retention of international nurses in healthcare settings. It provides a knowledge base for healthcare organisations to enhance employee retention and ensure quality care for patients, as well as setting the foundation for future studies in this area.
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Affiliation(s)
- Sidra Hareem Zulfiqar
- Department of Work and Employment Studies, Kemmy Business School, University of Limerick, Limerick, Ireland
| | - Nuala Ryan
- Department of Management and Marketing, Kemmy Business School, University of Limerick, Limerick, Ireland
| | - Elaine Berkery
- Department of Management and Marketing, Kemmy Business School, University of Limerick, Limerick, Ireland
| | - Claire Odonnell
- Department of Nursing Studies and Midwifery, School of Medicine, University of Limerick, Limerick, Ireland
| | - Helen Purtil
- Department of Mathematics and Statistics, Science and Engineering, University of Limerick, Limerick, Ireland
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Lachmann H, Löfvenmark C. Academic emotions and attitudes regarding interprofessional collaboration in health care activities: a prospective study among newly arrived physicians participating in a fourteen-week course. BMC MEDICAL EDUCATION 2023; 23:643. [PMID: 37679684 PMCID: PMC10486000 DOI: 10.1186/s12909-023-04620-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/28/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND One way of facilitating entrance into the Swedish health care system, for newly arrived physicians from outside the European Union/European Economic Area, could be to set up and offer a course aimed to enhance understanding of it. This course was offered to increase insight about clinical practices, interprofessional teamwork and topics such as, Swedish health care laws, culture, and ethics. Acceptance of, and a flexible attitude towards, interprofessional teamwork are important for maintaining both the physician's professional identity and a high quality of patient care. The aim of this study was to investigate newly arrived physicians', academic emotions, experience of stress and flow during a fourteen-week course, as well as attitudes to interprofessional collaboration, both before and after. METHOD A prospective study was conducted, with participants asked to respond on one questionnaire every course day, by using the Contextual Activity Sampling System methodology. The participants were asked to complete a questionnaire comprising ten questions about ongoing activity and in what way they experience, e.g., collaboration, interprofessional teamwork, academic emotions, flow, and stress. Furthermore, the participants were asked to score their attitude towards interprofessional teamwork by using the interdisciplinary education perception scale both before and after the course. RESULTS The total sample comprised 27 qualified physicians, from outside the European Union/European Economic Area. In the interdisciplinary education perception scale category, "perception of actual cooperation¨, the participants had significantly higher scores after the course. Flow and academic emotions were felt mostly during own periods of study, seminars, and lectures. The academic emotions were apathy, anxiety, and boredom. The most frequently experienced academic emotion was apathy. Course participants rated stress highest in connection with the examination. CONCLUSION The results show that the course had a positive impact on the participants perception of actual cooperation. It appears that participating in this kind of course was a positive experience for the participants, since they mostly experienced high levels of flow. Collaborating with others was experienced as positive, with participants reporting a high degree of flow in activities during collaboration.
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Affiliation(s)
- Hanna Lachmann
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Caroline Löfvenmark
- Department of health promoting science, Sophiahemmet University, P. O. Box 5605, 114 86, Stockholm, Sweden
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Högstedt D, Jansson I, Eriksson E, Engström M. Three paths to a Swedish nursing license: Two for internationally educated nurses and one for regular nursing students - A cross-sectional study of self-rated professional competence, self-efficacy, and thriving. NURSE EDUCATION TODAY 2022; 119:105595. [PMID: 36265213 DOI: 10.1016/j.nedt.2022.105595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 09/19/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Bridging programs are offered to support migrated nurses, but in some countries, nurses can also choose to validate their nursing competence. Thus far, little is known about how migrated nurses estimate their competence when they are about to enter working life in a new country and how this differs from regular nursing students. OBJECTIVE To compare two groups of internationally educated nurses' - those from bridging programs and those who chose validation - and one group of regular nursing students' self-rated professional competence when they are about to start working as registered nurses. The hypotheses were: 1) internationally educated nurses rate their competence higher than regular nursing students and 2) those from bridging programs rate their competence higher than those who chose validation. In addition, the aim was to compare the groups' self-efficacy and thriving. DESIGN A cross-sectional, comparative design. SETTINGS Five universities in Sweden. PARTICIPANTS Nurses educated in non-European countries from a bridging program (n = 128, response rate 79.0 %) or validation process (n = 61, response rate 59.2 %) and students graduating from the regular nursing program (n = 213, response rate 68.3 %). METHODS Data were collected with coded questionnaires (paper or online) between 2019 and 2021 and analyzed using non-parametric tests, e.g., Kruskal-Wallis. RESULTS Both groups of internationally educated nurses had higher median scores on total nursing competence (both groups p < 0.001), general self-efficacy (bridging programs p < 0.001, validation p = 0.020), and total thriving (bridging programs p < 0.001, validation p = 0.012) than regular nursing students did. However, comparing the groups of internationally educated nurses showed no significant differences. CONCLUSION Internationally educated nurses rated their competence high but with differences within the groups for different competence areas. More research is needed to investigate whether the different paths are important for nurses' competence later in working life, and some of the competence areas might need extra attention when nurses start working.
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Affiliation(s)
- D Högstedt
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
| | - I Jansson
- Institute of Health and Care Sciences, University of Gothenburg, Göteborg, Sweden
| | - E Eriksson
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - M Engström
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
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Eriksson E, Hjelm K. Relatives' perspectives on encounters and communication in nursing homes during the Covid-19 pandemic: a qualitative interview study. BMC Geriatr 2022; 22:706. [PMID: 36008775 PMCID: PMC9409621 DOI: 10.1186/s12877-022-03364-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/30/2022] [Indexed: 11/10/2022] Open
Abstract
Background Relatives of nursing home (NH) residents have experienced national or local restrictions on visiting their elderly family member during the Covid-19 pandemic. Today, many NHs have a multicultural environment, as staff, residents and their relatives speak different languages. Thus far, studies of remote communication with staff with limited language skills during the Covid-19 pandemic are lacking. Aim The aim of the present study was to explore relatives’ experiences of encounters and communication with staff and residents in NHs during the Covid-19 pandemic. Method An explorative qualitative study using semi-structured telephone interviews with 17 relatives of NH residents (12 women and 5 men). Data were analyzed using qualitative content analysis to identify four main categories and nine sub-categories. Results Communicating during visiting restrictions was challenging, and relatives experienced ups and downs when trying to stay in contact with NH residents and staff. Relatives received general information, but desired information about residents’ everyday life without having to ask for it. Moreover, remote communication was difficult for residents with hearing impairment or dementia. Even relatives who understood different languages had to develop strategies to communicate with staff with limited language skills in Swedish and English. Relatives did not mention using translating applications to facilitate communication. Conclusion During visiting restrictions, relatives lacked information about residents’ everyday life and found communication with staff with limited language skills challenging. For this reason, and to enable communication with staff with limited language skills, there is a need to find practical and technical solutions for facilitating remote communication between relatives, residents and staff at NHs. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03364-1.
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Affiliation(s)
- Elisabet Eriksson
- Department of Public Health and Caring Sciences, Uppsala University, Box 564, 751 22, Uppsala, Sweden. .,Faculty of Health and Occupational Studies, University of Gävle, 801 76, Gävle, Sweden.
| | - Katarina Hjelm
- Department of Public Health and Caring Sciences, Uppsala University, Box 564, 751 22, Uppsala, Sweden
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Al-Haddad M, Jamieson S, Germeni E. International medical graduates' experiences before and after migration: A meta-ethnography of qualitative studies. MEDICAL EDUCATION 2022; 56:504-515. [PMID: 34859484 DOI: 10.1111/medu.14708] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 11/12/2021] [Accepted: 11/23/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION International medical graduates (IMGs) represent a large portion of practising doctors in many countries. Many experience difficulties, including higher rates of complaints against them and lower exam pass rates. The UK's General Medical Council (GMC) recently set targets to 'eliminate disproportionate complaints' and 'eradicate disadvantage and discrimination in medical education'. Our timely meta-ethnography aimed to synthesise existing qualitative literature on the wider personal and professional experiences of IMGs to identify factors affecting IMGs' professional practice (either directly or indirectly). METHODS In September 2019, we systematically searched Medline, Embase, Cochrane, PsycINFO, ERIC and EdResearch for peer-reviewed qualitative and mixed-methods articles that described experiences of IMGs. We extracted participant quotes and authors' themes from included articles and used the technique of meta-ethnography to synthesise the data and develop new overarching concepts. RESULTS Of the 1613 articles identified, 57 met our inclusion criteria. In total, the articles corresponded to 46 studies that described the experiences of 1142 IMGs practising in all six continents in a range of settings, including primary and secondary care. We developed five key concepts: migration dimensions (issues considered by IMGs when migrating), a challenging start (the stressful early period), degree of dissonance (between the IMG and host country in relation to the four main barriers of language, culture, medical education and belonging), levelling the playing field (interventions to reduce the impact of the barriers) and survive then thrive (adjustments IMGs made). A conceptual model that brings these constructs together in a line of argument is presented. CONCLUSIONS This meta-ethnography, based on a large amount of diverse qualitative studies, is the first to provide a comprehensive picture of the experiences and challenges that IMGs face before and after migration. Our results should be used to guide the development of interventions aiming to support IMGs and meet the GMC targets.
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Affiliation(s)
- Mo Al-Haddad
- School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, UK
| | - Susan Jamieson
- School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, UK
| | - Evi Germeni
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Markey K, Prosen M, Martin E, Repo Jamal H. Fostering an ethos of cultural humility development in nurturing inclusiveness and effective intercultural team working. J Nurs Manag 2021; 29:2724-2728. [PMID: 34309969 DOI: 10.1111/jonm.13429] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 07/21/2021] [Indexed: 11/28/2022]
Abstract
AIM To discuss the importance of fostering an ethos of cultural humility development in cultivating inclusiveness and effective intercultural team working. BACKGROUND Widening cultural and ethnic diversity of the health care workforce enriches the working environment and encourages a broader perspective on health care services and delivery. However, the intricacies of learning to work effectively within intercultural health care teams and adapting to new ways of working are often under estimated and thus overlooked. EVALUATION In adopting a framework for cultural humility development (Hughees et al., 2020, 10.1016/j.profnurs.2019.06.005), this paper proposes some practical suggestions for nurturing intrapersonal, interpersonal and system level cultural humility simultaneously. KEY ISSUES Fostering an ethos of cultural humility development within the workplace can support inclusiveness and better intercultural team working relationships. Nurses need support in developing awareness of their own cultural beliefs, whilst examining perceptions of cultural difference. CONCLUSION Examining cultural factors that influence intercultural working relationships will help in identifying structures, supports and approaches required for integration and inclusiveness. IMPLICATIONS FOR NURSING MANAGEMENT Nurturing ways of supporting interpersonal, intrapersonal and systems levels cultural humility development inspires the self-awareness, openness and respect for cultural difference required. Developing culturally responsive leadership styles and prioritizing their own cultural humility development is critical.
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Affiliation(s)
- Kathleen Markey
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Mirko Prosen
- Department of Nursing, Faculty of Health Sciences, University of Primorska, Izola, Slovenia
| | - Emer Martin
- Chief Executive Officer; Hospital Administration and Management, St John's Hospital, Limerick, Ireland
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Markey K, Sackey ME, Oppong-Gyan R. Maximising intercultural learning opportunities: learning with, from and about students from different cultures. ACTA ACUST UNITED AC 2021; 29:1074-1077. [PMID: 33035086 DOI: 10.12968/bjon.2020.29.18.1074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Nurses continue to experience challenges when caring for culturally diverse patients and while working with staff from different cultural, ethnic and linguistic backgrounds. The widening landscape of cultural diversity in the nursing classroom provides a vehicle for intercultural learning, supporting intercultural competence development. However, students must embrace culturally diverse learning environments and maximise opportunities to learn with, from and about students from different cultural backgrounds. This requires developing the courage, curiosity and commitment to maximise all intercultural learning opportunities. Drawing on experiences of international students studying in culturally diverse classrooms, this article presents some practical suggestions for meaningfully engaging and capitalising on intercultural learning opportunities.
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Affiliation(s)
- Kathleen Markey
- Lecturer, Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Science Institute, University of Limerick, Ireland
| | - Margaret Efua Sackey
- MSc Student, Department of Nursing and Midwifery, Faculty of Education and Health Sciences, University of Limerick, Ireland
| | - Richard Oppong-Gyan
- MSc Student, Department of Nursing and Midwifery, Faculty of Education and Health Sciences, University of Limerick, Ireland
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Högstedt D, Engström M, Jansson I, Eriksson E. Attending a bridging program to obtain a Swedish nursing license: An interview study with internationally educated nurses. NURSE EDUCATION TODAY 2021; 99:104744. [PMID: 33549959 DOI: 10.1016/j.nedt.2021.104744] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/17/2020] [Accepted: 12/26/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Bridging programs have been created to facilitate internationally educated nurses' integration process. Thus far, studies on bridging programs have been few and have only been conducted in English-speaking countries. Due to language barriers, it may be a greater challenge to attend a bridging program in a non-English-speaking country. OBJECTIVES The aim was to examine internationally educated nurses' experience of attending a one-year bridging program to obtain a Swedish nursing license. DESIGN A qualitative study with a descriptive design was applied. SETTINGS The study setting was the five universities offering the one-year, full-time Swedish bridging program. PARTICIPANTS Purposive sampling was used. Eighteen nurses participated in the study at the end of the program. METHODS Semi-structured interviews were conducted and analyzed using qualitative content analysis. RESULTS Studying in a new environment and language was challenging and intensive, as were adapting to a new healthcare system and relearning some nursing practices. However, attending the bridging program was also rewarding and gave feelings of happiness and pride; the nurses developed their nursing skills as well as their language and academic skills. Moreover, they became familiar with Sweden's nursing practices, healthcare system, and culture. Good support was important, but not always enough. CONCLUSIONS By attending a bridging program, nurses can become familiar with the country's healthcare system and nursing practices. Moreover, develop their language skills and attain skills important to lifelong learning. Although the program may not eliminate all difficulties nurses often experience in a new country, it can offer the support nurses need to handle the challenges. However, for some nurses, due to different backgrounds and prerequisites, the support offered may need to be more individualized.
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Affiliation(s)
- D Högstedt
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
| | - M Engström
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Nursing Department, Medicine and Health College, Lishui University, China.
| | - I Jansson
- Institute of Health and Care Sciences, University of Gothenburg, Göteborg, Sweden.
| | - E Eriksson
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
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Experiences of nurses educated outside the European Union of a Swedish bridging program and the program's role in their integration into the nursing profession: a qualitative interview study. BMC Nurs 2021; 20:7. [PMID: 33402164 PMCID: PMC7784301 DOI: 10.1186/s12912-020-00525-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/17/2020] [Indexed: 11/17/2022] Open
Abstract
Background Countries all over the world are experiencing a shortage of registered nurses (RNs). Therefore, some countries, including Sweden, have tried to solve this by recruiting internationally educated nurses (IENs). Countries offer bridging programs as educational support to qualify IENs for nursing work in the destination country. However, there is little research on IENs’ experiences of bridging programs in European countries and how these programs facilitate their integration into the world of work and their new society. The aim of this study is to explore the experiences of nurses, originally educated outside the EU (European Union)/EES, of the Swedish bridging program and of the program’s role in facilitating their integration into the nursing profession in Sweden. Methods A qualitative descriptive design was used to explore the topic based on 11 informants’ perspectives and experiences. Purposive sampling was used to recruit participants at one university in Sweden. Data were collected by individual interviews using a semi- structured interview guide during the year 2019 and were analysed using an interpretative thematic approach. Results Two main themes emerged from the analysis: 1) Return to nursing, and 2) The bridging program as a tool for transition to nursing in Sweden. The first theme includes conditions and experiences such as personal motivation and determination, and support from others that the participants described as important in order to achieve the goal of re-establishing themselves as registered nurses in Sweden. Furthermore, the second theme describes the participants’ experiences of the bridging program as mostly positive because it led to new learning and achievements that were valuable for the transition to nursing in Sweden; however, the participants also emphasised the challenges of their transition into the nursing profession, which were related to instances of misrecognition of their professional competence and the uncertain outcome of the program. Conclusions This study found that the bridging program facilitated integration into the nursing profession for nurses educated outside the EU/EES, especially knowledge gained in clinical-based training. Thus, it is important to recognise and value the IENs’ experience and previous knowledge and training when developing the bridging program’s curriculum. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-020-00525-8.
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Nortvedt L, Lohne V, Dahl K. A courageous journey: Experiences of migrant Philippine nurses in Norway. J Clin Nurs 2019; 29:468-479. [DOI: 10.1111/jocn.15107] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/20/2019] [Accepted: 11/10/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Line Nortvedt
- Department of Nursing and Health Promotion Faculty of Health Sciences OsloMet – Oslo Metropolitan University Oslo Norway
| | - Vibeke Lohne
- Department of Nursing and Health Promotion Faculty of Health Sciences OsloMet – Oslo Metropolitan University Oslo Norway
| | - Kari Dahl
- Department of Nursing and Health Promotion Faculty of Health Sciences OsloMet – Oslo Metropolitan University Oslo Norway
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Sturesson L, Öhlander M, Nilsson GH, Palmgren PJ, Stenfors T. Migrant physicians' entrance and advancement in the Swedish medical labour market: a cross-sectional study. HUMAN RESOURCES FOR HEALTH 2019; 17:71. [PMID: 31615515 PMCID: PMC6794744 DOI: 10.1186/s12960-019-0414-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 09/10/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Worldwide, physicians are migrating to new countries and want to practise their profession. However, they may experience difficulties doing so. To optimise and accelerate their entrance into and advancement within the Swedish healthcare system, there is an urgent need to explore how they are currently doing so, as their competences should be put to use without any unnecessary delay. The aim of the study was to explore how migrant physicians with a medical degree from outside EU/EEA enter and advance within the medical labour market in Sweden and to identify perceived barriers and facilitating aspects in the process. The empirical findings are discussed in light of Bourdieu's concept symbolic capital as adapted in the Swedish medical field. METHODS A cross-sectional study with a self-administrated questionnaire was disseminated. A sample of 498 migrant physicians were identified. Descriptive statistical analysis and qualitative thematic analysis were used to analyse the data. RESULTS The response rate was 57% (n = 283). Respondents mainly found their first positions via spontaneous job applications, during internships, while participating in an educational intervention or via personal contacts. Perceived barriers to entering and advancing within the medical field in Sweden were mainly related to having a medical degree from and/or originating from another country, which could in turn represent discrimination and/or having one's competence undervalued as a result. Facilitating aspects included having or developing contacts in Swedish healthcare and gaining proficiency or fluency in the Swedish language. CONCLUSIONS When MPs find their first positions, the contacts they have developed appear to play a role, and when advancing in their positions, the active development of a variety of contacts seems to be beneficial. MPs experience a variety of barriers to entering and advancing within the field that could be related to discrimination. Many MPs perceived having their competences undervalued due to their origin or to being educated abroad. Based on the respondents' experiences, our interpretation is that MPs as a group are hierarchically positioned lower in the Swedish medical field than physicians trained in the country. Facilitating aspects included educational interventions, having contacts and developing language skills. For optimal entry into the labour market, it is vitally important for MPs to learn the new language and obtain a job or internship in the field as soon as possible.
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Affiliation(s)
- Linda Sturesson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Magnus Öhlander
- Department of Ethnology, History of Religions and Gender Studies, Stockholm University, 106 91 Stockholm, Sweden
| | - Gunnar H. Nilsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Per J. Palmgren
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Terese Stenfors
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden
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