Factors that influence international nursing students' experiences and perceptions of their learning environments: a scoping review.

Objective: The objective of this review was to explore factors that influence international undergraduate nursing students' experiences and perceptions of their learning environment.

Introduction: In the past 2 decades, international student enrollment in tertiary education increased globally, with English-speaking countries such as Australia, Canada, the United Kingdom, and the United States attracting a significant majority of these students. Many of these international students are attracted to studies in health professions and related sciences, particularly nursing. Despite their economic and cultural contributions to the host country, international nursing students face numerous challenges that affect their learning experiences.

Inclusion criteria: Peer-reviewed studies reporting on the factors that positively or negatively influenced international undergraduate nursing students' perceptions or experiences of their learning environment within the higher education sector, onshore in any country other than their own, were included. Studies of any research design and from any country were considered. Studies reporting on students whose educational preparation was vocational or led to registration to work under the supervision of registered nurses were excluded. Perceptions or experiences reported by educators, mentors, or clinical facilitators who supported international nursing students were also excluded.

Methods: A search for relevant records was conducted in CINAHL (EBSCOhost), MEDLINE (Ovid), Embase (Ovid), Emcare (Ovid), PsycINFO (Ovid), Web of Science Core Collection, Scopus, and ScienceDirect. Databases were searched from 1995 onward for published studies on October 12, 2020, then subsequently updated on July 1, 2022, and March 15, 2024. Gray literature was searched using Google Scholar, CORE, and BASE. A data extraction tool developed by the reviewers was used to extract data from the included studies. The extracted data were analyzed through content analysis and simple qualitative synthesis based on the review questions. The findings are presented in narrative format, supported by mind maps and tables.

Results: A total of 1928 records was identified in the databases. Of these, 10 were duplicates. The titles and abstracts of the remaining 1918 records were screened, and 1876 records were excluded for not meeting the study inclusion criteria. Forty-two full-text reports were retrieved and assessed against the eligibility criteria. Of the 42 reports, 13 discrete studies met the criteria for inclusion in this review. Findings from the included studies showed that international student nurses faced language barriers, cultural challenges, and discrimination in academic and clinical settings, compounded by inadequate support and high academic demands, which affected their well-being. International student nurses employed strategies, such as seeking mentorship and participating in simulations, to adapt. They also benefited from orientation programs and peer networks for adjustment.

Conclusion: The challenges faced by international nursing students, such as language barriers and discrimination, may significantly affect their educational experiences. The findings of this scoping review underscore the need for further research to develop and evaluate support programs and resources to promote positive experiences for international nursing students within their learning environment.

Supplemental digital content: A Chinese-language version of the abstract of this review is available at: http://links.lww.com/SRX/A85.