title: Internationally educated nurses' reflections on nursing communication in Canada.
abstract: OBJECTIVE
  The overall goal of this study was to explore internationally educated nurses' perceptions of the English language and nursing communication skill requirements in a Canadian bridging education program.
  
  
  BACKGROUND
  The increased global mobility of nurses creates a need to address the educational needs of migrating nurses. A large percentage of these nurses require additional language and professional education. New research is needed that would represent an in-depth analysis of their educational experiences associated with learning academic English and Canadian nursing communication.
  
  
  BACKGROUND
  Developing proficiency with a new language has been documented as posing challenges for new immigrants. Since language proficiency is a key requirement of Canadian nursing regulatory bodies, previously unrecognized barriers such as attitudes and beliefs about required English language and nursing communication competency which may hinder their ability to meet local practice standards need to be explored.
  
  
  METHODS
  Using a grounded theory study design, narratives from 22 participants from the Philippines, Nigeria and Europe enrolled in bridging education were collected and analysed.
  
  
  RESULTS
  The participants identified the incongruence in professional norms between Canada and their home country as a major challenge. The major themes identified included cultural dissonance, academic literacy challenges and skepticism regarding unexpected communication competency requirements.
  
  
  CONCLUSIONS
  The participants possessed varying degrees of comprehension and acceptance of new educational and professional regulatory requirements. A certain degree of culture shock, which may be associated with frustration and disillusionment, is a typical and anticipated aspect of the immigration process. Their perceptions need to be recognized and accommodated when assisting internationally educated nurses to integrate into the Canadian practice culture.
  
  
  CONCLUSIONS
  Any generalizations to other host countries need to be made cautiously.
  
  
  CONCLUSIONS
  Clear communication from regulators about English language and nursing communication requirements during the pre-arrival period is recommended. If bridging education is required, these programs need to be designed to address English language competency and nursing communication skills of non-native English speakers.
authors.affiliation: School of Nursing and School of Health Policy and Management, Faculty of Health, York University, Toronto, Ontario, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Lum
authors.affiliation: Department of Sociology, York University, Toronto, Ontario, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Dowedoff
authors.affiliation: Department of Languages and Literature, York University, Toronto, Ontario, Canada.
authors.forename: K
authors.initials: K
authors.lastname: Englander
mesh_terms: D002170:Canada; D003142:Communication; D004506:Education, Nursing; D005060:Europe; D006801:Humans; D007802:Language; D009726:Nurses; D010679:Philippines
keywords: Canada; Communication; English Language Literacy; Grounded Theory; Immigrant Integration; Internationally Educated Nurses; Language Competency; Nursing