Professional nursing programs in the United States are rigorous and demanding, particularly for students whose first language is not English. Language, culture, and academic expectations are the most common areas of difficulty for those who teach multicultural students. According to recent research, early academic interventions, tutoring, and culturally sensitive educational practices can foster success and promote a more ethnically diverse nursing community.

Many nursing schools are admitting record numbers of students categorized as English Language Learners (ELL). In fact, the number of ELL students seems to be growing more rapidly than the general student population. The National Center for Educational Statistics reports the U.S. population grew 9% between 1993 and 2003; the ELL population increased by 65% during that same time. Now, ELL students comprise over 10% of all students.

Faced with completing assignments in a language they are not comfortable with, ELL students tend to score lower on standardized tests and receive lower grades than their English speaking classmates. Their teachers even sometimes perceive them to have lower academic abilities, according to research by Moss and Puma, 1995.

In 2002–2003, baccalaureate and graduate nursing program enrollment indicated that 21.6% of nursing students came from minority populations. However, there are no clearly outlined procedures for identifying ELL students in higher education. Determining the exact criteria for classifying the ELL student has been controversial. Poor classification of ELL students results in insufficient annual reporting and inadequate provision of student services.

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There has been minimal research associated with the challenges experienced by ELL students. Some researchers have posited that one of the reasons may be that researchers do not have the patience to listen to someone with an accent. Increased diversity in our nation’s college classrooms and communities, including new immigrants from many different parts of the world, requires greater understanding of student education needs.

In order to accelerate nursing academic progress in the next decade, schools of nursing must consider recruitment, acceptance, and graduation of culturally diverse nursing students. This will require change in the current education system, with specific improvements to address challenges faced by international nursing students and students who speak English as a second language. The following research gives a voice to the obstacles encountered by the English language learner nursing student.

Achieving a higher education requires a partnership between student, teacher, and institution. The successes of each entity are interdependent. Ten ELL nursing students enrolled in two separate associate degree in nursing programs in San Antonio, Texas, were interviewed. The goal of the interview was to identify and describe unique challenges experienced by students who speak English as a second language. The group was representative of nine nationalities and fluent in a total of 15 languages. It was concluded that student success was based on four areas: student study habits, student distress, student support system, and student learning tasks.

Student study habits included a tedious, time-consuming approach to reading assignments. Often students reread an assignment several times in order to grasp its true meaning. Additionally, the students described their exam study habits. The single most helpful study method was reviewing the National Council Licensure Exam (NCLEX) practice questions. Personal study habits, including reading practices, note taking, small study groups, use of printed lecture PowerPoint handouts, and reviewing websites, were also described.

ELL students also reported an increase in stress related to their relationship with their instructors, lack of time to complete exams, and anxiety around approaching teachers with questions. More importantly, they felt unable to communicate clearly in English, resulting in a negative self-image.

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The study demonstrated that participants had a strong desire for emotional support. First, ELL students valued a positive relationship with their nursing faculty. Second, students showed progress and confidence in the nursing program based on strong emotional support from their family and friends.

Student learning tasks comprised three areas: nursing vocabulary comprehension, confidence to speak publicly in English, and comfort level posing a question during class. The single most important point discerned was the students’ needs to comprehend nursing vocabulary. Use of study guides and Internet tools, along with repetitive verbalization of terms, developed both vocabulary as well as English language confidence. Posing questions in class is something English speaking instructors and students take for granted. ELL students are perceptive and sensitive about their ability to correctly pronounce English terminology. Inability to ask a question in class hinders a student’s learning experience. A silent suffering is taking place as it applies to English communication skills.

By the year 2020, non-white American citizenship is expected to rise by 50%, according to the U.S. Census Bureau, 2000. English Language Learners seek higher education, so institutions of higher learning, nursing instructors, and students must all come together to understand what processes are needed to create success for this group of students. ELL students will become a larger part of nursing classrooms, as is reflected in their demographic advancement.

Said one male participant from Burundi, Africa: “I came to study. And I believe that if I study, I can—I can succeed!”

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