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Background. Global nursing shortages have led to the recruitment of culturally and linguistically diverse nurses from various countries. However, nurses face integration challenges in their host countries. Objective. This systematic review aimed to find the most recent evidence of factors associated with integrational strategies and models to support the transition and adaptation of culturally and linguistically diverse nurses to the professional workforce in healthcare settings. Methods. This systematic review used the population, exposure, outcome framework to select studies according to JBI guidelines. Original peer‐reviewed quantitative studies published between 2000 and 2021 were identified. Two researchers independently screened the studies based on eligibility criteria using title, abstract, and full text. The JBI critical appraisal tool assessed the methodology's quality for analytical cross‐sectional studies. Data were extracted, tabulated, and analysed narratively. PRISMA checklist was used in reporting. Data Sources. CINAHL (Ebsco), PubMed, Medic, ERIC (ProQuest), and Scopus. Results. The systematic review encompassed 19 articles and identified multiple factors associated with successful integration. These factors were classified into the following six categories: sociodemographic characteristics, discrimination, social support, organisational support, workplace environment, and acculturation. Conclusions. Comprehensive cultural competency training for healthcare staff, including managers, enhances cultural proficiency in work environments. Clear guidelines addressing bias and discrimination create a supportive environment where culturally and linguistically diverse nurses feel valued and respected, facilitating their adaptation and integration. Relevance to Clinical Practice. Patient care quality can be improved by ensuring sustainable culturally and linguistically diverse nurses' integration into healthcare organisations. Cultural diversity is a unique opportunity to bring a diverse range and experience to clinical settings. The diversity can also help enhance the cultural competence of healthcare staff, allowing them to better understand and cater to the needs of culturally diverse patients. Patient or Public Contribution. Not required for study design. [ABSTRACT FROM AUTHOR]

Background: Many countries are becoming increasingly culturally and linguistically diverse due to globalisation and migration. The global shortage of nurses and the consequent migration of nursing professionals is leading to increasing cultural and linguistic diversity in health care and nursing education. Nurse educators play a significant role in supporting nursing students' competence and working life readiness., Research Aim: To describe nurse educators' experiences and perceptions regarding competence and competence development of CALD nursing students., Methods: The study was conducted using a descriptive qualitative approach utilising individual thematic interviews for data collection. A purposive sample consisting of 20 volunteer nurse educators from five higher education institutions was used for the purpose. Data was collected in semi-structured interviews based on a literature review of previous studies. The data were analysed using inductive content analysis. The COnsolidated criteria for REporting Qualitative research (COREQ) criteria were used in the reporting of this study., Results: According to the content analysis, three main categories describing aspects related to the competence and competence development of CALD nursing students were identified: 1) educator's competence to support student's learning process and competence development, 2) development of supportive structures and safe learning environments, and 3) student-specific competence and competence development. The educators emphasised that setting clear goals, providing encouragement, having an open discussion, and student-centered approach to support their learning process and create a safe learning environment., Conclusions: Supporting the learning process of CALD nursing students and developing safe learning environments were considered essential for the development of competence. These areas must be supported by developing educators' pedagogical and cultural competence and providing sufficient resources for both students and educators. In addition, the curriculum must be designed to support these aspects., Competing Interests: Declaration of competing interest Given the role as Editor on this journal, Professors Kristina Mikkonen had no involvement in the peer-review of this article and has no access to information regarding its peer-review. Full responsibility for the editorial process for this article was delegated to an independent., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Highly competent health care experts are needed for the development of the social and health care sectors. More knowledge is needed on the levels of generic competencies that health sciences experts possess, particularly in the context of complex decision-making., Objectives: To describe self-evaluated generic competence of health sciences students and its associated factors., Design: A cross-sectional observational study design., Participants: A total of 291 health science students in five universities in Finland participated in this study during the spring of 2022., Methods: The data was collected by using the HealthGenericCom instrument with 88 items and 8 sum dimensions using a five-point Likert scale (1-poor to 5-excellent): 1) competence in leadership, administration, and finance; 2) people-centred guiding competence; 3) competence of health promotion; 4) competence of evidence-based practice; 5) digital competence; 6) competence in work well-being and self-management; 7) competence in collaboration and problem-solving, and 8) competence in societal interaction. The K-means cluster algorithm was used to classify generic competence profiles to identify the profiles of health sciences students., Results: Four generic health sciences competence profiles (A = 18 %, B = 23 %, C = 33 %, D = 26 %) were identified. Profile A demonstrated the lowest level of most generic competencies in health sciences. Digital competence was shown to be at the lowest level among the participants, whereas competence in collaboration, problem-solving, and health promotion was evaluated as the highest competence level. The students evaluated their competence as being higher when they were older, were currently engaged in master's degree programmes, had completed work-based practical training in social and health care, and had varied work experiences or held leading positions., Conclusions: Students need to improve their generic competencies in health sciences, with a particular focus on developing their digital competence. More focus should be given to work-based practical training., Competing Interests: Declaration of competing interest Given her role as Editor of the target journal, Professor Kristina Mikkonen had no involvement in the peer-review of this article and has no access to information regarding its peer-review. An independent editor was given full responsibility for the editorial process of this article., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Aim: To describe nurse leaders' experiences of how culturally and linguistically diverse registered nurses integrate into healthcare settings., Design: A qualitative descriptive study design., Participants: A total of 13 nurse leaders were recruited from four primary and specialized healthcare organizations in Finland., Methods: Data were collected through individual semi-structured interviews and analyzed using inductive content analysis., Results: Nurse leaders' experiences were categorized into seven main categories as follows: leadership, which concerns a leader's roles, style, and experience; organizational strategy and culture, which includes structure, policies, and intra-organizational culture; support strategies, including workplace and outside-of-work integration strategies; relationships and interactions, which considers interpersonal relationships and interactions; nurse competence requirements and development, which concerns both organizational and ward level competence demands, and support for competence development; language competence, which concerns challenges relating to language proficiency and development of language competence; and cultural diversity, which considers the importance of competence development brought about through experiences of being in a multicultural workplace., Conclusions: Culturally and linguistically diverse nurses are important within healthcare systems. These nurses constitute additional human resources, bring diverse experiences and expertise, and add to organizational cultural capital. Nurse leaders require competencies that are suitable for leading a diverse workforce, utilizing its competencies, establishing staff members' needs, and ensuring their continuous development. Resourcing, planning, and structuring the integration process affects nurses' experiences of the organizational socialization process., Impact: The findings of our study can offer guidance to healthcare organizations with regard to structural integration strategies at an institutional level. Leadership and management educators can benefit from the findings towards developing a curriculum that supports leaders' diversity, equity and inclusion, knowledge management and formal leadership competencies. Finally, nurse leaders may benefit from this study through being more aware towards supporting a multicultural, cohesive, and competent workforce through strong social capital., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The international mobility has increased cultural diversity in social- and health care. As such, ethical and cultural competence is an essential skill among educators. They are promoting the ethical and cultural competence and professional growth of students with diverse backgrounds and, therefore, must be ethically and culturally competent., Aim: The aim of the study was to identify distinct ethical and cultural competence profiles of social- and health care educators and explore the associated factors., Research Design: A descriptive cross-sectional survey design was used to collect quantitative observational data in 2020-2021. Competence profiles were identified by K-means clustering based on answers to an instrument focussing on educators' ethical and cultural competence., Participants and Research Context: Participants (N = 1179, n = 243) were social- and health care educators based at 10 universities of applied sciences and 10 vocational colleges in Finland., Ethical Considerations: The research adhered to good scientific practice. A research permit was received from each educational institution that participated in the study. The privacy of the participants was protected throughout the study., Results: The analysis identified three profiles of educators (A, B, C) based on self-assessed ethical and cultural competence. Profile A educators demonstrated high scores across all three competence areas. Profile B educators had high scores for ethical knowledge and intermediate scores for other competence areas. Profile C educators demonstrated intermediate scores across all three competence areas. An educator's pedagogical education was found to significantly influence which profile they belonged to., Conclusions: The educators generally evaluated their ethical and cultural competence highly. Educators understand the importance of professional ethics in their work, but they need additional support in developing ethics skills in their daily work. Among all educators, there is a need for developing international and culturally diverse collaboration., (© 2023 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.)

Aim: To describe nurse educators' views of how culturally and linguistically diverse future registered nurses are integrated into healthcare settings., Design: A qualitative descriptive design was adopted., Participants: A total of 20 nurse educators were recruited from three higher education institutions in Finland., Methods: Participants were recruited in the spring of 2021 through snowball sampling. Individual semi-structured interviews were held and recorded. The collected data were analysed using inductive content analysis., Results: The performed content analysis identified a total of 534 meaning units from the data, which were categorized into 343 open codes and 29 sub-categories. Furthermore, nine categories were identified and categorized into three main categories. The first main category was pre-graduation and represented a time point during which educators experienced early integration, nurse educator support and cooperation with stakeholders. The second main category was integration strategies into healthcare settings, which included workplace strategies, language competence and individual competencies and attributes. The third main category was the post-graduation experience, during which educators reported organizational readiness, migration and efficacy of the integrational model., Conclusions: The results revealed a need for increased resources linked to how nurse educators support the integration of culturally and linguistically diverse future registered nurses. Moreover, a nurse educator's presence during the last clinical placement, early transition and integration was found to exert a significant effect on the smooth integration of culturally and linguistically diverse future nurses., Impact: This study establishes the need to enhance stakeholder cooperation between universities and other organizations towards supporting the integration process. Maximizing nurse educators' support during the final clinical practice, early transition and post-graduation allows for successful integration and intention to stay., Reporting Method: This study was reported according to the Standards for Reporting Qualitative Research (SRQR)., Patient or Public Participation: Participating educators shared their experiences of culturally and linguistically diverse future nurses' integration., (© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Aim(s): To describe nurse leaders' perceptions of culturally and linguistically diverse (CALD) nurses' competence-based management., Design: A descriptive qualitative study of the competence-based management of CALD nurses, from the perspectives of nurse leaders in three primary and specialised medical care organisations. This study followed the COREQ guidelines., Methods: Qualitative semi-structured individual interviews were conducted with 13 nurse leaders. Eligible interviewees were required to have management experience, and experience of working with or recruiting CALD nurses. Data were collected during November 2021-March 2022. The data were analysed using inductive content analysis., Results: Competence-based management was explored in terms of competence identification and assessment of CALD nurses, aspects which constrain and enable competence sharing with them, and aspects which support their continuous competence development. Competencies are identified during the recruitment process, and assessment is based primarily on feedback. Organisations' openness to external collaboration and work rotation supports competence sharing, as does mentoring. Nurse leaders have a key role in continuous competence development as they organise tailored induction and training, and can indirectly reinforce nurses' work commitment and wellbeing., Conclusion(s): Strategic competence-based management would enable all organisational competencies potential to be utilised more productively. Competence sharing is a key process for the successful integration of CALD nurses., Relevance to Clinical Practice: The results of this study can be utilised to develop and standardise competence-based management in healthcare organisations. For nursing management, it is important to recognise and value nurses' competence., Impact: The role of CALD nurses in the healthcare workforce is growing, and there is little research into the competence-based management of such nurses., Patient or Public Contribution: No patient or public contribution., (© 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Aims: This study aimed to identify mentors' cultural competence profiles at mentoring culturally and linguistically diverse nursing students in clinical practice and explore associating factors., Background: Globalization has had a significant impact on healthcare, increasing the diversity of healthcare workforces and the number of culturally and linguistically diverse nursing students in clinical practice. The cultural competence of mentors is important to secure students' safe and successful learning. The mentor role in clinical practice contributes toward enabling and ensuring students' high-quality and goal-oriented development of competence., Design: This study implemented a cross-sectional design with a final sample of 270 clinical practice mentors from Finland, Lithuania, Spain and Slovenia., Methods: The data were collected using an online survey including the Mentors' Cultural Competence Instrument, Mentors' Competence Instrument and background questions during 2020-2021. The data were analyzed using a K-mean cluster algorithm to identify mentors' competency profiles., Results: Three significantly differing mentor competency profiles (Profile A 42%, Profile B 41%, Profile C 17%) were identified in this study. The cultural competence of the mentors in clinical practice varied between intermediate and high levels. Mentors rated their cultural competence as best in the area of cultural sensitivity and awareness, whereas the lowest scored area was cultural interaction and safety., Conclusions: This study showed that the cultural competence of mentors in clinical practice varied and was influenced by mentors' work experience, age, job title and frequency of mentoring. This study provides new knowledge that could help to develop cultural competence operating models and education to enhance the cultural competence of healthcare professionals., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The nursing shortage is a global and ongoing phenomenon that is expected to worsen. In many countries, imbalances in the nursing workforce will require international recruitment and plans to increase domestic and international nursing graduates. Nurses from culturally and linguistically diverse backgrounds have been reported to experience challenges while integrating into the workforce., Aim: To describe culturally and linguistically diverse registered nurses' experiences of their integration into the Finnish nursing workforce., Methods: The study adopted a qualitative descriptive design. Data were collected during the spring of 2021 from 24 culturally and linguistically diverse registered nurses working in various healthcare settings in Finland. Data were analyzed using content analysis, which resulted in 596 open codes, 21 sub-categories, and 8 categories., Results: According to the performed analysis, culturally and linguistically diverse nurses in Finland face cultural, ethnic and linguistic challenges. Organizational acceptance and acknowledgement of culturally and linguistically diverse nurses' competence can help decrease the practice of deskilling and the perception that foreign nurses have purely opportunistic goals. Cultural and language learning support, tailored orientation programs, and mentorship are the most common organizational strategies for supporting integration and competence development. The role of the nurse manager and organizational strategies were also identified as essential components of smooth integration, work wellbeing and retention., Conclusions: Finnish healthcare organizations need to implement strategies that support culturally and linguistically diverse nurses' integration into the workforce. Nurse managers are important leaders that can foster culturally and linguistically diverse nurses' competence development, ensure the efficient use of their specialized skills, promote work wellbeing, and improve nurse retention., Competing Interests: Declaration of competing interest Given their role as Editor on this journal, Professor Kristina Mikkonen had no involvement in the peer-review of this article and has no access to information regarding its peer-review. Full responsibility for the editorial process for this article was delegated to an independent Editor. The authors have no conflict of interests to declare., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Health care experts need high levels of competence, yet there is little evidence on the influence of digital learning on health science students' competence development., Objectives: This study aims to describe health sciences students' experiences of the development of their competence and the influences of digital learning upon their competence., Design: A qualitative descriptive research., Participants: A total of 15 health sciences students were interviewed., Methods: The data was collected by using individual semi-structured interviews during the spring of 2021. The data was analyzed using content analysis., Results: The health sciences students felt that their expertise encompasses motivation for future career development, understanding the social and professional influences on their career development, versatile expertise in various aspects of health sciences, and developing competence in different learning environments. The students recognized that digital learning requires the active participation, digitalization is a part of a successful learning environment, and digital learning challenges social interactions. The students' digital learning facilitated competence development, which broadened their understanding of skills relevant to health sciences; however, these benefits could only be obtained when including adequate support., Conclusions: The results hold social value for the development of health sciences education as policy-makers can use the presented information to develop high-quality, digital learning procedures., Competing Interests: Declaration of competing interest Given her role as Editor of the target journal, Professor Kristina Mikkonen had no involvement in the peer-review of this article and has no access to information regarding its peer-review. An independent editor was given full responsibility for the editorial process of this article., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Aims: The aim of this umbrella review was to establish recent evidence on integration strategies and models to support transition and adaptation of culturally and linguistically diverse nursing staff into healthcare environments., Design: Umbrella review conducted according to Joanna Briggs institute guidelines., Data Sources: Data were collected from CINAHL, PubMed, Medic, ProQuest and Scopus electronic databases in 2021., Review Methods: Two researchers simultaneously screened studies' eligibility by title, abstract and full text. Quality appraisal for the selected studies was assessed according to Joanna Briggs institute critical appraisal. Data were synthesized by conducting content analysis., Results: Twenty-seven reviews were included in the final synthesis. Strategies and models for supporting the transition and adaptation of culturally and linguistically diverse nursing staff into healthcare environments were structured as intra-organizational, sociocultural, and professional development. Intra-organizational strategies and models were unique to a particular organization and included policies and support, diversity, collegial and peer support, employee treatment and workplace environment. Sociocultural strategies and models addressed social, cultural and group dynamics using cultural training, learning and support, social support and friendships, language and communication, and personal skills development. Professional development enhanced nursing competence, ability to practice and workplace professional development. This was supported through licensure and orientation to work, career and competence development, and workplace mentorship and preceptorship., Conclusion: There is a need to understand culturally and linguistically diverse nurses' needs and motivation to integrate, which is essential toward developing efficient integrational strategies and models. Strategies and models also need to support cultural and personal competence development of native nurses to aid efficient integration of culturally and linguistically diverse colleagues. Future studies can evaluate nursing workforce shortages and their implications on integration process., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)