ABSTRACT Because of cultural differences and language barriers, some Asian nursing students who speak English as a second language (ESL) have not realized their full potential and career goals. Based on an exhaustive search through existing electronic databases in health sciences, this article synthesizes the published literature between 1980 and 2010 on this subgroup of nursing students in four domains: conceptual frameworks, language and communication, support and infrastructure, and instructional strategies. However, some of the classic works were published before 1980. Findings indicate that a body of literature on ESL nursing students has emerged in the last decades, with several limitations. Based on this review, implications for future educational practice and research are elaborated, with an emphasis on an evidence-based approach.
Keywords Asian Nursing Students - English-as-a-Second Language - Nursing Education - Cultural Variability - Language Barriers - Instructional Differences - Instructional Strategies
TRADITIONALLY, ASIA HAS PROVIDED THE GREATEST SHARE OF INTERNATIONAL NURSING STUDENTS TO THE UNITED STATES. During 2008-2009, 62 percent of the 671,616 international students in the United States came from Asia (Institute of International Education, 2010), primarily Chinese, Asian Indians, Koreans, Taiwanese, Japanese, and Vietnamese. Despite diversity among these groups, there are certain commonalities among people of Asian origin. Asian students who speak English as second language (ESL) face cultural barriers their non-ESL peers may not experience.
For the purpose of this article, ESL students are defined as students who attended grade school outside the United States and use a language other than English in daily functions, or students raised in a non-English-speaking environment who continue to use their native language in the home while using English in environments where the native language is not used. Although most Asian students develop some English reading and writing skills before coming to the United States, they typically have few opportunities to speak English in their native countries or at home. Thus, they often have difficulty speaking and understanding English when they enter the US educational system.
Common difficulties with the English language are gender and tense; in some spoken Asian languages, such as Chinese, there is no need to differentiate gender and tense. There are also instructional differences at both the philosophical and classroom levels. For instance, in Asian educational systems, emphasis is placed on memorizing details of important facts. In contrast, reading widely and then synthesizing or critiquing is a common educational strategy in the United States. The large amount of required reading in most US nursing curricula can be overwhelming, causing Asian students to fall behind their peers (Abu-Saad, Kayser-Jones, & Tien, 1982).
There is very limited research on Asian ESL students in nursing. An extensive literature search indicated that there are no specific reported statistics on the attrition rate of Asian ESL nursing students. However, published articles (Abriam-Yago, Yoder, & Kataoka-Yahiro, 1999; Abu-Saad et al., 1982; Guhde, 2003; Kataoka-Yahiro & Abriam-Yago, 1997; Phillips & Hartley, 1990; Xu & Davidhizar, 2005) and anecdotal evidence revealed a concern over attrition rates among these students as both their numbers and proportion continue to increase in nursing programs across the United States.
This review synthesizes the existing literature on Asian ESL nursing students. Specifically, it reviews the conceptual frameworks used in studying Asian ESL nursing students and challenges encountered by these students. Research findings regarding academic strategies of Asian ESL nursing students published between 1980 and 2010 are summarized. The authors elaborate on the use of an evidence-based approach to apply the findings to Asian ESL nursing students in order to enhance their learning outcomes and educational experiences. …