Abstract
Faced with an increasingly diverse population and a shortage of nurses, US schools of nursing need to educate nurses from diverse backgrounds. These students may use English as a second language (ESL), leading to challenges that can place them at risk for not passing the NCLEX-RN. The authors present several challenges for ESL students preparing for the NCLEX-RN and successful strategies to coach them. These preparation issues and strategies may also help foreign-educated nurses prepare for the NCLEX-RN.
As the United States population becomes increasingly diverse, 1 the number of nurses in the workforce decreases, 2 and the federal government encourages schools of nursing to increase student diversity, 3 faculty are educating men and women from a variety of ethnic and cultural backgrounds. Many of these nursing students speak English as a second language (ESL), which may pose testing difficulties throughout their academic career. 4 In particular, they may have difficulty interpreting and passing the National Council Licensure Exam-Registered Nurse (NCLEX-RN) exam, a computer-adaptive, multiple-choice test.
Passing the NCLEX-RN is key not only to the ESL graduate, but also to the nursing profession in providing more ethnically and culturally diverse RNs. Nursing faculty who help ESL students prepare for the NCLEX-RN have a delicate challenge; they must teach the nuances of the language and majority culture in the United States, while respecting and preserving each student's culture. Doutrich 5 found that international students experience "cultural dissonance and confusion" when attempting to interpret and put into practice American ideals of nursing. Patient expectations (informed consent and being told "the truth" about their condition) and the nurse's role as a patient advocate were especially difficult concepts to learn.
Several ESL students at the University of Massachusetts School of Nursing have sought extra assistance in preparing for the NCLEX-RN. This article addresses various challenges these students faced, along with strategies the nursing faculty learned while coaching them.