Jenny Wraight

304 – Transitioning registered nurses with english as an alternative language (EAL) into an english-speaking health environment

Competent communication is a fundamental component of providing safe nursing care.  A communication assessment was used as an adjunct to the Objective Structured Clinical Assessment (OSCA), prior to EAL nurses’ commencement in a hospital placement. A rubric score sheet enabled OSCA assessors to more appropriately score the level of communication during the OSCA.  This accurately specified where improvement in English communication needed to be focused.


Concerns about English language competence in the hospital workplace are reported in several countries where internationally qualified (IQ) EAL nurses seek registration. A Clinical Communication Assessment Framework (CCAF) was sourced (San Miguel & Rogan, 2015).  This had the potential to identify the level of competency of English language communication required prior to entering the hospital setting.

Out of 11 nurses, 25% scored “unsatisfactory”, 30% “needed development” and 45% scored a “satisfactory” level of clinical communication in a simulated clinical environment. This indicated that although the students gained a pass level in the International English Language Testing System, some required more support to develop their English communication skills prior to and during their clinical placement.

Recommendations for future practice
A CCAF should be used during the OSCA and should also be integrated into the clinical placement assessment for EAL nurses seeking registration in the English-speaking destination country. Addressing clinical communication competency will enable EAL RNs to fully transition into the health care team. This will meet the needs of the future to ensure integration of competent IQ RNs into the nursing workforce of English speaking countries.

Key words: Clinical communication; internationally qualified (IQ); registered nurses (RN); English as an alternative language (EAL).