Transition-to-U.S. Practice Experiences of Internationally Educated Nurses: An Integrative Review

Lauren V. Ghazal, Chenjuan Ma, Maja Djukic, Allison Squires

Research output: Contribution to journalReview articlepeer-review


Internationally educated nurses (IENs) are an important part of the U.S. nursing workforce. Optimizing their transition-to-practice (TTP) experiences in the United States is crucial for ensuring high-quality patient and IENs’ outcomes. The purpose of this integrative review is to analyze and synthesize the current evidence surrounding IEN TTP experiences in the United States from 2000 to 2018 to inform improvements in TTP. Eighteen studies were included. TTP was defined through IENs’ description of facilitators and barriers of the transition process and presented in seven themes. Two themes were facilitators: support from family and nursing colleagues, and perceptions of self-efficacy. The remaining five themes were barriers: (a) the stigma associated with educational preparation, (b) communication and language, (c) differences in culture, (d) differences in nursing practice, and (e) legal issues. Findings are important for improving TTP programs. Further research focusing on the outcomes of transition programs is needed to inform policymaking surrounding IEN recruitment and retention.

Original languageEnglish (US)
Pages (from-to)373-392
Number of pages20
JournalWestern Journal of Nursing Research
Issue number5
StatePublished - May 1 2020


  • integrative review
  • internationally educated nurses
  • transition to practice

ASJC Scopus subject areas

  • General Nursing


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