Introduction
Nurses require theoretical and practical training that can enable them to perform their duties in nursing care. Experienced nurses accredited for educational duties provide nursing education to nursing students, and this depends on the relevant areas of nursing, including mental health and physical health (Gormley, 2003). In most countries, the issue of language barrier presents some difficulty in education delivery, and this requires educators in the nursing industry to consider different languages to nurture their students, especially in a multicultural environment.
The language barrier is a challenge in both local and international nursing schools. When nurses are trained to use their native language such as English, they have a hard time attending patients from culturally diverse backgrounds such as those who speak Arabic as their native language. Language barriers can have negative results on a student’s academic excellence. Many universities in the faculty of nursing have not been able to deliver education on multicultural nursing (Gilchrist & Rector, 2007). However, few colleges which have given students multicultural nursing education have produced graduates who have knowledge, ability and wide understanding of multiculturalism and hence they are capable of attending patients from different cultural backgrounds. This paper focuses on language barriers in nursing education delivery.
In essence, nurses have played a great role in delivering health care in many countries all over the world. Their task entails educating patients as well as the public on how to stay healthy and prevent diseases, provide health care, support in the cure, recuperating and any other assistance. Nurses usually have broad roles as compared to other health care professionals. They teach the patients about the emotional, mental and cultural experiences they come across during the period of illness. They also help patients to live with incurable diseases, manage the illness, and deal with the disease situation (Potter, Perry, 2005). Moreover, nurses have the responsibility of evaluating a patients’ health and their intense observation skills allows doctors to make clear diagnoses and provide the right treatment. Nurses have saved many lives because of their zeal to prevent diseases such as cardiac arrest through early diagnosis (Kreber, 2005).
Nursing Education
Battin (2007) argues that nurses are still advancing their education to gain more knowledge. As this knowledge increases, nurses help in improving patients’ lives. There is a need to keep on learning because new diseases continually arise, and nurses have to learn and give the patients up to date treatments while learning to communicate with the patients and understanding their ailments. Attaining more knowledge enables a nurse to be more marketable and they can become specialists in many clinical areas such as oncology. Since the nursing licensing laws are unpredictable and may give licenses to only the bachelor’s degree holders, there is a need for the students to keep on learning.
Nevertheless, many barriers hinder nursing education, and they are mostly communication-related problems. These barriers include language barriers, ethnic barriers, staffing barriers, distractions, and jargon (Schim et al., 2007). Due to language barriers, the nursing students are not able to communicate well with the patients and this leads to incorrect signals since there are few translators in most cases. Language barriers also hinder communication between different patients with dissimilar cultures who have diverse opinions such as the extent of body exposure. For instance, patients from Arabic countries are very strict on the extent of body exposure because the Islamic religion, which is common in the region, is sensitive to the matter.
Merriam and Simpson (2000) argue that there is a need to overcome the barriers that affect the delivery of nursing education because many people from diverse cultures are migrating from one country to another, especially in the United States. In the United States, there is a large number of upcoming Spanish speakers. These people are either not able to speak English at all or do not speak English well. It is easy to speculate that nurses who are English native speakers are not able to provide efficient nursing care to Hispanic patients. Thus, there is a need for diversity among learning students and lecturers. The value of the students and lecturers interaction in the nursing class is very important because it either helps or hinders the students learning. In light of this, language barriers have hindered the teachers to teach multi-linguistic students.
Similarly, Gormley (2003) affirms that Students have faced many challenges in learning other languages. For instance, English learners in Arabic universities have had many challenges in translating English to Arabic as a second language. This is because the teachers are native Arabic speakers and they might find it difficult to teach other international languages. Nursing students have learned English as a second language, but they are yet to grasp other languages such as Arabic. The nursing students admitted to Arabic universities have low proficiency in the Arabic language. They pursue their careers in nursing but have difficulties communicating in Arabic languages. Inappropriate teaching of foreign languages in schools causes these problems and students find it difficult to arrange their ideas since it is a new language.
For these students to be successful in learning foreign languages, they should have a proper learning environment with both English and Arab translators. For example, nursing schools in Ireland have a large number of international students ever since the government allowed Eastern European to migrate into their country in 2004 (Potempa et al., 2001). Therefore, language and cultural barriers affect the international student’s performance. Most of them are not able to communicate with the local students because of different accents and hence prefer to keep friends who have from their community.
Davies (2002) reckons that many countries lack qualified or registered nurses and hence, there is a need to promote diversity of nursing students. Diversity of students and teachers as well as the introduction of multilinguistic learning programs will promote learning many languages and dealing with patients’ cultural differences. In this regard, Australian universities have many strategies for attracting international nursing students. This is evident with the government’s provision of universities’ information in different languages and pictorial advertisement materials, which reflects different cultures (Markey & Tilk, 2007). Other strategies include having groups on career development and international nursing programs. These programs have many events such as visiting elders within different cultural groups, community events, participating in ethnic radio stations and religious groups.
Arabic universities have also facilitated student and teachers exchanges in overseas countries as well as subject exchanges to cater for diverse students. There are many student support centres with advisers. They also give financial support and scholarships. This implies that there is a need to evaluate the expectations of overseas students. Spreading out diversity in the student’s organization and profession is critical because it benefits the practice discipline and the patients served by the students (Link, Swann, & Bozeman, 2008).
As a point to consider, transforming nursing education entails the elimination of language barriers because there is a need to have well-trained nurses to sustain and have high-quality healthcare. Since there is a serious shortage of nurses, there is a need to encourage the minorities such as men to enrol in nursing colleges to meet the industry demands. According to the Council of Higher Education Accreditation (2002), innovating nursing education is essential for many reasons: one is transforming the learning methods to accommodate languages such as Arabic. The school administrators and other staff in the faculty of nursing must work jointly to see that this transformation takes immediate effect. They must have a passion to learn from other people who speak different languages and with diverse cultures and avoid sanctions against them due to diverse views and unpopular views.
Moreover, Potempa et al. (2001) suggest that students’ expectations from their teachers have changed and hence, they expect interactions with the faculty heads through electronic mails. Most faculty heads may not meet the student’s expectations because they might be lacking the necessary skills. They face the challenge of embracing technology and adopting online education. However, those who have adopted the new technology may not be able to respond to online students need due to language barriers. For example, English students may not be able to communicate with Arabic teachers and hence, the teachers are unable to give feedback. Teachers may also have less experience in online teaching since many of them have learnt old skills of observation and imitation, as well as getting feedback. The teachers need to do online research on their own so that they will be able to assist students using web-based technologies.
Online Learning
Online teaching poses some challenges, not only to the teachers but also to the students. Many nursing learners are not proficient with online technology and hence they have difficulties in adapting to it. It is also difficult for some colleges to change their curriculum and adapt to online technology. In a study done by Kozlowski in 2004, many students complained that online work consumed most of their time as compared to face-to-face classes (Billings, 2000). Ali, Hodson-Carlton, and Ryan (2002) argue that colleges should take students through an online orientation to prepare them for online learning. With this orientation, they become familiar with online technology. They also participate in online discussions while being assisted by their facilitators. As the students begin to accept the technology, their instructors allow them to take control of online communication and relations and thus, increasing their dependability in learning.
Billings (2000) affirms that online programs have been of great help to the students and teachers who have adapted to them, although some nurses who speak languages such as Arabic may not be able to access and understand articles written in English. In addition, online programs have helped to overcome the problem of the shortage of professional nurses.
Many faculty members receive rewards for their online research output, but they fail to look at the students’ results. To them, recognition is important rather than looking at their students’ needs. In this regard, nursing faculty leaders all over the world have had many challenges such as communication and language. It is essential for them to actively monitor the design of the existing curriculum and adjust it to meet the student’s needs. Many have very important innovative ideas but are unable to overcome such challenges since faculty development is important for nursing education success (Trautmann, 2008).
Challenges Faced by Nursing Educators
Nurse educators serve as role models and they have the responsibility of putting into practice, evaluating, and revising curriculums and programs for nursing education, which enables the students to get their certificates or degrees (Merriam & Simpson, 2000). They are key players in providing high-quality education that enables the workforce to cope with the dynamic health care environment. The educators work in hospital schools, universities and other organizations with healthcare facilities. They teach the high school graduates and those who want to advance for degrees and other certificates. They also do other tasks such as advising students, doing scholarly work, being involved in nursing associations, presenting lectures for students at conferences, peer reviews, and upholding clinical competence. Nurse educators are few and hence, many countries have faced these shortages; the few available have many responsibilities, which they are not able to handle due to this situation (Battin, 2007).
In this light, Porter and Perry (2005) confirm that nursing educators have had many challenges since they act as teachers and scholars. They must teach and at the same time attend to the patients. They are involved in making it easy for students to learn socialization and act as agents of change. They are required to keep on acquiring knowledge so that they give their students quality learning, and be involved in career growth and change.
According to Trautmann (2008), quality education in nursing is vital to the students because they are tomorrow’s education providers. Poorly trained students will give poor healthcare, as they become practising nurses. For example, in Cameroon, educators who have less or no proper teaching experience usually teach nursing students. They do not have proper guidelines on how to teach and supervise the students. These educators face many challenges since they cannot supervise, guide or review their performances during field placements, thus becoming ineffective as educators. Since nursing education is a key to the delivery of better nursing services, there is a need for the most qualified and experienced trainers and the nursing faculty in general to address the issues nursing students and trainers face. Proper understanding of the problems will give an outline for their needs and improve their teaching skills.
Language Barrier in Nursing Examinations
Kreber (2005) argues that Language gives people words to convey their messages and expressions to each other. Language barriers can be a threat to foreign nursing students. This is due to the use of foreign languages where communication can be frustrating and in some cases raise conflicts. Unfortunately, students are not familiar with many languages spoken by people in foreign countries. As these students migrate to other countries, say Arabic countries, they face challenges of learning new languages. As they learn these languages, they are unable to understand the dialects and regionalisms used by the people in foreign countries.
Regionalism is a certain way that people phrase and pronounce their words while dialects are unique ways of how various groups speak a language. In this case, some institutions provide interpreters to translate to the students and from the students to the patients, but in most cases, they learn it the hard way. Some of these interpreters may use difficult idioms, slang and street talks and hence, the students do not understand some of the wordings (Schim et al., 2007).
Frankena, Raybeck, and Burbules (2002) delineate that nursing students have failed their exams due to language barriers. For example, in Japan, many foreign students applying for exams fail because questions are in English, which is their second language. The solution to this problem is having those exams translated into their language: this might take time and in many cases, question presentation changes. Similarly, nurses from Indonesia can work in Japan temporarily, but they can stay longer under the condition that they will pass the test written in the Japanese language. Thus, there is a need to simplify the wordings in an exam so that these students get the concepts. Exams have put extra burdens on the students who are supposed to repeat the failed test until they pass (Gilchrist & Rector, 2007).
In the case of Japan, the translators will help the foreign students and applicants to read and understand what the examiner expects. According to Trautmann (2008), Japan is one of the countries that impose strict laws about immigration, but it permits nursing students from countries such as Indonesia and the Philippines due to the high demand for health workers. These students have to learn the Japanese characters as well as medical terms to pass their exams and consequently provide healthcare to Japanese people. Although most of them fail the exams, they still provide healthcare services as they wait to go to other countries where they will learn without language problems, and where they will understand the patients needs better. Language barriers have discouraged many students to immigrate to such countries and there is a need for countries like Japan to develop ways of how to teach foreign students.
Merriam, Caffarella, and Baumgartner (2007) confirm that some countries have developed computer tests for non-native students. These assessments aim at eliminating the language barriers. Foreign students receive instructions in their native language to gauge their knowledge; the students in the classrooms have used computer-based testing. There are also other tools such as computer adaptive assessments to test both the level of student’s knowledge. The computer-adaptive systems are online tests arranged in a way that allows the student to answer questions correctly before going to the next one. If the student can answer all the questions, it is easy to tell that he has achieved much in class, and if a student fails, it means that they have not achieved much. The computer-adaptive assessment gives the students a summary of their performance. They also provide immediate feedback and personalize each student learning experience.
Other tests for student performance include the performance and achievement series. Performance series is a web-based test that educators use to assess students’ proficiency levels. It is easy to see each student’s progress and anticipate his/her overall performance. The achievement series is also a web-based test that educators use to deal with current tests and develop other tests. Achievement tests also give the answer or result instantly (Billings, 2000).
Even though the translators and other online tools assist international nursing students, the language barrier is still a major issue. Other than the language barrier, the classroom atmosphere and relationships with other faculty members stress students. Countries need to be diverse to accommodate nurses and students from different backgrounds (Dubois, Padovano, & Stew, 2006).
Conclusion
Proper and understandable language is essential in nursing education. Both the students and educators must strive to achieve a feasible mode of communication in their educational tasks. There is a need to address the issue of the elimination of language barriers by developing ways to cater for both the students and patients’ needs. The students need to understand what the patients are saying during their learning processes, attachments, and placements. When both the health care provider and the patient communicate well, there is increased patient satisfaction, following medical instructions, and improving the health care outcome. Therefore, with the elimination of language barriers, the nursing faculty all over the world will be able to accommodate foreign students. There will be diversity in nursing staff who will attend to the needs of patients from diverse cultures. However, the elimination of language barriers will still pose challenges as the curriculum in the nursing profession is still evolving because of emerging diseases and healthcare issues.
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