The Assessment of Workplace Integration of Migrant Nurses and Midwives in Global Healthcare Settings: A Scoping Review

ABSTRACT

Aim

To map the available evidence on the assessment of migrant nurse and midwife workplace integration in global healthcare settings.

Background

Globally, migrant nurses and midwives are important resources in mitigating workforce shortages. Existing evidence focuses on the orientation stages of migrant nurse and midwife transition into the healthcare setting rather than their long‐term workplace integration.

Design/Methods

The nine databases searched were CINAHL, Medline, Web of Science, Embase, PsycINFO, ASSIA, SicELO, Maternity & Infant Care and Global Index Medicus. An initial search was performed in December 2021 and updated in December 2025.

Results

A total of 91 articles were included, comprising qualitative (n = 48), quantitative (n = 13), mixed‐methods (n = 6), others (n = 23) and one book chapter. Multiple definitions of workplace integration were found, and 23 tools were identified.

Conclusions

Workplace integration, a multidimensional, time‐dependent process, requires collaboration among stakeholders. A standard definition will help to clarify their responsibilities. Key factors ensuring successful integration include promoting effective communication, supporting knowledge advancement, facilitating career development and skill utilisation. The development of standardised interventions with flexibility for local adaptation will support successful workplace integration.

Implications for nursing/health policy

Findings highlight the need for policy developers to support migrant nurses and midwives with interventions focused on linguistic challenges, cultural competence and differing care models, that are key to successful integration. Future research must include host stakeholders’ perspectives to fully understand the dynamics of workplace integration.

1. Introduction

A migrant nurse/midwife is a registered nurse/midwife who has obtained their nurse/midwife qualification outside the host country in which they are employed. According to Pilette's seminal Model of Adjustment (1989), the integration phase typically begins between nine and twelve months of employment in the host country (Pilette 1989; Bayuo et al. 2023; Zakaria and Yusuf 2023; Roth et al. 2025).

Recruitment of this population is a strategy for managing current and predicted workforce shortages. In the Gobal North (Australia, Canada, Ireland, New Zealand, the United Kingdom and the United States), migrant nurses comprise up to 50% of the healthcare workforce (National Audit Office 2020; Canadian Institute for Health Information [CHI] 2024; Organisation for Economic Co‐operation and Development [OECD] 2023). However, the percentage in the United Arab Emirates (UAE) is much greater, at 96% (Al‐Yateem et al. 2021). The World Health Organization (WHO 2020) predicts a global shortfall of six million nurses by 2030 and a concomitant retirement of four million (WHO 2025). Consequently, countries such as Canada, Germany, the United States and New Zealand will continue to recruit migrant nurses and midwives to meet workforce requirements (Lauxen et al. 2019; Smith et al. 2022; Buchan and Catton 2023; Cipriano 2024; ICN 2024).

Transition into a new healthcare setting occurs in two distinct phases. Phase one is orientation, whereby migrant nurses and midwives acquire clinical skills appropriate to the host setting. Phase two is integration, whereby they gain independence within their professional role, achieved through the acquisition of linguistic, cultural and professional competencies (Xu 2008; Oikarainen et al. 2022). Integration experiences of migrant nurses and midwives, a heterogeneous group from culturally diverse backgrounds, vary significantly and are contingent on their country of origin and the host healthcare setting. The varying languages, cultures, religion and ethnicity of migrant nurses and midwives (Pham et al. 2021), and their initial nurse–midwife education is also different from that of the host countries (Hawthorne 2005; Habermann and Stagge 2010), which has implications for successful workplace integration. Workplace integration is complex, multidimensional, resource‐ and time‐dependent (Hayne et al. 2009; Njie‐Mokonya 2014; Bond et al. 2020), involving migrant nurses and midwives, their host colleagues, managers and organisation (Sherwood and Shaffer 2014; Buttigieg et al. 2018; Gea‐Caballero et al. 2019). Workplace integration, therefore, creates challenges for healthcare organisations and host stakeholders who support the workplace integration process (Viken et al. 2018; Pressley et al. 2022).

Migrant nurses and midwives have up to seven years of professional experience prior to migrating (Likupe 2015; Covell et al. 2017; Salami et al. 2018) and considerable transferable clinical skills; however, challenges associated with their integration have been extensively documented (Primeau et al. 2014; Pung et al. 2017; Aggar et al. 2020), including ethno‐cultural components (Ogilvie et al. 2007; Jayasundar et al. 2025), discrimination, linguistic differences, racism, isolation, role ambiguity and compromised decision‐making (Viken et al. 2018). Racism and discrimination emanate from peers in addition to patients and visitors (Viken et al. 2018; Efendi et al. 2020; Antón‐Solanas et al. 2022; Tanaka and Yoshimura 2024). Limited linguistic proficiency compromised teamwork, while ambiguity around the nursing role, attributed to difficulties in decision‐making, posed a risk to safe practice (Smith and Ho 2014; Näre and Silva 2021).

Little is known about workplace integration; most sources focus on initial orientation, which is a precursor to workplace integration (Covell et al. 2014). Several reviews examined the integration of migrant nurses and midwives, concentrating on individual national contexts such as Japan and New Zealand (Jenkins and Huntington 2015; Abuliezi et al. 2021) or general migrant nurse populations (Jayasundar et al. 2025). There is a paucity of literature investigating workplace integration across nations, with previous reviews focusing on recertification (Covell et al. 2017), specific health settings (Viken et al. 2018; Balante et al. 2021) or countries (Zhong et al. 2017; Bond et al. 2020). Results are context‐specific and do not address how to achieve successful workplace integration. In this scoping review, workplace integration refers to the process by which migrant nurses and midwives use their existing culture, professional knowledge and expertise to acquire new knowledge, language, social skills and values to participate fully in the healthcare workforce (Pettersson and Glasdam 2020; Kamau et al. 2023; Tanaka and Yoshimura 2024). To the best of our knowledge, no reviews have explored workplace integration within a global healthcare context. This scoping review aims to map the existing evidence on workplace integration, and to identify key concepts, gaps and future research directions, consistent with scoping review methodology (Peters et al. 2020).

2. Methods

This scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews (Peters et al. 2020) and reported using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for scoping reviews PRISMA‐ScR guidelines (Tricco et al. 2018). A protocol (anonymised) was developed for this review and registered with the Open Science Framework on 8 October 2021 (McBrien B et al. 2022). The objectives and inclusion criteria were specified in advance and documented in a protocol.

2.1. Review Questions

The review questions are outlined in Table 1.

TABLE 1.

Review questions.

	Review questions
1	How is workplace integration for migrant nurses and midwives defined and conceptualised?
2	What research methods are used to assess migrant nurses’ and midwives’ workplace integration?
3	What instruments are used to assess the workplace integration of migrant nurses and midwives in healthcare settings?

2.1.1. Inclusion Criteria

The inclusion criteria are outlined in Table 2.

TABLE 2.

Population, concept, context (PCC) for identifying the main concepts within the scoping review.

Criteria	Determinants
Population	The review considered all sources featuring migrant nurses and midwives employed outside their country of initial nurse–midwife registration for at least nine months.
Concept	The review considered sources that explored the assessment of workplace integration in all healthcare settings. In this review, workplace integration is described as the process by which migrant nurses and midwives use their existing culture, professional knowledge and expertise to acquire new knowledge, language, social skills and values to participate fully in the host healthcare workforce (Pettersson and Glasdam 2020; Kamau et al. 2023; Tanaka and Yoshimura 2024). Sources focusing on integration into the general host society, such as local communities, were excluded.
Context	The review considered sources from all geographical locations that examined the assessment of workplace integration. As migrant nurses and midwives are employed across diverse clinical settings, all healthcare settings, including hospital and community, were included.

2.2. Types of Sources

The scoping review considered qualitative, quantitative and mixed‐methods primary studies. As commentaries and opinion pieces are non‐empirical, they were excluded, along with presentations and conference proceedings. Reviews and grey literature meeting the inclusion criteria were included; however, data from reviews and grey literature were used solely to map definitions and conceptualisations of workplace integration. Sources focusing on unregistered nurses or the first nine months of migrant nurses’ and midwives’ employment were excluded.

2.3. Search Strategy

With a specialist librarian, a three‐step approach was undertaken. Initial scoping searches were conducted on MEDLINE, CINAHL Ultimate and Embase. These searches provided a list of synonyms using MeSH terms, CINAHL subject and Emtree headings. This was followed by an analysis of the keywords contained in the title and abstract and of the index terms used to describe the articles retrieved. The search was reviewed by the review team. Search terms included derivatives of migrant nurse–midwife (e.g. overseas, minority and nonnative) and integration (e.g. facilitate, transition and merge). A double‐strand search strategy was applied, running the thesaurus terms first and then keywords. These two searches were then combined using the OR operator and were repeated for each concept. The final concept searches were then combined using AND. The Peer Review of Electronic Search Strategies checklist was adopted to ensure a rigorous search (McGowan et al. 2016). Aligning with Berry's theory of acculturation (Berry 1997), all databases were searched from 1996 onwards. An initial search was performed in December 2021 and then updated in December 2025 (Table A1).

2.4. Search Outcomes

The comprehensive search of academic databases generated 36,120 records, including (n = 31) identified through additional sources such as the grey literature. From this combined total, 15,005 duplicates were removed. Titles and abstracts of 21,146 records were screened, resulting in the exclusion of 20,742. Full texts of 404 records were retrieved and assessed against the eligibility criteria, with 313 excluded for reasons such as wrong concept (n = 186), wrong source type (n = 47), wrong population (n = 47), insufficient detail (n = 25), not available (n = 6) and wrong setting (n = 2). In total, 91 sources were included in the final review (Figure 1).

FIGURE 1.

PRISMA flow diagram.

2.5. Data Extraction

To ensure accuracy, data extraction was conducted by two independent reviewers (BMcB and SK) using the JBI SUMARI's data extraction tool, adapted by the review team to include assessment of workplace integration. Extractions included data on participants, concept, context, methodology and key findings aligning with the review questions (Table A2). Extractions were cross‐checked for consistency. Discrepancies were resolved through discussion with a third reviewer (GB).

2.6. Data Analysis and Presentation

Mapping was used to identify the research methods, the instruments employed to assess workplace integration, and the definitions of workplace integration. Further analysis was undertaken to identify the key concepts underpinning these definitions, which were subsequently grouped into categories. This information was summarised in tabular format.

3. Results

3.1. Characteristics of the Included Sources

A total of 23 sources were evidence syntheses; one was a book chapter; the remaining were research studies. All studies were published after 2000, with the majority from Australia (n = 12), the United States (n = 12), the United Kingdom (n = 8) and Canada (n = 6). A small number of studies were from the UAE (n = 4), New Zealand (n = 2), Finland (n = 2), Japan (n = 2), Malta (n = 2) and Singapore (n = 2). One research study was sourced from Chile, Germany, Iceland, Italy, Kuwait, Norway and Turkey. Eight studies were conducted within multiple countries. No sources were located from Africa or South Asia. All sources were published in English apart from one in Korean (Seo and Kim 2016), which was translated using artificial intelligence (AI) technology (e.g. Google Translate).

Fifty‐eight studies included migrant nurses and midwives working in general hospital settings. One was conducted in neonatal care (Alexis and Shillingford 2012), one in a mental health setting (Joseph et al. 2022) and three in aged‐care settings (Pung et al. 2017; Pawlak 2021; Schembri 2024). One scoping review focused on the aged‐care sector (Sheehy et al. 2024). Three sources included the population working exclusively as midwives (Sidebotham 2010; Javanmard et al. 2018; Javanmard et al. 2020). Overall, there was representation from mental health nursing, general nursing, and midwifery, but no representation from children's nursing.

Forty‐six studies were qualitative. Thirteen studies were quantitative (Brunero et al. 2008; Alexis and Vydelingum 2009; Hayne et al. 2009; Ea et al. 2010; Alexis 2015; Goh and Lopez 2016; Covell et al. 2017; Pung et al. 2017; O'Callaghan et al. 2019; Covell and Rolle Sands 2021; Shoki et al. 2023; Berdida et al. 2025; Dervishi et al. 2025), employing either a descriptive or cross‐sectional approach. Six studies utilised mixed methods (Winkelmann‐Gleed and Seeley 2005; Alexis 2006; Smith and Ho 2014; Javanmard et al. 2018; Brunton et al. 2020; Atta et al. 2025). Twenty‐three sources used a review approach, and one study was published in a book (Figures 2 and 3). Qualitative methods for data collection included open‐ended questionnaires, semi‐structured interviews and focus groups. One study (Brunton and Cook 2018) utilised a critical incident technique combined with semi‐structured interviews. Another study used reflective diaries along with interviews (Sidebotham 2010). Additional data are presented in the Supplementary Data extraction tables.

FIGURE 2.

Methodology of included sources.

FIGURE 3.

Methodology of included sources: other.

3.2. Review Question 1: How Is Workplace Integration for Migrant Nurses and Midwives Defined?

Twenty‐six sources utilised explicit definitions, where sufficient clarity was provided to distinguish it from other concepts. Sixty‐five sources used implicit definitions whereby the meaning was implied from the measurements, results, presentations and the discussion of findings (Table A3). There was conceptual congruity across the definitions describing workplace integration as purposeful action, at an individual level, to practise in the host healthcare setting, often involving socialisation (n = 29), cultural competence (n = 44) and communication (n = 35). Table 3 lists the different concepts used across sources to assess and define workplace integration and the number of sources that used these concepts.

TABLE 3.

The concepts used to assess and define workplace integration.

Concept	Count (n =)
Communication	48
Cultural competency	44
Socialisation	29
Knowledge advancement	38
Professional values	18
Skill utilisation	17

Seven sources defined workplace integration as a two‐way process (Nichols and Campbell 2010; Njie‐Mokonya 2014; Xiao et al. 2014; Brunton and Cook 2018; Buttigieg et al. 2018; Ramji et al. 2018; Ramji and Etowa 2018) but provided no information on how this might occur or who might be involved. Nine sources defined it as a sense of belonging (Winkelmann‐Gleed and Seeley 2005; Lin 2014; Goh and Lopez 2016; Javanmard et al. 2017; Ramji and Etowa 2018; Kamau et al. 2022; Smith et al. 2022; Lanada and Culligan 2024; Ung et al. 2024). Five sources used the term ‘job satisfaction’ (Sidebotham 2010; Moyce et al. 2016; Pung et al. 2017; Chun Tie et al. 2018; Brunton et al. 2020). Overall, no single, agreed definition was found; there was, however, agreement that workplace integration includes a range of concepts.

3.3. Review Question 2: What Research Methods Are Used to Assess Migrant Nurses’ and Midwives’ Workplace Integration?

Given the predominance of qualitative studies, the research methods were mapped and described to provide an overview of how workplace integration was assessed across the included studies. The thematic concepts identified in Review Question 1 were used as organising headings. These included communication, cultural competence, socialisation, professional values, knowledge advancement and skill utilisation (Table A4, A5, A6).

3.4. Communication

Many studies (n = 44 qualitative and n = 4 quantitative) identified local‐language proficiency as the primary determinant of successful workplace integration, revealing persistent linguistic challenges despite migrant nurses and midwives possessing formal language qualifications (Sherman and Eggenberger 2008; Takeno 2010; Smith and Ho 2014; Bayuo et al. 2023; Zhong et al. 2023). The two‐way nature of integration was investigated in a multi‐site Maltese case study comparing migrant nurse and host stakeholder experiences of language proficiency (Buttigieg et al. 2018). This case study employed Berry's (1997) theory of acculturation, the findings revealing that migrant nurses perceived their communication as effective, which was inconsistent with the host counterparts’ assessment. Three qualitative studies reported difficulties with conveying clinical information (Thekdi et al. 2011; Lin 2014; Seo and Kim 2016). An American qualitative–descriptive study reported Filipino migrant nurses’ (n = 31) level of language proficiency as acceptable after one year, but telephone communication remained problematic (Lin 2014). Another qualitative–descriptive study involving six migrant nurses from four countries reported their level of English as competent after five years, despite being deemed competent prior to host country professional registration (Thekdi et al. 2011). An American phenomenological study explored local‐language acquisition of 15 Korean nurses who were assessed as lacking fluency after 20 years’ experience of residence (Seo and Kim 2016). Rodríguez et al. (2014) used ethnography to examine migrant nurse communication in Chile, which revealed that migrant nurses experienced telephone communication difficulties, as being unable to observe the caller, they could not utilise non‐verbal cues to assist with comprehension. In Singapore, Pung et al. (2017) tested the associations between job satisfaction and communication using the 37‐item JSQ and the language domain of the 23‐item DIS instrument. Results showed that respondents who were taught the host language in their country of origin reported higher job satisfaction level than those who were not taught the host language in their native country (B = 0.486, p < 0.005). Thus, possessing language proficiency qualifications alone does not guarantee functional fluency, underscoring the need for targeted language support in host clinical settings.

3.5. Cultural Competence

The included studies referred to cultural competence as the ability to practise professionally within the host country's cultural norms, ensuring respectful engagement and appropriate healthcare delivery, with 10 qualitative studies identifying cultural misunderstanding as significantly impeding workplace integration (Tregunno et al. 2009; Thekdi et al. 2011; Wolcott et al. 2013; Lin 2014; Njie‐Mokonya 2014; Rodríguez et al. 2014; Xiao et al. 2014; Ncube 2017; Chun Tie et al. 2019; Joseph et al. 2022). The 12‐item ASASFN was used to assess migrant nurse (N = 814) acculturation in a cross‐sectional study in Singapore, finding a positive correlation between acculturation and the workplace, with a lower acculturation level being associated with a lower reported perception of their workplace (Goh and Lopez 2016). The data also demonstrated a variation in acculturation amongst nationalities; Filipino and Malaysian respondents reported the highest levels of acculturation, and Chinese respondents reported the lowest. Utilising ASASFN, Ea et al. (2010) reported higher levels of acculturation among Filipino migrant nurses (n = 50) in the United States, compared with those in Israel. The ASASFN measured three dimensions of acculturation: workplace language use, the selected language when watching television and the preferred ethnicity of friends in social situations. The latter two dimensions are activities outside of the workplace, hence unrelated to workplace integration. Developing cultural competence occurs in a complex sociocultural milieu (Brunton and Cook 2018). Migrant nurses navigate cultural competence by utilising migrant colleagues, host staff and organisational cultural adaptation resources (Antón‐Solanas et al. 2022).

3.6. Skill Utilisation

Seventeen studies, including qualitative (n = 11), quantitative (n = 4) and mixed‐methods (n = 2), identified activities that require advanced clinical skills and leadership capabilities as a key component of migrant nurse and midwife integration (Alexis and Vydelingum 2005; Alexis 2006; Tregunno et al. 2009; Ea et al. 2010; Smith et al. 2011; Alexis and Shillingford 2012; Rodríguez et al. 2014; Xiao et al. 2014; Goh and Lopez 2016; Javanmard et al. 2017; Ncube 2017; Pung et al. 2017; Allen 2018; Brunton and Cook 2018; Chun Tie et al. 2019; Covell and Rolle Sands 2021). A phenomenological study conducted in the United States (Allen 2018) underpinned by Purnell's model (2019), which advises that migrant nurses need expertise in the host culture to provide culturally congruent care, rendering the model highly relevant for studies investigating workplace integration. Findings revealed that migrant nurse participation in hospital committees contributed to the success of their integration. A mixed‐methods study (Javanmard et al. 2017) exploring the integration of UK midwives working in Australia demonstrated a significant difference between migrant midwives (n = 66) and host counterparts concerning opportunities for professional development and career progression (p ≤ 0.001). Deskilling and inadequate recognition of migrant midwives’ competencies can engender feelings of marginalisation, potentially compromising self‐efficacy and psychological well‐being (Xiao et al. 2014).

3.7. Socialisation

Two quantitative studies investigated the level of support available for migrant nurses in Canadian (Covell and Rolle Sands 2021) and UK (Alexis 2015) settings. The Canadian cross‐sectional study investigated the predictors of workplace integration (N = 1,215) utilising a seven‐item instrument. Although unable to establish a cause‐and‐effect relationship, Covell and Rolle Sands (2021) reported that good relationships with host colleagues showed a significant and positive association with workplace integration (p < 0.005). Alexis's (2015) UK quantitative descriptive study used a researcher‐generated instrument to investigate migrant nurse (N = 188) perception of discrimination, support and adjustment. Data showed a significant result where the migrant nurse sample (N = 188) reported a supportive workplace (p < 0.001). The data also indicated Filipino, Indian and Pakistani migrant nurses were more likely to perceive host counterparts as supportive, unlike their African counterparts, who reported the lowest level of perceptions of support. An Australian study using grounded theory investigated how migrant and host nurses work together (Chun Tie et al. 2019). The theory ‘Playing the Game’ was generated with key constructs illustrating how organisational factors influence the socialisation of migrant nurses. A qualitative–descriptive study conducted in Turkey, guided by a phenomenological approach, revealed that collegial support, including nurse managers, was critical to workplace integration (Aydogdu and Baykal 2023).

3.8. Professional Values

Eighteen studies rejected the assumption that migrant nurses and midwives shared identical professional values and can integrate seamlessly between settings (Tregunno et al. 2009; Sidebotham 2010; Takeno 2010; Jose 2011; Wolcott et al. 2013; Lin 2014; Smith and Ho 2014; Zhou 2014; Seo and Kim 2016; Javanmard et al. 2017; Ncube 2017; Buttigieg et al. 2018; Chun Tie et al. 2019; O'Callaghan et al. 2019; Pawlak 2021). A Norwegian ethnographic study explored the professional identities of Polish migrant nurses working in aged care (Pawlak 2021). Findings revealed that despite commonalities in education between Norway and Poland, sociocultural disparities between the two countries influenced migrant nurses’ professional identity. Similar findings were reported in two Australian phenomenological studies (Sidebotham 2010; Smith et al. 2011). In the United States, Hayne et al. (2009) used the 140‐item Occupational Stress Inventory Revised (OSI‐R) instrument to measure role clarity. Role clarity was measured and compared to a normative group using t‐scores (mean = 50, SD = 10). Results were variable; eight scored within the normative range, four reported little role confusion, and three indicated moderate role confusion, highlighting that role expectations were unclear, due to the mismatch between anticipated and actual roles, a key factor influencing workplace integration. A US phenomenological study (Jose 2011) of 20 migrant nurses revealed that role ambiguity dissipated over time.

3.9. Knowledge Advancement

The included studies (qualitative, n = 29; quantitative, n = 9) report that education, support and effective mentorship are positive indicators of workplace integration (Montayre et al. 2018; Covell and Rolle Sands 2021; Thomas and Lee 2024). Eleven qualitative studies reported that effective mentorship was critical for migrant nurses to utilise their clinical skills, develop professional competence and achieve rapid integration (Jose 2011; Brunton and Cook 2018; Iheduru‐Anderson and Wahi 2018; Ramji et al. 2018; Chun Tie et al. 2019; Efendi et al. 2020; Kuzemski et al. 2021; Thirlwall et al. 2021; Aydogdu and Baykal 2023; Kamau et al. 2023; Tanaka and Yoshimura 2024). Both qualitative and quantitative studies showed that having a mentor of the migrant nurses’ ethnicity, who had undergone a similar integration process, was perceived as positively influencing workplace integration (Sherman and Eggenberger 2008; Lin 2014; Covell et al. 2017; Covell and Rolle Sands 2021).

Thirteen qualitative and two quantitative studies reported organisational support as essential to successful integration (Alexis and Vydelingum 2005; Takeno 2010; Alexis and Shillingford 2012; Lin 2014; Njie‐Mokonya 2014; Rodríguez et al. 2014; Xiao et al. 2014; Javanmard et al. 2017; Ncube 2017; Pung et al. 2017; Allen 2018; Buttigieg et al. 2018; Chun Tie et al. 2019; O'Callaghan et al. 2019; Covell and Rolle Sands 2021). An Italian qualitative study of Indian nurses revealed that expensive organisational courses caused them to navigate their own knowledge advancement (Stievano et al. 2017). Utilising a mixed‐methods approach, Brunton et al. (2020) revealed that migrant nurses who seek assistance and embrace new practices achieve successful workplace integration.

3.10. Review Question 3: What Instruments Are Used to Assess the Workplace Integration of Migrant Nurses and Midwives in Healthcare Settings?

Eighteen studies used instruments to assess workplace integration (Table 4). Excluding Winkelmann‐Gleed and Seely (2005), all studies incorporated measurements of language acquisition, ranging from 2 items by Covell and Rolle Sands (2021) and 12 by Goh and Lopez (2016). The remaining studies included practice environment measurements (Winkelmann‐Gleed and Seeley 2005; Hayne et al. 2009; Goh and Lopez 2016; Covell et al. 2017; Covell and Rolle Sands 2021; Berdida et al. 2025), acculturation (Ea et al. 2010; Goh and Lopez 2016), work quality of life (Goh and Lopez 2016) and job satisfaction (Pung et al. 2017; Berdida et al. 2025). Eight studies used unnamed researcher‐generated tools (Alexis and Vydelingum 2005, Brunero et al. 2008; Alexis and Vydelingum 2009; Smith and Ho 2014; Alexis 2015; Brunton et al. 2020; Shoki et al. 2023; Dervishi et al. 2025). Table 4 provides an overview of the instruments identified, outlining their psychometric properties alongside information on cultural adaptation and the original target population for which they were developed.

TABLE 4.

Instruments identified in the scoping review.

Source	Measurement instrument	Country used in	Population initially developed for	Reported cultural adaptation	Tests of validity	Tests of reliability
(Atta et al. 2025)	The professional self‐concept of nurses (Arthur 1995)	Australia	3rd‐year student nurses in Australia	None reported	Factorial analysis used. No results provided.	Cronbach α range: 0.7–0.83
(Javanmard et al. 2018)	A survey of workforce experience of foreign‐educated registered nurses (Javanmard et al. 2018)	Australia	Midwives	Not reported	Content validity conducted. Score not reported. Face validity conducted.	Not reported
(Javanmard et al. 2020)	Australian Midwifery Workforce Survey (Javanmard et al. 2020)	Australia	Midwives	Not reported	Content validity conducted. Score not reported. Face validity conducted.	Not reported
(O'Callaghan et al. 2019)	Working in a Culturally Diverse Staff Environment survey (O'Callaghan et al. 2019)	Australia	Nurses	Not reported	Not reported	Not reported
(Covell et al. 2017)	Perceived Organisational Values questionnaire (Covell et al. 2017)	Canada	Internationally educated nurses	Culturally adapted	Content validity conducted. Score not reported. Face validity conducted.	Test and retest conducted
(Covell and Rolle Sands 2021)	Support for IEN workplace integration questionnaire – on perceived degree of workplace integration (Cohen 1992)	Canada	Internationally educated nurses	Not reported	States previously validated. Score not reported.	Not reported
(Pung et al. 2017)	Demands of immigration scale (DIS) (Pung et al. 2017)	Singapore	General migrant populations	Not reported	CVI score = >0.86	Cronbach α = >0.60
	Job satisfaction Questionnaire (JSQ) (Pung et al. 2017)	Singapore	General private and public sector employees	Not reported	CVI score = >0.86	Cronbach α = >0.60
(Goh and Lopez 2016)	A Short Acculturation Scale for Filipino Nurses (ASASFN) (Dela Cruz et al. 1998)	Singapore	Filipino nurses	Not reported	CVI score = >0.89	Cronbach α = 0.93
	Practice Environment Scale of the Nursing Work Index‐Revised (PES‐NWI‐R) (Lake 2002)	Singapore	Nurses	Not reported	CVI score = >0.89	Cronbach α = 0.93
	World Health Organisation Quality of Life‐BREF (WHOQOL_BREF) (WHO 2012),	Singapore	Population not specified	Not reported	CVI score = >0.89	Cronbach α = 0.89
(Winkelmann‐Gleed and Seeley 2005)	Quality of Working Life Survey (IES 2000)	UK	National Health Service (NHS) employees	Not reported	Not reported	Cronbach α range: 0.80–0.93
(Hayne et al. 2009)	Occupational Stress Inventory‐Revised (Osipow 1998)	USA	General employees	Not reported	States, convergent, criterion and predictive validity are established. Results not reported.	Cronbach α range 0.88–0.93
	Nursing Work Index‐Revised (Aiken and Patrician 2000)	USA	Nurses generally	Not reported	Not reported	Cronbach α = 0.96
(Atta et al. 2025)	Cultural competence self‐assessment checklist (CVIMS 2012),	USA, Germany and the UK	General population	None reported	Face validity. Content validity. CVI = 0.87	Cronbach α range 0.72–0.83
(Ea et al. 2010)	A Short Acculturation Scale for Filipino Americans (ASASFA) (Dela Cruz et al. 1998)	USA and Israel	Filipino immigrants	Not reported	Not reported	Cronbach α = 0.84
(Berdida et al. 2025)	Perceived Stress Scale (PSS) (Cohen et al. 1983)	Multiple countries	General adult population	None reported	No results provided. Homogeneity utilised to enhance validity	Cronbach α = 0.92
	Psychological Well‐Being Scale (Ryff 1989)	Multiple countries	General adult population	None reported	No results provided. Homogeneity utilised to enhance validity	Cronbach α = 0.93
	Multidimensional Scale of Perceived Social Support (MSPSS) (Zimet et al. 1988)	Multiple countries	General adult population	None reported	No results provided. Homogeneity utilised to enhance validity	Cronbach α = 0.95
	Connor–Davidson Resilience Scale (CD‐RISC) (Connor and Davidson 2003)	Multiple countries	General adult population	None reported	No results provided. Homogeneity utilised to enhance validity	Cronbach α = 0.97
	Job Satisfaction Index (Schriesheim and Tsui. 1980)	Multiple countries	General workforce populations	None reported	No results provided. Homogeneity utilised to enhance validity	Cronbach α = 0.93
	Short Acculturation Scale (Dela Cruz et al. 2000)	Multiple countries	Filipino population	None reported	No results provided. Homogeneity utilised to enhance validity	Cronbach α = 0.95
	Brief Nurses’ Practice Environment Scale (Sansó et al. 2021)	Multiple countries	Spanish nurses	None reported	None reported Homogeneity utilised to enhance validity	Cronbach α = 0.90

Of the 23 instruments identified, three were developed for migrant nurse and midwife populations (Covell et al. 2017; Javanmard et al. 2018; Covell and Rolle Sands 2021). Three were developed for nurse populations, including the Working in Culturally Diverse Staff Environment (O'Callaghan et al. 2019) and the Practice Environment Scale of the Nursing Work Index (Hayne et al. 2009; Goh and Lopez 2016). Twelve were developed for non‐nurse populations (Winkelmann‐Gleed and Seeley 2005; Hayne et al. 2009; Pung et al. 2017; Atta et al. 2025; Berdida et al. 2025). The Australian Midwifery Workforce Survey was developed specifically for midwives (Javanmard et al. 2017). The DIS (Pung et al. 2017) was developed for general migrant populations and A Short Acculturation Scale for Filipino Nurses (ASASFN) was developed for Filipino migrants (Ea et al. 2010; Goh and Lopez 2016; Berdida et al. 2025). Finally, one instrument was originally developed for student nurses in Australia and later adapted for application among migrant nurses in Australia (Atta et al. 2025).

4. Discussion

The aim of this scoping review was to map the available evidence on the assessment of migrant nurse and midwife workplace integration in international healthcare settings. The review brings together findings from 91 sources representing data from 1996 to 2025. The multifaceted definitions of workplace integration found in this review highlight the importance of a clear, concise definition to ensure consistent understanding across various contexts.  Despite methodological and contextual variations, six key concepts consistently emerged in definitions of workplace integration: communication, cultural competence, socialisation, professional values, knowledge advancement and skill utilisation. These concepts are useful to consider as keywords when defining workplace integration. Based on the mapping of the included literature, workplace integration is defined as the process through which migrant nurses and midwives adapt their communication, skills, cultural understanding and professional values to practice effectively, socialise and contribute to knowledge advancement in the host healthcare setting.

Workplace integration as a two‐way concept involving the migrant population and the host stakeholders was a recurring theme in several studies (Xiao et al. 2014; Brunton and Cook 2018; Buttigieg et al. 2018; Iheduru‐Anderson and Wahi 2018; Ramji and Etowa 2018; Ramji et al. 2018; Suleiman et al. 2022; Roth et al. 2023; Alostaz and Chen 2024; Joensuu et al. 2024; Roth et al. 2025). However, this review highlights a significant gap in the literature: the under‐representation of stakeholders’ perspectives, particularly those of host nurses and managers, who play a pivotal role in supporting migrant nurses and midwives within clinical and organisational contexts. Identifying the stakeholder's role in workplace integration was not the intention of this review. However, investigating these viewpoints would offer valuable insights into how workplace integration strategies can be effectively designed and implemented. Future studies should include the perspective of host stakeholders in supporting migrant populations with workplace integration.

Twenty‐three instruments were identified across five countries: Australia, Canada, Singapore, United Kingdom and the United States (Winkelmann‐Gleed and Seeley 2005; Hayne et al. 2009; Covell et al. 2017; O'Callaghan et al. 2019; Javanmard et al. 2020). Apart from Hayne et al. (2009), criterion validity was not reported, possibly as no ‘gold standard’ measurement exists. In the review, the most used instruments included the ASASFN and PES‐NWI (Hayne et al. 2009; Ea et al. 2010; Goh and Lopez 2016). These instruments demonstrated limited construct completeness. The ASASFN explored cultural adaptation and language acquisition, omitting skill utilisation, and the PES‐NWI focused on the practice environment and did not include cultural competence.

The application of these instruments followed well‐designed methodologies and was reported to be valid and reliable in assessing workplace integration, which contributes valuable insights into how it is understood. The selection of measurement instruments often depends on the study's aims and the researcher's conceptual framework. Given the multidimensional components of workplace integration, careful consideration is needed when categorising constructs to ensure the selection of appropriate instruments. Future research, adopting comparative methodologies, could test the effectiveness of various instruments, generating insights into their strengths and limitations, ultimately identifying the most effective instrument.

Previous research and policy initiatives predominantly concentrate on the orientation phase, emphasising early‐stage supports. For example, in Ireland, migrant nurse–midwife support policies are largely confined to professional registration processes, which precede workplace integration (Nursing and Midwifery Board of Ireland 2025). This scoping review illuminated a critical gap concerning the long‐term workplace integration of migrant nurses within host healthcare systems. The included studies revealed local‐language acquisition as the key indicator of successful integration. Findings of this review are similar to other reviews investigating the integration of other migrant healthcare professional groups (Safari et al. 2022; Sheehy et al. 2024). Consistent across all reviews is the importance of addressing the barriers and unique needs of the migrant population, concerning language and communication skills. Targeted language training, including assertiveness and healthcare‐specific terminology, is essential for inter‐professional collaboration and safe patient interactions. Workplace integration programmes should prioritise local‐language acquisition. Research indicates that embedding language and communication supports within these programmes leads to positive outcomes for all stakeholders (Holmes and Grech 2015; Aggar et al. 2020). Consequently, policy development should be informed by this evidence.

Managing the challenges associated with cultural adjustment aligns with findings from three previous reviews (Konno 2006; Chun Tie et al. 2018; Ng Chok et al. 2018). A tailored cultural orientation initiative could enhance awareness of cultural variations and biases and help uncover ethnocentrism that may influence interactions within the workplace (O'Callaghan et al. 2019). The evidence mapping conducted in this review underscores the need for targeted research to develop and evaluate interventions that support migrant nurses–midwives beyond the orientation phase. Such efforts are essential to facilitate sustained workplace integration and workforce retention.

5. Implications for Nursing and Health Policy

Policy developers must support migrant nurses and midwives to enable them to practise safely in their new healthcare reality. Interventions focused on cultural competence, linguistic challenges and differences in the models of care contribute to successful integration. Existing research has included the perspective of migrant nurses and midwives; however, it is essential to incorporate the perspectives of host stakeholders who work alongside this population to generate a comprehensive understanding of the dynamics and challenges associated with their collaboration in workplace integration.

6. Conclusions

The absence of a standardised definition of workplace integration contributes to inconsistent support for migrant nurses and midwives. This review identifies key concepts: communication, cultural competence, socialisation, professional values, knowledge advancement, and skill utilisation that can inform the development of a clearer definition. There remains an urgent need for comprehensive and robust instruments to assess integration and evaluate interventions. Research using appropriate methodologies is essential to understand integration effectiveness and guide policy, especially amid global workforce shortages.

7. Limitations

No clearly established definition was found for workplace integration, which created challenges when retrieving information. The included studies were mainly from Global North countries, which limits the diversity and experiences of migrant nurses and midwives globally. This review did not represent all migrant nurses and midwives equally, as the included studies were predominantly conducted with nursing populations, making it difficult to establish the experiences unique to each discipline.

Author Contributions

Conceptualisation: Barry McBrien, Frances O’ Brien, Shobha Rani Shetty and Gobnait Byrne. Data collection: Barry McBrien, Sinead Keogh and Jessica Eustace‐Cook. Data analysis: Barry McBrien and Sinead Keogh. Study supervision: Barry McBrien, Frances O’ Brien, Shobha Rani Shetty and Gobnait Byrne. Manuscript writing: Barry McBrien, Frances O’ Brien, Shobha Rani Shetty and Gobnait Byrne. Final approval: Barry McBrien, Frances O’ Brien, Shobha Rani Shetty and Gobnait Byrne

Funding Information

The authors have nothing to report.

Conflicts of Interest

The authors have nothing to report.

Ethical Statement

The analyses in this study were based on published articles, and ethics committee approval was not required.

Supporting information

Supporting File 1: inr70207‐sup‐0001‐Tables.docx

1.

TABLE A1.

Search results.

Database	Population (P)	Concept (C)	Combination
	#1	#2	#1 and #2
ASSIA	((nurs* OR midwife* OR midwiv* OR ‘nurse‐midwife’ OR ‘nurse‐midwive*’) N2 (migrant* OR refuge* OR transient* OR emigrant* OR immigrant* OR foreign* OR ‘non national*’ OR ‘nonnational*’ OR ‘non west*’ OR ‘nonwest*’ OR ‘non native’ OR ‘nonnative’ OR abroad* OR expat* OR nationalit* OR import* OR oversea* OR ‘over sea*’ OR internat* OR minority* OR ethnic* OR relocat* OR nonenglish* OR ‘non English*’)) OR TI ((nurs* OR midwife* OR midwiv* OR ‘nurse‐midwife’ OR ‘nurse‐midwive*’) N2 (migrant* OR refuge* OR transient* OR emigrant* OR immigrant* OR foreign* OR ‘non national*’ OR ‘nonnational*’ OR ‘non west*’ OR ‘nonwest*’ OR ‘non native’ OR ‘nonnative’ OR abroad* OR expat* OR nationalit* OR import* OR oversea* OR ‘over sea*’ OR internat* OR minority* OR ethnic* OR relocat* OR nonenglish* OR ‘non English*’))	AB (Challeng* OR hinder* OR difficult* OR barrier* OR negative* OR hindra* OR belief* OR believe* OR conflict* OR race* OR racial* OR bias* OR cultur* OR racism* OR racist* OR bigot* OR discrim* OR unfair* OR integrat* OR success* OR merge* OR ‘work load*’ OR ‘work place*’ OR workload* OR facilitate* OR accomodat* OR transition* OR ‘work environment*’ OR burnout*) OR TI (Challeng* OR hinder* OR difficult* OR barrier* OR negative* OR hindra* OR belief* OR believe* OR conflict* OR race* OR racial* OR bias* OR cultur* OR racism* OR racist* OR bigot* OR discrim* OR unfair* OR integrat* OR success* OR merge* OR ‘work load*’ OR ‘work place*’ OR workload* OR facilitate* OR accomodat* OR transition* OR ‘work environment*’ OR burnout*)	Results n = 24,982,233

Database	Population (P)	Concept (C)	Combination
	#1 OR #2 = # 3	# 4 OR # 5 = # 6	#3 AND #6 = #7
CINAHL (EBSCO)	# 1 (MH ‘Foreign Nurses’) OR (MH ‘International Nursing’) # 2 AB ((nurs* OR midwife* OR midwiv* OR ‘nurse‐midwife’ OR ‘nurse‐midwive*’) N2 (migrant* OR refuge* OR transient* OR emigrant* OR immigrant* OR foreign* OR ‘non national*’ OR ‘nonnational*’ OR ‘non west*’ OR ‘nonwest*’ OR ‘non native’ OR ‘nonnative’ OR abroad* OR expat* OR nationalit* OR import* OR oversea* OR ‘over sea*’ OR internat* OR minority* OR ethnic* OR relocat* OR nonenglish* OR ‘non English*’)) OR TI ((nurs* OR midwife* OR midwiv* OR ‘nurse‐midwife’ OR ‘nurse‐midwive*’) N2 (migrant* OR refuge* OR transient* OR emigrant* OR immigrant* OR foreign* OR ‘non national*’ OR ‘nonnational*’ OR ‘non west*’ OR ‘nonwest*’ OR ‘non native’ OR ‘nonnative’ OR abroad* OR expat* OR nationalit* OR import* OR oversea* OR ‘over sea*’ OR internat* OR minority* OR ethnic* OR relocat* OR nonenglish* OR ‘non English*’))	# 4 MH ‘Social Integration’) OR (‘Cultural Diversity’) OR (MH ‘Cultural Competence’) OR (MH ‘Cultural Safety’) OR (MH ‘Cultural Bias’) OR (MH ‘Transcultural Care’) OR (MH ‘Work Environment’) OR (MH ‘Organizational Culture+’) # 5 AB (Challeng* OR hinder* OR difficult* OR barrier* OR negative* OR hindra* OR belief* OR believe* OR conflict* OR race* OR racial* OR bias* OR cultur* OR racism* OR racist* OR bigot* OR discrim* OR unfair* OR integrat* OR success* OR merge* OR ‘work load*’ OR ‘work place*’ OR workload* OR facilitate* OR accomodat* OR transition* OR ‘work environment*’ OR burnout*) OR TI (Challeng* OR hinder* OR difficult* OR barrier* OR negative* OR hindra* OR belief* OR believe* OR conflict* OR race* OR racial* OR bias* OR cultur* OR racism* OR racist* OR bigot* OR discrim* OR unfair* OR integrat* OR success* OR merge* OR ‘work load*’ OR ‘work place*’ OR workload* OR facilitate* OR accomodat* OR transition* OR ‘work environment*’ OR burnout*)	Results n = 99,268,760

Database	Population (P)	Concept (C)	Combination
	#1 or # 2 = #3	# 4 OR # 5 = #6	#3 AND #6 = #7
Embase	# 1 ‘foreign nurse’/exp # 2 ((nurs* OR midwif* OR midwiv* OR ‘nurse‐midwife’ OR ‘nurse‐midwive*’ OR ‘nursemidwif’ OR ‘nursemidwiv*’) NEAR/2 (migrant* OR refuge* OR transient* OR emigrant* OR immigrant* OR foreign* OR ‘non national*’ OR ‘nonnational*’ OR ‘non west*’ OR ‘nonwest*’ OR ‘non native’ OR ‘nonnative’ OR abroad* OR expat* OR nationalit* OR import* OR oversea* OR ‘over sea*’ OR internat* OR minority* OR ethnic* OR relocat* OR nonenglish* OR ‘non English*’))	# 4 ‘integration’/exp OR ‘workplace’/exp OR ‘attitude’/exp OR ‘cultural bias’/exp OR ‘cultural sensitivity’/exp OR ‘job adaptation’/exp # 5 (Challeng* OR hinder* OR difficult* OR barrier* OR negative* OR hindra* OR belief* OR believe* OR conflict* OR race* OR racial* OR bias* OR cultur* OR racism* OR racist* OR bigot* OR discrim* OR unfair* OR integrat* OR success* OR merge* OR ‘work load*’ OR ‘work place*’ OR workload* OR facilitate* OR accomodat* OR transition* OR ‘work environment*’ OR burnout*) OR TI (Challeng* OR hinder* OR difficult* OR barrier* OR negative* OR hindra* OR belief* OR believe* OR conflict* OR race* OR racial* OR bias* OR cultur* OR racism* OR racist* OR bigot* OR discrim* OR unfair* OR integrat* OR success* OR merge* OR ‘work load*’ OR ‘work place*’ OR workload* OR facilitate* OR accomodat* OR transition* OR ‘work environment*’ OR burnout*	Results n = 49,384,313

Database	Population (P)	Concept (C)	Combination
	#1	#2	#1 AND #2
Maternity and Infant Care Online	# 1 ((nurs OR midwife OR midwiv OR ‘nurse‐midwife’ OR ‘nurse‐midwive*’) N2 (migrant OR refuge OR transient OR emigrant OR immigrant OR foreign OR ‘non national*’ OR ‘nonnational*’ OR ‘non west*’ OR ‘nonwest*’ OR ‘non native’ OR ‘nonnative’ OR abroad OR expat OR nationalit OR import OR oversea OR ‘over sea*’ OR internat OR minority OR ethnic OR relocat OR nonenglish* OR ‘non English*’))	# 2 (Challeng OR hinder OR difficult OR barrier OR negative OR hindra OR belief OR believe OR conflict OR race OR racial OR bias OR cultur OR racism OR racist OR bigot OR discrim OR unfair OR integrat OR success OR merge OR ‘work load*’ OR ‘work place*’ OR workload OR facilitate OR accomodat OR transition OR ‘work environment*’ OR burnout) OR TI (Challeng OR hinder OR difficult OR barrier OR negative OR hindra OR belief OR believe OR conflict OR race OR racial OR bias OR cultur OR racism OR racist OR bigot OR discrim OR unfair OR integrat OR success OR merge OR ‘work load*’ OR ‘work place*’ OR workload OR facilitate OR accomodat OR transition OR ‘work environment*’ OR burnout)	Results n = 29,376

Database	Population (P)	Concept (C)	Combination
	# 1 OR # 2 = # 3	# 4 OR # 5 = # 6	#6 AND #3 = #7
MEDLINE (EBSCO)	# 1 MH ‘Nurses, International’) # 2 AB ((nurs* OR midwife* OR midwiv* OR ‘nurse‐midwife’ OR ‘nurse‐midwive*’) N2 (migrant* OR refuge* OR transient* OR emigrant* OR immigrant* OR foreign* OR ‘non national*’ OR ‘nonnational*’ OR ‘non west*’ OR ‘nonwest*’ OR ‘non native’ OR ‘nonnative’ OR abroad* OR expat* OR nationalit* OR import* OR oversea* OR ‘over sea*’ OR internat* OR minority* OR ethnic* OR relocat* OR nonenglish* OR ‘non English*’)) OR TI ((nurs* OR midwife* OR midwiv* OR ‘nurse‐midwife’ OR ‘nurse‐midwive*’) N2 (migrant* OR refuge* OR transient* OR emigrant* OR immigrant* OR foreign* OR ‘non national*’ OR ‘nonnational*’ OR ‘non west*’ OR ‘nonwest*’ OR ‘non native’ OR ‘nonnative’ OR abroad* OR expat* OR nationalit* OR import* OR oversea* OR ‘over sea*’ OR internat* OR minority* OR ethnic* OR relocat* OR nonenglish* OR ‘non English*’))	# 4 (MH ‘Organizational Culture’) OR (MH ‘Community Integration’) OR (MH ‘Social Integration’) OR (MH ‘Cultural Diversity’) OR (MH ‘Cultural Competency’) OR (MH ‘Transcultural Nursing’) # 5 AB (Challeng* OR hinder* OR difficult* OR barrier* OR negative* OR hindra* OR belief* OR believe* OR conflict* OR race* OR racial* OR bias* OR cultur* OR racism* OR racist* OR bigot* OR discrim* OR unfair* OR integrat* OR success* OR merge* OR ‘work load*’ OR ‘work place*’ OR workload* OR facilitate* OR accomodat* OR transition* OR ‘work environment*’ OR burnout*) OR TI (Challeng* OR hinder* OR difficult* OR barrier* OR negative* OR hindra* OR belief* OR believe* OR conflict* OR race* OR racial* OR bias* OR cultur* OR racism* OR racist* OR bigot* OR discrim* OR unfair* OR integrat* OR success* OR merge* OR ‘work load*’ OR ‘work place*’ OR workload* OR facilitate* OR accomodat* OR transition* OR ‘work environment*’ OR burnout*)	Results n = 79,636,866

Database	Population (P)	Concept (C)	Combination
	# 1	# 2 OR # 3 = # 4	#1 AND #4 = #5
PsycINFO	# 1 AB ((nurs* OR midwife* OR midwiv* OR ‘nurse‐midwife’ OR ‘nurse‐midwive*’) N2 (migrant* OR refuge* OR transient* OR emigrant* OR immigrant* OR foreign* OR ‘non national*’ OR ‘nonnational*’ OR ‘non west*’ OR ‘nonwest*’ OR ‘non native’ OR ‘nonnative’ OR abroad* OR expat* OR nationalit* OR import* OR oversea* OR ‘over sea*’ OR internat* OR minority* OR ethnic* OR relocat* OR nonenglish* OR ‘non English*’)) OR TI ((nurs* OR midwife* OR midwiv* OR ‘nurse‐midwife’ OR ‘nurse‐midwive*’) N2 (migrant* OR refuge* OR transient* OR emigrant* OR immigrant* OR foreign* OR ‘non national*’ OR ‘nonnational*’ OR ‘non west*’ OR ‘nonwest*’ OR ‘non native’ OR ‘nonnative’ OR abroad* OR expat* OR nationalit* OR import* OR oversea* OR ‘over sea*’ OR internat* OR minority* OR ethnic* OR relocat* OR nonenglish* OR ‘non English*’))	# 2 DE ‘Professional Socialization’ OR DE ‘Working Conditions’ OR DE ‘Acculturation’ OR DE ‘Culture Shock’ OR DE ‘Culture Change’ OR DE ‘Cultural Identity’ # 3 AB (Challeng* OR hinder* OR difficult* OR barrier* OR negative* OR hindra* OR belief* OR believe* OR conflict* OR race* OR racial* OR bias* OR cultur* OR racism* OR racist* OR bigot* OR discrim* OR unfair* OR integrat* OR success* OR merge* OR ‘work load*’ OR ‘work place*’ OR workload* OR facilitate* OR accomodat* OR transition* OR ‘work environment*’ OR burnout*) OR TI (Challeng* OR hinder* OR difficult* OR barrier* OR negative* OR hindra* OR belief* OR believe* OR conflict* OR race* OR racial* OR bias* OR cultur* OR racism* OR racist* OR bigot* OR discrim* OR unfair* OR integrat* OR success* OR merge* OR ‘work load*’ OR ‘work place*’ OR workload* OR facilitate* OR accomodat* OR transition* OR ‘work environment*’ OR burnout*)	Results n = 29,192,562

Database	Population (P)	Concept (C)	Combination
	#1	#2	#1 and #2
Web of Science	# 1 ((nurs* OR midwife* OR midwiv* OR ‘nurse‐midwife’ OR ‘nurse‐midwive*’) NEAR/2 (migrant* OR refuge* OR transient* OR emigrant* OR immigrant* OR foreign* OR ‘non national*’ OR ‘nonnational*’ OR ‘non west*’ OR ‘nonwest*’ OR ‘non native’ OR ‘nonnative’ OR abroad* OR expat* OR nationalit* OR import* OR oversea* OR ‘over sea*’ OR internat* OR minority* OR ethnic* OR relocat* OR nonenglish* OR ‘non English*’))	# 2 (Challeng* OR hinder* OR difficult* OR barrier* OR negative* OR hindra* OR belief* OR believe* OR conflict* OR race* OR racial* OR bias* OR cultur* OR racism* OR racist* OR bigot* OR discrim* OR unfair* OR integrat* OR success* OR merge* OR ‘work load*’ OR ‘work place*’ OR workload* OR facilitate* OR accomodat* OR transition* OR ‘work environment*’ OR burnout*) OR TI (Challeng* OR hinder* OR difficult* OR barrier* OR negative* OR hindra* OR belief* OR believe* OR conflict* OR race* OR racial* OR bias* OR cultur* OR racism* OR racist* OR bigot* OR discrim* OR unfair* OR integrat* OR success* OR merge* OR ‘work load*’ OR ‘work place*’ OR workload* OR facilitate* OR accomodat* OR transition* OR ‘work environment*’ OR burnout*)	Results n = 71,006,033

Other database searches	Population (P)	Concept (C)	Combination
Global Index Medicus	Index search only		Results n = 5531
Scielo	Index search only		Results n = 286,353

TABLE A2.

Data extraction tool.

General Source Details
Author
Year of publication
Title
Host country
Average length of time migrant nurses and midwives resided in the host country
Nurse or midwife
Objectives/purpose of the study
Concept: Definition of workplace integration
Context or setting:
Acute hospital
Non‐acute hospital
Community setting
Data collection method
Was workplace integration assessed	Yes ◻ No ◻
Tool used to assess workplace integration
If a quantitative tool used, validity and reliability used to assess workplace	Integration
Limitations of the study

TABLE A3.

Definitions of workplace integration as defined by authors in the included studies.

Explicit definitions (n = 26)

Country: Australia – Learning the norms of the setting as well as adapting and modifying knowledge and skills to meet the organisational and professional expectations (Chun Tie et al. 2019).

Country: Australia – Integration of IENs is evaluated as successful when job satisfaction increases, positive work environments are sustained, and staff retention improves (Chun Tie et al. 2018).

Country: Australia – An understanding of the different factors that help internationally qualified midwives adapt to Australian culture, such as differences in midwifery practices (Javanmard et al. 2020).

Country: Australia – Aligned with Berry's definition of cultural integration where IENs interact with host nurses to adapt their professional practice in a host country and the process of adaptation is reciprocal (Xiao et al. 2014).

Country: Canada – When IENs become staff members of an organisation where they can use their knowledge and expertise (Covell et al. 2014).

Country: Canada – Becoming a member of a workgroup within an organisation (Covell et al. 2017).

Country: Canada – Becoming members of a workgroup within a nursing organisation where they can use their nursing knowledge and expertise to fulfil their patient care responsibilities in collaboration with other healthcare providers (Covell and Rolle Sands 2021).

Country: Canada – Integration of internationally educated nurses in the workplace is a two‐way process requiring efforts from both IEN and the organisation to provide a sense of belonging once they are integrated (Ramji et al. 2018).

Country: Canada – Workplace integration is a two‐way process requiring efforts on the part of the migrant nurses and midwives as well as the organisation. Integration is when the migrant nurses and midwives are happy at work, when there is a sense of belonging and satisfaction in his/her professional capacity (Ramji and Etowa 2018).

Country: Canada – Having comfort and pride in identifying as being a ‘Canadian nurse with international experience’. Aligns with being integrated (Ramji and Etowa 2021).

Country: Canada – Having taken on the ‘values, behaviors, norms and lifeways of their domestically educated counterparts’ (Tregunno et al. 2009).

Country: Finland – A process which includes competence recognition and support, positive cultural relationships in the workplace, organisations support acceptance of diversity, and the promotion of well‐being (Kamau et al. 2023).

Country: Malta – Associated with the integration of nurses from one healthcare system to another; it embraces the integration of nurses as a two‐way process (Buttigieg et al. 2018).

Country: Miscellaneous – Being acknowledged for their professionalism and the quality of their work, not by their cultural identity (Antón‐Solanas et al. 2022).

Country: Miscellaneous – Integration entails simultaneous adoption of some aspects of the dominant culture while keeping the values of one's own original culture (Balante et al. 2021).

Explicit definitions (n = 26)

Country: Miscellaneous – process of integration involves nurses developing a sense of belonging, becoming part of the workforce and organisation and can effectively practice nursing (Kamau et al. 2022).

Country: Miscellaneous – Integration is the promotion of a work environment that maximises the benefits of a diversified workforce (Primeau et al. 2014).

Country: Miscellaneous – Defined through the importance of education to the successful transition of international nurses (Sherman and Eggenberger 2008).

Country: Multiple countries – The process of IENs becoming members of a workgroup within an organisation where they can use their professional knowledge and expertise (Shiju et al. 2024).

Country: New Zealand – A sense of adjustment and mindful of challenges whilst integrating into the healthcare context locally and in the wider community (Jenkins and Huntington 2015).

Country: Singapore – Sense of belonging, decreased acculturation stress and better psychological well‐being (Goh and Lopez 2016)

Country: Turkey – Refers to the process by which new employees become integrated into the work environment and culture of the organisation (Aydogdu and Baykal 2023).

Country: United Arab Emirates – Integration is a process of professional socialisation into a new organisational culture among professionals, whereby the migrant nurses and midwives modify their professional practices and professional identity as they integrate into the new work environment (Ncube 2017).

Country: United States of America – Being able to adapt culturally and learn the system to integrate into the United States (Iheduru‐Anderson and Wahi 2018).

Country: United States – Learning what is normal practice in the United States as opposed to motherland (Smith and Ho 2014)

Country: United States – To practise safe, effective and efficient delivery care in the US healthcare setting (Thomas and Lee 2024).

Implicit definitions (n = 65)

Country: Australia – Overcoming the notion of professional dissonance (Brunero et al. 2008).

Country: Australia – Fitting into the new healthcare setting and being safe and competent in the new workforce (Javanmard et al. 2017).

Country: Australia – Equate integration with adjustment and align it with the Pilette (1989) model, where integration occurs between the 9th and 12th months. – ‐Feelings of belonging and fitting into the dominant culture are pivotal factors for successful multicultural teamwork (Javanmard et al. 2018).

Country: Australia – Integration is referred to as a transition from one healthcare service to another (Joseph et al. 2022).

Country: Australia – Effective practitioner in the workplace (Konno 2006).

Country: Australia – Integration is when migrant nurses and midwives feel valued and can utilise leadership skills (Kurup et al. 2022).

Country: Australia – When migrant nurses and midwives report a supportive workplace (O'Callaghan et al. 2019).

Country: Australia – The relationship between job satisfaction and acculturation (Sidebotham 2010).

Country: Australia – Adjusting practice to fit the host country and gaining new skills while losing others (Smith et al. 2011),

Country: Australia – Learning to adapt to the model of care (Takeno 2010).

Country: Australia – Adapting to the differences in their professional roles and in their perceptions of nursing practice (Zhong et al. 2023).

Country: Australia – Being able to reconcile different realities and the process of making congruent, letting go and reframing unpleasant experiences (Zhou 2014).

Country: Canada – Support workplace and a good attitude toward their host colleagues and workplace (Njie‐Mokonya 2014).

Country: Chile – Acceptance and gaining trust whilst adapting to a new cultural environment. Professional adaptation in a new cultural scenario (Rodríguez et al. 2014).

Country: Germany – Demonstrating adaptability, resilience, a willingness to learn and proactive behaviour (Dervishi et al. 2025).

Country: Italy – Good professional relationships with work colleagues (Stievano et al. 2017).

Country: Japan – Feeling comfortable about asking questions (Miyata 2023).

Country: Japan – Continuing to work as a nurse in Japan (Shoki et al. 2023).

Country: Japan – A sense of being trusted and motivated (Tanaka and Yoshimura 2024).

Country: Kuwait – Understanding and accepting the local culture (Efendi et al. 2020).

Country: Malta – Building a sense of belonging and professional identity (Schembri 2024).

Country: Miscellaneous – Standing up for oneself, looking beyond discrimination and experiencing growth (Bayuo et al. 2023).

Implicit definitions (n = 65)

Country: Miscellaneous – Being comfortable in the use of the host culture's language in personal, social and work‐related functions and in interacting with members of the host culture (Ea et al. 2010).

Country: Miscellaneous – Able to decide and contribute to the decision‐making process (Montayre et al. 2018).

Country: Miscellaneous – Job satisfaction and making a positive contribution to the workforce in the host country (Moyce et al. 2016).

Country: Miscellaneous – The process by which an individual begins to settle in a new culture and learns about its practices and values (Pressley et al. 2022).

Country: Miscellaneous – Understanding the scope of practice and model of care and build effect relations with colleagues (Safari et al. 2022).

Country: Miscellaneous – Feeling comfortable in the workplace and receiving recognition of skills (Sheehy et al. 2024).

Country: Miscellaneous – Feelings of well‐being and belonging alongside the camaraderie and support of colleagues and new friends (Smith et al. 2022).

Country: Miscellaneous – A sense of belonging (Ung et al. 2024).

Country: Miscellaneous – Overcoming the challenges of transitioning into a new healthcare setting (Zanjani et al. 2018).

Country: Multiple countries – The process by which newcomers become familiar with an organisation's goals, culture and structure, while learning roles, expectations and building relationships with colleagues (Atta et al. 2025).

Country: Multiple countries – The process of professional, cultural, and social adjustment (Rajpoot et al. 2024).

Country: Multiple countries – The process of achieving professional identity, autonomy, and social belonging within organisational norms while overcoming cultural, linguistic, and systemic barriers (Rezaiye et al. 2025).

Country: New Zealand – The effective use of communication in the workplace (Brunton and Cook 2018)

Country: New Zealand – Intercultural integration and job satisfaction which require the management of teamwork, communication, and clinical practice (Brunton et al. 2020)

Country: Saudi Arabia – learn new things, apply their knowledge to the workplace, and balance both physical and psychological demands (Zakaria and Yusuf 2023)

Country: Norway – Implied by learning and adapting to different ways of working, speaking and listening (Pawlak 2021)

Country: Singapore – Becoming an Insider (Magnusdottir 2005)

Country: Singapore – Level of Job satisfaction (Pung et al. 2017)

Country: United Kingdom – Overcoming discrimination and negative manifestations of integrative power (Alexis 2006)

Country: United Kingdom – Aligns with social integration within the MDT (Alexis 2013)

Country: United Kingdom – Being able to socialise, develop relationships with other cultures within the workplace (Alexis 2015)

Country: United Kingdom – Feeling comfortable in the workplace setting (Alexis and Shillingford 2012)

Country: United Kingdom – Feeling valued and empowered and able to build relationships in which they can work together synergistically and on an interdisciplinary basis (Alexis and Vydelingum 2004)

Country: United Kingdom – Building a good relationship with colleagues while maintaining their identities in the workplace (Alexis and Vydelingum 2005)

Country: United Kingdom – When all have equal opportunities and do not feel disenfranchised (Alexis and Vydelingum 2009)

Country: United Kingdom – Being able to learn about other cultures and teach others about their own nurses reporting positive integration experiences as an empathetic manager, or an understanding colleague (Bond et al. 2020)

Country: United Kingdom – Understanding multi‐disciplinary teams and their role in it (Davda et al. 2018)

Country: United Kingdom – A sense of belongingness in the workplace (Lanada and Culligan 2024)

Country: United Kingdom – Feeling personally valued and professionally respected (Nichols and Campbell 2010)

Country: United Kingdom – Having a positive sense of self‐identity and also a sense of belonging to the in‐group or majority group (Winkelmann‐Gleed and Seeley 2005)

Country: United Arab Emirates – An increase in migrant nurses and midwives’ belief in their ability to affect change, and using critical thinking when implementing best practice, opportunities such as establishing more patient‐centred practice through migrant nurses and midwives’ use of self and greater understanding of the needs and values of their patients (Kuzemski et al. 2021)

Country: United Arab Emirates – Adapting behaviour sufficiently to complete basic practical work in the workplace, whilst maintaining their original culture in private (Thirlwall et al. 2021)

Country: United States – Being accepted as someone from the outside, fitting in culturally (Allen 2018)

Country: United States – Developing collaboration among the healthcare team member (Dumalagan 2016)

Country: United States – Feeling safe enough to be able to communicate freely and express uncertainties and opinions without criticism from host nurses or peers (Hayne et al. 2009)

Country: United States – Effective communication skills in the workplace (Jose 2011)

Country: United States – Adjusting to cultural differences, overcoming communication barriers, and becoming accustomed to the US healthcare system and developing a sense of belonging (Lin 2014)

Country: United States – Overcoming cultural differences, adapting to the workplace and learning new practices and systems to cooperate with the team members (Seo and Kim 2016)

Country: United States – ‘Learning the system’ and ‘learning the American culture.’ (Thekdi et al. 2011)

Country: United States – The ability to adapt to changes in the environment leading to shared goals and communication (Wolcott et al. 2013)

Country: United States – Adapting to the new environment, learning new things, apply their knowledge to the workplace and balancing both physical and psychological demands (Yi and Jezewski 2000).

Country: Various countries – Adapting to the host country's culture, accessing resources and systems and undergoing psychosocial changes to balance them with their own culture (Berdida et al. 2025).

Country: Various countries – The effective professional, cultural and social adaptation of migrant nurses within the host country's healthcare system (Yalcinkaya and Unsal 2025).

TABLE A4.

Themes (qualitative).

Communication	Cultural competence	Socialisation	Professional values	Knowledge advancement	Skill utilisation	Method	Reference
						Qualitative
√		√	√	√	√	Qualitative–phenomenology	Alexis and Shillingford (2012). Exploring the perceptions and work experiences of internationally recruited neonatal nurses: A qualitative study.
√	√			√	√	Qualitative–phenomenology	Alexis and Vydelingum (2004). The lived experience of overseas black and minority ethnic nurses in the NHS in the south of England.
	√					Qualitative–phenomenology	Alexis (2013). Internationally educated nurses’ experiences in a hospital in England: An exploratory study.
	√			√	√	Qualitative–phenomenology	Alexis and Vydelingum (2005). The experiences of overseas black and minority ethnic registered nurses in an English hospital: A phenomenological study.
√	√			√	√	Qualitative–phenomenology	Allen (2018). Experiences of internationally educated nurses holding management positions in the United States: Descriptive phenomenological study.
√						Qualitative–phenomenology	Antón‐Solanas et al. (2022). Migrant and ethnic minority nurses’ experience of working in European health services: A qualitative study.
				√		Qualitative–descriptive	Aydogdu and Baykal (2023). Experiences lived by international nurses concerning professional integration and interpersonal relationships in the workplace: Qualitative research
√	√	√			√	Qualitative–descriptive exploratory study	Schembri (2024). A model for personal, social and professional acculturation of overseas nurses: A qualitative study in Malta
	√	√			√	Qualitative–descriptive	Yalcinkayaand Ünsal (2025). ‘When I migrated, I faced challenges but gained much more…’ challenges and support needs of internationally educated nurses – A qualitative study.
√	√	√	√	√	√	Qualitative–descriptive exploratory	Bruntonand Cook (2018). Dis/Integrating cultural difference in practice and communication: A qualitative study of host and migrant registered nurse perspectives from New Zealand.
√	√	√	√	√		Qualitative–case study	Buttigieg et al. (2018). The integration of immigrant nurses at the workplace in Malta: A case study.
√	√	√	√	√		Qualitative– grounded theory	Chun Tie et al. (2019). Playing the game: A grounded theory of the integration of international nurses.
√				√		Qualitative–descriptive	Dumalagan, (2016). Foreign‐educated nurses’ transition in the United States workforce
	√					Qualitative–phenomenology	Efendi et al. (2020). The lived experience of Indonesian nurses in Kuwait: A phenomenological study.
√	√			√	√	Qualitative–phenomenology	Iheduru‐Anderson and Wahi, (2018). Experiences of Nigerian internationally educated nurses transitioning to United States health care settings.
√	√	√	√		√	Qualitative–descriptive	Javanmard et al. (2020). Transition experiences of internationally qualified midwives practising midwifery in Australia.
√	√	√	√		√	Qualitative–phenomenology	Jose (2011). Lived experiences of internationally educated nurses in hospitals in the United States of America.
√	√				√	Qualitative–phenomenology–hermeneutic	Joseph et al. (2022). Transition experiences of Indian nurses into Australian mental health system.
√	√	√	√			Qualitative–hermeneutic phenomenological approach	Rezaiye et al. (2025). Mirage or oasis? Iranian immigrant nurses share their stories of working in overseas healthcare settings: A phenomenological hermeneutic study.
					√	Qualitative–descriptive	Kamau et al. (2023). Culturally and linguistically diverse registered nurses’ experiences of integration into nursing workforce – A qualitative–descriptive study
√				√		Qualitative–descriptive exploratory	Kuzemski et al. (2021). I speak a little Arabic: Nursing comm in a cross‐cultural context.
√	√	√	√	√	√	Qualitative–descriptive	Lin (2014). Filipina nurses’ transition into the US hospital system.
√						Qualitative–descriptive	Miyata (2023). Challenges and career consequences of internationally educated nurses: Empirical research qualitative.
√	√	√	√	√	√	Qualitative–grounded theory	Ncube (2017). Influence of Leadership styles on expatriate nurses’ professional integration in the UAE.
√	√	√	√	√	√	Qualitative–phenomenology	Njie‐Mokonya (2014). Exploring the integration experiences of internationally educated nurses (IENs) within the Canadian health‐care system
	√	√	√			Qualitative–ethnographic	Pawlak (2021). Ways of walking, speaking and listening: Nursing practices and professional identities among Polish nurses in Norway
√	√			√	√	Qualitative–case study	Ramji and Etowa (2018). Workplace integration: Key considerations for internationally educated nurses and employers.
√	√	√	√	√	√	Qualitative–case study	Ramji and St‐Pierre (2018). Unpacking ‘two‐way’ workplace integration of internationally educated nurses
√	√	√	√	√	√	Qualitative–ethnographic	Rodríguez et al. (2014). Cultural experiences of immigrant nurses at two hospitals in Chile.
√	√	√	√		√	Qualitative–phenomenology	Seo and Kim (2016). Clinical work experience of Korean immigrant nurses in U.S. hospitals.
√	√	√	√	√	√	Qualitative–descriptive	Sherman and Eggenberger (2008). Transitioning internationally recruited nurses into clinical settings.
√	√	√	√	√	√	Qualitative–phenomenology	Sidebotham (2010). United Kingdom educated migrant midwives’ experience of working in Queensland.
√	√	√	√	√	√	Qualitative–phenomenology	Smith et al. (2011). Rediscovering nursing: A study of overseas nurses working in Western Australia.
√	√	√	√	√	√	Qualitative–descriptive	Stievano et al. (2017). Indian nurses in Italy: A qualitative study of their professional and social integration.
√	√	√	√	√	√	Qualitative–descriptive	Takeno (2010). Facilitating the transition of Asian nurses to work in Australia.
√						Qualitative–descriptive	Tanaka and Yoshimura (2024). Factors associated with foreign‐educated nurses’ willingness to continue working in Japan: A qualitative study.
√	√	√	√		√	Qualitative–descriptive	Thekdi et al. (2011). Understanding post‐hire transitional challenges of foreign‐educated nurses.
√						Qualitative–descriptive	Thirlwall et al. (2021). ‘Every day is a challenge’: Expatriate acculturation in the United Arab Emirates.
√	√	√	√	√	√	Qualitative–grounded theory	Tregunno et al. (2009). International nurse migration: U‐turn for safe workplace transition.
√	√	√	√	√		Qualitative–grounded theory	Wolcott et al. (2013). Integration of internationally educated nurses into the U.S. workforce.
√	√	√	√	√	√	Qualitative–double hermeneutic	Xiao et al. (2014). Factors affecting the integration of immigrant nurses into the nursing workforce: A double hermeneutic study.
				√		Qualitative–grounded theory	Yi and Jezewski (2000). Korean nurses’ adjustment to hospitals in the United States of America.
				√		Qualitative–descriptive	Zakaria and Yusuf (2023). Sacrifices from relocation to a foreign land: Multifaceted challenges experienced by self‐initiated expatriate female nurses during cross‐cultural adjustment.
√		√	√			Qualitative–descriptive	Zhong et al. (2023). Professional adaptation experiences of Chinese migrant nurses in Australia: A qualitative study.
√	√	√	√			Qualitative–grounded theory	Zhou (2014). The experience of China‐educated nurses working in Australia: A symbolic interactionist perspective.

TABLE A5.

Themes (quantitative).

Communication	Cultural competence	Socialisation	Professional values	Knowledge advancement	Skill utilisation	Type	Reference
						Quantitative
				√		Quantitative–descriptive	Alexis and Vydelingum (2009). Experiences in the UK National Health Service: The overseas nurses’ workforce.
	√					Quantitative–descriptive	Alexis (2015). Internationally recruited nurses’ experiences in England: A survey approach.
√	√			√		Quantitative–cross‐sectional	Covell and Rolle Sands (2021). Does being a visible minority matter? Predictors of internationally educated nurses’ workplace integration.
√		√	√			Quantitative cross‐sectional study	Shoki et al. (2023). Factors related to job continuance of nurses who migrated to Japan: A cross‐sectional study.
√	√	√				Quantitative–descriptive cross‐sectional	Dervishi et al. (2025). Integration of Albanian nurses in Germany: Employment challenges and opportunities: A descriptive study.
√	√				√	Quantitative–descriptive correlational	Covell et al. (2017). Internationally educated nurses in Canada: Predictors of workforce integration.
√	√				√	Quantitative–descriptive	Ea et al. (2010). Acculturation among immigrant nurses in Israel and the United States of America.
√	√	√	√	√		Quantitative–descriptive	Brunero et al. (2008). Expectations and experiences of recently recruited overseas qualified nurses in Australia.
√	√	√				Quantitative cross‐sectional and correlational design	Berdida et al. (2025). Stress, psychological well‐being, social support, practice environment, resilience, job satisfaction, and acculturation among Filipino internationally qualified nurses: A structural equation model.
√	√	√	√	√	√	Quantitative–cross‐sectional descriptive correlational	Goh and Lopez (2016). Acculturation, quality of life and work environment of international nurses in a multicultural society: A cross‐sectional, correlational study.
√	√	√	√	√	√	Quantitative–descriptive	Hayne et al. (2009). Filipino nurses in the United States: recruitment, retention, occupational stress, and job satisfaction.
√	√	√	√	√	√	Quantitative	O'Callaghan et al. (2019). Exploring the experiences of internationally and locally qualified nurses working in a culturally diverse environment.
√	√	√	√	√	√	Quantitative–cross‐sectional	Pung et al. (2017) Job satisfaction, demands of immigration among international nursing staff working in the long‐term care setting: A cross‐sectional study.

TABLE A6.

Themes (mixed‐methods, books and reviews).

Communication	Cultural competence	Socialisation	Professional values	Knowledge advancement	Skill Utilisation	Type	Reference
						Mixed methods
√	√	√	√			Mixed methods	Atta et al. (2025). Challenges and opportunities faced by migrant nurses in the receiving country: A mixed‐methods study on cultural adaptation and professional integration.
√	√		√	√	√	Mixed methods	Alexis (2006). Surviving through adversity: the experiences of overseas black and minority ethnic nurses in the NHS in the south of England
	√	√	√	√		Mixed methods	Brunton et al. (2020). Home and away: a national mixed‐methods questionnaire survey of host and migrant registered nurses in New Zealand.
√	√	√	√	√	√	Mixed methods	Javanmard et al. (2018). Transitional experiences of internationally qualified midwives practising in Australia: An e‐survey.
√	√	√	√	√	√	Mixed methods (qualitative phase of mixed methods)	Smith and Ho (2014). How to positively integrate internationally educated nurses.
	√			√	√	Mixed methods	Winkelmann‐Gleed and Seeley (2005). Strangers in a British world? Integration of international nurses
						Books
					√	Book chapter	Ramji and Etowa (2021). Becoming a Canadian nurse with international experience: Workplace integration of internationally educated nurses in the Global North.
						Reviews
	√	√			√	Integrative literature review	Chun Tie et al. (2018). The experiences of internationally qualified registered nurses working in the Australian healthcare system: An integrative literature review.
√	√	√				Integrative review	Lanada and Culligan (2024). The experiences of internationally educated nurses who joined the nursing workforce in England.
√	√	√			√	Integrative review	Nichols and Campbell (2010). The experiences of internationally recruited nurses in the UK (1995–2007): An integrative review.
		√		√	√	Integrative review	Primeau et al. (2014). Foreign‐trained nurses’ experiences and socioprofessional integration best practices: An integrative literature review.
√	√			√	√	Literature review	Thomas and Lee (2023). Factors influencing the transition of foreign‐educated nurses to the US.
√	√				√	Literature review	Javanmard et al. (2017). Experiences of internationally qualified midwives and nurses in Australia and other developed nations: A structured literature review.
√	√	√				Literature review	Jenkins and Huntington (2015). A missing piece of the workforce puzzle. The experiences of internationally qualified nurses in New Zealand: A literature review
√	√				√	Literature review	Zanjani et al. (2018). Challenges and experiences of overseas qualified nurses adjusting to new roles and healthcare systems: A narrative review of the literature
√	√				√	Narrative systematic review	Rajpoot et al. (2024). Transitioning experiences of internationally educated nurses in host countries: A narrative systematic review
√	√				√	Qualitative– meta‐synthesis	Bayuo et al. (2023). A meta‐synthesis of the transitioning experiences and career progression of migrant African nurses.
	√	√	√	√	√	Qualitative– synthesis of literature	Bond et al. (2020). The experiences of international nurses and midwives transitioning to work in the UK: A qualitative synthesis of the literature from 2010 to 2019.
√	√	√	√	√	√	Qualitative– meta‐synthesis review	Davda et al. (2018). Migration motives and integration of international human resources of health in the United Kingdom: systematic review and meta‐synthesis of qualitative studies using framework analysis
√	√				√	Qualitative evidence synthesis	Kurup et al. (2023). Transition of internationally qualified nurses in Australia: Meta‐synthesis of qualitative studies.
√	√	√			√	Qualitative evidence synthesis review	Shiju et al. (2024). Barriers and enablers of successful workplace integration of internationally educated nurses (IENs) in a host country: A qualitative evidence synthesis.
√				√		Rapid review	Smith et al. (2022). Nurse migration in Australia, Germany, and the UK: A rapid evidence assessment of empirical research involving migrant nurses.
√	√		√			Umbrella review	Balante et al. (2021). How does culture influence work experience in a foreign country? An umbrella review of the cultural challenges faced by internationally educated nurses
		√		√	√	Scoping review	Covell et al. (2014). A scoping review of the literature on internationally educated nurses in Canada: mapping a research agenda.
√	√				√	Scoping review	Safari et al. (2022). Transition experiences of internationally qualified healthcare professionals: A narrative scoping review.
√	√				√	Scoping review	Sheehy et al. (2024). The reported experiences of internationally qualified nurses in aged care: A scoping review.
√	√	√				Systematic review	Konno (2006). Support for overseas qualified nurses in adjusting to Australian nursing practice: A systematic review.
√	√				√	Systematic review	Moyce et al. (2016). Migration experiences of foreign‐educated nurses: A systematic review of the literature.
√	√				√	Systematic review	Pressley et al. (2022). Global migration and factors that support acculturation and retention of international nurses: A systematic review.
√	√	√			√	Systematic review	Ung et al. (2004). Global migration and factors influencing retention of Asian internationally educated nurses: A systematic review.

Data Availability Statement

Research data are not shared.