Background: Overseas qualified nurses (OQNs) face various challenges while adjusting to the Australian healthcare system. However, few studies to date have identified specific factors affecting their sociocultural adjustment, health and psychology.Aims: The primary aim was to examine factors associated with OQNs' sociocultural adjustment to the Australian healthcare system. A secondary aim was to determine whether there was a correlation between OQNs' sociocultural adjustment and their mental and physical health.Methods: A questionnaire was sent electronically to 2,250 randomly selected OQNs through the Australian Health Practitioner Regulation Agency, and later distributed to 50 OQNs in person through Western Health, Melbourne. Sociocultural adjustment was assessed using the Sociocultural Adaptation Scale-Revised. The Nurse International and Transition Questionnaire-2 was used to explore the factors involved in sociocultural adjustment: these were pull factors, push factors, initial experiences, job satisfaction, feeling at home, and reactions to the working environment. The Perceived Stress Scale and General Health Questionnaire-12 were used to assess psychological adjustment and general health, respectively.Findings: A total of 200 participants completed the questionnaire. The mean age (SD) of the participants was 32.79 (6.91) with 161 (80%) holding a bachelor degree. In the adjusted multivariate linear regression, job satisfaction ( β = 0.24, 95% CI 0.13 to 0.36), current work environment ( β = 0.27, 95% CI 0.05 to 0.49) and feeling at home ( β = 0.32, 95% CI 0.13 to 0.50) were independently positively associated with sociocultural adaptation. Sociocultural adaptation was negatively related to PSS (r = −0.14, β = −0.16, p = 0.04) and GHQ12 (r = −0.36, p < 0.001, β = −0.59).Discussion: Three factors (job satisfaction, current work environment, and feeling at home in Australia) were found to be significant in measuring OQNs' level of sociocultural adaptation. When the level of sociocultural adaptation was high, OQNs reported better general and psychological health. Conclusion:Job satisfaction and feeling supported in the workplace are the most important factors influencing OQNs' successful adjustment into the Australian healthcare system.

BackgroundThere is conflicting and limited information regarding factors that influence undergraduate nursing students' academic and clinical performance prior to entry to practice.ObjectiveTo identify factors influencing the academic and clinical performance of undergraduate nursing students throughout the course.DesignMixed methods study utilizing a retrospective cohort and a qualitative study.SettingMonash University, Melbourne, Australia.ParticipantsLongitudinal existing data of nursing undergraduate students who commenced in 2017 (n = 176) and 2018 (n = 76), and two focus groups with final year nursing students were analyzed.MethodsRetrospective students' records were used to determine the students' academic and clinical performance using the weighted average mark (WAM) of the theoretical and clinical components of the curriculum, separately. The WAM considered the year level of each unit and was scored out of 100. Multivariate linear regression was used to determine predictor factors of academic and clinical performance. Variables include entry cohort (with no previous nursing qualification vs. diploma of nursing), admission category (domestic vs. international), campus (metropolitan vs. outer metropolitan), and secondary school (year 12) results. Two focus group discussions were conducted and thematically analyzed.ResultsMore than two-thirds of the students were aged 18–20 years and mainly female. Almost 20% of the participants were international students. Students with higher secondary school (year 12) results and studying at the outer metropolitan campus achieved a higher academic performance while international students had significantly lower academic performance compared to domestic students. Students with a previous diploma of enrolled nursing and international students had lower clinical performance. Students identified that a comprehensive orientation, interactive curriculum, formal and informal support structure, and educator qualities influenced their academic and/or clinical performance.ConclusionsA supportive educational environment with an interactive curriculum may enhance students' academic and clinical performance and readiness for practice. Furthermore, targeted interventions for international students, those with lower secondary school (year 12) results, and those with a former diploma of nursing may be required to increase academic and clinical performance.