Clinical placement experiences of nursing students with English as an additional language: a qualitative meta-synthesis

INTRODUCTION: Clinical placements are fundamental to nursing education, yet English as an additional language (EAL) students encounter distinct barriers that impede their professional development and well-being. This study aimed to synthesize existing research for a comprehensive understanding. CONTENT: A qualitative meta-synthesis was conducted via systematic searches across five databases, with quality appraisal using the CASP checklist. Thematic analysis of 11 international studies generated three core themes: (1) Language as a barrier to participation, (2) marginalization and exclusion in clinical settings, and (3) support, resilience, and coping strategies. SUMMARY AND OUTLOOK: The synthesis confirms that EAL nursing students face challenges that require targeted interventions. Effective strategies include structured language support, culturally sensitive mentorship, and proactive inclusion by clinical educators. These findings carry clear implications for international curriculum design, staff training, and institutional policy reform. Future research should prioritize intervention-based studies to empirically evaluate the long-term effectiveness of such support mechanisms, ensuring equitable and enriching clinical environments for an increasingly diverse nursing workforce.