Supporting nursing students for whom English is an additional language in undergraduate nursing education: An integrative review

Objectives To synthesize current literature examining strategies that support students for whom English is an additional language (EAL) in undergraduate nursing education. Design Integrative review. Data sources CINAHL, PubMed, ERIC, Scopus, and Google Scholar were searched for studies published between 2016 and 2025. Review methods Studies were included if they examined EAL students in nursing or higher education and described instructional or supportive strategies applicable to nursing education. Twenty-four studies met inclusion criteria and were synthesized using thematic analysis. Results Four themes emerged: linguistically responsive teaching strategies, linguistically accessible assessment, inclusive learning environments and affective support, and peer support and leadership opportunities. Multimodal instruction, active learning, linguistically modified assessment items, supportive faculty relationships, and structured peer mentoring were associated with improved comprehension, engagement, and persistence among EAL learners. Conclusions Supporting EAL nursing students requires coordinated strategies addressing linguistic, academic, and psychosocial dimensions of learning. Implementing linguistically responsive teaching and inclusive learning environments may improve educational outcomes and help prepare a diverse nursing workforce.