Abstract

Background: The increasing global migration of internationally educated nurses (IEN) underscores the need for effective transition programs to bridge competency gaps across international nursing standards. IENs preparing to enter the US healthcare system face challenges in adapting to new practices and technologies. To address these gaps, a hybrid International Transition to Practice Program was developed, integrating cloud-based simulation technology and immersive learning to enhance clinical readiness.

Methods: This 16-week hybrid program combined didactic instruction, skill-based training, and simulation-based education (SBE). A cloud-based simulation platform enabled real-time interaction between US-based educators and learners in the Philippines. In 2024, 39 immersive simulations were conducted by the team resulting in 494 learner interactions. Sessions included structured prebriefing, standardized clinical scenarios, and outcomes-focused debriefing. Cloud-based technology allowed educators to remotely monitor simulations, provide live feedback, and assess learner progress, creating a dynamic and interactive training environment. Program effectiveness was measured using a validated clinical competency tool and a self-efficacy survey. Participants completed pre- and post-tests, with self-efficacy assessed across three domains: assessment, independent nursing interventions, and communication.

Results: The results showed significant improvements in both competency and self-efficacy. The mean pre-test score of 81.77 (SD = 9.11) increased to 96.49 (SD = 3.20) in the post-test (t = 16.75, p < 0.0001). Self-efficacy scores across the three domains also improved significantly (p < 0.001). Assessment scores increased from 5.7 to 6.5, independent nursing interventions from 5.8 to 6.5, and communication from 5.8 to 6.5. These improvements reflect enhanced clinical confidence and readiness for US healthcare practice.

Conclusions: The hybrid training model, leveraging cloud-based simulation technology, proved highly effective in preparing IENs for the US healthcare environment. The integration of real-time feedback and SBE bridged the gap between international nursing standards and US practices, enhancing participant competencies and self-efficacy. This program demonstrates the transformative potential of emerging technologies in global nursing education, paving the way for more effective training models that support IENs in their transition to new healthcare systems.

Description

A 16-week hybrid program using cloud-based simulation technology improved the competency and self-efficacy of international nurses transitioning to US healthcare. Real-time interaction with US-based educators during immersive simulations enhanced clinical readiness across three domains: assessment, independent nursing interventions, and communication. This model demonstrates the effectiveness of technology in bridging global nursing standards.

Author Details

From title slide: Jose Arnold Tariga, PhD, MSN, RN, CNE, NPD-BC, NE-BC, CPHQ, FFNMRCSI; Lisa McEathron, MSN, RN, NPD-BC, CCRN; Christian Striggow, DHSc., MED, CHSE, RRT-NPS, RPFT

Sigma Membership

Phi Gamma (Virtual)

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Competence, Simulation, Transition to Practice or Onboarding, Internationally Educated Nurses, International Nursing Standards

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Click on the above link to access the slide deck.

Additional Files

References.pdf (76 kB)

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Cloud-Based Hybrid Training: Bridging International Nurses' Competency for US Healthcare

Seattle, Washington, USA

Background: The increasing global migration of internationally educated nurses (IEN) underscores the need for effective transition programs to bridge competency gaps across international nursing standards. IENs preparing to enter the US healthcare system face challenges in adapting to new practices and technologies. To address these gaps, a hybrid International Transition to Practice Program was developed, integrating cloud-based simulation technology and immersive learning to enhance clinical readiness.

Methods: This 16-week hybrid program combined didactic instruction, skill-based training, and simulation-based education (SBE). A cloud-based simulation platform enabled real-time interaction between US-based educators and learners in the Philippines. In 2024, 39 immersive simulations were conducted by the team resulting in 494 learner interactions. Sessions included structured prebriefing, standardized clinical scenarios, and outcomes-focused debriefing. Cloud-based technology allowed educators to remotely monitor simulations, provide live feedback, and assess learner progress, creating a dynamic and interactive training environment. Program effectiveness was measured using a validated clinical competency tool and a self-efficacy survey. Participants completed pre- and post-tests, with self-efficacy assessed across three domains: assessment, independent nursing interventions, and communication.

Results: The results showed significant improvements in both competency and self-efficacy. The mean pre-test score of 81.77 (SD = 9.11) increased to 96.49 (SD = 3.20) in the post-test (t = 16.75, p < 0.0001). Self-efficacy scores across the three domains also improved significantly (p < 0.001). Assessment scores increased from 5.7 to 6.5, independent nursing interventions from 5.8 to 6.5, and communication from 5.8 to 6.5. These improvements reflect enhanced clinical confidence and readiness for US healthcare practice.

Conclusions: The hybrid training model, leveraging cloud-based simulation technology, proved highly effective in preparing IENs for the US healthcare environment. The integration of real-time feedback and SBE bridged the gap between international nursing standards and US practices, enhancing participant competencies and self-efficacy. This program demonstrates the transformative potential of emerging technologies in global nursing education, paving the way for more effective training models that support IENs in their transition to new healthcare systems.