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A foreign-language nursing student needs the support of a supervisor and the work community during practical training

Published on 15.5.2024
Tampere University of Applied Sciences
Päivi Vartiainen.Photo: Emmi Suominen
The experiences of students and instructors in functionally bilingual nursing education (TOKASA) were studied for the first time. Senior Specialist Päivi Vartiainen considers education in Finland to be a more ethical option than recruiting nurses from abroad.

When a bilingual nursing student goes to the workplace for their first practical training, they need special support from the internship supervisor and the work community. In the workplace, however, many people are nervous about speaking English and avoid bilingual students, which can slow down or hinder learning and the feeling of belonging to the work community.

The observations were made in a study conducted by Tampere University of Applied Sciences and Metropolia University of Applied Sciences, whose first peer-reviewed article was published in the journal Investigative Nursing.

"Some of the students said that they had experienced social exclusion or even discrimination during the internship. It would be important for workplaces to dare to include foreign-language nursing students as well," says Senior Specialist, PhD Päivi Vartiainen from Tampere University of Applied Sciences.

The study revealed that for many bilingual nursing students, the internship is the first fully Finnish-speaking environment. Practical training plays an important role not only in learning the skills needed in the profession, but also in Finnish.

"Workplaces need encouragement and encouragement to be able to use English and Finnish side by side. The work community does not need to know English perfectly and the student does not need to know Finnish perfectly. The most important thing is that interaction progresses," Vartiainen emphasises.

Sufficient time should be reserved for guidance

Functionally bilingual nursing education (TOKASA) is a pilot project of Tampere University of Applied Sciences and Metropolia University of Applied Sciences for students who have moved to Finland from abroad. The education begins in English, and the Finnish language is gradually added as integrated into the studies. The aim is for students to be able to work in their profession in Finnish after graduation.

The experiences of students participating in the pilot training and their supervisors will be investigated through a follow-up study conducted by Päivi Vartiainen from Tampere University of Applied Sciences and doctoral researcher, lecturer Hanna Repo from Jamal Metropolia University of Applied Sciences.

In the first part of the study, 23 students and 11 internship supervisors were interviewed about their experiences of the first internship. In addition, students evaluate the training environment using a structured CALD indicator. The data was collected in spring and autumn 2022.

The study reinforced the view that linguistic and cultural diversity in the workplace involves challenges that should be taken into account in the time resources of instructors.

"The work should be organised so that the instructors have a little more time to supervise foreign-language speaking students. It would also be important for instructors to be rewarded for tutoring foreign-language speaking students," Vartiainen says.

It was positive that the students felt that their internship environment was mainly good. The students received constructive feedback from their instructors, which promoted learning.

The instructors, on the other hand, described the nursing learning motivation of TOKASA students as high. The students' interest in elderly care, which not all Finnish-speaking nursing students are necessarily motivated to learn, was particularly praised.

Nurses are needed from abroad – but how?

Finland's care and health care services suffer from a shortage of labour, which has been filled by recruiting nurses from abroad for years. In particular, they have been attracted here from Southeast Asia.

Usually, ready-made nurses have been brought to Finland who have completed a short language training in their country of origin. Päivi Vartiainen sees many ethical problems in this.

"Thousands of Filipino nurses work as nursing assistants in Finland. They have completed a four-year higher education as nurses in their country of origin, but here they are only qualified for auxiliary work."

Some nurses recruited to Finland from abroad have had to pay illegal recruitment fees to intermediaries. It has also emerged that people in Finland have been promised jobs in the care sector, but only cleaners have been available.

According to Vartiainen, bilingual nursing education organised in Finland is a more ethical and transparent model for recruiting labour from abroad. The aim of the TOKASA project is to create a functional and permanent degree education model that can also be utilised in other universities of applied sciences in the future.

"The goal is that nurses graduating from the programme will find employment in Finland in jobs corresponding to their education," Vartiainen sums up.

The project is funded by the Ministry of Education and Culture's TalentBoost programme and discretionary funding. More information can be found at


Text: Virpi Ekholm