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BACKGROUND: Studying in a foreign country can be accompanied by challenges, including difficulty understanding the curriculum, culture shock, and a new language. These additional challenges place international students at risk and predispose them to developing mental health problems compared to domestic student. AIMS: This study explores psychological well-being and help-seeking behaviours of international nursing students who commenced their program onshore or in a remote learning capacity. MATERIALS & METHODS: This paper reports the findings of the mixed-methods study. Research was conducted among international students enrolled in the Bachelor of Nursing programs across multiple campuses at two Victorian universities in 2022. Data was collected using a survey questionnaire with open-response questions and incorporated a validated Student Stress Survey. RESULTS: Findings indicated that international students require support financially and to settle in Australia upon arrival. Participants highlighted that they require additional support to keep up with academic workloads and require further academic support tailored for international students. There was no patient or public contribution in the design, conduct, analysis or preparation of this manuscript. DISCUSSION & CONCLUSION: Participants highlighted that they require additional support to keep up with academic workloads and require further academic support tailored for international students. There was no patient or public contribution in the design, conduct, analysis or preparation of this manuscript.

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BACKGROUND: In this era of rapid globalization, our knowledge regarding the clinical performance perceptions and stress coping behaviors of international students in nursing education is quite limited. The unexplored nature of this topic has the potential to manifest as future clinical challenges. OBJECTIVE: To examine the relationship between international nursing students' perceived self-efficacy in clinical applications and their coping behaviors with stress. METHODS: Our cross-sectional and correlational study collected data from 117 international nursing students at a state university between June 2022 and July 2023. The data collection tools included the Participant Identification Form, Self-Efficacy in Clinical Performance Scale (SECP), and The Coping Behavior Inventory with Stress Scale for Nursing Students (CBIS-NS). t-test, ANOVA, correlation analysis, and Bonferroni test were used for data analysis. RESULTS: Students, predominantly Azerbaijani (15.4 %) and 64.1 % female, engaged in practices, mainly in medical (34.2 %) and surgical units (33.3 %). Clinical self-efficacy was high, stress coping moderate. A significant positive link existed between coping behaviors and clinical self-efficacy (p < 0.05). Those in public health/mental health units (8.12 ± 1.46) had higher self-efficacy than surgical unit peers (6.94 ± 1.71) (p < 0.05). Satisfied students showed better stress coping (t = 2.645; p = 0.009). Weak positive links were found between transfer/avoidance coping behaviors and clinical self-efficacy (p < 0.05). CONCLUSION: This study demonstrated a statistically significant positive relationship between international nursing students' perceptions of clinical performance and coping behaviors with stress. Given the rapid globalization of education in the global era, especially in diverse educational and clinical environments with students from different ethnic backgrounds, it is recommended to develop new intervention strategies to enhance students' clinical performances and foster positive coping behaviors with stress.

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Background: Australia provides education services to international students which includes international students completing a health professional education (HPE) degree. Studying for a HPE degree can be challenging for most students. There are specific challenges for international students when completing a degree with clinical placements. The challenges international students can face include receiving adequate and timely information, understanding health service access, and receiving the correct information from education providers and agents.Objectives: To gain an in-depth understanding of the challenges for international health professional education students in accessing healthcare, understanding the requirements of compliance to attend clinical placements and the difficulties with attending clinical placements.Design: A semi-structured interview schedule based on findings from a survey (N = 318 participants) was used to explore international student perspectives in one-on-one interviews.Methods: Data were collected from international HPE students from a single Australian metropolitan multi-campus university using a questionnaire, which included qualitative open-ended questions, in addition to semi-structured follow-on interviews. Data collection took place between March and October 2021 and qualitative data were inductively thematically analysed.Results: Challenges reported in interviews by six international students were focused on understanding the navigation of new administrative systems and compliance processes. Students noted gaps in the communication of understanding legislative compliance requirements to attend clinical placements, difficulties accessing healthcare and making use of overseas student health cover, organisational issues, and transport issues when attending clinical placements.Conclusions: Higher education providers and international education agents must address communication deficits in course requirements linked to clinical placement prerequisites. This study highlights gaps in commencing international students' understanding, and higher education providers' communication of clear, timely detailed information.

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INTRODUCTION: International student mobility (ISM) is increasingly utilised in higher education to allow students the opportunity to engage authentically with cultures outside their own, providing an opportunity for self-growth. These growth opportunities often extend skills such as cultural competency, academic learning and self-efficacy, all of which are important skills for diagnostic radiography graduates. This study explores the motivations, benefits and pitfalls of an ISM program and highlights key considerations for academics considering organising a program within their own university. METHODS: This study utilised a combination of individual and small group interviews to collect data about diagnostic radiography students' motivations, perceived benefits and pitfalls of undertaking ISM. Data were analysed using reflexive thematic analysis and overarching themes were developed. RESULTS AND DISCUSSION: Three themes were developed from the data, challenges and uncertainty, personal growth, and support. Participants undertaking ISM faced challenges such as cultural differences, as well as feelings of uncertainty. Additionally, they highlighted the importance of organisation in mitigating these challenges. Despite the challenges faced, participants reported significant personal growth and success as a result of the program, integral to this success was the support of their peers and academic advisors. CONCLUSION: ISM programs may lead to enhanced employability of diagnostic radiography graduates, with integral skills such as teamwork, communication cultural competence being enhanced in participants. The role of support during ISM is integral to the success of the program. It is imperative for academics organising ISM programs at their institutions to deliberately consider the way in which radiography students are supported both before and during the program to enhance the experience and ensure outcomes are maximised.

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Alongside academic learning, there is increasing recognition that educational systems must also cater to students' well-being. This study examines the key factors that predict adolescent students' subjective well-being, indexed by life satisfaction, positive affect, and negative affect. Data from 522,836 secondary school students from 71 countries/regions across eight different cultural contexts were analyzed. Underpinned by Bronfenbrenner's bioecological theory, both machine learning (i.e., light gradient-boosting machine) and conventional statistics (i.e., hierarchical linear modeling) were used to examine the roles of person, process, and context factors. Among the multiple predictors examined, school belonging and sense of meaning emerged as the common predictors of the various well-being dimensions. Different well-being dimensions also had distinct predictors. Life satisfaction was best predicted by a sense of meaning, school belonging, parental support, fear of failure, and GDP per capita. Positive affect was most strongly predicted by resilience, sense of meaning, school belonging, parental support, and GDP per capita. Negative affect was most strongly predicted by fear of failure, gender, being bullied, school belonging, and sense of meaning. There was a remarkable level of cross-cultural similarity in terms of the top predictors of well-being across the globe. Theoretical and practical implications are discussed.

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In this study, we investigated whether the interaction effects of self-efficacy, life satisfaction, and sociocultural adjustment have significant negative effects on culture shock. The data were collected from 323 international students in Turkey, and the sample comprised 197 undergraduates (61%) and 126 graduates (39%). We administered the "Culture Shock Questionnaire," "General Self-Efficacy Scale", "The Satisfaction with Life Scale", and "Sociocultural Adaptation Scale" through an online survey. Of the participants, 86 were female (26.6%), and 237 were male (73.4%). The ages of the participants ranged from 18 to 32 (M = 22.11; SD = 4.23). In this study, we identified three structural models to test the relationships between culture shock, self-efficacy, life satisfaction, and sociocultural adjustment. The results supported our hypothesis (H1) that there would be a significant negative relationship between self-efficacy and culture shock. One-way MANOVA revealed that students with lower self-efficacy scores experienced greater culture shock. Conversely, students with higher self-efficacy scores experienced lower culture shock and interpersonal stress. Additionally, a multigroup analysis was conducted to test the assumed relationships in structural models for Muslim (such as Turkey, where the research was conducted, which is 90% Muslim) and Christian students. The results indicated that self-efficacy has a significantly greater negative impact on culture shock for Christian students than for Muslim students. Our study confirmed the hypothesis (H4) that life satisfaction and sociocultural adjustment serve as mediating variables between self-efficacy and culture shock. Both life satisfaction and sociocultural adjustment were found to have significant direct impacts on culture shock, and a meaningful mediating effect on the relationship between self-efficacy and culture shock was identified. Based on these findings, we concluded that self-efficacy may be particularly beneficial for coping with culture shock for people who do not embrace dominant religious beliefs in a local culture.

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Many countries attract international students to higher education programs to invest in human resources. However, living abroad can be stressful and adversely affect international students' mental and physical health. This study, conducted during the COVID-19 pandemic, investigated stress-related factors affecting the socio-psychological health of Chinese students, the greatest proportion of international students in Korea. The path coefficients and mediating effects of COVID-19-related stress factors were analyzed via a transaction-based stress model for 307 students using partial least squares structural equation modeling. Cultural adaptive stress had the greatest impact on mental health. Perceived financial stress was not statistically significant. Additionally, because the COVID-19 situation in Korea is relatively mild, anxiety regarding the pandemic did not lead to stress. However, excessive COVID-19-related information on social networking services negatively impacted mental health. Understanding the causes of stress and taking preemptive measures to prevent it will result in positive educational and social impacts for both international students and host countries. This study's results have implications for the formulation of international student policies.

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Although research has identified the impact of school connectedness on a variety of outcomes for adolescents, much less work has focused on identifying its precursors. This study examined the relative influences of classroom interactions and parental support on elements of school connectedness among a sample of 4838 students (Mage = 15.84, SD = 0.29; 49.1% female) in the United States from the Programme for International Student Assessment (PISA) 2018 data. The results showed that three domains of classroom interactions (i.e., classroom management, instructional support, and emotional support) and parental support played unique roles in predicting school connectedness (i.e., teacher support and school belonging). Specifically, classroom management positively predicted both teacher support and school belonging; instructional support, especially directed instruction, positively predicted teacher support; emotional support was unrelated to teacher support and school belonging. Parental support positively predicted school belonging, but not teacher support. Overall, these findings highlight the roles of both teachers and parents in providing developmentally appropriate support to facilitate school connectedness.

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Background: and Purpose: As the number of international students from Belt and Road Initiative countries continues to increase in China, it is essential to find methods to improve cross-cultural adaptation in the host country, a crucial aspect of the experiences of international nursing students. Therefore, this study aimed to investigate the change in cross-cultural adaptation of international nursing students during the first year in China. Methods: Data collection was conducted for international nursing students (n = 108) between September 2019 and August 2020, focusing on sociocultural adaptation, academic adaptation, and academic performance of international nursing students using validated questionnaires. Results: The mean score at the follow-up time verified an increased level of sociocultural and academic adaptation and academic performance. Academic adaptation is a complete mediator between sociocultural adaptation and academic performance at two-time points, and the size of the mediation effect accounted for 95.9 % of the total effect in six months and 99.0 % in one year. Conclusions: The findings emphasized the importance of sociocultural and academic adaptation in cross-cultural adaptation and suggest that educational institutions should provide learning environments supporting these factors to ensure academic success.

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Background: Student mobility across borders poses challenges to health systems at the university and country levels. International students suffer from stress more than their local peers, however, do not seek help or underutilize existing help offers. Some barriers to help-seeking among international students are insufficient information regarding the health offers, stigma, and language, which might be overcome via culturally adapted internet and mobile-based interventions (IMI). Method: A randomized controlled feasibility trial with a parallel design assessed the feasibility and potential efficacy of an online mindfulness intervention adapted for international university students. Participants were randomized into either an adapted online mindfulness intervention (StudiCareM-E) (IG, n = 20) or a waitlist control group (WL, n = 20). Participants were assessed at baseline (t0) and eight-week post-randomization (t1). The feasibility of StudiCareM-E was evaluated regarding intervention adherence, client satisfaction, and potential negative effects. The potential efficacy of StudiCareM-E was measured by means of the level of mindfulness, perceived stress, depression, anxiety, presenteeism, and wellbeing. Efficacy outcomes were evaluated with regression models on the intention-to-treat (ITT) sample (n = 40), adjusting for the baseline values. Results: Participants' formative feedback suggested improvements in the content of the IMI. There were no crucial negative effects compared to WL. Assessment dropout was 35% (IG: 50%: WL: 20%), and intervention dropout was 60%. StudiCareM-E yielded significant improvements in mindfulness (ß = .34), well-being (ß = .37), and anxiety (ß = -.42) compared to WL. Conclusion: StudiCareM-E might be used among culturally diverse international student populations to improve their well-being. Future studies might carefully inspect the extent of the adaptation needs of their target group and design their interventions accordingly.

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Objective The objective is to determine the impact of a health education intervention on self-rated health knowledge, levels of stress and anxiety, and ability to find and access school resources for international students studying at a Canadian University and College. Participants and setting This is a pre- and post-intervention survey. Undergraduate and graduate international students on the shared campus of Durham College and Ontario Tech University in Oshawa, Ontario were included. Interventions  International students participating in this study received two structured visits, scheduled two weeks apart. At the start of the first visit, students completed a baseline survey which included questions on self-rated health knowledge, stress levels, and ability to access school resources. At this visit, students received 30 minutes of structured health education from a registered nurse on the topics of sexual health and adult immunizations.  At the second visit, students received 30 minutes of structured teaching from the registered nurse on the topics of mental health, COVID-19, and campus resources. Upon the completion of this teaching, students completed a post-intervention survey with the same questions as the pre-survey, to gauge for changes related to the intervention. Results T-values were calculated for each survey item from the pre and post-survey. These t-values were used as the outcome measure to determine changes in health knowledge, stress levels, and ability to access resources following the intervention. In total, there were 202 participants. Statistical analysis showed significant t-values for all survey items in the pre- and post-analysis. Following the education intervention, the highest t-values were noted in self-rated sexual health knowledge (t-value 16.80, p < 0.001), ability to find and access school resources (t-value 16.14, p < 0.001), and current level of stress/anxiety in regard to being in a new country (t-value 14.04, p < 0.001). Conclusion Following a structured health education intervention, international students reported significant increases in self-rated health knowledge for specific topics, ability to find and access school resources, ability to get help for a mental health issue, and significant decreases in self-rated stress/anxiety. These results can support further exploration of health education in international student populations to ensure these students are adequately informed and supported when arriving in a new country.

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This study seeks to compare fixed and mixed effects models for the purposes of predictive classification in the presence of multilevel data. The first part of the study utilizes a Monte Carlo simulation to compare fixed and mixed effects logistic regression and random forests. An applied examination of the prediction of student retention in the public-use U.S. PISA data set was considered to verify the simulation findings. Results of this study indicate fixed effects models performed comparably with mixed effects models across both the simulation and PISA examinations. Results broadly suggest that researchers should be cognizant of the type of predictors and data structure being used, as these factors carried more weight than did the model type.

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For Chinese international students attending colleges and universities, COVID-19 and protests related to racism intertwined to create impactful experiences. In this narrative inquiry study, Emma's experiences as a graduate student culminate in her story of identity and racism. Narrative themes of personal and cultural identity, experience and interactions with racism, privilege, and advocacy and social responsibility were constructed.

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This paper applies Appadurai's notion of scapes in globalisation to study international student mobility. Thirty mainland Chinese students were interviewed; the majority of whom studied at prestigious institutions in the West before enrolling in their current PhD programmes at a research-intensive university in Hong Kong (HK) in the immediate aftermath of HK's large-scale social protests and amidst the Covid-19 pandemic. We seek to understand why these students relocated to HK to further their studies given these turbulent circumstances and how their mainlander identity and sojourns in the West influence their perceptions of HK's social movements from the perspectives of ethnoscape and ideoscape, respectively. Our findings reveal that HK represented the 'best' compromise for our participants, mitigating their nostalgia for home (i.e. mainland China) whilst offering a superior education to the Chinese mainland. Most participants perceived HK as a nationalistic ideoscape, wherein HK people's pursuit of autonomy is subordinated to the putative Chinese national interests. Moreover, ethnoscape and ideoscape dynamics were found to crisscross other scapes. Generous scholarships (i.e. financescape) provided additional incentives driving student relocations. The persistent consumption of Chinese social media (techno-mediascape) was found to have resulted in worldview conformity between our participants and the Chinese state.

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WeChat is a highly popular social media in China and many other Asian countries, but little is known about its effectiveness in facilitating international students' academic and social functioning. Hence, the present study aimed to examine causal or reciprocal relationships among WeChat usage intensity, behavioral engagement in academic learning (BE-academic) and in local social activities (BE-social), and academic and social adjustment. To this end, we employed a three-wave longitudinal design among international students in China with data collected at three times (i.e., Time 1 data collected in December of 2020, Time 2 data collected in March of 2021, and Time 3 data collected in June of 2021). Results based on the cross-lagged panel analyses indicated that in academic domains, WeChat usage intensity positively predicted longitudinal changes in BE-academic and academic adjustment positively predicted longitudinal changes in WeChat usage intensity across Time 1 and Time 3. In social domains, WeChat usage intensity positively predicted longitudinal changes in BE-social and social adjustment, and BE-social positively predicted longitudinal changes in social adjustment from Time 1 to Time 2. Additionally, the reverse effects of social adjustment on WeChat usage intensity were revealed across Time 1 and Time 3.

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Empirical research on international student migrants has sometimes homogenised this group, framing it as predominantly made up of privileged members of the global middle-class. This has led to calls to acknowledge and address the precarity faced by international students in their respective host countries more comprehensively. This study aims to explore how levels of financial precarity vary among international students in Australia, and how this in turn contributes to varying levels of precariousness in the personal spheres of students' lives. In doing so, we centre and refine the concept of precarity for use in studies of internationally mobile students, arguing for its use as a 'relational nexus', bridging financial precarity and broader lived experiences. Drawing on a large-scale survey and semi-structured interviews with 48 students, we emphasise the linkages between financial precarity and precariousness as a socio-ontological experience, explored through the examples of time poverty, physical and mental wellbeing, and relationships.

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The rapid growth of international student mobility has attracted much research on the many benefits it offers to students, higher education institutions, and societies in general. However, studies on the costs and potential tribulations caused by mobility are comparatively rare, despite increasing evidence of such costs inherent in the marketization of higher education. Furthermore, the few existing studies are predominantly framed in terms of consumerism and the commodification of education, but they give less attention to mobility in the context of wider social issues. The climate crisis is foremost among such social impacts, with the extensive air travel inherent in global mobility patterns causing significant damage, combined with curricula, pedagogies, and institutional strategy that are either ambivalent or contradictory on the climate crisis. This paper examines international student mobility in European higher education to better understand how the environmental costs of higher education can be conceptualized in policy and practice. It contrasts policies and practices that promote international student mobility in Europe-in which mobility has aspects of what are commonly referred to as "public goods"-with initiatives that promote mobility to Europe, which illustrate a historic and ongoing entanglement between European colonialism, higher education, and climate change. It concludes with reflections on possibilities for greater sustainability in international student mobility in Europe.

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AIM: To determine the core competencies of clinical internships for international postgraduate nursing students undertaking a two-year professional program in China. BACKGROUND: Clinical internship is an important part of nursing education and is the cornerstone for the future training of nursing professionals. However, in terms of providing a basis for the training and assessment of international postgraduate nursing students undertaking a two-year professional program in China, their core competencies of clinical internships have not yet been sufficiently determined. METHODS: Focus group interviews and a two-round Delphi method were conducted. The preliminary list of core competencies was determined based on a scoping review and focus group interviews. Subsequently, experts provided suggestions for modifications to the core competencies in two rounds of the Delphi survey. The response rate (RR), composite reliability (Cr), coefficient of variation and Kendall coefficient of indices were calculated. RESULTS: Twenty experts completed two rounds of Delphi expert consultation and reached consensus on five first-level indices and 13 s-level indices with 27 connotations. The RR values for the two rounds of consultation were 100 %, the Cr values were 0.853 and 0.873 and the Kendall coordination coefficients were 0.134-0.250 (p < 0.05). CONCLUSION: The core competencies identified in this research can provide a basis for further training international postgraduate nursing students undertaking a two-year professional program in China through internship programs. This research also provides a reference for effectively evaluating and improving clinical programs.

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Understanding the cross-cultural adaptation of students studying in foreign countries by exploring acculturative stress factors is crucial to ensure the smooth academic performance of the students and, in turn, to enhance the global reputation of their universities. Therefore, it is an area of interest for the authorities (Ministry) and the corresponding management of universities. Using a random sample of 138 international students in China, descriptive and logistic regressions were conducted to assess the levels and influence of acculturative stress factors on cross-cultural adaptation, specifically on international students' sense of security and belonging during the COVID-19 pandemic outbreak. The results revealed that students were most concerned about homesickness, which obtained the highest mean score. The regression results indicated that the perception of fear and discrimination significantly impacted international students' sense of security. The perception of fear, guilt, and how long the student stayed in China also significantly affected the sense of belonging. We argue that the reflections provided herein are essential for universities to improve how they manage and handle international students to mitigate the effects of acculturative stress, particularly when additional stressful conditions are present, such as the COVID-19 pandemic.

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A variety of approaches have been presented for assessing desirable responding in self-report measures. Among them, the overclaiming technique asks respondents to rate their familiarity with a large set of real and nonexistent items (foils). The application of signal detection formulas to the endorsement rates of real items and foils yields indices of (a) knowledge accuracy and (b) knowledge bias. This overclaiming technique reflects both cognitive ability and personality. Here, we develop an alternative measurement model based on multidimensional item response theory (MIRT). We report three studies demonstrating this new model's capacity to analyze overclaiming data. First, a simulation study illustrates that MIRT and signal detection theory yield comparable indices of accuracy and bias-although MIRT provides important additional information. Two empirical examples-one based on mathematical terms and one based on Chinese idioms-are then elaborated. Together, they demonstrate the utility of this new approach for group comparisons and item selection. The implications of this research are illustrated and discussed.