A common concern of employers when considering whether to recruit healthcare team members from overseas is the issue of cultural difference. Cultural differences embody a range of factors such as: 

• Accent and ease of communication 
• Core nursing capabilities and Patient focus 
• The ability to gel well with other team members 

• The risk of “factionalism”  

  

Some of this can be assessed at interview – for example a patient’s core values and how easy the interviewer finds it to build a rapport with the candidate. However, if the region has a very strong accent or a very low proportion of non-native speakers, the communication skills of the candidate may be even more important.  

  

It is important to note that all international nurses must have demonstrated their English Language skills to a high degree (either via the IELTS or OET) prior to registering as a nurse, however the exam doesn’t always filter out those with a strong accent or account for a candidate working within an area that has a very strong local accent. (Following previously poor conversion rates, it is now standard across the industry to only interview candidates for nursing positions who have already attained their English Language test pass.) 

  

In terms of core nursing capabilities, this is assessed in a number of ways in the registration process for an international nurse: 

• The Nursing and Midwifery Council (NMC) review the candidate’s educational record in order to ensure their training was comparable. 
• They also administer a Test of Competence in two parts – an initial theory test called the “CBT (Computer Based Test) and a UK based OSCE Test (Objective Structured Clinical Examination) which involves a practical assessment of their clinical skills at an invigilated test environment. 
• International employers will also assess this at interview via various means including invigilated drug calculation tests and Scenario-based interview questions.  

 

As part of their assessments, the NMC do place a focus on patient-centred care. However, this concept can be quite different to certain candidates’ training and therefore an element of candidate adaptability must be considered and questions around this are common at interview. 

  

When it comes to onboarding new team members, it is important that cultural differences are acknowledged and appropriate ways of working are communicated. For example: Ensuring team members know it is important not to speak in their own language whilst on duty -either in front of patients or UK team members because it is excluding and breeds’ mistrust.  

 

Cultural differences also need to be called out, so they are recognised and accommodated – for example, noting that mental health treatment is very different in the Philippines (where it tends to very community oriented) to the UK (where interventional therapies and medication are much more common) so that it is clear a new and different way of working is required.  

 

Training materials should also be considered carefully and addressed throughout both new joiner training and also existing team member training to promote effective integration and minimise unconscious bias.  

  

Different healthcare organisations have different approaches to international recruitment – some will deliberately recruit from a wide range of countries to promote maximum diversity, whereas other employers may limit recruitment to just one or two countries. The variation in approach can be both a reflection of their own experience (“We know this works”) or a reflection of the make-up of their patient population. 

 

However, according to the King’s Fund, we need to do better at integrating and welcoming these individuals to our workforce: 

  

“The health and care workforce is one of the most diverse workforces in England, but the experience of staff from minority ethnic backgrounds does not match that of their white colleagues. Too often staff from ethnic minority backgrounds report far worse experiences than their white colleagues on witnessing or experiencing bullying and harassment, and availability of training and opportunities to progress…To ensure that all staff can be their best at work, serious attention needs to be given to improve diversity and inclusion at every level of the system, in national policies through to everyday practice in teams – from listening to staff and collecting regular data to understand staff experience, to taking action to address inequalities.” 

 

My Healthcare Recruit supports UK healthcare employers in the public, private, and care sector to find international nurses who are a great fit for their organization, by using market-leading video interviewing tools to connect them to our database of qualified candidates. Our innovative approach makes international candidates easier to find and more cost-effective to source than ever before. Find out more at www.myhealthcarerecruit.com.