Internationally Educated Nurse Integration as a Strategy to Support Health Workforce Transformation: A Realist Evaluation Protocol

Introduction: Globally, the COVID-19 pandemic has amplified nursing shortages. In Canada, there have been targeted efforts to address the critical issue of nursing recruitment and retention. In 2022, the province of Nova Scotia addressed this need by collaborating with intersectoral partners to support the recruitment and integration of internationally educated nurses (IENs). Methods and Analysis: We will use a realist evaluation approach (Pawson & Tilley, 1997) to explore the integration of IENs in Nova Scotia. Data will be collected via relevant document review and semi-structured interviews with selected IENs (n = 15–20) and partners that have supported IEN recruitment and integration (n = 15–20). Examples of partners include senior leaders [macro-level]; managers, clinical nurse educators [meso-level]; and preceptors [micro-level]. Interviews will be audio-recorded and transcribed verbatim. Data will be analyzed to generate context-mechanism-outcome configurations (CMOCs); with a focus on identifying specific strategies and contextual factors that promote successful integration for IENs. Ethics and Dissemination: This research study is led by a Health System Impact Postdoctoral Fellow, co-funded by the Canadian Institutes of Health Research (CIHR) and Nova Scotia Health. This research study has received approval from the Nova Scotia Health Research Ethics Board (#1030123). The findings from this evaluation will inform strategic nursing workforce planning in Nova Scotia and will also be of interest to health care leaders and decision-makers seeking strategies to improve targeted supports for IENs in other jurisdictions and other internationally educated health professionals.