This paper reports on the design, delivery and evaluation of a pilot oral communication skills program for first year students in a Bachelor of Nursing (BN) degree at an Australian university. This program was introduced in 2004 to meet the needs of first year undergraduate students from non-English speaking backgrounds who had experienced difficulties with spoken English while on clinical placement in hospitals. The program consisted of early identification of students in need of language development, a series of language classes incorporated into the degree program to address students' needs and a clinical placement block at the completion of the language classes. The paper describes how the program was integrated into the BN , discusses some of the major problems students faced in the clinical setting, and presents some of the teaching strategies used in the language program to address these problems. Finally the paper discusses evaluations of the program, which suggest that students' language skills and confidence improved as a result of the language classes, resulting in a more positive clinical experience for the majority of students.

Nurses of ethnically diverse backgrounds are essential in providing multicultural populations in western societies with culturally and linguistically competent health care. However, many nurses from non-English speaking backgrounds (NESB) are at high risk of failure in university programs particularly during clinical placements. Few studies investigate the clinical experiences of students from NESB and strategies to support their learning. This study describes perceptions of fifteen undergraduate nursing students from NESB about their first clinical placement in an Australian university program and the effect of a language support program on their oral clinical communication skills. Three categories arose: *Wanting to belong but feeling excluded; *Wanting to learn how to...; and *You find yourself. While many students find clinical placement challenging, it appeared difficult for students in this study as language and cultural adjustments required some modification of their usual ways of thinking and communicating, often without coping strategies available to other students.

Students from culturally and linguistically diverse backgrounds play a valuable role in meeting the health care needs of multi-ethnic and multi-lingual societies. However, such students may face challenges during clinical placements due to difficulties with spoken communication. This paper is a report of an evaluation of the long-term effects of a language programme that aimed to improve students' spoken communication on clinical placements. Final year students who had completed the programme in the first year of their undergraduate degree were interviewed about their experiences of clinical placements and their perceptions of any long-term effects of the programme. The results suggest that early intervention language programmes may contribute to greater confidence and success for students. However, there is a need for further language programmes for some students as well as institutional changes to improve students' clinical learning experiences.

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Many nursing students for whom English is a second language (ESL) face challenges related to communication on clinical placement and although clinical facilitators are not usually trained language assessors, they are often in a position of needing to assess ESL students' clinical language performance. Little is known, however, about the particular areas of clinical performance facilitators focus on when they are assessing ESL students. This paper discusses the results of a study of facilitators' written assessment comments about the clinical performance of a small group of ESL nursing students over a two and a half year period. These comments were documented on students' clinical assessment forms at the end of each placement. The results provide a more detailed insight into facilitators' expectations of students' language performance and the particular challenges faced by ESL students and indicate that facilitators have clear expectations of ESL students regarding communication, learning styles and professional demeanour. These findings may help both ESL students and their facilitators better prepare for clinical placement.