“…International nursing students with English as a Second Language (ESL) sometimes find they are unable to fully engage in their university studies and clinical placements as a result of communication difficulties (for example, see Chiang & Crickmore, 2009;Donnelly, McKiel, & Hwang, 2009;Guhde, 2003;Gunn-Lewis & Smith, 1999;Shakya & Horsfall, 2000;Starr, 2009). The factors contributing to their communication problems include: the range of language registers (from colloquial to specialist language), the physical environment (usually a noisy clinical placement or group-based tutorial/laboratory space), and communicative pressure (quickly, accurately, and under pressure) (Author, 2011).…”