Barriers and Facilitators of International Health Care Students' Well-Being in Higher Education: Protocol for a Systematic Integrative Review

Background: International health care students encounter unique hurdles as they pursue education in foreign countries. These challenges, stemming from adjustment to new cultural environments and stressful academic programs, significantly impact their well-being. Understanding the barriers and facilitators experienced by international health care students is crucial for ensuring their successful integration into academic and professional spheres. Most existing reviews focus on specific populations or disciplines, thus limiting their generalizability. Objective: This systematic integrative review aims to provide a comprehensive understanding of barriers and facilitators of international health care students' well-being in higher education. Methods: The protocol follows the Joanna Briggs Institute's guidance for a mixed methods systematic review. The main information sources will include PubMed, Scopus, Web of Science, and EBSCOhost, supplemented with manual reference search and citation tracking using Google Scholar. The study selection will be done independently by 2 reviewers based on predetermined eligibility criteria. The study population will consist of international higher education students enrolled in human health-related disciplines including medicine, pharmacy, nursing, and allied health care fields. Qualitative and quantitative data relating to barriers and facilitators of international health care students' well-being will be extracted using a customized data extraction template in Covidence review management software. Quantitative data will be “qualitized” and integrated with qualitative data using a convergent integrated approach, as described in the Joanna Briggs Institute's guidance. The integrated data will then be synthesized using a thematic analysis approach to provide a comprehensive understanding of barriers and facilitators of international health care students' well-being. Results: The initial literature search yielded 2408 papers from the selected databases. The findings of this review will be presented in a narrative format, supported by visualizations such as tables and diagrams. The review is expected to be completed by December 2024. Conclusions: This systematic integrative review will identify barriers and facilitators of international health care students' well-being in higher education. The findings could inform the development of targeted interventions and support initiatives in higher education institutions globally, with the ultimate goal of enhancing the well-being as well as the academic and professional success of international health care students.