Empowering International Students to Succeed

An Innovative and Beneficial Initiative for Health Professions





academic success, coping, dietetics


International students report higher sociocultural and academic stress when settling into a new university compared with their local counterparts. Three disciplines in the health professions collaborated to create a transition program addressing international student health and well-being in Australia. Commencing students and senior student mentors participated in a four-session program of activities to reflect on their current study/work practices and learn self-management strategies. They developed plans for coping with cultural, language, academic, and social barriers, and assisted in improving physical and mental health and well-being. Of the 26 participants who attended sessions, 15 participated in in-depth interviews. Facilitating adjustment, establishing relationships, gaining new skills and knowledge, and transforming beliefs and behavior were the four themes identified that captured and explicated the impact of the initiative. Although limited by the number of student participants, the program demonstrated a positive impact in creating a supportive learning environment for international students.

Author Biographies

Joy Penman, Monash University, Australia

JOY PENMAN, PhD, Senior Lecturer in Nursing and Midwifery, Monash University. Her major research interests lie in the area of higher education teaching and research, palliative, spiritual and pastoral care and migrant health.

Gulzar Malik, Monash University & La Trobe University

GULZAR MALIK, PhD, Senior Lecturer in Nursing and Midwifery, La Trobe University. Her major research interests lie in the areas of evidence-based practice, non-pharmacological pain management, Collaborative online international learning, flipped classroom and international students.

Eli Chu, Monash University, Australia

MAND YEE ELI CHU, PhD, Senior Lecturer, Department of Occupational Therapy, School of Primary and Allied Health Care Monash University. Her major research interests lie in the areas of simulation-based education, higher education research, occupational therapy professional practice education, rehabilitation, health outcomes and multiculturalism.

Giselle Kett, Monash University Australia

GISELLE KETT, MA(AppLing), is a lecturer in the Student Academic Support Unit in the Faculty of Medicine, Nursing and Health Sciences at Monash University. Her major research interests lie in the area of academic literacies, academic integrity, higher education research, discipline specific language acquisition, healthcare communication, and English as an additional language (EAL).

Kerry Hampton, kerry.hampton@monash.edu

KERRY HAMPTON, PhD, is a specialist in natural fertility care and lecturer in the school of nursing and midwifery at Monash University. Her major research interests lie in the areas of fertility awareness, family planning and primary healthcare.

Nikos Thomacos, Monash University Australia

NIKOS THOMACOS, PhD, is a Senior Lecturer in the Occupational Therapy Department at Monash University. His major research interests lie in the areas of social support and supportive relationships across the lifespan; ageing, retirement, and transition, and well-being; and, mental health and well-being of minority and marginalised populations.

Maya Ebrahimi-Zanjani, Monash University Australia

Maya Ebrahimi-Zanjani, PhD is a lecturer at Monash University. Her major interests lie in the area of ageing.

Yaping Zhong, Monash University Australia

Yaping Zhong, PhD, Teaching associate, Research interests: the transition experience of migrant nurses, resilience of international students in tertiary education, and education of clinical nursing specialists.

Wendy McKenzie, Monash University Australia

WENDY McKenzie, PhD, PhD, is an Adjunct Associate Professor (Education-focused) in the Faculty of Medicine, Nursing & Health Sciences at Monash University. Her major research interests are educational and cognitive psychology.


Alharbi, E. S., & Smith, A. P. (2018). Review of the literature on stress and well-being of international students in English-speaking countries. International Education Studies, 11(6), 22-44. https://doi.org/10.5539/ies.v11n6p22

Andrade, M. S. (2006). International students in English-speaking universities: Adjustment factors. Journal of Research in International Education, 5(2), 131-154. https://doi.org/10.1177/1475240906065589

Andrade, M. S. (2009). The value of a first year seminar: International students’ insights in retrospect. Journal of College Student Retention, 10, 483-506. https://doi.org/10.2190/CS.10.4.e

Bai, J. (2016). Perceived support as a predictor of acculturative stress among international students in the United States. Journal of International Students, 6, 93-106. http://jistudents.org/

Baker, G. & Hawkins, K. (2006). The international student journey [online]. Australian Universities’ Review, 48(2), 20-25. https://search.informit.com.au/documentSummary;dn=148783682709892;res=IELHSS> ISSN: 0818-8068

Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191–215.

Bandura, A. (2019). Applying theory for human betterment. Perspectives on Psychological Science, 14(1), 12-15. https://doi.org/10.1177/1745691618815165

Briggs, P., & Ammigan, R. (2017). A collaborative programming and outreach model for international student support offices. Journal of International Students, 7(4), 1080-1095. https://doi.org/10.5281/zenodo.1035969

Brunsting, N. C., Smith, A. C., & Zachry, C. (2018). An academic and cultural transition course for international students: Efficacy and socio-emotional outcomes. Journal of International Students, 8(4), 1497-1521. https://doi.org/10.5281/zenodo.1467805

Clarke, V., Braun, V., Terry, G. & Hayfield, N. (2019). Thematic analysis. In P. Liamputtong, (Ed.), Handbook of research methods in health and social sciences (pp. 843-860). Springer.

Colvin, J. W., & Ashman, M. (2010). Roles, risks, and benefits of peer mentoring relationships in higher education. Mentoring & Tutoring: Partnership in Learning, 18(2), 121–134. https://doi.org/10.1080/13611261003678879

Council of Australian Governments [COAG] (2010). International students strategy for Australia: 2010-2014. https://apo.org.au/system/files/23118/apo-nid23118-25546.pdf.

Creswell, J. W. (2009). Research design: Qualitative, quantitative, and mixed methods approaches (3rd ed.). Sage Publications.

Department of Education and Training. (2018). International student data monthly summary. https://internationaleducation.gov.au/research/International-Student-Data/Documents/MONTHLY%20SUMMARIES/2018/Jun%202018%20MonthlyInfographic.pdf

Department of Health and Ageing. (2013). Eat for Health: Australian Dietary Guidelines. https://www.eatforhealth.gov.au/sites/default/files/content/n55_australian_dietary_guidelines.pdf

Forbes-Mewett, H. & Sawyer, A. M. (2011, November). Mental health issues amongst international students in Australia: Perspectives from professionals at the coal-face [Paper presentation]. The Australian Sociological Association Conference Local Lives/Global Networks, University of Newcastle, New South Wales, Australia.

Forbes-Mewett, H., & Sawyer, A. M. (2016). International students and mental health. Journal of International Students, 6(3), 661-677. https://files.eric.ed.gov/fulltext/EJ1100336.pdf

Goodwin, J., Behan, L., Kelly, P., McCarthy, K., & Horgan, A. (2016). Help-seeking behaviors and mental well-being of first year undergraduate university students. Psychiatry Research, 246, 129-135. https://doi.org/10.1016/j.psychres.2016.09.015

He, F. X., Lopez, V., & Leigh, M.C. (2012). Perceived acculturative stress and sense of coherence in Chinese nursing students in Australia. Nurse Education Today, 32(4), 345-350. https://doi.org/10.1016/j.nedt.2011.05.004

Hendrickson, B., Rosen, D., & Aune, R.K. (2011) An analysis of friendship networks, social connectedness, homesickness, and satisfaction levels of international students. International Journal of Intercultural Relations, 35, 281-295.


Hirai, R., Frazier, P., & Syed, M. (2015). Psychological and sociocultural adjustment of first-year international students: Trajectories and predictors. Journal of Counselling Psychology, 62(3), 438-452. https://doi.org/10.1037/cou0000085

Johnson, L. R., Seifen-Adkins, T., Sandhu, D. S., Arbles, N., & Makino, H. (2018). Developing culturally appropriate programs to promote international student adjustment: A participatory approach. Journal of International Students, 8(4), 865-1878. https://doi.org/10.5281/zenodo.1468100

Khawaja, N. G., & Dempsey, J. (2008). A comparison of international and domestic tertiary students in Australia. Journal of Psychologists and Counsellors in Schools, 18(1), 30-46. https://doi.org/10.1375/ajgc.18.1.30

Krause, K. L. (2006, May). Transition to and through the first year: Strategies to enhance the student experience [Keynote presentation]. Inaugural Vice-Chancellor’s Learning and Teaching Colloquium, University of the Sunshine Coast, Queensland, Australia.

Marginson, S., Nyland, C., Sawir, E., & Forbes-Mewett, H. (2010). International student security (1st ed.). Cambridge University Press.

Martin, J. M. (2010). Stigma and student mental health in higher education. Higher Education Research & Development, 29, 259-274. https://doi.org/ 10.1080/07294360903470969

McKenna, L., & Copnell, B. (2018). Fundamentals of nursing and midwifery research: a practical guide for evidence-based practice. Allen & Unwin.

McKenna, L., Robinson, E., Penman, J., & Hills, D. (2017). Factors impacting on psychological well-being of international students in the health professions: A scoping review. International Journal of Nursing Studies, 74, 85-94. https://doi.org/ 10.1016/j.ijnurstu.2017.06.007

McLachlan, D. A., & Justice, J. (2009). A grounded theory of international student well-being. Journal of Theory Construction and Testing, 13(1), 27-32.

Mitchie, S., West, R., Campbell, R., Brown, J., & Gainforth, H. (2014). ABC of behaviour change theories. Silverback Publishing.

NEWSTART. (2020). The NEWSTART program. https://www.newstart.com/

Penman, J. (2015). Empowering female immigrant nurses to care for their own mental health [Paper presentation]. 26th International Nursing Research Congress, Sigma Theta Tau International Honor Society of Nursing, San Juan, Puerto Rico.

Penman, J., Goel, K., & Sathasilvam, S. (2019). Exploring the value of a university-driven mental health self-management programme. Rural Society, 28(3), 198-211. https://research.monash.edu/en/publications/exploring-the-value-of-a-university-driven-mental-health-self-man

Polit, D. F. & Beck, C. T. (2018). Essentials of nursing research: appraising evidence for nursing practice, 9th ed. Wolters Kluwer.

Redfern, K. (2016). An empirical investigation of the incidence of negative psychological symptoms among Chinese international students at an Australian university. Australian Journal of Psychology, 68, 281-289. https://doi.org/10.1111/ajpy.12106

Roberts, P., & Dunworth, K. (2012). Staff and student perceptions of support services for international students in higher education: a case study. Journal of Higher Education Policy and Management, 34(5), 517–528. https://doi.org/10.1080/1360080X.2012.716000

Ryan, M. E. & Twibell, R. S. (2000). Concerns, values, stress, coping, health and educational outcomes of college students who studied abroad. International Journal of Intercultural Relations, 24(4), 409–435. https://doi.org/10.1016/S0147-1767(00)00014-6

Ryan, R., Dowler, B., Bruce, S., Gamage, S., & Morris, A. (2016). The wellbeing of international students in the city of Sydney. University of Technology Sydney, Institute for Public Policy and Governance, Sydney. https://opus.lib.uts.edu.au/handle/10453/72289

Sherry, M., Thomas, P., & Chui, W.H. (2010). International students: A vulnerable student population. Higher Education, 60(1), 33-46. https://doi.org/10.1007/s10734-0099284-2

Sit, A., Mak, A. S., & Neill, J. T. (2017). Does cross-cultural training in tertiary education enhance cross-cultural adjustment? A systematic review. International Journal of Intercultural Relations, 57, 1–18. https://doi.org/10.1016/j.ijintrel.2017.01.001

Smith, R.A., & Khawaja, N.G. (2011a). A group psychological intervention to enhance the coping and acculturation of international students. Advances in Mental Health, 12, 110-124. https://doi.org/10.1007/s10897-013-9661-8

Smith, R. A., & Khawaja, N. G. (2011b). A review of the acculturation experiences of international students. International Journal of Intercultural Relations, 35(6), 699–713. https://doi.org/10.1016/j.ijintrel.2011.08.004

Staying well. (2018). Managing symptoms of anxiety, depression and suicide. Beyond Blue. https://www.beyondblue.org.au/get-support/staying-well

Sullivan, C., & Kashubeck-West, S. (2015). The interplay of international ’students’ acculturative stress, social support, and acculturation modes. Journal of International Students, 5(1), 1–11. http://jistudents.org/

Thomson, C., & Esses, V. (2016). Helping the transition: Mentorship to support international students in Canada. Journal of International Students, 6(4), 873-886. http://search.proquest.com/docview/1861791247/

Thomson, G., Rosenthal, D., & Russell, J. (2006). Cultural stress among international students at an Australian university [Paper presentation]. Australian International Education Conference. http://aied.idp.com/uploads/pdf/Thomson%20(paper)%20Fri%201050%20MR5.pdf

Tolman, S. (2017). The effects of a roommate-pairing program on international student satisfaction and academic success. Journal of International Students, 7(3), 522-541. https://doi.org/10.5281/zenodo.570013

Townsend, P., & Poh, J. (2008). An exploratory study of international students studying and living in a regional area. Journal of Marketing for Higher Education, 18(2), 240-260. https://doi.org/10.1080/08841240802487411

Toyokawa, T., & Toyokawa, N. (2002). Extracurricular activities and the adjustment of Asian international students: A study of Japanese students. International Journal of Intercultural Relations, 26, 363-379. https://doi.org/10.1016/s0147-1767(02)00010-x

Universities Australia. (2019). Higher Education: Facts and figures - July 2019. Canberra, Australia: https://www.universitiesaustralia.edu.au/wp-content/uploads/2019/08/190716-Facts-and-Figures-2019-Final-v2.pdf

Van Der Riet, P., Rossiter, R., Kirby, D., Dluzewska, T., & Harmon, C. (2015). Piloting a stress management and mindfulness program for undergraduate nursing students: Student feedback and lessons learned. Nurse Education Today, 35(1), 44-49.

Whitehead, D. & Whitehead, L. (2016). Sampling data and data collection in qualitative research. In Z. Schneider, D. Whitehead, G. LoBiondo-Wood, & J. Haber, Nursing and Midwifery research methods and appraisal for evidence-based practice (5th ed) (pp. 111-126). Elsevier, Australia.

Yeh, C. J., & Inose, M. (2003). International students’ reported English fluency, social support satisfaction, and social connectedness as predictors of acculturative stress. Counselling Psychology Quarterly, 16(1), 15-28. https://doi.org/10.1080/0951507031000114058

Zhang, J. & Goodson, P. (2011). Acculturation and psychosocial adjustment of Chinese international students: Examining mediation and moderation effects. International Journal of Intercultural Relations, 35, 614-627. https://doi.org/10.1016/j.ijintrel.2010.11.004



How to Cite

Penman, J., Malik, G. ., Chu, E., Kett, G. ., Hampton, K., Thomacos, N. ., Ebrahimi-Zanjani, M. ., Zhong, Y., & McKenzie, W. . (2021). Empowering International Students to Succeed: An Innovative and Beneficial Initiative for Health Professions . Journal of International Students, 11(4), 832–852. https://doi.org/10.32674/jis.v11i4.2226



Research Articles (English)