Teacher and students setting around a table in an office meeting room.
Evdoxia Tsimika-Chronis, standing left, and Dr. Ryan Cate Gibson, standing right, lead a session of E2: Engage & Excel, a multifaceted support system for students in The University of Alabama in Huntsville’s (UAH) College of Nursing.

Nursing programs prepare students to enter a profession where a mistake, such as a misunderstood word, could mean life or death. To ensure its students have the literacy, coping and other skills to thrive in this challenging learning environment, the UAH College of Nursing created E2: Engage & Excel.

This unique-to-UAH program grew out of the needs of a group of highly motivated students who were non-native English speakers. Dr. Karen Frith, dean of the College of Nursing, believed they would make excellent nurses, and she didn’t want to lose them. But their English proficiency could have been a barrier.

“These students needed to develop better auditory discrimination and to also have a more intelligible pronunciation when they were speaking to their patients or co-workers,” says Evdoxia Tsimika-Chronis, lead instructor for E2.

“If somebody tells you quickly ‘50 milliliters’ and you hear ‘15 milliliters,’ or if you’re a non-native speaker with a heavy accent and you’re trying to tell someone 50 but the other person is hearing 15 because the words are not clearly articulated, it can be very dangerous.”

The multifaceted support system started with Dr. Andrea Word and Dr. Ryan Cate Gibson, who were affiliated with the Language and Culture Program in the UAH Office of International Services. Later, Tsimika-Chronis joined the program. Cate Gibson’s doctoral thesis included the literacy programming that they developed for E2.

Launched in spring 2016, the program initially focused on non-native speakers of English but grew to include native speakers. The instructors soon realized that E2 was making a big difference in graduation rates. Not only did students who used E2 services graduate with a B.S. in nursing, but many also completed graduate degrees in nursing.

“Our retention numbers were going through the roof,” Cate Gibson says. “The College of Nursing added a doctoral program at that time, and we also provided mentoring and support to their doctoral students who were non-native. We still do that.”

The typical retention rate for students who attend E2 sessions is approximately 90% to 95%, according to Frith. Citing research published in Teaching and Learning in Nursing, she notes that this far exceeds typical retention rates of about 50% for non-native English speakers.

The success of E2 brings highly qualified nurses who are bilingual or multilingual speakers into communities that need their care, she says.

E2 clients include undergraduates, graduate-level students and faculty members. Some are recommended for the program; others decide on their own to seek assistance. For non-native English speakers, E2 provides instruction in accent modification, language accuracy, cross-cultural topics in learning and education, and thesis and dissertation presentation assistance. The program gives native speakers the chance to improve their literacies, including but not limited to comprehension of material, retention of information and application of knowledge, and professional behavioral applications.

But E2 offers more than literacy instruction, Cate Gibson says.

“We come at everything from a holistic perspective. It’s about how you can balance the needs of your career, your family and your community with your language capacity, your communicative capacity and your engagement. I believe the holistic component is what differentiates the E2 from other support systems used in nursing colleges across the world.”



Kristina Hendrix