{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:05:30Z","timestamp":1792425930189,"version":"4.5.0"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005967","name":"Linnaeus University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005967","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Nurs"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>To aid in the recertification and integration process of internationally educated nurses (IENs), many countries have organized bridging programs to provide support and education and align their knowledge and competence with local requirements. The importance and relevance of these programs for IENs are highlighted in related research. However, the experiences of university teachers, supervisors in clinical placement, and administrators organizing these programs are scarcely explored. The aim of this article is to explore the experiences of professional educators engaged in bridging programs at two universities in Sweden.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A descriptive qualitative approach was employed. The data were collected between December 2021 and March 2023 through semi-structured interviews with 15 educators involved in bridging programs at two universities in Sweden. The participants included university teachers, administrators, and supervisors in clinical placement. The data were analyzed using thematic analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Findings<\/jats:title>\n            <jats:p>The thematic analysis identified two main themes: (1) teaching a heterogeneous group of students and (2) organizational constraints of bridging programs. In relation to the first main theme, three subthemes were identified: educational and professional heterogeneity of IENs, varying language competencies of IENs and finding new approaches to teaching IENs. For the second main theme, three sub-themes were identified: compressed time in bridging programs, lack of resources for a time-consuming education and bridging programs as competition for resources.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>This study contributes to the understanding of the challenges associated with the recertification process of IENs through bridging programs from the perspective of educators. The findings highlight that educating a heterogeneous group of students, such as internationally educated nurses with differences in professional experience, knowledge and local language competencies, is time-consuming. Educators need to learn about the level of knowledge of the student group and individual learning needs and adapt the instructions accordingly, which is constrained by the organization of the programs. The findings also indicate that educators can find ways to mitigate these challenges and adapt their instructions to meet the needs of students. Therefore, it is important to allocate time and resources to running bridging programs and to support the cooperation and exchange of information between universities and clinics. We also suggest the need to increase the competency level of educators on how to support learning through a second language and enhancing collaboration with language instructors to ensure high-quality education for IENs.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12912-025-03414-0","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T09:02:23Z","timestamp":1751014943000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Professional educators\u2019 experiences teaching internationally educated nurses attending bridging programs: a qualitative interview study"],"prefix":"10.1186","volume":"24","author":[{"given":"Anna-Maria Sarstrand","family":"Marekovic","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emina","family":"Hadziabdic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e4ivi","family":"Juuso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristiina","family":"Heikkil\u00e4","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,27]]},"reference":[{"key":"3414_CR1","doi-asserted-by":"crossref","unstructured":"Kingma M. Nurses on the move: migration and the global health care economy. Cornell University Press; 2018.","DOI":"10.7591\/9781501726590"},{"key":"3414_CR2","doi-asserted-by":"publisher","first-page":"100154","DOI":"10.1016\/j.ijnsa.2023.100154","volume":"5","author":"C Pressley","year":"2023","unstructured":"Pressley C, Newton D, Garside J, Stephenson J, Mejia-Olivares J. Internationally recruited nurses and their initial integration into the healthcare workforce: A mixed methods study. Int J Nurs Stud Adv. 2023;5:100154.","journal-title":"Int J Nurs Stud Adv"},{"key":"3414_CR3","unstructured":"Socha-Dietrich K, Dumont J-C. International migration and movement of nursing personnel to and within OECD countries\u2013\u20092000 to 2018. 2021."},{"issue":"3","key":"3414_CR4","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1111\/inr.12787","volume":"69","author":"K Dahl","year":"2022","unstructured":"Dahl K, Nortvedt L, Schr\u00f8der J, Bj\u00f8rnnes AK. Internationally educated nurses and resilience: A systematic literature review. Int Nurs Rev. 2022;69(3):405\u201315.","journal-title":"Int Nurs Rev"},{"issue":"1","key":"3414_CR5","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.outlook.2013.11.001","volume":"62","author":"GD Sherwood","year":"2014","unstructured":"Sherwood GD, Shaffer FA. The role of internationally educated nurses in a quality, safe workforce. Nurs Outlook. 2014;62(1):46\u201352.","journal-title":"Nurs Outlook"},{"issue":"12","key":"3414_CR6","doi-asserted-by":"publisher","first-page":"4876","DOI":"10.1111\/jan.15054","volume":"77","author":"D H\u00f6gstedt","year":"2021","unstructured":"H\u00f6gstedt D, Engstr\u00f6m M, Eriksson E, Jansson I. Nurses\u2019 experiences of a recertification process involving a series of examinations to obtain a nursing license in a new country. J Adv Nurs. 2021;77(12):4876\u201386.","journal-title":"J Adv Nurs"},{"issue":"3","key":"3414_CR7","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1111\/inr.12430","volume":"65","author":"CL Covell","year":"2018","unstructured":"Covell CL, Primeau MD, St-Pierre I. Internationally educated nurses in canada: perceived benefits of bridging programme participation. Int Nurs Rev. 2018;65(3):400\u20137.","journal-title":"Int Nurs Rev"},{"issue":"4","key":"3414_CR8","first-page":"215","volume":"30","author":"Y Xu","year":"2012","unstructured":"Xu Y, He F. Transition programs for internationally educated nurses: what can the united States learn from the united kingdom, australia, and canada? Nurs Economic. 2012;30(4):215\u201324.","journal-title":"Nurs Economic"},{"issue":"16","key":"3414_CR9","doi-asserted-by":"publisher","first-page":"3441","DOI":"10.1080\/1369183X.2019.1592397","volume":"46","author":"M Walton-Roberts","year":"2020","unstructured":"Walton-Roberts M. Occupational (im) mobility in the global care economy: the case of foreign-trained nurses in the Canadian context. J Ethn Migr Stud. 2020;46(16):3441\u201356.","journal-title":"J Ethn Migr Stud"},{"issue":"1","key":"3414_CR10","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/s12912-020-00525-8","volume":"20","author":"E Hadziabdic","year":"2021","unstructured":"Hadziabdic E, Marekovic AS, Salomonsson J, Heikkil\u00e4 K. Experiences of nurses educated outside the European union of a Swedish bridging program and the program\u2019s role in their integration into the nursing profession: a qualitative interview study. BMC Nurs. 2021;20(1):7.","journal-title":"BMC Nurs"},{"issue":"4","key":"3414_CR11","first-page":"1092","volume":"22","author":"EV Cruz","year":"2017","unstructured":"Cruz EV, Felicilda-Reynaldo RF, Mazzotta CP. Return to nursing: A Meta-Synthesis of academic bridging programs\u2019 effects on internationally educated nurses. Qualitative Rep. 2017;22(4):1092\u2013111.","journal-title":"Qualitative Rep"},{"key":"3414_CR12","doi-asserted-by":"crossref","unstructured":"Connelly DM, Guitar NA, Atkinson AN, Janssen SM, Snobelen N. Learnings from nursing bridging education programs: a scoping review. Nurse Educ Pract 2023:103833.","DOI":"10.1016\/j.nepr.2023.103833"},{"key":"3414_CR13","unstructured":"Bengtsson A, Viberg A. Etablering Efter kompletterande Utbildning\u2013 personer med Utl\u00e4ndsk Utbildning. In.; 2019:3."},{"key":"3414_CR14","doi-asserted-by":"publisher","first-page":"104744","DOI":"10.1016\/j.nedt.2021.104744","volume":"99","author":"D H\u00f6gstedt","year":"2021","unstructured":"H\u00f6gstedt D, Engstr\u00f6m M, Jansson I, Eriksson E. Attending a bridging program to obtain a Swedish nursing license: an interview study with internationally educated nurses. Nurse Educ Today. 2021;99:104744.","journal-title":"Nurse Educ Today"},{"key":"3414_CR15","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1111\/jonm.12617","volume":"26","author":"E Eriksson","year":"2018","unstructured":"Eriksson E, Engstr\u00f6m M. Internationally educated nurses\u2019 descriptions of their access to structural empowerment while working in another country\u2019s health care context. J Nurs Adm Manag. 2018;26:866\u201373.","journal-title":"J Nurs Adm Manag"},{"issue":"8","key":"3414_CR16","doi-asserted-by":"publisher","first-page":"370","DOI":"10.3928\/00220124-20120615-62","volume":"43","author":"L Atack","year":"2012","unstructured":"Atack L, Cruz EV, Maher J, Murphy S. Internationally educated nurses\u2019 experiences with an integrated Bridge program. J Contin Educ Nurs. 2012;43(8):370\u20138.","journal-title":"J Contin Educ Nurs"},{"issue":"4","key":"3414_CR17","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1111\/jnu.12147","volume":"47","author":"G Suva","year":"2015","unstructured":"Suva G, Sager S, Mina ES, Sinclair N, Lloyd M, Bajnok I, Xiao S. Systematic review: bridging the gap in RPN-To\u2010RN transitions. J Nurs Scholarsh. 2015;47(4):363\u201370.","journal-title":"J Nurs Scholarsh"},{"issue":"4","key":"3414_CR18","doi-asserted-by":"publisher","first-page":"e12311","DOI":"10.1111\/nin.12311","volume":"26","author":"MS Choi","year":"2019","unstructured":"Choi MS, Cook CM, Brunton MA. Power distance and migrant nurses: the liminality of acculturation. Nurs Inq. 2019;26(4):e12311.","journal-title":"Nurs Inq"},{"issue":"5","key":"3414_CR19","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1177\/0193945919860855","volume":"42","author":"LV Ghazal","year":"2020","unstructured":"Ghazal LV, Ma C, Djukic M, Squires A. Transition-to-U.S. Practice experiences of internationally educated nurses: an integrative review. West J Nurs Res. 2020;42(5):373\u201392.","journal-title":"West J Nurs Res"},{"issue":"1","key":"3414_CR20","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.outlook.2017.07.007","volume":"66","author":"CB Jones","year":"2018","unstructured":"Jones CB, Toles M, Knafl GJ, Beeber AS. An untapped resource in the nursing workforce: licensed practical nurses who transition to become registered nurses. Nurs Outlook. 2018;66(1):46\u201355.","journal-title":"Nurs Outlook"},{"key":"3414_CR21","doi-asserted-by":"publisher","first-page":"106100","DOI":"10.1016\/j.nedt.2024.106100","volume":"135","author":"M-M Juntunen","year":"2024","unstructured":"Juntunen M-M, Kamau S, Oikarainen A, Koskenranta M, Kuivila H, Ropponen P, Mikkonen K. The experiences and perceptions of nurse educators of culturally and linguistically diverse nursing students\u2019 competence development\u2013Qualitative study. Nurse Educ Today. 2024;135:106100.","journal-title":"Nurse Educ Today"},{"key":"3414_CR22","doi-asserted-by":"publisher","first-page":"104348","DOI":"10.1016\/j.nedt.2020.104348","volume":"87","author":"P Hagqvist","year":"2020","unstructured":"Hagqvist P, Oikarainen A, Tuomikoski A-M, Juntunen J, Mikkonen K. Clinical mentors\u2019 experiences of their intercultural communication competence in mentoring culturally and linguistically diverse nursing students: A qualitative study. Nurse Educ Today. 2020;87:104348.","journal-title":"Nurse Educ Today"},{"issue":"5","key":"3414_CR23","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1016\/j.colegn.2018.01.005","volume":"25","author":"L Newton","year":"2018","unstructured":"Newton L, Pront LM, Giles TM. Registered nurses\u2019 experiences supervising international nursing students in the clinical setting. Collegian. 2018;25(5):533\u201340.","journal-title":"Collegian"},{"key":"3414_CR24","doi-asserted-by":"publisher","first-page":"104934","DOI":"10.1016\/j.nedt.2021.104934","volume":"102","author":"R Hari","year":"2021","unstructured":"Hari R, Geraghty S, Kumar K. Clinical supervisors\u2019 perspectives of factors influencing clinical learning experience of nursing students from culturally and linguistically diverse backgrounds during placement: A qualitative study. Nurse Educ Today. 2021;102:104934.","journal-title":"Nurse Educ Today"},{"key":"3414_CR25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12909-015-0458-3","volume":"15","author":"SL O\u2019Reilly","year":"2015","unstructured":"O\u2019Reilly SL, Milner J. Supporting culturally and linguistically diverse students during clinical placement: strategies from both sides of the table. BMC Med Educ. 2015;15:1\u201312.","journal-title":"BMC Med Educ"},{"key":"3414_CR26","doi-asserted-by":"publisher","first-page":"105975","DOI":"10.1016\/j.nedt.2023.105975","volume":"131","author":"E Eriksson","year":"2023","unstructured":"Eriksson E, H\u00f6gstedt D, Engstr\u00f6m M, Jansson I. Preceptors\u2019 experiences of supervising internationally educated nurses attending a bridging program: an interview study. Nurse Educ Today. 2023;131:105975.","journal-title":"Nurse Educ Today"},{"key":"3414_CR27","doi-asserted-by":"publisher","first-page":"100083","DOI":"10.1016\/j.ijnsa.2022.100083","volume":"4","author":"C Pressley","year":"2022","unstructured":"Pressley C, Newton D, Garside J, Simkhada P, Simkhada B. Global migration and factors that support acculturation and retention of international nurses: a systematic review. Int J Nurs Stud Adv. 2022;4:100083.","journal-title":"Int J Nurs Stud Adv"},{"key":"3414_CR28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12909-018-1399-4","volume":"18","author":"E Eriksson","year":"2018","unstructured":"Eriksson E, Berg S, Engstr\u00f6m M. Internationally educated nurses\u2019 and medical graduates\u2019 experiences of getting a license and practicing in Sweden\u2013a qualitative interview study. BMC Med Educ. 2018;18:1\u201314.","journal-title":"BMC Med Educ"},{"key":"3414_CR29","unstructured":"Common European Framework of Reference for Languages. Learning, teaching, assessment\u2013 Companion volume [https:\/\/rm.coe.int\/common-european-framework-of-reference-for-languages-learning-teaching\/16809ea0d4]"},{"key":"3414_CR30","doi-asserted-by":"publisher","first-page":"237796082513139","DOI":"10.1177\/23779608251313901","volume":"11","author":"E Hadziabdic","year":"2025","unstructured":"Hadziabdic E, \u00c5restedt K, Juuso P, Marekovic A-MS, Heikkil\u00e4 K. Demographic and social characteristics of internationally educated nurses in sweden: descriptive statistical study comparisons between two different pathways for recertification. SAGE Open Nurs. 2025;11:23779608251313901.","journal-title":"SAGE Open Nurs"},{"issue":"5","key":"3414_CR31","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1177\/1744987119880234","volume":"25","author":"L Doyle","year":"2020","unstructured":"Doyle L, McCabe C, Keogh B, Brady A, McCann M. An overview of the qualitative descriptive design within nursing research. J Res Nurs. 2020;25(5):443\u201355.","journal-title":"J Res Nurs"},{"issue":"2","key":"3414_CR32","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","volume":"3","author":"V Braun","year":"2006","unstructured":"Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Res Psychol. 2006;3(2):77\u2013101.","journal-title":"Qualitative Res Psychol"},{"key":"3414_CR33","volume-title":"Tolkning, f\u00f6rst\u00e5else, vetande: hermeneutik i Teori och praktik, 3 Edn","author":"P-J \u00d6dman","year":"2016","unstructured":"\u00d6dman P-J. Tolkning, f\u00f6rst\u00e5else, vetande: hermeneutik i Teori och praktik, 3 Edn. Lund: Studentlitteratur; 2016."},{"key":"3414_CR34","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1080\/00313831.2021.2021444","volume":"67","author":"M Hietanen","year":"2022","unstructured":"Hietanen M, Svedholm-H\u00e4kkinen AM. Transition to distance education in 2020 \u2013 Challenges among university faculty in Sweden. Scandinavian J Educational Res. 2022;67:433\u201346.","journal-title":"Scandinavian J Educational Res"},{"key":"3414_CR35","doi-asserted-by":"crossref","unstructured":"Rosenb\u00e4ck R, Lantz B, Ros\u00e9n P. Hospital staffing during the COVID-19 pandemic in Sweden. Healthc (Basel) 2022, 10(10).","DOI":"10.3390\/healthcare10102116"},{"key":"3414_CR36","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/j.nedt.2016.02.013","volume":"40","author":"K Mikkonen","year":"2016","unstructured":"Mikkonen K, Elo S, Tuomikoski A-M, K\u00e4\u00e4ri\u00e4inen M. Mentor experiences of international healthcare students\u2019 learning in a clinical environment: A systematic review. Nurse Educ Today. 2016;40:87\u201394.","journal-title":"Nurse Educ Today"},{"issue":"3","key":"3414_CR37","first-page":"1555","volume":"13","author":"H Ruvang","year":"2020","unstructured":"Ruvang H, Koskinen M, Mikkonen K, Sj\u00f6gren T, Korpi H, Koivula M, Koskim\u00e4ki M, L\u00e4hteenm\u00e4ki M-L, Sormunen M, Saaranen T. Social-and health care educators\u2019 cultural competence. Int J Caring Sci. 2020;13(3):1555\u201362.","journal-title":"Int J Caring Sci"},{"issue":"1","key":"3414_CR38","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.colegn.2022.05.006","volume":"30","author":"E Lim","year":"2023","unstructured":"Lim E, Kalembo F, Bosco A, Ngune I, Adebayo B, Brown J. It\u2019s not their fault: clinical facilitators\u2019 experiences supporting english as second Language students. Collegian. 2023;30(1):9\u201316.","journal-title":"Collegian"},{"issue":"4","key":"3414_CR39","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.nepr.2015.02.006","volume":"15","author":"A Abu-Arab","year":"2015","unstructured":"Abu-Arab A, Parry A. Supervising culturally and linguistically diverse (CALD) nursing students: A challenge for clinical educators. Nurse Educ Pract. 2015;15(4):e1\u20139.","journal-title":"Nurse Educ Pract"},{"issue":"19\u201320","key":"3414_CR40","doi-asserted-by":"publisher","first-page":"3669","DOI":"10.1111\/jocn.14968","volume":"28","author":"M Brunton","year":"2019","unstructured":"Brunton M, Cook C, Kuzemski D, Brownie S, Thirlwall A. Internationally qualified nurse communication\u2014A qualitative cross country study. J Clin Nurs. 2019;28(19\u201320):3669\u201379.","journal-title":"J Clin Nurs"},{"key":"3414_CR41","doi-asserted-by":"crossref","unstructured":"Lum L, Vu J. How official Language and country of origin impacts health workforce integration in Canada. Med Res Archives 2020, 8(6).","DOI":"10.18103\/mra.v8i6.2146"},{"issue":"2","key":"3414_CR42","doi-asserted-by":"publisher","first-page":"e13038","DOI":"10.1111\/inr.13038","volume":"72","author":"F Cubelo","year":"2025","unstructured":"Cubelo F, Parviainen A, Kohanov\u00e1 D. The impact of bridging education programs on internationally educated nurses becoming registered nurses in high-income countries: A mixed\u2010methods systematic review. Int Nurs Rev. 2025;72(2):e13038.","journal-title":"Int Nurs Rev"}],"container-title":["BMC Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12912-025-03414-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12912-025-03414-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12912-025-03414-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T09:02:30Z","timestamp":1751014950000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcnurs.biomedcentral.com\/articles\/10.1186\/s12912-025-03414-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,27]]},"references-count":42,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3414"],"URL":"https:\/\/doi.org\/10.1186\/s12912-025-03414-0","relation":{},"ISSN":["1472-6955"],"issn-type":[{"value":"1472-6955","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,27]]},"assertion":[{"value":"2 July 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 June 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical vetting was sought and approved by the Swedish Ethical Review Authority (No. 2021\u201303844). The research was conducted in accordance with the principles outlined in the revised Declaration of Helsinki. Participants were provided with both written and verbal information about the study and the management of their personal data as well as their right to decline participation at any time. Informed consent was obtained and documented prior to each interview.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"672"}}