Learning to thrive in transcultural nursing education: A Constructivist Grounded Theory approach

Global nursing education increasingly emphasizes cross-cultural competence development through international exchanges. While existing research highlights that cross-cultural training enhances nursing students' language proficiency, clinical skills, and cultural awareness in the short term, less is known about their long-term professional and personal growth.

This study explored the growth trajectory of Chinese nursing students in Sino-U.S. exchange program, focusing on their experiences and transitions.

A constructivist grounded theory approach was employed.

This study examined Chinese nursing students who completed a one-year, three-semester program at a U.S. nursing school during their junior year.

From October to December 2024, 15 Chinese nursing students were recruited using purposive and theoretical sampling methods. Eligible participants had completed a one-year Sino-U.S. nursing exchange program during their junior year (program period: 2015-2024), with the length of time since program completion ranging from 1 to 8 years (mean ± standard deviation: 5.47 ± 2.23 years).

Semi-structured interviews were conducted via Zoom, exploring participants' growth trajectories. Data analysis followed constructivist grounded theory, using constant comparison to progress from initial to theoretical coding, identifying core concepts.

Fifteen participants were included in the study. Analysis of the interview data generated four theoretical codes: (1) Self-Awaking, (2) Self-Responsibility, (3) Self-Empowerment, and (4) Self-Expansion-along with ten focused codes. These codes collectively formed the 4S Spiral Growth Model (4S-SGM) within the context of transcultural nursing education.

This study employed Constructivist Grounded Theory to examine nursing students' personal growth after studying abroad. It introduces a novel model illustrating the impact of international exchange on their development. The findings offer practical insights for improving exchange programs and provide empirical support for fostering globally competent nursing professionals.