Learning journeys and identity transformation of foreign undergraduate nursing students in China: a journey mapping...

With the internationalization of higher education, foreign undergraduate nursing students studying in China need to adapt not only to a new cultural and academic environment, but also to nursing-specific learning requirements and emerging professional roles. Existing studies have provided valuable insights into international students' challenges and coping strategies, but less attention has been paid to how learning adaptation, intercultural experience, and identity reconstruction unfold together over time. This study used journey mapping to explore the learning journeys and identity transformation of foreign undergraduate nursing students in China.

A descriptive qualitative design was adopted. Semi-structured interviews were conducted with 23 foreign undergraduate nursing students studying in China between May 2025 and March 2026. Data were analyzed using conventional content analysis, and journey mapping was used to organize students' experiences along a temporal and process-oriented trajectory.

The learning journeys of foreign undergraduate nursing students in China involved four interrelated stages: initial entry, negotiated exploration, adaptive development, and transformative reconstruction, which were further refined into 12 substages. Students moved from early disorientation and classroom uncertainty to help-seeking, strategy formation, intercultural integration, and identity reconstruction. The four-stage model represents a synthesized developmental tendency rather than a uniform linear pathway followed identically by all participants.

Foreign undergraduate nursing students' adaptation in China is shaped by language-related challenges, pre-arrival preparation, cultural environment, classroom norms, nursing-specific learning requirements, and support resources. The findings suggest that adaptation may develop into learner identity reconstruction and future professional orientation. Nursing education should provide staged and sustained support to help foreign students adapt to cross-cultural learning and transform their experiences in China into resources for professional growth.