A Grounded Theory of Spiritual Development Within Holistic Professional Formation in Undergraduate Nursing Students

PurposeTo explore how undergraduate nursing students from different academic years experience and describe their spiritual development, and to explain how this process contributes to holistic professional formation.DesignA qualitative grounded theory study informed by Corbin and Strauss was conducted.MethodsTwenty-one undergraduate nursing students from different academic years participated in semi-structured interviews, and 11 of them also completed reflective online diaries. Data collection and analysis were conducted concurrently using constant comparative analysis. Ethical approval was obtained.FindingsSpiritual development emerged as a meaning-oriented process situated within holistic professional formation, characterized by a movement from externally guided reassurance toward internally grounded meaning-making. Emotionally demanding clinical experiences disrupted students' assumptions and generated uncertainty. When supported through reflection and relational engagement, these experiences contributed to self-awareness, internal grounding, and students' capacity for presence, compassion, and engagement in care.ConclusionsFindings challenge the assumption that clinical exposure alone supports students' spiritual development. The MAMA-BEAR model offers a substantive grounded theory explaining how academic and clinical environments may support spiritual development as part of holistic professional formation, with implications for curricula, educator preparation, and whole-person care.