Building resilience to adapt: A grounded theory study of international nursing students' study abroad experience.

BACKGROUND: Study abroad programs offer transformative learning, yet few studies explore how international nursing students adapt and grow through such experiences. PURPOSE: To explore the adaptive process of Chinese nursing students enrolled in a year-long United States study abroad program and the impact on long-term personal and professional outcomes. DESIGN: Constructivist Grounded Theory. METHODS: Fifteen Chinese nursing students who completed a one-year (three-semester) United States exchange program participated in two sequential semi-structured interviews via videoconferencing. Data were analyzed using Charmaz's Constructivist- Grounded Theory (2014) and managed with NVivo Version 15 and as well as being reviewed manually. RESULTS: Analysis produced five categories through constant comparison of data: Surviving Rough Seas (coping with academic, cultural, and emotional challenges), Learning to Steer the Boat (developing support systems and strategies), Sailing into the Harbor (readjusting and facing reverse culture shock), and Thriving Because of the Journey (personal and professional growth). The core category, Becoming Resilient, unified all themes and represented the dynamic process of adaptation and transformation. CONCLUSION: This study demonstrated how resilience enables Chinese nursing students to move from initial hardship to coping, support-seeking, confidence, and rebuilding self-confidence. Ultimately, this process facilitates long-term personal growth and sustains professional development. Findings highlight the need for culturally responsive support, mentoring, and re-entry preparation to enhance outcomes in international nursing education.