Navigating cross-cultural experience of international students in traditional Chinese medicine universities
A qualitative exploration of learning, adaptation, and institutional support
DOI:
https://doi.org/10.32674/wsdmvm58Keywords:
higher education, international students, ChinaAbstract
As China emerges as a leading destination for global higher education, its universities of traditional Chinese medicine (TCM) have seen a surge in international enrollment. This study aims to explore the learning experience of international students within such culturally embedded, discipline-specific institutions. Using purposive sampling, 20 international undergraduate students participated in semistructured interviews, which were analyzed using conventional content analysis. Three themes emerged: academic experiences, social experiences, and institutional support systems. While students valued integrated TCM-Western training, clinical exposure, and cultural exchange, they faced challenges related to language barriers, discipline-specific curriculum demands, and institutional support. International students in TCM universities experience both enrichment and strain during their cross-cultural and motivational adaptation process. Reforms emphasizing bilingual instruction, culturally responsive teaching, and enhanced student support could foster greater inclusion and engagement in China’s specialized higher education context.
References
Bai, B., Ge, Y., & Li, Z. (2023). Psychological study of international doctoral students studying in China: cross-cultural adaptation. Current Psychology, 42(36), 32270–32283. https://doi.org/10.1007/s12144-022-04133-4 DOI: https://doi.org/10.1007/s12144-022-04133-4
Bliss, L. A. (2016). Phenomenological Research: Inquiry to Understand the Meanings of People's Experiences. International Journal of Adult Vocational Education and Technology (IJAVET), 7(3), 14–26. https://doi.org/10.4018/IJAVET.2016070102 DOI: https://doi.org/10.4018/IJAVET.2016070102
Cui, P.-A., Gong, Z.-X., & He, Z. (2024). A Brief Overview of the Development and Significance of Modern Scientific Medicine in China: Take Chinese Academy of Medical Science and Peking Union Medical College as an Example. Chinese Medical Sciences Journal, 39(2), 140–143. https://doi.org/https://doi.org/10.24920/004316 DOI: https://doi.org/10.24920/004316
El-Asri, S., & Karfa, A. (2024). The Role of Cultural Exchange in the Development of Intercultural Competence in the Context of Cultural Diplomacy. Journal of Humanities and Social Sciences Studies, 6, 62–70. https://doi.org/10.32996/jhsss.2024.6.1.7 DOI: https://doi.org/10.32996/jhsss.2024.6.1.7
English, A. S., & Zhang, R. (2020). Coping with perceived discrimination: A longitudinal study of sojourners in China. Current Psychology, 39(3), 854–869. https://doi.org/10.1007/s12144-019-00253-6 DOI: https://doi.org/10.1007/s12144-019-00253-6
Fan, A. Y., Wei, H., Tian, H., Huang, J., & Alemi, S. F. (2020). Universities of Chinese Medicine Enter the Global Stage of Best Universities Rankings in 2020. Med Acupunct, 32(3), 136–142. https://doi.org/10.1089/acu.2019.1403 DOI: https://doi.org/10.1089/acu.2019.1403
Gao, Y., & Zhu, X. (2023). Research on the learning experience of virtual simulation class experimental teaching and learning based on the perspective of nursing students. BMC Nursing, 22(1). https://doi.org/10.1186/s12912-023-01534-z DOI: https://doi.org/10.1186/s12912-023-01534-z
Hong, B., Bista, K., & Timmons, P. (2025). Mapping the scholarship on international students. Journal of International Students, 15(1), 1–24. https://doi.org/10.32674/sfwrch85 DOI: https://doi.org/10.32674/sfwrch85
Hsieh, H. F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qual Health Res, 15(9), 1277–1288. https://doi.org/10.1177/1049732305276687 DOI: https://doi.org/10.1177/1049732305276687
Hussain, M., & Shen, H. (2019). A Study on Academic Adaptation of International Students in China. Higher Education Studies, 9(4). https://doi.org/10.5539/hes.v9n4p80 DOI: https://doi.org/10.5539/hes.v9n4p80
Keji, C., & Hao, X. U. (2003). The integration of traditional Chinese medicine and Western medicine. European Review, 11(2), 225–235. https://doi.org/10.1017/S106279870300022X DOI: https://doi.org/10.1017/S106279870300022X
Kim, Y. Y. (2012). Cross-Cultural Adaptation. In (pp. 623–630). https://doi.org/10.1016/B978-0-12-375000-6.00115-4 DOI: https://doi.org/10.1016/B978-0-12-375000-6.00115-4
Kuo, Y.-H. (2011). Language Challenges Faced by International Graduate Students in the United States. Journal of International Students, 1(2), 38–42. https://doi.org/10.32674/jis.v1i2.551 DOI: https://doi.org/10.32674/jis.v1i2.551
Li, D., Xu, H., Wang, Y., & Wei, M. (2020). The Development of Chinese Medical Education. Journal of Craniofacial Surgery, 31(2), 453–455. https://doi.org/10.1097/scs.0000000000006333 DOI: https://doi.org/10.1097/SCS.0000000000006333
Li, J., Xue, E., & He, Y. (2023). Adjustment to Chinese Culture and Mental Health Issues among Foreign Students on Chinese University Campuses during the COVID-19 Pandemic: A Collaborative Ethnographic Study. Behavioral Sciences, 13(7), 526. https://doi.org/10.3390/bs13070526 DOI: https://doi.org/10.3390/bs13070526
Lv, W. (2021). Understanding traditional Chinese medicine. Hepatobiliary Surgery and Nutrition, 10(6), 846–848. DOI: https://doi.org/10.21037/hbsn-2021-25
Malterud, K., Siersma, V. D., & Guassora, A. D. (2016). Sample Size in Qualitative Interview Studies: Guided by Information Power. Qual Health Res, 26(13), 1753–1760. https://doi.org/10.1177/1049732315617444 DOI: https://doi.org/10.1177/1049732315617444
Marginson, S. (2014). Student Self-Formation in International Education. Journal of Studies in International Education, 18(1), 6–22. https://doi.org/10.1177/1028315313513036 DOI: https://doi.org/10.1177/1028315313513036
Mulyadi, E., Permatasari, D., Soares, D., Syarifudin, M., Da Silva Pinto, T., & Sarmento, J. (2024). Culture Shock: Challenges of International Students. International Journal of Health Engineering and Technology, 3(1). https://doi.org/10.55227/ijhet.v3i1.208 DOI: https://doi.org/10.55227/ijhet.v3i1.208
Ng, C. H., & Cheung, Y. L. (2024). Teaching and learning medical English for international medical graduates: A scoping review. Ibérica(48), 71–96. https://doi.org/10.17398/2340-2784.48.71 DOI: https://doi.org/10.17398/2340-2784.48.71
Ngwira, F. F., Adamseged, H. Y., & Kondowe, W. (2024). Acculturative Stress and Socio-Demographic Influences: A Comparative Study of Asian and African International Students in China. Journal of Intercultural Communication, 191–199. https://doi.org/10.36923/jicc.v24i4.990 DOI: https://doi.org/10.36923/jicc.v24i4.990
Niemiec, C. P., & Ryan, R. M. (2009). Autonomy, competence, and relatedness in the classroom: Applying self-determination theory to educational practice. Theory and Research in Education, 7(2), 133–144. https://doi.org/10.1177/1477878509104318 DOI: https://doi.org/10.1177/1477878509104318
Perez-Encinas, A., & Rodriguez-Pomeda, J. (2018). International Students’ Perceptions of Their Needs When Going Abroad: Services on Demand. Journal of Studies in International Education, 22(1), 20–36. https://doi.org/10.1177/1028315317724556 DOI: https://doi.org/10.1177/1028315317724556
Ramadhan, M. K., Sun, Q., & Haji, M. A. (2024). Challenges Faced by International Students in Adapting to Chinese Universities Life: A Case of Zhejiang Normal University. Journal of Scientific Research and Reports, 30(11), 1030–1044. https://doi.org/10.9734/jsrr/2024/v30i112630 DOI: https://doi.org/10.9734/jsrr/2024/v30i112630
Saunders, B., Sim, J., Kingstone, T., Baker, S., Waterfield, J., Bartlam, B., Burroughs, H., & Jinks, C. (2018). Saturation in qualitative research: exploring its conceptualization and operationalization. Quality & Quantity, 52(4), 1893–1907. https://doi.org/10.1007/s11135-017-0574-8 DOI: https://doi.org/10.1007/s11135-017-0574-8
Smith, R. A., & Khawaja, N. G. (2011). A review of the acculturation experiences of international students. International Journal of Intercultural Relations, 35(6), 699–713. https://doi.org/10.1016/j.ijintrel.2011.08.004 DOI: https://doi.org/10.1016/j.ijintrel.2011.08.004
Sutoi, D., Cindrea, A. C., Popa, D. I., Trebuian, C. I., Williams, C., Sutoi, M., Puscas, A. B., Marza, A. M., Buleu, F., Chiu, B., Marin, G., Chis, V. M., Ciontos, A., Sabau, L. D., & Mederle, O. A. (2025). Impact of hands-on workshops on future medical students' motivation, confidence, and career aspirations: an observational study. J Med Life, 18(2), 147–154. https://doi.org/10.25122/jml-2025-0030 DOI: https://doi.org/10.25122/jml-2025-0030
Tavares, V. (2021). International Students in Higher Education: Language, Identity, and Experience from a Holistic Perspective. https://doi.org/10.5040/9781666994827 DOI: https://doi.org/10.5040/9781666994827
Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care, 19(6), 349–357. https://doi.org/10.1093/intqhc/mzm042 DOI: https://doi.org/10.1093/intqhc/mzm042
UNESCO Institute for Statistics. (2009). Global education digest 2009: comparing education statistics across the world. UNESCO Institute for Statistics.
Wang, W. J., & Zhang, T. (2017). Integration of traditional Chinese medicine and Western medicine in the era of precision medicine. J Integr Med, 15(1), 1–7. https://doi.org/10.1016/s2095-4964(17)60314-5 DOI: https://doi.org/10.1016/S2095-4964(17)60314-5
Wilczewski, M., & Alon, I. (2023). Language and communication in international students’ adaptation: a bibliometric and content analysis review. Higher Education, 85(6), 1235–1256. https://doi.org/10.1007/s10734-022-00888-8 DOI: https://doi.org/10.1007/s10734-022-00888-8
Wu, H.-P., Garza, E., & Guzman, N. (2015). International Student’s Challenge and Adjustment to College. Education Research International, 2015, 1–9. https://doi.org/10.1155/2015/202753 DOI: https://doi.org/10.1155/2015/202753
Yin, Z., Ong, L. Z., & Qiao, M. (2024). Psychological factors associated with Chinese international students' well-being in the United States. Journal of International Students, 14(4), 529–551. https://doi.org/10.32674/jis.v14i4.6428 DOI: https://doi.org/10.32674/jis.v14i4.6428
Zhang, K., & Ting, S.-H. (2025). Prior cross cultural exposure and cross-cultural adaptation of Asian and non-Asian international students in China. Journal of International Students, 15(7), 65–84. https://doi.org/10.32674/a65sbb31 DOI: https://doi.org/10.32674/a65sbb31
Zubair, A., Ying, H., Fatima, S., & Gong, L. (2025). Cross Cultural Challenges and Health Outcomes among International Students in Higher Education in China. https://doi.org/10.21203/rs.3.rs-7326752/v1 DOI: https://doi.org/10.21203/rs.3.rs-7326752/v1
Downloads
Published
Issue
Section
Categories
License
Copyright (c) 2026 Edward N Duo, Pengding Lei, Yazhuo Gao, Xuehua Zhu

This work is licensed under a Creative Commons Attribution 4.0 International License.
https://creativecommons.org/licenses/by/4.0












