Heat exposure and perceived academic functioning among nursing students in a tropical higher education setting: a qualitative study

Background: Extreme heat presents a growing challenge for nursing education in tropical regions. However, there is limited qualitative evidence regarding students’ experiences across commuting, campus, and learning environments. Aim: This study explores nursing students’ experiences of heat, its perceived impact on academic functioning, and both personal and institutional responses. Methods: A qualitative descriptive design was employed. Forty-two second- to fourth-year nursing students from a private university in northern Philippines participated in seven focus group discussions. Audio-recorded data were transcribed, anonymised and analysed using collaborative deductive–inductive framework analysis. Results: Heat was experienced as a cumulative daily burden, affecting commuting, campus movement, waiting periods, and time spent in crowded or inadequately ventilated learning spaces. Four interrelated themes emerged: embodied and emotional strain; environmental conditions amplifying vulnerability; self-managed mitigation providing partial and potentially unequal relief; and perceived disruption of academic functioning. Persistent discomfort was associated with reduced concentration, slower information processing, lower productivity, diminished motivation, and decreased participation. Conclusion: Heat exposure was influenced by daily mobility, institutional conditions, and access to coping resources. Although the findings address perceived rather than objectively measured academic functioning, they support interventions such as hydration, occupancy management, facility maintenance, improved ventilation, enhanced cooling infrastructure and heat-sensitive scheduling.