“When stress is the air we breathe”: Contextual resilience sustains clinical excellence in nursing students amid chronic adversity — A cross-sectional study from war- and sanction-affected Southern Iran

Background Dominant models assume chronic stress impairs clinical performance, yet students in crisis-endemic regions often maintain high standards despite persistent adversity. This raises a question: might stress become a normalized backdrop, enabling rather than eroding excellence? Objectives To examine the association between academic stress and clinical performance among nursing students in war-, sanction-, and dust storm-affected Abadan, Iran, and to interpret findings through the lens of contextual resilience. Methods In a cross-sectional study (ethics code: IR.ABADANUMS.REC.1403.168), 177 nursing students completed the validated Student-Life Stress Inventory (SLSI; α = 0.78) and the 44-item Clinical Performance Questionnaire (α = 0.95). Hierarchical multiple regression controlled for demographic covariates. Results Participants reported low-to-moderate stress (M = 105.41, SD = 4.89) and high clinical performance (M = 188.53, SD = 12.51). No significant correlation emerged between total stress and performance ( r = −0.093, p = 0.220). In regression, stress remained non-significant (β = −0.072, p = 0.333), whereas marital status (β = 0.178, p = 0.022) and academic term (β = −0.170, p = 0.024) were significant predictors. The full model explained 10.5% of variance (adjusted R 2 = 0.057). Conclusion In this cross-sectional sample, academic stress was not significantly associated with clinical performance, suggesting the operation of contextual resilience—a capacity where excellence is maintained within, rather than despite, chronic stressors. These findings challenge deficit models, urging resilience-focused training.