BACKGROUND: In the 21st century, University Social Responsibility (USR) has become increasingly formalized, highlighting the role of universities in contributing to societal development beyond teaching and research. However, in nursing education, a clear definition of social responsibility for students remains lacking. Previous research has mainly focused on classroom instruction and clinical practice, with limited emphasis on applications in rural areas with insufficient medical services. OBJECTIVE: This study aims to explore the development of professional identity through rural service courses within the framework of the university's social responsibility program. Specifically, it examines the unique learning experiences offered by the Health Program for Rural Area Children and Adolescents' Health in Taiwan. Unlike traditional clinical settings, this program offers a distinctive and engaging learning opportunity. DESIGN AND METHODS: The study employs a comprehensive multi-method approach, integrating qualitative methods such as focus group interviews and self-reflection report analysis with a quantitative questionnaire. This combination approach aims to provide an in-depth understanding of nursing students' experiences in delivering healthcare to children and adolescents in rural areas. RESULTS: The analysis identifies four major themes: Realized Social Responsibility, Development of Empathy, Cultural Competence, and Professional Identity. Participation in rural service courses fosters personal growth and identity development among nursing students while also strengthening their professionalism and sense of social responsibility. The findings highlight the students' emotional and transformative journey. CONCLUSION: This study underscores the significance of early exposure to diverse healthcare environments in shaping nursing students' professional identities. It strongly advocates for nursing educators, researchers, and policymakers to incorporate such experiences into nursing education programs, not only to enhance health literacy but also to advance health equity.