Objectives: This innovative Collaborative Online International Learning (COIL) program aimed to enhance undergraduate nursing and midwifery students’ global health knowledge, cultural awareness, and global competence by connecting students and educators from multiple countries. Methods: Five international universities co-designed the program, delivering 5 online webinars incorporating global health themes and cultural activities. Retrospectively linked REDCap pre- and post-program surveys enabled within- participant analysis. As questionnaire data were ordinal and non-normal, medians and interquartile ranges (IQRs) were reported, with Wilcoxon signed-rank and exact McNemar tests used. Student evaluations explored learning experiences and perspectives. Results: Thirty-one of 45 enrolled students (69%) completed both questionnaires. Significant improvements were observed in Perspective Taking and Adaptability (median: 28 [IQR 25-29] vs 29.5 [IQR 28-35]; median change: 3 [IQR 0-6]; P = .002) and Global-Mindedness (16 [IQR 15-18] vs 19 [IQR 15-20]; median change: 0.5 [IQR 0-3]; P = .008). Awareness of intercultural communication increased but was not statistically significant at the subscale level. No baseline differences were identified by gender, university/region, year level, or completion status. Student evaluations indicated greater confidence engaging with culturally diverse individuals and enhanced inclusivity, adaptability, and openness to different perspectives. Conclusion: Participation in this COIL program was associated with improvements in key dimensions of global competence, particularly perspective taking, adaptability, and global-mindedness. Students valued the cultural learning and international peer engagement, supporting COIL as a practical internationalisation-at-home strategy. Future research should address questionnaire attrition and examine the sustainability of these gains over time.
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Malik et al. (2026) studied this question.
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