Abstract
Global learning is based on the principle that the world is a collection of interdependent systems and that higher education plays a vital role in fostering learners' ability to advance equity and justice (Zhou, 2022). Collaborative Online International Learning (COIL) is a pedagogical approach which allows students to participate in virtual global learning activities encouraging development of critical thinking, creativity, problem-solving and teamwork skills, while enhancing recognition of diverse and global perspectives (Shaw et al., 2025) viewed as essential for safe patient care (Te et al, 2019). COIL has been in use in many universities in the United States and partnering institutions world-wide with a central tenant being a collaboration between educators and learners. In COIL partnerships, instructors in two or more countries collaborate to co-design and co-teach within a course in which small groups of blended students work together online over sustained periods in a project-based learning environment (Hackett et al., 2024). The instructors and students involved in a COIL-enhanced course are mutually dependent on each other to develop, implement, and complete the collaboration’s learning activities.
In Fall 2023, undergraduate reproductive health courses in the United States and Norway launched a COIL partnership to promote global engagement and cross-cultural learning. This ongoing initiative brings learners together in small, blended groups to participate in both asynchronous and synchronous activities. Through facilitated discussion and collaborative projects, students compare nursing education and reproductive health systems in their respective countries and co-design a model healthcare system that integrates best practices from both settings.
Methods: To evaluate the effect on cross-cultural learning, participants were recruited to complete pre- and post-COIL surveys. We used the ASKs 2+ survey (Holgate et al., n.d.), a 14-item instrument measuring changes in intercultural attitudes, skills and knowledge. Participants also completed two faculty-developed questions to reflect on their experiences and future application in their nursing career. Results were analyzed using a qualitative descriptive approach.
Results: Mean scores increased significantly between pre- and post-COIL survey responses (t = 2.16, p<.001). Qualitative results reveal the meaningful impact of COIL on students’ readiness to provide person-centered, culturally responsive care.
Notes
References:
Hackett, S., Dawson, M, Janssen, J., & van Tartwijk, J. (2024). Defining Collaborative Online International Learning (COIL) and distinguishing it from Virtual Exchange. TechTrends, 68, 1078-1094.
Holgate, H.A., Parker, H.E., & Calahan, C.A. (n.d.). Intercultural Attitudes, Skills, and Knowledge Short Scale PLUS - ASKS 2+. Purdue Center for Instructional Excellence. https://www.purdue.edu
Shaw, L., Turick, M., & Kiegaldie, D. (2025). Collaborative online international learning in health professions education: A 10-year scoping review. Nurse education today, 148, 106602. https://doi.org/10.1016/j.nedt.2025.106602
Te, M., Blackstock, F., & Chipchase, L. (2019). Fostering cultural responsiveness in physiotherapy: Curricula survey of Australian and Aotearoa New Zealand physiotherapy programs. BMC Medical Education, 19(1), 326.
Zhou, J. (2022). Global learning: Definition, assessment, and approaches. Journal of Global Education and Research 6(2), 115-132.
Sigma Membership
Alpha Alpha
Lead Author Affiliation
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Teaching and Learning Strategies, Virtual Learning, Collaborative Online International Learning, Collaboration, Learning Methods, Online Education
Recommended Citation
Crawford, Catherine; Lanning, Rhonda; Aanensen, Elisabeth Hemnes; and Aarreberg, Grethe, "Incorporating Global Perspectives Through COIL in Reproductive Health Nursing Education" (2026). International Nursing Research Congress (INRC). 45.
https://www.sigmarepository.org/inrc/2026/presentations_2026/45
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-24
Funder
American Association of Colleges and Universities (AAC&U) Institute
Incorporating Global Perspectives Through COIL in Reproductive Health Nursing Education
Toronto, Ontario, Canada
Global learning is based on the principle that the world is a collection of interdependent systems and that higher education plays a vital role in fostering learners' ability to advance equity and justice (Zhou, 2022). Collaborative Online International Learning (COIL) is a pedagogical approach which allows students to participate in virtual global learning activities encouraging development of critical thinking, creativity, problem-solving and teamwork skills, while enhancing recognition of diverse and global perspectives (Shaw et al., 2025) viewed as essential for safe patient care (Te et al, 2019). COIL has been in use in many universities in the United States and partnering institutions world-wide with a central tenant being a collaboration between educators and learners. In COIL partnerships, instructors in two or more countries collaborate to co-design and co-teach within a course in which small groups of blended students work together online over sustained periods in a project-based learning environment (Hackett et al., 2024). The instructors and students involved in a COIL-enhanced course are mutually dependent on each other to develop, implement, and complete the collaboration’s learning activities.
In Fall 2023, undergraduate reproductive health courses in the United States and Norway launched a COIL partnership to promote global engagement and cross-cultural learning. This ongoing initiative brings learners together in small, blended groups to participate in both asynchronous and synchronous activities. Through facilitated discussion and collaborative projects, students compare nursing education and reproductive health systems in their respective countries and co-design a model healthcare system that integrates best practices from both settings.
Methods: To evaluate the effect on cross-cultural learning, participants were recruited to complete pre- and post-COIL surveys. We used the ASKs 2+ survey (Holgate et al., n.d.), a 14-item instrument measuring changes in intercultural attitudes, skills and knowledge. Participants also completed two faculty-developed questions to reflect on their experiences and future application in their nursing career. Results were analyzed using a qualitative descriptive approach.
Results: Mean scores increased significantly between pre- and post-COIL survey responses (t = 2.16, p<.001). Qualitative results reveal the meaningful impact of COIL on students’ readiness to provide person-centered, culturally responsive care.
Description
Collaborative Online International Learning connects students and educators across countries to promote intercultural collaboration and critical thinking. In a prelicensure course, nursing students in the US and Norway compared reproductive health systems and co-designed care models. Pre/post ASKs 2+ surveys showed significant gains (t=2.16, p<.001) and qualitative findings revealed improved readiness for culturally responsive, person-centered care.