Development of cultural competency and cultural sensitivity through collaborative online international learning among advanced practice nursing students: A quasi-experimental pilot study

OBJECTIVE: This pilot study assessed the impact of Collaborative Online International Learning (COIL) participation on cultural competency and sensitivity among advanced practice nursing (APN) students. BACKGROUND: APN students often report limited exposure to intercultural learning. COIL provides opportunities for collaboration across countries, promoting cultural awareness and engagement. METHODS: A quasi-experimental, one-group pretest-posttest design was used. Participants included APN students from a U.S. university (n = 9) and a Norwegian university (n = 8) enrolled in an advanced assessment course in spring 2025. Students met synchronously online for up to three 1.5-hour sessions examining APN roles and healthcare systems. They practiced advanced assessment and diagnostic reasoning through case studies and interactive discussions. A ten-item pre/post survey evaluated cultural exposure, competency, and awareness. Descriptive statistics summarized responses; the Wilcoxon signed-rank test and Hedge's g assessed pre-post changes. RESULTS: Six of nine items showed increased mean scores. Notably, "I meet many patients with needs related to culturally specific factors" and "I have enough expertise to meet these needs" had medium and large effect sizes (0.51 and 1.2), with the latter increasing by 1.5 Likert points. CONCLUSIONS: COIL participation shows promise for enhancing APN students' cultural awareness, sensitivity, and confidence in delivering culturally competent care. REGISTRATION: Not registered. SOCIAL MEDIA ABSTRACT: APN students boost cultural competence & confidence in patient care through international COIL exchanges. #GlobalNursing #CulturalCare.