A Global Approach to Nursing Education: Evaluating the Impact of COIL on Undergraduate Students in the US and Brazil

Abstract

This article presents a Collaborative Online International Learning (COIL) project conducted over four academic semesters, involving more than 500 undergraduate nursing students from the United States and Brazil. Guided by the Cross-Cultural Alignment Model, the project aimed to evaluate whether COIL enhanced students' self-reported efficacy in applying key global nursing concepts when working with pediatric patients with chronic conditions and their families across both countries. Additionally, the study explored potential differences in satisfaction and self-reported efficacy among different student groups. Data were collected using an online, retrospective, pre-post survey that included Likert-scale items and demographic information. Data analysis was conducted using Stata/MP 18.0. The results provide valuable insights into the impact of COIL on nursing students' competencies and perceptions, particularly in the context of pediatric nursing and global health. COIL was found to significantly improve students' cultural responsiveness, ability to provide family-centered care, awareness of health disparities and social determinants of health, and perceptions of the nursing role. Results also identified notable differences in the impact of COIL among student groups. Future research should include rigorous study designs and objective measures of outcomes along with self-reports. Additionally, qualitative research would help to understand nuances behind student responses, inform targeted improvements in COIL, and help to establish best practices for COIL implementation.