By Zahra Aziz and Lilani Arulkadacham
Posted Tue 5 March, 2024

In today’s globalised world, there is considerable demand for health professionals capable of delivering high-quality care to an ever-diverse array of social and cultural groups. When healthcare is enriched with cultural sensitivity and delivered by a unified team of professionals working in tandem, the impact on patient health outcomes is profound (Handtke, Schilgen & Mösko, 2019). By placing a strong emphasis on multidisciplinary collaboration, students from diverse health disciplines can unite to provide integrated and cooperative care, resulting in better health outcomes. This not only breaks down silos but also champions holistic patient wellbeing (Srivastava, 2022). 

When healthcare is enriched with cultural sensitivity and delivered by a unified team of professionals working in tandem, the impact on patient health outcomes is profound.

When we talk about culturally responsive healthcare, we’re really looking at a team effort. It starts with having a curriculum that’s tuned in to different cultures, and it needs everyone, educators and institutions, to be on board and contribute focused work. So, in the world of health education, we’re talking about working together, being flexible, and making sure our educators keep growing too. One method to weave in culturally responsive healthcare is through Collaborative Online International Learning (Hacket et al., 2023), or COIL for short.

Why COIL?

COIL refers to a pedagogical approach that connects students in different parts of the world for collaborative learning experiences through online communication. COIL offers an engaging educational journey by bringing collaborators together in shared learning environments (Hacket et al., 2023).  

COIL refers to a pedagogical approach that connects students in different parts of the world for collaborative learning experiences through online communication.

Embedding culturally diverse and multidisciplinary experiences, where students engage with peers from other health professions and international locations, can expose students to global perspectives, enhance their ability to understand cultural nuances, appreciate the importance of shared care, and facilitate collaborative learning. Students engage in collaborative projects online, without the need for travel.

How did we approach COIL?

Earlier this year, education researchers from Monash University Australia (MUA), Monash University Malaysia (MUM) and the University of Padua (UNIPD), Italy, received seed funding for piloting a joint COIL program bringing together interdisciplinary health professions – Public Health and Psychology students from MUA and MUM and Nursing students from UNIPD.

The project required academics from participating Universities to co-design and co-deliver an innovative, multidisciplinary and multicultural learning experience for students from three different disciplines and three different countries. The COIL activities were embedded within two undergraduate units, PSY3120 – Introduction to Counselling and PBH3008 – Case Studies in Global and Public Health. The shared learning outcomes included appreciating cultural diversity, enhancing cultural responsiveness and enhancing the understanding of shared healthcare practice for improved patient outcomes, all through global learning.

We utilised a range of teaching and learning methods including flipped classrooms; interactive sessions with external expert panels; storytelling; case studies, simulation and role plays; use of collaborative platforms; guided Moodle discussion forums; collaborative group projects; and individual reflective journals. The content developed was customised for co-facilitation (by Monash and Padua educators) to meet the needs of all interdisciplinary collaborators, their respective units, academic schedules (semester dates) and timezones.

A specialised COIL Moodle site was created to support students’ learning. All students from MUA, MUM and UNIPD were granted access to the Moodle site (see image below). 

Collaborative Online Learning Moodle site

Given that English wasn’t the primary language for approximately two-thirds of the participants, deliberate measures were taken to create a secure co-learning environment that was both enjoyable and authentic. One effective method was a weekly forum post, bringing students from around the world together to collaboratively address various questions (see image below).

(Forum Post)
Hello everyone,

We’re about to begin our COIL journey, and what a better way to start than with a fun icebreaker activity that reflects our incredible diversity?

Introducing ‘Getting to Know You: Local Cuisine Edition!‘

We know that our virtual classroom spans across different continents, and each one of you brings a unique flavour to our learning community. So I want you to imagine you’re a dish local to your country (whether it be where you are located now or something that reminds you of home) and share with us what disch you’d be and why. Whether it’s a beloved Malaysian delight, a classic Italian favourite, or a true-blue Aussie treat. In doing so, I encourage you to respond to and connect with your peers before we begin next week.

The four joint Monash-Padua COIL sessions were delivered in October 2023, attended by 65 students and 11 educators from two institutions. 

International online Zoom class

This COIL experience, particularly the co-designing and co-delivering of an international collaborative tertiary education unit, where multiple stakeholders, educators, guest speakers and funders, worked together to create a multidisciplinary curriculum that is relevant, flexible, engaging and effective was challenging but rewarding. The COIL team is currently collating evaluation findings, however, the initial feedback from both students and educators was overwhelmingly positive. Based on this experience, discussions are currently underway to expand this program to larger cohorts of students for Sem 2, 2024.

What’s next?

The project served two primary objectives. The first was to design, implement and deliver the COIL methodology in collaboration with international partners as a ‘proof of concept’. The second objective focused on enhancing the skills of health professions educators to sustain and expand the COIL program, encompassing more students, units, departments, and schools. To achieve this, our team of educators and collaborators are committed to being  COIL champions for their respective Schools, assisting other educators to adopt and embed this methodology within relevant units. Feedback from students and educators is instrumental in our iterative improvement process, and their insights will be vital for scaling up and ensuring the sustainability of the COIL program.

To support these endeavours, our team has recently been awarded the COIL GROW Grant which will assist with the expansion of the current program to other disciplines and faculties.

Our journey with the COIL program has provided us with valuable insights and raised important considerations for future endeavours in multicultural and interdisciplinary education. We navigated through the challenges of integrating COIL into existing curricula, employing strategies to overcome timezone differences and ensuring effective communication among students for whom English was not the primary language. The early evaluation findings show that the COIL program had an impact on enhancing students’ cultural competence and collaborative skills. However, measuring the extent of this impact accurately remains an ongoing challenge. 

Our experiences have yielded key lessons for other educators interested in similar programs, particularly in managing the intricacies of timezone differences and ensuring inclusivity in digital learning environments.

How can you help?

If you have experience with COIL methodology, culturally responsive care or collaborative curriculum for health professions education, we want to hear your thoughts and learn from your experience as we continue with the expansion and scale-up efforts.

If you wish to embed COIL activities into your units and courses, we would be happy to share our experiences and lessons with you and your team.

References

Srivastava, R. H. (2022). The Health Care Professional’s Guide to Cultural Competence-E-Book. Elsevier Health Sciences.

Hackett, S., Janssen, J., Beach, P., Perreault, M., Beelen, J., & van Tartwijk, J. (2023). The effectiveness of Collaborative Online International Learning (COIL) on intercultural competence development in higher education. International Journal of Educational Technology in Higher Education, 20(1), 5.

Handtke, O., Schilgen, B., & Mösko, M. (2019). Culturally competent healthcare–A scoping review of strategies implemented in healthcare organizations and a model of culturally competent healthcare provision. PloS one, 14(7), e0219971.