Enhancing perceived global health competency among undergraduate nursing students: a pre-test–post-test course evaluation

Abstract

Global health challenges, including emerging infections, population mobility, climate-related health risks, noncommunicable diseases, and health inequities, increasingly shape nursing practice. Preparing undergraduate nursing students with global health competency is therefore essential for developing a workforce capable of providing culturally responsive, equity-oriented, and globally informed care. However, evidence remains limited on the effect of structured, curriculum-embedded global health courses on nursing students’ perceived competency, particularly in contexts where global health education is still developing within undergraduate nursing curricula. This study evaluated changes in undergraduate nursing students’ perceived global health competency following completion of a structured global health course. A one-group pre-test–post-test design was used. Eighty undergraduate nursing students enrolled in a global health course completed pre-test and post-test questionnaires. Perceived global health competency was assessed using a course-aligned adaptation informed by the Global Health Competencies for Nurses framework. The adapted scale included seven domains: global burden of disease, global health priorities, social and environmental determinants of health, professional practice, health equity and social justice, programme management, and economic, sociocultural, and political awareness. Descriptive statistics, paired-samples t tests, 95% confidence intervals, and paired-samples effect sizes were used to examine changes in competency. Students demonstrated significant improvement in overall perceived global health competency from pre-test (M = 2.46, SD = 0.81) to post-test (M = 3.08, SD = 0.44), with a mean increase of 0.62 points, 95% CI [0.40, 0.84], t(79) = 5.62, p < .001, Cohen’s d z = 0.63. Significant improvements were observed across all competency domains. The largest improvement was in health equity and social justice, with a mean increase of 0.90 points, 95% CI [0.68, 1.12], t(79) = 8.14, p < .001, Cohen’s d z = 0.91. Students who had previously participated in global health activities reported higher baseline competency, but post-test competency did not differ significantly across participant characteristics. The findings support the integration of global health education within undergraduate nursing curricula as a scalable approach to preparing future nurses for equity-oriented, culturally responsive, and globally informed practice. Strengthening perceived global health competency in nursing education may support progress toward health equity and the sustainable development goals related to health and quality education.

The authors' abstract, as published at the source. BMC Nursing, 2026 · DOI ↗