Importance: Designing, implementing, and measuring the effectiveness of sustainable Internationalization at Home programs will support the development of cultural competence among occupational therapy students.

Objective: To explore potential sustainable, effective methods for enhancing cultural competence in occupational therapy students through cross-cultural online collaborations.

Design: Pretest–posttest, parallel mixed-methods design.

Setting: An online collaboration using video conferencing technology and classrooms at the European University Cyprus and the University of St. Augustine for Health Sciences.

Participants: Bachelor of science and master of occupational therapy students at the European University Cyprus and the University of St. Augustine for Health Sciences, respectively.

Intervention: Online video conferencing collaboration between occupational therapy students in which students discussed their perspectives and experiences regarding social injustice and occupational therapy’s role in working with vulnerable populations.

Outcomes and Measures: Each campus participated in focus groups, and students completed individual reflections. Themes were derived from the qualitative information gathered. Quantitative data were collected using the Cultural Awareness Scale for Occupational Therapy Students (CASOTS).

Results: CASOTS did not reflect changes in cultural awareness. The qualitative measures identified students’ desire to participate in more frequent and culturally diverse experiences. Challenges included length of preparation and actual communication time. Inclusion of prior asynchronous sessions and methods to overcome the language barrier was suggested for future implementation.

Conclusion: Synchronous cross-cultural collaborations may enhance occupational therapy student’s cultural awareness and may be more attractive than traditional in-class teaching. Further development is necessary to overcome challenges.

What This Article Adds: Documenting the benefits and barriers of implementing Internationalization at Home experiences will allow academic institutions to create sustainable methods for enhancing occupational therapy students’ cultural competence. Recommendations to further enhance Internationalization at Home experiences provide opportunities for increased cultural collaboration.