Background: As the U.S. population becomes increasingly diverse, the demand for culturally responsive care is growing (AOTA, 2020; USAFacts, 2024). Occupational therapy (OT) students must be equipped not only with clinical competencies but also the cultural humility and reflective skills necessary to work in global and cross-cultural contexts (Kokorelias et al., 2025; Speer & Conley, 2024). Although international service learning (ISL) has been shown to foster these skills, many programs lack standardized, evidence-informed pre-departure training to adequately prepare students (Amerson, 2014; Chabot et al., 2021; Kalbarczyk et al., 2019; Short et al., 2020)

Objective: To explore the importance of a structured, evidence-informed pre-departure training curriculum in preparing occupational therapy doctoral students for ISL experiences, with a focus on enhancing cultural competence, clinical skill development, and critical reflection. This project also aimed to design and pilot an International Service Learning Opportunity (ISLO) guide to support student preparation and faculty implementation.

ACOTE Area: This project primarily aligns with ACOTE standard (d) Program Development and Evaluation through the creation and pilot of a structured pre-departure training curriculum and ISLO guide. It also supports (g) Education by preparing students for global clinical practice and (a) Clinical by addressing cultural competence and clinical skill development.

Methods: This mixed-methods capstone project was conducted through Georgia State University’s OTD program. A multi-part needs assessment was completed, including (1) surveys of 28 graduate OT students and 4 faculty who participated in a study abroad in the past five years, (2) an informal interview and review of the Dominican Republic ISL program, and (3) the author's personal experience as an ISL participant. Following the needs assessment, a revised pre-departure training curriculum was developed and implemented with students attending the 2025 Dominican Republic ISL trip. Outcome measures included pre- and post-surveys using a modified Clinical Cultural Competency Questionnaire (CCCQ) and a professional skills self-assessment. Quantitative data were analyzed using descriptive statistics and paired t-tests; qualitative feedback was analyzed using thematic analysis.

Results: The revised pre-departure curriculum included sessions on cultural humility, guided reflection using the Gibbs Cycle, condition-specific clinical content, interpreter collaboration, and a student reflection journal. Results (n=23) showed statistically significant gains in cultural competence across multiple CCCQ subscales: knowledge (p = .001), skills (p = .013), comfort (p = .008), and perceived importance of training (p = .008). Professional skills subscales showed gains in interpersonal communication (p = .011), performance skills (p = .010), and clinical reasoning (p = .029). However, changes in ethical reasoning and reflection were not statistically significant (p > .05). Qualitative feedback indicated that while students valued reflection, its implementation varied, and opportunities for deep critical thinking could be expanded.

Conclusions and Relevance: Findings support the development and integration of a structured pre-departure training curriculum to enhance OT students’ readiness for global practice. The program contributed to measurable improvements in cultural competence and several domains of professional skills. These results highlight the importance of structured preparation and provide a scalable model for future ISL initiatives within occupational therapy education. Improved training can help produce more competent, reflective, and culturally responsive practitioners prepared for diverse clinical environments.