Skip to main content

Video Pen-Pals

Building Comparative Understanding of Health Care Systems in the U.S. and Abroad


Faculty collaborating on this project will develop an out-of-class assignment requiring students at St. Olaf College and Macalester College to conduct regular video-conference conversations with college students outside the U.S. The subject under study is health care systems.

In preparation, students will gather and review basic information about the operation and outcomes of typical health care systems addressed in the exchange. During the exchanges, "video pen pals" will help students in each country augment their understanding by conversing about cultural assumptions and patient experiences not apparent in basic information. On the strength of these conversations, our students will collaborate to create a video that conveys to a broad audience what they learned. Videos can feature clips from the students’ actual conversations, quantitative information about the different health care systems, the most difficult questions they confronted, and insights they derived during the project


Updated Nov 16, 2015

This project seeks to:
1) Foster and sustain conversation between ACM students and their counterparts abroad about health care systems, considering different cultural or system perspectives.
2) Foster interdisciplinary exchange among ACM faculty about health care and health care systems.
3) Develop student interest and capacity to use video media to conduct academic exchange.
4) Enhance faculty skills to facilitate productive exchange with their counterparts in other countries and disciplines.

The project addresses the challenges health care and health care systems pose to young U.S. scholars. The complexities of disease and medical science combine with intricate business models, funding mechanisms and policy deliberation to make health care systems very difficult to parse. The relationship of policy or practice to the lived experience of health care users is especially difficult to decipher. Through this project, students temper their understandings of complex systems with information and accounts they exchange with their peers abroad.
We coined the term “video pen-pals” to describe students using video conferencing (Skype and Google Hangout) for a series of conversations with peers in other parts of the country and world. “Pen-pal” captures the peer-to-peer aspect of the assignment and recalls the familiarity and insight gained by the exchange of letters in previous eras. Video technology updates this exchange and familiarizes students with the professional use of on-line conferencing they will likely employ after graduation.

On the strength of these conversations, ACM students will work together to create a video that conveys to a broad audience what they learned. Videos can feature clips from the students’ actual conversations, quantitative information about the different health care systems, the most difficult questions they confronted when comparing health care systems, and insights they derived during the project. The video is a graded course assignment.

In addition to serving as a course assignment, the videos would be posted to YouTube, to share with the students’ families and friends. Additionally, YouTube posting is an easy way of disseminating this project to professors intending to integrate video conferencing into their courses or those curious about doing so. The videos also serve as a summation that students can share long after the course ends and faculty can share at teaching conferences and professional development workshops.

The assignment will begin about a third of the way through the semester, and students will devote one to two hours per week to it, out of class. In the first few weeks of the course, students collect information from academic sources on another country’s health care system. In this phase, St. Olaf and Macalester students will work in teams to plan for interactions with their counterparts in different disciplines and countries. Later in the semester, students will conduct one video-conference per week with one or more students abroad. Along the way, students will receive guidance from their professors in the form of topics and questions to focus on, feedback on their plans, and in-class discussion of conversations with their peers abroad. We plan for at least four video-conversations covering a range of topics.

Ashley Hodgson (St. Olaf) will pilot the assignment in her health care economics course (Spring 2016, academic year 2015-2016). Then Eric Carter (Macalester) will introduce it to his medical geography course (academic year 2016-2017). We will assess each offering, using an evaluation schema developed in consultation with St. Olaf’s Office of Institutional Research and Evaluation. The schema will include use of a case-study method to measure and compare student ability to facilitate video exchanges, both before and after completing the assignment. This pilot phase will produce outcome data on three student cohorts. Hodgson and Carter will collaborate on the analysis of this data. They plan to share the results through an article submitted to a scholarly journal and through teaching and learning workshops for college faculty sponsored by ACM and/or other academic organizations.

During the pilot phase, we will collaborate with Prof. Marie Bussey Rask, affiliated with the Danish Institute for Study Abroad. Prof. Bussey Rask co-teaches a course called Health Economics and Health Policy in Europe at the Danish Institute for Study Abroad ( Marie is Danish and is an expert on the Danish health care system and on other European systems. Marie teaches with a health care economist, Prof. Claus Rehfeld, who is also on board with the project. Marie is the main point person. Professors and students at the Danish Institute for Study Abroad have access to Skype on their own devices.

We will use Skype or Google Hangout so that students can continue conversations on their own, beyond the assignment, if so inclined. Also, use of familiar technology to pursue academic projects enables students to learn multiple modes of interaction, from casual to professional, and to judge which mode is appropriate for their purposes in any given instance..

To launch this project carefully, our first efforts will involve U.S. students in Minnesota and in Copenhagen. We will focus on identifying and resolving any technical difficulties. Students connected via video will compare the Danish health care system to the US health care system. The navigation of cultural disconnections will be easier once the communication linkage functions well. This initial offering will also enable Professors Hodgson and Carter to gain facility with the technology,

In subsequent semesters, we will repeat the exchange with Prof. Bussey Rask, and, through her, to foster additional relationships with international faculty who study health systems. Face-to-face interaction with these faculty will occur at health systems conferences Professors Hodgson and Carter attend in Europe. These conferences attract faculty with expertise in health systems from all over the world.

The video conversations occur in the second half of the course, after basic knowledge is in place. Students from each country teach one another about their health care system, and its most prominent issues. Students also exchange their personal experiences and beliefs about each system and prospects for change going forward. This will entail 4-5 video conversations, each lasting 30 minutes to an hour.

Throughout the semester, the professor would check in with students about what they are learning during in-class conversations. For example, students will be prompted to think about elements that hinder effective communication across disciplines and across cultures, and ways to surmount these challenges. The students in the course would take video-clips from their conversations to help with dissemination.

Development of this assignment requires ACM faculty to initiate or deepen relationships with faculty across various disciplines and around the world. Most of the funds we request underwrite this effort, by bringing collaborators together at conferences. Funds will also enable dissemination of the project and its findings at teaching conferences and ACM workshops. Finally, we request funds for a student technology assistant to familiarize participating students with the set up and conduct of video-conferencing.

If the video-conferencing assignment fulfills its promise, we’ll take several steps to promote its use beyond the grant period. The technical uncertainties about video-conferencing are likely to be a factor in the adoption of this assignment. To reduce technical difficulties, we will make available the documentation prepared for students and for the student technology assistant who oversees the conference system. When possible, St. Olaf information technology staff will assist their counterparts on other campuses as the latter acquire or modify video conferencing technology.

We would also seek out relationships with collaborators abroad who would be interested in continuing the relationship. In our initial conversations with potential collaborators, we would frame the initial semester with the collaborator as a test-run, to see if it works. However, we would check with these collaborators to make sure that they would be interested in continuing, if the initial trial goes smoothly and benefits their students in addition to ours. By seeking a number of collaborators who are interested in continuing with the project if it is successful, we hope to make the comparative health systems video-pen-pal assignment a regular feature of our courses at St. Olaf and Macalester.

In addition to benefiting students, this project also benefits ACM faculty members. The project develops both Ashley and Eric as faculty members by enabling them to foster international connections and enabling them an outlet through which they can learn about health care systems abroad. Moreover, the piloting of this idea would create a template that other ACM faculty could use when considering connecting their own students to peers abroad. The language faculty at St. Olaf have been particularly interested in this project, and a similar format might benefit them once the details are worked through. The summer 2017 ACM faculty workshop would allow faculty members from other disciplines to come together and brainstorm new places to implement similar assignments.

Why this project is important and timely:

Liberal arts colleges are eager to prove their worth in a changing economy. St. Olaf College focuses on those skills that enable humans to span boundaries between disciplines, cultures and nations. One of the most important skills the college cultivates is the ability to initiate and sustain dialogue among people not already well acquainted.

This ability is especially relevant to health care, a large and growing sector of many economies. The most serious challenges in health care can only be met through interdisciplinary and intercultural exchange. For instance, policy makers now recognize how multiple silos within health care systems compound difficulties for patients, practitioners and managers. “Care coordination” is the new buzz word in health care policy. The Affordable Care Act funds organizations to integrate or coordinate patient care provided by many different specialists. The need for effective collaboration among medical professionals is a primary reason medical schools are quickly adopting team-based learning.

Moreover, the ability to improve our health care system requires the capacity to talk across the borders between disciplines and countries so we can learn more effectively and more rapidly from one another. As we experiment with new structures, the U.S. has a lot to learn from systems implemented abroad.

To converse across boundaries that separate countries, cultures and academic disciplines is a highly prized capacity. Liberal arts students who can engage and collaborate across such boundaries fulfill the promise of our colleges. The project proposed here enables students to learn by doing, to practice this capacity and to learn from their early mistakes. Direct interaction with people from other cultures is indispensable to fostering this capacity.

Spanning boundaries does not mean ignoring them. In fact, any meaningful understanding of different health care systems recognizes how they are shaped by cultural values and ideological beliefs of the people they serve. Textbook descriptions of health care systems abroad cannot easily convey this context, nor the complex economic and social issues surrounding health care. We believe that by connecting our students to students in other countries who are also studying health care systems we can cultivate deeper understanding of this context. It will also develop skills in having conversations with people from different perspectives, which is a valuable skill in and of itself,.

Students familiar with video-conferencing offer more to employers after they graduate. Video-conferencing is increasingly common in the workplace. While students are accustomed to casual exchange via video, most have little experience of video conferencing as a medium for intellectual exchange or policy deliberation. This project develops professionalism through practice and makes cross-cultural collaboration more feasible to students.

The project advances St. Olaf’s mission to educate “responsible and knowledgeable citizens of the world,” especially for students who do not participate in a study-abroad program. Despite their value, study abroad programs do not align with the resources or priorities of many St. Olaf students. Students committed to music or sports programs or civic service, and those completing more than one major often decide against international study. The project enables them to sample what can be gained through international engagement.

This project also serves Macalester’s mission: “Macalester is committed to being a preeminent liberal arts college with an educational program known for its high standards for scholarship and its special emphasis on internationalism, multiculturalism, and service to society.” The cross-cultural and international exchange about health care systems brings all three values into alignment.

This direct collaboration between Ashley Hodgson (health care economics, St. Olaf) and Eric Carter (Medical geography, Macalester), tests two different forms of collaboration: video-conferencing among individuals and video-conferencings between classrooms on our two campuses to exchange ideas across disciplines. The video-conferencing with students abroad is the main focus of the collaboration.

If the project goes well, we can expand its scope through the proposed ACM faculty workshop in the summer of 2017. The workshop is likely to attract faculty from a wide range of disciplines, most especially in the languages. The “video pen pals” assignment illustrates the importance of linguistic ability and cultural knowledge to the exchange of information and insight about global issues such as health care..

This project also fits in well with the theme of this round of the FaCE grant, “Technology-Enabled Education: Enhancing Faculty & Student Engagement in the Liberal Arts”. The project brings about conversations that might never occur otherwise, using technology to connect people separated by oceans, languages and ideologies. It familiarizes faculty with the use of video-conferencing, both as a pedagogy and as a vehicle for collaboration and exchange with colleagues across the globe.


Updated Nov 16, 2015

Support for international collaborators:

We request funds to compensate international collaborators for their participation. These modest stipends help to convince new partners to invest time and energy in the project. The compensation acknowledges the risks of the venture. We do not intend for faculty to be compensating for adopting video-conferencing once its value as a pedagogy is proven.

In addition to funding those who collaborate with Profs. Hodgson and Carter, we request four additional collaborator stipends to support projects by y other ACM faculty members.. This enables other faculty members in various departments to adopt the assignment, after Profs. Hodgson and Carter have refined it.

Support for Conferences & Workshops (Profs. Hodgson and Carter):

While video-conferencing can sustain and deepen academic exchange, it is not the ideal medium for initiating international relationships. Face-to-face interactions remain the best way to gain familiarity and align expertise. Funds requested for travel to conferences and workshops outside the U.S. enable the project co-directors to establish relationships with their counterparts in a range of disciplines. Recruiting additional participants in the project extends its lifespan beyond this initial award and its first participants. Both Prof. Hodgson and Eric Carter would plan to attend a health systems conference abroad sometime in 2016.

During the summer of 2017, we will convene a workshop for ACM faculty. We will target language faculty and those use comparative or international frames to understand culture, literature and humanity. This one-day workshop will attract participants in the Twin Cities area. We will offer travel awards for participants from ACM campuses more than a half-day’s drive from the Twin Cities.

We also request support for faculty workshops on ACM campuses that profile the project and its results. We will plan these workshops in cooperation with faculty development leaders on each campus. We anticipate a workshop on our home campuses and at two other ACM colleges during the 2016-17 academic year. We will also explore the use of video-conferencing to present subsequent workshops.

Support for information technology student workers

We request support to provide participating classes with a dedicated technology student worker trained to assist new users of video-conference applications. We estimate the project will require 45 hours of support per semester on each participating campus. . In addition to face-to-face support, the students will produce documentation of the set up of devices/systems and the solutions for the most frequent trouble shooting or assistance requests received. This documentation will be available to other ACM schools as they experiment with video-conferencing. Our use of free software, such as Skype or Google Hangout means that purchase of proprietary software is not necessary to adopt video-conferencing as a pedagogical tool.

Support for Project Evaluation:

Evaluation of project outcomes will be conducted by professional staff in the St. Olaf College Office of Institutional Research and Evaluation, in addition to their current duties. We request support for data collection and analysis described in the “Results” section of the proposal. This support will enable us to generate evidence needed for the article manuscripts we will produce and to guide changes in the project that we cannot anticipate in this proposal.

In addition to the project directors and international collaborators already identified, we will invite participation of 15-25 ACM faculty in the workshop proposed for Summer2017. We will also foster connections with other more international collaborators before the end of the project. Prof. Carter will confer with colleagues in Argentina, Costa Rica and Chile, during the project. Prof. Hodgson will confer with international colleagues at health care economics conferences during January or May-August of 2016.

Summer & Fall 2015: Logistics and assignment design
• Prof. Hodgson would work with collaborators abroad to iron out details about the syllabus language for the assignment, guidelines, grading, and responsibilities of the student technology assistant.
• Prof. Hodgson would seek to attend a conference abroad in January of 2016 to network for new collaborators for the 2016-2017 academic year.

Spring 2016: Piloting the assignment
• Prof. Hodgson will implement the video-conferencing assignment in Prof. Hodgson’s health care economics course, in collaboration with Prof. Marie Bussey Rask’s health economics and policy class at the Danish Institute for Study Abroad.
• Prof. Carter will conduct a video-conferencing session with Prof. Hodgson’s healthcare economics students to report his research and findings in Argentina, Chile and Costa Rica.
• During his sabbatical, Prof. Carter will seek collaborators in Argentina, Chile and Costa Rica.
• Prof. Hodgson will conduct a pre- and post- assessment of students conversation facilitation skills.

Summer of 2016: Re-design and building collaboration relationships.
• We will re-design the assignment based on initial assessments and student evaluations. The details of the assignment will likely evolve as new partners bring new ideas, and as we iron out logistical issues.
• Prof. Hodgson and Prof. Carter would seek out international collaborators as they ing attend conferences and pursue research.

Academic Year 2016-2017: Implementation on both campuses
• Prof. Carter will implement the redesigned version of the video-conferencing assignment in his Medical Geography class.
• Prof. Hodgson will implement the redesign with her healthcare economics class.
• Assessment of both uses of the revised assignment will be conducted, using methods similar to Spring 2016.
• Prof. Hodgson and Prof. Carter will co-author professional paper on the project, for presentation at academic conference(s).
• Prof. Hodgson and Prof. Carter would present findings at their own campus and at one other ACM campus.
• Videos produced by students will be aired or made available

Summer 2017: ACM Faculty Workshop
• ACM faculty will come together for a day-long workshop to brainstorm ideas for using video-conferencing technology in similar ways in other classes.

Academic Year 2017: Dissemination & Planning Steps Going Forward
• ACM faculty from the summer workshop will experiment with video-conferencing in their courses. They could test similar projects in their own classes. Four faculty member will receive funds to recruit and acknowledge an international collaborator for their projects.
• Prof. Hodgson and Prof. Carter will write an article on the project for submission to a national journal on teaching and learning in higher education.
The grant period ends at the conclusion of the 2017-2018 school year. Both Prof. Hodgson and Prof. Carter anticipate continued use and refinement of the “video pen pal” assignment.

Dissemination Strategies

1) Conduct an official assessment of the project each semester it is implemented, described below.
2) Present at four ACM campuses in faculty development lunches. At St. Olaf the organization for this is CILA.
3) Host a day-long ACM summer workshop for faculty to come and discuss how video-conferencing could benefit their own classes.
3) Attend a conference (such as Educause, National Conference on Teaching and Research in Economic Education) to disseminate results and get feedback and ideas from other educators. One of these conferences would be after the first stage, but before the January term course
4) Write a paper about the results of the project to be published in a teaching journal.

We would be intentional about assessment from the very beginning and would use a writing-based case study on the first day of class and last week of class designed to test the learning outcomes. This case study would test, for example, their ability to come up with a plan to facilitate a conversation about health care systems, to identify barriers of communication, strategies for handling those, and appropriate topics of discussion. We could then conduct an analysis of student’s progress, comparing the pre- and post- case study. This information would be included in the dissemination process, such as data for articles and presentations on the project.

Outcomes and Significance

The intended results are:
1) A well-honed video-pen-pal assignment in St. Olaf’s healthcare economics course and Macalester’s medical anthropology course. This assignment would become a regular way for students to connect with students studying health care systems in other countries.
2) A summer ACM workshop for ACM faculty to discuss the results of the project and how the project format could be used in other ACM classes.
3) A published article with instructions and insight for professors interested in building similar video collaborations into their classrooms.
4) A video created through one of the courses showing how the process works, students in action, and what students learned. This video could be used to disseminate the ideas quickly, and to present at conferences.
5) Lunch discussions on at least four ACM campuses discussing the results of the project.
6) A presentation at a national teaching conference on the findings from the project.

There is also potential to expand the teaching methodology, depending on the success of the project. For example, we could also eventually create a comparative health systems course utilizing the video-conferencing assignments more heavily.

The main long-run outcomes relating are the video-conferencing assignments built into St. Olaf’s healthcare economics course and Macalester’s medical geography course. This would foster a working relationship and interdisciplinary exchange of ideas, where Prof. Hodgson and Prof. Carter present research in one another’s classes and share experience with knowledge gained from the video-conferencing assignment.

However, there is also potential to use this project to generate synergy around the idea of video-conferencing with people in other parts of the world. One potential way of using the results would involve the language faculty. The language faculty who have heard about the pr0ject at St. Olaf are excited about its potential to get their language students using their cultural knowledge and skills in classes outside of the language department. Integrating language and cultural skills into non-language courses is a goal on St. Olaf’s campus. In fact, the language faculty were the ones to put us in touch with our first international collaborator, because of their support of the idea.

The summer workshop and faculty development lunches would offer opportunities for faculty to come together to brainstorm new ways of using video-conferencing technology in this way. Many different courses could potentially benefit from a project that connected students directly to students in other cultures. Language classes, political science classes, anthropology classes, and history classes may all benefit from this kind of exchange, and the summer workshop would give faculty a chance to explore possibilities.

Lead Partner
Ashley Hodgson
Assistant Professor, St. Olaf College
Collaborating partner
Eric Carter
Assistant Professor, Macalester College
ACM Program Funding
Funding Cycle
Project Duration
Related Projects

See more »