Background. The Internet provides the opportunity for international comparative study and collaboration when learning about ethics in clinical nursing practice.
Aim. This paper aims to discuss Internet links developed between US and UK postregistration nursing students who were reflecting on clinical practice in order to explore how political and organizational structures of the health care system affect ethical decision-making.
Discussion. An analysis is presented of the stages in developing an exchange course for students from these countries, which involved various combinations of classroom-based teaching, on-line discussions and international visits by students and teachers during its evolution. The strengths and weaknesses of the different methods are considered, and future developments identified.
Conclusion. The Internet collaboration resulted in postregistration nursing students using reflection on practice in the study of ethics in clinical practice and an understanding of how systems structures and procedures affect ethical decision making. Internet-assisted teaching offers opportunities for collaboration, and student participants demonstrate sophisticated critical thinking in ethical decision-making. Issues of access barriers and motivation remain challenges to wider use.