The UM SONHS has bi-directional exchange agreements with three institutions of higher healthcare education in Spain: Universidad de Alicante Faculty of Health Sciences, Universitat de Barcelona School of Nursing and Universidad Francisco de Vitoria in Madrid. Under these agreements, UM SONHS students travel to Spain, where they can observe firsthand the workings of that nation’s single-payer healthcare system,  vastly different from the patient care experience in U.S. hospitals. At the same time, visiting nursing students from all three of these Spanish institutions of higher healthcare education have been received at our school, for immersion in clinical observational and hands-on simulation activities based on the U.S. healthcare model. In this era of increasing globalization, these transnational experiences greatly benefit the worldview and cultural competence of our future nurses on both sides of the exchange.