In this project the interactive online learning platform ICON was used as a vehicle to explore the research question in which way a cooperative use of virtual cases within an interactive learning platform affects the learning process and dynamic in mixed student groups from the US and Germany. The ICON platform allows students to interact with each other, faculty and virtual patients in neurological cases. Students of Harvard University and the University of Witten worked in the winter semester 2009 in two mixed groups. The students from the different universities communicated via the ICON platform and created diagnostic hypotheses, and treatment proposals. As a result the international student group collaboration showed a positive effect regarding the efficiency and accuracy of students achievement of case learning objectives.