BackgroundUnder the digital transformation trend nursing education, online formative assessment (OFA) provides a new opportunity. However, the OFA of nursing humanities course lacks design and practice, and faces the challenge of enhancing effective communication between teachers and students, student participation and autonomous learning. ObjectivesTo enhance the reliability of OFA in nursing humanities courses and provide practical experience for online teaching in the nursing profession. DesignA quantitative research approach was used. SettingThis study was conducted in a comprehensive university in China. ParticipantsWe conducted teaching practice on 185 nursing undergraduates, with 89 students in the experimental group, and 96 students in the control group. MethodsIn the 2020–2021 multicultural nursing course, student learning outcomes and questionnaires were analyzed through the online learning tool Superstar Learning, student feedback and satisfaction questionnaires, and descriptive analysis and independent sample t-tests were conducted using SPSS 25.0 software. ResultsThe OFA of students using Superstar Learning differed in learning performance and time to receive feedback from teachers between the experimental and control groups, and both groups had higher satisfaction levels. The experimental group's instructional design contained a synchronous classroom discussion module with better participation. ConclusionsDuring the COVID-19 pandemic, the use of online learning tools can support the implementation of OFA, build an environment where teachers and students participate together, have a positive impact on the continuous updating of teachers' teaching programs and students' learning outcomes. Simultaneous classroom discussions are expected to be an effective way to improve the reliability of OFA. Our instructional design, provides best practice suggestions for future online teaching and learning.