A presentation given by Dr. Liza Hopkins at the CHA Conference October 2012, The Journey, in the 'Service Redesgin & Innovation' stream

1. Incorporating education into the
holistic care of pediatric patients:
The CL@RCH (Children’s Learning
at The RCH) project
Liza Hopkins
Tsharni Zazryn
Sue Wilks
Kira Macleod
Royal Children’s Hospital Education Institute

2. CL@RCH: Overall premise
• To strengthen the capacity of a
children’s hospital to keep children
engaged with learning in a dynamic and
flexible environment.

3. CL@RCH: context
• Development of a new children’s
hospital

4. CL@RCH: Our questions
1. What do children and young people value
about learning during hospitalisation?
2. In what ways do they and their families use
the hospital environment to stay engaged in
learning related activities while in the
hospital?
3. How can physical spaces where children and
young people spend time across the hospital
be used to strengthen the promotion of
children’s learning?

5. CL@RCH: Our questions (2)
4. What partnerships could or should be
developed to enhance learning opportunities
at the RCH and how should these
partnerships be fostered?
5. What are the critical components for
children’s learning applicable to a hospital
environment?

6. CL@RCH products
• Learning spaces literature review
• Learning spaces issues and needs framework
• Consultation report
• Snapshot booklet
• Key messages framework
• Set of principles for teaching and learning
• RCH procedure for education support

7. Literature review findings
• Effective spaces connect with best practice teaching
and learning
• Learners need ownership of the learning space
• Technology connects learners wherever they are
• The importance of the outdoor environment
• Connecting spaces with people – a holistic learning
environment
• Arts based pedagogy contributes to education, well-
being and health

8. Consultation methodology
• Consultations with:
• 57children & young people (3-19 years)
• 29 parents
• 10 external education professionals
• 23 RCH Education Institute staff
• 4 junior medical doctors

9. Example: Children & young people
• Across all areas of hospital
• except ED & ICU
• purposive & convenience sampling
• Stimulus – photographic slide show
• Semi-structured interview questions
• A3 design activity

10. Photographic stimuli

11. Children & young people questions
Domain Examples of guiding questions
Children as learners • Which activities in the photos would you like to do? Why?
• What sort of activities/things have you done today while here in the hospital?
What was your favourite? Why?
• How do you know when you have learnt something?
• Can you tell me about something you have learnt whilst here in the hospital?
Learning communities • Do you like working/playing with other children/people? Why?
• Do you sometimes like working/playing on your own? Why?
Continuity of learning • Have you worked with a teacher/play therapist here? What was that like?
• Do you keep in touch with your friends from school while you are in the
hospital? How? Why?
Physical spaces • What is your favourite place to learn? What makes it your favourite place?
• What areas of the hospital do you spend time in? What do you do while you
are there? Are there things you wish you could do there?

12. A3 design activity

13. Children and young people
• Children and young people have a deep and
broad understanding of what ‘learning’ is
• Fun/games/interactivity are the key to
engagement in learning opportunities in a
hospital setting
• Children and young people are social beings
and learning opportunities should reflect this

14. Children and young people (2)
• Children and young people want to access
activity rooms and outdoor spaces for social
interactions
• Children and young people want more
appropriate fit outs for furniture/activities in
activity rooms and are capable of being
included in decision making in this regard

15. Children and young people:
Perceptions of learning
“... I like working in groups more. Because ... everyone has different ideas,
and so ... you can learn different things off different people, and, if your
answer’s wrong or something, they can be up there to help you learn
different ways that they’ve learnt how to learn it.”
“It feels good. Before you didn’t know what it is. You now know how to do
it.”
“It’s easier to learn when working with others. You learn more... it’s
sometimes better [to work alone] if you need to concentrate.”
“If you work with other people, they might get something wrong.”
“You can teach it to someone else.”
“I know something else.”

16. Parents
• Parents value and expect the inclusion of
education and learning support as part of the
holistic care of their children
• Many parents have limited knowledge of the
education support that is available in hospital
• Parents of hospitalised children undervalue
the early years of education
• “Um, cause she’s only at Kinder I don’t think it’s ... much of an issue.
The Kinder stuff they do is all play to learn, it’s not sit down and write ...
it’s all blocks and play dough ... and things like that.”

17. Parents (2)
• Parents of hospitalised children view learning
and education as formal schooling only
“There’s nothing you guys can do that is actually gunna get me over the
thorough dislike I have of the fact that he’s not at school.”
“He doesn’t bring his work from school, his homework in here – he
conveniently forgets a lot! And um, that’s actually a concern for me
now”
“I hate it when she misses school. I really hate it.”
“And ... during the school term we’ve organised work from school and he’s
had to do some schoolwork. So you can’t just take games all the time.”

18. Parents (3)
• Parents highlighted a need to reduce social
and educational barriers for their hospitalised
children and were unaware of the
opportunities available for better connections
to be established
• Families want to be able to utilise the outside
spaces more
• Communication between school and hospital
is critical

19. Parent comments
• “... I’m trying to explain to her that she needs her education to further
her um expenditure on – going forth in her life ...”
• “[Education] - it’s very important for her to be all she can be.”
• “... just to maximise all opportunities he’s got. To give him opportunities
to do whatever he wants to do really. And um, cause I know that
education can give you access to things ... and education allows you to
achieve things that other people don’t think you can.”
• “And even if he makes it up to 20 [years old] you know, he’s still going
to need to think ahead ... So if he does, then he’s going to need to be
able to go forward and have a job.”
• “I want her to be able to think well, you know she can do anything in life
if she wants to. But she also needs to be, we have to try and keep her
normal, too. So school and her health are very… on my top of the list.”

20. Education Institute staff
• Integration of education into a health
dominated environment is challenging and
takes a considerable time to be achieved
• There is an increasing understanding from
ward teams about the role of the Education
Institute and the teachers
• Communication and consultation are key to
teachers being successful in
their role

21. Education Institute staff (2)
• There are vast differences (both positive and
negative) between teaching and learning in a
school setting and teaching and learning in a
hospital setting
• There is the potential to better involve parents
in the education and learning opportunities in
this setting, but in some instances it is better
to allow parents ‘time out’

22. Education Institute staff comments
“... what I’ve seen in the play and learning spaces [in the hospital] are
safe spaces. So they’re one of the very few places in the hospital where
there’s no procedures undertaken. No medical staff can come in, unless
it’s to engage in learning or play activities. And that’s a really important
thing for children in a hospital to have. A space that they know if
someone comes in with a lanyard on, they’re not going to be doing
something to them that they don’t want.”
“I always think a space in which students are comfortable to take risks I
think is one of the most important things.”

23. What we hope to achieve
• Outputs – procedure incorporated into the
RCH & an evidence-based framework to
guide teaching & learning in a paediatric
setting
• Embed notion of ‘children as learners’ into the
core business of the new hospital
• See evidence of this in:
• budgets
• key messages
• infrastructure
• decision making processes

24. Recommendations
• The RCH Education Institute and RCH
Executive should continue to advocate and
provide opportunities for patients as learners
• Government and non-government education
organisations, and the RCH Education
Institute, need to provide opportunities to
build parent knowledge and skills
• The education support available in the
hospital needs to be publicised to staff,
patients and visitors

25. Acknowledgements
• Thanks to the children, families, hospital &
non-hospital-based professionals who have
generously given their time and voice to this
research
• The work of the Royal Children’s Hospital
Education Institute is made possible by
funding provided by the Victorian Government
Department of Education and Early Childhood
Development

26. More info
http://www.oecd.org/edu/ceri/inventorycas
es.htm