Case Studies
Royal Children's Hospital Education Institute
Victoria has been graced with the presence of the Royal Children’s Hospital (RCH) for 140 years as a setting to meet the health and learning needs for children and adolescents. Beginning in July 2010, the RCH Education Institute became one of ten educational settings across Victoria to participate in the iPads for Learning Trial – In Their Hands. Twenty iPads provided by the Department of Education and Early Childhood Development (DEECD) were placed in the Children’s Neuroscience Centre to determine the benefits of cutting edge technology to student learning in this unique setting.
The Children’s Neuroscience Centre is a 32-bed ward that provides:
- care to children and young people with neurological, neurosurgical, ophthalmological and otolaryngology conditions
- care to children and young people within the Victorian Paediatric Rehabilitation Service including care for muscular skeletal injuries and psychosocial support for patients receiving treatment for an acquired brain injury.
Hospitals are primarily health environments with limited space. At the RCH, iPads allow teachers to create more of a group learning environment than has been previously possible. The use of iPads enables teachers to create a sense of group and peer-support with students who are spread out across various wards in the hospital and in some cases confined to bed. This further enables RCH to fulfil its desire to be not just a health space but a learning space for young people in its care. For young people returning to their classroom after an illness, this gives them a seamless transition in their learning.
Technology and learning at The Royal Children's Hospital
For some children and young people, long stays in hospital, repeat admissions and recovery at home may compromise social wellbeing or lead to educational disadvantage or disengagement from school.
In 2010, more than 45,000 school-aged children and young people (six–18 years) visited The Royal Children’s Hospital Melbourne (RCH), as either inpatients (staying at least one night at the hospital) or outpatients (visiting for an appointment or a day-long procedure, such as dialysis).
The RCH Education Institute supports the learning needs of these children and young people and helps them remain connected to their school and peers.
Central to this is the creation of learning environments across the hospital where patients are engaged, interested and curious, just as they would be if they were at school.
Teachers at the RCH provide creative and individualised learning opportunities on wards and outpatient areas, facilitate communication with school and work closely with the Education Institute research team to investigate the best ways to support the education, wellbeing and development of children and young people.
This includes exploring, integrating and evaluating the use of high-quality technologies, such as netbooks, iPads, interactive whiteboards, iPod touches, mobile music centres and digital cameras, for teaching and learning and connecting patients to their school teachers and classmates.
iPads in Action
The iPads are so successful at RCH that they are now being shared across three Wards to maximise student’s access to the device.
1. Intensive care unit
This ward has a 16 year old long term patient with limited physical and communication abilities who has been in the ward for over 200 days. She is severely sick, cannot connect with other students, has limited movement in her hands and has her own ward staff twenty four hours a day, seven days a week. The iPad has been a major event in this young person’s life. The touch interface has assisted her therapy and she can now apply pressure through her fingertips. This touch interface, alongside the text to speech capability of the iPad, has allowed this young woman to more fully communicate with the hospital staff and vice versa. Doodle Buddy and Scrabble are allowing her to re-engage with her school work. She can now also reconnect with her school friends through email and is continuing her Mandarin Course through specific mandarin apps.
2. Adolescent Ward
Students in the Adolescent Ward attend for a maximum of two months with the majority in for one to two weeks. There is a school session each morning for one and a half hours with a variety of ages present, some young people with chronic illness come back each month. The main purpose of this time is to increase student socialisation with their peers and to establish re-engagement with their schooling. The teachers develop an activity and bring the iPads to each session. The students use a range of apps depending on the activity.
3. Neuroscience and Rehabilitation
The 8th floor is where you will find the Children’s Neuroscience Centre, two iPad sessions are run in the play centre each week for mobile kids who can leave their beds. The minimum stay here is four weeks however two young people have just been discharged after seven and thirteen months respectively. Typically student learning is focused on individualised learning programs and inquiry based pedagogy is used where possible. There is an emphasis on literacy and numeracy and on connecting students with their peers back at school.
When rehabilitation patients are discharged the family and, with the family permission, the school gets a team report from the physiotherapist, occupational therapist, clinical psychologist and teacher. This includes an assessment and progress report and suggestions for the type of support that young person might need when they go back to school. Quite often the team receive feedback on how valuable it is for students to keep up to date with their schoolwork, making reintegration into their school classroom that much easier. Occasionally teachers from the student’s school and classmates will visit, in one notable case a long term patient receives visits every Thursday morning from the classroom teacher and three or four classmates.
A Story about Quinten
Quinten is a Grade 5 student who is an inpatient under the Rehabilitation team at the Royal Children’s Hospital. He was admitted in July 2010 with a neurological disorder caused by inflammation in the spinal cord that results in long term scarring of the spinal cord. This affects the areas of the body supplied by the nerves beneath the spinal cord and results in both motor (paralysis) and sensory impairments.
As of December 2010 Quinten has no movement and very limited sensation in his lower legs. He also has poor control of his trunk muscles making sitting upright for periods of time difficult. Quinten has some limited movement in his right arm (strength remains significantly decreased and purposeful movement difficult) and some slight movements of his left hand only. He has some altered sensation in a patchy distribution in all limbs. Many areas have no sensation.
A whole series of conversations occurred to establish Quinten’s academic level including an initial conversation with him and parents and of course communications with the school and classroom teachers. Recently, numerous conversations with the Principal, Assistant Principal and Integration Co-ordinator established the support Quinten will require when he returns to school and the availability of funding for this support. Quinten’s school teachers and classmates come to visit him at the hospital on a weekly basis. An Educational Consultant and Clinical Psychologist provide education to Quinten’s peers and teachers to prepare for his return to school.
In the meantime, Quinten is a recipient of an iPad at RCH. When Quinten was first introduced to the iPad, he initially found it difficult to manage, given the limited mobility he has with his right arm. However, over time and with much practise, he is now able to manage many of the apps that he uses. It is the use of the touch-sensitive interface that does not require high-level fine motor skills that gives Quinten access to content relevant to his learning.
Quinten has completed an enquiry driven project (that his class was completing at the time) on the ‘environment’, used the iPad for research via internet (Safari) and presented his information using Keynote. In addition to this, he loves making cartoons using Puppet Pals, drawing using Doodle Buddy and playing Scrabble.
Organisational matters
Organisational and management observations with the iPads at RCH include:
- Physical space for students to use iPads can be an issue so there is a need to work in with the play therapist for classroom sessions to ensure access to the room.
- All iPads are returned to the Education Institute office in the afternoon for charging on a rotational basis.
- In the mornings ten iPads go to the Adolescent Ward between 9:00 and 10:30 am. After this time the iPads are available to other teachers within the hospital on a book in book out system. Typically this will involve some students from the cancer ward utilising the iPads to reengage with their learning and ambulatory students– ie students coming in once a week for blood transfusions or dialysis.
- Two or three long term patients in Rehabilitation have an iPad on a semi permanent basis. These students have long term use of the iPads outside the shared learning space. The students provide feedback about the apps and how they find using them. This information is then recorded in a central database along with teacher observations; the app used; the activity planned with that app/s and the observed outcomes.
Next Steps
At this stage staff are still in the process of getting their heads around the technology and are learning a lot from the students and their own use of the iPad. Everyone would like to see improvement in learning outcomes for the students.
While social networks are not allowed at this point in time, Education Institute staff are currently investigating research around the use of social networks in hospital settings.
Moving to Voice Over Internet Protocol for staff is impacting on the wireless network, however moving to a fibre optic network should rectify this problem. The new state of the art site currently being built for the RCH is expected to resolve all the wireless issues.
The iPads provide a means to bridge the gap between the child being in the hospital for a health reason against their educational needs. They are also providing new avenues for engaging the multidisciplinary aspect of the hospital, the Occupational Therapists, Physiotherapists and Speech Therapist. Currently, the Play Therapy Group and Clinical Support Services are investigating the use of iPads to take young people’s mind off procedures they need to undergo.
"The touch-sensitive interface, that does not require high-level fine motor skills, gives Quinten access to content relevant to his learning."
