Hospital-based education programs for children with chronic conditions are commonplace across the US. Research on this subject highlights the different benefits these programs can bring — whether it be maintaining a sense of normalcy during periods of prolonged absence from school, continuing to learn and grow academically, or promoting mental health and emotional wellbeing. But proof of positive impacts is generally lacking: as one recent study notes, "there is a need to generate more robust evidence about the effectiveness of these types of education support programs."

As the evaluators of a program called Science Journeys, we've seen firsthand how transformative hospital-based learning can be. Developed and implemented by Children's National Hospital, the program offers high-quality STEM educational opportunities to children and families in hospitalized settings. Through surveys, interviews, and on-site observations, we've found that Science Journeys is successfully sparking children's STEM interests, promoting understanding of different STEM topics, and bolstering mental and emotional health in ways that may improve long-term therapeutic outcomes and the transition back to children's daily living environments.

Perhaps most notably, the program is helping children see themselves not simply as patients, but as patient-students who play an active role in their journeys toward health through exploration, discovery, and learning.

This blog post spotlights some salient learnings from our ongoing evaluation of this innovative program.

Engaging Student Interests

Children and families have been highly engaged with Science Journeys lessons. "You just hear them engaging with their peers," a hospital employee who had observed the program said. "They're getting excited, discovering new things, and asking a lot of questions." Agreeing with this, another employee said Science Journeys was "helpful" for their work, highlighting how excited they were to see "increasing [children's] engagement in our unit" because of the program.

During our trips to the hospital, we've seen firsthand how engaging and enjoyable Science Journeys is for children. At one visit, we found an exceptionally high level of engagement around an activity focused on handwashing — which gave participants a chance to learn a concept, make a prediction, and conduct an experiment. Many children were seen holding their breaths while awaiting the results of their experiments, and after observing what happened with their soap, exclamations such as "oh cool," "woah," and "wow" were heard across the table.

Two factors are key to the high levels of engagement and enjoyment the program is cultivating. First is the fact — as caregivers have noted — that Science Journeys lessons are taught "in a fun manner," with games, puzzles, and real-time experiments being a key part of the curriculum. As a hospital employee who observed the program noted, Science Journeys teaches STEM content "in a gamified way that sparks children's interest."

Second is the way Science Journeys connects STEM to "what children are going through" in the hospital. The topics children learn about frequently align with their diagnoses. At the beginning of an interaction with a child being treated for a heart condition, a facilitator asked, "Do you know why you're here?" When the child answered, "because I can't breathe," the facilitator proceeded to a lesson on how the heart carries oxygen to different parts of the body. Individually tailored lessons like this enable Science Journeys to revolve around "questions that most patients can relate to," a hospital employee observed. The curriculum's relevance to children's specific needs and interests has been key to the high levels of engagement and enjoyment it's seen.

Building Knowledge and Skills

Science Journeys activities are helping children learn and build both academic and social skills. For those who "have placement issues" or "miss a lot of school," hospital staff see Science Journeys as one support keeping children from "not falling behind in school." Demonstration of learning has been particularly high in group-learning sessions, where participants pose complex questions and make connections across lessons and topics from week-to-week. Even in one-on-one activities, children are having "developmentally appropriate conversations," sharing their thinking processes outloud, and thinking scientifically.

In their remarks, caregivers have drawn attention to the diverse array of STEM subjects children and learning about, including:

• "Different types of print"
• "How gravity works on earth versus other planets"
• "How many different types of blood there are"
• "How fingerprints are formed"
• "Physical or behavioral stressors that cause adaptations and changes in melanin"

Children are also deepening their knowledge of subjects they're already familiar with. One caregiver said their child was "obsessed with insects, but realized there was so much more he didn't know, like that they have six legs, a thorax and antenna."

One thing that's been critical to Science Journey's success in helping children build STEM literacies is the program's positive impacts on their mental and emotional health. When discussing how the program provides "great activities for children to learn," caregivers have emphasized the ways it helps counteract some of the negative psychological impacts of hospitalization — including "isolation and depression." Caregivers have appreciated how Science Journeys is giving children access to learning experiences that "distract from the hospital setting while increasing scientific knowledge." Among other things, this is helping children relax, cheer up, and take their minds off of things like "missing school." As one put it, "this is a wonderful way to keep children happy in the hospital." When asked how Journeys had impacted their child, another simply said, "socialization and keeping her busy."

Hospital employees have echoed this point. "There's a lot of socialization that happens [with this program]," one said. The activities and accompanying human interaction also "connect [children] to things they used to do at home and school," offering much-needed normalcy in a hospital setting. Part of this social learning comes from working with children to be comfortable with and express their emotions. As a facilitator put it, Science Journeys lessons can help children understand that "we all have lots of emotions, and that no emotion is 'good' or 'bad'."

Let's Put it to Work

Through fun, highly enjoyable lessons that build both STEM literacies and social-emotional learning, Science Journeys is demonstrating what it takes to create effective hospital-based education programs. Both the curriculum and its implementation are answering calls for hospitals to go beyond traditional approaches to patient learning. They are showing — as one article puts it — that hospitals can be "not just a place to continue learning, but also a safe and welcoming environment where students, despite being patients, can develop their abilities and find the support they need to cope with their medical condition."

To help others reach that goal, our evaluation suggests that programs like Science Journeys are most effective when hospitals:

Focus on building strong relationships with a child's full caregiving network

Engagement with hospital-based learning programs is highest when educators first focus on building trusting relationships with children. Children in hospital settings are often seeing multiple health professionals a day and are accompanied by several family members. Establishing strong relationships with children and the network of caregivers around them is key to increasing participation and making children feel comfortable.

Create engaging and varied learning materials that can be easily adapted

One of the things that's made Science Journeys so effective is its curricular flexibility. As this suggests, doing effective hospital-based education requires a curriculum that can be tailored to children's interests — along with what learners and families are going through. Helping participants understand themselves, and leaning into children's interests and experiences, is one key to maintaining high learner engagement.

Balance educational content with personal experiences

Creating successful learning experiences requires a knowledge of what each individual child likes and finds stimulating. As facilitators told us, in many cases, there's a fine line between doing an activity that relates to a child's experience and something that hits "too close to home." To figure out where that line is, educators need to proceed on a case-by-case basis. They also need to learn how to make "quick judgment calls" based on their conversations with (and observations of) children. In some cases, this results in situations where educators target lessons to specific circumstances without asking children to dwell on difficult medical information.

Account for social learning and human interaction in addition to STEM learning

According to families, hospital workers, and Science Journeys facilitators, one of the program's most important interventions is boosting participants' mental, emotional, and social health — combatting the negative impacts hospitalization can have on children. This suggests that when designing hospital-based learning programs, it's essential to prioritize activities and materials that can help "distract from the hospital setting." Our evaluation suggests that this is crucial to "bringing back a sense of play and curiosity and imagination" for hospitalized youth.

About this Article

This blog post is part of a partnership between Knology and Science Journeys, funded by the NIH and SEPA. It is part of a multi-year project at Children's National Hospital, and continues previous STEM-education programs, "Discover SCIENCE with Dr. Bear" and "Being Me." You can read more about Science Journeys here.

Photo courtesy of Monkeybusinessimages @ iStock