Tjaša Funa Štamfelj is a teacher of English at Hospital School Ledina in Ljubljana, where she has been working with long-term ill and chronically ill students aged between 8 and 18. Mostly she has been teaching in the departments for child psychiatry, adolescent psychiatry and at the paediatric oncology department. Besides IT in teaching and learning, her other areas of interest include the promotion of reading, and teaching English as a second language.  Email: tjasa.funa@gmail.com

 

Introduction

In Hospital School Ledina, which is set at the University Children’s Hospital in Ljubljana, we teach about 1,500 students, who go to different primary and secondary schools across Slovenia. Mostly the lessons are carried out at the departments of child and adolescent psychiatry, at the department of nephrology, at the oncology department and at the rehabilitation institute. We cover educational, advisory and research work. The key learning objectives for long-term ill or chronically ill students are to enable continuity in learning and avoid disruptions of school activities, to identify strengths and weaknesses in learning, and to strengthen and preserve life perspectives. The scope of the educational work is carried out within the prescribed curriculum and depends on the difficulty of an illness, methods of treatment and, above all, on the extent a student can be involved in the lesson. Lessons are mostly individual or in small groups and so differentiated and individualized to the maximum. Disease is often accompanied by pain, fatigue, bad physical or psychological well-being and numerous examinations. Due to all these factors we prepare individualized programs, which are the basic documents for the adapted educational work (Bečan, 2012).

Our students are mostly long-term ill or chronically ill. Long-term (chronic) illness is persistent or otherwise long lasting in its effects. The term chronic is often applied when the course of the disease lasts for more than three months (Prevec, 2017). We also teach students who are not chronic patients, but are hospitalized for a longer period and need help in the educational work and reintegration into the primary/secondary school. There are several ways we carry out the lessons: we teach at the hospital when the student is hospitalized, at the hospital when a student is at home and cannot go to his/her home school, at the student’s home, we can use distance education, or other combined forms of individual teaching assistance (a combination of the teaching of the primary school and the hospital school).

Due to the changes in treatment of children and adolescents, the time of hospitalization itself is getting shorter, while the time when students need to stay at home after hospital treatment is prolonging. Teachers in hospital school offer to help with distance learning when a home school cannot support a long-term ill student, either because he/she has not received a decision about adjustments in the class yet, the school cannot provide home education, the health situation of the student, or the student’s home is too far from his/her school. During that time, we use VOX web conference as a distance-learning tool, which helps to bridge the gaps.

 

Web-conferencing in hospital school

With the help of the VOX web conference, we can help long-term students acquire knowledge even when they are not in the hospital. The use of ICT in distance learning prevents time separation by allowing synchronous communication between pupils and teachers.

The VOX system is provided by The Academic and Research Network of Slovenia (ARNES), and is aimed at organisations that do not have videoconferencing equipment and that have lesser audio/video requirements. Lessons take place entirely within a web page via ARNES’ web server, which is one of the main reasons we decided to use it, as we need no additional software. Web conferences enable very simple and user-friendly videoconferencing communication with multiple simultaneous users using average computers with speakers and a web browser. If you want to speak, you also need a microphone, while to send your own video, you also need a cheap web camera (which usually has a built-in microphone). No other equipment is needed.

A teacher and (a) student(s) enter an online classroom at the same time and participate in the lesson, exchanging live images and sound, sharing screens, displaying computer desktops, using chat rooms, recording, etc. To the teacher it is important that it enables the use of the already prepared e-materials and that there is the board we can write on. With the option “share screen” the teacher can easily get an overview over the student's screen, which is extremely useful when the student solves his tasks independently. In addition, the teacher can easily pass from e-materials to writing with the help of a graphic tablet. VOX online conference also allows the student to have a good look at the teacher's screen, as there is an option of a sufficiently large and thus distinct record. All this contributes to the quality of learning.

For every student a teacher needs to open his/her own online classroom and sends him/her a link, which allows him/her to enter it. Once he/she is in, the lessons are carried out similarly to live face-to-face teaching due to all the functions that the system offers. We always introduce the VOX web conference to students while they are still at the hospital, so that there is no discomfort with the use when they are at home. At the beginning, we had some problems with writing, especially of mathematical, physical and chemistry symbols, as the writing was awkward and time-consuming. To improve it, we decided to buy a graphic tablet, which makes the writing easier and more legible.

 

Whom have we taught and why?

Ana was a first year student of veterinary technician secondary school, when she fell and broke her femur. The fracture was very complicated so she stayed at hospital for a while and after she was discharged, she was not allowed to return to school until the end of the school year, because the doctors were afraid that she could fall again, making the recovery worse or impossible. She lived far from Ljubljana, so it was not possible for us or her home school teachers to visit her at home; this is why we decided to try distance learning. When she was still in the hospital, we introduced the system to her, so she could try it out several times. At first, she was a bit sceptical and afraid that something might not work, but at the end, it went fine. Together with her school, we made a plan of the subjects she needed to cover and formed a timetable. She was assessed when she had regular check-ups in the hospital, two or three times our teacher also visited her with tests at home. With this kind of combination of work, she was able to finish her first year successfully and continued to the second year with her classmates.

Most often during the last years, we used distance learning with students treated at the oncology department. These students are hospitalized on and off or stay at home for the whole year and cannot go to school. With them, we use the combination of teaching in the hospital, when they are there, and distance learning, when they are at home. Even after they finish treatment, they cannot return to school immediately, because their immune system is still weakened. During that time, they can come to hospital school from home if they live in Ljubljana, or we use the VOX system. When we teach children treated for cancer, we need to be extremely careful to check with them often how they feel. We learned that we need to use their good moments to the fullest, because their state of health can change quickly. When they feel well, they have more subjects and more lessons, when they do not, we wait for them to regain strength. Because of this type of work, we cover the necessary topics in shorter periods.

 

What do we need to bear in mind when using distance learning with ill students?

The first thing is their state of health (physical and mental). If we teach them in the hospital, we might notice ourselves that the student does not feel well, even before they say something themselves. If we teach them online, their current state is not so obvious, so we need to check continually if they are well. The age of the student is another important thing. From our experience, it is best to teach secondary school students or upper classes of elementary school, when students are mature enough to be left alone and independent enough to take care of their notes and other organisational things. Also, teaching younger children differs from teaching upper classes, as usually there are a lot of games involved, movement, group work, etc. These are some things young children miss if they are only taught online. We should also not forget about different characters and temperaments of our students. To some distance learning might present an additional pressure, because they feel exposed in one to one teaching, others might feel safer hidden behind the computer. Some will be confident and cooperative, others will barely respond to your ideas and suggestions. Some will be glad to make the most out of one to one teaching, having the teacher only for himself or herself; others might find the idea a bit intimidating. If the students stay at home longer, feelings of isolation and loneliness might arise. In such cases, it is necessary to have the support of the family. In addition, it means a lot to long term ill students if their classmates and a class teacher stay in touch, send good wishes, postcards, etc. Finally, the students need the basic skills in computers. Luckily, the use of the VOX system itself is quite simple and the students have no problems with its use.

 

Conclusion

Often distance education is the only possible solution for continuous teaching and learning. The continuity of education is frequently disrupted in long-term ill children and adolescents. Furthermore, due to illness their abilities to concentrate are also often reduced, which means they might have difficulties following the regular work, let alone compensate for the delay. Therefore, hospital teachers strive for students to do as much as possible during the illness (the amount depends on each individual and his state of health). It has been shown that ill students should not be left alone to learn, whether it be from notes, books, or e-materials, as the explanation of the teacher contributes to a great extent to the fact that students acquire as much knowledge as possible in the shortest possible time, and this is often of vital importance to them. Hospital teachers in cooperation with the health team, therefore follow the current abilities of the student; when he/she feels bad, there is less or no school, an when he/she feels better, the number of hours of lessons increases, and with them the number of subjects we teach. The time when students are at home after hospitalization gaining strength for full schoolwork is ideal for the learning of what had been missed. With the use of distance learning hospital teachers could be very helpful at this time, enabling the students to integrate into regular school activities when the time is appropriate.

 

References

Bečan, T. 2012. Ko naš učenec zboli, Ljubljana, Zavod RS za šolstvo, 11.

Prevec, A. 2017. Jaz pa hodim v bolnišnično šolo, Interno gradivo Bolnišnične šole Ljubljana, Ljubljana, 2.

Bečan, T.,et al. 2011. Koncept dela v bolnišničnih šolskih oddelkih., Interno gradivo Bolnišnične šole Ljubljana. Ljubljana, 7.

https://www.arnes.si/about-arnes/, Retrieved 22. 8. 2018.

 

Please check the Creative Methodology for Using ICT in the English Classroom course at Pilgrims website.

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Please check the Practical uses of Mobile Technology in the English Classroom course at Pilgrims website.