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Pedagogic practice in a hospital environment
Práctica pedagógica en un ambiente hospitalario
Ximena Pinos-Benavides
Universidad Central del Ecuador, Quito, Ecuador
Facultad de Filosofía Letras y Ciencias de la Educación, Carrera de Pedagogía de las
Ciencias Experimentales Matemática y Física
cxpinos@uce.edu.ec
https://orcid.org/0000-0001-6441-3590
(Received on: 20/03/2024; Accepted on: 20/04/2024; Final version received on: 30/06/2024)
Suggested citation: Pinos-Benavides, X. (2024). Pedagogic practice in a hospital
environment. Revista Cátedra, 7(2), 78-97.
Abstract
The article analyzes the importance of pedagogical actions in hospital environments,
considering the educational inclusion of children and young people in situations of illness
and hospitalization. The main problem is the lack of attention from educational and health
administrations, and the lack of knowledge of processes that lead to a continuity of the
school curriculum; to this is added feelings of anguish and anxiety about the academic
aspect, since the absence of the patient in the classroom causes delay and desertion in their
studies. The purpose of the research is to investigate experiences and results of research
related to this study. It is an exploratory qualitative approach research, it analyzes a
problem from different perceptions; it considers the inductive-deductive method and the
empirical method as the immediate experience of the undergraduate students of the
Pedagogy of Experimental Sciences, Mathematics and Physics of the Faculty of Philosophy,
Letters and Education Sciences of the Central University of Ecuador who participated in the
pedagogical practice in a hospital environment. The results obtained from the analysis of
the interview script indicate that, in addition to the teaching that should be provided
through playful and didactic activities, emotional support is important. Finally, the study
proposes different pedagogical actions and teaching strategies adapted to the special
educational needs derived from the disease and hospitalization.
Keywords
Hospital environment, educational inclusion, pedagogical practice, academic mentoring.
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Resumen
El artículo analiza la importancia de las actuaciones pedagógicas en ambientes
hospitalarios, se considera la inclusión educativa de niños y jóvenes en situaciones de
enfermedad y hospitalización. Se plantea como problema fundamental la escasa atención de
administraciones educativas, sanitarias, y el desconocimiento de procesos que conlleven a
una continuidad del currículo escolar; a esto se suma sentimientos de angustia y ansiedad
por el aspecto académico, pues, la ausencia del paciente en las aulas provoca retraso y
deserción en sus estudios. El propósito de la investigación es indagar experiencias y
resultados de investigaciones relacionadas con este estudio. Es una investigación de
enfoque cualitativo exploratorio, analiza un problema desde diferentes percepciones;
considera el método inductivo-deductivo y el método empírico como la experiencia
inmediata de los estudiantes de pregrado de la carrera de Pedagogía de las Ciencias
Experimentales Matemática y Física de la Facultad de Filosofía, Letras y Ciencias de la
Educación de la Universidad Central del Ecuador que participaron en la práctica pedagógica
en ambiente hospitalario. Los resultados obtenidos a partir del análisis del guion de la
entrevista señalan que, además de la enseñanza que se debe brindar a través de actividades
lúdicas y didácticas es importante el apoyo emocional. El estudio, finalmente, propone
actuaciones pedagógicas diferentes y estrategias de enseñanza adaptadas a las necesidades
educativas especiales derivadas de la enfermedad y la hospitalización.
Palabras clave
Ambiente hospitalario, actuaciones pedagógicas, inclusión educativa, tutoría académica.
1. Introduction
Pedagogical practice in hospital environments means contributing to an educational
normalization of the convalescent child or young person that responds to specific
educational needs. The analysis of these needs and possible responses depends on a large
number of factors such as: the training of professionals who accompany the student-patient,
the methodology used to design an intervention through academic tutoring and public
policy that promotes an appropriate pedagogy according to the specific needs. Hence, these
factors are essential to legally standardize an efficient pedagogical performance.
The most common problems faced by children and young people who are hospitalized are
related to disinterest, indifference on the part of educational and health administrations,
and the lack of knowledge of an agile process to provide continuity to a school curriculum.
It is also observed that in most Latin American countries there is no specialty in hospital
teaching; to this is added the indifference of society in general.
The present study proposes to determine the advantages of hospital education. The
pedagogical performance implies a systematic review of how the training of teachers who
teach in hospitals is treated. The main findings of this research are the study of teaching
strategies adapted to the special educational needs derived from illness and hospitalization.
Regarding the methodology, the research has used an exploratory qualitative approach,
since it analyzes a problem from different perceptions. The technique used was the
interview with the interview script instrument. The interview was directed to 32
students/trainers of the Mathematics and Physics Department of the Philosophy Faculty of
the Universidad Central del Ecuador who applied the Hospital Classrooms project to 136
children hospitalized in the pediatric area of the Carlos Andrade Marín Hospital in the city
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of Quito-Ecuador. The study is based on an inductive-deductive method because it is based
on the observation of facts in order to establish teaching strategies adapted to special
educational needs.
Regarding the structure and content of the article, section 2 presents the studies related to
the research. In section 3, the concepts related to the research topic are presented. Section
4 details the methodology used to develop this research. Section 5 shows the results of the
interview script. In section 6, conclusions are drawn according to the results obtained.
2. Related studies
In 2020, a research entitled La formación docente en la modalidad hospitalaria domiciliaria
en argentina: un desafío del porvenir gives an account of their teaching practices in
hospitals. Regarding the training of professionals, this research does not show a curricular
support that guarantees the academic development of the teaching staff. In terms of policy,
Law No. 26,206 created in 2006 establishes Home and Hospital Education as one of the
modalities of the Argentine Education System; in its Article 60, it guarantees home and
hospital education at all educational levels (initial, primary and secondary) and establishes
the right to education of students who, for health reasons, are unable to attend an institution
on a regular basis. Methodologically, the authors of this project indicate that their practice
was based on the metaphor of the kaleidoscope (a self-evaluative return of their individual
and group construction process, necessary to be objectified), Cuidarse para Cuidar that
addresses the importance of life and its sustainability with quality of life both for those who
stay and for those who leave, the Hospitacuentos and a thousand and one places to play
(Vitarelli and Margall, 2020).
In the year 2023, the Ministry of Education of the Plurinational State of Bolivia points out
general norms for educational management. Regarding teacher training, Art. 62 states that
the Specialized Unit for Continuing Education (UNEFCO) develops refresher courses for
teachers, with emphasis on theory and practice in classrooms other than regular education.
In the political sphere, education and health are established as universal rights with
community support, with their own cosmovisions. In public policy, pedagogical action is
based on the constitution of the Plurinational State of Bolivia 2022, considering the
international human rights policy (Ministry of Education of the Plurinational State of
Bolivia, 2023). Methodologically, curricular planning responds to a Pluricultural Bolivian
State, emphasizes the implementation of hospital support classrooms, develops
competencies on knowing how to be, knowing how to do, knowing how to know and
knowing how to live together (Ministry of Education, 2019).
In 2017, a research entitled El abordaje de la pedagogía hospitalaria en el contexto
venezolano describes the experiences of different programs developed in hospitals. In the
training of professionals, there is no investment in higher education with respect to teachers
in hospital environments. In terms of policy, its hospital pedagogical performance responds
to the special education modality implemented since 1970 through the Department of
Exceptional Children, which depended on Preschool Education. In the Public policy since
1976, specifically, in the 1st document of Conceptualization and Policies of Special
Education and in 2003 in the Report of the Special Education Modality: they raise in their
mission and vision, respect for diversity, access to comprehensive education, heterogeneity
as a natural fact of the school for all, and the social integration program (Serradas-Fonseca,
2017). Methodologically, the aim is to develop therapies with educational sense (Romero
and Alonso, 2007).
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In 2017, a research entitled La pedagogía clínica-hospitalaria en el Perú. A challenge and
challenge for the education and health sector points out the characteristics of a hospital
pedagogy based on three strategic lines: support for educational intervention, attention to
the patient's family and hospital pedagogical research. Regarding the training of
professionals, there is no specific and officially recognized university education in hospital
pedagogy in this research. Public policy is based on the General Law of Education, its
Regulation of Special Education guarantees a hospital education (Mendoza-Carrasco, 2017).
Methodologically, the existing program has been adjusted to the particularities of the
Peruvian context, considering that the children served come from different regions of the
country, with varied educational levels and even different languages (Chaves-Bellido,
2012).
In 2018, in a program entitled Libros de Educa Hoy llegan a escuela del Hospital Bloom gives
an account of the existence of an educational center, whose facilities are on the upper floors
of the Hospital Bloom, it is the only one of its kind at the level of Central America and the
Caribbean; in addition, it has served as an example and model for implementation in
countries such as Chile. As for the training of professionals, there is no mention of education
for hospital teachers; the educational center is staffed by teachers who work in regular or
special education schools. The public policy establishes legal norms that regulate the
function of this hospital classroom, based on Decree No. 917; the General Education Law of
December 12, 1996; the Law of Equal Opportunities for Persons with Disabilities 2000 and
its regulations; and the Law of Integral Protection of Children and Adolescents 2000.
Methodologically, it focuses on the plastic arts through this resource affective and academic
contents are taught (Martínez, 2018).
In 2020, in a research entitled Aulas hospitalarias en Paraguay points out that since 2009
the Ministry of Education and Science through an agreement carried out procedures for the
habilitation of hospital classrooms as proposed solutions for children suffering from any
disease. In the training of professionals, they point out that no specific competences are
developed to attend to the student-patient; this is done as a practice of continuous training.
The public policy is framed in Law No. 6749 on Hospital Pedagogy, whose objective is to
guarantee the right to education of hospitalized or ill children and young people.
Methodologically, the classroom is organized by modalities: hospital classroom; hospital
ward and home care (García-Tatera and Sánchez-Bobadilla, 2020).
In 2019, through the page of the Costa Rican Ministry of Education, it was indicated that the
high school educational service for hospitalized adolescents at the San Juan de Dios Hospital
had been inaugurated. Regarding the training of professionals, there is no specific
educational program for hospital pedagogy; however, it is complemented with courses,
workshops and seminars on hospital pedagogy. In public policy, hospital care is supported
by Article 21 of Law 7600 on Equal Opportunities for Persons with Disabilities and its
Regulations; the Code for Children and Adolescents and the National Policy for Children and
Adolescents 2009. The learning methods and strategies have an inclusive approach and are
oriented to the development of competencies (Díaz, 2019). The Methodology used is flexible
and adapts to the needs of each student, it is noted that they work one hour a week and the
lessons are divided into moments of beginning, development and closing with individual or
group work sessions (Ardón et al., 2017).
In 2008, a research entitled Pedagogía Hospitalaria Chile - España - Centro América
(Hospital Pedagogy Chile - Spain - Central America) describes the history of hospital
classrooms in Chile. In professional training, it is observed that undergraduate education is
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limited to specific actions associated with practical cases, while postgraduate training offers
diplomas in specific areas, but not in hospital pedagogy. In public policy, pedagogical action
is based on the Declaration of the Rights of Hospitalized Children and Young People. On the
other hand, it contemplates the 2015 Framework Law on Hospital Pedagogy in Latin
America. Methodologically, it is based on the continuity model of the educational process
and prioritizes the recovery of health, and then focuses on the objectives of education
(Garcés, 2008).
In 2024, a study entitled Anteproyecto de Ley 197. Derecho a la educación de los niños, niñas
y jóvenes hospitalizados o en situación de enfermedad en Panamá raises some perspectives
for hospital education. As for the professional training of teachers, there is no specific
curriculum on hospital pedagogy in the country. In public policy, pedagogical action is
protected by the Political Constitution of the Republic of Panama, Chapter 5, Art. 91, 92,
right to education, Convention on the Rights of the Child 1989, Art. 28 and 29, specifically
on the right to education of children and young people in a situation of illness. In terms of
methodology, it is indicated that the priority is to give continuity to education, and for this
purpose it has been divided into three care modalities: hospital classroom, hospital ward
and home care; all modalities have as methodology the continuity of their studies (Center
for Latin American Studies on Inclusive Education |CELEI|, 2024).
3. Related concepts
3.1.1 Inclusive education
Inclusive education is understood as any political attitude, collective commitment or
educational trend that seeks to integrate individual differences and needs. In this regard,
UNESCO (2001) states that educational inclusion "is seen as the process of identifying and
responding to the diversity of needs of all students through greater participation in learning,
cultures and communities, and reducing exclusion in education" (p. 15). With this
appreciation, inclusion is perceived not only as integration, but also as adaptation.
Adaptation to different learning styles and needs; learning difficulties are various, and if
illness and hospitalization are added to this, the situation of school continuity is further
aggravated. Inclusive education projects the access of children and young people to formal
education. In this sense, the presence of pedagogical action in the hospital environment is
imperative.
3.1.2 Hospital education
The teaching process can be developed in the hospital classroom (physical space
determined to receive classes), in the room (mobile classroom) or at home depending on
the specific needs of each patient. The Ministry of Education of Ecuador (2016) increased
the National Model of Hospital and Home Education Management and Care, the program
states that "hospital education is the teaching service provided to children and young people
who are in periods of illness and hospitalization"(p. 8). The situation of illness and the
hospital environment is an unfamiliar and, in some cases, discouraging place for children,
young people and their families. In this sense, the educator plays a fundamental role, since
the strategies and methodologies used should promote school activities that strengthen the
continuity of the curriculum, an environment of well-being and resilience for patients and
their families.
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3.1.3 Pedagogical practice
The development of inclusive pedagogical practices focuses on the organization and
planning of all the resources used in the classroom, this action is a consequence of the joint
reflection of all educational actors, López-Machín (2000) expresses "in any pedagogical
project, the soul is the teacher. He is the architect par excellence of the development of the
work with the students, and of carving the human soul, which is the most important part of
the educational work" (p. 2). Hence, the pedagogical performance must be supported by a
curriculum that trains the hospital teacher.
In Ecuador, this practice is legally based on the Constitution of the Republic of Ecuador
(2008), since in Title II, Chapter One, Section Five, Art. 27 states that "Education (...); will
stimulate the critical sense, art and physical culture, individual and community initiative,
and the development of skills and abilities to create and work (...)" (p. 33). Similarly, in Title
VII, Chapter One, Section One, Art. 343 refers to the fact that "the national education system
(...) will have as its center the subject who learns, and will function in a flexible and dynamic,
inclusive, effective and efficient manner (...)" (p. 160).
It should be noted that the Organic Law of Intercultural Education (LOEI) framed in the
Constitution, in force since 2011 and updated in 2016, also constitutes a legal basis that
supports inclusion. In Art. 2 referring to the Educational Principles, literal (b) points out
that "education constitutes an instrument for the transformation of society; (...)" (p. 9),
while literal (s) refers to the flexibility of education, while literal (ll) mentions that "students
are guaranteed an education that responds to the needs of their social, natural and cultural
environment at the local, national and global levels" (p.13). However, in Ecuador there is no
third level academic offer in hospital pedagogy. Methodologically, it is observed that
students/teachers attending hospitals are based on value criteria and on the recognition of
people as holistic, integral and diverse human beings.
3.1.4 Academic tutoring
The purpose of tutorial action is to help and guide the student in the learning process.
According to Álvarez (1995)
is a systematic process of assistance, addressed to all people in their
formative period, professional performance and leisure time, with the
aim of developing in them those vocational behaviors that prepare them
for adult life, through a continuous and technical intervention, based on
the principles of prevention, development and social intervention, with
the involvement of educational and socio-professional agents (p. 12).
Thus, tutoring as a substantial element of the educational process presents as a
characteristic a continuous, systematic and coherent curricular planning to the students'
learning, considering their specific circumstances. In this process, it is also important for
the tutor-counselor to develop empathy, emotional stability, confidence and leadership
skills; but, above all, to possess learning strategies and participative methodologies such as
help among students, the joint action of two teachers in the classroom, the formation of
interactive groups, cooperative learning, dialogues, personalized tutoring, diversified
teaching, meaningful learning, and the use of information technologies, among others.
For this reason, the curriculum should be made more flexible, curricular programs should
be proposed that make possible different learning contexts, committing to overcoming
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barriers of access, participation and commitment to meet diversity. In this sense,
pedagogical practices in hospital environments have been conceived as a service that brings
educational benefits to a process of educational inclusion in which the social reality and the
contextual situation of each child and young person are combined with the psychosocial and
educational needs. One of the first principles of these educational support units is that of
comprehensive globalized education, integrating the context and the subject, here plays an
important role the didactic resource and motivation.
Well-used didactic resources, in my personal opinion, make the teaching process more
concrete, the class becomes attractive, fun, and knowledge becomes meaningful. The task of
education according to Simbaña-Gallardo et al. (2017) "must allow living a constant process
of interaction, that the person discovers and cultivates individualities and at the same time
strengthens coexistence in collectivity, that manages to achieve corporate objectives
through the cultivation of the spirit, morals, values" (p.93). Hence, academic tutoring in
hospital environments must be based on values such as respect, empathy and good
treatment of the student-patient; the tutor must develop good human relations with the
patient's family, colleagues, hospital staff, etc.
Thus, the tutor anticipates what the student needs; love is paramount in this context, the
teacher must attend in a loving and humane way to the student, but without being dragged
by the pain. The task in the hospital environment is to ensure school learning, but also to
help to understand the disease and the hospital environment, offering emotional and
affective support to students and their families. For this reason, teaching-learning activities
are only effective if they are carried out in an interpersonal way, but, in addition, the factors
involved in the activity are directly related to the notion of care to the extent that
hospitalized students require comprehensive care that promotes humanism, health and
quality of life with due consideration of individual differences.
The principle of teaching responsibility, as well as the principles of justice and equality of
educational care, are not marked by the prescriptions of duty, but consist in the recognition
of students in their individual being. Simbaña-Gallardo et al. (2017) also indicate that in this
task it should not be forgotten that "in society there are forms of social organization, and it
will be up to education to articulate various social, economic, political, ideological and
cultural scenarios that converge in the educational system" (p. 96). The educational
curriculum responds to study plans or programs, but in practice it does not manifest unified
criteria, it does not respond to social needs of interdisciplinarity and multidisciplinarity of
knowledge; the educational curriculum then implies teaching from the problems
encountered, from the comprehensiveness and complexity in a given context.
4. Methods and materials
The research has an exploratory qualitative approach and applies the empirical method
based on experience. The following is a description of the steps developed:
1. Location of the study area. The research focused on the pediatric area of the Carlos
Andrade Marín Hospital.
2. Selection of the sample. Thirty-two trainers from the Mathematics and Physics
Department of the Philosophy Faculty of the Universidad Central del Ecuador
applied the Hospital Classrooms project to 136 children hospitalized in the pediatric
area of the Carlos Andrade Marín Hospital in the city of Quito-Ecuador.
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3. Design and application of the research instruments. The technique applied to collect
information was the semi-structured interview, this instrument was validated by
experts in the area of Pedagogy of Experimental Sciences, Mathematics and Physics
and experts in the area of Psychopedagogy of the Faculty of Philosophy, Letters and
Education Sciences of the Central University of Ecuador. The interview was directed
to 32 students of the Pedagogy of Experimental Sciences, Mathematics and Physics,
who were the trainers of the project. The interview questions were related to the
following dimensions: teaching experience in the context of hospital classrooms,
beneficiary situation (children hospitalized in the pediatric area of the Carlos
Andrade Marín Hospital), and academic tutoring in the context of hospital
classrooms. To identify the participants, coding [ENT] was applied, assigning the
number according to the order of intervention.
4. Data processing. Once the research instruments were applied, the interview was
transcribed. Subsequently, the codes were created and the respective quotes were
selected using the Atlas ti program. With the help of the Atlas ti program, the codes
and quotes were recorded in a matrix, and a semantic network was elaborated for
each dimension, in which the type of relationship between the codes was
established.
5. Analysis and discussion of results. On the basis of the matrix of relevant codes and
quotations, together with the semantic networks, the results were theorized and
discussed. Finally, the conclusions of the study were drawn.
5. Results
Table 1 shows a summary of the categories: teacher perception, situation of the
beneficiaries and academic tutoring in the context of hospital classrooms with their
respective codes and frequency of rooting. Subsequently, through the formation of semantic
networks, the most relevant aspects for the aforementioned categories are described.
Category
Freq
Relevant quotations
Identifi-
cator
Teaching
experience
23
"one of the most rewarding experiences
I've ever had."
ENT-5:1
"A good experience"
ENT-6:1
"really wonderful experience"
ENT-8:1
"very pleasant experience due to the fact
that we shared with wonderful children".
ENT-9:1
"I liked this work very much, I got very
attached to it".
ENT-10:2
"The experience at the hospital was very
gratifying"
ENT-11:1
"it was a very gratifying experience for the
spirit".
ENT-12:1
"it was a very nice experience because of
the sharing of knowledge".
ENT-15:2
"the experience was very nice and
pleasant".
ENT-16:5
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"It was one of the most unforgettable
experiences that we as students and
human beings can have.
ENT-18:1
"it was very pleasant since this
intercultural education project".
ENT-19:1
"hospitalarias has been very satisfactory"
ENT-23:1
"one of the most gratifying experiences
that we could have".
ENT-28:1
"it was a very gratifying experience"
ENT-29:1
"it was an unrepeatable experience".
ENT-31:1
"it was a rewarding experience".
ENT-32:1
10
"teachers are obliged to offer our service
to those social groups that are excluded" "I
would like us to continue in this way".
ENT-11:6
"I would like us to continue with this social
work that changes our lives and above all
fills us with joy.
ENT-17:5
"to change their mentality to achieve true
inclusion".
ENT-27:3
"helps you to transform as a person and
find the human side".
ENT-31:2
"I learned in a practical way what
"INCLUSIVE EDUCATION" means".
"it was very enriching to be able to learn
from them, the most defenseless".
4
"it helps me to gain experience for my
working life".
ENT-8:2
"There is learning that is not taught in the
classroom when you are training in a
profession".
ENT-18:2
"to forget for a while the situation in which
they were in".
ENT-19:5
"We were able to get a little bit out of the
environment full of doctors and nurses.
ENT-20:3
3
"but finally I was able to distract myself,
smile and learn how beautiful this subject
is".
ENT-1:9
"right to a quality and warm education".
ENT-14:5
"We teachers have the obligation to offer
our service to those social groups that are
excluded.
ENT-27:2
3
"We must educate for life, to love it and
respect its diversity.
ENT-8:3
"support that they give to each other".
ENT-11:6
"learn to understand what kindness,
companionship and most importantly
empathy are".
ENT-20:4
2
"to see the other reality that is not
observed in a normal classroom".
ENT-4:4
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2
"We learn values such as perseverance and
perseverance.
ENT-15:4
1
"equal opportunities to learn and be
included in society".
ENT-14:2
1
"I would like us to continue with this social
work that changes our lives and above all
fills us with joy.
ENT-3:3
1
"Many times they are excluded because of
their disability.
ENT-8:4
1
"to motivate them that life goes on and
they have to keep on preparing
themselves".
ENT-17:5
1
"There is a lack of teachers to provide
support in these areas.
ENT-28:2
1
"solidarity they have among themselves".
ENT-19:4
1
"opportunity to work with children for the
first time".
ENT-11:5
1
"anxious to be able to receive classes"
ENT-4:3
1
"with their smiles on their faces"
ENT-4:1
Beneficiary
status
7
" enthusiasm with which the children were
waiting for us"
ENT-1:7
"The excitement of watching them learn"
ENT-2:2
"she smiles and welcomes you with open
arms"
ENT-3:2
"she was waiting for me patiently and
eager to learn"
ENT-7:2
"they were excited when I came in".
ENT-12:2
"patients with different types of illnesses"
ENT-20:1
"girls with different illnesses that did not
allow them to attend regular classes"
ENT-25:1
5
"illness depress them even more"
ENT-1:1
"bedridden without access to their
studies".
ENT-15:1
"We encountered lucky and not so good
situations.
ENT-16:3
"And it was enough to arrive for the child
to smile.
ENT-26:1
"she waited patiently for me and was
eager to learn".
ENT-27:1
3
"They were excited when I came in".
ENT-17:4
88
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"children and adolescents who, due to life
circumstances, had to postpone their
studies momentarily".
ENT-20:1
"girls with different illnesses that did not
allow them to attend normal classes".
ENT-25:1
3
"bedridden children without access to
their studies".
ENT-14:3
3
"smiles and welcomes you with open
arms".
ENT-15:1
3
"they made the children very happy"
ENT-26:1
3
"The affection that the children give us is
unparalleled.
ENT-12:2
3
"they can't attend classes normally"
ENT-15:3
3
"they can't attend classes normally"
ENT-29:2
2
"They tend to be a little depressed.
ENT-1:3
2
"they fight day by day to improve
themselves and be better".
ENT-22:2
1
"bedridden, without access to their
studies".
ENT-16:1
1
"strive to learn and to be able to catch up".
ENT-6:3
1
"not being with their families"
ENT-26:1
1
"miss their classmates"
ENT-1:10
1
"remain alone most of the time".
ENT-16:4
1
"miss classes"
ENT-16:2
1
"constantly struggle day by day for their
health "
ENT-1:6
1
"vulnerable situation"
ENT-1:4
1
"think about it, since it is a part of teaching
that is not analyzed or taught to us".
ENT-1:2
1
"it makes me reflect on life, on what we are
doing today, on what you should improve
or change".
ENT-32:2
Academic
Tutoring
12
"to improve in all aspects of my life to be
someone better in the future".
ENT-5:2
"It taught me that life does not have to be
based only on seeking my well-being and
in the future as a professional, only to
teach.
ENT-6:2
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"It changes you and transforms you,
making your way of thinking different.
ENT-6:4
"I was able to acquire other qualities that
we did not know yet".
ENT-7:1
"It made us bring out our most human side
and understand that life is harder with
other people.
ENT-10:1
"It was very enriching to be able to learn
from them, the most defenseless ones.
ENT-11:2
"There is learning that is not taught in the
classroom when you are training in a
profession".
ENT-13:2
"there are more curricula like this".
ENT-18:2
"To reflect that we always have to give our
best whatever our problems are".
ENT-20:3
"to analyze my life and to propose to
myself to change, to strive daily for my
ideals".
ENT-23:2
"it was not only to teach the subject but
also to accompany them".
ENT-26:2
"We played games, I explained something
they didn't understand.
ENT-30:1
7
"We went to teach them what we are
strong in Mathematics, Physics and
Geometry, but not in an environment of
boring them".
ENT-9:4
"it does not imply just making the student
learn".
ENT-17:1
"giving them personalized tutoring"
ENT-19:2
"accompanying them pedagogically"
ENT-20:2
"We have to act wisely and quickly.
ENT-21:1
"mathematics area but providing moral
and emotional support."
ENT-29:3
"the psychological part also requires it"
ENT-32:3
7
"to give them more than direct
pedagogical support, it was emotional
support".
ENT-1:5
"mainly to support them and give them
encouragement at all times so that they
feel at ease".
ENT-11:4
"if not that the presence of one of us was
enough to make the child feel happy".
ENT-14:4
"I carried out another type of didactics,
familiarizing myself with the two children
I had to teach.
ENT-17:2
"They need emotional support".
ENT-17:3
"In the area of mathematics, but by
providing moral and emotional support.
ENT-19:3
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"They learn mathematical knowledge from
us.
ENT-22:4
6
"They don't only need help in the academic
area.
ENT-1:5
"We go to teach them what is our forte,
Mathematics, Physics and Geometry, but
not in a way to bore them.
ENT-3:1
"to teach them mathematics subjects".
ENT-11:3
"to teach mathematics, to a very sweet and
beautiful little girl".
ENT-19:2
"methods to explain and to make them
reason".
ENT-22:3
"look for the most appropriate way to
share by scrutinizing activities according
to each situation".
ENT-24:2
5
"it helps me to gain experience for my
working life".
ENT-4:5
"there are more study plans like this one".
ENT-9:2
"you have to act wisely and quickly".
ENT-19:5
"to give them more than direct
pedagogical support, it was an emotional
support".
ENT-23:2
"we go to teach them what we are strong
in Mathematics, Physics and Geometry, but
not in a way that bores them".
ENT-32:3
3
"to accompany them pedagogically"
ENT-14:4
"activities according to each situation"
ENT-19:2
"giving them personalized tutoring"
ENT-29:3
2
"a challenge to keep a child's attention".
ENT-9:3
"look for the most appropriate way to
share by scrutinizing activities according
to each situation".
ENT-21:1
2
"return to their studies without any delay
in their specific subject of mathematics".
ENT-4:2
"When they leave the hospital and
integrate into their daily life, there are no
gaps in the educational field".
ENT-9:2
2
"through games they are motivated to fight
to get out of there".
ENT-26:3
"we played, explained something they did
not understand".
ENT-29:4
2
"area of mathematics but providing moral
and emotional support."
ENT-2:3
"having a lot of understanding"
ENT-17:1
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1
"doing some didactic activity"
ENT-1:5
1
"one of the most rewarding experiences
I've ever had"
ENT-4:6
Table 1. summary of the categories: Teacher's perception, Beneficiaries' situation and Academic tutoring in the
context of hospital classrooms
With respect to the category of teacher perception in the context of hospital classrooms, the
most relevant aspects are as follows:
1. Rewarding experience: with a frequency of rootedness of 23, this code indicates
that teachers find their work in hospital classrooms to be rewarding and
meaningful.
2. Promoting inclusive education: with a frequency of rootedness of 10, this code
clearly emphasizes that teachers see their experience in hospital classrooms as
an opportunity to learn and promote inclusive education in a professional
context.
3. Other codes, such as "helps to forget about their problems" and "provide quality
and warm education," also have a frequency of rootedness of 3 or 4, indicating
that teachers value aspects related to inclusion, emotional support, and quality
of education in the hospital setting.
4. Some codes have a rootedness frequency of 1, suggesting that there is a need for
more teachers to support children. A sense of solidarity is seen by teachers as
indispensable but may not be as prominent in their overall perception of the
hospital classroom experience.
In addition, in reference to the category teacher perception in the context of hospital
classrooms, Figure 1 shows the semantic network with the most relevant codes analyzed
above, through this analysis it was determined that teachers who performed their work in
hospital classrooms found their experience rewarding and meaningful, demonstrating that
they deeply value their work and commitment to learning inclusive education, taking
advantage of this opportunity to develop these skills and knowledge.
Importantly, teachers value key aspects related to inclusion, emotional support and
educational quality in hospital classrooms. This was reflected in the frequency of
rootedness of codes such as "promote inclusive education", "help to forget about their
problems" and "provide quality and warmth education". Another important aspect that
emerges from this analysis is the need for more teachers to support children in this
situation.
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Figure 1. Semantic network category Teaching perception in the context of hospital classrooms
With reference to the category: situation of the beneficiaries in the context of the hospital
classrooms, the most relevant aspects detected (see Table 1) are as follows:
1. Eager to receive classes: with a frequency of 7, this situation indicates that the
beneficiaries of hospital classrooms have a strong desire to receive classes, despite
their health conditions.
2. Other situations, such as "different illnesses" and "postponing studies due to illness"
have a frequency of 5 and 3 respectively, suggesting that illnesses and the need to
postpone studies are common challenges for these beneficiaries.
3. "Joy in receiving classes" and "receive classes with joy" have a frequency of 3 each,
indicating that, despite difficulties, beneficiaries find happiness and satisfaction in
participating in hospital classes.
4. "Do not attend classes normally" and "vulnerable situation" have a frequency of 2
and 1 respectively, suggesting that some beneficiaries face additional difficulties in
accessing education due to their health conditions and personal situations.
5. Several other situations, such as "depression", "missing relatives" and "health
problems", have a frequency of 1 each, indicating that these aspects are also relevant
in the context of hospital classrooms, although less frequent compared to other
challenges mentioned.
Similarly, Figure 2 shows the semantic network, with the most relevant codes analyzed in
this category. This analysis revealed the different situations and challenges faced by
children in hospital classrooms, such as health problems, loneliness, depression. However,
despite these factors, their desire to learn, eagerness and joy to receive classes are
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highlighted, and relevant aspects that teachers should develop such as the importance of
providing adequate emotional and educational support in this context are detected.
Figure 2. Semantic network category Situation of beneficiaries in the context of hospital classrooms
Finally, with respect to the Academic Tutoring category in the context of hospital
classrooms, the most relevant significant aspects detected (see Table 1) are as follows:
1. Reflect on learning new methodologies: with a frequency of 12, this aspect
indicates that teachers who carried out their professional practice in hospital
classrooms are aware of the need to keep updated on new teaching
methodologies, which suggests a willingness to continuously improve and adapt
in order to provide quality education to hospitalized students.
2. Personalized accompaniment and emotional support: both aspects have a
frequency of 7, which emphasizes the importance of teachers providing
comprehensive individualized academic and emotional support to students in
the hospital environment.
3. Tutoring in the area of mathematics: with a frequency of 6, this aspect indicates
that tutoring in the area of mathematics is considered important by teachers,
which reflects the attention given to the specific academic needs of students.
4. Methodologies adapted to specific educational needs: with a frequency of 5, this
aspect highlights the importance of adapting the teaching process to meet the
individual needs of students in the hospital environment.
5. Finally, other aspects such as adapting resources to maintain the child's
attention, helping them to return without delay in their knowledge, teaching
through games, moral support, understanding needs and carrying out didactic
activities, have a lower frequency but are still considered important in the
context of academic tutoring in hospital classrooms.
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Likewise, Figure 3 shows the most relevant codes that make up this category through the
formation of the semantic network, which allows us to establish that the teachers who
worked in the hospital classrooms showed a strong commitment to learning new
methodologies and creating personalized educational resources adapted to the specific
needs of hospitalized children. This indicates a willingness to constantly improve and adapt
in order to provide quality education to hospitalized students. It was also highlighted that
personalized accompaniment and emotional support are fundamental aspects in the
context of hospital classrooms, thus recognizing the importance of providing
comprehensive support that addresses both the academic and emotional needs of the
students.
Figure 3. Semantic network category Academic tutoring in the context of hospital classrooms
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6. Discussion and Conclusions
The teaching experience in hospital classrooms is truly gratifying, because through this
noble work one experiences a deep learning about inclusive education in the professional
field. Working in hospital classrooms allowed us to get to know a reality that goes beyond
the conventional walls of the classroom, in this space teachers and children learn, both are
enriched with their stories, their dreams and their challenges.
However, it is important to mention that this experience also confronts us with the harsh
reality of exclusion due to illness and emphasizes the urgent need to provide equal
opportunities for all children and young people, regardless of their health conditions or
disabilities, everyone deserves access to quality education, regardless of their medical
situation. In this sense, it is essential to continue with the hospital classrooms and
strengthen support through the insertion of more committed teachers. On the other hand,
the participation of Higher Education Institutions is indispensable, it is necessary that they
commit themselves to the creation of careers in hospital pedagogy, training in new teaching
methodologies, creation of personalized educational resources adapted to the specific
needs of the student and forms of emotional support for children and young people in
hospital classrooms.
It is essential to recognize and support the patient/student in their daily struggle to have a
normal life, the tutor's support must be decisive to help them overcome different obstacles
and provide access to quality education for their integral development. For this reason, it is
emphasized that, in hospital classrooms, it is urgent to create and innovate new learning
methodologies to guarantee quality education for children and young people in difficult
medical situations. Therefore, it is necessary to focus on personalized accompaniment
where emotional support is also provided, and the implementation of methodologies and
educational resources adapted to the specific educational needs of each child and young
person.
In this line, it is important to highlight that teaching through games was an effective strategy
to make learning more fun and attractive for children in this environment. Through playful
and didactic activities, active learning was promoted and creativity and participation were
stimulated. The use of methodologies adapted to Information and Communication
Technologies (ICT) can be an effective tutoring option, and this accompanied by a process
of emotional support will provide efficient educational tools to continue growing,
regardless of the challenges they face.
Acknowledgment
I thank God for the opportunity to share with my students and staff of the HCAM hospital
the experience of serving children and adolescents with effort, social commitment and love.
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Author
XIMENA PINOS-BENAVIDES obtained her Master's degree in Procedural Law, mention in
Criminal Law, Universidad Tecnológica Indoamérica (Ecuador) in 2012. She obtained the
degree of Specialist in Procedural Law, Universidad Tecnológica Indoamérica (Ecuador) in
2009. Obtained a Superior Diploma in Procedural Law, Universidad Tecnológica
Indoamérica (Ecuador) in 2008. He obtained the degree of Senior Specialist in Applied
Geography, Universidad Andina Simón Bolívar (Ecuador) in 2007. She obtained the degree
of Doctor in Jurisprudence and Lawyer of the Courts and Tribunals of the Republic,
Universidad Central del Ecuador (Ecuador) in 2005. She obtained a degree in Education
Sciences and is a secondary school teacher specializing in History and Geography,
Universidad Central del Ecuador (Ecuador) in 2004.
She is currently a professor in the career of Pedagogy of Experimental Sciences,
Mathematics and Physics at the Faculty of Philosophy, Letters and Education Sciences of the
Central University of Ecuador. She is the author of several books and articles published.