On her first day as a volunteer in a children’s hospital, Megan Nickels walked into a room where a 14-year-old girl was recovering from brain surgery. Carrying a packet of worksheets, the math teacher thought they’d study fractions.
What she found instead was chaos. The family spoke Spanish, and Nickels did not. Two preschoolers were playing with loud toys, the TV was blaring, and the medical staff came in to do rounds. Nickels had barely introduced herself when the patient was given a painful injection and started to cry.
Nickels was still standing there with her worksheets, finally brave enough to slide one near the child. “No” was the response, and Nickels left. That was her first rejection of many. Sometimes she’d hear the word before crossing the room’s threshold. Not surprisingly, children undergoing chemotherapy or recovering from open heart surgery have no interest in learning about equations.
The former elementary school teacher volunteered at the hospital because she was working on her Ph.D. in mathematics education at Illinois State after having earned her master’s degree in elementary and middle school math education. She missed working with children, and was passionate in helping those sidelined from their education by illness keep pace with their learning.
While driving home from a day of visits, she remembered her childhood grade school used a computer program to teach math. An internet search took her to LEGO Mindstorms, and she purchased a robotics kit. The next day she asked her student if she wanted to build a robot. That changed everything. The child’s interest blossomed, as did an idea that Nickels cultivated for seven years before creating a teaching curriculum designed for hospitalized patients from ages 3 to 21.
Nickels, M.S. ’12, Ph.D. ’15, is founder and faculty director of PedsAcademy at Nemours Children’s Hospital in Orlando, Florida. The pediatric school that opened in fall 2018 is believed to be the only one of its kind, offering bedside and classroom teaching through robotics and virtual reality.
Also an assistant professor of STEM education at the University of Central Florida (UCF) in Orlando, Nickels spent years developing the academy that creates educational experiences tied to a patient’s disease or condition.
“I do immersive virtual reality, developing interventions to teach mathematics in ways that are engaging and meaningful, and can also address some of their unique concerns,” she said.
As a result, children with chronic and critical illnesses are exploring Mars, the Louvre in France, and Australia’s Great Barrier Reef while learning science, technology, engineering and math (STEM) subjects, literacy, and the humanities.
Nickels has explored King Tut’s tomb in Egypt with a 10-year-old with bone cancer. Other chronically ill students have landed on asteroids, scaled Asia’s Mount Everest and swam with sea turtles, practicing the breaststroke from a hospital bed and strengthening weakened muscles while learning.
On the day they’re admitted, young patients are visited by PedsAcademy staff consisting of UCF doctoral students and pre-service teachers. Lessons are tailored to the children’s areas of interest.
“If they’re here, we’re serving them,” said Nickels, who has taught children with traumatic brain injuries, HIV/AIDS, and heart defects. “Each child is unique in what their treatment plan looks like. It’s precision education, the counterpart to precision medicine.”
Children receive up to three hours of teaching a day, Monday through Friday. The year-round classes don’t provide credit, but give the students a sense of normalcy and keep them from falling behind their peers.
The program is free, supported through private donors and foundations, including $2.3 million from NASA. Using the space agency’s robots, students work with math and science curricula that correlate with actual missions. Marine biology is also popular, with patients creating robotic crabs and sea turtles for a cybernautic zoo.
Norm Jeune III is Nemours’ director of Patient and Family Centered Care. When he joined the hospital that opened in 2012, he noticed there was no school program. He was making progress with a school district when he met Nickels. He praises PedsAcademy, saying “it has totally exceeded my expectations in every possible way. It has changed our hospital.”
Physicians are acutely aware of how much a child needs schooling, he said, but it’s a stressor for parents to figure out how to make it happen. Children also miss out on a social life when not in school. Having a classroom in the hospital lifts their spirits. “We’re giving them back some piece of what they had before they were taken out of their school environment,” Jeune said. “I think that helps the healing process.”
Virtual reality headsets and computers are becoming as common as water pitchers in patient rooms. In addition to bedside teaching, there’s a hub of activity in what looks like an elementary classroom, except that students arrive in wheelchairs with IV poles.
“We have to lock it if we leave even for five minutes, because the kids will sneak in—even from other units. They love having something to do,” Nickels said. “We’ve had parents drive their kids here on days they’re not scheduled to be seen. They want to be here.”
Nemours is a 100-bed hospital, but also treats more than 1,000 children a day in outpatient clinics. Nickels is expanding the program to include them. “As we continue to grow, hopefully we can catch them all. We even teach siblings while they’re here,” Nickels said, noting they’re a population that doesn’t get a lot of attention.
Virtual reality can also be a powerful tool in terms of medicine, at times replacing sedation before a procedure. “It can be a distractor before a procedure a child might be anxious about,” Nickels said. “We can also use it in physical therapy to get them to do things that are really uncomfortable. They’re so willing to do it in virtual reality.”
ISU Associate Professor of Mathematics Education Craig Cullen was Nickels’ dissertation chair. They worked together on the NASA grant and collaborate on research. “I certainly would not be where I am or doing half the work that I do without Craig Cullen,” Nickels said. “He’s continued to be extremely supportive.”
Cullen responds by crediting Nickels for her success. “She’s really driven. She’s a ferocious leader,” he said. “I just happened to be the one standing near her when she was doing the work.”
Cullen understands Nickels’ vision and the need for PedsAcademy, as it’s natural for families with seriously ill children to focus on healing. That deprives the child of learning experiences.
“A lot of good-intentioned people start pulling back from what’s expected of kids in a hospital,” he said. “Megan’s vision is different, that they are still capable. Even if a child isn’t going to survive to adulthood, they still need and deserve the opportunity to participate in science, technology, engineering, and mathematic experiences. That’s part of being human. If you strip that away from them, they’re being quarantined off from the world.”
Nickels has another Illinois State educator in her life. She’s married to Matthew Nickels, who earned a bachelor’s degree in political science in 2004 and returned to get his middle school education degree in 2010. He is a civics and chemistry teacher at Florida Connections Academy, a virtual school based out of Tampa, Florida.
Nickels would like to see the PedsAcademy model spread across the country, as there are nearly 250 children’s hospitals in the U.S. treating an average of 8,000 inpatients a year and 180,000 outpatients.
Nickels also hopes to change the perspective of educators in school districts, beginning with the student teachers she mentors through the academy. “If they take a job in a brick and mortar classroom, at least when a child comes into their classroom with a complex medical illness,” she said, “they’ll know not to send worksheets.”