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Cancer Kids Tutors

Hospital-based educational support for children undergoing cancer treatment.

Pediatric cancer patients face challenges during treatment that interfere with proper education. The COVID pandemic and poor governance have worsened the quality of education. The oncology program has 350 patients in treatment and school abandonment in patients is higher than the national mean. Our solution is to create a hospital-based tutoring program to support patients in school.



HundrED shortlisted this innovation

HundrED has shortlisted this innovation to one of its innovation collections. The information on this page has been checked by HundrED.

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Target group
April 2023

About the innovation

Why did you create this innovation?

Pediatric cancer patients face challenges that interfere with education. The COVID pandemic and political turmoil have worsened the quality of education. At this time, schools are returning to in-person education, on-line opportunities are closing leaving children with cancer behind. Their education is lacking, deficient, and demotivating. Children need additional help with education.

How does your innovation work in practice?

We have created a hospital-based tutoring program that aims to support children enrolled at regular school with their education by maintaining contact with schools and helping them keep up with schoolwork while children are at the hospital and online while at home. The process begins with patient's schools being informed of the tutoring program through a letter. Weekly guidelines, classes, homework, and evaluations are shared with the hospital´s tutors by the school teachers or parents. In addition to schoolwork, teachers can submit objectives and indicators as well as comments and requests for the tutor. Patients work with the tutors when they attend hospital appointments and during hospitalizations. The tutors help with school work, communicate with teachers to help understand the disease and treatment process, support with school planning and organization, and assist in the patient's return to school.

How has it been spreading?

A systematic approach has been included by periodically assessing patient's educational status by the psychosocial team. This has allowed to support more patients by inviting them to the program. Also, this solution has been spreading by word-of-mouth among families and patients. Usually, patients ask for educational support. Although the tutoring has not been universal for lack of funds, we have used the knowledge of many of our teacher volunteers and have found this process to be motivating and helpful for patient students and their parents. We have also begun developing strategic alliances with three local universities to have education students as formal tutors at the hospital. Children who have worked with tutors report the tutoring as helpful for them.

If I want to try it, what should I do?

With every patient start with an educational status assessment of the opportunities offered by the current school. If not available, refer to a hospital school program. If available, the team should contact the school, offer support, and request the teacher to share objectives and indicators every week so tutors can help patients achieve the curricular goals by helping with schoolwork and exams


A glimpse to our model
We work collaboratively with the schools. This is a graphic representation of out workflow. Regular school teachers, and sometimes, the special education teacher, provide guides for every week or period. This allows tutors to support patients on the specific topics they need to understand and complete schoolwork such as homework and test that are sent back to the teachers for grading. This represent a collaborative liaison between the school, the community and our pediatric cancer program. 
Love and numbers
We believe that emotions are an important component of education. Take Amalia as an example, last week she spent hours learning the numbers with her tutor without even noticing. Our tutors promote engagement by showing a deep respect to learners. Children love their tutoring hours because they feel connected, supported and heard. By caring consideration of their emotion we can enhance learning in subjects as math that can usually be a challenge. Picture shown with Amalia's mother written consent. 
She's made to thrive
Silvia came to our program at 14, she was diagnosed with Acute Lymphoblastic Leukemia and soon started treatment. During her educational assessment we found that Silvia was feeling highly demotivated towards school because she had already missed a couple years and felt ashamed to be seen bald by younger classmates. At first, she was reluctant to continue with her studies. After being enrolled in Cancer Kids Tutors, we rapidly discovered how smart, fun and proactive Silvia can be. This program helped her feel more confident on her ability to learn, do schoolwork, but the biggest win was the new motivation to continue studying. This was possible thanks to her tutor that spend whole mornings with her practicing, explaining and motivating while she fought pediatric cancer. Picture shown with Silvia's mother written consent. 
How can math and corn work together?
Mirna, our tutor from a local university works with our patient Sofia (8 y/o). The 2nd grade curricula includes substractions as part of the math plan. In this tutoring session Mirna helped Sofia based on the topics, objectives and indicators provided by the teacher and respecting the Ministry of Education guidelines. Mirna found that Sofía could benefit from a visual approach and decided that the next session they will use corn grains as a mean to practice substractions. Picture shown with Sofia's mom written consent

Implementation steps


Every child with cancer has a unique experience with education. Some of them have access to a school at their communities to attend in-person classes and have means to keep a fluent communication with their educators during hospitalizations and absences due to treatment.  Nevertheless, others face barriers to proper education, such as long distances from their homes to the school and lack of opportunities to keep studying due to lack of resources and support. To leverage this, individually tailored interventions are applied by the psychosocial team at Fundación Ayúdame a Vivir and the tutors. 

We actively asssess our patient's educational status. For this purpose, we ask them about several parameters that help us understand what are their needs and what we can do to promote education during treatment. The following list shows some of the most relevant data we collect:

  • Basic clinical data: Such as diagnosis, phase of treatment, sex, age, etc. 
  • Enrollment status: To know wether a given patient is enrolled or not in a public or private school. Responses can vary from being actively participating, being enrolled but not attending for a number of reasons and being completely out of school. 
  • Current year: This allows to know if the patient's is in the grade that they're supposed to be based on their age. 
  • Last approved year: This information allow us to know the child's trajectory during the last year. Our experience has taught us that when asking this question, families tend to inform about complete trajectory since the early years. 
  • Modality: Families inform wether the child has been attending to school in-person before diagnosis and initial treatment or is studying on-line. Asking about this allows us to also understand the barriers that children face accessing to education as well as studying at home. Some typical answers to this questions are that there is no school nearby or that studying on-line is discouraging due to lack of support and social contact. 
  • Years lost: Typically at our center we can expect that some children present with some school years lag. We believe that children that loose more than a school year have a higher risk to indefinitely drop out of school. 
  • Reasons for inactivity: This is one of the most important questions. We ask for the particular reason a given child is not in school. Typically families report that they have fear to push school continuity due to fear to stress the child, that school teachers prefer them to focus on their health or that they don't have the resources or support to study on-line. We directly intend to tackle this reason by counselling, offering support or contacting the school. 
  • "Compassionate" promotion: We call compassionate promotion to the act of duplicating grades or arbitrary assigning grades to unsubmitted schoolwork such as homeworks, projects or tests by the teachers to promote the student to the next school year. An overwhelming 25% of our patients are being promoted without fulfilling academic achievements. 
  • Other data: Data such as the number of interventions performed related to the child's academic status, information and communication sent to school, etc. 

This information provides a clear panoramic of a child's academic status. With this information, and carefully considering the clinical situation, we make decisions along with the family and the community school. We have found that the best intervention proposals that we present to families and schools are the ones that rely on this data. 


Once we have a clear picture of a child's educational status we set our goals for each patient, typically these goals are:

  • to maintain that child in school achieving curricular goals measured by indicators  , wether in person or on-line during cancer treatment, or
  • to help that child go back into school, recover lost time and catch-up with his/her classmates. 

To achieve this goals, we need to ensure that our patients have all the resources they need. We have identified several categories of resources needed and providers as described bellow:

  • Children need a curricula: To achieve meaningful goals that help out patients reach out of poverty by education means, we need to follow the stablished curricula by the Ministry of Education in El Salvador. School teachers can provide the administrative and pedagogical guidelines. By this, we refer to the sequence of topics that need to be covered on any given quarter, the indicators that children need to achieve and the means of evaluation. Teachers can also request projects and homework when needed to strengthen our patient's skills. 
  • School supplies are needed: School supplies such as printed materials, notebooks, tablets, internet access, pencils, etc are the physical means children with cancer and their tutors use to achieve learning.
  • Children need support: One-on-one tutoring experience is at the core of our innovation. In this context, support means having a tutor teaching contents, explaining homework, providing support and helping with evaluation.  

How do we find resources and coordinate logistic to reach families? 

Our strategy consists on us being proactive by contacting teachers either by call, mail or chat. During our communications we share the diagnosis, explain the treatment phases and what teachers can expect with the child diagnosed with cancer. We express the interest of the family in educational continuity and explain that our tutors can be a teacher's extension at the hospital. Schools are informed of their roles as providers of curricula and schoolwork. Teacher often offer support sending materials and lately assigning governmental laptops or tablets. Attached readers can find a visual representation of our model that shows how collaboration is made. 

Our centre is allied with a special-needs school based at Hospital Benjamín Bloom, one of our strategic allies). In case a child is not enrolled in their community school they can be enrolled and followed-up by this program. Teachers from this school also provide students with pedagogical guidelines. Being part of this program has curricular and legal validity. 


Before starting with Cancer Kids Tutors, Marina struggled with on-line school. Because she didn't have clear understanding of what to do with the guides her teacher sent weekly, on one occasion she just copied word-by-word the guide on her notebook. Actually, the task consisted on performing an experiment, but since Marina didn't have anyone to explain this, she did what she thought was right. Guides are a common strategy in El Salvador to manage children attending on-line classes due to pandemic or other reasons such as health issues. When her tutor discovered this, she made sure that Marina was aware that guides contain prompts to be followed so in the future she would follow indications. She also helped her to complete the tasks, homework and projects that the guides required. Marina gained a greater understanding of the mechanisms than underly electric propagation. 

As Marina, many children struggle with on-line education and non-classroom methodologies. Children with cancer face limitations due to their inmmunosupressed condition to attend school in-person. Having little to none contact with educators can make difficult to complete schoolwork, present evaluations and achieve meaningful learning. Under this conditions, it is hard to thrive at school.  Children can benefit from one-to-one tutoring as Marina did in the testimonial above. 

During hospitalizations, the tutors work with our patients to complete their schoolwork and present evaluations. This is made in a one-to-one basis, mostly twice a week. We have learned that children feel more motivated to keep studying with the physical presence of a tutor. They also feel that schoolwork is not an impossible task that can actually be completed. 

What topics and objectives guide the tutor's work? Teachers provide topics and evaluations according to the grade's curricula. This is key since achieving educational goals should allow our patient's to aspire to higher education and better paid jobs in order to get out of poverty. 

Our patients love their study time because their tutors are kind, caring and understand that learning is more than just reading, we work on providing an emotionally safe environment for learning. 

Feed back

As stated before, teachers provide the curricula and administrative conditions to promote our patients. In order to promote a child, teachers need to evaluate our patient's proficiency in every subject. Evaluation is described in the curricula and teachers use their own methodology. After completing schoolwork, students along with tutors send schoolwork to teachers for grading and feedback. 

This step is highly important because if there was no evaluation or feedback from teachers, patients and tutors wouldn't know what areas need harder work and if they're really achieving the programatic goals. Teacher can suggest optimizations. In this step, we aim for real, creative, challenging and fair evaluation were our kids can really demonstrate what they've learnt. We believe that fairness in evaluation means that whatever strategy is used it is not extremely easy to fulfill so it doesn't challenge them or too hard that it becomes impossible. Using formative evaluation reflects deep respect to our patients capabilities.


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