Abstract:

Children often experience anxiety in medical contexts known as “white coat fear.” Evidence shows that play-based and experiential learning approaches can reduce such anxiety and improve children’s health and science understandings. Such initiatives are scarce in rural regions, where informal science education and health literacy opportunities are limited. Implementing and evaluating context-adapted interventions is essential to promote early engagement with science and health.

We describe the design, implementation, and evaluation of an evidence-informed, play-based health education activity, inspired by the “Teddy Bear Hospital” model, developed during the 2025 European Researchers’ Night in Armamar, a rural municipality in northern Portugal, based on a pilot held in summer 2025. The main goals were to promote health and science literacy among children, demystify medical environments, and foster positive attitudes toward science and healthcare. Children were invited through local schools and 91 children (aged 2-15), with parental consent, participated in both the pilot and the main event. The clinic was staffed by a multidisciplinary team of 14 health and science professionals.

The main event featured six thematic stations: triage, consultation, nursing, radiology, emotions, and “screens”. At each station, children acted as caregivers for their toys, using real medical instruments and engaging in guided learning. Each station targeted specific objectives such as recognizing equipment, understanding healthcare, and expressing emotions.

To assess impact, each child carried a “passport” that recorded individual data, the main complaint, emotional responses (at four moments: start, pre-vaccine, pre-diagnostic exam, and end), perceived health knowledge (stethoscopes, vaccines, exams) and parent-estimated screen time. Three open-ended questions captured participants’ favorite and least liked station, and improvement suggestions.

For the main event, a total of 53 participants attended, with 44 valid and collected activity passports (27 female and 17 male). Participants’ age ranged from 2 to 15 years. In the role play, the three most common health complaints were lower limb trauma (21,15%), lower limb pain (13,46%) and headache (9,62%). Overall, 50% of the complaints involved “pain” of any kind and 36,54% involved trauma in any region. Regarding emotional responses, a Friedman test revealed a significant difference in median Likert-type ratings across the four time periods (χ²(3)=34.585, p<0.001). Concerning perceived knowledge, 86.4% (92.7% valid) of participants demonstrated basic knowledge about stethoscopes, 47.7% (55.3% valid) about vaccines and 38.6% (85% valid) about diagnostic exams. Reported screen time averaged over three hours/day (M=3.441, SD=1.113). After the course, 52.4% reported joy, 9.5% fear, and 38.1% sadness. Among the 53 responses to the questions, Radiology was the most liked station (37.74%). Most participants (88.68%) did not mention any disliked station, and 30.19% offered improvement suggestions such as adding “an ambulance,” or “microscopes.”

This experience demonstrates that playful, experiential approaches can positively shape children’s perceptions of science and healthcare, particularly in underserved rural areas. Beyond reducing anxiety, the Teddy Bear Clinic fostered curiosity, empathy, and early scientific literacy. Future work will consolidate partnerships with schools and evaluate long-term impacts on children and families.

Keywords:

Play-based learning, Rural community, Health and science literacy.