Children with Complex Medical Care Needs and Inclusive Education
Project overview and background
Rethinking Inclusive Education
Inclusive education is widely recognised as a fundamental principle: all children should have the opportunity to learn together in mainstream educational settings. This principle is grounded in the idea of acting in the best interests of the child.
However, in practice, an important question remains:
What does inclusive education actually look like in everyday school life?
Simply placing a child in a mainstream classroom does not necessarily mean that inclusion is being achieved. True inclusion requires more than physical presence—it involves meaningful participation, appropriate support, and the ability for each child to learn, develop, and thrive.
This raises a series of critical questions:
How do we recognise when inclusive education is truly taking place?
Who is responsible for enabling it?
Where do the benefits lie—for children, families, and schools?
And where do tensions or unintended consequences emerge?
Why This Matters Now
The number of children who require complex medical care in their daily lives—such as ventilator support or tube feeding—is increasing globally. In Japan alone, approximately 20,000 children have such needs, with around 11,000 attending mainstream schools.
Ensuring meaningful access to education for these children is one of the most pressing challenges in advancing inclusive education today.
The Missing Piece: Who Makes Inclusion Work?
While inclusive education is often framed as a policy goal, much less attention has been paid to how inclusion is actually realised in practice. In many schools, this depends on individuals who work across boundaries—between health and education, between systems and everyday life. Among these, the role of the school nurse is becoming increasingly visible.
Key Questions Guiding Our Research
Our research explores the potential mediating role of school nurses in enabling inclusive education.
- We ask:
- How do school nurses operate within educational settings, given their clinical training?
- What are the expectations placed on them by parents, teachers, administrators, and children?
- What kinds of roles do they actually take on in practice?
- Can school nurses facilitate inclusive education—and if so, how?
- What are the rewards and challenges of this role?
- How does their presence affect children with complex medical needs and their families?
What We Aim to Achieve
Through this project, we aim to:
- Clarify and conceptualise the educational role of school nurses
- Explore inclusive education from the perspective of children themselves
- Develop practical frameworks through international comparative research
- Contribute to policy and training in Japan and globally
- Ultimately, we seek to move beyond abstract principles and contribute to a deeper understanding of what it takes to make inclusive education work in practice.
What We Are Doing
- Clarify and conceptualise the educational role of school nurses
- Explore inclusive education from the perspective of children themselves
- Develop practical frameworks through international comparative research
- Contribute to policy and training in Japan and globally
- Ultimately, we seek to move beyond abstract principles and contribute to a deeper understanding of what it takes to make inclusive education work in practice.
Project History / Timeline
Sep 2020: Launch of Japan-UK Joint Research Project Title: Experiences of Children with Complex Medical Needs and Their Families under COVID-19 (Supported by UCL-Osaka Strategic Partnership Funds 2020/2021)
- Conducted interviews and mobile ethnography surveys in both Japan and the UK.
Feb 2022: Survey on Nursing Practice in School Settings
Initiated work surveys and interview-based research focusing on school nurses.
Jul 2022 – Mar 2024: International Comparative Study on School Nursing Title: Supporting the Education of Children with Complex Medical Needs
- Conducted a global web survey across 8 countries (Japan, USA, UK, Spain, Slovenia, Taiwan, Philippines, and Nepal).
Apr 2023 – Mar 2026: KAKENHI Project (Grant-in-Aid for Scientific Research C) Title: Qualitative Research on Developing Expertise and Establishing the Professional Roles of School Nurses
- Interviews with school nurses.
- Questionnaire surveys for school nurses and school staff.
- Interviews with children with complex medical needs and their families.
Current Focus
We are currently developing conceptual and practical frameworks to better understand the educational role of school nurses, while expanding our international comparative research. Our work is helping to clarify how school nurses contribute to inclusive education in practice
