Purpose: Chronic health conditions can cause children extended school absences, creating significant barriers for continued education. Out-of-school learning environments, such as hospitals, provide opportunities to maintain children's learning identities during school absences. This paper seeks to present an example of hospital-based teaching and learning and to explore the challenges of providing child-centred learning opportunities in this environment. Design/methodology/approach: A case study narrative describes the underpinnings of child-centred teaching and learning within a children's hospital. The "Around the World" learning activity is used to discuss the challenges and strategies when fostering learning environments for children with diverse needs. Findings: The paper highlights how pedagogy is apparent in a children's health setting. Reflective teacher practice translated pedagogical principles into dynamic, situated learning activities that engaged children visiting a hospital Out-patients area. The display of learning artefacts within Out-patients helped raise awareness of the learning identities of children within the hospital. Research limitations/implications: This case study is one example of the learning opportunities that can be fostered within a hospital. The findings have implications for educators in both traditional and alternative learning environments regarding how spaces can be used to "seize the moment" with children in their care. The learning needs of adolescents spending time in hospital also need to be met in developmentally appropriate ways. Originality/value: This paper illustrates how a hospital, as a traditionally held "health" space, can be reconceptualised as a learning space to accommodate the multiple identities of children and build a shared understanding between education and health professionals of the value of integrating learning into a holistic and child-centred model of care. (Contains 1 table and 4 figures.)