Thursday, September 27, 2007

Do I really know what's best for pregnant women?

Last year I have to admit to getting quite despondent about midwifery and how I worked with women. I felt I was giving 110% to the women in my care, being passionate about continuity of care, informed choice and all the other features of partnership between pregnant women and midwives. But it didn't seem to matter what I said and did, women chose to have epidurals, induction of labour and so on. I seemed to loose my connection with women. What happened to the days when I worked alongside women in their homes and hospital to achieve a low intervention birth. I seemed to turn from being a hands-on midwife to a nurse, doing nothing but fiddle with machines. Don't get me wrong, I have nothing against medical intervention for women who need it. And the reason I believe epidural and induction of labour is problematic for women who have no indication for it is that it increases their chances of having instrumental births, cesarean section and all the connotations of that. But it had seemed so long since I had 'fought the fight' so to speak, with women who wanted to do it on their own and considered birth to be a natural event that they took in their stride without any great drama. What happened to women's fortitude?!!

Now, I know I'm going to get lots of comments from women telling me to get stuffed and that they should have their epidural if they want them. And yes, I quite agree. In fact, my question is: does it matter if women end up having an epidural? Does that make me any less of a midwife? Does my high epidural rate reflect on my practice as a midwife? Am I a 'bad' midwife because my alternative measures do not work, and by that I mean things like supporting women to labour at home as long as possible; keeping them upright and mobile; getting them to use water for analgesia. Who am I to say that women should not have their babies when they want them to fit in with their life plans? If they do not mind that cesarean section can be the outcome of induction of labour, why should it matter to me? After all, what's wrong with having a cesarean section?

I have come across a couple of references that show if women have an attitude where they are more likely to accept medical intervention, then they are more likely to have an assisted birth.

Have Women Become More Willing to Accept Obstetric Interventions and Does This Relate to Mode of Birth? Data from a Prospective Study. Green & Baston (2007), Birth, 34 (1), 6–13.

Hulst van der, L.A.M., et al. (2004) Does a pregnant woman's intended place of birth influence her attitudes towards and occurrence of obstetric interventions? Birth, 31: 28-33.

In some ways, this research has been reassuring because it emphasizes that childbirth is not all about me. Doh, you say, it's taken you nearly 30 years to come to that conclusion? No, I have always known that. What it allows me to do is be able to step back and take a more objective view of my role - to put boundaries around my practice, which in turn will guide my reflection and keep me safe from burnout. Yes, as a midwife I walk alongside women, pointing out the way. But ultimately, women are responsible for the decisions they make and I cannot wear their shoes for them.

Monday, September 24, 2007

Who am I? How do I present myself as a midwifery teacher?

I have just read the latest entry from Konrad Glogowski entitled "Learning to be myself". In the article Konrad explains how he is presenting himself as a man, not just a teacher, in the blog he is sharing with his 8th grade students. I asked him about doing this in a adult teaching/learning environment and he believes it is a very good strategy, although this approach causes difficulties for educators because they have to reveal themselves as human, not all-knowing which the teacher may feel undermines his/her authority.

One of the exciting things about being a teacher/lecturer is the opportunity for learning from your students. This is especially true when working with adults. They challenge and provoke, which in turn enthuses and stimulates more questions and learning. However, I am not so sure about Konrad's concept of opening myself right up to students. Yes, I agree with role modeling in developing a classroom or virtual community. Yes, I do not want to enforce a position of power over students. But can you really be partners with students when you have ultimate power over them-when you have the final say in whether they pass or fail? What am I-a friend, nurturer, or fellow colleague? I do not know if it is my role to nurture students. I am not their mother. However, I do see that it is important for me to be approachable and a support to them, but I have professional boundaries that I like to maintain which keeps me safe in my teaching practice. I enjoy sharing my midwifery experiences, especially if it illustrates or re-enforces the information I am sharing. Nevertheless, it is vital that my voice is not constantly heard above those of the student. So, whilst I am very interested in how Konrad gets on with 'being himself' I am not sure that I would take that approach - I'm not even sure if my students could cope with me being myself!! Having said all that, if my students read this blog, they will probably get more of a feel of who I am than they would from my classroom presence, so maybe I have totally contradicted myself? Will it be easier for me to be 'myself' in a virtual rather than face-to-face form?

I would be very interested to hear what others think. How do you present yourself in a face-to-face or virtual class? If you are a student, what do you expect from your lecturer?How interested are you in her as a person?

Sunday, September 23, 2007

Oh, to be an English sports fan!

I am absolutely shattered because I stayed up all night watching the Rugby World Cup, paying particular attention to the England vs Samoa match. What a relief that England won, and that Jonny Wilkinson was back on deck. So here as a tribute to the English sports fan, who has to be the most long-suffering fan in the world (because England only ever wins a major sports event once in a blue moon) is a clip of Jonny and David Beckham.


Thursday, September 20, 2007

Lurking in online communities


I have recently been privy to a discussion about what makes an online community. There has been an degree of disquiet articulated about the number of lurkers in the community ie people who listen and observe but do not take part either by entering discussion or leaving comments. Lurking has a negative connotation because it is not making a positive or creative contribution to the community. This made me wonder why people lurk and what makes them take the step of joining activities. Lurking in online communities mirrors what happens in the real world - how many groups do you belong to that are driven by a core group of people and how many times do you hear complaints that it is always the same people who do things?

Lurking in a online group/community is probably a good idea initially so you can get an idea of how the group works. The last thing you want to do is put your foot in it, so to speak. One of the groups I belong to is made up of highly respected midwifery scholars and I am very careful about what I write and when I write it, in case I end up with egg on my face. I may not participate because I feel I have nothing to add or what I wanted to say has already been said. I may feel intimidated or lack confidence - I do not want to take a risk or expose myself. I may also be concerned with privacy issues eg I do not want my thoughts or comments to get back to colleagues or my boss. Whilst the Internet seems at times to have infinite capabilities, in many ways online communities are very small worlds. It may be that I do not know how to contribute- what buttons to press or where to put my comment. At the same time, as a blogger I find it really frustrating that people may read my blog and not leave a comment. If they don't, how do I know what they think of it? Does what I am saying ring a bell or do they think its complete rubbish? Feedback may stimulate more thought and knowledge generation.

Lurkers do, however, carry out a useful purpose. In some ways I think of them as honey bees, flying from one flower to another, gathering pollen and cross-pollinating (I hope that's what honey bees do - if it isn't, I hope you get the idea!). Ton Zijlstra writes that lurkers are necessary links, even if they are weak links. If all links were strong, there may be no change or movement in the community.

What about the students who lurk in formal education courses? Well, they may learn in different ways to the people who are at the hub of the group. One strategy for encouraging lurkers in formal online communities is to make it compulsory for them to contribute. But how do you measure that contribution? Do you inhibit their learning when you make participation compulsory? Salmon (2000) talks about carrots and sticks. The carrots are selling the benefits of computer-mediated communication and participating in the course/community; adding value to participation and ensuring that the participants get something from joining in. The sticks are attaching participation to assessments and linking it to group work with other students. Salmon warns against bullying lurkers into participating or excluding them from the community if they do not. It is also imperative that make sure people have the technological capability and knowledge to be able to join it.

I would be really keen to hear people's views and experiences about how effective it is to link online participation with assessments.

Salmon (G). 2000. E-moderating. The key to teaching and learning online. London: Kogan Page

Wednesday, September 19, 2007

Taking charge!













Following a discussion about the difference between communities and networks, I was given a link to Stephen Downes, who describes and discusses the difference between these two concepts. Stephen's web site is an exciting resource for people wanting to know about Web 2.0 and e-learning. In particular I enjoyed a web cast that can be downloaded entitled 'Web 2.0 and Your Own Learning and Development'. It is a very simple explanation of the principles of learning and teaching using Web 2.0 as well as a overview of social networking tools such as blogs and wikis.
I would recommend it as a resource for students, especially
as an introduction to e-learning.

The elements that really resonated with me was the emphasis Stephen laid on the learner taking charge of his/her own learning. I have spent a lot of time thinking about how the teacher interacts with students. Is she a facilitator or curator? Does she take 3 stages, 5 levels or dance the okey dokey?! So its great to think about how I am as a learner, particularly as I am being challenged by the course I am doing at the moment. As I have said in a couple of posts, I feel as if I am on a rapidly speeding roundabout. But Stephen talks about how you must put yourself in the center of the web/information/resources/learning opportunities and pull content to you rather than allow it to be pushed onto you. I really like the idea of being at the center with things revolving around me-this is why I have the picture of the carnie or roustabout-he stands in the middle of the merry-go-round, controlling it. At last I feel as if I am taking control of the information out there by using tools such as Google Reader although I acknowledge there are still a number of steps I can take to improve my organization.

PS: How cool are web casts/podcasts!?! A brilliant tool for very busy people who lead unstructured lives such as midwives who are on call or work unsocial hours. I definitely want to learn how to make one!


Tuesday, September 18, 2007

The teacher as a curator


Today I attended an Elluminate session led by George Siemens who presented the idea of the teacher being a curator. George sees the teacher/curator as the expert who guides the learner; provides the artifacts or information that informs the students' learning. Even when there is little material available, he sorts through material to ensure that the student has access to quality information. I see a curator as a dry, dusty individual who disapproves of any individual who interferes with the exhibits but George presents the teacher/curator as an individual who has variety of roles; who is active in presenting artifacts/information in a way that encourages deep thinking.

I am not sure I am sold on the idea of a curator. Whilst I totally agree that the teacher should not take a position of power, dictating to students and I agree with George's statement on his blog about teachers providing "spaces in which knowledge can be created, explored, and connected", I cannot get past the vision of a curator wearing his dickey bow, yelling at children for putting their sticky fingers on the glass. Or, being chased through the corridors by a raving monster like Ben Stiller in "Night at the museum". I'm not sure what the raving monster is; the student?!?

Monday, September 17, 2007

Flight of the Conchords- Business Time

Here's a bit of light relief after all the last few boring posts-its a bit rude but great fun with two Kiwi lads who are top of YouTube ratings at the moment, and hugely popular in the USA.

Online facilitation and Gilly Salmon

I have taken all day to 'catch up' on blogging about my various virtual experiences over the last few days. As you may have sensed in my previous posts, I have been rushing around the Internet, installing programs and getting the hang of various devices but have done little or no reflection, and certainly no reading. This illustrates one of my main concerns about the implementation of e-learning: playing with the tools is very exciting but we need to understand the theoretical underpinnings before we rush off left, right and center. We also need to understand that e-learning isn't just about putting lectures onto PowerPoint slides and posting them on the Internet with, maybe if you're lucky, an email discussion group to go with it.

One pioneer of online learning and teaching is Gilly Salmon. Gilly has developed the 5 stage model of online facilitation which can be found in her books:

Salmon, G. (2000 & 2004) E-moderating: the key to teaching and learning online, London: Taylor and Francis.

Salmon, G. (2002) E-tivities: the key to active online learning, London Taylor and Francis.

Gilly's model takes the facilitator from stage one where there the facilitator is heavily involved in providing both technical support and welcoming participants, to stage five where the facilitator is working with participants to think outside of their current learning environment.

I have become cognizant of Gilly's work in connection with e-mentoring. I have set up an e-mentoring system that matches mentor with mentee via email. These are one-to-one dyads as opposed to a community. I have been very disappointed to find that people have not conversed with each other despite being very enthusiastic about the principle of e-mentoring. What I have realized is that a more proactive moderator is required to facilitate the relationship, just as Gilly describes. This has been the conclusion of other researchers who have developed e-mentoring systems (Headlam-Wells, Gosland & Craig, 2006). That facilitation may take place on line but I am keen to provide support to my e-mentoring participants by phone - this adds another element of personal support as I cannot do face-to-face work with participants.

What I need to keep reminding myself is that people do not necessarily have the same technological knowledge or enthusiasm for online learning as I do. The 5 stages of moderation reminds me of the importance of the initial work one must do to help people find their way around the online learning environment. I also think its important not to forget the telephone, which may be an old fashioned technology these days but is one that everyone knows and understands. Maybe in the early days phone contact between moderator and students will enhance learning.

Headlam-Wells, J., Gosland, J., & Craig, J. (2006). Beyond the organisation: the design and management of e-mentoring systems. International Journal of Information Management, 26, 372-385.

Skype

I have been using Skype for some time; it saves so much money on international calls because it is free. But I have been very frustrated because the people I am most likely to want to call either have not installed it; do not have broadband, which makes it a little less effective to use or never switch it on, even if they have it installed on their computer. Time differences are also difficult to manage at times. The other day I tried to 'skype' my parents in England, but gave up and rang them. But on the whole, I have found it to be a wonderful tool, and using web cam brings people even closer to you.

Since our community meltdown the other day, I have added more contacts to my Skype list and I had a great chat with a fellow student yesterday. It started off as a social call but we got to talking about e-portfolios, which is her interest. I am about to develop an assignment for my midwifery students, requiring them to make a start on developing their professional portfolios, so that they have them ready for when they are registered (it is part of the NZ Midwifery Council's requirements for annual recertification). I had not thought about the option for e-portfolios, but this may be a very appropriate thing to look at. The only problem I can think of is that the midwifery portfolio is very focused on clinical midwifery, so I am not sure how an e-portfolio would work in this context. However, it is definitely something I need to look at.

The joys of iGoogle

A constructive outcome of the 'technological chaos' that ensued last week was my introduction to iGoogle. iGoogle is Google's homepage that you can alter to tailor to your own particular needs. I am not gong to put the instruction here: however, you can see a screen cast with instructions on YouTube. Sue Waters has also published a useful guide to iGoogle. My favorite elements are the quick reference to Google Reader and the templates that I have customized so that I can see the latest blog entries about a topic I have chosen ie I have set up two templates that allow me to monitor the latest that is said on a blog about midwifery and e-mentoring.

This is a great resource, alongside Google Reader-well worth taking the time to install into your virtual life.

Midwikery

I just love this phrase 'midwikery' which was thought up by Leigh Blackall. I did a quick Google search on the phrase and it only comes up as a spelling mistake for 'midwifery'. So it looks as Leigh has coined a new word which I am going to define as a midwifery wiki or the process of using a wiki.

I just love this whole concept of Web 2.0 and realize now that my interest has gone back as far as 1997, although it has only now received an official name, as far as I am concerned. I set up a midwifery email discussion group in 1997 when I first moved to New Zealand. I had been a member of American and Australian groups but I felt they did not serve New Zealand midwives' needs. So I set up this group purely as email, I did not know about listserv at this stage. We had 20 people, who emailed me and I then sent the email to everyone manually. We joined a listserv a couple of years later and then I resigned as list owner/moderator a couple of years after that. I understood it was still going, but couldn't find it when I carried out a search for it today.

Today, my interest in the Internet as a social networking tool has led to my PhD project: e-mentoring. When I get around to it, I will post something about my PhD, especially as it feeds into what I am learning about Web 2.0. Meanwhile, life goes round in circles, one thing feeding into another - I just realized all my imaginary is circular: the spinning head and the roundabout.

Meanwhile, I have really got into blogging although I am finding it a lot more time consuming than I thought it would be. It is not just a matter of writing a post, but also searching for blogs to comment on so that you can slowly but surely build your blog network. As for wikis, at first I was not convinced. It seemed to be a great idea in theory, being able to collaboratively work on a project without a lot of email going back and forth, which can be very hard to track. But the wiki programs seemed to be a lot harder to come to grips with, compared to this blog program.

At first, I was introduced to wikispaces. I have set up a fun page for midwives: developing an information leaflet for pregnant women about the pros and cons of eating cake. Initially, I did not find Wikispaces very easy to navigate and I am very concerned that midwives will find this off-putting. However, I have been working with Carolyn McIntosh on another project and I am now finding my way around it and finding it easy to use - now I know how.

The project I have been working on with Carolyn is the development of an abstract for a workshop that we are going to submit to New Zealand Rural GPs Network conference in March. This is only a small project but has been a great way to find my way around the facilities that are offered. It is also very useful to use the 'discussion' page to email each other as we go along with ideas and comments; that way we can keep a running record of the decisions that are made. This can then act as evidence for further reflection, maybe in our professional portfolios or if we ever get around to submitting a paper about the midwikery process.

Wikieducator is the wiki that I have not quite got my head around yet. I think it has a much better appearance than Wikispaces; a lot cleaner and tidier which inspires more confidence in its use. My plan for the next couple of weeks is to think how it can be used for my midwifery students, especially those who are in their third year of practice.

Saturday, September 15, 2007

A severe case of head spin


So much has happened in the last 10 days with regards to the course I am attending about online learning that I feel my head is spinning like the girl who was possessed in the film 'The Exorcist'(a real symptom of how I have caught this blogging bug-I spent half the morning trying to find a clip from 'The Exorcist' on YouTube to place here is an illustration of how I feel, but they were all too gory!). So here's a picture of a speeding merry-go-round, which is a much more pleasant picture but still accurately illustrates how I feel.

I have pretty much got the hang of blogging and am really interested in how I can use it to be a 'leader' in midwifery; in other words, how I can introduce Web 2.0 to midwives and encourage them to investigate how it can be used for collaboration, knowledge sharing and so on. I have written an article for the New Zealand College of Midwives Journal that is about to be published, about wikis and blogs and used my efforts as examples. So I hope that inspires some discussion. It is also where a replication of Merrolee Penman's work would be useful - getting midwives into a computer lab and showing them how to use blogs, wikis etc as a means of starting the revolution, so to speak.

However, this has caused me to think about 'ego-blogging'. Is wanting to use a blog to be a 'midwifery leader' actually a severe case of ego-blogging, which is described by Michelle Martin. Michelle is a consultant for professional development, life long learning, education and learning. This blog appears to be a great resource for people just learning about blogs, although I must admit, I have not yet had time to have a really good look at what she is doing. Anyway, one of her posts was about what she calls 'ego blogging'- this is Michelle's definition "ego-blogging is when I write a post primarily because I'm hoping that it will get me noticed and that others will link to me".

I must admit that I thought ego-blogging was when all you did was write about yourself. I know that some people see blogs as self-gratifying with no value to anyone than the person who writes them. In other words, keeping a blog is being a virtual drama queen, which is probably why they appeal to me!! Which leads me to question why I want to keep a blog - more about that later.

But is there anything wrong in wanting to encourage people to visit your blog? Being very new at blogging, I am very keen to join the blogging community so I need to increase people's awareness of my blog, which in turn will hopefully help me to connect to people. I am conscious of the strategies you can use to achieve this:

leave comments on other people's blogs which encourages them to visit your blog;
strategies about headings which come up in blog searches and tags;
advertise your blog in any way you can eg add the URL to your email signature.

So this brings me back to why I want to keep a blog and what I want to do with it. As I have said previously, there are three threads to this blog. The first is as a requirement for the course on online learning that I am currently doing. The second thread is personal: this blog is a way I can express myself and interact with people, especially family and friends who are overseas. I also see it as a valuable networking tool for my own professional and career development, which is where I could see myself doing ego-blogging, especially if I want to use this to market myself professionally.

The third thread is midwifery. I am really keen to introduce Web 2.0 to midwives in NZ because I think it is a wonderful tool for teaching, collaboration and so on. So again, I might end up being guilty of ego-blogging or is it providing leadership? I have not quite made up my mind. I guess when I am sitting here crying because no one has posted comments, then I really know I am a virtual drama queen.

PS: the thing I really hate about blogging is that I have to think of titles, which I cannot do to save my life. When I write a paper for publication, I always get friends to come up with titles. Do 'sexy' titles attract more readers? Or, should you be strategic about your blog title, using words that are more likely to be tagged?

Technological chaos

I feel I have to make a comment about how this blog is evolving. I am finding that this blog has three themes: professional (midwifery), online learning (tied up with my activities in a course about the facilitation of online learning) and of course, personal. I almost feel that I have three blogs but I could not be bothered to do that. So for the time being, I'll continue with one blog even if I feel it is a bit messy - any comments?

Anyway, my title of 'technological chaos' refers to my experiences this week. As a part of the course I am doing, I was to attend an online conference on Elluminate. We have had a number of very successful conferences in the past, but twice this week the technology let us down. This resulted in chaos-we were all running around like headless chickens until a few of us got together using Skype. A number of issues resulted from this experience for me:
1. If you are going to use technology for a project, make sure you have a back-up plan for when things go wrong.
2. Make sure your back up plan is feasible. I wanted to get people talking using Skype, but a number of people had not even heard of Skype let alone have access to it.

The outcome of all this confusion is that quite a few of us have logged onto Skype and I am looking forward to having spontaneous , informal chats about our course-like you would if you bumped into someone in the corridor or tea room.

The other point to online learning is the importance of communication and facilitation. While we were waiting for things to be sorted, Merrolee Penman told us about her work. Merrolee is an occupational therapist with a great interest in online learning. She did a fantastic job of bringing us together as a group, telling us about her work (more about this in future posts). She also kept us abreast of what was going on, which was essential to stop us from going off in a huff. A very valuable learning experience for me to remember when I am attempting to use technology in my teaching.

Friday, September 14, 2007

Being a midwife

For those of you who I asked advice about whether to go to Tanzania as a private midwife, I have decided not to go. There were a number of reasons why I decided this, not least that next year I will be concluding my PhD research. I have been reflecting on why this decision has been hard to come to and I think a lot has been due to my own feelings about midwifery. Normally a decision like this is very easy for me: I either plunge on ahead as happy as a lark or I dismiss it as yet another of my mad schemes (which I am full of, as many of my friends will tell you). However, this time, I have been in a real quandary.

I am taking a break from being a practicing midwife at the moment to concentrate on my studies. I also very badly hurt my back at a birth a couple of years ago, so I am thinking of how I can fulfill the requirements of having a Midwifery Council of New Zealand practicing certificate without the stress of being on call and attending long births. I think I got a bit burnt out last year, so it has been nice to take a break. It is very difficult combining a teaching career and PhD as well as midwifery practice, research and fulfilling the obligations of being a teacher. S0... something has had to give this year. I think I am just not quite ready to plunge back into practice just yet. The moral of the story...balance in life!

Thursday, September 13, 2007

And now, for something different - "True"Friendship

"True" Friendship

None of that Sissy Crap

Are you tired of those sissy "friendship" poems that always sound good, But never actually come close to reality?

Well, here is a series of promises that actually speak of true friendship.

You will see no cutesy little smiley faces on this card-
Just the stone cold truth of our great friendship.

1. When you are sad -- I will help you get drunk and plot revenge against
the fu*king bastard who made you sad.
2. When you are blue -- I will try to dislodge whatever is choking you.
3. When you smile -- I will know you got laid.
4. When you are scared -- I will take the piss out of you about it, every chance I get.
5. When you are worried -- I will tell you horrible stories about how much worse it could be until you quit whinging.
6. When you are confused -- I will use little words.
7. When you are sick -- Stay away from me until you are well again. I don't want whatever you have.
8. When you fall -- I will point and laugh at your clumsy ass.
9. This is my oath.... I pledge it to the end. "Why?" you may ask;
"because you are my friend".

Friendship is like peeing your pants, everyone can see it, but only you can feel the true warmth.

Send this to 10 of your closest friends,
Then get depressed because you can only think
of 4

An interesting midwifery proposition

I was contacted a couple of weeks ago by a man who is looking for a midwife for his African wife. The interesting aspect of this inquiry is that he lives just outside Dar es Salaam, which is the capital city of Tanzania. He is a kiwi who has lived in Tanzania for a few years. He would like a western-trained midwife to attend his wife for a home birth - they have had terrible experiences in the health system there, so are extremely wary of having a baby in a hospital there. He does not want to go to one of the European hospitals in South Africa because he does not know anyone there. So the options for them are: to import a midwife or come back to NZ for the birth. The problem with coming back to NZ is the woman will be away from her family and culture.

He has contacted a number of midwives, but has narrowed them down to me. We have talked on the phone and I am reassured that this is a genuine proposition. There are a number of issues to consider but I just cannot make up my mind what to do. He has offered to fly me there next month to meet them and check them out. Here is a list of pros and cons: I would really appreciate your feedback that will hopefully help me make up my mind.

Pros

1. Expenses will be covered - ticket will be sent to me before hand so I am not stranded in Africa.
2. Amazing opportunity to get a taste of Africa; to challenge myself, both on a personal and professional front.
3. Give me an opportunity to meet third world health professionals (in my usual manner of not wanting to let any opportunity go past, I would make sure I hooked up with local midwives and maybe offer to do some teaching/research).
4. This experience would no doubt lead to some sort of research output even if its a published reflection of what happened.
5. They have access to the Internet so I could keep in touch and continue to monitor my PhD research.

Cons

1. In a professional situation where I would have minimal back-up. They do have access to an obstetrician and if the worst came to the worst, would have access to a hospital for emergency treatment. Equipment would not be an issue because they would be able to access it there. Even if I had a really bad day, my care would be 100% better than what would be provided there. Bottom line: I would be the bottom line - do I have the confidence and ability to take on that degree of responsibility without a trusted midwifery colleague there to back me up, which is how I would normally practice here in NZ. It is not as if I would get sued if anything did go wrong, but I obviously have my own professional standards to maintain.
2. This would take me away from my PhD for a month. She is due in the middle of March which is when I am supposed to be starting to interview participants about their experience of the e-mentoring. It would not be a matter of life and death if I delayed things by a month but would add a little pressure to my time line.

I'm sure there are more cons but my mind has gone blank at the moment. As I said, all feedback would be very gratefully received so if you would like to add a comment please do so in the box below.


Monday, September 10, 2007

James Farmer - online identity and ownership

Have finished listening to another recorded Eluminate session in which James Farmer talks about online identity, especially in relation to blogs. The main thing I really took away from this session is that using blogs, especially as a teaching tool, is messy. You cannot keep things rigid and structured like you can in learning platforms like BlackBoard. I have been really struggling with this - I have spoken on more than one occasion of feeling like I am on a merry-go-round and cannot get off. What I actually have to do is hang on tight and enjoy and the ride. Having said that, now I have got the hang of Google reader, I am feeling a lot more confident about finding my way around the Internet and the community of blogs that is out there.

Konrad Glogowski - Classrooms as Third Places

Just listened to a recording of an Elluminate session led by Konrad Glogowski in which he talks about classrooms being third places - home is the first place and work is the second place. My first comment is how much I have enjoyed having the flexibility to listen to a 'lecture' that actually happened some time ago. In my teaching environment, there is a great deal of pressure on students to ensure they attend lectures: this can be problematic when they have so many other pressures on their time such as picking kids up from school, attending pregnant women and so on. There is also a lot of pressure on lecturers to be 100% fit and well - if we go sick, who will give our seminars/lectures. The idea of recording a session so that it can be accessed any time or place is extremely appealing on both counts.

My second comment is: how do I respond to Konrad's challenge particularly in making the learning environment 'learner-centered' and move away from the more traditional teacher role. I love that whole concept, especially with adult learners who come to 'class' with their own huge amount of experience and knowledge which they can pass on to each other and me. However, I have found that that mind set is not only challenging to me as the 'teacher' but also to the student - they expect to sit in class and receive material and be told what to do. When they are challenged to take responsibility for their learning, which I think this environment encourages, they can find that very difficult. I guess that is why it is so important to set the scene so well, which is what Konrad postulates.


Online friends

I took this photo of my son and his friend chatting to each other online yesterday at the same time as physically sitting next to each other. I want to look at this some more with the literature but am a little time challenged at the moment. Suffice to say, my other thought was about the digital divide - this photo is only possible because the young people have access to lap tops-think of all the kids in the world who cannot even read and write.

Google reader

I have been getting my head around Google Reader. This program constantly checks your favorite news sites and blogs for new content and alerts you when there has been addition to the web site you are monitoring. So, here I am watching my favorite blog, Caroline's Blog, but it is a pain in the neck to keep checking it through my 'Booksmarks' to see if Caroline has added anything to it. So I subscribe her blog to Google reader, and that alerts me every time she adds something to her blog. I know I still have things to learn about it, but I have worked out that I have to 'cut and paste' the URL of the blog/website I am watching into Google reader. The other thing I've just worked out is that I must 'mark as read' the items when I have read them, otherwise they build up, which makes it difficult to manage. As with everything on the Internet, I am finding it takes time and 'playing' before I get my head around it.

Friday, September 7, 2007

Computer-Mediated Social Networking (ICCMSN), 2008 - Dunedin, NZ

Computer-Mediated Social Networking
Dunedin, New Zealand
11-13 June 2008

http://www.business.otago.ac.nz/infosci/Conferences/Isn2008/

The International Conference on Computer-Mediated Social
Networking (ICCMSN 2008) will explore social networking issues
such as formation of online communities and how collaboration and
cooperation can be achieved. The topics covered encompass
multiple disciplines, including Computer Science, Sociology,
Epidemiology, Economics, Marketing, Education, etc. Some of the
applications that can benefit from social network structural
models include social norm spreading, disease propagation,
opinion dynamics, and collective knowledge construction. Network
topologies can play an important role in these applications. The
conference will examine the links between these topics.

Topics of interest include:

* Facilitating effective structure in a Social Network Structure
(SNS)

* Agent-based simulation for studying the dynamic behaviour in
on-line societies

* Issues and solutions in modelling virtual collaborative
environments

* Integration of various communication tools such as Wikis, Blogs,
Discussion Boards etc.

Important dates:

Submission date: 15 February 2008
Acceptance notification: 8 March 2008
Camera-ready submission date: 30 March 2008
Conference: 11-13 June 2008



Attaching vocals to PowerPoint slides

Here is Leigh's advice on how to attach vocals to a PowerPoint presentation.

One way is with the slidecast feature in slideshare: http://www.slideshare.net/slidecasts

The first step is to record audio for your slides. My advice is NOT to use the inbuilt audio record in the modern version of PowerPoint. Use an audio recorder and create a seperate audio file to add later. A free and open source audio recorder = Audacity

Thursday, September 6, 2007

Carolyn on YouTube

This is Carolyn demonstrating how to put on sterile gloves in a video that she has posted on YouTube. Will be a great tool for our midwifery students. I tend not to think of YouTube but it's a wonderful resource for teaching visual things, although you have to thoroughly check the content before showing it to students.

Wednesday, September 5, 2007

Otago's yellow eyed penguin

I have been ranting on for ages so here's a nice photo of a yellow eyed penguin which is native to the Otago coastline, to make things a little less boring. This penguin was photographed in February when he was moulting.

Sheryl Nussbaum-Beach - Building online communities

I attended an online seminar on Tuesday 4th September led by Sheryl Nussbaum-Beach, based on her work 'The Art of Building Virtual Communities'. This has led me to think about the online communities I have been a member of or still am - are they communities or networks? I have not thought about the 'to be or not to be' argument about communities and do not really want to go down that track because it will lead me away from my thinking about e-mentoring and the role of communities, and communities of practice and mentoring - more about that later.

The first online communities I belonged to were email discussion lists, both midwifery related. One was based in the USA and the other one I set up for New Zealand midwives. The activities were passing on information, reflection and debriefing. The list that I moderated was small with only about 60 participants (out of total of over 2,000 registered midwives). It was hard work keeping the list going at times, and I would often try to generate posts by introducing topics. I don't know whether you would say it was a community because of the work that was required by me to keep it going - I'll have to go back to Sheryl's definition of community. Having said that, it is still going after 10 years although I left the list a few years ago.

I now belong to several international research lists: midwifery research and Association of Internet Researchers. We support each other in various ways, giving each other ideas and resources. On the midwifery list, there is huge scope for international collaboration which hopefully, one day, will come to fruition. As a result of being a member of the two lists I have had three books chapters published/accepted for publication, spoken at two conferences and been a visiting scholar in the USA. This ties in with what Sheryl said the other day about the new digital divide between those who network online and those who do not - those opportunities would never have eventuated if I had not been a member of those two email lists.

Going back to community of practice and e-mentoring, I tend to think of mentoring as being in one-to-one dyads, but group mentoring is just as valid as one on one. In fact, isn't that what we do in groups without even realizing it. Blog networks and wikis lend themselves really well to electronic e-mentoring, be that formal or informal. There is very little in literature about the use of blogs and wikis in e-mentoring, so this is an exciting avenue to think about.

Caesarean section rates - a marker of quality?

Attended a presentation by Mike Robson, who is the Master of National Maternity Hospital, Dublin. His presentation was about cesarean section rates and the way they are categorized and recorded. There were a number of salient points that resonated with me. Mike's over arching message was: the issue is not whether cesarean section rates are too high or too low, but whether we know what the rate is; why it is at the level it is; how is it changing and what are the consequences. I am particularly concerned about that last question. As far as I am aware, there is no longitudinal research that is looking at what the long term effects of cesarean are for women, and we certainly do not know what the implications are for subsequent generations. There is already evidence that women are encouraging their sisters and friends to have cesareans. And we do not know the effect that media has on women's choices-how influential are the actions of Hollywood stars when they are open about their choice to have elective cesarean.

As yet we really do not know about maternal request for c/s. There is a general feeling that it is increasing but there is no concrete evidence to prove it. What was worrying was Mike's statistics which showed that it is women who have had babies and labored before who mostly request elective c/s. This emphasizes the importance of getting it right for women in their first labour and birth. Mike also contended that there is not the interest in normal labour and birth by midwives and obstetricians, which I would suggest is actually where we should be concentrating our efforts. The thing is: it is time consuming and emotionally wearing supporting a woman in labour - delivering a baby via ceasearen section is relatively quick and 'easy' in comparison.

I would go one step further and ask whether we are losing our skills at supporting women in normal birth. There has been lots of discussion about this in relation to breech birth, but I would suggest that it is also true of so-called 'normal' birth. How much easier it is to organize an epidural than to walk the corridors with a women, talking her through each contraction; rubbing her back; filling and emptying warm baths; driving to her home to assess her in the middle of the night and so on. Alongside with that loss of skills is loss of confidence and faith in normal birth. Much has been written about this so I will not rant on. Suffice to say, I agree with Mike that we need to carefully collect data about c/s and ask ourselves about the ongoing implications of an increasing c/s rate. But we also need to get back to basics and ask ourselves what we are doing to promote normal birth in an ever increasing complex social context.

Teaching tips - PowerPoint

I have just been given a link to a discussion about using technological tools to enhance teaching - Effective Use of Technology In the Classroom?' I was particularly interested to see the discussion about the use of PowerPoint. I must admit I use it a lot because it acts as a framework for my talk and reminds me what I need to say. It is also an easy way to display graphics which is handy if I am trying to explain a practical topic eg what a baby birthing in water looks like. I always make my slides available to students so they do not need to be scribbling madly throughout the session. Nevertheless, I am conscious that PowerPoint can be used to disguise a bad talk ie it doesn't matter how fancy the slide show is if you have nothing decent to say. It also really drives me mad when people add a whole load of fancy animation, which makes it difficult to concentrate on the subject matter. I have never forgotten a session I ran when I suddenly lost my access to PowerPoint so I was driven back to using the good old white board. That session went so well - the students really enjoyed it because I was a lot more inclusive than I usually was when working with PowerPoint - a salutary lesson!

For another view of PowerPoint, have a look at what Edward Tufte has to say about it in his article 'PowerPoint is evil'. Whilst I would not agree with his position because I believe PP has its benefits, I would recommend that you use it with caution. These would be my hints for using PowerPoint.

1. Don't use font any smaller than size 24/28
2. Do not use animation, and if you do, check the timing so it is not too slow ( or too fast, for that matter).
3. Keep the number of slides to the minimum.
4. Do not pack your whole talk onto slides - just pick out the main points and summarize them on the slides.

Be glad to hear of any other tips for using PowerPoint

Saturday, September 1, 2007

Return of the prodigal daughter


My darling daughter, Ellen, has left me a message that I have not commented on this blog about her return from the UK. She went to England for seven months to see family and supposedly earn some money. Anyway, she got home sick and missed her old mum and arrived home on Wednesday. I missed her hugely as well-she is more of a friend than a daughter. We do girly things together like watch Colin Firth in 'Pride and Prejudice' and 'The sound of music'. Anyway, she's back with a vengeance-loud music, wet towels everywhere and she's got no money! I've been nagging her already about getting a job, so nothing's changed. I love you dearly, Ellen and will be even happier when you're gainfully employed!

First day of Spring


Its the first day of Spring, here down-under. The mornings and evenings are get getting lighter, and there are baby lambs in the fields. We've had a couple of really warm days, so my spirits are lighter and lets hope we get a bit of global warming this summer!

Nancy White - looking over our shoulders

Attended an online conference/teaching session via Elluminate - this is an online program that allows meetings/conferences. I do not know if it is freely available on the Internet - I think it is one of those propriety programs that are bought by institutions. If you want to use similar software which is free, you cannot go wrong with Skype, in my opinion.

Anyway, the session was led by Nancy White who does a lot of work with blogs. She talked about we support each other as peers to learn - looking over each other's shoulders. I find this a really effective way to learn, especially if the topic is a practical one eg using how to use a particular Internet tool. We have an open plan office at my work place, which often is a real pain because the noise and activity is off-putting, especially when you are trying to concentrate. However, the concept of 'looking over a shoulder' works really well in that environment. Leigh Blackall came to talk to one of the team about wikis, and we were all able to eavesdrop. The consequence of that session is the development of this blog and a midwifery wiki.

I think that midwives do a lot of their learning by looking over each other's shoulders but there are barriers. Nancy White's 'peer assist' concept really rang a bell with me. Some years ago I had a run of 'retained placentas' (or I should the women I was caring for did) ie the placentas got stuck and would be come out once the babies were born. So I called an informal meeting at my house for all my midwifery colleagues, made come cakes, and asked them what they thought I was doing wrong, if anything. The consensus was that it was a run of bad luck and the upshot was I was reassured that I was doing the right thing as far as my practice was concerned. However, I believe that the inability to reflect or lack of insight can be a barrier to this form of learning. The other problem is the need to be seen as all-knowing, or expert - worrying you'll be seen as a failure if you ask for some sort of peer assist, which in turn may have some sort of litigation implication.

In New Zealand, we have a type of compulsory 'peer assist' in the form of the midwifery standards review process, which we have to undergo as part of our registration requirements. To cut a long story short, we present a review and reflection of our practice to a panel of peers - midwives and consumers - and work through any issues with the end result being a plan of action for the next year. Geographical and professional isolation may act as an impediment to peer assist, which is why online communication tools should be so useful for midwives and any health professional working in rural or remote communities. Mentoring is another form of 'peer assist', so I have come full circle back to my PhD topic of online mentoring.