Saturday, September 1, 2007

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.


Nancy White said...

Sarah - you are a midwife! Lovely. (Both my kids came into the world with the able hands of a midwife - which was a bit rarer in Seattle 22 years ago!) My sense of the midwifery practice was that they were very much using 'over the shoulder' learning, particularly as they started working with hospitals and more "mainstream" OBGYN folk. There was a lot of culture gaps and practice differences, some subtle and some large, that needed attending to.

I suspect your peer assist was successful even moreso because you baked cakes. Food is a wonderful lubricant for peer learning!

Thanks for sharing your reflections and I look forward to learning how you are facilitating learning in your midwifery community!

Leigh Blackall said...

Hi Sarah,

My blog is actually Learn Online. The one you linked to is a blog for a course we are facilitating :)