Online Midwifery Meetings - Q&A

A couple of questions and answers that have come up about the online midwifery meetings:

Do I have to have Skype downloaded to make this work?

No, you don't need Skype-that's a different application altogether. The only thing is: if Elluminate doesn't work (by some terrible twist of fate), we could mini-conference using Skype. But I have arranged the first session deliberately during daylight hours so we've got technical help available if we require it.

I hope to be able to participate if you are amenable to cross Tasman involvement! Can I clarify that you have reversed the times for each session - the first is NZ time 1000 and the second is NZ time 2200 - is that correct?

I'd be thrilled if you could/would join. I tried to organize times so I could capture as many time zones as possible: Australia being one of them, although the time is not as good as it could have been for you. I have swapped the times around as an experiment to see what suits people best. Also, the first session I want to have as many support people around as I can get, as its my first international Elluminate session. Please feel free to invite as many people as you like.

How many people can attend the meetings?

The meetings are limited to 50 people due to constraints of license so make sure you log in on time to make sure you get a place.


Do I need a user name or password?

No

My virtual make-over

My darling daughter has decided that she cannot bear me looking like a hobbit in Second Life any more. So she gave me a make-over when I went to make a cup of tea. She did let me keep my shape but has given me new clothes, apparently made of silky material. I now look as if I need a decent bra!

Petal's adventures in Second Life

I joined the big kids in Second Life last night - I met the Kiwi Educators Group last at Koru for their regular Sunday evening meeting at 8pm (I am the relatively 'normal looking person' and Carolyn is Lala (the fox wearing stockings!)). Isa Goodman took us on a tour of some snazzy IBM sim sites. I am still at the stage of having to concentrate too much on basic things like walking to be able to concentrate on more sophisticated activities. I was a bit disgruntled initially because I had little help-I needed a buddy to hold my hand and walk alongside me. There seemed to be little conversation although when people got talking about hacking into the the simulation, I was scared to death. I found it very intimidating to be with these experienced SLers. I got very fed up because it seemed like a massive waste of time. And my dear husband was annoyed that I was spending my Sunday evening on an activity that excluded him and wasn't benefiting me in any way. However, once I had logged off, a SLer emailed me and volunteered to take me on a tour the next time I logged in. So I'll be taking her up on that.

The question is: do I invest a lot more time getting used to this when I know that very few midwives use it, and we're not using it in our program yet? Do I take the lead in using SL in midwifery with Carolyn, or do I concentrate on developing skills in areas that have more immediate application such as facilitating online meetings with Elluminate? Any thoughts?

Online Midwifery Meetings

Here are two opportunities to attend online midwifery meetings using Elluminate, which is an online conference program. I will be your host along with Carolyn McIntosh.

New Zealand Midwifery

The first meeting is on Wednesday 21st November at 10am New Zealand time (London Tuesday 20th 9pm UCT/GMT). Check here to see the time where you live - Time zone

http://elluminate.tekotago.ac.nz:80/join_meeting.html?meetingId=1193473498671

This meeting is open to anyone who is interested to learn about midwifery and the maternity services in New Zealand. The format will be a 10 minute presentation followed by an opportunity for questions and discussion.

Postgraduate Midwifery Research

This meeting is being held on Thursday 29th November at 10pm New Zealand time (London Thursday 29th 9am UCT/GMT). Check here to see the time where you live - Time Zone.

http://elluminate.tekotago.ac.nz:80/join_meeting.html?meetingId=1193474325250

This meeting is open to anyone interested in midwifery research, especially postgraduate midwifery research students and their supervisors. Format for this meeting will be announced. This is an opportunity for researchers, especially postgraduate midwifery students to network and share information about their research. This particularly aimed at midwives who are studying/researching in an isolated context.

Instructions

Tools that you require:
Internet connection
Headphones if in room with other users
Microphone, if you wish to speak. Otherwise, you can communicate with instant text "chat"
Web browser such as Firefox, Internet Explorer or Netscape.

Click on the URLs above and follow instructions. It is strongly suggested that you get ready a few days ahead of the meeting to make sure your computer hardware, network and firewall policies allows the software download and operation. Firewall and administrative access privileges are the two main reasons new users have problems. This is often problematic if you are using an institution computer. Before you can access the meeting, you will need to download software called 'Java Webstart'.

At the time of the meeting, I would recommend that you log on at least 10-15 minutes early so you become familiar with things like use of the microphone and set your volume and mic controls.

You do not need a user name or password

The meetings are free.

Contact me

Elluminate provides the information you require about using the software which should answer all your questions. However, please feel free to contact me if you have any further questions about the meetings or how to log onto the Elluminate site. I am also often available on Skype. You can find me using my user name:
sarah.m.stewart or email: sarahstewart07@gmail.com .

These meetings will be recorded and made available on this blog after the meetings.

I hope midwives will take this opportunity for international networking and exchange of information. I look forward to meeting you all.

Here are some more Q&A

My virtual appearence in Second Life

I have had a number of very rude comments from my dear friends about my Second Life appearance. To be honest, my SL appearance isn't too dissimilar from my 'real' identity. I made a deliberate decision not to develop a 'sexy' persona because I have a major problem with women being depicted as young and nubile, with incredibly big breasts in computer games etc. I mean, have you seen the latest incarnation of the game hostess in 'Buzz' - not only does she have big breasts, but her dress is see-through - and this is supposed to be a family game!! So, I decided to be a good feminist and resist the huge temptation to reinvent myself as a gorgeous young thing.

What has surprised me has been the comments from my girl friends. One said I looked like an egg cup. The other said she couldn't understand why I would resist the opportunity to develop a whole new persona and lets face it, my SL bum is huge (a bit like my real one, I'm afraid)! Now this has surprised me, coming from a load of dedicated feminists! So, I am wrestling with this moral dilemma - do I stay with my fat SL self and stay true to my principles or do I undergo a metamorphosis into a irresistible hot chick?!? The third answer could be: shut up, no one gives two hoots! What do you think?

Me and the naked flying men!

I had the funniest time last night and, no, I wasn't drowning my sorrows following England's rugby defeat nor had I OD'd on herbal pills: instead of seeing dead people, I saw naked flying men!! This is a result of joining Second Life. This is a virtual world that has an educational focus: for those who do not know about it, have a look at the Wikipedia entry about it which explains it better than I can. It works in the same way as virtual games. You get yourself an identity or avatar, and work your way around a virtual world.

I must admit I am somewhat skeptical about the use of SL in education: what would I use it for in the education of midwives? And my experience last night did nothing to reassure me. Clearly, it's going to take me some time to get my head around how it works. However, I have got past the point that some people were at last night- I did manage to get clothes on, although they didn't appear to fit me very well. I think its going to be helpful to hook up with some experienced Second Lifers and get them to show me around. The education 'island' is Jokadia, which Leigh has volunteered to show me around, so I am looking forward to that.

The benefit for midwifery education? How about the development of a virtual birthing centre? I'll have to ponder this further once I have had more experience of SL. My main concerns are:

how time consuming is it going to be, weighed up against advantages?
what are the advantages?
how would we support students to become confident in its use?

Meanwhile, I am keen to learn and my next aim is to make my avatar's bottom smaller because at the moment its huge!!

The end of the road for the 'sweet chariot'

Oh well, that's it for another four years. England didn't quite make back-to-back World Cup Rugby wins, but they did really well and made us English fans proud. Congratulations to the South Africans who had a great tournament. Meanwhile, I'm off to join the All Blacks for some grief counseling!!
Photo: BBC Sport

Developing 'community' in a formal education program

I tried to 'attend' an online seminar/lecture led by Derek Chirnside as part of the course I am taking part in. It was at 7.30 last Monday. The advantage of being able to 'attend' an event like this is obvious: I do not have to stir myself away from my cosy home. The downside, I discovered, is that one has to negotiate family obligations at the same time, like cooking the dinner. Consequently, I am having major problems trying to remember what was said for this reflection (which is a course requirement). So I am going to cheat and say that I agree with Carolyn's reflections. Like Carolyn, the main thing I got out of the session was the discussion about open and closed 'classes'. I agree that we would need a mix of open and closed resources/forums because we have legal, professional and ethical expectations about disclosure of information. We would not expect midwifery students to disclose their experiences with a woman or midwife in an open forum that anyone on the Internet could look at-we may open ourselves up to charges of breaching the New Zealand Privacy Act. Nevertheless, there is much to recommend the sharing of resources that can be accessed by students and midwives anywhere online. After all, midwifery knowledge can hardly be copyrighted by one individual school of midwifery.

My main thoughts from the evening are:

1. How can we teach students to share information online in a professional way that protects confidentiality but encourages deep reflection and learning ( this needs to be applied equally to face-to-face interactions)?
2. How can we protect our intellectual property (and meet institutional requirements) yet share it in a way that promotes sharing of knowledge and invites collaboration?

The example I gave about how the open/closed forums could be run is this:

in an open forum I would share information and facilitate discussion about post partum hemorrhage (excessive bleeding after a baby is born) - PPH;

in a closed forum, we would explore the students' individual clinical experiences of PPH.

Any thoughts about this?

My article: "Surfing the net"

I have just had my regular column entitled "Surfing the net" published in the New Zealand College of Midwives Journal. In it, I wrote about Skype, blogs, wikis and del.icio.us. I am a little embarrassed about it because I wrote it in June/July and it is very basic and naive. I have learnt so much about social networking since then and would have loved the opportunity to re-write it, incorporating what I know now into it. Be that as it may, the aim behind it was to introduce midwives to these tools, so it will be interesting to see if I have any 'callers'. So if you are a midwife visiting this blog as a result of my article, I would be really grateful if you would drop me a quick line to say 'hello'. Was the article of any help or interest? Is there anything you would like me to explain further? What are your needs that may be met by online communication? What would you like me to write about in my next Internet column in the NZCOM Journal?

Rural midwives' wiki

I am very pleased to be able to write about the Rural Midwives Wiki which has been developed by Carolyn McIntosh. Carolyn is a New Zealand midwife who is passionate about rural midwifery, not just in New Zealand, but internationally. She is aiming to use this wiki as a resource for midwives, not just those who work in rural and remote areas. However, she is particularly keen to network with rural midwives and health professionals.

Another resource for rural health professions and those who are interested in rural health issues is the online journal: Rural and Remote Health, the international, electronic Journal of Rural and Remote Health education, practice and policy. It is an electronic journal that is very easily accessible and free to users.

Are you a fearful midwife?

I was recently reading a blog entry by Carla Hartley, who set up a distance education midwifery program in the USA. Carla talks about un-learning fear based midwifery. That caused me to reflect on my practice: am I a fearful midwife?

Burnout
As you can see from my profile, I have many roles. Up until this year, I carried a small caseload as a Lead Maternity Carer. Most of my work has been done in the summer holidays so as not to interfere with my teaching responsibilities. However, last year, for the first time in over 20 years, I did not enjoy my work and dreaded phone calls in case they were my clients wanting something. I resented the questions women asked and the time I was spending with them. I found births to be incredibly stressful; I lost all confidence and any enjoyment or satisfaction I got out of my job. Hardly any of the births I attended were straight forward. The crunch came for me when I attended a home birth which I spent the whole time in a state of fear: I felt like a rabbit frozen in a car's headlights. There was no joy or excitement from the home birth which usually makes up for the more complicated births that happen in hospital and invigorates my midwifery soul. Looking back on this year, I was exhibiting all the symptoms of burnout.

So how did I get to this state: an experienced midwife who is 100% committed to women, birth and midwifery? How could I keep faith with students when I had lost the 'spark' that was so necessary to be able to practice as a midwife; when I did not want to be a midwife any more?

Litigation
One of the major contributing factors was the various legal cases that were going on at the time, which led to a concentrated attack on midwives by the media in New Zealand. Whilst midwifery leaders rightly exhorted us to continue with 'business as usual' there was no doubt that the issues brought up by the press impacted on my personal beliefs about midwifery. How could I offer a service that would meet a woman's needs yet keep myself safe as a health professional? I have no doubt that my fears about litigation had an impact, with the effect that I was far more 'conservative' in my approach than I normally would be. By this, I mean that I was quicker to refer to obstetricians which in turn resulted in medical intervention. Whilst this may have been justified, it resulted in a further loss of confidence.

Workload
My own personal workload was another contributing factor: it is not easy being a midwifery educator with the tensions of managing teaching, research, updating qualifications and clinical practice. A further factor was (and is) a chronic back condition. After many years of lifting clients, bending over breastfeeding women, bending over birthing pools and long hours in non-ergonomic positions, I have a vulnerable back and sciatica. Working with women when they are in labour, especially when it is a long labour, sets off my pain. Those people who have chronic back pain will know how much it wears one down and how challenging it is to manage.

Feeling the love?
So, how do I get my midwifery mo-jo back? Firstly, I think it is really important to recognise that it is 'normal' to have times when one doesn't want to do the job, as I have eluded to in other posts. Going back to Carla Hartley, she talks about her belief in normal birth which was supported by several mentors or people who influenced her practice. I believe that maintaining one's belief in normal birth is vital and developing strategies for doing that, whatever the context in which one practices as a midwife. Alongside that is having a mentor or wise woman/person, or similar person who helps to guide and sustain, or be a resource person or adviser. Mentoring or supervision, I believe, isn't just for new graduates but for all midwives, be it in an informal or formal context. I am very blessed to be working with a group of educators who are very firmly grounded in midwifery. They challenge me, but in a way that sustains me when I have my moments of doubt and disbelief. I am truly blessed to know these women (they'll wonder what I've been drinking when they read this!). I also agree with Joan Skinner when she says that rather than going straight to medical staff for advice, first turn to colleagues especially experienced midwives who are likely to be able to help with alternatives to medical interventions. That leaves those of us who are more experienced to make sure we are approachable, especially to new graduates.

Working with midwifery students
I am also very thankful to the students I work with, both in the academic and clinical environment. They are also challenging which can be quite intimidating at times, but that makes me think and helps me clarify things that I may not have thought about for some time. They also have a joy and sense of purpose that invigorates me, and they see things in an uncomplicated way that brings me back to the basics of why I am a midwife; they remind me of the joys of being a midwife because they are not bogged down with things that actually do not matter in the grand scheme of things. For those of you midwives who are thinking abut working with students, I urge you to do so. Yes, it can be hard work at times but it is also very stimulating and extremely rewarding.

Evidence-based practice
One of the things I have done is read about the effect of the media on clinical practice and I found an article written by a midwife called Andrew Symon to be very useful. Andrew urges midwives to be strong and not to let the threat of trial by media to influence practice, pushing them into non evidence-based actions. This emphases the importance of being up to date and clear about evidence-based practice; being able to critique research and policy as well as being self-reflective and questioning. Another great resource is the book Andrew edited called "Risk and choice in maternity care". The book looks at the concept of risk in maternity care and the effect it has on women's choices and midwifery practice.

Sustrainability
Clearly sustaining midwifery practice is a national and international issue, especially for midwives who carry a caseload to provide total midwifery care. Karen Wakelin and Joan Skinner have just published their research which looked at the sustainability of caseload practice in Auckland. They conclude that whilst providing continuity of care supports the sustainability of midwifery, it also threatens it as midwives continue to struggle with issues of time off and financial renumeration. Whilst this isn't necessarily my particular problem, being mindful of workload pressures is. One of the things I have been working hard to achieve is feeling that I can say 'no' to things; 'no' to women, 'no' to colleagues, 'no' to family and friends. Whilst I have found it very difficult, it is getting easier. Just about the only things I will not say 'no' to is a glass of wine with dear friends, and chocolate!

Looking after myself
As for the other issues, as I get older the more I realise how important it is to look after one's health. So I would say to any 'young' midwife who reads this blog: take care of your health, physical and mental. And in particular, look after your back. Take breaks during long labours; don't be afraid to ask colleagues to come and relieve you. Get lots of exercise and pay particular attention to back strengthening. Do not lift women and when you are bending, make sure you are in ergonomic positions. It may sound like a very sensible and obvious thing, but I wish I had $5 for every nurse and midwife I know who are only in their 40s and cannot practice because of chronic back conditions.

I realize that this posting is sounding a bit like the sunscreen song and how I have deviated from the 'fear' theme. However, I hope it has raised some questions that you might wish to respond to. What are the issues that you face in sustaining your practice and midwifery philosophy? What do you do to 'keep the faith'? How would you like the midwifery profession to address the issues of sustainability, not just in New Zealand but overseas? If you are a non-midwife reading this, what are your impressions and perspectives?

Symon, A. (2006). Midwives must not allow publicity to push them into defensive practice. British Journal of Midwifery, Sep; 14(9): 542-3.
Wakelin, K., & Skinner, J. (2007). Staying or leaving: a telephone survey of midwives, exploring the sustainability of practice as Lead Maternity Carers in one urban region of New Zealand. New Zealand College of Midwives Journal, Oct; 37: 10-14.

Dedicated to my kids!

Mom's Overture by Anita Renfroe

England in the final - the gloating continues!

I know none of my friends and colleagues are interested in this but I cannot stop gloating now that England is in the World Cup Rugby final. Maybe the unlikely dream will become a reality after all and we retain the title. Whatever the outcome, England has surpassed this fan's expectations and made for a great world cup as far as I am concerned.

Photo from BBC news.

To teach or not to teach? That is the question.

Have just finished reading an excellent post by Leigh Blackall, who has been struggling with the concept of whether to be a teacher or facilitator. This has been brought about in part by the course that he is teaching/facilitating: Facilitating online learning communities. This is the course that I am following although I have not officially enrolled. The discussion has been around whether there has been enough direction or 'teaching'. Some students appear to have been left floundering, feeling they have not received enough direction for what is a pretty mind-boggling topic, especially for those who have had little exposure to online communication and teaching tools. The whole topic of whether you are a teacher or facilitator is fascinating and one that I struggle with at times. However, it has been a fascinating process being a student and looking at delivery of materials from the student's view. Sue Waters (in the comments section of Leigh's post) suggested that all the students review their learning thus far, so here are my reflections (have a look at Carolyn's blog for a review of her learning).

What have been the highlights?

The highlights have been my growing knowledge around how to develop a blog and wiki as well as other tools such as Google Reader, gmail, co.mments, and iGoogle. I have also had my eyes opened to the potential of YouTube, which I was very prejudiced against, thinking it was a site purely for the use of teenagers who wanted to post silly videos of themselves. It is, in fact, a repository of many educational resources and its potential for midwifery education is hugely under utilized to my mind. Another highlight has been my experience with putting together a slidecast. I envisage that this will be a tool I use a lot and already plan to put my next couple of conference presentations on 'slideshare'. An unexpected highlight has been my developing relationship with Carolyn. We work together and are colleagues, but have never carried out any teaching or projects together. I now know her much better and feel (I hope she doesn't come along now and say she hates me!) that she is a really good friend: this has come about because of our online communication and our wiki work together, which has had the outcome of a submission of a conference abstract. The 10 minute lectures have been excellent because it has given me an opportunity to get my head around Elluminate as well as meet some of the 'names' in e-learning. Finally, I have been thrilled with the number of people who have responded to the posts on my blog and also to the comments I have put on their posts - I am already feeling like I am starting to develop an online relationship with them.

What aspect(s) caused you the most anxiety?

These have been getting my head around the technological aspects and the volume of resources and information. I got a little frustrated when developing my slidecast, but emails from course participants as well as online resources helped me work my way through my problems.


Was there any aspect(s) that surprised you?

I have been surprised at how quickly I have picked things up which has been very pleasing. The other big surprise has been the wealth of resources online that I can use in my teaching practice, especially on web sites that I would not have previously looked at such as YouTube.

Whilst I can see where people's anxieties have come from, especially those who are not familiar with online communication, I have enjoyed Bron and Leigh's facilitation/teaching of this course. I have found it to be a lot more time consuming than I would have thought, but that's probably because I am addicted to the Internet and have gone mad with this blog. I am now keen to explore Facebook, Ning, Secondlife and Twitter.

I cannot wait to apply this knowledge into my teaching practice, and introduce online social networking to registered midwives with the aim of increasing national and international communication and collaboration. I am particularly keen to run a mini Elluminate midwifery conference, so if you are a midwife and fancy this idea, please let me know.

Safer childbirth: minimum standards for the organisation and delivery of care in labour

The Royal College of Obstetricians and Gynecologists (UK) alongside organizations like The Royal College of Midwives (UK) have just released a report. The executive summary:

"Concerns from the Confidential Enquiry into Maternal and Child Health (CEMACH) and its predecessor organisations the Confidential Enquiry into Stillbirths and Deaths in Infancy
(CESDI) and the Confidential Enquiry into Maternal Deaths (CEMD), have indicated the need for a fresh look at the organisation of care in labour. The requirements of Standards for Better Health and the recommendations arising from investigations conducted by the Healthcare Commission have added to the breadth of this report, which also incorporates the aspirations of UK maternity service policies."

This report has come about as a result of the findings from the last few 'Confidential Enquiry into Stillbirths and Deaths in Infancy' reports. In the UK, information about maternal and infant deaths are collated into the CESDI report. I find it really interesting that a recurring theme is a lack of recognition of complications on the parts of both midwives and doctors, as well as poor communication between health professions. A further concern is the fall in midwife numbers in the UK so that one-to-one care for women, which is optimum care, is very difficult to provide.

Clearly, these issues are global: in Dunedin, we have had a number of workshops to explore how to improve communication between health professionals. As for midwife numbers, there is a noticeable shortage of midwives which has led the Midwifery Council of New Zealand to consider the option of maternity assistants. I was going to discuss these issues in greater depth but have run out of time, so I put the question to you - both midwives and non-midwives - what can be done to improve communication between health professionals and how can we recruit and retain midwives in the health profession?

Mammograms: are women over screened?

I have to admit that up to recently I had not thought much about mammograms. I have thought about screening in relation to pregnancy and newborns and have believed for a considerable time that screening is a tricky business; the benefit of preventing the illness/condition may be outweighed by the downside of the screening. Screening can be an ineffective use of financial resources in a low risk population and may lead to unnecessary medical intervention. Routine screening has been seen by some feminists as a means of controlling women: the posit behind screening being that women's bodies are inherently faulty and therefore must be regularly monitored. But two things have recently made me think about my own personal decision about mammograms. The first event is that a very dear friend of mine, the same age as me, has breast cancer and has been/is very sick. Being with her as she deals with the implications of her prognosis has been thought-provoking, to say the least. The second event is that an appointment for a mammogram turned up in my letter box today; I turned 45 recently and mammograms are offered to women free of charge in New Zealand, to women over 45.

I am rather scared about having a mammogram because I have heard it is painful. I must admit I have done no reading about the risks of breast cancer versus the benefits of screening. So, do I just go along because that's what is recommended or do I practice what I preach: read the evidence and make an informed choice? It's not so easy being a health consumer as some would make out!

E-mentoring tools: chicken before the egg or egg before the chicken?

I am writing this as a reply to a blog entry by Jennifer Lubke, who is a teacher interested in e-mentoring. First of all, I am very excited because Jennifer is the first person to ever cite me in a blog (to my knowledge) - so that must add to my online score, surely!?

As an aside to those of us who are New Zealand academics: would a mention in a reputable blog count toward PBRF? For those of you who live/work outside New Zealand, Performance Based Research Funding is a rating system and measurement of research outputs by academics, similar to RAE in the UK.

Back to Jennifer: she is looking at online tools that may be used for e-mentoring. She has developed an assessment tool for looking at the viability/effectiveness of social networking tools for e-mentoring. Jennifer talks about teachers who are linked by a common interest and want to go 'virtual'. They should think carefully about what they want to achieve and then select the appropriate tools. But in our own enthusiasm for online social networking, we must not forget the obvious; to make sure that people have the knowledge to be able to make the choice about the tool to use. I am afraid that I am very guilty of assuming that people have the same knowledge and motivation to use computer-mediated communication that I am. However, in my experience of setting up an e-mentoring email scheme for health professionals, there is a considerable reluctance to use CMC, despite the participants articulating an appreciation of the advantages of CMC, such as flexibility of time management and breakdown of geographical barriers. I have even been surprised by the lack of knowledge of online tools by the teachers I work with. So when we are working with people to develop formal online systems of mentoring or teaching/learning programs, assessing participants' needs and knowledge must come into one's planning and thinking.

Another trap we must be very careful not to fall into is thinking that the latest technology has to be the best tool to use. If you are working with people who have a resistance to technology, keeping it simple has to be a key point. It's often things that we haven't considered that impedes uptake of CMC and networking tools. I have never forgotten talking to a rural midwife who always lost her Internet connection whenever her next door neighbour, who was a farmer, put his electric fence on. Jenny refers us to George Siemens who writes that 'it's not about the tools. It's about change'. Rather than focusing on the ins and outs of blogs, wikis, RSS feeds and so on, we need to think about collaboration, open communication and 'democracy of voice'. A salutary reminder.

What to do to develop an online identity

Inspired by another post by Michele Martin, I have had a look at my online identity score. I scored a grand total of zero! This means I have no online identity! According to the score, I am 'digitally disguised'. I am totally gutted! Now I am going to have to seriously market myself so that I become a real person on the Internet, or is that a complete contradiction of terms?!

What really upset me was that when I followed the instructions to find out my score, the only context in which I registered a presence was on Amazon. So instead of having an identity as a highly professional and articulate health professional, educator and researcher, I am famous on Google for my review of a historical romance!! How sad is that!

Ode to Graham Henry: coach of the All Blacks (courtesy of Edith Piaf)

Dedicated to the All Blacks

Well, shiver me timbers, its not going to be a southern hemisphere white wash after all. The All Blacks have fallen to France, who will meet us (Jonny and the boys) next week. Meanwhile, here is a little ditty from Monty Python to console the All Blacks and their fans, as well as the Aussies.

Develping my online identity

I have been thinking about online identity for some time and mulling over the aim of this blog, what my identity will be, and what the problems with this are. On the one hand I want to have a professional blog that attracts readers, informs them and becomes a productive part of the blogging community. At the same time, I think it is important that readers catch a glimpse of who I am as a person. However, I believe there is a real tension between the two things and the potential problem is that people such as employers or potential employers may be prejudiced against me by my writing especially if I am challenging or questioning in my opinion. Or, the 'personal' side of me may be seen to be unprofessional. For example, I have posted several posts today about the Rugby World Cup-is that professional behavior, or of any particular interest or relevance? So I am very conscious about what I blog and would say that I am not as provocative or questioning as I would like to be. Having said all that, what is the difference between publishing here on this blog and in a professional academic journal - my reputation will depend just as much on what I publish in journals, yet I never angst about that.

I am also conscious about the language I use and the way I write my blog. I wish to attract midwives and women who are interested in midwifery and childbirth, not just academics. So I think it is really important that I write in a relaxed manner that is easy to read and enjoyable. I have really enjoyed reading the blog of Gráinne Conole, Professor of E-learning in the Institute of Educational Technology at the Open University. She has a really user-friendly way of writing and she displays a great sense of humor. That has really attracted me to her blog and makes me feel that she is approachable, despite being a 'professor'. This in turn has prompted me to leave comments on her blog.

Going back to my online identity, I have been challenged in my thinking by several articles by Michele Martin who has been pondering the same issues of online identity and transparency. Michele contends that one should be transparent in order to be honest and show people how your processes work. To be transparent online, one has to be transparent with oneself which promotes learning. Exposing oneself may be a frightening prospect but Michele believes it is rewarding. At the same time, it is probably very advisable not to write about unprofessional activities such your drinking binge at the weekend. Michele contends that employers are more likely to value a person who is multi-faceted with strengths and weaknesses.

So my reflections on all this: you cannot live your life designed to keep in people's good books all the time, and I would say that applies equally to your online life. Displaying critical thinking and reflection is more likely to add to your professional identity than detract from it. So whilst I will not be posting details of the orgy I attended at the weekend, I won't stop celebrating England's famous rugby victory this morning! I look forward to reaping the rewards of being more courageous and transparent in my postings.

Needing resusitation

I thought I was going to require CPR last night after staying up for most the night finishing off my slidecast and then watching the England/Australia World Cup rugby match. The game was so suspenseful I hardly took a breath for 90 minutes. And against all the odds, England won!! Woohoo!! Go, Jonny and the boys!! (Photos from BBC Sport)

Just given birth: my very first slidecast!

Well, it has taken me a few hours but I got there in the end. I struggled and struggled, was in 'transition' for a very long time, but eventually (with a lot of help from my friends) I birthed my very first slidecast - I swear actual birth was easier!

Posting the PowerPoint presentation onto SlideShare was easy - I just followed the instructions. Attaching audio to the presentation was the real challenge. Firstly, I was advised to use Audacity which is a free, open source software for recording and editing sounds, and makes audio recordings into MP3 files. This is really useful if you do not have a MP3 player to record on. The reason for making a separate audio file as opposed to recording directly onto the PowerPoint presentation is that you have a lot more ability to edit and apply effects. Just be mindful when you download Audacity that you also need to download the LAME MP3 encoder which allows you to save the file as a MP3 file. Leigh Blackall's slidecast about this was really helpful. I recorded the voice-over easily but got seriously stuck when I tried to save it as a MP3 file. My epiphany moment came once I read Sue Waters' instructions on how to download Audacity and encoder. What I needed to do was open the encoder file and save it separately into another folder. Once I worked all that out, everything else feel into place and I had my MP3 file all ready to go.

The next step was to save my MP3 file on the Internet and again, I followed Sue Waters' instructions which are very comprehensive, and used Internet Archive. This is an online library where you can save files on the Internet. Once the file was saved, I was then able to go back to my presentation on SlideShare and add the audio as per Sue's instructions. Adding the audio to the slides and synchronizing it was much easier than I imagined, but there are plenty of slidecasts to help you if you need it. Sue Waters recommends MyPlick as a host for presentations because you can store both presentation and audio file there, as opposed to SlideShare where you have to store your audio file in a different location. However, I found the process of adding audio to the presentation to be very easy on SlideShare, especially compared to the process of using Audacity.

My next challenge is to go back to Audacity and have a real play with it and try some editing and making special effects. It looks relatively easy and there are a number of Slidecasts and videos on YouTube that will help you with this, such as the video by Rodney Rumford.

My main learning from this whole process is not to forget to look for resources and information on websites such as YouTube and SlideShare. Instead of getting into a mad panic and asking for help at the first hurdle, I must get into the habit of first consulting YouTube etc. There is such an overwhelming amount of information and resources on the Net and consulting these resources needs to become second nature to me. I sent out a couple of SOS emails but by the time they were answered I had managed to work things out for myself by using videos etc. I am really pleased that I managed to work this all out by myself without any face-to-face support. However, I must remember that not all students would be able to do something like that without much more hand-holding. The second interesting thing was the number of medias that I used in the process: Skype, email, YouTube, Slidecasts, wikis and blogs. If I can do all that to find out how to make a slidecast, why can't my students use the same process to find out about a midwifery topic? I think it's a very powerful process, with a reflective element at the end of the process. It also fits the whole concept of problem-based or scenario-based learning so well.

So, here's my baby: it is a very crude first attempt: http://www.slideshare.net/sarahs/welcome-to-my-experiment

I need to learn a lot more about sound quality, editing etc. I could not believe how difficult it was to come up with a script or how nervous I was. What I would appreciate is feedback from people: what it sounded like; how easy/difficult it was to download and any tips for improving quality.

A slide presentation about e-mentoring

This was downloaded from SlideShare. I realised after I downloaded this slideshow that its author is Sheryl Nussbaum-Beach: it is a small world after all.

Email meltdown

I have finally got around to creating a Gmail account. I have been resisting because I do not like having lots of different email accounts but things came to a head this morning. My husband had a fit because of all the emails we were getting into our family email account from TradeMe, which is the New Zealand equivalent of E-bay. I am totally hooked on it and buy and sell historical romances, much to the disgust of my more academic friends - no, I lie - much to the disgust of all my friends! The other crises point is that my work email is going to be down ALL weekend. I have used my work email to log into all my accounts such as YouTube, Google etc. I could not bear to be without access my emails for such an horrendously long time, so have now switched everything into my Gmail account. I just hope it all works.

Making effective PowerPoint presentations

Here is a great slidecast on how to make an effective PowerPoint presentation.

On the road again

I am just about to start my travels again. I have had an abstract accepted to present a paper about the potential of e-mentoring for recruitment and retention of health professionals. This conference is at the Gold Coast in Queensland. The conference is called 'Recruitment and Retention in the Health Workforce'. I am really looking forward to attending this conference because I hope it will answer some of the questions I have raised in previous posts in this blog. Submitting this abstract has been an interesting exercise in thinking beyond my first professional interest/skill, midwifery ie recruitment and retention issues facing midwives are equally as relevant to health professionals, whatever their profession or geographical location. It is easy to get so immersed in one's own profession that one forgets the lessons that can be learnt from other professions and the valuable collaboration that can take place. I plan to have a go at either putting my slides and vocal commentary on 'SlideShare' or develop a small podcast. But it's a scary prospect. Talking to a small audience at a conference is one thing: putting your words and thoughts out for the whole world to see is a very intimidating thought.

The other place I am off to is Singapore to attend the annual ASCILITE conference in December. ASCILITE is The Australasian Society for Computers in Learning in Tertiary Education which 'is a society for those involved in tertiary computer-based education and training'. I have been very fortunate to work with a mentor to develop a paper that has been accepted about the design of an e-mentoring system. My mentor talked me into writing a 7ooo word paper, which sounds great in theory but now I have to present it in a 30 minute plus presentation slot. To say I am nervous at the prospect is an understatement. If it was a midwifery or nursing conference, I would not think twice. But this is the first educators' conference I have attended, so it will be a very interesting experience for me because it will take me out of my comfort zone. What have you done recently that has challenged you or put you outside your comfort zone?

NICE clinical guidelines for labour and birth

The latest NICE guidelines on labour and birth have just been released. I must admit I have not looked at them in detail yet. When you are reading these sorts of publications you must remember the context that they are generated from and the politics that go into their development that you may be completely unaware of. Generally, the NICE publications are widely respected and can be a very useful tool for implementing change of practice. After having a quick browse, a couple of things caught my eye:

• water is recommended as pain relief - it is great that water is now recognized as a main stream method of managing pain in labor;
  
• 'term' is defined as 42 weeks gestation- not 40 or 41 weeks, which should be remembered when discussing routine induction of labor for so-called post-dates pregnancy;
  
• no pre-load intravenous fluid required for epidural, nor maintenance fluid - hopefully this will prevent all the fluid overloading that occurs;
  
• women should be told the average length of labor for first time mothers is 8 hours and for subsequent babies is 5 hours - this strikes me as problematic for several reasons: firstly, you must be quite sure when a woman is in true, established labor; secondly it makes no allowance for women who have long but perfectly normal labors
  
• strict time frames for intermittent monitoring of baby's heart rate - at least it does not recommend continuous monitoring for low risk women;
• birth plans should be adhered to when possible if women have them - shouldn't every women have some sort of documented plan that has been agreed to in the antenatal period? I am not talking about pages and pages of tree hugging but rather some documentation about what has been discussed and agreed.

These are just a few quick impressions. What do you think?

Keeping track of your blog comments

I have worked out how to keep track of people's blogs but what has really frustrated me is trying to keep track of the comments I have posted on blogs. I have found it to be really time consuming going back to blogs to check if anyone has responded to my comment or to the main post. Thanks to Sue Waters, I have found a program called 'co-mment' which allows you to keep track of those comments. Its an easy program to use and Sue has posted directions on how to use it.

Midwifery: a job for life?

I have finished reading a brilliant post by Sage Femme entitled 'wanting to work at starbucks'. In her post, she talks about her feelings of failure and self-doubt, and how she needs to center herself on the present and not look back at the past. I loved her post for a number of reasons, not least that it made me think about how I am as a midwife. The main thing I loved about this post is that she is totally honest about how she feels. She acknowledges that she is a midwife through and through; being a midwife is who she is, not just what she is. However, there are times when it gets too much and she 'wants to work at starbucks'. It is not often we see that sort of honesty in print. Yes, we may say these things to each other, but there's almost a sense that we have failed if we admit to not wanting to be a midwife any more, or that we're being disloyal to the profession. Or that there's an easy fix: drop your hours; work in a different setting; look at your time management; be a better midwife! Or, that you should just stop whining and harden up!

But is midwifery changing? It used to be and for many still is, a vocation. It was also a job for life. But are the pressures of being a midwife too much for women (and men) these days. Certainly, there is an international shortage of midwives. The average age for midwives in New Zealand is 50, and I suspect it will be similar around the world. Who is going to follow us oldies when we retire? Last month, I wrote in my blog that my daughter was thinking about becoming a midwife. When a new graduate pointed out to her how being on-call would affect her life, she swiftly went off the idea. Of course, she is very young and may come back to the idea when she has matured, but I could see that issue is a very valid one. Of course, a midwife may work in a shift pattern, in a birthing facility or hospital. But there are issues faced by hospital midwives including trying to work family life around shifts; lack of autonomy; lack of flexible working environment; horizontal violence and so on.

Now I am not really sure where I am going with this and I always feel I should have some sort of conclusion. I do not think there is an easy conclusion to this but I do think that talking about our problems in an honest and open way is the beginning of being able to deal with them. Stress and burnout should not be ignored, either on a personal or professional level. As midwives we need to recognise stress and burnout and develop strategies for dealing with it. We should support each other in a loving and non-critical way. At a professional level, what are we doing to recruit and retain staff? How can we introduce and maintain flexible working practices? How can we meet the professional development and support needs of our midwives? One of the ways we could do it is by exploring online social networking: e-mentoring being one such potential resource. But my big plea is not to brush things under the carpet or dismiss them as being hearsay only: lets be honest and open about how we feel. Only then can we go on to work together to address the issues.

Midwifery students connecting with each other

The value and potential of blogging for connecting with people who have the same interests or experiences has really been brought home to me in the last few days. I have been keeping an eye on midwifery blogs via iGoogle and my Google Blog Search, which informs me every time a blog entry is made with midwifery as its topic. There aren't too many midwifery blogs out there, but I have come across a number of blogs by midwifery students. It is fascinating (and humorous for me, as a lecturer and OLD midwife) to read the trials and tribulations of the students. And I have to say...thank goodness I'm not going through that! But I have been really struck with how these blogs can act as a portal of information about midwifery and midwifery education in other countries and how supportive they can be to students as they work their way through the various challenges they face. Ideas about international collaborative teaching and support via blogs have been flowing thick and fast. The problem I can see is time constraints. Midwifery students have many demands on their time, not least study and clinical requirements. As many are mature students, they have to juggle family commitments as well. So , if blogging could be worked into the requirements for their assessment, that may inspire them to make use of this form of networking. For example, this sort of international networking would fit in really well with the papers that teach 'midwifery knowledge' eg international midwifery context. I would love to hear from any midwifery educators or students who are interested in exploring this concept further.