Off to Brisbane

I am off to Brisbane tomorrow for nearly a week, so you probably won't hear too much from me for the next few days.

New PhD supervisor
There are two reasons for going. One of them is to meet my new PhD supervisor. I have been floating around in limbo for the last couple of months whilst I have been looking for a new supervisor. So I am very excited to be meeting her and re-focusing on my PhD and getting it finished.

Aged Care, Queensland
The second reason I am going to Brisbane is to present a session on e-mentoring at a workshop hosted by Aged Care, Queensland. The workshop is focusing on how new entrants to the aged care sector can be supported by mentoring. My session will be very generic, looking at e-mentoring both from a one-to-one view and also from a community, social networking angle.

Getting out of midwifery
One of the reasons I choose to look at e-mentoring for my PhD was because it is a topic that can be related to any profession in health care. So I am really looking forward to meeting people who work in a very different area of health to midwifery.

Having said that, I am quite positive that we will have the same generic recruitment and retention problems, and will be able to have very useful discussions about professional development and life-long learning.

On a personal level
I am really looking forward to getting away from the cold, damp weather we're having in Dunedin. I am feeling very drained by the cold and cough I have had for over a week now. So I am hoping that a change of scene and focus as well as the Queensland warmth will help re-energize me, ready for Spring.

The other thing that will re-energize me is meeting my fellow PhD students working at the Centre for Online Health at the Royal Brisbane Children's Hospital. I know I am a great exponent of online relationships, communication and learning. But I must admit I always get an extra special buzz when I meet my fellow colleagues face-to-face.


Image: 'Freedom's on the Wallaby' monkeyc.net
www.flickr.com/photos/73584213@N00/118675592

Integrating Delicious into my ePortfolio

I have been recording any mention or citations of my work in my ePortfolio, which is set up in Wikispaces. This has become important for me as an academic in New Zealand, because citations are evidence of peer esteem, which in turn is an element of PBRF - a process whereby my research performance is evaluated and 'rewarded' with funding at an institutional level.

I also collect evidence of 'peer esteem' in my ePortfolio because it will enhance my CV and hopefully will stand me in good stead when I have my annual performance/job review or if I look for a new job.

Tracking citations
In order to track what is being said about my work, I have set up a Google 'alert' for my name, which means I get an email whenever I am mentioned in other people's blogs or web sites. I also have a Technorati account which gives me similar information. And on occasion, I carry out a search in Google Scholar to see if any of my material that has been published in traditional journals has been cited.

Now, all this may seem narcissist to say the least, but I'm afraid it's the game we play in academia - and that is a blog post for another time.

'Citations' section of my ePortfolio
The problem I have found with recording citations in my ePortfolio has been that it is a little boring, and I never remember to do it as and when I come across citations. But I find that I forget the reference if I do not record it at the time I find it.

Using Del.icio.us to keep track
So I think I have found the solution suggested by Michele Martin in her post "Using Del.icio.us to Create an Easy, Always Updated Online Portfolio". What I do now is bookmark any mention of my work with the tag 'SarahStewart' in Del.icio.us. I also - when I remember- write a comment to describe the citation and why it is important to me and my professional profile.

Integration in Wikispaces
The problem with this solution was that I was replicating my work - the tagging aspect of Del.icio.us was quick and easy, but I was still recording the same citation in my ePortfolio.

But now I have set up a widget in my ePortfolio which imports my del.icio.us tags straight into the wiki page. So the only citations I have to record in my ePortfolio now are non-electronic ones.


Image: 'What's In The Bag?' Jim Nutt
www.flickr.com/photos/76479100@N00/6462349

Getting Grandma to blog

It must have been about a year ago that I heard about Olive Riley who was deemed to be the world's oldest blogger at the grand old age of 107, and I left her a note on her blog. Alerted by 'Clinical Cases and Images' I see that she has recently died in her Sydney nursing home.

Inspiration
Olive turned the whole idea that 'it is only young people who engage with technology' on its head and is an inspiration to us all.

What especially inspired me was that Olive used blogging and video to pass on her knowledge and memories, which is now a wonderful historical resource for us all.

Tell a story
So next time you are visiting an elderly relative or friend, get out your tape recorder, MP3 player or video camera and capture a story before it is lost for all time.

Or for that matter, have a think about a story you have to tell that you should record to pass on to future generations?

Blog audit for health professionals

I have followed the advice of Clinicalcases.org in the post "Content of Weblogs Written by Health Professionals: More Bad than Good?" and applied for this blog to be accredited by the Health on the Net Foundation. HON is globally recognized as one of the prime monitors of quality of health information on the Internet. Consequently, if you visit a web site that has been accredited by HON, you can be reassured as to the quality of the site.

Auditing your blog
Seeking HON accreditation may be over kill, especially for blogs that deal mostly with personal opinion and reflection. However, looking at the eight HON principles and auditing your blog against them is not such a bad idea even if you don't apply for accreditation, especially in the light of concerns about confidentiality of health blogs and online behavior. The principles are:

1. Authoritative - the website indicate the qualifications of the authors, especially if medical advice is given.
2. Complementarity - information should support, not replace, the doctor/midwife-patient/woman relationship
3. Privacy - privacy and confidentiality of personal data submitted to the site is respected
4. Attribution - all information is attributed and referenced
   
5. Justifiability - web site must back up claims relating to benefits and performance of any treatment or services that are discussed
6. Transparency - accessible presentation, accurate email contact
7. Financial disclosure
8. Advertising policy

Results of my audit
The HON web site poses a series of questions that allows you to audit your blog against the eight principles.

The results of my audit have led me to:

• add a 'last modified' date to my profile and this blog's 'about' page;
• write a statement about my advertising policy ie I do not advertise or receive funding from advertising;
• write a statement that I receive no funding for this blog;
• be clear that I will not disclose any personal information that people send to this blog without their permission;
• write a disclaimer that any medical or midwifery information I pass on is for education purposes only. Any queries should be checked with a doctor or midwife.

Useful tool or inhibiting?
Do you feel that this HON audit goes some way to alleviate fears about confidentiality and online behavior or do you feel it is not relevant for a blog such as this?

Should students be informed about the HON principles or do you think it only applies to medical web sites that give advice as opposed to blogs used solely for professional reflection?

Is the HON audit a useful tool or one that is overly prescriptive with the effect of inhibiting refection, conversation and discussion?

Image: 'Strangle Hold' Randy Son Of Robert
www.flickr.com/photos/46042146@N00/459432985

Out of an acorn

Here is the link to this afternoon's midwifery Elluminate meeting: Making space for childbirth by Dr Deborah Davis.

Again the group was small but we had a new midwife join us who is based in Australia. She enjoyed the meeting and promised she would help disseminate information to colleagues in Australia about future meetings.

It's a very small beginning but as they say...out of acorns grow great oaks


Image: 'acorns' simonsterg
www.flickr.com/photos/36267672@N00/264144666

Midwives doing cesareans

Here is a link to an amazing documentary called 'Birth of a surgeon'.
It tells the story of midwives who undergo surgical training in order to be able to perform cesarean sections in Mozambique. This is one solution to bring down the horrendous maternal and neonatal mortality rates in this developing country.

Questions
The documentary is harrowing at times yet inspiring. But it also raises questions about how resources should be managed with regard to tackling mortality rates in developing countries. In several of the comments accompanying the documentary, people ask whether money would be better spent improving sanitary and nutritional conditions, and providing contraception.

Taking life for granted
I am truly in awe of the midwives who work in countries such as Mozambique. I just don't appreciate how lucky I am to be a woman and midwife in a country that has full medical and midwifery facilities.

Image: 'Enfants du Mozambique' speedd200
www.flickr.com/photos/15196393@N04/2043809467

The 'after' photo

Yesterday I posted my little dog Angel's 'before' photo.

This morning I dragged her to the canine beautician...here is her 'after' shot.

Supporting midwives in rural practice

I had message via Twitter the other day from a member of my network. She was telling me that a friend of hers has to travel to Christchurch from the West Coast of the South Island to give birth. This journey takes a number of hours by car, across the Southern Alps. It's not a trip I would want to take whilst in labour.


Shortages of midwives and medical staff
The press has been concentrating on the shortage of medical staff but there is an equal shortage of midwives. The problem of attracting staff to rural areas is an ongoing one and is likely to become a political issue in the upcoming New Zealand election.

A bonus payment has been made to rural midwives so that is a positive move. But in the meantime, women have the expense and emotional trauma of having move out of their locale to have their babies, away from family and friends.


Supporting colleagues in rural locations
This makes me thinking that what the rest of us can do to support our colleagues to stay working in rural areas, including finding ways to provide forums for reflection and information exchange like the online midwifery seminars I facilitate.

Somehow I have got to find ways of getting the message out about the online seminars not just to my local community of midwives but throughout New Zealand. My current method of using snowballing to disseminate information about them doesn't appear to be working. Any other ideas about what I could do?


Image: Southern Alps 'Bleak Horizon' Timmy Toucan
www.flickr.com/photos/74693095@N00/1246813861

Getting a makeover

No, it's not me although I could probably do with one.

It's Angel...my dog.

She's getting a hair cut tomorrow.

So...here is the 'before' photo.

Going round in circles

I don't know, I just seem to be going round and round in circles and just not getting anywhere.

Mind you, it could be to do with the fact I have a stinking cold and am dosed up to the eye balls with medication.

Maintaining confidentiality
I have been enjoying the discussions that have been sparked by a couple of posts I have written about blogging, clinical practice and confidentiality. On the whole, we all seem to agree that blogging should not be suppressed.

However, there are concerns about divulging patient/women (s) personal details and contravening professional standards of practice. We do not want our students to be doing that in a public arena and getting themselves (and blogging) into trouble. I have suggested that we should only be blogging about births and our clinical experiences only in general terms.

Muzzling students
Lisa suggested that if we try to muzzle students' blogs we are interfering with the process of free speech and they should be able to work out for themselves what is appropriate material to blog about. And Leigh Blackall challenged me to think about how I can work with students in an open environment to manage the 'risk' of blogging, because they're going to do it whether or not we like it.

Angela, who is an occupational therapist in England agrees with Leigh. She has picked up my posts and has led a discussion about confidentiality. One blogger used the thread to get feedback on a post that he had written because he was a little concerned about the level of detail he had included. Angela has written in response to this:

By building a strong and supportive blogging community we can hopefully use each other (as bloggingot has done here) to engage in peer "supervision" of blog posts.

Full circle
So I am back where I started but enjoying the discussions, accepting challenges and increasing my own networks through the conversations we have been having.

This is exactly what blogging is about and why I think it is such a valuable teaching/learning tool for students and midwives, and why it should be encouraged.

Image: Stonehendge Mark Stewart
http://www.flickr.com/photos/92632631@N00/2656343529/

Making space for childbirth

This presentation reports on research conducted in New Zealand exploring the practice of case-loading midwives. The practice of case-loading midwives within the obstetric hospital provides a focus, exposing the contested nature of maternity care and illustrating the way that midwives negotiate this contested terrain. Midwifery practice is described as “making space for childbirth”.

Presenter: Dr Deborah Davis

Date/Time: 23rd July, 2008 16.00-17.00 hours NZ Time International Time

Elluminate Link: http://elluminate.tekotago.ac.nz:80/join_meeting.html?meetingId=1213863421151

Just enter your name where it says 'user name'. You do not need a password.

Using Elluminate
The meeting room is available now so you can have a play with the technology before the meeting.

Please click here for more information on how to use Elluminate or contact me.

If you can't make the meeting
The session will be recorded and you will be able to listen to the meeting via the link which I will post on this blog.

Image: 'A Classic Still Life, Holiday in the+Hospital' cobalt123
www.flickr.com/photos/66606673@N00/331811924

Getting our knickers in a twist?

I am still thinking about the whole issue of confidentiality and blogging, especially in the context of health practice. And I am wondering if some people are getting their knickers in too much of a twist? Are health professional really incapable to blogging in a way that is professional and protects the privacy of the people they work with? Yes, I know of a few instances where health professionals including students have been less than careful about what they write, but is it really as much of a problem as some people seem to think? Is there really a need for blogging guidelines?

What's the evidence?
To be honest, I do not know if there has been an analysis of the content of blogs belonging to health professionals. So I do not know how much the concerns about blogging and confidentially are based in fact or general impressions.

Detecting the risk to security and confidentiality
With two colleagues of mine, Liam Caffrey and Anthony Smith, I looked at the content of emails sent between health professionals who are involved my PhD e-mentoring research. I was concerned that the emails should be kept in a secure, closed email system so that confidentiality could be maintained. But Liam questioned the need to do this - he asked if the health professionals did actually write about things that could cause confidentiality problems?

Developing a risk assessment tool
Liam and I developed an assessment tool by which we were able to anylise the risk to security and confidentiality ranging from 1 — breach of patient confidentiality — indicating a high need for security and privacy of the email’s content, to a score of 8 which had no need for either security or privacy.

1. Email contains patient identifiable content where the confidentiality of the patient is breached by identifying medical condition or treatment eg "Mr Smith has liver disease"
2. Email contains patient identifiable information but does not disclose medical condition or treatment eg “Mr Smith is a nice man.”
3. Email identifies staff member involved in a practice that places them or other staff member at professional risk eg “I accidentally gave a patient an overdose.”
   
4. Email identifies staff member and divulges possible stigmatizing information about themselves or other staff member eg “I am on medication for depression.”
   
5. Email identifies staff member and divulges information that could embarrass themselves or other staff member eg“My supervisor is hopeless.”
   
6. Email identifies staff member and describes a clinical event or professional event eg“I have a patient who is having triplets.”
   
7. Email identifies staff member and divulges personal information about themselves or other staff member eg“I am going for a job interview next week”
   
8. None of the above
   

Results
The analysis showed that there were no emails that had a score of 1 or 2 ie no emails disclosed patient information. We concluded that there was no need to be concerned about security or confidentiality in this context. But there was an email that scored 3 ie the author disclosed an action that could put her at professional risk so we agreed that there was still a need for caution about what one writes in emails and other electronic forums.

Future research
I must admit that this assessment tool is rather crude and it could probably be refined. But it would be interesting to carry out a similar exercise looking at the blogs of health professionals. This might give us a better idea about what health professional disclose online and whether there is a risk of breaching confidentiality. This in turn could help inform decisions made about the development of guidelines.

Reference:
Caffery, L; Stewart, S; Smith, A. (2007). An analysis of the security and privacy of email messages used in e-mentoring. Journal of Telemedicine and Telecare, Vol. 13, Supp. 3, Dec. 2007 , pp. 24-26(3)

Image: 'A blue lock for George' Darwin Bell
www.flickr.com/photos/53611153@N00/406208791

Blogging about birth

As my regular readers know, I am committed to blogging as a learning tool for midwives and students. And I have been very concerned about moves by educational institutions to prevent students from blogging. I feel this is a mistake because it prevents students from using a very effective forum for learning from experienced midwives and networking with fellow students.

Concern
However, I have read a few students' blogs in the past couple of days and I have become concerned about what is being written in open forums. I have seen students write very detailed accounts of their clinical experiences, especially births. Whilst they have not used names, there is always a possibility for women to be identified.

Using stories to learn
Health professionals rely heavily on telling stories as a means of teaching and reflection. Our blogs are not dissimilar to the staff tea room at the end of the hospital corridor where health professionals do so much story-telling. The difference is that the door to the tea room is closed, whereas our blogs are open to all passers-by.

Who owns birth stories?
It isn't just an issue of confidentiality, but also a question about ownership. Whose story is it? A birth story is the woman's story. Do we the right to plaster a woman's birth story all over the Internet without her permission? What do you think?

Reflecting on clinical experiences
I am thinking that the best way to blog about clinical experiences is to write in a general way as opposed to a specific description of events. Make the story about you and your learning, not about the woman.

I also think it is important to consider the aim behind blogging about clinical events and practice. I think it is to help the processing of learning. But it also can be a resource for fellow students and midwives. So I would recommend that you should keep this aim in mind when you blog about your clinical experiences - that will help to focus your writing. If you are a student or midwife, what would be your aim for reflecting on a blog?

The scenario
Here is a suggestion for how you could blog about a clinical experience. First, read the scenario.

• A student midwife is working on the labour ward (or delivery suite) alongside a midwife who is caring for a woman in labour.
  
• The woman is expecting her first baby and has had her labour induced because she is seven days overdue. The woman goes into painful labour and ends up with an epidural. After two hours of pushing, the woman has her baby. The baby is a little slow to start breathing when he is born and requires some attention from the second midwife attending the birth. Once the baby is fine, he has his first breastfeed.
• The student has a busy time, getting a chance to do a number of clinical skills like urinary catheterisation and intravenous cannulation (putting up a drip). She carries out a vaginal examination, supports the woman and her husband, catches the baby, does some documentation and even has a go at suturing. She helps the woman with the first breastfeed and watches the midwife carry out the first check of the baby.

The learning
There are any number of issues that the student may wish to think and write about, and share with fellow students and colleagues.

• Induction of labour - indication, evidence, midwifery care and responsibilities, outcomes of birth.
• How to care for women in labour so they do not require pain medication.
• How to facilitate normal birth when a labour is no longer physiologically 'normal' ie when there has been some sort of medical intervention.
• How to develop skills of accurate, detailed and contemporaneous documentation.
• Caring for a woman who has an epidural including the 'management' of second stage.
  
• Feelings of own inadequacies when dealing with the unexpected, such as when a baby who needs resuscitation.
• Acquisition of clinical skills - competency and confidence.

How to blog
Here are a couple of ideas on how you could blog about this scenario.

• Explore feelings about competency and confidence. Describe what you are going to do to become more skilled and suggest helpful resources that you have found useful eg YouTube video on cannulation.
• Explore the evidence about induction of labour and critically evaluate it. Publish a list of useful references.
• Same applies to evidence about epidural. Formulate a set of guidelines for midwives about caring for women who have an epidural based on the appraisal of the evidence.
• Start a discussion about alternative ways of pain relief for women in labour.

What the...
"BORING!" "That's not what blogging is about". "Those suggestions sound like writing mini essays and I do enough of that already"

You may well be right - I'd love to hear what you think.

But writing posts like this as opposed to detailed and personal recounting of events will help develop critical thinking skills, develop resources that can be passed on to other students and hopefully inspire useful discussion.

Message to students
So my particular message to students is to think carefully about what you write in a blog. If you have any doubt, consult with your lecturers before you hit that 'publish' button. And do not forget the stringent institutional and professional rules about confidentiality.

Opening up discussion
I am not saying that this is how you should blog and you may completely disagree with what I have said. The last thing I want to do is be prescriptive about the contents of a blog. However, I would love to hear from you if you are a health professional - how do you think we should blog about our clinical practice? Do you think we should be developing guidelines for blogging? If so, what should they contain? Do you think there should be different guidelines for students compared to registered practitioners? What do you think about all this as students - what would you suggest?

If you are not a health professional, I would also value your opinion. What would you feel about having your health care related in a student/practitioner's blog? What would you like included in guidelines or do you think the content of a health professional's blog should be left to individual discretion?

Reference: Learning through storytelling. Maxine Alterio and Janice McDury. 2002. Dunmore Press, Palmerston North, New Zealand.


Image: Mark's trip 2008 Mark Stewart
http://www.flickr.com/photos/92632631@N00/2657175418/in/photostream/

A black night for Dunedin

In my 'real' life I am a great rugby union fan, so the highlight of the year was always going to be the test match between the All Blacks and South Africa at Carisbrook, in Dunedin.

A Boy Scout is always prepared
Well, actually I was a Brownie, but the principle is the same when you attend nights games at Carisbrook, in the middle of winter. So I prepared with a couple of glasses of bubbles, a nice hot curry and at least six layers of thermals and jumpers.

Sadly for New Zealanders the evening ended in a loss to the All Blacks and quite honestly, the game was a tad boring. But the atmosphere was electric and there is nothing as stirring as watching the All Blacks do the haka at Carisbrook.

National mourning
So no doubt there will be much wailing and gnashing of teeth for the rest of the week amongst the boys. As for me...I went home and cuddled up with the heat pump and a mug of hot chocolate.

A noisy birth

Years ago when I was a staff midwife working on the 'labour ward' , I distinctly remember how disapproving all the staff would be if there was a 'shouter' or 'screamer' giving birth. And woe betide if she was the woman you were looking after. Having one of 'your' women scream her head off while giving birth was a poor reflection on you and your skills as a midwife - on your ability to 'control' the woman and the 'situation'. I remember saying things to women like "don't make that noise, conserve your energy and put it into your pushing."

Birthing noises
What I have come to realise over the years is that some women need to make noise, that it helps them to focus on giving birth. The other thing I have realised is that the noise women make during birth changes as labour progresses. So one of the tips I would pass on to students is to listen carefully, because the noises women make tell us about how she is progressing.

A lovely birth
Here is a video of a beautiful waterbirth at home. Close your eyes and listen to how the noises the woman makes changes from humming to grunting, which tells us that the baby isn't too far away. Then listen to the quiet, and the next noise you will hear is the baby crying - just wonderful!

The other thing I love about this video is the presence of the older sibling who is more interested in playing in the birthing pool.



http://www.youtube.com/watch?v=sbjuAJcJtsU

Communities of Practice and Rural Midwives

Here are the results of a research study carried out by Carolyn McIntosh, a midwife, educator and colleague of mine. Carolyn has just presented her research at the ICM conference held in Glasgow, a few weeks ago.

Carolyn's research focused on how rural midwives in New Zealand inform their practice and form communities of practice.

| View | Upload your own

http://www.slideshare.net/midwikied/icm-presentation-2

Closing Down Midwifery

It has been interesting and at the same time, worrying to watch the recent trends in attitudes of midwives to the Internet and online behavior. In education there is a growing movement toward openness and learning by social networking. But in midwifery there appears to be a trend toward closing down which is causing me considerable concern, both on a personal and professional level.

Online midwifery
There is no doubt that health professionals have specific concerns and responsibilities with regards to online behavior and communication that are not felt by the general population. And I am the first person to advise midwives to consider how to behave professionally in online forums. However, I have taken the view that midwives should be open about their practice so that colleagues and women can learn from ongoing online discussions.

But with the current environment being what it is, I am wondering if I am living in cloud cuckoo land. It doesn't seem to take much for the media and critics to attack the midwifery profession. And it looks like the focus is currently on students and midwives in online environments. So I am wondering if I am digging a hole for myself by opening up online discussions about my midwifery and teaching practice.

Latest news from the UK
My concerns abut the closing down of midwifery online networks has been highlighted this week by the news that student midwives are being investigated by their universities for their use of blogs. The main concern appears that the universities do not want to be identified in students' blogs.

This was followed up by guidelines published by the moderator of a large online community for student midwives: StudentMidwife.net. The guidelines have been in response to the latest Code of Practice issued by the midwifery governing body in the UK. The Code says:

• Act with integrity - You must demonstrate a personal and professional commitment to equality and diversity
• You must uphold the reputation of your profession at all times.

The guidelines that have resulted includes advice to be completely non-identifiable ie using anonymous names, avatars and photos.

Missed opportunities
What saddens me is that some educational institutions and midwives appear to have lost sight of the many advantages of online social networking. I am still convinced that the way to manage online activities is to facilitate them, rather than push them underground - to encourage constructive conversation and critique, as opposed to censorship.

Students will always talk about their lecturers and the institutions they are enrolled with. Surely, it will be more beneficial if we all work together to ensure that we use tools such as blogs to support learning; that experienced midwives and educators model good practice in blogging and online communication, and we support students as they explore communities of practice and develop their online identity. I mean, if teachers can manage blogging with their primary students, surely we can do the same with our adult learners!?

Online identity
As much as I understand the rationale for having an anonymous identity online, in some ways I think an open identity is our best protection. However you try to control what is said about you, either as an individual or institution, you will never be able to stop people talking about you.

As an institution, would it not be better to look at what students are saying in their blogs and online spaces and respond proactively to their feedback? By putting out information under your own name or 'brand' you have far more control over what is being said and done then if you ignore what is going on or worse still, try to censor conversations.

By being anonymous and remaining in closed spaces, one is severely restricting the opportunities for communication and collaboration. And the sharing of resources and expertise, such as the current collaboration between Pakistani and New Zealand midwives, will never happen.

Guidelines for using the Internet
I have recently read a post by Tony Karrer about the most common objections to learning by social networking and I think I have heard just about every objection. Tony's post eventually led me to IBM's Social Computing Guidelines which covers media such as blogs, wikis and virtual worlds. Whilst IBM's corporate context differs from that of health, I much prefer their emphasis on open participation compared to the reactionary guidelines I have seen for health professionals.

Do you think midwives and health professionals need guidelines for their online behavior? What do you think should be included in the guidelines?


Disclaimer: These opinions are entirely my own and not necessarily those of my employer or any other midwife.

Image: Me with my cat, Blackie.

YouTube and the next New Zealand elections

According to Tom Pullar-Strecker, New Zealanders are going to be able to ask politicians video questions via YouTube in the run up to the next NZ elections in November. A special web site is going to be set up in September and the best questions will be chosen to play before a live TV audience and put to political leaders.

What question would you like to ask?

Thanks to Mashable for the link via Twitter.

Image: 'New Zealand Mount Cook' swisscan
http://www.flickr.com/photos/7578081@N07

A free online course

A free online course 'Facilitating Online Communities' starts on 28th July.

The course is open which means you can join as an informal learner and do it for 'fun', or you can enroll and receive formal recognition of your learning.

I did the course last year as an informal learner and found it to absolutely invaluable. Eventually, I enrolled, did the assessments and received the qualification. I would highly recommend the course itself, as well as being an informal learner in a course like this.

For more information, get in touch with the course facilitator, Leigh Blackall.

DIL: Editing my video

The Digital Literacy Research Project in which I am a participant, is coming to a close and this is probably one of my last posts on the subject. I have my plan and I have researched the principles for making a video. Once I have made the video, then I need to think about how to edit it.

Have I got the right medium?
It is probably too late to ask this question because I have already made up my mind to make a video. However, Dan Meyer has a very important point: using video to get a message across complicates things considerably. So make sure video is the right medium to use, as opposed to more traditional mediums such as text.

I am using video to talk about portfolios because of my own need to learn about that medium. But I also think midwives will appreciate something a little different from plain text, and I am hoping it will catch their attention.

Keep it simple
The other invaluable rule that Dan Meyer passes on about making videos and editing is to keep things simple. What I do not want is to make life too complicated for myself as well as time-consuming.

I want to make a short and sweet video that gets a message across in a way that is accessible to students, yet costs me little in terms of emotional energy and time consumption - have a look at the comments to Dan's post for discussion about sustainability of video in education.

Editing video
There are a huge number of resources on the Internet that will help with the actual editing of a video using Windows Movie Maker, not least on the WMM web site itself.

As for putting the 'story' together, I have found Langwitches' post on digital story telling to be very useful. In it Silvia explains that digital story telling is about connecting, communicating and collaborating:

• Connecting - midwives telling stories about their portfolios will forge a connection with the audience on a personal level that may be missing from plain instructional text. The video will give a personal context to portfolios and link the audience with the midwives telling their stories because of shared experience.
  
• Communicating - information about portfolios is communicated.
  
• Collaborating - working with midwives to tell and share their stories.
  

Silvia has also put together an amazing page on how to use WMM.

Evaluation
Helen Barrett has collated a number of resources for digital story telling. Included is a rubric that the video can be evaluated against. Amongst the things I will need to consider are:

• the purpose is articulated at the beginning and the focus is maintained throughout the video
  
• it is clear that the audience's needs are met in terms of audio, graphics and vocabulary
  
• voice quality is clear
• there is a conversational style throughout the video
• all music is original and creates emotional response
• images create atmosphere and matches story
• timing is appropriate.

DIL participants, video participants and midwifery colleagues will be asked to give feedback about the video.

Is there anything I have forgotten? Can you suggest anything else I need to consider with regards to editing my video?

Theft of Olympic Togs

Oh, no, I've been named as a chief suspect by the police!

Look here for details - I think one of my 'dear' friends has dobbed me in!

DIL: I have a plan, Stan

Here is the plan for my video of midwives talking about their professional portfolios.

The Story
The story will tell the story of New Zealand midwives and their professional portfolios.

The questions

• Why have portfolios been identified as a key element of the New Zealand midwifery re-certification program (professional development)?
• What are the key elements of a portfolio?
• What was your experience of putting your portfolio together?
• How do you use it on an every day basis?
• What tips would you pass on to midwives who are just starting to put theirs together, or want to develop it further?

Participants
This is my wish list of participants - they have yet to be confirmed.

• Member of the NZ Midwifery Council
• Midwife who has recently gone through the Midwifery Standards Review Process, which will mean she would have just got her portfolio up to date
• Member of the Standards Review Committee who will have a 'big picture' understanding of how portfolios are used in practice
• Me-with my view of e-portfolios

Things to do
1. Invite people to participate in video.

• Sent out a call for participation to the local group of midwives but as yet have had no replies. Will have to ask on individual basis.
• Will need to make sure that participants agree to having this video used in an open access environment. May need to think about them signing some sort of consetn form.
• If using this as a teaching tool, will I need to run it pass my colleagues for reveiw?
• Will I need to run it past the participants before I publish it?
  

2. Check equipment.

• I am keen to use my little digital camera because I am so familiar with how it works. The camera produces excellent picture but the sound is not so good.
• One way to get around this is to use an external microphone but there does not appear to be a way that I can fit an external mic into my camera. So the only alternative is to borrow another camera. I am reluctant to do this because it defeats the object of me using my own camera, and I will have to become familiar with yet another camera.
• I think what I will do is a dummy run to test how my little camera holds up. If the quality of sound and picture is not good enough, I will see about borrowing a digital video camera.
• Will need to obtain a tri-pod.
• Check I have an appropriate size memory card and my batteries are fresh.
  

Practicalities

• Allow plenty of time for several 'takes'.
• Think about how I am going to edit the video after shooting it.

Is there anything else you would say I should think about?

Image: 'self portrait2' matt_cinque
www.flickr.com/photos/7388083@N07/2079393087

DIL: Making a video using interviews of people

I have been thinking further about the midwifery video I am going to make as part of the Digital Literacy Research project that I am participating in. As I said in a previous post, I have settled on making a video using interviews to explain about professional portfolios and how midwives can use them in practice. Hopefully, the quality will be good enough to use the video as a teaching resource.

A digital framework
I have really enjoyed this YouTube video called: Blogging - The staff experience.



http://www.youtube.com/watch?v=7PIiizu4yVg

Taking Bronwyn's advice, here are a couple of guidelines that I have developed from watching the video above and others.

• Keep it short. I have given myself a time of under 10 minutes for my video which will fit YouTube's criteria and hopefully not bore people to death.
• Keep it simple. Too many flashy effects can distract from the message of the video.
• If filming people, make sure the lighting is good. Same applies with sound.
• Tell a story.
  

Tips for videoing interviews
Here is a review of some of the tips and guidelines about interviewing that I have found.

Technical tips
From the US Veterans History Project comes this advice:

• Use very good quality recording equipment, both video and audio.
• Use a microphone that is external from the video camera, positioning it about 9 inches from the interviewee.
  
• Test the equipment before you start recording.
• Make sure there is no external noise that will interfere with the recording, such as a telephone ringing.
  

The Online Journalism Review advises:

• Use a tripod, so that handshake does not affect the quality of the film
• Use a light source that comes behind the camera. If you shoot with light behind your subject, the person will appear as a silhouette
• Do not use the zoom feature unless you really need to. This is because it doesn't look very good when showing on the Internet and it slows up the download speed.

Interviewing people
Robin Liss says:

• Keep the interviewee to the side of the shot
• Film the person's head and upper chest
• Get the interviewee to maintain eye contact with you, rather than the camera
  
• Get the interviewee to talk to you in a natural conversation

Advice from The Media College includes:

• Encourage the interviewee to relax
• Have a plan and stick to it
• Don't worry if the person makes a mistake, especially if the interview is going to be edited

Lorraine Grula believes it is important to:

• Have the questions prepared before the interview so the participants are comfortable with what they want to say, and the interviewer does not forget what she is trying to find out.
• Keep the audience in mind when making the video. Make sure things are explained in a language that the general public will understand, not just midwives.
  
• When devising questions remember to ask who, what, when, where, why and how.

The final words goes to Thomas Clifford:

• Ask open ended questions
• Keep the questions short
• Think about the answers you want which will help you devise the questions that will create the answers.
  

Have you made a video interviewing people, or you yourself been interviewed on camera? What other tips for interviewing people on camera can you think of?

Image: 'Speaking out' chrisschuepp
www.flickr.com/photos/11883362@N00/2279740170

How men cope with health problems

A big 'thank you' to Leigh Blackall who pointed this video out to me. I am surprised he had the nerve, considering he is a man.

Girls, have a look. True or what?!?



http://www.youtube.com/watch?v=IsvWK_EedLU

Communities of Practice: just another buzz word?

This week I went to a workshop led by Etienne Wenger about communities of practice. Etienne was one of the first people to come up with the concept of 'community of practice', which is a "group of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly". In other words, learning is essentially a social activity facilitated all the more effectively if it is shared with people.

Why I attended the workshop
It has seemed to me that the phrase 'community of practice' is banded about without little thought or appreciation about what it means. It is used to describe any group and network, but as Etienne says, a community is not necessarily a community of practice. Nor is a website. So I attended the workshop to try to gain a clearer idea of the concept.

I am also very interested to think how the concept of e-mentoring can be carried out in an online community setting as opposed to one-on-one relationships.

What did I learn?
The workshop was really full on, and even now I have not completely processed everything that was discussed. Etienne was a wonderfully approachable and enthusiastic speaker. I particularly enjoyed the way he used stories to get his point across. So if nothing else, the session emphasized three key presentation elements:

• enthusiasm for subject
• using stories as illustrations
• being human, warm and approachable which includes admitting when you do not know the answer to a question.

Communities become communities of practice when they have three elements in place:

• domain - common interest
• community - the group members help each other, share information and engage in group activities
• a shared practice - this is more than just a shared interest; it is shared experiences, resources and stories or tools.

Natural or constructed?
I have been a little confused about the idea of constructing a community of practice - I have always thought that these communities only occur naturally. However, Etienne believes they can also be constructed and it does not matter how they arise, as long as the outcome is learning. However, they cannot be imposed on people and they will only work if they are perceived as useful by the participants.

Power within the group can be an issue for example, can a COP work effectively if it contains both teachers and students, one with 'power' over the other? Whilst this can be problematic, it is not insurmountable when learning drives the group.

What makes a COP work?
What Etienne did make clear is a community of practice needs support, both from within the community, and externally in the form of sponsorship. The community must find its own practice - it cannot be micro-managed. This means that if you have set up a COP, you must be prepared that the outcome may not be the one you expected or planned for.

For a COP to be truly effective, it needs participation and commitment from its members. At the same time, with an online COP, it is important to remember the 1% rule - 99% of the community will lurk whilst only 1% of people will actively participate. In order to encourage participation, there needs to be community members who take on the role of nurturing or leading the group. These are people who have a strong vision about the group and its domain.

Network or community?
In thinking about my own learning, I am still a little confused about the difference between network or community? Do I learn through my network, or is my network a community? For example, is my Twitter network actually a community of practice? After all, we share ideas and resources. I'm still getting my head around these concepts so if anyone can help provide some clarity, please let me know.

In the grand scheme of things, isn't it all semantics? Does it matter what we call what we do as long as we recognize that learning is a social activity and the outcome of our interactions is learning?

Image: 'Street party' qwertyuiop
http://www.flickr.com/photos/21278447@N00/233169292

Those incompetent midwives are at it again

Here we go again! The hounds have been let loose. It's hunting season again and midwives are the quarry.

Death of a baby
A baby has died in Wellington following a breech (bottom first) birth. I am truly sorry to hear about it and my heart goes out to the parents.

Knee jerk reaction
But I get so fed up with the knee jerk reactions by both politicians and the media. One death compared to more than 50,000 live births in a year and all midwives are incompetent, murdering health professionals according to some. An immediate inquiry has been announced by politicians, ignoring the fact that there are official channels for investigating incidents such as this.

Response from the Midwifery Council of New Zealand
Sally Pairman has released a statement from Midwifery Council which sums things up really well:

There is no evidence to support claims made by public health physician Ate Moala through the media yesterday. This use of anecdote and generalisation is inappropriate and serves only to unnecessarily undermine midwives and public confidence in midwifery and maternity services.

Dr Pairman goes on to say:

There are a number of processes available for proper investigation of complaints about midwives whether these are raised by women, by other practitioners or by DHBs. The interface between the Health and Disability Commissioner’s Office and the Midwifery Council is robust. Where there is evidence gained through a fair and transparent process that a midwife has indeed fallen short of expected standards then that midwife is held to account. Processes that ensure natural justice and transparency for all parties are the appropriate way to deal with concerns about individual practitioners and about the maternity service as a whole.

I am not advocating that midwives should not take responsibility for their mistakes, but just for once I'd love to hear a positive story in the press and midwives actually get thanked for all the long hours and hard work they put into supporting women and their families during childbirth.

A thankless job?
When we get bashed like this in the press without any justification, I must ask is it any wonder midwives are leaving the profession and we cannot attract young women to take their place?

I'm all for letting Ate Moala and her like get on with it and see if she can do better: be on call for 24 hours a day, day in and day out; work for hours on end to ensure women are supported to achieve all that they wish; miss special family events like birthdays and Christmas because she is putting someone else's family before her own; carry the responsibility not just for the time of birth but for years after wards...shall I go on?!

A great maternity service
Again, from the press release from the Midwifery Council of New Zealand:

The public of New Zealand should be justifiably proud of our midwifery and maternity services. The perinatal mortality rate is similar to that of the UK and Australia and the neonatal mortality rate is lower than both. The vast majority of women continue to have safe and positive birth experiences and healthy babies.

How do you feel about health professionals when you see and hear stories of their alleged mistakes in the press?

Ditching BlackBoard

I have written before about how I am developing a short seven week post-graduate course for midwives. I want to use the course to introduce the participants to social networking as a means of learning but because of the short time frame, I will have to be selective about what tools I use and how I integrate them into the course.

Developing a course in a blog
I will be moving out of BlackBoard and developing this course in a blog. For the time being, the course will be closed which might lead you to ask why bother using a blog - why not just stay in BlackBoard?

The answer is that I want to introduce the concept of a blog even if it is a closed one. If ever it is possible to make the course open access, all I will have to do is lift the restrictions I have placed on it.

Keeping it simple
In view of the course being so short, I have to keep things simple so will use the blog to relay information about the course and an email group to update people and facilitate discussion. I wasn't too sure how I would encourage people to communicate with each other, but I think that I will 'allow' people to use either forum - what ever they are more comfortable with - as long as they do talk to each other.

Using cell phones
The other idea that has been mooted was from Leigh Blackall who suggested that I should make more use of the communication mode that midwives are familiar with ie cell phones. Leigh suggested that I use text to send out reminders about blog posts and meetings, which I agree is an excellent idea.

Online meetings
The other tool I am going to integrate into the course is Elluminate and/or Skype for online meetings and seminars. This course is about reflective practice and the development of a professional midwifery portfolio. It will be important for the learners to communicate with each other in order to share ideas and experiences, as well as ask questions and seek guidance for future professional development. So I think it will be important to have an synchronous element to this course. And if learners cannot attend, they will have access to the meeting recordings.

There is no doubt that there is a movement toward synchronous online communication in midwifery in New Zealand, so the sooner midwives become familiar with the technology, the better. I am hoping that I will be able to provide open access to the seminars, which will hopefully encourage midwives in the use of the technology as well as increase interest in post-graduate study.

Looking for feedback
Here is the basic shell for the course. Obviously, I have the course material to add. But before I do that, I'd be interested in any feedback about the layout and tools I have incorporated.

Possibly, the other thing I need to get my head around is Google Calenders, how to set up a course calender and integrate it into the blog. So any advice about how to do that will be gratefully received.

Image: 'First Light on the Bend' Fort Photo
www.flickr.com/photos/70619288@N00/259521477

Digital story telling: Patient experiences of health and illness

DIPEx is a charity whose remit has been to develop a health web site aimed at health professionals, patients and their families. The web site focuses on digital stories told by patients about their experiences of a number of illness and health. The web site also has an active forum for questions, as well as links to other information resources.

Of interest to women
One section includes stories about pregnancy, antenatal screening, breastfeeding and making decisions after cesarean section. What I particularly like is that the web site also provides information that deals with questions and issues that arise in the story.

Other sections that may be of interest to women are breast and cervical cancer, immunization and young people's experiences, including sexual health.

The power of story telling
I did have a few technical difficulties with the web site. There were a couple of times that I went to listen to a story and the network or server was down.

But other times, everything worked very well and I really enjoyed listening to/watching the people tell their stories. To me, this was a lot more powerful than reading text about a particular topic.

How do you use story telling to get your point across?

Image: 'hey you!' cactusbeetroot
www.flickr.com/photos/69623171@N00/635645484