Reflecting about the virtual birth unit project

The Second Life Education New Zealand project is moving into its evaluation phase. My involvement as lead midwifery educator on the project has come to an end. The birth unit has been built and the normal birth scenario is complete. We have spent the last four weeks making ourselves available to educate and support midwifery students to use the resource. Now it is time to sit back and reflect on the project: what worked well, what didn't work so well, my personal learning and future developments.

I didn't really know where to start with my reflections, so I am using the questions that are being asked of me as part of the project evaluation. This is the first of a few posts where I answer the evaluation questions and reflect on my learning during this project.

What have been the most challenging aspects of the work?
There were a number of challenges as you can imagine, but I think one of the greatest ones was that I was unfamiliar with Second Life and the technological aspects of how it worked. I had an avatar, had attended a couple of meetings in SL, and had a concept of what we could achieve in SL but apart from that, my knowledge of how it worked was minimal. This in turn affected my confidence with using SL ie because I didn't feel confident with it, I didn't use it.

Immersion
This lack of familiarity hindered my understanding of what and how could be achieved both in terms of technology and design of role play. John Waugh, one of the SLENZ team members has always argued that educators should be more immersed in order to champion SL but I have always resisted this stance. I have always felt that the benefit of using SL to deliver education is outweighed by the time and effort to become confident in SL. Indeed, Terry Neal, the project manager has agreed with me in her reflections about the barriers to SL in education. Nevertheless, I agree that as a designer of learning activities in SL it would have been beneficial to have immersed myself to find out more about virtual role play. I also think that a beginning understanding of building would have been beneficial.

Lack of access
The other major challenge was the six months when I was working in Brisbane. Whilst I was able to communicate with people in New Zealand by email and Skype I had very limited access to the technology that allowed me to use Second Life. That meant I was unable to 'pop into' SL at the drop of a hat and meet the SL developer, and give feedback. It made me feel a little displaced and disconnected. At the same time, this problem with access emphasized the problems that many students will have with SL, and encouraged me to think about how these problems can be overcome.

Working in a virtual team
Working in with the SLENZ team was both one of my greatest achievements yet at the same time, one of my greatest challenges. We were a team of different experiences, knowledge and communication styles. We were scattered throughout New Zealand , and at one time, Australia. We didn't really know each other and had only met face-to-face a couple of times.

I'll be the first to admit that I did not communicate adequately at times and made assumptions about people's knowledge and understanding which were inaccurate. And at the same time, people did the same thing with me. However, we worked very hard to overcome these communication challenges and I am very proud to have been a part of the team. I have learned so much about SL and instructional design from the team and for that I am very grateful.

To my mind, Skype and Google Documents have been two key elements for communication and the development work - if you're thinking of bringing a virtual team together, don't even contemplate it without Google Documents.

Time
A further challenge has been time frames. I don't know about anyone else but I found that everything took twice as long to do as I thought it would take. Getting my head around some of the tools we used like Wikieducator took a long time, and my work was often hindered by the time it took for people to give me feedback on my work.

My family have threatened to shoot me if I ever say 'Second Life' again - now the project is finished I feel I am getting my 'real life' back.

Engaging students
The final and probably greatest challenge has been how to engage students. Because of time frames the learning activities have been 'voluntary' and not integrated into formal lessons. Thus, very few students have engaged with the scenario and I can't say I blame them when you think what other demands are on their time. We have used a variety of tactics to generate interest including use of a Facebook group and online meetings. Whilst there appears to be interest in the concept, issues such as time constraints and access to technology have proved to be barriers to students' investigation of the scenario.

Another barrier has been students' perceptions of SL. Several students have articulated concerns about safety and body image. Other students have questioned its credibility as a teaching/learning tool because they see it mainly as a game.

Ultimately, I believe the way to engage students is to embed the normal birth scenario into formal lessons.....this is the challenge for midwifery educators to run with.

What do you regard as your biggest successes?
I am thrilled with what we have achieved. I believe the end result is unique and very 'useable' and sustainable. This is already being commented on in reviews such as the one by Lewell Cremorne in Metaverse Health. It has been developed by midwives for midwives and based on 'real life' clinical scenarios.

Creative commons
I am also very proud that the resource has a Creative Commons license which means any midwife anywhere in the world can use the resource for their own use or midwifery education and the lesson plans are freely available in Wikieducator for midwifery educators.

To my mind the most exciting stage of the project faces us....national and international collaboration to extend the birth unit and normal birth scenario still further.

How to use the normal birth scenario in Second Life

Here is a video that shows you exactly how to use the normal birth scenario in Second Life. This resource is open for all to use, so feel free to have a look -let me know if you want to know more.


http://www.youtube.com/watch?v=Kw-KL-lCesE

Learning how to use a wiki

Here is a free opportunity to learn more about how to use a wiki so you can make your own entries in wiki such as wikipedia, wikiversity and wikieducator.

Learning4Content is hosting two free online workshops in the next couple of months. The dates are:

August 24 to September 7, 2009

September 21 - October 2, 2009

Click here to register.

Dog grooming

I had to laugh the other day.

I visited a friend who is dog-sitting for a few weeks. She also has a cat.

The cat loves nothing more than to groom his new friend - have a look at this :)


http://www.youtube.com/watch?v=3tgHLrED4jQ

When the truth hurts

Last week I was in Te Anau running an ante natal clinic and I finished early with time on my hands. My husband had come down to stay with me for a couple of days and we decided we'd be tourists for the afternoon.

Mark wanted to go on the Luxmore jet boat and a trip down the river to Lake Manapouri. I wasn't desperately keen because it was rather cold and damp - I wanted to find a nice warm cafe and have a long, hot chocolate. Anyway, to keep the peace, I gave in and went on the jet boat trip.

Suffice to say, I had a fabulous time because the scenery was fantastic.

At the end of the trip I thanked the jet boat driver (the chap on the right - I think his name was John) and told him how I hadn't wanted to go but actually really enjoyed myself. His artless reply was:

"Yes, we get that a lot with middle aged women".

MIDDLE AGED WOMEN!! Who is he calling middle aged! OK. I know I'm middle aged but I don't need him to remind me...

In my mind, I'm still a young and gorgeous 25 year old.

Middle aged, my foot! That's the last time I go on a tourist trip in Southland!

Organizing chaos

My other little job at the moment is facilitating an online course “Facilitating Online”. Leigh Blackall is the teacher – he has put the course together and is marking all the assignments. I am facilitating, which means I am responsible for the every day running of the course, keeping a track of the formal students and ensuring that everyone has access to the course materials.

Open access learning
The course itself is made up of about 35 people – half are formally enrolled students doing the course for a qualification, and the other half are informal students doing the course for free and for the fun of learning. This is my first experience of this sort of facilitation. Up to now, I have been the ‘teacher’ in very structured online courses that have had no informal students.

This is also my first experience of blogs as learning/reflection tools from the point of view of the facilitator as opposed to the student. So there’s lots of learning going on in this course, for myself as well as the students.

Chaos is good
We are only into our third week but what is fascinating me at the moment is how students are organizing themselves in terms of how they will communicate to support each other and share resources. As a student in courses such as this, I have found that it takes me a few weeks to work out what best suits me as a communication tool and who I like to work with.

The students of this course are currently going though the same process. It is looking chaotic at the moment and feels quite painful – I feel like a parent to the toddler who is learning to walk and keeps falling over – I want to take the pain away. I know that the students will eventually learn how to walk but have to go through the ‘falling over’ process first. So the lesson I am learning about facilitating in this context is that it is my job to guide students and provide access to tools and resources; not to restrict them but to let them get on and organize themselves. But I find it really hard not to interfere :)

Over-whelming newbies
At the same time, I also have to be mindful of the students who are new to online courses and communication, and must ensure that they do not become overwhelmed by what is going on and the plethora of information and tools.

Formal and informal students
The other thing that I am learning is how to manage formal and informal students. The bottom line is that I am being paid to support formal students but it is very tempting to get heavily involved with the informal students because they are so enthusiastic about the course. The five hours a week that I am contracted for could easily become twice as long if I am not careful. So I have to be very disciplined about how much time I devote to supporting informal students, which at the moment I am finding hard to do.

For me personally I feel a tension between the model of free and open access education and the actual reality of delivering it. I’d be very interested to hear from people who are delivering similar models of education – how do you maintain the balance between supplying free quality education that engages students and balancing the budget?


Image: 'in the red #25' clickykbd
www.flickr.com/photos/37718677955@N01/63152557

Students’ first experience of the Second Life normal birth scenario

Last night was the first time I took midwifery students through the Second Life normal birth scenario which has been developed by the Second Life Education New Zealand team.

Interactive learning in Second Life
I am conscious that the main complaint about the virtual birth unit has been that it is not very interactive so I am keen to introduce students to the scenario as soon as possible before they lose all interest in the birth unit. I am also keen to take a ‘teach the teachers’ approach to this – to get a few students experienced in using the scenario so they can encourage and mentor their classmates and my involvement decreases as time goes by.

My strategy for disseminating information about the scenario this week is to initially use Elluminate, as this is a platform that students are more familiar with. Then I offer students the opportunity to go with me into Second Life and ‘have a play’. Three students turned up to the first meeting last night. All students were from Christchurch Polytechnic. I talked about the scenario for about 10 minutes and then took the students to Second Life.

Set up
I took the student through the first scene. Helping them set themselves up and being with them as they worked through the first scene took nearly two hours. It was very intense because the students had so much to learn in terms of working out the technology. It was also hard to juggle two people at the same time, but I tried to ensure that one person was always occupied with reading instructions or with an action as I supported the other person to get sorted.

Light, camera, action
It took a while to get the students sorted with their huds and the student who played the pregnant woman, to get her ‘pregnant shape’. But once they were sorted, they quickly got into the role play of the telephone call. I have to say that the students were absolutely fantastic. On the one level they had me in fits of laughter because they acted the scene so well. Ffion was very persistent as the anxious mother-to-be – I just wanted to tell her to relax and take a chill pill. Mina who played the midwife was very reassuring and a lot more patient with Ffion than I would have been :)

On a more serious level, they were able to engage with a scene that will face them many times as a ‘real life midwife’. Indeed, I had replicated that phone call earlier in the evening to a woman who thought she was in labour at the maternity unit where I am currently working as a locum midwife. The beauty of this scenario and role play in Second Life is that students can experience the authenticity of the scene and learn from it, but are unable to do any harm to the woman. And because they have supporting visual tools and resources the role play is a lot more immersive than it would be if they were carrying out the role play in the classroom.

Reflections

Technology
It did take time for the students to get the hang of the technology and the scenario and I think it was invaluable to have me around to support them. I am going to advise the students to give themselves at least an hour and a half when they first engage with the scenario. In turn, I was grateful to have Clare Atkins around to support me. However, as we all become more and more familiar with the scenario, both myself and the students will become a lot more confident and competent. Indeed, just last night I learned a couple more tips – how to see what I am wearing and how to turn off the noise I make when I take snapshots.

Instructions
It is imperative that the students read all their instructions before they start so that they not only understand the technology but they also appreciate the background to the scenes. I made the mistake last night of not fully reading the instructions for the pregnant woman, and consequently Ffion was unable to take off her pregnant shape. So she has been left pregnant until I get advice about how to remedy the situation.

I am going to advise students to read the instructions in Wikieductor before they enter Second Life with their partner. Hopefully, this will save time and better prepare them before they get going.

Who will the scenario benefit?
What is interesting to me is that the students who came along with me last night were first year students. These students have had little clinical midwifery theory – this comes in the second year of their program. Consequently, the scenario was not designed with them in mind. However, last night the students were able to pick up the scene and run with it. What I am looking forward to seeing is how they cope with the more complex scenes. Ultimately, it does not matter that they have not had the clinical midwifery theory at this stage. They can work their way through the scenes, guess what they have to do and ignore what they have no knowledge about. As I have said already, they won’t be doing any harm and no doubt they will learn as they go. Indeed, this scenario may better prepare them when they do get the theory that these scenes are based on next year.

How students will use the scenario
An interesting contrast will be the reactions of the first year students to the scenes compared to the second and third year students who have had both clinical theory and practice. The first years will be learning for the first time; the second and third years will be using the scenario as more of a revision tool.

I will be continuing with the evening introductory sessions for the rest of the week and giving a face-to-face demonstration at Otago Polytechnic on Monday. Then it is over to the students.

Learning about normal birth in Second Life

I am thrilled to announce that the second stage of the Second Life Education New Zealand virtual birth unit project has gone live. This stage of the project is a normal birth scenario containing five scenes from early labour to the first hour after the baby is born. The students will have the opportunity to role play either/or the birthing woman and midwife.

Midwife
As the 'midwife', students will assess, plan and carry out midwifery actions as well as document their midwifery care. They will receive very valuable feedback from midwifery lecturers about their documentation, and have the ability to self-assess their performance. The scenario has been based on the New Zealand College of Midwives' decision points in labour.

Birthing woman
As the 'woman', students (or anyone else who wishes to role play the part) will see how labour and birth feels from the woman's perspective. This includes the ability to be able to give the 'midwife' feedback, based on the New Zealand College of Midwives' consumer feedback form.

Video
Here is a video that gives a brief overview of what the Second Life normal birth scenario offers midwifery (and other health professionals) students.


http://www.youtube.com/watch?v=BEhK_wjIa74

More information
If you are interested in learning more about this learning resource, have a look at the project page on Wikieducator. Information about the lesson plans for the normal birth scenario can be found here, and specific information about how to get to the resource in Second Life can be found here.

Guided tour
If you would like to be given a guided tour of the birth unit in Second Life and shown how the normal birth scenario works, please get in touch with me.

Second stage of the Second Life virtual birth unit project

I have admitted on this blog that I have been a tad skeptical about Second Life for teaching and learning. But this week my whole perception of Second Life has been turned on it's head and I am becoming a huge enthusiast. And this is because I have started to see the second stage of the virtual Second Life birth unit project come together.

Normal birth scenario
The second stage of the birth unit involves developing a scenario where a midwife works with a woman in labour and birth. The scenario has been split into five separate scenes which follows the woman's birthing journey from very early labour to the first hour after the birth of the baby.

Role of the the birthing woman
The student (or woman or whoever) who role plays the woman will have a script to guide all her responses in each scene. And at the end of the scene she will be asked to give the midwife feedback about her midwifery care.

Role of the midwife
In turn, the student who plays the midwife will be expected to assess the woman, plan and carry out midwifery actions and evaluate her care. She will be asked to document all her actions and submit her documentation so that lecturers can give her feedback at a later stage. She will also be encouraged to assess her own performance against a list of actions and considerations that is provided.

All the resources are based on resources that a 'real' midwife in New Zealand uses eg the feedback that the woman gives the midwife is the same that is used in the New Zealand College of Midwives Midwifery Standards Review Process.

Trying out the first scene
Terry Neal (the SLENZ project manager) and I tried out the first scene a couple of days ago. Here is Terry's reflections of the experience (NB: Terry is not a midwifery student). Terry says

this was more fun than role plays I have experienced in real life

and

I could see the 'movie' in front of me - the pregnant me, the phone ringing, the birth unit - that helped me to feel it was making sense. It also meant that the experience seemed linked to entertainment and fun in my brain.

My reflections
I had an absolute ball!

I am a bit of a drama queen at the best of times and really enjoyed this opportunity to do some acting. I was amazed at how I instantly became immersed and became the midwife on the end of a phone, talking to a pregnant woman. I thought like a midwife...I talked like a midwife...I behaved like a midwife - which of course is a considerable relief considering I am a midwife :)

I felt no embarrassment. In fact, I was disappointed when the scene ended, and all I wanted to do was get into the next scene.

Power of Second Life and role play
I believe that the students are going to love this stage of the project and find the normal birth scenario a wonderful tool for learning, reflecting and revision.

My only concern is that we support them thoroughly to get their heads around the technology, and I am thinking in light of the feedback I have received so far that they'll need a lot more real-time support than we have planned for.

Can't wait for this stage to go live in a couple of weeks!!

NB: I will link to all the supporting information and resources for the second stage of the project once they are fully developed.

What midwifery students think of the show so far

This week I have have a number of meetings with the first year midwifery students who are trialling the virtual birth unit in Second Life as part of the Second Life Education New Zealand project. These meetings have taken place in Elluminate and Second Life. Here are the impressions and feedback I have been left with.

Barriers to using Second Life
The barriers to Second Life are all things we have heard before but are very real concerns for students.

• Perception that Second Life is an unsafe place to be.
• Fears that it is time-consuming and can be addictive - haven't got enough time for their 'real' studies, let alone playing around with Second Life.
• Second Life uses up a lot of band width in rural locations.
• Don't understand what to do or how to do it.
• Don't understand relevance of Second Life to midwifery studies.
  

Understanding what the project is about
One of my main impressions is that the students still do not realise what the project is about. This is either because they have not read the information and instructions properly, or we haven't explained it very well. There have been lots of questions about what they are supposed to do in the birth unit, both in terms of how to interact with it and what they are supposed to be 'learning'. Several students have admitted they do not even know how to get to the birth unit, and many of them have not read the information about the learning activities.

When I have showed students around it has been obvious that they have not worked out how to click on the objects in the birth unit such as the birthing pool, heating system, birthing ball etc. The result of this is that they have not full appreciated what we are trying to tell them about the 'hows', 'whys' and 'wherefores' of the design of the unit. Consequently, they have been left with the impression that their 'learning experience' is incomplete and have been slightly bored with looking around an "empty" and "static" place.

How to engage the students
My other impression is that the students are enthusiastic to learn more and once they have a better understanding of what we are aiming to achieve, they see the benefit for their learning. However, they have needed me to explain everything in a 'real time' context (using Elluminate and Second Life) - they haven't 'got it' by just reading the orientation material we have given them.

The students have also required a lot more 'tutoring' in Second Life in terms of how to do very simple things like retrieving information from objects and notecards. Spending the extra time in SL with them and demonstrating these basic tasks has been very beneficial. Several of these very constructive sessions has been with small numbers of students and in spontaneous meetings which has required me to be very flexible in my time management.

Having fun
I know I have said this a number of times (and is old news for educators who regularly use Second Life), but I am realizing more and more that students need to have fun in Second Life and do things that may not have any particular relevance to the learning activities that are planned. It helps them develop their skills, build their confidence and immerse them more fully.

One of my favorite activities that I have started doing regularly is taking the students to the TLC Maternity Unit. There we play with the interactive animations and do silly things like the kids chicken dance and hand stands.

Some people would argue that this sort of fun activity is wasting students' valuable time, and we should be concentrating on the serious learning activities such as the normal birth scenario that we are currently developing. Nevertheless, the more confident and skilled students are when they come to the 'serious' activities, the more they will get out of them.

Reflecting of the implications of this feedback for learning design
The main lessons for me personally (and not necessarily that of the SLENZ project or the other team members) is that students need a lot more real time support than I anticipated. This shouldn't be news to me when I consider my own personal learning in SL.

I don't think that real time support needs to be in a face-to-face computer laboratory but it does require time spent with students in SL or other online places where students can be shown how things work and guided in their learning, as opposed to being left to get on with it.

I believe midwifery students are a lot more motivated to explore Second Life than I originally gave them credit for. It is up to us as educators to harness and direct this motivation into meaningful learning experiences.

Virtual 'follow-though' for midwifery students

In my previous post I was pondering how we could make the learning experience of student midwives more social in Second Life.

Pregnancy in Second Life
One of the things I am learning is that there are a number of people who role-play pregnancy and birth in Second Life. I have been reading the blog of Sai Pennel who has just started her SL pregnancy. Her thoughts on why she is doing it and what other people may think about it is fascinating.

My question is: how can we hook up with women who are having virtual pregnancies? Is there any way we can bring these women together with student midwives to enhance the learning of students, and add to the women's experience.

Follow-through
Then it hit me...why don't we do what we do in 'real life'?! Arrange 'follow-through' experiences where a student midwife works with a pregnant woman in Second Life, just as we do in 'real life'.

The student could attend the woman's ante natal checks and birth, and be around when she has her new baby. And the joy of a SL pregnancy is that it only usually lasts a few weeks.

Learning communication skills
The key learning would be how to communicate and build relationships with women the students have never met before, which is the focus of their 'real life' follow-through experiences.

Down-side
The down-side of this idea is the aggravation of organising it - it is hard enough organizing real life 'follow-throughs'. I have no idea how many women role-play pregnancy so have no idea if we'd be able to get enough SL follow-throughs.

Virtual life working alongside real life?
But as we sometimes struggle in 'real life' to get the students adequate experience, maybe following a virtual pregnancy is an alternative idea. What do you think?

If you are a pregnant woman in SL, would you be prepared to work with a student midwife? If you're a student midwife, what do you think of the idea? What do you think are the potential problems with this idea?