Monday, March 31, 2008

Disparties between medicine and midwifery

Over the years there has been many complaints about the way doctors get heaps of freebies from drug and medical equipment companies - funding, gifts, equipment, fancy holidays! Midwives get nothing, especially since we have been banned from accepting advertising material from formula companies who were the only ones interested in giving us anything.

But today my boat came in...the trend has been reversed...I have received a free gift in the post from a drug company. I have finally benefited from my job of being midwife. Those doctors can keep their fancy cars and expense accounts! At last, my chance to be bribed and corrupted by a drug company into unethical behavior!

My free gift...?

A box of powder free rubber gloves from a drug company that makes hemorrhoid cream!

My midwifery philosophy: a slidecast

A few days ago I posted my midwifery philosophy in my ePortfolio. In the feedback I have received about this, Michele Martin thought it would be even more effective if I added audio to the text.

So what I have done is made a slidecast, talking about my work as a midwife and what is I view is important for my midwifery practice. This will go along side the text I have written in my ePortfolio.

I would be really interested in your feedback. Is it too wordy and boring? I think I probably could be more succinct - what do you think?

Being a midwife to a pregnant man

Here would be an interesting challenge for a midwife.

Thomas Beattie is a transgender, legal male who is living with his wife, Nancy who is unable to have children. Thomas is pregnant and due to birth his baby in July this year. You can read all the details here in 'The Advocate'.

I am not 100% sure if this story is true although it has been picked up by a number of bloggers including Sage Femme. Her commentary about this is interesting to read and she asks some very relevant questions. But the date on the original article is the 8th April, 2008 so I would be very interested to know if this is truly authentic.

But even if it isn't true, the article does raise the challenge for midwives about how they care for people who do not fit into the 'normal' mold?

Have there ever been situations where you have been challenged to look at your beliefs and values about gender, identity and relationships when caring for women and their families?

Sunday, March 30, 2008

Reflecting on the New Zealand Rural General Practice Network 2008 Conference

I have just got back from the 2008 New Zealand Rural General Practice Network conference in Christchurch. It was a very interesting conference more because of the themes that ran through it, as opposed to the actual sessions themselves.

The first thing that was painfully obvious was the complete lack of midwifery presence. The Network was set up for GPs, and nurses are now becoming very influential in the organisation. It would be very interesting to see how midwifery could contribute because we all do face the same challenges in the rural context. However, whilst I do believe there is a lot of positives that can be achieved by collaborative inter-professional teamwork, it is really important that the team consists of equal partners, with no one profession constantly taking the lead (and power).

The second thing that struck me was how more and more education is taking place in rural communities - medical, nursing and midwifery. The rationale for this is that if you educate people in rural communities, they are more likely to stay there and practice. There are a number of issues that arise from this strategy.

The first is the pressure on clinical opportunities. Whilst there should not be too much of a clash for midwives, we are already being affected by the placement of medical students in some rural communities. This may prove to be more and more problematic as time goes on. So I think it is going to be really important to communicate with the other professions about this matter. The second implication is resources in the community such as study space, computers and clinical laboratories. This could be an opportunity for pooled resources and teaching collaboration.

Another theme was the pressure on rural medical teachers. They commit much time and energy to teaching medical students and junior doctors without little or no recompense. And the effect is that they are getting burnt out and cannot commit the time alongside their own busy clinical practices. I think it is going to be really important that we learn from the medical experience and think carefully about how we are going to support our midwifery teachers in the learning communities that we are going to set up in our new midwifery program. Relying on good will just will not be enough.

The final theme was the interest in online education and professional development. I was surprised at the interest in my talk on e-mentoring. Whilst there are still a number of barriers to online activities in the rural communities in New Zealand, not least access to decent Internet coverage, there appears to be recognition that e-learning does overcome geographical isolation. The trick now is how to harness that interest and develop education programs that really meet the needs of rural practitioners.

For me, the value of this conference has been to bring my thoughts back from Australia to New Zealand and consider what research, professional and funding opportunities there are in the areas of professional development and e-mentoring, especially in the rural context here. I am left to think about how midwives can contribute to the wider discussions of sustainability of rural health care. And I also have been encouraged to think about the personal networking I can do for my own career development.

Image: Seagulls in Christchurch.
Sorry about the boring image: I was stuck for picture of Christchurch because FlickrCC was 'down' and the 'seagulls' photo was the only Christchurch-related one that I had!

Thursday, March 27, 2008

Off to Rural GPs conference

I am off to Christchurch for a few days to attend the New Zealand Rural General Practice Network conference. I am presenting a paper on e-mentoring.

This is the conference that Carolyn and I submitted several papers to on social networking for professional development and they were all rejected. As a second thought, I was eventually invited along to do my thing on e-mentoring.

This network mainly consists of GPs and I know that they were not too keen on hearing from midwives. I think that is because of the historical and on-going power struggle between the two professions. I think this is a real shame because if ever there was a case for collaboration, then it is here in the rural context of New Zealand.

So, I'm off to the lion's den. Will let you know how I get on. If the worst comes to the worst, I can always go shopping instead!

Wednesday, March 26, 2008

Video conference versus web conference

Today I attended a video conference. It included most of the educators in New Zealand who teach undergraduate student midwives about screening for family violence. We were based as far afield as Wellington, Hamilton, Auckland and Christchurch. It was good to catch up with these teachers and find out about the latest teaching practices in this area.

But there were a couple of things that made an impression on me.

The first is what a pain video conferencing is. It took me half a morning to organize access to the compatible equipment. I had to go to another institution to use it - I could have used Otago Polytechnic's equipment, but it would have cost a significant sum to bridge into the system that was being used.

Then this morning, I had to make my way into town, find a parking space and then find the venue as well as the technician. This took an age and I was late - no one knew anything about it even though I had arranged it weeks ago. How much easier for me (being the extremely lazy person that I am) to have just hooked up into a web conferencing program like Elluminate on my home computer.

Now, after being a grumpy old person about this, I must acknowledge that midwives seem to really like video conferencing because they like to be able to 'see' who they are talking to. A lot of midwives do not have access to Internet resources that support web conferencing and do not have the skills to be able to use it. And there is an increasing number of video units being installed around New Zealand which will make video conferencing more accessible for midwives. I, for one, was very pleased that I did not have to take a full day out of my schedule to fly half way around the country for a two hour meeting. But in the long run, I wonder who will carry the cost of this.

The second thing that was impressed upon me was how much work has to be done to encourage people to think about things like open access, creative commons and collaborative work in blogs, wikis and so on.

This morning we had a discussion about the resources we use. They have been developed by The New Zealand College of Midwives and as such is copyrighted for restricted use. I have suggested that NZCOM thinks about making this material available on its web site under a creative commons license. I have also suggested that NZCOM thinks about using a wiki or blog for the collaborative work that is scheduled to be done on this family violence screening program later in the year.

It will be interesting to see if and how this eventuates.

What do you prefer - video or web conferencing?

My ePortfolio: Organising my Midwifery Standards Review

Maintaining a professional portfolio is a requirement of the recertification program as set down by the Midwifery Council of New Zealand ie you need a portfolio in order to get an Annual Practicing Certificate which allows you to practice as a midwife.

One of the very important elements of the portfolio is the Midwifery Standards Review, which is an aspect of the recertification program. This is an audit process and opportunity for reflection on one's practice. Hospital midwives do this once every three years and LMC midwives who carry a midwifery caseload ( ie care for women from conception to 4/6 weeks postpartum) do it every year. Until 2005 it was a voluntary process - now it is compulsory. The process involves:
  • writing a reflective statement about one's practice over the year
  • reviewing practice statistics
  • reviewing consumer feedback forms (every client/woman is asked to complete an anonymous feedback form)
  • reflecting on practice compared to the New Zealand College of Midwives' 10 Standards of Practice
  • reviewing information that one gives to women
  • completing a professional development plan for the following year.
My last Review was in 2006 and is next due in 2009.

There are several issues for me.
  1. How to organise this material in the portfolio.
  2. How to get all this information into my ePortfolio without compromising the anonymity of the women I look after.
  3. How to get all this information into my ePortfolio without compromising the power of reflection yet keeping me professionally 'safe'. In other words, how can I be honest and reflective in an open environment?
I will address the issues of openness and anonymity in upcoming posts. But for the time being, I want to concentrate on the format.

I did play with the idea of having a page per year and having all aspects of my review on the one page. However, I have chosen the format illustrated above because I think it will be interesting to compare my reflections year by year. However, I am also mindful that I do not want to dump a whole heap of text on a page in a way that does not engage the reader.

Please feel free to have a look at what I have done so far, paying particularly attention to the 'professional development' page and comment here: what did you think of the format? What suggestions do you have for improving the format or doing it differently?

Monday, March 24, 2008

31 Days to Building a Better Blog: Day 31

This is it...the last day of the 31 Day Blog Challenge! The last challenge is to do a SWOT analysis of my blog.

1. Define my blog's mission and goals
The goal of this blog is to disseminate information and encourage discussion and collaboration in the areas of midwifery and education.

2. Strengths
  • Easy to read both in terms of writing and navigation
  • A resource for students and midwives
  • Is one of only a handful of midwifery education blogs
  • Is looking good with less side clutter
  • Has tools that help readers keep in touch with me, like the 'search' and subscription
  • Small core of regular readers and contributers
  • Has been noticed by MIDIRS and Creative Commons
  • I always respond to my readers both here in my space and also in theirs
3. Weaknesses
  • Too much of a mish-mash. Wanders between education and midwifery so not interesting enough for educators, but not 'clinical' enough for midwives and sometimes is too technical for midwives who know nothing about web 2.0 tools
  • Only has small number of regular subscribers
4. Opportunities and threats

My main opportunity is the fact that there are so few blogs on midwifery education. However, that is also a threat because it is such a small field of interest. So the question is whether to be a big fish in a small midwifery pond or small fish in the much bigger education/web 2.0 pond? I think I have to come to terms with the fact that this blog bridges both ponds and remember that this blog is as much about my learning as anyone else's, and not get too hung up on statistics and readership numbers.

5. Analyze my refections and make a plan

The 31 Day Blog Challenge has been a great learning project although I think I benefited more from the experiences of people such as Sue Waters and Michele Martin who had worked through the challenge before me. The community aspect of this challenge is very important ie having people critique what you are doing, giving advice and sharing their experiences. So if you decide to take part in this challenge, it is very beneficial to join a community such as the 'Building a better blog' community at Ning.

The aspects that have been the most useful have been thinking about:
  • the technical tools that support blogging such as statistical analysis and RSS subscription
  • format and layout, the most important being my 'about page' and the development of my ePortfolio which complements this blog and visa versa
  • the 'human' side of blogging, interacting with people who visit this blog as well as commenting on other blogs
  • this blog as the hub of my personal learning
My plan is to re-visit this challenge regularly, especially the elements that are devised to encourage reader participation. To be honest, Michele puts it a lot better than me, so have a look at her page that summarizes the 31 Day Challenge.

Have you thought about taking the 31 Day Challenge? How have you got on? What feedback would you give me about this blog?

Here are all the challenges I addressed.

Image: 'North Shore Clouds 2'

Sunday, March 23, 2008

Open access midwifery education - update on proposal

A few weeks ago I wrote that I had been asked to write a paper justifying my request to make some midwifery courses open access. Here is the work I have done so far. I do not have time to make it too deep and meaningful, however I would be grateful for any feedback. Please feel free to 'play' with the paper if you can see any areas that you can contribute to.

Advice to senior midwifery students

One of the last challenges I have to address in the 31 Day Blog Challenge is making a reader famous, which is the challenge for Day 21. So I have asked Megan to write a guest post for me.

Megan is a new midwifery graduate working as a Lead Maternity Carer in New Zealand. This means she carries a total midwifery caseload, caring for women from conception until 4/6 weeks after they have had their babies. I asked Megan if she could pass on any advice to senior midwifery students who are contemplating life as a new graduate. Whilst Megan's thoughts are focused on midwifery in New Zealand, a lot of what she says has relevance to midwifery students anywhere in the world. Thank you, Megan.

Your biggest learning begins when you graduate”. These were the words a midwife said to me in my first month of practice and these words ring in my ears most days!

I graduated in December 2007 and am practicing as an independent Lead Maternity Carer (LMC) midwife in a practice with three other midwives. I am well supported within the practice and have a mentor outside of this practice.

Sarah suggested to me that I might like to do a 'guest' blog with advice/suggestions for senior midwifery students who are about to embark on their midwifery practice.

The one thing that struck me the most after graduating was that the responsibility and decision making for the women in my care fell on me and me alone! I needed to make decisions and deal with the middle of the night phone calls and try and remember all the things to ask! This gets easier with experience, as do most things, but I remember being asked what I wanted to do in terms of a woman's care and I didn't really know! One of my colleagues I graduated with keeps her New Zealand College of Midwives “Handbook for Practice” by her bed, so that she can refer to it if a woman rings her in labour in the middle of the night. This way, ensuring she doesn't miss anything!

If as a third year student you are doing your placements in the area you are planning to work, the first suggestion I would make is to network. Networking with the midwives who already work in the area is beneficial in a number of ways. Firstly, they can help you through your third year, these women are a great source of knowledge and wisdom and are more than often happy to explain something to you and help you, whether it is assistance with finding equipment in Delivery Suite or practical help with a clinical skill or the institution's paperwork! When you graduate the most significant benefit I have found is the support given as a new graduate. It can be a frightening and overwhelming time as a new graduate if you're with a woman in labour for example, and the labour is not progressing normally. There are a number of possible things that may need to be done, for example, documentation, the woman needs support and an explanation of what's happening, as well as discussion with the core midwifery staff and possible consultation with the medical staff. If you have developed a relationship with the midwives, I have found it is easier to ask for their help and support and to make use of their experience and wisdom!

A lot of these midwives have a huge amount of wisdom, knowledge and experience. This is a great source of learning for a new graduate! Being able to openly communicate your personal needs, whether you need a cup of coffee, or professional advice. Being able to ask for support and making the most of the midwifery knowledge is hugely beneficial, often our midwifery colleagues have the information and can provide the guidance you need to make the decision without the need to refer to a doctor straight away. Of course, there will be times when it is necessary to refer to the medical staff straight away, and their advice and support in this situation, is reassuring and a good way to discuss what your actions might be. I accept that the culture in each institute is different and therefore, the way a new graduate midwife is accepted (or not) is different as well.

Another challenge to a new graduate or in fact all midwives is how do we keep up to date with the latest research in order to have an evidence based practice. This would be especially challenging for those midwives who are not working in major centres with access to a library or an institution where you can access online databases or journals. Another challenge in keeping up to date with the latest evidence could be finding the time! Getting your head around the paperwork and other responsibilities that come with being a midwife, sometimes leave little time, at least initially for making the time and effort to find out where and how to access relevant journals.

When I think about finding time, it always tends to lead me to thoughts about finding balance in your life. Making sure that it isn't always work and finding time for yourself and your family. As individuals we determine what works for us and what we need. I personally need time off call without a pager when I know that I can spend time with my young children without the thought that I could be rung or called out. In order to achieve this, I made a decision from the beginning that I would start as I meant to continue and take every second weekend off. This works for myself and my practice partner. Taking this time off, as well as planning a longer break in the year I hope, will lead to a long and sustainable midwifery career!

My final thoughts that I thought I would share on this subject is being kind to yourself, treat situations that don't necessary go as expected as a reflective and learning experience. Having a mentor or a trusted person to debrief I've found is of great benefit.

Image: 'ellie_newborn_4_bw'

How open is your teacher, lecturer, professor?

I have been fascinated by an article in The New York Times that is doing the rounds: The Professor as Open Book. It talks about how professors and academic staff are getting into networking sites such as Facebook and MySpace, as well as having their own web sites and blogs. They are giving out personal information about their private lives in an effort to engage with students, which makes them and their teaching appear to be less boring.

This whole issue of how much of your personal identity you make visible to students is one that I have been working through since I started this blog. Initially I was very against the idea because I was adamant I wanted to keep my professional life separate from my personal life. And then there is the issue of being professional - is it appropriate or relevant for students, potential employers, PhD supervisor, conference conveners etc to know that I am a passionate rugby fan?

However, as this blog has evolved and I have started to put my ePortfolio together, I have started to realize that my personal and professional selves intertwine quite significantly online. And that overlap is spilling into my face-to-face professional life. For example, I have started to put my ePortfolio together and have made it open access, and have shared what I am doing with my students. I will be using it to demonstrate how to develop a portfolio in my face-to-face teaching. So I feel I have moved my 'whole' self, personal and professional, from an online context into a real environment, as opposed to a lot of people who are thinking how they can move their 'real' identity into an online context. Being myself online has given me a lot more confidence to be myself in the face-to-face environment.

Of course, there are still boundaries that I must observe. I am a role model to students, so there must be an element of being professional in my online behavior. And I am in no great rush to become friends with anyone on Facebook because I hate all the irrelevancies of Facebook. But if students find me more approachable and learn from my online activities and writings, then I am doing my job and learning myself at the same time.

How do you feel about your online identity? What are you happy to share with students? If you are a midwife, what about sharing your online identity with the students you work with and the women in your care?

If you are a student, what are you happy to share with your lecturers/teachers? How do you want to interact with them online - would you make your teacher your 'friend' in Facebook?

Image: 'She Was Completely Transparent With Me'

Super 14 Rugby: I hate to be right!

Well, I said at the beginning of the Super 14 rugby season that I had as much chance of becoming a super model as the Highlanders has of winning the Super 14 rugby. And...I am right. We now have had 5 straight loses and are at the bottom of the table.

To add insult to injury, one of my best mates has started doing the Telecom virtual rugby competition with me. She knows nothing about rugby and hates it. But she is beating me. How can that be? It might be something to do with the Excel spreadsheet she is keeping?! Honestly, some people take life far too seriously!

Image: 'crying Ava'

Saturday, March 22, 2008

Safety and identity on the Internet: the case of Al Upton and the miniLegends

I have been following a fascinating story in blogging land about a teacher called Al Upton. He teaches young children in South Australia and for the past few years has got his class blogging and has hooked the children up with online mentors from all over the world. Despite going through stringent procedures to ensure the children's safety, there has been complaints and the authorities have closed down the scheme. I am not going to go into the whole story here - to find out more, have a look at Al's blog.

Whilst this story has no direct relevance as such to me as a midwifery educator because my students are adult learners, there is no doubt that even adults worry about their online safety. When I first started this blog, I couldn't make up my mind as to whether I would be anonymous or not. In the end, I have made a deliberate choice to use my online identity as a branding exercise and as an authentic way of engaging with midwifery and education communities.

Two things has struck me about this ongoing story. The first thing is the power of social networking. When you look at the comments left on Al's blog as well as blogs written by people all over the world, you realize how far this story has traveled and how it has affected people. Social networking has an amazing global potential for collaboration and lobbying. Just imagine what midwives and women could achieve if we all got together to run a campaign promoting normal birth using online social networking principles and Web 2.0 tools.

The second thing that has made a big impression on me is how powerful education can be when it is led by teachers like Al Upton. When I consider my son's journey through education, I wonder what his attitude to school would be if his attention and imagination had been captured by innovative teachers like Al. He views school as a waste of time, which greatly saddens me as his mother.

But I also have to ask myself, how can I be the 'Al Upton' of midwifery education? How can I engage with my students in an innovative and exciting way? If nothing else, Al's story has made me think about my own teaching, and has resonated with people all over the world.

Image: Yellow eyed penguins, Dunedin

Thursday, March 20, 2008

Kids - who'd have 'em?!

It isn't often we do things as a family these days - my kids are in their late teens, and one has left home. But last Sunday was my husband's birthday, so they had to tow the line and hang out with mum and dad.

My husband is just getting into golf so the birthday treat was a family golf lesson. We turned up at the golf course and started talking to the coach, and noticed a couple of young children about to go and have a game of golf. The coach told us that they were junior champions. The kids were very impressed and one of them turned to me and said "I wish you'd got me into something when I was a child". The other earnestly agreed.

WHAT!?! I nearly strangled the pair of them! I tried to get them into rugby, football, archery, violin, Scouts, Brownies, clarinet, sailing, ice hockey, athletics, ballet, swimming, diving, netball, hockey, ten pin bowling...need I go on!?!

The moral of the story - blowed if I can think of one! Kids - who'd have 'em!

Open access education at Otago Polytechnic

Otago Polytechnic, the institution I work for, is a tertiary education provider in Dunedin, New Zealand. It provides a range of vocational courses from Certificate in Automotive Engineering to MA Midwifery.

Otago Polytechnic has a policy of open access intellectual property in conjunction with creative commons with attribution. I was very interested to find out more about this, especially as I am currently developing a paper that supports the development of open access midwifery education courses.

So I asked Deputy Chief Executive Dr Robin Day a couple of questions to explain more about why and how Otago Polytechnic supports open access.

What is Otago Polytechnic's Open Access policy?
Otago Polytechnic has considered the issues around open access to information and Intellectual Property over the past couple of years and have come to the view that to be consistent with our strategies around teaching and learning and research, we need to have a much more open view. The recognition of Creative Commons with attribution as our default position has been widely accepted and feedback has been that it has been instrumental in building OP's reputation as an educational provider.

Why did OP come up with this policy?
We struggled somewhat with the traditional views of controlling ownership / copyright and found these to be very restrictive. Significant feedback from staff was that we needed to be more open to support creative thinking and application of theory to practice in a way that was less constraining. This debate took a significant amount of time with key stakeholders and the outcomes were a change in our position to be less restrictive and more open. Similar moves of course are happening in many areas including things like Wikieducator, open source learning / software and so on.

What are the benefits for OP?

The benefits are many - including reputation as a quality place of learning. We are much more open and collaborative and the networking of individuals is not constrained artificially. Individuals are less likely to feel that their creative works are going to be taken from them and indeed will, and are feeling supported in developments

What about the danger of other institutions using OPs material and running the courses themselves in competition with OP?

Well they might do that - however we will gain the reputation over time of being a quality provider especially since under CC they have to attribute the source to OP. Those institutions will do that anyway - they will just go somewhere else. It's better to work with them, I think.

I would love to hear what people think of this. What is your institution's policy about open access and intellectual policy? Do you know of any open access midwifery education?

Image: Otago Polytechnic F Block

Sunday, March 16, 2008

Head down...bum up!

This is just a note to say that I will not be posting much over the next few weeks. I have a new PhD supervisor and some rather daunting challenges to attend to. So, I'll catch up with you all as and when I can take a breath.

Friday, March 14, 2008

My ePortfolio: Thinking about my midwifery philosophy

I have done very little work to my ePortfolio in the last couple of weeks. However, I have just finished writing out my midwifery philosophy.

I first articulated this philosophy in the early 1990s. It hasn't changed much over the years. But I would confess that my scope of practice does not extend like it did a few years ago. By this I mean that I do not stretch the boundaries of the care I provide in a way that I used to eg I would not consider a breech (baby coming bottom first) birth at home, whereas years ago I would have.

There are a couple of reasons for this. Firstly, I do not do much clinical work these days because of my other roles of teacher and researcher, so I am probably not so confident as when I was practicing as a midwife full time. The second reason is my concern about litigation. I have written about this before and constantly challenge myself to ensure that I am not a fearful midwife. But it can be hard at times.

Please feel free to have a look at my midwifery philosophy and give me feedback. What aspects would you agree with and in what areas would your beliefs differ?

Image: 'Grin'

14th Reflective Practice Conference

Here's a conference that sounds fabulous - 14th Reflective Practice Conference. The only snag is the call for abstracts closes today. I thought I might submit an abstract about how I use this blog for reflection and the issues that arise form that such as professional identity and privacy.

The School of Nursing and Health Studies, Waiariki Institute of Technology, Rotorua is very proud to announce that the 14th Reflective Practice Conference will be held at the Millennium Hotel, Rotorua, New Zealand, from 3rd to 5th September, 2008.

This is the first time that this international conference, whose aim is to improve professional practice through reflection, has been held in the southern hemisphere. It is convened by Prof Christopher Johns, a world expert in reflective practice.

International Speakers Professors Christopher Johns, Arthur Bochner and Carolyn Ellis will present workshops prior to the conference.

This conference is multidisciplinary and will attract Nurses, Doctors, Social Workers, Teachers, Complementary Therapists, Physiotherapists and others.

Whilst most of the delegates will be from New Zealand and Australia, the conference is expected to attract delegates from Europe, UK, USA and parts of Asia.

Rotorua Sunrise

Fetal circulation and Baby's first breath

I have to admit that anatomy and physiology is my weak point, and fetal circulation is one of those things I have always struggled don't ask me any questions about it!

Here is a video about how baby's circulation changes when he is born. It has been recommended by my friend who teaches midwifery students this topic. It is a complicated subject but will be of interest to parents who have never thought about how their babies live and 'breathe' in pregnancy and when they are born.

Wednesday, March 12, 2008

Having to admit defeat!

I have just joined an open course about designing flexible learning. It looks a great course but I am afraid I am withdrawing. I am having a major, major PhD meltdown so can't attend to both things at the same time. Good luck to all who are doing the course.

Birth video: 'hands off' approach to twins and breech

Here's another amazing birth video in which the woman is having twins - the second is a breech birth (bottom first). Again, the birth attendants intervene only minimally.

I was interested that for the breech birth, the midwives/doctors kept the woman on her back instead of getting her up on her knees to allow the baby to 'hang' and descend. Nevertheless, note how there is minimal medical paraphernalia likes drips and monitors.

31 Days to Building a Better Blog: Day 30

The second but last day of the 31 Day Challenge is to visit a social media site: social bookmarking or networking site. I have chosen to look at, which is a social bookmarking site.

I must admit that I am cheating a bit by doing this because I actually joined last year. But I have not engaged with it, and only really started thinking about its functions a few days ago when I was considering what tools I would recommend to students and midwives as time-saving tools. I was also very intrigued by a post by Alan Cann at Science of the Invisible, where he explains how can be used for networking and sharing information. He used network explorer to show how his network extends from one person to another. This got me thinking about how I use

Up until now, I have used as a bookmarking service. In other words, it does not matter what computer I use, if I come across a website I want to save as a bookmark or 'my favorite', will allow me to do that. This is hugely advantageous if you use more than one computer.

I became aware of how valuable the networking aspect of is the other day. I was writing an academic paper about social networking and I needed to find some literature to explain what it is and how it came about. I went to Google Scholar and to my usual databases, but I couldn't get a sense of what was the key literature. So I thought of someone who would know, Sue Waters, and checked on what she has bookmarked in her account. In no time I found an article by Tim O'Reilly who was one of the first people to talk about Web 2.0. I knew this must be an important or credible article because it has been saved by 505 people.

Here's a hypothetical example of how it could be used from a midwifery perspective:

I want to know more about breech presentation (baby coming bottom first). I know that Maggie Banks is perceived as a midwifery expert in this area and I wonder what articles on breech babies she has been reading lately. So I find her in and see what articles she thinks are worth looking at. It gives me an insight into what Maggie is reading (if it's good enough for her, it must be good enough for me?), can be a time-saving strategy and may lead me to literature that I otherwise would not have come across.

Now the only snag to all this is, I cannot find Maggie on so I don't think she has an account. But just think how amazing it would be if we were able to link with key international midwives with a tool like this!

The image above shows my network - I am the green dot in the middle. As you can see, currently I am only networked to three people. You can also see how my very small network compares to the much larger network of one of the people I am networked to - hope that makes sense.

Postscript: Have a look at what Sue Waters has written about - it is a very thorough account of how to use it to its full potential.

Tuesday, March 11, 2008

31 Days to Building a Better Blog: Days 27 - 29

At the moment I feel like I am in one of those slap-stick race films with Tony Curtis like 'The Great Race' or 'To Monte Carlo or Bust' - nothing is going to stop me finishing the 31 Day Blog Challenge - evil laugh, twirl of mustache!

Anyway, I skipped Day 27 because I do not want/need a sponsor for my blog.

The challenge for Day 28 is to make my mission statement really clear. I have done that in my 'About this blog' page, so have a look at that if you have not done so already.

Day 29 involves emailing a blogger who has linked with me to thank him/her. So I have dropped by Mamma Mid(Wife) Madness to thank her. She has my blog in her blog roll and I regularly get visitors to this blog who have come from hers. So, thanks a lot, mad midwife!

Image: 'tony'

Monday, March 10, 2008

31 Days to Building a Better Blog: Day 26

Linking with 'competitor's' blogs is today's challenge for the 31 Day Blog Challenge. This is what helps to build the networks that becomes part of your learning and development experience.

I have tried to do this all the time but recently I have noticed that instead of linking out, I have been linking into my blog as an effort to entice people deeper into my blog - this is a strategy that is mentioned on Day 15 of the Challenge. But the bottom line is this blog would not grow (and my learning would be stunted) if I kept it in the dark - linking out to other people is what gives it life, along with the comments that people leave which inspire me to develop my thinking further.

Image: 'A Digiscoped Full Moon'

Sunday, March 9, 2008

A new midwifery education blog

Inspired by Carolyn's blog and the midwifery meetings we have been having in Second Life, Lisa Hanson has started her own midwifery education blog. Lisa is a midwifery educator in Milwaukee, USA. I look forward to watching her blog grow and exploring opportunities for collaboration.

Drop along and say 'hello' to Lisa to encourage her along the way.

Image: 'untitled'

Second Life wiki for midwives

We had our second midwifery meeting in Second Life this morning. I nearly overslept and missed it. Just as well I have an avatar because no one would have wanted to see me in real life! We changed the time this meeting which allowed a couple of American midwives join us, as well as a midwife from Australia.

Carolyn has set up a wiki for us to document our adventures in Second Life. So check that out for the latest details of midwifery meetings.

Do not be afraid to add and edit contents, eg your views on how we can use Second Life for education, professional development, communication and collaboration.

Or, if you are an educator who uses Second Life, what tips and hints would you have for us?

31 Days to Building a Better Blog: Day 25

Well, I am on the last stretch to the winning post as I contemplate Day 25 of the 31 Day Blog Challenge. In this activity, Problogger suggests you go shopping. The idea is that you observe what is happening and relate that back to your blog. Have a look at Michele Martin's reflections on this activity - that will give an idea of how this challenge works.

I did cheat a little because I did not go and spend a great deal of time observing what was going on - I only have today to finish my paper that I am submitting to the ICCMSN conference. But I did run a quick trip to the supermarket. Here are a couple of thoughts about that shopping experience and how I feel as a shopper.

One of the things that has changed about my shopping habits lately is that I rarely go into the main shopping center in Dunedin any more. I find parking is difficult and expensive, and everything is too time consuming compared to nipping into my local shopping community at South Dunedin. Time is a huge issue for people today so I think it is important that my blog does as much as it can to help people utilize it in a time-effective manner. To this end, I have added a Lijit search facility as well as ways to easily subscribe to my post.

I went down to the supermarket wearing my old study clothes - baggy trousers, old teeshirt with last night's dinner splashed on it, old worn furry slippers, hair and eyebrows that should have been 'dealt to' at least several days ago. I thought it didn't matter because I planned a quick 'in and out' trip. But who do I bump male boss! Moral of the story - you never know who you are going to meet at your blog so it is important that the blog is looking at its best all the time. No poor spelling or grammar errors! Kate Olson has written more about this in her post 'Let's clean up the web'.

My final thought is that I want help from sales assistants when I want it - I hate being harassed when I am just browsing, but I also hate hate HATE being ignored when I want service. That will make me take my business to another shop. I do not know about harassing people, but I think it is vital that I respond to people whenever they leave a comment or ask for help. That personal connection is what contributes hugely to the networking process.

Image: '100_2058.JPG' Dunedin Main Shops

Saturday, March 8, 2008

The next midwifery meeting in Second Life

The next midwifery meeting in Second Life is tomorrow 9.30am NZ time. For more details, see Carolyn's post.

All welcome - midwives and anyone else interested in using Second Life for education.

31 Days to Building a Better Blog: Day 24

Another big task for Day 24 of the 31 Day Blog Challenge: to do a search engine optimization (SEO) audit of my blog. In other words, look at how I can write my posts in such a way that I will get them recognized in search engines and get a high ranking so that people will find me quickly.

I certainly try to be careful about how I title my posts ensuring I write them in such a way that they will get noticed by search engines but I probably do not worry much beyond that. For example, look at my previous post. Initially, I titled it 'old health education films'. As you can see, it is now titled 'old sex education films', with the rationale that 'sex' is more likely to turn up in the search engines. That certainly has been true about the post I wrote about my experiences in Second Life which I titled '....naked flying men'. I also pay attention to how I label my posts, using terms I think will attract readers and queries in search engines.

Problogger, who devised this Blog Challenge, has written a detailed post about how to do SEO. The key things I have taken from this are:
  • link with the people who are the key bloggers in your area
  • try to get the key bloggers to link with you - this requires you to write politely to the key person and explain how your post may interest them and their readers
  • pay attention to the key words you use in your post because these will be picked up by search engines
  • use the key words in your label, title and frequently in the first few sentences of your post.
These are all things I try to do as much as I can but I do not have the time to be too obsessive about it. Not only that, but I write for a small niche market and will never get a huge audience. And I believe that if I spend all my time thinking about what will attract readers, I will miss the whole point of my blog, which is to write posts that will inform readers and encourage discussion and networking.

When Sue Waters did this challenge, she advised people to register with Technorati, which is a blog search engine. I have followed Sue's advice and now have an account and icon on my blog which allows people to add my blog to their Technorati account. The key is to remember to use as many of my Technorati key terms as possible in my posts, such as 'midwifery', 'eportfolio', 'blog' as possible. You'll be glad that I haven't made 'sex' as one of my key words!

Image: 'Key in Ignition'

Friday, March 7, 2008

Old sex education films for teenagers

Today, I was cruising around Internet Archive, which is an online library, and found some old health education films. My interest in the historical perspective of menstruation, sparked by last night's talk by Professor Barbara Brookes, led me to a couple of wonderful old films.

The first film which comes from 1953, is for young girls and talks about menstruation. Note that it is very unwise to go square dancing when you have your period. It is also recommended that you "wear your prettiest dress and be your most attractive self".

The health education film for boys (1957). Note how the boys are 'allowed' to masturbate but girls only get to wear a romantic dress!

What differences in approach and information do you see between the two films? Would you use them for sex education today?

Skeletons in the cupboard, women and shame

Last night I attended a talk by Professor Barbara Brookes, who is the head of the History Department at Otago University in Dunedin. This event was hosted by the local Zonta group to celebrate International Women's Day.

Professor Brookes put a historical perspective on three aspects of women's life that have brought shame to women and their families and have consequently become skeletons in the cupboard: menstruation, illegitimacy and ....for the life of me, I cannot remember the third element - I think that third glass of free wine I had wiped my memory. Suffice to say, as a midwife, it was the two aforementioned aspects of women's lives that really resonated with me.

What I found particularly interesting to note was how attitudes to menstruation have changed. Now, menstruation is a shameful thing - women do not want people to know they have their 'period'. Commercial products have been developed over the years to conceal all signs of menstruation. But years ago, when fertility was valued, women were much more overt about their menstruation because it signaled to men their ability to breed. So my question would be: what do men value in women now and how do they seek that out? If a woman's fertility is not her' selling point' to men, what is? Her readiness to have a sexual relationship? Her financial state? Or does this only apply to a certain element of society - a woman's fertility is still highly valued in many developing countries.

What was the most fascinating part of the evening for me was talking to my daughter about this issue afterwards. She came with me because she is very interested in women's issues and is studying gender and ethics at university. I asked her what she would consider was shameful for young women these days. She agreed that menstruation definitely was. She added that rejection was another, be that in the context of a relationship, education, employment or whatever. She also felt that one's body could be shameful, especially you are overweight. Would you agree with this analysis or would you have other ideas about what is considered to be shameful in today's society?

But what was the most special thing about this evening was that I was able to spend it with a woman who has the same interests in women's issues as me, is intelligent, articulate and insightful - my daughter! How blessed can a mother be!?

Image: 'Floating'

Thursday, March 6, 2008

Designing flexible learning: an open access course available for you

I have just joined another open access course which follows on from the one I did last year. This course is 'Designing for flexible learning practice' which is being offered by Otago Polytechnic and run by Leigh Blackall and Bronwyn Hegarty. All the details about the course can be found on Wikieducator.

I think I'll be a 'proper' student this time and enroll from the beginning. But I am concerned that I will get distracted from my PhD, which I am in the throes of finishing off this year. So what I have decided to do is use this course to help me with my discussion/recommendations chapter.

To cut a long story short, I am running a RCT comparing e-mentoring with traditional support and professional development for health professionals. The e-mentoring system has not engaged the participants at all. So I am going to use this course to have another look at the system and come up with a plan for re-developing it. This will then go into my PhD thesis - killing two birds with one stone!

Image: 'I am thy father’s spirit....'

31 Days to Building a Better Blog: Day 23

I am plodding on with the 31 Day Blog Challenge and have got to Day 23. I must admit to being very bored with it now and have moved on to other projects: my ePortfolio, as well as developing a paper supporting my aim to make some midwifery courses into open access resources for the international midwifery community. I have also joined another open access course being offered by Otago Polytechnic:Designing for flexible learning practice. But, I am determined not to admit defeat and am plodding on.

Today's challenge involves checking my blog for dead end links. There is nothing more frustrating for the reader to follow a link and find it is no longer connected to anything. If this happens consistently, one's reputation as a blogger will be affected. I certainly do not have the time to check all the links on my blog so I used two free online programs to do it for me: W3C Link Checker (as suggested by Sue Waters) and Dead-Links.

W3C Link said I had 3 links missing whereas only 1 was missing in reality. Dead-Links said I had a lot more missing and the ones I checked appeared to be fine. I got bored with checking them all and did not find the report anything as user friendly as the W3C Link report. So I would stick with W3C Link.

Incidentally, I have a guest blogger appearing soon who will fulfill the requirements for Day 21 so keep an eye out for that.

Tuesday, March 4, 2008

Putting Web 2.0 into perspective

During the last eight months I have:
But it is Carolyn's latest post that has just put Web 2.0 totally in perspective for me.

The sum of my worries are whether I have enough broadband width or if Second Life is going to revolutionize midwifery education. Meanwhile Carolyn has reminded me of the terrible reality of the lives of millions of women throughout the world. Thousands and thousands of women die from childbirth related causes. Makes my concerns about how fat my Second Life avatar looks, superficial to say the least.

I would echo Carolyn's questions about how we can use Web 2.0 to support the midwives who are working with these women in the most challenging of conditions. And whilst I acknowledge that many of these midwives will not have access to electricity let alone computers, I also think we should not completely discount the potential that Web 2.0 offers midwives in developing countries.

Open access
to midwifery information, resources and education programs may be one way that we can aid these midwives. We can ensure that meetings, conferences, and education programs are made available using synchronous means such as the MIDIRS webinars or recorded in some way and openly stored on the Internet. This may present financial and political challenges to institutions and companies who underwrite the conferences, but I am convinced that this is one way that we can work toward global midwifery sustainability.

What do you think about this? What do you think we can do to support midwives in developing countries - does Web 2.0 have a role?

Image: 'Jammu (North India)'

Learning tools 'drop in' session for students

Tomorrow I am running a computer 'drop in' session for students at lunch time. We do not really integrate Web 2.0 tools into our midwifery program other than what is offered on BlackBoard, although Carolyn has set up a class blog for her first year students as an additional support/learning mechanism. So I offering students some lunch time sessions which aim to provide opportunities to learn about online tools, primarily to help them to manage their information seeking and increase their digital literacy.

Essentially I plan to offer an open session and address the students' needs as they identify them. However, if the students come with no particular queries, I have decided to look at, RSS, Google Reader and email discussion groups.

I have never run a session like this before and I cannot wait to see how it goes - to see if students feel they need such a session and what they want to know about, compared to what I think they should know about.

If you are a student, what would you like to know about?

If you are a teacher, what have you found are new students' greatest needs as regards to searching for information and networking?

Image: 'Students working on class assignment in computer lab'

What I Learned ...from the law

Robert Hruzek's writing challenge this month at New Middle Zone Musings is: what I have learned from the law.

I honestly don't know what to write about with regards to this challenge because I have had little cause to think much about the law, especially in a personal context. There was the time I had to rescue my son from the police station for being a mischievous teenager but apart from that, my family is very law abiding.

So I am going to be a little rebellious and change the title to: what I have learned from lawyers.

A few years ago I was privileged to become involved with an amateur dramatic production. The play was called "Jerusalem, Jerusalem" and was about a renown New Zealand poet called J.K.Baxter. It was written by Mike Riddell and directed by his wife, Rosemary who is now a family judge in the North Island. I played the part of a middle aged woman who had lived in the commune with Baxter as a young woman. I had never acted before.

I had always thought that lawyers were stern, cold people but Rosemary is the exact opposite. She is warm, funny, incredibly articulate and caring. More than anything she taught me that I had to follow my dream and that I was capable of doing what I had always dreamed of...acting. She gave me confidence and made me believe in myself. Whilst I haven't done any acting since, I will always be grateful to her because she gave me the chance to fulfill one of my life's ambitions.

Thank you, Rosemary.

The significance of the photo is that Baxter had his commune 'Jerusalem' by the side of the Whanganui River, New Zealand.

Image: 'Whanganui River'

Sunday, March 2, 2008

Midwifery meeting in Second Life

This evening I attended my first ever midwifery meeting in Second Life which was organized by Carolyn McIntosh.

It was great fun and I was very pleased to meet midwives from the UK and USA. We all agreed that we were interested in continuing with regular meetings. But the technology continues to be a challenge. Here is a short video about my experience and impressions.

Making a video about my ePortfolio using Jing

I think Jing is a great program to use to make short videos and capture screen photos. So if you want to show someone how to do something on their computer or show them a slide show of photos, Jing allows you to do that very easily. Here is a very basic video I made introducing people to my ePortfolio.

What I haven't worked out, and would really appreciate help with is how to embed the video into this blog. I've read the written instructions and even watched the 'how to' video, but still cannot get my head around what I'm supposed to do. I have used the html code from where the video is stored but when I embed the code into this blog, the video is far too big for the page. I have played with the code but that has not worked. Any suggestions?

My ePortfolio: all sorted on Wikispaces

I have started to develop my ePortfolio on Wikispaces, which is a wiki platform. I was struggling for a short while, trying to work out how I should format the ePortfolio and getting it to work in Wikispaces.

Dominick and Damian very kindly responded with written instructions but it was Michele Martin's screencast that showed me what to do. In it, Michele goes through all the steps to set up pages within pages in Wikispaces - a great resource if you are just getting your head around setting up a wiki in Wikispaces.

This incident has shown me the power of video and audio as teaching tools. I did not respond at all well to the written word, although I have always thought of myself as a 'reader/writer' learner. But I got 'it' straight away when Michele showed me what to do using the video. A salutatory lesson for me, as I consider how I can engage students and midwives more with online learning and professional development.

Saturday, March 1, 2008

My question is...?

As I said yesterday, my reader stats have shot up in the last 48 hours, which is very exciting. Looking closer at my stats it appears that there are two reasons for this.

The first is the problem Telecom was having with its virtual rugby website - rugby fans have been finding my rugby posts by default. The second reason is my blog has just been featured in the MIDIRS Essence electronic newsletter. MIDIRS is an international information resource for midwives, and I am very proud to say that that they have awarded this blog 5 stars.

Looking at my 'popular pages' in my stats, it is my post entitled "Me and the naked flying men" that is currently getting most of the attention.

So my question is: who is interested in naked fans or midwives!? Answers on a postcard...

Postscript: The post about the naked men is about my experiences in Second Life, a virtual world that has great potential for midwifery education.

Do I make my ePortfolio public?

The issue of privacy and security has arisen with regards to my ePortfolio. In the comments to my previous post, there were some concerns raised about making this ePortfolio public. So I have had to go back to the reasons why I have decided to have an ePortfolio.

Most of the reasons for having an ePortfolio are tied up with giving it a public profile ie role modeling to my students and midwives, and using it as a teaching tool. My friends know I am quite shameless in wanting to build a public profile as a midwife and educator who uses Web 2.0 and social networking effectively in her professional practice. And ultimately, I may want to change my job one day which will require my ePortfolio to be made available for potential employers to view. So if I wish to achieve these aims, my portfolio will have to be public. portfolio is also an extremely important part of my ongoing professional midwifery recertification and has the potential to contain some very sensitive material and personal reflections about women, students, and colleagues. It is highly unlikely that I am going to write anything sensitive about what I learned from attending a conference, but it is much more likely if I am talking about my clinical midwifery practice. I have a professional and legal requirement to maintain my clients' anonymity. My position as educator could also be seriously compromised if I published inappropriate material, be it in my portfolio or on this blog. And as Merrolee pointed out, being 'too' open may affect employment opportunities in the future, although others such as Michele Martin would disagree and say that it is vital to maintain a transparent online identity.

So, how am I going to manage this.

For the time being I am going to continue with keeping my portfolio open but refrain from publishing sensitive material about women and the people I work with. It may be that I eventually end up with two portfolios - one with public information and the other containing very sensitive reflections will be kept private.

I think it is important for me to make aspects of my midwifery practice open to the public: surely potential midwifery clients should have access to my practice statistics? That will help them make an informed choice about whether they choose me as their midwife or not. However, I must admit I am very likely to keep information about any cataclysmic mistakes I make private. I believe that if health professionals were a lot more open about their practice, weaknesses and errors as well as strengths, there would be a lot less litigation than there is now. Women and families are less likely to sue if health professionals are open with them and acknowledge their mistakes. Maybe if we were more open about our cataclysmic mistakes, others would learn from our experiences and be a lot more supportive of us- but that is another post altogether. And I should also add at this point that I have not made any cataclysmic mistakes, so I am speaking hypothetically!

I am really keen to continue this discussion so please feel free to drop by with a comment. If you have an ePortfolio, what do you make public and what do you keep private? What do you think I should keep private and why?

As a midwife, what information about your practice would you make public in a space like a blog or ePortfolio? If you are a non-midwife, what information abut a midwife would you want to have access to?

Image: 'pay heed'