Distance and flexible learning for midwives and midwifery students.

Cathedral of learning

Image: Cathedral of learning. From Macwagen’s photos on Flickr.com.

Week 4 DFLP

How can distance, correspondence and/or online learning create flexible learning opportunities for midwives or midwifery students?

Undergraduate midwifery

As I stated in a previous post we already have a significant workforce shortage in midwifery and we face a looming crisis as the aging midwifery population approach retirement. A creative approach is needed to provide education which is accessible, with the opportunity for women to remain in their own community while gaining a midwifery qualification. Anecdotally women from areas where there is a shortage of midwives identify this shortage and choose to train, planning to return to their area once they qualify. These plans often change when families are uprooted and establish a new home during the three years of the midwifery program. Moran and Rumble (2004) suggest that online delivery provides opportunities for collaboration between education providers and the private sector. They state that conventional education is not providing enough skilled workers and governments, educational providers and employers are looking to distance education as a solution to workforce shortage.

A large component of midwifery education is theory which may be relatively easily adapted to a flexible design which can be delivered at a distance. There are components of midwifery education which has a strong clinical focus and will not be suitable for distance education requiring face to face teaching. Midwifery students require professional supervision of clinical practice until they are qualified and able to care for women on their own authority. The foundation of any course is the pedagogical framework. This may vary from an instructivist model to a constructivist (or behaviourist) model. Siragusa , Dixon and Dixon (2007) suggest that highly technical courses require a more instructivist approach in the first year of the program. which can gradually change over time, as knowledge increases to a more constructivist approach. How these two are blended is dependent on several factors. Some of these are;

  • How focussed or unfocussed is the instructional design
  • How much content is provided or is student constructed
  • Whether students are extrinsically or intrinsically motivated
  • Whether the lecturers role is didactic or facilitative
  • Whether the lecturer has novice or expert online capability
  • Whether the course is structured to be “teacher proofed” or easily modified
  • Whether collaborative learning is teacher or student guided

Information technology is rapidly changing the way that information is shared and how knowledge is generated. Learning is a life long activity and workers need skills to locate and critically appraise information on which to base their practice decisions and continual professional learning development (Moran & Rumble, 2004). Annand (2007) suggests that universities have been slow to realise the potential of information technology and continue to deliver courses in a preindustrial revolution structure. Annand challenges the assertion that a community of learning is an essential component of learning. He states that there are three types of interaction, student–teacher, student-student and student-content. He states that, if one of these is delivered at a high level, the other two are of lesser importance. Annand suggests this may be an important consideration when considering the financial costs of a course but could these perhaps also be related to learning style and might one or other be more or less important to individuals?

Postgraduate midwifery

Postgraduate study lends itself more readily to a fully constructivist approach (Moran & Rumble, 2004). Options for a fully student led, integrated and less formal learning process may be easier to achieve (Siragusa, 2007).

At Otago Polytechnic our postgraduate midwifery program has been delivered largely at a distance for several years now. In acknowledgment of our workforce shortage and in and attempt to reach more students we are embarking on a flexible model for our first year students in 2009. We are mindful and aware that we need to balance distance education with a face to face component for students in our new program. Having done the background work and developed the new curriculum document in collaboration with Christchurch Polytechnic we are now turning our attention to the process for delivery of the individual components for the program through individual courses which will be either totally online or blended online and face to face.

Annand, D., (2007). Reorganizing universities for the information age. The international review of research in open and distance learning. 8, (3) downloaded from the world wide web on the 3rd April 2008 from ; http://www.irrodl.org/index.php/irrodl/article/view/372/952

Moran, L., Rumble, G (2004). Vocational education and training through open and distance learning. Kentucky: Routledge

Siragusa, L., Dixon, K. C., Dixon, L. (2007) Designing quality e-learning environments in higher education. Conference presentation, Ascilite 2007 Singapore

Leave a comment


  1. Carolyn, it is good you mention the necessity for different models of learning depending on the type and stage of learning, i.e., instructive for technical subjects in first year and constructive later on when learners have some knowledge, e.g. post-graduate.

    You provide a great list of factors which may influence the type of educational approach, and it is good to see mention of ideas by Annand (2007) about communities of learning.

    I wonder is Annand correct in his thinking that all will be okay as long as you enable one type of interaction out of – student-student, student-teacher or student-content? I would be interested in your thoughts around this.

    Think about self-paced learning options and communities of learning – which model would suit your students and can you do both in parallel?

    Good to see your example relating to distance education for midwifery.

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