Back in class for the undergraduate midwifery students in our new blended learning programme

I have been blogging about the development and progress of our new programme for undergraduate midwifery education. Class of 2009

This photo graph and article appeared in the Otago Daily Times during our first intensive in January.

Our new programme has a longer academic year than our previous programme, beginning earlier in the  year and finishing later. Instead of being divided into two semesters our new programme is divided into three trimesters. Each trimester begins with the students coming together in class for two weeks of sharing, learning, doing class presentations (which are part of the assessment processs) and having some face to face lectures.  It is really good to see everyone back together. We all know each other quite a bit better and there is an air of cammeraderie and friendship.

How is it going?

We decided to get some feedback from the students about how the programme is going for them. What is working well and what they feel needs to change.

Yesterday the students got into groups and discussed this then fed back to the class. This is what I took out of this discussion.

It was overwhelmingly postive. The students said they are enjoying the course and the online learning. There were only one or two who said they felt they would prefer to be in class and have lectures, most are more than happy with being able to engage with the learning resources when they want to and in the way that suits them.

Online resources:

Feedback on the online learning resources was very positive. Most like this way of learnign and enjoy the quizzes and activities.  They have aparticular topic that they cover each week and are given a list of questions related to that topic to investigate and discuss in the Elluminate session later in the week. The students wanted the questions to be posted at the same time as the modules.

Online quizzes

The learning resources are interspersed with quizzes and case studies to make the students think and to improve the learning experience. Most of the students enjoy these althous some acknowledge that they feel now compulsion to do them and so do not bother.  They felt it might help if the Quiz had to be completed before progressing on with the module and this is something I am going to look into. They particularly liked doing the crosswords but some of the quizzes were less useful. In particular they mentioned a memory game that I had set up so I will not bother with that one again. I have had trouble getting crowwords to work for me so I will have to find out how I can do this from those that are managing to get crosswords up. I was told Hot potatoes was a good programme for this and I have tried but have not managed to master it yet. I have done some lovely crosswords in Eclipse but i cannot get them to load properly so that the students can use them. These activites are formative assessments which are recognised as an integral part of online learning and so it is important that we find ways to help the students engage with these to improve their learning and the retention of the material they are covering.


We use Elluminate for weekly class tutorials which the whole class can attend online. Again most really appreciate this and find these tutorials useful the questions that have been put to them in the online learning for the week are discussed here. A couple of students said they would prefer video conference . There was also some discussion about the possibility of having a class session for those in Southland and Dunedin who can attend while doing the same think on Elluminate for those who cannot attend or prefer to be online. This would be very tricky I think as there is alot for the lecturer to consider in facilitating an Elluminate session, text chat, voice chat and running the material on the white board screen. I think trying to manage this online and face to face at the same time would be too difficult and we do not have the manpower to run session twice.

Some students are very willing to discuss issues in Elluminate, some prefer just to text. some said they would be happy to speak face to face but do not feel so confident online. They wanted to point out that if they do not speak it does not mean that they are not engaging or learning. Some just like to sit and listen and learn. This is very similar to the classroom situation and it seems to be the same people who are happy to talk in class that are the ones who are happy to speak online. The lack of body language cues was discussed as a disadvantage.

Practice skills

The students are really enjoying the midwifery practice experiences they are getting. They are aware that thsi is much more than the previous students had and they really appreciate this. I had hoped that some of the skills assessment would be able to be done in an actual clinical setting with the midwives in practice but this is proving very difficult to achieve. The midwives feel a bit threatened and overwhelmed by these skills assessment forms and this is not happening so we will have to go back to doing this in the class room setting.

Small group tutorials

The students really like the small group tutorials and most feel that these are working really well for them, helping with the course work and learning and providing an opportunity to debrief and learn together.


Overall it seems that the programme is working well for the students. I would like to try to do something to help them engage more with the formative assessments we have in place and will look into the idea of making these compulsory to complete before moving on. At least for some of the quizzes. I think the change to doing some of the skills assessment in the weekly face to face session will be positive. I have been reluctant to do this previously as it would be outside the topics time tabled for the week and was worried that this may confuse the students but I think they can all see the rationale and I think this will work. It is very pleasing that this feedback was so postiive. We also gave the students a questionnaire to complete and that is being analysed. It will be interesting to see if these results are any different to this feedback.


Round up of developing a midwifery practice skills course for flexible delivery.

Image: Pohutakawa, the NZ Christmas tree. from Andy Eakin’s photos on

As the year comes to a close Lorna and I have been making great progress towards the midwifery practice skills course we are developing in a blended 334968150_7632df69fddelivery format. I have not been blogging much because I have been so busy working on this but I now need to record what I have  been up to for the last few weeks. So to bring you up to speed on what this is all about here is a brief outline of the programme.


We have been developing a midwifery program to be delivered in a blended format over the last couple of years. We start at the beginning of 2009. Students will be located in groups or cohorts in various rural towns as well as the main centers. Otago Polytechnic are developing this in collaboration with Christchurch polytechnic.  The process we have developed is as follows

We are using the moodle LMS for the online course delivery. All content is being developed in modular format using EXE as a development tool. We are using a mix of written material, links to online content and free online resources. We are also using  powerpoints with voice over, converted into shockwave flash files with ispring and either embedded or hyperlinked to exe files. Students are given a plan for progress through these modules although they can also work at their own pace if they wish. It is expected that they will progress through this material ready to attend the face to face components ready to discuss and debate the theory they are learning and to gain experience with the practical skills they will need for midwifery practice.There are formative assessments, such as quizzes and interactive games, to support learning in the online resources. Each section has clear learning outcomes to help students understand what they are expected to learn from the resources.

Students will meet in their local groups once a week with a local midwife/educator who will facilitate their discussion, direct them to learning support services if they are having difficulty with the learning and provide teaching and guidance with selected midwifery practice skills. The facilitator will also encourage the students to share and support each other through their learning experience and will coordinate placements in the various clinical or midwifery practice areas, liaising with midwives and other health care providers.

In addition the entire class will come together at four two week blocks in the year. At the start of the year they will be introduced to each other, the courses, the technology and  support services they can access. Some face to face teaching and team building and group activities will be scheduled. Later their will be more face to face teaching and at the final two week block examinations and summative assessments will take place. In addition to this teaching and learning students will  have midwifery practice placements in a variety of settings.

Progressing to this point

As we approach the start of this new programme. I am feeling very positive about it. We have been working very hard to structure our course in a logical way which should clearly link theory and practice and progress the students through from the basics to to more complex practice skills, while keeping these firmly linked to the context of midwifery practice.

As I have recorded in previous posts we separated the skills into modules which made sense in terms of midwifery practice. These are, antenatal, labour and birth, postnatal mother and child and therpeutics. More recently we realised we needed another module for the core component which overrides all of these others, that is communication. In this fifth module we will have material on communication skills and also include material on documentation, which is another form of communication. We were going to put material about the components from this course which will fit into the student developing portfolio, either paper based or electronic. However at the moment we feel that we will keep this alongside the course information, which is where the students will enter the course.

I have been working on the EXE files, which are on my hard drive, developign the course content. I then felt I needed a better overview of how the students would actually move through the course material. Which aspects would be taught face to face in the intensives. Which would be taught face to face in the tutorial groups and which would be principally online learning. I sat down and worked out where all these components would fit within the year of the course. At this point we hit a small block as we were not all thinking along the same lines here. My boss, head of the school of midwifery and head of the health group at Otago Polytechnic, Sally Pairman, obviously liked the way I had shaped this up and developed this further alongside all of the other courses the first year students will be involved in.

Earlier this week I flew up to Christchurch and had a meeting with Lorna. This was very positive. Lorna and I share very similar ideas about how the course will work and so we have very few problems in working alongside each other. It was lovely to spend some time with her and her family, she gave me a bed for the night.  We have negotiated with the math department from CPIT to run the examination of Math for our students and to take a couple of tutorial sessions with them as well. This is fantastic and will definitely be a bonus for us.

So now the road ahead is very clear, there is still some development needing to be done with the online resources but I am feeling confident and positive about the programme.

What have been the highs a lows of the development process.


I have been very lucky to be working alongside Lorna in CPIT. It has been great that we agree so well on so much. Lorna identified EXE which has been a godsend for course development and also ispring which has been great for converting power point to shockwave flash files.

I am sooo…  glad I participated in the Facilitating online learning communities course with Leigh Blackall and Bronwyn Hegarty and also the Design for Flexible Learning also with Leigh and Bronwyn. I would not be nearly so able to engage with this process without the learning I did in these courses.

Finding all the great stuff that is out there on the internet, free for anyone to use has been just amazing. The generosity of those who have developed these resources is amazing. I wish we were able to reciprocate, perhaps in time??


The main point of difference is with our institutions and the way that they perceive students should engage with learning. OP has an open policy where we as lecturers own the material we develop, we can take it with us when we go as long as we acknowledge OP if we use it. We can make it freely available on the internet if we wish to. CPIT on the other hand have a closed policy, all of their resources belong to CPIT and cannot be shared in an open environment. None the less I have loaded some of the content I have developed onto wikieducator and slide share etc, and I hope to do more development of this as time permits.

The time frame has been tight, the pressure has been quite enormous, and the workload allocation for development in no way related to the reality of the job. It has also been a struggle to do this and keep our existing students ontrack. I have to say our first year students this year have been a group of wonderful women and have been enthusiastic is supporting us as we have worked to develop the new course materials. Some of this new work has also filtered through to them to their benefit also I think.

A times I have felt quite alone and isolated. It is hard to get the IT support needed as we are experts in midwifery and so we really have to develop things ourselves. I do think the IT support has been less than it could have been at times however.


So now I am on leave for abpout 3 weeks. I am going to have a total rest from this and back into it on January 5th.

Merry Christmas ( or happy celebration of whatever you celebrate at this time of year). Happy holidays to all.

Evaluating course development resources

At the end of the DFLP course Bronwyn raised the question of evaluation, and invited us to consider why evaluation is important in education. She discussed the role of evaluation during all stages analysis, design, development and implementation of a course ( the Addie model)

As I have been developing the learning units I have been working on I have been loading them onto the CPIT and OP Moodle LMS for other lecturers to view and have invited them to comment. I have not initiated a formal process for these comments however and I have not had a great deal of feedback from this. I am wondering if I should seek answers to specific questions about these resources from other lecturers. I also wanted to get feedback from students and discussed this with the larger group at one of our regular meetings through Elluminate. Although there was general approval for this idea I did not want to give students access to all the work we are developing in its raw stages. On discussion with Terry Marler, who is supporting us with the IT side of development of this programme, we decided to create a special course where students could be enrolled and material could be loaded specifically for this purpose.

I asked the current first year students if they would be interested in reviewing some material. Several said thy would but to this point only two have actively pursued this. Here is the feedback from these students. I asked them to consider how long it would take to complete this resource, how easy it was to navigate, how easy it was to understand, did it flow well etc.

Student one

“I went through the unit this morning. It was very thorough and well thought out. I liked the videos, its nice to not have to read everything and get the change in learning style. Under the heading “how does infection spread” when you click on it, it only goes to the page with the objectives for a split second and then takes you elsewhere to a page that has the heading at the top corner: “up to date for patients”. I think it may just be a problem with the link where it goes there automatically so you can’t read the introduction page. I thought that things were worded very clearly, and that the quiz at the end explained the answers if you pressed the wrong answer.
I have to admit I was skeptical about how the whole online learning thing would work, but this is incredibly easy to follow and very thorough. This may actually be better than what we’re doing because people can go at their own pace and go over the material and refer back to it all at their fingertips. Even though blackboard does this for us, I think that this moodle is a lot easier to follow and you have done a great job with covering all your bases in this topic without having to download a powerpoint presentation. I wouldn’t mind seeing another one just to compare the two, but this one I found was really good.”

Student two

“I have been to have a look at the moodle course. I worked through it over the weekend, although it didn’t take very long maybe 3 hours.
The things I liked were the combination of media and sources giving a variety of ways to access the information. The little videos and quiz things were particularly good. I didn’t feel overwhelmed by the amount of information. Each topic flowed to the next and was not to difficult to process and understand.
The things I didn’t like. It took a moment to figure out the flow of the pages, when I got to the bottom I expected to be able to click next and move onto the next section. I don’t know if it will be available when the full course is up and running. But if I knew nothing about this topic I would have liked to be able ask questions of the topic tutor, maybe something like a feedback page?? I would have liked to have known which text book (and pages) to refer to If I wanted.
Overall it was rather good and would be happy to do this type of module in future.”

This has given me some useful feedback on the material reviewed from a students perspective. I have some ideas of things that I can change to improve the learning unit. I believe this has been a useful exercise and I would like to try to get more feedback if I can.

Beginning to construct a course which supports flexible learning

While completing courses myself around flexible learning and course construction I am also working on the development and construction of the midwifery practice skills course. There are several features of this course which could be described as ‘flexible learning’. Students will be able to enrol from a  variety of locations and study predominantly from those locations supported by a local facilitator. They will also be able to come together as a larger class for some face to face  learning. Learning resources will be delivered face to face during the class ‘intensives’ and during tutorials with their local facilitator, students will also have midwifery practice time, working alongside midwives. Learning resources will also be available on-line for the students to access. They will be able to pace themselves through these learning resources and move backwards a forwards through them as they wish, however there will be  structure around the course and students will e expected to have completed the learning resources at each stage so that they can discuss and gain practical hands on skills in the face to face intensives and tutorials. Some features of this course delivery will be (following categories from; Gluc, 2006)

Individualised learning – As part of  this course students will be developing a portfolio which will include a learning contract. This will allow them to idenrify their own learning needs and to track their own learning and progress towards their individualised learning goals.

Peronalised learning support – Students will  have support from their local facilitator and the course co-ordinator and will be able to meet and discuss with them both within the class or local groups and on an individual basis as required. This contact and discussion can take place face to face or online through Elluminate meetings, discussion forums, personal emails, cell phone text messaging or telephone or cell phone chats.

Collaborative learning – Students will meet together as a whole class and will be supported to develop connections and networks with each other through a variety of online resources such as skype, weblogs cell phone text and chat groups. They will also have a local group which will be 2 or more students in a particular location and will be encouraged to support each other through the learning journey. Some course work may be required to be completed in group activities which will involve them working with other students from different locations and networking with them  online or by cell phone.

Virtual learning environments– We will not be using virtual worlds initially but we are continuing to explore the possibilities for using a virtual environment for scenario based learning. Each aspect of the learning resources will be accompanied by formative assessments scattered throughout and some of these will include case studies, where the students are invited to consider situations, decisions and actions that they might make.

Flexible study– All aspects of the course will have a thorough online component, which will allow the students to study at their own pace in their own time and wherever they have internet access.

The first step in course construction

After considering our learners and different learning styles that need to be incorporated. We established our collaboration teams to work on course development. I have been working alongside a Christchurch colleague Lorna Davies .  We started by brainstorming  with everyone from the two schools what the content  would be. We then had to consider how this content might be divided up into the three trimesters (This course will be delivered in three trimesters rather than two semesters) of the year.  It seemed important that the skills the students would be learning should have some context around them rather than task specific skills. to do this it made sense to develop modules focused around antenatal, labour and birth and postnatal care. These are all in the context of normal uncomplicated birth at this stage of the students learning journey. Some basic skills that need to be covered do not easily fit within these aspects and so a fourth module was decided on which would focus on therapeutic interventions that may be required, either in the community or hospital setting. We then divided these modules Lorna is developing the antenatal and postnatal modules and I am developing the labour birth and therapeutic skills modules. Lorna and I decided very early in the process that we needed to have good communication between us and established weekly meetings on Elluminate where we can discuss progress and brainstorm issues as they arise.

Using EXE as a development platform and moodle for course delivery

Lorna was able to attend a conference where she learned about EXE for developing course content which can then be loaded onto moodle. We decided to give this a go and found it very easy to use, none the less getting to grips with these two new technologies has been a learning curve which is ongoing.

Developing the modules

It became evident that these modules would need to be broken down further into learning units otherwise they would be too large. This has largely been up to our own discretion but we discuss and share ideas in our weekly meetings. I decided that I would like to evaluate the material that I am developing with current students. I would also like to get some feedback from midwives in practice eventually. To this end we have established a separate development portal on our Moodle to allow current students access to modular components that have been developed. I will develop an evaluation tool to get some feedback from these students about the resources.


Gluc, E. (2006). Using Blended Learning to Accommodate Different Learning Styles. University of Hertfordshire. Online retrieved 17th October 2008 from:

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