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.
References;

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

For week three of the DFLP course we are asked to comment on a post from Leigh Blackall’s blog on the topic of flexible learning, providing supporting or counter arguments and supporting evidence. I have decided to comment on his posting Revisiting content is not king. Connectivity is priority KAREN . In this post Leigh suggests that, for learners, connecting with one another and establishing professional networks has primary importance over the delivery of course content. He suggests that a lot of content is ignored, and that learning occurs primarily through social interaction between course participants. Leigh goes on to present data which suggests that only 33% of New Zealand households have a broadband internet connection. Most people therefore do not have high speed internet access which may impact on their ability to connect through this medium.

Vgotsky theorised (thanks to Bronwyn for this link) that social interaction plays a fundamental role in cognitive development. He focussed on the connections between people and their socio-cultural context. When considering continuing professional development for health professionals, research has consistently found a preference for keeping up to date with current practice, through practice communities and professional networks. Communities of practice may be used for problem solving, sharing information, sharing resources, discussing developments as well as establishing where there is existing knowledge or gaps in knowledge and highlighting areas worthy of further investigation (Fahey & Monaghan, 2005; Gabbay & Le May, 2004; Lee, 2006; Tolson McAloon, Hotchkiss & Schofield, 2005; Wenger, 2006). I recently completed a course [Facilitating online learning communities ] where I explored the use of online tools to support the development of learning communities.

I agree that practice communities, and group interaction, play a large role in learning. I also believe that learning is life long. We need our students to learn the skills, and access resources, that will support their continuing learning and development after they have completed their course of study, and gained accreditation in their chosen profession. There is also a significant amount of course content that students need to access and interact with. In the traditional classroom setting this would be done through the delivery of lectures, in the new flexible model of course delivery, there is an opportunity to reconsider this, and look at other ways to guide students to this material and support their learning. George Siemens discusses the concept of curatorial teaching. He suggests that lecturers provide access to resources for students to peruse and learn from. Gilly Salmon developed a five stage model for e-moderation, which is an alternative to traditional teaching for the online environment. The e-moderator and the curator seem to share some aspects in common. Both encourage autonomy for the learner, while they also provide direction to resources that will support learning. Salmon’s model provides a framework for scaffolding learning, as students learn and develop more knowledge of their topic.

As the time is fast approaching when we will be delivering our midwifery course through a more flexible model, with much of the course delivered at a distance, these issues are taking on greater urgency for me. If community is an important component of learning, how can we support students, who are geographically distant from each other, to develop connections and a sense of community? I provide a rural midwifery locum service, and I am aware of the slow internet connections in places that I work. These locations and other similar locations, are where our students will be located. Kildea et al (2006) identified technical difficulties and communication problems amongst rural and remote rural midwives in Australia in relation to the provision of education resources. How can we overcome technical difficulties to support student communities and facilitate learning? I am not sure that these issues have been addressed. I am interested to see the KAREN project, which Leigh referred to, and which promises high speed internet access for universities and education institutions, but will this help midwifery students located in rural areas?

During the previous course I learned a great deal about web 2.0 and social networking tools. I am now familiar with tools such as RSS, blogs, wikis igoogle, del-ici-ous, YouTube, Flickr, Creative commons etc. These things have very quickly, over the last 6 months, become part of my life and make my online existence much easier and more satisfying. It has been a huge journey and has taken a lot of time to become reasonably comfortable and familiar with these tools. I am aware however that I am in a minority in the midwifery, and perhaps even the education, community. Just accessing email is enough for many. I do believe that it is of considerable importance that staff involved in flexible delivery are familiar and comfortable with the use of at least some of these tools, but I see no real commitment from individuals or programme managers to promote acquisition of these skills. When we embark on the flexible delivery of our midwifery course we will have enough to think about just getting to grips with the course without also having to gain new skills with web 2.0 tools. I have started a blog with a group of students I am working with this year. It is early yet but is not being used much at the moment.

How can we support the techno-challenged to become the techno-savy? Do we need to? Can a course of study be delivered in a flexible mode, with a proportion of distance learning and online components without familiarity with these tools? Only time will tell I think.

Image: Hip Hop Connected. Jayes fluid step1: From Scott Eric William’s photos at flickr.com

References

Gabbay, J., & Le-May, A. (2004). Evidence based guidelines or collectively constructed “mindlines”? Ethnographic study of knowledge management in primary care. British Medical Journal, 329, 1013-1017.

Gosling, A. S., Westbrook, J. L., & Spencer, R. (2004). Nurses use of online clinical evidence. Journal of Advanced Nursing,

Kildea, S., Barclay, L., & Brodie, P. (2006). Maternity care in the bush: using internet to provide educational resources to isolated practitioners [Electronic Version]. Rural and Remote Health. Retrieved 10th September 2006 fromhttp://rrh.deakin.edu.au.47(2), 201-211.

Lee, S. W.-Y. (2006). The interplay between self directed learning and social interactions: Collaborative knowledge building in online problem-based discussion. Paper presented at the 7th International conference on learning sciences. ICLS’06., Bloomington IN.

Tolson, D., McAloon, M., Hotchkiss, R., & Schofield, I. (2005). Progressing evidence-based practice: an effective nursing model? Journal of Advanced Nursing, 50(2), 124-133.

Wenger, E. (2006). Communities of practice, a brief introduction. Retrieved 29th December 2006, from http://www.ewenger.com/theory/index.htm