Embarking on a more creative pathway

I started this blog back in 2008 when I was involved in developing a course, to be delivered in a blended format of face to face teaching, small group tutorials, online content and online tutorials. It seemed like a huge task but it is one that was successfully achieved and has been tried and tested for a several years now. It has developed and grown and changes have been made over this time some of which I am yet to blog about. 

Blogging has been very sporadic for me over the last few years, time is the issue and also having ideas to explore and present on a blog is not always easy. 

The stimulus for this blog post is a MOOC I have enrolled in called Creativity, Innovation and Change, from PennState University. The course has several mechanisms for students to connect with each other and a group of New Zealanders, myself included, have joined a Google plus group to keep in touch and to share throughout the course. The course is 8 weeks long and I look forward to seeing where it goes. I have watched one or two of the course videos, which I have found quite generic. Clare Atkins, one of our NZ group participants posted a video, part serious part comedy by John Cleese, which did stimulate my thinking about the whole topic. Paula Lourie, another group member posted a video presentation she had been involved in developing on the topic of this course which also gave me food for thought.

I am not the best student and I am not very good a following the rules and doing what I am told. I suspect many of my students are the same. I tend to follow my own path and explore the things I find to be of interest. One of the first week course activities was to build a paper tower, which many course particpants seemed to embrace with some enthusiasm but it did nothing for me. I was not really that interested. 


Strangely though I have found that my brain is bursting with ideas of things to do, innovations to try and changes that I believe could improve the way my course and perhaps other practice skills courses are delivered to our students and the learning experiences students have. I don’t know if this has anything to do with the course or if it is just something that has just happened. I do know that I am an impulsive person by nature. I feel I have some good ideas burning away I just need to identify where it is that I put my energy and work out how to move things forward.


End of first year of new Bachelor of Midwifery Programme:Reflection on “intensives”.


The academic year finally ended yesterday for  first year students in our new undergraduate midwifery programme in the South Island of New Zealand. This is the first in a series of posts reflecting on the year. I wrote extensively in this blog about my development process for the first year practice skills course. It has been a very busy year one way and another, and I have been somewhat less diligent in blogging about progress during the actual first year of course delivery. Now that we have reached the end of first year it is timely to reflect on how the programme in general and the practice skills course in particular have gone.

We started the year a couple of weeks before other Polytechnic students began and have ended the year a couple of weeks later than other students. This is because we are now delivering the equivalent of a four year midwifery degree programme in three years (more about that later).  As a lecturer it has been challenging to be working with students from virtually the very start of the year right through until  my last day in Polytech. Anyone involved in undergraduate education will know that the start and end of the year are times of preparation and consolidation when a lot of administrative tasks are undertaken. Having to do these things while also continuing to be involved with preparation and assessment of students is a challenge. In this post I will overview the class “intensives” where the student all come together as a class at Otago Polytechnic in Dunedin. Our programme involves the students coming to Otago Polytechnic for classroom learning and assessment four times in the year. We call these blocks “Intensives”.

Intensive 1

Students arrived at the beginning of February. We all went off for a couple of days stay at Wairua Scout camp after a couple of days looking around campus and introduction to lecturers and courses . Staff from the sports school came along and ran some activities for us. We also did some work on communication as well as having fun and getting know each other. During the second week we started formal learning with face to face lectures and skills practice. In the practice skills course students learned about standard precautions and vital signs monitoring.

As the year progressed we have reflected on what we are doing. Everyone seemed to feel the camp was a good activity helping us all to get to know one another and particularly useful as we were then going to be working at a distance from each other. I felt there was a problem with the second week. Lectures are now all online as self learning packages and the idea is that students learn online first then come to class ready to focus on learning the practical skill. There was no time for this online learning to occur so we had to deliver some lectures around the topic before the students could start to practice the skills. This meant that there was not really enough time for the class to work together on the practice skills. As a result of this reflection in 2010 we will split the first two weeks of the course. Students next year will arrive for the first week of the intensive and will then have a couple of weeks to work with the online learning resources before completing the second week of face to face intensive course work.

Intensive 2

It was good for all to get together once again in intensive two. This was also a two week intensive and had been planned as we felt there would be things that required face to face  delivery to the whole class. While this is the case for some  courses items we discovered that there was less needing to be delivered face to face than we have previously thought would be necessary, as a result this intensive will be reduced  next year from two weeks to one week.

Intensive 3

As with intensive two there was actually less teaching that needed to be done in this intensive than we had thought would be required. Students began the course on Maori health during this intensive and students and staff spent a couple of days and one night on a local Marae learning about issues around health care and birth for Maori women and their families. Students commented on how relaxed this was and how good it was to have another activity where they had an opportunity to come together in this way, but this time knowing each other a little better. I have to admit that I was somewhat skeptical about these two overnight activities before we began the new programme but I do now admit that they are valuable additions to a distance based blended programme such as ours. I would recommend this to any other institutions considering adopting a similar approach to midwifery education.

Intensive 4

The first week of this intensive  is the time for assessment and of course nerves are high at this time. Our students had some traditional class exams to do. The first was a three hour bioscience examination. The next was an exam loosely based on an “OSCE” type practice skills exam. Here student are randomly allocated one of 5 scenarios that they are already aware of and have had the opportunity to practice. Within these scenarios are two practice skills that the students have learned during the year. Women from our local community role play for these scenarios and a lecturer marks the students practical skill ability while the women are able to comment on students communication skills. Finally the students sit a one hour mathematics examination on professional calculations including drug calculations and infusion rates. We had intended to bring all students to Dunedin for all of these examinations but, in response to students feedback, we arranged supervised examinations for Bioscience and Procal in the students own area, with their practice facilitator invigilating, and they were only required to travel to Dunedin for the OSCE.

The final week of the year for students is the second week of this intensive. It is taken up with Midwifery Integration. This is a short course which is completed in both first and second year of the midwifery programme. Students are given a scenario and are  randomly allocated to groups. They have to explore the scenario with consderation of all the different aspects they have been learning about, in all their courses, over the year. At the end of the week they give a presentation to the class and lecturers about their scenario. This is an opportunity for students to integrate learning and consider a practice scenario from a variety of professional perspectives. This is a course we have run over the past five or so years at Otago Polytechnic. We usually run it over two weeks, one in the middle of the year and the other towards the end of the year. This year we dropped the first week as it has always been a challenge to find things the students can explore at this early time. The work the students did in this final week was extremely good. The presentation were generally excellent and the scenarios were well explored. As a lecturer it was very satisfying to see how the students were able to work with these scenarios and suggested that our new programme is working well and students are learning. Some of the work was well in advance of what we would generally expect in first year.This was a good way to complete the year and a nice way to say goodbye to the students.

Final reflection on the intensives

The intensives will always be an important part of this blended programme of midwifery education. It is interesting however that we did not need as much time for these as we had thought we would. In part this is probably because of the weekly tutorial groups which students attend and support a great deal of their practical learning . In my next post I will reflect on these tutorial groups. Students are aware before they enrol that these intensives are a key part of the programme and that they will be required to travel to Dunedin for them. This did not stop some students from complaining about the cost of travelling to Dunedin, of course, understandably, money is always an issue for students. As a result we did do more in the local areas with students than we had thought we might. Student also made connections with Dunedin based students and all our distance students were able to find billets during their stay in Dunedin which would reduce the cost to them.

Assessment in the new midwifery programme

I have started the final course in the GCTLT at Otago Polytechnic. Here I am starting to reflect on the assessment process.

3353295436_0916afc680Image:  X class examinations from Bindass Madhavi’s phtos n flickr.com

In midwifery it seems  to me that much of what students learn is assessment driven, this is common amongst health professional education (Wass, Vlueten, Shatzer & Jones, 2001). The reality of student learning is that students feel pressured from their workload and gear their learning to meet the criteria of course assessments. Wass et al, stress the importance of ensuring that assessment of students is aligned with the competencies expected of them in clinical practice. They suggest there is no one way to assess clinical competence for medical student, the assessment process will comprise a variety of assessment styles which provide the students with a variety of ways to demonstrate their understanding. Factual written tests can demonstrate what the student’s background knowledge, written tests with a clinical focus can demonstrate that the student knows how to approach clinical issues, OSCE (objective structured clinical examination) allows the student to show the skills that they have developed and performance assessment (through practice supervision, video of skills in clinical practice or reflective logs can demonstrate that the student can act appropriately in the practice setting.  Osce’s have been found to be a useful tool for supporting learning and identifying competence in the nursing professions (Mason,  Fletcher, McCormick, Perrin &Rigby, 2005; ) however, although they have been found to be beneficial they need to be part of a broad picture of assessment of students competence (Rushforth, 2007).

In the school of midwifery we are always trying to look critically at what we assess and how many assessments we require students to do. In the new curriculum much of the online material is accompanied by formative assessments, quizzes and such like, which are not marked but will guide the students through key points of the learning resources they are accessing. A few students complete these and value this process however the majority seem to ignore them and only concentrate on assessments that are marked or are at least looked at and acknowledged by the teaching staff. This suggests to me that we need to consider carefully what we assess, how we do it and how this will support students learning.


Mason, S.,  Fletcher, A., McCormick, S., Perrin J. &Rigby, A. (2005). Developing assessment of emergency nurse practitioner competence – a pilot study. Journal of advanced nursing. 50 (4), 425-432

Rushforth, H. E. (2007). Objective structured clinical examination (OSCE): Review of literature and implications for nursing education. Nurse Education Today. 27 (5), 481-490.

Wass, V. Van der Vlueten, C. Shatzer, J.  & Jones, R. (2001). Assessment of clinical competence. The Lancet, 357,  945-948

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

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

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.

E Learning for midwives

In my roll as a midwife in a rural facility I have been enrolled in a course which is completely online. This is the first practical midwifery course I will have done in this way. It is about breast feeding and human lactation and is an international course for lactation cunsultants. I have bogged more about this in my midwifery blog. I am interested in this not only for the course content which will be useful for my midwifery practice, I hope, but also to see how the course is constructed. It has been deveoped using the moodle platform.

Another option for my plan

I think I agree with Sarah that trying to design a whole course is perhaps a bit ambitious just at the moment, given everything else that is happening. As I have alluded to many times previously the midwifery school are developing a new joint curiculum and midwifery undergraduate program in collaboration with Christchurch Polytechnic. We had a meeting last week and discussed how the first year clinical paper might look. We spoke about what aspects we felt need to be face to face and what might be able to be taught in the students local area with support from her local midwife teacher and online resources. There are several aspects of the course that will need to be developed to be delivered in a blended fashion, with some face to face components, some online and some practical support in the students local area.

For the Design for Flexible Learning Practice I would like to look at one of these, bearing in mind that others will also be being developed alongside this,  the process I use and design I arrive at will both influence this parallel process and will be influenced by it.

Currently I am considering developing  a plan for flexible learning of medication administration. I hope that others will comment and feedback now whether they feel this is a reasonable and realistic thing to do. Is there something else that would be more useful? Should I be looking at the overall plan rather than breaking it down into this small component? You can either comment below or email me at my polytech address or to cardacs@gmail.com if you feel reluctant to comment on a blog.

I am aware that I need to start working on this very soon and will have to make a decision. Thank you for your support.

Image: Medicine, from Toei’s photos on Flickr.com

Flexibility, bending over backwards to be accessible

When considering issues of flexibility in learning we have been considering the different ways in which courses we teach can be flexible. Some types of flexibility might be:

Fexibility of time [start and end dates of courses]

Flexibility of place [where the course is delivered]

Flexibility style [incorporating a variety of learning styles]

Flexibility and adaptability [to meet changing needs of learners and industry]

A good demonstration of flexibility in learning has been this course, Design for flexible learning practice. Through this course I have been exploring the topic of flexibility in education and have not always followed the format set out in the course structure. Non the less I believe I am fulfilling the basic requirements of the course. As i explore this topic and find things which interest me I have considered these and blogged about them. I am definitely learning as i explore and expanding my thinking on teaching and learning as I go. I hope that this might also be of some use to others but principally it is for my own growth. Although it is always good to know that others find some aspects of my writing of interest this is not my primary goal.

Ultimately I have to come up with a plan for a flexible learning opportunity in my context as the assessment in this course. Flexibility is something that I feel we are very familiar with in the School of Midwifery at Otago Polytechnic. We cannot be flexible with start and end dates, as we are constrained by the requirement for students to complete the program within 4 years, however since I started work there, five of six years ago, there have been quite dramatic changes in the way that the whole program is delivered. Next year our program is to change again as we start to deliver the program predominantly at a distance, with three two week blocks of face to face attendance during the year. This will allow students who could not have considered undertaking this course of study to do so. Much of our content will be delivered online using a variety of resources. Most of this will be delivered through a learning management system, probably moodle. Although our material and course work will be online it will only be available to those who have enrolled and paid for the course. This seems to be a logical choice, after all we do not allow just anyone to sit in on our classes and course work at present. However it is a great pity that the time and energy for developing the resources that we will be using will not be utilised to their fullest by reaching the widest possible audience. I accept that to put this material openly on the internet is a very large step that many of us feel uncomfortable with. We cannot know how or whom might find our material useful and valuable and how they might adapt it to meet their own needs. Is this a bad thing? I wonder if we will use resources that have been developed by others in our new course. It would make sense to do so as there is a lot of material out there which has been developed by other Universities and is freely available, why reinvent the wheel. For example the University of California have several courses freely available online. One of these is this Biology course. This contains material which is relevant to our students to which they could be directed. There will be components of our new course which will be suitable and useful to others also, to keep it all within a learning management system such as Moodle means that it will not be available to others. Perhaps we can consider having some components available through the world wide web.

I teach in a paper which has been developed principally to support midwives who were educated outside of New Zealand to gain skills and knowledge of prescribing for midwifery practice, per the New Zealand legislation. I would like to work towards developing this as course along a similar line to the DFLP course to be freely available on the world wide web. I have already prepared an argument for why this should be so and Sarah Stewart prepared a proposal for this and other courses within the school of Midwifery to be available openly on the world wide web. I would like to now take this a stage further and start to develop a plan for how this might be able to happen. I am aware that this might take a significant amount of my time and energy and I am away on leave from the 23rd May until the 10th July. As well as this I have to be working towards the new first year clinical papers, am I being too ambitious?

Image: Bending over backwards. From Tennessee wanderers photos, on Flickr.com

Wk 6: Open source: Threat or enhancement for formal education

This week we have been asked to explore whether open access presents a threat or enhances formal education. I have looked at one open access course which I think is a good example of the possibilities for this type of  learning resource. In this post I discuss this and some of the arguments for and against this type of learning. I also discuss recognition of prior learning and how it might be related her. finally I consider my plan for designing a flexible learning resource.

Example of open access

I just had a look at the Harvard Law School course CyberOne: Law in the court of public opinion I am very impressed with this it seems to use a variety of online media and is well organised and reasonably clear to use. Looking at this makes me feel excited at the opportunities this presents for anyone, anywhere to engage with the course and expand their knowledge and skill. There is also an opportunity to meet with others from anywhere in the world and to share, collaborate, communicate and learn. Not only can this course be taken by students within the environs of Harvard, it can also be taken by students at a distance from anywhere in the world. The course content is also available for anyone, anywhere to access at anytime and engage with in what ever way they wish.

Arguments against

I wonder does this pose a threat to Harvard Law school? In what way might that threat be posed?

  1. By losing control of the material when it is out in the public domain is there a risk that the public might misuse this, bringing the name of the institution into disripute?
  2. By giving this material away does it make the material somehow less valuable or less desirable as academic attainment for those who pay to participate?
  3. If the material is given away for free why would people want to enrol and pay for this course?
  4. Can the institution afford to ‘give away’ its skill and expertise ? After all this is all that educational institutions have to sell to generate an income.

These are arguments that seem to have some validity and are arguments I have heard expressed against the idea of open access to educational resources.

Arguments for

I will address these points as I see them

  1. This is not a new thing. Since Caxton invented the printing press knowledge has been available through printed media for around 600 years. There has been a gradual process of making printed material more and more accessible. The current evolution of ease of searchability and accessibility has opened up access to many more people in recent years however the information has always been there for those who chose to find it and use it.
  2. By expanding the accessibility of a course and opening it up to a wider audience you are also opening up the learning opportunities not only for those who are getting this for free but also for those who are paying a fee. Education is moving away from the didactic approach of knowledge transfer from expert to novice and embracing an approach of learner centered learning, where learning communities explore and investigate topics of interest and expand and create new knowledge through this exploration.
  3. I can see that what is accessed for free is actually not the same as being enrolled and working through the course with lecturer and institutional support. Doing this course for free online might give me a feeling of personal satisfaction and personal growth but I will not have any evidence of the learning that I have done. To gain this recognition I would need to enrol.
  4. Although the institutuion appears very generous in giving this course to the wider community it does raise the profile of the institution. Of course I have heard of Harvard, but now I can actually see what happens there to some degree. I could even aspire to enrol in a course from there, which I never could have before, and gain a Harvard qualification. I will not be alone in thinking this I am sure. So by giving away something for free, the institution is also actually opening itself up to a whole new market.

I believe this open access course provides a good example of the possibilities for open access. The benefits to individuals and to the institution are clear to me and i am sure I am not alone. John Seely Brown clearly outlines these benefits. I think the arguments above would also be relevant to any open access course that we might be considering for our Midwifery School at Otago Polytechnic.

Recognition of prior learning

If I do engage with a course such as this online and then later decide to enrol in the course in order to get the qualification do I need to repeat all the learning that I have already done. This week in DFLP we had Willy Campbell from the CAPL talk to us about assessment for prior learning and recognition of prior learning. I was nnot able to attend but was able to listen to a recording of the session through Elluminate. Willy explained this process very clearly and the discussion that followed was very useful. Willy explained that learning can be formal through courses completed or partially completed, non formal through group work and workshops etc and informal through on the job learning. CAPL have processes through which they can assess all of these against recognised course outcomes and can help individuals to prepare a portfolio which they can then present for recognition of the qualification. There was an interesting discussion about performing an assessment, or getting students to self assess themselves at the start of a course. This would identify the students existing knowledge and would enable them to tailor the course to suit themselves. There was some concern expressed about taking those with some knowledge out of the group as this can be an important part of the learning for others and is also valuable for the more knowledgeable members of the group also. This avenue of RPL is a way for work which has already been completed to be recognised and rewarded.

My plan

I need to now be planning what I will work on developing for my presentation at the end of this course. I have been thinking perhaps about the digital literacy project. I am wondering if I could work on something that could be intertwined within courses in the midwifery program rather than as a separate entity. I have also been very interested in developing an Open Access midwifery resource online. I have already prepared a wiki which I have done a little work on and I may look at developing this further. I may change my mind very soon however as next week we have our first collaborative meeting with CPIT to get to grips with the new program delivery. something might transpire out of that to which I need to give my attention


In this post I have discussed open source learning and given and example with some discussion about the for’s and against’s in to this. I feel there is a clear argument for this type of resource. I have explained how recognition of prior learning might have a place in this process. Finally a brief discussion about possibilities for my final presentation in this course.

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

Techno-savy or Techno-challenged

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


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


Developing a flexible learning plan for first year midwifery students

In the school of midwifery at Otago Polytechnic we are heading into a new world of midwifery education. We have a shortage of midwives in the workforce and this is set to worsen as many of our workforce head towards retirement. Currently our midwifery students are required to leave their homes and come to one of the main centres to complete their midwifery education. Families have to be uprooted and leave home. Women have expressed interest in a program of study which allows them to remain in their own area for the bulk of the course. This has required a major reconsideration of how we could accommodate these needs and provide a course that is accessible to more women. There have also been some changes to midwifery education requirements by the Midwifery Council of New Zealand which need to be accommodated into our three year degree program. Over the last two or three years we have been getting to grips with this and have entered into a partnership with the Christchurch School of Midwifery. From next year we will have one South Island School of Midwifery operating out of the two centres. We have a new curriculum which has been developed over the last year, is nearing completion and is in the approval processes.

Time for studyThe new program is to begin next year with the first year being offered in a flexible mode with distance and some face to face. I teach the first year clinical skills course and my job is to now identify how the course that we teach can be delivered flexibly in a mix of distance and face to face study next year. I am to do this while also continuing to teach in the current program and meet my other responsibilities within the school of midwifery. I am feeling that I need to develop some supernatural powers in order to achieve this. I am hoping that others in this course may be able to help me and offer support, encouragement and perhaps suggestions as I travel along this path. I am excited as I do believe that the new program is an exciting innovation. I am anxious about the time it will take and all the other commitments I have.