Wednesday, September 26, 2007

Bloggers teachers and learners

I am very new to blogging. Just learning the skill and starting to see the possibilities. I am enjoying using a blog as a personal and professional reflective tool while having that visible for others to share, to stimulate their own reflection. When they too share it creates a spiral of learning and growing. I do not believe learning is ever a two dimensional process, i.e. material delivered = learning occurs. Learners make connections with past experiences growing their understanding, raising questions to which they seek answers, and so the cycle continues. The experiences to which they can relate their learning are not limited to the subject in which they are involved at the particular point in time. Thought processes can make varied links and connections all of which add to the ability to learn and grow. I am thinking about blogging and how this can be used a reflecting and learning tool for our students. How much of ourselves should we share in our own blogs and what form should they take. I have been stimulated to consider this by these blogs from Konrad Glogowski and Sarah Stewart.

As teachers I think we should keep a focus on what our students need to learn. We need to create a climate of learning which will engage students and stimulate the possibilities for sharing and reflection. Dewey (the educational theorist and philosopher who died the year I was born) believed that education must engage with and enlarge experience. Dewey also identified the importance of reflection and thinking on how we learn and was concerned with education creating an environment in which this could happen. I think Dewey would be enraptured by the possibilities of this new medium to stimulate and support learning.

Newman, Michael (2006) 'Throwing out the balance with the bathwater', the encyclopaedia of informal education, . Last updated: September 21, 2007.Suggests that "In the objective world we act as subjects to objects, in the social world as subjects to other subjects, and in the subjective world as subjects to ourselves, and so we engage and make meaning through physical action, through our interaction with others, and through self-reflection". When we blog we are creating another sphere where we are blending the subjective and the social in ways that were previously only possible in small philosophical intelluctual groups. Newman suggests that "Our purpose in working in adult education at any of the levels, meta or otherwise, is to help people quell their angst and so liberate them from their own inactivity. It is to help them identify and understand their unrequited yearning, and to help them act in order to satisfy that yearning. It is to help them give an object, an objective, to their desire." As teachers then I think we should embrace this new environment for sharing and learning. We can stimulate deeper thinking and point out connections that students might not otherwise see which can lead to that Ah Ha! insightful moment. The spark that brings the subject to life.

In my relatively short career in teaching I have often felt that if only the few students who really get it, who have that insight could share in a meaningful way with their fellow students how valuable that would be. This value is not only to those who could be inspired by this insight and perhaps help to attain this for themselves, but helps the entire group to learn, grow adapt and change.

Now I am getting on a role and could probably go on and on but I think I will stop here. I have more thoughts floating around in my brain but I am really interested to know what others think? Please, if you do drop by, leave me a word or two to let me know your thoughts.

Monday, September 24, 2007

Video conference

I have just participated in a video conference. The first such meeting I have attended. I thought it might be appropriate to blog my thoughts.

There were 6 groups participating in the video conference. I was the only one on my own. Three others centers had two in the room. The main center had a group of four participating and one other center had four participants.

Positive aspects of this meeting

*It was a good opportunity to get people together without having to travel too far
*It is nice to be able to see each other as well as to speak
*There was the ability for the main center to present a slide show on full screen and to talk over this to present it (I do not know if participants in other areas would have been able to also do this or not).
*Connection was acheived through a television with the aid of a remote control.
*Particpants who are not at all happy about using computers or technology found this easy to use and enjoyed participating, saying that they would happily do more of this and use it for different educational and meeting purposes.
*For most it was very simple to get going and use this without it having to be a big learning curve

Negative aspects
*I am challenged by televisions and remote controls.
(I know this is ludicrous as I am quite happy finding my way around a computer and enjoy learning about all these new technologies.)
*Perhaps I did not have adequate instruction but it took me ages to work out when I was able to speak and when I was muted.
*I could quite often hear background noise which I found distracting.
*I found the conversation quite stilted and difficult to get a good flow going.
*Access is limited to the places that have this network available. I believe that Otago has access in the main rural centers and one in Dunedin.

Overall it was a good way to get together and it is interesting that those who abhor anything to do with computers and technology did not have similar feelings about this, expressing support and enjoyment of the process. This being the case perhaps this is a good way to get rural and isolated people together. However it does not provide an opportunity for establishing ongoing communication and is limited to access at certain times in certain locations. Whereas communicating online is more spontaneous and for most can occur anytime from wherever they can access a computer, for most this would be their own home or workplace. It would be very difficult to have a meeting with more centers than were present in this meeting. The screens would not be big enough to see people and it would be too confusing about when people could speak or not speak. Using online group networks such as Elluminate it is possible to have quite a large group participating and to share documents and resources as you go. I feel that participation and interaction is generally more limited in the video conference medium.

Additional thoughts.

Using this is useful for people who cannot use computers. However if they rely on this instead of learning how to use web based communication and networking tools they are cutting themselves off from a huge source of valuable information sharing and networking tools which could benefit them in so many ways. In many ways I feel a bit sorry that we are going down this track instead of encouraging midwives to get up to speed with the internet and web based communication, which i believe has a lot more to offer.

Sunday, September 23, 2007

Suturing videos

The following videos will help you with your suturing practice. Start with the bottom video of Scott and pal and work your way up.

All the best with this. Enjoy your practicing and impress your family and friends with your skills. Get ready to come back next year and start learning the next stage of suturing skills.

Feel free to leave a comment about these videos and how useful you find them. Your comments might help your class mates to decide which ones they want to view.

Holding instrument and knot tying

Nice demo of holding instruments and knot tying. We did not watch this one in class but it looks quite good and covers some aspects not covered int he other videos below.

Surgical knot tying with instruments

Scott and pal show you how to tie surgical knots with instruments

One hnded surgical knot tie

Embedding is not allowed on this video. So follow this link to see Scott demonstrate a one handed tie, right hand predominant.

Scott and friend help you with suturing

In this video Scott and his pal introduce you to suturing.

thinking about students blogging

I have been thinking about the potential for students blogging since I found the previous mentioned resource, 21 Classes cooperative learning, where it would be possible for students to have their own blogs within a closed group. I have been thinking about how these could be used within the Bachelor of Midwifery program and possibly also for groups of health professionals who wish to be able to communicate in a secure environment.
I wonder if these blogs could be assessed in some way as part of the students course requirements. I wonder if the SOLO taxonomy could be used to assess how the students are using blogs as a tool for personal learning and reflection. I can see how this might be a useful way to look at how students make connections between clinical experience and research evidence and use this to inform their learning and future practice. I would be interested if anyone else has any thoughts about this.

Friday, September 21, 2007

Education bloggs

Just found a site where educators can setup an account, for $8.95/ month for a group of students. Up to 100 students and can create closed groups within this. Sounds like exactly what I have been looking for.

delicious tags and clouds

Well I have managed to create a tag cloud so will try to explain here how I have done this.
a) A delicious account is created and items on the web are saved to it through the tag option toolbar button which comes with delicious. This first part should be easily worked out when you download delicious from the web.

b) When items are added to delicious you are given an option of creating your own tags for these item. That is create key words which mean something to you for the items you are saving. It is best to try to match these tags with other similar items, like a filing system.

c) when you open delicious you will see a setting option on the top right side, next to your user name. Open settings

d)You now have a variety of options (I do not know what they all are). Third column along is tags. I chose to bundle tags. ( I do not know if you have to do this prior to creating a cloud. I think this is a separate option). If you click on this you can now select major file names for your tags. Once you select a category name you can click on your tag names that appear there and they will file into that bundle name. You then click save and those tags are grouped in the particular category, I chose Midwifery, Research and E-learning for mine, but I might change these.

e)In the fifth and final column along you will see an option, third down for tag rolls. Click on that and it will bring up a tag cloud. you can now change the size of the font etc by using the slide gauges.

f)Select the 'embed link' and copy this.

g) open your blog and go to customize. Select add a page element and choose html/java script and hit add to blog.

h) paste the embedded link in the window, choose your title and you are done.

Hope this helps those who are trying to do this.

Thursday, September 20, 2007

Working on wiki

I have not done much blogging lately because I have been doing heaps of work on the midwifery wikieducator page. I do feel that I am probably wasting my time here, other than meeting course requirements, as I feel it is very unlikely that any of this will end up in the midwifery program. However I am starting to get a bit more of a feel for this and I am beginning to develop a bit of skill in putting it together. I am still struggling with trying to get images into these pages however and have not been successful in doing this yet. It can end up looking very "wordy" so I am breaking it up into different pages. If anyone has the energy to go and look at this resource and wants to give me any feedback that would be great.

Wednesday, September 19, 2007

Group B strep slide share

Here is that exciting group B strep slide show I put on slide share. Leigh and Sarah tell me I have to add audio now. That will have to wait for a wee while I think.

Google docs

I just discovered another neat online tool to make document sharing easier. Nancy White had posted a commoncraft youtube introductory video to Google docs on her blog. this is very timely for me, as Sarah Stewart and I are collaborating on a workshop we are hoping to present at the Rural GP network conference next year. The abstract is on but we will need to collaborate also on the preparation of the workshops, which will probably involve some powerpoint slides. It seems that we can share these sorts of documents through google docs only to the people with whom we wish to share them. I can see this will be very useful for working on this project and could also have application in online delivery of material to students which they could respond to and alter, but only those invited would be able to see and alter the documents.

Playing with open access on the www

I am feeling just a wee bit chuffed at the moment. i have just created a slide share account and have loaded my Group B Streptococcus presentation onto it. so this is now available on the world wide web. How is that? Hope you are all impressed.

Tuesday, September 18, 2007

I found the following quote from Best practice in online teaching

It is always important to remember that in the online environment, we present ourselves in text. Because it is a flat medium, we need to make an extra effort to humanize the environment. In the face-to-face classroom, students have the opportunity to get to know one another as people--before or after class, during classroom discussions, and in other campus locations such as the student lounge. In the online environment, we need to create these opportunities more purposefully" (Palloff & Pratt, 2001, p. 32).

Palloff, R.M., & Pratt, K. (2001). Lessons from the cyberspace classroom: The realities of online teaching. San Francisco: Jossey-Bass.

This clarifies our use of skype as an out of classroom communication tool for us as students in this course and the potential for this type of tool for students in the future. There are some sound files at this site that I am going to try to find time to have a listen to.

Sunday, September 16, 2007

International networking

I am absolutely amazed at this blogging thing and where it can lead to. I blogged in my post "now I hate to moan" about my experience on Elluminate. over the weekend I have been in correspondence with someone located in Alberta, Canada, who is in charge of elluminate customer services. I do not know if she was directed to my post by our esteemed leaders, [aka Bronwyn Leigh and Terry], or whether she stumbled upon my problem. Anyway we have set up a support session with me and some technical advisers from elluminate to work on my problem. How is that for service?

Thursday, September 13, 2007

Thoughts on wikis

I missed some important aspect of last nights class session. (As blogged earlier) however (as I am wont to do) my thoughts were hanging around this topic over night.I only teach in the undergraduate clinical papers and so my thoughts are related to this aspect of the course. Of course there are other uses for other theoretical aspects of the course.

I believe that developing online communication networks has enormous potential for midwives. As a scattered, and often quite isolated population, it provides opportunities to engage in one or many communities of practice . This is something that will certainly be of benefit to our students in the future and can be really beneficial to them in their third year of study. In this year they can be all over the country, sometimes overseas. It could provide the opportunity for them to come together as a class during this year and share experiences. They could also highlight how they feel they are growing as midwives and this could help to support members of the class who may have less confidence.

I believe that the needs of our students and the online learning environment they will require changes as they move through the course.

In year one I think this will be a tool to point students to useful information. To encourage the establishment of a supportive peer group. Tutorial groups could be held in a virtual environment and be facilitated by a lecturer but the lecturer would be able to sit quietly in the background and only interject if necessary. In a face to face group this can be very hard to do and should be much easier online. However in our Elluminate sessions I note that we do not necessarily join in and it is up to Bronwyn to try to stimulate us to do so. So perhaps my thoughts about the online environment are pretty unrealistic. As the midwifery course is being taught in seminar blocks we would have the opportunity for more regular contact with tutorial groups than is possible at present. It would also allow members of the group to come together while the group are on clinical avoiding long gaps in contact with each other. It also would allow the lecturer to have a better finger on the pulse of what is happening for students. I believe Elluminate would be a good tool for these sessions. I am confident the problems we are currently experiencing with Elluminate will be sorted out.

Students will be able to share what they are finding out with each other and with lecturers. This will allow lecturers to encourage critical evaluation of resources the students are identifying.

Clearly any open source network needs to have some clear ground rules for students so that they do not divulge confidential material. However students do need to have the opportunity to debrief in a secure environment . As far as open source learning material is concerned I think Otago Polytechnic has some decisions to make about whether this is where it wants to go i can think of several learning resources for midwives that could easily be adapted to an open source environment. I think if this material is out on the web midwives could access it from anywhere. They could work on it in their own time and then enroll to complete the assessment and gain the qualification. Concern about this seems to be principally,

a) What is to stop the material being altered and midwives accessing this not knowing whether this is the original material or something which has been altered by others.

b) Other institutions might use the material and create their own assessments from it granting qualifications from it. This would then lose revenue for the Polytech. I wonder if this would really matter if there is a much wider national and international audience would we not be guaranteed more participants in the course anyway. At least some of these must want the original qualification surely.

I need to get to my wiki now and start work. It seems to me that we are being asked to create wikis much as we did blogs and to comment on each others thoughts as we are being encouraged to comment on each others blogs. Or am I way off the track again. Who knows maybe someone will let me know!

Now I hate to moan

Some reflections on my experiences of Elluminate this week. I was looking forward to my first 'live' lecture through Elluminate as I have really enjoyed the recorded lectures.

On Monday I rushed home from Polytech. I live about one hours drive away and was just home in time to get my laptop turned on and connected up. My husband was here and was preparing a lovely tea. Then I could not get into Elluminate. Started having a Skype conversation with Sarah who was having the same problem. For the next 1 1/2hrs I ate mouthfuls of food while we Skyped, waited patiently, tried to get into a Skypecast (without success) and finally gave up. The lecture and meeting were changed to Thursday.

On Thursday I bought fish and chips and got home a little earlier so was able to enjoy my meal before the drama began. Same thing again, could not get onto Elluminate. Started Skyping with Sarah; discovered that it is possible to have a reasonably synchronous communication through the online forum as we found several other group members also waiting with some frustration to get live on Elluminate. A few of us gathered on Sarah's Skype chat and had a wee discussion about Wikis and our feelings that we really did not know what we were doing with them. We agreed we were too nervous to make changes to the main page and were lacking direction in our own wiki pages. Finally the Elluminate problems were fixed and we got on. Hurray! The scheduled speaker however had deserted us. Not really surprising. None the less we entered into our discussion initially facilitated by Merolee, as Bronwyn searched cyberspace for our missing speaker.

Once we got on I found that every now and again I would get disconnected and have to reconnect again. Initially I thought this was because my husband was using the other computer online but when he stopped this continued to happen. The result of this was that I missed the important parts of the discussion, just catching bits here and there. Merolee mentioned I google and I asked what this was, then I was disconnected and came back on as Sarah was saying she would catch up with Merolee about this. We started talking about Wikis and then I was disconnected, came back on to hear Sarah comment that clearly we (Sarah and I) have the wrong idea of what we are doing. However I missed the bit about what we should actually be doing except for little bits here and there.

If we are using online teaching and learning tools this is the sort of thing that will happen for our students. They will want answers to why this happens and it might be impossible to provide answers. I am reasonably computer savvy but I was very frustrated. The importance of recording sessions was brought home to me as it provides the opportunity for those who were unable to participate to still find out what was said. However this changes the nature of the discussion. If it is to be saved and be available in another forum are the speakers 'safe' in the comments they make. Are the speakers able to respond spontaneously or will the conversation be more guarded. This is particularly an issue for healthcare students who may be wanting to discuss clinical topics which may be sensitive information.

I did learn some important things from this session however.
1. I found the instant messaging on the forum to be quite useful
2. It was great getting together with one or two others on Skype. It kind of felt like students meeting together and having a chat outside the classroom. I would love to do more of this. I think it is probably an important part of reflection for students. Could this be something we could encourage students to do or are there dangers here too.
3. I started reflecting more on wikis and although I missed a lot of the discussion i think I have an improved understanding. I will blog this separately.

Overall this has not been a waste of time. It increases my understanding of the realities of the online learning environment which our students will experience.

Monday, September 10, 2007


I have just started a Midwifery wiki at wikieducator. and have managed to create links to my blog and my wikispace. this feels like a pretty huge achievement although it actually doesn't really achieve a whole lot at this point.

Getting organised on Google reader

I am using Google reader as an RSS feeder. This means that any online sites that are of interest to me are listed on the one page and I can immediately see if there are any new items which have been published. Although I rapidly decided this was a very good thing I have been having some problems with managing this resource. I needed to load all the blogs form the online learning course I am participating in onto Google reader but could not work out how to do this and keep this manageable on one page. I just discovered I can add folders to Google reader and so I can have all of these blogs in one folder. I don't know why it has taken me a whole week to work this one out, I am getting there but very slowly I think. I am about to try to work out wiki educator and will try to spend some time on this today. I have already created a wikispaces site for rural midwifery and I am wondering if I coudl adapt that into wiki educato.

Saturday, September 8, 2007

Caeserean section rates

A few days ago I was privileged to attend a lecture at Dunedin Public Hospital presented by Mike Robson, Master of the National Maternity Hospital in Dublin, Ireland. Most health professionals involved in maternity care have thoughts about the rate of caesarean section delivery. We often argue and debate what is the right rate. The obstetric argument is often that caesarean's are not done unnecessarily and therefore the rate must be right, whatever it is. Mike suggested that we should be concerned with what the consequences are of our high rate of operative delivery. He presented the list of complications that can arise from caesarean section(a long list) the list of things which are unchanged by having a caesarean section (much smaller) and the things which are improved by having a caesarean section (only three things). These lists are available on page 19 of the Caesarean section guideline from NICE UK web site . A message for all of us is that, in order to understand what the effects are of treatments that we offer, we need to keep reliable and consistent statistics. High numbers of babies being born by caeserean section is a relatively new phenomenon and we cannot know what impact this will have in the future.
A major concern, from his statistics, was that most women 'requesting' caesarean section are women who have birthed before. We clearly need to do better with supporting women having their first babies. I wonder if these statistics can be broken down at all, to show us if there is any particular thing that contributes to these women requesting caesarean. For example do women who have planned a homebirth fall into this category more or less often? Do women who have planned waterbirth? Do women who have had an epidural? Whatever the case, this is something that lies firmly in the hands of midwives. We need to take responsibility for this statistic and we can do something to improve it.

Friday, September 7, 2007

Thursday, September 6, 2007

This is a short video of sterile gloving technique which I have posted on youtube. If you like it you could go the the link and rate it.It should be useful for any beginning health professionals who need to use this skill.

Reflections on Nancy White and Sheryl Nussbaum-Beach's lectures

I listened last evening to Nancy White's 10 minute lecture on elluminate and things feel like they are really coming together for me. I am really pleased to be involved in 'online learning communities'. I think it is time to go back to my thesis and see how all of this is linking in together.

My study found that midwives love to learn by getting together (communities of practice). For those who were lucky enough to have local accessible groups they were involved with, this was reasonably easy and was satisfying for them. For those who were more isolated there were few opportunities to physically get together with other midwives and also very limited access to other health professionals. The more isolated midwives were mostly stronger users of online sources for information however they still stated a preference for face to face networking. These midwives wanted the ability to get together and chat with other rural midwives to share stories and experiences and find out how other midwives deal with issues for practice or the management of the rural midwifery service.

Another comment that was made by one of the midwife participants related to Nancy White’s ‘looking over the shoulder’. She said that it was difficult in rural practice to introduce new concepts or skills into practice as there was no-one to role model it for them. She found that she would hear about new innovations at workshops or study days but would not necessarily have the confidence to go back and put it into practice because she did not have the opportunity to look over someone’s shoulder and see it used in practice.

Pulling some of the thoughts I am having together. If individuals with a shared experience come together in a trusting and sharing relationship, as described by Sheryl, they have the opportunity to pool knowledge and experience. This provides an opportunity to identify common themes that might be emerging in practice. As Nancy said, “Together we have so much more potential”. I think this potential is to generate new ways of looking at things and perhaps start the beginning of a research process that can provide evidence of what works and what does not work in practice for the group. It also provides the opportunity to look over the shoulder of others and perhaps build confidence in trying new things.This is in addition to the benefit of the supportive relationships that can be built through networking.

The challenge is how to provide the opportunity for rural midwives (or any isolated group) to do this. Perhaps if our midwifery students are happily using these types of networking tools when they go out into the rural areas it will stimulate interest with rural midwives. Perhaps the NZCOM journal article which my colleague Sarah Stewart has written will be a start and provide a opportunity here. There is definitely room for more thinking and reflection on this.

Tuesday, September 4, 2007

Pharmac Study day.

Normal or Not: Neonate in the first six weeks.

Thanks to Pharmac and to Marion hunter for a well organised day with very interesting speakers.
Sharon Gardiner research fellow from the Christchurch School of Medicine provided an interesting and thought provoking discussion about drug therapy during lactation. Blew away some of the myths about witholding necessary therapy from breastfeeding women or insisting that they stop feeding in order to have therapy. Although all drugs reach breast milk very few reach toxic levels in the neonate. Sharon gave us a good insight into pharmacokintetics and the neonate and gave us a contact who are happy to answer questions about drug therapy during pregnancy and lactation. Will only respond to questions from health professionals and need to have as full a picture of the scenario as possible. They are looking for funding to write a book specific to this topic which will be a useful handbook for midwives. This was particularly interesting for me as it is the Christchurch school which produced the resource in my previous posting.
Diana Purvis a neonatal dermatologist from Starship children's hospital outlined the common and not so common skin rashes that might be seen with neonates. Reassuring that most of these are normal and not a cause for concern. However there are rare conditions which do need to be recognised and early referral to specialist care is necessary. Infections such as bullous impetigo, herpes, pemphligas and scalded skin syndrome can be highly infectious and need referral and treatment. Subcutaneous fat necrosis of the newborn is more common infants who have experienced cold stress and asphyxia. Treatment is a low calcium diet. Neonatal lupus is caused by transplacental passage of antibodies (Rh or anti-La) usually resolves but there is a risk of the infant developing lupus later in life.
Cheryl Benn from Massey chaired a session on normal and abnormal weight loss in the neonate and stressed that 10% or greater weight loss needs to be investigated, and a clear plan of care should be established and followed. Interesting discussion about the variety of "normal" patterns for newborn feeding and sleeping and the need to be flexible to the babies needs. Also the need to adjust care to the needs or the particular woman and her baby.
It was a very interesting but whirlwind session from Dr Lindsay Mildenhall covering growth, jaundice, congenital heart disease, group B streptococcus and hips. A lot was covered and it would perhaps have been good to have more time for this session. He showed us a really neat baby stool chart from the Pediatrics journal which would be great to have in our wellchild books. I wonder why it is not there? Biliary atresia is rare but needs to be picked up early, grey stools are indicative as is bile coloured vomit, must refer asap. Lindsay also stressed the importance of recording the neonatal rectal temperature as this is the most accurate, axilliary and aural being very inaccurate in the neonate. I need to investigate this further as we moved away from rectal temps because of concerns about trauma and we teach students not to do this now. He also commented on the difference between clicks and clunks in hip checks, clicks are common and benign, clunks are not and are the indicator for developmental hip dysplasia (used to be congenital hip dyplasia). These are not always present from birth, thus the change in title and why we recheck.
Overall a really good day. I did not really learn anything totally new to me, however brought things I did know to the surface and made me think about these things in clear way. It was good sensible no nonsense advice.

Online discussion with Sheryl Nussbaum-Beach

I just listened to an elluminate session which took place today through Otago Polytechnic with Sheryl Nussbaum-Beach from the USA. There were also participants from around New Zealand and from Brazil. It was a very interesting discussion about communities of practice and online communities. Based on the original concepts developed by Etienne Wenger. Very relevant to my thesis. I found that rural midwives really want to get together with other rural midwives to share stories, practice experience and tips and to ask questions. Midwives love to talk and chat but usually want to physically get together. I am interested in looking at how developing communication tools could assist these midwives to have one or more communities of practice in which they can share and support each other.
Communites of practice can’t be created but Sheryl described how those with a passion can initiate the ideas and as others become comfortable trust in the community can develop. Communities members need to have trust in each other. Lots of discussion about global communities of practice. However I think this can also be of value to a geographically isolated scattered group who share common practice concerns. For example rural professionals who do not have the opportunity to meet with follow professionals could find support in online communication groups.

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