Monday, March 31, 2008

Calling all midwives interested open access elearning

Image: Super-dupont-we-need-you, from Sorenshaman's photos on

Sarah and I are keen to see educational material availble for midwives free of charge through the internet. If you wish to study at your own pace that would be fine. When you feel that you can meet the assessment requirements of the course you would then enrol and only then would pay the fee for the course.

Do you want access to free open access midwifery educational material?

Would this type of resource aid your professional development?

If you are interested tell us why.

What would be the benefits for you?

We need your support to make this happen. If we cannot demostrate a need for this type of resource then it is unlikely to happen. Spread the word, get others to visit this blog or Sarah's blog and tell us why you would like this to happen for you.

We especially need to hear from New Zealand midwives but would like to also hear from midwives around the world who think this would support their professional activites.

I will add a poll to my side bar but please also add your thoughts and comments about this here. We need your help

Monday, March 24, 2008

Second life and flexibility in learning

I have also posted this on my other blog
As you know I have an interest in second life and have been considering the educational potential of this virtual world for students. When we have students who are at a distance from one another I think second life could be useful for collaboration and establishing a sense of community. It does require a good internet connection however and also a good quality computer. I was perusing the internet today and found a conference presentation delivered by Sarah Robbins “Intellagirl”. this presentation gives a great overview of second life as an educational tool. She also describes the characteristics of the average student population and how this is evolving. It is a worthwhile view when considering flexible course delivery and presents some excellent arguments about why learners need flexibility in courses. Click on the view presentation on the page linked to conference presentation. When I played this video it stalled half way through, I managed to fix this by fast forwarding a couple of times and it started to play again. It is wise to stop the video from playing and allowing the whole thing to load before trying to play it. This will allow it to play without stopping and starting, which can be annoying.

Another very interesting aspect of this presentation is the Medialandscape player which is the software application through which it is delivered. This plays the video and also presents the slide show alongside. I am hugely impressed with this tool and would love to learn more about it.

By the way I have a whole new look in second life, this is me now.

Saturday, March 15, 2008

Thinking about midwives in second life

I have just returned from a walk up the river with my dog. He is a Clumber Spaniel just in case you are wondering and he is called Buster.
As Buster and i were walking along I was pondering the meeting I had in Second Life this morning with a couple of midwifery educators, one from Canada and the other from America. We had a really nice time, just the three of us. We went dancing on Koru Island. We listened to music, communicated through text and watched our avatars dance. We were all amazed at how good it felt and from my perspective it increased our connection and comfort with one another enabling us to communicate more freely.

Sudbury, Lisachris and I cavorted across the dance floor and did some amazing maneuvers. We spoke about possibilities of meeting with students in this sort of environment. We also discussed how we had been searching for places in second life where our students might be able to learn some midwifery skills. We had been looking for clinical spaces for students to learn some of these midwifery skills. This was a preoccupation of mine when I first came into second life and is something that has concerned me since then. My thoughts on this are changing and this was one of the things that preoccupied me on my walk with Buster.

Internationally there is a great deal of concern about rising intervention in birth In Australia in Florida and here is another from Australia, with some good discussion about the problems of caesarean, and this from my friend Sarah . There is lots and lots more on this and easy to find.

So we are concerned about this and many of these posts suggest that midwives are the answer. Midwives are the guardians of normal birth. Midwives can support women to avoid caesarean section. I believe the problem is that many midwives, who are receiving their midwifery education in this time of increasing intervention and rising rates of caesarean section, never get a chance to see women outside the clinical environment of a hospital, or perhaps an clinic type birthing centre. Those who have been fortunate enough to care for women in their own homes, even if they do not birth there, will know that there is a whole world of difference. This virtual environment, of Second Life, provides us with the opportunity to give our midwifery students a totally different environment. I believe many midwives are frightened of stepping outside the walls of the medical establishment. They are worried and concerned about how they might cope without the security they perceive within these walls.

I think the ideal birthing centre in Second Life already exists and I believe it is called Arwenna's Secret Garden. (I am not sure if Arwenna would agree though), somewhere very like this anyway. Imagine working with a woman who is labouring in this environment. Supporting her as the intensity of the contractions increase. Affirming her ability to do this job. When she feels the birth is near there are several places to go. There is a small hut with mats on the floor or there is the lovely rock pool. If there are problems we can talk with our colleagues in the medical establishments if we need to. If the labour was not going so well we could liaise as we would in the real world and transfer the woman to the hospital with all the bells and whistles. This would be great learning for our students. Supporting normal and helping the woman to birth in a lovely peaceful setting observing in case intervention is required. Talking with medical colleagues and supporting the woman as she transfers to a medical establishment and maybe continuing the care in this environment.

When I first came to New Zealand and for about 10 years I worked in Rangiora Rural Maternity Hospital. while I was there we created a small, peaceful, private garden for labouring women. More recently I have worked in Balcutha and Lumsden. All of these have private outside spaces where women can labour in a peaceful garden setting. This is not so unusual in rural maternity units in New Zealand.

Why should we recreate the medical environment that we know increases intervention in birth? Is it not more appropriate for us, as midwifery educators to try to give our students a sense of how it is to care for women outside this clinical environment?

I am not suggesting that this type of scenario based learning is just around the corner. I think as educators we have a lot more to think about and learn before we are ready to start supporting student learning in this environment. But we do need to think about what we want for our students when we are ready to do this and I do think this will happen. We could also be talking with our medical colleagues about how they see this working and the learning opportunities involved in inter-collegial communication. I do not believe that the profession of Obstetrics is happy about the rising caesarean section rates either, but normal birth is not their specialty it is ours. It is for us to support the normal and consult appropriately. This is the real way forward I feel. Mutual support and respect for the place and skills of the other, while keeping the woman and her choices at the center and as the focus of care.

I look forward to your thoughts and comments on this.

Second life

I will be online in second life tomorrow morning at 0900hrs New Zealand time. I will be in the Koru Island Sandbox and will watch out to see if others come along. Remember you can also join the Kiwi educators who meet at 2000hrs New Zealand time on Sunday evenings in the Kiwi educators meeting place on Koru Island.

here are some world times for tomorrow morning 0900 hrs NZ time

and for 2000hrs for the Kiwi educators meeting

Learning about birth. Midwifery students at Otago Polytechnic

Image: Amy does her first catch supported by Renee.

First year midwifery practice
This week we have been learning about normal birth. We started with learning about the size and shape of the foetal head and then the size and shape of the female pelvis. We then moved on to how the baby's head and body move through the pelvis to allow the baby to be born. To remember the movements and manipulations that occur to allow this to happen we use the Acronym
Families In Childbirth Expect Really Impressive Excellent Love
F = Flexion (the force of contractions push the baby down, it meets resistance from the pelvic floor and flexion is increased causing the occiput to become the leading part).
I= internal roatation (the occiput moves towards the area of least resistance, the vaginal opening and this rotates it forwards on the pelvic floor)
C= Crowning (The largest part of the head, the biparietal diameter, passes the ischial spines, the narrowest part of the pelvis. The Occiput escapes under the pubic arch. The head can no longer slide back into the vagina. Point of no return.)
E= extension (the head extends, the face sweeps the perineum and the head is born)
R= restitution (the head undoes the small turn it made and aligns with the shoulders once again)
I= Internal rotation (the anterior shoulder reaches the pelvic floor and follows the line of least resitance and so rotates anteriorly
E= External rotation (As the shoulder rotates anteriorly the head also rotates along with it. The baby now looks towards the mothers thigh)
L= Lateral flexion (The anterior shoulder escapes under the pubic arch and the body is born following the natural curve of the birth canal, in an attitude of lateral flexion.

This is a very exciting time for the students. They really enjoy learning about this aspect of their future job and life as midwives.

Here is a really interesting article that questions some of the traditional teaching about the mechanism of birth, and poses some important questions for midwives on this topic.

It has been a very exciting and invigorating few weeks. Meeting and getting to know this new group of women who will be our future midwives.
In the previous clinical block we covered how to record vital signs, temperature, pulse, blood pressure. The have also considered documentation and collecting specimens for laboratory tests. We have also introduced them to to a program to learn about drug calculations. This is free open source software.

The journey has begun.

Thursday, March 13, 2008

Must see birth video

My friend Sarah
has posted a video that you must go and watch in her blog. Go now! It is fantastic.
Sarah's blog has a great repository of resources and information on matters midwifery.

Tuesday, March 11, 2008

New Midwifery education

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.

The 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.

This is also posted on my other blog Fled: Flexible learning education design

Image: Time for study from pb31's photos

Saturday, March 8, 2008

Todays midwives meeting in second life

See the second life midwives wiki for information about future meetings in second life.

We had our second meeting of midwives in second life today. I was great to meet up with three midwives from the North American continent and one from Australia. Thank you to you all for coming and also once again to Arwenna for helping us all out and to Sarah for also coming along and supporting.

I would love to add audio to this slide show but do not have time at the moment.

We struggled at the start of the meeting to get audio working and gave up in the end just communicating through text. This is quite a challenge with a group and I am doubly glad audio worked for us last week. We also had problems for some with getting connected at all and Sarah crashed out of second life once while I crashed and had to resume four times. Others did not seem to crash. The sexual health area looked very interesting but there were lots of scripts being offered to us all the time. if we had been communicating in voice it may have been OK but trying to communicate in text when lots of other text was appearing all the time was too much really. Arwenna's garden and cave are quite magical places and a real pleasure to see.

On reflection for a group such as ours I think second life does hold tremendous possibilities for collaboration and networking. I think these possibilities are yet to be realised. I would not feel happy at this stage to use second life to meet with students as i do not feel it is reliable enough and would cause some anxiety for students. At this stage I would prefer to use software such as elluminate to have meetings with students. Given the pace of development in second life I believe that the time when it is more suitable for meeting with students is probably not far away. I therefore am happy to continue developing my skills in this environment.

It was disappointing that none of the others from last week made it. Understandable though given our busy lives. I have not organised a further meeting at this stage and will wait and see if there is support for this. I will go online on Sunday Mornings around 0900hrs NZ time 1200hrs Saturday Second life time as often as I can at Koru Island Kiwi educators sandbox, (Koru 161, 212, 34 PG - Koru Sandbox). I can then practice building while I am waiting. If anyone turns up I will be happy to see them. I will wait for a little while before logging off. I am not around every weekend however as I often have midwifery locum work in the weekends.

See the side bar of this blog or the bottom of the Midwives in Second Life wiki.
both lead to the same survey form. It is simple and easy and should not take long to complete.

Friday, March 7, 2008

New Blog

I have just created a new blog on Wordpress for the course I have just commenced on Design for flexible learning practice an open access course i have commenced. My new blog is called Fled: Flexible learning education design. Hope to see those with an interest in this area there.

Thursday, March 6, 2008

Next meeting in Second life.

See the second life midwives wiki for information about future meetings etc.

The time is fast approaching for our next meeting in second life. It has been pointed out to me that although it is Sunday morning here and Sunday evening in the UK it will actually still be Saturday in North America so something for you to remember.

Times are Date: Sunday 9th March in New Zealand

Time: 09.30am NZ, 3.30pm New York, 8.30pm London, 0530 am Perth (sorry :)), 0730 am Sydney, 12.30 pm Vancouver.


Meeting in second life at the Kiwi educators meeting place on Koru Island (Koru 155,122,27 (PG)-Koru)

I had thought about breaking into discussion groups and brainstorming a topic at this meeting but on further reflection would like the group who meet to decide what they want to do. So will leave it very loose at the moment. Arwenna has been preparing lots of possibilities for us.

More information can be found at the Second Life Midwifery group Wiki
Please don't leave until we plan where we go from here, how often we meet etc and also until I have you all signed into the midwives group of second life, if you want to of course.

Building an international midwifery community

I am feeling very excited at the moment and feeling that I am teetering on the edge of something that could ultimately be very consuming.
I have been exploring facilitation of online learning communities and have just completed this course and I am now moving into another teaching course designing for flexible learning . I have learned an enormous amount about online communication, networking and web2.0 from this first course and I am interested to see where the next course takes me.

At the culmination of the last course I facilitated an online meeting of midwives, educators and researchers in Second-life. During the preparation for this I established some international midwifery connections and was helped to form a midwives group in second life. I have now also set up a wikieducator space for this group, this links from the Midwifery wiki I had already established. So online midwifery resources are growing. So far I have not been fortunate enough to have input from anyone else on these resources but I am hoping as others find them they will start to add content.

I am also very interested in the Wikiversity project. I believe that some of the material we are currently delivering is not reaching the audience that it could reach because it is held within our institution and is not freely available. I am very fortunate to work in an academic institution which is committed to delivering as much content as possible through free open access. I am committed to exploring the possibility for presenting educational material that will support midwifery professional development in this way.

I also have a strong interest in the Safer Motherhood campaign . I am aware of the very difficult circumstances for many women on our planet and admire the midwives who work so hard to assist and support these women. I have always had a desire to do something in some way to help and support midwives in these situations. The problem is that the reality of practice for these people is so very different from ours. There is much I believe that we could do to help them but they also have much that they can teach us. Any educational material that is presented in an open access format would need to take account of the diversity of experience of humanity and would need to have some collaborative input from those who are living this experience. To this end I have made a connection with a midwife who is living and working in Africa and who may be able to help me with making some connections, forging links and potentially developing something very supportive and useful to midwives wherever they are working.

I also have a vision of midwives connecting as sisters around the world to raise our understanding and support of one another. I would like to establish a shared mentoring experience where one midwife in the developed world is linked with one midwife in the developing world. They can then support one another share practice stories and perhaps offer some practical assistance as well. Perhaps they could spend a little time together, travelling to the area of the other for a short 'working holiday' and gain a better understanding of the situation of the other. The midwife in the wealthier of the two countries might also be able to raise funds and provide some practical support for her buddy. I would like to know your views on this. Please comment on this post.

Image: African mother, from Joram jojo's photos on

Facilitating online learning communities.

Facilitating online learning communities

Facilitating a meeting of midwives and midwifery educator in second life
Meeting the requirements of assignment 4

Considering what to do
As I pondered what activity I might engage in to facilitate an online learning community my thoughts went towards hosting a meeting of midwives in second life. I was introduced to second life as a part of this course and had developed a love/hate
relationship with it as can be seen from previous postings
. None the less I have felt from the very beginning that there is potential here for midwifery collaboration, midwifery meetings and continuing professional development activities as well as scenario or problem based learning.

I am involved principally in teaching the first year midwifery student undergraduate program at Otago Polytechnic. Our course is already delivered in seminar blocks however it is moving into a more distance based learning program next year and I will be involved in preparing this for the students. So I am interested in anything that could help to get students together to facilitate a sense of a learning community. Communities of practice have been identified as important aspects of learning in practice (Boud & Middleton, 2003: Fahey & Monaghan, 2005; Rogers, 1983; Tolson, McAloon, Hotchkiss & Schofield, 2005; Wenger, 2006). Educational researchers have also identified the importance of facilitation and community to an enhanced learning experience in schools (Roberts & Pruit, 2003) and in tertiary study (Hmelo-Silver, Duncan, Chinn, 2007). Others debate the benefits of teaching or facilitating learning which has been a feature of this course with some vigorous debates on the topic. Case, Harper, Tilley and Wiens (1994) argue that facilitating and teaching are not mutually exclusive but occur together. They suggest that teaching is facilitative when the intention of the teaching is to empower and support students. A feature of facilitation is shared control between lecturers and students over what and how they learn (Case et al., 1994). Hmelo-Silver (2006) discuss student learning as a constructive, collaborative process where students are given goals which scaffold to challenge the students at varying levels. Once students have investigated an area a small teaching sessions may be delivered by ‘experts’ who engage the students in conversation or deliver small lectures, providing rationale for the processes the students have been engaged in. Leigh has challenged us to facilitate learning as opposed to teaching. My understanding of his argument is that the two cannot co-exist at the same time. While a facilitator may also be a teacher they cannot teach and facilitate but they may facilitate a session where someone else teaches as occurred throughout this course with the small 10 minute lectures we experienced through Elluminate. I also have a interest as a rural midwife in midwifery professional development. I investigated this issue from the perspective of how midwives inform practice for my recently completed Master in Midwifery thesis (McIntosh, 2007). My findings suggested that rural midwives in New Zealand value coming together and sharing information, so this is another reason to look at the potential for second life .

We live in a rapidly changing world. Communication technology continues to advance in leaps and bounds (Leiner, Cerf, Clark, Kahn, Kleinrock& Lynch, 2003); it is hard to keep up, while at the same time, we are hearing about dwindling natural resources and increasing costs of travel around the world. In recent years we have become accustomed to conferences, with expert speakers in our field attending, and simulating interest and learning. Would it be possible to have a similar experience in Second-Life? Could we hold a conference with various workshops and plenary sessions in this environment? I had no way of knowing and decided to see if I could arrange a group of interested midwives who might be interested in exploring this further.

Planning the event
I was very new to second life and barely had the ability to move in a straight line so I approached this exercise with a high level of caution. I was very lucky to have the support of Clare Atkins one of the administrators of Koru Island and the kiwi educators meeting place. She offered to give me assistance with anything I needed, including a place for the meeting, a slide show projector and assistance with managing the whole process. This was a major benefit, and helped to make sure things went smoothly. I also had the support of my friend and colleague Sarah Stewart, who has equal skill to my own in Second-life but offered whatever support she could. Just meeting up with her a few time in second life and brain storming how the session might go and who I might invite was a huge help.

I advertised the meeting on my blog. I do have a good amount of traffic on my blog but I do not know how much of that is midwives, so I obviously needed to advertise elsewhere as well. I put a notice out on a midwifery research email list that I had recently joined. This stimulated a good amount of interest and led to a connection with a midwife from the UK (Sufia shepherd in SL) who had good Second-Life skills and was able to help Sarah and I set up a midwives group in second life. Several midwifery educators and researchers, mostly from the UK and Canada expressed interest in attending however there were also one or two from Australia, a couple from Michigan and one other midwife from New Zealand who also expressed interest. I had no idea how many might eventually make it into second life and attend the meeting. My initial attempt at setting a date was not acceptable to some as it coincided with the mid-term holiday in the UK. The date I finally settled on coincided with Mothers day in the UK but I do not think this affected attendance at all.

I made a posting on my blog very early in the planning of this event providing instructions about what to do and how to get online in Second-life. I found some useful YourTube videos which were very helpful. I followed this up with several more postings find tuning instructions regarding timing etc. I found a program on the internet which provided world times which was also very useful. I also emailed several times on the research forum email list, but I was very cautious about this as I did not want to misuse this valuable resource by making unnecessary postings. No one complained however and it has been a great way to promote the event and keep in touch with people.

I had to consider what my goals were for this event and how I was going to do it. I knew that most of the people attending would be fairly new to second life and so I did not want to be moving them around too much. At the same time I wanted them to get a feel for the potential and have the ability to interact with one another. I met up with Clare the week before the meeting and we decided that we would try using voice communication rather that typing everything. This might make the meeting flow better but would mean that not everything would be transcribe as would occur if the communication was purely text based. I wanted the meeting to be as unstructured as possible as this is the basis of facilitation, as described above. However I felt that I needed some structure given that everyone was new to the environment and I had some concern that communication might not flow. As a midwife I should have known better. Midwives do not usually have a problem communicating with one another.

Clare (Arwenna) suggested I prepare a slide for when the group arrived to help them get started with voice communication. This was a great idea and I do think it helped most participants although some my not have realised it was there. I also decided to make a few slides outlining the aims of the meeting. I believe that this still could fall within the realms of facilitation however Leigh has suggested that at this point it became more of a teaching session. Perhaps I did do a bit too much here. My initial power point was quite brief but then I thought I should perhaps add something about where my interest in this had come from, mentioning my Masters Thesis and perhaps outlining my academic credentials for this. Perhaps this was little self serving, not really necessary and getting into teaching mode.

I told everyone that I would keep an eye on when they came online and would teleport them to the venue for the meeting. I asked them to be patient if I did not get to them as soon they came online. I also prepared a list of everyone who had given me their details, Bronwyn and Debbie Corder had agreed to come along and offered to keep an eye on this for me. I am not sure but I think they may have teleported one or two in. Merrolee Penman had also said she would like to come and I co-opted her to keep notes of what was happening.

Sarah and I hoped to be physically in the same place for the meeting to offer moral support to one another. This proved impossible as the broadband at her house could not handle two computers in second-life together. We also tried the computers at Polytech but they were much too slow. This is an indication of the power and technology required to run this program.

The evening before the meeting while I was online I met up with a couple of the midwives who had hoped to come along. One from Vancouver did not make it to the meeting but it was good to speak with her then.

Finally on the day of the meeting I discovered that there was a new version of Second-Life available. I downloaded this onto both of my computers and got it running. I had two computers available to me as I was very worried about the reliability of my computer. The new version works well on my newer computer but not so good on the old one. I wonder if it is more graphics intensive

The meeting

I met Clare at the Kiwi educators meeting place and she loaded up my new slides for me. This was not without some hiccoughs and I admire her patience as I tried to get the slides renamed etc. In the end we reloaded the whole lot. There is a very small cost involved in loading slides onto second life, but it is next to nothing really.

People started to arrive almost immediately. Some seemed to teleport in themselves, but may have been assisted by Bronwyn and Debbie. Most I saw come online and I teleported them in. I had to keep my window of contacts open which limited my view of the group that had assembled. One arrived with her ‘newbies’ torch in hand, a good indication that this was her first excursion into second life. With help from Clare I managed to get everyone in and seated. Not everyone who had said they might come did but some of my colleagues from this course came and we had a good attendance.
I think I counted 15 people at one time,4 from this course and the rest midwives, educators, researchers and academics. Most stayed for the duration of the meeting, about an hour and a half.

We started off by having to do some sound adjustments. One participant was very loud but managed to turn down, it was still not optimal but it was good enough. Another popped in with some heavy breathing sounds from time to time, I wonder if this was Merrolee and her shift key? Everyone seemed to be able to hear what was being said but one or two could not speak and so they communicated through text.

Once I felt we had most people there I started off by asking everyone to say who they were and give wee bit of background on where they were from and what there interest was in second life. This is a good way to help people feel at ease and get them involved. It helps to create an environment conducive to learning (Russell and Russell, 2003). This worked quite well, as I invited people to speak I was working though the list on my contacts screen and was still keeping an eye on people who were still arriving. I missed a couple of people but they let me know that they were still to introduce themselves. After this I presented my slide show presentation. I outlined what I thought some of the benefits and some of the difficulties of meeting in this environment might be. I posed these questions to the group.
• How can we use this?
• What is holding us back?
• What is the future of second life for midwifery education and development?
• Could this be a resource for a midwifery community of practice?
I then opened this up to the group to discuss and some useful discussion did occur.
There was general agreement that the technology is improving all the time. For example using voice communication is a recent development that is making communication much easier. Educational resources in second life are expanding all the time. Problems such as time difference can be overcome in part by providing minutes and transcript.

There was a problem for at least two possibly more people who wanted to participate. One was having difficulty getting going as her system was crashing and did not make it at all. Another tried very hard to get to Koru Island but every time she arrived she crashed and had to leave. Sarah crashed her computer once during the meeting and missed some of the chat. I lost connection and had to reconnect once, which was good for me, I usually do this much more. So problems with the technology are reasonably common with second life. Everyone coming had several other contact details for me including skype, as a back up. When I lost the connection I was able to tell Sarah through skype and she told the group. So making sure potential participants can actually access second life is important but there is not much that can be done if they cannot. Providing an alternative contact in case the technology does not work or breaks down. This may limit the type of student or midiwife that could participate.

Arwenna spoke about the Kiwi educators group and gave everyone membership of this group. She also offered the space for future meetings and offered to escort anyone who wanted to stay on for a while to the Sandbox to practice building skills.

As the meeting was coming to a close most said they would like to meet again. There was mention of having some midwifery topic to discuss which might help some communicate and give a comparison with face to face communication. They also suggested changing the time around to make it easier for the North American group to attend.

Most left after this and a few went to the Sandbox with Arwenna and Isa Goodman, the other administrator of Kiwi educators. They helped the small goup of about 6 or 7 who were left to start building. Arwenna also give the group a box of landmarks to other areas.

Overall I think the meeting was a success. I think this is demonstrated by the willingness to have another meeting. I was a bit surprised at the desire to meet again in a week. I think that might be a bit soon but we will see how this goes. Several people who did not make this meeting have said they will come to the next one.

Having someone available who has skills in second life and group interaction is a big plus and I was very lucky to have Arwenna.

I think the planned strategy of not moving around too much worked well for this first meeting, I think this helped people feel a part of the group and concentrate on talking. Some said thy liked being able to move their camera around while they were sitting and look around. Everyone seemed to manage the environment well.

The strategy of getting people to introduce themselves also worked well. Everyone got a chance to speak at least once and most joined in the later conversation.

On reflection I do think the rest of the slide show was superfluous. Had I just asked the group to talk about benefits and pitfalls I think the communication would have been improved also this would have come from the group, not me. I wonder if I did shut the conversation down by doing this presentation. It also meant I had to concentrate on the screen at this time rather than the group. Leigh has since said I was in teaching mode at this time. After a lot of thought I think I do agree with him. Perhaps I could have kept the conversation going and only used the slideshow if it seemed that conversation was not happening. As adults with considerable experience in education and/or midwifery practice this group were very knowledgeable and could easily have brainstormed these issues themselves without me having to lead them. Knowles (1990) developed the theory of adult learning described as Androgogy. According to this theory adults need to be involved in the planning and evaluation of their learning. They need to be able to experience learning and have the opportunity to make mistakes. I believe I limited this by guiding the content in this way. Friere known for his 'pedagogy of the oppressed' believed in shared learning, building learning communities. He believed that learning occurred through conversation and dialogue (Smith, 2007). I need to consider this for future facilitation, particularly with a group such as this. According to Gilly Salmon's five stage model of moderation I think I was functioning at about level 2 or level 3 for this meeting. I was very focussed on the technology and just getting people sorted. I was not really able to participate in the discussion much at all other than to encourage others to participate. I hope I can move this with the greater understanding that I now have of the medium and where I went wrong with this session and can do better next time.

I wish I had taken more time to close the meeting and make proper arrangements for the next meeting. As the facilitator I should have done this better. I also wanted to raise awareness of the midwives group in second life and did not do this.

I think the timing of the meeting for people from this course was quite good as people were interested in getting back into second life and seeing how it all went.

Plan for the future
After the meeting Clare and Merrolee gave me their notes.
Clare had added some of the verbal conversation into the text script and Merrolee had kept notes. I had to find somewhere to store these. This has led me to create a wikieducator page for the midwives second life group. I have developed this up as another online midwifery resource. I also finally managed to get a picture into wikieducator, something I have been struggling with. I put an note and link to this on my blog and also posted to the midwifery research email list.

The next meeting time has been posted on my blog, on the wiki, on the midwifery research list and through the Second life midwifery group notices in Second life. I have also individually emailed everyone I have email addresses for. On some feedback form the first group I suggested we choose a topic for this meeting and suggested normal birth as this topic. On the further reflection that I have done here, I have decided to leave this open and let the group decide when we meet. I have that up my sleeve if I need to pull it out.

Once again we will meet at the Kiwi Educators meeting place. I will open the meeting and invite the group to set the agenda. Arwenna had prepared a few places where the group can break off into small groups to have a chat if they wish. I will teleport these groups to these locations to save them all having to walk, or fly, there if they are struggling with moving around. I will leave this very much up to the group this time and see how this goes. I would like the group to identify what they think we could do with this group in the future. I will introduce them to the second-life midwives group and the second-life wiki. I will try to get email addresses from those for whom I do not have these details and will try to get plan and time for the next meeting.


Boud, D., & Middleton, H. (2003). Learning from others at work: communities of practice and informal learning. Journal of Workplace Learning, 15(5), 194-202.

Fahey, C. M., & Monaghan, J. S. (2005). Australian rural midwives: perspectives on continuing professional development [Electronic Version]. Rural and Remote Health, 5. Retrieved 25th June 2006 from

Hmelo-Silver, C. E., Duncan, R. G., Chinn, C. A. (2007) Scaffolding and achievement in problem-based and inquiry learning: A response to Kirschener, Sweller and Clark (2006). Educational psychologist, 42 (2) 99-107

Knowles, M. S. (1990). The adult learner: A neglected species. Houston: Gulf Publishing Company.

Leiner, B. M., Cerf, V. G., Clark, D. D., Kahn, R. E., Kleinrock, L. L., & Lynch, D. C. (2003). A brief history of the internet. Retrieved 26th June, 2004, from

McIntosh, C. (2007) Wise women's web, rural midwives communities of practice. Unpublished masters thesis. Dunedin, Otago Polytechnic.

Roberts, S. M., Pruitt, E. Z. (2003) Schools as professional learning communities. Thousand Oaks: Corwin press. Available online

Russell, L,. Russell, J.(2003) Leading change training. American Society for training and development.

Smith, M. K. (2007) 'Paulo Freire and informal education', the encyclopaedia of informal education. [ Last update: December 28, 2007]

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

Wednesday, March 5, 2008


I have created an online survey using freely available software. This will gather anonymous data about the impression midwives and others have about second life and its potential use in midwifery education and professional development. I have loaded a link to this survey into my side bar so it is permanently available here. I have also loaded a link onto the Midwives in Second Life Wiki

I hope to gather some data to support any future publication or presentations I may make about the use of second life for midwives.

I would value your input to this and it will take very little time to complete. When you click on the link the survey should appear straight away and you can complete it there and then,

Thanks for your help

Minutes from midwives in Second life

I have created a wikieducator page to save documentation from our virtual meetings in second life. Here you will find two links at the moment, one to the notes or 'minutes' that were made of the meeting, which is stored on another Wikieducator page. The other is to the complete transcript of the meeting which is stored in Google docs.

If you have information you feel could be added to the Wikieducator page please feel free to do so. You will need to register with Wikieducator first but this is free and simple to do. You then just need to hit the edit button and you can edit the page. If you wish you can hit the Discussion tab at the top of the page and leave a comment. I welcome your feedback on this. Thanks to Clare for this picture.

By the way I finally managed to add a photo to Wikieducator with a lot of help from the tutorials for wikieducator.

Monday, March 3, 2008

Safer Motherhood. Supporting midwives in third world countries.

Image : Mother and son. from Teseum's photos on

While I am busy trying to provide an opportunity for midwives to come together and collaborate, using second life, my thoughts go to midwives working in situations of poverty, in third world countries. These midwives and the women they are caring for need our support. Her is a link to a shocking statistic that I think will impact on anyone who sees it. At the time of writing this 89,365 women have died due to childbirth related causes in 2008 when you read it it will have ticked up even more.

The midwives who are struggling to provide care and support to women in these situations must find the whole situation so emotionally draining. I just cannot imagine it. One such midwife is an amazing young woman who has made her home in Malawi. It is this blog posting that made me think of this in the first instance. Many of her postings bring tears to my eyes and I admire her hugely. I was going to suggest she might find some support by connecting with other midwives, perhaps through this virtual environment and then I think about the challenges that she faces on a daily basis. Would this provide her with support or appear shallow and futile? Can collaboration in this way do anything to support midwives and women in these environments? Would she even be able to find the resources to do this. Clearly she does have internet access at least from time to time as she blogs.
What about midwives working in war torn areas of the world, Iraq, Afghanistan, what could we possibly do for them. Or the poverty stricken areas of South America or Asia. I was also moved byt the trailer for this movie Born Into Brothels: Calcutta's Red Light Kids.
I would love to help and support these people in some way.

Here is one young mothers story

Just wanted to add a little to this post. I was chatting with a fellow midwife here recently and we were talking about the dreadfully high caesarean section rate in parts of South America. This midwife had spoken with someone who told her that women in the location he came from choose elective caesarean a little before the due date as they do not want to have to travel to the hospital in the middle of the night when they could be hijacked shot and/or robbed. Elective ceasarean is by far the safer option. It does put another perspective on the situation doesn't it?

Next second life meeting

We need to organise the next second life meeting quite speedily as the weekend fast approaches again. I have not yet documented my full reflection but I am basing this meeting on some feedback from the previous meeting. Someone wanted to see how it would be to explore a topic that we might discuss in real life to compare the quality of the interaction. I would appreciate your thoughts on this and if you feel changes need to be made. I have been thinking more about this and want to talk about what we might do on the day rather than nail it down here now.

Date: Sunday 9th March
Time: 09.30am NZ, 3.30pm New York, 8.30pm London, 0530 am Perth (sorry :)), 0730 am Sydney, 12.30 pm Vancouver.
Here is a link to World times for this meeting
(Please note that this clock was stating Friday 7th this was incorrect, the meeting is Sunday 9th morning as now stated on this time chart. Sorry about this, I have trouble keeping the time and date correct while I paste for some reason)

Meeting in second life on at the Kiwi educators meeting place on Koru Island (Koru 155,122,27 (PG)-Koru)

Theme: Supporting normal, natural childbirth. (Alternatively we could go to the sandbox and play at building things).

All gather at the Koru Island meeting place.
If we have a large group we could break into smaller groups to brainstorm the topic. Have a think about what you would like to do. It would be fine to go and practice building. We will be talking while we do that. Arwenna has a couple of good ideas also. Can you give me suggestions for how long this should last, I think at least 30 minutes perhaps 45 minutes.

Introduce Midwives group. Get contact details for those who wish to give this. Discuss theme, time and place for the next meeting and firm up arrangements before leaving.

Sunday, March 2, 2008

We made it. Midwives met in Second life

Thanks to everyone who who supported this initiative and came along to our midwives and educators meeting in second life on Kiwi educators Koru Island. I am still feeling a bit tired so just a brief feedback from this session at this time and I will write more comprehensively later.

I am particularly grateful to the following people
Claire Atkins (Arwenna) has been wonderful supporting me to learn more about second life. Setting up the slide show and redoing the whole thing at the last minute when I wanted to change things. Claire also helped me keep an eye on the crowd and helped me to make sure everyone had a chance to participate. The meeting would not have been nearly as successful without her.

Merrolee Penman (Koru Bracken) . Merrolee is and Ocupational therapy lecturer and is a leader in blogging for that profession. She also has an interest in exploring Web 2.0 uses in tertiary education. Merrolee was keen to come along and I co-opted her to keep some notes, rough minutes, of this meeting. She did this job superbly for me. I will finalise these soon and post them in Google docs, linking here very soon. These notes of the meeting are available now in Wikieducator with a link also to the transcript of the meeting which is available in google docs

Sarah Sewart (Petal Stransky) who has encouraged and supported me to get to this point. Sarah came along and contributed to the conversation keeping this alive when I was busy concentrating on other things.

Brownyn (Branwen) and Leigh (leeroy) who ran the course on 'facilitating online learning communities'. I have learned so much from this course and would never have explored second life at all had it not been for this course.

The meeting was a great success, most particpants were from the UK, one came from Michigan where it was 3am when the meeting stared. Arwenna and her co-owner of Koru Island Isa Goodman gave everyone Kiwi Educator status which means they cna return here and can practice constructing things here also. We have been welcomed to return and hold further meeting here. Everyone was keen to meet again in one week. It was suggested that we make it Morning for NZ and evening for UK. This would make it midday or afternoon in North America and a better time for North American residents to participate. There were several midwives from North America and Canada who were interested but were not able to attend. I had met one Trinny Dreamscape from Vncouver a little before the meeting. also met up with Aastra Apflebaum who had difficulty with her computer crashing in second life. She popped in and out a couple of times but had to quit in the end.

Here is the slide show presentation that I gave to the group to initiate discussion about the usefulness of second life for professional networking and midwifery education.

Saturday, March 1, 2008

Final instructions for virtual midwives meeting

Meeting 9pm tonight our time
2100hrs-NZ, 0800hrs-UK, 0300hrs-New York, Midnight-Vancouver, 7pm-Sydney, 5pm-Perth.

Meeting at Koru Island, Kiwi educators meeting place.
Second life coordinates; Koru 155,122,27 (PG)-Koru

When you go online I should see that you are there and will offer to
teleport you to Koru Island, you should accept this invitation. If I do not
see you immediately give me a minute or two, it could take some time
to get everyone sorted. If you are late arriving and I don't notice
you are there can you send me an instant message (IM)? Sarah will be
helping me (Petal Stransky), so she may offer to teleport you also, you can accept either invitation.

If you are having difficulties, you could send me a message either by email or through skype - carolynmcintosh . Both of these will let me know instantly that I have a message.

Hope that all who wish to attend make it, fingers crossed for a successful meeting. It will be interesting to see how this works for us and will be good comparison with Sarah's previous Elluminate meeting and the upcoming Elluminate virtual conference on the 6th of March, see previous email from Soo.

See you tonight on Koru.
Dacary Dumpling (Second life)
carolynmcintosh (skype) (email)

Last night before the midwives meeting

I arrived home tonight from a visit to my Mother-in-Law to find several more midwives signed up with second life and ready to participate in our meeting tomorrow night. Very exciting! Some of my colleagues from Otago Polytechnic and the "facilitating online learning communities course' that Sarah and I are completing are also going to join us. One of these is a colleague from Occupational therapy at Otago Polytechnic who has been a leader in blogging for this profession and has developed quite a community of OT bloggers. My mentor in second-life, Arwenna, who has helped me with setting up my presentation and other aspects of second life, will also be there helping me out, thank goodness. I hope she, and some of the others with more skills in second-life than myself, will be able to help answer some of your questions.

The meeting is tomorrow night at 2100hrs -NZ time 0800hrs-UK time 0300hrs-Montreal, 0100-Edmonton, Midnight-Vancouver. Midnight-secondlife

Hope this is helpful, here are the other word times for this meeting.

When people arrive I will teleport them to the location for the meeting. There will be some displays with one or two helpful 'how to's' to help get you started communicating. I will ask everyone to give brief introduction about their professional background and interest in Second-life. I have a small presentation prepared to introduce some of the possibilities I have discovered in Second-life and where my interest arises. I will then open the floor to everyone to discuss their thoughts about this medium and how it might be used for the benefit of the midwifery profession and midwifery education. I am hoping we can get people communicating in voice however if this is too difficult we will revert to text communication. When communicating in voice online it is important to watch for the signal above an avatars head, indicating that they are speaking. Trying to have one person speaking at a time is important. We will need to discuss these ground rules before we all start trying to communicate. Participants will be able to also communicate by text even if we are communicating with voice. Thankfully Sarah will be there to help me too. Hopefully between the two of us and with Arwenna's help we will be able to keep ahead and eye on communication and make sure everyone gets a chance to speak. I also want to try to keep some minutes of the meeting and might be able to delegate this task to one of my friends.

After the meeting if people want to go together to explore another second-life environment we might be able to do this, although it may be a challenge to get everyone moving together. If there is enough interest we may be able to arrange a future meeting before we leave. I also hope to get a photo of all participants if we can manage this.

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