Speaker: Carolyn McIntoshSpeaker: Carolyn McIntosh

Master in Midwifery Master in Midwifery thesis presentationthesis presentation

Currently:Currently:Rural midwife Rural midwife Midwifery Lecturer Midwifery Lecturer Otago New Zealand.Otago New Zealand.

Funding support from Otago Funding support from Otago Polytechnic research grantsPolytechnic research grants

Ethical approval from Otago Ethical approval from Otago Polytechnic ethics committeePolytechnic ethics committee

Qualitative descriptive studyQualitative descriptive study Four focus groups from around the Four focus groups from around the

South Island of New ZealandSouth Island of New Zealand

Aim of studyAim of study To identify how particular To identify how particular

groups of rural midwives groups of rural midwives from around the South from around the South Island of New Zealand Island of New Zealand informed their practiceinformed their practice

• to discover if they had any issues with informing practice

• what they would like to see in the future

Reality of rural midwifery practice Reality of rural midwifery practice in New Zealandin New Zealand

Diverse - no real ‘norm’- evolved and Diverse - no real ‘norm’- evolved and evolvingevolving

Local service meets needs of the local Local service meets needs of the local community and developed around the community and developed around the service providers in the area.service providers in the area.

Might be:Might be:– Local practice groups Local practice groups

OrOr

– Individual midwives or midwives working in pairsIndividual midwives or midwives working in pairs Limited opportunities to meet with other Limited opportunities to meet with other

midwives or other health professionals midwives or other health professionals Geographical isolationGeographical isolation

How did the midwives inform How did the midwives inform practicepractice

Journals Journals – MidirsMidirs– NZCOMNZCOM

BooksBooks Formal study / Formal study /

workshopsworkshops

– Practice groupsPractice groups– Other groupsOther groups

On study daysOn study days

““The greatest benefit of it for me was The greatest benefit of it for me was sharing things with, other midwives, sharing things with, other midwives, midwives in a room, partly through not midwives in a room, partly through not having that, was one of the having that, was one of the inspirations for starting to convene inspirations for starting to convene these meetings here, I was not really these meetings here, I was not really meeting many other midwives meeting many other midwives otherwise, which is the best way of otherwise, which is the best way of getting information”getting information”

On connecting with On connecting with colleaguescolleagues

““I have to say personally I gain most of I have to say personally I gain most of my knowledge from my colleagues, from my knowledge from my colleagues, from working with more experienced, or highly working with more experienced, or highly experienced, other midwivesexperienced, other midwives””

““Even from team to team we often learn Even from team to team we often learn different things from each other, which is different things from each other, which is good, it’s all knowledge sharinggood, it’s all knowledge sharing” ”

Rural Midwife

RuralMidwives Rural

Facility

RuralGPs

StandardsReview

committeeRegionalMidwives

PerinatalAuditGroup

Obstetricians

AccessHoldersGroup

Rural Midwife

SpecialistServices

Rural GP Rural facility

Nursing Staff

OtherRural

MidwivesOne hour

away

Two hours away

Social learning theorySocial learning theory

VgotskyVgotsky Social interaction plays a fundamental role in Social interaction plays a fundamental role in

learning.learning.

BanduraBandura We learn through modeling others behaviour, We learn through modeling others behaviour,

attitudes and outcomes of this behaviour.attitudes and outcomes of this behaviour.

LaveLave Learning is embedded within activity, context and Learning is embedded within activity, context and

culture.culture.

Communities of practiceCommunities of practiceLave and Wenger (1991);Lave and Wenger (1991); understanding the technology of practice is understanding the technology of practice is

more than learning to use tools; it is a way to more than learning to use tools; it is a way to connect with the history of the practice and to connect with the history of the practice and to participate more directly in its cultural life participate more directly in its cultural life (p.101).(p.101).

participation in the cultural practice in which participation in the cultural practice in which any knowledge exists is an epistemological any knowledge exists is an epistemological principle of learning. The social structure of principle of learning. The social structure of this practice, its power relations, and its this practice, its power relations, and its conditions for legitimacy define possibilities conditions for legitimacy define possibilities for learning (p.98). for learning (p.98).

Communities of practiceCommunities of practice

Communities of practice are groups of people Communities of practice are groups of people who share a concern or passion for who share a concern or passion for something they do and learn how to do it something they do and learn how to do it better as they interact regularly. better as they interact regularly.

(Wenger, 2008)(Wenger, 2008)

– Wenger, E. (2008). Communities of practice: a Wenger, E. (2008). Communities of practice: a brief introduction. Retrieved May 14brief introduction. Retrieved May 14,, 2008, from 2008, from

http://www.ewenger.com/theory/communities_of_http://www.ewenger.com/theory/communities_of_practice_intro.htmpractice_intro.htm

Sharing the learningSharing the learning

““And so really for myself, it would be nice And so really for myself, it would be nice to go with your colleagues so you can to go with your colleagues so you can disseminate the information together, but disseminate the information together, but we can’t do that because we would leave we can’t do that because we would leave the place empty”the place empty”

““The first support in a storm for me is The first support in a storm for me is always my collegial support”always my collegial support”

Networking through the Networking through the internet.internet.

““But certainly a rural midwives network But certainly a rural midwives network would be fantastic, that we could ring would be fantastic, that we could ring other people and say what do you think other people and say what do you think about this? about this? “ “

““Just share over the internet, a case study Just share over the internet, a case study from our area, this is what we found and from our area, this is what we found and how we managed ithow we managed it” ”

Supporting shared learning and Supporting shared learning and communities of practicecommunities of practice

Web 2.0 facilitates social networking in an Web 2.0 facilitates social networking in an online environment through various online online environment through various online toolstools

Facilitates connections between individuals Facilitates connections between individuals who have a shared understanding and shared who have a shared understanding and shared interestsinterests

Online resources facilitate information Online resources facilitate information sharing and collaboration in a variety of wayssharing and collaboration in a variety of ways– Otago Polytechnic have recently won funding to Otago Polytechnic have recently won funding to

produce an online resource to develop a produce an online resource to develop a midwifery community of practicemidwifery community of practice

http://ecomidwife.wetpaint.com/

http://mymidiblog.blogspot.com

http://del.icio.us/carolynmcintosh

http://www.youtube.com/carolynmcintosh

http://midirs.org/webinar

ConclusionConclusion Rural midwives inform practice in a variety of ways Rural midwives inform practice in a variety of ways

but prefer to share and acquire new information but prefer to share and acquire new information through communities of practicethrough communities of practice

Rural midwives have limited opportunities to Rural midwives have limited opportunities to engage with or develop communities of practiceengage with or develop communities of practice

Online social networking provides new and Online social networking provides new and exciting opportunities to facilitate this for rural exciting opportunities to facilitate this for rural midwives midwives

Links can be forged both nationally and Links can be forged both nationally and internationallyinternationally

ReferencesReferences

Bandura, A. (1977). Bandura, A. (1977). Social learning theory.Social learning theory. New Jersey: Prentice HallNew Jersey: Prentice Hall

Lave, J. Wenger, E. (1991). Lave, J. Wenger, E. (1991). Situated Situated learning: Legitimate peripheral learning: Legitimate peripheral participation.participation. Cambridge: Cambridge Cambridge: Cambridge University PressUniversity Press

Vgotsky, L., S. (1978). Vgotsky, L., S. (1978). Mind in societyMind in society (ed. (ed. M. Cole, V. John-Steiner, S. Scribner and M. Cole, V. John-Steiner, S. Scribner and E. Souberman). Cambridge, MA: E. Souberman). Cambridge, MA: Harvard University Press.Harvard University Press.