The virtual birthing unit project/Phone call

''This lesson should take approximately 60 minutes and is appropriate for senior midwifery students, as well as anyone interested in childbirth. With a partner you will work your way through a scenario that focuses on the phone call that a pregnant woman makes to the birth unit when she is in early labour, and the midwife's response to it. This scenario is designed to support you to think about midwifery assessment and actions, decision-making and sharing information when you are talking to women on the telephone.''

Resources

 * Computer and Internet with access to Second Life
 * Basic ability to use Second Life and access the virtual birth unit http://slurl.com/secondlife/Kowhai/82/213/35/
 * Resource Pack that can be found in the meeting room on the second floor of the birth unit. -need to check that!!!
 * Midwife's self-assessment form and script for woman.
 * Extra resources to support this scenario either as links or printed handouts:
 * New Zealand College of Midwives. 2008. Midwives handbook for practice. New Zealand College of Midwives: Christchurch


 * New Zealand College of Midwives. (No date). Providing feedback about your midwife. Retrieved 15 July, 2009, from: http://www.midwife.org.nz/index.cfm/1,136,html


 * Pairman, S., Pincombe, J., Thorogood, C., & Tracy, S. (2006). Midwifery. Preparation for practice. Sydney: Elsevier.

Self-assessment form for midwife
Use this self-assessment form to assess your performance, reflect on what you did well and what you can improve in the future.

Script for woman
Here is the information about the last few hours for you to pass onto the midwife, along with your background story as and when it is appropriate or relevant. Feel free to add lib a little but please keep everything ‘normal’.

The idea of this exercise is for the midwife to assess your condition over the phone, and make a judgment about what is the right course of action to take. Wait until the midwife asks you questions – don’t give out all the information at once. Feel free to ask questions which you think will help to test the midwife's knowledge of normal childbirth


 * Contractions
 * You started getting contractions three hours ago 1:15 minutes. They started like period pains, all in your back. They are now 1:10 minutes, lasting 30 seconds. You can talk very easily through them. They feel like severe period pains when they come. They are bad enough to make it difficult to relax properly.<br


 * General health


 * Usually you don’t have any problems with passing urine but over the last couple of hours you have been on and off the toilet but it doesn’t hurt when you pass urine. You have had a couple of bouts of diarrhea today but you think that was because of the curry you had for supper yesterday. You have been very slightly nauseated all day so have only been snacking as opposed to eating regular meals. You don’t think your waters have broken. You have been wearing a thin sanitary pad and have noticed a small amount of mucusy jelly-like substance on the pad the last time you went to the toilet, but there has been no blood in it.


 * How you feel


 * Your husband is away on work at the moment but you have a girl friend, Sally, who lives just around the corner who can keep you company if you need it. You are excited about possibly being in labour but are a little anxious about what to expect. You want to stay at home as long as you can.

Here are some questions you may wish to ask.
 * When will I have my baby?
 * When shall I come to the birth unit?
 * What can I take for pain relief? Is it alright to take Panadol?
 * What should I do if my waters break?
 * How will I know if my waters have broken?
 * What should I do if the baby starts to come and I am all alone at home?

Learning objectives

 * Demonstrate an understanding of the role of the midwife in the normal childbirth process.
 * Demonstrate effective evidence based, midwifery practice guided by a sound knowledge base.
 * Demonstrate an understanding of significance of concepts of accountability, responsibility and independent practice as they relate to midwifery practice in New Zealand.

Instructions for Scenario One - Phone Call
1. Read the 'Introduction for students' which will give you a general background to the virtual birthing unit project. Set up your Second Life account and create your avatar. If you are using a personal computer, download Second Life. 2. Read the orientation package which will introduce you to Second Life and the skills you will need in this scenario.

3. Make your way with your partner to the back room of the birth unit, on the second floor.

4. Open the Resource Box - here are the instructions on how to open the Resource Box.

5............

6............

7.

8. The scenario ends when the woman is happy she has all the information she needs and has had all her questions answered and the midwife is satisfied with her assessment of the situation and the plan of action that she has developed.

9. Once the scenario ends, the woman will pass her feedback form to the midwife. The midwife will also carry out a self-assessment for her personal learning.

10. The midwife will complete her documentation on a notecard and post it into the filing cabinet in the midwives' office. The documentation will be automatically sent to a midwifery lecturer (in real life) who will give you feedback on how effectively you have documented your assessment and actions. The midwife will also be able to send her documentation to the woman. The student playing the woman will also be able to give feedback about the documentation. 11. Feel free to ad lib and role play as much or as long as you like but please remember that the scenario is programed to be a 'normal' labour and birth. For example, if you decide you would like to practice how to deal with an obstetric emergency, you will be unable to do so because the scenario has not been set up to present that eventuality.

12. This scenario involves role play so do not be shy; let your imagination run so that you and your partner gain maximum learning benefit from this simulation. At the same time, have fun. If you make a mistake or miss an action or assessment, you can start all over again and keep practicing until you are happy with your performance.