Exploring knowledge work and leadership in online midwifery communication.

AIM This paper reports a study to answer the following question: if given a user-friendly online system, that enabled communication across the practice community, would midwives function as knowledge workers? BACKGROUND Globally, the demand for quality-led and innovative service delivery requires that nurses and midwives shift from being 'information workers', or passive receivers of managerial and organizational decisions, to become 'knowledge workers' who are able to create, lead and communicate service innovation and practice development. New communication technologies may offer a means for healthcare professionals to interact as knowledge workers and develop supportive communities of practice. METHODS An online discussion forum was implemented as a low-cost technological intervention, deploying existing hardware and a standard hospital intranet. The evaluation of the forum was constructed as case-study organizational research. The totality of online communication, both traffic and content, was analysed over a 3-month period (193 messages downloaded 2003/2004), and 15 in-depth interviews were undertaken with forum users. FINDINGS Given simple, facilitative, innovative technology, supported by a positive working culture and guided by effective leadership, midwives could function as 'knowledge workers', critically reflecting upon their practice and translating knowledge into action designed to achieve change in practice. Participation occurred across all staff grades, and midwives were predominantly supportive and facilitative towards the contributions made by colleagues. CONCLUSION; Midwives may be well placed to exemplify the 'ideal' characteristics of the knowledge worker being demanded of modern healthcare professionals. The deployment of online interactive technologies as part of strategic vision to enhance knowledge work among healthcare professionals should be given attention within health systems.

[1]  C. Begley.  'Great fleas have little fleas': Irish student midwives' views of the hierarchy in midwifery. , 2002, Journal of advanced nursing.

[2]  H. Stapleton,et al.  Midwives' support needs as childbirth changes. , 2000, Journal of advanced nursing.

[3]  Susan E. Anderson,et al.  Using Electronic Mail Surveys and Computer-Monitored Data for Studying Computer-Mediated Communication Systems , 1995 .

[4]  M. Kirkham.  The culture of midwifery in the National Health Service in England. , 1999, Journal of advanced nursing.

[5]  D. Levine,et al.  Computer-Mediated Communication as Employee Voice: A Case Study , 1999 .

[6]  野中 郁次郎,et al.  The Knowledge-Creating Company: How , 1995 .

[7]  Lorena F. Ruberg,et al.  Student Participation, Interaction, and Regulation in a Computer-Mediated Communication Environment: A Qualitative Study , 1996 .

[8]  M. Kramer,et al.  Shared Values: Impact On Staff Nurse Job Satisfaction And Perceived Productivity , 1989, Nursing research.

[9]  Jennifer Preece,et al.  Lurker demographics: counting the silent , 2000, CHI.

[10]  P. Brodie.  Addressing the barriers to midwifery--Australian midwives speaking out. , 2002, Australian journal of midwifery : professional journal of the Australian College of Midwives Incorporated.

[11]  Ross Hightower,et al.  Effects of Communication Mode and Prediscussion Information Distribution Characteristics on Information Exchange in Groups , 1996, Inf. Syst. Res..

[12]  A Kitson,et al.  Enabling the implementation of evidence based practice: a conceptual framework. , 1998, Quality in health care : QHC.

[13]  Fiona Stewart,et al.  Internet Communication and Qualitative Research , 2000 .

[14]  S. Condon,et al.  Functional comparisons of face-to-face and computer-mediated decision making interactions , 1996 .

[15]  Jean Hartley,et al.  Case study research , 2004 .

[16]  Joyce E Thompson,et al.  The WHO Global Advisory Group on Nursing and Midwifery. , 2002, Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing.

[17]  Winston Tellis,et al.  Results of a Case Study on Information Technology at a University , 1997 .

[18]  Ojelanki K. Ngwenyama,et al.  Communication Richness in Electronic Mail: Critical Social Theory and the Contextuality of Meaning , 1997, MIS Q..

[19]  A. Clegg.  Leadership: improving the quality of patient care. , 2000, Nursing standard : official newspaper of the Royal College of Nursing.

[20]  Frank Blackler,et al.  EDITORIAL INTRODUCTION: KNOWLEDGE WORKERS AND CONTEMPORARY ORGANIZATIONS , 1993 .

[21]  B. Hunter.  Conflicting ideologies as a source of emotion work in midwifery. , 2004, Midwifery.

[22]  David Perideaux,et al.  Facilitating reflective learning in higher education , 2001 .

[23]  G. Whitney.  Computer‐mediated communication: Linguistic, social, and cross‐cultural perspectives , 1998 .

[24]  John Gabbay,et al.  A Case Study of Knowledge Management in Multiagency Consumer-Informed `Communities of Practice': Implications for Evidence-Based Policy Development in Health and Social Services , 2003 .

[25]  Alexander Ardichvili,et al.  Motivation and barriers to participation in virtual knowledge-sharing communities of practice , 2003, J. Knowl. Manag..

[26]  S. Herring.  Two variants of an electronic message schema , 1996 .

[27]  Ian Alexander,et al.  An introduction to qualitative research , 2000, Eur. J. Inf. Syst..

[28]  N. Leap.  Making sense of ‘horizontal violence’ in midwifery , 1997 .

[29]  John M. Dirkx,et al.  Book Review: Building Learning Communities in Cyberspace: Effective Strategies for the Online Classroom , 2003 .

[30]  P. Scott,et al.  Knowledge work in nursing and midwifery: an evaluation through computer-mediated communication. , 2006, International journal of nursing studies.

[31]  Nigel Shadbolt,et al.  Towards a knowledge technology for knowledge management , 1999, Int. J. Hum. Comput. Stud..

[32]  John Storey.  Leadership in organizations : current issues and key trends , 2004 .

[33]  B. Posner,et al.  Leadership challenge. , 1996, Nursing times.

[34]  Richard E. Boyatzis,et al.  Transforming Qualitative Information: Thematic Analysis and Code Development , 1998 .

[35]  C. Furber.  Interactive multimedia in midwifery education , 2001 .

[36]  Ian McGill,et al.  Facilitating Reflective Learning in Higher Education , 1998 .

[37]  Ulrike Schultze,et al.  A Confessional Account of an Ethnography About Knowledge Work , 2000, MIS Q..

[38]  M. Crossan.  The Knowledge-Creating Company: How Japanese Companies Create the Dynamics of Innovation , 1996 .

[39]  Glenn Robert,et al.  Knowledge management and communities of practice in the private sector: lessons for modernizing the National Health Service in England and Wales , 2002 .

[40]  D. Schoen.  Educating the reflective practitioner , 1987 .

[41]  R. Deery,et al.  A critical ethnographic approach to facilitating cultural shift in midwifery. , 2002, Midwifery.

[42]  M. Avery,et al.  The transition to Web-based education: enhancing access to graduate education for women's health providers. , 2003, Journal of midwifery & women's health.

[43]  Christopher M. Johnson,et al.  Communities of Practice , 2001 .

[44]  Paul Quintas.  Managing knowledge in a new century , 2001 .

[45]  T. Lavender,et al.  An exploration of midwives' views of the current system of maternity care in England. , 2004, Midwifery.

[46]  E. Wenger,et al.  Communities of Practice: The Organizational Frontier , 2000 .

[47]  Natasa Rupcic,et al.  The fifth discipline-the art and practice of the learning organisation , 2002 .

[48]  Giuseppe Mantovani,et al.  Is Computer-Mediated Communication Intrinsically Apt to Enhance Democracy in Organizations? , 1994 .

[49]  Bradley L. Kirkman,et al.  Beyond Self-Management: Antecedents and Consequences of Team Empowerment , 1999 .

[50]  Fiona Stewart,et al.  Internet Communication and Qualitative Research: A Handbook for Researching Online , 2000 .

[51]  J. Brown,et al.  Organizational Learning and Communities-of-Practice: Toward a Unified View of Working, Learning, and Innovation , 1991 .

[52]  J. Cross.  Building Learning Communities in Cyberspace , 2004 .

[53]  Bernt Schnettler,et al.  Virtual Ethnography , 2007 .

[54]  Leanne Wood,et al.  Small Business Use of Electronic Networks , 2000, Woman, Work and Computerization.

[55]  P. Duguid,et al.  Balancing act: how to capture knowledge without killing it. , 2000, Harvard business review.