Can you think of any clinical procedures that have no benefit?
How up to date are your hospital/facility policies?
What do you do as a matter of routine that you wonder may be of no value?
When was the last time you looked at evidence about an element of practice?
Mary notices a problem with dehydration in the women in her care Mary explores the issue of fasting in labour Mary decides to try allowing women to eat and drink in labour Mary reflects on the consequences of her new practice approach Assess & Plan Implementation Evaluation
Susan ‘made’ a woman have an epidural Susan thinks about her attitudes to pain in labour and how she supports women Realizes that she finds it hard to see women in pain Decides she must work on her own confidence in being a midwife Experiencing Interpreting Learning
What are the power relationships that constrain my practice?
How can I improve my practice in the light of those constraints?
How does my perceptions of me and my practice constrain me?
Lisa (midwife) shouts at Ann (student) for encouraging a woman to birth standing Thinks about student/midwife relationship Ann considers Lisa’s feelings about being midwife responsible Ann talk to Lisa about birth positions, show her evidence & plans for future births Construct Deconstruct Confront Reconstruct