TOTEMM - An International Project!

Learning about international midwifery perspectives is something that I strongly believe will benefit my own practice and after going to Norway last year, my eyes were really opened to the ideas. A few weeks ago, I applied for the opportunity to be one of two Student Ambassadors to be a part of an international project involving four different countries. Of course, I jumped at the chance and was very excited to be successful. 

I spoke about it briefly in my Week of the International Student but the project forms a larger part of TOTEMM, which is a much shorter title for the full name: Transforming Transnational Intercultural Sensitivity for Midwifery Students through an Inclusive Mobility Model. The project aims to promote equity, inclusion and participation of non-mobile midwifery students studying in 4 countries through implementing virtual and physical mobility activities, to help develop intercultural sensitivity. 

Usually,  a one week group activity would occur once a year and it would be hosted in a different country, with alternate hosts each year. This year of course, it's all happening online. I still wanted to share my experience of attending and talk about what I took away from the sessions! It was so interesting being able to discuss concepts between different countries and also have free time to talk to the other students about the different midwifery programmes in Estonia, Italy, Netherlands and England. 

The first day was a little more of an introductory session and felt quite dry because there wasn't a whole lot of interaction from the student's perspective. Having said that, hearing different presentations from other countries was really informative and interesting. I really enjoyed one on abortion in different countries. The care pathway is very different to that in the UK. Instead of taking place over a number of days, it is quite a quick process. A tablet is placed under the tongue to dissolve for 30 minutes, then repeated 3 hours later and again until complete. Bleeding begins after around 6 hours. The crucial point about this was that the information was readily available to the public via cartoon animated videos which were easily understandable and accessible. 

Hearing different perspectives also inspired new ways to look at working from my perspective. All the countries agreed that time constraints prevented the gold standard of care from being provided and in a way, I'm glad it's not just the UK that feels that way. The Netherlands discussed a concept of centring which was a way they approached antenatal care. Each "appointment" is 90 minutes long, with a small portion at the start of the session for individual clinical assessments and then the education aspect is done as a large group. It's not completely dissimilar to our antenatal classes but much more in depth and with 8-12 women, without partners. it also involved a lot more discussions between group members, rather than teaching at them. Through this, they hoped to normalise the negative sides of pregnancy e.g. miscarriage, discharge etc. Small pilot studies in the US showed that this method reduced preterm deliveries and although relatively new in the Netherlands, initial results show less pain relief is required in labour, more breast feeding, increased satisfaction and reduced smoking.

To end the day, whilst the programme leads and partners met about the process of the project, the students went off to a separate "room" online and did a pub quiz. It was a very hard and completely unrelated quiz where none of us really knew the answers, all very historical about the Netherlands. But it also gave us opportunity to speak more freely between just the students and ask questions to each other. Even though we couldn't socialise in person, it very much felt like a social, albeit, a facilitator was there to help manage.

Day two and three were much more interactive for us as students and much more enjoyable for myself, but both very similar. I sadly had to leave half way through the first day as I was going to work to do a late shift, but I still got to help develop 2 of the 4 packages. It started with a presentation on how the system works, how to plan and what to do to design the packages. For me, it was quite dry and repetitive because it was our team in charge of the e-learning platform and therefore I was already familiar with the process and understood what we were designing. Nevertheless, it was somewhat interesting to see what goes into each of the packages. 

The four package topics were all very different and had overarching themes that the partners wanted including in the packages based on the aims of the TOTEMM project. It was a unique perspective and not one I find we often get taught, nor does it come naturally when thinking of the particular topics. I also found the topics quite difficult to initially brainstorm the concepts. Once the conversation started, the ideas started flowing. My favourite part was designing the student activities for each topic. From past experience, I've found a lot of our self-directed packages throughout the course quite boring and I wanted to make something students would enjoy and find interesting, whilst hitting the objectives. I feel we've made a really good start on this and although I will no longer be a student when the packages go live at the start of the new year, I hope they are a huge success. 

The event ended with a lovely chat talking about our favourite parts of the event and any advice we would give to improve it in the future. For anyone who has the opportunity to get involved in the future, I would 100% say go for it. Whilst being online does have it's disadvantages, it did mean the sessions were relatively flexible around placement so I didn't have to miss a week and make it up. It also made it much cheaper. Of course, going abroad would have been another huge bonus of the project and meeting people in person would have been lovely. I felt like everyone was nice but didn't really get to know anyone well because the opportunities for talking were limited and very much scheduled. Overall, I loved it and I just think it's a shame I won't get to enjoy the final products!