Distance learning is the study mode void of the immediate or constant supervision of the instructors or the lecturers; it benefits from the guidance of tutorials and planning of a tutorial organization. Distance learning is where the student is far away from the tutors, and the institution of learning, the model lacks the interactivity or face-to-face contact between the student and the tutor (Banas & Emory, 1998).

Modern communication media play an indispensable role in ensuring that that the tutorials of the tutor and counseling system reach the student in local centers or any other place where the student can access that medium in real time. Distance learning no doubt has a value to the busy and well-motivated adults because they can access the learning environment at the comfort of their homes.

Distance learning day in day out is attracting so many learners across the globe who are either busy to attend the classes in person or lack the financial capability to do so. The learner is supposed to have a reliable media through which the tutors can access them (Carr, 2000). One of the common media that is in distance learning is the internet that connects all the places in the world. The tutor may also decide to use phone calls or the radio depending on the agreement they make with their students.

In this case, the study pack will revolve around the continuing education in the field of shoulder dystocia. Shoulder dystocia is a complication that occurs at childbirth such that the after-birth of the unborn baby, the baby’s anterior shoulders remain dislodged behind the mother’s pubic bone in the vagina. Shoulder dystocia is the most anxiety provoking emergencies that the health professional encounter in the maternity ward. It results from the impaction of the posterior shoulder on the sacral promontory. So many factors influence the shoulder dystocia inclusive of the mother’s health and the extraction mechanism used during delivery.

The learning program in question is the continuing education. Continuing education here means that the students are professionals seeking to enhance their knowledge about shoulder dystocia. Shoulder dystocia captures our interests, as it is the most challenging emergencies that tend to trouble physicians and midwifes. The learning resources are within the confines of the system, on the internet or any other open learning resources as specified by that institution. Interestingly, the open learning institution module is common to many colleges and universities and any middle-level institution offering post-high school studies. Any educational institution that wishes to offer distance learning can access it by buying the software and programme the site to suit their demands or as per the requirements of the course (Li, Tsai & Tsai, 2008).

At the end of this program, we are going to know how we are going to handle different situations leading to shoulder dystocia. Just like any other institution that the students are attending, open learning offers great opportunities for their students to develop skills, professionalism, and discipline. A student is not supposed to miss the online tutorials because they will account for the overall aggregate grade. In some institutions, the students make attempts and attend live classes for the lecturers and tutors to access their personalities.

2. Describe the type of model

Pedagogical model used in this study because it meant for open and distance learning (E-learning) and it entails of the students who are away from classes because they are busy, or they are self- motivated somewhere. The nurses are students of this program of the course, and they form the same audience with the labor. In pedagogical model of education, the students and the teacher or the tutor cannot meet at any point but discuss their class work through the internet. In studying shoulder dystocia, the nurses can find material for use on the internet or bookstores.

In the pedagogical model education is not only a social tool that delivers messages from one individual to another, but also to expedite another person’s social status. This type of a model boosts an individual’s cultural aspect and at the same instance, develops the character’s skill at will. Educators do not have individualism and do not have a lot of freedom. The program is tailor-made for home-based students. The nurses are required to login to the educational site and follow the instructions. The choice of this program in the shoulder dystocia is because most of the nurses are busy with their jobs, therefore, cannot afford to attend physical classes. The program ensures that nurses can attend their online classes at their convenient time.

3. Describe the learning program

Continuing education is a post-secondary education meant to enable one to acquire additional certificates or credits in order to enable them maintain their Licence. Therefore, nurses are required to undergo this training to add value towards their career and consequently increase their knowledge as far as their nursing is concern. Shoulder dystocia is a dangerous problem that many women suffer. The nurses are required to know how they should handle such patients to avoid further maternal deaths.

The program will also require each nurse to cover all the required topics as stipulated in the curriculum; the topics covered revolve around handling shoulder dystocia cases. The program’s aim is to educate nurses on the recent advances of shoulder dystocia and other aspects of attending a laboring woman in the maternity room. Coming to the end of this course, those students who will be successful will receive a certificate as proof of having undergone training on handling shoulder dystocia cases.

The program encompasses many learning objectives about shoulder dystocia. The learners should be in a position of stating the common risks factors that a patient with shoulder dystocia can face. Students will also be required to describe the potential complications of shoulder dystocia. The study will also focus on the areas where the student performs maneuvers to relieve shoulder dystocia. Finally, the study will also describe the components of a shoulder dystocia.

This program on shoulder dystocia will cover the following topics:

Introduction- this is a brief introduction of the term shoulder dystocia. The introduction gives the definition of the term shoulder dystocia

Identify the risk factors: in this case, we are going to discuss some of the dangerous factors that may have caused the problem of shoulder dystocia to happen. It will include factors such as the gestational diabetes, short stature, postdates pregnancy, abnormal pelvic anatomy, and previous shoulder dystocia.

Complications of shoulder dystocia: in this case we are going to consider some of the dangers ta woman is likely to incur after she has been affected by shoulder dystocia such as the uterine rupture, symphyseal separation postpartum hemorrhage, recto-vaginal fistula and brachial plexus palsy.

Reduction maneuvers: this will cover on how the nurse should respond to the state of shoulder dystocia such as call for help, McRobert maneuver. Suprapubic pressure, enter maneuver and removal of the posterior arm.

Simulation case: comprises of case studies that will help in the analysis of the shoulder dystocia. The nurses in the delivery room are ready to deliver the patient. It will also consider what the labor and delivery nurses are going to do? The doctors at this stage are having hard time to deliver this patient.

Posttest: consider some of the risk factors for shoulder dystocia, post-delivery complications, and components of a shoulder dystocia.

There must be the development of a portfolio, in a way that it tests all the students across the board. The portfolio will act as a platform through which the instructor and the students are supposed to check their quality work there. The lecturer can trace the student who never did the assignment or test. The portfolio will thereafter send the information to the instructor for assessment and grading. Therefore, distance learning will put the nurses to task and have the course done. Every student who is in the program must have a portfolio that will enable the tutors to do pre-and –post-tested with a standardized way of an assessment that will educational functioning level.

The portfolio will serve as a checker of the students to the lecturer and therefore serve the following functions:

It will serve as the only way that the lecturer will use to determine the student progress without solely on the standardized test scores.

It identifies the students who drops very earlier from the portfolio and establish the standard way of dealing with such students.

Portfolio also ensures the students have participated in an online educational learning process. The portfolio, on the other hand, will ensure that references are up to date to ensure that the student has moved to a certain level thus meeting academic and personal goals.

Every portfolio must include specific components to its students. It is to ensure that the components belong to each and ensure standardization of the education or access to all the students across the board.

The tutorials in the portfolio will take at most 60minutes and later automatically reviewing every 90 days. The learners now are required to a sitting paper, which will prepare them for graduation.

4. Teaching strategies

Learning strategies involves ways in which the teacher uses to improve the understanding of its students. In distance learning, therefore, the nurses are equipped with the simplest ways of understanding better the concept of shoulder dystocia in the delivery room. Online learning, therefore, incorporates the element of teaching strategies that are likely to be in class in its teaching and learning. It means that the learners can still get to understand as if they were in class attending lectures of a live teacher.

There is a lot of activeness from the student for the sake of understanding. The student portfolio is in a way that no more usage of time than set. The student, therefore, must have to ensure that he must work within the specified time for him to earn good marks. Another element is a critical thinking; a learner must have to read and critically analyze the question to give a collect answer to a particular question. The labor and delivery nurses must ensure that whatever they are going to write about the shoulder dystocia is justified and stands to be true according to the nursing profession.

In distance learning, the student learns about inter-disciplinary teaching just like a live class. It happens when the lecture assesses its students online and ensures that he or she copes with the speed and answers all the questions that are in her portfolio. If a student fails to observe time and answer all the questions, discipline is for those with low marks.

There is also instructional learning where the student has instructions based on what the lecturer demands from him. It happens because the instructor guides the student on what to do in every step he or she takes. This way of learning ensures a live serene between the instructor and the student, instructions followed and where possible the student can ask questions.

5. Literature on shoulder dystocia

A study done by Genon (1992) showed critical value of clinical estimation of fetal weight may be slightly higher than when it is with trasonography. Later the second part of this study will focus on prenatal diagnosis of microsomia caused by the occurrence of the shoulder dystocia and the birth trauma resulting to preventing it from occurring again.

Levine (1992) showed that if the microsomia were present then ninth percent of the fatal in birth would increase given gestational age. Therefore, he concluded that the sonographic prediction was wrong citing it was 50% of the both underestimation and overestimated that fetal weight.

McFarland (1998) argued that microsomic infants of diabetic mothers have larger shoulder that makes it impossible for a kid not to get out of the mother’s vagina. Anthropomorphic characteristics explain the propensity for shoulder dystocia amongst this population. This characteristic makes the fetus grow abnormally in their shoulders thus making it difficult for a child to pass through vagina.

Orskou 2003 discovered that women with parity of more than two had a great chance of giving birth to a microsomic baby who is underweight hence having difficulty in giving birth due to shoulder dystocia. Baskett (1995) gave evidence on microsomia associated continued growth of the fetal growth in pre-birth pregnancies thus presenting a high risk of shoulder dystocia.

Acker (1986) pointed that the relative frequency of shoulder dystocia varied directly with the increasing weight of the baby there it a fact that the babies who were in the average body size recorded an ordinary delivery. In a research conducted in Beth Israel Hospital that forth seven percent of the babies who were shoulder dystocia and weighed more than 4000gms weight category thus encompassing ninth one percent of the total deliveries.

Moodle is the online technology that can transmit and offer academic programs such as videos and text messages. Moodle provides a suitable interface in which the learner and the instructor’s responses can reach each of them in a proper way. Moodle is for educational reasons, can make an evaluation in regard of what the student has written.

The course will take three months comprising a whole semester. There will be 3 hours a week, and it will be a standalone session. Students attend their online classes on Thursdays starting exactly ten o’clock in the morning to one afternoon.