Joanne is Head, Graduate School of Health at the University of Technology Sydney. Joanne is a registered nurse and midwife and has been involved in midwifery and nursing education in the higher education sector for many years. She has worked as a midwife in both rural and metropolitan New South Wales. Joanne has played a key role in the development and implementation of midwifery curricula, including the first distance education midwifery program for registered nurses (Charles Sturt University, 1990) and the first Bachelor of Midwifery to be offered in NSW (UTS, 2005).
Joanne is a member of the Centre for Midwifery, Child and Family Health and supervises higher degree research students in the areas of midwifery workforce, midwifery education and simulation in midwifery.
Joanne's research focusses on midwifery education, the embedding of continuity of midwifery care experiences and innovative approaches to learning, teaching and assessment. In 2017 Joanne led a team who were awarded a Citation for Outstanding Contributions to Student Learning through the Australian Awards for University Teaching (AAUT) for the development of Indigenous professional capability in nursing and midwifery students.
Since 2011 Joanne has been a member of the Australian Nursing and Midwifery Accreditation Council (ANMAC) Midwifery Accreditation Committee. She Chairs the Professional Reference Group to review the Midwifery Education Standards (2019).
Joanne is also the current Chair of the UTS Academic Board, a position she has held since 2015.
Chair, Midwifery Accreditation Committee, Australian Nursing and Midwifery Accreditation Council (ANMAC)
Practitioner member, NSW Board of the Nurses and Midwives Board of Australia
Fellow, Australian College of Midwives
Can supervise: YES
Simulation in midwifery and nursing education
Teaching and learning
Midwifery - undergraduate / postgraduate
Higher degrees supervision
Gray, JE & Smith, RM 2008, Midwifery essentials, Churchill Livingstone, Sydney, Australia.
The Illustrated Dictionary of Midwifery is an adaptation of the popular UK dictionary, of the same name, for Australian and New Zealand student and practicing midwives. This highly illustrated dictionary contains approximately 4,000 midwifery terms and abbreviations. The Australian authors have further developed the dictionaryâs women-centred care approach and updated the evidence throughout.
Sheehy, A, Smith, RM, Gray, JE & Homer, CSE 2019, 'Midwifery pre-registration education and mid-career workforce participation and experiences.', Women and birth : journal of the Australian College of Midwives, vol. 32, no. 2, pp. e182-e188.View/Download from: Publisher's site
Midwives in Australia are educated through a range of routes providing flexible ways to become a midwife. Little is known about whether the route to registration impacts on mid-career experiences, in particular, whether the pathway (post-nursing pathway compared with 'direct-entry') makes any difference.The aim of this study was to explore the midwifery workforce experiences and participation in graduates six to seven years after completing either a post-nursing Graduate Diploma in Midwifery (GradDip) or an undergraduate degree, the Bachelor of Midwifery (BMid), from one university in New South Wales, Australia.Data were collected from mid-career midwives having graduated from one NSW university from 2007-2008 using a survey. The survey included validated workforce participation instruments - the Maslach Burnout Inventory (MBI), the Practice Environment Scale-Nursing Work Index (PES-NWI) and the Perceptions of Empowerment in Midwifery Scale (PEMS).There were 75 respondents: 40% (n=30) Bachelor of Midwifery and 60% (n=45) GradDip graduates. The age range was 27-56 years old (mean age=36 years) Bachelor of Midwifery graduates being on average 7.6 years older than Graduate Diploma in Midwifery graduates (40 vs 33 years; p<0.01). Almost 80% (59), were currently working in midwifery. Nine of the 12 not working in midwifery (75%) planned to return. There were no differences in workforce participation measures between the two educational pathways. Working in a continuity of care model was protective in regards to remaining in the profession.Most mid-career graduates were still working in midwifery. There were no differences between graduates from the two pathways in relation to burnout, practice experiences or perceptions of empowerment.
Sweet, L, Bazargan, M, McKellar, L, Gray, J & Henderson, A 2018, 'Validation of the Australian Midwifery Standards Assessment Tool (AMSAT): A tool to assess midwifery competence.', Women and Birth, vol. 31, no. 1, pp. 59-68.View/Download from: Publisher's site
There is no current validated clinical assessment tool to measure the attainment of midwifery student competence in the midwifery practice setting. The lack of a valid assessment tool has led to a proliferation of tools and inconsistency in assessment of, and feedback on student learning.This research aimed to develop and validate a tool to assess competence of midwifery students in practice-based settings.A mixed-methods approach was used and the study implemented in two phases. Phase one involved the development of the AMSAT tool with qualitative feedback from midwifery academics, midwife assessors of students, and midwifery students. In phase two the newly developed AMSAT tool was piloted across a range of midwifery practice settings and ANOVA was used to compare scores across year levels, with feedback being obtained from assessors.Analysis of 150 AMSAT forms indicate the AMSAT as: reliable (Cronbach alpha greater than 0.9); valid-data extraction loaded predominantly onto one factor; and sensitivity scores indicating level of proficiency increased across the three years. Feedback evaluation forms (n=83) suggest acceptance of this tool for the purpose of both assessing and providing feedback on midwifery student's practice performance and competence.The AMSAT is a valid, reliable and acceptable midwifery assessment tool enables consistent assessment of midwifery student competence. This assists benchmarking across midwifery education programs.
Power, TJ, Virdun, C, Gorman, E, Doab, A, Smith, R, Phillips, A & Gray, J 2018, 'Ensuring Indigenous cultural respect in Australian undergraduate nursing students', Higher Education Research and Development, vol. 37, no. 4, pp. 837-851.View/Download from: Publisher's site
Similar to other Westernised countries, Australia’s history of colonisation, racism and oppression has impacted upon Indigenous Peoples’ health and wellbeing. It is also evident that institutional racism and ongoing colonisation are present in the Australian health system. Better preparation of health professionals to work in a culturally respectful way can contribute to addressing health disparities and prejudices. One approach to enabling the development of cultural respect, is through embedding an Indigenous Graduate Attribute (IGA) across curricula and ensuring the process is thoughtfully developed and assessed. This paper describes and discusses the process of developing an Assessment Criteria Template (ACT) to assess Indigenous cultural respect in an undergraduate nursing degree program. Critical to the project was meaningful engagement with Indigenous stakeholders and Indigenous leadership to inform the development and implementation process. Although the context will vary globally due to the diversity of Indigenous Peoples and each country’s history of colonisation, by publishing this work, we intend to provide transparency into the process we undertook to embed and assess an IGA ACT in an undergraduate nursing curriculum. We hope this is helpful for other tertiary institutions internationally who are also engaging in this space.
Cummins, AM, Smith, R, Catling, C, Watts, N, Scarf, V, Fox, D & Gray, J 2018, 'Midwifery Graduate Attributes: A model for curriculum development and education.', Midwifery, vol. 61, pp. 66-69.View/Download from: Publisher's site
Models of midwifery education need to evolve to meet changing needs of the profession. This requires a constant process of review and re-evaluation of curricula. Courses that lead to midwifery registration must not only meet national and international standards, but many also commit to producing graduates who meet course-specific graduate attributes. These attributes differ between models of education and courses and are pivotal in providing clear direction for the development of higher level abilities in graduates. Visionary graduate attributes provide the opportunity to prepare graduates to function and flourish in a fast changing social and professional environment and to prepare them for a future that is largely unknown (Bowden et al., 2000).
The University of Technology Sydney (UTS) has embraced the concept of graduate attributes and all graduates are expected to demonstrate capability in both University and course-specific attributes. The UTS model of learning provides a framework for practice oriented learning that aligns graduate attributes and curriculum design. The model is focussed on three distinctive areas, practice oriented education situated in a global workplace through learning that is research inspired and integrated (UTS 2017). Each course offered by UTS has embedded graduate attributes that reflect the overall aim of the course. These provide important information for students, the public and future employers as to what personal, professional and intellectual attributes to expect from a graduate of that course.
Commencing in 2012, the midwifery team undertook a project to develop visionary attributes for midwifery graduates and this paper describes and discusses the development and implementation process of the graduate attributes model.
BACKGROUND: In 1997 a group of midwifery academics, researchers and practitioners met to discuss issues of concern related to the midwifery profession in Australia. It became clear from this discussion that midwifery in Australia was lagging behind similarly developed countries and that urgent action was required. From this meeting, a plan was developed to seek funding for a major national study into midwifery education and practice standards and as such, the Australian Midwifery Action Project (AMAP) was born. DISCUSSION: This discussion paper presents an overview of a number of midwifery education and regulation changes within the framework of the recommendations from the Australian Midwifery Action Project. A key question arising from this discussion is whether our current midwifery education and regulation standards provide a fit-for-purpose workforce that ensures all women and their families receive best practice midwifery care. Over the past 20 years the Midwifery profession in Australia has undergone significant changes and developments and these changes have had, and continue to have, significant impact on midwifery education and therefore on the quality of midwifery practice in Australia. CONCLUSION: Many changes have been implemented in the nearly 20 years since AMAP was first conceived. However, many of the issues that provided the impetus for a project such as AMAP remain and are still to be resolved. The midwifery profession continues to be subsumed with nursing, it is not possible to gain accurate midwifery workforce data and, despite the development of national standards for midwifery education, wide variations in courses still exist across Australia.
Midwife-led continuity of care models demonstrate a number of benefits to women with no adverse effects. These benefits include a reduction in childbirth interventions, an increase in spontaneous vaginal births for women of low and increased risk (Begley et al., 2011, Hartz et al., 2013 and Sandall et al., 2015) and a reduction in rates of caesarean sections in women of low risk (McLachlan et al., 2012). This model of care also demonstrates increased satisfaction for women when compared to other models of maternity care (Sandall et al., 2015).
Given the significant benefits to women, the inclusion of a requirement for students to experience midwife-led continuity of care models was considered to be fundamental to all midwifery education programs. Prior to the introduction of Bachelor of Midwifery programs in Australia in 2002 there were no requirements for midwifery students to experience midwifery continuity of care. Indeed, there were very few continuity of midwifery care models in Australia (Gray, 2010) and students therefore gained their midwifery knowledge, skills and abilities by working with women in models of care with little exposure to the concept of continuity. Midwifery leaders were aware of the integration of continuity experiences in midwifery education programs in the United Kingdom (Anderson and Lewis, 2000) and in New Zealand (Pairman, 2000) and the opportunities that these provided to students to both work with women and experience and understand continuity of midwifery care.
Halcomb, E, Jackson, D, Daly, J, Gray, J, Salamonson, Y, Andrew, S & Peters, K 2016, 'Insights on leadership from early career nurse academics: findings from a mixed methods study', JOURNAL OF NURSING MANAGEMENT, vol. 24, no. 2, pp. E155-E163.View/Download from: Publisher's site
Power, T, Virdun, C, Sherwood, J, Parker, N, Van Balen, J, Gray, J & Jackson, D 2016, 'REM: A Collaborative Framework for Building Indigenous Cultural Competence', JOURNAL OF TRANSCULTURAL NURSING, vol. 27, no. 5, pp. 439-446.View/Download from: Publisher's site
Townsend, L, Gray, J & Forber, J 2016, 'New ways of seeing: Nursing students' experiences of a pilot service learning program in Australia', NURSE EDUCATION IN PRACTICE, vol. 16, no. 1, pp. 60-65.View/Download from: Publisher's site
Jackson, D, Peters, K, Andrew, S, Daly, J, Gray, J & Halcomb, E 2015, 'Walking alongside: a qualitative study of the experiences and perceptions of academic nurse mentors supporting early career nurse academics.', Contemporary Nurse, vol. 51, no. 1, pp. 69-82.View/Download from: Publisher's site
This study explores the experiences and perceptions of academic nurse mentors supporting early career nurse academics (ECNAs).Interviews were undertaken with mentors following a mentoring partnership with ECNAs. Data were transcribed verbatim and analysed using a process of thematic analysis.Four themes emerged from the data, namely; motivation for mentoring; constructing the relationship; establishing safe boundaries and managing expectations.This study provides a unique insight into the experiences of mentoring within the context of an academic leadership programme for nurses. Such insights highlight the issues facing academics from professional disciplines and can inform strategies to support their career development.A sustainable academic nursing workforce is crucial to ensure that effective preparation of future generations of expert clinical nurses. Therefore, it is important to consider strategies that could strengthen the academic nursing workforce.
Virdun, C, Gray, JE, Sherwood, J, Power, TJ, Phillips, AB, Parker, NJ & Jackson, DE 2013, 'Working together to make Indigenous health care curricula everybody's business: a graduate attribute teaching innovation report', Contemporary Nurse, vol. 46, no. Special Issue, pp. 97-104.View/Download from: Publisher's site
Previously there has been commitment to the idea that Indigenous curricula should be taught by Indigenous academic staff, whereas now there is increasing recognition of the need for all academic staff to have confidence in enabling Indigenous cultural competency for nursing and other health professional students. In this way, Indigenous content can be threaded throughout a curriculum and raised in many teaching and learning situations, rather than being siloed into particular subjects and with particular staff. There are many sensitivities around this change, with potential implications for Indigenous and non-Indigenous students and staff, and for the quality of teaching and learning experiences. This papers reports on a collaborative process that was used to reconceptualise how Indigenous health care curricula would be positioned throughout a program and who would or could work with students in this area. Effective leadership, establishing a truly collaborative environment, acknowledging fears and perceived inadequacies, and creating safe spaces for sharing and learning were crucial in effecting this change.
Gray, JE, Leap, N, Sheehy, AD & Homer, CS 2013, 'Students' perceptions of the follow-through experience in 3 year bachelor of midwifery programmes in Australia', Midwifery, vol. 29, no. 4, pp. 400-406.View/Download from: Publisher's site
Background: providing opportunities for students to participate in midwifery continuity of care experiences is a challenge in many midwifery education programmes. The `follow-through experience' was a deliberate strategy introduced into midwifery education programmes in Australia to ensure that students experienced midwifery continuity of care.
Raymond, J, Homer, CS, Smith, RM & Gray, JE 2013, 'Learning through authentic assessment: An evaluation of a new development in the undergraduate midwifery curriculum', Nurse Education in Practice, vol. 13, no. 5, pp. 471-476.View/Download from: Publisher's site
Assessment is a powerful influence on learning, and can form an important strategy amongst a variety of teaching and learning approaches. Authentic assessment activities are designed to mimic the complexity of 'real world' situations that students may encounter in professional life, and require the application of a combination of skills related to knowledge, skills and attitude.
Dignam, DM, Duffield, CM, Stasa, H, Gray, JE, Jackson, DE & Daly, J 2012, 'Management and leadership in nursing: an Australian educational perspective', Journal of Nursing Management, vol. 20, no. 1, pp. 65-71.View/Download from: Publisher's site
Aim: In this article, we present an Australian perspective on issues influencing management and leadership education in nursing. Background: Nurse leaders and managers work in a context of high pressure, uncertainty and rapid change, and face unprecedented challenges on a daily basis. Evaluation and Key Issues: In the present paper, we reflect on the issues and challenges facing providers of management education for nursing, and consider these challenges in relationship to current trends and imperatives. Conclusions: Collaborative approaches between educational and clinical settings are needed to ensure quality, relevant educational support for managers and leaders, and enhance curriculum integrity. Implications for Nursing Management: There is a need for contemporaneous and relevant research to inform innovative models of collaborative education.
Smith, RM, Gray, JE, Raymond, JE, Catling, C & Homer, CS 2012, 'Simulated Learning Activities: Improving Midwifery Students' Understanding of Reflective Practice', Clinical Simulation in Nursing, vol. 8, no. 9, pp. 451-457.View/Download from: Publisher's site
Graduate Diploma in Midwifery students at an Australian university poorly evaluated a compulsory theoretical subject (unit of study) titled Becoming a Reflective Practitioner over several years. Method: Authentic practice-based simulated scenarios were introduced to improve student learning and as an innovative approach to teaching reflective practice. The introduction was evaluated using student feedback surveys, pre- and post simulation knowledge questionnaires, and 6-week retention-of-knowledge questionnaires. Students reported improved levels of satisfaction, greater earning, and increasing knowledge in the simulated practice area. The students rated the scenarios as useful in increasing reflective practice, but this was secondary to skill acquisition. Simulated activities may prove useful in developing reflective practice, but further investigation is required to examine how to shift the focus from clinical skill acquisition to reflective practice.
Gray, JE, Leap, N, Sheehy, AD & Homer, CS 2012, 'The 'follow-through' experience in three-year Bachelor of Midwifery programs in Australia: A survey of students', Nurse Education in Practice, vol. 12, no. 5, pp. 258-263.View/Download from: Publisher's site
The follow-through experience in Australian midwifery education is a strategy that requires midwifery students to follow a number of women through pregnancy, labour and birth and into the parenting period. The experience was introduced by the Australian College of Midwives as part of national standards for the three-year Bachelor of Midwifery programs. Anecdotally, the introduction caused considerable debate. A criticism was that these experiences were incorporated with little evidence of their value. An online survey was undertaken to explore the follow-through experience from the perspectives of current and former students. There were 101 respondents, 93 current students with eight recent graduates. Participants were positive about developing relationships with women. They also identified aspects of the follow-through experience that were challenging. Support to assist with the experience was often lacking and the documentation required varied. Despite these difficulties, 75% felt it should be mandatory as it facilitated positive learning experiences. The follow-through experience ensured that students were exposed to midwifery continuity of care. The development of relationships with women was an important aspect of learning. Despite these challenges, there were significant learning opportunities. Future work and research needs to ensure than an integrated approach is taken to enhance learning.
Fenwick, JH, Hammond, AD, Raymond, JJ, Smith, RA, Gray, J, Foureur, M, Homer, CS & Symon, A 2012, 'Surviving, Not Thriving: A Qualitative Study Of Newly Qualified Midwives' Experience Of Their Transition To Practice', Journal Of Clinical Nursing, vol. 21, no. 13-14, pp. 2054-2063.View/Download from: Publisher's site
Aim and objectives. The study explored the experiences of newly qualified midwives and described the factors that facilitated or constrained their development during the transition from student to registered midwife.
Smith, R & Gray, J 2011, 'Simulated, stimulated and self-efficacy measures: Evaluation of a pilot project in midwifery education', Women and Birth, vol. 24, pp. S5-S6.View/Download from: Publisher's site
Hammond, AD, Gray, JE, Smith, RM, Fenwick, JH & Homer, CS 2011, 'Same ... Same But Different: Expectations Of Graduates From Two Midwifery Education Courses In Australia', Journal Of Clinical Nursing, vol. 20, no. 15-16, pp. 2315-2324.View/Download from: Publisher's site
Aims and objectives. To identify the expectations and workforce intentions of new graduate midwives from two different preregistration educational courses at one Australian university. Background. In Australia there are two different educational pathways to midwifery qualification, one offered for registered nurses, commonly at a postgraduate level and the other for non-nurses, at an undergraduate level. The knowledge about midwifery graduates in general is reasonably limited and there is no specific research that examines the similarities and differences between graduates from the two different courses. Design. A cross-sectional design was used. Method. Data were collected by questionnaire from both undergraduate and postgraduate midwifery graduates in 2007 and 2008 at one Australian university. Data were analysed using descriptive statistics. Results. Almost all the graduates from the two different pre-registration courses intended to enter the midwifery workforce with both groups rating the factors that influenced this decision similarly. There were, however, significant differences in graduates age and their intention to work part time. Their views of their ideal roles and subsequent uptake into formal new graduate transition programmes differed. Graduates from the two courses also reported philosophical differences regarding their concepts of job satisfaction and ways their jobs could be improved.
At the University of Technology, Sydney (UTS), Australia, a pilot study was conducted to introduce and integrate mobile point-of-care technologies into the clinical laboratory experiences of students in the Bachelor of Midwifery program. The pilot study was a collaborative project between Intel Healthcare and the Faculty of Nursing Midwifery and Health at UTS and was conducted using Intel's mobile clinical assistants (MCA). Through role playing, students were exposed to a number of case scenarios drawn from authentic midwifery practice. The MCA was used to gain information such as test results, clinical practice protocols, and best evidence guidelines. The students were expected to discuss the information with the woman. Following the activity, students completed an online survey to identify the impact of the MCA on the role-playing situations. They also participated in a focus group where they could discuss the use of the point-of-care technology in relation to preparation for practice. Results from these evaluations indicated that the students were positive about using the MCA in simulation sessions and they also considered that this technology would be helpful in their practice. It is hoped that the use of such point-of-care technology will be integrated across the Faculty's pre-registration midwifery and nursing programs to provide students with access to the most recent information technology innovations in health care.
Gray, JE 2010, 'Working with Mothers and Babies' in Stagnitti, K, Schoo, A & Welch, D (eds), Clinical Fieldwork Placement in the Health Professions, Oxford University Press, South Melbourne, pp. 26-36.
Common across all the health professions are fieldwork issues such as clinical placements in hospitals, community based service provision, and client-therapist interaction. They all demand knowledge of skills and techniques, and all require proficiency in problem solving and clinical reasoning. Clinical and Fieldwork Placement in the Health Professions prepares students for their work in clinical and fieldwork settings, where their understanding of the various clinical and client-centred environments is dependent not only on their knowledge and skills, but on how well they work with other health professionals. The text is intended to be used throughout the health students' course. It is interdisciplinary rather than discipline-specific, and incorporates both clinical placement and fieldwork education within the context of professional health care services and delivery. Some chapters will be more relevant for first year students, particularly the specific settings section, while others will be more appropriate for final year students, where broader issues such as ethics and legal responsibility are covered.
Smith, RM & Gray, JE 2009, 'Integrating point-of-care technology into the midwifery curricula', Integrating point-of-care technology into the midwifery curricula, Information Technology and Communications in Health, IOS Press, Victoria BC, Canada, pp. 55-61.