Q&A with Dr. Allison Shorten

Allison Shorten, PhD, MS, RN, RM, FACM, FAAN, joined the UAB School of Nursing in 2016, following seven years as a professor at Yale University School of Nursing. Shorten is an Australian registered nurse and nurse midwife, and her research on evidence-based practice in midwifery and birth choices decision aids has impacted practices internationally. In addition to her role as professor and chair of the Department of Acute, Chronic and Continuing Care, Shorten serves as Director of UAB Office of Interprofessional Curriculum.

Q: What first drew you to a career in nursing, and how did you begin your journey into research? 

My interest in nursing began in high school when I completed a St. John Ambulance first aid course at our local Ambulance Station in Australia. I could see the difference that first aid and emergency care could make in saving lives, so I joined the local St. John Ambulance Brigade to learn more about it. I loved teaching first aid and regularly provided first aid services at various sporting and community events on the weekends. Nursing was a logical next step in my education. Then, in my first year of nursing school, I discovered midwifery.

Midwifery care combines all of the elements of health care that I am passionate about – particularly education. Midwives have a unique opportunity to educate and promote the health of women during pregnancy, birth and beyond – which can have life-long impact on families and our community.

My midwifery research came from a desire to gather the best available evidence about the best models of midwifery care, and to implement practices that improve outcomes for women and their babies. As a student and young clinician, I had often asked the question “Why are we doing it this way?” and had the reply “Because this is the way we have always done it.” I searched for the scientific reason and robust evidence behind our practices and policies – so began my journey in research.

In 1996, as a junior lecturer in midwifery at the University of Wollongong, I published an article with a colleague, Margaret Wallace, in the Australian Nurses Journal titled “Evidence Based Practice – the future is clear.” This was the first time the term evidence-based practice had appeared in the nursing literature in Australia. Two articles followed in 1997 and 1998 – “Evidence based practice – when quality counts” and “Evidence based practice – we don’t have a choice.” These pioneering articles became the foundation of my research and still inform and underpin my practice and research today.

Our ideas informed nursing curriculum and sparked clinical conversations about nursing and midwifery — moving from ritual, routine and rough guess to care that is based on the best available evidence. Our articles on information literacy and “steppingstones to evidence-based practice” are still cited today.

Q: Tell me a bit about your research on evidence-based practice in midwifery and birth choices. How did your initial research develop into a Birth Choices decision aid, and what is its impact? 

My vision for making an impact in midwifery research has always been to provide women with opportunities to make informed and supported choices using the best available evidence about their options for care during pregnancy and birth in order to achieve the experiences and outcomes that are best for them.

My original Birth Choices decision aid booklet was designed to support women making a decision about their next birth after previous cesarean. When I started this work in the late 1990s in Australia, there was a growing concern about women not being given the opportunity to try vaginal birth after cesarean, even though there was evidence that many women could achieve good outcomes if given the chance. My Birth Choices decision aid walks women through the pros and cons of their birth options, helps them to discuss their options with their provider, to ultimately choose which method of birth is best for them. The original Birth Choices booklet has been translated into different languages and there is now an interactive Birth Choices website for women to use on-line. Women around the world could potentially benefit from decision aids like Birth Choices, and this is what drives my research forward.

Q: What brought you to UAB, and how has your role grown and developed since joining the University and School? 

UAB is the most collaborative place I have ever worked – I always say UAB is a hidden gem. I was attracted to UAB by our world class school of nursing – we have the best faculty! I also was drawn to the positive energy, innovative spirit, opportunities for research and unique environment for professional growth in leadership. Soon after my arrival, in January 2017, I accepted the position of Director of the Office of Interprofessional Curriculum, within the Center for Interprofessional Education and Simulation. Then in 2019, I also accepted the position of Chair of the Department of Acute Chronic and Continuing Care in our school of nursing. UAB SON is a place where you can step up to lead and feel confident that you will be supported.

Q: 2020 is the International Year of the Nurse and Midwife, and while a lot of plans have had to change as a result of the COVID-19 pandemic, it has also highlighted the importance and strength of nurses. Do you think this pandemic has changed how the public view nurses and nursing, and if so how? 

The COVID-19 pandemic has put nurses and midwives where they have always served best – at the front and center in health care. Wherever nurses and midwives practice, they demonstrate resilience and creative ability to think outside the box to make things work for patients, no matter what the circumstances. The public seems to have affirmed their appreciation of nurses and midwives and their critical role in promoting health and wellness in our community.

Q: Why do you think it is important to recognize nursing and midwifery this year. Are there any misconceptions that you think more information can help clarify? 

Nurses and midwives have the opportunity to embrace the new landscape in healthcare. The pandemic has broken down some long-standing barriers in scope of practice, location for care and use of technology. We have the opportunity to gather and use evidence about best practices in nursing and midwifery care, to step forward as leaders, and to become the innovators and architects for new models of nursing and midwifery care, that will ultimately better serve patients, no matter where they work and live.  

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