• Read instructions, precautions and implications on medication packaging, e.g. read dosage instructions on medications, such as pitocin and methergine, when attempting to stop post-partum hemorrhaging. (1)
• Read email messages, e.g. read email messages from colleagues to confirm details of meetings. (2)
• Read short comments in a variety of forms, e.g. read text on intake forms to learn about clients' medical histories, family backgrounds, social environments and lifestyles. (2)
• Read case notes and clients' files, e.g. read case notes and client files to review observations, diagnoses, assessment conclusions and recommendations. (2)
• Read letters, e.g. review letters from health care professionals to learn about case details and the medical opinions of referring practitioners. (2)
• Review information on patients' charts, e.g. read observations written on client's charts by other health professionals to learn about changes in client condition. (2)
• Read instructions, e.g. read instructions to learn how to set up, operate and maintain equipment, such as epidural pumps and sphygmomanometers (blood pressure monitors). (3)
• Read industry publications and trade magazines, e.g. read articles in publications, such as Midwifery Today, to keep abreast of new initiatives and training opportunities in midwifery. (3)
• Read clinical journals, e.g. read articles in journals, such as The British Journal of Midwifery and The Journal of the Society of Obstetricians and Gynecologists of Canada, to learn about new research and processes. (4)
• Read medical textbooks, handbooks, manuals and online reference materials, e.g. read Principles of Anatomy and Physiology to learn technical knowledge that will assist with health diagnoses and the delivery of client services. (4)

• Observe symbols and icons on products, packaging and equipment, e.g. observe symbols on packaging to determine bio-hazard risks. (1)
• Enter data into schedules and log books, e.g. enter clients' names and contact information into calendars and appointment schedules. (1)
• Scan labels on medications to verify patients' names, dosages, administration schedules, ingredients and reconstitution instructions. (1)
• Complete a variety of forms, e.g. enter clients' medical, social and family histories and describe relevant lifestyle factors on intake and assessment forms. (2)
• Locate and plot data in charts, e.g. plot measurements of fundal heights on intrauterine growth charts to monitor growth of the fetus. (2)
• Locate data in a variety of tables, e.g. locate data about amniotic fluid amounts, fetal anatomy and biometry in obstetrical ultrasound reports. (3)
• May complete complex forms, e.g. complete insurance claim forms to identify their professional credentials, record client information and provide summaries of the services they provided. (3)
• May study and interpret anatomical drawings and diagrams, e.g. study anatomical drawings to learn how to explain medical conditions or disease processes to clients. (3)
• May interpret ultrasound images, e.g. midwives interpret ultrasound images to monitor the growth and body position of a fetus during pregnancy. (3)

• Write reminders and short notes, e.g. write short notes to remind office staff of tasks and activities to be performed. (1)
• Write case notes, e.g. write case notes to record health concerns, past treatments and ongoing conditions, as well as their own observations. (2)
• Write short letters and email messages, e.g. write letters to provincial health care systems to provide information about clients and the services provided. (2)
• May write marketing and promotional materials, e.g. may write marketing materials to describe their services and philosophies of practice. (4)
• May write articles for health publications, magazines, newspapers and clinical journals to educate readers about midwifery. (4)

• Calculate reimbursements for the purchase of clinical and administrative supplies. (1)
• Take a variety of vital sign measurements, e.g. measure vital signs, such as blood pressure and temperature, using digital tools, such as blood pressure monitors and thermometers. (1)
• Measure body parts using their hands as measurement tools, e.g. midwifes measure dilation of the cervix using their fingers. (1)
• Compare vital sign measurements, such as temperature, heart rate and blood pressure, to normal ranges. (1)
• Estimate quantities of material and equipment needed for job tasks, e.g. estimate the amount of supplies needed for client care. (1)
• May schedule client appointments, allocating realistic amounts of time for consultations, treatments, last minute requests and health emergencies. (2)
• Monitor inventories, drugs and supplies to ensure sufficient stock is available when needed. (2)
• Estimate fetal gestation and due dates by considering menstrual cycle dates and ultrasound measurements. (2)
• Calculate reimbursement amounts for the services they provide. (3)
• Compare data from multiple readings to baseline norms in order to identify differences that may indicate health problems, e.g. compare weight and growth measurements between visits to ensure a pregnant woman is gaining weight at a pace considered normal and healthy. (3)
• May prepare annual operating budgets by forecasting monthly expenditures, revenues and capital purchases. (4)

• Speak with support staff to discuss scheduling and delegate administrative tasks, such as filing. (1)
• Speak with suppliers, e.g. order clinical supplies from suppliers by telephone. (1)
• Exchange information with clients, e.g. speak with clients about their physical, social, mental and emotional well-being and provide relevant evidence to facilitate informed choices. (2)
• Explain complex medical information, e.g. explain complex medical information, such as diagnoses, in terms that clients can understand. (3)
• Exchange information with other health practitioners, e.g. share information about clients' health, seek professional opinions and co-ordinate client care with physicians and other health professionals. (3)
• May instruct clients and students, e.g. midwives may facilitate workshops on preparing for labour and delivery. (3)
• Provide clear instructions and encouragement in a calm manner to women in labour. (3)
• Provide detailed information in emergency situations, e.g. provide detailed information to emergency medical personnel when clients are in medical distress. (3)

• Clients do not show up for appointments or cancel at the last minute. They reschedule appointments and use the time to catch up on administrative duties. They encourage clients to provide sufficient notice if they cannot keep appointments. (2)
• Face time shortages when several clients require priority care at the same time. They set priorities for seeing clients according to their needs and arrange for back-up support from other midwives if required. (2)
• Decide to accept new clients. They consider their availability and whether they have the energy and expertise to meet clients' needs. (2)
• Locate information about the status of clients by speaking with them, reading charts and files and talking to other health care professionals. (2)
• Encounter clients who experience unexpected health complications. They consult with physicians and specialists to develop appropriate health plans and refer clients to other health care providers as required. (3)
• Determine which birthing approaches to use. They base their decision on the client's preferences, health factors and their comfort level with the approach. (3)
• Make critical decisions to seek additional help and medical intervention in emergency situations. They follow protocols set out by organizations, such as the College of Midwives Ontario, to decide when to transfer the care of a client to a physician. (3)
• Evaluate the health of clients. They consider factors, such as vital signs, feedback provided by clients and other health care professionals and the results of examinations. (3)
• May juggle multiple clients with competing needs and must be prepared to respond to onset of labour and unexpected medical emergencies. They are available to clients 24 hours a day, often seven days a week. They maintain close contact with other midwives to co-ordinate duties and respond to clients' requests for support. Midwives who have hospital privileges co-ordinate with hospital support staff and other health practitioners to provide care and deliver babies. (3)
• Consult textbooks, reference manuals, academic journals and publications to find specific information that will aid in assessment and delivery of client services. (3)
• Assess health risks to clients. They consider changes to readings, such as vital signs and pain level indicators, over periods of time to assess the health of women in labour and their babies. (4)

• May use spreadsheets to record numerical information, such as clients' vital signs. (1)
• Operate hand-held personal digital devices, e.g. use smartphones to access and send texts, email messages and speak with colleagues and clients. (1)
• Operate hand-held scanners to determine vital signs, such as body temperature, blood pressure and glucose level. (1)
• May use electronic office equipment, such as printers, scanners, fax machines, copiers and postage meters. (1)
• Use word processing programs to write and format short documents, such as referral letters, to physicians and reports for insurance companies. (2)
• May use graphics software to design presentations to students and colleagues. (2)
• May use spreadsheets to record income and expenses and to create client lists. (2)
• May use databases to enter and retrieve information, e.g. may enter the names of clients, locations visited and the duration of visits into specialized health care administration databases. (2)
• Use communication software, e.g. they exchange email and attachments with clients and other members of the health care team. (2)
• Use the Internet to locate health-related information on medical websites. (2)
• May use the Internet to access training courses and seminars offered by suppliers and trainers. (2)
• May use the Internet to access blogs and web forums where they seek and offer advice. (2)
• May use time management software to track the amount of time spent with clients. (2)
• May use digital obstetric sonography equipment to measure the growth of fetuses and establish gestation periods and expected delivery dates. (2)

Midwives often work in practice groups with other midwives which require the close coordination of schedules and tasks. They may supervise practicum students or act as mentors to practitioners who are new to the profession.

Midwives need to learn continuously to keep abreast of new research and information in medicine and allied health. Licensing and regulation vary considerably between occupations and provincial jurisdictions in Canada and continuous learning requirements follow suit. Most occupations have provincial and national professional associations that offer opportunities for professional development and learning. However, some midwives must travel abroad to develop their skills. For example, midwives must renew training in cardiopulmonary resuscitation and neonatal resuscitation annually.

All essential skills are affected by the introduction of technology in the workplace. Midwives' ability to adapt to new technologies is strongly related to their skill levels across the essential skills, including reading, writing, thinking and communication skills. Technologies are transforming the ways in which workers obtain, process and communicate information, and the types of skills needed to perform in their jobs. In particular, midwives need the skills to use increasingly complex software applications, such as specialized health care administration databases. Furthermore, the use of digital tools, such as X-ray equipment, requires midwives to develop the skills needed to interpret radiographic images.

Technology in the workplace further affects the complexity of tasks related to the essential skills required for this occupation. For example, with electronic devices, such as monitors and sensors, midwives do not have to manually measure temperatures or heart rates. The use of electronic databases and keyword search functions can also make it easier to locate data, such as previously measured weight and blood pressure. Tasks done manually, such as entering dates, times, and amounts into client charts, are completed with speed and accuracy using digital equipment.

• Read instructions and precautions, e.g. read instructions on labels of natural remedies, nutritional supplements, essential oils and herbs for use, precautions and potential risks prior to recommending or prescribing them. (1)
• Read email messages, e.g. read email messages from colleagues to confirm details of meetings and to exchange advice about natural health treatments and remedies. (2)
• Read short comments in a variety of forms, e.g. read requisitions and lab test results to learn about clients' medical histories and their current health status. (2)
• Read case notes and clients' files, e.g. read case notes and client files to review observations, diagnoses, assessment conclusions and recommendations for treatments. (2)
• Read letters, e.g. read letters from health care professionals to learn about case details and medical opinions of referring practitioners. (2)
• Read instructions, e.g. read instructions to learn how to set up, operate and maintain digital equipment, such as sphygmomanometers (blood pressure monitors). (3)
• Read industry publications and trade magazines, e.g. read articles in publications, such as Homeopathy Today, to keep abreast of new initiatives, treatments and training opportunities in midwifery natural health. (3)
• Read Acts and regulations, e.g. read information contained in provincial health profession Acts to learn the regulations governing professional conduct and quality assurance. (4)
• Read articles in clinical journals, e.g. read original peer-reviewed articles in The International Journal of Clinical Acupuncture to learn about new research and treatment options. (4)
• Read alternative health and medical textbooks, e.g. read textbooks, such as Principles of Anatomy and Physiology, to gain clinical knowledge that will assist with health diagnoses and the treatment of clients. (5)

• Enter data into schedules and log books, e.g. enter clients' names and contact information into their calendars and appointment schedules. (1)
• Locate information on labels, e.g. view labels on herbs, natural remedies and nutritional supplements for dosages, expiry dates and lists of ingredients. (1)
• Complete a variety of forms, e.g. enter clients' medical, emotional, social and family histories and describe relevant lifestyle factors on intake and assessment forms. (2)
• Locate data in a variety of tables, e.g. iridologists refer to tables listing symptoms of health weaknesses associated with pigmentation of the iris and shiatsu therapists read tables listing symptoms associated with different meridians of the body and their functions. (2)
• May interpret radiographs, e.g. study radiographs (x-ray images) to identify injuries, structural angles and alignment and physical stressors that affect clients' health. (2)
• May complete complex forms, e.g. complete insurance claim forms to identify their professional credentials, record case summaries and provide diagnoses and recommendations for treatments. (3)
• Interpret pictures and drawings of the human body, e.g. acupuncturists interpret complex anatomical drawings to identify acupoints and body meridians. (4)

• Write reminders and short notes, e.g. write short notes to remind office staff of tasks and activities to be performed. (1)
• Write case notes, e.g. write case notes to record health concerns, past treatments and ongoing conditions as well as their own observations, concerns, diagnoses and recommended treatments. (2)
• Write short letters and email messages, e.g. write letters to insurance companies to provide information about clients' presenting issues, diagnoses, descriptions of treatments received and recommendations for further interventions. (2)
• May write marketing and promotional materials, e.g. write marketing materials, such as web copy, to describe their services and philosophy of practice. (3)
• Write reports, e.g. Rolfers write reports for lawyers and insurance companies to explain client diagnoses and the outcomes of treatments. (4)
• May write articles for health publications, magazines and newspapers to educate readers about the benefits of natural health services. (4)

• Receive cash, cheque, credit and debit card payments and provide change. (1)
• Calculate reimbursements for the purchase of clinical and administrative supplies. (1)
• Take a variety of vital sign measurements, e.g. measure vital signs, such as blood pressure and temperature, using digital tools, such as blood pressure monitors and thermometers. (1)
• Measure body parts using their hands as measurement tools, e.g. acupuncturists use a thumb's width to measure distances between meridian points of the body. (1)
• Compare vital sign measurements, such as temperature, heart rate and blood pressure, to normal ranges. (1)
• Estimate quantities of materials and equipment needed for job tasks, e.g. estimate the amount of supplies needed for a client's care. (1)
• Schedule client appointments, allocating a realistic amount of time for consultations, treatments, last minute requests and health emergencies. (2)
• Use mixture ratios to prepare varying amounts of homeopathic solutions and herbal remedies for clients, e.g. aromatherapists use mixture ratios to mix essential oils. (2)
• Monitor inventories of homeopathic drugs and supplies to ensure sufficient stock is available when needed. (2)
• Estimate the number of treatments clients will need to produce the desired health effects using assessment results and responses to treatments. (2)
• Prepare invoices and collect payments from clients for consultations and treatments. They calculate service amounts according to established fees or hourly rates and add applicable federal and provincial sales taxes. (3)
• May prepare and review financial statements to monitor their profit margins and plan for capital expenses, such as new equipment purchases. (3)
• Compare data from multiple readings to baseline norms in order to identify differences that may indicate health problems. (3)
• Analyze health statistics to determine which treatments will be most effective with clients and to educate clients about the pros and cons of various treatment methods. (3)
• May prepare annual operating budgets by forecasting monthly expenditures, revenues and capital purchases. (4)

• May interact with support staff to discuss scheduling and delegate administrative tasks, such as filing. (1)
• Speak with suppliers, e.g. order clinical supplies, such as acupuncture needles, herbal plants, essential oils, speculums and compresses, from suppliers by telephone. (1)
• Exchange information with clients, e.g. speak with clients about their physical, social, mental and emotional well-being to gain a comprehensive understanding of their health and to gather information that will assist with diagnoses and treatments. (2)
• Explain complex medical information, e.g. explain complex medical information, such as diagnoses and treatment options, in terms that clients can understand. (3)
• Provide medical treatments using special communication techniques, e.g. hypnotherapists guide clients into hypnotic states and provide treatment using vocal scripts and hypnotic suggestions. (3)
• Exchange information with other health practitioners, e.g. share information about clients' health, seek professional opinions and co-ordinate client care with medical doctors and other health practitioners. (3)
• May interact with clients' families and friends, e.g. explain the purpose of their treatments and healing interventions, provide direction and answer questions that do not compromise clients' confidentiality. (3)
• May instruct clients and students, e.g. acupuncturists provide information about acupuncture, explain processes and respond to questions during workshops. (4)
• May present information to colleagues at seminars and conferences, e.g. traditional Chinese medical doctors may present new information about dietary supplements and herbs to colleagues at conferences. (4)

• Lose income when clients do not show up for appointments or cancel at the last minute. They reschedule appointments with clients and use the time to catch up on administrative duties. They encourage clients to provide sufficient notice if they cannot keep appointments. (2)
• Face time shortages when several clients require priority care at once. They set priorities for seeing clients according to their needs and arrange for back-up support if required. (2)
• Decide to accept new clients. They consider their availability and whether they have the expertise needed to meet the clients' needs. (2)
• Decide whether to treat clients. They consider clients' conditions, feedback, responses and prognoses before making decisions to treat them or make referrals to physicians, therapists and other practitioners of natural healing. (2)
• Locate information about the status of clients by speaking with them, referring to their charts and files and talking to other health care professionals. (2)
• Learn about patient treatment plans by reading client files and charts and by speaking with co-workers, supervisors and other healthcare professionals. (2)
• Encounter clients who are uncooperative, hostile and unreceptive to treatments or who have unrealistic expectations about treatment outcomes. They address their clients' behaviour and beliefs, explain the purpose of treatments or therapies and try to build rapport through appropriate conversation and body language. (3)
• Treat clients who develop health complications that interfere with treatments. They consult with physicians and specialists to develop appropriate health plans and refer clients to health care providers. (3)
• Determine which treatment approaches and remedies to use. They base their decisions on test results, clients' health conditions, prognoses for success and their comfort levels with treatment methods. (3)
• Make critical decisions to seek additional help and medical intervention in emergency situations. (3)
• Evaluate clients' health and wellness. They examine patterns of symptoms and consider the interconnectedness of clients' physical, emotional, mental and spiritual health. They collect information from clients about their emotional state, diet, lifestyle, social support and stress factors and compare this data to benchmarks for wellness. (3)
• Evaluate effectiveness of natural health treatments, therapies and interventions by observing and measuring changes in clients' health over time. They re-evaluate the course of treatment for clients who are not responding well to interventions by reviewing all possible indicators of health to see if they can identify anything overlooked in the original evaluation. (3)
• Assess the health risks to clients. They examine vital sign readings and monitor changes during treatments to ensure they fall within ranges considered normal. They follow risk guidelines published by local health regions and consult other health professionals if second opinions are required. (3)
• Establish their own schedules and book client appointments. They shift priorities and appointments to accommodate cancellations and emergencies. (3)
• Consult textbooks, reference manuals, academic journals and publications to find specific information that will aid in assessment and treatment of clients' overall health. Reference materials detail information about symptoms associated with specific meridian points, herbal treatments, natural remedies and preventative measures. (3)

• May use spreadsheets to record numerical information, such as clients' vital signs. (1)
• Operate hand-held scanners to determine vital signs, such as temperature, blood pressure and glucose levels. (1)
• May operate point-of-sale equipment, such as electronic cash registers, bar scanners, scales and touch-screens to complete sales. (1)
• May use electronic office equipment, such as printers, scanners, fax machines, copiers and postage meters. (1)
• May use digital equipments, such as cameras, to take pictures of clients' postures before and after treatment. (1)
• Use word processing programs, e.g. use basic features of word processing programs to write and format short documents, such as referral letters, to physicians and reports for insurance companies. (2)
• May use graphics software to design slide shows for presentations to students and colleagues. (2)
• May use spreadsheets to record income and expenses and to create client lists. (2)
• May use databases to enter and retrieve information, e.g. may enter the names of clients, locations visited and the duration of the visits into specialized health care administration databases. (2)
• May use electronic databases to search for information about natural remedies. (2)
• Use communications software, e.g. they exchange email and attachments with clients and other members of the health care team. (2)
• Use the Internet to locate health-related information on medical websites. (2)
• May use the Internet to access training courses and seminars offered by suppliers and trainers. (2)
• May use the Internet to access web blogs and web forums where they seek and offer medical and treatment advice. (2)
• May use time management software to track the amount of time spent with clients. (2)
• May operate digital equipment, such as ultrasounds (digital sonography), to view subcutaneous body structures, such as muscles, joints and internal organs. (2)

Practitioners of natural healing primarily work alone or independently to provide health assessment, counselling and treatment to clients on an individual basis. Many are self-employed and responsible for all aspects of their businesses, including administration. Others have administrative assistants who schedule their appointments, collect payments and help with other office duties. They may supervise practicum students or act as mentors to practitioners who are new to the profession.

Practitioners of natural healing need to learn continuously to keep abreast of new research and information in medicine and natural health. Licensing and regulation vary considerably between occupations and provincial jurisdictions in Canada and continuous learning requirements follow suit. Most occupations have provincial and national professional associations that offer opportunities for professional development and learning; however some practitioners of natural healing must travel abroad to develop their skills. For example, traditional Chinese medical doctors may travel to China to learn more about their practice.

All essential skills are affected by the introduction of technology in the workplace. The ability of practitioners of natural healing to adapt to new technologies is strongly related to their skill levels across the essential skills, including reading, writing, thinking and communication skills. Technologies are transforming the ways in which workers obtain, process and communicate information, and the types of skills needed to perform in their jobs. The use of digital tools, such as X-ray equipment, requires practitioners of natural healing to develop the skills needed to interpret radiographic images. Workers must also be able to operate devices, such as monitors and hand-held scanners, which allow them to establish heart rates, measure temperature, and determine blood pressure and glucose levels electronically rather than manually.

Technology in the workplace further affects the complexity of tasks related to the essential skills required for this occupation. In particular, practitioners of natural healing need the skills to use increasingly complex software applications, such as using electronic databases to search for information about natural remedies. At the same time, the use of electronic databases and keyword search functions can make it easier to locate data, such as previously measured weights and blood pressures. Tasks previously done by hand, such as entering dates, times and amounts into patient charts, are completed with speed and accuracy using electronic office equipment.