Search

This paper reports on a completed field study that examined the usability and effectiveness of learning objects designed for Australian and New Zealand primary and secondary schools. It focuses on student engagement by observing the ways students interacted with learning objects and by listening to what they said about them. Questions that guided the field study included the following: Could the students use the learning objects easily? Did they enjoy the experience? Did they engage with the intended learning? These questions are examined with reference to students at different levels of schooling, and examples drawn from the fieldwork illustrate that, while some learning objects achieved their potential as engaging multimedia educational resources, others fell short. The paper provides a detailed examination of two learning objects to reveal what worked and what created barriers or subverted the intended learning. In particular, it explores interest, challenge and importance as elements that contributed to engagement and socially constructed learning. [ABSTRACT FROM AUTHOR]

Abstract: The development and refinement of an acute pain service based on the increased availability of clinical evidence would be expected to improve the quality of postoperative pain control. This report reviews the application of postoperative patient-controlled analgesia (PCA) using intravenous morphine in a single institution between 2002 and 2005. More than 5000 patients were evaluated and the results were compared with a similar study performed 10 years ago. Prescription of PCA had increased by more than threefold. Morphine consumption from post-operative day 1 to day 3 (19.1 vs. 26.1, 8.6 vs. 18.1 and 4.5 vs. 19.0μg/kg/h, respectively), demand-to-delivery ratio (1.35–1.76 vs. 2.4–2.8) and the incidence of respiratory depression (0.06% vs. 2%) were significantly reduced (p <0.001), but there was no improvement in pain relief. A substantial proportion of patients still experienced postoperative nausea (47%) and vomiting (18.5%) despite a reduction in morphine consumption. Most patients ranked PCA as good and only 0.3% were dissatisfied. We conclude that, in our institution over the last decade, PCA has become more popular for postoperative pain management but with no attendant improvement in pain relief or reduction in side effects. Using PCA alone may result in poorer quality postoperative analgesia. Our findings add to the growing body of evidence that postoperative pain management has not substantially improved despite increased adoption of acute pain services. [Copyright &y& Elsevier]