PENERAPAN PEMBELAJARAN KOOPERATIF MODEL GROUP INVESTIGATION (GI) UNTUK MENINGKATKAN MOTIVASI DAN HASIL BELAJAR BIOLOGI

Model pembelajaran mempengaruhi motivasi dan hasil belajar Biologi siswa sekolah menengah atas. Berdasarkan observasi awal, diketahui bahwa pembelajaran Biologi di kelas X-1 SMA Negeri 7 Malang memiliki beberapa ciri, yaitu (1) motivasi belajar siswa cenderung kurang, (2) dalam menyelesaikan suatu tugas, siswa dengan karakteristik yang sama cenderung mengelompok sehingga terbentuk kelompok homogen yang tidak seimbang di kelas, dan (3) metode ceramah yang diterapkan oleh guru tidak menarik minat siswa sehingga mempengaruhi hasil belajarnya. Berdasarkan kondisi tersebut maka dilakukan penelitian dengan menggunakan pembelajaran kooperatif model Group Investigation (GI) untuk meningkatkan motivasi dan hasil belajar Biologi siswa. Jenis penelitian ini adalah penelitian tindakan kelas dengan menggunakan pendekatan kualitatif dan dirancang dalam dua siklus. Hasil penelitian menunjukkan penerapan pembelajaran kooperatif model GI dapat meningkatkan motivasi dan hasil belajar Biologi siswa. Motivasi belajar siswa meningkat sebesar 31, 48% yaitu dari 46, 15% dengan kategori cukup pada siklus I menjadi 77, 63% dengan kategori baik pada siklus II. Hasil belajar siswa juga mengalami peningkatan, terlihat dari nilai rata-rata siswa sebesar 81, 94% pada siklus I menjadi 89, 18% pada siklus II dan siswa yang tuntas belajar juga mengalami peningkatan dari 79, 49% pada siklus I menjadi 97, 44 % pada siklus II. Hasil angket juga menunjukkan bahwa siswa menyukai dan lebih termotivasi untuk belajar Biologi setelah mengikuti pembelajaran dengan pembelajaran kooperatif model GI.

The Impact of a Multimodal Approach to Pre-Emptive Analgesia on Postoperative Pain and Analgesic Requirements for Patients Undergoing Orthopaedic Lower Limb Surgery at the Aga Khan University Hospital, Nairobi: A Single Blind Randomised Controlled Trial

Study Objective: The aim of this study was to evaluate the postoperative morphine-sparing and pain reducing effects of a preemptive, multimodal, perioperative analgesic regimen incorporating the use of preincisional intrathecal blockade plus parenteral anti-inflammatory agents, in patients undergoing lower limb orthopaedic surgery. Study design: Prospective Single blinded Randomized Controlled Trial. Study setting: The Aga Khan Hospital, Nairobi, Kenya. Methods: 44 ASA physical status 1 and 2 patients undergoing lower limb orthopaedic surgery were randomly allocated into two groups of 22 patients each. Patients in the Intervention group were given a preincisional subarachnoid injection of 15mg hyperbaric Bupivacaine and 25mcg Fentanyl, plus, parenteral Paracetamol 20mg/kg and Diclofenac 1mg/kg. Patients in the Control group received a standardized general anaesthetic protocol consisting of Midazolam and Propofol, Oxygen, N2O, Isoflurane and cis-atracurium. Analgesia intraoperatively was maintained by remifentanil 0.1-0.3mcg/kg/min with Paracetamol 20mg/kg and Diclofenac 1mg/kg given at the end of surgery. PCA morphine 2mg/ml was instituted once the patient complained of pain. Intramuscular rescue doses of 10mg morphine were administered on patient request. Visual analog score (VAS) was used to assess pain over 48 hours, the cumulative PCA morphine dose and the total number of morphine rescue doses requested were calculated and compared for both groups. Results: 44 consecutive patients undergoing lower limb orthopaedic surgery completed the study (Intervention group, n=22; Control group n=22). The cumulative PCA morphine consumption at 2, 24 and 48 hours following patient first request for the control and intervention groups were 6.72 ± 6.33mg versus 5.72 ± 7.62mg ( P=0.6383), 19.682 ± 16.50mg versus 24.09 ± 17.83mg (P=0.3995), 34.409 ± 32.99mg versus 34.818 ± 23.11mg (P=0.9622) respectively. The mean difference in the number of Intramuscular 10mg morphine rescue doses requested by the patients between the control and intervention groups at 48 hours was 8.1818 ± 19.673 versus 3.2727 ± 9.228 (P=0.295). The median VAS at 2 hours was significantly lower in the intervention than control group, 5 ± 2.17 versus 3 ± 2.37 (P=0.0068). VAS at 6, 12, 24, 48 and 72 hours postoperatively were not significantly different between the two groups. The McGill pain questionnaire present pain intensity showed a significant difference between the control and intervention group, 2.31 ± 0.70 versus 1.81 ± 0.65 (P=0.00001). There was no significant difference in the pain rating index between the control and intervention group, 8.681 ± 2.46 versus 8.59 ± 2.30 (P= 0.8998). Conclusion: A non-statistically significant trend towards a