A recent article in this journal took an important step toward rethinking the utility of behavioural instruments designated as learning style tests (Jewett et al. 1987). The authors of that paper made much of a distinction between the terms 'learning style' and 'learning preference'. However, the results of their study do not seem to substantiate a marked difference between the function of the Rezler Learning Preference Inventory (LPI) and Kolb's Learning Style Inventory (LSI) with which it was contrasted. The most important aspect of their paper was that it rescued the concept of learning style analysis from the arena of career choice prediction at the undergraduate level and applied these ideas to doctors who had already made their specialty selections and were actively engaged in residency training. Clinical instructors in teaching institutions have, for the most part, little or no formal background in educational principles. For these individuals, an easily comprehensible model of resident-instructor psychology can be very useful on a daily basis. This article reviews the authors' experience with the LSI and describes their utilization of Kolb's Experimental Learning Model in the areas of resident counselling and residency curriculum design. The results of two recent studies are also presented in which learning style was examined as a predictor of success in residency, and teacher-resident learning style distributions were shown to exhibit parallel relationships at four different anaesthesiology residency training programmes.

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Rational use of premedication for anaesthesia must always be modified and updated to keep pace with the evolving fields of anaesthesiology and surgery, as well as to meet changing patient needs and preferences. It is no longer axiomatic that all patients require, and therefore should receive, premedication. Unfortunately, a variety of traditional reasons have been proposed to justify routine premedication in many institutions. Smoothing induction, decreasing reflexes and arrhythmias, decreasing nausea and vomiting, decreasing pain, decreasing secretions, and producing sedation and amnesia have all been claimed historically as beneficial results of premedication. Modern anaesthetic agents and techniques have come a long way towards eliminating the routine need for premedication. In the preoperative period, the goal of an anxiety-free patient who is physiologically uncompromised requires an individualised approach based on experience and an adequate knowledge of current pharmacology. As our knowledge of potential problems associated with anaesthesia has expanded, we have added other classes of drugs such as the H2-histamine receptor blockers and antacids to our premedicant armamentarium. Outpatient and short-stay patients have further challenged our preoperative goal of an anxiety-free patient by requiring individuals to be 'street ready' within a brief period of time after surgery. Even for in-house elective procedures, not every patient is a candidate for routine premedication. A frank preoperative discussion is all that is necessary to effectively allay anxiety in many persons. In these and other special situations, this article will hopefully guide the reader toward a more rational approach to premedicating patients.

Regional Anesthesia and Pain Medicine celebrates its 30th anniversary in 2006. What began as a 10-page, industry-sponsored bulletin has evolved into a major anesthesiology and pain journal. This history article chronicles the journal's growth and development over 3 decades.