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Penelitian ini dilakukan untuk mengetahui proses pengolahan nilai siswa di SMP Tunas Dharma, untuk mengetahui proses penghitungan nilai hingga dimasukkan ke dalam raport, dan untuk mengetahui dokumen apa saja yang diperlukan selama proses pengolahan nilai siswa berlangsung. Tujuan dari penelitian ini adalah untuk mengetahui dan membuat sistem pengolahan nilai siswa yang efektif dan efisien, melakukan analisis terhadap pengolahan nilai akhir siswa untuk dimasukkan ke dalam raport, serta melakukan analisis organisasi yang berjalan dan analisis dokumen yang diperlukan di SMP Tunas Dharma. Metode yang digunakan yaitu metode pengembangan sistem, metode analisis dan metode pengumpulan data. Metode pengembangan sistem yang sering digunakan untuk memudahkan perancangan dalam penelitian ini adalah metode SDLC dalam model Waterfall (air terjun), sedangkan metode analisis yang digunakan adalah metode analisis PIECES (Performance, Information, Economy, Controlling, Efficiency, dan Services). Hasil yang diperoleh dari penelitian ini adalah adanya pengetahuan dan pemahaman terhadap proses pengolahan nilai siswa dan perhitungannya hingga nilai tersebut dimasukkan ke dalam raport, adanya pemahaman terhadap organisasi yang berjalan di SMP Tunas Dharma, dan adanya pengetahuan terhadap dokumen yang diperlukan selama proses pengolahan nilai berlangsung. Kesimpulan yang dapat ditarik dari hasil penelitian ini adalah adanya efisiensi dan efektivitas waktu dalam pengolahan dan pencarian data nilai siswa sehingga tidak mudah hilang ataupun cepat rusak, serta proses pengolahan nilai siswa dapat berjalan lebih mudah dan cepat apabila menggunakan sistem.

Purpose Difficulty in recruiting and retaining community preceptors for medical student education has been described in the literature. Yet little, if any, information is known about community outpatient preceptors who have stopped or decreased teaching time with students. This study aimed to examine these preceptors' perspectives about this phenomenon. Method Using a phenomenology framework, this multi-institutional qualitative study used semistructured interviews with community pediatric preceptors who had stopped or reduced teaching time with medical students. Interviews were conducted between October 2017 and January 2018 and transcribed verbatim. Interviews explored factors for engaging in teaching, or decreasing or ceasing teaching, that would enable future teaching. An initial code book was developed and refined as data were analyzed to generate themes. Results Twenty-seven community pediatricians affiliated with 10 institutions participated. Thirty-seven codes resulted in 4 organizing themes: evolution of health care, personal barriers, educational system, and ideal situations to recruit and retain preceptors, each with subthemes. Conclusions From the viewpoints of physicians who had decreased or stopped teaching students, this study more deeply explores previously described reasons contributing to the decline of community preceptors, adds newly described barriers, and offers strategies to help counter this phenomenon based on preceptors' perceptions. These findings appear to be manifestations of deeper issues including the professional identify of clinical educators. Understanding the barriers and strategies and how they relate to preceptors themselves should better inform education leaders to more effectively halt the decline of community precepting and enhance the clinical precepting environment for medical students.

1. Catherine Krafft, MD* 2. Cynthia Christy, MD†,‡ 1. *Department of Pediatrics and 2. †Division of Pediatric Infectious Diseases, University of Rochester School of Medicine and Dentistry, Rochester, NY 3. ‡Rochester General Hospital, Rochester, NY * Abbreviations: CAP: : community acquired pneumonia EM: : erythema multiforme FDA: : Food and Drug Administration MIRM: : Mycoplasma pneumoniae– induced rash and mucositis PCR: : polymerase chain reaction SJS: : Stevens-Johnson syndrome Mycoplasma pneumoniae is a frequent cause of respiratory infections, including community-acquired pneumonia, in school-age children. However, as the science surrounding the diagnosis of this pathogen improves, our knowledge of its epidemiology, including asymptomatic carriage, and the management of this disease is evolving. After completing this article, readers should be able to: 1. Understand the microbiology and epidemiology of Mycoplasma pneumoniae infection. 2. Describe the variable clinical presentation of M pneumoniae infection and extrapulmonary manifestations. 3. Understand the difficulties associated with diagnosing infection with M pneumoniae and current recommendations for diagnosis. 4. Appropriately treat patients with suspected Mycoplasma infection. A 9-year-old girl presents to her pediatrician with a fever, decreased energy, and a cough for 10 days. She was initially evaluated 4 days ago when she had rhinorrhea, a cough, and decreased energy over the previous week. Her examination at that time was notable only for a mildly erythematous posterior oropharynx and nasal discharge. She was diagnosed as having a viral upper respiratory tract infection, and supportive care measures were recommended. Since that visit, her cough is more persistent and she has developed fevers. On examination her temperature is 100.8°F (38.2°C), heart rate is 100 beats/min, respiratory rate is 40 breaths/min, and oxygen saturation is 90% on room air. She is generally well-appearing. Her physical examination is remarkable for an erythematous posterior oropharynx, nasal discharge, and bilateral diffuse crackles on auscultation of her lungs. What is the next step in diagnosis and management? ### Microbiology Mycoplasma pneumoniae is a tiny, pleomorphic bacteria belonging to the class Mollicutes and is the smallest self-replicating bacteria pathogenic in humans, its only known host. M pneumoniae is unique in having no …

Background Acute otitis media (AOM) is the most frequent indication for antibiotic treatment of children in the United States. Its diagnosis relies on visualization of the tympanic membrane, a clinical skill acquired through a deliberate approach. Instruction in pediatric otoscopy begins in medical school. Medical students receive their primary experience with pediatric otoscopy during the required pediatric clerkship, traditionally relying on an immersion, apprentice-type learning model. A better understanding of their preceptors’ clinical and teaching practices could lead to improved skill acquisition. This study investigates how pediatric preceptors (PP) and members of the Council on Medical Student Education in Pediatrics (COMSEP) perceive teaching otoscopy. Methods A 30-item online survey was administered to a purposeful sample of PP at six institutions in 2017. A comparable 23-item survey was administered to members through the 2018 COMSEP Annual Survey. Only COMSEP members who identified themselves as teaching otoscopy to medical students were asked to complete the otoscopy-related questions on the survey. Results Survey respondents included 58% of PP (180/310) and 44% (152/348) of COMSEP members. Forty-one percent (62/152) of COMSEP member respondents identified themselves as teaching otoscopy and completed the otoscopy-related questions. The majority agreed that standardized curricula are needed (PP 78%, COMSEP members 97%) and that all graduating medical students should be able to perform pediatric otoscopy (PP 95%, COMSEP members 79%). Most respondents reported usefulness of the American Academy of Pediatrics (AAP) AOM guidelines (PP 95%, COMSEP members 100%). More COMSEP members than PP adhered to the AAP’s diagnostic criteria (pediatric preceptors 42%, COMSEP members 93%). The most common barriers to teaching otoscopy were a lack of assistive technology (PP 77%, COMSEP members 56%), presence of cerumen (PP 58%, COMSEP members 60%), time to teach in direct patient care (PP 46%, COMSEP members 48%), and parent anxiety (PP 62%, COMSEP members 54%). Conclusions Our study identified systemic and individual practice patterns and barriers to teaching pediatric otoscopy. These results can inform education leaders in supporting and enabling preceptors in their clinical teaching. This approach can be adapted to ensure graduating medical students obtain intended core clinical skills.

The recruitment and retention of community preceptors to teach medical students is difficult. The authors sought to characterize the underlying motivational factors for becoming a preceptor and to identify strategies for recruiting and retaining community-based pediatric preceptors.This multicenter qualitative action study included semistructured interviews with community-based pediatric preceptors affiliated with 12 institutions from August to December 2015. Only active preceptors were included, and participating institutions were diverse with respect to geographic location and class size. Interviews were conducted over the telephone and transcribed verbatim. Six investigators used deidentified transcripts to develop a codebook. Through a constant comparative method, codes were revised as data were analyzed and disagreements were resolved through discussion. All investigators organized the themes into dimensions.Fifty-one preceptors were interviewed. Forty-one themes coalesced into four dimensions: (1) least liked aspects of teaching, (2) preparation to teach, (3) inspiration to teach, and (4) ways to improve recruitment and retention. Time constraints and patient care demands were the most commonly cited deterrents to teaching. Successful preceptors balanced their clinical demands with their desire to teach using creative scheduling. External rewards (e.g., recognition, continuing medical education credit) served as incentives. Internal motivation inspired participants to share their enthusiasm for pediatrics and to develop longitudinal relationships with their learners.Changes in health care delivery have imposed more time constraints on community-based preceptors. However, this study identified underlying factors motivating physicians to volunteer as preceptors. Strategies to recruit new and retain current preceptors must be collaborative.