SABBATICALS: see This Link
SALARY Payment made by an employer to a physician for rendering medical care, irrespective of items of service or list size. Conditions of payment are regulated by contract, individually or collectively agreed.
SAMPLE A selected subset of a population. A sample may be random or non-random and may be representative or non-representative. A sample can be described with regard to the way it has been selected: i.e. stratified random sample, probability sample, systematic sample. (See Last, 1988).
SAMPLING VARIATION The results of analysis from two or more samples will differ because the inclusion of the individuals in each sample is determined by chance. The samples can never be identical.
SATISFACTION (Syn: patient satisfaction) The extent to which a patient when asked, expresses satisfaction with a specified medical procedure, health care service or outcome. Health outcome measures are available to assess many dimensions of patient satisfaction.
SCHARR: School of Health and Related Research, University of Sheffield.
SCIENTIFIC PROCESS The systematic enterprise of gathering knowledge about the world and organising and condensing that knowledge into testable laws and theories
SCREENING (Syn: screening test) The attempt to identify an unrecognised health problem in an individual or population by means of tests and/or other methods which discriminate between those who probably have or are at risk for a given health problem and those who are not so affected. This can be split up into:1. Mass: large screening of whole population groups. 2. Selective: screening of high risk groups in the population. .
SCREENING LEVEL The normal limit or cut-oft' point at which a screening test is regarded as positive, i.e. uncovering an unrecognised health problem.
SEASONAL VARIATION Change in physiological status or in the occurrence of health problems that conforms to a seasonal pattern.
SECONDARY CARE One of two levels of referred care (secondary and tertiary). Usually refers to care provided by a broadly skilled specialist such as a general surgeon, general internist or obstetrician, to whom the patient may be referred from primary care, e.g. the general practitioner/family physician.
SECONDARY CARE PHYSICIAN A physician who has undergone a period of higher postgraduate training in an organ/disease based discipline, and who works predominately in that discipline in a hospital setting.
SECONDMENTS – a set period of time eg 1-2 weeks, when an individual is transferred to another organisation and is undertaking a structured programme of learning and assessment
SEE ONE, DO ONE (TEACH ONE). Clinical method involving demonstration followed by repetition of exact procedure by the student
SELF DIRECTED LEARNING (SDL) may be an informal, ongoing, habitual activity directed to the maintenance of professional competence, may involve semi structured learning experiences that typically have their basis in immediate patient care, may be a formal intention to engage in a planned activity (a learning project)
SELF DIRECTED LIFE LONG LEARNING. You decide want you need to learn, then ask questions.
SELF MANAGEMENT PROGRAMME: any formalised patient education programme aimed at providing the patient with information and skills necessary to manage their condition within the parameters of the medical regime (this reflects the related concept of concordance). Some models extend the use of self management skills to enable individuals to take control of the emotional and social consequences of living with long term illness.
SELF-ADMINISTRATION Respondents read and answer questions without help from others.
SEMINARS – smaller scale group or meeting under the guidance of a professional to discuss and exchange information
SEMI-URBAN PRACTICE POPULATION A practice serving a population where the majority are located in a town with a population between 2000 to 50 000. In countries where this is not appropriate the range should be stated, i.e. countries with a smaller population, the range is between 2000 and 10000.
SENSITIVITY The extent to which a measure detects the true differences or changes in a construct being measured. The sensitivity of a diagnostic or screening test is the proportion of people who truly have a designated disorder and are so identified by the test. The test may consist of or include clinical observations. A test with high sensitivity detects a high proportion of true cases.
SENSITIVITY: the proportion of patients with the target disorder who have a positive test result.
SENTINEL PRACTICE A general practice which undertakes to maintain surveillance of, and report certain health problems, adverse drug reactions or other notifiable health events.
SERVICE An action taken by the provider in order to improve or maintain the health and well-being of the patient and/or the family. See also DIAGNOSTIC SERVICE, THERAPEUTIC SERVICE, PREVENTIVE SERVICE, ADMINISTRATIVE CARE, COMMUNITY CARE.
SETTING In research SETTING means under which conditions the study has been carried out. Population from which the study population is sampled. One of the sections of an abstract format, e.g. Public Health Service for school children, primary care, ambulatory care or hospital care.
SEVERITY OF ILLNESS The degree to which health problems impact the health of persons, individually or in groups. Severity can be measured by instruments such as the Karnofsky Performance Scale or the Duke Severity of Illness Checklist (DUSOI). See also CASE-MIX.
SEX RATIO The ratio of males to females or the rate of a health problem observed in males and in females.
SHADOWING – offering individuals the opportunity to spend time with a professional observing their working routine and environment
SHARED DECISION-MAKING: Sharing all the knowledge with the patient before patients makes a decision about their care
SHAUGHNESSEY’S EQUATION. The usefulness of any source of information is equal to its relevance multiplied by its validity divided by the work required to extract the information
SIBLINGS Children born by the same mother.
SICKNESS A state of social dysfunction, i.e. a role that the individual assumes when having a health problem (the sickness role).
SIDE EFFECT An unintended effect caused by a preventive, diagnostic or therapeutic procedure.
SIFT Service Increment for Teaching. One of the NHS funding streams for training(MADEL, SIFT. NMET)
SIGN In medicine an objective finding during a physical examination of a patient.
SIGNIFICANT EVENT AUDITING (SEA): Uses an event either a success or failure to examine the process of working and celebrating success or correcting errors
SIGNIFICANT EVENT this is an occurrence that is significant or pivotal in either a desirable or undesirable way and which, if not discovered or corrected in time, did or could lead to patient morbidity or mortality
SIMULATION. (Role play) Learners are given social roles to act out in a given situation
SINGLE LOOP LEARNING: (aka Adaptive), see also Generative and Meta learning
SKEWNESS The extent of asymmetry in a frequency distribution.
SKILLS Practical knowledge in combination with ability.
SMART CARD A small, electronic data carrier in the size of a credit card, that can hold substantial amounts of information, e.g. medical record, allergies, risk factors, etc.
SMART, acronym for assessing actions. Actions should be specific, measurable, achieveable, realistic and timetabled
SMOKE-FREE BRISTOL: An action plan led by the Bristol Partnership to reduce harm from smoke by tackling smoking in enclosed workplaces, public places and homes.
SMR: Standardised Mortality Rate (see definition)
SOA Super Output Area (see definition)
SOCIAL CLASS A group of individuals or families in a society which are characterized by the same education, occupation and income.
SOCIAL EXCLUSION: Defines a wide range of people who are isolated in society such as children excluded from school, the unemployed, teenage mothers, the homeless, people with mental illness and some people from minority ethnic groups.
SOCIAL MEDICINE (Syn: community medicine) The branch of medicine which deals with the health of the population and its impact on society.
SOCIAL POWER Lukes proposed three dimensions of power. First dimension A forces B to do something, Second is A controls the agenda in any interaction with B, Third is A controls the world as B sees it.
SOCIO-ECONOMIC CLASSIFICATION Classification according to social class and/or income.
SOCIO-ECONOMIC STATUS Descriptive term for a person's position in society, often using criteria as income, education, occupation, housing, etc.
SOCRATIC A dialectic style of teaching using questions to lead the learner to correct conclusions as determined by the teacher.
SOCRATIC METHOD. Using questions that lead learners to think and arrive at new understanding about the subject being discussed
SOLO PRACTICE A practice consisting of one principal providing health care for patients.
SOUTHERN CLUSTER A group of SHAs over a wide geographical area – in this case Kent to Cornwall. The Local Service Provider has been contracted under the National Programme for IM&T to implement the Ebooking systems.
SPECIALIST A medical practitioner who by his approved training and/or experience is specially competent in one particular field of medicine, which is recognized as a speciality. General family practice is presently in many countries obtaining recognition as a speciality, giving general/family practitioners status as specialists.
SPECIALIST A physician from whatever discipline who has undergone a period of higher postgraduate training.
SPECIFICITY the proportion of patients without the target disorder who have a negative test result The specificity of a diagnostic or screening test is the proportion of people who are truly free of a designated disorder and are so identified by the test. The test may consist of or include clinical observations. A test with high specificity has few false positives.
ST1 - first year of a GP specialist training program
ST2 - second year of a GP specialist training program
ST3 - third year of a GP specialist training program
STABLE SYSTEM; Stable practice system is one where the way of working has settled down into a well-used and familiar pattern
STANDARD (see criteria): This is the level of performance in a guideline or protocol that is being sought. Any established measure of extent, quantity, quality or value. 1. Absolute is based on mastery or perfect performance. 2. Criterion-related require explicit specification of the level of performance required, but differ in that it may be set at any chosen level. 3. Relative where the performance of one is compared with that of another.
STANDARD DEVIATION A measure of variation of a frequency distribution. It is equal to the positive square root of the variance: The standard deviation tells how widely the values are dispersed around the mean, which is the centre for a group of values.
STANDARD ERROR The standard deviation of an estimate.
STANDARDIZATION Recalculation or weighting of data to correct for unequal distributions between groups or classes like age or gender. STANDARDIZATION can be performed in two different ways: l. Direct method: the specific rates in a study population are averaged, using as weights the distribution of a specific standard population. , The direct standardized rate represents what the crude rate would have been in the study population if they had been equally distributed with regard to the variable for which the population is standardized. 2. Indirect method: this is used to compare populations where the specific rates are unknown or unstable. The specific rates in the standard population are averaged, using as weights the distribution of the study population. (See Last, 1988).
STANDARDISED DEATH RATES in which allowances have been made for Mortality Rate different age structures of populations. This means that fair (SMR) comparisons can be made between populations with, for example, different proportions of children or older people.
STANDARDIZED MORTALITY (MORBIDITY) RATIO (SMR) The rate of the mortality (morbidity) rate of groups corrected for inequalities in age-group distributions.
STATISTICAL POWER The probability of detecting an effect of a given size under the conditions of a particular study.
STATISTICAL SIGNIFICANCE TEST A statistical test which allows an estimate to be made of the probability of whether the null hypothesis can be accepted or rejected, i.e. whether there is equality between two groups or not. This statistical test has a specificity of 95% or higher, if the significance level set at <0.05. The sensitivity of this test to diagnose inequality depends on the sample size. The prior probability in clinical diagnostics is conform to the prior belief in inequality between groups in STATISTICAL SIGNIFICANCE TESTING. The complement of specificity (I - specificity) in clinical diagnostics is conform to a type I error (alpha, significance level) in significance testing. The complement of sensitivity (1 - sensitivity) in clinical diagnostics is conform to type II error (beta, power). Alpha is set beforehand on 0.05 or 0.01 by convention or choice, or calculated. Beta is set beforehand on 0.20 or 0.10 by convention or choice, or calculated. Sample size, alpha and beta are mathematically related. If two of the three values are known or chosen, the third can be calculated. All formulas contain a measure for variation of the data (Standard Deviation) and a measure for the minimal difference to be detected between groups that is judged to be clinically relevant (MIREDIF). See P-VALUE, NULL HYPOTHESIS.
STATISTICAL TEST A mathematical method used to decide whether the null hypothesis should be accepted or rejected. The test can be parametric and non-parametric.
STATISTICS AND ANALYSIS The collection of the following demographic data should be considered: 1. Patient identification: should be unique. 2. Residence: there are several options for the classification of residence which include address, telephone number, census tract, postal or zip code, grid, or municipal jurisdiction. 3. Date of birth: should be collected in such a way that age, may be calculated to the nearest year or, in infants, to the nearest month. 4. Sex: male or female. 5. Marital status: married (includes common-law), single, separated, divorced, or widowed.6. Socio-economic status: may be derived by several techniques which use occupation, education, ; income, method of payment, area of residence within census tracts, or a combination of two or more of these parameters.Other demographic data like language group, ethnic origin, religion, etc. may be considered, depending on the data needed.
STATUS QUO BIAS: being willing to take a bigger gamble to maintain the status quo than you would to achieve it in the first place
STI Sexually transmitted infection
STRATIFICATION Separating a sample into several sub-samples according to specified criteria, such as age groups, socio-economic status, etc.
STRUCTURE The characteristics of the providers of care, of the tools and resources at their disposal, and of the physical and organizational settings in which they work.
STUDENT, a person who is trying to learn
STUDY POPULATION All patients included in a study during the period of the study.
SUBACUTE A period longer than 4 weeks and shorter than 6 months.
SUBSTANCE MISUSE: The use of any substance (drugs, alcohol etc) in a way that is detrimental to the health of the person concerned.
SUMMATIVE ASSESSMENT: Assessment used to discover what level of competence you have achieved (see also Formative)
SUPER OUTPUT AREA: Small geographical area with a population of approximately 1,500 (SOA) people.
SUPPLEMENTARY CLASSIFICATION A separate additional classification which exists without standard conversion structure. They are used in combination with other more basic classification systems. The ICD is a basic classification of disease while a classification of morphology is a supplementary classification.
SUPPORTIVE CARE Services which promote the maintenance of bodily functions and psychological well-being, but are generally not considered to be curative.
SURVEILLANCE Observation and follow-up of health problems in the individual patient or in the population.
SURVEY this is a data collection exercise undertaken to establish the extent to which a standard or protocol is being achieved Observational or descriptive, non experimental study in which individuals are systematically examined for the absence or presence (or degree of presence) of characteristics of interest.
SURVIVAL RATE (Syn: cumulative survival rate) The proportion of survivors in a group, e.g. of patients, studied and followed over a period of time.
SYMPOSIUM: A conference; a collection of views on on one topic
SYMPTOM Any subjective evidence of a health problem, i.e. such evidence as perceived by the patient. Cough, pain, and tiredness are symptoms.
SYNDICATE METHOD. (Jigsaw approach) Divide class into groups working on different aspects of same problem with intermittent teacher support
SYNDROME (Syn: syndrome diagnosis, nosological diagnosis) A symptom complex in which a combination of symptoms and signs occurs more frequently than would be expected on the basis of chance alone. The term is used in three different ways: 1. The symptomatic presentation of a health problem or group of health problems. For instance the hyperthyroid syndrome. This use of the term is prevalent in general practice as many health problems are met in an early phase, or cannot or need not be diagnosed by additional diagnostic procedures. See DIAGNOSIS. 2. As synonymous jargon on basis of a historical vocabulary. Example: Down's syndrome; this is in fact a well-known disease: trisomy-21. 3. As synonym for the concept behind the term nosological diagnosis. A prerequisite for considering a set of symptoms and signs as a SYNDROME is its clinical utility for understanding, diagnosis, prognosis or treatment. See DISEASE.
SYNTHESIS: making sense of facts and concepts in your own words
SYSTEMATIC REVIEW A review that strives to comprehensively identify, track down and appraise all the literature on a topic (also known as systematic literature review)