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Glossary of Primary Care - Second Draft

Library Documents

A. GENERAL TERMS
B. TERMS OF MEDICAL EDUCATION
C. TERMS OF THE EDUCATIONAL PROCESS
D. TERMS USED IN VOCATIONAL TRAINING
E. TERMS OF PERFORMANCE REVIEW AND CONTINUINE MEDICAL EDUCATION

E.TERMS OF PERFORMANCE REVIEW AND CONTINUINE MEDICAL EDUCATION
E.1.	ASSESS
	To determine the value or the amount of something and to express this in terms of something which is known, i.E.may be quantitative or qualitative and impIies comparison. (HORDER-ANTWERP)
	The awarding of a. score or value which may be arbitrary rather than direct measurement. (KVIST from Crombie)
	"Measurement, by as objective a method as possible, of the learning achieved by an individual". (DJ PEREIRA GRAY)
E.2.	EVALUATE
	A generic term covering the application o-F .techniques in the quest -for measurements of quality in medical carE.(KVIST from Crombie)
	"Measurement by as objective a method as possible, of the learning achieved by a programme or by groups or learner. "(DJ PEREIRA GRAY)
	'The making of judgements about the value, for some purpose of ideas, works, solutions, methods, material, etc. It involves the use of criteria as well as standards for appraising the extent to which particulars are accurate, effective, economical, or satisfying. The judgements may be either quantitative or qualitative, and the criteria may be either those determined by the student or those which are given to him.' (BLOOM in TAXONOMY of EDUCATIONAL OBJECTIVES).
E.3.	QUALITY
	The degree of excellence; the relative valuE.(OED)
E.4.	QUALITY ASSESSMENT
	The measurement of the degree of excellence of the services rendered. (HEYRMAN)
E.5.	QUALITY ASSURANCE
	A guarantee by the providers of medical services that they are being maintained at a certain standard, based upon the actual measurement of their degree of excellence and their modification where necessary to reach it. (HEYRMAN)
E.6.	MEDICAL AUDIT
	A study of some part of the structure, process, and outcome of medical care, carried out by those personally engaged in the activity concerned, to measure whether set objectives have been attained, and thus assess the quality of care delivered. It includes self audit and peer review. (SHELDON).
E.7.	EXTERNAL AUDIT
	Assessments of performance carried out by persons or authorities not personally involved in the activity under review. (SHELDON)
E.8.	COLLEAGUE
	One who is associated with others in o-f -f ice or-employment. (QED)
E.9.	PEER
	An equal in standing or rank. (OED)
E.10.	PEER REVIEW
	A critical study of their mutual performance by persons of equal standing. (NLG:MJB)
E.11.	STANDARD
	Any established measure of extent. quantity, quality or valuE.(NLG:MJB)
	A definite level of excelIence, attainment, wealth, or the like, or a definite degree of any quality, viewed as a prescribed object of endeavour or as the measure of what is adequate for some purposE.(OED)
	ABSOLUTE: based on mastery or perfect performance.
	CRITERION-RELATED: require explicit specification of the level of performance required, but differ in that it may be set at any chosen level.
	RELATIVE: where the performance of one is compared with that of another. (FABB&MARSHALL)
E.12.	ESTABLISHED
	Proven or placed beyond disputE.(OED)
E.13.	VALUE (noun)
	That which is desirable or useful or both, (HORDER)
E.14.	PERSONAL VALUES
	That which is regarded by an individual as desirable or useful or both. (NLG:MJB)
	NOTE:
	Standards may be derived from: (MJB)
	Personal values
	Peer review
	Research literature
	Authoritative sources
	(the value's of those regarded as experts).
E.15.	NORM
	A rule or authoritative standard. (QED)
E.16.	NORMATIVE
	Derived from the standard textbooks and the work of experts. The "best" level of carE.(DONABEDIAN 1966)
	Establishing a. norm or standard. (OED)
E.17.	EMPIRICAL
	Derived from many studies where the statistical average is obtained after evaluating the habits of many doctors. The "average" level of care." (DONABEDIAN 1966)
	That which is guided by mere experience, without knowledge of principles. (OED)
E.18.	CRITERION
	A characteristic attaching to a thing, by which it can be judged or estimated. (OED)
E.19.	EMPIRICAL STANDARDS
	Those derived -from statistical averages obtained from simiIar settings. (McWhinney)
E.20.	NORMATIVE STANDARDS
	Those derived from traditional sources of orthodox medical standards. (McWhinney)
E.21.	EFFECTIVENESS
	The quality of being able to accomplish a result. (OED)
	A measure of the success in achieving a clearly stated objectivE.(McCormick JRCGP May 1981)
E.22.	COST
	The price which must be paid, whether in objective terms, (money), or subjective terms (distress, discomfort) in achieving the objectivE.(McCormick 1981)
E.23.	EFFICIENCY
	Cost effectiveness, that which is most effective at least cost. (McCormick 1981)
E.24.	STRUCTURE
	Is the sum of the doctor's personal attributes, the facilities available to him, and the administration used by patients to gain access to his services. (SHELDON) 'The settings and instrumentalities available and used for the provision of care.' (DONABEDIAN)
E.25.	PROCESS
	The sum of activities to which inputs are subjected in order to achieve the objectivE.(MJB:NLG) 'The activities of ...health professionals in the management of patients.' (DONABEDIAN)
E.26.	OUTCOMES
	The state of the inputs (whether or not that is measurable) at any time after the process is completE.(MJB:NLG)
	'The end results (of health care) in terms of health and satisfaction.' (DONABEDIAN)
E.27.	PERFORMANCE
	The manner in which a defined activity is carried out or a defined role fulfilled.
E.28.	COMPETENCE
	The sum of personal attributes required to carry out a defined activity or fulfill a defined role.
E.29.	ACCESS
	The manner in which an individual wishing to avail of health care may do so, and in which health care providers allow their services to be used. (NLG:MJB)
E.30.	ACCESSIBILITY
	Ease of access. (MJB)
E.31.	PERFORMANCE ASSESSMENT
	A generalisation about the performance of an individual derived from an observation of a sample of his behaviour (assuming that the observation is valid and reliable). (FULOP).'
E.32.	PROGRAMME EVALUATION
	The making of an informed judgement about the character and quality of an educational programme or parts thereof.
	"In-formed Judgement" = using all relevant data, reliably gathered from dependable sources, a considered decision based upon comparison with sound criteria. (FULOP').
E.33.	TREATMENT EFFICACY and EFFECTIVENESS
	EFFICACY= "Does it work under ideal circumstances?"
	EFFECTIVENESS' 'Does it work under the realities of clinical practice?"
	DM BARR in COMMON DILEMMAS IN FAMILY MEDICINE ed. FRY.)
E.34.	TEST VALIDITY
	The accuracy with which a test measures what it purports to measure.
	Content Validity: concerned with the adequacy of sampling of the specified universe of content, avoiding overemphasis of some areas and under emphasis of others.
	Criterion Related Validity: test performance related to some accepted external contemporary criterion of performancE.
	Predictive Validity: test performance related to subsequent performance in practice.
	Construct Validity: inferences made about phenomena which cannot be observed directly, from phenomena which can be observed directly. (FABB&MARSHALL)
E.35.	TEST RELIABILITY
	The extent to which results obtained in an assessment are consistently reproduciblE.(FABB&MARSHALL)
E.36.	TEST OBJECTIVITY
	The extent to which the test items and their scoring are free from subjective bias. (FABB&MARSHALL)