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          Program Survey Development

          Chad Hensley, PhD, R.T.(R)(MR)

                 tandard 6, Objective 6.3 of the Joint Review   improvements. Responding in this manner is referred
                 Committee on Education in Radiologic        to as optimizing.  Respondents might answer some ques-
                 Technology (JRCERT) Standards highlights    tions with optimizing behaviors but become fatigued
         Sthe importance of continuous program               as the questions continue, which might lessen their
          improvement.  To accomplish continuous improvement,   cognitive efforts. In addition, respondents often answer
          programs solicit feedback—often in the form of a   surveys because it is required. They lack the intrinsic
          survey—from their communities of interest          motivation to put forth cognitive effort, a behavior
          (eg, students, graduates, employers, clinical staff,   known as satisficing.  Respondents using satisficing
          administration). JRCERT defines communities of     behaviors provide satisfactory or good enough answers
          interest as, “The internal and external stakeholders, as   that are not as accurate or as thoughtful as answers pro-
          defined by the program, who have a keen interest in the   vided using optimizing behavior. 4
          mission, goals, and outcomes of the program and the
          subsequent program effectiveness.” 1               Writing Comprehendible Questions
            If properly developed, a survey can be an effective,   A survey should be written based on the assump-
          inexpensive, and easy tool with which to gather data.   tion that most respondents use satisficing behaviors.
          Understanding why respondents answer in specific   Each question should be written in a clear manner to
          ways helps avoid survey pitfalls and ensure that the   ensure that respondents can comprehend it (see Table).
          feedback allows for continuous program improvement.  Addressing more than 1 concept in a question, known
                                                             as a double-barreled question, often creates confusion
          Respondent Psychology                              and makes the question difficult to answer.  For exam-
            When answering a survey, respondents often fol-  ple, a question that asks responders to rate the level of
          low a 4-step process called the cognitive aspect of survey   agreement to a statement but then provides 2 options is
          measurement. This method involves comprehending    considered a double-barreled question (eg, the clinical
          the question, retrieving the information from memory,   placement provided sufficient volume and variety of
          integrating the information into a single judgment,   examinations). To avoid double-barreled questions, 2
          and reporting the judgment to the best response.   2  separate questions should be crafted regarding volume
          The method might explain why some surveys receive   and variety.
          inaccurate or unreliable information. For example,    Using terms that respondents could interpret in dif-
          respondents might :                                ferent ways also can lead to inaccurate results. Take, for
                ƒ not understand the question                example, a question that asks students to rate the level
                ƒ not remember the information               of agreement regarding a clinical instructor’s profes-
                ƒ make judgments from inaccurate memories    sionalism. Without defining the term professionalism,
                ƒ be influenced by previous questions        respondents will apply their own perspective regarding
                ƒ edit their responses and not report the best answer  how a professional should act and what is considered
            Respondents should be motivated to go through    professional behavior. To avoid confusion, profession-
          each cognitive step for each question, resulting in reli-  alism should be defined based on the behaviors the
          able information that facilitates effective program   program wants to assess.

          RADIOLOGIC TECHNOLOGY, January/February 2021, Volume 92, Number 3                               297
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