Assessing Survey Satisficing: The Impact of Unmotivated Questionnaire Responding on Data Quality

Vriesema, Christine Calderon; Gehlbach, Hunter

doi:10.3102/0013189x211040054

Cited by 18 publications

(12 citation statements)

References 24 publications

(30 reference statements)

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“…Due to the sequential design, we removed raters who did not complete all ratings. We also removed raters who used 2 or fewer response items on the 5-item survey because this may be a sign of inattention and poor rater quality [ 24 ]. We defined outliers as raters who reduced the interrater reliability of their task by 0.1 or more.…”

Section: Methodsmentioning

confidence: 99%

Video-Based Communication Assessment of Physician Error Disclosure Skills by Crowdsourced Laypeople and Patient Advocates Who Experienced Medical Harm: Reliability Assessment With Generalizability Theory

White¹,

King²,

D'Addario³

et al. 2022

JMIR Med Educ

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Background Residents may benefit from simulated practice with personalized feedback to prepare for high-stakes disclosure conversations with patients after harmful errors and to meet American Council on Graduate Medical Education mandates. Ideally, feedback would come from patients who have experienced communication after medical harm, but medical researchers and leaders have found it difficult to reach this community, which has made this approach impractical at scale. The Video-Based Communication Assessment app is designed to engage crowdsourced laypeople to rate physician communication skills but has not been evaluated for use with medical harm scenarios. Objective We aimed to compare the reliability of 2 assessment groups (crowdsourced laypeople and patient advocates) in rating physician error disclosure communication skills using the Video-Based Communication Assessment app. Methods Internal medicine residents used the Video-Based Communication Assessment app; the case, which consisted of 3 sequential vignettes, depicted a delayed diagnosis of breast cancer. Panels of patient advocates who have experienced harmful medical error, either personally or through a family member, and crowdsourced laypeople used a 5-point scale to rate the residents’ error disclosure communication skills (6 items) based on audiorecorded responses. Ratings were aggregated across items and vignettes to create a numerical communication score for each physician. We used analysis of variance, to compare stringency, and Pearson correlation between patient advocates and laypeople, to identify whether rank order would be preserved between groups. We used generalizability theory to examine the difference in assessment reliability between patient advocates and laypeople. Results Internal medicine residents (n=20) used the Video-Based Communication Assessment app. All patient advocates (n=8) and 42 of 59 crowdsourced laypeople who had been recruited provided complete, high-quality ratings. Patient advocates rated communication more stringently than crowdsourced laypeople (patient advocates: mean 3.19, SD 0.55; laypeople: mean 3.55, SD 0.40; P<.001), but patient advocates’ and crowdsourced laypeople’s ratings of physicians were highly correlated (r=0.82, P<.001). Reliability for 8 raters and 6 vignettes was acceptable (patient advocates: G coefficient 0.82; crowdsourced laypeople: G coefficient 0.65). Decision studies estimated that 12 crowdsourced layperson raters and 9 vignettes would yield an acceptable G coefficient of 0.75. Conclusions Crowdsourced laypeople may represent a sustainable source of reliable assessments of physician error disclosure skills. For a simulated case involving delayed diagnosis of breast cancer, laypeople correctly identified high and low performers. However, at least 12 raters and 9 vignettes are required to ensure adequate reliability and future studies are warranted. Crowdsourced laypeople rate less stringently than raters who have experienced harm. Future research should examine the value of the Video-Based Communication Assessment app for formative assessment, summative assessment, and just-in-time coaching of error disclosure communication skills.

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Section: Methodsmentioning

confidence: 99%

Video-Based Communication Assessment of Physician Error Disclosure Skills by Crowdsourced Laypeople and Patient Advocates Who Experienced Medical Harm: Reliability Assessment With Generalizability Theory

White¹,

King²,

D'Addario³

et al. 2022

JMIR Med Educ

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show abstract

“…We sought at least 8 raters per response after removing raters with indications of inattention or low contributions to reliability [ 28 ]. Ratings were aggregated across raters, items, and vignettes to create an overall score for each resident at time 1 and at time 2.…”

Section: Methodsmentioning

confidence: 99%

Effects of Practicing With and Obtaining Crowdsourced Feedback From the Video-Based Communication Assessment App on Resident Physicians’ Adverse Event Communication Skills: Pre-post Trial

White¹,

King²,

D'Addario³

et al. 2022

JMIR Med Educ

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Background US residents require practice and feedback to meet Accreditation Council for Graduate Medical Education mandates and patient expectations for effective communication after harmful errors. Current instructional approaches rely heavily on lectures, rarely provide individualized feedback to residents about communication skills, and may not assure that residents acquire the skills desired by patients. The Video-based Communication Assessment (VCA) app is a novel tool for simulating communication scenarios for practice and obtaining crowdsourced assessments and feedback on physicians’ communication skills. We previously established that crowdsourced laypeople can reliably assess residents’ error disclosure skills with the VCA app. However, its efficacy for error disclosure training has not been tested. Objective We aimed to evaluate the efficacy of using VCA practice and feedback as a stand-alone intervention for the development of residents’ error disclosure skills. Methods We conducted a pre-post study in 2020 with pathology, obstetrics and gynecology, and internal medicine residents at an academic medical center in the United States. At baseline, residents each completed 2 specialty-specific VCA cases depicting medical errors. Audio responses were rated by at least 8 crowdsourced laypeople using 6 items on a 5-point scale. At 4 weeks, residents received numerical and written feedback derived from layperson ratings and then completed 2 additional cases. Residents were randomly assigned cases at baseline and after feedback assessments to avoid ordinal effects. Ratings were aggregated to create overall assessment scores for each resident at baseline and after feedback. Residents completed a survey of demographic characteristics. We used a 2×3 split-plot ANOVA to test the effects of time (pre-post) and specialty on communication ratings. Results In total, 48 residents completed 2 cases at time 1, received a feedback report at 4 weeks, and completed 2 more cases. The mean ratings of residents’ communication were higher at time 2 versus time 1 (3.75 vs 3.53; P<.001). Residents with prior error disclosure experience performed better at time 1 compared to those without such experience (ratings: mean 3.63 vs mean 3.46; P=.02). No differences in communication ratings based on specialty or years in training were detected. Residents’ communication was rated higher for angry cases versus sad cases (mean 3.69 vs mean 3.58; P=.01). Less than half of all residents (27/62, 44%) reported prior experience with disclosing medical harm to patients; experience differed significantly among specialties (P<.001) and was lowest for pathology (1/17, 6%). Conclusions Residents at all training levels can potentially improve error disclosure skills with VCA practice and feedback. Error disclosure curricula should prepare residents for responding to various patient affects. Simulated error disclosure may particularly benefit trainees in diagnostic specialties, such as pathology, with infrequent real-life error disclosure practice opportunities. Future research should examine the effectiveness, feasibility, and acceptability of VCA within a longitudinal error disclosure curriculum.

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“…In practice, satisficing results in a number of response behaviors that lead to low-quality survey data: these include (1) rushing through a survey; (2) selecting the first reasonable answer; (3) agreeing with all statements presented on the survey; (4) selecting the same options repeatedly, in a straight line (socalled straightlining); (5) selecting ''don't know'' or ''not applicable'' without actually thinking about the question being asked; and (6) skipping items or entire sections of a survey. 2 Satisficing is epitomized by this quote from a resident at a large Midwestern academic medical center who was asked about their survey behaviors: ''A lot of the time. .…”

Section: Motivation and Satisficingmentioning

confidence: 99%

“…One weakness, supported by decades of empirical evidence in fields like public opinion polling, sociology, and psychology, is that low levels of respondent motivation can lead to poorquality data. 2 In GME the problem may be even more acute, as resident physicians have many competing time constraints, including clinical and educational responsibilities, as well as life beyond work. These and other constraints make prioritizing surveys difficult, regardless of the merit of any particular GME study or evaluation effort.…”

mentioning

confidence: 99%

Getting the Most Out of Surveys: Optimizing Respondent Motivation

Artino

Youmans

Tuck

2022

Journal of Graduate Medical Education

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Assessing Survey Satisficing: The Impact of Unmotivated Questionnaire Responding on Data Quality

Cited by 18 publications

References 24 publications

Video-Based Communication Assessment of Physician Error Disclosure Skills by Crowdsourced Laypeople and Patient Advocates Who Experienced Medical Harm: Reliability Assessment With Generalizability Theory

Video-Based Communication Assessment of Physician Error Disclosure Skills by Crowdsourced Laypeople and Patient Advocates Who Experienced Medical Harm: Reliability Assessment With Generalizability Theory

Effects of Practicing With and Obtaining Crowdsourced Feedback From the Video-Based Communication Assessment App on Resident Physicians’ Adverse Event Communication Skills: Pre-post Trial

Getting the Most Out of Surveys: Optimizing Respondent Motivation

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