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Effect of the framing of questionnaire items regarding satisfaction with training on residents' responses

Guyatt, G. H., Cook, D. J., King, Derek ORCID: 0000-0002-2408-4558, Norman, G. R., Kane, S. L. and van Inevald, C (1999) Effect of the framing of questionnaire items regarding satisfaction with training on residents' responses. Academic Medicine, 74 (2). pp. 192-194. ISSN 1040-2446

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PURPOSE: To determine whether framing questions positively or negatively influences residents' apparent satisfaction with their training. METHOD: In 1993-94, 276 residents at five Canadian internal medicine residency programs responded to 53 Likert-scale items designed to determine sources of the residents' satisfaction and stress. Two versions of the questionnaire were randomly distributed: one in which half the items were stated positively and the other half negatively, the other version in which the items were stated in the opposite way. RESULTS: The residents scored 43 of the 53 items higher when stated positively and scored ten higher when stated negatively (p < .0001). When analyzed using an analysis-of-variance model, the effect of positive versus negative framing was highly significant (F = 129.81, p < .0001). While the interaction between item and framing was also significant, the effect was much less strong (F = 5.56, p < .0001). On a scale where 1 represented the lowest possible level of satisfaction and 7 the highest, the mean score of the positively stated items was 4.1 and that of the negatively stated items, 3.8, an effect of 0.3. CONCLUSIONS: These results suggest a significant "response acquiescence bias." To minimize this bias, questionnaires assessing attitudes toward educational programs should include a mix of positively and negatively stated items.

Item Type: Article
Official URL:
Additional Information: © 1999 Association of American Medical Colleges
Divisions: Personal Social Services Research Unit
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > R Medicine (General)
Date Deposited: 21 Dec 2010 11:59
Last Modified: 15 May 2024 23:44

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