Cristen R. Wall, MD Mark J. DeHaven, PhD Kevin C. Oeffinger, MD Dallas, Texas From The University of Texas Southwestern Medical Center at Dallas, the Department of Family Practice and Community Medicine, Dallas, TX. Presented at the 33rd Annual Conference of the Society of Teachers of Family Medicine, Orlando, FL, May 2000, and at the North American Primary Care Research Group, Amelia Island, FL, November 2000.
Use of lottery appears to also increase response rate in both physicians and the lay public, although there are no studies comparing lottery to a monetary incentive enclosed for all participants.31,49 Use of either certified or priority return mail appears to increase response rates, and may be more cost effective when used for the second mailing.45,48
Pilot testing
Though pilot testing is generally included in the development of a survey, it is often inadequately conducted Figure F Final Preparation). Frequently, investigators are eager to answer their research question and pilot testing is synonymous with letting a few colleagues take a quick look and make a few comments. Table 2 illustrates a problem that could have been avoided with proper pilot testing.10 One of the questions in the survey asked about how time is allotted for faculty to pursue scholarly activities and research (Format A). Unfortunately, the question mixes 2 types of time in 1 question: extended time away from the institution (sabbatical and mini-sabbatical) and time in the routine schedule. This was confusing to respondents and could have been avoided by separating the content into 2 separate questions (Format B).
Investigators should consider carefully whom to include in the pilot testing. Not only should this include the project team and survey “experts”, but it should also include a sample of the target audience. Pilot testing among multiple groups provides feedback about the wording and clarity of questions, appropriateness of the questions for the target population, and the presence of redundant or unnecessary items.
Conclusions
One of the authors (C.R.W.) recently worked on her first questionnaire project. Among the many lessons she learned was the value of a team in providing assistance, the importance of considering if the time spent on a particular activity makes it cost effective, and the need to be flexible depending on circumstances. She found that establishing good communication with the team cuts down on errors and wasted effort. Rewarding the team for all of their hard work improves morale and provides a positive model for future projects.
The mailed self-administered questionnaire is an important tool in primary care research. For family practice to continue its maturation as a research discipline, family practitioners need to be conversant in survey methodology and familiar with its pitfalls. We hope this primer-designed specifically for use in the family practice setting-will provide not only basic guidelines for novices but will also inspire further investigation.
Acknowledgments
The authors thank Laura Snell, MPH, for her thoughtful review of the manuscript. We also thank Olive Chen, PhD, for research assistance and Janice Rookstool for manuscript preparation.
