As part of the CaHRU Improvement Science and Research Methods seminar series, Fiona Togher presented a fascinating seminar on the use of cognitive interviews on 28 June 2016. Fiona eloquently described how cognitive interviews can and indeed should be used as an integral part of questionnaire design. She explained how some of the potential problems found in data collected by questionnaires can be directly apportioned to participants understanding and perception of the questions along with issues of memory retrieval and the response process. Traditional field testing of questionnaires does not highlight these issues as this type of testing will only analyse whether a participant answers a question or not. It does not assess the thought process behind the participant’s decision to answer the question in that way.
Cognitive interviews are an in-depth question by question discussion with typical participants designed to assess their comprehension, retrieval, judgement and response process. From this it is possible to determine the suitability and relevance of questions to the target audience, thereby producing clear questionnaires that will themselves produce more robust data. Fiona was able to show practical application of this technique through her own experiences whilst developing a Patient Reported Experience Measure (PREM) for use in Ambulance Services in England. Her personal experience of using cognitive interviews and relaxed and engaging presentation style made this an interesting, informative and enjoyable seminar.
Fiona recommended the following book as a good starting place for understanding this method: Willis, G. B. (2004) Cognitive Interviewing: A Tool for Improving Questionnaire Design Sage Publications, Inc. There is also a follow on book: Willis, G.B. (2015) Analysis of the Cognitive Interview in Questionnaire Design (Understanding Qualitative Research) OUP, USA. The next Improvement Science and Methods seminar will take place on 13th September, 2016 where Prof Chris Bridle, director of the Lincoln Institute for Health, will be discussing accumulative evidence synthesis.
By Dr Stephanie Armstrong