Top Ten Tips - Shaping and Sharpening a Clinical Survey

Dr. Akshay G. Nair, DNB FACS
Published Online: March 2nd, 2023 | Read Time: 9 minutes, 14 seconds

Surveys are helpful in understanding trends in the management of disease, the changes in the way a disease is treated and also how different factors can affect the choices a clinician makes. But the best surveys are the ones that bring out new information on topics, questions or trends that may seem familiar. Here are a few ways on maximising the responses to your survey questions:

1. Brief honest introduction:

Usually invitations to participate in surveys are shared through email, social media platforms like Facebook or WhatsApp. It is important to include a brief and crisp introduction about who the investigators are and what does the survey aim to do. Also mention if the survey is anonymous or not: i.e. whether it requires the respondents to identify themselves or not and how long would it approximately take to fill up the survey form and who should be taking this survey.

For example:

Hello,

Greetings. Request all ophthalmology residents in India to take this survey on cataract surgical training in residency. It is a 2 minute survey with 12 questions and is completely anonymous. The survey will help us understand the baseline of surgical training in India and also give the data to the policy makers for consideration in designing and restructuring residency programs.

Thank you.

PS: The survey is only for trainees currently pursuing ophthalmology residency.

http://lnkiy.in/cataract

Regard,

Akshay G Nair,

akshaygn@gmail.com

2. Clarity of the idea:

It is important to have a clear idea about what exactly is the topic on which you wish to survey the concerned population. The more specific the topic is - the more focussed questions you can ask and they are more likely to get better responses. Do not try to cover too many issues in a single survey.

3. Anonymity:

This is a double-edged sword because anonymity can get people to be more honest and truthful in their responses. But at the same time it can promote irreverence. In most cases, it is best to not have people identify themselves with name/email addresses; this usually gets a higher response rate.

4.Know your target audience:

This will help you get an idea of what a good number of responses would be. For example, if a service being planned about practice patterns during COVID-19, then this survey would be applicable to all ophthalmologists practising in India. In this case you know then that 150 - 200 responses would be inadequate and not truly representative of national trends. On the other hand, if it is a specific survey designed to assess practice patterns of neuro ophthalmologists regarding treatment of optic neuritis - it becomes very niche survey. Therefore, accordingly the expected number of responses would be lower.

5. Literature review:

One must review the literature for similar surveys conducted in the past – this helps on many counts:

a. An estimate for what would be a good number of responses in order to make a useful comparison

b. To understand the trend in the past – repeating the same questions that were asked in a survey 10 years ago can help understand shifting trends on the same topic

c. To help understand what questions were missed in previous surveys that one can ask in the presently planned survey

6. Stratify the respondents:

Have questions that help classify your participants: by age, number of years of experience, geographical location, educational background, nature of practice (academic vs. private vs. government), etc. These responses will help us understand what are the factors that go behind the decision making process and how these factors are impacted.

For example: We conducted a survey to assess how many independent cataract surgeries does a resident trainee in India get to perform during residency. Here we asked the respondents to mention their training program: MS/MD or DNB as well as specify the year of training (1st/2nd/3rd). A total of 740 resident ophthalmologists participated in the survey. 59.9% of the trainees had not independently performed cataract surgery and of those who were not performing independent cataract surgeries, 62.5% (277/443) were in third year of residency. Crucially, a significantly higher proportion of trainees who were not operating independent cataract surgeries were enrolled in MD/MS programs as compared to DNB courses (65.6% vs. 43.7%; p<0.0001). Thus, having the respondents specify their training program has helped us understand finer nuances regarding cataract training in residency in India.

7. Avoid Ambiguity and Confusion:

While framing the different options to multiple-choice questions, it is imperative to stick to simple answer options. The options for answer should not be complicated long sentences that overlap making it difficult to make a choice. Remember, you can also have questions where more than one response may be allowed by the respondent.

8.Ensure uniformity:

Most survey options allow you to make responses to every question mandatory. This should always be done – as it ensures that all questions are answered and number of responses for every question is identical. One is thus able to create uniformity in the responses and analyse it more effectively. Questions that require the participant to type in an answer are usually poorly received and these responses are difficult to include in the analysis.

9. Have a deadline in mind:

Do not keep extending the survey period indefinitely - one or two extensions of a week or so to get more responses are adequate. Once you have reached your target number of responses, one should quickly wrap it up. Researchers should utilise the analytical tools available with Google Forms or SurveyMonkey to analyse the data. Do not sit on it for more than a week. Surveys are the easiest to write up, present and publish. Therefore surveys should be converted to manuscripts at the earliest.

10. Proof read and have a friend do it too!

A small pilot survey always helps - before making the survey public and sending it out to everybody, it is advisable to have a closed group of four or five colleagues take the survey. Having additional sets of eyes and minds go through the questions and the options is invaluable as they may always come up with better questions, better framing of responses and alternative questions that one could have missed. Also, in our experience, nearly 75% of the respondents participated in our surveys using smart devices. In most cases, they used their mobile phones; therefore, always preview the survey on your phone to check for formatting errors.

Less is more:

Do not have more than 15 questions in a survey. Seeing a very long survey can be putting off for respondents. Remember - the participants doing you a favour by taking the time out to fill in the responses. Be respectful of their time and efforts.

Dr. Akshay G. Nair, DNB FACS
Akshay G. Nair DNB FACS is an oculoplastic surgeon practicing in Mumbai affiliated with Dr. Agarwal Group of Eye Hospitals. Trained at Sankara Nethralaya, Chennai and LV Prasad Eye Institute, Hyderabad; he has been the recipient of Achievement Awards from the American Academy of Ophthalmology and the Asia Pacific Academy of Ophthalmology. Nair features in the top 2% of the most-cited researchers globally in 2021 across all specialties (per the Stanford study published by Elsevier). He has published over 125 peer-reviewed indexed papers and 20 textbook chapters: his publications include 15 surveys that have been published in various journals such as Indian Journal of Ophthalmology, Journal of Craniofacial Surgery, European Journal of Ophthalmology, Clinical Ophthalmology, Work and International Journal of Pediatric Otorhinolaryngology. His pioneering surveys on the impact of COVID-19 on ophthalmic practice have been cited over 400 times within a year of publication.
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