Practice points

Questionnaires are widely used in medical education research, yet the processes employed to develop questionnaires vary in quality and lack consistent, rigorous standards. This AMEE Guide introduces a systematic, seven-step design process for creating high-quality survey scales fit for program evaluation and research purposes. The seven-step design process synthesizes multiple techniques survey designers employ into a cohesive process. The survey design process described in this Guide includes the following seven steps: (1) conduct a literature review, (2) carry out interviews and/or focus groups, (3) synthesize the literature review and interviews/focus groups, (4) develop items, (5) collect feedback on the items through an expert validation, (6) employ cognitive interviews to ensure that respondents understand the items as intended and (7) conduct pilot testing. This seven-step design process differs from previously described processes in that it blends input from other experts in the field as well as potential participants. In addition, this process front loads the task of establishing validity by focusing heavily on careful item development.