Table 1.

A seven-step, survey scale design process for medical education researchers.

Step	Purpose
1. Conduct a literature review	To ensure that the construct definition aligns with relevant prior research and theory and to identify existing survey scales or items that might be used or adapted
2. Conduct interviews and/or focus groups	To learn how the population of interest conceptualizes and describes the construct of interest
3. Synthesize the literature review and interviews/focus groups	To ensure that the conceptualization of the construct makes theoretical sense to scholars in the field and uses language that the population of interest understands
4. Develop items	To ensure items are clear, understandable and written in accordance with current best practices in survey design
5. Conduct expert validation	To assess how clear and relevant the items are with respect to the construct of interest
6. Conduct cognitive interviews	To ensure that respondents interpret items in the manner that survey designer intends
7. Conduct pilot testing	To check for adequate item variance, reliability and convergent/discriminant validity with respect to other measures

Adapted with permission from Lippincott Williams and Wilkins/Wolters Kluwer Health: Gehlbach et al. (2010). AM last page: Survey development guidance for medical education researchers. Acad Med 85:925.