Are you making common mistakes in your online survey questionnaire?

Are you using online survey software such as SurveyMonkey, SmartSurvey, SnapSurveys etc. for your health and social surveys? If you are, are you confident you know enough about questionnaire design that you can really make informed decision based on the information you are collecting?

Online survey questionnaire design software provides us with a real opportunity to create and field relatively easily, your patient survey. What it does not provide is you with the skills needed to produce a questionnaire that enables you to make informed decisions about improving your practice.

Not only is a badly designed questionnaire a waste of time for you, but also for the respondent in giving you information that in most cases will not provide the real answers you want.

Respondent involvement is a great start in developing your survey and should always be your starting point. Nevertheless, it does not prevent the common mistakes generally found in questionnaires designed by the non-expert.

Usually these mistakes can be simply rectified by an expert eye, costing little and ensuring you will be getting reliable and relevant information.

In the following we illustrate with two case studies just how easy it is to get it wrong and how the design can be improved.

Example 1:

“On a scale of 1-5 with 1 being not satisfied and 5 being very satisfied could you please rate the following:

Friendliness of GP’s and nurses”


This type of question is known as a double-barrel question” which is two questions being asked in one. The problem for the patient is having not been provided with an opportunity to respond should the patient’s experiences of friendliness be different for GPs and nurses, if some nurses or GPs are less friendly than others, the patient has only ever seen one GP or nurse or has never seen a nurse. The question should be rewritten as two questions along the lines shown opposite

Revised question:

How satisfied or dissatisfied are you overall with the friendliness of the doctor(s) you have seen?

  • Very satisfied
  • Quite satisfied
  • Neither satisfied or dissatisfied
  • Quite dissatisfied
  • Very dissatisfied
  • Have not been seen by a doctor

How satisfied or dissatisfied are you overall with the friendliness of the nurse(s) you have seen?

  • Very satisfied
  • Quite satisfied
  • Neither satisfied or dissatisfied
  • Quite dissatisfied
  • Very dissatisfied
  • Have not been seen by a nurse


Example 2:

“On a scale of 1-10 (where 1 is very poor and 10 is excellent) how satisfied are you with the quality of care received from our nurses?”


The first issue with this question is that “quality of care” lacks a clear definition. Although in common usage, a more specific definition would help the respondent interpret the question.

Scales with a 10 point range without adjective anchors can be cognitively demanding for the patient to complete. Based on much field and academic research, a 10-point scale is likely to yield ratings concentrated between scores of 7 and 9, with little of the lower half of the scale ever being used. The question also assumes the patient has seen a practice nurse at some time.

Revised questions:

In general how would you rate the quality of care you have received from any of the practice nurses?

  • Poor
  • Fair
  • Good
  • Very Good
  • Excellent
  • Have not received care from a practice nurse



  • Determine the specific purpose of the survey
  • Clarify survey objectives
  • Obtain respondent input in the design stage
  • Ask valid questions that make sense to the respondent
  • Construct questions that are concrete and specific
  • Avoid negative wording
  • Use conventional and simple language
  • Avoid loaded and biased wording
  • Choose open and closed questions appropriately
  • Use appropriate response formats e.g. nominal, categorical, ordinal
  • Proper use of skip patterns

If you would like to know more on how we can help you get the most from your survey questionnaire please complete the contact form below.


Categories: Questionnaire design

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