Investigating the use of negatively phrased survey items in medical education settings: common wisdom or common mistake?

Academic Medicine : Journal of the Association of American Medical Colleges
Thomas J Stewart, Ann W Frye

Abstract

Attitude surveys in medical education often combine negative items with positive items, a "common wisdom" strategy to counteract response sets. A body of research in other fields has demonstrated that negatively phrased items affect reliability and validity by introducing measurement artifact into scores. The authors investigated the effect of negatively phrased items in the Medical School Learning Environment Survey (MSLES) with data from six medical student cohorts at the University of Texas Medical Branch, Galveston, Texas. This study describes the impact of negatively phrased items in the MSLES through analysis of item and scale means and comparisons of coefficient alpha values. Findings indicate that negatively phrased items performed differently than the positively phrased items. Negatively phrased items were associated with lower scale reliability. The authors conclude, as did earlier studies, that negatively phrased items introduce an artifact into attitude measurement. The "common wisdom" practice of routinely including negative items should be employed with care.

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Citations

Aug 10, 2011·Evidence-based Complementary and Alternative Medicine : ECAM·Ryan B AbbottLaurence Brunton
Jun 15, 2011·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Hui-Ying ChiangHuan-Fang Lee
Jun 30, 2006·Medical Teacher·Thomas J Stewart
Mar 22, 2016·Education for Health : Change in Training & Practice·Victor Mogre, Anthony Amalba
May 13, 2015·Journal of Clinical Epidemiology·Kurt KroenkeJacob Kean
Sep 11, 2018·Journal of Nursing Management·Diana SladeSuzanne Eggins
Apr 26, 2007·Academic Medicine : Journal of the Association of American Medical Colleges·Marcy E RosenbaumKristi J Ferguson
Jun 13, 2006·Journal of Nursing Measurement·Jaclene A ZauszniewskiSukuma Tithiphontumrong
Feb 26, 2019·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Soo Jin YoonChuhl Joo Lyu
Feb 15, 2012·Cadernos de saúde pública·Valdiney V GouveiaLarisse Helena Gomes Macedo Barbosa

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