Self-report questionnaires are frequently used in health fields; however, subjective interpretation is often ignored. One way of assessing this is using techniques derived from cognitive interviewing. Of these, ‘think-aloud’, in which respondents speak their thoughts aloud as they complete a questionnaire, is the original paradigm. The thesis focusses on the use of ‘think-aloud’ methodology in the evaluation of questionnaires already in use in the health domain. The current thesis has been prepared in the format of scientific papers. Paper 1 is a systematic review (23 studies) of the appropriateness and usefulness of think-aloud techniques for evaluating health-related questionnaires. A descriptive account is provided of the aims of the studies reviewed; the justification for using think-aloud; populations studied; and methodology; an evaluative account depicts the usefulness of the think-aloud method in addressing researchers’ aims. Think-aloud was successfully used to address researchers’ aims and was effective at elucidating problems with questionnaires. Theoretical and clinical implications are discussed, and recommendations made for future research. Paper 2 is a cross-sectional observational study using think-aloud methods to examine the way in which people with End Stage Renal Disease (N=25) interpret and respond to the Emotion Regulation Questionnaire (ERQ). All questions were found to be problematic to some extent and reappraisal questions yielded the most problems. A tendency to deny or minimise negative emotions and present a positive self-image was also noted. Implications are discussed for use of the ERQ and replication with further samples suggested. Paper 3 is a critical appraisal of the above papers and provides personal reflections on the research process as a whole. The current thesis was a transition from a different study; amended due to time constraints. The journey is also outlined from this original study to the present thesis. Strengths and limitations are considered as well as areas for improvement and future research.

Background: Carpal Tunnel Syndrome (CTS) is a condition affecting wrists and hands, causing pain, tingling, and numbness. Despite the high prevalence of CTS and the existence of several diagnostic tools, there is no consensus over a diagnostic gold standard test. Thesis Objectives: To conduct a systematic review of diagnostic test accuracy of clinical scales, questionnaires and hand symptom diagrams/maps for the diagnosis of CTS in people suspected with this condition; and to do a cognitive interviewing qualitative study of the Kamath and Stothard questionnaire, a diagnostic tool for CTS, to identify and resolve potential sources of error. Methods: In the first study, we searched MEDLINE, CINAHL, and Embase databases keywords related to diagnostic accuracy and clinical tests of CTS. In the second study, we interviewed clinicians and people diagnosed with CTS and other upper extremity conditions. We recorded, and content analyzed their opinion on comprehensiveness and comprehensibility of Kamath and Stothard questionnaire. Results: Twenty-one articles met the eligibility criteria of the systematic review, of which nine were on the diagnostic accuracy of hand symptom diagrams and twelve assessed the diagnostic accuracy of clinical scales and questionnaires for the diagnosis of CTS. Positive likelihood ratios (LRs) to diagnose or rule in CTS ranged from 0.94 for Boston carpal tunnel questionnaire to 10.5 for CTS-6 scale, and negative LRs to rule out CTS ranged from 1.05 to 0.05 for the same diagnostic tools. In the cognitive interviewing study, we categorized the areas of uncertainty in the participants’ responses into five themes: clarity and comprehension (51%), relativeness (38%), inadequate response definition (3.75%), perspective modifiers (3.75%), and a reference point (2.5%). Conclusions: Very few high-quality studies exist on the diagnostic accuracy of CTS-6, Kamath and Stothard questionnaire, Bland questionnaire, and Katz and Stirrat’s hand symptom diagram. By doing cognitive interviews, we identified options for potential improvement in the wording of the Kamath and Stothard questionnaire. Future studies should assess the diagnostic properties of the proposed modified questionnaire, and high-quality studies are warranted to assist in deciding on ruling in or out CTS. / Thesis / Master of Science (MSc) / Carpal tunnel syndrome is a condition affecting the hands, causing feelings of burning pain, pins and needles, heaviness and/or lack of sensation. This condition is very common among people who do manual work and can make them unable to do their jobs and daily living tasks. Early diagnosis of carpal tunnel syndrome is very important in starting an appropriate plan of treatment. The best diagnostic test for carpal tunnel syndrome is still uncertain. In the first study, we collected studies of the questionnaires and hand maps that exist for the diagnosis of carpal tunnel syndrome. We then tried to summarize the information that assists clinicians in making a diagnostic decision. In the second study, we interviewed people about their opinion of a questionnaire that is used in hand clinics to diagnose carpal tunnel syndrome. We concluded that more studies with high quality are needed to confidently decide which diagnostic test is best. Also, we revised a questionnaire that is currently used, and we hope that these revisions make the questionnaire more relecant and understandable for people.

Too few community college students who intend to transfer and earn a baccalaureate degree actually do. Further, low-income and first-generation college students are overrepresented at community colleges. Education is considered a means of social and economic mobility for low-income, first-generation students; therefore, retaining this population through baccalaureate attainment is a critical issue. Because of the multitude of obstacles these students must conquer, it is crucial to implement effective strategies for improving transfer rates. This dissertation has three components: (1) companion research study, (2) individual research study, and (3) reflective essay examining pretesting and telephone-administered survey methods. The companion study was conducted by a research team comprised of four members. A quantitative analysis was conducted to describe characteristics of the institutions and student population, which included 338 Spring/Summer 2009 Associate in Arts (AA) and/or Associate in Science (AS) graduates from four community colleges in Appalachia Kentucky. This study found that differences in institutional transfer rates were not explained by student characteristics. Two institutions were identified as high-impact institutions promoting transfer success, with their graduates at least two times more likely to transfer than students attending the two low-impact institutions. The individual research study addressed how mattering perceptions of low-income, first-generation students influence transfer persistence. The Mattering Scale Questionnaire for College Students (MSQCS) was administered to 80 graduates of the three community colleges in the study. There were two research questions: (1) Was mattering perception statistically significant among the three community colleges? and (2) Did mattering perception influence transfer persistence when student characteristics were controlled? Analysis of variance found no significant differences between the three community colleges on any MSQCS subscale. Logistic multiple regression found MSQCS Faculty Subscale, MSQCS Multiple Roles Subscale, and first-generation status to be predictors of transfer persistence. Community colleges can use the results to increase social and academic integration and mattering perceptions of students on their campuses. The reflective essay discussed the benefits and pitfalls of utilizing both cognitive interviewing pretesting and telephone-administered survey methods utilized in the individual research component. Implications of cognitive interviewing in higher education were discussed.

This thesis is focused on exploring marking and grading in higher education. Using a phenomenological approach 26 interviews were undertaken with a heterogeneous sample of health academics at four universities. The sample included novice lecturers with two years or less experience in the academy to those with academic careers spanning more than 20 years. Two interview methods were utilised, Protocol Analysis (PA) and Cognitive Interviewing (CI). Protocol Analysis enables close contact with the marking and grading, in the moment, whilst Cognitive Interviewing is a novel method for exploring lecturer practices in higher education. Analysis was completed by applying a modified framework analysis to both data sets, facilitating synthesis of the two series of research findings. A wealth of rich data was gathered which resulted in close exploration of marking and grading practices, with the production of corroboratory evidence for issues previously identified on these phenomena. Close connection as an insider practitioner researcher has enabled close exploration and the gaining of new insights into practice, resulting in the identification of previously unexplored areas. My original contributions to knowledge in this area are: identifying the messiness of marking and grading and troublesome knowledge, the ‘rubric paradox’, importance of communities of practice, dual identity of health academics, working environments, experience recast as expertise, and using current interview techniques (PA and CI) for supporting continuing professional development. This thesis develops these themes suggesting ways in which they could impact upon contemporary marking and grading practice.

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This thesis is focused on exploring marking and grading in higher education. Using a phenomenological approach 26 interviews were undertaken with a heterogeneous sample of health academics at four universities. The sample included novice lecturers with two years or less experience in the academy to those with academic careers spanning more than 20 years. Two interview methods were utilised, Protocol Analysis (PA) and Cognitive Interviewing (CI). Protocol Analysis enables close contact with the marking and grading, in the moment, whilst Cognitive Interviewing is a novel method for exploring lecturer practices in higher education. Analysis was completed by applying a modified framework analysis to both data sets, facilitating synthesis of the two series of research findings. A wealth of rich data was gathered which resulted in close exploration of marking and grading practices, with the production of corroboratory evidence for issues previously identified on these phenomena. Close connection as an insider practitioner researcher has enabled close exploration and the gaining of new insights into practice, resulting in the identification of previously unexplored areas. My original contributions to knowledge in this area are: identifying the messiness of marking and grading and troublesome knowledge, the ‘rubric paradox’, importance of communities of practice, dual identity of health academics, working environments, experience recast as expertise, and using current interview techniques (PA and CI) for supporting continuing professional development. This thesis develops these themes suggesting ways in which they could impact upon contemporary marking and grading practice.

No description available.

The ways in which faculty navigate the relationship between their personal identity and the identities of their military connected students, especially concerning their approaches to teaching behaviors (Barnard-Brak, Bagby, Jones, & Sulak, 2011) are influenced by normative values that their institution or department supports (Weidman, 1989) as well as by the values that they themselves hold (Barnard-Brak et al., 2011). Given the fraught history of academia and the military (Summerlot, Green, & Parker, 2009; Downs & Murtazashvili, 2012), such variables are especially important to measure as student-faculty interaction impacts student learning outcomes (Cruce, Wolniak, Seifert, & Pascarella, 2006; Ethington, 2000; Kim, 2010; Kim & Sax, 2009, 2011, 2015). Toward that end, the primary purpose of this study was to create a multi-institutional survey instrument that operationalizes perceptions of teaching behaviors amongst faculty who educate military-connected students (MCS) at civilian colleges and universities. Main objectives included creating and developing items specific to unique teaching behaviors and ensuring validity of this instrument. I used a variety of analyses to create the instrument and to ensure validity of content within the survey. I followed DeVellis’ (2017) model for scale development to create and validate the Military-Connected Student-Faculty Interaction Questionnaire (MCSFI-Q). Eleven field experts participated in cognitive interviews to provide sources of evidence for construct validity (Miller et al., 2014) as well as to uncover and resolve content validity and construct validity issues (Padilla & Benítez, 2014). Following data collection, I conducted content and construct validity analysis to develop a valid and more parsimonious survey instrument. Results from all analyses led to the conclusion that the MCSFI-Q is comprised of conceptually valid items that operationalize teaching behaviors amongst faculty who educate MCS at civilian colleges and universities and that the MCSFI-Q has the potential to collect accurate data. Research next steps include further empirical testing in order for the MCSFI-Q to be useable in measuring teaching norms amongst faculty who educate MCS at civilian colleges and universities.

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The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a leading patient-reported outcome measure of disability. However, patients' perspective of the WHODAS 2.0 self-administered Swedish version have not been sufficiently described. Similarly, knowledge of its construct validity in the general population is missing. This creates a gap because updated norm data to use as reference is also missing. The overall aim of this study was to establish evidence of the measurement properties of the self-administered Swedish version of the WHODAS 2.0. Both qualitative and quantitative methods were adopted. In Study I, interviews with patients (n = 12) with orthopaedic or psychiatric conditions were performed and data were analysed by deductive content analysis. In Study II, a cross-sectional general population survey (n = 3 482) was conducted, and statistical methods based on classical test theory were used in the data analysis. The results show that the items were well understood, acceptable and easy to answer by outpatients, with the exception of six items (Study I).The internal consistency reliability was good or excellent and the construct validity was overall acceptable, with partial support for the factor structure in the general populations (Study II). The self-administered Swedish 36-item version of the WHODAS 2.0 is comparable to other language versions of the instrument. Some of the previous known weaknesses of its construct validity in relation to the item content and insufficient instructions were confirmed. The evidence of overall good content and construct validity together with available norm data supports its use in clinical settings and research.