Michael Keating

The Effectiveness of Survey Recruitment Methods in Second Life

Online virtual worlds are 3D graphical environments in which users create avatars that live, work, and play—some are actual games; others are social networking sites. These worlds offer significant potential for expanding the study of social and economic behavior. One of these worlds, Second Life (SL), began in 2003 and now has more than millions of unique accounts held by virtual residents and approximately 800,000 users who log in each month. Although few results from SL surveys have been published, automated surveys are common in the virtual world. They are conducted through links to web surveys, by in-world “survey bots” (programs that administer questionnaires), and through e-mail invitation to panel members recruited through SL. This article evaluates the effectiveness of recruitment techniques to complete a self-administered survey within SL. The authors tested several techniques: a billboard in an SL public space, classified ads in SL publications, paid search engine advertisements, and SL web forum posts. All survey recruits completed the same survey administered at the RTI SL facility kiosk. Our findings suggest that a diverse convenience sample can be obtained in SL at a minimal cost.

Factors Associated With Interest in Subspecialty Training Among Neurology Residents

Phenomenon: Previous studies have not explored factors associated with decisions among neurology residents to pursue subspecialty training within neurology. Understanding career choices among neurology residents, particularly decisions regarding subspecialty training, is critical, as neurologists with specialized knowledge can help meet the needs of patients with specific disease conditions. This study addresses the knowledge gap about subspecialty training decisions by examining factors associated with neurology residents interest in pursuing subspecialty training and the types of subspecialty training neurology residents consider. Approach: We surveyed a geographically stratified sample of neurology residents in U.S. training programs using a two-stage survey design. In Stage 1, we randomly sampled half of the accredited neurology residency programs stratified by U.S. census region; Stage 2 involved a survey of neurology residents within these programs. Findings: The majority (approximately 81%) of residents expressed interest in subspecialty training. Resident demographic characteristics and educational debt did not influence interest in pursuing subspecialty training. Residents were more likely to express interest in subspecialty training when they participated in any neurology research (odds ratio [OR] = 2.39), 95% confidence interval (CI) [1.13, 5.07], p = .02, and indicated more interest in careers involving teaching (OR = 8.33), 95% CI [1.64, 42.19], p = .01. Considering the “medical content of subspecialty” as a more important factor approached but did not reach statistical significance (OR = 3.12), 95% CI [0.97, 10.06], p = .06. Insights: Participation in any neurology research and interest in careers involving teaching are associated with interest in subspecialty training among neurology residents. Further research is needed to determine whether exposure to research and teaching stimulates interest in subspecialty training and whether residents believe that subspecialty training is instrumental in pursuing an academic career.

Advertising for Cognitive Interviews

Researchers commonly rely on relatively small convenience samples for cognitive pretesting questionnaires. Methods used to recruit these samples vary depending on the population of interest, study timeline, study budget, and other factors. Over the past decade, one method that has become popular because of these considerations is online classified advertisements (e.g., Craigslist ads). A concern with the use of this recruitment method is that it leads to a set of participants who repeatedly participate in cognitive interview studies, changing the cognitive processes used in interviews, potentially resulting in misleading findings. Advertisements placed on social networking sites, such as Facebook, may give researchers more control over targeting recruitment advertisements, produce more participant diversity, and reduce the prevalence of “professional participants” who respond to ads. Recent research has shown that Craigslist and Facebook advertisements do result in selection pools with different demographic characteristics and experiences as study participants. However, we are not familiar with any research that has attempted to address concerns about data quality as a result of (a) professional participant cognitive bias or (b) recruitment method. Using data from two studies for which recruitment advertisements were placed on Craigslist and Facebook, we assess whether there are differences in recruitment speed, demographic diversity, the extent to which professional participants comprise the recruitment pool, and the extent to which a geographically dispersed recruitment pool can be attained. Evidence across the measures of quality was mixed. Facebook advertisements resulted in much faster recruitment than Craigslist advertisements among an online population in which the study topic was virtual worlds and avatars (Study 1), but the inverse was true among an older population in which the study topic was long-term care (Study 2). Mixed evidence was also found for relationships between recruitment platform and demographic composition. In Study 1, we found relationships between recruitment method and education, ethnicity, and race. In Study 2, there was only a relationship between recruitment platform and marital status and employment status. Furthermore, Facebook recruits were significantly younger than Craigslist recruits in Study 1, while in Study 2, Craigslist recruits were younger. Professional participants were identified in the recruitment pools when the concept was operationalized as attempts to deceive the researchers in how they learned about the study. No evidence was found, however, when professional participant was operationalized as the number of times one had participated in research in the past 12 months. Finally, while no comparison is available between platforms, we found that Facebook advertisements resulted in a geographically dispersed recruitment pool with per capita rates ranging from 0.05 to 1.6 and only one state having no representation. The findings from this research will help survey practitioners who conduct cognitive interviews make important decisions in which platforms to expend limited resources for the best recruitment pools from which to draw interview participants.

Comparing Traditional and Crowdsourcing Methods for Pretesting Survey Questions

Cognitive interviewing is a common method used to evaluate survey questions. This study compares traditional cognitive interviewing methods with crowdsourcing, or “tapping into the collective intelligence of the public to complete a task.” Crowdsourcing may provide researchers with access to a diverse pool of potential participants in a very timely and cost-efficient way. Exploratory work found that crowdsourcing participants, with self-administered data collection, may be a viable alternative, or addition, to traditional pretesting methods. Using three crowdsourcing designs (TryMyUI, Amazon Mechanical Turk, and Facebook), we compared the participant characteristics, costs, and quantity and quality of data with traditional laboratory-based cognitive interviews. Results suggest that crowdsourcing and self-administered protocols may be a viable way to collect survey pretesting information, as participants were able to complete the tasks and provide useful information; however, complex tasks may require the skills of an interviewer to administer unscripted probes.

Interest in providing multiple sclerosis care and subspecializing in multiple sclerosis among neurology residents.

BACKGROUNDnAlthough detailed knowledge regarding treatment options for multiple sclerosis (MS) patients is largely limited to neurologists, shortages in the neurologist workforce, including MS subspecialists, are predicted. Thus, MS patients may have difficulties in gaining access to appropriate care. No systematic evaluation has yet been performed of the number of neurology residents planning to pursue MS subspecialization. This study identifies factors affecting interest in providing MS patient care or MS subspecialization among current neurology residents.nnnMETHODSnWe randomly selected half of all Accreditation Council of Graduate Medical Education-certified neurology residency programs in the continental United States to receive the neurology resident survey. Completed surveys were received from 218 residents.nnnRESULTSnResidents were significantly more likely to have increased interest in MS care when they participated in MS research, were interested in teaching, and indicated that the ability to improve patient outcomes and quality of life was a positive factor influencing their desire to provide MS patient care. Residents who were interested in providing MS care, interested in teaching, and indicated that research opportunities was a positive factor for providing MS patient care were significantly more likely to express interest in MS subspecialization.nnnCONCLUSIONSnIncreasing opportunities to interact with MS patients, learn about MS care, and participate in MS research may increase interest in MS care and subspecialization among neurology residents. Opportunities to educate residents regarding MS patient care may affect residents attitudes.

Factors influencing professional life satisfaction among neurologists

BackgroundPredicted shortages in the supply of neurologists may limit patients’ access to and quality of care for neurological disorders. Retaining neurologists already in practice provides one opportunity to support the overall supply of practicing neurologists. Understanding factors associated with professional life satisfaction (and dissatisfaction) and implementing policies to enhance satisfaction may encourage neurologists to remain in clinical practice. In this paper, we present results from the first study examining factors associated with professional life satisfaction among a large sample of U.S, neurologists.MethodsWe collaborated with the AAN to survey a sample of U.S. neurologists about their professional life satisfaction. Analyses examined the association of physician and practice characteristics with aspects of professional life satisfaction, including satisfaction with their career in medicine, medical specialty, current position, relationship with colleagues, relationship with patients, work/life balance, and pay.ResultsThe study population consisted of 625 neurologists. In multivariate regression analyses, no single group or population stratum indicated high (or low) responses to all aspects of satisfaction. Older neurologists reported higher satisfaction with career, specialty, and relationship with patients than younger neurologists. Female neurologists had significantly lower satisfaction with pay than male neurologists. Neurologists who spent more time in research and teaching had greater satisfaction with specialty, relationship with colleagues, and relationship with patients than those spending no time in research. Neurologists who practiced in small cities/rural areas reported lower satisfaction across multiple dimensions than those practicing in large urban areas. Neurologists in solo practice had greater satisfaction with the relationship with their patients, but lower satisfaction with pay.ConclusionsSatisfaction is a multidimensional construct that is associated with physician and practice characteristics. Enhancing professional life satisfaction among neurologists requires multiple strategies, such as promoting comparable wages for men and women, providing collaboration and research opportunities, and providing resources for small and rural practices.

Factors influencing the desire to provide MS patient care in clinical practice among physiatrists

BACKGROUNDnRehabilitation care is an important part of care for individuals with multiple sclerosis (MS). Little is known about factors influencing physiatrists desire to provide MS care.nnnOBJECTIVEnThis study examines factors associated with physiatrists attitudes towards providing MS care.nnnMETHODSnWe collaborated with the American Academy of Physical Medicine and Rehabilitation to survey a sample of 300 U.S. physiatrists. Analyses examined the association of exposure to MS care resources during residency, physician demographic and practice characteristics with attitudes toward providing MS care.nnnRESULTSnPhysiatrists indicating negative factors limiting the number of MS patients seen in clinical practice were more likely to practice in a setting other than a major city and less likely to have interacted with MS specialists during residency. Physiatrists indicating factors having a positive influence on providing MS patient care were more likely to practice within a major city, see one or more MS patients per week, and serve as the primary physiatrist directing care for one or more MS patients.nnnCONCLUSIONSnPhysiatrists indicated positive and negative attitudes towards MS care. Increasing exposure to MS patients, providing resources for MS care, and participating in continuing education on MS, may encourage physiatrists to provide MS patient care.

Factors influencing interest in providing MS patient care among physiatry residents.

BACKGROUNDnRehabilitation care is an important part of comprehensive care for MS patients. Little is known about the number of physiatry residents who are interested in providing care to individuals with multiple sclerosis [MS].nnnOBJECTIVEnThis study examines factors that influence physiatry residents interest in providing care to MS patients.nnnMETHODSnWe randomly sampled half of all Accreditation Council for Graduate Medical Education-certified physical medicine and rehabilitation residency programs in the continental United States and Puerto Rico. Surveys were received from 74% of programs (Stage 1 response rate) and from 221 residents (45% Stage 2 response rate).nnnRESULTSnResidents expressing interest in providing MS care were more likely to be female, Asian, and to select statements emphasizing multidisciplinary care approaches and a community of dedicated professional colleagues as positive features of MS patient care. Residents interested in teaching and with more education debt were marginally more likely to express interest in MS care.nnnCONCLUSIONSnMedical education should emphasize the need for physical medicine and rehabilitative care among individuals with MS, the ability of physiatrists to improve the functional status and quality of life for MS patients, and the team-based nature of MS care.

Factors Associated with Neurologists’ Provision of MS Patient Care

Neurologists are central to providing quality care for individuals with MS. However, neurologist shortages may restrict access to care for MS patients. To examine factors influencing neurologists provision of MS care, we surveyed 1,700 US neurologists to assess demographic/practice characteristics, training, and attitudes toward MS care. The study population consisted of 573 respondents: 87 (15.2%) MS subspecialists and 486 (84.8%) “other neurologists,” including subspecialists in other neurology areas (i.e., non-MS) and general neurologists. MS subspecialists indicating they “enjoy interacting with MS patients” had a significantly greater rate of MS patients seen per week. In separate analyses of the “other neurologists” group, the rate of MS patients seen was lower among neurologists in university-based groups or those practicing in major cities; female neurologists; and neurologists who indicated lack of sufficient knowledge regarding MS patient care. Rates of MS patients seen were significantly greater for other neurologists who agreed that MS care involved “ability to improve patient outcomes and quality of life”; “dynamic area with evolving treatment options”; and “enjoy interacting with MS patients.” Understanding factors influencing MS patient care by neurologists and developing policies for appropriate access to care is critical for optimal outcomes among this population.