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Description: . . 43. Chapter 5. Interviews, Focus Groups, and Surveys.

. . 43. Chapter 5. Interviews, Focus Groups, and Surveys. 

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Chapter 5.  Interviews, Focus Groups, and Surveys

Data collection through observation yields rich information about how people do

things, but this insight only provides part of the story. It is also important to understand 
why a system has been set up, or things are being done, in a particular way. Understanding 
why from the subject’s perspective helps to prevent you, the observer, from introducing 
bias by assigning your own assumptions to something you have observed. It is also 
important to help you learn about people’s mental models, preferences, and knowledge, in 
the context of technology use. Sometimes observations do result in an understanding of 
why the system functions as it does; namely, if you have the time and freedom to talk with, 
and ask questions of the people you are shadowing. However, in reality this is usually 
difficult because those being observed are busy, with little time to answer questions at 
length. This is why it is a good idea to plan to collect data in a number of ways, from 
multiple subjects, including using methods like interviews, focus groups, and surveys.

Interviews, focus groups, and surveys are all qualitative data collection methods

used to gather information from subjects by asking them questions. They are useful for 
gathering data about participant perceptions, user preferences, or knowledge about a 
process, task or organizational issue, and are often applied in conjunction with 
observations (Chapter 4). However, they do not always correlate with optimized user 
performance and improved patient safety. This dissonance is an established human factors 
phenomenon called the performance versus preference paradox, [28] which states that 
users do not always perform better with items they prefer. As a result, make sure to 
interpret user preference data with caution, and in conjunction with supporting user 
performance data. For more information about generating user performance data, see 
Chapter 8, Usability Testing.

Interviews, focus groups, and surveys may be used to collect data that range from

being exploratory to structured in nature, and can be carried out in person, by phone, or 
electronically. Data collection tools for these methods vary depending on the type of data 
being collected, and could range from a blank notebook and pen to a formal series of 
electronic survey questions with predefined responses.

While planning for data collection through interviews, focus groups, or surveys, the

project objectives, target subject group, and available resources should be considered to 
ensure relevant data are collected. Identifying interested participants can be a challenge, 
and before conducting interviews and focus groups, especially, it is important to first 
contact the managers of the departments you would like to include as part of your data 
collection. Introducing yourself during a staff meeting can be an excellent way to inform

. . 44. staff of upcoming interview or focus group opportunities to boost interest and participation. For surveys, consider working with a manager, contact person, or organization familiar to your target participants to enhance your credibility, help you reach as many interested parties as possible, and improve the chances of people completing your survey.. 

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staff of upcoming interview or focus group opportunities to boost interest and 
participation. For surveys, consider working with a manager, contact person, or 
organization familiar to your target participants to enhance your credibility, help you reach 
as many interested parties as possible, and improve the chances of people completing your 
survey.

Interviews are meetings, usually conducted either in person or by phone, where a

data collector obtains information from one or more participants. Interviews can range 
from being exploratory, or semi-structured, to structured in nature, with questions 
prepared in advance by the interviewer being either more specific or open-ended. 
Depending on the nature and purpose of the interview, the same participant may be 
interviewed once or multiple times, and the interview length could last from just a few 
minutes to several hours.

Interviews are an excellent way to understand a person’s perceptions, preferences,

and knowledge, as related to their roles and responsibilities. In addition to getting 
information about why systems function in a particular way, interviews can also provide 
insight to challenges, opportunities, and solutions from the perspective of an individual 
participant. Interviews allow some flexibility to the data collector, as topics of interest can 
be further probed and explored in real-time based on the responses of the interviewee.

Conducting interviews with staff prior to observing in the field can help acclimatize

you to what you are about to see in advance, which can streamline your observation 
sessions. Interviews are also a great way to build rapport with a staff member who you will 
be observing later. In contrast, conducting interviews with staff after observing in the field 
can support the development of interview questions and provides an opportunity to get 
clarification of items not fully understood during the observation sessions.

From the biomedical technology professionals’ perspective, conducting interviews

• An overview of how a clinical area operates (e.g., funding, staffing, layout,

• Information about policies and prescribed work practices (i.e., how people

• Information about a subject’s perspective, preferences, and experiences 
• Historical information about a particular technology, issue, or incident 
• Confirmation and clarification about observational data that have been

. . 45. Section 5.2.2. When should they be used?. 

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Interviews should be conducted before observing in the field if an understanding of

the environment is required, or if the biomedical technology professional wants to build 
rapport with a participant before observing them. Additionally, if any confirmation or 
clarification is required based on what was observed in the field, conducting an interview is 
highly recommended.

Section 5.2.3. Preparing for Interview Data Collection

Regardless of whether interviews are open-ended, semi-structured, or structured in

nature, a preliminary list of questions should be developed to serve as an interview guide, 
to ensure all required information is obtained from a participant at a minimum. This is 
especially important if the participant only has a limited amount of time available for the 
interview. No matter whether interviews are meant to be open-ended, semi-structured or 
structured, individual questions should be open-ended to avoid biasing or leading the 
participant and to solicit as much information and context from them as possible. Try to 
familiarize yourself with the set of questions, and to organize them in the interview guide 
so you can easily jump around from one to another as the conversation evolves. Keep track 
of any questions that have already been answered, as well as any outstanding questions, so 
you can optimize your time during the interview.

Think also about your strategy for recording information during the interview. If

possible, arrange to have a second person attend the interview so one person can facilitate 
the session while the other records detailed notes. If it is not possible to have two people 
present, consider other strategies to capture data, like taking short-form notes, or using an 
audio recorder to tape the session. If an audio recorder is preferred, ensure you have 
proper permission (e.g., see discussion of consent and research ethics approval in 
Appendix A: Confidentiality and Anonymity), and that the participant is aware of the 
recorder, and gives their permission, before recording any part of the session.

Arrange to conduct the interview at a time and location convenient for the

participant. Provide the participant with any background information such as the purpose 
of the interview or objectives of the project, and answer any questions they may have about 
the interview process. If the participant asks for a list of questions in advance, try to give 
them a general sense of what you will ask, but it is usually not necessary to share the exact 
questions with the participant in advance.

Section 5.2.4. Conducting Interview Data Collection

Introduce yourself and the project to the participant if they are not already familiar

with the purpose and goals of data collection. Ensure they are still willing to participate, 
and if required, have them sign a consent form (Appendix A: Confidentiality and 
Anonymity). Using the interview guide, ask the participant the questions you prepared in 
advance. Keep track of the questions that have been asked, as well as the participant’s

. . 46. responses, so that if the participant volunteers an answer to a question that has not yet been asked, you do not ask the participant to answer the same question again.. 

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responses, so that if the participant volunteers an answer to a question that has not yet 
been asked, you do not ask the participant to answer the same question again.

Record the responses of the participant in real-time, and in as much detail as

possible. If detailed notes cannot be taken during the interview, immediately following the 
interview, write down the participants’ responses, and any thoughts or impressions you 
remember.

After the interview, send a thank you note to the participant to let them know you

appreciate and value their contribution to the project. If they are interested in learning how 
their input impacted the project, commit to sharing any outcomes with them.

While interviews are useful for learning about staff perspectives, experiences, and

preferences, they should not be considered reliable for learning about how staff complete 
their work in reality. Many factors affect human behaviour and perceptions, and so when 
subjects are interviewed about how, or how often, they do a task or interact with a device, 
although they may be recounting things to the best of their ability, there will sometimes be 
a mismatch between what is shared during an interview and what is observed in reality.

Another limitation of interviews is that the interviewer can unintentionally

introduce bias depending on how questions are posed to the subject. When questions are 
leading (e.g. ‘don’t you think that x is better than y?’) or prompt subjects to provide only 
“yes” or “no” answers (e.g., ‘is x time consuming for you?’), the data yielded from interviews 
will not be very useful at all. To avoid introducing bias based on the wording of the 
interview questions, as the interviewer, try to keep questions open-ended (e.g. ask ‘what 
happened?’ rather than ‘did x happen?’), and avoid bringing assumptions into your 
interpretations. To ensure you fully understood what the subject said, verbally summarize 
what you think they said and ask them if you have interpreted correctly.

Bias can also be introduced by the order in which questions are asked. Where

possible, balance topics in the interview to minimize this effect.

A focus group is essentially a group interview, typically done in person, where a data

collector obtains information from multiple subjects at once. A facilitator or moderator 
(who may also be the data collector) leads a focus group, and although the size of a focus 
group can vary from just a few participants to many, a group size of about six to eight is 
ideal [29]. A general set of questions to promote discussion among focus group participants 
is prepared in advance, but questions can also be added or modified in real time as 
required. A focus group is different from an interview not only in terms of the number of 
people participating, but also because the data generated during the session is synergistic:

. . 47. participants share their own perspectives and preferences and listen to others’ viewpoints, which may ultimately change their own.. 

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participants share their own perspectives and preferences and listen to others’ viewpoints, 
which may ultimately change their own.

Focus groups provide an opportunity for the human factors practitioner to become

exposed to multiple participant perspectives in a relatively short amount of time. 
Perspectives, preferences, challenges, and opportunities can be explored based on the 
experiences of the participants. When presented with an issue or solution, focus group 
participants are likely to share multiple perspectives, and if the session is well facilitated, to 
talk through those perspectives as a group. As participants agree or disagree on topics, a 
clearer understanding of the differences within and between user groups, and the 
variations in practices, preferences, and knowledge within and between the groups can be 
achieved.

Focus groups are a great way to involve staff from across the organization in a

project, and to share information across units, specialties, or departments, that would not 
typically work together. Participation in a focus group tends to improve staff interest and 
motivation in supporting subsequent steps of a project, especially if a focus group has been 
done early in the project. The opportunity to have staff build off one another’s ideas in a 
collaborative manner can be a very positive experience for everyone involved.

From the biomedical technology professionals’ perspective, conducting a focus

• Exposure to multiple participant perspectives and experiences in a short

• A multidisciplinary team to think about, and collaborate on, a common issue

• Consensus from a group of stakeholders about a particular issue or solution 
• Buy-in for a strategy or solution, especially if focus group participants helped

A focus group should be conducted when a range of perspectives or experiences is

desired, when a range of candidate solution are sought after, or when consensus or group 
buy-in are required.

Section 5.3.3. Preparing for Focus Group Data Collection

For a focus group to be fruitful, similar to preparing for an interview, a preliminary

list of questions should be developed in advance to ensure the required information is 
obtained from the group. Questions should be open-ended to encourage discussion among 
group members.

. . 48. If possible, arrange to have a second person attend the focus group so one person. 

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If possible, arrange to have a second person attend the focus group so one person

can facilitate the discussion while the other records detailed notes. Facilitating a focus 
group requires quite a bit of skill to ensure each participant has a chance to share their 
opinion if they wish, and to help keep the discussion on track to get the required 
information. If it is not possible to have two people present, as for an interview, consider 
other strategies to capture data like taking short form notes or using an audio recorder to 
tape the session if it is allowed and if all the focus group members consent.

Arrange to hold the focus group at a time and location convenient for the

participants to attend. Consider bringing coffee, juice, and snacks for participants, 
especially if the session is scheduled to last for more than about an hour. Be prepared to 
have participants join and leave the focus group throughout the session, especially if it has 
been scheduled during working hours.

Section 5.3.4. Conducting Focus Group Data Collection

At the start of a focus group, introduce yourself and the objectives of the session.

Roundtable introductions, or an icebreaker activity can be helpful in making participants 
feel more comfortable, especially if they do not all know each other. Using the questions 
you developed in advance, ask the group a question and listen to the discussion that 
follows. Record the discussion in real-time and in as much detail as possible.

Facilitating a focus group requires specific communication skills to ensure each

participant’s ideas and opinions are respectfully heard. It is important to show participants 
you are actively listening and interested in what they have to say. If there is a designated 
note taker, it can be helpful to project typed notes, or to write participant’s perspectives on 
a chalkboard or chart paper so everyone can see what has been discussed and the group 
can ensure each participant’s thoughts have been captured accurately. Using probing 
questions and clarifying what participants have shared can be helpful in encouraging 
further discussion among focus group members.

Depending on the dynamics of the group, you may have to solicit responses,

especially at the beginning of the session, by asking individual people if they would like to 
share. Often as a focus group progresses, people become more and more comfortable in 
sharing their perspectives.

When one or two participants dominate a focus group, it is the role of the facilitator

to ensure that all participants’ ideas and opinions are respectfully heard, and that everyone 
has the opportunity to contribute if they wish. As a facilitator, try to solicit responses from 
all participants by asking specific people open-ended questions to give them an 
opportunity to share.

. . 49. For additional information and guidance on conducting focus groups, see the Toolkit. 

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For additional information and guidance on conducting focus groups, see the Toolkit

for Conducting Focus Groups resource included in Section 5.6.

Section 5.3.5. Limitations of Focus Groups

When one or two individuals dominate a focus group, it will fail to provide the

biomedical technology professional with a balanced, or consensus view of the group’s 
experiences, perspectives, and preferences. To avoid this either involve, or take on the role 
of, an effective facilitator who encourages all group members to share their opinions. This 
can be challenging depending on the different personalities, reporting relationships and 
organizational culture of the group. Encourage having a single person speak at a time and 
ensure group members are respectful of one another. Try to avoid having a staff member 
and their manager in the same focus group because the staff member may feel 
uncomfortable speaking freely due to the presence of their boss.

Surveys are data collection tools, administered by a data collector, to obtain

information from subjects. Surveys include a written set of questions, prepared in advance, 
to gather a range of pre-defined and open-ended responses from subjects. Surveys can vary 
in content, format, length, and delivery mechanism, depending on the purpose of data 
collection and the intended subjects.

Surveys can be an efficient and cost effective means of collecting data about many

participants’ perspectives, preferences, and knowledge in a relatively short amount of time, 
without having to coordinate the schedules or locations of participants. Exploratory, or 
open-ended survey questions help the data collector to understand the range of 
experiences and preferences of participants, while more structured questions shed light on 
the perceptions and preferences of the majority of subjects. Depending on the survey 
design, standardized information across multiple survey respondents can be compared and 
quantified using statistical analysis.

Some staff members may prefer completing a survey to participating in other data

collection methods like interviews or focus groups, because survey responses can remain 
anonymous and participants can take time to reflect before responding to a question.

From the biomedical technology professionals’ perspective, conducting a survey will

• Demographic information about a group of participants 
• Information about the level of experience of a group of participants 
• An understanding of the range of perceptions, preferences, or knowledge of

. . 50. • An understanding of the perceptions, preferences, or knowledge of the. 

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• An understanding of the perceptions, preferences, or knowledge of the

• Standardized datasets to conduct descriptive statistical analyses about

participants’ perspectives and preferences

Surveys should be administered when the perspectives, preferences, or knowledge

of many people is desired, or when it is difficult to schedule participants for interviews 
because of their availability or geographical location. Exploratory questions should be used 
when a range of perspectives is desired, and structured questions should be used when a 
more standardized understanding of the average or majority of respondents is required.

Section 5.4.3. Preparing for Survey Data Collection 
 
Survey questions should be prepared in advance regardless of whether the survey

will be presented in paper or electronic format. Questions should be tailored based on the 
target participant group, and whether open-ended (exploratory) or closed-ended 
(structured) responses are desired. An example of an exploratory versus a structured 
approach to a survey question is included in Figure 8.

Which smart pump feature(s) do you use the most frequently?

_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________

Of the smart pump features listed below, which do you use the most frequently? (Check all 
that apply)

! Drug library 
! Rate calculator 
! Body surface area calculator 
! Bolus function

Figure 8. Comparison of an exploratory versus a structured survey question

As you can see, with the more structured question, participants are prompted to

choose their answers from the supplied list, while the exploratory version leaves it up to 
the participant to think of the most correct answers from their perspective. The

. . 51. exploratory question is likely to extract a wide range of possible answers from participants, while the structured question is likely to cause participants to home in on one or more of the options provided.. 

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exploratory question is likely to extract a wide range of possible answers from participants, 
while the structured question is likely to cause participants to home in on one or more of 
the options provided.

If a goal of your survey is to be able to analyze data using descriptive statistics, a

more structured survey approach will be required. In this case, in addition to questions 
about the project objectives and content of interest, it is also recommended that structured 
questions about a person’s gender, age range, experience level, and unit type or specialty 
be included to provide additional demographic context to survey responses.

When developing your survey, another important consideration will be how to keep

track of respondents to ensure duplicate responses can be accounted for. This tends to be 
easier when participants’ identities do not need to be kept confidential, as the respondent’s 
name can be used as an identifier. However, when participant’s identities must remain 
anonymous, other approaches to tracking respondents will have to be used. A possible 
approach is to link a confidential participant name to an anonymous participant 
identification number so a respondent’s identity is not directly included on the survey. 
Another option would be to use an electronic survey tool, that limits the number of 
responses coming from a single computer to one, and includes features like customized 
survey links to help manage tracking multiple respondents. If you are concerned about 
receiving duplicate responses, an affidavit or declaration could be included at the beginning 
or end of your survey, stating that by checking the box, the participant confirms they have 
not completed your survey already. The rigour with which responses are tracked, and 
restrictions for including personal information or tracking numbers, will depend on your 
institution, your subjects, and the objectives of the project.

Before distributing your survey to participants, it is highly recommended you

validate it through pilot testing with one or more representative end users to ensure it is 
clear and covers material that is relevant to your target participants. This is because when 
surveys are unclear, the data collected may not accurately reflect the opinions or 
experiences of participants. If you have a project contact person, reach out to them to see if 
they would be willing to review your survey or if they know of a colleague who might 
review your survey instead.

Section 5.4.4. Conducting Survey Data Collection

Once your survey form is complete and has been validated, participants can be

invited to complete your survey either in person or electronically, depending on your 
target population and the number of people you hope will complete your survey. If you can 
arrange to invite participants to complete your survey through a familiar and trusted 
source, such as a clinical colleague, clinical manager, or recognized organization, it is often 
easier to get your target population to participate. Alternately, if you can inform

. . 52. participants about your survey in person, such as during a staff meeting, you can answer any questions about the survey or the project, and potential participants will later know to expect your invitation to complete the survey.. 

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participants about your survey in person, such as during a staff meeting, you can answer 
any questions about the survey or the project, and potential participants will later know to 
expect your invitation to complete the survey.

When surveys are used in isolation of other data collection methods like

observations, or even interviews and focus groups, there is a risk that an incomplete 
picture of a subject’s perspectives, perceptions, and knowledge will be collected. Unlike 
interviews and focus groups, where the data collector can rephrase questions or probe 
deeper on a subject in real-time, surveys are static data collection tools. If questions are 
confusing or easily misinterpreted, the data collected through a survey will not be useful to 
the biomedical technology professional, and may even be incomplete or incorrect. Testing 
the validity of a survey (i.e., how well the survey measures what has been set out to 
measure) is highly recommended to ensure you get the most out of your survey tool. Pilot 
testing your survey with a small number of representative users to get feedback about the 
survey design and to determine how respondents interpreted questions as they were 
posed is a good way to validate your survey.

Another limitation of surveys is that when used to collect information about past

issues and incidents, it can be difficult to design them to capture the level of detail required 
to understand the real root causes and contributing factors of those issues and incidents. 
Consequently, the human factors practitioner should almost always interpret this type of 
survey data in conjunction with data collected from other sources.

Although subjects may be more comfortable answering survey questions than

participating in an interview or focus group, it can still be difficult to get participants to 
complete a survey. Surveys are less likely to be completed by participants if they are:

• 
Have little perceived value to the participant

• 
Distributed from an unfamiliar source (e.g., a person or organization that is 
unknown to the participant)

• 
Accompanied by too short or too long a timeframe to respond (2 weeks is 
usually appropriate as it allows time for people who are on vacation or not 
on shift for a few days).

• 
Not presented in a timely manner (e.g., surveys about particular equipment 
are best distributed immediately after their use)

. . 53. Again, pilot testing your survey with a small number of representative end users in. 

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Again, pilot testing your survey with a small number of representative end users in

order to solicit feedback is a good way to gain insight about whether any of these rules of 
thumb have been violated.

Section 5.5.  What to do with Interview, Focus Group, and Survey Data

The methods chosen to analyze interview, focus group, and survey data will

partially depend on the type of data that was collected (e.g., structured versus semi-
structured interviews), and the objectives of the project. Qualitative data analysis 
techniques, such as the constant comparative method [30] are commonly used to examine 
these data. However, as a health technology manage, interview, focus group and survey 
data will usually be linked with observational data, and used as an input to other human 
factors analysis techniques and methods like task analysis, usability testing, HFFMEA and

HFRCA. The subsequent sections of Part II of this book will discuss these human factors 
methods in greater detail.

Section 5.6.  Additional Interview and Focus Group Resources

http://www.rowan.edu/colleges/chss/facultystaff/focusgrouptoolkit.pdf

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