Attachment 6 - Example Cognitive Testing Debriefing/Satisfaction Questions

Web Survey Satisfaction Questionnaire

Please circle the numbers that most appropriately reflect your impressions about using this Web survey.

1. Overall reaction to the Web site:	terrible wonderful
		1	2	3	4	5	6	7			not applicable
2. Screen layouts:	confusing clear
		1	2	3	4	5	6	7			not applicable
3. Use of terminology throughout the Web survey:	inconsistent consistent
		1	2	3	4	5	6	7			not applicable
4. Instructions displayed on the screens:	inadequate adequate
		1	2	3	4	5	6	7			not applicable
5. Questions displayed on the screens:	inadequate adequate
		1	2	3	4	5	6	7			not applicable
6. Arrangement of necessary information (FAQ, Help, etc.) on the screen:	illogical logical
		1	2	3	4	5	6	7			not applicable
7. Questions can be answered in a straight-forward manner:	never always
		1	2	3	4	5	6	7			not applicable
8. Organization of question, instruction and response categories in the survey:	confusing clear
		1	2	3	4	5	6	7			not applicable
9. Forward navigation:	impossible easy
		1	2	3	4	5	6	7			not applicable
10. Slider scale:	illogical logical
		1	2	3	4	5	6	7			not applicable
11. Number of questions per page:	inadequate adequate
		1	2	3	4	5	6	7			not applicable
12. Overall experience of completing the survey:	difficult easy
		1	2	3	4	5	6	7			not applicable

Additional Comments:

Debriefing Questionnaire

1. Can you walk me through your thinking on why you marked (a particular SATQ item) especially low/high? (Do this for several low/high SATQ ratings).

2. What was your first impression of the web survey/ web site?

3. What was your overall experience from logging into the web survey to the first survey question?

4. What do you think of the basic screen layout?

a. Overall?

b. Colors?

c. Slider response options?

d. White/blue grid response options?

e. Other?

5. What do you think of the navigational methods?

a. Previous and Next buttons?

6. What do you think of the questions asking you ________________________?

1. Was it easy for you to find and select the appropriate category?

2. Do you feel confident that you selected the best category?

7. What do you think of the questions asking you _________________________?

1. Was it easy for you to find and select the appropriate category?

b. Do you feel confident that you selected the best category?

8. How easy or difficult was it to complete the survey in general?

9. What did you think of the follow-up questions that prompt you for an answer when you did not provide an answer the first time? (if necessary)

10. What did you like best about the Web survey?

11. What did you like least about the Web survey?

12. Is there anything that you feel should be changed?

13. Is there anything that you feel should stay the same?

14. How easy or difficult do you feel it was to complete the questions? What made a question easy or difficult?

15. Was there any information you needed that you could not find or was not provided on the screen?

16. Is there anything you would like to mention that we haven’t talked about?