Table 1. Summary of participant data

B. Non-Response Survey Findings

Reasons for non-response varied among the participants. The most common reasons included: there were too many surveys (74.4%), lack of time (25.5%), the original survey was too long (10.6%), participant erroneously thought they had completed the survey (8.4%), and participant did not think they were eligible (2.1%). Of note, two of the participants (4.3%) responded unfavourably to the offer of the follow-up survey, finding it annoying and offensive.

IV. DISCUSSION

The response rate to the follow-up survey was 50.5% which was lower than anticipated. Non-responders to the index questionnaire were re-contacted to explore reasons behind the observed low response rate. The most common cited reasons were there were too many surveys requests (‘survey fatigue’), and lack of time. Just under 10% of participants had genuinely thought that they completed the original survey, which may indicate an underlying technical problem/lack of clarity. These reasons generally echo those voiced by physician specialists when asked about their response rates (Cunningham et al., 2015), although no studies have examined these reasons in medical students or junior doctors. 

Only a handful of previous studies have specifically examined the rates of survey response by medical students and junior doctors. Canadian medical students had response rates of 30.8–31.2% to an electronic version of the Canadian National Physician Surveys in 2004 and 2007 (Grava-Gubins & Scott, 2008). From our experience over several studies in New Zealand, the average response rate from medical students seems to be around 30–35% (Alamri et al, in press). Response rates from junior doctors seem to be even lower, with 27.9–35.6% response rates in Canada (Grava-Gubins & Scott, 2008), and 24.9% in New Zealand (Alamri et al, in press). The range of response rates to surveys by junior doctors varies significantly—at least in part due to the fact that some of the surveys were compulsory to complete (thus, resulting in very high response rates).

Whilst a survey’s response rate ought not be the sole judge of the study’s validity (Cunningham et al., 2015), it is important to understand the reasons behind low survey response rates. We are unaware of any studies that have examined reasons for students’ survey non-response, or factors that would influence them. On the other hand, several randomised trials examined the effect of various factors on the response rates by physicians. Factors that increased response rates by physicians included: contact by regular mail (Akl et al., 2011) (although this finding was inconsistent among studies (Viera & Edwards, 2012), and the availability of the survey in several local languages (Grava-Gubins & Scott, 2008). Factors that worsened response rates included: offering continuing medical education credits for completing a survey (Viera & Edwards, 2012), and surveys on sensitive topics (Cunningham et al., 2015). Finally, factors that had no influence on response rates included: length of the survey (Akl et al., 2011), the day of invitation to the survey (Akl et al., 2011), and monetary compensation for participation (Akl et al., 2011).

V. CONCLUSION

Our findings generally reflect those reported in the literature of the response rates to research surveys by medical professionals; these seem to vary between 25 and 50% (usually at the lower end for junior doctors/medical students, and the higher end for specialists). Several factors that impede response to surveys (survey-related, and participant-related) have been identified, including the number of surveys sent to medical professionals, and the general lack of time.

The current study was limited by the relatively small number of participants, and by the fact that it originates from a single centre in New Zealand which may limit its generalisability. However, it provides a unique perspective by targeting survey non-responders (i.e., the population of interest), offers recent and updated data, and corroborates findings from previous studies in other settings/countries.

Finally, it is imperative to acknowledge that a high response rate may not necessarily be the panacea to the perfect survey study. How factors can be manipulated in order to yield higher response rates remains to be answered. One solution could be the implementation of an advisory body that provides guidance to researchers about how to design surveys, and regulates the number of survey invitations received by medical professionals in order to avoid ‘survey fatigue’.

Notes on Contributors

The sole author conceived the idea, collected and analysed the data and wrote the manuscript.

Ethical Approval

This study was approved by the University of Otago Human Ethics Committee (reference D18/207). All participants provided consent on the electronic survey form.

Data Availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request after completion of data publication as this remains a work in progress.

Acknowledgement

The authors would like to extend their gratitude to the Department of Psychological Medicine, University of Otago, Christchurch, for their financial assistance with participant compensation. The Department had no involvement in the study otherwise.

Funding

The author received financial assistances (NZ $1,500) from the Department of Psychological Medicine, University of Otago, Christchurch in the form of gift vouchers in order to reimburse participants in our study.

Declaration of Interest

The author declares no conflicts of interest, including financial, consultant, institutional and other relationships that might lead to bias or a conflict of interest.

References

Akl, E. A., Gaddam, S., Mustafa, R., Wilson, M. C., Symons, A., Grifasi, A., McGuigan, D., & Schünemann, H. J. (2011). The effects of tracking responses and the day of mailing on physician survey response rate: Three randomized trials. PLoS One, 6(2), e16942. https://doi.org/10.1371/journal.pone.0016942

Cunningham, C. T., Quan, H., Hemmelgarn, B., Noseworthy, T., Beck, C. A., Dixon, E., Samuel, S., Ghali, W. A., Sykes, L. L., & Jette, N. (2015). Exploring physician specialist response rates to web-based surveys. BMC Medical Research Methodology, 15, 32. https://doi.org/10.1186/s12874-015-0016-z

Grava-Gubins, I., & Scott, S. (2008). Effects of various methodologic strategies: Survey response rates among Canadian physicians and physicians-in-training. Canadian Family Physician, 54(10), 1424-1430. https://www.cfp.ca/content/54/10/1424.long

Viera, A. J., & Edwards, T. (2012). Does an offer for a free on-line continuing medical education (CME) activity increase physician survey response rate? A randomized trial. BMC Research Notes, 5, 129. https://doi.org/10.1186/1756-0500-5-129

Weaver, L., Beebe, T. J., & Rockwood, T. (2019). The impact of survey mode on the response rate in a survey of the factors that influence Minnesota physicians’ disclosure practices. BMC Medical Research Methodology, 19(1), 73. https://doi.org/10.1186/s12874-019-0719-7

*Yassar Alamri
Department of Medicine, Christchurch Hospital,
2 Riccarton Avenue, Christchurch 8011,
New Zealand
Email: yassar.alamri@nzbri.org