Survey research: be careful where you step …

Two interesting articles recently appeared in QSHC. Kho et al1 published their findings about the test-retest reliability and internal consistency of different forms of the Safety Climate Survey,2 and this was followed by some guidelines by Pronovost and Sexton3 about the measurement of culture. Given that researchers are focusing more on using surveys to measure different issues related to culture, the focus of the present discussion is to examine common misconceptions about the reliability and validity of different constructs. Advances in other fields are also mentioned to shed light on some of the perplexing issues faced by health services researchers attempting to study culture. While Pronovost and Sexton3 are correct in stating that “we must understand these sources of variation in order to target” different improvement opportunities and that “failure to understand these important issues can cause managers to make incorrect inferences regarding scores” (page 231) on any measure, we believe that several incorrect statements in their editorial need to be examined so that culture research (and survey research in general) can …