The number of response options in survey questions

When designing healthcare feedback surveys, the number of response options you offer in each question can influence the quality and usefulness of the feedback you receive. This article delves into the various scales and numbers of options, their pros and cons, and best practices for using them effectively.

Types of rating scales

Here’s an overview of the most common scales used for feedback survey questions, along with their advantages and disadvantages:

Binary scale

The simplest form of response, providing only two options: Yes or No. Often used for straightforward questions such as "Did you receive the care you expected?"

These questions are easy for respondents to answer and they provide clear, decisive feedback. However, a binary scale doesn’t capture nuanced opinions or details, and may not be suitable for questions requiring more than a simple affirmation or negation.
Use it for clear, objective questions, and avoid with complex or subjective inquiries where more detail is required.

3-point scale

This type of scale offers three response options, often representing a simple continuum such as Poor, Fair, Good. It’s suitable for basic assessments of patient satisfaction or experience.

A 3-point scale is easy to understand and quick to respond. It provides more detail than a binary scale, but it’s still relatively simplistic, and might not capture all shades of opinion. It’s best to use it for quick surveys where detailed feedback isn’t critical — e.g., for preliminary assessments or triage situations.

5-point scale

A popular choice in surveys, the 5-point scale usually provides options such as Very Dissatisfied, Dissatisfied, Neutral, Satisfied, Very Satisfied. Also known as a Likert scale, it’s commonly used in patient satisfaction surveys to gauge overall experience.

A sidenote: you can also use an ordinary 1-5 grading scale — these are often used in patient satisfaction surveys to simplify the rating process and encourage higher response rates.

A 5-point Likert scale offers a good balance between simplicity and depth of insight. It’s also widely used, making it easier to compare results across different studies. It does come with some cons as well, and one of them is the Central Tendency Bias — respondents might choose the middle option (Neutral) more often.

The Likert scale is ideal for assessing general satisfaction and other broad measures. To make the most of it in your surveys, ensure that the question wording clearly differentiates each point on the scale to avoid confusion.

7-Point Scale

Another version of the Likert scale, but with a more granular range of options — such as Very Poor, Poor, Fair, Neutral, Good, Very Good, Excellent. The 7-point Likert variant is useful for more detailed feedback, especially in cases where fine distinctions are important.

Due to its granularity, it offers greater nuance in responses. This also helps in identifying subtle differences in patient experiences. However, a 7-point scale can be slightly more complex for respondents to process, and a more detailed analysis will be required to interpret the results.

Use it sparingly, when detailed feedback is absolutely necessary. When you do use it, provide clear descriptions for each scale point to avoid respondent confusion.

10-Point Scale

This type of scale extends the range of response options, and is often used in Net Promoter Score (NPS) surveys. In most use cases, it measures the likelihood to recommend services on a scale from 0 to 10.

A 10-point scale is highly granular and captures fine distinctions in opinion. It’s also useful for in-depth statistical analysis. Its potential downside is its cognitive load — it can be more difficult for some respondents to distinguish between so many options. It’s best used for specific metrics like NPS, or any other contexts where detailed, granular feedback is critical.

Open-ended questions

Open-ended questions allow respondents to provide feedback in their own words, without being constrained by predefined options. They’re ideal for capturing detailed feedback, suggestions, and unique experiences.

These questions provide rich, qualitative data because respondents can elaborate on their thoughts and feelings. To be fair though, they are more challenging to analyze and interpret, and require more time and effort from respondents.

Use open-ended questions sparingly, to complement quantitative questions. You can analyze the responses using text analysis tools to identify common themes, insights, and overall sentiment.

Insider tips for choosing the number of options

Based on our experience, here are some tried and tested tips for how and where to limit the number of options you’ll offer:

• Align with objectives: Choose scales that align with the goals of your survey. For example, use a 5-point scale for general satisfaction and a 10-point scale for more detailed feedback like NPS.
• ‍Balance detail with simplicity: Detailed scales provide richer data, but simpler scales encourage higher response rates; balance the need for detailed insights with the need to minimize respondent burden.
• ‍Test and iterate: Always pilot your surveys with a small group to identify any issues with question clarity or scale appropriateness; use their feedback to refine your survey before broader deployment.
• ‍Provide clear descriptions: Ensure that each point on your scale is clearly defined to avoid confusion, because this helps respondents choose the most accurate response.
• ‍Mix question types: A combination of scaled and open-ended questions can gather both quantitative and qualitative data, yielding a more comprehensive understanding of patient experiences.

Conclusion

To obtain useful, actionable data in healthcare feedback surveys, you must be careful with selecting the right number of options and types of questions. Different scales and question types come with their respective strengths and limitations, and a thorough understanding of these can help you design surveys that effectively capture patient feedback — and ultimately drive improvements in care quality. InsiderCX can help you create, distribute, and analyze surveys, ensuring you get the most valuable insights from your patient feedback efforts.