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Enhancing Face Validity Using Cognitive Interviewing Techniques: Applying Tourangeau's Framework to the Nursing

Farzaneh Bagheriyeh¹, Akram Ghahramanian^1,2, Vahid Zamanzadeh³

¹Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.

Journal of Caring Sciences

|July 6, 2026

Summary

Applying Tourangeau's Question-and-Answer Framework systematically improved cognitive interviews and enhanced the face validity of a nursing talent scale. This structured approach identified and resolved item-level issues effectively.

Keywords:

Cognitive interviewing Face validity Instrument development Self-report instrument Tourangeau’s framework

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Area of Science:

Healthcare Research Methodology
Cognitive Psychology in Survey Design

Background:

Cognitive interviewing enhances self-report instrument face validity but often lacks structure.
Tourangeau's Question-and-Answer Framework offers a systematic approach to cognitive interviewing.

Purpose of the Study:

To introduce and apply Tourangeau's framework for structured cognitive interviews.
To enhance the face validity of self-report instruments in healthcare research.

Main Methods:

A two-phase methodological study utilizing Tourangeau's four cognitive stages (comprehension, retrieval, judgment, response).
Application of the framework in a case study to refine the Nursing Talent Identification Scale.
Cognitive interviews with 20 undergraduate nursing students using think-aloud and probing, analyzed via qualitative content analysis.

Main Results:

The framework precisely identified and categorized item-level issues, primarily ambiguous wording and misinterpreted intent.
Most problems were linked to the comprehension and judgment stages, leading to the revision of 20 items.
Specific examples include clarifying vague phrases and negative wording in survey items.

Conclusions:

Tourangeau's framework offers a systematic method for cognitive interviews and improving face validity in healthcare.
The framework successfully enhanced the Nursing Talent Identification Scale.
Future research should validate the framework in diverse populations to improve generalizability.