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

Although cognitive interviewing is an efficient method for assessing and enhancing the face validity of self-report instruments, the lack of a structured framework can limit its effectiveness. This study aims to introduce and apply Tourangeau's Question-and-Answer Framework as a systematic guide for conducting cognitive interviews and enhancing face validity.

This methodological study was conducted in two phases. First, Tourangeau's theoretical framework comprising the four cognitive stages of comprehension, retrieval, judgment, and response was used to structure interview probes. Second, this framework was applied in a case study to improve the Nursing Talent Identification Scale. Cognitive interviews using think-aloud and verbal probing techniques were conducted with 20 first-year undergraduate nursing students selected via purposive sampling. Data were analyzed through qualitative content analysis explicitly guided by Tourangeau's stages.

The application of Tourangeau's framework enabled the precise identification and categorization of item-level issues. Analysis of the initial 95-item pool revealed problems primarily related to ambiguous wording and misinterpreted intent. Most issues were traced to the comprehension (16 items) and judgment (11 items) stages, leading to the revision of 20 items. For example, items with vague phrases (e.g., "relationships between components") or negative wording were clarified.

Tourangeau's framework provides a systematic approach to conducting cognitive interviews and improving face validity in healthcare research. Its application enhanced the Nursing Talent Identification Scale; however, the small, region-specific sample may limit generalizability. Future studies should apply this framework in larger and more diverse populations to strengthen its external validity and broader applicability.