Breaking the mold of the ‘classic’ survey

Editor's note: Brian Mondry is global head of digital innovation at research firm Kantar Health, New York. Leah Fink is research manager at Kantar Health, Paris.

Already popular in the marketing space, gamification is now seeing broader adoption in market research. Survey gamification is becoming a necessity in these days of declining completion rates and the propensity of some survey-takers to speed through questionnaires. To get higher completion rates plus more thoughtful responses on a questionnaire, you need to employ some aspects of gamification into your studies.

The term “gamification” refers to using game design and mechanics in non-gaming contexts, which for online surveys could include enhancements such as achievement badges, progress bars, avatars, virtual currency and respondent challenges.1

However, the use of gamification techniques in market research must go beyond just graphics. A truly successful gamified questionnaire puts respondents in a more interactive setting that will better engage their sub-conscious thinking and motivations, allowing them to think outside the box, give a less obvious answer and be more engaged in the survey-taking process. These benefits can extend across industries from consumer research to surveying physicians or patients in the health care sector.

Given the often sensitive subject matter we deal with in health care, there may be concerns about executing some of the more elaborate gaming tactics listed above. However, in most cases, it is perfectly acceptable to replace long, repetitive text- and grid-heavy survey formats with interactive visual response options and features for a more playful design; or creating story-like scenarios that set a more interesting and realistic context in which respondents answer questions; or formulating questions as problems or challenges using the logic of games, all while maintaining the integrity of the subject matter.

One often-used quantitative survey technique is the awareness, trial and usage (ATU). The objective of ATU surveys is to assess key performance indicators related to awareness, importance of various criteria, brand/product performance on these criteria and intent to use. Therefore, metrics resulting from an ATU are often incorporated into tracking studies.

Despite the key role ATU surveys play in analyzing and tracking performance, these surveys are known to have some limitations. Specifically, respondents (in particular those who are part of panels) have become very used to the standard survey format. These questionnaires are typically composed of large blocks of questions that are repeated frequently for different products/brands and for different indicators (satisfaction, importance, etc.). Therefore, frequent survey respondents may be answering automatically, not taking the time to carefully read all questions and response modalities.

In addition, traditional ATU survey design typically asks respondents to rate various attributes on a scale of 1 to 7. This type of rating system has been associated with country-level bias in scoring. For example, respondents in Spain are known to generally provide higher scores compared with their French and German counterparts.

When a client needed an update to its long-term ATU study completed by a physician panel, we worked with our sister company Lightspeed GMI to break the mold of “classic” surveys. This survey suffered from many of the standard limitations of ATUs: It was a multicountry survey used to track performance of very similar products. The same physicians responded to the questionnaire as many as three times per year.

To address the challenges, Kantar Health and Lightspeed GMI worked together to develop a new approach based on gamification techniques that would incorporate a questionnaire design to increase physician involvement.

The new survey design had three main objectives: improve physician engagement while responding to the survey; diminish country bias to better track aggregated data; and identify new strategic points of differentiation for our client’s brand.

Improving physician engagement while responding to the survey

For this specific project, more than 80 percent of the sample responded to the survey three times a year. Therefore, the physicians were at great risk of speed-taking the survey. The first action taken to improve engagement was the removal of all grid-like question layouts. In the gamified survey, only one question appeared per page and physicians used a drag-and-drop function to respond for all products at the same time. Question labels were shortened and scales were personalized to make sure physicians read the questions prior answering. In the traditional ATU, physicians would rate overall survival and impact on quality of life on the same scale. Now, physi-cians rate overall survival on a scale of “longest” to “shortest” and impact on quality of life from “least impact” to “most impact.”

Physician engagement was also addressed by creating a more interactive way of asking some standard questions. For example, a non-gamified survey might ask a physician respondent, “Approximately what proportion of your patients do you treat with the following regimens?” For a gamified survey, however, a series of questions designed to better engage the physician would be asked, such as:

  • Which treatment would you be most likely to offer this patient?
  • Can you predict the most popular treatment selected?
  • Would you choose the same treatment?
  • If not, which treatment would you personally have selected?

Diminish country bias to better track aggregated data

Prior to adapting the ATU questionnaire, each wave of research produced the same results: the Spanish physicians were more satisfied with all products. However, based on other sources of information, we knew this was not necessarily the reality. For satisfaction questions, replacing numerical scales (“Please indicate on a scale of 1-7 how each brand performs on response rate”) with sliding scales (“Do these treatments increase response rate? Definitely not…..Definitely so”) harmonized country data.

In addition to being more satisfied, in the traditional ATU survey, Spanish physicians also appeared to be more knowledgeable about all clinical trials and pipeline products, possibly out of worry that their competency was being tested. For questions relating to knowledge, the 1-7 scale was replaced by a four-item scale with short phrases: Not aware; Aware but not of details; Quite familiar; Very familiar. Each item had an accompanying visual logo. The results of this change were clear; all countries in the scope now had much more comparable answers, making it possible to aggregate country-level data.

Identify new strategic points of differentiation for our client’s brand

In the case of this research, our client was facing a challenge of having a direct competitor with a very similar product. In the traditional survey format, differences between the two products were not always obvious, with the majority of physicians providing similar responses for both products. However, in the gamified version of the survey, physicians needed to place both products on a single scale using a drag-and-drop, therefore highlighting slight nuances in performance that were previously undetected on the seven-point scale.

Another change involved asking respondents to think about overall product satisfaction in a new way. Instead of asking them to rate satisfaction on the seven-point scale as they rated other criteria, respondents were asked how many stars they would give the product if they were to publish a guidebook for it.

While their rational mind may consider the two products identical with a score of six out of seven, if physicians picture a guidebook, they may be willing to give one product five stars and the other four stars. The new star rating gives the rare opportunity in quantitative research to assess subconscious thinking when making a decision between two similar brands.

Interactive and pleasant

In addition to yielding richer data, the newly gamified survey design made the ATU experience interactive and pleasant while increasing user engagement. We found that the new and dynamic presentation of questions actually increased physician involvement in the questionnaire. Time to complete the ATU questionnaire increased from 14 minutes for the classic version to 17 minutes for the gamified version yet physicians frequently mentioned that the new questionnaire “seemed shorter” or was “quick.”

But gamification goes far beyond simply using nicer-looking surveys. A survey that yields data that can uncover hidden opportunities or challenges is predicated on having a strong questionnaire. A survey employing gamification does not mean just using the previous ATU survey and adding some graphics. The survey must be designed with the user experience in mind and the questions written in a way that takes full advantage of the new interface. Working to bring out the simplicity in the questionnaire makes the questions come alive with the design of the interface.

Has great potential

Gamification in the health care sector has great potential to unlock new insights into prescription rationale, allowing us to peek behind the curtain to learn physicians’ reasoning. In addition, applying gamification techniques to patient surveys can unlock insights into how adherent they are (or aren’t) to their medications, their side effects, their comorbidities and relationships with their doctors, thereby improving their experiences and health outcomes.

The days of long, repetitive, grid- and text-heavy surveys are coming to an end. In these days of short attention spans and always-on connectivity with the office that has expanded the workday beyond the traditional 9-5, we need to employ new strategies that maximize engagement with research studies as well as ensure those studies yield not only comprehensive but high-quality data. Better data leads to better insights and better in-sights lead to smarter business decisions.

1 “Using gamification in online surveys.” Survey Gizmo. March 14, 2013.