Survey Instrument Item Development

Survey Research Demographic Questions

These are the standard ways that researchers may want to gather information. Every survey does not have to include every demographic, but use this reference as a guide.

Campus of Enrollment – “Which Ohio State campus do you currently attend?”

• Columbus
• Lima
• Mansfield
• Marion
• Newark
• CFAES Wooster/ATI

Enrollment Status – “What is your enrollment status?”

• Part-time 
• Full-time
• Non-degree seeking

Residency Status – “Where is your permanent residence?”

• In-state
• Out-of-state
• Outside of the United States

Age – “What is your age?”: Open box here

Current Cumulative Grade Point Average (GPA) – “What is your current cumulative grade point average (GPA)?”: Open box here (but use content validation to force the number to be between 0.0 and 4.0)

Please answer the following question with your year in school, not your rank based on credit hours, in mind. For example, you might be a first-year student on campus with enough credit hours to be considered Rank 2. In this case, please select “First-year undergraduate.”

Year in School - “What is your year in school?”

• First-year undergraduate
• Second-year undergraduate
• Third-year undergraduate
• Fourth-year undergraduate
• Fifth-year or beyond undergraduate
• Graduate (Master’s)
• Graduate (Professional)
• Graduate (Doctoral)

Current Residence - “Which of the following describes your current residence?”

• On-campus housing (university-managed apartment or residence hall)
• Off-campus housing within the 43201 ZIP code area
• Off-campus housing outside of the 43201 ZIP code area
• Fraternity or sorority housing

Optional Variation:

Current Residence – “Which of the following describes your current residence?”

• On-campus housing (university-managed apartment or residence hall)
• Off-campus housing within walking distance
• Off-campus housing outside of walking distance 
• Fraternity or sorority housing 

Transfer Status (for current degree) – “Are you a transfer student? (Current degree only)”

• No
• Yes, I have made a campus change from an Ohio State regional campus
• Yes, I transferred from another college or university

Religious Affiliation (condensed) 

• Buddhist
• Christian - Catholic
• Christian - Protestant
• Christian - Other
• Hindu
• Jewish
• Muslim
• Other
• Unaffiliated (e.g., Agnostic, Atheist, none)
• Prefer not to answer

Political Affiliation

• Democrat
• Republican
• Independent
• Libertarian
• Other ______________________
• None
• Prefer not to answer

Employment Status: "What is your current employment status?"

• Do not work
• Only work during the academic year
• Only work during academic breaks
• Work during both the academic year and academic breaks

Employment Status – “If you work for pay off campus during the academic year, about how many hours per week do you work?”

• Do not work during the academic year
• 1-5 hours
• 6-10 hours
• 11-14 hours
• 15-19 hours
• 20 or more hours

Employment Status – “If you work for pay on campus during the academic year, about how many hours per week do you work?”

• Do not work during the academic year
• 1-5 hours
• 6-10 hours
• 11-14 hours
• 15-19 hours
• 20 or more hours

College (Undergraduate) – “In which academic college is your major at Ohio State?  Select all that apply.”

• College of Arts and Sciences
• College of Dentistry
• College of Education and Human Ecology
• College of Engineering
• College of Food, Agricultural, and Environmental Sciences
• College of Medicine
• College of Nursing
• College of Pharmacy
• College of Public Health
• College of Social Work
• John Glenn College of Public Affairs
• Max M. Fisher College of Business
• University Exploration
• Other: Fill in

College (Graduate/Professional) – “Which academic college are you getting your degree in at Ohio State? Please select all that apply.”

• College of Arts and Sciences
• College of Dentistry
• College of Education and Human Ecology
• College of Engineering
• College of Food, Agricultural, and Environmental Sciences
• College of Medicine
• College of Nursing
• College of Optometry
• College of Pharmacy
• College of Public Health
• College of Social Work
• College of Veterinary Medicine
• John Glenn College of Public Affairs
• Max M. Fisher College of Business
• Moritz College of Law
• Other: Fill in

At Ohio State, you are considered a first-generation student if neither parent earned a four-year degree. Note: Undergraduate students are asked if either parent/guardian has a bachelor’s degree via the Common Application and the Ohio State Internal Application.

Are you a first-generation college student (neither of your parents or caregivers earned a four-year bachelor’s college degree).  

• Yes
• No 

What is your race/ethnicity? (select all that apply) 

Note: If any race/ethnic group has fewer than 10 respondents, the group may be collapsed (i.e., meaning analyzed together for the purposes of reporting) with other groups to protect participant privacy. If you have any questions on how to collapse the categories, please contact… 

• American Indian, Alaska Native, Indigenous, Native American and/or First Nations 
• Asian/Asian American, Pacific Islander, Desi American (APIDA) and/or Native Hawai’ian
• Black and/or African American 
• Latine and/or Hispanic 
• Middle Eastern and/or North African (MENA) 
• Multiracial and/or Biracial 
• White and/or European American 
• Prefer to self-describe: ______
• Prefer not to answer 
• Would you like to expand on what you selected above? If so, below is space for that

An alternative inclusive Ethnicity/Race question 

Ethnicity/Race

Although the categories listed below may not represent your full identity or employ the language you use, for the purpose of this survey, please indicate which group most accurately describes your racial/ethnic identification. (If you are of a multiracial/multiethnic/multicultural identity, mark all that apply.)

• Alaska Native/American Indian/Native American/Indigenous (If you wish, please specify your enrolled or principal tribe.):
• Asian/Asian American (If you wish, please specify.):
• Black/African/African American (If you wish, please specify.):
• Hispanic/Latinx/Latine (If you wish, please specify.):
• Middle Eastern/North African (If you wish, please specify.):
• Native Hawaiian (If you wish, please specify.):
• Pacific Islander (If you wish, please specify.):
• South Asian (If you wish, please specify.):
• White/European American (If you wish, please specify.):
• A racial/ethnic identity not listed here (If you wish, please specify.):

Sex/Gender 

• What is your current gender/gender identity? 
• Agender
• Genderqueer
• Nonbinary
• Man
• Transgender
• Woman
• A gender/gender identity not listed here: _________
• Prefer not to answer

Sexual Identity

Although the categories listed below may not represent your full identity or employ the language you use, for the purpose of this survey, please indicate which choice most accurately describes your sexual identity.

• Bisexual
• Gay
• Heterosexual or Straight
• Lesbian
• Pansexual
• Queer
• Questioning or Unsure
• A sexual identity not listed here (Please specify):
• Prefer not to answer

An alternative question 

Sexual Orientation – Which choice best describes your sexual orientation? 

• Asexual
• Bisexual
• Gay
• Straight (Heterosexual)
• Lesbian
• Pansexual
• Queer
• Questioning or Unsure
• Same-gender loving
• Preferred Identity (in addition to or not listed above) _____________
• Prefer not to disclose

Disability status?

Do you have a condition/disability that influences your learning, living or working activities? 

• Yes
• No

[If yes] Are you receiving accommodations for your condition/disability?

• Yes
• No
• Prefer not to answer

Veteran

• What is your primary military status? 
• I have never served in the military
• I am currently on active duty
• I am currently a member of the National Guard or Reserves
• I am not currently serving, but have served (retired, veteran)
• I am the child, spouse or domestic partner of a currently serving or former member of the military
• Prefer not to answer

Or

Are you retired or a veteran of the U.S. military?

• Yes
• No

If you plan to conduct a department climate survey at Ohio State, please contact Michele Hansen.676@osu.edu before administering it. Developing and implementing effective climate surveys can be challenging, and they can contain sensitive data and information. Also, external factors should be considered when implementing these surveys and addressed before survey administration. Please contact Michele Hansen and or Mitsu Narui (narui.1@osu.edu) for assistance in designing your survey instrument or planning your study. 

This section contains a few tips about the survey planning process. 

Climate refers to the current attitudes, behaviors and standards of employees and students concerning the inclusion and level of respect for and access of individual and group needs, abilities and potential. 

The key to a successful climate study is spending time intentionally planning the survey instrument, administration process, dissemination and facilitating use. Effective climate studies involve careful pre-preparation, asking the right questions on the survey instrument, and developing and acting on recommendations within a structure that is equitable, impactful and transparent. Below are a few tips: 

• Allow ample time for planning in advance of designing and administering a climate survey. This involves meeting with key leaders and constituents that may be impacted by the results of the study. 
• Secure a commitment from leadership and key decision-makers. They should have an effective plan for using the results and translating the results into practice.
• Develop a plan for data collection and ensuring that respondents’ sensitive data will be secure and protected from inappropriate use.
•  Be sure to explain to respondents if their information is anonymous versus confidential. 
  • Anonymity. Claiming that a project or data collection is anonymous means two things:
    • The survey instrument does not collect any unique identifiers of individual subjects (e.g., name, address, email address, Social Security number, phone number, etc.). They can’t be identified.
    • The survey does not collect any identifiers that combined would allow an individual to be identified. The combination of demographics like age, sex, department, college, rank and years in rank could allow a respondent to be identified.
    • Note: If data is in any way identifiable or can be connected to the participant (directly or indirectly, even if only by the researchers), the data-collection process cannot make the claim of being anonymous.
  • Confidentiality. Claiming that information collected will be kept confidential means that only the investigator(s) or co-investigator(s) will be able to identify the responses of individual subjects. 
    • This means that data will never be reported in a way that allows an individual respondent's identity to be known or tied to their responses.
    • This clarification of terms does not mean that no unique identifiers should ever be collected. Rather, this clarification of terms is designed to provide a greater level of precision when communicating with survey participants.
    • It is important to understand the claims that you are making regarding their responses. In general, participants are at greater risk when their responses can be tied to their identity. Typically, it is best to collect only the data that is necessary to complete the research objective.   

Adapted from this source. 

Include this definition with the questions below. Climate refers to the current attitudes, behaviors and standards of employees and students concerning the inclusion and level of respect for and access of individual and group needs, abilities and potential.

Response Scale: 1 = very comfortable, 2 = comfortable, 3 = neither comfortable nor uncomfortable, 4 = uncomfortable, 5 = very uncomfortable

1. Overall, how comfortable are you with the climate in your college or unit?
2. Faculty/Staff/Graduate Students/Postdocs only: Overall, how comfortable are you with the climate in your department/program or work unit at Ohio State? 
3. Students: Overall, how comfortable are you with the climate in your classes within the department?

Inclusive Climate and Belonging Questions (Faculty and Staff) 

Response scale: 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree to 5 = strongly agree

1. I feel a sense of belonging in my college, department or unit.
2. I can voice a contrary opinion without fear of negative consequences.
3. I feel like my colleagues understand who I really am. 
4. I feel like I can show up at work as my true authentic self.

Goodenow and Grady (1993) define sense of belonging as “the extent to which students feel personally accepted, respected, included, and supported by others in the school social environment” (p. 80). Social psychologists Gregory Walton and Geoffrey Cohen define a sense of belonging as the feeling of being accepted, included, and valued by others. They also coined the term "belonging uncertainty" to describe the state of feeling doubtful about being fully accepted in a particular environment. Investigations have found that socially stigmatized groups were more susceptible to belonging uncertainty (Walton and Cohen 2007). When marginalized students worry about belonging and something goes wrong, they may feel isolated, criticized or disrespected. This in turn can increase stress and undermine students’ motivation and engagement (Yeager, et al., 2011). Sense of belonging is also an important construct for staff and faculty. 

The following sections contain sample items. 

General Sense of Belonging Items 

Response scale: 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree to 5 = strongly agree

1. I see myself as a part of the Ohio State campus community
2. I feel that I am a member of the Ohio State campus community
3. I feel a sense of belonging to the campus community
4. I feel that I fit right in on campus
5. I feel connected with other Ohio State students (or faculty or staff)
6. I feel that the Ohio State campus is very welcoming to students (faculty members or staff members) like me
7. My experience with Ohio State is aligned with my expectations in terms of what the college experience (or faculty or staff experience) should be
8. I feel I can be my authentic self at Ohio State
9. I feel like my identities are affirmed at Ohio State 
10. I feel valued and important at Ohio State 
11. I feel like others care about me at Ohio State 
12. I feel supported by others at Ohio State 
13. I feel respected by others at Ohio State 

Domain or College/Major/Department Sense of Belonging Items

Response scale: 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree to 5 = strongly agree

Replace blank with college, program, unit or department. 

1. I see myself as a part of the (e.g., Engineering) community
2. I feel that I am a member of the ______ community
3. I feel a sense of belonging to the (e.g., Mathematics Department) community
4. I feel that I fit right in 
5. I feel connected with other ______ students (or faculty members or staff) 
6. I feel that the ______ is very welcoming to students/faculty/staff like me
7. My experience with ______ is aligned with my expectations in terms of what the college experience/faculty experience/staff experience should be
8. I feel I can be my authentic self at ______
9. I feel like my identities are affirmed at ______
10. I feel valued and important at ______
11. I feel like others care about me at ______
12. I feel supported by others at ______
13. I feel respected by others at ______

Sense of Belonging Scale for Students

Response scale: 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree to 5 = strongly agree

1. I feel valued by Ohio State faculty.
2. I feel valued by Ohio State staff.
3. I feel valued by Ohio State senior administrators (e.g., offices of the dean, vice president, provost, and president).
4. I feel valued by faculty in the classroom.
5. I feel valued by other students in the classroom. 
6. I feel valued by other students outside of the classroom.
7. I believe that Ohio State’s climate encourages open discussion of difficult topics.
8. I have faculty whom I perceive as role models.
9. I have staff whom I perceive as role models.

AAC&U defines High-Impact Practices (HIPs) as "techniques and designs for teaching and learning that have proven to be beneficial for student engagement and successful learning among students from many backgrounds.”

Engagement in High-Impact Practices 

Response Scale: 0 = Do not plan to do  1 = Have not decided  2 = Plan to do  3 = Done or in progress 

Which of the following have you done or do you plan to do before you graduate? 

1. Participate in an internship or field experience related to your major
2. Participate in industry mentoring in which you receive mentoring from a person already employed in your major profession 
3. Hold a formal role in a student organization group
4. Participate in a learning community or some other formal program where groups of students take one or more classes together
5. Participate in a living-learning community where students of the same major all live in the same place on campus
6. Participate in a study abroad or international experience program
7. Work with a faculty member on a research project 
8. Complete a culminating senior experience (capstone, senior project or thesis, comprehensive exam, portfolio, etc.) 
9. Complete a community-based or service-learning project 
10. Work on campus for pay 
11. Serve in a formal or paid capacity as a student peer mentor
12. Complete an e-portfolio of your learning experiences (A digital repository that allows you to organize, document and display your most important learning experiences in one place. May include artifacts like writing, presentations and project reports.)

The Ohio State University has identified this set of HIPS, and this list is periodically updated. 

Please visit here for more information  

• Buck-I-Serv
• Buckeye Leadership Fellows 
• Internships (courses ending in 191)
• Non-Profit Immersion Program 
• Service Learning 
• STEP (Second-year Transformational Experience Program) 
• Living-Learning Communities
• Study Abroad 
• Undergraduate Research (credit courses #4998, 4999)
• Undergraduate Research (paid student employees with titles contain lab or research)

Hope is defined as, “the process of thinking about one’s goals, along with the motivation to move toward those goals (agency), and the ways to achieve those goals (pathways)” (Snyder, 1995, p. 355). Pathways thinking entails creating a plan to achieve goals or an alternative plan if significant barriers are faced, while agency thinking includes the motivation to achieve them and involves the perceived ability to carry out the plan (Snyder, 2002).

Academic Hope Scale   

Response scale: 1 = strongly disagree, 2 = disagree 3 = mostly disagree, 4 = mostly agree, 5 = agree, 6 = strongly agree

1. If I should find myself in a jam, I could think of many ways to get out of it.                                 
2. At the present time, I am energetically pursuing my academic goals.                                              
3. There are lots of ways around any school-related problems that I am facing now.                  
4. Right now, I see myself as being pretty successful.                                                                                      
5. I can think of many ways to reach my current academic goals.                                                            
6. At this time, I am meeting the goals I have set for myself.                                                                       

(above scale adapted from Snyder, Sympson, Ybasco, Borders, Babyak, and Higgins, 1996). 

Grit is defined as, "perseverance and passion for long-term goals" (Duckworth, 2016). Grit is characterized by having a combination of resilience, determination, and perseverance. According to Duckworth, Gritty individuals are able to maintain their focus and motivation even in the face of setbacks and obstacles, and they are willing to put in the hard work and effort required to achieve their goals.

Grit: Perseverance and Passion for Long-Term Goals Short Scale 

Response scale: 1 = not like me at all to 5 = very much like me

Consistency of Interest

1. I often set a goal but later choose to pursue a different one. 
2. I have been obsessed with a certain idea or project for a short time but later lost interest.
3. I have difficulty maintaining my focus on projects that take more than a few months to complete.
4. New ideas and projects sometimes distract me from previous ones.
5. My interests change from year to year. 
6. I become interested in new pursuits every few months.

Perseverance of Effort

1. I finish whatever I begin. 
2. Setbacks don’t discourage me. 
3. I am diligent. 
4. I am a hard worker. 
5. I have achieved a goal that took years of work. 
6.  I have overcome setbacks to conquer an important challenge.

Duckworth, Peterson, Matthews, & Kelly (2007) 

How students perceive their academic success often contributes to their decision to persist in higher education. Research indicates that when students experience an unwelcoming college climate, they also experience a decline in persistence and academic performance.^[1]

Response scale: 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree to 5 = strongly agree

1. I am performing up to my full academic potential.
2. I am satisfied with my academic experience at Ohio State.
3. I am satisfied with the extent of my intellectual development since enrolling at Ohio State.
4. I have performed academically as well as I anticipated I would. 
5. My academic experience has had a positive influence on my intellectual growth and interest in ideas. 
6. My interest in ideas and intellectual matters has increased since coming to Ohio State.

Self-efficacy refers to an individual's belief in his or her capacity to execute behaviors necessary to produce specific performance attainments (Bandura, 1977, 1986, 1997). Self-efficacy is a domain-specific construct, and survey items should contain the specific context like academic self-efficacy, career decision making self-efficacy, exercise self-efficacy, teaching self-efficacy  or other domains.

Academic self-efficacy (ASE) refers to a student’s global belief in his/her ability to master the various academic challenges at a university and is an essential antecedent of well-being and performance. 

1. I generally manage to solve difficult academic problems if I try hard enough.             
2. I know I can stick to my aims and accomplish my goals in my field of study.                
3. I will remain calm in my exam because I know I will have the knowledge to solve the problems.      
4. I know I can pass the exam if I put in enough work during the semester.     
5. The motto, “If other people can, I can, too,” applies to me when it comes to my field of study. 

Response scale: 1 = strongly disagree, 2 = disagree 3 = mostly disagree, 4 = mostly agree, 5 = agree, 6 = strongly agree 

Alternatively 

Response scale: 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree to 5 = strongly agree

According to van Zyl et al. (2022) “the results showed that a single, first-order factorial model of overall academic self-efficacy fitted the data well, was reliable and invariant across time. In line with Nielsen et al. (2018), our findings show that the GASE measures general academic self-efficacy (ASE) validly and reliably. Therefore, the mean scores of the GASE could be used by educational practitioners to measure ASE and track the effectiveness of educational programs or interventions aimed at enhancing ASE over time” (p. 786). 

References and resources: 

Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191-215.

Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall.

Bandura, A. (1997). Self-Efficacy: The exercise of control. New York, NY: W. H. Freeman.

van Zyl, L. E., Klibert, J., Shankland, R., See-To, E. W. K., & Rothmann, S. (2022). The General Academic Self-Efficacy Scale: Psychometric Properties, Longitudinal Invariance, and Criterion Validity. Journal of Psychoeducational Assessment, 40(6), 777-789. https://doi.org/10.1177/07342829221097174 

Burnout is a legitimate occupational experience that organizations need to address, characterized by three dimensions: 1) Feelings of energy depletion or exhaustion, 2) Increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job, and 3) reduced professional efficacy.

The Maslach Burnout Inventory™ (MBI) is recognized as the leading measure of burnout. It has been validated by the extensive research that has been conducted in the more than 35 years since its initial publication. The MBI assesses each of the three dimensions of burnout separately. 

The MBI is a proprietary instrument, and more information is available here. 

This site contains information about how to measure burnout effectively and ethically.

Maslach Burnout Inventory (Sample Items only) 

1. I feel run down and drained of physical or emotional energy.
2. I have negative thoughts about my job.
3. I feel that I am achieving less than I should.
4. I feel that there is more work to do than I practically have the ability to do.

Single Item Overall (does not indicate specific dimensions of burnout for intervention) 

Overall, based on your definition of burnout, how would you rate your level of burnout? Response options are:

(1) “I enjoy my work; I have no symptoms of burnout.” 

(2) “Occasionally I am under stress, and I don’t always have as much energy as I once did, but I don’t feel burned out.” 

(3) “I am definitely burning out and have one or more symptoms of burnout, such as physical and emotional exhaustion.” 

(4) “The symptoms of burnout that I am experiencing won’t go away. I think about frustration at work a lot.” 

(5) “I feel completely burned out and often wonder if I can go on. I am at a point where I may need some changes or may need to seek some sort of help.”