Using cognitive interviews and think-aloud protocols to understand thought processes

Our situation: Cognitive interviews (CIs) and think-aloud protocols (TAPs) are two strategies that offer unique approaches to capture participant thought processes when engaging with instruments and interventions. In this paper, we describe the origins of CIs and TAPs, the types of research questions they can be used to address, and strategies to implement these approaches. Methodological literature review: CIs and TAPs are interview methods that make thought processes more explicit. CIs include targeted interview questions that are focused on evaluating participant comprehension during an activity, such as a survey. TAPs request the participant to think-aloud while they solve a problem or complete a task; this is to help understand the problem-solving process. Our recommendations and their applications: An understanding of the research aim is critical to identify whether a CI or TAP is preferred. Researchers should ensure that participants are selected based on the needs of the research and that they are appropriately prepared for the selected interview type. Individuals can analyze verbal reports from CIs and TAPs using qualitative and quantitative methods, and researchers are encouraged to disseminate their findings to inform design practices of other researchers. Potential impact: CIs and TAPs are methods that help pharmacy education researchers explore thought processes; specifically, these methods are useful to study test response processes, improve survey construction, and map cognitive models of complex thought processes. CIs and TAPs are methodologies that should be in the toolbox of pharmacy education researchers to support design, evaluation, and refinement of instruments and educational interventions.