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모든 템플릿

Medical Examination & Check-Up Experience Survey

Captures how patients experience scheduling, wait times, communication, and results delivery during routine or diagnostic medical exams. Includes a best-worst trade-off to prioritize service improvements and an AI follow-up interview that reconstructs what actually happened during the visit — especially around how results were explained — rather than just a satisfaction score.

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샘플 질문

템플릿에 포함된 내용을 미리 확인해 보세요. 모든 질문은 설문 공개 전에 자유롭게 수정할 수 있습니다.

질문 12개 · 약 7분
Q01
메시지

Thanks for taking a few minutes to share feedback on your recent medical exam or check-up. Your responses are completely confidential and anonymized. Your honest answers help the clinic improve patient care. This should take about 5 minutes.

Q02
객관식필수

Which best describes the exam or check-up you recently had?

  • Annual physical / general check-up
  • Specialist diagnostic exam (e.g., imaging, cardiac, women's/men's health)
  • Preventive screening (e.g., blood work, cancer screening)
  • Pre-employment or insurance-required exam
  • Follow-up exam for an existing condition
  • Other
Q03
의견 척도필수

How easy was it to schedule this appointment?

척도: 1 – 7
최소:Very difficult최대:Very easy
Q04
평점 척도

How would you rate the friendliness and helpfulness of the front-desk / check-in staff?

범위: 1 – 5
최소:Poor최대:Excellent
Q05
매트릭스필수

Thinking about the exam itself, how much do you agree with each statement?

5개 행 × 5개 열
  • The wait time before being seen was reasonable
  • The exam felt thorough and unrushed
  • The provider explained what they were doing and why
  • The facility felt clean and well-organized
  • My results were explained in a way I understood
열: Strongly disagree · Disagree · Neutral · Agree · Strongly agree
Q06
의견 척도필수

How likely are you to recommend this clinic for a similar exam to a friend or family member?

척도: 0 – 10
최소:Not at all likely최대:Extremely likely
Q07
최선·최악 선택형(MaxDiff)

If the clinic could only improve a few things, which of these matter most to you, and which matter least?

  • Shorter wait times
  • Lower out-of-pocket cost
  • Clearer explanation of results
  • Friendlier staff
  • Cleaner, more comfortable facility
  • Easier online scheduling
  • Faster follow-up after the visit
세트별 최선·최악 선택최선:Matters most최악:Matters least
Q08
AI 인터뷰

Reconstruct exactly what happened when the respondent's results were shared with them: who explained them, what was said, whether they understood next steps, and whether anything was left unclear or worrying. If they gave a low recommend score, probe for the single most negative moment of the visit and what would have fixed it in the moment; if high, probe what specifically stood out as exceptional.

Q09
장문형

Is there anything else about your exam experience — good or bad — you'd like the clinic to know?

Q10
객관식

What is your age range? (optional)

  • Under 25
  • 25-34
  • 35-44
  • 45-54
  • 55-64
  • 65 or older
  • Prefer not to say
Q11
객관식

What is your gender? (optional)

  • Woman
  • Man
  • Non-binary
  • Prefer to self-describe
  • Prefer not to say
Q12
메시지

Thank you for sharing your experience! Your responses will be reviewed by the clinic's patient experience team to improve scheduling, communication, and overall care quality.

포함된 기능

  • AI 후속 질문

    정형화된 설문이 놓치는 세부 내용을, 주관식 답변에 맞춰 AI가 심층 질문으로 끌어냅니다.

  • 주의력 확인 장치

    성의 없는 답변과 저품질 응답자를 걸러내는 내장 안전장치입니다.

  • AI가 작성한 문안

    문구, 질문 순서, 분기 로직까지 AI가 연구 목표에 맞춰 작성합니다.

  • 자동 리포트

    응답이 모이면 주요 주제, 인용문, 이해하기 쉬운 요약이 자동으로 작성됩니다.

다른 서비스와 비교

다른 설문 도구의 가장 유사한 템플릿을 검토했습니다. 그 도구들이 잘하는 점과, 이 템플릿이 한발 더 나아가는 지점을 정리했습니다.

이 템플릿을 선택하는 이유

  • Includes a best-worst (MaxDiff) trade-off question so clinics know which specific improvements (scheduling, wait times, communication, results delivery) to prioritize, rather than a flat satisfaction average.
  • Uses an AI follow-up interview specifically to reconstruct what actually happened when the patient's results were shared — surfacing miscommunication or gaps in explanation that a scale question would miss.
  • Combines a matrix of agreement statements about the exam itself with opinion-scale questions on scheduling ease and likelihood to recommend, giving both structured and open-ended signal in one flow.
  • Closes with an open-ended long-text question and optional demographics, so qualitative detail and benchmarking data are captured without forcing every respondent to answer them.

QuestionPro

Medical Examination Services Survey Template

A ready-to-field static survey template covering patient experience of medical examination services, built on QuestionPro's standard survey engine. It's directly comparable in topic and intent to our template, focused on patient-reported experience rather than clinical documentation. Customization relies on QuestionPro's usual question library rather than adaptive interviewing.

잘하는 점

  • Fielding-ready template purpose-built for medical examination patient experience, not a generic form repurposed for this use case
  • Backed by QuestionPro's broad survey feature set (logic, multiple question types, reporting dashboards)
  • Likely easy to customize and deploy quickly for clinics already familiar with QuestionPro

아쉬운 점

  • Static question set with no adaptive AI follow-up to probe deeper into how results or diagnoses were actually communicated
  • No indication of per-response automated quality scoring to flag low-effort or contradictory answers
  • No published transparent methodology or prompt logic behind how questions are interpreted or scored

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