Ten Common Misunderstandings, Misconceptions, Persistent Myths and Urban Legends About Likert Scales and Likert Response Formats and Their Antidotes‪.‬

INTRODUCTION In the process of reviewing literature related to assessments in medical and health education, we came across a recent article by Jamieson in Medical Education that attempts to outline some of the (alleged) abuses of Likert scales with suggestions of how researchers can overcome some of these methodological pitfalls and limitations(1). However, many of the ideas advanced in the Jamieson article relative to Likert "scales," as well as a great many of articles it cited(2)-(6), are themselves common misunderstandings, misconceptions, conceptual errors, myths and "urban legends" about Likert scales and their characteristics and qualities that have been propagated and perpetuated across decades, for a variety of different reasons, including a lack of first hand familiarity and understanding of primary sources (i.e., Likert's actual writings), and various and definitive primary empirical studies done by Likert and others (see below). In this respect, Jamieson is no different from the dozens of sources over a twenty year period she cites in her article about "Likert scales." Further, this problem is not just confined to the field of medicine and medical education, as the majority of the articles that are the source and propagators of many of the most important errors and misunderstandings currently extant concerning "Likert scales," are from psychology, education and the field of psychometrics in the fifties and early sixties(7-13). These "root of current urban legend" articles, moreover, are additionally more than just "historical curiosities" to anyone who has actually read Likert in the original or constructed and empirically developed a "Likert scale" according to his theoretical model and writings(14),(15). This article, therefore, addresses this important problem and a number of persistent misconceptions, misunderstandings, and factual and empirical errors, myths and untruths about Likert scales and their characteristics and properties with the hope of helping researchers and practitioners understand the various factors, complexities, specifications and sophisticated nuances that must be considered whenever any given measurement scale (or response format) is used, developed, or analyzed. Further, one of the central points in this article for medical and allied health educators and researchers (as well as those in other fields) is that the same level of skill, ability, theory, and rigor that goes into all scientific and biomedical measurements is also required in educational measurements of all types and kinds for the serious educational scholar and researcher, as the principles of scientific measurement are the principles of scientific measurement (and the "heart of science") in virtually all domains(16).