The review of the items was carried out by means of cognitive interviews, via the ‘concurrent think aloud protocol’ [35] with the aim of identifying problems and difficulties in terms of the intelligibility and comprehensibility of the items, documentation with problems in reply to the items and their ranking within the questionnaire, documentation of interests and awareness of the items, and the documentation of technical problems encountered when completing the questionnaire.

This cognitive test was carried out with dental students, four each from the 2nd, 4th and 10th semesters and took place in the summer semester of 2018. Participation in the study was voluntary. The inclusion criteria were the admission to one of the above-mentioned semesters, a written letter of informed consent and sufficient knowledge of the German language to take part in the interview. After agreeing to participate, a personal interview time slot was arranged with each student. In case of more volunteer students, a randomised selection was carried out per draw. All interviews were carried out by the same member of the working group.

Prior to the interview, a short questionnaire was filled in, with regard to the sociodemographic background, voluntary work or potential prior experience with a personal event that raised ethical questions. Each interview was recorded under standardised headings, such as ‘problems encountered’, ‘disruption during the interviews’ and ‘time required’. The questionnaire and the interview were coded identically for all students. No code list was conducted; therefore, it was not possible to conclude which student was involved in which interview (anonymised).

Each interview was recorded with a digital audio device and the interview was transcribed according to the formulated transcription rules. A qualitative content analysis was conducted, and problems in terms of comprehension and replies to the items were systematically evaluated.

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