Nominal Group Technique
This technique was devised in 1968 by Delbecq and Van de Ven, as a way of enabling groups to generate ideas and reach consensus on issues. The group has a set five stage structured process, which takes participants through a process, which allows all participants to engage as equals and prevents individuals dominating. This technique can be useful in avoiding some of the challenging aspects of the group dynamics of a focus group and can be helpful in mixed groups where hierarchies or status may be an issue.
Five stages of the nominal group technique process
1. Generating ideas - Participants are asked to list all of their ideas on a set topic/issue e.g. what do you think are the most important elements of a crisis service? Participants are usually given a set amount of time to do this (usually 5 minutes). This should be done in silence without discussion between participants, to allow individual ideas to emerge.
2. 'Round robin' - Each participant is asked to read out their first idea in turn. The facilitator lists these on a flip chart. This process is repeated in the round, until all participants have run out of ideas. This should be carried out as a systematic process without further discussion at this stage.
3. Clarification of ideas - Each idea is discussed in turn to ensure everyone has a shared understanding of the meaning and duplicate ideas are discarded.
4. Voting and Ranking - Each participant is given a set number of cards (usually between 5 and 10 dependent on number of ideas generated). Participants are asked to pick from the list on the flipchart the 10 ideas that they view as most important and write 1 idea separately on each card. They are then asked to give the full number of points e.g. 10 points, to the idea they view as most important and 1 point to the idea they view as least important. Once they have recorded this rank on the cards, these are placed aside and 9 points are then allocated to the next most important idea and 2 points to the least. This process is repeated until all the 10 points have been used up.
5. Aggregating scores - The ranked responses of each participant are transferred to the flip chart and thereafter the total number of points for each idea is calculated. This allows the ideas to be ranked according to the groups consensus of their importance.
The technique of rapid appraisal
This can be used to involve the public in the identification of local health needs and can supplement more formal methods of assessing needs:
- it is best used in homogenous communities
- can be modified to focus on the needs of specific groups
- can give a structured orientation to new workers in the community
- can be adapted to introduce medical students to the concept of
- community diagnosis as a natural companion to individual clinical
- diagnosis
Strengths
- Identifies and prioritises community, practice, group, family, individual need
- Identifies areas for research, development and staff training
- Identifies and corrects gaps between needs and service delivery
- Sets targets for health promotion and illness prevention
- Provides evidence with which to justify additional resources
- Provides a method by which public can become involved in decisions
- Informs decision-makers
- Provides information with which to determine the direction of community nursing services
- Provides a method of improving partnerships within and between disciplines, agencies and clients
- Annual compilation and measurement helps to assess and evaluate health interventions
Weaknesses
- Data collection and analysis is time consuming
- Data sources may be difficult to locate, and information may not be reliable
- Profiling may be competing with other types of data gathering within organisations, and its value may be lost
- Social needs may be revealed that cannot be resolved easily
- Strategies resulting from the profile may not be compatible with organisational policies and priorities
- Lack or commissioning support may prevent professionals from changing practice in response to profile results
- Ethical problems associated with gathering of personal data from people who may not benefit from new services
- Loss of confidentiality for participants
- Profiles are often unable to include the consumer perspective which is a challenging task
- As profiling methods vary from place to place, cross-comparison of need is often not possible
Five stages of the NGT technique
1. Individual listing of ideas on paper
2. Display of lists produced
3. Discussion of ideas
4. Voting and ranking
5. Aggregation of scores and summarising
Individual listing of ideas on paper
Each member of the group is given pen and paper.The main question is explained to participants, who
are asked to record their responses in a list.This is done in silence.
Display of the lists produced
The moderator asks each participant in turn for their first idea and records it on a flip chart
This process continues round the group until all ideas are included in the list.
Similar ideas are grouped together. This is a systematic process, without discussion or clarification
Discussion of ideas
Each idea in the list is discussed and clarified so that it means the same to everyone. Duplicated ideas are discarded
Voting and ranking
Each participant is given 7 blank papers and asked to write on them the 7 ideas which they consider most important. The idea which they consider most important is given 7 points, while their least important idea is given 1 point. These papers are put aside.
This step is repeated twice, awarding 6 and 2 points, and then 5 and 3 points. The remaining idea receives 4 points.
Aggregation of individual scores and summarising results
The moderator systematically transfers the ranked responses of each participant on to the flip chart. The total number of points for each idea is calculated.The ideas are then ranked according to the score they received