Using a modified nominal group technique to develop general practice

Abstract

BackgroundThere are few areas of health care where sufficient research-based evidence exists and primary health care is no exception. In the absence of such evidence, the development of assisted support must be based on the opinions and experience of professionals with knowledge of the relevant field. The purpose of this research project is to explore how the nominal group technique can be used to establish consensus by analysing how it supported the development of structured, knowledge-based, electronic health records for preventive child health examinations in Danish general practice.MethodsWe convened an expert panel of five general practitioners with a special interest in the preventive child health examinations. We introduced the panel to the nominal group technique, a well-established, structured, multistep, facilitated, group meeting technique used to generate consensus. The panel used the technique to agree on the key clinical and socioeconomic themes to include in new electronic records for the seven preventive child health examinations in Denmark. The panel met three times over a four-month period between 2013 and 2014 and their meetings lasted between two-and-a-half and five hours.Results1) The structured and stepwise process of the nominal group technique supported our expert panel’s focus as well as their equal opportunities to speak. 2) The method’s flexibility enabled participants to work as a group and in pairs to discuss and refine thematic classifications. 3) Serial meetings supported continual evaluation, critical reflection, and knowledge searches, enabling our panel to produce a template that could be adapted for all seven preventive child health examinations.ConclusionThe nominal group technique proved to be a useful method for reaching consensus by identifying key quality markers for use in daily clinical practice. Our study focused on the development of content and a layout for systematic, knowledge-based, electronic health records. We recommend the method as a suitable working tool for dealing with complex questions in general practice or similar settings, and we present and discuss modifications to the original model.

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“…Using a modi ed NGT analysis approach (31), the data analysis proceeded in four steps(32) Data from each of the nominal groups were individually transcribed and collated per group on Excel™ sheets. Then the multiplegroup data was collated to provide the context and background for understanding the ranked-consensus data (33).…”

Opportunities and challenges to Integrating mental health into HIV programs in a Low- and Middle-Income Country: Insights from the Nigeria Implementation Science Alliance

“…Using a modi ed NGT analysis approach (31), the data analysis proceeded in four steps (32) Data from each of the nominal groups were individually transcribed and collated per group on Excel™ sheets. Then the multiple-group data was collated to provide the context and background for understanding the ranked-consensus data (33).…”

Development of an empathy and clarity rating scale to measure the effect of medical improv on end-of-first-year OCSE performance: a pilot study

“…The narrative comments may challenge current electronic scoring systems for an OSCE; however, narrative feedback can be richer and more meaningful to students, thus providing more direction to those working to improve their communication skills. The melding of CIS [37] domains, CARE [41] measure items, and the rich themes that emerged from the three focus groups provided an innovative framework for assessment of student communication skills that is very patient-centered.…”

“…Scale development included multiple steps: identifying a set of standard content; conducting three focus groups comprised of diverse participants; recording, transcribing and using open coding followed by axial coding of themes; and using modified nominal group [37] process to refine the scale. First, we selected the domains used for the USMLE Step 2 Communication and Interpersonal Skills (CIS) [38] to serve as the framework for development of the scale as the domains are standardized, deemed valuable in the licensing process, and have been selected as useful in other communication models.…”