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Nominal Group Technique (NGT): Stages, Benefits, Examples

Home Blog Project Management Nominal Group Technique (NGT): Stages, Benefits, Examples

Nominal Group Technique (NGT) is a problem-solving and decision-making process that can be used in various ways. It involves gathering a group of people to discuss a problem or issue and then rating the ideas or solutions that are put forward. The technique can be used in business, project management, or academic settings, and several stages need to be followed to get the most out of NGT.    

So, how is the Nominal Group Technique (NGT) used? What benefits does it offer? This article will answer these questions and more. First, we'll explore what NGT is and how it works.  To cut down the time and improve the quality, NGT technique should be carried out perfectly by regularly brushing up the skills by going for  Project Management professional course online  and other certifications.    

What is  Nominal Group Technique ?  

The Nominal Group Technique (NGT) is a tool that is used to generate ideas and reach a consensus. The technique was developed in the late 1960s by Andre Delbecq and Andrew Van de Ven and has since been used in various settings, from business to education to government. The basic structure of NGT involves four steps: brainstorming, idea reduction, idea prioritization, and consensus building.  Participants are encouraged to generate as many ideas as possible in the first step without judgment or discussion. In the second step, participants work together to reduce the list of ideas to a manageable number.    

In the third step, each participant ranks the remaining ideas in order of importance. Finally, in the fourth step, the group works together to reach a consensus on the most important ideas. NGT is an effective tool for generating new ideas and reaching an agreement within a group.  However, it is important to note that NGT is not well suited for complex problems that require critical thinking and analysis. Additionally, NGT can be time-consuming, so it is important to consider whether it is the best tool for the task.     

What are the Stages of Nominal Group Technique?

The Nominal Group Technique (NGT) is a structured brainstorming process that encourages all group members to contribute their ideas equally. This decision-making technique can generate ideas, solve problems, or make decisions. There are four stages to the Nominal Group Technique:   

• Brainstorming    
• Voting    
• Discussion    
• Consensus  

How Does Nominal Group Technique Work?

The technique is often used in business settings but can also be applied in other areas, such as education and healthcare. Here's a look at how NGT works and how it can be used to achieve success:  

1. Brainstorming

In the first stage of the NGT, each group member brainstormed independently for a set period (usually 5-10 minutes). During this time, members are encouraged to generate as many ideas as possible without judging or critiquing them.    

Once the brainstorming period is over, each member now ranks their ideas from most to least important. Each idea is then given a score based on its rank; for example, an idea that is ranked first would receive a score of 4 (if there are 4 members in the group), while an idea that is ranked last would receive a score of 1.   

3. Discussion

The next stage is to discuss the ideas that received the highest scores. Members should try to reach a consensus on which ideas are most promising or have the most potential.    

4. Consensus

In the final stage, the group decides how to move forward with the ideas generated during the brainstorming session. This may involve further discussion, refinement of ideas, or development of a plan of action. The NGT is one of the flexible group decision-making techniques that can be adapted to fit the needs of any group; it is an especially useful tool for groups that are trying to generate new ideas or solve complex problems.  

Where is the Nominal Group Technique Used?

• The beauty of the NGT is that it can be adapted to fit any situation where you need to make a decision as a group. Here are just some of the ways it has been used:    
• Businesses:  The NGT can be used when making strategic decisions, such as setting goals or choosing product lines. It can also be used for everyday decisions, such as what new products or services to offer customers.    
• Schools  can use NGT when deciding curriculum, budgeting, and extracurricular activities. Any time there is a need for input from multiple stakeholders, the NGT can be an effective tool.    
• Non-profit Organizations:  Non-profits often need to decide how to allocate their resources. The NGT can help organizations identify their priorities and reach a consensus on how best to use their limited funds. This has led to the rise of  professional courses in Project Management , with organizations looking to make their people adept with PMP abilities.  

When to Use Nominal Group Technique?

The Nominal Group Technique (NGT) is a tool that can be used to generate ideas and reach a consensus. It is particularly helpful when there is a need to explore a complex issue or when there are competing perspectives. NGT can be used with a small group of people or adapted for larger groups. The NGT decision-making technique involves four steps: idea generation, round-robin voting, ranking, and discussion.    

After each step, the NGT group facilitator will summarize the results and see if there is consensus. If not, the group will continue to the next step. NGT is an effective tool for reaching a consensus on complex issues, and it can be adapted to different group sizes and needs.  

Who Should Use Nominal Group Technique?

The Nominal Group Technique can be used in various settings, from the classroom to the boardroom. When used correctly, it can help groups to generate ideas, reach a consensus, and make decisions. However, not every group is well suited to using NGT. In general, small groups (5-10 members), diverse and have a clear purpose, are more likely to benefit from using this technique.    

Additionally, groups that have difficulty generating ideas or reaching consensus may also find NGT to be helpful. If you are unsure whether your NGT group would benefit from using it, it is best to consult an expert. With the help of a skilled facilitator, you can ensure that your group makes the most of this powerful tool.  

How to Use Nominal Group Technique?

The key advantage of NGT is that it allows all group members to contribute their ideas without being influenced by others. This makes it ideal for situations where there is a need to explore many different options or to reach an agreement on a complex issue.     

To use NGT, gather a group of people and give each a pen and paper. Explain that the goal is to generate as many ideas as possible on the given topic. Each person should write down their ideas independently, without discussing them with others.    

Once everyone has finished, the facilitator should collect all ideas and read them aloud. The group should then vote on their favorite ideas, with the most popular ones recorded for further discussion. NGT can generate ideas on almost any topic, making it a valuable tool for individuals and groups.  

Uses for NGT

This  Nominal group technique  can be used in various settings, including businesses, schools, and community organizations. One of the key benefits of the  nominal group technique  is that it encourages all group members to participate in the discussion.  

This technique can also help to identify the group's most popular ideas and any areas of disagreement. Additionally, the  nominal group technique  can prioritize ideas and create action plans. As such, it is an essential tool for any group that wants to work together effectively.  

Nominal Group Technique Steps

The Nominal Group Technique (NGT) is a structured way for a group to generate ideas and reach a consensus. It is particularly useful for groups who may have difficulty reaching an agreement or when you want to ensure that all members have an equal opportunity to contribute. The technique involves six steps:    

• Silent generation of ideas   
• Round-robin recording of ideas,  
• Discussion of similarities and differences  
• Ranking of ideas  
• Group consensus  
• Action planning  

What is the Standard Procedure of Nominal Group Technique?

The basic procedure of nominal group technique steps is here below:

• Silent Generation of Ideas:  Each member of the NGT group writes down their ideas independently, without discussion. It ensures that everyone has a chance to contribute and that the more outspoken members do not dominate the discussion.   
• Round-robin Recording of Ideas:   The moderator collects all of the ideas and reads them out loud, one at a time. This ensures that everyone is aware of all the ideas and allows for clarification if necessary.   
• Discussion of Similarities and Differences:   Once all the ideas have been presented, the group discusses them, looking for similarities and differences. It helps to identify any areas of agreement or disagreement and can help to generate new ideas.   
• Ranking of Ideas:  The group ranks all ideas in order of importance or preference. It helps identify the most popular ideas that may need further discussion.   
• Group Consensus:  The group reaches a consensus on the final ranking of the ideas. This step is important to ensure that everyone agrees with the final decision and that there is no resentment or feeling of being forced to agree.   
• Action Planning:  The NGT group develops an action plan based on the final ranking of ideas. This ensures that the decision made by the group is put into action, and everyone knows their role in implementing it.  

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Effects of Nominal Group Technique

The nominal group technique (NGT) is a facilitation method used to generate ideas and reach a consensus. The process involves a small group of people coming together to discuss a topic, with each person sharing their ideas independently. Once everyone has had a chance to share their thoughts, the group brainstorms possible solutions or courses of action.    

The NGT is an effective way to generate new ideas and achieve consensus because it allows everyone in the group to have their say without the pressure of coming up with an idea on the spot.    

Additionally, the independent sharing of ideas helps prevent the group's dominant voices from overwhelming the conversation. However, it is important to note that the NGT is inappropriate for all situations. For example, if time is limited or there are already strongly-held opinions in the group, another facilitation method may be more effective.  

NGT Advantages and Disadvantages

Ngt advantages.

This NGT process is particularly useful when many stakeholders have diverse opinions or when the topic is sensitive and people are reluctant to share their views publicly. Some of the main nominal group technique advantages are that it is:   

• Flexible and can be adapted to different situations   
• Provides a level playing field for all participants   
• Encourages everyone to contribute their ideas   
• It is quick and efficient compared to other methods, such as brainstorming   
• It can be used in both face-to-face and virtual meetings   

If you are considering using NGT in your next meeting or facilitation sessions, keep in mind that it is important to have a clear objective and focus for the group and to give participants enough time to generate and discuss their ideas. With careful planning and facilitation, NGT can be a powerful tool for generating new ideas and reaching consensus.  

NGT Disadvantages

Although the nominal group technique is a highly effective decision-making tool, it does have a few potential disadvantages.   

• First, because NGT relies on written responses, it may not be suitable for all types of problems or all groups of people.   
• Second, generating and ranking ideas can be time-consuming, which may not be ideal in all situations.    
• Finally, NGT can sometimes result in fewer ideas than other brainstorming methods. Despite these potential drawbacks, NGT can be an effective way to generate ideas and reach consensus when used in the right context.  

Nominal Group Technique Examples

1. product development.

The product development process is full of important decision points, from deciding which features to include in a new product to deciding on a go-to-market strategy. The nominal group technique can be used at each stage of the product development process to ensure that all stakeholders have a say in the decisions. For example, NGT can gather input from engineers, designers, marketers, and salespeople on what features should be included in a new product.    

2. Customer Service Improvement 

Generating ideas for improving customer service can be challenging, especially if your team is stuck in a rut. The nominal group decision-making technique jumpstarts the brainstorming process by soliciting input from customer service reps, managers, and customers. Once you've collected a list of ideas, you can use NGT again to prioritize which ideas are worth pursuing.    

3. Marketing Campaign Planning 

From choosing the right mix of channels to determining your budget allocation, many important decisions are needed when planning a marketing campaign. The nominal group technique helps you make these decisions by gathering input from your marketing team and other stakeholders, such as salespeople and finance professionals.    

4. Human Resources Strategy Development

Human resources strategies must align with the overall business strategy to be effective. The nominal group technique in project management assists you in developing an HR strategy that meets the needs of your business by soliciting input from employees, managers, and executives. This input can be used to develop an HR strategy that meets the needs of your business while also being achievable and realistic.    

To have a detailed insight into the NGT process and its applications, you must have the expertise to align with the trends of the changing market landscape.

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The Nominal Group Technique is an extremely beneficial tool that can be used in various ways to improve communication and decision-making. By understanding the different stages of the technique, as well as the benefits and examples associated with it, you, too, can start using NGT in your work. Take  KnowledgeHut Project Management professional course online  and get acquainted with the latest concepts and strategies on Nominal Group techniques in project management.

Frequently Asked Questions (FAQs)

1. what are nominal group technique examples.

The Nominal Group Technique (NGT) is a process that allows a group of people to generate ideas and reach consensus on a particular issue. The technique is often used in business settings, as it can help to promote creativity and collaboration among employees. Some common examples of NGT include Product Development, Customer Service Improvement,  Marketing Campaign Planning, Human Resources Strategy Development, etc.  

2. Where is the Nominal Group Technique used?

The  Nominal Group Technique  is a tool used to help groups generate ideas and reach a consensus. It is often used in business meetings, classrooms, and research groups. The technique involves asking participants to brainstorm ideas independently and then share them with the group. Once all ideas have been shared, the group votes on the best ones. The Nominal Group Technique is an effective way to generate many ideas and reach a consensus within a group.  

3. What are the four stages of the Nominal Group Technique?

There are four stages to the  Nominal Group Technique :  

• Brainstorming   
• Voting   
• Discussion   

4. What is the difference between Nominal Group Technique and Brainstorming?

When we talk about  nominal group technique Vs brainstorming  , both are methods of generating ideas, but they differ in how those ideas are generated and organized. NGT is a structured process in which a group of people anonymously generate ideas, which are then compiled and votes are cast to prioritize the ideas.   

On the other hand, brainstorming is a more free-flowing process in which ideas are generated spontaneously and then discussed and refined as a group. While NGT can be more efficient at generating many ideas, brainstorming may be better at producing creative or unexpected solutions.  

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Nominal Group Technique Explained with Examples

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Do you ever look at your list of ideas and wish there was a way to pick the best one? There is, and it’s called the nominal group technique (NGT). NGTs divide respondents into small groups and ask each which option they prefer in a series. From this collective judgement, it’s possible to work out which option is most preferred before individual opinions are known.

Nominal group techniques can be a very useful way of improving concepts, increasing innovation and providing other benefits. They can also be seen as training wheels for managing innovation. They are particularly useful when your groups are homogeneous.

What is Nominal Group Technique

Nominal group technique refers to an organized method in which a group uses to listen to each member’s views and ensure swift agreement on crucial issues, challenges, or solutions. The team members usually note down their opinions and settle on the idea that best fits the problem.

Each team member has enough time to write their ideas, and once everyone is ready, the team leader gives them the chance to share their best ideas. The group members air out their views and settle on the one they value using a point system.

Who Should Use the Nominal Group Technique?

Nominal group technique is appropriate for:

• Group members who tend to be more vocal than the other
• Group members who value silence
• Group members who fail to participate in decision making
• Groups which don’t come up with quality ideas
• A team in which new members have joined them
• Team members who have conflict in the decision-making process

Steps to Conduct Nominal Group Technique

To facilitate a nominal group technique, each group member must have a pen, flipchart, tape, pencil, and marking pens. Below are the crucial steps to perform a nominal group technique:

• The Group leader highlights the issue, question, or challenge in question and ensures everyone is familiar with it.
• Each group member has quality time to silently ponder the ideas and solutions that pop in their minds while thinking of the problem. They then are allocated 5 to 10 mins to write down their thoughts.
• All discussions are forbidden.
• The proposed ideas aren’t supposed to come from the group members’ written lists. A lot of ideas don’t appear on the original plan as time passes.
• Members are allowed to skip their allocated turns and may give their thoughts on a subsequent turn.
• The discussion continues until all members agree on the ideas mentioned or reach the time they had allocated for the debate.
• The member engages in a discussion over each member’s idea. During this process, they may alter a member’s opinion upon approval from the member. Only repeated statements are left out. The members may group ideas into categories, and the discussion solves and clearly outline the analysis or logistics. It also solves disagreements and answers members’ questions.

An example is the nominal group technique a travel agency system. Below are the results from the three team members who assigned user requirements based on the estimated work involved.

Advantages of Nominal Group Technique

• Diversity in opinions

A team comprises many members, and each member has their views and opinions regarding the issue in discussion. Every person’s idea may be unique and add impact to an organization compared to individual decision making. The statements offer more effective alternatives that result in successful decisions.

• Participation and interests of members

Nominal group technique encourages each member to participate in decision making, and each idea is appreciated. Active participation may make the members more interested and dedicate all their efforts to giving ideas that would add value to their company.

• Positive and understanding members

All members have to be familiar with and understand the matter at hand because their decisions will be highly accountable and benefit the group. Appreciation of each member’s ideas motivates the group members to give quality decisions that facilitate the success of an organization.

• The collective contribution of ideas

The nominal group technique removes the concept of monopoly in decision-making. Collective decision-making works in favor of all group members compared to individual decision-making, which may only work in an individual’s favor.

• Team building

Every member’s decision is valued. The involvement motivates all the group members to actively participate in decision-making, elevating their morale and creating coordinative and healthy relationships. Participation helps the members to acquire skills in the decision-making process, which adds value to the group and the group members.

• Democratic decision making

The nominal group technique allows each member to air their views on the situation at hand. The freedom of expression builds trusts between the members since they have the privilege to express their opinions and removes disagreements and conflicts between group members, hence the organization’s success.

• Plentiful information

Every member may have a different view on the solution of a problem. The ideas create excellent information for the group and help the members think according to each concept and develop the solution. Thus, easy decision-making compared to individual decision-making, where one may have limited views.

• Expert opinions

Every member usually has a unique opinion concerning the matter in discussion. Some ideas may be similar, and the group members may combine them and develop an expert opinion that may solve their problem. Some members may also have excellent ideas since they may be experts in the area in question.

• Voting System

All the member’s ideas are voted upon to decide on the decision that favors all the group members. The concept which gets more vote is given priority and becomes the final decision. Voting helps to reduce biasness in the organization and ensures every member is comfortable with the decision made.

Disadvantages of Nominal Group Technique

• Consumption of time

The larger the size of the group, the larger the time consumed in decision-making. Every member’s opinion accounts and some members may have a wide range of ideas, which may consume a lot of time in trying to vote for the best idea.

• Different ideas and opinions  

In nominal group technique, each member comes up with the idea that favors their interest. The decisions cause conflicts among the members, which is unhealthy. Which, in turn, reduces the efficiency and quality in deciding which decision the group should adopt.

• Social pressure

Some team members may choose to remain silent during the decision-making process due to the environment’s pressure. Social anxiety may significantly affect a group member’s mindset. After that, change in their behavior which may affects the decision-making process.

• Giving some ideas more priority over the others

Group members may emphasize specific ideas and not develop other statements, which may even be more beneficial. The preference restricts the members’ choices and makes them stick to the few ideas that may not significantly impact the company.

• Uncertainty in the risk-bearing factor

The risk-bearing factor will always come up when the decision-making process involves the group as a whole. The group may tend to settle towards more risk or less risk in favor of the group. The moment they decide for higher risk; they tend to get greater rewards after fulfilling all the objectives. However, the group members need to take certain risks to ensure the success of the organization.

• Preceding some important decisions

During the decision-making process, the group members may give some decisions higher priority over the others. After that, put more effort into the high priority decisions and forego the low priority decision. In this process, they may end up forgetting important choices which are of more value.

• Rushed decision making

Group members may hurriedly make decisions in a situation where the decision is needed very fast. The rush may lead them to make poor decisions that may incur consequences in the future. The effects may be fatal that can result in destroying the organization.

• The leader denies responsibility .

The group members usually appoint leaders who they think are responsible enough to handle the group members. In a scenario where a decision is needed urgently, the group leader may appoint some committee members to provide help without discussing it with the members. The findings may result in consequences that may affect all the group members as a whole.

• Overuse of authority

The nominal group technique mainly involves considering all the group members’ ideas to ensure unity and achieve the group’s goals. However, some members may misuse the authority and rule over the group with their opinions. Misuse of power may cause some members to keep their distance from the group decision-making process, thus demeaning the group’s concept.

• Highly expensive

All the team members have to gather in one place and contribute effectively to the discussion. The process involves using money, energy, and time which can be expensive, especially when the decision-making process takes place within a short period.

Examples of Nominal Group Technique

A director in charge of project management, trying to improve their organization’s performance, meets with all the staff members and states the meeting’s agenda to ensure all the members understand what they must do to achieve their objectives.

They all agree on a problem statement of ‘Which methods to put in place to ensure their organization’s success.’ The director then gives all the members six cards each to write on their best ideas that offer a solution to the problem. Each view on each card and gives them one day to come up with their ideas.

In the next meeting, the director had written the problem statement from the previous discussion on a blackboard. He then confirms that everyone had reported the problem solution on their cards. He illustrated the technique he was going to imply and answered the questions posed by the members.

He took all the cards from the members, shuffled them, then reread them out one after the other, ensuring everyone understood what was on each card. He helped rewrite some statements and put them down on the flipchart, writing a capital letter against each one.

The team members had the opportunity to add new ideas to the cards. They then voted with five votes each, ranging from five points down to one end. They put down the name of an excellent idea on ballot slips that had the point values printed on them. They handed them to the director, who summed them up and noted the final score against the right ideas.

Six ideas emerged with high scores. However, none of the ideas scored more than the others. They had to conduct a second ballot to separate this group. And the second round, one thought came to the top, which they settled on as the final idea.

The nominal group technique’s primary purpose is to ensure every member participates in the decision-making process. Small groups can apply the nominal group technique to establish the consensus on identifying main problems in developing solutions that they can test by use of rapid change cycles.

The nominal group technique is a very reliable tool as it provides all the group members with an equal opportunity to express their ideas. Thus, it stimulates excellent performance of the organization and healthy relationships between the members.

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Understanding and applying the nominal group technique (NGT)

On a typical workday, you log into your work laptop and look at your calendar. Sure enough, tons of meetings are on your schedule. No matter what role you are in an organization, meetings are an inevitable part of your work.

Product managers play multiple hats at work. One of the tasks we do is facilitate meetings. Everyone appreciates an effective, efficient meeting, and the nominal group technique (NGT) can help you do this.

What is the nominal group technique (NGT)?

The nominal group technique (NGT) is a structured decision-making method used in group settings. Teams can generate ideas, prioritize them, and make collective decisions with NGT.

This technique is particularly useful when a group needs to reach a consensus or make a decision about a specific problem.

5 steps to nominal group technique (NGT)

So how does NGT work? The five main steps are:

Step 1: Introduction

Step 2: silent idea generation, step 3: idea sharing, step 4: group discussion, step 5: voting.

At the beginning of a group meeting, the meeting facilitator states the objective of the meeting and explains the decision-making method used in this meeting — the nominal group technique.

Give a brief introduction to NGT to the group members. Go through the steps and lay out the key activities you are going to do so that the members can have a general idea.

This step may take 5-10 minutes.

Group members brainstorm ideas — the potential solutions to the problem they agreed upon in the previous step — individually.

In this stage, the group members are asked not to discuss with others. We want to ensure that all participants have an equal opportunity to contribute without being influenced by other opinions or ideas.

This step may take 10 minutes.

In this step, every group member shares the ideas they generated in a round-robin fashion. The facilitator records these ideas on a whiteboard (or any collaboration platform the company is using). In this idea-sharing process, the facilitator can group similar or duplicated ideas together.

Note that we don’t judge or debate these ideas at this step. We want to ensure everyone has the same opportunity to speak.

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This step may take 15–30 minutes.

After all ideas have been shared, group members discuss to clarify any unclear points or seek additional information. In this step, we discuss for clarification and not for judgment. The facilitator helps avoid criticism and ensures the group doesn’t spend too much time on a single idea.

This step may take 30–45 minutes.

Finally, in the last step, group members vote on the presented ideas. There isn’t a best way to vote or rank, and the key to this step is that it should be conducted in private.

One common approach is to provide each individual with a certain number of votes or points. They can distribute the votes/points among the ideas based on their preference. This helps with prioritization and identification of the most popular or preferred ideas.

Once the voting process is done, the result should be announced to the participants immediately. The voting result also means the meeting reaches a conclusion.

This step may take 5–10 minutes.

What are the benefits of the nominal group technique?

NGT is a structured approach that helps prevent dominance by certain individuals, encourages diverse perspectives, and leads to more informed decisions. Its main benefits include its emphasis on equal participation, its prevention of groupthink, and its ability to arrive at an objective consensus.

Let’s go into more detail about these below:

Encourages equal participation

NGT fosters an environment that allows all participants to have an equal opportunity to contribute their ideas. This is especially beneficial for introverted or less vocal individuals who might be overshadowed in traditional group discussions.

Moreover, equal participation also means that diverse perspectives can be seen. This can lead to more well-rounded solutions.

Prevents groupthink

Groupthink is a psychological phenomenon where group members tend to conform to a dominant viewpoint without critical evaluation to avoid conflicts. The silent idea generation step and voting step help reduce the influence of group dynamics.

Arrives at an objective consensus

The voting process facilitates an objective way to prioritize ideas. This can help identify the most preferred ideas or solutions based on the collective preferences of the group.

The disadvantages of the nominal group technique

NGT can be very effective in certain situations. However, it might not be suitable for every decision-making scenario and requires careful consideration:

It only solves one problem at a time

As you may already notice, NGT is structured to focus on one topic at a time. There are two sides to every coin. Dealing with only one problem at a time helps teams focus but the lack of flexibility can also be a major disadvantage to some teams.

It’s time-consuming

NGT involves steps of idea generation, sharing, and voting. Though each step should be timed, the processes can still lead to long meetings. The whole process typically can take 60 to 90 minutes.

There’s limited spontaneous collaboration

The silent idea generation, on the one hand, fosters equal participation. On the other hand, it may limit spontaneous collaboration among participants on the other side. The lack of real-time interaction can restrict some creative ideas that emerge from dynamic discussions.

It adds complexity for large groups

The ideal group size is around 5–10 individuals. While a larger group can generate more ideas, it can take too long to go through the NGT steps of idea generation, sharing, and voting.

If NGT has to be implemented in the larger group, consider dividing the group into smaller sub-groups to proceed. The smaller groups can bring their top five ideas to the larger groups for further discussion and voting.

When should we use NGT?

Now that we’ve learned the advantages and disadvantages of NGT, let’s further discuss when and in what scenario to use this technique:

When some individuals are more vocal than others

There can be multiple reasons that cause some people to be more vocal than others. For instance, some are more introverted than others, or there’s a power imbalance between members. Regardless, NGT is structured to level out the playing field for diverse group members.

When some individuals are new to the team

As a new member, sharing ideas with a group of new faces can be daunting. NGT creates a safe space for all participants, including the newbie, to contribute. NGT has a significant advantage in ensuring equal participation.

When the topic is controversial

One trait of NGT is “no criticism.” When the topic is controversial or the conversations are heated, individuals may tend to conform to the major voice of the room so that conflicts can be avoided. The anonymous voting step in NGT helps teams to reach a rational and objective conclusion.

Tips for facilitating a meeting with NGT

Before we wrap up, let me share some tips and best practices for facilitating a meeting using the nominal group technique.

Have a clear objective

At the beginning of the meeting, declare the objective of the meeting and the problem the group is going to discuss and solve in this meeting. We want to ensure we have an agreement here to avoid unnecessary inefficiency and potential scope creep.

Keep it simple

The process of NGT is simple and intuitive. Let’s keep it simple as it is. Only when the participants understand where they are in the process of the meeting can they follow through and provide their thoughts and knowledge.

Foster a safe space

NGT provides a structure that helps everyone have a voice in the meeting. The meeting facilitator should strive to provide a feeling of equality among members. This should be done and is easier to do at the beginning of the meeting rather than at the middle or end.

Visualize the discussions

In group meetings, people often get lost in the processes. While you are hosting a meeting, recording the ideas and discussion with some simple graphs or diagrams or simply just writing them down on the screen or whiteboard can be helpful. There are also tons of collaboration platforms to help you visualize your meeting on the screen.

Ultimately, we won’t agree 100 percent of the time, but it is still valuable that group members can feel valued and respected when they are involved in the decision-making process.

The nominal group technique finds a nice balance of group collaboration and individual creativity. It allows all kinds of ideas and perspectives and aims for a genuine consensus.

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How to use the nominal group technique to reach consensus as a team

When trying to reach a group consensus on your team, you might struggle to take everyone’s opinions into account. Some people might even miss the opportunity to share their opinions at all if they’re overshadowed by outspoken members of the group.

Fortunately, there is a way to make this process easier to manage and more efficient: the nominal group technique.

If you’re looking for a way to help your team with the decision-making process , the nominal group technique could be exactly what you need. It helps teams make fast and informed decisions, taking everyone’s opinion into account.

In this article, we’ll take a look at what the nominal group technique is and how it can help you create informed and fast decisions.

• What is the nominal group technique?

The nominal group technique (NGT) helps teams identify problems and create solutions as a group. It streamlines the decision-making process and identifies solutions as quickly and efficiently as possible.

Although the technique is similar to brainstorming , it’s not the same thing. Unlike a brainstorming session, the NGT has a key focus on making sure every group member contributes to the solution. As a result, you have a well-informed solution that takes everyone’s perspective into account.

The structure of the NGT typically has five stages:

Here’s how it works:

• Introduction: The group facilitator explains the purpose of the meeting and the items for discussion.
• Idea generation: Sometimes known as ‘silent generation,’ group members formulate their ideas alone before the group idea discussion.
• Sharing ideas: Every member of the group gives their view of the solution and a short explanation.
• Group discussion: This stage involves a back-and-forth debate about items that have been shared. Project team members discuss their perspectives and ideas in relation to the problem.
• Voting: Duplicate solutions are now eliminated from the list before the ranking process begins. Members in the group rank the solutions 1st, 2nd, 3rd, etc.

There are some variations of this process. For example, the solutions don’t always have to be ranked but could be evaluated more subjectively. The right option depends on the group you’re working with and the reason behind why you’re using the technique in the first place.

Ultimately, it’s up to the group facilitator to identify the best way to manage the process.

• What are the benefits of using the nominal group technique?

On top of speeding up the decision-making process, are there any other benefits of using the NGT?

In short, yes.

Let’s take a look at what they are.

Encourage naturally shy team members to speak up

For some people, speaking on the spot in front of a group of people can be daunting. They might even struggle to fully formulate ideas if they feel under pressure. Instead of voicing their opinion, they keep it to themselves.

Unfortunately for you, this means you might miss out on a potentially great idea.

This is where the nominal group technique can be helpful.

Everyone has a chance to speak their mind without worrying about being put on the spot. They have time to develop detailed and thoughtful responses, and there’s no pressure to respond immediately (which some team members will be grateful for).

There might be some people who want to speak more than others, but everyone will have a chance to think about a solution and present their perspective in a comfortable environment.

Consider different perspectives

Everyone approaches problems from a different standpoint. Even if ideas are similar, there are often small differences in the ways people approach a problem.

Because the nominal group technique requires equal participation from all team members, you can incorporate all the different perspectives into your solution. With a variety of ideas in the melting pot, you’ve got a better chance of creating the best possible solution.

Taking everyone’s ideas into account also shows team members that their opinions and voices are valid. Everyone has a chance to have their say and work as a group to decide on the best course of action.

Increase productivity in other areas of the business

We already know that the NGT is an efficient way to make fast, informed decisions. Everything happens in one location in a short space of time.

Now we want you to think about the effect this has on the rest of the business.

Making one process more efficient frees up time for team members to focus on other tasks.

Let’s say that by using the nominal group technique, each team member saves themselves three hours that day. Those three hours can then be put to use elsewhere, allowing them to maximize their time and be more productive in other areas.

By using the NGT and streamlining the decision-making process, you’re also helping the business grow and develop quicker. It’s a win-win.

• Are there any disadvantages of the nominal group technique?

Although there are clear advantages of using the NGT, there are some downsides to be aware of. Let’s take a look at what they are.

Only able to address one problem at a time

Because of the NGT structure, you can only address individual issues before moving on to the next. It’s pretty rigid in its format, and there’s no room for spontaneity in the process.

So if you need something with a little more flexibility, this might not be the right option.

But despite the lack of flexibility to discuss multiple problems at once, you are likely to get through individual problems faster with the NGT framework. Even if you have multiple issues to solve, chances are you’d power through them faster with the NGT in comparison with a typical brainstorming session.

Requires all members to be available at the same time

To conduct an NGT session, everyone in the group must be available at the same time. But we know that finding a time when everyone is available is easier said than done — especially if you’re working in a remote team or across different time zones.

If you can’t round up your team to discuss the issues at the same time, you won’t be able to use the NGT.

An NGT session doesn’t necessarily need to be in person, though. With the use of online collaborative tools , you can still run the session virtually.

This means you don’t have to worry about roping everyone into the office to run the session. So long as everyone working remotely is available at the same time, you can do it online with a video chat .

Time-consuming for group leaders and team members

Although NGT sessions are an efficient way to make fast decisions, they can take up a lot of time.

Think about it. Instead of spreading the discussion across multiple timeframes, you discuss everything in one go. Sure, it’s a fast way to overcome problem-solving in the long run. But it takes large chunks of time out of the working day — particularly if you’re running multiple sessions back-to-back.

Not to mention the amount of time required beforehand for the group leader to prepare the session. The entire process must be carefully planned to make sure everything runs smoothly and that you get to a solution as efficiently as possible.

If your team members don’t have large chunks of time available, the NGT might not be the most effective method to make a fast decision.

• When should you use the nominal group technique?

Typically speaking, there are three main consensus methods:

• Nominal group technique
• Consensus development panels
• Delphi technique

So how do you know if and when the nominal group technique is right for your project team?

Let’s take a look.

Certain group members are more vocal than others

If you have a few team members that are particularly outspoken and vocal in group settings, the NGT can be helpful.

Because it encourages every team member to take part and voice their opinion.

With the NGT, you create a level playing field. You won’t have a few members dominating the discussion because everyone has a chance to say their part. Everyone in the group should feel more open to contributing because they’ll have the time to talk through their ideas.

Simply put, it prevents dominant members from taking the floor for too long and provides space for all participants to have their say.

Some group members need time to think things through

As we’ve already mentioned, some employees don’t perform well on the spot. They prefer to think before providing an answer.

Fortunately for these employees, the nominal group technique allows them to think things through.

During the generation of ideas phase, team members have a chance to think and reflect on their ideas before presenting them to the group. It takes away the pressure of responding on the spot, helping employees feel more confident in their communication.

So if you have some employees that prefer to think things through before making suggestions, use the NGT. It creates a comfortable and inclusive environment for sharing ideas without the pressure of sharing ideas on the spot.

The team is struggling to find a solution on their own

If your team has been working on a problem for a while and they’re not coming to a solution on their own, it might be time to use the nominal group technique.

Let’s say there’s been an issue with one of your internal processes. It’s been an issue for some time, and it’s causing problems in the efficiency of your workflow . Different employees have suggested possible solutions, but nothing has hit the mark.

Enter: the nominal group technique.

By using the NGT, your team works together to create a viable solution for your long-standing problem.

Instead of suggesting solutions separately, the NGT brings everyone together to collaborate and focus on the best solution for the problem. As they say, two (or more) heads are better than one.

There’s a new member in the team

It’s always a little nerve-wracking being a new employee. You’re trying to impress your team, make a good impression, and do your job well.

The day comes when you’re asked to join your first team meeting. You’re a little apprehensive and not 100% sure what to expect. Before you know it, you’re being asked to share your ideas on the spot with your new team.

It sounds pretty overwhelming, right?

That’s because it is.

If you have a new employee join your team, you might want to think about ways to relieve some pressure. Focus on creating an inclusive and collaborative environment for them to be a part of so they’ll be confident sharing their ideas with the team.

The nominal group technique is a great way to do exactly that.

Yes, they’ll still have to contribute in the team setting, but they’ll have time to think their ideas through before sharing. It allows them to discuss their opinions in a safe space and work with their team to create a solution, making them feel more comfortable in a new setting.

• Using a collaborative platform to facilitate the nominal group technique

When it comes to hosting a nominal group technique session, you might want to consider using a collaborative platform like Miro.

With the right software, you can host your NGT session virtually, discuss ideas, and make notes throughout the entire process. Think of it like a virtual flip chart that you can customize to your heart’s content.

And when everything’s wrapped up, you can share the information with relevant parties — including external stakeholders.

Let’s take a look at how a collaborative platform can help you facilitate an NGT session in more detail.

Prepare your session in advance

Preparing NGT sessions can be a pretty time-consuming process. But with the right platform, it’s much easier to get everything up to scratch before the session takes place.

Take a look at Miro as an example. With our intuitive whiteboard , you can use an existing template , customize the layout , and upload files to create a plan that’s perfect for your needs.

And once you’ve created a template that works well, you can save it to use again in the future.

Record the outcome in an accessible location

With a collaborative platform, group members can see the NGT notes in real-time. When the session is over, you can also share the information with your team so that they can reflect on what happened. Everyone will have access to the outcome when the session is done.

This is particularly helpful if you’re working as part of a distributed team. It’s easy for remote workers to access the information when they need it.

Share the information with stakeholders

In addition to sharing internally, an online platform also allows you to share information with key stakeholders.

With Miro, for example, teams can invite external visitors to view and edit their online whiteboards. You can choose their level of access (view, comment, or edit access) based on your subscription plan.

The visitor doesn’t need an account with Miro to access and edit the board. They simply join via the link you’ve created, and it’s like they’re part of the team.

Start planning for an NGT session today

By now, you’ve got a pretty good understanding of what the nominal group technique is and how to use it.

Are you thinking about using the nominal group technique in your business? Sign up to Miro to start planning and preparing for the session.

And when everything’s wrapped up, you can store all the information in one of our intuitive and visual online whiteboards. Everyone involved in the project will have access, and you can share it externally with any key stakeholders.

Discover more techniques for group decision-making

Explore our decision-making templates, miro is your team's visual platform to connect, collaborate, and create — together..

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Level the Playing Field with the Nominal Group Technique

Updated: March 27, 2023 by iSixSigma Staff

While there are many group methods for solving an issue or reaching a goal , the nominal group technique differs in a few key ways. Let’s look at what the nominal group technique is and what makes it unique.

What is the nominal group technique?

Like other group problem-solving methods, the nominal group technique involves utilizing a group to make decisions, solve problems, and generate solutions. The difference with this technique is that, with this method, every member of the group shares their view of the situation. From here, any duplicate solutions are eliminated, and what is left is ranked in order of preference by vote. The most favored solution is then decided as the decision to run with.

There is an alternative version of this method that focuses on hybridization, in that, various solutions combine to create hybrids. This way, a sort of super-solution can be created that uses the most favorable aspects of the solutions proposed.

3 benefits of the nominal group technique

There are some clear benefits to utilizing the nominal group technique over other group participation methods which should not be overlooked:

1. Efficiency

This technique can be an ideal way to gather everyone’s ideas quickly and come to a consensus.

2. Better ideas

Since this technique is so collaborative and democratic, better ideas might be heard than in other group technique options.

3. Equal participation

This technique, in its design, fosters the equal participation of all members of the group.

Why is the nominal group technique important to understand?

Understanding how the nominal technique works can be useful in the workplace for the following reasons:

It is useful if you find some group members tend to dominate.

If you have had experiences where a few group members have dominated the proceedings, leaving little room for others, this group technique is worth understanding as an alternative.

This technique is a great introduction for new team members.

Understanding how to implement the nominal group technique gives you a tool to get a feel for new team members as it encourages their equal participation and input.

Power imbalance

If there is a dynamic in the workplace where some key individuals hold the bulk of the power, the nominal group technique can act as a great leveler.

An industry example of the nominal group technique

A toy company is having difficulty deciding what product would be best to lead with for the upcoming year. A group meeting is called, where the nominal group technique will be utilized. Ten members from throughout the company are chosen to be part of the group.

At the beginning of the meeting, a team leader introduces each member of the team. Each participant is given a sheet of paper and is asked to list all of their ideas about which product would be best. Once everyone has written down their ideas, each participant is asked to share them with the group. Once everyone has shared, a group discussion takes shape where all of the ideas are discussed. Finally, voting and ranking of the ideas take place. It is ultimately decided to release the top three choices at the beginning of the new year.

5 best practices when thinking about the nominal group technique

Each stage of the nominal group technique has at least one practice to consider that will likely contribute to a more successful meeting:

1. Maintain a feeling of equality in the introduction phase

Foster a feeling of equal footing early on in the process by not putting any emphasis on any member of the group during the introduction phase of the meeting. Briefly introduce everyone in a manner that has them on the same footing and explain the process and procedure.

2. Independent generation of ideas

During the next phase, when each participant is to be writing down their ideas, be sure to make sure this happens in silence without collaboration.

3. Avoid debate as ideas are being shared

At the next stage, when participants go around the table sharing their ideas, there will possibly be an inclination for some members to begin to debate the merits of different ideas. Preemptively avoid this by making sure that everyone understands what the rules are for the exercise.

4. Do not spend too long on a single idea

During the group discussion, there could be the temptation to spend a lot of time on a single solution. This should be avoided. By allowing any one idea to take a longer amount of time in the spotlight, the voting process could be influenced.

5. Share the results immediately

When the voting is done, share the results immediately so that it feels like there is a swift feeling of closure to the process .

Frequently Asked Questions (FAQ) about the nominal group technique

What is the difference between the nominal group technique and brainstorming.

The tallying and equal participation in the nominal group technique separate it from brainstorming.

How many people participate in the nominal group technique?

The technique works best with 5 to 10 participants, but it works well with large groups as well.

Is the nominal group technique anonymous?

This technique is definitely not anonymous during the sharing of ideas portion of the group discussion. The ranking itself is anonymous.

The nominal group technique democratizes your group problem-solving sessions

If you have tried other group problem-solving techniques and found that they left a lot of room for improvement, the nominal group technique has many built-in attributes that could make for a more satisfactory process.

About the Author

iSixSigma Staff

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How to use the nominal group and Delphi techniques

Sara s. mcmillan.

School of Pharmacy, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Gold Coast, QLD Australia

Michelle King

Mary p. tully.

Manchester Pharmacy School, University of Manchester, Oxford Road, Manchester, UK

Manchester Academic Health Sciences Centre, Oxford Road, Manchester, UK

Introduction The Nominal Group Technique (NGT) and Delphi Technique are consensus methods used in research that is directed at problem-solving, idea-generation, or determining priorities. While consensus methods are commonly used in health services literature, few studies in pharmacy practice use these methods. This paper provides an overview of the NGT and Delphi technique, including the steps involved and the types of research questions best suited to each method, with examples from the pharmacy literature. Methodology The NGT entails face-to-face discussion in small groups, and provides a prompt result for researchers. The classic NGT involves four key stages: silent generation, round robin, clarification and voting (ranking). Variations have occurred in relation to generating ideas, and how ‘consensus’ is obtained from participants. The Delphi technique uses a multistage self-completed questionnaire with individual feedback, to determine consensus from a larger group of ‘experts.’ Questionnaires have been mailed, or more recently, e-mailed to participants. When to use The NGT has been used to explore consumer and stakeholder views, while the Delphi technique is commonly used to develop guidelines with health professionals. Method choice is influenced by various factors, including the research question, the perception of consensus required, and associated practicalities such as time and geography. Limitations The NGT requires participants to personally attend a meeting. This may prove difficult to organise and geography may limit attendance. The Delphi technique can take weeks or months to conclude, especially if multiple rounds are required, and may be complex for lay people to complete.

Introduction

The Nominal Group Technique (NGT) and the Delphi Technique are commonly referred to as consensus methods [ 1 ]. They aim to achieve a general agreement or convergence of opinion around a particular topic. Consensus methods are used in research that is directed at problem-solving, idea-generation, or determining priorities [ 2 ]. How consensus is defined and operationalised will vary from study to study, depending on the research objectives [ 3 ].

Consensus techniques such as the NGT and Delphi Technique are superficially similar to focus groups, a commonly used method in pharmacy practice research. All methods involve interaction within a group of participants, yet they can provide different outcomes. Focus groups are useful for investigating an issue in-depth, including the identification of problems, questions or significant issues. Consensus methods, however, raise potential solutions or answers to a question, which can then be prioritised or agreed upon. A key strength of consensus methods is the balanced participation from group members, unlike a focus group, whereby the facilitator must control for, and minimise the risk of, a dominant participant influencing the discussion. The structured format of consensus methods avoids this issue.

The aim of this paper is to provide an overview of the NGT and Delphi technique, including the steps involved and the types of research questions best suited to each method, with examples from the pharmacy literature. Therefore, it provides a useful starting point for pharmacy practice researchers new to consensus methods. Initially it describes how to conduct the NGT and Delphi Technique and provides examples of their use within the pharmacy context. Then, it considers the choice of experts for the panels and which types of research questions are best suited to which method.

Nominal group technique

The NGT is a highly structured face-to-face group interaction, which empowers participants by providing an opportunity to have their voices heard and opinions considered by other members [ 4 ]. It was designed by Delbecq and Van de Ven and comprises four key stages: silent generation, round robin, clarification and voting (ranking or rating) [ 2 ]. These stages are briefly explained below.

How to run the nominal group technique

While groups of between two and fourteen participants have been used in nominal group research (Table  1 ), a maximum of seven has been recommended [ 5 ]. A nominal group generally involves one to two questions which are sent to participants in advance. At the beginning of the meeting, participants are given up to twenty minutes to silently reflect or record their individual ideas in response to a question, i.e. silent generation [ 6 ]. The facilitator then asks one participant at a time to state a single idea to the group in a ‘round robin’ fashion. Participants are able to think of new ideas during this process, but must wait their turn before they can share with the group. This stage takes as much time as needed until no new ideas are forthcoming. It is recommended that there be no discussion at this stage and ideas are merely recorded verbatim on, for example, a flipchart or white board [ 2 ].

Table 1

Examples of studies using the nominal group technique

a n = number of nominal groups; size range = range of participant numbers for all groups

b Each item was assigned a similar weighting

c There was also an additional mixed-group event or discussion involving participants, followed by re-ranking

d Size range per group was not stated (total number of participants was 17)

The third stage is clarification of the ideas, which also provides the opportunity for a grouping step, where similar ideas are grouped together with agreement from all participants. Participants may also exclude, include or alter ideas, as well as generate grouping themes [ 7 ]. All ideas should be discussed to ensure participant understanding [ 2 ], thus enabling them to make an informed decision when they come to voting on ideas. Facilitators should emphasise that participants do not have to agree with all ideas listed as, at the end of the clarification stage participants are able to ignore ideas by voting on personal preferences. The round robin [ 8 ] and clarification phase [ 9 ] can take up to 30 min each. Facilitators should not direct participants during the clarification process, which may make this stage particularly difficult.

Participants are then provided with a ranking sheet, where they are asked to select their top preferences from the generated ideas. The number of items chosen by participants depends on the topic, but the ranking of five ideas is common in the literature [ 2 , 5 , 10 ]. The facilitator should specify that a number should be allocated to each selected item, with larger numbers reflecting greater importance [ 2 , 5 ]. For example, for five ideas, the most important idea is scored five points. Although there is no anonymity for participants during nominal group discussions, individual scoring on a ranking sheet is confidential. Finally, the scores for each idea are summed and presented to the group for discussion. The timing for this stage is likely to depend on a number of factors, including the complexity of the topic and how many items need to be prioritised (the more items to rank, the harder the process and more time consuming it can become). Dening et al. [ 10 ] noted that voting could take up to 10 min to complete.

Ultimately, the time to complete one nominal group is variable, and depends on group size, how many questions are asked, and the type of participants involved. For example, Bradley et al. [ 11 ] documented a 2-h time limit to conduct a NGT for one question, whereas Hutchings and colleagues allocated half a day to conduct a NGT for two questions, followed by another half-day for a forum event [ 12 ] (see “ Variations on the nominal group technique ”).

Variations on the nominal group technique

The NGT is a highly adaptable method, and can be used in addition to [ 7 ] or to inform, other methods, e.g. a discrete choice experiment [ 13 ]. NGT variations may be influenced by the available research and participant time, or the level of clarification, consensus or generalisability required for the topic. Ultimately, researchers need to ensure that the NGT is working for each participant group; it may be that stages need to be adapted. For example, for indigenous or culturally and linguistically diverse populations, it may be the cultural norm to discuss ideas as a group. Thus, a more appropriate variation to the process for generating ideas has been to combine the round robin and clarification stages [ 5 ]. Other variations could be in direct response to participant ability. If it is too difficult for participants to group similar ideas at the clarification stage then this grouping step could be avoided altogether [ 5 ]. While this may make it harder for participants to vote, i.e. there is a longer list of ideas to consider, it may cause less frustration for participants.

Generally, variations are seen in relation to generating ideas, and how ‘consensus’ is obtained from participants, i.e. the ranking process (Fig.  1 ):

• Generating ideas instead of silent generation followed by a round robin, ideas are obtained from a literature review[ 13 ], or exploratory surveys are used which could be viewed as a way to achieve greater consultation [ 14 , 15 ];
• Ranking this may be completed by either allocating a score[ 16 ] or by a rating on a Likert scale [ 15 ];
• Re - ranking allowing participants to revise their original ranking, i.e. re-ranking, either in the original NGT meeting [ 9 ], via a secondary survey [ 14 ], or obtaining validation by sending a survey of nominal group results to other participants [ 15 ]. Alternatively, the re-ranking process could continue until no further changes are seen with the most important ideas [ 13 ].

A simplified model of the NGT process and possible adaptions from the literature. *Traditional nominal group process is given in bold

Where separate nominal groups are held for similar participants, e.g. consumer groups, health professional groups or stakeholder groups, a mixed-forum event can provide the opportunity for consensus to be achieved by forming new groups with different participant types [ 12 ]. In a study that exemplified the use of a mixed forum event, Hutchings and colleagues asked previous participants to individually review the overall NGT results (overarching themes), and to rank the themes (pre-forum responses). At the forum, participants were asked to discuss the pre-forum responses in their newly allocated groups, which consisted of participants from differing backgrounds. Individuals were then asked to re-rank themes for a third time.

Other researchers have provided valuable information on important nominal group design considerations [ 3 ], its practical application [ 4 ] and method of analysis [ 5 ]. Black et al. [ 3 ] reviewed the literature to identify the evidence for certain ‘best practice recommendations’ for consensus methods. While that review provides some important considerations for researchers wishing to use these methods, the articles included are, at a minimum, over 15 years old. Using specific examples, Tully and Cantrill [ 4 ] discuss the steps involved in a nominal group, and guidance for researchers with respect to group composition. While a discussion of qualitative and quantitative analysis is also included, McMillan et al. [ 5 ] take this one step further in their paper by detailing the entire analysis process for researchers who undertake more than ten nominal groups.

Applications to pharmacy research

The NGT has been applied in numerous healthcare settings, to develop guidelines [ 17 ] or explore opinions of different health professionals [ 18 ], lay people and carers [ 10 , 19 , 20 ], or to compare views of both parties [ 9 , 21 ]. It is gradually building traction within the pharmacy setting, as seen in Table  1 . Researchers have generated evidence based guidelines or criteria for pharmacy practice situations [ 7 , 22 , 23 ], informed practice change [ 11 , 24 ] and the profession [ 12 , 16 ] about particular topics, and identified attributes to be included when interviewing pharmacy students [ 25 ].

The Delphi technique

Like the NGT, the Delphi Technique is a highly structured group interaction. However, the Delphi Technique uses interactions between group (called panel) members via questionnaires rather than face-to-face communication. This means that it preserves participant anonymity, if that is relevant. The Delphi Technique was developed by the Rand Corporation in 1953 [ 26 ] and uses a multistage self-completed questionnaire with individual feedback.

How to run the Delphi technique

There is no standard method to calculate a panel size for the Delphi Technique; however, the aim of the study and available resources are important [ 27 ]. A sample of about fifteen has been suggested [ 26 ] but larger panels have also been used (Table  2 ). Inviting more participants increases the variety of expertise, but eventually leads to diminishing returns [ 3 ].

Table 2

Examples of studies using the Delphi Technique

a Number not given

The first-round questionnaire will present a series of statements that the respondent is asked to rate on a clearly defined Likert scale. The content of the statements may come from a variety of sources, singly or in combination, including the literature [ 28 – 30 ], clinical practice [ 31 , 32 ], or from previous research findings, including NGT studies [ 30 , 33 ]. Respondents are asked both to rate the item and to write free-text comments that, for example, explain their rating or express disagreement with the statement’s relevance. Reminders are sent to non-responders in the usual way.

The responses to the first-round questionnaires are collated and used to create the second-round questionnaire. The latter presents the same statements as before, together with both the individual respondent’s rating and the median rating from the entire panel. A selection of the free-text responses is given, to represent the breadth of opinion. Respondents to the previous round thus get a personalised, unique questionnaire. Figure  2 provides an example of a statement from a second-round questionnaire seeking consensus on indicators for assessing medicines reconciliation processes [ 34 ]. After considering the group median and free-text comments, respondents re-rate the statements, by either giving the same rating as before or an amended rating. Respondents may give further comments about the statements if they wish.

Example of individual feedback for a second-round questionnaire in a Delphi study [ 34 ]. Respondents were given a definition of appropriateness and asked to assess the appropriateness of indicators of medicines reconciliation

The number of survey rounds is usually decided in advance and is dependent upon the level of dissension expected. In most studies, two rounds are used but occasionally, only a single round has been run [ 35 ]. More than two rounds increases panel attrition, so this is rarely done. The minimum time for a two-round Delphi can be as long as 30 days, although it may well take longer if multiple reminders are needed. The time required for the collation of responses and the creation of personalised second-round questionnaires should not be underestimated.

Often a 9-point Likert scale is used for the rating [ 29 – 31 , 34 ], although 3-point [ 36 ], 5-point [ 28 , 37 ] and 7-point [ 33 ] scales have also been used. The decision as to when consensus will have been reached must be made at the beginning of the study. For example, if the aim is to develop assessment criteria using the RAND 9-point scale [ 38 ], then consensus is reached that a statement is appropriate if the median score is greater or equal to 7, and it is inappropriate if the median score is less than or equal to 3. Disagreement is defined as where at least one third of respondents rate the statement at the opposite end of the scale to their peers. Such a finding would mean that consensus had not been reached.

Variations on the Delphi technique

A common variant is for the initial study questionnaire to collect ideas in response to open questions [ 26 ]. Only subsequent questionnaires then ask respondents to conduct the rating process described above [ 33 , 37 , 39 ].

Examples of other modifications include researchers including only items that had failed to reach consensus in the second questionnaire (rather than all items, regardless of the ratings they received initially [ 29 , 36 ]) and asking respondents to choose between alternatives (rather than rate items) for each question [ 32 ]. Traditionally, the questionnaire was sent by post, but more recently, e-mail has been used for the so-called e-Delphi Technique [ 40 ]. Emailed questionnaires per se are now so commonplace, that this is probably the new norm.

The RAND appropriateness method has been described as a variant of both the Delphi technique [ 38 ] and the NGT [ 3 ], as it has features of both. It involves participants reading a detailed literature review, followed by a traditional Delphi questionnaire. However, participants discuss the first-round results at a face-to-face meeting, followed by a second-round Delphi questionnaire and re-rating of the items.

An early use of the Delphi Technique in pharmacy practice research was in forecasting the future of hospital pharmacy in Australia [ 41 ]. It has been used to gain consensus on indicators for assessing prescribing appropriateness [ 33 ] or quality [ 31 ], criteria for safety features [ 36 ], clinically significant interactions [ 28 ] or aspects of student education [ 37 ] including communication skills [ 30 ] and professional engagement [ 35 ], or definitions, such as prescribing error [ 29 ]. This range of topics reflects the common use of the technique for the generation of clinical guidelines within the wider healthcare arena [ 3 ].

Choice of experts

Experts, in the context of consensus methods, are those people who have knowledge about the topic of concern. Understandably, this is dependent upon the research aims and objectives, but such experts may not always be healthcare professionals. Given that greater importance has been placed on involving health consumers in research, consensus methods can be used to identify what is currently important to, or valued by, these experts. McMillan and colleagues, for example, explored the views of both the public and pharmacy staff on ideal community pharmacy services [ 16 ]. Therefore, their experts included people living with chronic conditions, their carers, and pharmacy staff who provided the relevant services. Campbell and colleagues, on the other hand, identified prescribing indicators that used data from dispensed prescriptions [ 31 ]. Therefore, their experts were the medical and pharmaceutical advisors who would be using the resultant indicators.

The NGT appears to be used more commonly with lay people than the Delphi Technique, although the reason why is not clear. Lay people may feel more comfortable participating in a face-to-face meeting, than in a relatively complex survey. For example, the NGT can be adapted to accommodate people with poor literacy [ 5 ]. The Delphi Technique has been used with patients in a small number of studies to prioritise outcome measures for clinical trials [ 42 ] and has begun to be used with members of the public (in this case, parents of children with attention deficit/hyperactivity disorder) in pharmacy practice research [ 43 ].

Power differentials between people in the NGT may mean that people with less power may feel unable to contribute their own views or contradict the views of someone more powerful. Therefore, it is usual for the experts in each meeting to be relatively homogeneous in status (see Table  1 ), such as running separate meetings for consumers and pharmacists [ 5 ]. This power differential may be less relevant for the Delphi Technique, as the experts are anonymous. Nonetheless, in those few Delphi studies that included both lay people and healthcare professionals, only patient data from the first-round questionnaire was sent to patients in the second-round questionnaire [ 44 ].

Choice of consensus method

The decision whether to use the NGT or the Delphi Technique is influenced by various factors, including the research question, the perception of consensus required, and the associated practicalities and limitations such as time and geography.

If researchers are seeking to explore ideas in relation to a problem or question, this best aligns with the NGT, as idea generation is an integral part of this method. If researchers want to develop guidelines, a Delphi Technique involving experts who are likely to use the guidelines in question would be more suitable. The development of guidelines requires a more rigorous process, with consensus needed from a larger number of experts, which is easier with the Delphi Technique. This larger group may be needed to give authority to the final decision [ 3 ].

While some researchers have specified a numerical level of consensus when using the NGT, this is not well documented and would likely require further re-ranking beyond the initial steps. Alternatively, most researchers using the Delphi method will explicitly refer to a consensus value, i.e. a numerical level of agreement, determined by researchers in advance. Thus, it could be viewed that these two techniques sit along a spectrum of consensus, with a clearer description of the level of agreement thought to be given by the Delphi Technique [ 3 ].

As the NGT involves participants for only a few hours, results can be obtained quickly, suiting researchers who require a prompt result. It is particularly suited if participants are likely to only want to attend a single session compared to answering multiple questionnaires several weeks apart. The NGT requires face-to-face meetings, but this may be more culturally appropriate even if participants are at a distance. However, it may be more difficult to organise a nominal group meeting for a time that suits everyone. In contrast, the Delphi Technique is more flexible. The Delphi Technique, especially if conducted by email, is accessible to participants regardless of location, thereby avoiding travel expenses. Yet, this method can take weeks or months to conclude, especially if multiple rounds are undertaken.

The NGT and Delphi Technique are both consensus methods that involve a group of ‘experts’ to generate ideas and determine priorities. The NGT has been used to explore consumer and stakeholder views, while the Delphi technique is commonly used to develop guidelines with health professionals. The NGT requires face-to-face discussion in small groups, and provides a prompt result for researchers. Alternatively, the Delphi technique uses questionnaires to preserve participant anonymity, can involve more participants but takes place over a longer time period.

Conflicts of interest