The use of the nominal group technique as an evaluative tool in the teaching and summative assessment of the inter-personal skills of student mental health nurses

A Gamified Real-time Video Observed Therapies (GRVOTS) Mobile App via the Modified Nominal Group Technique: Development and Validation Study

BACKGROUND

The success rate of tuberculosis (TB) treatment in Malaysia remains below the recommended World Health Organization target of 90% despite the implementation of directly observed therapy, short-course, a physical drug monitoring system, since 1994. With increasing numbers of patients with TB in Malaysia defaulting on treatment, exploring another method to improve TB treatment adherence is vital. The use of gamification and real-time elements via video-observed therapies in mobile apps is one such method expected to induce motivation toward TB treatment adherence.

OBJECTIVE

This study aimed to document the process of designing, developing, and validating the gamification, motivation, and real-time elements in the Gamified Real-time Video Observed Therapies (GRVOTS) mobile app.

METHODS

The modified nominal group technique via a panel of 11 experts was used to validate the presence of the gamification and motivation elements inside the app, which were assessed based on the percentage of agreement among the experts.

RESULTS

The GRVOTS mobile app, which can be used by patients, supervisors, and administrators, was successfully developed. For validation purposes, the gamification and motivation features of the app were validated as they achieved a total mean percentage of agreement of 97.95% (SD 2.51%), which was significantly higher than the minimum agreement score of 70% (P<.001). Further, each component of gamification, motivation, and technology was also rated at 70% or more. Among the gamification elements, fun received the lowest scores, possibly because the nature of serious games does not prioritize the fun element and because the perception of fun varies by personality. The least popular element in motivation was relatedness, as stigma and discrimination hinder interaction features, such as leaderboards and chats, in the mobile app.

CONCLUSIONS

It has been validated that the GRVOTS mobile app contains gamification and motivation elements, which are intended to encourage medication adherence to TB treatment.

A Simulation-Based Clinical Nursing Education Framework for a Low-Resource Setting: A Multimethod Study

Simulation-based clinical education is a useful strategy for teaching, learning, and assessing clinical competence in health professions education. However, the use of simulation-based clinical nursing education (SBCNE) in low-resource settings such as Ghana has been hampered by the lack of a context-specific framework to guide its design, implementation, and evaluation. This study sought to develop a context-specific framework to guide the design, implementation, and evaluation of SBCNE in a low-resource setting. The study employed a sequential multimethod design, comprising a scoping review; qualitative descriptive design (situational analysis) made up of two parts–focus group discussions (FGDs) with post-registration nurses and nursing students, and semi-structured interviews with nurse educators; and narrative synthesis of the scoping review and situational analysis data, used to develop a draft SBCNE framework for a low-resource setting. The draft SBCNE framework was evaluated by stakeholders of nursing education and practice using nominal group discussions. The framework is comprised of five constructs (context, planning, design, community of learning, and outcomes). The user-centric, comprehensive, context-specific SBCNE framework has the potential to enhance the implementation of simulation in nursing education and the development of clinical competence in a low-resource setting. As a result, we urge nursing leaders and nurse educator unions to take the lead in lobbying regulatory bodies, the central government, and their development partners to provide the necessary financial support and resources for the implementation of the framework and adoption of SBCNE in low-resource settings.

The standards of practice for delivery of polypharmacy and chronic disease medication reviews by general practice clinical pharmacists: a consensus study

Background General practice in the UK is experiencing a crisis. Greater multidisciplinary working is a potential solution. The new general practice contract in Scotland encourages this and includes a new pharmacotherapy service to be delivered by General Practice Clinical Pharmacists (GPCPs). Consensus is lacking for the standards of practice for delivery of pharmacotherapy medication reviews (which are polypharmacy and chronic medication reviews) as part of this service. Aim To identify and validate standards of practice for polypharmacy and chronic disease medication (pharmacotherapy level 3) reviews conducted by GPCPs. Method A two-phased mixed-methods consensus methodology was used. Phase 1: An expert group of GPCPs (n = 4) and clinical pharmacist managers (n = 2) responsible for delivering the pharmacotherapy service used a Modified Nominal Group Technique to generate potential standards. Phase 2: Two-round Delphi survey involving GPCPs with ≥ 1 year of experience of working in general practice (n = 159). Results The expert group identified 44 potential standards of practice for polypharmacy and chronic disease reviews. Practicing GPCPs indicated during the Delphi phase that the 44 standards were applicable to practice. The standards of practice covered seven main categories: skills, environment, qualifications, qualities and behaviours, knowledge, process and experience. Conclusion Practicing GPCPs indicated that the standards identified by the expert group are acceptable and valid for current practice and the delivery of polypharmacy and chronic medication reviews. The application of these standards to practice may help GPCPs and general practices to ensure equitable delivery of patient care.

A practical guide to the systematic application of nominal group technique

BACKGROUND

Nominal group technique (NGT) is a highly structured, commonly used way of exploring areas of interest and developing consensus. However, it is sometimes conflated with focus group methods.

AIM

To provide a rationale for selecting NGT as a research method and to examine its systematic application in a doctoral Q-methodology study exploring nursing students' perspectives of preserving dignity in care.

DISCUSSION

An outline of NGT is provided, and it is distinguished from focus group methods. As well as providing a step-by-step guide to using NGT, each step is illustrated with its practical application in the study, and the lessons learned concerning the limitations and strengths of NGT in the context of one study are shared.

CONCLUSION

When applied systematically, NGT enables nurse researchers to collaborate in a meaningful and engaging way with participants and generate tangible outcomes relatively quickly.

IMPLICATIONS FOR PRACTICE

This paper offers practical insight into the use of NGT to explore perceptions and develop consensus.

Accessible and inclusive transportation for youth with disabilities: exploring innovative solutions

Background: Although access to reliable transportation is an essential component of quality of life, young people with disabilities encounter many transportation-related obstacles.Objective: To explore solutions to the challenges that youth with disabilities encounter in accessing and navigating transportation.Methods: A nominal group technique was used in two consultation workshops (one involving rehabilitation clinicians and accessible transportation stakeholders; and one with youth with disabilities and parents). Fifteen participants across two workshops took part and prioritized their solutions and we used a comparative analysis within and between groups to explore overarching themes.Results: The workshops resulted in 122 solutions (76 from youth/parents; 46 from stakeholders). Although there was considerable overlap within the ideas generated between the groups, they each prioritized them differently. The following themes emerged across the two group's prioritized solutions: training, funding, enhancing access, and improved efficiency.Conclusions: Our findings highlight that youth with disabilities, parents and key stakeholders offered many practical solutions for enhancing accessible transportation for youth with disabilities.Implications for RehabilitationClinicians and educators should explore different apps and transportation training programs that could help support youth with disabilities to enhance their independence and participation in the communityClinicians and educators should be involved in the development of disability awareness training programs for public transit and school bus drivers to enhance youth's inclusion and participation in society.Clinicians, educators, youth and parents should continue to advocate for inclusive, accessible, affordable and efficient transportation for people with disabilities.

Identifying the needs of critical and acute cardiac care nurses within the first two years of practice in Egypt using a nominal group technique

Nursing in Egypt faces many challenges and working conditions in health care settings are generally poor. Little is known about the needs of new nurses transitioning in Egypt. The literature focuses on the first year of practice and only a small body of research has explored the transition needs within acute care speciality settings. This paper reports on the important professional needs of new graduate nurses working in an acute cardiac setting in Egypt during the first two years of practice and differences between their perceived most important needs. The total population participated and two group interviews were conducted (n = 5; n = 6) using the nominal group technique. Needs were identified and prioritised using both rankings and ratings to attain consensus. Content analysis was conducted to produce themes and enable cross-group comparison. Rating scores were standardised for comparison within and between groups. Both groups ranked and rated items as important: 1) education, training and continued professional development; 2) professional standards; 3) supportive clinical practice environment; 4) manageable work patterns, and 5) organisational structure. It is important that health care organisations are responsive to these needs to ensure support strategies reflect the priorities of new nurses transitioning in acute care hospitals within Egypt.

A Consensus Approach to Investigate Undergraduate Pharmacy Students' Experience of Interprofessional Education

Objective. To assess the development of knowledge, attitudes, and behaviors for collaborative practice among first-year pharmacy students following completion of interprofessional education. Methods. A mixed-methods strategy was employed to detect student self-reported change in knowledge, attitudes, and behaviors. Validated survey tools were used to assess student perception and attitudes. The Nominal Group Technique (NGT) was used to capture student reflections and provide peer discussion on the individual IPE sessions. Results. The validated survey tools did not detect any change in students' attitudes and perceptions. The NGT succeeded in providing a milieu for participating students to reflect on their IPE experiences. The peer review process allowed students to compare their initial perceptions and reactions and renew their reflections on the learning experience. Conclusion. The NGT process has provided the opportunity to assess the student experience through the reflective process that was enriched via peer discussion. Students have demonstrated more positive attitudes and behaviors toward interprofessional working through IPE.

Revealing factors hindering halal certification in East Kalimantan Indonesia

Purpose

– This study aims to explore various factors that hamper halal certification in food service industries in East Kalimantan, Indonesia. World halal business as well as awareness in halal products and services consumption has been growing rapidly for the past few years. However, many industry players have not yet realized those huge potential concepts of halal business. Food service industries such as restaurants and caterings show less concern in putting priority on the issue of halal certification.

Design/methodology/approach

– A qualitative data collection technique called nominal group technique (NGT) was used in this study. Four categories of stakeholders participated in this NGT to represent certifying body, consumers, industry player and government. Each category was given a fundamental question: “What factors are hindering restaurant and catering in East Kalimantan, Indonesia, in obtaining halal certification?”

Findings

– The authors found that through NGT, the authors can obtain top priority issues to be followed up by the respecting institutions which are concerned. The lack of socialization and information have led to the lack of knowledge and awareness. This is the most important issue addressed by the participants.

Research limitations/implications

– This research was conducted to collect data from various stakeholders in East Kalimantan Province of Indonesia. Considering the vast expanse of Indonesia and different level of development in each province, results of this study could not be generalized as Indonesia situation in general.

Practical implications

– Halal certification in food service industry gains low interest from industries. This research presents hampering factors in various perspectives and offers some suggestions to overcome those issues accordingly.

Originality/value

– It is hard to find research paper discussing halal management from the Indonesian perspective. This paper extends the use of NGT in halal management with the perspectives from many stakeholders in food service industries. It provides a relatively new finding from the Indonesian point of view.

Psychiatric nursing: an unpopular choice

Research studies in the United States, the United Kingdom, New Zealand and Australia suggest that students do not consider psychiatric nursing as a popular career option. According to this research, there is a widespread concern about the nursing shortages in psychiatry. The demand for mental health services continues to grow and there is a need for strategies to recruit nurses for this specialized field. The purpose of this study was to identify the factors preventing undergraduate nursing students in South Africa (SA) from choosing psychiatric nursing as a career. A qualitative research design that aimed to explore and describe was used. Data were collected through the Nominal Group Technique. A sample of convenience of 27 final year nursing students from the School of Nursing at the University of the Free State as well as the Free State School of Nursing, situated in Bloemfontein (SA), voluntarily participated in this research. The following categories emerged from the content analysis of the data: personal factors, working environment, unprofessional behaviour, learning environment and the unclassified category. Psychiatric nursing as a career choice is in a predicament and nursing schools need to implement practical strategies to recruit future nurses for this field.

Obtaining consensus about patient-centred professionalism in community nursing: nominal group work activity with professionals and the public

AIM

  To report on the development of a ranked thematic list encompassing the positive and challenging exemplars of patient-centred professionalism in community nursing.

BACKGROUND

  There has been little research exploring what 'patient-centred professionalism' means to those working within the healthcare settings. Consensus methods, such as those developed through Nominal Group Work, can help establish the extent of agreement on a particular issue whilst overcoming some of the problems associated with group decision-making.

DESIGN

  Mixed methods studying through consultation workshops.

METHOD

  The study took place in South-west Wales, UK between October 2009-September 2010. Thirty-four participants consisting of community nurses (9), newly qualifying nurses (13), nursing stakeholders (6) and members of the public (6) took part in the study. An adapted Nominal Group Work approach was used in five individual consultation workshops: two with community nurses, one with newly qualifying nurses, one with stakeholders and one with members of the public followed by a mixed-group Forum event.

RESULTS

  Each of the five workshops resulted in the production of approximately ten positive and ten challenging exemplars of patient-centred professionalism. The thematization of these exemplars allowed the development of eight broad themes. The Forum event then provided a mechanism for ranking the importance of these themes. The patient, community nurse as a person and nursing ethos were ranked as the most important themes by study participants.

CONCLUSIONS

  The adapted Nominal Group Work approach was a useful method to allow the development of a ranked thematic list that illustrated the important positive and challenging exemplars of patient-centred professionalism in community nursing.

[Indicators of local actions for reporting and recording cases of domestic violence and sexual exploitation of children and adolescents]

Information is essential for combating violence against children and adolescents and reclaiming their rights. This study presents indicators for the evaluation of local government actions for reporting and recording cases of domestic violence and sexual exploitation of children and adolescents, based on participatory, consensus-based methodologies: the nominal group technique (NGT) and the Delphi method. The frame of reference was the set of Brazilian policies focusing on the issue of violence against children and adolescence. Experts from Brazil's five major regions participated in the study. The consensus produced two different analytical scenarios, with three and 20 indicators, respectively.

Veterinary students' usage and perception of video teaching resources

BACKGROUND

The purpose of our study was to use a student-centred approach to develop an online video learning resource (called 'Moo Tube') at the School of Veterinary Medicine and Science, University of Nottingham, UK and also to provide guidance for other academics in the School wishing to develop a similar resource in the future.

METHODS

A focus group in the format of the nominal group technique was used to garner the opinions of 12 undergraduate students (3 from year-1, 4 from year-2 and 5 from year-3). Students generated lists of items in response to key questions, these responses were thematically analysed to generate key themes which were compared between the different year groups. The number of visits to 'Moo Tube' before and after an objective structured practical examination (OSPE) was also analysed to provide data on video usage.

RESULTS

Students highlighted a number of strengths of video resources which can be grouped into four overarching themes: (1) teaching enhancement, (2) accessibility, (3) technical quality and (4) video content. Of these themes, students rated teaching enhancement and accessibility most highly. Video usage was seen to significantly increase (P < 0.05) prior to an examination and significantly decrease (P < 0.05) following the examination.

CONCLUSIONS

The students had a positive perception of video usage in higher education. Video usage increases prior to practical examinations. Image quality was a greater concern with year-3 students than with either year-1 or 2 students but all groups highlighted the following as important issues: i) good sound quality, ii) accessibility, including location of videos within electronic libraries, and iii) video content. Based on the findings from this study, guidelines are suggested for those developing undergraduate veterinary videos. We believe that many aspects of our list will have resonance in other areas of medicine education and higher education.

Use of the Nominal Group Technique and the Delphi Method to draw up evaluation indicators for strategies to deal with violence against children and adolescents in Brazil

OBJECTIVES: the aim of this study is to present a method for the production and selection of indicators to evaluate and/or monitor strategies to: a) prevent violence and promote protective family and community relations; b) provide care for victims of such violence and their family members; c) upgrade the recording and reporting of such violence; d) guarantee the rights of child and adolescent victims; and e) ensure due prosecution of perpetrators. METHODS: consensus-generating participatory methodologies were used (Delphi Method and Nominal Group Technique). RESULTS: 113 indicators were produced, with 27 and 91 indicators selected in scenarios with different scores. CONCLUSIONS: the consensus methodologies were adequate for the selection and validation of evaluation indicators, but criteria need to be established for selection among the indicators adopted.

Atendimento pré-hospitalar ao idoso vítima de violência em cinco capitais brasileiras

Este artigo analisa as características e a operacionalização no cotidiano da atenção pré-hospitalar aos idosos vítimas de violências e acidentes de cinco capitais (Manaus, Recife, Brasília, Rio de Janeiro e Curitiba), abordando ainda suas capacidades, seus obstáculos e potencialidades. Pautou-se na triangulação de métodos quantitativos e qualitativos. Analisaram-se dados de oitenta serviços da atenção pré-hospitalar móvel e fixa: 32 em Manaus; 18 em Recife; dez em Brasília; 12 no Rio de Janeiro e oito em Curitiba. Entre os achados estão as diferenças (de tamanho e diversidade de categorias profissionais) e dificuldades das equipes para identificar, atender e notificar os casos por falta de capacitação; pouca atuação preventiva; quase nenhum envolvimento com a família e orientação a ela; praticamente nenhum atendimento ao autor da agressão; incipiente articulação e parcerias da rede, sobretudo dos serviços pré-hospitalares com os hospitalares.

Translating theory into practice: using Action Research to introduce a coordinated approach to emotional care

OBJECTIVE

This paper describes a translational project that explored the feasibility and effect of introducing a coordinated approach to emotional care.

METHODS

The project was undertaken using Action Research on one ward at St John of God Hospital Subiaco, Western Australia. A senior Registered Nurse was appointed to provide the leadership and direction to staff regarding emotional care and an education program for staff was provided. The project was evaluated using both quantitative and qualitative data.

RESULTS

Data demonstrated an increase in the patient's evaluation of emotional care, although levels were found to fluctuate throughout the project. Factors such as the emotional distress of the staff were hypothesised as impacting on the delivery of emotional care.

CONCLUSION

The approach used in this project was found to be a useful method of improving emotional care. However, the data collected in this study revealed the complexity of emotional care delivery and the possible impact of a number of factors within the environment.

PRACTICE IMPLICATIONS

Emotional care delivery can be improved by using a coordinated research-based educational approach led by a clinical champion. However, the impact of other factors within the hospital environment needs to be considered and more research is required.

O medicamento na rotina de trabalho dos agentes comunitários de saúde da unidade básica de saúde Santa Cecília, em Porto Alegre, RS, Brasil

Desde o estabelecimento do Sistema Único de Saúde (SUS), busca-se enfatizar a atenção básica e a saúde familiar. Uma das estratégias que vem sendo utilizada é o Programa de Saúde da Família (PSF) constituído por equipes de profissionais que incluem os agentes comunitários de saúde. Entre os diversos problemas enfrentados pelas equipes de saúde da família está o uso irracional dos medicamentos. Este trabalho teve o objetivo de examinar o papel do medicamento na rotina dos agentes, estabelecer sua percepção em relação aos serviços da farmácia de uma unidade básica de saúde e identificar as necessidades de informação sobre medicamentos para elaboração de treinamento. Para tanto, foi realizada uma sessão utilizando-se a técnica grupo nominal, em que oito de onze agentes de saúde participaram respondendo a quatro perguntas. O medicamento foi considerado importante, com valorização das ações preventivas. A percepção em relação aos serviços da farmácia foi positiva. Segundo os agentes, as dúvidas sobre medicamentos, freqüentemente relatadas pela população, refletem falhas na consulta e na aquisição dos medicamentos. O agente de saúde é reconhecido pela população como o profissional que pode auxiliá-la no uso de medicamentos, promovendo o seu uso racional.