EXERCISES PPT.ppt

8/22/2019 EXERCISES PPT.ppt

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11 Group Process


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Learning Objectives

list key concepts for working in groups describe the Delphi Method and the

nominal group process

practice the nominal group process


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Comments on exercise just

completed


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THURSDAY interim presentationeach group to take 8 minutes, to talk about a work in

progress

FOCUS on techniques used, their effectiveness,

supplemented with findings

don't be fancy

helps you see what you have learned, and where

you may want to go

gets the others to see what you have learned, and

they may have helpful ideas


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OverviewComing to end of intro to techniques

no one gets good at too many methods

much has been extractive, but there have been

participatory ideas too

today we discuss another series of group processes,

and another way to observe


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Overview

May 17, do RAP 90s fast paced idea

guest lecturers present ideas & applications

meanwhile, you work together in groups on

your projects


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Idea generation:

Group Process vsIndividual Process


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Individual Idea Generation

person can think up twice as many ideas in a

group than alone

general impression: group participation

facilitates idea production,

think about meetings of group with TA or

instructor


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Individual Idea Generation

number of ideas produced by a individuals

independently is considerably less than produced

by an equal number of individuals together

studies confirm this


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Group Idea Generation


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Brainstorming

shared problem solving: all members of agroup spontaneously contribute ideas


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Brainstorming

shared problem solving: all members of a groupspontaneously contribute ideas

group settings can hinder creative process,

intimidate people

very culture dependent

American Indians

Asians, others, not wanting to confront or becritical, or be ridiculed

physical arrangement of space


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Brainstorming

Principles for generating ideas have clearly defined subject

try to maintain criticism free setting when

ideas generated,

ideas flow freely,

not be hampered by critical comments orattacks from other group members

all ideas receive approval or neither praised nor criticized


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Brainstorming

Principles for generating ideasrelated atmosphere

sufficient time

small group

leader or not?


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Brainstorming

Limitations discussion generally succumbs to influence of few

individuals due to status, personality & other forces

Post idea generation

analysis is separate function, apart from ideageneration

ranking of ideas by group members

task force to review suggestions & makerecommendations

group leader to choose


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Nominal Group Technique (NGT)

nominal refers to process in which individualsare together in a group,

in name only since verbal exchange is excluded or

limited

reflects silent and independent generation of ideas


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History:Developed and tested in late 1960s by Van de Ven

& Delbecqderived from studies of decision conferences, of

aggregating group judgments and from social work

studies of problems surrounding citizen participation

in program planning


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ObjectivesAssure different processes for each phase of

creativity in problem solving fact finding phase

problem search & generation of data about problem or about

different proposed solutions

evaluation phase

information synthesis, screening and choosing among strategic

elements of a problem or component elements of alternativesolutions


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Objectivesbalance participation among members

voting techniques for group judgment


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Preparation: membersMembers can be heterogeneous, unlike a focus

group heterogeneous groups can be more creative

there can be communication difficulties

individuals should be able to speak a common language

if have doctors and patients, doctors should not use medical

jargon

could have a variety of social scientists


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Preparation: members

members in an NGT should be

interested in the problem

have either experience or education which makesthem a resource to the group

flexible so they can openly explore various points ofview

selection bias if suspect, try a different mixture of participants in

future groups


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Preparation (leader)leader (facilitator): skills necessary

understanding of NGT processself-confidence to lead group through process steps

legitimate so accepted by group

male nurse poor leader for female research medicalstaff

ensure all participants are able to express theirviews and the keep particular personal or

professional views from dominating the

discussion


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Preparation: supplies:table & chairs

flip chart for each table,

3x5 cards for each table,

felt pens,

paper & pencil for each participant


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focus of NGT meetingon listof ideas placed on flip

chart rather than on individual

participants

open U, with flip chart at

open end of table

5 to 10 participants, leader

or recorder

flip chart


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Determine purpose of meeting,structure proposed question,

assemble members


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Process: leaders welcoming statement:

cordial welcome

sense of importance concerning the groups task

members gathered because of analytic abilities &

problem solving skills

clarify importance of each members contribution indicate of use or purpose of the meetings output


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Process: leader serves as recorderResists non-process clarifications

Presents question in writing; PRETEST THEQUESTION

Models good group behavior by writing in silence

Sanctions individuals who disrupt the silentindependent activity

Avoids leading: any answer that comes to your

mind should be written on the worksheet

P f NGT


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Process of NGT

1. Silent generation of ideas in writing

2. Round-robin feedback from members to record

each idea

(could have people hand in idea slips anonymously, might

be good for some situations)

3. Serial discussion of each recorded idea for

clarification and exploration

4. Individual DISCRETE voting on priority ideas5. Discussion of preliminary vote

6. Final vote


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Process of NGT1. Silent generation of ideas in writing

2. Round-robin feedback from members torecord each idea,

-one idea from each group member in each goaround,

-written in a terse phrase on flip chart

3. Serial discussion of each recorded idea forclarification and exploration


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Process of NGT1. Silent generation of ideas in writing

2. Round-robin feedback from members to

record each idea,

3. Serial discussion of each recorded idea forclarification and exploration

4. Individual DISCRETE voting on priority

ideas5. Discussion of preliminary vote

6. Final vote

il t ti f id i iti


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silent generation of ideas in writing

adequate time for thinking

facilitates work by other group members reflecting &

writing together,

constructive tension created by observing other group membersworking hard

avoids interruption of each others thinking


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silent generation of ideas in writing

sufficient time for search & recall

avoids premature focusing on single ideas

eliminates dominance by high-status or aggressive

members in idea generation

keeps group problem centered


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Round-robin feedbackfrom members to record each idea, one idea

from each group member in each go around,written in a terse phrase on flip chart

equalizes opportunity to present ideas, only oneidea each time around

members can hide substantial number of

ideas if had to present entire list at once

separate ideas from personalities,


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Round Robin Feed backplaces conflicting ideas briefly and comfortably in

front of group

forces group to fully explore problem

write ideas on language used by participant

groups patience on this step is brief, so write as

quickly as possible


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Written record and guideideas to be presented in brief words or

phrases, variations on themes are desirable, can give numbers or letters as a label

increases ability to deal with large number of

ideas

avoids loss of ideas

confronts group with an array of clues

encourages hitchhiking

(ideas written on flip chart may stimulate another

member to think of an idea he had not written before

so he can add that idea & report it)

Serial discussion


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Serialdiscussion

of each recorded idea

for clarification and exploration


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Serial Discussion Guidelines:

leader verbally defines the role of the

step as clarification

leader should pace the group to avoid arguments or

neglect of some items at expense of

others


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Serial Discussion Guidelines:

avoid discussion focusing on particular idea

eliminate misunderstanding

opportunity to express logic behind items

allows members to disagree without argumentation

I di id l DISCRETE ti


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Individual DISCRETE voting

on priority ideas

independent (discrete) judgments in writing helpseliminate social pressures

can rank from 5 to most important item to 1 for

least important, could place this on separate 3x5cards, collected, shuffled & recorded

can also have numbers/letters on each of 5

cards & rank then in order for those non-

literates

five items are about the most you can rank


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Individual DISCRETE voting

on priority ideas

expressing judgments by rank-ordering increases

accuracy of consensus

displaying the array of individual votes highlights

areas needing further clarification or discussion

Di i f li i


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Discussion of preliminary vote

shows the distribution of the groups response

provides group members with final opportunity to

clarify their positions

ensures that spread votes really reflected differences

of judgment,

people can change their minds

voting, discussion, then re-voting

Fi l


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Final vote

can rank as before, or rate each item

Ad


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Advantages

different group processes for independent idea

generation, feedback & voting

increased attention to each idea

increased opportunity for each individual to assure

her or his ideas are heard

avoids arguments & extraneous interactions

Ad


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Advantages

more egalitarian

ensures participation, avoids dropping out

may generate more options & ideas per unit time

keeps discussion focused

Li i i


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Limitationscross-fertilization of ideas diminished because of

structure imposed by NGT

reduced flexibility,structure is imposed on meeting

puts people on the spot to produce something

composition of group is important, need minimallevel of education

bringing people together may be cost-prohibitive,but consider the use of video or web-conferencing

C i ith B i t i


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Comparison with Brainstorming

average number of unique ideas

average total number of ideas

quality of ideas produced, varies

can have collective ignorance rather than wisdom triangulate

research suggests that when group task is togenerate information on a problem (idea

generation), interacting groups inhibit creative

thinking


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Class Exercise

NOMINAL GROUP PROCESS

Q ti


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Question:

What should be done by the University of

Washington administration to lessen the

stress on public health students at UW?


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Nominal Group Technique: Break

into four groups

present the question in writing

select one person to be recorder

silently generate ideas in writing

in turn, write each idea on blackboard or

flip chart, without debate

N i l G E i


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Nominal Group Exercisemove group discussion serially through ideas for

clarification and elaboration (but not advocacy)

compile and display preliminary vote on itemimportance in descending order

hold brief discussion for clarification,interpretation, and refinement of results

obtain, analyze and display final vote as descendingorder of ranked priorities

R i f N i l G


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Review of Nominal Group

Techniquepre-test question

pre-tested

related to meetings objective

leader should avoid leading the group with

exemplary answers

focus groups can clarify issues and help frame the

(challenge) question for the NGT


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NGT: participants can be from

diverse cultural backgrounds,

less threatening than other forms of idea

generation


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NGT: if use flip chart, have a

record of the meeting, preferable

to blackboard

NGT: round robin idea


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NGT: round robin idea

generation equalizes opportunity

to present ideas, only one ideaeach time around

members can hide substantial number of ideas if

had to present entire list at once

separate ideas from personalities, since whocontributed what is not stressed, with each

persons ideas are not clustered


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NGT: discussion of ideas

can/should proceed serially toavoid focusing on one, and is for

clarifying ideas only


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NGT: used with minimal

literates, and with aphasic people

stress that worksheets will not be collected

recorder has to assist participants with what is

written on flip charts

NGT: Applications


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NGT: Applicationsone MPH student from CAR used it in rural

settings there for his MPH thesis to determinelocal perceptions of how clinics could be

improved under cost-recovery

study in the Philadelphia school district to

determine adolescent perceptions of 3 study

questions (what characteristics of a careprovider, site, and getting more people to

come for care) that were generated from

focus groups (JAMA 273 1913, 1995)

Ginsburg, K. R., G. B. Slap, et al. (1995). Adolescents'


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g, , p, ( )

perceptions of factors affecting their decisions to seek health

care. JAMA 273(24): 1913-8.

Philadelphia 9th graders 39/42 schools (6821 students) Majority were Black, then White, then Latino

Focus groups to frame study questions

Nominal groups to general student responses

Surveys to assess importance of 35-40 items, inc. Likert, Three surveys, then merged to one survey

Focus groups to have students explain variables associatedwith decision to seek care, adding qualitative depth

Provider characteristicsHand washing, clean instruments, honesty, respect,

cleanliness, know-how, carefulness, experience, HIV -ve,equal treatment of all, confidentiality

SES, sex, race little variation

NGT: Applications


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NGT: Applicationsidentifying design criteria for improving mental

health services for Mexican-Americanfarmworkers in California (Am J Prev Med 19851 47-55)

developing treatment guidelines by providers forvarious diseases

VA ambulatory care clinic in Pocatello, ID

changes in US health care system that wouldfacilitate improved care for NIDDM in US

HMO treatment guidelines for sinusitis anddyspepsia

standardization of measures of arthroscopy of knee

NGT: Applications


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NGT: Applicationsimproving efficiency in pharmacies (input from

manager, pharmacist, full-time and part-timesales people) generates input from all employees

NGT: Applications


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NGT: Applications

improving curriculums and solving other

problems in various educational institutions(used on students & administrators)

use of learning contracts among nursing students

implementing different models of nursing practicein South Dakota

developing university student safety programs

NGT: Applications


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NGT: Applications

caregivers in chronic care settings

different groups of caregivers (nurses,orderlies, professionals, student orderlies,volunteers) communicating with residents

having different disabilities (e.g. dementia,aphasia) (little change needed incommunicating with people having suchdisabilities)

NGT: Applications


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NGT: Applications

patients in nursing homes

evaluating different measures of functional status

bridging gap between different levels of workers

researchers and practitioners in one study ofcommunity nursing

incorporation health promotion ideas from

personnel from health and from social services

Appropriate for


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Appropriate foridentifying elements of a problem situation

identifying elements of a solution program

establish priorities where judgments of severalindividuals must be aggregated into a groupdecision CONSENSUS BUILDING

Table 2-2 Comparison of Differences amongInteracting, NGT & Delphi Groups, Pg 32,Delbecq & Gustafson


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