Using the nominal group technique with clickers to research student experiences of e-learning: a project report

Using the nominal group technique with
clickers to research student experiences of
e-learning: a project report

Project team:
Tünde Varga-Atkins
Nick Bunyan
Jaye McIsaac
Ray Fewtrell
University of Liverpool

November 2011

Please cite this guide as:
Varga-Atkins, T; with Bunyan, N.; McIsaac, J; Fewtrell, R (2011) Using the nominal group
technique with clickers to research student experiences of e-learning: a project report.
Written for the ELESIG Small Grants Scheme. Liverpool: University of Liverpool.
Contributions and acknowledgments
Nick Bunyan and Tünde Varga-Atkins contributed to the early research on using Nominal Group
Technique, and initiated the project idea regarding the exploration of using technology in this
process. Ray Fewtrell carried out training and consultancy on the Nominal Group Technique. Ray,
Nick and Tünde worked together successfully on securing the ELESIG grant. Tünde coordinated
the project and conducted the session together with Jaye, who contributed to the adapted focus
group sessions. Tünde authored the report, with Nick and Jaye‟s feedback. Robin Sellers and
Debbie Prescott helped with proofreading. The project team would also like to thank Ben
Watson, WordWallWeb, for his continued support with the clickers and offering training as and
when team needed it. Finally, a great thanks to ELESIG for making the project possible.
Contact: Tünde Varga-Atkins (tva@liverpool.ac.uk)

Contents
Introduction: how the project came about ..................................................................................................... 3
Aims .......................................................................................................................................................................... 4
Project Outputs ..................................................................................................................................................... 4
The Nominal Group Technique and its stages ............................................................................................... 4
The Nominal Group Technique: a literature review ..................................................................................... 5
Uses of the Nominal Group Technique in educational contexts ........................................................... 5
Benefits of the Nominal Group Technique ................................................................................................. 6
Issues and challenges when using the Nominal Group Technique......................................................... 8
Methodology ........................................................................................................................................................... 9
The team‟s adaptation of the Nominal Group Technique ..................................................................... 11
Findings .................................................................................................................................................................. 12
Findings with regards to the Nominal Group Technique ...................................................................... 12
Clickers: the use of technology in Nominal Group Technique ............................................................ 15
Conclusion ............................................................................................................................................................ 22
References............................................................................................................................................................. 23

Using the Nominal Group Technique with clickers to research student experiences of e-learning: 2
a Project Report
eLearning Unit, University of Liverpool,
November 2011

Introduction: how the project came about

Two members of the project team, Tünde Varga-Atkins and Nick Bunyan (eLearning Unit,
University of Liverpool) became first acquainted with the Nominal Group Technique a few years
ago during a research seminar presented by Ray Fewtrell (Medical Education, University of
Liverpool) where the potential for this technique to be used as a curriculum evaluation tool
became clear. After training from Ray, Tünde and Nick successfully piloted the technique during a
curriculum review session with undergraduate law students in 2009/10. Jaye McIsaac (Educational
Development, University of Liverpool) was then recruited to the team for her expertise in
curriculum review in 2011.

Given that two team members‟ job role is supporting staff to enhance their teaching and learning
using technology, the team then became interested in whether technology could be used to
support the various stages of the Nominal Group session to make the process more efficient.
With the help of the ELESIG small-grants scheme the project „Using the nominal group technique
with clickers to research student experiences of e-learning‟, was initiated.

The project team were not aware of any other studies that had used technology in the conduct of
face-to-face Nominal Group sessions before, though sessions had been run at a distance using
web-conferencing software (Kristofco et al 2005). As this project report demonstrates, the team
did not just look at the opportunities technology can bring to enhancing the technique, but also
learned a lot more about the Nominal Group Technique as an evaluation technique in itself. These
findings are presented in the following project report sections:

 The aims of the research.
 The project outputs.
 The Nominal Group Technique and its stages.
 A literature review of the Nominal Group Technique.
 Methodology.
 Findings, and finally,
 Conclusion.

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Aims

The aims of the research project were to:

1. Share the project team‟s learning with fellow researchers on the experiences of running student
feedback groups using the Nominal Group Technique.

2. Trial text-entry clickers in order to see whether their use can make the process of conducting
student feedback sessions more efficient and engaging.

As the report will demonstrate, the achieved aims extend the above two original aims to also
include our more in-depth learning about the technique itself, especially when it concerns the
suitability of Nominal Group Technique in different educational contexts.

Project Outputs

The project outputs include:

 A practical guide entitled „The Nominal Group Technique – a practical guide for
facilitators‟ (available at http://slidesha.re/s5KPUr)
 This project report.
 An ELESIG-hosted webinar (forthcoming in 2011/12).

The Nominal Group Technique and its stages

The Nominal Group Technique is a structured face-to-face group session with the purpose of
achieving group consensus and action planning on a chosen topic (see also Varga-Atkins 2011). It
was originally developed by Delbecq et al (1975). The term „nominal‟ group signals that the group
is only „in name‟ a group, in reality, it requires individual input from its members.

The stages and the process of the technique is described in detail in the Practical Guide that
accompanies this project report (Varga-Atkins 2011), so for brevity, only the stages are listed
below:

 Introduction – the facilitator introduces the purpose of the session, the rules and its
structure, and poses the question to participants.
 Stage 1 – individual responses are collected to the question in a silent generation phase.
 Stage 2 – clarification and consolidation: responses are read out one by one and
clarified by participants; then similar/same items are consolidated e.g. merged under the
same item.
 Stage 3 – ranking responses: individually, participants rank their top five responses in
order of importance.
 Ranking results are calculated and shared with the group.
 Closure and thanks.

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The Nominal Group Technique: a literature review

In this section, the ways in which the Nominal Group Technique has proved useful are examined.
The work sourced is focussed on Higher Educational contexts that happened to be found in the
US and the UK, enumerating the benefits and challenges encountered by researchers and
educators who have employed the technique.

Uses of the Nominal Group Technique in educational contexts
The literature review demonstrates that the Nominal Group Technique has been used in a number of disciplines
number of disciplines ranging from health to humanities and social sciences, and as the cited studies in

studies in

Table 1 show, its use is particularly widespread in education and health sciences. The majority of
the cases examined used the Nominal Group Technique related to some kind of curriculum
development in Higher and Further Education, whether it was for the purposes of curriculum
review, evaluation or design.

Authors Discipline Purpose Participants N= NGT question

O‟Neil and BEd Curr. planning Academic staff 11 “What are the important
Jackson ingredients in the revised BEd?”
1983

Lomax and BEd Curriculum Students, 12 122 [not included, the question was on
McLeman evaluation groups of 7-14 the evaluation of the BEd
1984 students programme]

Chapple and Nursing (UG) Curriculum 3 groups of [unclear: “How the course might be
Murphy evaluation students, with but at strengthened?”
1996 subgroup size least 43]
bw 10-23

Davis, Nursing (UG) Curr. review Academic staff 40 ”What are the strength of the
Rhodes and undergraduate curriculum?”;
Baker 1998 “Within the UG curriculum, what
are the areas that need
improvement?”

Lloyd-Jones Medical Curr. Evaluation Students 10 „In what way can the course be
et al 1999 education and questionnaire strengthened?‟ „What are the
development strengths of the course‟

Dobbie et al Medical Curriculum Students 30 “What were the strengths of the
2004 education evaluation course?” “What were the
suggestions for improvement?”

Kristofco et Medical Organizational 2 sessions, with 20 “What are the key attributes that
education - define the ideal CME [continuing

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Authors Discipline Purpose Participants N= NGT question

al 2005 CPD planning panel experts medical education] institution?”

Williams et Radiographers Curr. design 8 regional 92 “With regards to clinical education
al 2006 groups incl. and training in diagnostic imaging &
managers, therapeutic radiography, what
educators, factors do you think affect quality
practitioners and capacity?‟
and learners

Crenshaw Cultural Curr. design 4 * 4 different 45 “What should be included in the
et al 2011 competence groups incl curriculum that focuses on cultural
(medical medical competence training for
education) students, physicians?”
residents,
community &
academic
physicians

Table 1 Uses of the Nominal Group Technique in educational contexts: a summary

Participants across the studies quoted above included academic staff members, students and also
stakeholders (such as panel experts, clinicians). The typical number of participants per group was
between 8-12, and the total number of participants per study ranged from 11 up to 122.

Benefits of the Nominal Group Technique
The above studies cite a range of benefits that using the Nominal Group Technique can bring.
These are grouped under five subheadings: benefits for individual participants, benefits for the
group dynamics and participants, benefits for the purpose/task, benefits for the facilitator, and
benefits for the commissioner of the research to whom findings are reported.

Benefits for individual participants
In the Nominal Group session, the Stage of individual-responses precedes group discussion, which
has been cited to help maintain the autonomy of individual viewpoints (Lomax and McLeman 1984)
and members making their own judgements (Williams et al 2006). It allows equal input by each
participant (Kristofco et al 2005) and encourages participants to consider all options (Crenshaw et
al 2011). Also inherent in its structure is that it generates its own issues rather than those
prescribed by the researcher, for instance as it is the case with surveys (Lomax and McLeman
1984, Chapple and Murphy 1996, Dobbie et al 2004, Lloyd-Jones et al 1999).

Benefits for group dynamics
As far as group dynamics are concerned, the structure of the Nominal Group Technique helps to
value every member‟s input, even that of shy or reticent members (Chapple & Murphy 1996); it
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helps reduce vocal voices or bias in the group (Dobbie et al 2004), and so, promotes equal
participation (Williams et al 2006; Crenshaw et al 2011). During a nominal group session, the
generated ideas and responses to the question(s) are displayed to the whole group. This visual
representation of mental processes was found to enhance the satisfaction felt by group members
in the process (Delbecq et al 1975; O‟Neil and Jackson 1983; Crenshaw et al 2011). In the last
stage, ranking the list is the product of group consensus and provides a direct reflection of the
implicit views held by a group, i.e. the achieved consensus (Kristofco et al 2005).

Benefits for the purpose/task
One of the benefits in terms of the purpose of the research or evaluation itself is, according to
Delbecq et al (1975) and a number of studies, is that using the Nominal Group Technique
produces a greater number of ideas than with other group methods, e.g. focus groups or
brainstorming (O‟Neil and Jackson 1983; Lloyd-Jones et al 1999; Dobbie et al 2004; Kristofco et al
2005; Crenshaw et al 2011). In addition, Williams et al (2006) have found that using the technique
allowed to carry out „substantial work‟ in a short time. Others have found that in terms of the
research purpose, the prioritisation stage helps decision-making by devolving it to the group
(Lomax and McLeman 1984).

Benefits for the facilitator
Studies on the benefits of using the Nominal Group Technique also cite advantages for the
facilitator that leads the session. Most of these stem from the fact that the structure of the session
restricts the role of the researcher (Lomax and McLeman 1984) and avoids the facilitator putting
their own inference or interpretation on the group member‟s input (Williams et al 2006). If the
discussion topic is controversial and is likely to end in heated discussions, the structure inherent in
the session can act as a control mechanism that discourages the responses to be evaluated and
discussed (Kristofco et al 2005). For the same reason, the technique can also be useful in a
research setting when participants are seen as having more power than the facilitator (Williams et
al 2006). According to Dobbie et al (2004), nominal groups require little facilitator input or
preparation time, although this benefit is not necessarily shared by others.

Benefits for the ‘commissioner’ of the research
And finally, there are a number of benefits that Nominal Group sessions can bring to the
„commissioners‟ of the research itself, who include the institution or the group of people to whom
results are reported. In some of the above curriculum review examples, „commissioners‟ therefore
include the higher education institution and the academic teams involved in the undergraduate
programmes.

The Nominal Group Technique can report the group consent between a large number of
participants in a way that merges the views between groups, not only reporting on each small sub-
group‟s views separately (as opposed to for example focus groups). This benefit is realised by the
rank ordered responses between sub-groups and also having a quantitative output of results
(Dobbie et al 2004) and by providing a concise summary of generated responses (Kristofco et al

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2005). The Nominal Group Technique is also reported to maximise efficiencies in the research
process and is an economic way of identifying teaching and learning issues (Lomax and McLeman
1984, Lloyd-Jones et al 1999).

Issues and challenges when using the Nominal Group Technique
The examined studies suggest that there are a number of issues and challenges to consider when
using the Nominal Group Technique. The importance of setting the question for the Nominal
Group Technique has been discussed by Lomax and McLeman (1984) and Williams et al (2006)
who stress that the question needs to be well-focused and not too wide. The training needs and
the demands placed on the facilitator are also mentioned as characteristics of the Nominal Group
Technique (O‟Neil and Jackson 1983; Chapple and Murphy 1996; Williams et al 2006).

A number of studies report interesting challenges with regards to the consensus achieved in using
Nominal Group Technique. For instance, Lomax and McLeman (1984) found that some
participants felt strong ownership about the wording of responses, which was an issue when it
came to members consolidating responses. They also found that views of individuals still influenced
others in the discussion phase, similarly to Chapple and Murphy (1996). Other studies also
encountered the group result to „mask minority disagreement‟ (Williams et al 2006; Chapple and
Murphy 1996). Another way researchers resolved the potential tension of group consensus,
fearing that results are not representative of the whole cohort of students beyond the subgroup of
students taking part in the Nominal Group Technique, was to run a follow-up survey with the
whole year, based on the top 10 ranked items in the Nominal Group Technique (Lloyd-Jones et al
1999).

The work by Chapple and Murphy (1996) also discovered that the timing of nominal group
sessions can bear an influence on the outcome of the research. In this study, a significant issue was
not concluded to be a major problem at the time of the sessions, but which surfaced later with a
greater vehemence. This was partly due to the timing of the session, and partly due to the nature
of the ranking task, which asked participants to select their top five priorities, and although the
issue was present in the list of issues identified by participants at this initial session, it did not make
it into the top five most important ideas, and so was not further reported.

Other studies also detected the reporting of only the top five items to be an issue. One reason
was that participants found it hard to select their top five items only (Chapple and Murphy 1996),
and partly because when especially working with sub-groups and combining the top five responses
of each group and re-ranking them across all the groups as a whole, significant items could be
missed off the final top-five ranking (O‟Neil and Jackson 1983).

Other concerns or challenges included that items produced by participants could be at different
levels, which made them difficult to work with as a single list of very dissimilar items (O‟Neil and
Jackson 1983), or the visibility of all items in large groups in the discussion and voting phases
(Lomax and McLeman 1984). In one instance, participant anxiety at the initial individual response
producing stage was discerned but resolved (O‟Neil and Jackson 1983).

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Having discovered the benefits and challenges, the following section will now describe the project
study, with regards to the methodology used.

Methodology

The project started in November 2010 and ran up to October 2011. The work included carrying
out a literature review on the Nominal Group Technique. The University Library‟s meta-engine,
Discover, was used to identify articles focusing on studies on the Nominal Group Technique that
included a curriculum review element, therefore is not necessarily representative of the whole
body of research on the technique itself across the disciplines. For instance, the project team was
less interested in organisational development studies and more so in studies which employed the
technique for educational purposes in Higher Education. This focus was reflected in the search
terms used – and which included „curriculum review‟ and „nominal group technique‟.

The project team also drew on experiences of previous nominal group sessions carried out for the
purpose of curriculum evaluation with undergraduate students in 2009/2010. These sessions
consulted 7 and 10 students undertaking an undergraduate degree in Law. The purpose of the
consultation was to find out students‟ learning experiences after a curriculum review initiative
entitled „TeachSmart‟ that involved elements of technology-enhanced learning. These sessions
were conducted using pen-and-paper methods, including post-it notes. There were two questions
used in the session: “What helps your learning?” and “What doesn‟t help your learning?” Students
were also asked to relate these comments to particular modules (which were either TeachSmart
or non-TeachSmart modules) so the analysis was able to cross-reference student comments and
analyse them in relation to the new initiative. The ranked list of results were forwarded and
presented to the academic programme team in Law.

The arrival of text-entry clickers, or personal response systems, was in February 2011. Clickers
are electronic handsets that allow students to input textual or numeric input to a given question,
and which responses are recorded electronically and can be immediately shown to the whole
classroom audience, as well as recorded for further use. WordWall clickers were chosen as they
were handsets developed for text-based entries (as opposed to other clickers which favour
numeric entries). The project team was trained in their use in March by the software developers.
During this initial training, the functions were reviewed and those selected that best suited each
stage of the Nominal Group Technique. Some of these were not exact matches but approximation
of the stages of the technique. A pilot Nominal Group Technique session with staff was run in
April. At this stage, a pilot ranking tool was developed for the purposes of our project in time for
the first student session.

The first student session using clickers was run using Nominal Group Technique in May 2011 with
students of Music. The purpose of this session was to find out students experiences with a
particular module, „Study skills in Music‟, and the new teaching approach it involved, in particular a
wiki task. The number of participants was 12. The „question‟ was: „What would you include in a

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future Study Skills in Music module?‟ This session used the clickers in all of the stages. The results
were fed back to the academic lead of the module.

Two further student focus group sessions, although using an adapted technique, were conducted
with undergraduate students in BSc (Hons) Radiotherapy for the purpose of undergraduate
curriculum review in October 2011. The project team is coordinating and contributing to,
institutional curriculum review. The purpose of the focus group sessions was to explore student
views of, and propose changes to, their current programme. The programme team provided the
key content for the focus group, based on assessment, structure, content and delivery methods.
Given that the Nominal Group Technique is more suitable to explore one single topic in a session
and that the brief for the project team was to explore a number of issues (from assessment
through to delivery methods), the Nominal Group Technique was found to be less useful in this
given context. The project team, in collaboration with the programme team, therefore decided to
use a focus group method that combined the use of open-ended questions along with elements of
the Nominal Group Technique.

In this adapted method, the project team ran a two-part session. In the first part („Open-ended
structured questions‟), a structured focus group discussion explored all areas under focus. In the
second part („Making decisions‟), using elements of the Nominal Group, students were asked to
individually respond to three suggestions on three questions. These were then themed by the
facilitator, using face-to-face facilitated discussion, based on achieving group consensus, instead of
individual ranking.

The three „questions‟ were:

 Name three things there could be less of for your learning in the programme;
 Name three things there could be more of for your learning in the programme and;
 Name three things that could stay the same (about right) for your learning in the
programme

The advantage of running these adapted focus group sessions was that the project team were able
to compare and contrast this adapted method with both focus groups and the Nominal Group
Technique.

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The team’s adaptation of the Nominal Group Technique
Due to a number of factors, such as time and availability, the context and focus of the
„commissioned‟ research the project team used various adaptations of the original Nominal Group
Technique as invented by Delbecq et al (1975). For instance, the project team typically did not
have 2-2.5 hours to run a full nominal group session with volunteer students, only 1 – 1.5 hours.

Stages of the Nominal Group Nominal Group Adapted focus
Nominal Group Technique for Technique for module group/Nominal Group
Technique curriculum evaluation in Music Technique for curriculum
evaluation in Law Review in Radiotherapy
Welcoming Introduction – Introduction – questions Introduction
statement questions and session and session structure.
structure.
Step 1 Silent Stage 1 – individual Stage 1 – individual Part A – open-ended questions:
generation responses responses focus group discussion on specific
Step 2 Round robin Stage 2 – clarification Stage 2 – clarification and topics (e.g. assessment, delivery
recording of ideas, and consolidation: consolidation: responses methods, programme structure)
Step 3 Serial responses are read are read out, clarified and
discussion and out, clarified and discussed, similar items
clarification discussed, similar items consolidated
consolidated
Step 4 Preliminary Stage 3 – individual Stage 3 – individual ranking Part B – making decisions: up to 3
vote on item ranking of responses of responses (top five) individual suggestions for each of
importance; (top five) the 3 questions („What would
Step 5 Discussion you like to have more of/less
of preliminary vote of/stay the same for your learning
(optional); in your programme?‟)

Step 6 Final vote Ranking results are Ranking results are Part B – facilitator themes similar
calculated and shared calculated and shared with suggestions, clarification and
with the group. the group. group consensus via discussion
Top five shared All the ranked list is All the ranked list is All the list is shared with the
with the shared with the shared with the commissioners of the research
commissioners of commissioners of the commissioners of the
the research research research
„Technology‟ of Ideas recorded on Ideas are typed in using a Ideas recorded on post-it notes
recording ideas: post-it notes which are clicker and displayed on which are pinned up by facilitator.
pen and flipchart, pinned up by facilitator. screen. Ranking by Theme-ing by facilitator re-
facilitator writes on Ranking by paper. clickers. arranging post-it notes and
board as reading out to participants. (No
participants dictate. ranking.)
Ranking by paper.
Table 2 The sessions ran by the project, with detail on our adaptations of the Nominal Group Technique

Table 2 summarises these adaptations in the different sessions. One of the main differences
concerned the „clarification‟ stage. Although Delbecq et al (1975) allows for discussion in this
stage, many subsequent studies on Nominal Group Technique did not allow for discussion of the
issues suggested by participants, but just to clarify ideas. The facilitator wanted to emphasise that
in this stage, students were actively asked to discuss some of the items in order to gain enough
detail through this stage on the items produced. Another difference was that whilst in other

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Nominal Group Technique studies only the first, top five ranked items were shared with the
commissioners of the research, in our case, the project team shared the whole ranked list where
this was available. And finally, the main difference between the team‟s use of the Nominal Group
Technique and the adapted version of focus group/Nominal Group Technique was that the session
started with a group discussion using focused questions, which was then followed by individual
item generation; group consensus was achieved by a facilitated discussion without the stage of
ranking.

Findings reported below are drawn from the above student sessions, both in terms of the data
collected in the student sessions as well as on the basis of the project team member‟s reflections,
which were carried out post-session in October 2011. This is in line with the methodologies used
by other studies.

Findings

The purpose of this project was to share our experiences with running student feedback sessions
using the Nominal Group Technique, and to see whether the use of clickers can make the process
of conducting these student sessions more efficient and engaging. Both of the findings for these
aims are discussed in this section.

Findings with regards to the Nominal Group Technique
The project team found that for the different purposes of module & curriculum evaluation and
review the use of the Nominal Group Technique was extremely useful. The results were fed back
to the academic teams and were found to be useful indicators of student feedback.

Many of the benefits discussed in the Literature Review section (page 6 onwards) were realised, in
terms of the individual members, giving equal voice to participants or helping to promote
participation, giving a sense of satisfaction to students when they see their suggestions in writing. It
was a clear benefit that students were generating their own issues rather than those prescribed by
academic staff members in module evaluation forms. The team was also able to compare the
number of items generated during the combined method in the radiotherapy sessions: in part A,
the open-ended focus group session 44 items were discussed under 7 themes. In part B, the
„nominal‟ part, as a result of individual item generation (the „nominal‟ part), 112 items were
generated in the 3 questions in 24 themes, which suggests that the individual item generation does
have the potential to yield a large number of responses. Although the project team did audio-
record the sessions to save the clarification and discussion stage, and used these recordings to
fine-tune writing up of results, the results were immediately available after each session, making it
an efficient method for consulting students for feedback. The team also found students to be very
engaged in the whole feedback process.

Despite the various benefits of the Nominal Group Technique, the project team also came across
a number of issues that ranged from practical advice for future sessions through to the more
fundamental aspects of the technique itself. These included:
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Practical considerations:

 If the structure is not properly introduced, students can get confused especially in the
clarification stage when the merging of items occurs.
 Students can start combining responses on the same post-it notes, so they need reminding
to write one suggestion or item per post-it note, so that they can be manipulated later as a
separate item.

Considerations in the various stages of the nominal group session:

 Differences in facilitation – although differences in facilitation concerned mainly the
practical aspects of running the group session, it was nevertheless an issue worth noting.
This regarded subtle differences, for instance when the project team ran the Law
Curriculum Review sessions in two subgroups, the two facilitators ended up using
numbering the items and then the subsequent ranking in slightly different ways which only
became evident when merging the two ranked lists between groups. It is important to
highlight that this was a minor procedural issue which did not influence the outcome of the
process.
 Item generation – the „question‟ needs to be really clear and well introduced, so that
people do not get stuck at the start. Facilitators felt that students were not always
„warmed up‟ well enough to start talking about their programme in detail, straight after
announcing the research question , e.g. „What helps your learning?‟ or „What changes
would you make to this module?‟
 Clarification and consolidation - students were found in this stage „theme‟-ing items
(e.g. grouping all items that concern feedback on their coursework together) rather than
appreciating the different aspects that each individual formulated. The facilitator needs to
be alert so that theme-ing of responses does not happen. (So for instance, if student A has
put what helps my learning is „when I get individual feedback‟ and student B has put „when I
get timely feedback‟; students in the consolidation stage may say A & B are the same, they
are both about feedback. Whereas, A and B responses are different and should stay as
different items.
 Ranking – the facilitators always forwarded the whole of the ranked list of items, not just
top five, as all those that students recommended were deemed relevant to the programme
team, with the top five being indicators of the most important ones. This was to overcome
the danger of presenting only the top five priorities (Chapple and Murphy 1996; O‟Neil and
Jackson 1983).

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Using the Nominal Group Technique in different contexts
What the project allowed the project team to better understand was the suitability of the
Nominal Group Technique in different research contexts. This has been summarised in the
accompanying The Nominal Group Technique: a practical guide for facilitators, and also copied below.

Context NGT is more useful for: NGT is less useful for:

Research purpose Evaluation and decision-making Researching general learner
experiences
Topic focus When you have one single topic to explore When you have more topics or a
complex topic to explore
Likely research “What changes would you make to your “What are your experiences with
questions programme/curriculum?” your programme so far?”
“What would help you improve the quality “What are your experiences with
of feedback on this course?” the quality of feedback on this
course?”
Participants Participants with different power relations If power relations are not a major
within the same group; when consulting issue in the group.
various stakeholders groups within same
research (e.g. from students through to
experts).

Table 3 The usefulness of the Nominal Group Technique under different research and evaluation contexts
(source: Varga-Atkins (2011) The Nominal Group Technique: a practical guide for facilitators)

Based on the project team‟s work-to-date, the Nominal Group Technique appears more useful for
exploring single topics, and for evaluation, decision-making and action planning, whereas it appears
it is less useful in contexts that involve exploring the general experiences of learners or
multiple/complex topics. It would then appear an especially useful tool when consulting staff on
their view on curriculum review or design, and who – as individuals - are likely to have set views
about teaching/learning. The Nominal Group Technique can serve as a useful method in reducing
the opportunities for vocal members to engage in debate, and instead, allow each participant to
express views, with the majority making the final decision. With students, the power between
participants was found to be less of an issue: students could be focusing on one issue that was
close to their heart, but this usually did not impact or deter other students from voicing (or
having) different experiences. Nevertheless, the Nominal Group Technique was useful in allowing
even shy and reticent group members to contribute, and therefore the project team consider it a
useful tool to engage students or staff members in curriculum feedback. An important innovation
was the running of an adapted session which combined elements of the Nominal Group Technique
in a focus group session. The advantage of this approach was that it made it possible to run a
session with the purpose of multiple topics (not possible via only a Nominal Group session), as
well as „warming‟ up the students in a group discussion, whilst also keeping the element of
individual work which preceded effective group decision. The next section will detail the project
findings as to the use of clickers in Nominal Group Technique.

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Clickers: the use of technology in Nominal Group Technique
One of the aims of this study was to find out whether the use of personal response systems, i.e.
„clickers‟, can make the conduct of the Nominal Group Technique more engaging and efficient.

The consulted studies in our literature review – with the exception of one – all used pen-and-
paper methods for conducting Nominal Group sessions. Only Kristofco et al (2005) conducted the
session using technology. Their participants were located at different sites so they used a
synchronous web-conferencing platform to conduct the whole session online. No studies
consulted experimented using technology in conducting face-to-face sessions.

As mentioned in the Methodology section (page 9), one of the reasons for the project team to
experiment using clickers in a face-to-face session was to see whether the process of the various
stages can be made more efficient. For instance, in previous sessions, the facilitator had to write
responses manually on a board whilst the participants waited for this to complete (and which
handwritten responses then needed to be converted electronically for report writing at a later
stage); or the post-it notes were not always legible. Reducing the time spent on handwriting
responses and improving whole-group visibility and legibility of suggestions were all expected
benefits of implementing a technological solution.

What follows in this section is therefore the evaluation as to the efficiency of the particular
clickers and software used, namely the WordWall clickers, with indication as to what an „ideal‟
software solution would look like that would improve the efficiency of facilitating a Nominal
Group session.

Firstly, Figure 1- Figure 5 illustrates the stages of the Nominal Group process. The session with
clickers started with the introduction of the purpose of the session, its structure and handsets
were handed out to each participant, with a laptop connected to a projector. Students then
entered their individual responses.

Figure 1 Stage 1 of the Nominal Group Technique: entering individual responses using a clicker

Responses then were collected in a „TextBank‟ (the examples used in the illustrations are not from
a real session).

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Figure 2 Stage 1 of the Nominal Group Technique: individual responses (see TextBank where responses are
recorded in right panel of the screen)

The facilitator then dragged all responses from TextBank onto the central screen for all
participants to see.

Figure 3 Stage 2 of the Nominal Group Technique: consolidating responses dragged from TextBank on to screen
after everyone has submitted their responses

After a clarification and consolidation stage, duplicate items were deleted or edited together.
Finally, students were asked to select the five most important items and rank them in order of
importance.

Figure 4 Stage 3 of the Nominal Group Technique: ranking responses with the clickers

The ranked results were automatically calculated and displayed to students.

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Figure 5 Stage 3 of the Nominal Group Technique: the top five ranked responses (in this tool, the item gaining
the least points is the one designated with the highest importance)

When the session was run in May, a full ranking tool was not yet operational; a pilot ranking tool
was, however, available, but this pilot tool was not yet very intuitive. As the software development
team was very responsive to the team‟s requests and feedback, the ranking tool had undergone
further development so at the time of writing these teething problems had been resolved.

Stages of the Nominal A. Nominal Group Technique B. Nominal Group Technique
Group Technique without technology with technology
(WordWall clickers)
Introduction – questions and None. None.
session structure. (Facilitator speaks.) (Facilitator speaks.)
Stage 1 – individual responses 1 Participants write each response on a 1.1 Participants enter responses via
post-it note. clickers (anonymously).
1.2 Items are dragged onto screen
from ItemBank.
Stage 2 – clarification and 2.1 Participants stick post-it note on a 2.1 Each response is displayed on
consolidation: responses are flipchart screen for whole group to see.
read out, clarified and 2.2 Participant or facilitator reads out
discussed, similar items each response one by one. 2.2 Similar items are merged.
consolidated 2.3 Facilitator numbers each item.
2.4 Consolidation by grouping similar
post-it responses together.
2.5 Re-numbering items (if merged).
Stage 3 – individual ranking of 3 Using a paper voting sheet, the 3 Participants vote their top five
responses (top five) numbered items are ranked (top five). using their clicker
Ranking results are calculated 4.1 Participants read out ranked items, 4 Results are automatically
and shared with the group. facilitator codes results on a calculation calculated by the software.
sheet.
4.2 Facilitator manually calculates top five
results (or using a calculator).
All the ranked list is shared 5 Post-it notes & ranked items need typing 5 Ranked list is available
with the commissioners of the up electronically so that they can be electronically and can be shared
research shared. immediately.
Table 4 The use of technology in each stage

Table 4 shows above a side-by-side comparison of the stages of the Nominal Group Technique in
two scenarios: A) when the session was run using traditional „technologies‟, i.e. with pen, paper,
post-it notes and flip charts and B) when the session was run using the WordWall clickers.
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Table 4 shows the potential savings that had been envisaged by using technology to enhance the
efficiency of conducting the session. These were in the areas of:

 Stage 1 – answers using clickers are immediately saved.
 Stage 2 – responses are immediately visible to the whole participant group; grouping and
editing items is „easy‟ and that the facilitator does not need to worry about numbering
items for the ranking stage.
 Stage 3 – the ranking tool numbers the items, the ranking results are calculated
automatically and so the final results (the list itself together with its priority ranking) are
immediately available for forwarding to the commissioner of the research.

In Table 5, the different Stages are summarised, together with how well they worked using the
clickers and how they then related to the envisaged benefits.

The Nominal Group Technique How did this work?
using WordWall clickers
Stage 1 – individual responses 1.1 This worked well – responses were saved electronically and
1.1 Participants enter responses via could be retrieved later.
clickers. 1.2 The disadvantage in this stage was that responses were not
free floating on screen but had to be associated with grid cells and
1.2 Items are dragged on to screen that responses needed to be dragged out on to screen to display,
from ItemBank. it was not an automated process. It was still much quicker than
writing each response on the flipchart by hand.
Stage 2 – clarification and 2.1 Whole-group display worked well.
consolidation
2.1 Each response is displayed on 2.2 This was the most difficult stage to achieve electronically
screen for whole group to see. Although the end-product was ok, i.e. all responses were
consolidated, in comparison with the flipchart/post-it method, it
2.2 Similar items are merged. was clunky.

Responses were displayed and whereas post-it notes could be
easily grouped, this wasn‟t the case with items in cells of a table
(they were less „groupable‟). Another issue was that the
WordWall software did not allow in-line editing of a grid text, you
had to use backspace to delete text before re-editing the new text
(e.g. if you wanted to change ‘Mi item’ to ‘My item’, you had to delete
the whole text up to ‘M’ and then re-enter ‘My item’).1 Merging of
items was visually difficult, because of the lack of flexibility to move
items around on screen and the issue of editing.

Overall, there were gains in immediately having electronic texts
which was counterbalanced by the loss of flexibility of post-it
notes.

1
This feature is coming in the next version of the product.

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The Nominal Group Technique How did this work?
using WordWall clickers
Stage 3 – individual ranking The ranking tool in WordWall is much better improved now since
3 Participants vote their top five when it was first piloted in May 2011. One consideration in this
using their clicker and the ranking stage should be that at the point of ranking, students should be
tool able to see all items together as a list so that they can choose their
top five easily.
4 Results are automatically calculated The ranking tool calculates the prioritised list automatically.
by the software. Calculation with WordWall clickers uses a slightly different
method than described by Delbecq et al (1975) in which the top-
ranked items get the most points. The calculation of the
WordWall software computes in a way that the top chosen item
has the least score.
5 Ranked list is available This wasn‟t tested at the May 2011 session, but it should be no
electronically and can be shared problem to have ranked results electronically.
immediately.

Table 5 Findings: the use of technology in each stage

To summarise the findings: using clickers (in this particular case with these particular
clickers/software) worked best in Stages 1 and 3 for entering responses and calculating ranking
(with some of the provisos in ranking as outlined in Table 5). Clickers worked least well in stage 2.
The „functions‟ the team were trying to enhance using technology were grouping and editing
similar items together for clarification, and merging similar items together if they were considered
the same. The clicker software was a bit too rigid for these functions and even if it was possible to
conduct the session in line with the Nominal Group Technique, it was slightly more time-
consuming than expected for a technological solution and required more attention on the part of
the facilitator. The software developers of WordWall were however very responsive to the
suggestions made by the project team, especially in creating the ranking tool on request, and it is
possible that future versions of the software may be more suited to the conducting a Nominal
Group Technique with clickers.

To conclude, using the WordWall clicker software, and in general clickers, has the potential to
enhance the efficiency of the stages, though currently these advantages surface mainly for stages 1
and 3 of the process, and less so for Stage 2, clarification and consolidation. On the basis of
project experiences, the next section examines the desired features of an ideal clicker which
would make the conduct of the Nominal Group Technique more efficient. In this search for an
ideal tool, alternative software tools are also considered.

‘Ideal’ technology requirements and alternative tools
Presuming that a potential tool would seamlessly aid the facilitator in the conduct of all the stages
of the Nominal Group Technique, a list of requirements is drawn up (Figure 6).

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Stage 1
1 Participants use handsets, or mobile phones, to type their responses. These are
automatically saved as a list.
Stage 2
2.1 The responses are displayed on screen for everyone to see.
2.2 Items can be dragged-and-dropped across the screen to visually group similar items
together. (Similarly to how we can group post-it notes.)
2.3 Items can be easily edited (text changes), or deleted, if relevant.
Stage 3
3 Participants vote their top five using their clicker and the ranking tool. (The tool numbers
the items automatically, ready for voting.)
4 Results are automatically calculated by the software, preferably using the ranking method
by Delbecq et al (1975).
5 Ranked list is immediately available electronically and can be shared with others.

Figure 6 Technology requirements of a tool that can enhance the conduct of a Nominal Group Technique session

Another issue in using such a technological solution would need to consider is the maximum
capacity that a display screen can cater for in terms of the number of items generated. If for
instance, in a group of 12, every participant generates 3 responses, a total of 36 responses needs
to be displayed, which should be okay and visible in a room of 12 people (dependent on the
projector‟s placement as well). But as the number of participants or items generated may grow,
any solution that uses a computer screen would need to accommodate all responses.

Clearly, the clickers and software, such as WordWall, are being developed further, and would
serve as one technological solution. The project team has also started exploring other tools that
may be useful to those considering the Nominal Group Technique. One such freely available tool
is Google Moderator (http://moderator.appspot.com/), which allows the setup of a topic to which
participants are invited to add suggestions. These suggestions are displayed to all on the web and
participants can tick the suggestion they like, therefore creating the ranking/voting element (Figure
7). The combination of item generation with the voting element gives the option to approximate
the technique.

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November 2011

Figure 7 A Google Moderator topic: topics can contains suggestions and each suggestion can be voted on by
invited participants

This online tool has the advantage that it is free, suggestions can be further discussed online, and
ranking is simple. It suits an online consultation better than it being used within a face-to-face focus
group session. Therefore, it would seem to sit better as an approximation of The Delphi tool
(Delbecq et al 1975), which was developed for consultation at a distance, rather than the Nominal
Group Technique. Another difference with regards to the Nominal Group Technique is that the
responses are immediately displayed to participants, it does not require them to commit their
responses before seeing others‟, and that the individual response and voting stages are not as
clearly separated as they are in the Nominal Group Technique. (Although facilitators could set
two deadlines, one for response generation and one for voting to keep up this separation.)

Another, recently discovered relevant piece of software is WallWisher (www.wallwisher.com), which
is an online notice-board maker tool.

Figure 8 WallWisher.com – a tool for online post-it notes on a given topic

WallWisher allows participants to log on to a „Wall‟ and create post-it notes which they can drag
and drop, this feature may be particularly useful for certain stages of the Nominal Group
Technique. If this tool allowed participants to add post-it notes via mobile phones or upload them
using a list of responses already generated by WordWall, then this technique would be especially

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useful for Stage 2 of the Nominal Group Technique. (The authors are currently investigating the
potential of this tool.)

To conclude, in this section the use of clickers in the conduct of Nominal Group Technique was
evaluated, the project team examined the technological requirements of an „ideal‟ tool that could
enhance the efficiency of conducting such a session and also other tools that could be useful
alternatives. In the final section, the project team conclude our project findings.

Conclusion

The aims of the research project were to:

1. Share the project team‟s learning with fellow researchers on the experiences of running
student feedback groups using the Nominal Group Technique.

2. Trial text-entry clickers in order to see whether their use can make the process of
conducting the student feedback sessions more efficient and engaging.

This project report detailed the project team‟s learning about the use of Nominal Group
Technique. It included the examination of other, relevant learner evaluation studies, which used
the technique, together with its benefits and challenges. A way of sharing these experiences with
both staff and students was in the form of a practical guide on the Nominal Group Technique
(Varga-Atkins 2011), one of the project‟s outputs. Using the Nominal Group Technique appeared
to bring the same benefits as outlined in the consulted literature (page 6 onwards). The Technique
offers a democratic way of consultation, which gives equal voice to all participants, encourages
participation and engagement. Its inherent structure allows members to come up with their own
suggestions, yielding in a prioritised list of action items based on group consensus. It is also an
efficient method in that it provides a high number of suggestions in a short space of time.

The project also described the ways in which the Nominal Group Technique was adapted to suit a
range of purposes. The Nominal Group Technique seems best suited to single topic evaluations or
when items for action need to be identified (e.g. typically answering the question „How could this
programme be improved?‟), and less suited to researching general experiences, or when a
complex topic needs exploring (e.g. a typical research question could be „What are your
experiences with XY teaching approach?‟)

One of the main rationales for the project was to explore whether the use of text-entry clickers
can make the process more efficient and engaging during facilitation. No other studies
experimented with using technology in the conduct of a face-to-face session. A particular clicker,
WordWall, was tested and it was concluded that the use of clickers does have the potential to
enhance the different stages (1) individual response generation, 2) clarification and consolidation of
responses, 3) ranking. In its current version, the software can enhance stages 1 and 3, whilst it is

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less flexible when it comes to consolidating items on screen (stage 2). The report compiled a list
of requirements that such a technological solution would need to cater for, as well as indicated
some alternative tools as approximations, though not complete matches, as to the Nominal Group
Technique. These tools included an online voting site, Google Moderator and the online post-it
board tool, WallWisher. The project team feels that the work undertaken has usefully contributed
to the assessment that the use of clickers does have the potential to make the conduct of sessions
more efficient. Although the clickers used in the study in their current form are less suited for
conducting groups. However, the project team was able to identify the technological requirements
of any potential system to be considered, and so is in a much better position to evaluate whether
the use of any other tool would make the process more efficient. One limitation of the report is
that of examining student engagement in a systematic way in relation to the technique. The data
relied on comprised of facilitators‟ observation and reflections of students. One recommendation
for future study includes the gathering of systematic primary data from students with regards to
their engagement in the process.

Finally, for the project team, the work has provided a valuable learning opportunity, an extension
to the two original project objectives. The learning gained includes a deeper conception about the
technique itself, especially the suitability of Nominal Group Technique in different educational
contexts. As a result, and a further outcome of the project, the team has developed a technique
that combines focus group methodology with elements of the Nominal Group Technique. One of
the advantages of this combined technique was that it seems more suited to a context in which
multiple topics needed to be explored, and in which context the Nominal Group Technique was
found less useful. The other advantage was that the initial group discussion „warmed up students‟
to the topic(s) in question so by the time their „nominal group‟ work occurred in the second part
of the session, they had a chance to think through these issues. This combined method was found
to be a really useful alternative method to use in student feedback sessions. Further exploration of
this combined method is recommended for future study, as is the continuation for a search for
appropriate technologies that can aid the facilitator‟s conduct of face-to-face Nominal Groups.

References

Chapple, M., & Murphy, R. (1996). The Nominal Group Technique: extending the evaluation of
students‟ teaching and learning experiences. Assessment & Evaluation in Higher Education, 21(2), 147-
160. http://dx.doi.org/10.1080/0260293960210204

Crenshaw, K., Shewchuk, R. M., Qu, H., Staton, L. J., Bigby, J. A., Houston, T. K., Allison, J., et al.
(2011). What Should We Include in a Cultural Competence Curriculum? An Emerging Formative
Evaluation Process to Foster Curriculum Development. Academic Medicine, 86(3), 333-341.
http://dx.doi.org/10.1097/ACM.0b013e3182087314

Davis, D., Rhodes, R., & Baker, A. (1998). Curriculum revision: Reaching faculty consensus through
the nominal group technique - ProQuest. Journal of Nursing Education, 37(7), 326-328.

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Delbecq, A.; Van de Ven, A and Gustafson, D (1975). Group techniques for program planning: a
guide to nominal group and Delphi processes. Glenview Ill.: Scott Foresman.

Kristofco, R.; Shewchuk, R.; Casebeer, L; Bellande, B and Bennett, N (2005). Attributes of an Ideal
Continuing Medical Education Institution Identified Through Nominal Group Technique. The
Journal of Continuing Education in the Health Professions, 25, 221-228.

Lloyd-Jones, Fowell, & Bligh. (1999). The use of the nominal group technique as an evaluative tool
in medical undergraduate education. Medical Education, 33, 8-13. http://dx.doi.org/10.1046/j.1365-
2923.1999.00288.x

Lomax, P., & McLeman, P. (1984). The uses and abuses of nominal group technique in polytechnic
course evaluation. Studies in Higher Education, 9(2), 183-190.
http://dx.doi.org/10.1080/03075078412331378834

O‟Neil, M. J., & Jackson, L. (1983). Nominal Group Technique: A process for initiating curriculum
development in higher education. Studies in Higher Education, 8, 129-138.
http://dx.doi.org/10.1080/03075078312331378994

Varga-Atkins, T., with contributions from Bunyan, N; McIsaac, J; Fewtrell J. (2011) The Nominal
Group Technique: a practical guide for facilitators. Written for the ELESIG Small Grants Scheme.
Liverpool: University of Liverpool. October. Version 1.0. Available at http://slidesha.re/s5KPUr

Williams, P., White, N., Klem, R., Wilson, S., & Bartholomew, P. (2006). Clinical education and
training: Using the nominal group technique in research with radiographers to identify factors
affecting quality and capacity. Radiography, 12(3), 215–224.

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