The art of the Delphi technique: highlighting its scientific merit

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Consensus on a Specialist Clinical Learning and Teaching Framework for Australian Nurse Practitioners

Objective To develop a core competence evaluation index system for preventive medicine undergraduates. Methods Following the scientific, systematic and applicable principles, we proposed evaluation index system of core competence for professional medical prevention and selected 35 experts for three rounds expert consultation on the index system by using Delphi method. The basic situation, the positive and authority degree of experts and all levels of index weight coefficient were analyzed using SPSS 13.0 software. Results The core competence evaluation index system for preventive medicine undergraduates included six dimensionalities, fifteen secondary indicators and fortynine tertiary indicators. The six dimensionalities included professional value behavior (0.25), professional knowledge and skills (0.28), basic specialized knowledge (0.20), communication (0.13), information management (0.06) and systems thinking (0.08). Conclusion The establishment of the evaluation system can provide a scientific and objective reference for the evaluation of the core competence of medical students. Key words: Delphi method; Preventive medicine; Core competence; Evaluation system

تأمین پدافند غیر عامل شهر در شرایط پیش از بحران از مهم‌ترین وظایف برنامه ریزان و طراحان شهری است. در بررسی پدافند غیر عامل، عوامل و عناصر متعددی مانند کاربری اراضی، شبکه دسترسی، تراکم و... تأثیرگذارند که به وسیله آن‌ها می‌توان پهنه‌های آسیب پذیر شهر در شرایط بحرانی را تشخیص داد. هدف اصلی این پژوهش، شناسایی پهنه‌های آسیب پذیر پدافند غیر عامل در یک تحلیل چند معیاری و ارائه پیشنهاد‌های کاهش دامنه آسیب پذیری پدافند غیر عامل در شهرک شهید باهنر مشهد می‌باشد. بدین منظور پژوهش حاضر با رویکردی توصیفی – تحلیلی و با بررسی و تحلیل ادبیات موضوع گسترده پدافند غیر عامل به ارائه چارچوب نظری پژوهش پرداخته است و پس از تهیه نقشه‌های تحلیلی توسط نرم‌افزارهای (GIS) و (Space Syntax)، در ادامه با استفاده از روش‌های تحلیلی کیفی (Delphi) و (AHP) به تحلیل و اولویت‌دهی پهنه‌های آسیب پذیر پدافند غیر عامل اقدام نموده، و در انتها توسط روش تحلیل‌گر همپوشانی وزن‌دار (Weighted Overlay) به شناسایی پهنه‌های آسیب پذیر بافت شهرک شهید باهنر مشهد اقدام نموده است. یافته‌های این پژوهش نشان می‌دهد که از میان شاخص‌های قابل بررسی، سه شاخص معابر شریانی درجه یک، مراکز امدادی و مخازن آب بیشترین و شاخص‌های تراکم جمعیتی کم و بافت مرمتی کم ترین اهمیت را در فرایند شناسایی پهنه‌های آسیب پذیر داشته‌اند. از نتایج مهم این پژوهش می توان به تاثیر نبود دسترسی های جمع و پخش کننده پیرامونی بر آسیب پذیری محدوده و مشخص شدن میزان درصد پهنه های آسیب پذیر محدوده در سه طبقه حیاتی، حساس و مهم اشاره کرد.

Objective To develop a perioperative care model for patients with thyroid disease under the guidance of enhanced recovery after surgery and to provide a reference for the performance of enhanced recovery after surgery in clinical thyroid nursing mode. Methods The enhanced recovery after surgery care strategies during the perioperative period for thyroid neoplasms patients were formulated by literature review in combination with focal group interviews and the Delphi method from October 2016 to February 2017. Results The response rates for the questionnaires during the two rounds of communication with experts were both 100% (16/16) . The authority coefficients (Cr) of experts for the 2 rounds were 0.870 3 and 0.882 8, respectively. It was found that the nursing mode based on enhanced recovery after surgery included 13 primary indicators and 32 secondary indicators. The significance score of these primary indicators averaged 0.90-0.95, with a full mark ratio of 0.50-0.87, while the significance score of these secondary indicators was 0.89-0.96, with a full mark ratio of 0.56-0.93. The coefficient of significance variance was 0-0.15, and Kendall's W was 0.227 (P<0.01) . Conclusions The perioperative care strategies for thyroid surgery under the guidance of enhanced recovery after surgery are developed in this study using the Delphi method, which may provide a scientific reference for clinical nursing work. Key words: Thyroid neoplasms; Perioperative nursing; Delphi method; Enhanced recovery after surgery; Nursing mode

Objective To construct a scientific and objective assessment to value nurse's ability of scientific research in order to provide an objective unified standard and operable method to value nurse's ability of scientific research and provide a standard for medical institutions to select nurses of scientific research. Methods After searching literatures and interviewing 7 experts, Delphi method was used to construct primary variables of nurse's ability of scientific research. Then a second interview was given to each of 18 experts. The variables were weighted using analytic hierarchy process. Results Variables to assess nurse's ability of scientific research included 2 first grade indices, 9 second grade indices and 35 third grade indices. Questionnaire return rates for two rounds of interviews were 84.00% (21/25) and 85.71% (18/21), respectively. Degree of authority Cr was 0.938. Scores of variables' importance ranged at 4.06-4.96. Ratios of full scores ranged at 33.33%-94.44%. Variable coefficients ranged at 0.05-0.25. The weight coefficients of 3 first grade indices (scientific research accumulation, explicit ability of scientific research, and intrinsic ability of scientific research) were 0.475 and 0.525, respectively. Conclusions The nurse's ability of scientific research assessment system based on Delphi method and analytic hierarchy process is scientific and objective. This system combines quantitative and qualitative variables. It thus can calculate the ability of nurse's scientific research according to the three grade indices. It is operable to be used to assess the ability of nurse's scientific research. Key words: Nurses; Research ability; Aassessment system; Delphi method; Analytic hierarchy process

Objective The study aimed at establishing an evaluation index system of clinical competence of nursing undergraduate interns,which is more scientific,clearly guidable,comparative and convenient in order to provide the theoretical foundations to enhance the standardization,objectivity and fairness of the evaluation of clinical competence of nursing undergraduate interns.Methods Based on the Delphi method,the items of evaluation system was selected,the standards with 4 different levels for each item were set.Results The evaluation index system of clinical competence of nursing undergraduate interns was constructed,which was composed of 23 items from 5 domains including professional value,clinical nursing competence,communication and collaboration competence,teaching and management competence and professional development competence.Four different levels of evaluation standards were set for each item to differentiate different levels of clinical competence.The enthusiasm coefficient of experts was 96.2％(＞60％),the average authority coefficient of experts was 0.9128 (＞0.70).The harmonization coefficient of the 5 domains in the first grade index was 0.9262 and those of 23 items in the second grade index was 0.9127.Conclusions The index system of clinical competence of nursing undergraduate interns established evaluation standard of each level.The enthusiasm coefficient,authority coefficient and harmonization coefficient of expert consultation showed that it has high representativeness and reliability. Key words: Delphi method; Nursing undergraduate; Clinical competence; Evaluation

Objective To construct the gall-stone patients' nursing workload measurement project by Delphi method,so as to measure single disease workload scientifically and reasonably. Methods The gall-stone patients' nursing workload measurement project were designed on the basis of consulting literature and experts discussion, then two rounds of consultations were made with experts by using the Delphi method. Results The valid recovery rate of questionnaires of two rounds consultations were all 100% (22/22). The expert authority coefficient was 0.886 1. Nursing workload measurement project, directly related to the gall bladder calculi 54 nursing projects, including technical 46, unskilled 7; indirectly related to the gall bladder calculi 36 nursing projects, including technical 17, unskilled 19. Conclusions The measurement project of gall-stone patient determined by Delphi method has high reliability, which is significant to the scientific measuring of nursing single disease workload. Key words: Cholecystolithiasis; Delphi technique; Nursing workload; Measurement project

Objective Cervical radiculopathy treatment experts' consensus to establish radiculopathy type by using the modified Delphi method. Methods Use document retrieval method to review information and articles about the treatment guidelines and articles of cervical radiculopathy including domestic and international areas, established a protocol about clinical consensus of the treatments for cervical radiculopathy. This protocol included 23 questions (the effective proportion of non-operating therapy, neck immobilization, physiotherapy, pharmacologic treatment, surgical indications, contraindications, anterior surgical decompression, anterior surgical implants). We performed a modified Delphi survey in which current professional opinions from experienced experts, representing from almost all of the Chinese provinces, were gathered. And then we modified the protocol according to those professional opinions. Three rounds were performed and finally we established consensus. Consensus was achieved with ≥70% agreement. Results The panel included 30 experienced experts. The recycling questionnaire's quantity of three rounds were 30(100%), 24(80%) and 16(53.3%) respectively. After three expert assessments, there were 18 questions which achieved with ≥70% agreement and these questions accounted for 64.3%(18/28) of all the questions. Consensus of the treatments for cervical radiculopathy was reached on 7 aspects, including: the effective proportion of non-operating therapy (1 question), neck immobilization (1 question), physiotherapy (1 question), pharmacologic treatment (5 questions), surgical indications (3 questions), contraindications (4 questions), surgery (3 questions). Conclusion This modified Delphi study had reached a consensus concerning several treatment issues on cervical radiculopathy which had strong representativeness of experts and good convergence of opinions. In the absence of high-level evidence, at present, these experts' opinion findings will guide health care providers to define appropriate treatment in their regions. Areas with no consensus provide excellent insight for future research. Key words: Cervical spondylosis; Radiculopathy; Delphi technique; Consensus

Objective To understand the situation of college students' knowledge, attitude and practice (KAP) of innovation and entrepreneurship activities and analyze their influencing factors, in order to provide a scientific basis for further promotion of innovation and entrepreneurship activities. Methods A self-administered questionnaire survey using cluster sampling method was conducted among 850 undergraduates in a medical university in May, 2018. The demographic characteristics and questions pertaining to the KAP of innovation and entrepreneurship activities were collected, The weighted scores of KAP were calculated using the Delphi method. Chi-square test, multivariate logistic regression and linear regression analysis were used to analyze the data. Results A total of 850 questionnaires were sent out and 800 valid questionnaires were collected. The average scores and pass rates for the knowledge, attitude and practice of the 800 college students were (0.54±0.14), 38.1%; (0.56±0.23), 51.5%; and (0.37±0.19), 12.6%, respectively. Knowledge: the pass rate for the concepts related to innovation and entrepreneurship was 70.5%, and the pass rate for the policies related to innovation and entrepreneurship was 17.2%. The pass rate of senior students and excellent students were higher than those of junior students and students of lower academic competence (P=0.000, P=0.004). Attitudes: the pass rate for attitude towards the relationship between innovation and entrepreneurship and personal development was 63.6%, the pass rate for attitudes towards participation in innovation and entrepreneurship was 49.8%, and the pass rate for attitudes towards the school continuing to carry out innovation and entrepreneurship related activities was 23.8%. Practice: the pass rates for participation in scientific research and academic activities and social practice, voluntary cultivation of innovation ability and self-employment were 8.5%, 62.9%, 11.9% and 27.3%, respectively. The pass rate of senior grades was higher than that of junior grades (P=0.001). Scores for knowledge and those of attitude are positively correlated. Scores for practice and those of knowledge and attitude are positively correlated. Conclusion The higher pass rates for medical college students' attitude toward innovation and entrepreneurship activities as compared to those for knowledge and practice indicates high eagerness toward participation in innovation and entrepreneurship activities; a high rate knowledge is conducive to the cultivation of attitudes and the improvement of participation in activities. Therefore, it is necessary to strengthen the efforts in carrying out innovation and entrepreneurship activities, improve publicity and education, and promote the awareness-raising of innovation and entrepreneurship. Key words: Innovation and entrepreneurship; College students; Knowledge-attitude-practice (KAP); Influencing factors

Objective To construct the evaluation index system of home safety of empty nest elderly in community, and to provide a reference for the analysis of potential home safety hazards and the formulation of safety intervention measures for the empty nest elderly in the community. Methods From June 2018 to March 2019, based on literature review, Delphi expert consultation method was used to design the Expert Consultation Table for the Index System of home safety of the empty nest elderly in community, which included five first-level indicators (physiological status, home environment, psychological status, social support, safety knowledge, attitude and practice) and 52 second-level indicators. 15 experts in geriatric nursing, geriatrics and injury epidemiology were selected for two rounds of consultation. Results The positive coefficients of experts in the first and second rounds were 83.3% and 100.0%, respectively; the authoritative coefficient of experts was 0.91; Kendall W coefficients in the first and second rounds were 0.246 and 0.356, respectively (P<0.01) ; after two rounds of inquiry, an evaluation index system of the home safety of empty nest elderly in community was established, which consisted of 5 first-level indicators and 52 second-level indicators. Among them, the mean value of the importance assignment of the first level index was 4.64-4.91, the standard deviation was 0.30-0.67, and the coefficient of variation was 0.06-0.14; the mean value of the importance assignment of the second-level index was 3.55-4.91, the standard deviation was 0.30-0.92, and the coefficient of variation was 0.06-0.20. Conclusions Through Delphi expert consultation method, the evaluation index system of home safety of empty nest elderly in community is scientific and reliable. It plays a strong guiding role in the evaluation of home safety of empty nest elderly. Key words: Delphi method; Safety; Community; Empty nest elderly; Home safety; Evaluation

In this study, the authors aim to identify the competencies of science teachers based on the opinions of experts in the field. The Delphi technique was used to attain consensus among experts on science education through 3 rounds with 13 experts from 13 different universities. In the first round of the Delphi technique, open-ended questions sent to the expert group, which were created after a detailed literature review about teacher competencies. Descriptive analysis was applied for the qualitative data obtained at the end of first round. As a result of the analysis, a 5-point Likert-type questionnaire consisting of 172 items in 10 categories was prepared. The questionnaire was sent to the experts in the second round. The experts indicated their participation levels for each item. The data obtained at second round were analyzed by quantitative methods. In the third round, the results of the analysis from the second round were sent to the experts and they were asked to re-evaluate their responses in the previous round by considering other experts’ opinions. By the conclusion of the third round, 161 items referring to competencies of science teachers were identified and categorized into competencies for the science curriculum, competencies to improve students’ cognitive characteristics, competencies to improve students’ affective characteristics, competencies to improve students’ psychomotor abilities, competencies for the objectives of the science curriculum, competencies for the content of the science curriculum, competencies for the learning-teaching process in science, competencies for evaluation in science, competencies for instructional technologies, and competencies for effective communication. Article visualizations:

Objective To construct the critical illness patient inter-hospital referral process of primary hospitals based on Delphi method so as to provide a basis for the inter-hospital critical illness patient standardized referral process in the medical alliance model. Methods The inter-hospital referral process was designed by retrieving literatures at home and abroad, and was demonstrated and revised with the modified Delphi method. Results We constructed a total of 30 items from four aspects including work preparation of medical staff as well as reception medical staff before inter-hospital referral, risk-prevention during referral and patients' condition after referral. Among two rounds of expert consultation, the active coefficients were all 100% and the authority coefficients were all 0.843 respectively. Conclusions The critical illness patient inter-hospital referral process of primary hospitals based on modified Delphi method accords with the principle of scientific nature and operability which has positive a meaning for standardizing clinical inter-hospital critical illness patient referral. Key words: Patient transfer; Delphi method; Critical illness; Health care

Objective To build a comprehensive evaluation system for printable and online materials, and provide reference for the compilation and selection of patient education materials. Methods Taking Suitability Assessment of Materials (SAM) as frame and combined Patient Education Materials Assessment Tool (PEMAT) and CDC Clear Communication Index, we screened indicator of the evaluation system preliminary and all of them have been adjusted with the language habits and social and cultural characteristics of our country. By Delphi method, 15 experts in related fields were selected to conduct 2 rounds of expert consultation to establish the final indicator system. The weights of the different indicators were also analyzed by Analytic Hierarchy Process (AHP). Results The indicator system of printable and online patient education materials was consisted of 7 first-level indicators,28 second-level indicators,84 third-level indicators. The positive coefficients and the authority coefficients of the experts were 100% and 0.87 of the two rounds. The coordination factors of the experts in second-level and third-level were respectively 0.362 and 0.255 for the second round. The top three indicators of the first-level indicators were content (0.271 5), behavioral suggestion (0.190 4), and language expression (0.190 4); the highest-level index weight was scientific content (0.095 7), and the lowest was the use of commonly numbers, correct interpretation of numbers and units′ meaning (0.007 0). Conclusion The comprehensive evaluation system for printable and online materials is scientific, comprehensive and easy to operate. It can provide reference for medical worker to prepare and select printable and online materials. Key words: Patient education material; Delphi method; AHP method; Indicator system