Delphi Investigation Research Articles

A relational model of medical knowledge sharing and medical decision-making quality

Knowledge sharing has been recognised as a key approach in sustaining a competitive advantage. In knowledge-intensive firms like healthcare organisations, expertise is based upon well-developed and reshapeable knowledge networks. Hence, it is believed that in healthcare organisations, knowledge sharing among physicians improves medical decision-making quality. We propose a relational model between the factors influencing knowledge sharing, knowledge sharing outcome, and medical decision-making quality. Three-phased studies were conducted: in-depth interviews with 25 physicians, a case study using a survey approach, and a Delphi investigation. The relationships regarding how individual factors affect the knowledge sharing outcome and decision-making quality are confirmed through the three phases of the study.

Intrinsic and Extrinsic Factors Important to Manual Therapy Competency Development: A Delphi Investigation

A learner's development of orthopaedic manual physical therapy (OMPT) psychomotor skills may be influenced by selected intrinsic and extrinsic factors. The purposes of this study were to identify the factors that influence learners' development of manual physical therapy competencies and to define each factor as intrinsic or extrinsic. A 3-round Delphi method survey and a retrospective review of the data were used to develop composite scores and rankings. Eighty manual physical therapy educators participated in the 3 rounds. Thirty-six factor descriptor statements associated with manual physical therapy competency were established and further categorized as intrinsic (19 total), extrinsic (10 total), or conceptual outliers (7 total). Cognitive Processing ranked as the most important factor influencing manual physical therapy competency development. Adaptation ranked second, followed by Science Knowledge. This study is the first to establish manual physical therapy educational factors associated with attainment of competency. The majority of the factors distill into the theory of extrinsic and intrinsic factors identified by Schmidt and Lee. The outcomes of this study identify the factors to which OMPT educators should give particular attention when developing and executing the learning experiences for their learners.

Modified Delphi Investigation of Exercise Science in Physical Education Teacher Education

The purpose of this study was to determine the critical exercise science competencies and associated instructional methods recommended for inclusion in the physical education teacher education curriculum. The two-round modified Delphi procedure involved the repeated circulation of a questionnaire to a small panel of content experts. The Delphi panel members were asked to rate each questionnaire item in terms of theoretical importance and pedagogical relevance. The data collected during the second round of questioning were employed to provide a final measure of consensus regarding the critical strength of each exercise science competency. The Delphi panel members were also asked to complete an addendum survey concerning their recommendations regarding the most effective instructional methods for the delivery of exercise science content. The results of this process provide a conceptual framework upon which physical education teacher educators can make future curricular decisions in the area of exercise science.

Community nursing: health professional and public perceptions.

Almost 10 years ago senior United Kingdom nurses met at Heathrow Airport to discuss the challenges and opportunities facing nursing. One aspect of this 'Heathrow Debate' was to encourage nurses to work closer with members of the public. The resulting report stated that nurses have not been effective in working outside their professional area and, in particular, they have not been adept at working in partnership with the public. The aim of this paper is to report a study to obtain the views of general practitioners (GPs), community nurses and members of the public on how the public perceive community nursing. A further aim was to explore the perceptions of senior health care managers and policymakers about public involvement in primary care. A two-stage Delphi investigation was undertaken with community nurses (n = 38), GPs (n = 14) and members of the public (n = 8). In addition, one-to-one interviews were carried out with 34 senior health service managers and policymakers. There was agreement on the following issues: community nurses must work more closely with members of the public; there is a lack of public understanding on the roles of community nurses and specialist nurses; there is public support for nurse prescribing; there is a preference for seeing the community nurse as opposed to the GP; and people prefer one nurse to care for them rather than a variety of nurses. Comments from managers and senior policymakers showed agreement on the public being involved in primary care, but an acknowledgement that this was problematic. A number of recommendations are outlined.

The role of the community nurse in primary care led commissioning

Primary care policy and practice in Northern Ireland is unique for two main reasons: unlike elsewhere, Northern Ireland has an integrated health and social services system and the primary care reforms witnessed in many countries have not, as yet, taken place in Northern Ireland. This paper is based on a study in Northern Ireland that aimed to review the role and function of community nursing with reference to new developments in practice, education, research and policy. Service commissioning was one of many areas explored within the study and is the main focus of this paper. The study commenced with focus groups of community nurses (n = 38), general practitioners (GPs) (n = 14) and public representatives (n = 8). This was followed by a two stage Delphi investigation using self-report questionnaires. In addition, data from 34 senior policy makers were collected using semi-structured interviews. The research was primarily carried out in Northern Ireland but involved GPs, community nurses and members of the public from the Republic of Ireland. Findings from all these data sources suggest that there is a perception that community nurses do not have the skills to take a lead role in the commissioning of services, that they require intensive training to take on such roles, and those who do should have equal remuneration with GPs who are involved in service commissioning. Recommendations are offered in the form of action points to guide future practice and policy.

Generic and specialist nursing roles in the community: an investigation of professional and lay views.

In the UK, a number of policy documents have sought to outline and clarify the role of the community nurse in the past 10 years. Furthermore, the increasing specialisation of community nursing has been the topic of much debate in the UK and Ireland. The present study aimed to investigate the perceptions of community nurses, general practitioners (GPs), members of the public, and senior strategists and policy-makers in relation to specialist and generalist nursing roles within community nursing in Northern Ireland and the Republic of Ireland. Focus groups were undertaken with community nurses (n = 38), GPs (n = 14) and public representatives (n = 8). This was followed by a two-stage Delphi investigation using self-report questionnaires with the same samples. In addition, data were collected from 34 senior policy-makers using a semi-structured interview schedule. The results uncovered a mix of views. While there was much negativity about specialisation, the participants felt that the move away from generalism was unavoidable. There was concern that specialisation, whilst welcome in some areas, would lead to role conflict, role overlap and role confusion. Findings from this study have the potential to inform the specialisation-generalism debate within and outside the UK and Ireland. Recommendations are suggested for future policy and practice.

Identifying nurse and health visitor priorities in a PCT using the Delphi technique.

A three-stage Delphi investigation was undertaken over a 4-month period in a primary care trust to identify the perceived clinical needs of nurses. Practice nurses, district nurses, health visitors and community hospital nurses all participated. In round 1, there were 28 replies from these groups of nurses, in round 2 there were 31, and in round 3 there were 25 replies. In round 1, 77 issues (excluding duplications) were identified. These were separated into three themes according to the most appropriate method for addressing the issue: education (29 issues), research (16 issues) and management (32). In round 2, the issues were redistributed in the three areas and staff were asked to choose the ten most important issues from education, research and management. Finally, in round 3 the ten issues in education, research and management were prioritized in terms of the "most pressing". The most pressing education need was recognizing accountability; the most pressing research need was caseload/dependency scoring--matching staff levels to workload, and the most pressing management need was risk management, e.g. staff safety. The results have identified locally that there is a gap between the modernization agenda and what nursing staff consider to be the issues that need addressing locally. If measures are not put in place to address these local issues, there is a danger that nurses will not take a full and active role in the modernization of the NHS.

Delphi analysis of national specificities in selected innovative areas in Germany and France

The increasing complexity of the relations between technologies and economics combined with more social pressure, global competition, technological change, as well as national budget restrictions, imply new challenges for public policies. Thus, to be able to forecast the development of knowledge and technological change in some well-known trajectories could be one of the major stakes for science technology and industrial policies. It is then not surprising that recent years have brought a significant revival of public foresight activities in many countries. The purpose of the paper is precisely to propose a new foresight method in order to obtain a taxonomy of the future technologies, and consequently to provide a better understanding of industrial dynamics. We present a statistical analysis of a Delphi investigation, based on scientific and technological knowledge complementarities, in order to obtain coherent clusters, which may be looked upon as a theoretical tool for political decisions. Our methodology is then applied to French and the German sectors of life sciences, elementary particles, energy, environment and natural resources.

TEACHING AND RESEARCH PRODUCTIVITY IN TARBIAT MODARRES UNIVERSITY

Background: Universities play an important role in training people to meet the community demands for skilled manpower. Furthermore, It is a fact known that universities do most of the research projects in Iran and in most countries through out the world. It is, therefore, important to know about teaching and research productivity in universities and to determine this productivity. Theoretically, a systemic approach is considered to be necessary for productivity measurement in an academic setting. Purpose: This study was undertaken to measure teaching and research productivity in Tarbiat Modarres University. Methods: We developed the method based on relatively simple and commonly used partial productivity ratios in universities, which can be easily achieved. So, the decision to measure total productivity based on partial productivity in one year period was made. We used a Delphi investigation for compiling data needed for calculating partial productivities. Results: Teaching productivity in Tarbiat Modarres University was found to have increased by 87% and research productivity was found to have increased by 1133% during the period between 1985 and 1992. There has been almost 84% increase in teaching and research productivity in the same period. Conclusion: Results of this study demonstrate that there has been a considerable increase in teaching and research productivity in Tarbiat Modarres University from 1985 to 1992. The method that we used for productivity measurement has produced what we believe to be valid results, and our hope is that other researchers will benefit from our attempt at quantification by using out methodology, and we wish they develop it further. Keywords: SYSTEM, UNIVERSITY, PRODUCTIVITY, DELPHI

Technological clusters with a knowledge-based principle: evidence from a Delphi investigation in the French case of the life sciences

Recent works in the theory of technical change show the effect of irreversibility and lock-in on the diffusion and creation of innovation processes, which are able to stop the development of a generic technology. Therefore, industrial policies play a major role in selecting and supporting the innovative process. The purpose of this paper is to prove the possibility to derive a typology of future innovations in terms of generic technology from a Delphi type technology survey. Thus, it is possible to get a better understanding of the industrial dynamics and to design an interesting tool for industrial policies or for firm strategies, as far as they aim at developing stable technological trajectories. This is applied to the French case of the life sciences. The paper suggests interesting explanatory trajectories in order to fight against diseases such as cancer, Alzheimer or Schizophrenia.

The decision Delphi as a tool of technology policy - the Austrian experience

Foresight studies have come to be an important instrument of technology policy. No standard form, however, exists; custom-tailoring to the specific needs of the specific country is afforded. The Austrian foresight exercise had to investigate the market niches with a potential for Austrian dominance within the next 15 years. As a tool for this task, the instrument of the Decision Delphi was chosen and has been further developed. A Decision Delphi is a bottom-up approach, building on the participation of those persons involved in developing the relevant technologies. It is, therefore, a tool for foresight as well as for coordinating the expectations and decentralised actions. Panels of experts developed the questions in seven fields, selected by a set of preceding studies. The Delphi investigation had two rounds with a response rate of 46%; and 71%; and a total of 1127 responses at the end. Several interesting results emerged as to the most promising fields and the design of technology policy.

Future Directions in Education and Inclusion of Students with Disabilities: A Delphi Investigation

This article reports on a survey of 37 educators regarding future directions in the education of students with disabilities. The survey used the Delphi technique. For the decade of the 1990s and after the year 2000, respondents' predictions included the following: The movement toward increasing inclusion will occur; the belief will prevail that people with disabilities have a right to participate in inclusive environments; students with mild disabilities will be educated in general classrooms; teachers will increase their use of instructional approaches such as cooperative learning and instructional technology; and researchers will focus on matching instructional needs with learner characteristics.

Future directions in deinstitutionalization and education: a Delphi investigation.

A Delphi survey procedure was used to forecast future events and set goals relative to deinstitutionalization and educational services for handicapped children and youth. Thirty-three persons of varying organizational affiliations, occupations, and geographical locations participated in two rounds of mail surveys. Questionnaires presented forecasts for deinstitutionalization and residential services spanning the entire life cycle and educational services directed more at children and youth below 25 years of age. Among some of the major trends predicted were that the deinstitutionalization movement would not lose momentum and that community-based residential services would increasingly become available to all persons with handicaps. Panelists anticipated that children and youth with handicaps would be educated more in natural environments and situations, but did not foresee a wholesale movement of mildly handicapped students or special education teachers into regular classroom settings in the near future.

Morphological analysis: Its application to a company TF investigation

Of all the techniques used in technological forecasting, morphological analysis is probably the one least used by TF practitioners and least known to the public. Delphi investigations, trend analysis, scenarios, and most recently dynamic models are widely employed, but the use of morphological analysis is rarely reported, though it is mentioned in every textbook on technological forecasting. The reason may be that morphological analysis is a technique to structure a problem rather than solve it.