Delphi Method In Medical Education For PhD Research Scholars - Phdassistance
                     Delphi Method in  
Medical Education 
For  PHD Research 
Scholars
An Academic presentation by
Dr. Nancy Agnes, Head, Technical Operations, 
Phdassistance  Group www.phdassistance.com
Email: [email protected]
TODAY'S 
DISCUSSION
Outline
Introduction
Designing a Delphi 
study  Procedure
Procedure of running a Delphi 
study  Analysis of results
Conclusion
About Phdassistance
INTRODUCTION TO 
LITERATURE REVIEW
The Delphi method was created in the 1950s 
with the  goal of gathering expert input and 
reaching a  consensus (Dalkey & Helmer, 1963, 
p. 458).
It got its name because was created as
istystematic, participatory a  of
wpraeydicting the future, similar fotore chaoswti nagncoirent 
Greeks  went to the Oracle at Delphi to hear 
their fortunes.
The method gathers views from a panel of 
experts in  a field of real-world expertise and 
then aggregates  those judgments to achieve a 
consensus on an issue.
Contd...
It differsfrom typicalsurveysin that it aims to discoverwhat could
or  should be, rather than what is (Miller, 2006).
According to Delbecq, Van de Ven, & Gustafson( 1975, pp. 11), 
Delphi study  are used for the following:
Determine or create a variety of programme choices.
Investigate or revealthe assumptions or knowledge
that lead to differing  conclusions.
Look for facts that might lead to a consensus among the 
respondents.
Connect well-informed judgements about a topic
that spans a variety of  fields.
Contd...
Educate the response group on the topic's many and connected 
elements.
Other major aspects of Delphi Survey Research include the fact that the  
participants are strangers to one another and that the procedure is 
iterative, with  each round generated from the preceding one's 
conclusions.
In other words, each participant is given a summary of the variety of 
ideas  expressed in the previous round, as well as the chance to 
reconsider their own  views in light of the feedback provided by the other 
panellists.
This regulated feedback helps to decrease the influence of noise, which 
is  described as communication that distorts data due to personal 
prejudice and  interests rather than issue solving.
Contd...
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Delphi studies have been utilized in clinical education 
to  establish evaluation techniques that are not always  
straightforward to describe.
Clinical educators are concerned in changeable 
behaviors  and clinical competence, not so much in the 
knowledge and  abilities presented in the classroom as 
in their application in  practice. Because it is 
impossible to assess all potential  combinations of 
knowledge and abilities, assessments of the  
information and skills necessary for competent 
practice  generally take the form of a sampling of a 
small fraction of the  total possible range of things. Contd.
..
Furthermore, not all physicians agree on the most critical aspects 
of  practice and assessment.
As a result, the Delphi method is an acceptable methodological 
technique  for gaining consensus on the crucial question of what 
to assess, how to  assess it, and what measures to apply to 
improve practise.
In healthcare, Delphi studies have been used for service planning, 
study of  professional traits and skills, assessment instrument 
creation, and  curriculum development (Cross, 1999; Powell, 2003; 
Joseph, Hendricks &  Frantz, 2011).
DESIGNING A 
DELPHI STUDY
Participants in a Delphi survey are generally experts in 
their  fields, and their contributions should help to 
enhance  knowledge of issues, opportunities, and 
solutions.
Although there are no defined criteria for selecting the 
panel,  potential members should have similar 
backgrounds and  experiences in the subject, be 
capable of making useful  contributions, and be willing 
to change their minds in order  to achieve consensus.
It is not sufficient for participants to have a basic  
understanding of the topic under investigation (Pill, 
1971; Oh,  1974).
Contd...
While a diverse panel is suggested for General Delphi Research 
(Delbecq et  al., 1975), Jones and Hunter (1995) propose that domain 
specialists be  employed in clinical investigations.
Due to the aforementioned considerations, it is critical to 
demonstrate the  panel's credibility in order to back up the claim that 
they are true experts in the  subject.
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The panel size is the next factor to consider.
Contd...
This is frequently determined by the breadth of 
the  problem and the number of competent 
informants /  experts available, and there is no 
consensus in the  Literature On The Ideal size 
(Hsu & Sandford, 2007).
Depending on the situation, the higher the 
degree of  dependability of the given elements, 
the more  participants there are.
However, if the individuals' backgrounds are  
homogenous, it has been proposed that 10 to 15 
people  may be adequate (Delbecq, Van de Ven & 
Gustafson,  1975).
Contd...
The first round of questionnaires generally comprises of open-
ended  questions designed to collect particular information on a 
topic of expertise,  and it acts as a foundation for later rounds 
(Custer, Scarcella, & Stewart,  1999).
This questionnaire may be developed from the literature (Hsu & 
Sandford,  2007) and does not require validity or reliability testing.
The Data Analysis Methodologies used to establish agreement will 
be  determined by the structure of the questionnaires, the sorts of 
questions  asked, and the number of participants.
While the procedure might potentially go on indefinitely, most 
experts  believe that three rounds of surveys is generally enough 
to reach a  decision.

PROCED
URE
The first round's results are frequently utilised to 
detect  key themes arising from open-ended 
questions.
The replies are then compiled into questions that 
will  serve as the foundation for the future 
rounds.
The data is generally statistically analysed after 
the  second round, using either a rank order or 
rating  approach (this is usually dependent on 
larger sample  sizes).
The data is analysed to establish the degree of  
agreement in the ranking order.
Contd...
Researchers warn that this degree of agreement 
should be  determined prior to the start of Data 
Collection And A  Strategy for how the data will be 
analysed so that a clear  cut-off point for inclusion 
and exclusion can be established.
The degree of agreement is often set at 75%, 
although this  can be changed if no agreement is 
Pobarttaicinipeadn. ts may be requestedto justify rankin
tjuhdegirments in some circumstances, g  
particularly  panellists express opinions when  
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PROCEDURE OF RUNNING A 
DELPHI STUDY
Determine what you want to achieve. What do you 
want your  panellists to come to an agreement on?
Create your first set of questions after doing a 
thorough  examination of the literature. Make sure that 
the initial set of  questions is based on the goals you 
want to attain.
Check for ambiguity, timing, and appropriateness of 
replies in  your questions. Send it to a small group of 
specialists or at the  very least coworkers, and 
evaluate their replies to confirm  that your questions 
are relevant to your goal.
Contd...
The first round of the survey should be sent out.
Send a reminder to panellists around 1-2 weeks after the original 
survey was  sent, however the exact time periods may depend on the 
study.
Analyze the first round's replies and use the information to create 
the second  round's survey.
Round two should be tested on a limited group of panellists to ensure 
that the  replies will give the information you want.
Send out the second round of the 
survey.  Send a reminder for the 
second round.
Contd...
Again, the precise duration willbe
determined by your  specific 
requirements and the context of your research.
Analyze the findings of round two's surveyand
utilise  them to create the survey for round three.
For the third round, test the survey and send it 
out when  you're happy.
If necessary, remind panellists to 
finish.  Examine the results of the 
third round.
Check to see whether your goals have
been met. If you  find that you require 
more information, add more rounds.
Contd...
ANALYSIS OF 
RESULTS
QUANTITATIVE ANALYSIS
The panel size and questionnaire design are two 
factors to  consider when doing Quantitative Analysis.
As a result, the scale of the problem and the quantity 
of  competent informants/experts accessible to you are  
frequently factors.
Some studies feel that the greater the number of 
participants,  the better the degree of dependability of 
the listed factors.  Obtaining an agreement level is the 
most commonly utilised  approach for achieving 
consensus in this paradigm.
Contd...
Although there is debate over the degree or cut-off point for agreeme
nt, several 
 writers have suggested that 75% agreement is a good starting point.
Other rating procedures 
are often employed to establish consensus in addition  to 
getting a degree of agreement.
Ranking components in order of significance and computing the mean
 to  
determine the most important to the least important aspects are two 
of these 
 grading approaches.
Likert-type scales are also used to decide whether or not an element 
should be  included. As a result, the nature of the analysis will be 
heavily influenced by the  questionnaire structure, types of questions, 
and number of participants.
Contd...
QUALITATIVE ANALYSIS
The establishment of agreement among participants in 
a  Qualitative Delphi Research does not rely on 
statistical  measurements.
The conclusion is derived from the study of emerging 
themes  (assuming no structure was previously 
supplied).
Open-ended question responses are typically in the 
form of  brief narratives, which should be analysed 
using qualitative  methods.
The researcher will look over the replies and group 
them into  themes that emerge. Advantages and 
disadvantages of using  the Delphi method Contd.
..
Whereas dominating individuals in committees and face-to-face 
meetings  may monopolise the conversation's direction, the 
Delphi approach  eliminates this by placing all replies on a "even" 
basis.
Anonymity also means that attendees should only consider the 
facts in  front of them, rather than the speaker's reputation.
By allowing for the revision of previous judgements, anonymity 
also allows  for the expression of personal ideas, free critique, and 
acknowledgment of  errors.
Furthermore, the researcher may filter, summarise, and eliminate  
unnecessary data, which might be distracting for face-to-face 
meeting  participants.
Contd...
As a result, potentially distracting group dynamics are eliminated (Hsu &  
Sandford,  2007).One of the most significant drawbacks is the high likelihood of 
poor response rate and  attrition. Furthermore, a Delphi study generally consumes 
a substantial amount of time and  adds significantly to the researcher's burden.
The advantages of employing a Delphi research in the proper setting, 
however, are thought  to offer value that is difficult to attain with other
 approaches.
CONCLUS
ION
The Delphi method is a good way to reach 
an  agreement on subjects that have no 
clear  answers and are open to dispute.
If you want your study's results to be 
regarded  seriously, the trustworthiness of 
the panel you  choose is critical.
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