A critical review of the Delphi technique as a research methodology for nursing

https://doi.org/10.1016/S0020-7489(00)00044-4Get rights and content

Abstract

The Delphi technique is an approach used to gain consensus among a panel of experts. This is normally achieved through a series of rounds where information is fed back to panel members using questionnaires. It has been used extensively within social science research and is being increasingly employed by nurse researchers. This popularity has meant that the technique has been adapted in various ways and there is the possibility that the rigour associated with the original format has been threatened. This signals the need for a critical review of the Delphi as a robust and systematic approach to data collection. While there is a great volume of literature surrounding the ‘Delphi’, there is a dearth of papers critically analysing the technique. This paper aims to examine critically the Delphi technique from a range of perspectives. Discussion will focus on problems of definition and the advantages and disadvantages and the techniques’ application in nursing. The critique will be structured through an analysis of the key aspects of the Delphi process. These key aspects include analysis of sampling, anonymity, use of experts, rounds and application. The critical analysis highlights the increasing popularity of the Delphi and the modifications to the process which may cause methodological problems. Ultimately, the Delphi has much to offer in terms of gaining consensus from a wide range of individuals on specific topics.

Introduction

The Delphi technique, originally developed by the RAND Corporation, is a structured process which utilises a series of questionnaires or rounds to gather and to provide information. The process continues until ‘group’ consensus is reached (Beretta, 1996, Green et al., 1999). It is growing in popularity especially for nurse researchers and for health research in general (McKenna, 1994). This growth is centred upon the fact that, like a questionnaire, it allows the inclusion of a large number of individuals across diverse geographic locations and expertise. Unlike questionnaires however, the ‘Delphi’ aims to gather consensus of opinion, judgement or choice. One of its key advantages is that unlike a face to face meeting of experts, the postal ‘Delphi’ is useful when it is anticipated that a specific expert might (advertently or inadvertently) dominate the consensus process (Jaiarth and Weinstein, 1994; Critcher and Gladstone, 1998). While there is a great volume of literature surrounding the Delphi technique, there is a lack of critical examination of the process. The paper aims to fill this gap and take a critical look at the ‘Delphi’ through an analysis of its key aspects.

Section snippets

The Delphi process

In its original form, the Delphi process begins with an initial questionnaire (round one), which acts as an idea-generation strategy to uncover the issues pertaining to the topic under study. To do this, the respondents, referred to as panellists, should put forward as many relevant issues as possible in round one. Once analysed these responses act as a springboard for the rest of the Delphi process. Feedback from round one is provided in the form of a second questionnaire and opinion is asked

Defining the Delphi

The Delphi has been defined as an iterative process designed to combine expert opinion into group consensus (Lynn et al., 1998). According to Dalkey and Helmer (1963) it is a method “used to obtain the most reliable consensus of opinion of a group of experts by a series of intensive questionnaires interspersed with controlled feedback” (cited in McKenna, 1994). There are many differing forms of Delphi now in existence such as the ‘modified Delphi’ (McKenna, 1994), the ‘policy Delphi’ (Crisp et

Characteristics of the Delphi

There are a number of features that characterise the basic Delphi procedure that are of particular importance in terms of a critical review.

Reliability and validity

The Delphi has been criticised heavily as having no evidence of reliability. In other words if the same information were given to two or more panels there is no guarantee that the same results be obtained (Williams and Webb, 1978, Walker and Selfe, 1996). Other Delphi users have however found that the technique was accurate. For example, Ono and Wedemeyer (1994) report on the results of a study designed to replicate a Delphi study 16 years earlier. They state that results show that the findings

Consensus

It should be noted that the existence of consensus from a Delphi process does not mean that the correct answer has been found. This method is not a replacement for rigorous scientific reviews of published reports or for original research. There is a danger that the ‘Delphi’ can lead the observer to place greater reliance on their results than might otherwise be warranted. In addition, the Delphi has been criticised as a method which forces consensus and is weakened by not allowing participants

Ethical considerations

The Delphi is open to the same ethical considerations as any postal survey in that the researcher cannot be certain that the nominated individual is the person who completed the questionnaire or whether it has been the focus of discussion with other individuals. It is also impossible to ascertain whether individuals respond with honesty or respond according to their perception of what the researcher expected. This brings us once again to anonymity. Beretta (1996) points to studies by Hitch and

Applications of the Delphi in nursing research

The Delphi technique has been utilised by many nurse researchers in a wide variety of studies. McKenna (1994) used a modified Delphi using ward managers to select a nursing model appropriate for the care of psychiatric patients in Northern Ireland. Beech (1997) used a Delphi of three rounds to gain consensus on how multi-disciplinary clinical staff view the development of community mental health centres over the course of 2 years in North Staffordshire. Gibson (1998) also used a third round

Conclusion

From existing literature, especially recent literature, it is apparent that the Delphi technique is becoming increasingly popular in nursing research. As stated previously, however, modification to the classic version of the Delphi is widespread. This may cause difficulties methodologically (McKenna, 1994). The ‘Delphi’ however does have advantages over common survey methods. Consequently, used correctly and rigorously the Delphi can contribute significantly to broadening knowledge within the

References (36)

  • P. Davidson et al.

    Voices from practice: mental health nurses identify research priorities

    Archives of Psychiatric Nursing

    (1997)
  • C. Duffield

    The Delphi technique: a comparison of results obtained using two expert panels

    International Journal of Nursing Studies

    (1993)
  • R. Ono et al.

    Assessing the validity of the Delphi technique

    Futures

    (1994)
  • B.F. Beech

    Studying the future: A Delphi survey of how multi-disciplinary clinical staff view the likely development of two community mental health centres over the course of the next two years

    Journal of Advanced Nursing

    (1997)
  • R. Beretta

    A critical view of the Delphi technique

    Nurse Researcher

    (1996)
  • S. Bond et al.

    A Delphi survey of clinical nursing research priorities

    Journal of Advanced Nursing

    (1982)
  • A.J. Buck et al.

    Using the Delphi process to analyse social policy implementation — A post hoc case from vocational rehabilitation

    Policy Sciences

    (1993)
  • T. Butterworth et al.

    Identifying the characteristics of optimum practice: findings from a survey of practice experts in nursing, midwifery and health visiting

    Journal of Advanced Nursing

    (1995)
  • I. Chien et al.

    The field of American research

    American Psychologist

    (1984)
  • Couper, M.R., 1984. The Delphi technique: characteristics and sequence model, Advances in Nursing Science 7,...
  • J. Crisp et al.

    The Delphi Method?

    Nursing Research

    (1997)
  • Critcher, C., Gladstone, B., 1998. Utilising the Delphi technique in policy discussion: A case study of a privatised...
  • N. Dalkey et al.

    Delphi Technique: characteristics and sequence model to the use of experts

    Management Science

    (1963)
  • J.M.E. Gibson

    Using the Delphi to identify the content and context of nurses continuing professional development needs

    Journal of Clinical Nursing

    (1998)
  • C.M. Goodman

    The Delphi technique: a critique

    Journal of Advanced Nursing

    (1987)
  • B. Green et al.

    Applying the Delphi technique in a study of GPs information requirement

    Health and Social Care in the Community

    (1999)
  • P.J. Hitch et al.

    Professional communications in cancer care: a Delphi survey of hospital nurses

    Journal of Advanced Nursing

    (1983)
  • N. Jairath et al.

    The Delphi methodology (Part One): a useful administrative approach

    Canadian Journal of Nursing Administration

    (1994)
  • Cited by (0)

    View full text