What is the Nominal Group Technique?
The nominal group technique is a structured, face-to-face method for reaching consensus among a group of experts. It generates ideas and then prioritises them through a democratic voting process, so a clear position emerges from a single, well-facilitated session rather than an open-ended discussion. It typically involves a small group – around 8 to 12 participants — and follows a defined sequence of steps that give everyone an equal say.
In healthcare, the nominal group technique (NGT) is used to align clinicians, specialists and other stakeholders on practical questions: defining a care protocol, shaping a local guideline, or resolving an operational issue where the people in the room hold the expertise needed to answer it.
It sits alongside the Delphi method in the family of structured consensus techniques. Where a Delphi panel is remote, anonymous and iterative, the nominal group technique is live, interactive and fast – which makes each suited to a different kind of question. This page explains how it works and when it is the right choice.
How the Nominal Group Technique Works
A nominal group technique session follows five structured steps, each designed to draw out expert views evenly and move the group towards a ranked, agreed position.
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- Introduction and explanation. The facilitator sets out the topic or problem the group needs to address, and how the session will run, so every participant starts from the same brief.
- Silent idea generation. Participants write down their ideas or solutions independently, before any discussion. Generating ideas in silence first means the group’s thinking is not anchored by whoever speaks first.
- Round-robin sharing. Each participant shares one idea at a time, in turn, until all ideas are on the table. The round-robin format gives every voice equal airtime and surfaces the full range of views before any are debated.
- Discussion and clarification. The group works through each idea to make sure it is clearly understood. The aim at this stage is clarity, not persuasion – participants are aligning on what each idea means, not yet judging it.
- Voting and ranking. Participants individually rank the ideas by importance or preference. The highest-ranked items form the consensus, giving a clear, prioritised output the group has genuinely shaped.
Because the process is structured and time-limited, a nominal group technique session can be completed in a single sitting – one of the reasons it suits decisions that need to be made quickly. The structure is also what protects the quality of the result: independent idea generation, equal sharing and individual ranking are the safeguards that keep one or two strong personalities from steering the outcome.
The Nominal Group Technique in Practice
Triducive used the nominal group technique to build expert consensus on the role of AI in radiology, working with a large biotech and pharmaceutical company that produces contrast agents and other medical imaging products.
US radiology faced a widening gap between rising imaging workloads and a shrinking radiologist workforce. With more than 300 AI algorithms available and new FDA guidance on machine learning-enabled devices, the client needed a clear expert position on where AI could genuinely help radiologists, and where concerns remained.
Triducive convened an expert group of US-based radiologists, ran pre-meeting voting to prioritise the areas of focus, then facilitated a three-day, in-person consensus meeting structured around the nominal group technique.
The group generated 51 statements and worked through structured rounds of discussion until agreement was reached. By the end of the meeting the panel had produced 15 clear recommendations for the use of AI in radiology, together with a publication-ready manuscript that went on to peer-reviewed publication.
When to use the Nominal Group Technique
The nominal group technique is at its most valuable when a defined group of experts needs to reach a clear, prioritised position quickly, in a setting where discussion adds value. Its main strengths are:
Equal participation. Because ideas are generated silently and shared in turn, every participant contributes on equal footing. That is particularly useful in healthcare, where professional hierarchies can otherwise inhibit open input.
Speed. The method is highly structured and time-limited, so it can be completed in a single session. That makes it well suited to time-sensitive decisions — for example, agreeing an urgent treatment protocol or an emergency-response approach.
In practice, it is a strong fit for:
- Clinical guideline development – gathering input from providers and specialists to shape practical, evidence-based guidance.
- Patient care protocols – helping multidisciplinary teams align on treatment strategies or care pathways.
- Local policy and operational decisions – letting a hospital or institution resolve a specific issue with direct input from the relevant stakeholders.
It is equally important to know its limits. The nominal group technique works with a small group, so it captures less diversity of viewpoint than a large, dispersed panel. Its face-to-face format carries some risk of pressure to conform. And because a single session can only go so deep, it is not suited to projects with a large number of key questions – as a rule of thumb, more than three to five core items is usually too many for one session to handle well. Where any of those constraints bite, a Delphi panel is often the better route.
Nominal Group Technique vs The Delphi Method
The nominal group technique is in-person, real-time and interactive, works with a small group, delivers a result in a single session, and is best for a focused set of questions. The Delphi method is remote, anonymous and iterative, scales to large or geographically dispersed panels, runs over several rounds and months, and is built towards a defensible, publishable consensus.
| Feature | Nominal Group Technique | Delphi Method |
|---|---|---|
| Format | In-person, face-to-face meetings | Remote, conducted via questionnaires |
| Group Size | Small (typically 8–12 participants) | Large, often involving many experts |
| Anonymity | No anonymity; all participants are known | Full anonymity of participants |
| Time Frame | Short, typically one session | Several months |
| Cost and Logistics | Requires logistical coordination for a single meeting | Requires administrative effort for multiple rounds |
| Risk of Groupthink | Moderate risk due to face-to-face interaction | Minimal due to anonymity |
How Triducive Runs Consensus Studies
Triducive designs and facilitates structured consensus in healthcare, working as independent facilitators across the full range of methods, including the nominal group technique. Whichever method fits, our team scopes the question, facilitates the process and takes the findings through to communication and, where appropriate, peer-reviewed publication.
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FAQs
What is the nominal group technique?
A structured, face-to-face method for reaching expert consensus. A small group generates ideas independently, shares them in turn, discusses them for clarity, and then ranks them – so a clear, prioritised position emerges from a single session.
How does the nominal group technique work?
Through five steps: introduction and explanation, silent idea generation, round-robin sharing, discussion and clarification, and voting and ranking. The structure gives every participant an equal say and produces a ranked output the group has shaped.
How many people take part in a nominal group technique session?
Usually a small group of around 8 to 12 experts – large enough for a range of views, small enough for a focused, single-session discussion.
When should you use the nominal group technique rather than a Delphi panel?
Use the nominal group technique when a small group of experts needs a fast, interactive, prioritised decision. Use a Delphi panel when you need anonymity, a large or geographically dispersed panel, or a defensible, publishable consensus.
What are the limitations of the nominal group technique?
It works with a small group (so captures less diversity than a large panel), its face-to-face format carries some risk of pressure to conform, and a single session cannot handle more than a few core questions well – typically no more than three to five.