Preparation
01 · Define the focal question
- NGT works best with a clearly bounded question that calls for generating multiple responses: "What are the main barriers to parent participation in our school?" or "What changes would most improve the patient experience in this unit?"
- The question should be specific enough to generate comparable responses, but open enough to allow diverse answers.
- Avoid compound questions ("What are the barriers and what are the solutions?") — run separate NGT sessions for each.
02 · Prepare materials
- Index cards or slips of paper for each participant (silent generation phase).
- A flip chart or whiteboard visible to all to list ideas during sharing.
- Voting materials: small cards, dot stickers, or prepared voting sheets with rankings (5 points to the most important idea, 4 to the second, etc.).
- A timer to maintain the structured flow.
03 · Select participants
- 5–7 people per group is ideal. With 8–12, the process still works but takes longer.
- For groups larger than 12, run multiple simultaneous NGT groups, then consolidate results across groups in a second round.
- Participants should have direct knowledge of or stake in the focal question.
Step-by-step instructions
1
Introduce the session (5 min)
- Explain the purpose, the focal question, and the process steps.
- State the ground rules: no discussion during the silent generation phase; during sharing, each person presents one idea per turn without comment from others; during discussion, all ideas are treated with equal respect regardless of who generated them.
2
Phase 1 — Silent idea generation (10–15 min)
- Each participant writes their responses to the focal question individually and silently on index cards or paper.
- Aim for 5–8 ideas per person. Brief phrases are sufficient — detailed explanations come in the discussion phase.
- No talking, no looking at others' cards, no qualifying or filtering ideas. Everything goes on paper.
- This phase is the method's engine: because ideas are generated before group interaction, each person's thinking is independent of social influence.
3
Phase 2 — Round-robin sharing (15–20 min)
- Going around the table, each person shares one idea per turn. The facilitator records it exactly as stated on the flip chart, numbered.
- No discussion, evaluation, or comment while ideas are being shared — only clarification if an idea is genuinely unclear.
- Participants continue in rounds until all ideas are on the board. Duplicate ideas are grouped or marked as related — not deleted.
- The result is a complete, numbered list of all ideas generated by the group — often 20–40 items for a 7-person group.
4
Phase 3 — Clarification discussion (15–20 min)
- The facilitator goes through each item on the list, asking if any needs clarification.
- This is a clarification round, not an evaluation round: the purpose is shared understanding, not judgment or debate.
- True duplicates can be merged at this stage with group agreement. Items that seem similar but mean different things stay separate.
5
Phase 4 — Anonymous voting and ranking (10–15 min)
- Each participant independently selects their top 5 (or top 7 for larger lists) items from the full list and ranks them on a card.
- Ranking method: 5 points to the most important item, 4 to the second most important, down to 1 point for the fifth choice. (Adjust range based on list size.)
- Voting is done in writing and anonymously — participants hand in their ranking cards without discussion.
6
Phase 5 — Tally and reveal results (5–10 min)
- The facilitator tallies scores for each item and writes point totals on the flip chart.
- Items are re-sorted by total score, revealing the group's prioritized ranking.
- Brief discussion: does the ranking make sense? Are there surprises? Is there a clear threshold between high-priority and lower-priority items?
7
Optional: Second vote (for high-stakes decisions)
- After seeing the group ranking, participants may revise their vote once — this allows integration of new information from the clarification discussion while preserving independence of judgment.
- A second tally is produced. If rankings are stable, the process is complete. If significant shifts occur, it signals that more discussion is needed.
Materials
Index cards or paper slips for each participant
Pens or pencils for each participant
Flip chart or whiteboard visible to all
Markers for the facilitator
Voting cards or sheets (one per participant)
Timer
Digital tools
Practical recommendations
The most common facilitator error is allowing discussion during the sharing phase. Hold the line — even one evaluative comment during sharing changes the dynamic for everything that follows.
Record ideas exactly as stated by the participant. Do not paraphrase or improve language — the original phrasing belongs to the person who generated it and must be preserved for voting.
If an idea is truly unclear after one clarification attempt, keep it on the list anyway. The voting phase will naturally deprioritize ideas that others don't understand.
NGT handles disagreement better than consensus-based methods because priority differences become visible quantitatively — the group can see not just what won, but by how much, and whether there was near-consensus or real split.
For sensitive organizational topics, emphasize anonymity of voting and separate the identity of ideas from their authors in all subsequent discussion.
Inspiration
Application examples by context:
- Healthcare quality improvement: A ward team uses NGT to identify the top 5 patient safety risks they want to address in the next quarter — overcoming the tendency for junior staff to defer to senior physicians in open meetings.
- Education: A school faculty uses NGT at the start of the year to define shared priorities for professional development — giving equal voice to teachers across all experience levels and departments.
- Community planning: A neighborhood council uses NGT with residents to rank infrastructure improvement priorities before presenting proposals to the city government.
- Program evaluation: An NGO uses NGT with beneficiaries to identify what aspects of a program they value most — producing a ranked list that informs the next funding proposal.
- vs. Brainstorming: NGT structures the process to prevent social biases that compromise brainstorming. Produces a ranked output instead of just a list.
- vs. Dot voting alone: NGT's silent generation phase ensures that all ideas are considered before voting — dot voting on a list curated by a vocal minority produces a different (less representative) result.
- vs. Delphi Method: Delphi uses multiple rounds of questionnaires with experts, typically without face-to-face interaction. NGT is a single in-person session. Delphi is better for geographically dispersed expert panels; NGT works better for intact working groups.
Consulted sources
- Delbecq, A. L., Van de Ven, A. H. & Gustafson, D. H. (1975). Group Techniques for Program Planning: A Guide to Nominal Group and Delphi Processes. Scott, Foresman.
- Harvey, N. & Holmes, C. A. (2012). Nominal group technique: An effective method for obtaining group consensus. International Journal of Nursing Practice, 18(2), 188–194.
- McMillan, S. S., King, M. & Tully, M. P. (2016). How to use the nominal group and Delphi techniques. International Journal of Clinical Pharmacy, 38(3), 655–662.
- Potter, M., Gordon, S. & Hamer, P. (2004). The nominal group technique: A useful consensus methodology in physiotherapy research. New Zealand Journal of Physiotherapy, 32(3), 126–130.
