• Derrylea J Hardy, Anthony P O'Brien, Cadeyrn J Gaskin, Anthony J O'Brien, Erina Morrison-Ngatai, Georgina Skews, Tom Ryan, and Neil McNulty.
• School of Health Sciences, Massey University, Palmerston North, New Zealand. d.j.hardy@massey.ac.nz
• J Adv Nurs. 2004 Apr 1; 46 (1): 95-109.

BackgroundNumerous studies have employed the Delphi technique to seek expert opinion about aspects of clinical practice. When researching literature on the Delphi technique, however, we discovered discrepancies in its application, and a lack of detail when reporting design, administration, and analysis methods. Such lack of specificity hinders the replicability and assessment of the clinical and cultural validity and reliability of Delphi studies.AimThe aim of this paper is to detail the practical application of the Delphi technique as a culturally and clinically valid means of accessing expert opinion on the importance of clinical criteria.MethodsReference is made to a bicultural New Zealand mental health nursing clinical indicator study that employed a three-round reactive Delphi survey. Equal proportions of Maori and non-Maori nurses (n = 20) and consumers (n = 10) rated the importance of 91 clinical indicator statements for the achievement of professional practice standards. Additional statements (n = 21) suggested by Delphi participants in round 1 were included in subsequent rounds. In round 2, participants explained the rating they applied to statements that had not reached consensus in round 1, and summarized responses were provided to participants in round 3. Consensus was considered to have been achieved if 85% of round 3 ratings lay within a 2-point bracket on the 5-point Likert-scale overall, or in one of the Maori nurse, non-Maori nurse, or consumer groups. A mean rating of 4.5 after round 3 was set as the importance threshold.FindingsConsensus occurred overall on 75 statements, and within groups on another 24. Most statements (n = 86) reached the importance benchmark.ConclusionsWhen rigorous methods of participant selection, group composition, participant feedback, and determination of consensus and importance are employed, the Delphi technique is a reliable, cost-effective means of obtaining and prioritizing experts judgements.

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