Table 1. Nominal Group Process Step by Step.

Step	Group Facilitator Activities	Group Member Activities
Prior to group activity	Identify and clearly define the nature and scope of the problem to be discussed.	Inform group members on day 1 of conference that on day 5 the group process will occur.
	Obtain poster board, tape, and felt-tipped pen. Prepare a “nominal group task statement” and make it available to each participant.	Request that group members write their solutions to the problem statement on the poster board.
Introducing NGP to the group	Explain that the objective of the group activity on day 5 is to increase their understanding of the priorities of the movement. Explain that NGP will be the method of exploring problems.
	Relate time frame of 2 hr.
	Subdivide large groups into subgroups of 7–10 and provide a working place, recorder, and facilitator for each subgroup. (The “Moving Upstream” group had 13 members)
Silent generation of ideas in writing	Instruct members to spend time throughout the following 5 days listing their suggested solutions to the problem.	Each group member lists solutions on a note pad and adheres the note pages to the poster board at the front of the room.
	Encourage multiple entries.	Group members work independently.
	Instruct group members to save their discussion of the problem statement for the group activity on day 5.
Facilitated listing of ideas	Appoint two group members to number and write each idea on the white board at the front of the room.	Members may add additional items to the poster board while the listing process takes place if hearing the ideas of others inspires them. This is called “hitchhiking.”
	Ideas are recorded as close to verbatim as possible.
	Instruct the transcribers to leave a box to the left of each item where numeric rankings can be written later. (Consider having a staff member collect the pieces of notepaper to confirm that all ideas are represented on the white board. This person may then enter the ideas into a laptop and track the scoring electronically as well.)
Discussion of ideas on white board during transcription process	Position the white boards so that all participants can see all the distinct ideas.	Group members participate in rendering solutions as distinct or duplicate.
	Facilitate a discussion during the transcription process to clarify the meaning of similar sounding solutions and distinguish their differences.
	Similar solutions that are confirmed by the group members to be duplicates in meaning are identified and written as one solution. (In this case 45 ideas were reduced to 38 distinct solutions)
Rank ordering ideas	Advise participants to contemplate the solutions for 10 min to determine the five solutions they individually consider to be the most critical.	Group members ponder the ideas individually.
	Ask each of the group members to list the five most critical solutions from the list. Members should assign a “5” to the item they perceive as most critical to the problem “4” to the next most critical, and so on.	Group members may take notes on the items they consider to be finalists. This will expedite the process of recording their numeric scores on the white board.
	Suggest that group members keep notes as they narrow the field to five to facilitate the scoring process.	Group members take turns recording their scores on the white board.
	Provide dry erase markers and instruct 2–3 participants at a time to record their numeric ranking in the margins next to the solutions, as they are ready.
Total rankings	Before the totals are summed, the facilitator double-checks with the group members to be certain they recorded their votes with the number 1 appointed to their fifth choice.	Group members confirm that they recorded their scores in the correct order.
	After confirming that participants scored the ideas correctly, the facilitator and another group member each total the points for each item. Two people do this to ensure accuracy.
Discussion	After the ideas are ordered, group members are instructed to discuss the new list and then clarify and re-rank any of the items.	Group members may wish to change or re-rank the items and re-tally the final score.
Conclusion	The process ends when there is group consensus on critical items and their rank ordering. The group may choose at this time to move into a discussion of solutions based on the analysis of the problem. The facilitator thanks the group members for their attention and contributions.	Group members observe trends in the data.