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The Group Reduction Technique to Achieve Consensus Among Collectives in Health Care Training

Received: 30 January 2017    Accepted: 9 February 2017    Published: 28 February 2017
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Abstract

In training processes within professional practice, professional discourse can benefit from the study of language and its complexity, incorporating both its representational and presentational aspects. Integrating a professional’s thoughts and actions is key in the research of professionalizing knowledge, in which the use of narrative exceeds the dichotomy of thought and action. In many institutions it is common for many trainers to begin interventions with an initial study of expert opinions [1, 2, 3, 4]. However, when dealing with very specific disciplines, experts occasionally prioritize their own field of research over and above that of others, as they experience an intense connection with their field due to the social repercussions of their work; paradoxically, it is this same social commitment which defines concrete priorities and pushes other areas into second place, making it difficult to reach consensus among different professionals [5, 6]. The aim of this paper is to study how certain processes of reduction in the number of experts and variables can be carried out as an initial training step when interventions aimed at achieving consensus among experts have been unsuccessful. In our case, we intervened in the field of Health Management through a work group consisting of professionals in different specialties within the health sector (doctors, managers, pharmaceutical industry specialists, etc.). The evaluation of the degree of consensus was undertaken with the study of the deviations of the Delphi Method and Kendall’s coefficient of concordance W, as is often the case [7, 8, 9, 10]; we realized, however, that we had not achieved an acceptable degree of consensus. We therefore opted to apply a study of profiles and of variable reductions, in search of a more compact subgroups of opinion among the experts. We concluded that, when working with groups with a high level of identification or when no appropriate consensus techniques have been applied, it is possible to resort to this method to achieve more cohesive work groups. Moreover, when a consensus technique is applied as a correct intervention, this same technique can serve as an evaluation tool.

Published in Social Sciences (Volume 5, Issue 6-1)

This article belongs to the Special Issue Re-Imagine Education for Social Improvement

DOI 10.11648/j.ss.s.2016050601.17
Page(s) 50-58
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Health Care, Management, Course, Professional Discourse, Delphi Method

References
[1] G. Carrasco and J. Ferrer, “Las vías clínicas basadas en la evidencia como estrategia para la mejora de la calidad: metodología, ventajas y limitaciones,” Revista de Calidad Asistencial, 16:199-207, 2001.
[2] P. Comet, G. Escobar, T. González, A. De Ormijana-Sáenz, M. Rich, C. Vidal, P. Córcoles and C. Dolores Izquierdo y Silvestre, “Establecimiento de prioridades de investigación en enfermería en España: estudio Delphi” in Enfermería Clínica 20(2), March, 2010.
[3] I. Murua, “Las cibercomunidades de aprendizaje y la formación del profesorado” (doctoral thesis), Universidad Nacional de Educación a Distancia, 2015.
[4] A. Rushton and G. Lindsay, “Defining the construct of Masters level clinical practice in healthcare based on the UK experience”, Medical Teacher, 30:4, e100-e107, DOI: 10.1080/01421590801929950, 2008.
[5] C. Casilda, G. Bou, and J. Irigaray, “An alternative to Delphi’s Method: the detection of concordant groups. Application of a training plan within health management”, 11th annual International Technology, Education and Development Conference, 2017.
[6] D. Knight, C. L. Pearce, K. G. Smith, J. D. Olian, H. P. Sims, K. A. Smith, and P. Flood, “Top management team diversity, group process, and strategic consensus”, Strategic Management Journal, 20(5), 445-465, 1999.
[7] F. Pedrosa, “El control del cumplimiento de las normas de información financiera. Perspectiva sobre el sistema institucional de control- aplicación de un estudio Delphi”, Doctoral thesis, Universidad Autónoma de Madrid, 2006.
[8] N. Becheikh, “Conceptualisation d'un système de contrôle pour les organisations virtuelles de type réseau temporaire”, Doctoral thesis, Faculté des Sciences de l’Administration, Université de Laval (Québec), 2004.
[9] R. C. Schmidt, “Managing Delphi surveys using nonparametric statistical techniques”, Decision Sciences, 28 (3), Summer, pp. 763-774, 1997.
[10] C. Okoli and S. D. Pawlowski, “The Delphi Method as a research tool: an example, design considerations and applications”, Information & Management, 42, pp. 15-29, 2004.
[11] S. Purdy, M. Little, C. Mayes and W. Lipworth, “Debates about conflict of interest in medicine: deconstructing a divided discourse”, Journal of Bioethical Inquiry, 1, pp.1-15, 2017.
[12] C. Mayes, W. Lipworth and I. Kerridge, “Declarations, accusations and judgement: examining conflict of interest discourses as performative speech-acts”, Medicine, Health Care and Philosophy, 19 (3), pp. 455-462, 2016.
[13] S. L. Specker, “Dynamic axes of informed consent in Japan”, Social Science and Medicine, 174 (1), pp. 159-168, 2017.
[14] P. Andreassen, M. Neergaard, T. Brogaard, M. H. Skorstengaard and A. B. Jensen, “Talking about sensitive topics during the advance care planning discussion: a peek into the black box”, Palliative and Supportive Care, (1), pp.8-18. DOI: 10.1017/S1478951515000577, 2015.
[15] J. Paul, S. Metcalfe, L. Stirling, B. Wilson and J. Hodgson, “Analyzing communication in genetic consultations: a systematic review”, Patient Education and Counseling, 98 (1), pp. 15-33, 2015.
[16] A. Mª Mangues, “Gestión de la farmacoterapia desde el servicio de farmacia del hospital. Gestión del conocimiento”, España: SEIS; 2004 [consulted on 09/10/2014]; 241-242. Available here: http://www.seis.es/documentos/informes/secciones/adjunto1/CAPITULO9_0.pdf
[17] R. Cigolini, M. Cozzi and M. Perona, “A new framework for supply chain management conceptual model and empirical test,” International Journal of Operations & Production Management, 24:7–41, 2004.
[18] CSC Consulting Inc., “Efficient Healthcare Consumer Response. Improving the efficiency of the healthcare supply chain,” Chicago: American Hospital Association/American Society for Healthcare Materials Management, 1996.
[19] C. Chandra and J. Grabis, “Application in Health Care”, Supply Chain Configuration, New York: Springer; p. 277-88, 2016.
[20] S. S. Marimón, “La sanidad en la sociedad de la información”, Sistemas y tecnologías de la información para la Gestión y la Reforma de los Servicios de Salud, Barcelona, 1999.
[21] IMS Health, “Evolución del Mercado de Genéricos,” [consulted on 03/15/2016]. Available here: http://www.aeseg.es/documentos/Mercado%20Farmaceutico%20Genericos%20tras%20PRef%202013.pdf, 2013.
[22] S. Shortell and A. Kaluzny, “Health care management: organization design and behavior”, Clifton Park, NY: Thomson Delmar Learning, 2006.
[23] A. Rico, R. B. Saltman and W. B. Boerma, “Organizational restructuring in European health systems: the role of primary care”, Social Policy Administration; 37:592-608, 2003.
[24] K. Letford and T. Ashton, “Integrated family health centres”, Health Policy Monitor, April. Available here: http://hpm.org/en/Surveys/The_University_of_Auckland_- _New_Zealand/15/Integrated_Family_Health_Centres.html, 2010.
[25] Department of Health, “Operational productivity and performance in English NHS acute hospitals: unwarranted variations an independent report for the Department of Health by Lord Carter of Coles”, February 2016, https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/499229/Operational_productivity_A.pdf, 2016.
[26] V. Navarro, “La sanidad española. La situación social en España II”, V. Navarro (coordinator), Madrid: F. Largo Caballero-E. Biblioteca Nueva, 293–316, 2007.
[27] Various authors, “La implantación de la promoción de la salud en los hospitales: manual y formularios de autoevaluación”, Ministerio de Sanidad y Consumo, Madrid, 2007.
[28] Various authors, “El futuro de los hospitales”, Congreso Nacional de Hospitales y Atención Sanitaria, Escuela Andaluza de Salud Pública, 2016.
[29] M. Trapero, et al., “Cuestiones controvertidas en evaluación económica (ii): medidas de resultado en salud de las intervenciones sanitarias”, Revista Especializada de Salud Pública, 2015.
[30] A. Martínez Sahuquillo and M.ª C. Echevarría, “Métodos de consenso. Uso adecuado de la evidencia en la toma de decisiones”, “Método RAND/UCLA”, Revista Rehabilitación. Elsevier, 2001.
[31] J. Asua, “Entre el consenso y la evidencia científica”, Evaluación De Tecnologías Médicas, Departament of Health, Basque Government, Bilbao. Vizcaya, Spain, 2004.
[32] M. Pimentel, “Nuestra sanidad precisa salud”, Madrid: Ediciones de El País, (Opinión. Firmas Tribuna), recovered from www.cincodias.com, 2004.
[33] H. Tajfel, “Experiments in intergroup discrimination”, Scientific American, 223, 96-102 (abstract), 1970.
[34] J. M. Rabbie and M. Horwitz, “Arousal of ingroup-outgroup bias by a chance win or loss,” Journal of Perspective Social Psychology, 1969 Nov; 13(3):269-77, 1969.
[35] M. Sherif, “Group conflict and co-operation”, London: Routledge, 1967.
[36] M. Rubin and M. Hewstone, “Social identity, system justification, and social dominance: commentary on Reicher”, Jost et al., and Sidanius et al. Political Psychology, 25, 823-844, 2004.
[37] M. Rubin, C. Badea and J. Jetten, “Low status groups show in-group favoritism to compensate for their low status and to compete for higher status. Group processes and intergroup relations”, 17, 563-576. doi: 10.1177/1368430213514122, 2014.
[38] F. W. Kellermanns, K. A. Eddleston, T. Barnett and A. Pearson, “An exploratory study of family member characteristics and involvement: effects on entrepreneurial behavior in the family firm”, Family Business Review, 21 (1), 1-14, 2008.
[39] K. Puente and T. Puente, “Validación de una escala de medición del consenso estratégico en equipos pedagógicos”, Revista de Psicología, Vol. 31 (2), 2013, pp. 227-245 (ISSN 0254-9247), 2013.
[40] R. Swab, T. Postmes, I. Van Beest and R. Spears, “Perceived shared cognition as a product of, and precursor to, shared identity in negotiations”, Personality and Social Psychology Bulletin, 45, 187-199, 2007.
[41] J. E. Mathieu, M. T. Maynard, T. Rapp and Gilson, “Team effectiveness 1997-2007: A review of recent advancements and a glimpse into the future”, Journal of Management, 34, 410-476, 2008.
[42] K. Puente, T. Puente, T. Moreira and N. Lira, “El consenso estratégico como predictor de resultados de equipos de trabajo”, Revista de Psicología Vol. 33 (1), (ISSN 0254-9247), 2015.
[43] F. W. Kellermanns, K. A. Eddleston, T. Barnett and A. Pearson, “An exploratory study of family member characteristics and involvement: effects on entrepreneurial behavior in the family firm”, Family Business Review, 21 (1), 1-14, 2008.
[44] F. W. Kellermanns, J. Walter, C. Lechner and S. W. Floyd, “The lack of consensus about strategic consensus: advancing theory and research” Journal of Management, 31(5), 719-737, 2005.
[45] M. Carney, “How commitment and involvement influence the development of strategic consensus in health care organizations: the multidisciplinary approach”, Journal of Nursing Management, 15(6), 649-658, 2007.
[46] M. A. Roberto, “Strategic decision making processes: beyond the efficiency consensus trade off”, Group & Organization Management, 29(6), 625-658, 2004.
[47] G. G. Dess, “Consensus on strategy formulation and organizational performance: competitors in a fragmented industry”, Strategic Management Journal, 8(3), 259-277, 1987.
[48] T. F. Moreira, “O papel do consenso estratégico em equipes pedagógicas”, Brasilia: Universidade de Brasilia, 2011.
[49] J. Landeta, “El Método Delphi. Una técnica de previsión del futuro”, Barcelona, Ariel.31-35:93-4, 2002.
[50] R. Yañez and R. Cuadra, “La técnica Delphi y la investigación en los servicios de salud”, Ciencia y Enfermería XIV:9-15, 2008.
[51] M. De Villiers, P. De Villiers and K. Athol, “The Delphi technique in health sciences education research”, Med Teach 27(7);639-643, 2005.
[52] S.Mohammed and E. Ringseis, “Cognitive diversity and consensus in group decision making: the role of inputs, processes, and outcomes”, Organizational Behavior and Human Decision Processes, 85(2), 310-335, 2001.
[53] M. Varela, L. Díaz, and R. García Durán, “Descripción y usos del método Delphi en investigaciones del área de la salud”, Revista de Investigación En Educación Médica, Elsevier, 2012.
[54] M. García, and M. Suárez, “El Método Delphi para la consulta a expertos en la investigación científica”, Revista Cubana de Salud Pública, 39(2), 253-267, 2013.
[55] C. Pérez Andrés, “¿Deben estar las técnicas de consenso incluidas entre las técnicas de investigación cualitativa?”, Revista Española de Salud Pública, Ministerio de Sanidad y Consumo, Madrid, 2000.
[56] D. Badía, “Metodología de los mapas de concordancia para la stratificación de variables cuantitativas: aplicación a la asignatura de Medidas Electrónicas”, Doctoral thesis, Universidad Ramon Llull, 2012.
[57] G. Bou, “Aprendizaje comprensivo y procesos de la información”, Aplicaciones educativas, Universitat Autònoma de Barcelona (UAB), 1991.
[58] A. L. Delbecq, A. Van de Ven and D. H. Gustafson, “Group techniques for program planning: a guide to nominal group and Delphi processes”, Glenview, IL: Scott/Foresman, 1975.
[59] E. Vernette, “Evaluation de la validation prédictive de la méthode Delphi-leader”, Proceedings of the Congrés International de l ́AFM, pp. 988-1010, Toulouse. Cited by: Camisón, C. et al. (2009): “¿Hacia dónde se dirige la función de calidad?: la visión de expertos en un estudio Delphi”, Revista Europea de Dirección y Economía de la Empresa, 18(2), pp. 13-38, 1997.
[60] J. Aastrup, H. Kotzab, D. B. Grant, C. Teller and M. Bjerre, “A model for structuring efficient consumer response measures”, International Journal of Retail & Distribution Management, 36(8), 590-606, 2008.
[61] R. Zvirgzdiņa, I. Liniņa, V. Vēvere, “Efficient Consumer Response (ECR) – principles and their application in retail trade enterprises in Latvia”, European Integration Studies, 9, 257-264, 2015.
[62] Various Authors, “Efficient Healthcare Consumer Response. Improving the efficiency of the healthcare supply chain”, Chicago: American Hospital Association/American Society for Healthcare Materials Management. Report of CSC Consulting Inc, 1996.
Cite This Article
  • APA Style

    Jorge Irigaray, Guillem Bou, Casilda Güell, Francisco Benjamín Cobo. (2017). The Group Reduction Technique to Achieve Consensus Among Collectives in Health Care Training. Social Sciences, 5(6-1), 50-58. https://doi.org/10.11648/j.ss.s.2016050601.17

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    Jorge Irigaray; Guillem Bou; Casilda Güell; Francisco Benjamín Cobo. The Group Reduction Technique to Achieve Consensus Among Collectives in Health Care Training. Soc. Sci. 2017, 5(6-1), 50-58. doi: 10.11648/j.ss.s.2016050601.17

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    AMA Style

    Jorge Irigaray, Guillem Bou, Casilda Güell, Francisco Benjamín Cobo. The Group Reduction Technique to Achieve Consensus Among Collectives in Health Care Training. Soc Sci. 2017;5(6-1):50-58. doi: 10.11648/j.ss.s.2016050601.17

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  • @article{10.11648/j.ss.s.2016050601.17,
      author = {Jorge Irigaray and Guillem Bou and Casilda Güell and Francisco Benjamín Cobo},
      title = {The Group Reduction Technique to Achieve Consensus Among Collectives in Health Care Training},
      journal = {Social Sciences},
      volume = {5},
      number = {6-1},
      pages = {50-58},
      doi = {10.11648/j.ss.s.2016050601.17},
      url = {https://doi.org/10.11648/j.ss.s.2016050601.17},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ss.s.2016050601.17},
      abstract = {In training processes within professional practice, professional discourse can benefit from the study of language and its complexity, incorporating both its representational and presentational aspects. Integrating a professional’s thoughts and actions is key in the research of professionalizing knowledge, in which the use of narrative exceeds the dichotomy of thought and action. In many institutions it is common for many trainers to begin interventions with an initial study of expert opinions [1, 2, 3, 4]. However, when dealing with very specific disciplines, experts occasionally prioritize their own field of research over and above that of others, as they experience an intense connection with their field due to the social repercussions of their work; paradoxically, it is this same social commitment which defines concrete priorities and pushes other areas into second place, making it difficult to reach consensus among different professionals [5, 6]. The aim of this paper is to study how certain processes of reduction in the number of experts and variables can be carried out as an initial training step when interventions aimed at achieving consensus among experts have been unsuccessful. In our case, we intervened in the field of Health Management through a work group consisting of professionals in different specialties within the health sector (doctors, managers, pharmaceutical industry specialists, etc.). The evaluation of the degree of consensus was undertaken with the study of the deviations of the Delphi Method and Kendall’s coefficient of concordance W, as is often the case [7, 8, 9, 10]; we realized, however, that we had not achieved an acceptable degree of consensus. We therefore opted to apply a study of profiles and of variable reductions, in search of a more compact subgroups of opinion among the experts. We concluded that, when working with groups with a high level of identification or when no appropriate consensus techniques have been applied, it is possible to resort to this method to achieve more cohesive work groups. Moreover, when a consensus technique is applied as a correct intervention, this same technique can serve as an evaluation tool.},
     year = {2017}
    }
    

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  • TY  - JOUR
    T1  - The Group Reduction Technique to Achieve Consensus Among Collectives in Health Care Training
    AU  - Jorge Irigaray
    AU  - Guillem Bou
    AU  - Casilda Güell
    AU  - Francisco Benjamín Cobo
    Y1  - 2017/02/28
    PY  - 2017
    N1  - https://doi.org/10.11648/j.ss.s.2016050601.17
    DO  - 10.11648/j.ss.s.2016050601.17
    T2  - Social Sciences
    JF  - Social Sciences
    JO  - Social Sciences
    SP  - 50
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    PB  - Science Publishing Group
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    AB  - In training processes within professional practice, professional discourse can benefit from the study of language and its complexity, incorporating both its representational and presentational aspects. Integrating a professional’s thoughts and actions is key in the research of professionalizing knowledge, in which the use of narrative exceeds the dichotomy of thought and action. In many institutions it is common for many trainers to begin interventions with an initial study of expert opinions [1, 2, 3, 4]. However, when dealing with very specific disciplines, experts occasionally prioritize their own field of research over and above that of others, as they experience an intense connection with their field due to the social repercussions of their work; paradoxically, it is this same social commitment which defines concrete priorities and pushes other areas into second place, making it difficult to reach consensus among different professionals [5, 6]. The aim of this paper is to study how certain processes of reduction in the number of experts and variables can be carried out as an initial training step when interventions aimed at achieving consensus among experts have been unsuccessful. In our case, we intervened in the field of Health Management through a work group consisting of professionals in different specialties within the health sector (doctors, managers, pharmaceutical industry specialists, etc.). The evaluation of the degree of consensus was undertaken with the study of the deviations of the Delphi Method and Kendall’s coefficient of concordance W, as is often the case [7, 8, 9, 10]; we realized, however, that we had not achieved an acceptable degree of consensus. We therefore opted to apply a study of profiles and of variable reductions, in search of a more compact subgroups of opinion among the experts. We concluded that, when working with groups with a high level of identification or when no appropriate consensus techniques have been applied, it is possible to resort to this method to achieve more cohesive work groups. Moreover, when a consensus technique is applied as a correct intervention, this same technique can serve as an evaluation tool.
    VL  - 5
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Author Information
  • EAE Business School, Barcelona, Spain

  • EAE Business School, Barcelona, Spain

  • EAE Business School, Barcelona, Spain

  • Universidad Camilo José Cela, Madrid, Spain

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