Team work has always been found to be effective in solving problems faster and more effectively if the decision-making process is well organized. Therefore, any group or team might need to make decisions about performing a certain surgery for some patient, define their next research project, or financial decisions. The process of group decision making involves multiple individuals who try to act collectively to define the problem needed to be solved, define possible solutions, study and understand the possible methods and tools one can apply to solve the problem and finally define what should be done as a follow-up step to prevent future risks and uncertainties.

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It is also important to differentiate between the terms groups and teams. We sometimes use one of these terms in the place of another, but groups are different from teams from a business point of view. Groups usually have a leader, members of the group are responsible for their own individual accountability but not for the group, the group leader is responsible for measuring the efficacy of the work of the group, and finally the group discusses and decides together, but usually the person who is going to perform the required actions is a single person. To understand this difference, let us take a surgical meeting as an example. Usually, a group of internal medicine doctors, surgeons, and other health care providers attend such meetings. In most cases, a group leader governs these meetings and the goal is to decide whether the patient should undergo surgery, or continue medical treatment. Once the decision is made, let us say to go for surgery, the surgeon is going to do the surgery and not the whole group even though the whole group discusses and reached the decision together.

Tools and Procedures of Group Decision Making

While the process of decision making among groups might sound simple at the first glance, it is in fact difficult, time consuming and on many occasions, can end up without any meaningful decisions. Therefore, people who have a business background can usually go back to the basic methods of decision making which are applicable to both teams and groups. For example, the group might use the nominal group technique, the Delphi technique, brainstorming or dialectical inquiries to reach a decision. We will now discuss these different tools and show how they can help the group decide.

Nominal Group Technique

The process of nominal group decision making is structured and very well organized. Everyone is expected to come up with a list of ideas and decisions which is written privately and anonymously. After this process is finished, the lists of ideas are collected by the group leader and presented in front of everyone on the board. The next step is to discuss each idea, ask whether the writer of this idea can clarify more and explain and then to rank the idea in order of preference. Of course, none of the group members can criticize the ideas because negative criticism can make individuals more reluctant to participate in the decision-making process in the future.

Delphi Technique

The Delphi technique is very similar to the nominal group technique but with few subtle differences. Firstly, when the Delphi technique is used, usually outsourcing is applied to solve the problem. In other words, the Delphi group is a group of individuals who are highly experienced in the problem that is going to be discussed who can be physically far from each other and perhaps not members of the same team, hospital or business firm. These individuals send their ideas by email, fax or any other method of communication to the group leader. The group leader is then supposed to discuss these ideas with the local group, sometimes in the presence of the Delphi group by video conference, and try to reach a decision that both groups agree on as the most appropriate course of action. Surgical telemetry meetings are known to use such methods in complicated cases. Unfortunately, this technique is usually more time consuming. The most important advantage of the Delphi technique is that decisions are usually made based on a consensus that involves experts.


Brainstorming is one of the most common methods used to reach a decision in a group. All individuals can participate verbally with ideas which should be put on the board. Other group members are then encouraged to discuss these ideas, share their own ideas, or ask for more clarification from those who provided the ideas. This method is unstructured and not systemic. Usually, other group members might criticize the ideas which is strictly prohibited. Unfortunately, because individuals are expected to present their ideas verbally, those with poor presentation skills are usually going to be ignored in the decision-making process. Additionally, brainstorming while providing alternative solutions does not allow enough time to explain and evaluate such alternatives.

Brainstorming can be also done electronically where external experts might be included. Again, the process is not systemic, those who have poor presentation skills might be afraid to actually share their ideas and the decisions made are usually of a lower quality compared to the previous two methods.

Dialectical Inquiry

Dialectical inquiries can be considered as a second step after choosing one of the previously mentioned methods. Once a list of the ideas is formed by nominal group technique, brainstorming or the Delphi technique, the group members are divided into different teams. Usually, most solutions can be broadly classified into two, sometimes three, categories. For instance, while the exact surgical procedure might be debatable, sometimes it is easy to see that all ideas can be classified into either surgical or medical in a surgical telemetry meeting. The groups are divided into those who are pro-surgery and those who are pro-medical ideas for example and each sub-group is expected to provide explanation, clarification and reasoning for their side. Dialectical inquiries can help the group leader study in more depth all the alternatives for the given problem.

Pros and Cons of Group Decision Making

Group decision making processes are usually needed in any hospital or health care provider setting, but unfortunately, they might have few disadvantages. Before going into the disadvantages, let us first discuss the benefits of using such effective tools in decision making among groups.

Group decision making tools allow to explore more alternatives than individual decision making. It allows others to discuss their ideas, make them more involved in the team and to reach more evidence-based decisions. Finally, such tools and methods give room for opinions of experts who might be external.

Group decision making is usually slower to reach a decision when compared to individual decision making. Additionally, sometimes, group members might feel humiliated by others when their ideas are criticized or judged as completely irrelevant. Additionally, while alternatives are always provided in group decision making processes, the group leader usually chooses an idea early enough and becomes biased to that idea.

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