Focus groups. A unique approach to curriculum development.

The purpose of this article is to describe the use and effectiveness of focus group methodology for curriculum development. This unique approach grew from the investigators' belief in the application of the principles of primary health care in designing a curriculum for community-based nursing education. The specific content and outcomes of the focus groups in relation to three curricular themes are reported in this journal in the article "Community-Based Nursing Education' Research Stud7 from the NLN Vision for Nursing Education--Hawai'i, Phase II." The current article concentrates on the process and methods used. THE INVESTIGATORS DEVELOPED a qualitative methodology that would expand the meaning of each theme, using focus groups as the major strategy for generating data. Morgan "broadly defines focus groups as a research technique that collects data through group interaction on a topic determined by the researcher ... it is the researcher's interest that provides the focus, whereas the data themselves come from the group interaction" (1, p. 6). One major advantage of using focus groups is maximum participant involvement in the stimulating exchange of ideas, experiences, and attitudes about a specific topic. One disadvantage is the influence of the group on the data produced. In other words, the opinions of the group may influence the perspective of the individual. Carey calls this censoring and conforming (2). The strength of this methodology was seen to outweigh potential weaknesses. The underlying principles that guided all planning and activities were valuing, appreciating, and recognizing participants as the experts, seeking validation and feedback from them, and preserving their words, their voice, throughout. Therefore, the investigators instituted a number of measures to preserve the authentic individual voices of participants. The process was designed to foster individual reflection and capture that data first. An experienced facilitator was engaged to create a comfortable and trusting environment, encourage the sharing of ideas and opinions, and promote the synthesis of new insights based on group wisdom and negotiation. Planning for Sessions Early in the planning process, the investigators reflected on the three nursing-specific themes under consideration and reviewed the concepts embedded within them. This reflective process involved returning to the initial project and examining the genesis of each theme, negotiating and revising until the investigators reached consensus on the theme's general meaning and intent. Each focus group was planned to maximize development and expansion of a specific theme. To maintain the authentic voices of the participants, careful consideration was given to preserving their words and meanings. Details of activities during the sessions and the physical setup of the rooms were incorporated into a written script. Triggers, stimuli customized for each theme, were sent to participants in preparation for the focus groups. Open-ended questions were developed for use during the sessions to encourage exploration of the themes and stimulate new insights (3). Refreshments were included as part of the social context of the focus groups. Selecting Participants The use of focus group methodology for curriculum development grew from the investigators' belief in the value of community input. The selection of participants was purposive and deliberate. Individuals were selected based on their interests and expertise in relation to the theme to be developed. Those selected were known to the investigators as reflective individuals, perceived to be visionary beyond the boundaries of their own positions. It was thought that such individuals would provide fresh, innovative insights into new and emerging roles for nurses. In addition, community affiliations and/or areas of practice were considered to identify a pool of participants with a broad base of knowledge and skills. …