to identify all patients who underwent a vasectomy at the University of Wisconsin Health System, Madison, Wisconsin, USA, from 2010 to 2016. All vasectomies performed by urologists or FMPs in this time period were included. The study was approved by the Institutional Review Board (University of Wisconsin School of Medicine and Public Health, USA) for human subjects and did not require additional consent due to its retrospective nature.

Records were reviewed for vasectomy date, physician-performed procedure, number and timing of PVSAs obtained, as well as their results. PVSA follow-up was considered as obtaining at least one PVSA following vasectomy. Time to first PVSA was calculated as the difference between vasectomy date and date of the first PVSA. Positive PVSA was defined as the presence of motile sperm on athree different problems requiring creative thinking, the number of ideas produced by "nominal groups" (whose members were actually working alone) was greater than the number of ideas produced by real, face-to-face groups. The ideas generated by the nominal and real groups were rated qualitatively and for originality, and the nominal groups scored better on both of those measures.

Introduction and explanation: The facilitator welcomes the participants and explains to them the purpose and procedure of the meeting.

Silent generation of ideas: The Facilitator provides each participant with a sheet of paper with the question to be addressed and ask them to write down all ideas that come to mind when considering the question. During this period, the facilitator asks participants not to consult or discuss their ideas with others. This