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Developing Your Question
Developing your research question is one of the most important steps in the review process. At this stage in the process, you and your team have identified a knowledge gap in your field and are aiming to answer a specific question, such as
- If X is prescribed, then Y will happen to patients?
OR assess an intervention
- How does X affect Y?
OR synthesize the existing evidence
- What is the nature of X?
Whatever your aim, formulating a clear, well-defined research question of appropriate scope is key to a successful review. The research question will be the foundation of your review and from it your research team will identify 2-5 possible search concepts. These search concepts will later be used to build your search strategy.
PICOT Questions
Formulating a research question takes time and your team may go through different versions until settling on the right research question. A research question framework can help structure your systematic review question.
PICO/T is an acronym which stands for
- P Population/Problem
- I Intervention/Exposure
- C Comparison
- O Outcome
- T Time
Each PICO includes at least a P, I, and an O, and some include a C or a T. Below are some sample PICO/T questions to help you use the framework to your advantage.
For an intervention/therapy
In _______(P), what is the effect of _______(I) on ______(O) compared with
_______(C) within ________ (T)?
For etiology
Are ____ (P) who have _______ (I) at ___ (Increased/decreased) risk for/of_______ (O) compared with ______ (P) with/without ______ (C) over _____ (T)?
Diagnosis or diagnostic test
Are (is) _________ (I) more accurate in diagnosing ________ (P) compared with ______ (C) for _______ (O)?
For ________ (P) does the use of ______ (I) reduce the future risk of ________ (O) compared with _________ (C)?
Prognosis/Predictions
Does __________ (I) influence ________ (O) in patients who have _______ (P) over ______ (T)?
How do ________ (P) diagnosed with _______ (I) perceive ______ (O) during _____ (T)?
Melnyk B., & Fineout-Overholt E. (2010). Evidence-based practice in nursing & healthcare. New York: Lippincott Williams & Wilkins.
Ghezzi-Kopel, Kate. (2019, September 16). Developing your research question. (research guide). Retrieved from https://guides.library.cornell.edu/systematic_reviews/research_question
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- Last Updated: Sep 24, 2024 2:37 PM
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- PICO Examples
Forming Focused Questions with PICO: PICO Examples
Created by health science librarians.
- PICO's Limitations
Practice Your Skills
Cancer care and peer support, cultural awareness and nursing care, labor & delivery, infection control, nurse educator, nurse practitioner, public health, school nursing.
- Other Question Frameworks
Practice writing out PICO components and then forming a focused question about one of the case studies below. Choose one or several that interest you.
You have read that peer support interventions help individuals and families affected by cancer across the care continuum from prevention through survivorship and end-of-life care. You wonder about the characteristics of peer support programs and how peer support programs have been used to reduce disparities and barriers to care.
Open to check your PICO analysis of the scenario for cancer care.
Nurses in oncology units interact frequently with adults with cancer who do not speak English as their primary language. You are curious whether cultural awareness among nurses improves these patients’ care and participation in the decision-making process.
Open to check your PICO analysis of the scenario for nursing care.
You’re a new nurse on a labor and delivery unit. You’ve noticed that most women give birth in the lithotomy position at the encouragement of their doctors. However, you’re sure you heard in nursing school that other positions are less likely to lead to deliveries with forceps or a vacuum.. or did you? You want to find some literature to back up your claim.
Open to check your PICO analysis of the scenario for labor and delivery.
You work in the Big City Hospital ICU. Your mechanically ventilated patients sometimes contract nosocomial pneumonia, which leads to costly complications. You want to know if raising the head of the bed lowers the chance of the patient contracting pneumonia compared to letting the patient lie flat on their back.
Open to check your PICO analysis of the scenario for the ICU..
In the past few years, your hospital has installed antibacterial foam dispensers on all the nursing units. You’ve had nurses asking you if the foam is just as effective as washing their hands with water and soap.
Open to check your PICO analysis of the scenario for infection control.
Shift change on your busy med-surg unit can be frustrating for you and your coworkers. Report at the nursing station takes up to 30 minutes, by the end of which you’re anxious to see your patients. You read something in a recent ANA newsletter about other hospitals switching to a bedside shift report, and you want to find out if staff liked that style of shift change better.
Open to check your PICO analysis of the scenario in med-surg.
Open to check your pico analysis of the scenario in the nicu..
It’s the last semester of your BSN students’ time in school and they’re excited.. and anxious! They’ve been asking you if they should take the NCLEX right after they graduate or wait for a while after graduation so they can relax and study.
Open to check your PICO analysis of the scenario for nurse educators.
It’s winter at your family practice, and you have a lot of patients coming in with runny noses and general malaise. Brenda, a 35 year old working mother in for a checkup states, "I’m so busy between work and home that I definitely don’t have time to get sick! Can those vitamin C or zinc pills prevent colds?"
Open to check your PICO analysis of the scenario for nurse practitioners.
The main concern for most of your patients coming out of anesthesia in your PACU is pain. You want to explore nursing interventions you can use on top of medication administration to decrease pain. One coworker mentions trying to make the PACU feel less clinical by playing soft music to relax patients.
Open to check your PICO analysis of the scenario for PACU.
You work in a pediatrician’s office and give patients their routine vaccinations. The younger children are often fearful of needles, and some of the staff use toys to distract the patients. You want to know if this technique actually has an effect on the children's pain response.
Open to check your PICO analysis of the scenario for pediatrics.
You work on an inpatient psychiatric unit. One of your patients with chronic schizophrenia, Joe, normally mumbles to himself, but will occasionally speak to others when residents play games together. Noticing this, you say to a coworker that maybe social skills group training sessions would bring out Joe’s conversational skills. Your coworker shakes her head and says "I don’t think so. Joe is in and out of this hospital, he’s a lost cause."
Open to check your PICO analysis of the scenario for psychiatry.
You coordinate health education programs and have been holding seminars for teenagers about STI prevention. You’ve been found that they’re hesitant to open up to you during classes to ask you questions. You’re wondering if recruiting peer educators closer to their age will encourage them to actively participate and get more satisfaction out of the classes.
Open to check your PICO analysis of the scenario for public health.
On your pulmonary unit, many of your COPD patients receive injections of heparin to prevent pulmonary emboli, and patients find the bruises associated with heparin injections unsightly. You’ve had nursing students shadowing you lately, so you’ve been particularly concerned with injection technique. You want to find out if the duration of injection has any effect on the extent of bruising.
Open to check your PICO analysis of the scenario for pulmonary.
You’re a school nurse and one aspect of your job is counseling pregnant teens with the aim of enabling them to complete high school. You’ve even been conducting home visits on top of your normal in-school meetings as part of their preparation-for-motherhood counseling. You want sources to backup the effectiveness of these home visits.
Open to check your PICO analysis of the scenario for school nursing.
A diabetic patient from a nursing home has recently been admitted with a stage III pressure ulcers on his heels. The unit nurses have called you in for a wound consult. You have to choose between standard moist wound therapy and using a wound vac.
Open to check your PICO analysis of the scenario for wound care.
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- Last Updated: May 14, 2024 12:49 PM
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PICO- What's in a queston?
The PICOT question format is a consistent "formula" for developing answerable, researchable questions.
Note: Not every question will have an intervention (as in a meaning question) or time (when it is implied in another part of the question) component.
PICO(T) Templates
Template for Asking PICOT Questions
For an intervention/therapy:
In _______(P), what is the effect of _______(I) on ______(O) compared with _______(C) within ________ (T)?
For etiology:
Are ____ (P) who have _______ (I) at ___ (Increased/decreased) risk for/of_______ (O) compared with ______ (P) with/without ______ (C) over _____ (T)?
Diagnosis or diagnostic test:
Are (is) _________ (I) more accurate in diagnosing ________ (P) compared with ______ (C) for _______ (O)?
Prevention:
For ________ (P) does the use of ______ (I) reduce the future risk of ________ (O) compared with _________ (C)?
Prognosis/Predictions
Does __________ (I) influence ________ (O) in patients who have _______ (P) over ______ (T)?
How do ________ (P) diagnosed with _______ (I) perceive ______ (O) during _____ (T)?
Melnyk B., & Fineout-Overholt E. (2010). Evidence-based practice in nursing & healthcare. New York: Lippincott Williams & Wilkins.
Develop your Research Question
The PICO(T) Question
A clinical question that is composed using the PICO or PICOT format will help you to focus your search and help you to develop your research skills which are essential in finding the best available evidence.
The most common PICO(T) elements are:
P - Population
- How you would describe a group of people with a similar problem or complaint.
I - Intervention
- How you plan to treat, medicate, diagnose and/or observe the patient's care.
C - Comparison (if applicable)
- The main intervention alternative you are considering (i.e. placebo, alternative therapy, different drug, surgery).
O - Outcome
- The result from proposed treatment that is measurable, including improvement of symptoms,no symptoms, or complications.
(T) - Time (if applicable)
- The time frame of treatment and/or measurable outcome.
In order be successful in using Evidence Based Practice (EBP) you will need to learn how to develop well-composed clinical questions. By formatting your research question in a PICO(T) format you can gather evidence relevant to your patient's problem. Well-composed PICO(T) questions generally contain up to four components each represented in the acronym " PICO(T)" P=Patient or Population and Problem; I=Intervention or Indicator; C=Comparison or Control (not part of all questions); O=Outcome; T=Time or Type.
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- Last Updated: Sep 16, 2024 9:25 AM
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