The Clinical Issue and Research Questions Developed Using PICOT

PICOT is an acronym used to help develop clinical research questions and guide you in your search for evidence:

P = Patient population

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I = Intervention or issue of interest

C = Comparison of interventions or comparison of interests

O = Outcome

T = Time frame

For example, you may wish to research the effects of interrupted sleep on cognition of ICU patients 65 or older.

Using this PICOT model,

In _________(P), how does __________ (I) compared to _________ (C) influence _________ (O) over ________ (T)?

In ICU patients who are 65 or older, how does interrupted sleep (awakened one time or more in four hours) as compared to uninterrupted sleep influence the patient’s cognitive ability over 5 days?

Assignment Directions

Begin by selecting a topic in nursing or medicine that is of interest to you. Next, use PICOT to format possible research questions about that topic. Provide 3 possible PICOT research questions.

Include the following:

Title page
Provide a brief description of the topic and background information.
Explain the significance of the topic to nursing practice.
Provide 3 clearly stated PICOT questions.

Your paper should:

Be 2–3 pages (not including the title page and reference page)

Use current APA format to style your paper and to cite your sources.

EXAMPLES:

Table of Contents for PICO Search Strategies
A Sample Question Using PICO(T)
Background Questions: Examples
Foreground Questions/Information: Examples
Harvesting Search Terms
A Sample Question using PICO(T)

Evidence-based models use a process for framing a question, locating, assessing, evaluating, and repeating as needed. PICO (T) elements include: Problem/Patient/Population, Intervention/Indicator, Comparison, Outcome, and (optional) Time element or Type of Study.

1. Frame the Question

Write out your information need in the form of a question. For example:

Does hand washing among healthcare workers reduce hospital acquired infections?

The question above includes the PICO elements:

P (Problem or Patient or Population): hospital acquired infection
I (intervention/indicator) : hand washing
C (comparison): no hand washing; other solution; masks
O (outcome of interest): reduced infection

 

2. Plan a Search Strategy

Identify the major elements of your question, and translate natural language terms to subject descriptors, MeSH terms, or descriptors.

TIP: start with the P and the I only to begin your search and keep initial search results broad:

P (Problem/Patient/Population) in Natural Language: hospital acquired infection

P (Problem/Patient/Population) in Database Vocabulary: cross infection [MeSH] / cross infection [CINAHL Subject]

I (Intervention/Indicator) in Natural Language: hand washing

I (Intervention/Indicator) in Database Vocabulary: hand disinfection [MeSH] / handwashing [CINAHL Subject]

 

A simple database search strategy should begin with the P AND I: cross infection AND (handwashing OR Hand disinfection)

 

Start with both CINAHL and Medline/PubMed as initial article databases for a scoping search for most health sciences questions. If your topic has a behavioral/mental health component, also try PsycINFO.

 

 

3. Consider Comparison, Outcome, Time Factors or Type of Study

After viewing the initial search results you may decide to narrow your search with terms for the Comparison, Outcome, Time factors or Type of study. Or you may view results, abstracts, and full text of articles to view the comparison and outcome elements. Use database filters, explained in Filtering the Evidence.

 

4. Filter the Evidence

Tips for expanding your search or narrowing your search

MORE sample searches

Download a Boolean Worksheet to help plan your database search

 

*Heneghan, C., & Badenoch, D. (2002). Evidence-based medicine toolkit. London: BMJ Books

Search Strategies–Background Information

Beginning a literature search, you may be looking for overview/background information.

A BACKGROUND QUESTION asks for general knowledge about a disorder, disease, policy issue, etc.

Background information may be found in sources such as:

reference book entries or selected Ebooks/Encyclopedias in the health sciences
textbooks, chapters, appendices
drug monographs, guides to diagnostic tests, ebook drug guides (see Drug Information Research Guide)
the library’s Bobcat catalog
Sample Search Strategies for Background Questions:

 

Question 1: What are the side effects of Lipitor?

Appropriate Source Type(s):

Drug Reference Book

Sample Strategy

Search for drug name (consider brand name and generic name) in:

StatRef (collection of reference tools, including drug references)
Access Medicine

 

 

RUBRIC
Meets or Exceeds Expectations Mostly Meets Expectations Below Expectations Does Not Meet Expectations
Topic/ Relevance to Nursing
Points Range:
29.7 (29.70%) – 33 (33.00%)
A clear and succinct description of the topic is presented. Background information is relevant and specific to the topic. The significance of the topic to nursing practice is explained clearly and is supported with examples.

Points Range:
25.08 (25.08%) – 29.37 (29.37%)
A description of the topic is presented but may be ambiguous or confusing. Some background information is provided, but more is needed for a full explanation. The significance of the topic to nursing practice is somewhat explained and may not be supported with examples.

Points Range:
19.8 (19.80%) – 24.75 (24.75%)
A description of the topic is presented but is ambiguous or confusing. Some background information is provided, but more is needed for a full explanation. The significance of the topic to nursing practice is somewhat explained but is not supported with examples.

Points Range:
0 (0.00%) – 19.47 (19.47%)
An unclear description of the topic is presented or is missing. No background information is provided. The significance of the topic to nursing practice is not explained.

PICOT Research Questions
Points Range:
29.7 (29.70%) – 33 (33.00%)
All research questions are accurately framed as complete PICOT questions. PICOT questions provide a clear and specific focus for research within the topic.

Points Range:
25.08 (25.08%) – 29.37 (29.37%)
Only some research questions are framed as PICOT questions, or some PICOT questions are incomplete. PICOT questions provide a vague or unclear focus for research that may not be within the topic.

Points Range:
19.8 (19.80%) – 24.75 (24.75%)
Few questions are framed as PICOT questions, or are incomplete. PICOT questions provide a vague or unclear focus for research that is not within the topic.

Points Range:
0 (0.00%) – 19.47 (19.47%)
Research questions are missing or are not framed as PICOT questions.

APA and Mechanics
Points Range:
30.6 (30.60%) – 34 (34.00%)
Follows all the requirements related to format, length, source citations, and layout. Written in a clear, concise, formal, and organized manner. Responses are mostly error free. Information from sources is paraphrased appropriately and accurately cited.

Points Range:
25.84 (25.84%) – 30.26 (30.26%)
Follows length requirement and most of the requirements related to format, source citations, and layout. Writing is generally clear and organized but is not concise or formal in language. Multiple errors exist in spelling and grammar with minor interference with readability or comprehension. Most information from sources is paraphrased and cited correctly.

Points Range:
20.4 (20.40%) – 25.5 (25.50%)
Follows few requirements related to format, source citations, and layout. Writing may be unclear or informal in language. Multiple errors exist in spelling and grammar, interfering with readability or comprehension. Some information from sources is paraphrased and cited correctly.

Points Range:
0 (0.00%) – 20.06 (20.06%)
Does not follow format, length, source citations, and layout requirements. Writing is generally unclear and unorganized. Errors in spelling and grammar detract from readability and comprehension. Sources are missing or improperly cited.

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