Evidence-based practice begins with asking a focused clinical question. The acronym PICO(T) is a commonly used framework for developing clinical questions. By breaking a research question down into its major concepts, PICO(T) assists the researcher in searching for evidence efficiently with the most relevant keywords. PICO(T) stands for:
P=Problem or Patient or Population
Here is the basic structure of the six main types of PICO-based clinical questions:
1. THERAPY QUESTION
In ____________ is _________________ compared with ________________more effective for _________________?
Are ______________ who _______________ at higher/lower risk of ____________ compared with _____________ ?
3. DIAGNOSTIC QUESTION
In________________ is ________________more accurate in diagnosing _______________ compared with ____________?
4. PREVENTION QUESTION
In ___________ does the use of _________________ reduce the risk of ____________ compared with ______________?
5. PROGNOSIS QUESTION
In patients with _____________within __________________ what is the risk of __________________?
6. MEANING/QUALITATIVE QUESTION
How do _______________ diagnosed with _______________ perceive __________________?
Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Wolters Kluwer/Lippincott Williams & Wilkins.
Examine the resources below to learn how to use PICO to build a clinical question.
Let's look at an example of a scenario that we can turn into a PICO-based clinical question.
A hospital is experiencing a high rate of ER nurse turnover due to burnout. The hospital administration would like to investigate whether a mindfulness-based stress reduction program would be more effective in reducing burnout among their nurses compared to no intervention.
Our PICO keywords would be:
|P=Patient, Problem, or Population||I=Intervention or Treatment||C=Comparison; Alternative Treatment, Standard Treatment, or Placebo||O=Outcome; What do you want to measure or prove?|
|Emergency room nurses||Mindfulness-based training programs||No intervention||reduced burnout|
We can now use these PICO concepts to build our clinical question:
In emergency room nurses, what are the effects of participation in mindfulness-based training programs on nurse burnout compared to no intervention?
Try using one of these templates to guide you in developing your own PICO(T) clinical question.