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Nursing - RN to BSN

What is PICO?

PICO(T) is a question formula that allows you to define your research question and determine the key components of your research. It allows you to develop focused relevant questions. 

PICO(T) stands for:

P - Patient, Population, or Problem

I - Intervention or Indicator

C - Comparison or Outcome

O - Outcome

(T) - Time, Type of Study, or Type of Question

The Centre for Evidence Based Medicine (CEBM) states that "one of the fundamental skills required for practising EBM is the asking of well-built clinical questions. To benefit patients and clinicians, such questions need to be both directly relevant to patients' problems and phrased in ways that direct your search to relevant and precise answers". The PICO model assists you in organizing and developing your question to be able to search our databases effectively. 

Tutorials

PICO Questions

Characteristics of PICO Questions include:

  1. Structures and guides the search for literature evidence
  2. Promotes a relevant, direct, and clear search
  3. Answers, What do I want to know about?
  4. Focus the question by identifying the components in the question
  5. Defines the concepts that will be used when performing a complex literature search
  6. Promotes access to professional evidence relevant to the question
  7. Determines if the identified evidence is able to efficaciously address the question
  8. Focuses on elements to support and update clinical practice
  9. Provide the information needed to make a decision whether or not the intervention in the PICO question should be implemented

(Duke University, 2014; Upstate Medical University, 2010)

The following are the four specific PICO(T) question components that will promote developing an answerable clinical question and developing an efficient search strategy. 

Patient or Problem

Describe the population or clinical problem? What are the most important characteristics of the patient or problem?

Intervention, Prognostic Factor, or Exposure

What is the main intervention, prognostic factor, or exposure being considered? What do you want to do with this patient?

Comparison Intervention

What is the main alternative to compare with the intervention, if any?

Outcome

What are you trying to accomplish, improve, or affect?

Time/Type of Study

Time element or type of study

(Centre for Evidence-Based Medicine, 2014; Duke University, 2014; Occupational Therapy Evidence-Based Practice in Western New York, n.d.; Upstate Medical University, 2010)

Clinical questions are often classified as either background or foreground. 

A.  Background questions - questions that ask for general knowledge about an illness, disease, condition, or process (who, what, when, where, how, and why about disorders, tests, or treatments).  Questions like:  What is considered overweight in a 45 year old male?  What are some symptoms of diabetes?  Background questions are often answerable by using "background resources" such as textbooks, manuals, and narrative reviews in scholarly articles.

B.  Foreground questions - questions that ask for specific knowledge that

1) affect clinical decisions and

2) include a broad range of issues, including psychological, biologic, and sociologic issues. 

 These questions will usually concern a specific patient/particular population and tend to be more complex.  Often, foreground questions require investigation and comparison between two treatments and/or outcomes.  These questions ask for specific knowledge to be able to make informed clinical decisions.  These are questions that require a search of current medical literature.

PICO allows you to formulate articulate foreground questions to be able to effectively research your topic.

Subjects: Nursing