Formulating a clinical question using the PICO format

Formulating a clinical question using the PICO format provides a focus that will guide an efficient

electronic literature search.

• Remember, the findings of one study on a topic do not provide sufficient evidence to support a change in practice.

• The ability to critically appraise and synthesize the literature is essential to acquiring skills for


making successful presentations, as well as participating in EBP/QI projects.

Searching for evidence Students often state, “I know how to do research; why I need to go see the librarian?” Perhaps you have thought the same thing because you too have “researched” a topic for many of your course requirements. However, it would be more accurate for you to say that you have “searched” the literature to uncover research studies and conceptual information to prepare an academic paper on a topic. During this process, you search for primary sources and secondary sources. It is best to use a primary source when available. Table 3.1 provides definitions and examples of primary and secondary sources, and Table 3.2 identifies the steps and strategies for conducting an efficient literature search. Table 3.3 indicates recommended databases. The top two, CINAHL Plus with full text and PubMed (MEDLINE), are always a must. There are multiple databases that health science libraries offer, and most offer online tutorials for how to use each database. Using the CINAHL Plus and PubMed databases and at least one additional resource database is recommended. Example: ➤ If your topic is about changing a patient’s behavior, such as promoting smoking cessation or increasing weight-bearing exercises, you would use the top two as well as PsycINFO. Another recommendation if your clinical question focuses on interventions is to use the Cochrane Library (, which has full text systematic reviews as well as an extensive list of randomized control trials (RCTs) and other sources of studies.

TABLE 3.2 Steps and Strategies for Conducting a Literature Search: An EBP Perspective

Steps of Literature Review Strategy Step I: Determine clinical question or research topic.

Focus on the types of patients (population) of interest.

If the goal is to develop an EBP project, start with a PICO question. If the goal is to develop a research study, a researcher starts with a broad review of the literature to refine the research question or hypothesis (see Chapter 2).

Step II: Identify key variables/terms.

Review your library’s online Help and Tutorial modules related to conducting a search, including the use of each databases’ vocabulary, prior to meeting with your librarian for help. Make sure you have your PICO format completed so the librarian can help you limit the research articles that fit the parameters of your PICO question. If, after reviewing tutorials on Boolean connectors “AND, OR, and NOT” that connect your search terms when using a specific database, you don’t understand the use of these connectors, clarify with a librarian.

Step III: Conduct electronic search using at least two, preferably three if needed for your topic, recognized electronic databases.

Conduct the search, and make a decision regarding which databases, in addition to CINAHL PLUS with Full Text via EBSCO and MEDLINE via Ovid, you should search; use key mesh terms and Boolean logic (AND, OR, NOT) to address your clinical question.

Step IV: Review abstracts online and weed out irrelevant articles.

Scan through your retrieved articles, read the abstracts, mark only those that fit the topic and are research; select “references” as well as “search history” and “full-text articles” if available, before printing and saving or e-mailing your search.

Step V: Retrieve relevant sources.

Organize by type or study design and year and reread the abstracts to determine if the articles chosen are relevant research to your topic and worth retrieving.

Step VI: Store or print relevant articles; if unable to print directly from the database, order through interlibrary loan.

Download the search to a web-based bibliography and database manager/writing and collaboration tool (e.g., RefWorks, EndNote); most academic institutions have “free” management tools, such as Zotero. Using a system will ensure that you have the information for each citation (e.g., journal name, year, volume number, pages), and it will format the reference list. Download PDF versions of articles as needed.

Step VII: Conduct preliminary reading; eliminate irrelevant sources.

First read each abstract to assess if the article is relevant.

Step VIII: Critically read each source (summarize and critique each source).

Use critical appraisal strategies (e.g., use an evidence table [see Chapter 20] or a standardized critiquing tool) to summarize and critique each articles; include references in APA format.

Step IX: Synthesize critical summaries of each article.

Decide how you will present the synthesis of overall strengths and weaknesses of the reviewed research articles (e.g., present chronologically or according to the designs); thus, the reader can review the evidence. Compare and contrast the studies in terms of the research process steps, so you conclude with the overall similarities and differences between and among studies. In the end, summarize the findings of the review—that is, determine if the strengths of the group of studies outweigh the limitations in order to determine confidence in the findings and draw a conclusion about the state of the science. Include the reference list.

Get Professional Assignment Help Cheaply

fast coursework help

Are you busy and do not have time to handle your assignment? Are you scared that your paper will not make the grade? Do you have responsibilities that may hinder you from turning in your assignment on time? Are you tired and can barely handle your assignment? Are your grades inconsistent?

Whichever your reason may is, it is valid! You can get professional academic help from our service at affordable rates. We have a team of professional academic writers who can handle all your assignments.

Our essay writers are graduates with diplomas, bachelor's, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college diploma. When assigning your order, we match the paper subject with the area of specialization of the writer.

Why Choose Our Academic Writing Service?

  • Plagiarism free papers
  • Timely delivery
  • Any deadline
  • Skilled, Experienced Native English Writers
  • Subject-relevant academic writer
  • Adherence to paper instructions
  • Ability to tackle bulk assignments
  • Reasonable prices
  • 24/7 Customer Support
  • Get superb grades consistently

How It Works

1.      Place an order

You fill all the paper instructions in the order form. Make sure you include all the helpful materials so that our academic writers can deliver the perfect paper. It will also help to eliminate unnecessary revisions.

2.      Pay for the order

Proceed to pay for the paper so that it can be assigned to one of our expert academic writers. The paper subject is matched with the writer’s area of specialization.

3.      Track the progress

You communicate with the writer and know about the progress of the paper. The client can ask the writer for drafts of the paper. The client can upload extra material and include additional instructions from the lecturer. Receive a paper.

4.      Download the paper

The paper is sent to your email and uploaded to your personal account. You also get a plagiarism report attached to your paper.


order custom essay paper
Order a unique copy of this paper
(550 words)

Approximate price: $22

Basic features
  • Free title page and bibliography
  • Unlimited revisions
  • Plagiarism-free guarantee
  • Money-back guarantee
  • 24/7 support
On-demand options
  • Writer’s samples
  • Part-by-part delivery
  • Overnight delivery
  • Copies of used sources
  • Expert Proofreading
Paper format
  • 275 words per page
  • 12 pt Arial/Times New Roman
  • Double line spacing
  • Any citation style (APA, MLA, Chicago/Turabian, Harvard)

Our guarantees

We value our customers and so we ensure that what we do is 100% original..
With us you are guaranteed of quality work done by our qualified experts.Your information and everything that you do with us is kept completely confidential.

Money-back guarantee

You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.

Read more

Zero-plagiarism guarantee

The Product ordered is guaranteed to be original. Orders are checked by the most advanced anti-plagiarism software in the market to assure that the Product is 100% original. The Company has a zero tolerance policy for plagiarism.

Read more

Free-revision policy

The Free Revision policy is a courtesy service that the Company provides to help ensure Customer’s total satisfaction with the completed Order. To receive free revision the Company requires that the Customer provide the request within fourteen (14) days from the first completion date and within a period of thirty (30) days for dissertations.

Read more

Privacy policy

The Company is committed to protect the privacy of the Customer and it will never resell or share any of Customer’s personal information, including credit card data, with any third party. All the online transactions are processed through the secure and reliable online payment systems.

Read more

Fair-cooperation guarantee

By placing an order with us, you agree to the service we provide. We will endear to do all that it takes to deliver a comprehensive paper as per your requirements. We also count on your cooperation to ensure that we deliver on this mandate.

Read more

Calculate the price of your order

550 words
We'll send you the first draft for approval by September 11, 2018 at 10:52 AM
Total price:
The price is based on these factors:
Academic level
Number of pages
Open chat
You can contact our live agent via WhatsApp! Via +1 817 953 0426

Feel free to ask questions, clarifications, or discounts available when placing an order.

Order your essay today and save 20% with the discount code VICTORY