A Guide to Nursing - Evidence-Based Practice Research: Step One: PICO: Asking a Question

NAU School of Nursing Students

PICO Worksheet and Search Strategy.

2001 Syrene A. Miller, PICO Worksheet and Search Strategy, National Center for Dental Hygiene Research

University of North Carolina nursing tutorial on Evidence-Based Practice includes a PICO example.

The first step is to identify your information need.

With athletic training research, use the PICO formula to create a good question:

• • P=PATIENT – Who is your patient? Or who is your population?
  • I=INTERVENTION – What main intervention or treatment are  you considering? 
  • C=COMPARISON – What is the main alternative to compare with the intervention? Are you trying to decide between two drugs, a drug and no medication or placebo, or two diagnostic tests?
  • O=OUTCOME – What do you hope for the outcome?
• Some PICO questions also integrate the concept of time:  T

Step One: Ask a Question using PICO format - Ask a clinical question.

Step Two: Search Resources for the Best Evidence - Search for best evidence to answer question.

Step Three: Appraise Evidence - Critically appraise evidence, assess study quality, etc.

Step Four: Apply Evidence - Integrate evidence with clinical expertise and patient preferences/values to apply in practice.

These are the first four steps of Evidence-Based Practice according to Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice: Step by step: The seven steps of evidence-based practice. The American Journal of Nursing, 110(1), 51-53.

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