How to write a good PICOT QUESTION? | 7 Steps to follow

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As a nursing student, it is paramount that you question what is in the literature that is communicated through writing an excellent paper. But before we go any further, it is good to distinguish the difference between a PICOT question and a PICOT statement which most students tend to get confused with.

A PICOT question is a detailed, precise, and relevant clinical practice research question derived from studying practice difficulties or a patient case scenario. A PICOT statement, on the other hand, is a statement derived from the PICOT question that details the direction of an intervention or evidence-based practice. It limits the scope of a PICOT inquiry by describing the evidence-based practice or change needed in practice or to resolve a clinical condition.

As stated, a PICOT question is majorly related to the nursing field where a student finishing his or her advanced studies in nursing school begins a research query using evidence-based practice. The term PICOT is a mnemonic term that is derived from the clinical research question research elements patient, intervention, comparison, outcome, and time(University, 2020). So, let us demystify the PICOT acronym;

P – Patient or Population

Ask yourself who are the relevant patients. This should relate to their sex, age, location, and any other distinct characteristics vital to your question. There should be a commonality between these factors to make it be considered as a population of interest to a nurse. Please note that in selecting a population, ensure to narrow it down to the individual patient that is representing the entire population for the generalization of the findings(Gradecrest, 2021).

I – intervention or indicator

Ask yourself what action or treatment can you consider or the recommended management strategy to use in addition to diagnostic test, and interested exposure. Intervention simply means or refers to the actions that ought to be taken for the overall improvement of well-being of the patient.

The intervention can be pharmacologic such as diagnostic testing, medication, non-pharmacologic action, or surgery.

C – Control or compare

Ask yourself if there are any other interventions apart from the ones mentioned above that you can consider. At this point you have to compare your population of focus to another population that is totally opposite in nature.

The main goal of this comparison is to prove if the indicated or proposed change or intervention would for sure result to an effective change.

Remember that it is the alternative that is in focus at this point and thus is the one you are to use to compare with the intervention. Ensure that you use the information from the alternative population and the one from the intervention to have a detailed and complete comparison.

O – Outcome or Objective

Ask yourself what are the patient-relevant consequences of the intervention or expected objective. Upon completion of a detailed comparison of an alternative population to that of the intervention population, it is expected that you now provide a report of your expectations.

The expectations or outcomes can be in the form of qualitative statements or statistical findings; however, it must be rigor, authentic, and relevance. During documentation of the outcomes, it is key to note that, you can do so with the patient-orientation point of view.

T – Time

Ask yourself what time durations to consider in addition to the various study types that are mostly going to have the information you are intending to use. Lastly, the relevant clinical domains that your question might fall under.

However, you will find that in most guides it ends at PICO edging out the T. This is because the timeframe is not considered as a vital parameter as it quantifies the time it takes for a given intervention to generate a specific outcome

It also relates to the length of time the participants are monitored. Unless specifically required, include the time in both your PICO statement and the PICOT inquiry.

The PICOT process

The PICOT process initial stages start with a case scenario which lead to the question being phrased to an elicit answer. It is notable to note that a PICOT question is supposed to fall under four types or categories namely therapy or prevention, diagnosis, etiology, and prognosis.

In writing a PICOT question, it is good to establish the population or patient that you intend to undertake the study in addition to the intervention or treatment you intend to use, the comparison of one intervention in relation to another if it is applicable, and lastly the anticipated outcome.

A renowned Centre for Evidence-Based Medicine at University of Oxford states that through using a PICOT process, a student is assisted to develop a careful and thoughtful question that enables the search for evidence even easier.

Steps in developing the PICOT question

Researchers have stated that there is a need to establish a need or a reason for the study during the development of a PICOT question.

To further understand the process, consider the following EBSCO health whitepaper example: a committee agrees to undertake a case study to assess if after gum chewing for abdominal surgery patients may avoid postoperative ileus.

Upon having such an example or a scenario in mind, researchers worldwide have developed a seven-step guideline relating to a PICOT search. These seven steps are;

Step 1: PICOT question formulation

Upon having an idea in mind or case scenario, it is good to come up with ideas of a good research question to use. Based on our scenario, a good research question would be; Is there evidence that gum chewing postoperatively, as opposed to not chewing gum, affects postoperative ileus in individuals recuperating from abdominal surgery?”

Step 2: Establish the Keywords for the PICOT mnemonic

With the research question in mind, it is time to establish how it can be dissected and be inseminated to the PICOT mnemonic. With our research question in mind, it would look like this;

P – Individuals recuperating from abdominal surgery

I – Gum chewing

C – Not chewing gum

O – Affects postoperative ileus

Step 3: Search strategy planning

The search strategy planning involves establishing relevant databases and other informative sites that might be used in finding answers and information based on our research question. It is paramount to develop strategies that will maximize the identified search terms.

Step 4: Search execution

It is recommended to search the PICOT elements individually for a better search result. Using our example, some of the search terms that can be used include abdominal surgery, recuperating and postoperative.

Step 5: Refining of the results

Upon executing the search, it is important that you now narrow the search results which in most cases involves limiting the works to pertinent content. Such examples include research documents and peer-reviewed journals or articles.

Step 6: Content review

It is important that when you have the research results in place, you get to conduct a detailed review to identify if the in-fact research results have the necessary information that can be used to answer the PICOT question.

Step 7: Standards determination

Establish if the research results indeed meet the set standards which in this case should be providing the best available evidence.

Here is a link to picot question examples: https://guides.hsl.virginia.edu/c.php?g=921177&p=6638623

References

Gradecrest. (2021). How to write a PICO Question for Nursing Class. https://gradecrest.com/. https://gradecrest.com/how-to-write-a-picot-question/

University, D. (2020). Formulating a PICOT Question. https://onlinenursing.duq.edu/. https://onlinenursing.duq.edu/blog/formulating-a-picot-question/

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