Creating researchable questions is considered to be one of the challenges researchers face at the initial stages of their projects. Investigators have been forced to formulate questions in order to provide solutions to unanswered issues in the current clinical practice. This paper acts as a guide for researchers as it will describe the steps of formulating clinical questions. This paper describes Population, Intervention, Comparison, Outcome and Time (PICOT) a framework for forming research questions. It will also show the connection between research and evidence-based practice as well as the benefits that can be derived from using evidence-based practices and PICOT in research.
The Connection between Research and Evidence-Based Practice
Research and evidence-based practices are two common terms used in the nursing profession. Evidence-based practice allows the provision of quality care to patients and family members with the aim of improved patient outcomes and satisfaction. In an attempt of mastering evidence-based care, nurses tend to search out the best evidence to support interventions, assessment, develop new practices and refine policies. Research helps in developing a systematic system used to develop evidence ( Neipp et al., 2016 ). The medical practice expects nurses to develop evidence-based practices that integrate with research evidence, interpretation of patient needs and proper decision regarding care. Quantitative research offers healthcare providers’ effective evidence-based practices that are suitable for offering the best care and treatment to patients.
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Formation of Focused Clinical Questions
In the process of answering how focused clinical questions are developed, it is imperative to understand how they came up. There is a direct link between evidence-based medicine and clinical questions. Since evidence-based medicine entails the integration of best scientific evidence present within the patient preferences and physician experiences, it is important to develop a question based on issues patients encounter or disease and find evidence to answer the question ( Neipp et al., 2016 ) . Before coming up with the right clinical question, it is good to think about the type of questions available. There are four types of clinical questions that can be developed. This includes therapy, diagnosis, prognosis, and economic questions.
The first step of developing focused clinical question is by spending some hours to craft a question that can narrow the search for questions. Since clinical questions occur when managing patients or when prescribing care, the questions have to be clinically relevant, answerable and thoughtful. The second way is by looking at the patient problem populations. It is ideal for researchers to understand the group that they want information about. During the intervention, nurses must highlight the physical therapy event they are studying, its effects, validity, and reliability ( Harvey & Kitson, 2015) .
The third way of coming up with focused clinical questions is by establishing the evidence which is produced by intervention. One must also look at the validity of the evidence produced by clinical tests or other tests. Lastly, nurses must learn the effect of the intervention they want to put across. They should also determine the accuracy of the diagnostic test.
Components of the PICOT Model
The PICOT model is a helpful approach that is used by medical practitioners to summarize research questions that investigate the effect of therapy. It is an acronym which stands for population, Intervention, Comparison, Outcome and Time. Population (P) refers to the sample of subjects that should be included in the study. When selecting the best sample, it is important to define a sample that can respond to the interventions put across and another one that comprises of patients who are visible in the actual practice. Intervention (I) involves the treatment which is provided to subjects enrolled in a study (John, 2012). Comparison (C) is used to identify plans on who is to be used as the reference group and can be compared to the treatment intervention. Most studies refer to comparison as the control group.
The next component is the outcome (O) which represents the results to be measured in order to establish the effectiveness if an intervention. There are numerous outcome tools that are available for use among different clinical populations although they should be selected wisely since they both have strengths and weaknesses. The last element is time (T) which describes the entire period of data collection ( Harvey & Kitson, 2015) .
Components of the PICOT Model in the Article
The article that will be used is “What is your research question? An introduction to the PICOT format for clinicians.” by John J. Riva , Keshena M.P. Malik , Stephen J. Burnie , Andrea R. Endicott , and Jason W. Busse .
The journal that published this article is the Journal of the Canadian Chiropractic Association. This article is from the medical practice department and the authors identified and discussed the components of the PICOT model involved when developing clinical research questions. The researchers described a randomized controlled trial (RCT) to illustrate how clinicians can use the PICOT model format and existing literature to generate research questions on treatment efficacy (John, 2012) . The researchers identified five components of PICOT model including population, intervention, comparison, outcome and time.
In this article, population is defined as the sample of subjects that are included in a study. The most commonly defined sample according to these researchers is the population which is likely to correspond to the intended intervention. Questions nurses and physicians must ask themselves is whether they are interested in a specific age cohort, health cohort or a certain population. The second component is intervention. This is the treatment that all those who have involved the study are given. This involves asking questions such as where will the treatment be administered such as “legs only” or “hands only.” Comparison is the third component. This identifies the reference group that nurses are planning to use in comparison to treatment intervention. Researchers must have something to compare to sometimes known as the gold standard (John, 2012). Outcome, another component of PICOT represents results that a researcher is planning to examine in order to determine the effectiveness of the intended intervention. The best option that can be measured easily is mortality. The last component is time. This component describes the time that will be taken to complete data collection processes. Most medical research outcome is measured after 6 weeks.
Example of a focused Clinical Question Using Each Element of PICOT
The PICOT model is the most conversant method of formulating the focused question as well as finding their answers. In order to come up with the questions, researchers begin with a vague question like “How effective is Clinical Research Professional (CRP) really?” When developing focused clinical question using the PICOT, the question must identify the major problems of patients, what tests or treatment patients should receive, the set treatment or tests alternatives that are put in place and the expected outcome.
Population deals with patient problems. Examples of questions that can be asked here include, how will our group of patients be described with ours? What are the crucial traits of the patient?” These questions can include the basic problem, co-existing conditions or diseases. At some point, age, race or gender might also be significant to the treatment of the disease. Under intervention, the question that can be asked may read; which main exposure or prognosis factor will be considered? Should drugs be prescribed? Should a test be ordered? Or what elements are likely to influence the prognosis of the patient previous exposure ( Harvey & Kitson, 2015) ?
In comparison, the questions that can be asked include; what alternatives have been set aside to compare with intervention? Is it that you are trying to decide between a drug and no medication or two diagnostic tests? As much as these questions have a specific format, it is not a must that all of them should have a specific comparison. Formats are of different types and it’s up to the nurse to decide which one is the best (John, 2012).
Regarding outcome, what do you linger to measure, accomplish, or improve? What are you trying to achieve for the patient? Are you eliminating or relieving the symptoms? Are you trying to minimize the adverse events? Or improve the functionality or test scores? In time, the questions that can be asked include; has the patient recovered within the stipulated time? Or how long will the patients be hospitalized?
Importance of Evidence-Based Practice and the use of the PICOT Model
Evidence-based has the ability to minimize healthcare spending in the U.S by a whopping 30 percent in case all patients are subjected to the evidence-based practice. For instance, the process of aspirating a syringe during an intramuscular injection is no longer applicable in the current evidence-based practice. Evidence-based interventions improve patients’ outcomes and provide high-quality care to patients, minimize costs as well as eliminating obsolete that is not working in our hospitals ( Harvey & Kitson, 2015) . Many evidence-based studies regarding the Functional Movement Screen help in predicting the extent of an injury and other risks.
Evidence-based practice is associated with a number of fitness programs and rehabilitation which are essential tools for healthcare professionals when making decisions over patient care. Currently, the evidence-based practices offer the highest clinical guidelines that are based on RCTs. Students who embrace evidence-based practices as a standard practice and acknowledge its positivity can help them to provide the best care to their patients ( Neipp et al., 2016 ). Students can also make copies of evidence-based practices which they can read later.
POCOT model has also a number of benefits. First, by addressing a specific population, it is easy to identify the population of children with otitis media so that they can be put under care. By understanding the background of questions depending upon the experience and answering them accordingly, PICOT helps to address complex issues in healthcare. Intervention helps to relieve pain in patients while minimizing the chance of developing resistance to drugs among patients ( Harvey & Kitson, 2015) .
References
John J. Riva , Keshena M.P. Malik , Stephen J. Burnie , Andrea R. Endicott , and Jason W. Busse , (2012 Sep) What is your research question? An introduction to the PICOT format for clinicians. 56(3): 167–171.
Harvey, G., & Kitson, A. (2015). Implementing evidence-based practice in healthcare: a facilitation guide . Routledge.
Neipp, M. C., Beyebach, M., Nuñez, R. M., & Martínez ‐ González, M. C. (2016). The Effect of Solution ‐ Focused Versus Problem ‐ Focused Questions: A Replication. Journal of marital and family therapy , 42 (3), 525-535.
