Forming a Clinical Question is the first step of five in Evidence-Based Practice, followed by: searching the literature for relevant research, critically appraising the literature, applying the results in practice, and evaluating the performance of the prior four steps.
When forming a Clinical Question:
- It is important that the question is well built with precise phrasing so that you can search for the best evidence and so that your answer is relevant to your patient's needs.
- the PICO Model can be a useful tool to help you identify four major elements of a good clinical question:
Patient group;
Intervention (Exposure or Therapy or Diagnostic Test);
Comparison (gold standard or control comparison; note - note all questions will have a comparison intervention); and
Outcome.
Example:
You are a school nurse who regularly visits a number of elementary and middle schools (children aged 5 to 13 years) in your region. It is cold and flu season once again. One of the teachers stops you in the hall to ask you a question about his 10- year old daughter who also has a cold. He has heard that zinc lozenges can help to relieve cold symptoms and wonders if they really do work and if it is OK to give them to children. (sample scenario from Centre for Evidence Based Medicine - http://www.cebm.utoronto.ca/syllabi/nur/therapy/)
| Patient |
Children with colds |
| Intervention |
Zinc lozenges |
| Comparison |
No comparison |
| Outcome |
Cold symptoms |
| Clinical Question |
In children with colds are zinc lozenges safe and effective for relief of cold symptoms? |
For more examples on how to form a clinical question try these web sites:
Centre for Evidence Based Medicine: Evidence Based-Nursing
Construct Well-Built Clinical Questions using PICO - HealthLinks University of Washington
Now that you have formed a focused clinical question, you need to look for some answer(s). Click here to learn how to search the literature to answer clinical questions.
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