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NUR 550 - Evidence-Based Practice and Scholarly Inquiry

This Library Research Guide is intended to help you identify and locate scholarly and non-scholarly resources (books, articles, etc.) on the subject of evidence-based practice, scholarly research, appraising evidence, APA citation.

PICO Acronym

PICO(T) is a mnemonic used to describe the four elements of a good clinical foreground question:


P = Population/Patient/Problem - How would I describe the problem or a group of patients similar to mine?

I = Intervention - What main intervention, prognostic factor or exposure am I considering?

C = Comparison - Is there an alternative to compare with the intervention?

O = Outcome - What do I hope to accomplish, measure, improve or affect?

T = Time (if applicable) - The time frame of treatment and/or measurable outcome.

Fill in the blanks with information from your clinical scenario:

In_______________, what is the effect of ________________on _______________ compared with _________________?

Are ______________ who have _______________ at ______________ risk for/of ____________ compared with _____________ with/without ______________?

Are (Is) ________________ more accurate in diagnosing _______________ compared with ____________?

For ___________ does the use of _________________ reduce the future risk of ____________ compared with ______________?

Does ____________ influence ______________ in patients who have _____________? 

How do _______________ diagnosed with _______________ perceive __________________?

Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

Choosing Keywords

The library's databases are best searched using keywords rather than long sentences or phrases. It is common to use full sentences, phrases and any words that pop into mind while using a search engine like Google. It is important to note that library databases are not Google, they have their own way of searching for information. Using keywords and something called Boolean operators are the start to coming up with successful searching strategies. First, let's talk about a few ways you can brainstorm keywords for your topic:

Identify the main concepts that make up your topic. For example, if the topic is careers in librarianship perhaps main concepts related to this could be: librarians, information literacy, public libraries, academic libraries, research, education. 

Think about related and more specific terms for the concepts you identified at first. Maybe words such as children, adult learners, instructional design or others come up as you reflect on the first set of concepts you identified. Feeling stuck? Try using a thesaurus to look up synonyms or use a brainstorming strategy like mind mapping/problem-solving to see how the concepts in your topic are related. 

Once you have your keywords identified, it's time to try some searches! You can combine the keywords in various ways to create different searches to use in the library's databases. Here are some tips to help you combine your keywords and create effective searches.

Keyword Search Tips

Use Boolean Operators such as AND, OR, and NOT. The AND tells the search engine to only bring back results that use both search terms: cats AND dogs. The OR tells the search engine to bring back results that have either search term: cats OR dogs. The NOT will exclude the word or phrase that follows it: cats NOT dogs. Using parentheses can also help, like this: cats AND (dogs OR birds).

Use quotation marks around any important phrases. If your topic is human resources, then search for the phrase like this: "human resources" so that the search engine will look for the two words next to each other in that exact order, rather than the two individual words separately in the article.

Use an asterisk (*) as a wildcard. The asterisk tells the search engine to find any variation of the word that starts with the same root. For example, if one of your keywords is biology, search for it like this: biolog*. The search engine will look for the words biology, biologic, biological, etc.

Using the keywords that were brainstormed above, here are some examples of what a good search strategy would look like:

  • librarian AND education AND career
  • librarian OR academic librarian AND information literacy
  • education AND "academic librarian" AND instruct*

Any of these search strategies would be good to try in a library database. In the next section of the guide, we will look at some specific databases you can use in the research for this course.

PICO(T) and Its History

PICO is an acronym used to remember the key components of a clinical question. Physicians first developed the PICO framework in evidence-based medicine as a way to address knowledge gaps during patient encounters. Questions could arise around a patient’s diagnosis, prognosis, and therapy, as well as around prevention strategies and patient education. Since then, PICO has become the most widely used question framework for evidence-based practice.

The Purpose of PICO(T)

PICO(T) is useful in academic and clinical settings. It can help you:

  • form a question that focuses on the most important issue for a patient or a population
  • identify key terms to use in a search for evidence
  • select results that directly relate to the situation

PICO(T) has some limitations. The framework privileges interventions, experimental research, and dominant voices.

McKenzie JE, Brennan SE, Ryan RE, Thomson HJ, Johnston RV, Thomas J. Chapter 3: Defining the criteria for including studies and how they will be grouped for the synthesis. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.2 (updated February 2021). Cochrane, 2021. Available from This link opens in a new window.

How to Research a PICO(T) question

CINAHL or Multi-Search

Both CINAHL This link opens in a new window and Multi-Search This link opens in a new window have the PICO guided search link enabled. Click that link to type in your PICO keywords and synonyms.

Screenshot of where to find the PICO Search link on the CINAHL search page

Let’s say your PICO question is whether music therapy reduces the stress of premature infants? Fill out the PICO guided search with the appropriate keywords and synonyms like this:

Screenshot of the PICO guided search

Once you click Submit, it will populate the search box with your search terms and run the search. Make sure that you update your publication date if you can only use articles from the past 5 years. There’s a publication date filter over on the left side. Just type in the year you want into the left box and it should update your results immediately once you click Enter.

Screenshot of the search results page

Nursing Journals on OVID

In addition to CINAHL, we also recommend that you run a similar search in Nursing Journals on OVID This link opens in a new window. It does not have a PICO guided search tool, but you can copy and paste the search string from your CINAHL search just like this and plug it into the OVID search box:

(premature infants OR preterm infants) AND (music OR sing* OR song) AND (anxiety OR stress)

Screenshot of the search page in the Nursing Journals on OVID

Google Scholar

Finally, take that same search string and try Google Scholar This link opens in a new window, which can be linked up to our library’s full text using the instructions in the FAQ How can I use Google Scholar to find electronic articles held by the Shapiro Library?. Just click the “FullText@ShapiroLibrary” link to go to the full-text courtesy of Shapiro Library.

Screenshot of Google Scholar PICO Search

Interlibrary Loan

If you see an article that looks helpful, but you do not see the full-text link on the right, please submit an Interlibrary Loan request for it. It’s a free service for SNHU students and it generally only takes 2-4 business days to get you the PDF from a library that has it. This is highly recommended for nursing students as there are many nursing journals that put an embargo on the most recent issues.

Below are some sample questions using the PICO method of inquiry.

Element of the clinical question


 Describe as accurately  as possible the patient or  group of patients of interest.

Intervention (or cause, prognosis)

 What is the main intervention or therapy you wish to consider?
Including an exposure to disease, a diagnostic test, a prognostic factor, a treatment, a patient perception, a risk factor, etc.

Comparison (optional)

  Is there an alternative treatment to compare?
Including no disease, placebo,  different prognostic factor, absence of risk factor, etc.


  What is the clinical outcome, including a time horizon if relevant?


 In patients with acute bronchitis,

 do antibiotics


 reduce sputum production, cough or days off?


 Among family-members of patients undergoing diagnostic procedures

 does standard care,

listening to tranquil music, or audio taped comedy routines

make a difference in the reduction of reported anxiety.