What Is PICO(T)?

Let us assume you have a topic you wish to research but have yet to begin your searches. Before you begin, you must have a clinical question formulated - this will direct how you phrase your research queries. This approach is known as the PICO model. 

P - Patient and/or Population

• Who is your patient? Their age, sex, health history and problem at hand are all elements under this first category.

I - Intervention 

• What is your treatment plan? Tests, potential prescriptions & procedures go here.

C - Comparison 

• Which alternatives are available? What has come before in the literature?

O - Outcomes

• What is your goal? Do you need to give a new, correct diagnosis? Stabilize a condition?

T - Time

• How long did the aspects of the study take? What timeframes must be considered?

The 5 A's

From Ascension WI:

The 5 "A's" will help you to remember the EBP process:

1. ASK:  Information needs from practice are converted into focused, structured questions.
2. ACCESS / ACQUIRE:  The focused questions are used as a basis for literature searching in order to identify relevant external  evidence from research.
3. APPRAISE:  The research evidence is critically appraised for validity.
4. APPLY: The best available evidence is used alongside clinical expertise and the patient's perspective to plan care.
5. ASSESS / AUDIT:  Performance is evaluated through a process of self reflection, audit, or peer assessment.

Please note, there are several models for EBP with various named and numbered steps.  This guide will detail the first three steps ASK, ACCESS/ACQUIRE, APPRAISE.  Some models include a 6th step for DISSEMINATE.

* This box and graphic was created by Diane Giebink-Skoglind of ThedaCare. Used by permission.  The graphic is adapted from Melnyk, BM & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best pracatice. (2nd ed.)  Philadephia: Wolters-Kluwer/Lippincott Williams & Wilkins.

EBP Databases & Resources