Occupational Therapy: Ask the Question

1. Ask a Question guides your through the PICO process to set up a good research question for investigation. 
2. Searching for Evidence provides guidance on searching the research databases for articles to answer your research question. There isn't just one database, you will likely search more than one to find what you need. There will be guides to using MeSH subject headings as well as keywords and how to combine them to narrow your question. 
3. Cite the Evidence provides guidelines for citations in AMA (American Medical Association) formats, and quick guides to frequently used styles for articles, clinical practice guidelines and textbook citations. You will also find links to the list of journal title abbreviations you need to use for AMA.
4. Appraise the Evidence highlights the steps and provides guides to critical appraisal of topics (CATs) used in evidence based practice
5. Synthesize the Evidence details and illustrates the hierarchy of evidence standards for evaluation
6. Searching Databases "How To" Videos & Tutorials provides additional searching strategy help for library provided and other individual databases

Use these worksheets to turn your PICO research question into a search strategy to use in a research database. 

Foreground Questions

1. PICO (Problem/Population), Intervention, Comparison, Outcome

Appropriate for: clinical questions addressing the effect of an intervention/therapy/treatment

Example: For adolescents with type II diabetes (P) does the use of telehealth consultations (I) compared to in-person consultations (C) improve blood sugar control (O)?

2. PEO (Population, Exposure, Outcome)

Appropriate for: describing the association between particular exposures/risk factors and outcomes.

Example: How do preparation programs (E) influence the development of teaching competence (O) among novice nurse educators (P)?

3. SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research Type)

Appropriate for: questions of experience or perspectives (questions that may be addressed by qualitative or mixed methods research)

Example: What are the experiences and perspectives (E) of undergraduate nursing students (S) in clinical placements within prison healthcare settings (PI)

To develop a strong and reasonable foreground research question, it is important to have a firm understanding of the concepts of interest.  As such, it is often necessary to ask background questions, which ask for more general, foundational knowledge about a disorder, disease, patient population, policy issue, etc.

For example, consider the PICO question outlined above:

"For adolescents with type II diabetes does the use of telehealth consultations compared to in-person consultations improve blood sugar control?

To best make sense of the literature that might address this PICO question, you would also need a deep understanding of background questions like:

• What are the unique barriers or challenges related to blood sugar management in adolescents with TII diabetes?
• What are the measures of effective blood sugar control?
• What kinds of interventions would fall under the umbrella of 'telehealth'?
• What are the qualitative differences in patient experience in telehealth versus in-person interactions with healthcare providers?