Once you have selected your topic area, funnel down to an answerable review question:
Funnelling research question from topic
Note: Adapted from How to do a systematic Literature Review in Nursing (p. 14) by J. Bettany-Saltikov, 2024, McGraw Hill. Copyright 2024 by J. Bettany-Saltikov.
Create your question:
Once you have your question, you can identify all the important elements.
Sometimes it helps to write an answerable question that begins and ends with a patient, population, or problem. This helps to develop a clinical research and/or EBP question. Using one of the frameworks below for developing searchable and answerable clinical questions can be useful during the research process.
PCC is recommended by JBI to identify the main concepts in your Scoping Review question. Breaking down your question in this way allows you to check for any potentially missed inclusion and exclusion. (Definition from JBI Reviewer's Manual Ch.11)
| P | Population, Participants | Important characteristics of participants including age and other qualifying criteria |
| C | Concept | This guides the scope and breadth of scoping review. Should include interventions, outcome and/or phenomena of interest |
| C | Context | may include cultural factors such as healthcare setting, geographical location, age, gender |
e.g.
USING PCC TO INFORM YOUR SCOPING REVIEW QUESTION & SEARCH STRATEGY
What interventions (Concept) were used in care home settings (Context) to ensure older adults (Population) safety during COVID-19 (Concept) : a scoping review
| KEY TERMS, SYNONYMS WITH BOOLEAN | ||
| P |
Population, Participants |
("older adults" OR elderly OR seniors OR geriatrics) AND
|
| C | Concept |
(covid-19 AND lockdown OR isolation OR quarantine) AND (interventions OR strategies OPR "best practice" OR safety or protection or risk or danger) AND |
| C | Context | ("care home" OR "residential care" OR "nursing home" OR "residential home" OR "long term care") |
An example article using PCC framework:
Feo, R., Kitson, A., & Conroy, T. (2018). How fundamental aspects of nursing care are defined in the literature: A scoping review. Journal of Clinical Nursing, 27(11-12), 2189–2229. https://doi.org/10.1111/jocn.14313
PICO is most widely used in quantitative research questions. Originally designed for questions that include interventions or comparisons which can make it difficult if these elements are not included in your research question.
| P | Population, Patient, Problem | Who are the users, patients or community affected? What are their symptoms, age, gender etc |
| I | Interventions | what is being for patient/populations e.g. screening, surgery, rehabilitation, services, treatment |
| C | Comparison | is there a comparison? e.g. different treatment options, placebos etc. |
| O | Outcomes | what changes or measures for patient/population? |
e.g.
USING PICO TO FORM YOUR RESEARCH QUESTION & SEARCH STRATEGY
Does HRT (intervention) alleviate menopausal symptoms (problem) in women (population) more than SSRIs (comparison) ?
| KEY TERMS, SYNONYMS & BOOLEAN | ||
| P | population/patient/problem | (menopaus* OR perimenopaus*) AND (symptoms OR signs OR characteristics OR presentation ) AND |
| I | intervention | (HRT OR "hormone replacement therapy" OR "oestrogen replacement therapy" OR "estrogen replacement therapy") OR |
| C | comparison | SSRI OR "selective serotonin reuptake inhibitors" or antidepressants |
| O | outcomes | better sleep, improved mood and enhanced daily functioning |
*Note: It is not necessary to use every element in PICO or to have both a problem and population in your question. PICO is a tool that helps researchers frame an answerable EBP question.
PEO is most useful for qualitative research questions.
| P | Patient, population, problem | who are the patients or community being affected? what are their symptoms, gender, age etc.? |
| E | Exposure | is the population exposed to a condition or illness, risk factor, screening, rehabilitation, services? |
| O | outcomes or themes | patient experiences. Are you looking for improvements in pain, responsiveness to treatment, quality of life etc.? |
e.g.
USING PEO TO FORM YOUR RESEARCH QUESTION & SEARCH STRATEGY
What are the risk factors (Exposure) for informal carers (Population) caring for a spouse with dementia (problem)?
| KEY TERMS, SYNONYMS & BOOLEAN | ||
| P | Population, patient, problem |
("informal carer" OR "family caregiver" OR spous*) AND (dementia or alzheimer's or "cognitive impairment" or "memory loss" or "cognitive decline") AND |
| E | Exposure | ("risk factor" OR burden) |
| O | Outcomes or themes | quality of life, sleep, social support, relationship |
Example article using PEO framework:
Alving, B. E., Christensen, J. B., & Thrysøe, L. (2018). Hospital nurses’ information retrieval behaviours in relation to evidence based nursing: a literature review. Health Information & Libraries Journal, 35(1), 3–23. https://doi.org/10.1111/hir.12204
SPIDER can be useful for quantitative, qualitative or mixed methodology research questions. This can be used when the research is about attitudes and experiences rather than scientifically measurable data. It involves applying the right criteria to your question by focussing less on the intervention and more on the design of the study, and deals with "samples" rather than a "patient" or "populations". Research questions framed using the SPIDER tool tend to begin with "What are the experiences of ...?"
| S | Sample | the group of participants in qualitative research |
| PI | Phenomena of Interest | the hows and whys of behaviour and experiences |
| D | Design | how the study was devised and conducted |
| E | Evaluation | the measurement of outcome might be subjective and not necessarily empirical |
| R | Research type | qualitative, quantitative or mixed method? |
e.g.
USING SPIDER TO FORM YOUR RESEARCH QUESTION & SEARCH STRATEGY
What are the experiences (E) of postgraduate students (S) studying distance learning (PI): a qualitative study (R)?
| KEY TERMS, SYNONYMS & BOOLEAN | ||
| S | Sample | (postgraduate OR PG) AND |
| PI | Phenomena of Interest | ("distance learn*" OR "distance education" OR "online education" OR "online learn*") |
| D | Design | Survey |
| E | Evaluation | AND (experiences OR perceptions OR attitudes OR views OR feelings OR perspective) |
| R | Research type | qualitative |