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Nursing: MSN/DNP


Getting Started

Types of Frames


PICOTT is a mnemonic used to describe elements of a good clinical foreground question.

The PICOTT model is used in evidence-based practice to assist in formulation of searchable clinical questions.

How to Phrase Your PICO

PICO is a good framework to help clarify your (clinical, review, or research) question.

P -  Patient, Population or Problem: What are the important characteristics of the patients &/or problem?

I -  Intervention:  What you plan to do for the patient or problem?

C - Comparison: What, if anything, is the alternative to the intervention?

O - Outcome:  What is the outcome that you would like to measure?


Beyond PICO: the SPIDER tool for qualitative evidence synthesis.

5-SPICE: the application of an original framework for community health worker program design, quality improvement and research agenda setting.

PICO worksheet

Other Mnemonics

Search Concept Tools : PICO and other tools for developing research questions and search concepts

A variety of tools are listed that can be used to formulate your research question and identify possible search concepts for your literature search. As a rule of thumb pick the 2-4 concepts which are most simple to search for.*

1. CLIP –Health service management questions

C Client – at whom is the service aimed?
L Location – where is the service sited?
I Improvement – what do you want to find out?
P Professional – who is involved in providing/improving the service?

2. CMO or CIMO - Realist Synthesis questions

C Context
I Intervention
M Mechanism

3. ECLIPS(E) – Health service management questions

E Expectation—what does the search requester want the information for (the original ‘I’s)?
C Client Group.
L Location.
I Impact—what is the change in the service, if any, which is being looked for? What would constitute success? How is this being measured?
P Professionals.
S Service—for which service are you looking for information? For example, outpatient services, nurse-led clinics, intermediate care.

4. MIP – Medical ethics questions

M Methodology  e.g. in-depth interviews or questionnaires
I Issues e.g. Healthcare Rationing or  end-of-life decision-making
P Participants e.g. physicians or patients

5. PICO – Reviews of interventions for health

P Patient or population
I intervention
C comparator
O Outcomes

Nb add ‘S’ on end if study type is significant, a ‘C’ if context is significant or 'T' for timeframe or 'T' Type of question

6. SPICE – Social science questions (designed for librarian research questions)

S Setting – Where? In what context?
P Perspective – For who?
I Intervention (Phenomenon of Interest)– What?
C Comparison – What else?
E Evaluation – How well? What result?

7. SPIDER – Qualitative evidence synthesis

S Sample
P I Phenomenon of interest
D Design
E Evaluation
R Research type

*With thanks to Linda Mace-Michalik (The Library, Roseberry Park Hospital, TEWV NHS FT) for distributing her compilation of alternatives to the PICO framework.