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Undergraduate Nursing Research Guide

By starting your nursing research with a well-crafted PICO question, you can:

  • help clarify what you're investigating to give structure to your search
  • break a clinical issue into specific components that make it easier to identify relevant keywords and locate high-quality evidence
  • stay focused on the most important aspects of your topic

PICO (or any of the related formats, such as PICO(T)) is especially useful when you're exploring evidence-based interventions or patient outcomes. Always follow the guidance of your course assignments and professor's guidance when creating a question.

PICO Question Example

What are the components of a PICO question?

Patient/Population/Problem Intervention Comparison Outcome
Who is the patient or population? What is the health concern or condition? What is the main intervention, exposure, or treatment you want to investigate? Is there an alternative to compare the intervention to (e.g., placebo, different treatment)? What do you hope to accomplish, measure, or affect (e.g., reduced symptoms, fewer complications)?

Example PICO Question:

In adults with Type 2 diabetes (P), does participation in a structured diet and exercise program (I) compared to standard care without lifestyle counseling (C) improve blood glucose control (O)?

Creating a Search Term Table

Once you have established your question and are ready to locate evidence, a search term table can be a good way to:

  • understand the relationships between the concepts in your question and
  • organize and expand on your keywords to prepare for a systematic search.   

Search table with only keywords: 

Question:

In adults with Type 2 diabetes (P), does participation in a structured diet and exercise program (I) compared to standard care without lifestyle counseling (C) improve blood glucose control (O)?

Population Intervention Comparison Outcome
diabetes mellitus, type 2 Reducing diet (Standard care - no keywords) Glucose control
type 2 diabetes Exercise Glucose levels
type 2 diabetes, mellitus Healthy lifestyle

More complex example using MeSH terms: 

"Why would I use MeSH terms or subject headings?"

You can find more information on subject headings in the Controlled Vocabulary Video below. Here's a quick example to show the difference in a basic search with and without subject terms:

Search: diabetes type 2

Search Terms Number of Results Explanation
diabetes type 2 96,375 Any article that references "diabetes type 2" will show up in the results.
MH "Diabetes Mellitus, Type 2" 74,197 Articles in results have been tagged with type 2 diabetes as a key part (Major and Minor headings)
MM "Diabetes Mellitus, Type 2" 59,066 Articles in results have been tagged with type 2 diabetes as a Major heading only.

Search Term Table Template

PICO Question Example: In adult patients with diabetes mellitus type II (P), how do lifestyle modifications (e.g. diet and exercise) combined with anti-hyperglycemic medications (I) compared to anti-hyperglycemic medications alone (C), affect hemoglobin A1c levels (O) within six months (T)?

Column 1: Population (#1)

Diabetes mellitus, type 2 (MeSH, CINAHL) (#3)

type 2 diabetes mellitus (KW) (#2)

Type 2 diabetes (KW)

Column 2: Intervention

*lifestyle modifications

(e.g. diet and exercise)

Diet, Reducing (MeSH, CINAHL)

Reducing diet (KW)

Diet, Healthy (MeSH)

Healthy diet (KW)

Diet, Diabetic (MeSH)

Diabetic diet (CINAHL) KW

Exercise (MeSH) KW

Healthy Lifestyle (MeSH) KW

Column 3: Comparison

Hypoglycemic Agents (MeSH, CINAHL) KW

Antihyperglycemic (KW)

Column 4: Outcome

glycated hemoglobin A (MeSH) KW

Hemoglobin A, Glycosylated (CINAHL)

Glycosylated hemoglobin A (KW)

HbA1c (KW)

hemoglobin A1c (KW)

Note: To learn more about strategies for selecting keywords and controlled vocabulary, see the videos on the Pace Library YouTube channel for more details.

  1. In the first row, add the main concepts for each part of your question. You do NOT have to follow a PICO structure, but you can if it’s helpful.
  2. Add synonyms and similar concepts that will help you collect more relevant articles. Label them as KW for keywords.
  3. Locate the controlled vocabulary that applies to your keywords.
  4. When your search is created, the concepts in the columns are connected by AND so each result includes at least (1) concept from each column. Ex: Diabetes AND diet AND anti-hyperglycemic medications AND hemoglobin A1c levels
  5. When your search is created, the concepts in the rows are connected by OR to expand the options for how your main concepts are expressed in each search result. Ex: glycated hemoglobin A OR Hemoglobin A, Glycosylated OR Glycosylated hemoglobin A OR HbA1c OR hemoglobin A1c

Creating a Search Table

The video below will walk through the process of developing a search term table by reflecting on a research question and the desired outcomes for the research process.

You will also learn a bit about selecting controlled vocabulary terms.