Now that you've formulated your clinical research question using the PICO(T) templates, it's time to acquire evidence (research literature). You can use the information that you inserted into the blanks as keywords for searching. An example research question might be: "In patients undergoing abdominal surgery, is there evidence to suggest that chewing gum post-operatively compared with not chewing gum post-operatively affects post-operative ileus?"
| PICO Element | Keywords |
|---|---|
| P (Patient or Population) | Patients undergoing abdominal surgery |
| I (Intervention) | Chewing gum |
| C (Comparison) | Not chewing gum |
| O (Outcome) | Affects post-operative ileus |
Jensen, K. A. (2018). 7 Steps to the Perfect PICO Search: Evidence-Based Nursing Practice [White paper]. EbscoHealth. https://www.ebsco.com/sites/g/files/nabnos191/files/acquiadam-assets/7-Steps-to-the-Perfect-PICO-Search-White-Paper_0.pdf
You've already identified keywords for each of the PICO(T) elements in your research question. These keywords might need to be "translated" into subject descriptors or Medical Subject Headings (MeSH) depending on the database(s) you've chosen for your searches. Using synonyms may help expand your search. Using our example question from the first section, you might miss an article that describes a patient as "postoperative" or in "recovery" if you only use "surgery" as a search term.
| PICO Element | Keywords | Search Terms | Search Strategies |
|---|---|---|---|
| P (Patient or Population) | Patients undergoing abdominal surgery | Abdominal surgery |
Abdominal surgery |
| I (Intervention) | Chewing gum | Chewing gum | Chewing gum OR Gum |
| C (Comparison) | Not chewing gum | ||
| O (Outcome) | Affects post-operative ileus | Postoperative ileus |
Postoperative ileus |
Jensen, K. A. (2018). 7 Steps to the Perfect PICO Search: Evidence-Based Nursing Practice [White paper]. EbscoHealth. https://www.ebsco.com/sites/g/files/nabnos191/files/acquiadam-assets/7-Steps-to-the-Perfect-PICO-Search-White-Paper_0.pdf
Choosing databases to search may seem overwhelming. The Nursing and Health Databases page lists databases especially useful for nursing and family nurse practitioners. There are short descriptions of each database.
The Video Tutorials for Nursing Databases page has several tutorials on how to search CINAHL and Medline. UpToDate has several video tutorials available.
The National Library of Medicine has an interactive training course on Using PubMed in Evidence-Based Practice. The PubMed database is extremely large, making it difficult to narrow down your search results to just those articles that are relevant to clinical questions. You need to use the Clinical Queries tool to help narrow down search results to those articles that are relevant to clinical questions.The Perform a Clinical Queries Search and Filter Results module will help you search the clinical literature.