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Library and Research Resources for WT Health Science Students at RELLIS

Get to know the the Library, its services, and resources for students in the Bachelor of Science in Health Science program at RELLIS.

1. Ask a Question

Background versus Foreground Questions

Evidence-based practice (EPB) experts distinguish between background and foreground questions.

Background questions ask for general knowledge about a condition or thing.

  • Ask for general knowledge about a disease or disease process
  • Have two essential components:
    • A question root (who, what, when, etc.) with a verb
    • A disorder, test, treatment or other aspect of health care
    • Examples: What causes migraines? or What cooling methods are used to treat heatstroke?

Foreground questions ask for specific knowledge and often contain several concepts. These types of questions can usually be answered based on current research evidence on diagnosing, assessing, or treating patients, or on understanding the meaning or prognosis of their health problems. Foreground questions seek the specific information needed to make clinical decisions. Many health care professionals use PICO or PICO(T) to help develop their questions.

Asking a Health Care Research Question using PICO(T)

Many health care professionals use the acronym PICO(T) to help formulate clinical research questions for evidence-based practice.

  • P - Patient, Problem or Population. What are the key characteristics of the patient or people?
  • I - Intervention, Influence, or Exposure. What is the intervention or therapy of interest? What is a potentially harmful or beneficial influence?
  • C - Comparison. What is the intervention or influence being compared to? (Depending on your research question, you may not need to include a comparison.)
  • O - Outcome. What is the outcome or consequence of the intervention?
  • T - Timeframe, Type of Study, or Type of Question. Depending on your research question, you may want to add T to help find a specific level of evidence.

A good clinical question will address most, if not all, of the PICO framework. The PICO process starts with a case scenario from which a question is constructed that is relevant to the case, and is phrased in such a way as to facilitate finding an answer. Once you have written down what you know so far for each part of PICO, you will have some keywords to use as you acquire research evidence through library resources.

There are several types of PICO questions, depending on the category of your research question. Your question may not include all of the PICO(T) components, but it will always include P (Patient, Population, or Problem). These question templates may be helpful in getting started.

For an intervention/treatment/therapy question:

In ____________ (Population), what is the effect of ______________ (Intervention) in comparison to (Comparative/alternative intervention) on ______ (Outcome) within ____________ (Timeframe)?

For a diagnosis/assessment question:

For__________________ (Population), does _________________ (Identifying tool or procedure) yield more accurate or more appropriate diagnostic/assessment information than ________________ (Comparative tool/procedure) about ____________ (Outcome)?

For a prognosis question:

In ______________ (Population) does ________________ (Influence/exposure to disease or condition), relative to _________________ (Comparative disease/condition OR absence of the disease/condition) increase the risk of _____________ (Outcome)?

For an etiology/harm question:

In _________ (Population), does ____________ (Influence/exposure/characteristic) compared to ______________ (Comparative influence/exposure OR lack of influence/exposure) increase the risk of _______________ (Outcome)?

For description of prevalence or incidence:

In ____________________ (Population), how prevalent is ________________ (Outcome)?

Meaning or process:

What is it like for _________________ (Population) to experience (condition, illness, circumstance)? OR

What is the process by which ________________ (Population) copes with, adapts to, or lives with (condition, illness, circumstance)?


Polit, D. F and Beck, C. T. (2021) Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer.

Template for Asking PICOT Questions
A printable template from the American Association of Critical Care Nurses will help you structure your PICOT questions. There are also definitions of the different types of questions and some sample questions.
PICO Examples
This guide from the University of North Carolina Health Sciences Library has case studies from different nursing specialties to practice writing out PICO components and then forming a research question for different scenarios. Answers are included!
What Makes a Good Clinical Question?
A Centre for Evidence-Base Medicine blog post by David Nunan which discusses how and why to ask the right type of questions. Asking focused questions can help direct your search to more relevant and precise answers.
Introduction to Evidence-Based Practice Tutorial:  Module 1
A video tutorial developed by staff at the Duke University Medical Center Library and the Health Sciences Library at the University of North Carolina. Module 1 includes sections on differentiating between the two major types of clinical questions (background versus foreground) and creating well-built clinical questions using the PICO acronym.
Asking an Answerable Question
Practice building your PICO questions using this unit from Cochrane Public Health.
7 Steps to the Perfect PICO Search
A step-by-step guide to formulating a PICO search.