Nursing

Developing a search strategy is the starting point for finding relevant information. Depending on the type of project you are completing - whether you just need a few articles for a class assignment or you need to complete a complex search for your thesis - the level of advanced searching you use may vary, but the principles of a well structured search are the same. 

Use PICO or PCC to help structure your search and avoid searching frustration where ever and however you chose to complete your search! 

PICO is a commonly used tool to help break down the searchable elements of your clinical research question and is the most common way a search is constructed for a systematic review. This helps to structure your search so that essential components are not missed and can help to enhance the relevancy of your search results. PICO is an acronym for: 

Population / Patient / Problem 

What are the most important or defining characteristics of the group, person, or problem you are interested in? Do your patients have a specific condition? Are you interested in disease incidence in a specific sex? Or special population group, such as immigrants or indigenous peoples? Are they a certain age - children, adults, elderly?

The more details you can provide, the more potentially relevant your results will be.

Intervention

What is the treatment, technology, program, or initiative you are interested in applying? Try and be as specific as possible and have some definitions at the ready. For example, if you are investigating "Diet" as an intervention, what type of diet? Low-carb? Keto? Restricted? Vegetarian?  Vegan? What about dietary supplements? Vitamins and minerals? How do you define and understand the concept of "Diet"? 

Comparison

What is the direct comparison to your intervention? Don't worry if you don't have one, this PICO element is often left off unless there is a specific comparison. For example, calcium from food intake vs calcium from vitamins/dietary supplements. 

Outcome

What are you hoping to improve, measure, or evaluate? Reduce disease incidence? Manage or reduce symptoms? Improve systems and ways of working? 

PICO Example Question 

Among elderly long term care home residents with depression, are therapy animal visits effective for managing or reducing depressive symptoms? 

In this example, more work is needed to define a couple of elements for the search. How old are "elderly" residents? 60+? 65+? What types of therapy animals will be included? Dogs? Cats? Horses? Rabbits? Other? 

Thinking about definitions and the structure of your search early on in your process can help to avoid frustration later on with either too many or too few results. 

PCC is another way we can add structure to our question development and searching and this is the method we use most often with scoping review searches. PCC and PICO are similar, but PCC can be used for less clinically focused research questions where you may not necessarily have a direct intervention and outcome. 

Population / Patient / Problem

This piece of PCC is the same as PICO. Who are you interested in? What are the defining characteristics of this group? Age? Gender? Disease or medical condition?

Concept 

This is similar to the Intervention from PICO, but it is not exactly the same.  What is the core concept examined in your research question? Is this an intervention or treatment? A phenomenon, such as healthcare access or risk? Sometimes this is also a particular disease or medical condition experienced by your population. 

Context 

This is also sometimes referred to as a "lens". In what context are you looking for your population and concept to be represented? Common contexts could be a specific geographic location, clinical settings, or even a particular methodological approach (for example, qualitative literature or lived experience)

PCC Example Question

What are the experiences of mothers who develop gestational diabetes in West Africa? 

PICOT can be used when a time element plays an important part in your research question: 

SPIDER is a variant that is often used in qualitative research: 

Not sure which would be best? 

AND - Combines different concepts, narrows your search. Used to combine P AND I AND C AND O.

*This is usually the default operator of a database so it will automatically AND your terms unless you tell it otherwise. 

OR - Combines unlike terms, broadens your search. Used to combine your various keywords OR synonyms OR subject headings for a single concept. 

NOT - Excludes certain terms, narrows your search. USE WITH CAUTION! NOT is often used poorly by searchers and can eliminate potentially useful articles from your search. If you are struggling with relevancy in your search results, try working on refining your search concepts or consult with a librarian for help.