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• Determines elements of PICO relevant to the chosen scenario

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• Determines elements of PICO relevant to the chosen scenario



Assessment Item 1: Finding the evidence                            Weight: 15% of overall mark for the subject


Submission: 11.59 pm Sunday 02 April 2017, through Turnitin. No paper submission is required.


Task: Using clinical case scenarios, students will be expected to develop a question to address the area of clinical uncertainty and demonstrate their ability to use the PICO framework and document a systematic literature search.



This assignment will build on your learning during Week 2.  In the tutorial time and preparation activities in Week 2, you will learn what a PICO is, how to create one, why we use it, and how it helps us in searching for evidence. Face to face library workshops and online library study guide have been designed to assist you with assessment one. A discussion board has been set up for assessment one, so that you can share your ideas or find answer to your questions about this assessment. Research is a collaborative process, and so is learning in the clinical environment, so this activity will teach you skills in sharing your ideas with others so that you can all learn and achieve together.


In this assignment you will provide evidence of your learning on using PICOs and building a systematic literature search.


  1. Choose one of the three clinical case scenarios on the next page (page 2).
  2. Using the information from the case scenario, and your skills from Week 2, fill in the attached PICO worksheet to plan for your systematic database search.
  3. Using the information from your PICO Worksheet record your Search Strategy in the attached worksheet (please do this in Microsoft Word and not by hand)
  4. Enter your search terms into Medline (Ovid) using skills you have learnt in Week 2, the Online Library Study Guide, and the information in your Search Strategy Worksheet.
  5. Take a screenshot of your search and paste it into the section in the worksheet below (see example on page 3).
    1. Why Medline?? It is one of many databases, you just need to show us you are able to apply your learning into a database and in this instance we have asked you to use Medline – being able to carry out a prescribed task is part of learning :-)




Marking Criteria

  1. 1.       Develops PICO and search terms (8 marks)
  • Determines elements of PICO relevant to the chosen scenario (max 2 marks).
  • Converts the question into a succinct and searchable PICO format relevant to the given scenario (max 1.5 marks)
  • Identifies the type of the clinical question correctly (0.5 mark).
  • Identifies appropriate main and alternative search terms (max 3 marks)
  • Identifies appropriate limits for the search, if appropriate (gender, age range, publication dates, and/ or language) (1 mark)
  1. 2.       Applies a systematic search of the literature (7 marks)
  • Transfers PICO terms into the systematic search plan with terms grouped in a logical order (max 2 marks)
  • Appropriately combines the search using ‘OR’ and ‘AND’ Boolean operators (max 2 marks).
  • Transfers search to the Medline database accurately according to their planned search strategy and provides a clear screenshot/screengrab as evidence of the search in Medline (max 3 marks).


Choose one of the following case scenarios to guide your work in Assessment Item 1 and 2

Scenario 1: Anti-Embolism Stockings

You are working on the acute stroke unit where you encounter both ischaemic and haemorrhagic stroke patients. You notice that some doctors order knee length anti-embolism compression stockings while others order thigh length anti-embolism compression stockings, or prefer their patients not to have any stockings at all.

You are concerned about the diversity of practice and decide to search the literature to find any evidence supporting the length and the overall use of compression stockings.


Scenario 2: Managing Chronic Heart Failure

You are working as a clinical nurse specialist in the heart failure clinic and service in Dubbo. One of your patients travels 2 hours by car from Coonabarabran for his monthly consultation. His wife and he find the long trip from home very difficult and an added burden in their lives. Particularly as he takes frusemide for his chronic heart failure that causes diuresis, which means they have to stop the car often which is frustrating and makes the trip even longer and tiring.  They tell you that a friend of theirs, who also lives in regional NSW, uses a remote telemonitoring device to monitor their condition from their home. This means that their friend doesn’t have to travel to their clinic so much. They ask you whether you think it is better to keep coming into the clinic or to see about getting a remote telemonitoring device to help them manage the chronic heart failure. You are a little unfamiliar with telemonitoring, but you also don’t want your patient to have to travel unnecessarily. You tell the couple that you will search for the available research on the management of chronic heart failure using telemonitoring and bring this back to them.


Scenario 3:  Zinc lozenges

You are a school nurse who regularly visits a number of elementary and middle schools (children aged 5 to 13 years) in your region. It is cold and flu season once again. One of the teachers is interested in alternative and complementary therapies. She stops you in the hall to ask you a question about his 10- year old daughter who also has a cold. He has heard that zinc lozenges can help to relieve cold symptoms and wonders if they really do work and if it is OK to give them to children. You let her know that you will search for information and will get back to her.






Please complete your assessment activities in the following pages and submit this into Turnitin:

  • PICO Worksheet
  • Search Strategy Worksheet
  • A picture (must be readable!) of your systematic literature search in Medline


PICO Worksheet – Development of PICO and terms to be used in search

1. Use the following categories to help define your problem and what you are looking at in simple terms

PICO: Patient/Problem, Intervention, Comparison, and Outcome.

(remember to use  your readings to help you if you are unsure)

Patient/Problem:  _______________________________________________________________

Intervention:  __________________________________________________________________

Comparison:  __________________________________________________________________

Outcome:  ____________________________________________________________________


2. Now use these terms from the question above to create your PICO research question so that you have a clear purpose for your search:     

In (P)_________________________  does  (I) ____________________     compared with  (C)_____________________      improve/reduce  (O) _________________?


3. What type of clinical question do you think this PICO answers?

  □ Therapeutic      □ Aetiology      □ Diagnostic      □ Prevention     □ Prognosis            □ Others


4. The table below will help you to think of the other terms that you might also like to look up when searching for evidence to help you answer your question – this is part of basic planning for a research search.


  • We ask you to look up alternative terms because sometimes articles from health systems call things different names – for example, in Australia we sometimes us the term ‘community nurses’, but in the UK they often talk about ‘district nurses’ – if you only searched under ‘district nurse’ you’d miss all the articles which used the other term – you would be missing some of the picture!







(not commonly used in actual database search strategy)


(not commonly used in actual database search strategy)

What is your population? Main search term:



What other terms might have been used?

Alternative search terms:



What is your intervention? Main search term:



What other terms might have been used?

Alternative search terms:





What is your comparison? Main search term:



What other terms might have been used?

Alternative search terms:





What is you’re outcome? Main search term:



What other terms might have been used?

Alternative search terms:



5. Is there a particular group of people that you want to look at? List here any inclusion criteria you might use to refine your search if you have too many papers:


Gender:  ______________________________     Age Range:  ___________________________

Publication Dates:  ______________________     Language:  ____________________________


6. What kind of study do you think would best answer your question? Select here which type of article you might want to access. You can also use these to refine your search if you have a lot of papers.


□  Cohort Study

□  Randomized Controlled Trial (RCT)

□  Case-control Study/Case Series

     □  Qualitative Study

     □  Economic Evaluation

     □  Quantitative Study


Systematic Search Plan (this is what we call a Search Strategy)

7. Now that you have decided on WHAT you will be searching, you need to put down a plan of HOW you will search for your articles. This helps you and others to see how you got your evidence and how you made sure you got the best evidence to help you decide on your clinical action.

  • Using the PICO terms in your table, enter each term in a row (group them together under the PICO categories). You can extra rows or delete them as appropriate.
  • The next step is to combine similar terms using ‘OR’ so that you have all the papers on the same topic together
  • The final step is to find papers which only talk about both the population AND the intervention. To do this you use ‘AND’ in the database.



Key terms:
























__ OR___OR___OR___ (combine alternate terms for same topic)


__ OR___OR___OR___ (combine alternate terms for same topic)



OR = combine alternate terms for the same topic – to get as many potential papers as possible!

AND = combine the groups of topics to get papers which cover ALL the terms!


8. The final step is to paste in a picture (screenshot/screengrab) of the search that you did in the database. The picture has to be readable!!!

In providing this you show your marker that you are able to take your strategy and apply this into a database system. You also show us that you understand the systematic approach to searching and your understanding of how to use OR and AND as tools to draw together the articles you are interested in. You can use limits, but you would only do this if you wanted to refine your search because you had too many papers to search through.

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