Evidence-based practice (EBP) combines research-based information, clinical expertise, and patients' values and preferences when providing care. This involves five steps known as the Five As:

1. Ask: Convert your information needs into an answerable clinical (PICOT) question.
2. Acquire: Find the best evidence to answer your clinical question.
3. Appraise: Critically appraise the evidence for its validity, impact, and applicability.
4. Apply: Integrate the evidence with clinical expertise, the patient's values and circumstances, and information from the practice context.
5. Assess: Evaluate the outcomes of the applying the evidence to your practice.

This main focus of this guide is on Ask & Acquire - formulate an answerable question and find the best evidence for your question.

What is a PICOT Question?

The PICOT question format is a consistent "formula" for developing answerable, researchable questions. When you write a good one, it makes the rest of the process of finding and evaluating evidence much more straightforward.

• P - Population, patient, or problem
  • Examples: Age, gender, ethnicity, individuals with a certain disorder
• I - Intervention or indicator
  • Examples: Exposure to a disease, risk factor, prognostic factor, treatment
• C - Comparison or control
  • Examples: Placebo or no intervention, absence of risk factor, absence of disease
• O - Outcome
  • Examples: Risk of disease, accuracy of a diagnosis, rate of occurrence of adverse outcome
• T - Time
  • Examples: The time it takes for the intervention to achieve an outcome or how long participants are observed

Examples from Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice (2nd ed). Wolters Kluwer/Lippincott Williams & Wilkins.

Note: Not every question will have an intervention (as in a meaning question) or time (when it is implied in another part of the question) component.
For example, your question might be: Is Vitamin C more effective than echinacea in reducing the recovery time for the common cold? You can break that down into the PICOT format and use those terms as keywords for your searches.

• P: Adult with a cold
• I:  Vitamin C
• C: Echinacea
• O: Reduced cold symptoms
• T: Length of cold

The PICOT format will help you translate your question from an initial broad topic or a question specific to an individual patient's experience, to a concrete, objective question that you can find clinical evidence to answer