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Before You Start Searching

Clinical and epidemiological question frameworks.

• Basic Literature Searching
• Advanced Literature Searching
• Searching for Evidence with ABCDE
• Citation Management
• Citing Sources: APA and Other Styles

Step One: Start to formulate a research question or topic.

Aiming for clarity at the beginning of the project can help you get started right. It can be helpful to use one of the question frameworks detailed below.

Step Two: Do some background searching on the topic.

Taking a look in relevant resources to see what's already been written about your topic will help you understand how you can best contribute to the body of literature. It will also help you grasp the terminology around the topic, so that you'll be more prepared to do an effective literature search.

Step Three: Narrow down the question or topic if needed.

You may find that your original topic is too broad. After you have taken the time to evaluate what's already been written about your topic, you'll have a better understanding of what you're interested in.

Step Four: Meet with your librarian.

Step five: create a search for your topic in an appropriate database..

Try one of these tried and true clinical or quantitative research question frameworks. Not sure where to start? PICO is the most common clinical question framework. and PEO works well for public health and epidemiology.

• Condition, Context, Population
• Aromataris, E., & Munn, Z. (2017). Joanna Briggs Institute reviewer's manual. The Joanna Briggs Institute. Available from JBI Manual for Evidence Synthesis .
• Population, Exposure of Interest, Outcome or Response
• Population or Problem, Intervention or Exposure, Comparison or Control, Outcome
• Heneghan, C., & Badenoch, D. (2002). Evidence-based medicine toolkit. London: BMJ Books. https://www.worldcat.org/title/evidence-based-medicine-toolkit/oclc/62307845
• Population or Problem, Intervention or Exposure, Comparison or Control, Outcome, Study Type
• Methley, A. M., Campbell, S., Chew-Graham, C., McNally, R., & Cheraghi-Sohi, S. (2014). PICO, PICOS and SPIDER: a comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC health services research, 14, 579. https://doi.org/10.1186/s12913-014-0579-0 .
• Population or Problem, Intervention or Exposure, Comparison or Control, Outcome, Time
• Richardson, W. S., Wilson, M. C., Nishikawa, J., & Hayward, R. S. (1995). The well-built clinical question: A key to evidence-based decisions. ACP Journal Club, 123(3), A12-A12. https://pubmed.ncbi.nlm.nih.gov/7582737/
• Population, Index Test, Reference Test, Diagnosis of Interest
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• Next: Searching for Evidence >>
• Last Updated: Jun 24, 2024 2:18 PM
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Develop your research question

• Search for your assignment
• Find books and journal articles
• Find evidence (Government and organisation information)
• Data & statistics
• Forgotten Australians
• Clinical skills
• Aged care & mental health
• Mental health resources: 0-65 years
• Finding resources for your assignment
• HLTH 1036: Global and National Health – A1 Task 2 & A2
• HLTH 1047: First Peoples' Health – A1
• NURS 1072: Foundations of Nursing Practice
• NURS 2023: Health of Adults - Nursing Case Study Report
• NURS 2024: Health of Older Adults
• NURS 5164: Best Practice in Adolescent Mental Health
• NURS 3055: Evidence Based Nursing Practice
• NURS 3045: Nursing Context of Practice: Primary Health Care
• UniSA Online - NURS 1066: Living Skills and Life Routines in Aged Care

STEP 1: Understand your research objective

Before you start developing your research question, think about your research objectives:

• What are you trying to do? (compare, analyse)
• What do you need to know about the topic?
• What type of research are you doing?
• What types of information/studies do you need? (e.g. randomised controlled trial, case study, guideline, protocol?)
• Does the information need to be current?

Watch the following video (6:26) to get you started:

Key points from the video

• All good academic research starts with a research question.
• A research question is an actual question you want to answer about a particular topic.
• Developing a question helps you focus on an aspect of your topic, which will streamline your research and writing.
• Pick a topic you are interested in.
• Narrow the topic to a particular aspect.
• Brainstorm some questions around your topic aspect.
• Select a question to work with.
• Focus the question by making it more specific. Make sure your question clearly states who, what, when, where, and why.
• A good research question focuses on one issue only and requires analysis.
• Your search for information should be directed by your research question.
• Your thesis or hypothesis should be a direct answer to your research question, summarised into one sentence.

STEP 2: Search before you research

The benefits of doing a background search :

• You can gather more background knowledge on a subject
• explore different aspects of your topic
• identify additional keywords and terminology

STEP 3: Choose a topic

The resources linked below are a good place to start: 

• UpToDate It covers thousands of clinical topics grouped into specialties with links to articles, drugs and drug interaction databases, medical calculators and guidelines.
• An@tomedia This online anatomy resource features images, videos, and slides together with interactive, educational text and quiz questions.
• Anatomy.tv Find 3D anatomical images; functional anatomy animations and videos, and MRI, anatomy, and clinical slides. Test your knowledge through interactive activities and quizzes.

STEP 4: Brainstorm your questions

Now you have explored different aspects of your topic, you may construct more focused questions (you can create a few questions and pick one later).

Learn more: 

• Clear and present questions: formulating questions for evidence based practice (Booth 2006) This article provides an overview of thinking in relation to the theory and practice of formulating answerable research questions.

STEP 5: Pick a question and focus

Once you have a few questions to choose from, pick one and refine it even further.

Are you required to use "PICO"?

• PICO worksheet
• Other frameworks

The PICO framework (or other variations) can be useful for developing an answerable clinical question. 

The example question used in this guide is a PICO question:   How does speech therapy compare to cognitive behavioural therapy in improving speech fluency in adolescents?

Use the interactive PICO worksheet to get started with your question, or you can download the worksheet document.

• Building your question with PICO

Here are some different frameworks you may want to use:

There are a number of PICO variations which can be used for different types of questions, such as qualitative, and background and foreground questions. Visit the Evidence-Based Practice (EBP) Guide to learn more:

• Evidence Based Practice guide
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• Next: Search for your assignment >>
• Last Updated: Jun 5, 2024 12:31 PM
• URL: https://guides.library.unisa.edu.au/Nursing

The text within this Guide is licensed CC BY 4.0 . Image licenses can be found within the image attributions document on the last page of the Guide. Ask the Library for information about reuse rights for other content within this Guide.

Best Nursing Research Topics for Students

What is a nursing research paper.

• What They Include
• Choosing a Topic
• Best Nursing Research Topics
• Research Paper Writing Tips

Writing a research paper is a massive task that involves careful organization, critical analysis, and a lot of time. Some nursing students are natural writers, while others struggle to select a nursing research topic, let alone write about it.

If you're a nursing student who dreads writing research papers, this article may help ease your anxiety. We'll cover everything you need to know about writing nursing school research papers and the top topics for nursing research.  

Continue reading to make your paper-writing jitters a thing of the past.

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A nursing research paper is a work of academic writing composed by a nurse or nursing student. The paper may present information on a specific topic or answer a question.

During LPN/LVN and RN programs, most papers you write focus on learning to use research databases, evaluate appropriate resources, and format your writing with APA style. You'll then synthesize your research information to answer a question or analyze a topic.

BSN , MSN , Ph.D., and DNP programs also write nursing research papers. Students in these programs may also participate in conducting original research studies.

Writing papers during your academic program improves and develops many skills, including the ability to:

• Select nursing topics for research
• Conduct effective research
• Analyze published academic literature
• Format and cite sources
• Synthesize data
• Organize and articulate findings

About Nursing Research Papers

When do nursing students write research papers.

You may need to write a research paper for any of the nursing courses you take. Research papers help develop critical thinking and communication skills. They allow you to learn how to conduct research and critically review publications.

That said, not every class will require in-depth, 10-20-page papers. The more advanced your degree path, the more you can expect to write and conduct research. If you're in an associate or bachelor's program, you'll probably write a few papers each semester or term.

Do Nursing Students Conduct Original Research?

Most of the time, you won't be designing, conducting, and evaluating new research. Instead, your projects will focus on learning the research process and the scientific method. You'll achieve these objectives by evaluating existing nursing literature and sources and defending a thesis.

However, many nursing faculty members do conduct original research. So, you may get opportunities to participate in, and publish, research articles.

Example Research Project Scenario:

In your maternal child nursing class, the professor assigns the class a research paper regarding developmentally appropriate nursing interventions for the pediatric population. While that may sound specific, you have almost endless opportunities to narrow down the focus of your writing. 

You could choose pain intervention measures in toddlers. Conversely, you can research the effects of prolonged hospitalization on adolescents' social-emotional development.

What Does a Nursing Research Paper Include?

Your professor should provide a thorough guideline of the scope of the paper. In general, an undergraduate nursing research paper will consist of:

Introduction : A brief overview of the research question/thesis statement your paper will discuss. You can include why the topic is relevant.

Body : This section presents your research findings and allows you to synthesize the information and data you collected. You'll have a chance to articulate your evaluation and answer your research question. The length of this section depends on your assignment.

Conclusion : A brief review of the information and analysis you presented throughout the body of the paper. This section is a recap of your paper and another chance to reassert your thesis.

The best advice is to follow your instructor's rubric and guidelines. Remember to ask for help whenever needed, and avoid overcomplicating the assignment!

How to Choose a Nursing Research Topic

The sheer volume of prospective nursing research topics can become overwhelming for students. Additionally, you may get the misconception that all the 'good' research ideas are exhausted. However, a personal approach may help you narrow down a research topic and find a unique angle.

Writing your research paper about a topic you value or connect with makes the task easier. Additionally, you should consider the material's breadth. Topics with plenty of existing literature will make developing a research question and thesis smoother.

Finally, feel free to shift gears if necessary, especially if you're still early in the research process. If you start down one path and have trouble finding published information, ask your professor if you can choose another topic.

The Best Research Topics for Nursing Students

You have endless subject choices for nursing research papers. This non-exhaustive list just scratches the surface of some of the best nursing research topics.

1. Clinical Nursing Research Topics

• Analyze the use of telehealth/virtual nursing to reduce inpatient nurse duties.
• Discuss the impact of evidence-based respiratory interventions on patient outcomes in critical care settings.
• Explore the effectiveness of pain management protocols in pediatric patients.

2. Community Health Nursing Research Topics

• Assess the impact of nurse-led diabetes education in Type II Diabetics.
• Analyze the relationship between socioeconomic status and access to healthcare services.

3. Nurse Education Research Topics

• Review the effectiveness of simulation-based learning to improve nursing students' clinical skills.
• Identify methods that best prepare pre-licensure students for clinical practice.
• Investigate factors that influence nurses to pursue advanced degrees.
• Evaluate education methods that enhance cultural competence among nurses.
• Describe the role of mindfulness interventions in reducing stress and burnout among nurses.

4. Mental Health Nursing Research Topics

• Explore patient outcomes related to nurse staffing levels in acute behavioral health settings.
• Assess the effectiveness of mental health education among emergency room nurses .
• Explore de-escalation techniques that result in improved patient outcomes.
• Review the effectiveness of therapeutic communication in improving patient outcomes.

5. Pediatric Nursing Research Topics

• Assess the impact of parental involvement in pediatric asthma treatment adherence.
• Explore challenges related to chronic illness management in pediatric patients.
• Review the role of play therapy and other therapeutic interventions that alleviate anxiety among hospitalized children.

6. The Nursing Profession Research Topics

• Analyze the effects of short staffing on nurse burnout .
• Evaluate factors that facilitate resiliency among nursing professionals.
• Examine predictors of nurse dissatisfaction and burnout.
• Posit how nursing theories influence modern nursing practice.

Tips for Writing a Nursing Research Paper

The best nursing research advice we can provide is to follow your professor's rubric and instructions. However, here are a few study tips for nursing students to make paper writing less painful:

Avoid procrastination: Everyone says it, but few follow this advice. You can significantly lower your stress levels if you avoid procrastinating and start working on your project immediately.

Plan Ahead: Break down the writing process into smaller sections, especially if it seems overwhelming. Give yourself time for each step in the process.

Research: Use your resources and ask for help from the librarian or instructor. The rest should come together quickly once you find high-quality studies to analyze.

Outline: Create an outline to help you organize your thoughts. Then, you can plug in information throughout the research process. 

Clear Language: Use plain language as much as possible to get your point across. Jargon is inevitable when writing academic nursing papers, but keep it to a minimum.

Cite Properly: Accurately cite all sources using the appropriate citation style. Nursing research papers will almost always implement APA style. Check out the resources below for some excellent reference management options.

Revise and Edit: Once you finish your first draft, put it away for one to two hours or, preferably, a whole day. Once you've placed some space between you and your paper, read through and edit for clarity, coherence, and grammatical errors. Reading your essay out loud is an excellent way to check for the 'flow' of the paper.

Helpful Nursing Research Writing Resources:

Purdue OWL (Online writing lab) has a robust APA guide covering everything you need about APA style and rules.

Grammarly helps you edit grammar, spelling, and punctuation. Upgrading to a paid plan will get you plagiarism detection, formatting, and engagement suggestions. This tool is excellent to help you simplify complicated sentences.

Mendeley is a free reference management software. It stores, organizes, and cites references. It has a Microsoft plug-in that inserts and correctly formats APA citations.

Don't let nursing research papers scare you away from starting nursing school or furthering your education. Their purpose is to develop skills you'll need to be an effective nurse: critical thinking, communication, and the ability to review published information critically.

Choose a great topic and follow your teacher's instructions; you'll finish that paper in no time.

Joleen Sams is a certified Family Nurse Practitioner based in the Kansas City metro area. During her 10-year RN career, Joleen worked in NICU, inpatient pediatrics, and regulatory compliance. Since graduating with her MSN-FNP in 2019, she has worked in urgent care and nursing administration. Connect with Joleen on LinkedIn or see more of her writing on her website.

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Curse of a Nurse

Exposed to the golden wind in awakening there is limitless life, liberation, and love in holy harmony, health, and happiness, writing a nursing research question – undergraduate nursing.

Most undergraduate BSN students take a Research and Evidence-Based Practice course. Students are often assigned a small research project or review paper. The assignment begins with writing either a research question, or a clinical question. Usually, the student is given a range of topics, but let’s assume the student is starting from scratch. A good research question is essential to good research and not only answering a question but filling the gaps. I suggest you start my thinking of a research paper as a “who done it” story. Who killed X. What is your method going to be for figuring out who the killer is. Then you apply methods to the facts. Next you identify the killer using for example fingerprints, interrogations, and ballistic testing of the bullet. After you have the evidence, your results, you discuss the results. Finally, discuss the effectiveness of the methods. You conclude by saying in the future you can use these methods to do X, Y, and Z.

STEP 1: Review Variables

Before you start thinking about writing a research question it is good to review the difference between independent and dependent variables.

• Independent variable – a variable that is presumed to influence another variable. It is the variable the researcher can manipulate.
• Dependent variable –the effect. Its value depends on changes in the independent variable. It is what is being measured.

You will also need an operational definition, so it is possible to measure and manipulate the variable. The operational definition is essentially your measure.

STEP 2: Find a Topic and then Narrow

What is your research problem? It should be an area of concern where there is a gap in knowledge necessary for good nursing practice.

STEP 3: Narrow the Topic

Even if a broad area is given, you still need to narrow the topic. Some ways to do that include:

• Choose an interesting topic from within the scope of your assignment.
• Start with general references sources. Most universities have a search engine such as WorldCat for books, journals, articles, and more. Another place to start may be GoogleScholar. You only need a few articles to see what scholars in the area are doing and to help narrow your topic.
• Are there subtopics?
• Do the subtopics raise any specific questions?
• What is of specific interest to you?
• Are there how and why questions about this topic I should ask?
• Consider who your intended audience is for your research. There may be a tendency to think it is your class or your professor, but I suggest you think broader and decide who you want to be your audience, not who the class requires.
• Identify a theory or research finding within the assignment that needs further testing.
• Consider a patient care experience that impacted on the nurse’s or the patient’s experience.
• Talk to your colleagues and classmates. Be willing to question authority. Too much of what we do results from the way it has always been.
• Identify a knowledge gap.
• Apply personal experience and take the time to consider what is important to you. The research question should be more than a class assignment. It is an opportunity to express your concern about what matters and your commitment to taking responsibility for what happens to patients and nurses.
• Make a final research question selection by considering whether the idea is innovative, significant, reasonable, ethical, and will promote health equity.

STEP 3: Write Your Research Question

The FINER criteria are one way to write a good question (Hulley et al., 2007).

• The question should be feasible . Focus on one problem that can be accomplished within the semester and the time allotted for the assignment and is within your ability. Try not to have more than one or two variables.
• The question should be interesting to you. Even within limited topic made available to you choose what is most interesting and tweak it. If you are interested in the topic you will be more motivated.
• The question should be novel . You should bring new insights to the chosen topic. This may include confirming or expanding on prior research. There must be primary and secondary sources available to help answer your question.
• The question must be ethical and avoid any deceptive practices, such as only including articles that support your conclusion. Your research question and study must be able to be approved by appropriate review boards or authorities.
• The questions should be relevant to the assignment and of interest to nursing. It should also be relevant to public interest.

Ratan et al. (2019) add to FINER in their research question guide. They suggested the purpose of your paper and should be feasible, interesting, novel, ethical, relevant, manageable, appropriate, have potential value and publishability, and be systematic (Read more: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322175/ ).

• A manageable question can be managed by the researcher.
• The research question should be appropriate logically and scientifically.
• The research should have significant health impact and be of value and publishable .

Draft your research question based on what you hope to achieve. You can have primary and secondary research questions but remember that more questions generally mean more time and resources. McCombes (2019) suggest the table below as a way to consider drafting your research question.

Many nurses use the PICOT framework to construct research questions. If you prefer the PICOT format then follow this format.

• P – patient or population (age, gender, location, characteristics)
• I – intervention (diagnostic test, exposure, management strategy)
• C – comparison group (a comparison to the intervention or indicator)
• O – outcome (what are the consequences of the intervention)
• T – timeframe or type of the study (time periods that should be considered or study types most likely to have relevant information)

STEP 4: Evaluate Your Question

• Can you identify the relationship between the variables?
• Did you indicate the population to be studied?
• Did you identify a problem that can be addressed (in the time available)?

STEP 5: Making your research question strong

Focused, clear, feasible, specific, and researchable.

Complex and arguable

Relevant, original, and clear

Burns, N. and Grove, S.K. (2001) The Practice of Nursing Research: Conduct, Critique, and Utilization, 5 th ed. Elsevier Saunders.

Hulley, S.B., Summings, S.R., Browner, W.S., Grady, D.G., Newman, T.B. (2007) Desiging Clinical Research. Lippincott Williams & Wilkins.

Kerlinger, F.N. (1979) Behavioral Research: A Conceptual Approach. Holt, Rinehart and Winston.

McCombes, S. (2021) Developing strong research questions. Scribbr. https://www.scribbr.com/research-process/research-questions/

Polit, D. and Beck. C.T. (2022) Essential of Nursing Research: Appraising Evidence for Nursing Practice, 10 th Ed. Wolters Kluwer.

Ratan, S. K., Anand, T., & Ratan, J. (2019). Formulation of Research Question – Stepwise Approach.  Journal of Indian Association of Pediatric Surgeons ,  24 (1), 15–20. https://doi.org/10.4103/jiaps.JIAPS_76_18 .

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‘Nursing Times wants to ensure that the voices of nurses and midwives are heard’

STEVE FORD, EDITOR

• You are here: Nurse educators

Identifying and defining research questions

25 January, 2016

Successful clinical research depends on a properly constructed research question on a topic that is relevant for study. Discover the best process of developing one

Research is vital to improving nursing practice and patient outcomes, and therefore a key aspect of nursing degree programmes. All student nurses must show they can undertake an independent learning project before they can graduate and become registered nurses. This article outlines processes that can be followed to select a research area and narrow it down to generate a specific research question. Methodologies and models can then be used to compile a list of search terms that can be used to get the research underway.

Citation: Khodabux R  (2015) Identifying and defining research questions.  Nursing Times ; 112: 3/4, 16-19

Author:  Raouf Khodabux is senior lecturer, module leader for Approaches to Health and Social Care Research, Middlesex University, London.

• This article has been double-blind peer reviewed
• Scroll down to read the article or  download a print-friendly PDF here

Introduction

In 2011, pre-registration education in England became an all-degree programme (Nursing and Midwifery Council, 2010), so student nurses in their final year must carry out an independent learning project. In addition, many qualified nurses are returning to university to do their dissertation and complete their degree (Aveyard, 2014). These projects vary in scope and nature, from literature reviews or extended essays to small research projects.

For many students, the dissertation is a “nightmare” they have to endure to gain a degree (Lundgren and Halvarsson, 2009). This module can be challenging for a number of reasons such as:

• The requirement to be on placement;
• Long days and/or night duty;
• Working part-time to make ends meet;
• Family commitments.

However, perhaps the biggest challenge is the fact that this is an independent module in which a lot depends on students’ motivation and willingness – they have to determine the focus and direction of their work. This is usually carried out on an individual basis, although some tutor support, supervision and direction is provided.

The module is also demanding because there is typically a substantial research component to the project requiring primary data to be collected and secondary or existing data to be analysed. Furthermore, students are expected to have a more prolonged engagement with the chosen subject than they do with standard coursework, such as essays or reports; the work is consequently required to be more in-depth than students are accustomed to (Todd et al, 2004).

Many students struggle to start their project because they simply do not know where to begin. The most critical question for many is “What should I study?” Deciding between a research project and a literature review depends on the type of degree course being undertaken. However, for most undergraduate nursing courses, students are required to carry out a literature review.

Pole and Lampard (2002) stated that curiosity is, or at least should be, the driving force behind the conduct of any research. Research questions are an attempt to “tame” curiosity, so they are not asked in a haphazard manner but in relation to what is already known about the topic of interest (White 2013). The process of framing, developing and refining these questions allows researchers to make connections with existing theories and previous empirical findings; this helps avoid unnecessary repetition of, or overlap with, previous work (White, 2009). In the final analysis, a researchable question is an uncertainty about a problem that can be challenged, examined and analysed to provide useful information (Ellis, 2013). A clearly defined research problem is the fuel that drives the scientific process, and is the foundation of any research method and experimental design, from true experiment to case study (Shuttleworth 2008).

Framework for a literature review

Formulation of a research-focused question underpins any type of literature review, whether it is for a:

• Dissertation for a systematic or traditional/narrative review;
• Primary research project;
• Research proposal.

A literature review is an account of what has been published on a topic by accredited scholars and researchers. It is an objective, thorough summary and critical analysis of the relevant available research and non-research literature on the topic being studied (Hart 2012).

Conducting a literature review can be a daunting and confusing prospect. Wakefield (2015) identifies seven steps in the process (Box 1), at the top of which is formulating a research question. Aveyard (2010) argued that in order to write a robust evaluative literature review, it is essential to start with a sound research question. Even in the context of the research process, Gelling (2015) identified the development of a research question as the first stage, while Offredy and Vickers (2010) said the first step in writing a research proposal is to choose a topic and then to develop research questions.

Ionesco (1969) stated that it is not the answer that enlightens, but the question. According to Graziano and Raulin (2004): “Questions are everywhere; all you have to do is observe and be curious”.

To carry out a literature review, it is necessary to:

• Have a basic knowledge of research processes and methodologies;
• Understand the origins of the evidence, primary and secondary sources;
• Understand the terminology used;
• Know how the various types of literature reviews vary (Conner, 2014).

It is well documented that student nurses tend to disengage with the research module (Ax and Kincade, 2001). Undergraduates find research boring, and may have difficulty understanding the language and experience cognitive shutdown (Porter et al, 2006); this may come back to haunt them in the final year when they attempt the literature review for their dissertation. Since the literature review is an integral part of the research process, it is crucial for students to engage with the research module.

Box 1. Conducting a literature review

There are seven steps to follow when conducting a literature review:

• Formulate a research question
• Identify a term/terms that will be used to search the literature
• Create robust inclusion and exclusion criteria to select the most appropriate literature
• Select the most relevant databases to interrogate the literature
• Search the literature from a global perspective
• Analyse, synthesise and critique the research articles
• Present the findings

Source: Wakefield (2015)

Choosing a research topic

The starting point for any research project begins with the choice of topic. This should be a subject the student finds interesting, stimulating and worthwhile, as this will make the process more enjoyable and, ultimately, more rewarding. While the initial topic selected may be broad, it must be narrowed down to a focused question (Playle, 2000).

The topic should already have been researched by others so it is possible to search for relevant literature to review. The most interesting topic in the world will not create a successful literature review if nothing has previously been written about it. Sometimes it is a good idea to come up with a few alternative ideas and carry out some preliminary research on each – that way, if there has only been limited exploration of the first choice, there is an alternative to fall back on.

Most research projects start with an idea that arises from clinical practice (Gelling, 2015). However, it is generally agreed that research topics narrowed into focused questions arise from three basic sources:

• The literature;
• Experience (Springett and Campbell, 2006).

Using the literature

Sometimes studies raise far more questions than they answer so, when reading the literature on a particular topic, you may find new ideas are recommended for further investigation. For example, there may be observational studies that explain what is happening but not necessarily why. When reading the literature it is useful to bear in mind that:

• It is possible to replicate a study – this not only ensures its reliability but also provides additional information;
• Any recommendations made at the end of research articles may be followed up with another investigation;
• Sometimes there may be flaws in the original method used in a study, and the same question can be asked in a different way – this may then reinforce or challenge the findings of the earlier study.

Theoretical concepts that may be tested in practice are the second major source of research questions. Theories such as the promotion of continence and self-care as a framework for nursing or mentorship, and student nurses’ performance, can be tested in practice. An example of a theory is: “Promotion of continence will result in better quality of life for patients”. Like many other theories in nursing, this can be investigated inductively or deductively. A quantitative experimental design uses deductive reasoning to arrive at a testable hypothesis. According to Coates (2011), this approach focuses on replicability, objectivity, prediction and control; the distinguishing feature is a collection of numerical data that can be subjected to statistical analysis. Qualitative research designs use inductive reasoning to propose a research statement about how people interpret and structure their lives. This kind of research is used to explore, understand and interpret experiences, feelings and beliefs (Gelling, 2015).

Research ideas can also stem from experience in clinical areas where nurses observe practice that may be a source of concern or simply “interest”. The research question need not be about something that is “wrong” but something that could be done better or has not been thought about before. Student nurses are taught critical analysis to encourage them to ask:

• Why is this being done in this particular way?
• What will happen if this is done differently?

These are important ways to explore more about nursing inductively as they stem from the real world of nursing.

From a clinical practice perspective, when a research question is carefully composed it aims to close the gaps between what is known and what needs to be known about nursing care, and resolve the discrepancy between the way things are and how they ought to be to result in better patient care. However, research does not always lead to definitive answers.

Composing the research question

Deciding on the research question is challenging, but is one of the most critical aspects of the research process. A carefully constructed research question helps to guide the project to hit its scholarly target. Research is only as good as the question and plan on which it is based; this is relevant to healthcare research because new knowledge comes from having asked answerable questions (Haynes, 2006).

Beitz (2006) defined research questions as “an explicit query about a problem or issue that can be challenged, examined and analysed, and that will yield useful new information”.

The question is the fundamental core of a research project, study or literature review. It focuses the study, determines the methodology and guides all stages of inquiry, analysis and reporting. It also acts as an aide memoire, and helps keep the researcher focused on the specific area of enquiry, which is particularly helpful when searching the literature (Lahlafi, 2007).

Blaikie (2007) argued that the use of research questions in the design and conduct of research is often neglected. The key to defining a research question is focus. If it is too broad (for example, “Does regular exercise prevent heart disease in adult men?”), the search strategy will become unstructured and many important articles may be overlooked (Wakefield, 2015). The end product should be a specific query that is explicit in what it is looking for. However, Denney and Tewksbury (2013) have also argued against having a research question that is too narrow (for example, “Do daily 30-minute exercise sessions reduce the incidence of myocardial infarction in 40-60-year-old Asian men?”) as it can limit the search strategy. An appropriate question on the topic in the examples above might be, “Does daily exercise reduce the incidence of myocardial infarction in men over 40 years of age?”

Framing the research question

The development of the research question is important as it sets the parameters of the research. It provides opportunities for a wide range of research methodologies as well as a structure and direction for the student. Hanson (2006) argued that there are three important phases of developing a study question destined for success:

• Defining the research question(s);
• Refining the research question(s);
• Converting the research question(s) into a specific aim(s).

Similarly, Lipowski (2008) proposed three steps in the formulation of a great research question:

• Ask interesting questions;
• Select the best question for research;
• Transform the research question into a testable hypothesis.

There are three types of research question:

• Descriptive: describing something, using a descriptive approach that can simply be an observation of something, with the researcher taking the role of the “witness” and answering the basic question of “what happened?”;
• Relational: a relational or correlational study exploring relationships between two or more variables using statistical analysis, and asking the question: “how are these linked?”;
• Causal: exploring cause and effect to determine whether one or more variables causes or affects one or more outcomes using an experimental approach (Trochim, 2006).

Table 1 (attached) indicates some broad research topics and specific research questions; students should be able to identify which type of question each one is. Research questions should be:

• Manageable in terms of research and in terms of the individual’s own academic abilities;
• Substantial and with originality: rather than previously addressed topics, students should use their imagination and come up with ground-breaking ideas that can be turned into research issues or developed into a dissertation;
• Able to confirm or refute previous findings, extend or build on previous findings or provide new findings;
• Consistent with the requirements of the assessment;
• Clear and simple;
• Interesting and worthwhile;
• Feasible or able to be answered.

Framing models

Having selected a broad topic, the next step is to narrow it down. There are several frameworks that can be used to structure a sound research question in a strategic manner (Bettany-Saltikov, 2010); two models are PICO and SPICE (Box 2). Offredy and Vickers (2010) mentioned four stages in the research question formulation process, illustrating the process of narrowing the topic by focusing on surgery.

• Broad topic area – surgery;
• Narrow broad topic area – surgery and pain relief;
• Focused topic area – surgery, pain relief and patient-controlled analgesia;
• Research question.

In the fourth stage, when the focused topic area is converted into a research question, PICO or SPICE is used. According to Ellis (2013), PICO is useful when generating quantitative questions, whereas SPICE is most commonly applied to research aimed at exploring qualitative phenomena. However, not all components may be relevant when formulating a question.

Box 2. Framing models for research questions

P – Population I – Intervention C – Comparison O – Outcome

S – Setting P – Perspective I – Intervention C – Comparison E – Evaluation

Generating search terms

Once the question has been composed, it is essential to generate several key search terms or words, from which synonyms are identified, that can be entered into one or more databases. These key terms are combined using Boolean Operators such as “OR”, “AND” and “NOT”.

Fig 1 (attached) indicates the process by which search terms have been generated from the research question using the PICO model. These terms are entered in the databases for a comprehensive literature search and a number of articles will be found. Wakefield (2014) suggests that establishing and adhering to inclusion and exclusion criteria will ensure the most appropriate literature is selected, which addresses the research question.

Clinical practice is the main arena from which nurses can seek ideas for research, but those ideas can stem from experience, theories and the literature. With the advent of the internet and the increasing volume of articles being published, students can spend a lot of time sifting through the resources. Developing a research question, therefore, is an important systematic activity that provides a “road map” for a successful literature search.

Tools such as PICO or SPICE can be used to structure a sound research question. Not only is valuable time saved but the most appropriate articles are selected for review. Formulating a focused question is a disciplined method to beginning a research project.

• Students must complete an independent learning project as part of their nursing degree
• Before conducting research, students must have some knowledge of research process and methodologies
• Many issues encountered in clinical practice form the basis of research projects
• Once a broad topic has been selected, it should be narrowed down until a specific research question has been framed
• Research models can help generate relevant search terms from a research question

Related files

270116_identifying-and-defining-research-questions.pdf, table 1 research question types.pdf, fig 1 generating search terms from a research question.pdf.

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Nursing Research: Creating a Research Question

• Creating a Research Question
• Search Terms
• Search Strategies
• Recording Your Research
• Research Tips
• Reading and Understanding Research
• Finding Sources
• Health Statistics
• Grey Literature and Clinical Guidelines
• Research Sites
• Journal Articles
• Books & Other Sources
• Publisher URL
• Interlibrary Loan

Choosing a Topic

Sometimes the most difficult part of the research process is choosing a topic.  Here are some tips for selecting a research question that you will enjoy learning about and will ultimately lead to a good grade.

• Read through your assignment.   Professors design an assignment outline for a reason.  Make sure your topic can and will adhere to their requirements and guidelines.
• Choose a topic you are interested in.   If you don't like what you're researching, chances are you won't learn a whole lot or enjoy the process.  And really, what's the point of that?  
• Browse resources that relate to your course work.  Look through a newspaper, magazine, or database for current events or hot topics.  Browsing can spark a lot of great ideas and can help you refine your topic.
• Ask for help!   There is nothing wrong with asking your professor or a librarian to help you brainstorm ideas.

Where to Start

The links below are great places to start in developing a research question.  Browsing current events and hot topics can spark your interest and inspire a topic.

• Alvernia's "Opposing Viewpoints" Collection
• Alvernia's Reference Collection
• Anatomy & Physiology
• Athletic Training Websites
• Google Trends
• Health & Medicine
• Hot Paper Topics
• Hot Topics for Research Papers
• Human Diseases
• National Library of Medicine
• New York Times
• NPR Research News
• Pew Research Center
• Public Agenda's Programs and Reports
• MedLinePlus This link opens in a new window
• Opposing Viewpoints in Context This link opens in a new window

Subject Terms to Consider

Below is a list of subjects that often  relate to nursing issues .  Considering these subject terms can help you  develop a topic  or  focus your search .

• Nursing research
• Evidence-based nursing

How to Formulate an Answerable Clinical Question

P opulation/patients

I ntervention/indicator

C omparator/control

• P I C O: Formulate an Answerable Question
• Formulating Answerable Clinical Questions

Developing your Research Question

• Creating a Research Question Helps you to write a narrow, focused research question.

Try asking yourself these questions to help develop a research question:

Topic:  Obesity

Who?  teenagers

What?  consumption of high fat foods

Where?  school cafeterias

Question :  How does the consumption of high fat foods in school cafeterias contribute to teenager obesity?

Topic: Smoke Exposure

Who?   children exposed to smoke

What?   developmental abilities

Question :  How does smoke exposure alter the developmental abilities of children?

Below is worksheet which will help illustrate how a research question develops from a broad topic to a focused question.  This could be a helpful resource for you during the process of creating your research question.

Helpful Tools

• bubbl.us - Brainstorming Made Simple
• Critical Thinking Model
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PICO- What's in a queston?

The PICOT question format is a consistent "formula" for developing answerable, researchable questions.

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.

PICO(T) Templates

Template for Asking PICOT Questions

For an intervention/therapy:

In _______(P), what is the effect of _______(I) on ______(O) compared with _______(C) within ________ (T)?

For etiology:

Are ____ (P) who have _______ (I) at ___ (Increased/decreased) risk for/of_______ (O) compared with ______ (P) with/without ______ (C) over _____ (T)?

Diagnosis or diagnostic test:

Are (is) _________ (I) more accurate in diagnosing ________ (P) compared with ______ (C) for _______ (O)?

Prevention:

For ________ (P) does the use of ______ (I) reduce the future risk of ________ (O) compared with _________ (C)?

Prognosis/Predictions

Does __________ (I) influence ________ (O) in patients who have _______ (P) over ______ (T)?

How do ________ (P) diagnosed with _______ (I) perceive ______ (O) during _____ (T)?

Melnyk B., & Fineout-Overholt E. (2010). Evidence-based practice in nursing & healthcare. New York: Lippincott Williams & Wilkins.

Develop your Research Question

The PICO(T) Question

A clinical question that is composed using the PICO or PICOT format will help you to focus your search and help you to develop your research skills which are essential in finding the best available evidence.

The most common PICO(T) elements are:

P - Population

• How you would describe a group of people with a similar problem or complaint.

I - Intervention

• How you plan to treat, medicate, diagnose and/or observe the patient's care.

C - Comparison (if applicable)

• The main intervention alternative you are considering (i.e. placebo, alternative therapy, different drug, surgery).

O - Outcome

• The result from proposed treatment that is measurable, including improvement of symptoms,no symptoms, or complications.

(T) - Time (if applicable)

• The time frame of treatment and/or measurable outcome.

In order be successful in using Evidence Based Practice (EBP) you will need to learn how to develop well-composed clinical questions.  By formatting your research question in a PICO(T) format you can gather evidence relevant to your patient's problem.   Well-composed PICO(T) questions generally contain up to four components each represented in the acronym  " PICO(T)"  P=Patient or Population and Problem; I=Intervention or Indicator; C=Comparison or Control (not part of all questions); O=Outcome; T=Time or Type.

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Narrowing a Clinical Question

Two types of clinical questions, what is pico anyway, picott alternatives and additions, pico process in action, using pico to form the research question, tips and tricks.

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To begin to develop and narrow a clinical research question it is advisable to craft an answerable question that begins and ends with a patient, population, or problem. These are the beginnings of not only developing an answerable EBP question, but also using the PICO process  for developing well-built searchable and answerable clinical questions. 

There are many elements to developing a good clinical question. Clinical questions can be further divided into two major areas: Background Questions and Foreground Questions .

Background Questions refer to general knowledge and facts. The majority of the information that can be used to inform answers to background questions are found in reference resources like Encyclopedias, Dictionaries, Textbooks, Atlases, Almanacs, Government Publications & Statistical Information, and Indexes.

Foreground Questions are generally more precise and usually revolve around patient/s, populations, or a specific problem. Crafting an appropriate EBP question will not only inform your search strategy which you will apply to the medical literature but will also create a framework for how to maintain and develop your investigative process.

What are some examples of P ?

• Diabetes mellitus, Type 2 (problem) Obese
• elderly (population)

What are some examples of I ?

• Chlorpropamide

What are some examples of C ?

What are some examples of O ?

• Management of glucose levels

Using the example from the bottom-center we can start forming a research question: 

Is Chlorpropamide (intevention) more efficient than Metformin (comparator) in managing Diabetes Mellitus Type 2 (problem) for obese elderly patients (population)?

*Note: It is not necessary to use every element in PICO or to have both a problem and population in your question. PICO is a tool that helps researchers frame an answerable EBP question. 

Synonyms can very helpful throughout your investigative and research process. Using synonyms with boolean operators can potentially expand your search. Databases with subject headings or controlled vocabularies like MeSH in PubMed often have a thesaurus that can match you with appropriate terms.

Boolean operators allow you to manipulate your search.

Use AND to narrow your search

  eg. elderly AND diabetes  

Use OR to broaden your search

  eg. myocardial infarction OR heart attack

Use NOT to exclude terms from your search

  eg. children NOT infants  

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• Clinical Information Sources

How to Develop a Question

Developing a project.

• Evaluating Sources
• Qualitative vs Quantitative Studies
• Summarize Evidence
• Create Quick Citations
• Organize Your Research
• Writing Guides
• Instruments & Surveys
• Student Success materials
• For Faculty
• The PICO Format Simple tool to help focus your research question on a specific issue (from the Evidence Analysis Manual)
• Template for Asking PICO(T) Questions handout This template can help you figure out how parts of your research question fit into the PICO(T) format.
• Tips for Writing a Good PICO What is a bad PICO vs a good PICO? From Meyer, M.N. (2017). Evidence-based practice: Success of practice change depends on the question. In T.L. Christenbery, ed., Evidence-Based Practice in Nursing: Foundations, Skills, and Roles. Springer: New York, NY.
• Question Formulation Template Factors to consider when developing a research question (from the Evidence Analysis Manual)

• SRM Project Planner This tool is designed to guide you through your research project. First, think about what stage you're at in your research. If you've already gotten started, click on the stage below that best describes where you are. If you're just starting out, it might be helpful to read more about why we do research before getting started.
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• Library databases
• Library website

Evidence-Based Research: Phrasing Research Questions

The researchable question.

The first step in doing evidence-based practice research is forming a researchable question. Questions that are too broad or too narrow can make your research difficult, if not impossible.

Clinical example:

• This topic is so broad that you'd have difficulty wading through all of the results.
• This question is so specific that there probably hasn't been anything published on that specific location regarding that specific population.
• Just right : In the NICU, what is the effect of hand washing on infection control compared with hand sanitizers, over 6 months?

Non-clinical example:

• This topic is so broad that you'd have difficulty wading through all of the results.  Also the wording in the question has to be more specific (use synonyms to include all possible versions).  For instance, heart disease is better known in the literature as cardiovascular disease, so search both ways. 
• This question is so specific that there probably hasn't been anything published on that specific location regarding that specific population. It can be only be determined by accessing the electronic medical records in the hospital and finding the rate.
• This question is just right because the variable name like “cardiovascular mortality” are descriptive and reflective of what is found in the literature.  Additionally, there are some control variables included to make sure that even if each group of race had individuals with different ages or different incomes, this would not explain away the differences in cardiovascular mortality impacted by race.

PICOT and other models

PICOT is a mnemonic that helps you remember the key components of a well-focused question. It stands for:

• P = Patient, Population or Problem
• I = Intervention, Prognostic Factor, or Exposure
• C = Comparison (optional)
• O = Outcome

PICOT examples:

Intervention/therapy

In _______(P), what is the effect of _______(I) on ______(O) compared with _______(C) within ________ (T)? 

In the aged population, what is the effect of exercise programs on accidental falls, as compared with no exercise?  

Are ____ (P) who have _______ (I) at ___ (Increased/decreased) risk for/of_______ (O) compared with ______ (P) with/without ______ (C) over _____ (T)?

Are adult smokers with a history of childhood asthma at increased risk of COPD compared to adult smokers with no history of asthma?  

Diagnosis or diagnostic test

Are (is) _________ (I) more accurate in diagnosing ________ (P) compared with ______ (C) for _______ (O)? 

Is the Hemoglobin A1C test more accurate in diagnosing diabetes as compared with fasting blood sugar levels?  

For ________ (P) does the use of ______ (I) reduce the future risk of ________ (O) compared with _________ (C)? 

For people with type 2 diabetes, does zinc supplementation reduce the future risk of foot ulcers compared with placebo?  

Prognosis/Predictions 

Does __________ (I) influence ________ (O) in patients who have _______ (P) over ______ (T)? 

In adults with osteoarthritis, does low vitamin D levels in the bloodstream predict the rate of future hip fractures?  

Meaning 

How do ________ (P) diagnosed with _______ (I) perceive ______ (O) during _____ (T)? 

How do cancer patients diagnosed with alopecia perceive their self-esteem during and after chemotherapy?

Public Health:

PICO(T) is commonly used to formulate research questions, sometimes referred to as ‘PI/ECO’ (Population/participants, Intervention/Exposure, Comparison, Outcome). The PI/ECO structure can be readily amended for different question types ( NHMRC Guidelines, 2019 ). A simple example might be:   

• Population / participants: Non-institutionalized civilian residents of the United States   
• Intervention (or Exposure): Hypertension (or Low Socioeconomic Status)  
• Comparison: Respondents without hypertension   
• Outcomes: Cardiovascular disease or cardiovascular mortality   
• Types of studies: Cross-sectional, Longitudinal

Alternate Models:

• PECO  – Population | Environment | Comparison | Outcome Very similar to PICO but looking at the effect of exposure to something e.g. smoky atmosphere
• SPICE  - Setting | Population | Intervention | Comparison | Evaluation Another variant of PICO but this time including the setting (where? in what context?)
• ECLIPSE  - Expectation | Client group | Location | Impact | Professionals | Service Recommended for health policy/management searches
• SPIDER  – Sample | Phenomenon of Interest | Design | Evaluation | Research Type Developed to create effective search strategies of qualitative and mixed-methods research - more specific than PICO/PECO

Search terms

Once you've developed your question, it's time to find keywords or search terms that you can use in the Library databases to find articles relevant to your question. Remember that each article does not necessarily need to address ALL the aspects of your question.

To learn more about selecting and combining appropriate search terms, please see our guides:

• Keyword Searching: Keyword Search Strategy
• Guide: Keyword Searching: Boolean
• Previous Page: Overview
• Next Page: Levels of Evidence Pyramid
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• What is EBP?

Background vs. Foreground

Pico examples, asking different types of questions, pico resources & worksheet.

• Evidence Appraisal
• Clinical Tools and Databases
• Other Resources

Evidence based practice requires that clinicians make use of the best research they can find to help them in decision-making. To find that research efficiently, the clinician must ask a well-designed clinical question with all the elements that will lead to finding relevant research literature.

The first step in doing this is to determine the type of question: background or foreground. The type of question helps to determine the resource to access to answer the question.

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

• Broaden the scope - "The Forest"
• Provides basics for a a greater grasp of concepts
• Typically found in textbooks, guidelines, point-of-care monographs, encyclopedias, or topic reviews
• A question root (who, what, when, etc.) with a verb
• A disorder, test, treatment, or other aspect of healthcare

The background question is usually asked because of the need for basic information. It is not normally asked because of a need to make a clinical decision about a specific patient.

Foreground questions ask for specific knowledge to inform clinical decisions or actions.

• Focused in scope - "The Trees"
• Requires a grasp of basic concepts to fully comprehend
• Typically found in journals and conference proceedings
• Have 3 or 4 essential components (see PICO below)

PICO is a mnemonic used to describe the four elements of a good clinical foreground question:

P = Population/Patient/Problem - How would I describe the problem or a group of patients similar to mine?

I = Intervention - What main intervention, prognostic factor or exposure am I considering?

C = Comparison - Is there an alternative to compare with the intervention?

O = Outcome - What do I hope to accomplish, measure, improve or affect?

 Fill in the blanks with information from your clinical scenario: THERAPY In_______________, what is the effect of ________________on _______________ compared with _________________?

PREVENTION For ___________ does the use of _________________ reduce the future risk of ____________ compared with ______________? DIAGNOSIS OR DIAGNOSTIC TEST Are (Is) ________________ more accurate in diagnosing _______________ compared with ____________? PROGNOSIS Does ____________ influence ______________ in patients who have _____________? ETIOLOGY Are ______________ who have _______________ at ______________ risk for/of ____________ compared with _____________ with/without______________? MEANING How do _______________ diagnosed with _______________ perceive __________________? Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice . Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

• PubMed PICO Tool
• TRIP Database PICO Builder
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• Forming Questions

Nursing: Forming Questions

• Getting Started
• Background Info
• 6S/Foreground Info
• Further Research
• Clinical Practice
• Nursing Theory

A Good Question...

• Focuses your information needs
• Identifies key seach concepts
• Points you in the direction of potential resources

Background Questions

These questions are general in nature and provide foundational information on a single concept.  Background questions cover:

• Terminology
• General Pathology
• Patient Education Resources
• General Drug Information
• Examination/Assessment Procedures

What is the pathology of asthma ?

What drugs are used to treat hypertension ?

How do I perform a psychological assessment ?

What education resources exist for patients with gestational diabetes ?

How is hepatitis b diagnosed?

What does a normal heartbeat sound like?

These questions are best answered using the resources found in the Background Info page of this guide.

Foreground Questions

These questions bring together multiple concepts related to a specific clinical situation or research topic.  They may be divided into two  broad categories:

• Qualitative Questions  aim to discover meaning or gain an understanding of a phenomena or experience.  They ask about an individual's or population's experience of certain situations or circumstances
• Quantitative Questions  aim to discover cause and effect relationships, often through comparison. Comparison may occur between two or more individuals or groups based on outcomes associated with differences in exposures or interventions. Comparison may also be made to 'no intervention', standard care or standard practice, 'no exposure'.

These questions are best answered using the resources found in the 6S/Foreground Info page of this guide.

Forming Foreground Questions

Building an effective foreground question can be challenging.  The following models will help:

Qualitative Questions: The PS Model

P - Patient/Population

S - Situation

How do/does ___ [P] ____ experience _____ [S] _____?

What is the experience of ____ [P] ___ [S] ____?

Ex. How do  caregiver- spouses of Alzheimer patients  experience  placing their spouse in a nursing home ?

___________________________________________________________________________

Quantitative Questions: The PICO(T) Model

A quantitative approach can answer many different types of questions, but all can be formatted by following the  PICO(T) Model  outlined below:     

PICO(T) Templates

In ___ [ P ]___,  do/does ___[ I ]___ result in ___[ O ]____ when compared with ___[ C ]___ over ___[ T ]____?

E.g.) In nursing home residents with osteoporosis , do hip protectors result in fewer injuries from slips, trips, and falls when compared with standard osteoporosis drug therapy over the course of their stay ?

Are ___[ P ]___  with  ___[ I ]___  over ____[ T ]____ more likely to ___[ O ]____ when compared with ___[ C ]___ ?

E.g.) Are   female non-smokers   with  daily exposure to second-hand smoke  over  a period of ten years or greater  more likely to  develop breast cancer  when compared with  female non-smokers without daily exposure to second-hand smoke ?

Is/are ___[ I ]___ performed on ___[ P ]___   more effective than ___[ C ]___  over ___[ T ]____in ___[ O ]____?

E.g.) Are   self-reporting interviews and parent reports  performed on   children aged 5-10   more effective than  parent reports alone  over a  four-week consultation process  in  diagnosing depression ?

In ___[ P ]___,  do/does ___[ I ]___ result in ___[ O ]____ when compared with ___[ C ]___ over ___[ T ]____?

E.g.) In  emergency room visitors , do   hand sanitizing stations  result in   fewer in-hospital infections  when compared  with no hand sanitizing stations  over  a year-long pilot period ?

Do/does ___[ I ]___ performed on ___[ P ]___   lead to  ___[ O ]___  over ___[ T ]____compared with ___[ C ]____?

E.g.) Do  regular text message reminders  performed on  patients recently diagnosed with diabetes  lead to  a lower occurrence of forgotten insulin doses  over  the first six months of treatment  compared with  no reminders ?

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What is your research question? An introduction to the PICOT format for clinicians

John j. riva.

† Department of Family Medicine, McMaster University, Hamilton, Ontario.

Keshena M.P. Malik

¶ Graduate Student, Department of Rehabilitation Sciences, McMaster University, Hamilton, Ontario.

Stephen J. Burnie

‡ Canadian Memorial Chiropractic College, Toronto, Ontario.

Andrea R. Endicott

£ Senior Policy Analyst, Ontario Chiropractic Association, Toronto, Ontario.

Jason W. Busse

§ Institute for Work & Health, Toronto, Ontario.

* Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario.

Introduction

Clinicians often witness impressive treatment results in practice and may wish to pursue research to formally explore their anecdotal experiences. The potential to further new knowledge both within the profession and to the greater healthcare system is compelling. An obvious next step for a practitioner considering research is to connect with experienced researchers to convey their idea for a study, who may in turn ask, “What is your research question?” With limited understanding of how to respond, this interaction may result in the first and last experience these clinicians will have with the research community.

It has been estimated that between 1% and 7% of the chiropractic profession in Canada is engaged in research. 1 , 2 Arguably, this low engagement could be the result of practitioners’ perceived importance of research and levels of research literacy and capacity. However, increasing demands for evidence-based approaches across the health system puts pressure on all clinicians to base their decisions on the best available scientific evidence. Lack of clinician representation in research has the probable effect of limiting growth and new developments for the profession. Furthermore, lack of clinician involvement in research complicates the transfer of study findings into practical settings.

The Canadian Institutes of Health Research describes integrated knowledge translation as a process that involves collaboration between researchers and knowledge users at all stages of a research project. 3 This necessitates involvement of clinicians to help in forming a research question, interpreting the results, and moving research findings into practice. This shared effort between clinicians and researchers increases the likelihood that research initiatives will be relevant to practice. 3 Conversely, it has been reported that there is a growing communication gap between clinicians and academics in chiropractic. 4 Clinicians have important practice-related questions to ask, but many may lack the ability to map out their research strategy, specifically in communicating their question in a manner required to develop a research protocol.

David L. Sackett, Officer of the Order of Canada and the founding Chair of Canada’s first Department of Clinical Epidemiology & Biostatistics at McMaster University, highlights the importance of mapping one’s research strategy in exploration of the research question: “one-third of a trial’s time between the germ of your idea and its publication in the New England Journal of Medicine should be spent fighting about the research question.” (personal communication, November 30, 2011) We describe a randomized controlled trial (RCT) example to highlight how clinicians may use existing literature and the PICOT format to formulate a research question on treatment efficacy.

PICOT Defined

The PICOT format is a helpful approach for summarizing research questions that explore the effect of therapy: 5

• (P) – Population refers to the sample of subjects you wish to recruit for your study. There may be a fine balance between defining a sample that is most likely to respond to your intervention (e.g. no co-morbidity) and one that can be generalized to patients that are likely to be seen in actual practice.
• (I) – Intervention refers to the treatment that will be provided to subjects enrolled in your study.
• (C) – Comparison identifies what you plan on using as a reference group to compare with your treatment intervention. Many study designs refer to this as the control group. If an existing treatment is considered the ‘gold standard’, then this should be the comparison group.
• (O) – Outcome represents what result you plan on measuring to examine the effectiveness of your intervention. Familiar and validated outcome measurement tools relevant to common chiropractic patient populations may include the Neck Disability Index 6 or Roland-Morris Questionnaire. 7 There are, typically, a multitude of outcome tools available for different clinical populations, each having strengths and weaknesses.
• (T) – Time describes the duration for your data collection.

RCT Design Example Using PICOT

Dosage effects of spinal manipulative therapy for chronic neck pain.

Neck pain is second in frequency only to low back pain among musculoskeletal complaints reported in the general population and among those presenting to manual therapy providers. 8 , 9 Chronic neck pain (i.e. neck pain lasting longer than 90 days) is a common reason for presenting to a chiropractor’s office, and such patients often receive spinal manipulation or mobilization. 10 Recent systematic reviews of RCTs and prior observational studies have shown increases in cervical range of motion, 11 , 12 and decreases in self-rated neck pain 13 , 14 following cervical spine manipulation. In 2010, the Cochrane systematic review concluded, “Optimal technique and dose need to be determined.” 14

Despite evidence of benefit, there is a limited understanding of the optimal dose for neck manipulation; as such, frequency and duration of this treatment varies greatly between clinicians. Although patient characteristics and clinicians’ beliefs likely account for some of this variation, it seems likely that many cases of mechanical neck pain will require a minimal number of spinal manipulative therapy (SMT) treatments to derive benefit and that no further benefit will result after a certain upper threshold is reached. To properly examine the dose effects of manipulation for neck pain, it is necessary to consider three treatment factors:

• total number of manipulations

A factorial design RCT allows investigators to consider more than one treatment factor at a time and examine possible interactions between them. This trial design allows for determination of, not only, the effects of frequency and duration, but also whether it is more effective to provide a certain number of manipulations over shorter or longer durations (i.e. an interaction between the two factors). Considering a 3x4 factorial design, patients would attend 1, 2, or 3 sessions per week (i.e. the first ’factor’ of frequency) with manipulation provided over a duration of 2 weeks, 4 weeks, 6 weeks, or not at all (i.e. the second ‘factor’ of duration). To improve generalizability of findings, neck manipulation could be performed using standard rotary or lateral break diversified technique, which is the most common manually applied neck manipulation in chiropractic practice. Pain relief is a common concern among patients presenting with neck pain and detection of a resulting difference of 13 mm on the 100mm Visual Analog Scale (VAS) line is considered a clinically important change in intensity for patients with chronic pain. 15

Research Question: In adults with chronic neck pain, what is the minimum dose of manipulation necessary to produce a clinically important improvement in neck pain compared to supervised exercise at 6 weeks?

• (P) – Population: Adults 18 to 60 years of age, with a clinical diagnosis of chronic mechanical neck pain who have not received cervical SMT in the past year. Patients with non-mechanical neck pain or contraindications to cervical manipulation will be excluded.

Frequency and Duration of SMT

• (C) – Comparison: A standardized supervised exercise regimen would be used as an active control group. All subjects, regardless of group assignment, would perform a standardized exercise regime at each session over a period of 6 weeks. Using this strategy, we will be able to minimize the non-specific effects due to attending a clinic.
• (O) – Outcome: Changes in neck pain, measured using the 100mm VAS for pain.
• (T) – Time: The outcome would be measured weekly for 6 weeks.

Clinician input, assuming expertise in the ‘gold standard’ standard rotary or lateral break diversified technique and an ability to teach it, would be helpful during the planning of patient recruitment. Specifically, in leading training initiatives to calibrate each treating chiropractor to deliver his/her manipulation in a similar way (i.e. load, force, angle) and to assist in normalizing communication with study subjects. This standardization, through structured training sessions for those rendering treatment, will help ensure no additional interventions were inadvertently applied (i.e. education, extra advice).

Other Study Designs Amenable to PICOT

The PICOT format example described above represents a factorial RCT methodology that has been informed by the existing literature. While a well-conducted RCT is appropriate for answering many questions on treatment efficacy, they are typically costly, time-consuming and challenging to conduct. Not all research questions that clinicians wish answered are feasible using this research methodology and the use of a PICOT format is also applicable to other study designs.

The clinical research question being asked ideally determines the best research design for a study. A prospective or retrospective cohort design may be an easier methodology to administer in comparison to a RCT; but study results can by affected by confounding due to the comparison of non-randomized groups. Another methodology, used to look for associations between respondent characteristics and outcomes of interest, is a cross-sectional survey. This methodology is faster and less expensive to do in comparison to a RCT since it considers one time-point of individuals in various spectrums of the variables of interest. However, this design can also can be prone to recall problems by respondents who self-report information if investigators ask about events in the past. A case-control study is most appropriate when attempting to identify associations between patient characteristics and outcomes that take a long time to occur or are very rare. For example, the study by Cassidy et al. (2008) looking at risk of vertibrobasilar artery stroke following chiropractic care, whilst more complex in the design approach, used aspects of a case-control methodology. 16

While these study designs are common in clinical research today, they are not exhaustive of all designs available. Systematic reviews will be familiar to most as a study design aimed at summarizing bodies of studies; but other less familiar individual patient focus designs, such as N-of-1 RCT, 17 also exist which are amenable to the PICOT format depending on the research question that is being posed.

Many considerations need to be contemplated in the PICOT formulation: How detailed should the literature search be in breadth and quality level? What study design best fits the research question? Should the patient population include very similar types of patients or will there be more of a real-world wide variety of participants? Will the intervention be very specific and rendered by a clinical expert or will there be a combination of tailored interventions rendered by a non-clinician with a more general skill set? Will the comparison be against usual care (i.e. ‘gold standard’) or a sham placebo procedure? Will the outcomes measured be from validated instruments on a form or more from direct patient verbal communication and will these results be presented in a way most important to clinicians, patients or policy-makers? And if so, what amount of difference and how many patients would be required to both statistically and clinically conclude the intervention was effective? Will measurement of outcomes occur at multiple times or once at 5 days, 6 months or 10 years?

While these considerations are clearly complex and not inclusive of the entire process, to develop a strong research question framed in the PICOT format, it is an important basis to understand both the clinical area of investigation and the current literature that exists. As highlighted by the example above, it is necessary to review the type and quality of research that has already been performed in the area of interest to guide development of a question. When initially synthesizing the literature, some key entry questions to examine include:

• what are the important research questions in the field?
• what has been found?
• what areas need further exploration?
• would the proposed study fill a gap and better an understanding?

In our example design, the literature search identified existing knowledge in the respective area. A recent high-quality Cochrane review reported on previously completed RCTs in the area, strengths and weaknesses of these studies and offered direction as to gaps in current understanding that would benefit from further research exploration. 14 As research is a time consuming and often costly endeavour, building on the best available existing knowledge rather than “re-inventing the wheel” is favourable.

Only after a thorough literature synthesis and investigation into these answers should a research question be formulated – in some instances a systematic review methodology may actually align best with the PICOT framework for your research question. Turning an idea into a good research question requires it to be feasible, interesting, novel, ethical and relevant. 18 This feasibility refers to, not only, resources (time and money), but also to whether there is agreement on the meaning of the research question and to whether everything that needs to be measured can be measured by the study design. The question should be of interest to many in the clinical area to drive both team momentum for the project and dissemination of the results. Generating new knowledge in large existing gaps of healthcare provides the opportunity to help large volumes of patients who previously may have had poorer clinical outcomes. Practically, ethical considerations have to be accounted for in related study designs to ensure subjects are not harmed by the study. Finally, reflection is required on how well the study design will apply to the real world.

A strong research question should always pass the ‘so what?’ test. Who will the research help? What is the benefit? There should be a definitive and strong rationale for the purpose of the research. A well-thought-out focused research question leads directly into hypotheses; the predictions about the nature and direction of the relationship between the variables under study. Hence, the question acts as the foundation of the study.

The importance of moving from studies to empirically supported treatments to evidence-based practices may very well rest on whether or not a clinician views the research as relevant to their daily practice. It is common for clinicians to express frustration that researchers are not asking questions that are of most relevance to practice. Similarly, researchers often find that clinicians have difficulty distilling the important concepts they would like investigated in a way that can be feasibly researched.

To support both clinical and academic interests, an important clinical research question should therefore be one that is developed in conjunction with a diverse team. This expertise should align with the best research methodology available and propose a project feasible to complete through study that will adequately answer the research question asked. In Canada, the Canadian Chiropractic Research Foundation has reported that there are currently 12 university-based research chairs, 15 PhD candidates and 14 Masters students. 19 An opportunity exists to engage these researchers, as well as those from chiropractic schools, in helping to formulate important clinical research questions.

Clinicians interested in research pursuits, related to patient care, should consider the use of a literature search and the PICOT format when engaging clinical researchers. This approach will provide clinicians and researchers an initial basis for mutual understanding, communication and direction to help answer clinical study questions of most relevance.

• Clinicians should frame practice-based research questions in the PICOT format
• Look to existing literature for guidance in the formulation of a research question
• Clinicians have an important role in contributing to the integrated knowledge translation of research studies
• Framing of a research question offers a common language between clinician and researcher discourse

Funding: No funds were received for the preparation of this manuscript. Dr. Busse is funded by a New Investigator Award from the Canadian Institutes of Health Research and Canadian Chiropractic Research Foundation. Dr. Riva is funded by an award from the NCMIC Foundation. Drs. Burnie, Busse, Malik and Riva are members of the McMaster Chiropractic Working Group, which receives in-kind support from the Canadian Chiropractic Association.

Competing Interests: None.

Writing a Nursing Research Paper that Meets Professor's Requirements

As a nursing student, you will spend much time researching, reading, and writing papers. Many students find the entire process of writing research papers challenging.

Imagine on top of spending many hours in clinical practice shifts only to find yourself sparing more time researching and writing, not to mention the overwhelming information condensed in a few hours of in-class lecture sessions. Working shifts and studying while having family duties and obligations worsens it, and when done in a rush, you end up with subpar papers and average grades.

Even though many student nurses find writing research papers tricky and daunting, you can write a perfect paper that ticks all the checkboxes your professor uses to mark them and be sure to get an A+ grade on your nursing paper.

Our expert nursing research writers, who have written thousands of BSN, MSN, DNP, and Ph.D. papers, have compiled this comprehensive guide to help you write a strong nursing research paper that leaves a lasting impression on your professor.

Having marked many papers and supervised many theses, capstone projects, and dissertations, you can trust that the information herein is valuable and timely in your pursuit of nursing career success.

What is a Nursing Research Paper?

A nursing research paper is a scholarly and thesis-driven paper that a nursing student (at ADN, BSN, MSN, DNP, or Ph.D. level) writes to comprehensively explore a specific nursing research topic either of their choice or one that the professor assigns.

To write a perfect research paper, the student has to provide concrete, reliable, and trustworthy evidence. In most cases, even professionals such as RNs undertaking clinical practice, nursing education training, clinical studies and evaluations, and nursing research can also write research papers published in journals or conferences to advance and disseminate nursing knowledge. The typical length of most nursing papers ranges from 5 pages to 20 pages, depending mainly on the complexity of the subject, the word count limits, and the requirements. Nurses and nursing students write research papers to share their insights as they learn more about nursing processes and practices. Nursing research papers are used to: document research, organize information, advance nursing scholarship, and improve the writing skills of nurses. Students in the USA, Australia, Japan, and Canada write their research papers in the American Psychological Association (APA) format, while those in Australia and the UK write them in Harvard formats. The research papers fall under three main categories:

• Analytical research papers. These papers present an analysis of the topic using evidence, facts, and examples.
• Argumentative research papers. These research papers are analytical but with a twist where the writer uses evidence to reinforce their opinion and persuade the reader.
• Expository research papers. This category of nursing research papers explains the subject matter using credible evidence such as examples, facts, statistics, and other pieces of evidence.

Structure and Format of a Nursing Research Paper

A simple nursing research paper, especially an expository or informative type, can have 5 paragraphs, like a typical essay. However, longer research papers have additional sections.

Scientific Nursing Research Paper Structure

Here is a breakdown of how a well-formatted and scientific nursing research paper should look like.

• Title Page. The title page comprises the research paper title, details of the student or professional writer, course details, details of the school or institution, and the date. The cover page is the first contact point with the reader. It is brief.
• Abstract. The abstract summarizes the nursing research paper. It is 200-250 words long and should be focused on what the reader expects. It is a condensed version of the paper, which is critical to help professors know what your paper is about. It should not have acronyms. Note that the word count of the abstract is not considered part of the research paper.
• The Introduction. The introduction should have an attention-getter or a hook that can be a statement, statistic, or fact. It should be 10% of the entire word count. It also has background information that details the nursing issue or topic you are exploring. It also comprises a well-thought-out thesis statement related to the topic. If you have a long paper, ensure that your problem and purpose statements are part of the introduction. It should also list your PICOT question .
• Literature Review. This is a critical section of the research paper. Here, you should explore other nursing scholars' thoughts and scholarly findings. Focus on peer-reviewed scholarly articles that address the same issue as your thesis statement or topic. Explore your topic's theories, theoretical frameworks, and other facts. Do it so well that your professor marvels at your research, organization, and writing prowess. Consider the levels of evidence as you choose selection criteria for the papers to include in your nursing literature review.
• Research Methodology. This section of the research paper details the data collection methods, such as ethnographic studies, secondary data collection, literature review, quasi-experimental research, correlational studies, descriptive research, ethnography, phenomenology, grounded theory, meta-analyses, systematic reviews, or experiments. Ensure that you state and give a rationale for your research design (qualitative, quantitative, or mixed-methods). If you are writing a quantitative paper, explain how you tested the hypotheses. Also, report the sampling frame and the sampling strategy.
• Results and Discussion. This section of the paper presents the findings. You can use visual aids such as charts and graphs for a quantitative research paper. If you are writing a qualitative research paper, present the evidence chronologically. When presenting the findings, avoid making definitive facts. Instead, ensure that the results suggest something is true or false, even when testing a hypothesis.
• Conclusion and Recommendations. The conclusion should be 10% of the entire word count. You should restate the thesis and give a summary of your entire paper. Explore the recommendations for future research on the topic.
• Ensure that your reference list is arranged alphabetically. The list should adhere to the formatting requirements (Harvard, ASA, or APA formats). Only use scholarly peer-reviewed references.

Format for a General Nursing Research Paper

If you are writing a non-scientific nursing research paper, you will only have three sections as follows:

• Introduction. The introduction paragraph should introduce the topic by providing an attention-getter, background information, and a thesis statement.
• Body of the paper . The body paragraphs should have strong topic sentences, supporting details (examples, evidence, and explanation), and concluding sentences. It should also portray a good use of transition words. You should analyze the topic and use evidence to support the arguments, and give enough explanation. Use in-text citations within the body paragraphs.
• Conclusion. End the paper by recapping the main points, reasserting the thesis statement, and signaling the end of the paper to give your readers good closure.

An excellent nursing research paper follows this structure as long as it is not research-based. The three-part approach is super recommended if you did not conduct any study. In most cases, when assigned to write those 5-12 pages of nursing school research papers, you will be using this format.

So, what are the steps for writing a good nursing research paper? Let’s find out in the next section.

The 6 Main Steps for Writing a Nursing Research Paper

Writing assignments are an essential training aspect for nursing students. No wonder professors will stress that you write essays, discussion posts, responses, or proposals well. They are doing so to prepare you for research roles somewhere in your nursing career.

According to our most successful research paper writers, writing a top-grade research paper involves decoding the instructions, selecting a good topic, planning, researching, writing, and polishing the paper.

Here is a breakdown of each step for clarity and deeper understanding.

Step #1: Understand the Prompt or Instructions

You can only perfect what you know! Therefore, you can begin the research writing process by reading, analyzing, and understanding the instructions. It is an essential pre-writing stage process where you carefully read the instructions.

Although it sounds obvious, most nursing students who write off-topic and subpar research papers jump into writing without reading to understand the instructions.

You need to skim through the instructions on the first attempt, then read keenly and critically as you take note of the scope of the assignment, the topic, and other things you must fulfill in the paper. Take note of the:

• The number of words.
• Type of research paper (argumentative, analytical, exploratory, or persuasive).
• The structure of the paper (thesis-driven or research/study-based (scientific) research paper.
• The deadline.
• Whether you need to draft an outline.
• Reading materials.
• Whether you need external sources.
• Which sources to use and how many?
• The theoretical constructions or conceptual frameworks.
• The age limit of the scholarly sources.

If you need further clarification, ensure that you ask your peers, professor, or a professional writer in time.

Step #2: Select a Good Nursing Research Topic

Compared to average students, top nursing students always remember to select a research topic they are comfortable handling. When you are confident with a topic, you can develop it without procrastinating.

Sometimes you are given a list of nursing research paper topics, issues, and ideas to consider. Other times, you come up with the topic and consult your professor/educator for approval.  

Choose topics related to patient safety, nursing processes, nurse staffing, nursing policies, nurse privileges, nursing legislations, nursing ethics, mental health, health promotion, chronic disease management, healthcare systems, health informatics, changes in healthcare, and working conditions.

Choose any nursing topic that resonates with your specialization interests. It should be manageable, relevant, and explorable.

Related Readings:

• Nursing informatics research topics
• Capstone project ideas and topics for BSN, MSN, and DNP students
• Mental health nursing topics
• Epidemiology nursing topics
• List of the best nursing research paper topics
• Evidence-based nursing topics and ideas
• Nursing ethical dilemmas

Step #3: Plan your Paper

Create a thesis statement for your research paper if it is thesis-driven rather than study-based or scientific (experimental). After writing the thesis, like any of our nursing assignment slayers, write a good outline using Roman numbers and numbers.

List the ideas you wish to have in your paper in chronological order, starting with the introduction, body, and concluding paragraphs. As you outline, do some preliminary research so that you develop arguments the right way.

Include the in-text citations in your nursing research paper outline to simplify the writing process.

Step #4: Research and Organize Resources

Doing in-depth research as you refine the draft would be appropriate because you know what you want the paper to look like. Use scholarly nursing databases for research and limit yourself to topic-related scholarly articles published within the last 5 years.

You can read the abstracts of the articles to determine if they are fit to use in your paper. If you find the best articles, list them using online citation management tools such as RefWorks, Zotero, EndNote, Citefast, or any of your choice.

Ensure to list them in the most appropriate formatting styles. Take notes and list the points and ideas in your outline. Do your research meticulously and ensure that you organize the process to avoid any confusion.

Step #5: Write the First Draft

With the research, synthesis, and outline, you are now left with the chance to put rubber on the road. Use the Pomodoro technique, where you spend stretches of 25 minutes of focused work and have minor 5-minute breaks.

Ensure you cover as much ground in your research paper as possible before three-quarters of the deadline. When writing the paper, and considering that you have the outline, you can start chronologically from the introduction to the appendices.

Most research paper writing pros prefer working on the body section and conclusion before writing the introduction and finalizing the abstract. Whatever works best for you, adopt it. When writing the first draft, focus on piecing together the information rather than perfection.

Ensure you research lightly as you write and assert your voice while giving the right in-text citations for every idea you paraphrase from a source to avoid plagiarism. Each body paragraph should only have one idea.

Step #6: Edit, Proofread, and Polish the Paper

The final step towards completing your nursing research paper is ensuring everything is in its rightful place. A polished research paper scores 90% and above, which is an A. Begin by reading the paper aloud to identify areas that do not make sense.

If there is a need, do not hesitate to rewrite an entire section so that you have the right flow of information.

Check the grammatical, spelling, and syntax errors and make necessary corrections. You should also check the tenses used in the paper. If you feel like polishing the essay is too much work, you are better off hiring a nursing paper proofreader/editor.

When you receive feedback from your educator or professor, address the changes and resend the paper for grading.

Related Reading: How to write an evidence-based nursing paper.

Valuable Tips to Consider as You Write Your Nursing Research Paper

Nursing schools and educators have their standards and guidelines for writing a research paper. Therefore, ensure that before everything else, you familiarize yourself and adhere to these instructions, which include word count and citation styles.

Do not assume anything when writing a paper. You should also access and understand suggestions from your school’s writing lab. Apart from these essential tips, also ensure that you follow the insights we give below:

• Write your paper using a formal tone. Do not use passive voice when writing the paper. Instead, use active voice.
• Your paper should have a good organization from the introduction to the conclusion.
• Whenever you borrow ideas from a scholarly source, ensure you cite them correctly.
• Have a well-thought-out thesis statement that clarifies your arguments.
• Create a complete outline during the early stages of writing. It gives you a roadmap to follow as you write the paper. Organize the ideas chronologically based on their strength and weaknesses.
• Have a plan and schedule to trace your progress with the paper.
• If you have a more extended deadline, contribute to your research paper daily.
• When writing the paper, start with the body, the conclusion, and the introduction last.
• If you are writing a study-based research paper, include the literature review, methodology, discussion, and conclusion sections per the IMRAD format. A general nursing research paper follows the essay structure: introduction, body section, and conclusion.
• Use peer-reviewed scholarly sources from CINAHL, PubMed, Nursing Reference Center, Cochrane Library, MEDLINE, and other nursing research databases with peer-reviewed articles. Credible sources mean your research paper has rigor since you have strong points.
• Proofread and edit the paper thoroughly to remove any mistakes to signal your seriousness to your professor. If possible, use professional editing services.
• Have a compelling conclusion that is elaborate, clear, and concise.
• Read your paper aloud to identify mistakes.
• Revise the paper, and do not fear rewriting an entire section.

When writing a research paper, adhere to the writing conventions. You should also read well and understand how to communicate through academic writing effectively. Your paper should document evidence that supports your arguments and topic.

Write concisely, coherently, and accurately. It is not all in vain; you are training for your future role as a nurse when you will write conference papers, white papers, essays, policy documents, letters, blog posts, and professional nursing articles.

Checklist for a Great Research Paper in Nursing

Now that you have written your paper, you must align a few things to make it the best your professor will read. Most nursing classes, especially at the graduate levels (MSN, DNP, and Ph.D. levels), have small class sizes, and the professors spend time reading the papers from start to end. This means that you should leave nothing to chance.

Nursing research asserts professional identity, ensures accountability in nursing decision-making, and expands nursing practice. You have to be meticulous when writing a research paper in nursing.

A good research paper demonstrates a complete understanding of nursing knowledge, topic exploration, advanced organization, proper formatting, and mature academic writing skills. The following checklist enlists some main aspects to countercheck before hitting the submit button.

• Have I followed all the instructions outlined in the assignment prompt or rubric?
• Does my paper have the right title page?
• Does the paper have a written title that resonates with the thesis and the research question?
• Is the introduction presenting an attention grabber, background information, and a signpost of the ideas in the paper?
• Is the thesis statement well-thought-out, clear, concise, and elaborate?
• Is the problem statement clearly stated?
• If it is a PICOT-based research paper, is the PICO question well-outlined?
• Does the paper touch well on the nursing issue that the topic needs it to address?
• Is there a logical flow of the paragraphs?
• Are the words in each paragraph balanced?
• Does the paper have correctly formatted headings and subheadings?
• Are the in-text citations done correctly and consistently?
• Does every paragraph in the body of the paper build on the thesis?
• Does the paper demonstrate a mature choice of words and uses nursing lingo?
• Is the literature review section comprehensive? Does it have a theoretical and conceptual framework or constructs?
• Are the data and information presented in the literature review current?
• Has the methodology section listed the sample, sampling strategy, data collection and analyses, and rationale for each?
• Does the discussion section interlink the concepts from the literature review with the findings?
• Does the conclusion offer good closure to the readers? Does it restate the thesis? Does it summarize the recommendations?
• Is the entire paper formatted correctly? Does it follow the formatting guidelines?
• Is the paper devoid of spelling, syntax, and mechanical mistakes?

If your answer to all these questions is a resounding YES, you are sure it will fetch your professor a good grade. Our nursing writers, most of whom are alumni from top nursing universities and colleges such as Chamberlain, Capella, Herzing, Vanderbilt, SFU, Rutgers, Yale, Duke, NYU, UCLA, University of Pennsylvania, University of Toronto, McGill, Ottawa, Queens, and other best colleges in the USA, UK, Canada, and many other places. Besides, they are nursing educators in different capacities, and a couple are nursing professors with big titles; you can trust the checklist to guarantee you an excellent grade.

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Health (Nursing, Medicine, Allied Health)

• Find Articles/Databases
• Reference Resources
• Evidence Summaries & Clinical Guidelines
• Drug Information
• Health Data & Statistics
• Patient/Consumer Facing Materials
• Images and Streaming Video
• Grey Literature
• Mobile Apps & "Point of Care" Tools
• Tests & Measures This link opens in a new window
• Citing Sources
• Selecting Databases
• Framing Research Questions
• Crafting a Search
• Narrowing / Filtering a Search
• Expanding a Search
• Cited Reference Searching
• Saving Searches
• Term Glossary
• Critical Appraisal Resources
• What are Literature Reviews?
• Conducting & Reporting Systematic Reviews
• Finding Systematic Reviews
• Tutorials & Tools for Literature Reviews
• Finding Full Text

Defining the Question: Foreground & Background Questions

In order to most appropriately choose an information resource and craft a search strategy, it is necessary to consider what  kind  of question you are asking: a specific, narrow "foreground" question, or a broader background question that will help give context to your research?

Foreground Questions

A "foreground" question in health research is one that is relatively specific, and is usually best addressed by locating primary research evidence. 

Using a structured question framework can help you clearly define the concepts or variables that make up the specific research question. 

 Across most frameworks, you’ll often be considering:

• a who (who was studied - a population or sample)
• a what (what was done or examined - an intervention, an exposure, a policy, a program, a phenomenon)
• a how ([how] did the [what] affect the [who] - an outcome, an effect). 

PICO is the most common framework for developing a clinical research question, but multiple question frameworks exist.

PICO (Problem/Population, Intervention, Comparison, Outcome)

Appropriate for : clinical questions, often addressing the effect of an intervention/therapy/treatment

Example : For adolescents with type II diabetes (P) does the use of telehealth consultations (I) compared to in-person consultations  (C) improve blood sugar control  (O)?

Framing Different Types of Clinical Questions with PICO

Different types of clinical questions are suited to different syntaxes and phrasings, but all will clearly define the PICO elements.  The definitions and frames below may be helpful for organizing your question:

Intervention/Therapy

Questions addressing how a clinical issue, illness, or disability is treated.

"In__________________(P), how does__________________(I) compared to_________________(C) affect______________(O)?"

Questions that address the causes or origin of disease, the factors which produce or predispose toward a certain disease or disorder.

"Are_________________(P), who have_________________(I) compared with those without_________________(C) at_________________risk for/of_________________(O) over_________________(T)?" 

Questions addressing the act or process of identifying or determining the nature and cause of a disease or injury through evaluation.

In_________________(P) are/is_________________(I) compared with_________________(C) more accurate in diagnosing_________________(O)?

Prognosis/Prediction:

Questions addressing the prediction of the course of a disease.

In_________________(P), how does_________________(I) compared to_________________ (C) influence_________________(O)?

Questions addressing how one experiences a phenomenon or why we need to approach practice differently.

"How do_________________(P) with_________________(I) perceive_________________(O)?" 

Adapted from: Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

Beyond PICO: Other Types of Question Frameworks

PICO is a useful framework for clinical research questions, but may not be appropriate for all kinds of reviews.  Also consider:

PEO (Population, Exposure, Outcome)

Appropriate for : describing association between particular exposures/risk factors and outcomes

Example : How do  preparation programs (E) influence the development of teaching competence  (O) among novice nurse educators  (P)?

SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research Type)

Appropriate for : questions of experience or perspectives (questions that may be addressed by qualitative or mixed methods research)

Example : What are the experiences and perspectives (E) of  undergraduate nursing students  (S)  in clinical placements within prison healthcare settings (PI)?

SPICE (Setting, Perspective, Intervention/phenomenon of Interest, Comparison, Evaluation)

Appropriate for : evaluating the outcomes of a service, project, or intervention

Example : What are the impacts and best practices for workplace (S) transition support programs (I) for the retention (E) of newly-hired, new graduate nurses (P)?

PCC (Problem/population, Concept, Context)

Appropriate for : broader (scoping) questions

Example : How do nursing schools  (Context) teach, measure, and maintain nursing students ' (P)  technological literacy  (Concept))throughout their educational programs?

Background Questions

To craft a strong and reasonable foreground research question, it is important to have a firm understanding of the concepts of interest.  As such, it is often necessary to ask background questions, which ask for more general, foundational knowledge about a disorder, disease, patient population, policy issue, etc. 

For example, consider the PICO question outlined above:

"For adolescents with type II diabetes does the use of telehealth consultations compared to in-person consultations  improve blood sugar control ?

To best make sense of the literature that might address this PICO question, you would also need a deep understanding of background questions like:

• What are the unique barriers or challenges related to blood sugar management in adolescents with TII diabetes?
• What are the measures of effective blood sugar control?
• What kinds of interventions would fall under the umbrella of 'telehealth'?
• What are the qualitative differences in patient experience in telehealth versus in-person interactions with healthcare providers?
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• Last Updated: Jun 26, 2024 3:00 PM
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How to Write a Nursing Research Proposal Topics | Guide & Examples [Updated]

Rachel andel rn, bsn.

• July 24, 2023
• Nursing Writing Guides

Nursing research proposal topics can vary greatly, depending on the type of research you’re looking to conduct.

Whether you are interested in studying public health issues or improving patient care through innovative research methods, something on this list likely appeals to you.

Here’s a guide on writing a nursing research proposal and nursing research proposal topics , DNP research proposal topics, current nursing research proposal topics, and nursing research examples.

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How to Write a Nursing Research Proposal

A nursing research proposal serves as a blueprint for conducting studies that address important clinical questions, explore innovative interventions, and contribute to the overall body of nursing knowledge. 

To create a strong nursing research proposal, there are several key considerations that nursing students must take into account, which include;

• Defining a clear and concise research question addresses an important nursing knowledge gap.
• Selecting an appropriate research design and methodology that aligns with the research question and objectives.
• Ensuring ethical considerations are addressed and appropriate measures are in place to protect the rights and welfare of participants.
• Determining an appropriate sample size and recruitment strategy to ensure adequate statistical power and generalizability of findings.
• Developing a detailed data analysis plan that aligns with the research design and objectives.
• Consider dissemination and knowledge translation strategies to ensure research findings reach the intended audience and positively impact nursing practice.

Key components of a Nursing Research Proposa l

When creating a nursing research proposal, including all the components contributing to a comprehensive and well-structured document is crucial.

Understanding these components will ensure that your proposal is clear and organized and addresses the necessary aspects of your research endeavor. 

Problem Statement

• It should provide a clear description of a problem that will be solved.
• It shows the gap between the current situation and the future goal to improve it.

Research Question

• The research question forms the foundation of your nursing research proposal. It is a concise and focused statement that outlines the main objective of your research.
• Your research question should be specific, measurable, attainable, relevant, and time-bound (SMART), enabling you to address a particular problem or gap in the existing literature.

Study Design

• The study design section outlines the methodology and approach you will employ to conduct your research.
• It includes details on the type of study, such as quantitative, qualitative, or mixed methods, and explains how data will be collected, analyzed, and interpreted.
• The study design should align with your research question and ensure the validity and reliability of your findings.

Methodology

• The methodology component of your nursing research proposal describes the specific techniques and procedures you will use to gather data.
• This may include surveys, interviews, observations, or systematic reviews.
• Clearly outlining your methodology ensures transparency and allows others to reproduce your study if needed.

Sample Size Determination

• Determining an appropriate sample size is crucial in nursing research to ensure your findings’ statistical power and representativeness.
• This section will explain how you calculated the required sample size based on the research question, study design, and expected effect size.
• It is essential to consider factors such as the population size, confidence level, and desired margin of error.

Ethical Considerations

• Ethical considerations play a vital role in nursing research.
• This component addresses the protection and well-being of participants, safeguarding their privacy and confidentiality, and the potential risks and benefits associated with the study.
• Ethical considerations also involve obtaining informed consent from participants and ensuring compliance with institutional review boards or ethical committees.

Nursing Research Proposal Outline

List of Nursing research proposal topics

• Racial and ethnic disparities in nursing care
• The impact of technology on nursing care
• Prevalence and determinants of burnout in nurses
• Quality of life for people with chronic illnesses served by nurses
• Effectiveness of nurse-led interventions for short-term weight loss in adults
• Nursing home adjusted Living Experience Surveys: measuring resident satisfaction and quality of life
• Identification and characterization of health disparities among LGBT elders in long-term care facilities
• Role of nurses in the early detection and management of cancer diagnosis
• Effects of delegation on nurse burnout, patient safety, and coordination of care
• The use of technology in home health care: a study of patient and nurse perspectives11. The impact of nurse staffing on patient safety
• Effectiveness of Nurse-led interventions for promoting healthy physical Activity in hospitalized patients.
• The role of nurses in the development and implementation of evidence-based pain management guidelines
• Effectiveness of patient-centred communication interventions to reduce bed sores in nursing home residents
• Identification and characterization of best practices for providing hospice care
• Nurse-led stress reduction interventions for long-term care staff
• Nurses’ perceptions of work-life balance: a qualitative study
• Development and  evaluation of a web-based tool to support caregiver adherence to oral health care  guidelines among long-term care residents
• Effects of sleep deprivation on nurses’ cognitive performance, satisfaction with work, and daytime sleepiness
• A study exploring the  association between nurse  staffing levels and rates of infection in a university hospital setting
• A qualitative study exploring how  nurses manage  transitions from inpatient to outpatient settings
• The use of  social media by nurses in an acute hospital  setting
• Nurses’ experiences with burnout: a cross-sectional study
• Nurse preparedness for pandemic influenza: an examination of the role of  professional development
• The use of telehealth in long-term  care settings:  a study of nurses’ experiences
• Nurses’ experiences with  chronic pain:  a qualitative study
• The impact of the Affordable Care Act on the workforce and nursing
• Nursing care plans  for patients with dementia: a systematic review
• Implementation of evidence-based interventions for preventing  falls in older adults  living in long-term care facilities
• Nurse staffing and  quality of patient care:  a cross-sectional study
• Use of  social media  by nurses during preoperative assessment
• Nurses’ perceptions of resident safety in an acute hospital setting: a qualitative study
• The effects of nurse staffing on patient satisfaction and outcomes in an acute hospital setting
• A comparative study investigating the use of videoconferencing  among nurses  in different specialties
• A qualitative study exploring how  nurse educators use technology to engage students in online learning  environments
• Examining the effect on patient safety when using electronic health records to order medications on off-hours
• Nurse staffing, work demands, and burnout in neonatal intensive care units 38. Factors that predict nurses’ decision to leave their jobs
• Effects of nurse-led interventions to improve care for  veterans with chronic pain
• The use of wearable technology in hospitals: a systematic review
• Review and assessment of technologies used to support nurses during surgery
• Nursing care plans  for patients with cancer: a systematic review
• Nurse-led interventions to prevent falls in older adults living in  long-term care facilities:  a systematic review
• The use of electronic health records to  inform clinical  decision making: a systematic review
• Implementation of evidence-based interventions to  improve patient  safety in hospitals
• A qualitative study exploring how nurses use technology in the workplace
• Factors influencing  nurse satisfaction  with their work and workplace culture
• Identification and assessment of best practices for preoperative  patient communication in the surgical setting
• Effectiveness of nurse-led stress reduction interventions on nurses’ burnout
• Nurse staffing, workload, and burnout in intensive care units: a cross-sectional study
• There are many other nursing research proposal  topics that can be explored in order to improve patient care .

Some additional potential nursing research proposal topics include:

• Assessing the effectiveness of nurse-led interventions for reducing readmissions among hospitalized patients
• Evaluating the impact of nurse call patterns on patient safety
• Analyzing the influence of nurse staffing levels on patient outcomes
• Determining the best methods for measuring patient satisfaction with nurse care
• Studying the  factors influencing  nurse decision making
• Investigating the feasibility and  effectiveness of using remote patient monitoring technology to improve patient care

DNP Research proposal topics

There are countless  nursing research  proposal topics that could be explored in a doctoral or post-doctoral program. Below is a list of some DNP Research proposal topics consider:

• Investigating the feasibility and effectiveness of using remote patient monitoring technology to improve patient care
• The effect of sleep deprivation on nurses
• The use of technology in nursing care
• Investigating the relationship between patient satisfaction and nurse retention
• Studying nutrition-related issues in the context of nursing
• Assessing the impact  of patient satisfaction on nurse recruitment and retention
• The relationship between patient satisfaction and nurse retention
• Investigating the feasibility of using remote patient monitoring technology in healthcare settings
• Evaluating the impact of patient satisfaction on nurse retention
• Research the best methods for measuring patient satisfaction with nurse care
• Studying the feasibility of using remote patient monitoring technology in healthcare settings

Check out the additional DNP Research proposal topics as suggested by a Nursing Instructor

• Nursing research  on dementia care
• Nursing research on neonatal intensive care unit (NICU) management
• Nursing research on palliative care
• Nursing research on wound healing and reconstruction 5.  Nursing research on pediatric health  nursing
• Nursing research on geriatric care
• Nursing research on pharmacology for nursing
• Nursing research on infection control in the acute care setting
• Nursing research on nutrition for nursing
• The  Effect of Health Education on Patient Outcomes
• Development and Evaluation of Nursing Intervention  Programs
• Assessment of Patient Satisfaction with  Nursing Services
• Advocating for  Improved Patient-Nurse Communication
• Assessing the Effectiveness of Interventions to Address Nurses’ Burnout
• Investigating the Relationship between Nurse workload and Patient outcomes7. Evaluating the Impact of Technology on Nursing Care
• Investigating the Relationship between Professionalism and Patient Outcomes
• Studying Nutrition-Related Issues in the Context of Nursing
• Evaluating Patient-Nurse Interactions in the Context of Home Health Services

The list of DNP Research proposal topics above should guide you in creating a Research proposal.

Current Nursing research proposal topics

Nursing research proposal topics  can vary greatly, depending on the type of research you’re looking to conduct. Some common topics include:

• The effects of sleep deprivation on nurses
• The effect of patient communication skills on nurses’ outcomes
• How to improve patient safety in nursing care
• How to reduce readmissions among hospitalized patients
• Study the feasibility of using remote patient monitoring technology in healthcare settings
• Evaluate the impact of patient satisfaction on nurse recruitment and retention
• Evaluate the impact of nurse staffing levels on patient outcomes
• Research the feasibility of using remote patient monitoring technology in healthcare  settings
• Research the impact of patient satisfaction on nurse recruitment and retention
• Opioid use in the elderly
• Preterm birth and neonatal care
• Mobile health technology in nursing
• Nursing home  quality improvement
• The impact of social media on nursing

Nursing research proposal topics can vary greatly, so it’s important to select a  topic that is of interest to you and that will help you to improve patient care .

Nursing research proposal writing tips

When  preparing your nursing  research proposal, it’s important to keep the following tips in mind:

• Be organized

Planning and organizing your data will make your research proposal more concise and easier to read. Start by identifying the specific question you want to answer, and then list all the relevant sources that you consulted in order to reach your conclusions. Use headings and subheadings to help organize your information , and be sure to include detailed citations for all sources used.

• Use effective writing techniques

To produce a well-written research proposal, use effective writing techniques such as strong thesis statements , clear language, and well-organized data. You should also make use of persuasive arguments, vivid descriptions, and concrete  examples in order to make your case for the proposed study .

• Include references

In order for your nursing research proposal to be accepted, it  must include references  from reliable sources that support your findings. Always cite the source where you obtained the data presented in your proposal, as well as any other sourcesthat you used in order to support your arguments.

• Make sure your proposal is properly formatted

Your nursing research proposal should be properly formatted and error-free in order to be accepted for review. Always use the correct style and grammar when writing, and make sure all data is properly referenced. avoid using excessive jargon or acronyms, and try to keep your presentation as concise as possible.

• Submit your proposal well in advance of the deadline

The sooner you submit your proposal, the better chance you have of being accepted for review. Make sure to follow the submission guidelines outlined by the journal you are submitting to, as well as the submission system specific to that journal .

Nursing Research Proposal Examples

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In this article, we will provide you with some  ideas for nursing research proposal topics  that can be used in any discipline. Whether you are interested in studying public  health issues or improving patient care  through innovative research methods, there is likely something on this list that appeals to you. So get started on your Nursing Research Proposal now by  placing an order  with us.

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Examples of Research Questions

Phd in nursing science program, examples of broad clinical research questions include:.

• Does the administration of pain medication at time of surgical incision reduce the need for pain medication twenty-four hours after surgery?
• What maternal factors are associated with obesity in toddlers?
• What elements of a peer support intervention prevent suicide in high school females?
• What is the most accurate and comprehensive way to determine men’s experience of physical assault?
• Is yoga as effective as traditional physical therapy in reducing lymphedema in patients who have had head and neck cancer treatment?
• In the third stage of labor, what is the effect of cord cutting within the first three minutes on placenta separation?
• Do teenagers with Type 1 diabetes who receive phone tweet reminders maintain lower blood sugars than those who do not?
• Do the elderly diagnosed with dementia experience pain?
•  How can siblings’ risk of depression be predicted after the death of a child?
•  How can cachexia be prevented in cancer patients receiving aggressive protocols involving radiation and chemotherapy?

Examples of some general health services research questions are:

• Does the organization of renal transplant nurse coordinators’ responsibilities influence live donor rates?
• What activities of nurse managers are associated with nurse turnover?  30 day readmission rates?
• What effect does the Nurse Faculty Loan program have on the nurse researcher workforce?  What effect would a 20% decrease in funds have?
• How do psychiatric hospital unit designs influence the incidence of patients’ aggression?
• What are Native American patient preferences regarding the timing, location and costs for weight management counseling and how will meeting these preferences influence participation?
•  What predicts registered nurse retention in the US Army?
• How, if at all, are the timing and location of suicide prevention appointments linked to veterans‘ suicide rates?
• What predicts the sustainability of quality improvement programs in operating rooms?
• Do integrated computerized nursing records across points of care improve patient outcomes?
• How many nurse practitioners will the US need in 2020?

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