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Nursing Programs

Why Use a Framework?

Frameworks can help:

  • focus the question, protocol/project/scope and search strategy,
  • identify inclusion/exclusion and data extraction element and clarify the theoretical framework and
  • provide clarity for reviewers, readers/funders.

Critical appraisal is the systematic evaluation of clinical research papers to see if they address a clearly focused question, use a valid methodology, and have important results applicable to the researcher's question.  

Adapted from CEBM: The Centre for Evidence-Based Medicine


PICOT is useful for Clinical Questions about therapies and outcomes, often with a comparison.

Sample Topic:

Find evidence based medicine on alternatives to narcotic medicating for the elderly within home settings.

  • = elderly in home, senior, geriatric, home care  
  • I = cognitive behavior therapy (CBT)
  • C = no opiates/narcotics
  • O = lessened anxiety and associated behaviors (eg. over-eating, alcohol consumption)
  • T = within 3 months

Adapted from CHLA 2021 Conference presentation


Research questions framed using the SPIDER tool tend to begin with "What are the experiences of ...?"

  • Best for qualitative research questions that measure attitudes and experiences rather than clinical interventions and outcomes.
  • Focused more on the design of the study and less on the subjects (people or groups).

Taken from: Cooke, C., Smith, A., Booth, A. Beyond PICO: The SPIDER Tool for Qualitative Evidence Synthesis. Qualitative Heath Research. 2012 vol 22(10) :1435–1435.

Sample Topic:

What are the experiences of doctoral nursing students in using their library?

  • S = Doctoral students
  • PI = Library use
  • D = Survey
  • E = Experiences (of using the library)
  • R = Qualitative
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