Abstract
ObjectiveIn educating students in the health professions about evidence-based practice, instructors and librarians typically use the patient, intervention, comparison, outcome (PICO) framework for asking clinical questions. A recent study proposed an alternative framework for the rehabilitation professions. The present study investigated the effectiveness of teaching the alternative framework in an educational setting.MethodsA randomized controlled trial was conducted with students in occupational therapy (OT) and physical therapy (PT) to determine if the alternative framework for asking clinical questions was effective for identifying information needs and searching the literature. Participants were randomly allocated to a control or experimental group to receive ninety minutes of information literacy instruction from a librarian about formulating clinical questions and searching the literature using MEDLINE. The control group received instruction that included the PICO question framework, and the experimental group received instruction that included the alternative framework.ResultsThere were no significant differences in search performance or search skills (strategy and clinical question formulation) between the two groups. Both the control and experimental groups demonstrated a modest but significant increase in information literacy self-efficacy after the instruction; however, there was no difference between the two groups.ConclusionWhen taught in an information literacy session, the new, alternative framework is as effective as PICO when assessing OT and PT students’ searching skills. Librarian-led workshops using either question formulation framework led to an increase in information literacy self-efficacy post-instruction.
Highlights
In educating students in the health professions about evidence-based practice, instructors and librarians typically use the patient, intervention, comparison, outcome (PICO) framework for asking and classifying clinical questions
Out of a possible 151 eligible occupational therapy (OT) and physical therapy (PT) students, 103 consented to participate in the study, but several were lost due to withdrawal, drop-out, and failure to follow-up, leaving 64 with data
Our finding that the alternative framework was as effective as PICO in teaching OT and PT students how to search for evidence to answer their clinical questions reinforces results of prior research, which do not demonstrate clear improvements in search skills when teaching specific types of clinical question frameworks over others [3,4,5,6]
Summary
In educating students in the health professions about evidence-based practice, instructors and librarians typically use the patient, intervention, comparison, outcome (PICO) framework for asking and classifying clinical questions. This framework, first proposed by Richardson and colleagues [1] along with the categories of therapy, diagnosis, prognosis, and harm/etiology proposed by Sackett and colleagues [2], has been taught to students in jmla.mlanet.org. Though students in the health professions are commonly taught the PICO framework, research to date has been unable to consistently demonstrate that this improves clinical question quality [3], search skills, or search results [4,5,6]. A study by Booth and colleagues demonstrated that a structured search form provided to librarians led to more detailed questions and precise searches, the librarians expressed a preference for a lessstructured approach [8]
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