Welcome to SMIRK Unit
2 - Practice-based
questions


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SMIRK - Developing a practice based question by Jamie Frankis, Lesley Price, Ima Jackson SHLS modified by Marion Kelt, Glasgow Caledonian University is licensed under a Creative Commons Attribution 4.0 International License.

Why develop a question?

Sometimes you will be asked to develop your own question, either on your own or working in a group. These pages will help you to:

If you understand the components of a practice-based question, you will recognise how researchers focus these even further into investigative questions that form the starting point of a research study. Categorising questions and focusing them clearly will lead you to the right types of study to fill your knowledge gap. 

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Key steps to evidence based practice

 

key    

Step 5
Evaluate and reflect

 

Step 4
Implement the evidence

 
   

Step 3
Critically appraise the evidence

   
 

Step 2
Find the evidence

     

Step 1
Review the practice and ask the question

   

Key Steps to Evidence-based practice (CASP, 2002)

Here are the five steps to evidence based practice.  These are taken from the Critical Appraisal Skills Programme funded by the NHS. We will be concentrating on step 1, particularly on how to develop an appropriate focused question and pointing you in the direction of sources of evidence to match your question. 

In step 2, the sort of evidence we want you to find as part of this module is primary research evidence.  You are looking for this to build up a literature review which in turn is presented as a critically appraised body of evidence to examine your question.  In other words, did you find strong, good evidence in the form of six primary pieces of research, to answer your practice based question or is additional or better quality research required?

Step 3, the appraisal process - SHLS use the appraisal framework in the ‘Blue Book’, Accessing and Assessing Research for Evidence-based Practice’). Stages 4 and 5 are up to you in practice! 

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Step 1

The first step in the CASP framework is to review practice and identify a topic where there is a uncertainty about the evidence base for this practice. Normally in practice the topic would be obvious but for project work, the group needs to find an area of practice that you are all interested in and one in which obtaining some research evidence could enhance your practice. This is the first task of your group.

Examples of topic areas:

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Why focus a question?

Once you have decided on a topic you then need to focus it into an answerable question as vague, unfocused questions lead to wide, unfocused searches. These give articles that don’t really apply to your patient or client group.

If you ask the wrong question, you may miss out on relevant data in the literature because you have not searched efficiently for it.

Focused questions enable easier retrieval of appropriate evidence. In other words it is about being effective (finding the information you want) and efficient (finding it as quickly as possible).

So, in short, the key reasons for focusing your question are that it:

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Craig, J.V., Smyth, R.L. 2012, The evidence-based practice manual for nurses, 3rd edn, Churchill Livingstone Elsevier, Edinburgh ; New York. 610.73 EVI

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SMIRK - Developing a practice based question by Jamie Frankis, Lesley Price, Ima Jackson SHLS modified by Marion Kelt, Glasgow Caledonian University is licensed under a Creative Commons Attribution 4.0 International License.

Focusing your question

These three examples show how you can move from an unfocused to a very focused question.
Remember that an advantage of being very focused is that it saves time when searching as it ensures that only relevant research is obtained.
The disadvantage is that, if insufficient evidence exists, you’ll need to widen your search a bit. It is better to start with a focused search, then widen it out, rather than the other way round.
If you need a less focused question, it is also important to consider how to widen the question out – for example, are you more interested in Scottish women or the fact that they’re under 30?

So - on to focus a practice based question:

The next section will describe PICO and SPICE in detail.

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SMIRK - Developing a practice based question by Jamie Frankis, Lesley Price, Ima Jackson SHLS modified by Marion Kelt, Glasgow Caledonian University is licensed under a Creative Commons Attribution 4.0 International License.