Formulation of a PICO question and online defence of that question. Is the NHS Otoacoustic emission hearing screening (I) for newborn babies (p), more accurate in diagnosing hearing loss(o), compared with the Health visitor distraction test(c).
The assignment aim is to formulate a PICO question, discuss and demonstrate the skills, in formulating evidence based practice (EBP) questions, using the PICO framework and defence of that question. The question above was formulated by the student utilising the PICO framework by (Sackett et al. 1997), which focused my enquiries, PICO is a mnemonic used to describe the four elements of a good clinical foreground question P for population, I for Intervention C for comparison, and O for outcome, as devised by (Sackett et al. 1997). According to Sackett et al. (1997) the process of enquiry occurring within practice, stimulates questioning and these enquiries can be posed as (EBP) questions.
The inspiration for the (EBP) question was, based on practice experience, when clients asked how effective the Otoacoustic emissions test (OAE) method recommended by (United Kingdom. National Screening Committee, 2006) (UK NSC 2006), and how it compared with the, Health visitors distraction test (HVDT) (Great Britain. National Health Service patient choices, 2011). I became aware of a gap in my knowledge (Lai, 2009) proposes the ability to recognise issues in practice settings and translate into explicit questions to fill knowledge gaps, is crucial to undergraduate and practice development, likewise Horsley, O’Neill and Campbell (2009) believe if a practitioner is ill-equipped, to give evidence based responses, to questions arising in practice setting from clients, reliable research exploration, is required to establish evidence based answers. consequently formulation of the(EBP) question, was essential to begin the search for answers, nevertheless decisions needed to be made, on types of information required, to assist in formulating the question, Mckibbon and Marks (2001) recommend the use of two types of questions, background and foreground, the background questions are who? What? When? Etc enabling discovery surrounding client groups or problems, which was used as a primary search to begin question formulation, unfortunately this produced a hefty amount of information, because of the implicit nature of the question, but assisted when compiling the explicit (EBP) PICO question.
Mckibbon and Marks (2001) foreground or secondary stage ask more explicit questions, Sackett et al. (1997) designed PICO as a framework to ask foreground questions, which was utilised when developing my (EBP) question, population focused to newborn babies, intervention was OAE hearing screen and comparison the HVDT, the outcome was to measure the effectiveness of the comparatives. It is now apparent, how essential it is to begin the research journey, with a defined appropriate question, that facilitates a knowledge search as suggested by (Offredy and Vickers 2010), the formed PICO (EBP) question on (CINAHL) (MEDLINE), yielded precise appropriate search results, showing why a defined question is essential to expose appropriate answers to question, therefore defending the need for the question, the (EBP)question demonstrated a clear conclusion, consequently showing the (EBP) question was well formulated using PICO Horsley, O’Neill and Campbell (2009). The conclusion showed OAE testing was superior to HVDT on detecting hearing loss, as detection occurs much earlier, so the optimum support available can be offered, as recommended in the healthy child programme (Great Britain. Department of Health, 2010).

References
Great Britain. Department of Health (2010) Healthy child programme: Pregnancy and the first five years of life [Online]. Available at: http://www.dh.gov.uk/prod _consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_118525 (Accessed: 14th October 2011).

Great Britain. National Health Service (2011) Hearing tests how they are done. [Online]. Available at: http://www.nhs.uk/Conditions/Hearing-tests/Pages/How%20it%20is%20performed.aspx (Accessed 15th October 2011).

Horsley, T., O’Neill, J. and Campbell, C. (2009) ‘The quality of questions and use of resources in self directed learning: personal learning projects in the maintenance of certification’, Journal of Continuing Education in the Health Professions, 29(2), pp. 91-97.

Lai, N.M. (2009) ‘Dissecting Students bedside clinical questions using the PICO framework’, Medical Education, 43, pp471-499.

McKibbon, K.A. and Marks, S. (2001) Posing clinical questions framing the question for scientific enquiry. AACN clinical issues: Advanced Practice in Acute and Critical Care, 12(4), pp. 477-481.

Offredy, M. And Vickers, P. (2010) developing a healthcare proposal, an interactive student guide. United Kingdom: Wiley Blackwell.

Sackett, D.L., Richardson, W.S., Rosenberg, W. and Haynes, R.B. (1997) Evidence based medicine. How to practice and teach EBM. Edinburgh: Churchill Livingstone.

United Kingdom. National Screening Committee (2006). NHS Newborn Hearing Screening [Online]. Available at: http://www.screening.nhs.uk/cms.php?folder=2495 (Accessed: 14 October 2011).