Research, Evidence-Based Practice, and Informatics
This domain tests appraisal and use of evidence, research designs, ethics and safe use of health information systems.
Core rules and concepts
- PICO: population, intervention, comparison and outcome; use it to turn a clinical problem into an answerable question.
- Evidence hierarchy: systematic reviews and meta-analyses rank above randomised controlled trials, then cohort studies, case-control studies, case series and expert opinion.
- Validity and reliability: validity is whether a tool measures what it should; reliability is consistency and repeatability.
- Bias reduction: randomisation, allocation concealment, blinding and intention-to-treat analysis.
- Research ethics: voluntary informed consent, no coercion, right to withdraw, confidentiality and ethics committee approval.
- EBP steps: ask, acquire, appraise, apply and audit.
- Informatics: use least-privilege access, strong unique passwords, audit trails and de-identification; standard terminologies include SNOMED CT, ICD and NANDA-I.
Worked example
A nurse asks whether alternating pressure mattresses reduce pressure injuries compared with standard mattresses in immobile adults. PICO becomes: P immobile hospitalised adults, I alternating pressure mattress, C standard mattress, O pressure injury incidence. A systematic review or randomised trial is then searched before a case report, and the evidence is appraised for validity and applicability.
Traps that cost marks
- Confusing reliability with validity.
- Treating expert opinion as the strongest evidence.
- Sharing passwords or accessing records without a clinical reason.
- Assuming consent is valid when a patient feels coerced.