UPDATED: July 28, 2025. Original Post: November 8, 2017
Developing a clear question is an important first step when researching information to guide your work and/or decision-making, and when preparing for a potential research project. In health care, practitioners and researchers are faced with complex questions which make starting the research process a daunting task. A well-built question is clear, focused, and summarizes the issue to be investigated. Determining the type of question will help you select the best resource to consult for your answer.
Background vs. Foreground Questions
Background questions are used to gather general information, typically asking the 5Ws: Who? What? When? Where? Why? To answer these questions, start with general resources, such as overview textbooks, summaries, medical directories, etc.
Example: Looking for general information on diabetes care? Search for resources using Library Services' Discover search. Use the filters on the left-hand side of the page to retrieve results for books to find general information on the disease and its presentation.
Other helpful resources for answering background questions include Library Services’ Subject Guides, which contain best bets on library resources for specific topics in healthcare research. Need resources that inform patient care? Our collection of Clinical Practice Supports highlights information and tools for clinical staff.
Building Foreground Questions
Foreground questions are specific and complex. They often consider multiple factors to guide decision making and/or inform further research.
Example: In women with migraine and aura, how does use of combination birth control pills affect risk of stroke compared to progestin-only birth control?
Clearly articulating a foreground question and identifying key components can be challenging. Using the PICO(T) model can help you identify your key concepts and build your question before examining the literature.
PICO Example:
| Patient or Problem: | Women with migraine or aura |
| Intervention: | Progestin-only birth control pills |
| Comparison: | Combination birth control pills |
| Outcome: | Risk of Stroke |
| Time Period: | Optional |
This Evidence Based Practice module from Dalhousie University's Kellogg Library takes you through the steps of creating an answerable clinical question using PICO.
Structuring your Search
Using PICO to develop your question will help you identify key search concepts. Tools like a search planning grid can help you plan and organize your PICO criteria into search terms. Once identified, additional terms can be derived from synonyms and related concepts to expand your search results.
Once you have determined the key terms for your search, you will be able to search databases and search engines by combining your terms using Boolean operators (AND, OR, NOT).
Still have Questions?
Visit Library Services’ Searching guide for more tips and assistance. Book a one-on-one consultation with a Librarian Educator to discuss building effective research questions or request a custom education session on the topic. Want to get started on searching? Try out your question-building skills by submitting a literature search request. We bet your results will be more relevant!
Happy searching!
Selena MacDonald
Librarian Educator
Nova Scotia Hospital, Central Zone
Open Access: The article is free to access for everyone. You can click Open Access (2) to view the article, or click the article’s title to go to the article’s library record. From there, you can view more information about the article, as well as options for accessing the full-text.
Check for full text: We may not currently have access to the article. In that case, request a copy using the Document Delivery form attached to the article’s library record. Click the article’s title or Check for full text (3), then scroll down to complete the form.
“Add to Presentation” icon (12) for any image. You can then create a new presentation folder or add the image to an existing folder.
Both Zotero and Covidence can store, manage, and deduplicate citations. However, they differ significantly in their application and scope.
What is Zotero?
Zotero is a free citation management software that includes a desktop application and a browser extension.
What you can do with Zotero:
Learn more about accessing and using Zotero:
TIP: You can use Google to search within the Zotero blog and forum by adding site: forums.zotero.org/discussions or site: zotero.org/blog/ after your Google search query. This limits your search to only those sites. For example, to learn how to add full-text PDFs to your saved citations, search full text pdf site:zotero.org/blog/.
What is Covidence?
Covidence is a web-based software that lets members of a research team collaborate through the various stages of a knowledge synthesis project (such as a systematic review). Nova Scotia Health has an institutional license to Covidence, which means Covidence is now free to use for Nova Scotia Health staff!
What you can do with Covidence:
Learn more about accessing and using Covidence:
What’s the difference?
Zotero is great for organizing literature sources, creating reference lists, and assisting with in-text citation. You will likely find Zotero more useful for everyday research needs.
Covidence is best for conducting knowledge synthesis projects with a team that will lead to a published review article. Outside of scholarly publications, Covidence could also be used by a team to screen through a large amount of potentially relevant literature to find those that are most relevant to your specific needs.
Both tools have distinct features that make them suitable for different purposes. The table below lists the different strengths of each tool, depending on your project needs:
Interested in learning more about knowledge synthesis? Check out our Knowledge Synthesis and Covidence subject guide!
Reach out to LitSearch@nshealth.ca with your questions.
Kendell Fitzgerald
Librarian Educator
Halifax Infirmary, Central Zone
Vinson Li
Librarian Educator
Yarmouth Regional Hospital, Western Zone