Role of the Advanced Nurse: Evidence Evaluation Table & PICOT Narrative
Two nursing studies. One evaluation table. One page of narrative. Five things the rubric is actually checking. This guide walks through how to pick the strongest external evidence, assign Melnyk levels correctly, complete every column of the evaluation table template, and write a one-page analysis that connects both studies back to your PICOT intervention — without losing marks on the details that trip most students up.
The two deliverables here — an evaluation table and a one-page narrative — sound straightforward until you’re staring at a blank template wondering what “two of the strongest external studies” actually means. Strong isn’t a feeling. It has a definition: highest on the Melnyk hierarchy of evidence, most directly relevant to your specific PICOT intervention, from nursing literature. This guide breaks down exactly what to do at each step.
What This Guide Covers
Submission Requirements at a Glance
There’s more to submit here than just a paper. Read this list carefully before you start — students who miss a component lose marks they can’t get back after submission.
Complete Assignment Checklist
Selecting the Two Strongest Studies
“Strongest” is defined by the Melnyk hierarchy — not by how much you liked the article or how easy it was to read. The process is: search your PICOT intervention in nursing databases, screen for relevance, then rank what you find by evidence level and select the top two from nursing literature.
Four Things Must Be True About Each Study
A study qualifies as one of your two strongest if it: (1) addresses the specific intervention from your PICOT question, (2) comes from nursing — not a medical journal — per the assignment instruction, (3) is at the highest available Melnyk evidence level for your topic, and (4) is peer-reviewed and published within an appropriate timeframe (most programs consider within five years current, though seminal studies are sometimes exceptions).
Starting your search: CINAHL is the primary nursing database — start there. Search using your PICOT population, intervention, and outcome terms. Filter by peer-reviewed and by nursing journals. If your search produces no Level I or II studies directly on the intervention, widen the search terms before downgrading the evidence level you’ll accept.Best Databases for Nursing Studies
- CINAHL — primary database for nursing and allied health literature; filter by “nursing journals” if needed
- PubMed/MEDLINE — use MeSH terms; filter by nursing journals to stay within discipline
- Cochrane Library — best source for systematic reviews and meta-analyses (Level I); check if reviews include nursing interventions
- Joanna Briggs Institute (JBI) — nursing-specific systematic reviews and clinical evidence summaries
- ProQuest Nursing & Allied Health — broad nursing database with full-text access
Nursing vs. Medicine — Why It Matters
The assignment is explicit: studies must be within nursing, not medicine. In practice, this means the study should be published in a nursing journal, involve nursing-led or nursing-relevant interventions, and frame the practice question from a nursing perspective. A randomised controlled trial published in the New England Journal of Medicine does not qualify, even if it covers the same intervention. A systematic review in the Journal of Advanced Nursing or Worldviews on Evidence-Based Nursing does.
Every selection decision flows from your Week 1 PICOT question. The population, intervention, and outcome in your PICOT define what “directly related to the chosen intervention” means. A study on a different patient population, even with the same intervention, is not a strong match. Before selecting a study, check each element of your PICOT against what the study actually tested. If the population is different, the setting is different, or the outcome measured doesn’t match your PICOT outcome — that’s a limitation to note in your table, not a reason to exclude it, but only if it’s still the strongest available.
Understanding and Applying the Melnyk Evidence Level Rating
Page 21 of Melnyk and Fineout-Overholt (5th edition) is the reference the assignment specifies. The rating uses a seven-level hierarchy. Higher levels mean more methodological rigour and less bias risk. The level goes on the evaluation table — and your study selection should start by identifying the highest level available for your PICOT topic.
| Level | Study Type | When You’ll Find These |
|---|---|---|
| Level I | Systematic reviews or meta-analyses of randomised controlled trials | Cochrane Library, JBI, CINAHL systematic review filter — the strongest evidence; find these first |
| Level II | Well-designed randomised controlled trials (RCTs) | Nursing journals with clinical trials; look for CONSORT reporting standards |
| Level III | Controlled trials without randomisation | Quasi-experimental designs; common in nursing research where randomisation is not feasible |
| Level IV | Single descriptive or qualitative studies | Descriptive research, cohort studies, case-control studies |
| Level V | Systematic reviews of descriptive and qualitative studies | Meta-synthesis of qualitative nursing research |
| Level VI | Single descriptive or qualitative studies | Individual qualitative studies, survey research |
| Level VII | Expert opinion or consensus | Clinical practice guidelines, expert panels, opinion papers — use only if no higher-level evidence exists |
Look at the Study Design, Not the Journal or Author
The evidence level is determined by the study’s methodology — specifically its design and how participants were allocated to groups (if applicable). A well-known author publishing in a top-tier journal doesn’t make a qualitative case study Level I evidence. Read the methods section. Look for how the study was designed, whether randomisation occurred, whether there was a control group, and whether it synthesises multiple studies or reports on one. Then match that design to the Melnyk hierarchy and assign the level on your table.
Tip: If you’re unsure whether a study is Level II or III, look for the words “randomised” or “randomization” in the methods section. If participants were randomly assigned to intervention and control conditions, it’s a RCT (Level II). If the allocation wasn’t random — even if there was a control group — it’s Level III.Completing the Evaluation Table
The template is in the Week 3 module. Use it — don’t create your own format. The detailed samples on pages 119–145 and the narrative guide on pages 256–258 of Melnyk (5th edition) show exactly what goes in each column. Read those pages before you fill anything in. What follows is what to watch for in each section.
Bullet Points Only — No Full Sentences in the Table
The assignment instruction is explicit: information in the evaluation table should be in bulleted format, not sentences. This matters in every column — citation, purpose, design, sample, findings, limitations, level. A common mistake is writing narrative paragraphs inside the table cells. Short bullets. Keywords and values. Numbers where available. Save the sentence-level analysis for the one-page narrative.
Also required: A legend on the table. The legend defines abbreviations used in the table (e.g., RCT = randomised controlled trial, N = sample size, EBP = evidence-based practice). Place it at the bottom of the evaluation table, inside the appendix.Full APA 7th Reference
The full APA 7th edition reference for the study. This is also what appears in your reference list. Check the DOI is included — nursing databases provide them.
What Question Did It Ask?
The study’s stated purpose or research question, in a few bullet points. Pull directly from the abstract or introduction. Should clearly relate to your PICOT intervention.
Methodology Type
The study design: RCT, quasi-experimental, systematic review, descriptive, qualitative, etc. This is what you use to assign the Melnyk level. One or two words is enough.
Who, How Many, Where
Sample size (N=), patient population characteristics relevant to your PICOT, and the clinical setting. Note any inclusion/exclusion criteria that affect applicability to your population.
How Was Evidence Gathered?
Measurement tools, instruments, observation methods, or data sources used. Include validity and reliability data if the study reports it — this goes to quality, not just design.
What Did the Study Conclude?
Key results relevant to your PICOT intervention and outcome. Include statistics (p-values, effect sizes, confidence intervals) where the study reports them. These feed directly into your narrative analysis.
What Reduced the Study’s Strength?
Study-reported limitations and any you identify — small sample size, single site, lack of blinding, short follow-up period. Limitations affect how confidently the findings can be applied to practice.
Melnyk Level I–VII
The assigned level based on the Melnyk hierarchy (p. 21, 5th ed.). State the level and the study design that justifies it. For example: “Level II — RCT with randomisation and control group.”
This isn’t optional. The assignment instruction references these specific pages of Melnyk for a reason — they contain worked examples of how each column should be completed. The difference between a full-marks table and a partially complete one is usually that the student didn’t look at the sample entries. The template column headers won’t tell you how much detail to include in each cell. The sample entries will.
Writing the One-Page Narrative
One page is not a lot of space. That’s the point. The narrative should be tight — every sentence advances the analysis. The structure is fixed by the assignment: brief introduction, purpose statement, analysis of how the evidence supports the PICOT intervention, and a conclusion. Four distinct pieces in one page.
Brief Introduction — One to Two Sentences
Set the clinical context. Name the healthcare problem and why it matters. Don’t pad this. One or two sentences to orient the reader to the topic before the purpose statement. Third person throughout — no “I” or “we.”
Purpose Statement — One Sentence
State what this paper does: “The purpose of this paper is to evaluate the external evidence from two nursing studies to determine whether the evidence supports the intervention identified in the PICOT question.” Adapt to your specific PICOT. The purpose statement is not the PICOT question — it describes what the paper is doing with the evidence.
Analysis — The Core of the Narrative (Half a Page)
This is where you connect both studies’ findings back to your PICOT intervention. For each study: what did it find, how does that finding support (or fail to support) the intervention, and what is the strength of that evidence given the level you assigned? If both studies support the intervention, state that clearly with the evidence. If the evidence does not support the intervention, the assignment requires you to explain the next step in the EBP process — don’t skip this if it applies.
Conclusion — Two to Three Sentences
Summarise whether the two studies collectively support the intervention. State what the evidence suggests for practice. Don’t introduce new claims here — the conclusion restates the evaluative finding from the analysis in tighter language.
The Assignment Has a Specific Instruction for This
If neither study supports the PICOT intervention — or if the evidence is mixed or weak — the assignment says to describe what the next step in the EBP process would be. That’s not a failure of the assignment; it’s a realistic EBP scenario. The next step might be conducting a more thorough search for higher-level evidence, revising the PICOT question, considering a different intervention, or moving toward a pilot study. Name the step specifically and explain why it follows from the evidence gap.
Don’t force a conclusion: If the evidence doesn’t clearly support the intervention, say so. Acknowledging weak or mixed evidence and responding with the appropriate EBP next step shows clinical reasoning — which is what the rubric is testing.The assignment instruction lists every prohibited first-person form: I, we, you, me, our. It also prohibits referring to yourself as “the researcher” or “the author.” This is a common workaround students try — it doesn’t satisfy the requirement and the grader will catch it. Write about the evidence, the studies, and the intervention. If a sentence requires a subject, use “the evidence,” “the studies,” “the findings,” or a passive construction. Read the final draft and search for every instance of “I,” “we,” “you,” and “author” before submitting.
Full Paper Structure
The paper has more components than just the narrative. Here’s everything that goes in, in order.
Document Order
- Title page — APA 7th student format
- One-page narrative body — intro, purpose, analysis, conclusion; Level 1 APA headings
- Reference page — APA 7th; both studies cited here in full
- Appendix — completed evaluation table with legend
- Separate files: PDFs of both studies submitted alongside
Level 1 Headings in the Narrative
APA Level 1 headings are centred, bold, and title case. For a one-page paper, keep heading use minimal but consistent with the assignment instruction. Suggested headings: Introduction, Analysis of Evidence, Conclusion. The purpose statement goes at the end of the introduction paragraph — it doesn’t need its own heading. Check your course template if one is provided, as programs sometimes specify exact heading titles.
The assignment explicitly requires submitting copies of both selected studies as PDFs alongside the paper. This is a submission requirement, not optional. Most students upload the paper and forget the PDFs entirely. If you retrieved the articles through a library database, download the full-text PDF directly. Make sure the PDFs are the full articles — not just the abstract pages.
APA 7th Edition Tips for This Paper
APA 7th Appendix Rules
Label as “Appendix A” (or “Appendix” if there’s only one). Centre the label at the top, bold. Give it a title on the next line (also centred and bold). The table follows below. One appendix per table.
Reference the Appendix in Text
The appendix must be referenced in the narrative body: “(see Appendix A)” at the relevant point in the analysis section. APA 7th requires this — an appendix that isn’t referenced in the text is technically not properly formatted.
APA 7th Reference Entry
Author, A. A., & Author, B. B. (Year). Title of article. Journal Name, Volume(Issue), pages. https://doi.org/xxxxx — Include the DOI. If no DOI exists, include the journal homepage URL.
Cite Every Finding You Use
Every finding or conclusion from the studies you reference in the narrative needs an in-text citation: (Author & Author, Year). If citing a specific page or passage, add the page number: (Author & Author, Year, p. X).
Student Format (No Running Head)
APA 7th student papers do not require a running head. Include: paper title, your name, institution, course name and number, instructor name, and due date — all centred and double-spaced.
Tables Follow APA Table Rules
Even in an appendix, tables need a label (“Table A1”) and title above the table, and a note below if abbreviations or sources need explaining. The legend required by this assignment functions as the table note.
Mistakes That Get Points Deducted
Selecting Studies From Medicine, Not Nursing
Choosing a high-quality RCT from a medical journal because the evidence level is strong. The assignment disqualifies studies from outside nursing, regardless of their methodological quality.
Filter by Nursing Journals First
In CINAHL, use the “Nursing & Allied Health” journal filter. In PubMed, filter results by nursing journals after the search. When in doubt, check where the journal is indexed and what its stated scope is.
Writing Sentences in the Evaluation Table
Full narrative paragraphs in the table cells. The assignment says bulleted format. A grader reading a table full of sentences will deduct marks — and it makes the table harder to read.
Bullets, Numbers, Short Phrases
Every table cell gets bullets. “N = 142 adult ICU patients, single academic medical centre” — not “The study recruited 142 adult patients from the ICU of an academic medical centre.” Same information, correct format.
Missing the Legend on the Table
Submitting the table without a legend. It’s explicitly required. A missing legend means abbreviations in the table are undefined, and marks are lost for an easy item.
Add the Legend Below the Table
At the bottom of the evaluation table, add a legend defining every abbreviation used: RCT = randomised controlled trial; N = sample size; EBP = evidence-based practice; CI = confidence interval, etc. Format as a table note per APA 7th.
Narrative That Summarises Rather Than Analyses
A one-page narrative that describes what each study did without connecting the findings to the PICOT intervention. Summary ≠ analysis. Graders are looking for the connection between evidence and practice decision.
Connect Every Finding to the Intervention
For each study, state what the findings were — then explicitly state how those findings support or don’t support the specific intervention in your PICOT question. “Study A found X. This finding supports the use of [intervention] because Y.” That’s analysis.
Frequently Asked Questions
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Nursing Assignment Help Get StartedThe Table and the Narrative Work Together
The evaluation table is where you document. The narrative is where you argue. Both need to be complete and consistent with each other — whatever evidence level you assign in the table should match what you say about study strength in the narrative. Whatever limitation you note in the table should inform your discussion of how confidently the evidence supports practice change.
One page for the narrative sounds like a small ask. It isn’t. Fitting an introduction, purpose statement, analysis of two studies, and a conclusion into one page means every sentence carries weight. Cut anything that doesn’t directly advance the argument about whether the evidence supports the PICOT intervention.
And read pages 119–145 before you fill in the table. Seriously. Students who skip that step and fill in the template based on what the column headers say produce incomplete entries — the headers don’t tell you what level of detail is expected. The sample entries do.