Educational Innovations ABSTRACT Background: Many articles written about the PICOT (Population, Intervention, Comparison, Outcome, Time) method for developing research questions focus on search- ing the existing evidence base to review the impact of inter- ventions. The PICOT method evolved to craft questions that yield operative search terms. Currently, the PICOT method falls short in its utility for health care and doctoral educa- tion. For example, the Doctor of Nursing Practice scholarly practice projects evaluate the existing evidence base and compare the current real-world state with the evidence base, for which the current conceptualization of the PICOT method has limited applicability. Method: The PICOT-D adds digital data (D) components to the traditional PICOT, allowing for the explicit identifcation of data measures that form the basis of the evaluation of an intervention. Results: the PICOT-D has the potential to improve student efciency, efcacy, and confdence in the development of truly an- swerable questions that fully support improved patient care and systems-level change. Conclusion: This article demon- strates the need for the evolution of the PICOT format to the PICOT-D format. [J Nurs Educ. 2015;54(10):594-599.] T he PICOT (Population/patient problem, Intervention, Comparison, Outcome, Time) method of structuring questions for both clinical practice and research has a long and respected history in both medical and nursing practice (Noll & Murphy, 1993; Stone, 2002). The sciences of medicine and nursing have long benefited from the rigor that a struc- tured framework can provide. As an aid to time-strapped clini- cians when searching for answers regarding patient care and to patients’ questions, the PICOT method is intended to assist in crafting structured, applicable questions. Formulation of a well- constructed PICOT question yields a pathway for seeking and applying the body of existing knowledge and provides a mech- anism for determining whether the question, as posed, can be answered. In nursing education, the PICOT method has been used as a tool to shape students’ critical thinking skills through a standard- ized and rigorous process of developing clinical questions that connect the student to the body of knowledge (Fineout-Overholt & Johnston, 2005). The use of the PICOT method by students and health care professionals has the underlying purpose of promoting evidence-based practice (EBP) to integrate new technologies and interventions to improve patient outcomes, stimulate systems change or operational improvement, more effectively answer patient-generated questions, and generally advance health care through the integration of new technologies and interventions (Hendricks-Ferguson, Akard, Madden, Peters- Herron, & Levy, 2015). Proposed changes to the PICOT format have been suggested to better refine online searches (Forrest & Miller, 2002). Seng- stack and Boicey (2015) highlighted the importance of including electronic sources of patient data and addressed the need for a modification of the PICOT framework to capture these elements in a structured manner. This article proposes an evolution of the PICOT method that inclusively and intentionally captures electronic evidence-based resources, as well as emphasizes the emerging need to be fa- miliar with organizational or systems-level data sources and the data they collect and manage. This proposed evolution aspires to expand the PICOT method to the PICOT-Digital (PICOT-D) method. The PICOT-D method provides a structured framework that is more inclusive of broadening digital resources. The cur- rent authors also advocate for the use of the PICOT-D frame- work in the education of Doctorate of Nursing Practice (DNP) students to advance EBP and systems-based improvements—a Evolving the PICOT Method for the Digital Age: The PICOT-D Beth L. Elias, PhD; Shea Polancich, PhD, RN; Carolynn Jones, DNP, RN; and Sean Convoy, DNP, P-MHNP-BC Received: March 16, 2015 Accepted: May 5, 2015 Dr. Elias is Term Associate Professor, and Dr. Convoy is Clinical Associ- ate Professor, Department of Adult Health and Nursing Systems, Virginia Commonwealth University School of Nursing, Richmond, Virginia; Dr. Polan- cich is Assistant Professor, University of Alabama at Birmingham School of Nursing, Birmingham, Alabama; and Dr. Jones is Assistant Professor, The Ohio State University College of Nursing, Columbus, Ohio. The views expressed in this article are those of the authors and not an ofcial position of their institutions. The authors have disclosed no potential conficts of interest, fnancial or otherwise. Address correspondence to Beth L. Elias, PhD, Term Associate Profes- sor, Department of Adult Health and Nursing Systems, Virginia Common- wealth University School of Nursing, 1100 E. Leigh Street, Richmond, VA 23298; e-mail: belias@vcu.edu. doi:10.3928/01484834-20150916-09 This article has been amended to include factual corrections. An error was identified subsequent to its original publication. This error was acknowledged on page 623, volume 54, issue 11. The online article and its erratum are considered the version of record. 594 Copyright © SLACK Incorporated