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Nursing

Explore library resources for the Nursing program at McMaster.

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Foreground Information and the 6S Pyramid

Foreground questions are best answered by evidence found at different levels of the 6S Pyramid.

6 S pyramid of the hierarchy of evidence

The different levels of the pyramid are outlined and colour-coded to the right.


Learn more about the 6S Pyramid:

DiCenso, A., Bayley, L., & Haynes, R. B. (2009). Accessing pre-appraised evidence: Fine-tuning the 5S model into a 6S model. Evidence-based nursing, 12(4), 99-101. https://doi.org/10.1136/ebn.12.4.99-b [View record in Omni]


Use the concepts identified in your PICO Question to come up with approriate search terms, remembering that:

  • A piece of evidence's ability to guide clinical action increases as you move up the pyramid.
  • Topics become more specific as you move down the pyramid.

HSL's Database Fundamentals Tutorial will explain the process of building an effective and efficient search.

Icon Legend

Lock icon Library resource - you'll be prompted to login to access this resource from off-campus.

Open Access icon Free/Open Access

Maple Leaf icon Canadian Content

Mobile phone iconThere's an app for this.

Meta-Searches

Meta-Searches (aka "federated" search engines) search for evidence across multiple resources. These tools return information from all levels of the pyramid. They can be especially useful when you're unsure which database is best suited to answer a clinical question.

Citing Sources

Purdue Online Writing Lab (Purdue OWL):

Evidence-based texts: