EBP Resources for Asking Clinical Questions

EPB Resources
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based
practice in nursing & healthcare: A guide to best practice (4th
ed.). Philadelphia, PA: Wolters Kluwer.
· Chapter 2, “Asking Compelling Clinical Questions” (pp. 33–
54)
· Chapter 3, “Finding Relevant Evidence to Answer Clinical
Questions” (pp. 55–92)
Davies, K. S. (2011). Formulating the evidence based practice
question: A review of the frameworks for LIS professionals.
Evidence Based Library and Information Practice, 6(2), 75–80.
https://doi.org/10.18438/B8WS5N. Retrieved from
https://ejournals.library.ualberta.ca/index.php/EBLIP/article/vie
wFile/9741/8144
Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., &
Williamson, K. M. (2010a). Evidence-based practice, step by
step: Asking the clinical question: A key step in evidence-based
practice. American Journal of Nursing, 110(3), 58–61.
doi:10.1097/01.NAJ.0000368959.11129.79. Retrieved from
https://journals.lww.com/ajnonline/Fulltext/2010/03000/Evidenc
e_Based_Practice,_Step_by_Step__Asking_the.28.aspx
Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., &
Williamson, K. M. (2009). Evidence-based practice: Step by
step: Igniting a spirit of inquiry. American Journal of Nursing,
109(11), 49–52. doi:10.1097/01.NAJ.0000363354.53883.58.
Retrieved from
https://journals.lww.com/ajnonline/fulltext/2009/11000/Evidenc
e_Based_Practice__Step_by_Step__Igniting_a.28.aspx
Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., &
Williamson, K. M. (2010b). Evidence-based practice, step by

step: Searching for the evidence. American Journal of Nursing,
110(5), 41–47. doi:10.1097/01.NAJ.0000372071.24134.7e.
Retrieved from
https://journals.lww.com/ajnonline/Fulltext/2010/05000/Evidenc
e_Based_Practice,_Step_by_Step__Searching.24.aspx
Summary till now
Definition of product, product lines
Good
Services
Definition of brand, brand extensions
Brand lives in mind, while product is the delivery mechanism of
the brand
What is Product Management?
Product Management
As a discipline, product management provides managerial focus
to products and brands as profit-generating systems
It is the organizational function dealing with thoughtful and

proactive management of a product or a group of products
thoughout all stages of the product lifecycle
Product life cycle
Life span of a product
“cradle-to-grave”
Sigmoid Curve
time
Progress
Learning
Phase
Growth
Phase
Saturation
Phase
Decline
Phase
Product life cycle

7 distinct steps
Conceive
Plan
Develop
Qualify
Launch
Deliver
Retire
Why management of product is needed?
Without management
Guesswork
Chaos
Misguided development
Missed opportunities
Why management of product is needed?
With management
Increased probability of market success

2 models of Program Management
Upstream functions
Strategies of product roadmap
New product development
Downstream functions
Post-launch activities
Including refresh/new line items after launch
Case study: Intel Marketing
PC group: handles desktops and laptops segments of the market
Upstream product line managers
Responsible for new product roadmaps
Product planning and definition
Customer design wins
Selling guide
Launch planning
Case study: Intel Marketing
PC group: handles desktops and laptops segments of the market
Downstream product line managers
Sustaining the product
Tactical issues like new OS support

End-of life/conversion
PM Structure
Depends on the stage of the company
Startups: PM generally manages all aspects of product from
“cradle to grave”
Mid-size enterprise: due to increased complexity and growth,
PM function is done by a team
Mature organizations: Even more complex and hierarchical PM
structure
Case study: Google
Case study: Microsoft
Microsoft: PM

Case study: Facebook
PM relationship to GM
PM (Product Manager)
Strategy, planning, revenue, cost, marketing, sales, product
delivery, operational rollout, and support of product
GM (General Manager)
Profit and loss
Functional managers report to GM
PM, hence interact primarily through influence and shared
organizational objectives
Summary
As a discipline, product management provides _______ focus to
products and brands as profit-generating systems
Product life cycle
__ steps from Conceiving to Retirement
Value preposition of product management

______ probability of success in the market
Summary (contd.)
2 models of management
______
______
True/false: Structure of PM varies by the size of the company
Summary
Product life cycle
7 steps from Conceiving to Retirement
Value preposition of product management
Increased probability of success in the market

Summary (contd.)
Upstream
Downstream
Structure
Varies by size of the company
Next class:
Roles and responsibilities
Summary from last class
Product life cycle
7 steps from Conceiving to Retirement
Value proposition of product management
Increased probability of success in the market

Summary (contd.)
Upstream
Downstream
Structure
Varies by size of the company
What does a Product Manager do?
Product Manager
Responsible for managing 1 or more products
Ensure optimal balance between customers’ needs and the
organization’s capabilities
PMs cover the entire lifecycle

7 distinct steps
Concieve
Plan
Develop
Qualify
Launch
Deliver
Retire
Product Manager
Sales
Competition
Third Party (eco system)
Consumers
Marketing
R&D
Finance
Customer Service & Support
Other
Internal
External
Market facing
“The Firm”

6
Video:
What do Product Managers Do?
Summary of the video:
Role of Product Manager
User and market intelligence
Understand the market, competition
Business strategy
Tie the product to company’s business model
User experience design
Vision, user flow, blue-
Product development
Build the technical product
Analytics and growth
Launch, deliver and sustain
Engagement between the
teamsConceivePlanDevelopQualifyLaunchDeliverRetireResearc
h & Develop-mentMarketingManufactur-ing

Product Management
Role of Product Marketing Manager
Defines and manages product image in the market
E.g. Product announcement, building customer awareness,
supporting the sales team
Defines the product “promise” and ensures its successful
execution in the market
E.g. Managing product launch, conducting sales training etc.
Defines the product requirements
Also provides customer feedback
Case study: Product Ownership at Intel
Centrino™ development and launch
Case study: Product Ownership at Intel

Centrino = Microprocessor + WiFi component
Integration challenges
FCC guidelines, different development team, culture
Hot spot verification
Across US
Across the world
Result = successful intro in 2003
Hot spots now a “standard”
Summary
Role of product manager = optimal balance between _______
needs and ________ capabilities
Summary (contd.)
Responsibility of product manager = manage the product
throughout its lifecycle
Deliver to the _______ promise
Product Marketing Manager’s role/responsibility
Defines and manages product _____ in the market
Develops _______ & provides customer ______

Summary
Role of product manager = optimal balance between customer’s
needs and organization’s capabilities
Summary (contd.)
Responsibility of product manager = manage the product
throughout its lifecycle
Deliver to the brand promise
Product Marketing Manager’s role/responsibility
Defines and manages product image in the market
Develops customer requirements & provides customer feedback
Sigmoid Curve
timeProgressLearningPhaseGrowthPhaseSaturationPhaseDecline
Phase

Sigmoid Curve
time
Progress
Learning
Phase
Growth
Phase
Saturation
Phase
Decline
Phase
Product Management Framework (PMF)
The process of managing the entire lifecycle of product from
conception, through development and production
Business Analysis
Engineering Development
Project Management
PMF is where the supporting processes need to align and create
value

Project
Project is finite in nature, which means it has specific initiation
and finishing deadlines
Examples
Organizing an event e.g. networking event
Holding a meeting
Home improvement project e.g. upgrading the kitchen,
bathroom
Developing a website
Organizing a team
Solving a key problem for the customer
Project Management
Project management is the discipline of planning, organizing,
and managing resources to successfully complete specific
project goals and objectives
Business Analysis
Project Management

value
Project Management
Applying project management in the product management
process can increase:
Productivity
Quality
Efficiency
Time-to-market
Business Analysis
Project Management
Core project management methods and processes
5 major processes
Initiation
Planning
Execution
Control
Closing
Project initiation
Project planning
Project execution
Project control

Project closing
Project Initiation
Define new project (what needs to be done)
Decide if the project should continue into next phase assuming
the current phase is nearing completion
Project initiation
Project planning
Project execution
Project control
Project closing
Project initiation: core methods/processes
Review business case (financials, connection to business
strategy)
Develop charter – high level document that describes the
project, risks, milestones
Establish project baseline – cost, schedule, time and quality
Approve the next phase plan – decide if the poject should
continue to the next stage
Identify the project sponsor – determine the source of funding
Conduct a kick off meeting – communicate the project
information to the team

9
The “SMART” Approach
Specific: it’s easy to tell what will be produced
Measurable: there are concrete success indicators
Attainable: it can reasonably be accomplished
Relevant: it fits with the business objectives
Time-bound: the completion date and conditions are clear
10
Application Exercise #1
Directions:
Read the sample individual deliverables from a typical
company’s development team. Decide which part of the
SMART test each deliverable is most likely missing. Write the
missing letter (S, M, A, R, or T) in the first blank for each
deliverable (S=Specific; M=Measurable; A=Attainable;
R=Relevant; T=Time-bound)
Development Team Deliverables
1) ___ Create a Customer Satisfaction survey
(shareddrive/survey.doc) by March. 8 (2 weeks).
2) ___ Finish all 6 application requirements and have them

approved by tomorrow morning.
3) ___ Improve the requirements (shareddrive/spec1.doc) by
Dec 21.
Project planning
How the project will be implemented and who will perform the
activities
Project initiation
Project planning
Project execution
Project control
Project closing
Project planning: core methods/processes
Define scope – statement of work – work that needs to be
completed to produce the desired result
Implement work breakdwon structure – this provides basis for
activity cost, duration and control changes in the scope
Develop schedule
Determine the budget
Plan quality – map requirements to implemention
Plan communications – methods to gather and report
information as the project would progress. Also at what
frequency the information would be provided

Plan to manage risks – uncertainties e.g. organizational
changes, external factors (regulatory changes)
House of Quality (HOQ)
House of Quality is a diagram, whose structure resembles that
of a house
Aids in determining how a product is living up to customer
needs
It is a part of the quality function deployment (QFD) and
utilizes a planning matrix to relate what the customer wants to
how a firm (that produces the products) is going to meet those
wants
It looks like a house with a "correlation matrix" as its roof,
customer wants versus product features as the main structure,
competitor evaluation as the porch, etc.
It also is reported to increase cross functional integration within
organizations using it, especially between marketing,
engineering and manufacturing

Project execution, control
Steering the project to meet the requirements
Project initiation
Project planning
Project execution
Project control
Project closing
Project execution & control: core methods/processes
Verifying the work completed
Managing change requests
Change control process to keep out the “scope creep”
Performing quality assurance reviews
Acquiring resources, goods and services
Managing variances
Are you ahead of schedule or falling behind?
Managing expectations
Monitoring and managing risk
Project closeout
Bring project to an organized and well-planned conclusion
Project initiation

Project planning
Project execution
Project control
Project closing
Project closing: core methods/processes
Conducting final project reviews
Post-project review: key lessons learnt, areas of improvement
for the next time
Closing all financial accounts
Completing and closing all procurements
Recognition/rewards
Key take-aways
Project management is the discipline of ________, ________,
and ________ resources to successfully complete ___________
goals and objectives
5 major processes in project management are:
________
________
________
________
________
Project initiation addresses ______ needs to be done, whereas

planning addresses _____ and ____ will perform the activities
Are your project goals SMART?
S__________
M_________
A__________
R__________
T__________
True or false?
HOQ is Head of Quadrant
HOQ is a QFD tool
HOQ stands for House of Quality
Change control process to keep out the “____ ____”
True or false?
Post-project review includes key lessons learnt, areas of
improvement for the next time

Questions?
Key take-aways (answers)
Project management is the discipline of planning, organizing
and managing resources to successfully complete specific
project goals and objectives
5 major processes in project management are:
Initiation
Planning
Execution
Control
Closing
Project initiation addresses what needs to be done, whereas
planning addresses how and who will perform the activities
Are your project goals SMART?
Specific

Measurable
Attainable
Relevant
Timebound
True or false?
HOQ is Head of Quadrant (False)
HOQ is a QFD tool (True)
HOQ stands for House of Quality (True)
Change control process to keep out the “scope creep”
True or false?
Post-project review includes key lessons learnt, areas of
improvement for the next time (True)
What is a product?
Product is the overall experience provided by the combination

of goods and services to satisfy the customer’s needs before
they use it, while they use it and after they have stopped using
it
Product = Goods + Services
What is a “good” ?
Goods
“Tangible”
“Physical products”
Goods

Consumer products – items that are used daily
4 types
Convenience products – purchased immediately & frequently.
E.g. Food, beverages
Shopping products – goods that require research and analysis
before purchasing. E.g. automobiles
Specialty products – unique. E.g. luxury goods
Unsought products – don’t know about or want to think about.
E.g. burial plots
Business to business (b2b): used for running business or selling
directly to business customers
E.g. Copiers, Point-of-sale equipment
Other examples?
Industrial products: used by industry or business than by
individuals
E.g. Testers, Fork-lifts, Data Servers
Other examples?

Other products:
Perishable – non-durable, e.g. food
Durable – e.g. electronic equipment
Finished goods – do not require further processing, e.g. bottled
water
Services
Any activity or benefit that one party can offer to another which
is essentially intangible and does not result in ownership of
anything
Services
4 Characteristics
Intangibility
Perishability
Inseperability

Variability
What are examples of “service”?
Professional services – assistance by one person to another, e.g.
medical service (like doctor)
Business services – e.g. consulting
Technical support – often accompany a manufactured product
Financial services – e.g. insurances, investments
Service warranties – protection against repair cost etc. e.g.
maintenance service contracts

Brand
A strategic asset, experience, perception and reputation of an
organization’s values and beliefs, personality and behavior. It
also comprises the name and visual mark by which an
organization is recognized.
Which company’s brand is this?
What does the brand convey?
Which company is this?

What does this brand convey?
What does this brand convey?
the brand
Product Lines
A group of products that are closely related because they
function in a similar manner, are sold to the same customer
groups and marketed through the same types of outlets, or fall
within given price ranges

Any example of product lines?
Example
Extensions
Brand extension: using an established brand to introduce new
product
E.g.
jewelry etc
-Cola Coke
Summary
Definition of product, product lines
Good
Services
Definition of brand, brand extensions
the brand

Please read chapter #3 of the book
Next topic
Product Management – what is product management?
conception, through development and production, to retirement
Business Analysis
Project Management
value
Value Creation Processes
Value creation process is the way the product manager and the
project team organize around the work that needs to be
completed

3 types of processes
Serial
Iterative
Serial Processes: Waterfall & Phase-Gate
Works well in highly structured environments
After-the-fact changes are costly
Also, works well when the processes must be documented,
followed and with clear traceability
E.g: medical device or pharma
Typically, they take longer to complete
Requirements
Design
Development
Verification
Delivery
Phase-gate/Go-NoGo decision
Decision process whether to move forward to the next phase
depending on deliverables and achievements in that stage
E.g. Going from high-school to college requires passing the
high school and getting accepted by the college (SATs, ACTs
etc)
When a phase-gate review is complete, there are 4 possible

outcomes
Go
No Go
Redirect or rework
Defer or hold
Serial Processes are Time Consuming
t1, t2, t3, t4, t5 are time duration for each of the stages
Total time (T) from start to finish = t1+t2+t3+t4+t5
For example, a micro-processor development : 12-16 months!
Requirements
Design
Development
Verification
Delivery
t1
t2
t3
t4
t5
What are the Advantages & Disadvantages of Serial Process?
Advantages
Manages cost risk
Known and agreed-upon requirements

Trace-able
Disadvantages
Longer duration
Schedule delays due to defect identification and resolution
Case study: Intel’s processor development methodology
Product Life Cycle (PLC)
Exploration
Planning
Production
Development
Launch
Exploration
Ideas, concepts and strategies analyzed
Planning
Architectural analysis
Development
Implementation
Production

Volume shipments, launch
Development/Qualification/Production Model
QS
Beta
SW
PV
SW
Production
Beta Validation
Rollout Model
T-15
T-14
T-17
T-29
T-20
QS Validation

T-40
ES1
T-52
Pre-Alpha
SW
Early
Validation
T-32
ES2
Prod Test
& Pilot Build
Customer ready to ship
T-0
Alpha
Alpha
Validation
Beta
Cut off
T-21
Production
Cut off
Retail
On-Shelf
T+2
T-7

Iterative/Incremental Processes
Develop a product through repeated cycles (iterative) and in
small portions at a time (increments), allowing the team to take
advantage of what they learned while developing earlier parts or
versions of the system
The process starts by delivering a smaller subset of
Allows faster response where the requirements are changing
rapidly
Iteration vs. increment
Iteration refers to the cyclic nature of a process in which
activities are repeated in a structured manner
Increment refers to the quantifiable outcome of each iteration
In the above example, if the software code was for displaying
log-in screen, then increment = log-in screen
Agile
Describes number of development methodologies that share
common principles associated with incremental/iterative

processes
Common Agile processes include
Scrum
Extreme programming
Feature-driven development
Agile approach assumes that change is pervasive
Hence, the product manager’s ability to predict how to best
estimate customer needs is limited
As a result, use probe-and-learn approach to get customer
feedback
delays
There are 4 elements
Requirements – often written as user stories which capture who
it is for, what they are trying to accomplish, why it matters to
them
User stories are short, simple descriptions of a feature told from
the perspective of the person who desires the new capability,
usually a user or customer of the system. They typically follow
a simple template:
As a < type of user >, I want < some goal > so that < some
reason >.
User stories are often written on index cards or sticky notes,
and arranged on walls or tables to facilitate planning and
discussion. As such, they strongly shift the focus from writing
about features to discussing them.

Examples of User Stories
One of the benefits of agile user stories is that they can be
written at varying levels of detail. We can write a user story to
cover large amounts of functionality. These large user stories
are generally known as epics.
Here is an epic agile user story example from a desktop backup
product:
As a user, I can backup my entire hard drive.
Because an epic is generally too large for an agile team to
complete in one iteration, it is split into multiple smaller user
stories before it is worked on.
The epic above could be split into dozens (or possibly
hundreds), including these two:
As a power user, I can specify files or folders to backup based
on file size, date created and date modified.
As a user, I can indicate folders not to backup so that my
backup drive isn't filled up with things I don't need saved.
There are 4 elements (contd)
Requirements – often written as user stories which capture who
it is for, what they are trying to accomplish, why it matters to
them
Estimating and Planning
Product Backlog – prioritized list of requirements
Story points - measure of estimating resources

Team velocity = how fast is the team finishing up the backlog
Burnout chart
Burndown Chart - example
The 4 elements of Agile (contd.)
Iterative development: generally 1-4 weeks
Visual management
Task boardTo doIn progressDoneAs a …As a …As a …As a
…As a …As a …As a …As a …
Agile Overview (You Tube) – 15 minutes

conception, through development and production, to retirement
Business Analysis
Project Management
value
Value Creation Processes
Value creation process is the way the product manager and the
project team organize around the work that needs to be
completed
3 types of processes
Serial
Iterative
Scrum
Scrum is an Agile process, developed in mid 1990s by Jeff
Sutherland , Ken Schwaber, Mike Beedle and others
A Scrum team consists of
Scrum master: identifies and removes roadblock

Product owner: Responsible for the success of the product
Team: Responsible for developing the product (approximately
5-9 people)
Scrum’s implementation of Agile
FrameworkRequirementsEstimating and PlanningIterative
DevelopmentVisual managementScrumProduct VisionProduct
backlogSprintsBurndown chartsUser storiesBacklog
groomingDaily scrums
Sprint planningSprint review
Sprint retrospective
Agile Framework
Scrum process diagram
Product
vision
Product
Backlog
Sprint
planning
Daily Scrum
Sprint
Retrospective
Sprint
Review

Product
increment
Feedback
Sprint
Development occurs in iterations, known as sprints
Sprints are timebound. Generally, < 30 days
Each sprint is structured around 4 types of meetings
Planning, Development, Review, Retrospective
Daily Scrum: about 15-minute meeting to share what they did
from the last meeting
Scrum Process (You Tube) – 10 minutes
Questions?
EVP ASSIGNMENT

Assignment: Evidence-Based Project, Part 3: Advanced Levels
of Clinical Inquiry and Systematic Reviews
Your quest to purchase a new car begins with an identification
of the factors important to you. As you conduct a search of cars
that rate high on those factors, you collect evidence and try to
understand the extent of that evidence. A report that suggests a
certain make and model of automobile has high mileage is
encouraging. But who produced that report? How valid is it?
How was the data collected, and what was the sample size?
In this Assignment, you will delve deeper into clinical inquiry
by closely examining your PICO(T) question. You also begin to
analyze the evidence you have collected.
To Prepare:
· Review the Resources and identify a clinical issue of interest
that can form the basis of a clinical inquiry.
· Develop a PICO(T) question to address the clinical issue of
interest for the Assignment.
· Use the key words from the PICO(T) question you developed
and search at least four different databases in the Walden
Library to identify at least four relevant peer-reviewed articles
at the systematic-reviews level related to your research
question.
· Reflect on the process of creating a PICO(T) question and
searching for peer-reviewed research.
The Assignment (Evidence-Based Project)
Part 3: Advanced Levels of Clinical Inquiry and Systematic
Reviews
Create a 6- to 7-slide PowerPoint presentation in which you do
the following:
· Identify and briefly describe your chosen clinical issue of
interest.
· Describe how you developed a PICO(T) question focused on
your chosen clinical issue of interest.
· Identify the four research databases that you used to conduct
your search for the peer-reviewed articles you selected.
· Provide APA citations of the four peer-reviewed articles you

selected.
· Describe the levels of evidence in each of the four peer-
reviewed articles you selected, including an explanation of the
strengths of using systematic reviews for clinical research. Be
specific and provide examples.

EBP Resources for Asking Clinical Questions

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