| Course | PA 650 Capstone Project |
|---|---|
| Week | 2 |
| Paper type | Question refinement exercise |
| Length | About 540 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 650 Week 2
Question Narrowing Exercise: From "Do Muscle Relaxants Help Back Pain?" to a Question About Adding One to Naproxen at Discharge, Changed One Element at a Time, With Who Was Cut at Each Step
Student Name
Chamberlain University
PA 650: Capstone Project
Instructor Name
Month Day, Year
Question Narrowing Exercise: From "Do Muscle Relaxants Help Back Pain?" to a Question About Adding One to Naproxen at Discharge, Changed One Element at a Time, With Who Was Cut at Each Step
Version One, Left In
Version 1: "Do muscle relaxants help back pain?" This is how the question sounded when I first said it out loud on rotation. No study could answer it: it does not say which back pain, which muscle relaxant, compared with what or measured how.
One Change per Step
Version 2, population narrowed: "Do muscle relaxants help adults with acute low back pain?" Cut: chronic back pain, children.
Version 3, population narrowed again: "Do muscle relaxants help adults whose recent back pain followed no injury and stays above the knee?" Cut: people with fractures, falls or sciatica, whose pain has different causes and treatments.
Version 4, intervention specified: "Does adding a skeletal muscle relaxant to an NSAID help those same adults?" Cut: muscle relaxants used alone, which is a different decision.
Version 5, comparison specified: "In those adults, does naproxen plus a skeletal muscle relaxant, compared with naproxen plus placebo, help?" Cut: comparisons with opioids or with no treatment.
Version 6, setting and outcome specified: "In adults 18 to 64 discharged from an emergency department or urgent care with acute, nontraumatic, nonradicular low back pain, does adding a skeletal muscle relaxant to naproxen, compared with naproxen and placebo, improve function at one week, measured by the Roland-Morris Disability Questionnaire?"
A Note on Who Was Cut
Version 6 leaves out adults 65 and older, who are often the patients most at risk from sedating drugs. Their absence reflects the evidence, not their importance: the main trials excluded them, so the evidence could not answer the question for them. They are listed as a population for a separate question.
Each version's cut is recorded in this exercise so that the final recommendation can say plainly whom it does not cover. A question that silently drops people produces a recommendation that will be applied to them anyway.
The Floor, Not Just the Ceiling
A question can also be too narrow. A version limited to cyclobenzaprine 5 mg at bedtime in warehouse workers would be answerable only by a trial nobody has run. Version 6 is narrow enough to be answerable and broad enough that published trials exist, including randomized trials in emergency departments comparing naproxen with and without cyclobenzaprine (Friedman et al., 2015).
One Rejected Wording, Kept
Rejected: "Is cyclobenzaprine effective for back spasm?" "Spasm" is a mechanism the clinicians disagree about, not a finding that can be measured reliably, and building it into the question would assume the answer.
Another candidate, "Does cyclobenzaprine reduce return visits for back pain?", was set aside because return visits depend on access to primary care as much as on the drug, so the answer would say more about the health system than about the prescription.
References
Friedman, B. W., Dym, A. A., Davitt, M., Holden, L., Solorzano, C., Esses, D., Bijur, P. E., & Gallagher, E. J. (2015). Naproxen with cyclobenzaprine, oxycodone/acetaminophen, or placebo for treating acute low back pain: A randomized clinical trial. JAMA, 314(15), 1572-1580. https://doi.org/10.1001/jama.2015.13043
What the PA 650 Week 2 assignment asks for
The second week asks for a question narrowing exercise in which the first version is deliberately poor and stays on the page. Each following version changes exactly one element: population, intervention, comparison, outcome or setting. Under each change, note who or what was cut, so the cost of narrowing is visible. Check the floor as well as the ceiling: a question can become so narrow that no study could answer it. The final version should be specific enough to search for and broad enough that evidence exists, and you should show that it does. Keep one rejected wording and say why it was rejected. The final question may differ from the week 1 version, provided the change is explained. Cite a source showing the final question is answerable.
Inside the PA 650 Week 2 example
Version 1, "Do muscle relaxants help back pain?", is kept with a note on why no study could answer it. Versions 2 and 3 narrow the population to adults with acute pain and then to nontraumatic, nonradicular pain, cutting chronic pain, children, fractures and sciatica. Version 4 adds the NSAID, cutting muscle relaxants alone. Version 5 sets naproxen with placebo as the comparison. Version 6 adds the age band, the discharge setting, function at one week and the Roland-Morris questionnaire. A section explains cutting older adults because the main trials excluded them. The floor section rejects a version limited to cyclobenzaprine 5 mg in warehouse workers and cites Friedman et al. (2015) as evidence the final question can be answered. A rejected wording about spasm is kept with its reason.
PA 650 Week 2 rubric: what full points look like
The heaviest deduction in this exercise falls on removing or rewriting the first version so the starting point looks better than it was. Next comes changing several elements at once, which hides what each change did. Graders deduct for steps that never say who was cut. Faculty reward one change per step, a recorded cost for each and a final version that names population, intervention, comparison, outcome and setting. Testing the floor, and showing that evidence exists for the final question, earns a defined share. A rejected wording kept with its reason shows judgment. Citation of the source that proves answerability, in APA form, completes the rubric.
PA 650 Week 2 help: mistakes that cost points
Narrowing exercises most often go wrong by jumping from a vague question straight to a polished PICO, with nothing in between. Another frequent problem is a final question so narrow that no study exists. Some also forget to note who was cut, especially older adults or children. If your capstone question starts elsewhere, send your first rough version and the variation you saw; an exercise prepared for you would keep that version, change one element per step, note who each step cuts, test the floor and the ceiling, show evidence exists for the final version and keep one rejected wording. If your faculty require a specific question format, the last version would be written in it.
Get a PA-650 Week 2 example written to your instructions
Send the Week 2 instructions with your starting question exactly as you first asked it, and a custom narrowing exercise written to your rubric comes back inside 24-48h, the first one free. If your classroom supplies a worksheet with numbered rows, send that and the versions are written straight into its fields.
More PA 650 papers and MPAS samples
- PA 650 Week 1: Practice Variation Post
- PA 650 Week 3: Patient Population Definition
- PA 650 Week 4: Comparison Arm Rationale
- PA 650 Week 5: Strength of Evidence Table
- PA 650 Week 6: Harm and Benefit Balance
- PA 650 Week 7: Bedside Recommendation Statement
- PA 650 Week 8: Clinical Poster Draft
- PA 501 Week 2: Origins of the Profession Essay
- PA 648 Week 2: Remediation Contract
- PA 502 Week 2: Bedside Question Brief
- PA 503 Week 2: Illness Scripts
PA 650 Week 2 questions, answered
How many versions does the exercise need?
Three or four is what most sections publish, and more than five usually means single words were being swapped rather than elements. The count matters less than whether each step is a real decision with a cost attached. Where your classroom names a number, that number wins, and the sample is built to it.
Can the final question be different from the Week 1 one?
It usually is, and a version set showing no movement reads as an exercise done backwards from an answer already chosen. What should not move is the group of patients underneath, because that is the part everything later is built on. Where the group does change, say so in the note and treat the earlier versions as belonging to a different project.
What if narrowing leaves a question nobody has studied?
Several sections treat that outcome as a result in its own right. Record it in the exercise: the wording that survived, the search that came back with nothing close, and the nearest studied question with the distance between them named. A project can then argue from the neighbor while stating what it is borrowing across.
Where can I find a free PA 650 Week 2 sample paper?
The complete PA 650 Week 2 question narrowing exercise, moving from a vague question to an answerable one in six steps, is on this page.
Why are older adults cut in the PA 650 Week 2 sample?
The main emergency department trials enrolled younger adults, so the evidence could not answer the question for people 65 and older.