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Case Study – Methods, Examples and Guide

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A case study is a research method that involves an in-depth examination and analysis of a particular phenomenon or case, such as an individual, organization, community, event, or situation.

It is a qualitative research approach that aims to provide a detailed and comprehensive understanding of the case being studied. Case studies typically involve multiple sources of data, including interviews, observations, documents, and artifacts, which are analyzed using various techniques, such as content analysis, thematic analysis, and grounded theory. The findings of a case study are often used to develop theories, inform policy or practice, or generate new research questions.

Types of Case Study

Types and Methods of Case Study are as follows:

Single-Case Study

A single-case study is an in-depth analysis of a single case. This type of case study is useful when the researcher wants to understand a specific phenomenon in detail.

For Example , A researcher might conduct a single-case study on a particular individual to understand their experiences with a particular health condition or a specific organization to explore their management practices. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of a single-case study are often used to generate new research questions, develop theories, or inform policy or practice.

Multiple-Case Study

A multiple-case study involves the analysis of several cases that are similar in nature. This type of case study is useful when the researcher wants to identify similarities and differences between the cases.

For Example, a researcher might conduct a multiple-case study on several companies to explore the factors that contribute to their success or failure. The researcher collects data from each case, compares and contrasts the findings, and uses various techniques to analyze the data, such as comparative analysis or pattern-matching. The findings of a multiple-case study can be used to develop theories, inform policy or practice, or generate new research questions.

Exploratory Case Study

An exploratory case study is used to explore a new or understudied phenomenon. This type of case study is useful when the researcher wants to generate hypotheses or theories about the phenomenon.

For Example, a researcher might conduct an exploratory case study on a new technology to understand its potential impact on society. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as grounded theory or content analysis. The findings of an exploratory case study can be used to generate new research questions, develop theories, or inform policy or practice.

Descriptive Case Study

A descriptive case study is used to describe a particular phenomenon in detail. This type of case study is useful when the researcher wants to provide a comprehensive account of the phenomenon.

For Example, a researcher might conduct a descriptive case study on a particular community to understand its social and economic characteristics. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of a descriptive case study can be used to inform policy or practice or generate new research questions.

Instrumental Case Study

An instrumental case study is used to understand a particular phenomenon that is instrumental in achieving a particular goal. This type of case study is useful when the researcher wants to understand the role of the phenomenon in achieving the goal.

For Example, a researcher might conduct an instrumental case study on a particular policy to understand its impact on achieving a particular goal, such as reducing poverty. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of an instrumental case study can be used to inform policy or practice or generate new research questions.

Case Study Data Collection Methods

Here are some common data collection methods for case studies:

Interviews involve asking questions to individuals who have knowledge or experience relevant to the case study. Interviews can be structured (where the same questions are asked to all participants) or unstructured (where the interviewer follows up on the responses with further questions). Interviews can be conducted in person, over the phone, or through video conferencing.

Observations

Observations involve watching and recording the behavior and activities of individuals or groups relevant to the case study. Observations can be participant (where the researcher actively participates in the activities) or non-participant (where the researcher observes from a distance). Observations can be recorded using notes, audio or video recordings, or photographs.

Documents can be used as a source of information for case studies. Documents can include reports, memos, emails, letters, and other written materials related to the case study. Documents can be collected from the case study participants or from public sources.

Surveys involve asking a set of questions to a sample of individuals relevant to the case study. Surveys can be administered in person, over the phone, through mail or email, or online. Surveys can be used to gather information on attitudes, opinions, or behaviors related to the case study.

Artifacts are physical objects relevant to the case study. Artifacts can include tools, equipment, products, or other objects that provide insights into the case study phenomenon.

How to conduct Case Study Research

Conducting a case study research involves several steps that need to be followed to ensure the quality and rigor of the study. Here are the steps to conduct case study research:

• Define the research questions: The first step in conducting a case study research is to define the research questions. The research questions should be specific, measurable, and relevant to the case study phenomenon under investigation.
• Select the case: The next step is to select the case or cases to be studied. The case should be relevant to the research questions and should provide rich and diverse data that can be used to answer the research questions.
• Collect data: Data can be collected using various methods, such as interviews, observations, documents, surveys, and artifacts. The data collection method should be selected based on the research questions and the nature of the case study phenomenon.
• Analyze the data: The data collected from the case study should be analyzed using various techniques, such as content analysis, thematic analysis, or grounded theory. The analysis should be guided by the research questions and should aim to provide insights and conclusions relevant to the research questions.
• Draw conclusions: The conclusions drawn from the case study should be based on the data analysis and should be relevant to the research questions. The conclusions should be supported by evidence and should be clearly stated.
• Validate the findings: The findings of the case study should be validated by reviewing the data and the analysis with participants or other experts in the field. This helps to ensure the validity and reliability of the findings.
• Write the report: The final step is to write the report of the case study research. The report should provide a clear description of the case study phenomenon, the research questions, the data collection methods, the data analysis, the findings, and the conclusions. The report should be written in a clear and concise manner and should follow the guidelines for academic writing.

Examples of Case Study

Here are some examples of case study research:

• The Hawthorne Studies : Conducted between 1924 and 1932, the Hawthorne Studies were a series of case studies conducted by Elton Mayo and his colleagues to examine the impact of work environment on employee productivity. The studies were conducted at the Hawthorne Works plant of the Western Electric Company in Chicago and included interviews, observations, and experiments.
• The Stanford Prison Experiment: Conducted in 1971, the Stanford Prison Experiment was a case study conducted by Philip Zimbardo to examine the psychological effects of power and authority. The study involved simulating a prison environment and assigning participants to the role of guards or prisoners. The study was controversial due to the ethical issues it raised.
• The Challenger Disaster: The Challenger Disaster was a case study conducted to examine the causes of the Space Shuttle Challenger explosion in 1986. The study included interviews, observations, and analysis of data to identify the technical, organizational, and cultural factors that contributed to the disaster.
• The Enron Scandal: The Enron Scandal was a case study conducted to examine the causes of the Enron Corporation’s bankruptcy in 2001. The study included interviews, analysis of financial data, and review of documents to identify the accounting practices, corporate culture, and ethical issues that led to the company’s downfall.
• The Fukushima Nuclear Disaster : The Fukushima Nuclear Disaster was a case study conducted to examine the causes of the nuclear accident that occurred at the Fukushima Daiichi Nuclear Power Plant in Japan in 2011. The study included interviews, analysis of data, and review of documents to identify the technical, organizational, and cultural factors that contributed to the disaster.

Application of Case Study

Case studies have a wide range of applications across various fields and industries. Here are some examples:

Business and Management

Case studies are widely used in business and management to examine real-life situations and develop problem-solving skills. Case studies can help students and professionals to develop a deep understanding of business concepts, theories, and best practices.

Case studies are used in healthcare to examine patient care, treatment options, and outcomes. Case studies can help healthcare professionals to develop critical thinking skills, diagnose complex medical conditions, and develop effective treatment plans.

Case studies are used in education to examine teaching and learning practices. Case studies can help educators to develop effective teaching strategies, evaluate student progress, and identify areas for improvement.

Social Sciences

Case studies are widely used in social sciences to examine human behavior, social phenomena, and cultural practices. Case studies can help researchers to develop theories, test hypotheses, and gain insights into complex social issues.

Law and Ethics

Case studies are used in law and ethics to examine legal and ethical dilemmas. Case studies can help lawyers, policymakers, and ethical professionals to develop critical thinking skills, analyze complex cases, and make informed decisions.

Purpose of Case Study

The purpose of a case study is to provide a detailed analysis of a specific phenomenon, issue, or problem in its real-life context. A case study is a qualitative research method that involves the in-depth exploration and analysis of a particular case, which can be an individual, group, organization, event, or community.

The primary purpose of a case study is to generate a comprehensive and nuanced understanding of the case, including its history, context, and dynamics. Case studies can help researchers to identify and examine the underlying factors, processes, and mechanisms that contribute to the case and its outcomes. This can help to develop a more accurate and detailed understanding of the case, which can inform future research, practice, or policy.

Case studies can also serve other purposes, including:

• Illustrating a theory or concept: Case studies can be used to illustrate and explain theoretical concepts and frameworks, providing concrete examples of how they can be applied in real-life situations.
• Developing hypotheses: Case studies can help to generate hypotheses about the causal relationships between different factors and outcomes, which can be tested through further research.
• Providing insight into complex issues: Case studies can provide insights into complex and multifaceted issues, which may be difficult to understand through other research methods.
• Informing practice or policy: Case studies can be used to inform practice or policy by identifying best practices, lessons learned, or areas for improvement.

Advantages of Case Study Research

There are several advantages of case study research, including:

• In-depth exploration: Case study research allows for a detailed exploration and analysis of a specific phenomenon, issue, or problem in its real-life context. This can provide a comprehensive understanding of the case and its dynamics, which may not be possible through other research methods.
• Rich data: Case study research can generate rich and detailed data, including qualitative data such as interviews, observations, and documents. This can provide a nuanced understanding of the case and its complexity.
• Holistic perspective: Case study research allows for a holistic perspective of the case, taking into account the various factors, processes, and mechanisms that contribute to the case and its outcomes. This can help to develop a more accurate and comprehensive understanding of the case.
• Theory development: Case study research can help to develop and refine theories and concepts by providing empirical evidence and concrete examples of how they can be applied in real-life situations.
• Practical application: Case study research can inform practice or policy by identifying best practices, lessons learned, or areas for improvement.
• Contextualization: Case study research takes into account the specific context in which the case is situated, which can help to understand how the case is influenced by the social, cultural, and historical factors of its environment.

Limitations of Case Study Research

There are several limitations of case study research, including:

• Limited generalizability : Case studies are typically focused on a single case or a small number of cases, which limits the generalizability of the findings. The unique characteristics of the case may not be applicable to other contexts or populations, which may limit the external validity of the research.
• Biased sampling: Case studies may rely on purposive or convenience sampling, which can introduce bias into the sample selection process. This may limit the representativeness of the sample and the generalizability of the findings.
• Subjectivity: Case studies rely on the interpretation of the researcher, which can introduce subjectivity into the analysis. The researcher’s own biases, assumptions, and perspectives may influence the findings, which may limit the objectivity of the research.
• Limited control: Case studies are typically conducted in naturalistic settings, which limits the control that the researcher has over the environment and the variables being studied. This may limit the ability to establish causal relationships between variables.
• Time-consuming: Case studies can be time-consuming to conduct, as they typically involve a detailed exploration and analysis of a specific case. This may limit the feasibility of conducting multiple case studies or conducting case studies in a timely manner.
• Resource-intensive: Case studies may require significant resources, including time, funding, and expertise. This may limit the ability of researchers to conduct case studies in resource-constrained settings.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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The Ultimate Guide to Qualitative Research - Part 1: The Basics

• Introduction and overview
• What is qualitative research?
• What is qualitative data?
• Examples of qualitative data
• Qualitative vs. quantitative research
• Mixed methods
• Qualitative research preparation
• Theoretical perspective
• Theoretical framework
• Literature reviews

Research question

• Conceptual framework
• Conceptual vs. theoretical framework

Data collection

• Qualitative research methods
• Focus groups
• Observational research

What is a case study?

Applications for case study research, what is a good case study, process of case study design, benefits and limitations of case studies.

• Ethnographical research
• Ethical considerations
• Confidentiality and privacy
• Power dynamics
• Reflexivity

Case studies

Case studies are essential to qualitative research , offering a lens through which researchers can investigate complex phenomena within their real-life contexts. This chapter explores the concept, purpose, applications, examples, and types of case studies and provides guidance on how to conduct case study research effectively.

Whereas quantitative methods look at phenomena at scale, case study research looks at a concept or phenomenon in considerable detail. While analyzing a single case can help understand one perspective regarding the object of research inquiry, analyzing multiple cases can help obtain a more holistic sense of the topic or issue. Let's provide a basic definition of a case study, then explore its characteristics and role in the qualitative research process.

Definition of a case study

A case study in qualitative research is a strategy of inquiry that involves an in-depth investigation of a phenomenon within its real-world context. It provides researchers with the opportunity to acquire an in-depth understanding of intricate details that might not be as apparent or accessible through other methods of research. The specific case or cases being studied can be a single person, group, or organization – demarcating what constitutes a relevant case worth studying depends on the researcher and their research question .

Among qualitative research methods , a case study relies on multiple sources of evidence, such as documents, artifacts, interviews , or observations , to present a complete and nuanced understanding of the phenomenon under investigation. The objective is to illuminate the readers' understanding of the phenomenon beyond its abstract statistical or theoretical explanations.

Characteristics of case studies

Case studies typically possess a number of distinct characteristics that set them apart from other research methods. These characteristics include a focus on holistic description and explanation, flexibility in the design and data collection methods, reliance on multiple sources of evidence, and emphasis on the context in which the phenomenon occurs.

Furthermore, case studies can often involve a longitudinal examination of the case, meaning they study the case over a period of time. These characteristics allow case studies to yield comprehensive, in-depth, and richly contextualized insights about the phenomenon of interest.

The role of case studies in research

Case studies hold a unique position in the broader landscape of research methods aimed at theory development. They are instrumental when the primary research interest is to gain an intensive, detailed understanding of a phenomenon in its real-life context.

In addition, case studies can serve different purposes within research - they can be used for exploratory, descriptive, or explanatory purposes, depending on the research question and objectives. This flexibility and depth make case studies a valuable tool in the toolkit of qualitative researchers.

Remember, a well-conducted case study can offer a rich, insightful contribution to both academic and practical knowledge through theory development or theory verification, thus enhancing our understanding of complex phenomena in their real-world contexts.

What is the purpose of a case study?

Case study research aims for a more comprehensive understanding of phenomena, requiring various research methods to gather information for qualitative analysis . Ultimately, a case study can allow the researcher to gain insight into a particular object of inquiry and develop a theoretical framework relevant to the research inquiry.

Why use case studies in qualitative research?

Using case studies as a research strategy depends mainly on the nature of the research question and the researcher's access to the data.

Conducting case study research provides a level of detail and contextual richness that other research methods might not offer. They are beneficial when there's a need to understand complex social phenomena within their natural contexts.

The explanatory, exploratory, and descriptive roles of case studies

Case studies can take on various roles depending on the research objectives. They can be exploratory when the research aims to discover new phenomena or define new research questions; they are descriptive when the objective is to depict a phenomenon within its context in a detailed manner; and they can be explanatory if the goal is to understand specific relationships within the studied context. Thus, the versatility of case studies allows researchers to approach their topic from different angles, offering multiple ways to uncover and interpret the data .

The impact of case studies on knowledge development

Case studies play a significant role in knowledge development across various disciplines. Analysis of cases provides an avenue for researchers to explore phenomena within their context based on the collected data.

This can result in the production of rich, practical insights that can be instrumental in both theory-building and practice. Case studies allow researchers to delve into the intricacies and complexities of real-life situations, uncovering insights that might otherwise remain hidden.

Types of case studies

In qualitative research , a case study is not a one-size-fits-all approach. Depending on the nature of the research question and the specific objectives of the study, researchers might choose to use different types of case studies. These types differ in their focus, methodology, and the level of detail they provide about the phenomenon under investigation.

Understanding these types is crucial for selecting the most appropriate approach for your research project and effectively achieving your research goals. Let's briefly look at the main types of case studies.

Exploratory case studies

Exploratory case studies are typically conducted to develop a theory or framework around an understudied phenomenon. They can also serve as a precursor to a larger-scale research project. Exploratory case studies are useful when a researcher wants to identify the key issues or questions which can spur more extensive study or be used to develop propositions for further research. These case studies are characterized by flexibility, allowing researchers to explore various aspects of a phenomenon as they emerge, which can also form the foundation for subsequent studies.

Descriptive case studies

Descriptive case studies aim to provide a complete and accurate representation of a phenomenon or event within its context. These case studies are often based on an established theoretical framework, which guides how data is collected and analyzed. The researcher is concerned with describing the phenomenon in detail, as it occurs naturally, without trying to influence or manipulate it.

Explanatory case studies

Explanatory case studies are focused on explanation - they seek to clarify how or why certain phenomena occur. Often used in complex, real-life situations, they can be particularly valuable in clarifying causal relationships among concepts and understanding the interplay between different factors within a specific context.

Intrinsic, instrumental, and collective case studies

These three categories of case studies focus on the nature and purpose of the study. An intrinsic case study is conducted when a researcher has an inherent interest in the case itself. Instrumental case studies are employed when the case is used to provide insight into a particular issue or phenomenon. A collective case study, on the other hand, involves studying multiple cases simultaneously to investigate some general phenomena.

Each type of case study serves a different purpose and has its own strengths and challenges. The selection of the type should be guided by the research question and objectives, as well as the context and constraints of the research.

The flexibility, depth, and contextual richness offered by case studies make this approach an excellent research method for various fields of study. They enable researchers to investigate real-world phenomena within their specific contexts, capturing nuances that other research methods might miss. Across numerous fields, case studies provide valuable insights into complex issues.

Critical information systems research

Case studies provide a detailed understanding of the role and impact of information systems in different contexts. They offer a platform to explore how information systems are designed, implemented, and used and how they interact with various social, economic, and political factors. Case studies in this field often focus on examining the intricate relationship between technology, organizational processes, and user behavior, helping to uncover insights that can inform better system design and implementation.

Health research

Health research is another field where case studies are highly valuable. They offer a way to explore patient experiences, healthcare delivery processes, and the impact of various interventions in a real-world context.

Case studies can provide a deep understanding of a patient's journey, giving insights into the intricacies of disease progression, treatment effects, and the psychosocial aspects of health and illness.

Asthma research studies

Specifically within medical research, studies on asthma often employ case studies to explore the individual and environmental factors that influence asthma development, management, and outcomes. A case study can provide rich, detailed data about individual patients' experiences, from the triggers and symptoms they experience to the effectiveness of various management strategies. This can be crucial for developing patient-centered asthma care approaches.

Other fields

Apart from the fields mentioned, case studies are also extensively used in business and management research, education research, and political sciences, among many others. They provide an opportunity to delve into the intricacies of real-world situations, allowing for a comprehensive understanding of various phenomena.

Case studies, with their depth and contextual focus, offer unique insights across these varied fields. They allow researchers to illuminate the complexities of real-life situations, contributing to both theory and practice.

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Understanding the key elements of case study design is crucial for conducting rigorous and impactful case study research. A well-structured design guides the researcher through the process, ensuring that the study is methodologically sound and its findings are reliable and valid. The main elements of case study design include the research question , propositions, units of analysis, and the logic linking the data to the propositions.

The research question is the foundation of any research study. A good research question guides the direction of the study and informs the selection of the case, the methods of collecting data, and the analysis techniques. A well-formulated research question in case study research is typically clear, focused, and complex enough to merit further detailed examination of the relevant case(s).

Propositions

Propositions, though not necessary in every case study, provide a direction by stating what we might expect to find in the data collected. They guide how data is collected and analyzed by helping researchers focus on specific aspects of the case. They are particularly important in explanatory case studies, which seek to understand the relationships among concepts within the studied phenomenon.

Units of analysis

The unit of analysis refers to the case, or the main entity or entities that are being analyzed in the study. In case study research, the unit of analysis can be an individual, a group, an organization, a decision, an event, or even a time period. It's crucial to clearly define the unit of analysis, as it shapes the qualitative data analysis process by allowing the researcher to analyze a particular case and synthesize analysis across multiple case studies to draw conclusions.

Argumentation

This refers to the inferential model that allows researchers to draw conclusions from the data. The researcher needs to ensure that there is a clear link between the data, the propositions (if any), and the conclusions drawn. This argumentation is what enables the researcher to make valid and credible inferences about the phenomenon under study.

Understanding and carefully considering these elements in the design phase of a case study can significantly enhance the quality of the research. It can help ensure that the study is methodologically sound and its findings contribute meaningful insights about the case.

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Conducting a case study involves several steps, from defining the research question and selecting the case to collecting and analyzing data . This section outlines these key stages, providing a practical guide on how to conduct case study research.

Defining the research question

The first step in case study research is defining a clear, focused research question. This question should guide the entire research process, from case selection to analysis. It's crucial to ensure that the research question is suitable for a case study approach. Typically, such questions are exploratory or descriptive in nature and focus on understanding a phenomenon within its real-life context.

Selecting and defining the case

The selection of the case should be based on the research question and the objectives of the study. It involves choosing a unique example or a set of examples that provide rich, in-depth data about the phenomenon under investigation. After selecting the case, it's crucial to define it clearly, setting the boundaries of the case, including the time period and the specific context.

Previous research can help guide the case study design. When considering a case study, an example of a case could be taken from previous case study research and used to define cases in a new research inquiry. Considering recently published examples can help understand how to select and define cases effectively.

Developing a detailed case study protocol

A case study protocol outlines the procedures and general rules to be followed during the case study. This includes the data collection methods to be used, the sources of data, and the procedures for analysis. Having a detailed case study protocol ensures consistency and reliability in the study.

The protocol should also consider how to work with the people involved in the research context to grant the research team access to collecting data. As mentioned in previous sections of this guide, establishing rapport is an essential component of qualitative research as it shapes the overall potential for collecting and analyzing data.

Collecting data

Gathering data in case study research often involves multiple sources of evidence, including documents, archival records, interviews, observations, and physical artifacts. This allows for a comprehensive understanding of the case. The process for gathering data should be systematic and carefully documented to ensure the reliability and validity of the study.

Analyzing and interpreting data

The next step is analyzing the data. This involves organizing the data , categorizing it into themes or patterns , and interpreting these patterns to answer the research question. The analysis might also involve comparing the findings with prior research or theoretical propositions.

Writing the case study report

The final step is writing the case study report . This should provide a detailed description of the case, the data, the analysis process, and the findings. The report should be clear, organized, and carefully written to ensure that the reader can understand the case and the conclusions drawn from it.

Each of these steps is crucial in ensuring that the case study research is rigorous, reliable, and provides valuable insights about the case.

The type, depth, and quality of data in your study can significantly influence the validity and utility of the study. In case study research, data is usually collected from multiple sources to provide a comprehensive and nuanced understanding of the case. This section will outline the various methods of collecting data used in case study research and discuss considerations for ensuring the quality of the data.

Interviews are a common method of gathering data in case study research. They can provide rich, in-depth data about the perspectives, experiences, and interpretations of the individuals involved in the case. Interviews can be structured , semi-structured , or unstructured , depending on the research question and the degree of flexibility needed.

Observations

Observations involve the researcher observing the case in its natural setting, providing first-hand information about the case and its context. Observations can provide data that might not be revealed in interviews or documents, such as non-verbal cues or contextual information.

Documents and artifacts

Documents and archival records provide a valuable source of data in case study research. They can include reports, letters, memos, meeting minutes, email correspondence, and various public and private documents related to the case.

These records can provide historical context, corroborate evidence from other sources, and offer insights into the case that might not be apparent from interviews or observations.

Physical artifacts refer to any physical evidence related to the case, such as tools, products, or physical environments. These artifacts can provide tangible insights into the case, complementing the data gathered from other sources.

Ensuring the quality of data collection

Determining the quality of data in case study research requires careful planning and execution. It's crucial to ensure that the data is reliable, accurate, and relevant to the research question. This involves selecting appropriate methods of collecting data, properly training interviewers or observers, and systematically recording and storing the data. It also includes considering ethical issues related to collecting and handling data, such as obtaining informed consent and ensuring the privacy and confidentiality of the participants.

Data analysis

Analyzing case study research involves making sense of the rich, detailed data to answer the research question. This process can be challenging due to the volume and complexity of case study data. However, a systematic and rigorous approach to analysis can ensure that the findings are credible and meaningful. This section outlines the main steps and considerations in analyzing data in case study research.

Organizing the data

The first step in the analysis is organizing the data. This involves sorting the data into manageable sections, often according to the data source or the theme. This step can also involve transcribing interviews, digitizing physical artifacts, or organizing observational data.

Categorizing and coding the data

Once the data is organized, the next step is to categorize or code the data. This involves identifying common themes, patterns, or concepts in the data and assigning codes to relevant data segments. Coding can be done manually or with the help of software tools, and in either case, qualitative analysis software can greatly facilitate the entire coding process. Coding helps to reduce the data to a set of themes or categories that can be more easily analyzed.

Identifying patterns and themes

After coding the data, the researcher looks for patterns or themes in the coded data. This involves comparing and contrasting the codes and looking for relationships or patterns among them. The identified patterns and themes should help answer the research question.

Interpreting the data

Once patterns and themes have been identified, the next step is to interpret these findings. This involves explaining what the patterns or themes mean in the context of the research question and the case. This interpretation should be grounded in the data, but it can also involve drawing on theoretical concepts or prior research.

Verification of the data

The last step in the analysis is verification. This involves checking the accuracy and consistency of the analysis process and confirming that the findings are supported by the data. This can involve re-checking the original data, checking the consistency of codes, or seeking feedback from research participants or peers.

Like any research method , case study research has its strengths and limitations. Researchers must be aware of these, as they can influence the design, conduct, and interpretation of the study.

Understanding the strengths and limitations of case study research can also guide researchers in deciding whether this approach is suitable for their research question . This section outlines some of the key strengths and limitations of case study research.

Benefits include the following:

• Rich, detailed data: One of the main strengths of case study research is that it can generate rich, detailed data about the case. This can provide a deep understanding of the case and its context, which can be valuable in exploring complex phenomena.
• Flexibility: Case study research is flexible in terms of design , data collection , and analysis . A sufficient degree of flexibility allows the researcher to adapt the study according to the case and the emerging findings.
• Real-world context: Case study research involves studying the case in its real-world context, which can provide valuable insights into the interplay between the case and its context.
• Multiple sources of evidence: Case study research often involves collecting data from multiple sources , which can enhance the robustness and validity of the findings.

On the other hand, researchers should consider the following limitations:

• Generalizability: A common criticism of case study research is that its findings might not be generalizable to other cases due to the specificity and uniqueness of each case.
• Time and resource intensive: Case study research can be time and resource intensive due to the depth of the investigation and the amount of collected data.
• Complexity of analysis: The rich, detailed data generated in case study research can make analyzing the data challenging.
• Subjectivity: Given the nature of case study research, there may be a higher degree of subjectivity in interpreting the data , so researchers need to reflect on this and transparently convey to audiences how the research was conducted.

Being aware of these strengths and limitations can help researchers design and conduct case study research effectively and interpret and report the findings appropriately.

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Research Writing and Analysis

• NVivo Group and Study Sessions
• SPSS This link opens in a new window
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• Defense Schedule - Commons Calendar This link opens in a new window
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• Research Alignment Chapter 1 This link opens in a new window
• Step 1: Seek Out Evidence
• Step 2: Explain
• Step 3: The Big Picture
• Step 4: Own It
• Step 5: Illustrate
• Annotated Bibliography
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• Systematic Reviews & Meta-Analyses
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• Problem Statement
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• Quantitative Research Questions
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Writing a Case Study

What is a case study?

A Case study is: 

• An in-depth research design that primarily uses a qualitative methodology but sometimes​​ includes quantitative methodology.
• Used to examine an identifiable problem confirmed through research.
• Used to investigate an individual, group of people, organization, or event.
• Used to mostly answer "how" and "why" questions.

What are the different types of case studies?

Note: These are the primary case studies. As you continue to research and learn

about case studies you will begin to find a robust list of different types. 

Who are your case study participants?

What is triangulation ? 

Validity and credibility are an essential part of the case study. Therefore, the researcher should include triangulation to ensure trustworthiness while accurately reflecting what the researcher seeks to investigate.

How to write a Case Study?

When developing a case study, there are different ways you could present the information, but remember to include the five parts for your case study.

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Case Study Research Method in Psychology

Saul Mcleod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul Mcleod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

Learn about our Editorial Process

Olivia Guy-Evans, MSc

Associate Editor for Simply Psychology

BSc (Hons) Psychology, MSc Psychology of Education

Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.

On This Page:

Case studies are in-depth investigations of a person, group, event, or community. Typically, data is gathered from various sources using several methods (e.g., observations & interviews).

The case study research method originated in clinical medicine (the case history, i.e., the patient’s personal history). In psychology, case studies are often confined to the study of a particular individual.

The information is mainly biographical and relates to events in the individual’s past (i.e., retrospective), as well as to significant events that are currently occurring in his or her everyday life.

The case study is not a research method, but researchers select methods of data collection and analysis that will generate material suitable for case studies.

Freud (1909a, 1909b) conducted very detailed investigations into the private lives of his patients in an attempt to both understand and help them overcome their illnesses.

This makes it clear that the case study is a method that should only be used by a psychologist, therapist, or psychiatrist, i.e., someone with a professional qualification.

There is an ethical issue of competence. Only someone qualified to diagnose and treat a person can conduct a formal case study relating to atypical (i.e., abnormal) behavior or atypical development.

 Famous Case Studies

• Anna O – One of the most famous case studies, documenting psychoanalyst Josef Breuer’s treatment of “Anna O” (real name Bertha Pappenheim) for hysteria in the late 1800s using early psychoanalytic theory.
• Little Hans – A child psychoanalysis case study published by Sigmund Freud in 1909 analyzing his five-year-old patient Herbert Graf’s house phobia as related to the Oedipus complex.
• Bruce/Brenda – Gender identity case of the boy (Bruce) whose botched circumcision led psychologist John Money to advise gender reassignment and raise him as a girl (Brenda) in the 1960s.
• Genie Wiley – Linguistics/psychological development case of the victim of extreme isolation abuse who was studied in 1970s California for effects of early language deprivation on acquiring speech later in life.
• Phineas Gage – One of the most famous neuropsychology case studies analyzes personality changes in railroad worker Phineas Gage after an 1848 brain injury involving a tamping iron piercing his skull.

Clinical Case Studies

• Studying the effectiveness of psychotherapy approaches with an individual patient
• Assessing and treating mental illnesses like depression, anxiety disorders, PTSD
• Neuropsychological cases investigating brain injuries or disorders

Child Psychology Case Studies

• Studying psychological development from birth through adolescence
• Cases of learning disabilities, autism spectrum disorders, ADHD
• Effects of trauma, abuse, deprivation on development

Types of Case Studies

• Explanatory case studies : Used to explore causation in order to find underlying principles. Helpful for doing qualitative analysis to explain presumed causal links.
• Exploratory case studies : Used to explore situations where an intervention being evaluated has no clear set of outcomes. It helps define questions and hypotheses for future research.
• Descriptive case studies : Describe an intervention or phenomenon and the real-life context in which it occurred. It is helpful for illustrating certain topics within an evaluation.
• Multiple-case studies : Used to explore differences between cases and replicate findings across cases. Helpful for comparing and contrasting specific cases.
• Intrinsic : Used to gain a better understanding of a particular case. Helpful for capturing the complexity of a single case.
• Collective : Used to explore a general phenomenon using multiple case studies. Helpful for jointly studying a group of cases in order to inquire into the phenomenon.

Where Do You Find Data for a Case Study?

There are several places to find data for a case study. The key is to gather data from multiple sources to get a complete picture of the case and corroborate facts or findings through triangulation of evidence. Most of this information is likely qualitative (i.e., verbal description rather than measurement), but the psychologist might also collect numerical data.

1. Primary sources

• Interviews – Interviewing key people related to the case to get their perspectives and insights. The interview is an extremely effective procedure for obtaining information about an individual, and it may be used to collect comments from the person’s friends, parents, employer, workmates, and others who have a good knowledge of the person, as well as to obtain facts from the person him or herself.
• Observations – Observing behaviors, interactions, processes, etc., related to the case as they unfold in real-time.
• Documents & Records – Reviewing private documents, diaries, public records, correspondence, meeting minutes, etc., relevant to the case.

2. Secondary sources

• News/Media – News coverage of events related to the case study.
• Academic articles – Journal articles, dissertations etc. that discuss the case.
• Government reports – Official data and records related to the case context.
• Books/films – Books, documentaries or films discussing the case.

3. Archival records

Searching historical archives, museum collections and databases to find relevant documents, visual/audio records related to the case history and context.

Public archives like newspapers, organizational records, photographic collections could all include potentially relevant pieces of information to shed light on attitudes, cultural perspectives, common practices and historical contexts related to psychology.

4. Organizational records

Organizational records offer the advantage of often having large datasets collected over time that can reveal or confirm psychological insights.

Of course, privacy and ethical concerns regarding confidential data must be navigated carefully.

However, with proper protocols, organizational records can provide invaluable context and empirical depth to qualitative case studies exploring the intersection of psychology and organizations.

• Organizational/industrial psychology research : Organizational records like employee surveys, turnover/retention data, policies, incident reports etc. may provide insight into topics like job satisfaction, workplace culture and dynamics, leadership issues, employee behaviors etc.
• Clinical psychology : Therapists/hospitals may grant access to anonymized medical records to study aspects like assessments, diagnoses, treatment plans etc. This could shed light on clinical practices.
• School psychology : Studies could utilize anonymized student records like test scores, grades, disciplinary issues, and counseling referrals to study child development, learning barriers, effectiveness of support programs, and more.

How do I Write a Case Study in Psychology?

Follow specified case study guidelines provided by a journal or your psychology tutor. General components of clinical case studies include: background, symptoms, assessments, diagnosis, treatment, and outcomes. Interpreting the information means the researcher decides what to include or leave out. A good case study should always clarify which information is the factual description and which is an inference or the researcher’s opinion.

1. Introduction

• Provide background on the case context and why it is of interest, presenting background information like demographics, relevant history, and presenting problem.
• Compare briefly to similar published cases if applicable. Clearly state the focus/importance of the case.

2. Case Presentation

• Describe the presenting problem in detail, including symptoms, duration,and impact on daily life.
• Include client demographics like age and gender, information about social relationships, and mental health history.
• Describe all physical, emotional, and/or sensory symptoms reported by the client.
• Use patient quotes to describe the initial complaint verbatim. Follow with full-sentence summaries of relevant history details gathered, including key components that led to a working diagnosis.
• Summarize clinical exam results, namely orthopedic/neurological tests, imaging, lab tests, etc. Note actual results rather than subjective conclusions. Provide images if clearly reproducible/anonymized.
• Clearly state the working diagnosis or clinical impression before transitioning to management.

3. Management and Outcome

• Indicate the total duration of care and number of treatments given over what timeframe. Use specific names/descriptions for any therapies/interventions applied.
• Present the results of the intervention,including any quantitative or qualitative data collected.
• For outcomes, utilize visual analog scales for pain, medication usage logs, etc., if possible. Include patient self-reports of improvement/worsening of symptoms. Note the reason for discharge/end of care.

4. Discussion

• Analyze the case, exploring contributing factors, limitations of the study, and connections to existing research.
• Analyze the effectiveness of the intervention,considering factors like participant adherence, limitations of the study, and potential alternative explanations for the results.
• Identify any questions raised in the case analysis and relate insights to established theories and current research if applicable. Avoid definitive claims about physiological explanations.
• Offer clinical implications, and suggest future research directions.

5. Additional Items

• Thank specific assistants for writing support only. No patient acknowledgments.
• References should directly support any key claims or quotes included.
• Use tables/figures/images only if substantially informative. Include permissions and legends/explanatory notes.
• Provides detailed (rich qualitative) information.
• Provides insight for further research.
• Permitting investigation of otherwise impractical (or unethical) situations.

Case studies allow a researcher to investigate a topic in far more detail than might be possible if they were trying to deal with a large number of research participants (nomothetic approach) with the aim of ‘averaging’.

Because of their in-depth, multi-sided approach, case studies often shed light on aspects of human thinking and behavior that would be unethical or impractical to study in other ways.

Research that only looks into the measurable aspects of human behavior is not likely to give us insights into the subjective dimension of experience, which is important to psychoanalytic and humanistic psychologists.

Case studies are often used in exploratory research. They can help us generate new ideas (that might be tested by other methods). They are an important way of illustrating theories and can help show how different aspects of a person’s life are related to each other.

The method is, therefore, important for psychologists who adopt a holistic point of view (i.e., humanistic psychologists ).

Limitations

• Lacking scientific rigor and providing little basis for generalization of results to the wider population.
• Researchers’ own subjective feelings may influence the case study (researcher bias).
• Difficult to replicate.
• Time-consuming and expensive.
• The volume of data, together with the time restrictions in place, impacted the depth of analysis that was possible within the available resources.

Because a case study deals with only one person/event/group, we can never be sure if the case study investigated is representative of the wider body of “similar” instances. This means the conclusions drawn from a particular case may not be transferable to other settings.

Because case studies are based on the analysis of qualitative (i.e., descriptive) data , a lot depends on the psychologist’s interpretation of the information she has acquired.

This means that there is a lot of scope for Anna O , and it could be that the subjective opinions of the psychologist intrude in the assessment of what the data means.

For example, Freud has been criticized for producing case studies in which the information was sometimes distorted to fit particular behavioral theories (e.g., Little Hans ).

This is also true of Money’s interpretation of the Bruce/Brenda case study (Diamond, 1997) when he ignored evidence that went against his theory.

Breuer, J., & Freud, S. (1895).  Studies on hysteria . Standard Edition 2: London.

Curtiss, S. (1981). Genie: The case of a modern wild child .

Diamond, M., & Sigmundson, K. (1997). Sex Reassignment at Birth: Long-term Review and Clinical Implications. Archives of Pediatrics & Adolescent Medicine , 151(3), 298-304

Freud, S. (1909a). Analysis of a phobia of a five year old boy. In The Pelican Freud Library (1977), Vol 8, Case Histories 1, pages 169-306

Freud, S. (1909b). Bemerkungen über einen Fall von Zwangsneurose (Der “Rattenmann”). Jb. psychoanal. psychopathol. Forsch ., I, p. 357-421; GW, VII, p. 379-463; Notes upon a case of obsessional neurosis, SE , 10: 151-318.

Harlow J. M. (1848). Passage of an iron rod through the head.  Boston Medical and Surgical Journal, 39 , 389–393.

Harlow, J. M. (1868).  Recovery from the Passage of an Iron Bar through the Head .  Publications of the Massachusetts Medical Society. 2  (3), 327-347.

Money, J., & Ehrhardt, A. A. (1972).  Man & Woman, Boy & Girl : The Differentiation and Dimorphism of Gender Identity from Conception to Maturity. Baltimore, Maryland: Johns Hopkins University Press.

Money, J., & Tucker, P. (1975). Sexual signatures: On being a man or a woman.

Further Information

• Case Study Approach
• Case Study Method
• Enhancing the Quality of Case Studies in Health Services Research
• “We do things together” A case study of “couplehood” in dementia
• Using mixed methods for evaluating an integrative approach to cancer care: a case study

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Organizing Your Social Sciences Research Assignments

• Annotated Bibliography
• Analyzing a Scholarly Journal Article
• Group Presentations
• Dealing with Nervousness
• Using Visual Aids
• Grading Someone Else's Paper
• Types of Structured Group Activities
• Group Project Survival Skills
• Leading a Class Discussion
• Multiple Book Review Essay
• Reviewing Collected Works
• Writing a Case Analysis Paper
• Writing a Case Study
• About Informed Consent
• Writing Field Notes
• Writing a Policy Memo
• Writing a Reflective Paper
• Writing a Research Proposal
• Generative AI and Writing
• Acknowledgments

A case study research paper examines a person, place, event, condition, phenomenon, or other type of subject of analysis in order to extrapolate  key themes and results that help predict future trends, illuminate previously hidden issues that can be applied to practice, and/or provide a means for understanding an important research problem with greater clarity. A case study research paper usually examines a single subject of analysis, but case study papers can also be designed as a comparative investigation that shows relationships between two or more subjects. The methods used to study a case can rest within a quantitative, qualitative, or mixed-method investigative paradigm.

Case Studies. Writing@CSU. Colorado State University; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010 ; “What is a Case Study?” In Swanborn, Peter G. Case Study Research: What, Why and How? London: SAGE, 2010.

How to Approach Writing a Case Study Research Paper

General information about how to choose a topic to investigate can be found under the " Choosing a Research Problem " tab in the Organizing Your Social Sciences Research Paper writing guide. Review this page because it may help you identify a subject of analysis that can be investigated using a case study design.

However, identifying a case to investigate involves more than choosing the research problem . A case study encompasses a problem contextualized around the application of in-depth analysis, interpretation, and discussion, often resulting in specific recommendations for action or for improving existing conditions. As Seawright and Gerring note, practical considerations such as time and access to information can influence case selection, but these issues should not be the sole factors used in describing the methodological justification for identifying a particular case to study. Given this, selecting a case includes considering the following:

• The case represents an unusual or atypical example of a research problem that requires more in-depth analysis? Cases often represent a topic that rests on the fringes of prior investigations because the case may provide new ways of understanding the research problem. For example, if the research problem is to identify strategies to improve policies that support girl's access to secondary education in predominantly Muslim nations, you could consider using Azerbaijan as a case study rather than selecting a more obvious nation in the Middle East. Doing so may reveal important new insights into recommending how governments in other predominantly Muslim nations can formulate policies that support improved access to education for girls.
• The case provides important insight or illuminate a previously hidden problem? In-depth analysis of a case can be based on the hypothesis that the case study will reveal trends or issues that have not been exposed in prior research or will reveal new and important implications for practice. For example, anecdotal evidence may suggest drug use among homeless veterans is related to their patterns of travel throughout the day. Assuming prior studies have not looked at individual travel choices as a way to study access to illicit drug use, a case study that observes a homeless veteran could reveal how issues of personal mobility choices facilitate regular access to illicit drugs. Note that it is important to conduct a thorough literature review to ensure that your assumption about the need to reveal new insights or previously hidden problems is valid and evidence-based.
• The case challenges and offers a counter-point to prevailing assumptions? Over time, research on any given topic can fall into a trap of developing assumptions based on outdated studies that are still applied to new or changing conditions or the idea that something should simply be accepted as "common sense," even though the issue has not been thoroughly tested in current practice. A case study analysis may offer an opportunity to gather evidence that challenges prevailing assumptions about a research problem and provide a new set of recommendations applied to practice that have not been tested previously. For example, perhaps there has been a long practice among scholars to apply a particular theory in explaining the relationship between two subjects of analysis. Your case could challenge this assumption by applying an innovative theoretical framework [perhaps borrowed from another discipline] to explore whether this approach offers new ways of understanding the research problem. Taking a contrarian stance is one of the most important ways that new knowledge and understanding develops from existing literature.
• The case provides an opportunity to pursue action leading to the resolution of a problem? Another way to think about choosing a case to study is to consider how the results from investigating a particular case may result in findings that reveal ways in which to resolve an existing or emerging problem. For example, studying the case of an unforeseen incident, such as a fatal accident at a railroad crossing, can reveal hidden issues that could be applied to preventative measures that contribute to reducing the chance of accidents in the future. In this example, a case study investigating the accident could lead to a better understanding of where to strategically locate additional signals at other railroad crossings so as to better warn drivers of an approaching train, particularly when visibility is hindered by heavy rain, fog, or at night.
• The case offers a new direction in future research? A case study can be used as a tool for an exploratory investigation that highlights the need for further research about the problem. A case can be used when there are few studies that help predict an outcome or that establish a clear understanding about how best to proceed in addressing a problem. For example, after conducting a thorough literature review [very important!], you discover that little research exists showing the ways in which women contribute to promoting water conservation in rural communities of east central Africa. A case study of how women contribute to saving water in a rural village of Uganda can lay the foundation for understanding the need for more thorough research that documents how women in their roles as cooks and family caregivers think about water as a valuable resource within their community. This example of a case study could also point to the need for scholars to build new theoretical frameworks around the topic [e.g., applying feminist theories of work and family to the issue of water conservation].

Eisenhardt, Kathleen M. “Building Theories from Case Study Research.” Academy of Management Review 14 (October 1989): 532-550; Emmel, Nick. Sampling and Choosing Cases in Qualitative Research: A Realist Approach . Thousand Oaks, CA: SAGE Publications, 2013; Gerring, John. “What Is a Case Study and What Is It Good for?” American Political Science Review 98 (May 2004): 341-354; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Seawright, Jason and John Gerring. "Case Selection Techniques in Case Study Research." Political Research Quarterly 61 (June 2008): 294-308.

Structure and Writing Style

The purpose of a paper in the social sciences designed around a case study is to thoroughly investigate a subject of analysis in order to reveal a new understanding about the research problem and, in so doing, contributing new knowledge to what is already known from previous studies. In applied social sciences disciplines [e.g., education, social work, public administration, etc.], case studies may also be used to reveal best practices, highlight key programs, or investigate interesting aspects of professional work.

In general, the structure of a case study research paper is not all that different from a standard college-level research paper. However, there are subtle differences you should be aware of. Here are the key elements to organizing and writing a case study research paper.

I.  Introduction

As with any research paper, your introduction should serve as a roadmap for your readers to ascertain the scope and purpose of your study . The introduction to a case study research paper, however, should not only describe the research problem and its significance, but you should also succinctly describe why the case is being used and how it relates to addressing the problem. The two elements should be linked. With this in mind, a good introduction answers these four questions:

• What is being studied? Describe the research problem and describe the subject of analysis [the case] you have chosen to address the problem. Explain how they are linked and what elements of the case will help to expand knowledge and understanding about the problem.
• Why is this topic important to investigate? Describe the significance of the research problem and state why a case study design and the subject of analysis that the paper is designed around is appropriate in addressing the problem.
• What did we know about this topic before I did this study? Provide background that helps lead the reader into the more in-depth literature review to follow. If applicable, summarize prior case study research applied to the research problem and why it fails to adequately address the problem. Describe why your case will be useful. If no prior case studies have been used to address the research problem, explain why you have selected this subject of analysis.
• How will this study advance new knowledge or new ways of understanding? Explain why your case study will be suitable in helping to expand knowledge and understanding about the research problem.

Each of these questions should be addressed in no more than a few paragraphs. Exceptions to this can be when you are addressing a complex research problem or subject of analysis that requires more in-depth background information.

II.  Literature Review

The literature review for a case study research paper is generally structured the same as it is for any college-level research paper. The difference, however, is that the literature review is focused on providing background information and  enabling historical interpretation of the subject of analysis in relation to the research problem the case is intended to address . This includes synthesizing studies that help to:

• Place relevant works in the context of their contribution to understanding the case study being investigated . This would involve summarizing studies that have used a similar subject of analysis to investigate the research problem. If there is literature using the same or a very similar case to study, you need to explain why duplicating past research is important [e.g., conditions have changed; prior studies were conducted long ago, etc.].
• Describe the relationship each work has to the others under consideration that informs the reader why this case is applicable . Your literature review should include a description of any works that support using the case to investigate the research problem and the underlying research questions.
• Identify new ways to interpret prior research using the case study . If applicable, review any research that has examined the research problem using a different research design. Explain how your use of a case study design may reveal new knowledge or a new perspective or that can redirect research in an important new direction.
• Resolve conflicts amongst seemingly contradictory previous studies . This refers to synthesizing any literature that points to unresolved issues of concern about the research problem and describing how the subject of analysis that forms the case study can help resolve these existing contradictions.
• Point the way in fulfilling a need for additional research . Your review should examine any literature that lays a foundation for understanding why your case study design and the subject of analysis around which you have designed your study may reveal a new way of approaching the research problem or offer a perspective that points to the need for additional research.
• Expose any gaps that exist in the literature that the case study could help to fill . Summarize any literature that not only shows how your subject of analysis contributes to understanding the research problem, but how your case contributes to a new way of understanding the problem that prior research has failed to do.
• Locate your own research within the context of existing literature [very important!] . Collectively, your literature review should always place your case study within the larger domain of prior research about the problem. The overarching purpose of reviewing pertinent literature in a case study paper is to demonstrate that you have thoroughly identified and synthesized prior studies in relation to explaining the relevance of the case in addressing the research problem.

III.  Method

In this section, you explain why you selected a particular case [i.e., subject of analysis] and the strategy you used to identify and ultimately decide that your case was appropriate in addressing the research problem. The way you describe the methods used varies depending on the type of subject of analysis that constitutes your case study.

If your subject of analysis is an incident or event . In the social and behavioral sciences, the event or incident that represents the case to be studied is usually bounded by time and place, with a clear beginning and end and with an identifiable location or position relative to its surroundings. The subject of analysis can be a rare or critical event or it can focus on a typical or regular event. The purpose of studying a rare event is to illuminate new ways of thinking about the broader research problem or to test a hypothesis. Critical incident case studies must describe the method by which you identified the event and explain the process by which you determined the validity of this case to inform broader perspectives about the research problem or to reveal new findings. However, the event does not have to be a rare or uniquely significant to support new thinking about the research problem or to challenge an existing hypothesis. For example, Walo, Bull, and Breen conducted a case study to identify and evaluate the direct and indirect economic benefits and costs of a local sports event in the City of Lismore, New South Wales, Australia. The purpose of their study was to provide new insights from measuring the impact of a typical local sports event that prior studies could not measure well because they focused on large "mega-events." Whether the event is rare or not, the methods section should include an explanation of the following characteristics of the event: a) when did it take place; b) what were the underlying circumstances leading to the event; and, c) what were the consequences of the event in relation to the research problem.

If your subject of analysis is a person. Explain why you selected this particular individual to be studied and describe what experiences they have had that provide an opportunity to advance new understandings about the research problem. Mention any background about this person which might help the reader understand the significance of their experiences that make them worthy of study. This includes describing the relationships this person has had with other people, institutions, and/or events that support using them as the subject for a case study research paper. It is particularly important to differentiate the person as the subject of analysis from others and to succinctly explain how the person relates to examining the research problem [e.g., why is one politician in a particular local election used to show an increase in voter turnout from any other candidate running in the election]. Note that these issues apply to a specific group of people used as a case study unit of analysis [e.g., a classroom of students].

If your subject of analysis is a place. In general, a case study that investigates a place suggests a subject of analysis that is unique or special in some way and that this uniqueness can be used to build new understanding or knowledge about the research problem. A case study of a place must not only describe its various attributes relevant to the research problem [e.g., physical, social, historical, cultural, economic, political], but you must state the method by which you determined that this place will illuminate new understandings about the research problem. It is also important to articulate why a particular place as the case for study is being used if similar places also exist [i.e., if you are studying patterns of homeless encampments of veterans in open spaces, explain why you are studying Echo Park in Los Angeles rather than Griffith Park?]. If applicable, describe what type of human activity involving this place makes it a good choice to study [e.g., prior research suggests Echo Park has more homeless veterans].

If your subject of analysis is a phenomenon. A phenomenon refers to a fact, occurrence, or circumstance that can be studied or observed but with the cause or explanation to be in question. In this sense, a phenomenon that forms your subject of analysis can encompass anything that can be observed or presumed to exist but is not fully understood. In the social and behavioral sciences, the case usually focuses on human interaction within a complex physical, social, economic, cultural, or political system. For example, the phenomenon could be the observation that many vehicles used by ISIS fighters are small trucks with English language advertisements on them. The research problem could be that ISIS fighters are difficult to combat because they are highly mobile. The research questions could be how and by what means are these vehicles used by ISIS being supplied to the militants and how might supply lines to these vehicles be cut off? How might knowing the suppliers of these trucks reveal larger networks of collaborators and financial support? A case study of a phenomenon most often encompasses an in-depth analysis of a cause and effect that is grounded in an interactive relationship between people and their environment in some way.

NOTE:   The choice of the case or set of cases to study cannot appear random. Evidence that supports the method by which you identified and chose your subject of analysis should clearly support investigation of the research problem and linked to key findings from your literature review. Be sure to cite any studies that helped you determine that the case you chose was appropriate for examining the problem.

IV.  Discussion

The main elements of your discussion section are generally the same as any research paper, but centered around interpreting and drawing conclusions about the key findings from your analysis of the case study. Note that a general social sciences research paper may contain a separate section to report findings. However, in a paper designed around a case study, it is common to combine a description of the results with the discussion about their implications. The objectives of your discussion section should include the following:

Reiterate the Research Problem/State the Major Findings Briefly reiterate the research problem you are investigating and explain why the subject of analysis around which you designed the case study were used. You should then describe the findings revealed from your study of the case using direct, declarative, and succinct proclamation of the study results. Highlight any findings that were unexpected or especially profound.

Explain the Meaning of the Findings and Why They are Important Systematically explain the meaning of your case study findings and why you believe they are important. Begin this part of the section by repeating what you consider to be your most important or surprising finding first, then systematically review each finding. Be sure to thoroughly extrapolate what your analysis of the case can tell the reader about situations or conditions beyond the actual case that was studied while, at the same time, being careful not to misconstrue or conflate a finding that undermines the external validity of your conclusions.

Relate the Findings to Similar Studies No study in the social sciences is so novel or possesses such a restricted focus that it has absolutely no relation to previously published research. The discussion section should relate your case study results to those found in other studies, particularly if questions raised from prior studies served as the motivation for choosing your subject of analysis. This is important because comparing and contrasting the findings of other studies helps support the overall importance of your results and it highlights how and in what ways your case study design and the subject of analysis differs from prior research about the topic.

Consider Alternative Explanations of the Findings Remember that the purpose of social science research is to discover and not to prove. When writing the discussion section, you should carefully consider all possible explanations revealed by the case study results, rather than just those that fit your hypothesis or prior assumptions and biases. Be alert to what the in-depth analysis of the case may reveal about the research problem, including offering a contrarian perspective to what scholars have stated in prior research if that is how the findings can be interpreted from your case.

Acknowledge the Study's Limitations You can state the study's limitations in the conclusion section of your paper but describing the limitations of your subject of analysis in the discussion section provides an opportunity to identify the limitations and explain why they are not significant. This part of the discussion section should also note any unanswered questions or issues your case study could not address. More detailed information about how to document any limitations to your research can be found here .

Suggest Areas for Further Research Although your case study may offer important insights about the research problem, there are likely additional questions related to the problem that remain unanswered or findings that unexpectedly revealed themselves as a result of your in-depth analysis of the case. Be sure that the recommendations for further research are linked to the research problem and that you explain why your recommendations are valid in other contexts and based on the original assumptions of your study.

V.  Conclusion

As with any research paper, you should summarize your conclusion in clear, simple language; emphasize how the findings from your case study differs from or supports prior research and why. Do not simply reiterate the discussion section. Provide a synthesis of key findings presented in the paper to show how these converge to address the research problem. If you haven't already done so in the discussion section, be sure to document the limitations of your case study and any need for further research.

The function of your paper's conclusion is to: 1) reiterate the main argument supported by the findings from your case study; 2) state clearly the context, background, and necessity of pursuing the research problem using a case study design in relation to an issue, controversy, or a gap found from reviewing the literature; and, 3) provide a place to persuasively and succinctly restate the significance of your research problem, given that the reader has now been presented with in-depth information about the topic.

Consider the following points to help ensure your conclusion is appropriate:

• If the argument or purpose of your paper is complex, you may need to summarize these points for your reader.
• If prior to your conclusion, you have not yet explained the significance of your findings or if you are proceeding inductively, use the conclusion of your paper to describe your main points and explain their significance.
• Move from a detailed to a general level of consideration of the case study's findings that returns the topic to the context provided by the introduction or within a new context that emerges from your case study findings.

Note that, depending on the discipline you are writing in or the preferences of your professor, the concluding paragraph may contain your final reflections on the evidence presented as it applies to practice or on the essay's central research problem. However, the nature of being introspective about the subject of analysis you have investigated will depend on whether you are explicitly asked to express your observations in this way.

Problems to Avoid

Overgeneralization One of the goals of a case study is to lay a foundation for understanding broader trends and issues applied to similar circumstances. However, be careful when drawing conclusions from your case study. They must be evidence-based and grounded in the results of the study; otherwise, it is merely speculation. Looking at a prior example, it would be incorrect to state that a factor in improving girls access to education in Azerbaijan and the policy implications this may have for improving access in other Muslim nations is due to girls access to social media if there is no documentary evidence from your case study to indicate this. There may be anecdotal evidence that retention rates were better for girls who were engaged with social media, but this observation would only point to the need for further research and would not be a definitive finding if this was not a part of your original research agenda.

Failure to Document Limitations No case is going to reveal all that needs to be understood about a research problem. Therefore, just as you have to clearly state the limitations of a general research study , you must describe the specific limitations inherent in the subject of analysis. For example, the case of studying how women conceptualize the need for water conservation in a village in Uganda could have limited application in other cultural contexts or in areas where fresh water from rivers or lakes is plentiful and, therefore, conservation is understood more in terms of managing access rather than preserving access to a scarce resource.

Failure to Extrapolate All Possible Implications Just as you don't want to over-generalize from your case study findings, you also have to be thorough in the consideration of all possible outcomes or recommendations derived from your findings. If you do not, your reader may question the validity of your analysis, particularly if you failed to document an obvious outcome from your case study research. For example, in the case of studying the accident at the railroad crossing to evaluate where and what types of warning signals should be located, you failed to take into consideration speed limit signage as well as warning signals. When designing your case study, be sure you have thoroughly addressed all aspects of the problem and do not leave gaps in your analysis that leave the reader questioning the results.

Case Studies. Writing@CSU. Colorado State University; Gerring, John. Case Study Research: Principles and Practices . New York: Cambridge University Press, 2007; Merriam, Sharan B. Qualitative Research and Case Study Applications in Education . Rev. ed. San Francisco, CA: Jossey-Bass, 1998; Miller, Lisa L. “The Use of Case Studies in Law and Social Science Research.” Annual Review of Law and Social Science 14 (2018): TBD; Mills, Albert J., Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Putney, LeAnn Grogan. "Case Study." In Encyclopedia of Research Design , Neil J. Salkind, editor. (Thousand Oaks, CA: SAGE Publications, 2010), pp. 116-120; Simons, Helen. Case Study Research in Practice . London: SAGE Publications, 2009;  Kratochwill,  Thomas R. and Joel R. Levin, editors. Single-Case Research Design and Analysis: New Development for Psychology and Education .  Hilldsale, NJ: Lawrence Erlbaum Associates, 1992; Swanborn, Peter G. Case Study Research: What, Why and How? London : SAGE, 2010; Yin, Robert K. Case Study Research: Design and Methods . 6th edition. Los Angeles, CA, SAGE Publications, 2014; Walo, Maree, Adrian Bull, and Helen Breen. “Achieving Economic Benefits at Local Events: A Case Study of a Local Sports Event.” Festival Management and Event Tourism 4 (1996): 95-106.

Writing Tip

At Least Five Misconceptions about Case Study Research

Social science case studies are often perceived as limited in their ability to create new knowledge because they are not randomly selected and findings cannot be generalized to larger populations. Flyvbjerg examines five misunderstandings about case study research and systematically "corrects" each one. To quote, these are:

Misunderstanding 1 :  General, theoretical [context-independent] knowledge is more valuable than concrete, practical [context-dependent] knowledge. Misunderstanding 2 :  One cannot generalize on the basis of an individual case; therefore, the case study cannot contribute to scientific development. Misunderstanding 3 :  The case study is most useful for generating hypotheses; that is, in the first stage of a total research process, whereas other methods are more suitable for hypotheses testing and theory building. Misunderstanding 4 :  The case study contains a bias toward verification, that is, a tendency to confirm the researcher’s preconceived notions. Misunderstanding 5 :  It is often difficult to summarize and develop general propositions and theories on the basis of specific case studies [p. 221].

While writing your paper, think introspectively about how you addressed these misconceptions because to do so can help you strengthen the validity and reliability of your research by clarifying issues of case selection, the testing and challenging of existing assumptions, the interpretation of key findings, and the summation of case outcomes. Think of a case study research paper as a complete, in-depth narrative about the specific properties and key characteristics of your subject of analysis applied to the research problem.

Flyvbjerg, Bent. “Five Misunderstandings About Case-Study Research.” Qualitative Inquiry 12 (April 2006): 219-245.

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What Is a Case Study?

Weighing the pros and cons of this method of research

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Cara Lustik is a fact-checker and copywriter.

Verywell / Colleen Tighe

• Pros and Cons

What Types of Case Studies Are Out There?

Where do you find data for a case study, how do i write a psychology case study.

A case study is an in-depth study of one person, group, or event. In a case study, nearly every aspect of the subject's life and history is analyzed to seek patterns and causes of behavior. Case studies can be used in many different fields, including psychology, medicine, education, anthropology, political science, and social work.

The point of a case study is to learn as much as possible about an individual or group so that the information can be generalized to many others. Unfortunately, case studies tend to be highly subjective, and it is sometimes difficult to generalize results to a larger population.

While case studies focus on a single individual or group, they follow a format similar to other types of psychology writing. If you are writing a case study, we got you—here are some rules of APA format to reference.  

At a Glance

A case study, or an in-depth study of a person, group, or event, can be a useful research tool when used wisely. In many cases, case studies are best used in situations where it would be difficult or impossible for you to conduct an experiment. They are helpful for looking at unique situations and allow researchers to gather a lot of˜ information about a specific individual or group of people. However, it's important to be cautious of any bias we draw from them as they are highly subjective.

What Are the Benefits and Limitations of Case Studies?

A case study can have its strengths and weaknesses. Researchers must consider these pros and cons before deciding if this type of study is appropriate for their needs.

One of the greatest advantages of a case study is that it allows researchers to investigate things that are often difficult or impossible to replicate in a lab. Some other benefits of a case study:

• Allows researchers to capture information on the 'how,' 'what,' and 'why,' of something that's implemented
• Gives researchers the chance to collect information on why one strategy might be chosen over another
• Permits researchers to develop hypotheses that can be explored in experimental research

On the other hand, a case study can have some drawbacks:

• It cannot necessarily be generalized to the larger population
• Cannot demonstrate cause and effect
• It may not be scientifically rigorous
• It can lead to bias

Researchers may choose to perform a case study if they want to explore a unique or recently discovered phenomenon. Through their insights, researchers develop additional ideas and study questions that might be explored in future studies.

It's important to remember that the insights from case studies cannot be used to determine cause-and-effect relationships between variables. However, case studies may be used to develop hypotheses that can then be addressed in experimental research.

Case Study Examples

There have been a number of notable case studies in the history of psychology. Much of  Freud's work and theories were developed through individual case studies. Some great examples of case studies in psychology include:

• Anna O : Anna O. was a pseudonym of a woman named Bertha Pappenheim, a patient of a physician named Josef Breuer. While she was never a patient of Freud's, Freud and Breuer discussed her case extensively. The woman was experiencing symptoms of a condition that was then known as hysteria and found that talking about her problems helped relieve her symptoms. Her case played an important part in the development of talk therapy as an approach to mental health treatment.
• Phineas Gage : Phineas Gage was a railroad employee who experienced a terrible accident in which an explosion sent a metal rod through his skull, damaging important portions of his brain. Gage recovered from his accident but was left with serious changes in both personality and behavior.
• Genie : Genie was a young girl subjected to horrific abuse and isolation. The case study of Genie allowed researchers to study whether language learning was possible, even after missing critical periods for language development. Her case also served as an example of how scientific research may interfere with treatment and lead to further abuse of vulnerable individuals.

Such cases demonstrate how case research can be used to study things that researchers could not replicate in experimental settings. In Genie's case, her horrific abuse denied her the opportunity to learn a language at critical points in her development.

This is clearly not something researchers could ethically replicate, but conducting a case study on Genie allowed researchers to study phenomena that are otherwise impossible to reproduce.

There are a few different types of case studies that psychologists and other researchers might use:

• Collective case studies : These involve studying a group of individuals. Researchers might study a group of people in a certain setting or look at an entire community. For example, psychologists might explore how access to resources in a community has affected the collective mental well-being of those who live there.
• Descriptive case studies : These involve starting with a descriptive theory. The subjects are then observed, and the information gathered is compared to the pre-existing theory.
• Explanatory case studies : These   are often used to do causal investigations. In other words, researchers are interested in looking at factors that may have caused certain things to occur.
• Exploratory case studies : These are sometimes used as a prelude to further, more in-depth research. This allows researchers to gather more information before developing their research questions and hypotheses .
• Instrumental case studies : These occur when the individual or group allows researchers to understand more than what is initially obvious to observers.
• Intrinsic case studies : This type of case study is when the researcher has a personal interest in the case. Jean Piaget's observations of his own children are good examples of how an intrinsic case study can contribute to the development of a psychological theory.

The three main case study types often used are intrinsic, instrumental, and collective. Intrinsic case studies are useful for learning about unique cases. Instrumental case studies help look at an individual to learn more about a broader issue. A collective case study can be useful for looking at several cases simultaneously.

The type of case study that psychology researchers use depends on the unique characteristics of the situation and the case itself.

There are a number of different sources and methods that researchers can use to gather information about an individual or group. Six major sources that have been identified by researchers are:

• Archival records : Census records, survey records, and name lists are examples of archival records.
• Direct observation : This strategy involves observing the subject, often in a natural setting . While an individual observer is sometimes used, it is more common to utilize a group of observers.
• Documents : Letters, newspaper articles, administrative records, etc., are the types of documents often used as sources.
• Interviews : Interviews are one of the most important methods for gathering information in case studies. An interview can involve structured survey questions or more open-ended questions.
• Participant observation : When the researcher serves as a participant in events and observes the actions and outcomes, it is called participant observation.
• Physical artifacts : Tools, objects, instruments, and other artifacts are often observed during a direct observation of the subject.

If you have been directed to write a case study for a psychology course, be sure to check with your instructor for any specific guidelines you need to follow. If you are writing your case study for a professional publication, check with the publisher for their specific guidelines for submitting a case study.

Here is a general outline of what should be included in a case study.

Section 1: A Case History

This section will have the following structure and content:

Background information : The first section of your paper will present your client's background. Include factors such as age, gender, work, health status, family mental health history, family and social relationships, drug and alcohol history, life difficulties, goals, and coping skills and weaknesses.

Description of the presenting problem : In the next section of your case study, you will describe the problem or symptoms that the client presented with.

Describe any physical, emotional, or sensory symptoms reported by the client. Thoughts, feelings, and perceptions related to the symptoms should also be noted. Any screening or diagnostic assessments that are used should also be described in detail and all scores reported.

Your diagnosis : Provide your diagnosis and give the appropriate Diagnostic and Statistical Manual code. Explain how you reached your diagnosis, how the client's symptoms fit the diagnostic criteria for the disorder(s), or any possible difficulties in reaching a diagnosis.

Section 2: Treatment Plan

This portion of the paper will address the chosen treatment for the condition. This might also include the theoretical basis for the chosen treatment or any other evidence that might exist to support why this approach was chosen.

• Cognitive behavioral approach : Explain how a cognitive behavioral therapist would approach treatment. Offer background information on cognitive behavioral therapy and describe the treatment sessions, client response, and outcome of this type of treatment. Make note of any difficulties or successes encountered by your client during treatment.
• Humanistic approach : Describe a humanistic approach that could be used to treat your client, such as client-centered therapy . Provide information on the type of treatment you chose, the client's reaction to the treatment, and the end result of this approach. Explain why the treatment was successful or unsuccessful.
• Psychoanalytic approach : Describe how a psychoanalytic therapist would view the client's problem. Provide some background on the psychoanalytic approach and cite relevant references. Explain how psychoanalytic therapy would be used to treat the client, how the client would respond to therapy, and the effectiveness of this treatment approach.
• Pharmacological approach : If treatment primarily involves the use of medications, explain which medications were used and why. Provide background on the effectiveness of these medications and how monotherapy may compare with an approach that combines medications with therapy or other treatments.

This section of a case study should also include information about the treatment goals, process, and outcomes.

When you are writing a case study, you should also include a section where you discuss the case study itself, including the strengths and limitiations of the study. You should note how the findings of your case study might support previous research. 

In your discussion section, you should also describe some of the implications of your case study. What ideas or findings might require further exploration? How might researchers go about exploring some of these questions in additional studies?

Need More Tips?

Here are a few additional pointers to keep in mind when formatting your case study:

• Never refer to the subject of your case study as "the client." Instead, use their name or a pseudonym.
• Read examples of case studies to gain an idea about the style and format.
• Remember to use APA format when citing references .

Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach .  BMC Med Res Methodol . 2011;11:100.

Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach . BMC Med Res Methodol . 2011 Jun 27;11:100. doi:10.1186/1471-2288-11-100

Gagnon, Yves-Chantal.  The Case Study as Research Method: A Practical Handbook . Canada, Chicago Review Press Incorporated DBA Independent Pub Group, 2010.

Yin, Robert K. Case Study Research and Applications: Design and Methods . United States, SAGE Publications, 2017.

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

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• Introduction

The case study creation process

Types of case studies, benefits and limitations.

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• Table Of Contents

case study , detailed description and assessment of a specific situation in the real world created for the purpose of deriving generalizations and other insights from it. A case study can be about an individual, a group of people, an organization, or an event, among other subjects.

By focusing on a specific subject in its natural setting, a case study can help improve understanding of the broader features and processes at work. Case studies are a research method used in multiple fields, including business, criminology , education , medicine and other forms of health care, anthropology , political science , psychology , and social work . Data in case studies can be both qualitative and quantitative. Unlike experiments, where researchers control and manipulate situations, case studies are considered to be “naturalistic” because subjects are studied in their natural context . ( See also natural experiment .)

The creation of a case study typically involves the following steps:

• The research question to be studied is defined, informed by existing literature and previous research. Researchers should clearly define the scope of the case, and they should compile a list of evidence to be collected as well as identify the nature of insights that they expect to gain from the case study.
• Once the case is identified, the research team is given access to the individual, organization, or situation being studied. Individuals are informed of risks associated with participation and must provide their consent , which may involve signing confidentiality or anonymity agreements.
• Researchers then collect evidence using multiple methods, which may include qualitative techniques, such as interviews, focus groups , and direct observations, as well as quantitative methods, such as surveys, questionnaires, and data audits. The collection procedures need to be well defined to ensure the relevance and accuracy of the evidence.
• The collected evidence is analyzed to come up with insights. Each data source must be reviewed carefully by itself and in the larger context of the case study so as to ensure continued relevance. At the same time, care must be taken not to force the analysis to fit (potentially preconceived) conclusions. While the eventual case study may serve as the basis for generalizations, these generalizations must be made cautiously to ensure that specific nuances are not lost in the averages.
• Finally, the case study is packaged for larger groups and publication. At this stage some information may be withheld, as in business case studies, to allow readers to draw their own conclusions. In scientific fields, the completed case study needs to be a coherent whole, with all findings and statistical relationships clearly documented.

Case studies have been used as a research method across multiple fields. They are particularly popular in the fields of law, business, and employee training; they typically focus on a problem that an individual or organization is facing. The situation is presented in considerable detail, often with supporting data, to discussion participants, who are asked to make recommendations that will solve the stated problem. The business case study as a method of instruction was made popular in the 1920s by instructors at Harvard Business School who adapted an approach used at Harvard Law School in which real-world cases were used in classroom discussions. Other business and law schools started compiling case studies as teaching aids for students. In a business school case study, students are not provided with the complete list of facts pertaining to the topic and are thus forced to discuss and compare their perspectives with those of their peers to recommend solutions.

In criminology , case studies typically focus on the lives of an individual or a group of individuals. These studies can provide particularly valuable insight into the personalities and motives of individual criminals, but they may suffer from a lack of objectivity on the part of the researchers (typically because of the researchers’ biases when working with people with a criminal history), and their findings may be difficult to generalize.

In sociology , the case-study method was developed by Frédéric Le Play in France during the 19th century. This approach involves a field worker staying with a family for a period of time, gathering data on the family members’ attitudes and interactions and on their income, expenditures, and physical possessions. Similar approaches have been used in anthropology . Such studies can sometimes continue for many years.

Case studies provide insight into situations that involve a specific entity or set of circumstances. They can be beneficial in helping to explain the causal relationships between quantitative indicators in a field of study, such as what drives a company’s market share. By introducing real-world examples, they also plunge the reader into an actual, concrete situation and make the concepts real rather than theoretical. They also help people study rare situations that they might not otherwise experience.

Because case studies are in a “naturalistic” environment , they are limited in terms of research design: researchers lack control over what they are studying, which means that the results often cannot be reproduced. Also, care must be taken to stay within the bounds of the research question on which the case study is focusing. Other limitations to case studies revolve around the data collected. It may be difficult, for instance, for researchers to organize the large volume of data that can emerge from the study, and their analysis of the data must be carefully thought through to produce scientifically valid insights. The research methodology used to generate these insights is as important as the insights themselves, for the latter need to be seen in the proper context. Taken out of context, they may lead to erroneous conclusions. Like all scientific studies, case studies need to be approached objectively; personal bias or opinion may skew the research methods as well as the results. ( See also confirmation bias .)

Business case studies in particular have been criticized for approaching a problem or situation from a narrow perspective. Students are expected to come up with solutions for a problem based on the data provided. However, in real life, the situation is typically reversed: business managers face a problem and must then look for data to help them solve it.

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Blog Beginner Guides What is a Case Study? [+6 Types of Case Studies]

What is a Case Study? [+6 Types of Case Studies]

Written by: Ronita Mohan Sep 20, 2021

Case studies have become powerful business tools. But what is a case study? What are the benefits of creating one? Are there limitations to the format?

If you’ve asked yourself these questions, our helpful guide will clear things up. Learn how to use a case study for business. Find out how cases analysis works in psychology and research.

We’ve also got examples of case studies to inspire you.

Haven’t made a case study before? You can easily  create a case study  with Venngage’s customizable templates.

Click to jump ahead:

What is a case study, what is the case study method, benefits of case studies, limitations of case studies, types of case studies, faqs about case studies.

Case studies are research methodologies. They examine subjects, projects, or organizations to tell a story.

Numerous sectors use case analyses. The social sciences, social work, and psychology create studies regularly.

Healthcare industries write reports on patients and diagnoses. Marketing case study examples , like the one below, highlight the benefits of a business product.

Now that you know what a case study is, we explain how case reports are used in three different industries.

What is a business case study?

A business or marketing case study aims at showcasing a successful partnership. This can be between a brand and a client. Or the case study can examine a brand’s project.

There is a perception that case studies are used to advertise a brand. But effective reports, like the one below, can show clients how a brand can support them.

Hubspot created a case study on a customer that successfully scaled its business. The report outlines the various Hubspot tools used to achieve these results.

Hubspot also added a video with testimonials from the client company’s employees.

So, what is the purpose of a case study for businesses? There is a lot of competition in the corporate world. Companies are run by people. They can be on the fence about which brand to work with.

Business reports  stand out aesthetically, as well. They use  brand colors  and brand fonts . Usually, a combination of the client’s and the brand’s.

With the Venngage  My Brand Kit  feature, businesses can automatically apply their brand to designs.

A business case study, like the one below, acts as social proof. This helps customers decide between your brand and your competitors.

Don’t know how to design a report? You can learn  how to write a case study  with Venngage’s guide. We also share design tips and examples that will help you convert.

Related: 55+ Annual Report Design Templates, Inspirational Examples & Tips [Updated]

What is a case study in psychology?

In the field of psychology, case studies focus on a particular subject. Psychology case histories also examine human behaviors.

Case reports search for commonalities between humans. They are also used to prescribe further research. Or these studies can elaborate on a solution for a behavioral ailment.

The American Psychology Association  has a number of case studies on real-life clients. Note how the reports are more text-heavy than a business case study.

Famous psychologists such as Sigmund Freud and Anna O popularised the use of case studies in the field. They did so by regularly interviewing subjects. Their detailed observations build the field of psychology.

It is important to note that psychological studies must be conducted by professionals. Psychologists, psychiatrists and therapists should be the researchers in these cases.

Related: What Netflix’s Top 50 Shows Can Teach Us About Font Psychology [Infographic]

What is a case study in research?

Research is a necessary part of every case study. But specific research fields are required to create studies. These fields include user research, healthcare, education, or social work.

For example, this UX Design  report examined the public perception of a client. The brand researched and implemented new visuals to improve it. The study breaks down this research through lessons learned.

Clinical reports are a necessity in the medical field. These documents are used to share knowledge with other professionals. They also help examine new or unusual diseases or symptoms.

The pandemic has led to a significant increase in research. For example,  Spectrum Health  studied the value of health systems in the pandemic. They created the study by examining community outreach.

The pandemic has significantly impacted the field of education. This has led to numerous examinations on remote studying. There have also been studies on how students react to decreased peer communication.

Social work case reports often have a community focus. They can also examine public health responses. In certain regions, social workers study disaster responses.

You now know what case studies in various fields are. In the next step of our guide, we explain the case study method.

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A case analysis is a deep dive into a subject. To facilitate this case studies are built on interviews and observations. The below example would have been created after numerous interviews.

Case studies are largely qualitative. They analyze and describe phenomena. While some data is included, a case analysis is not quantitative.

There are a few steps in the case method. You have to start by identifying the subject of your study. Then determine what kind of research is required.

In natural sciences, case studies can take years to complete. Business reports, like this one, don’t take that long. A few weeks of interviews should be enough.

The case method will vary depending on the industry. Reports will also look different once produced.

As you will have seen, business reports are more colorful. The design is also more accessible . Healthcare and psychology reports are more text-heavy.

Designing case reports takes time and energy. So, is it worth taking the time to write them? Here are the benefits of creating case studies.

• Collects large amounts of information
• Helps formulate hypotheses
• Builds the case for further research
• Discovers new insights into a subject
• Builds brand trust and loyalty
• Engages customers through stories

For example, the business study below creates a story around a brand partnership. It makes for engaging reading. The study also shows evidence backing up the information.

We’ve shared the benefits of why studies are needed. We will also look at the limitations of creating them.

Related: How to Present a Case Study like a Pro (With Examples)

There are a few disadvantages to conducting a case analysis. The limitations will vary according to the industry.

• Responses from interviews are subjective
• Subjects may tailor responses to the researcher
• Studies can’t always be replicated
• In certain industries, analyses can take time and be expensive
• Risk of generalizing the results among a larger population

These are some of the common weaknesses of creating case reports. If you’re on the fence, look at the competition in your industry.

Other brands or professionals are building reports, like this example. In that case, you may want to do the same.

There are six common types of case reports. Depending on your industry, you might use one of these types.

Descriptive case studies

Explanatory case studies, exploratory case reports, intrinsic case studies, instrumental case studies, collective case reports.

We go into more detail about each type of study in the guide below.

Related:  15+ Professional Case Study Examples [Design Tips + Templates]

When you have an existing hypothesis, you can design a descriptive study. This type of report starts with a description. The aim is to find connections between the subject being studied and a theory.

Once these connections are found, the study can conclude. The results of this type of study will usually suggest how to develop a theory further.

A study like the one below has concrete results. A descriptive report would use the quantitative data as a suggestion for researching the subject deeply.

When an incident occurs in a field, an explanation is required. An explanatory report investigates the cause of the event. It will include explanations for that cause.

The study will also share details about the impact of the event. In most cases, this report will use evidence to predict future occurrences. The results of explanatory reports are definitive.

Note that there is no room for interpretation here. The results are absolute.

The study below is a good example. It explains how one brand used the services of another. It concludes by showing definitive proof that the collaboration was successful.

Another example of this study would be in the automotive industry. If a vehicle fails a test, an explanatory study will examine why. The results could show that the failure was because of a particular part.

Related: How to Write a Case Study [+ Design Tips]

An explanatory report is a self-contained document. An exploratory one is only the beginning of an investigation.

Exploratory cases act as the starting point of studies. This is usually conducted as a precursor to large-scale investigations. The research is used to suggest why further investigations are needed.

An exploratory study can also be used to suggest methods for further examination.

For example, the below analysis could have found inconclusive results. In that situation, it would be the basis for an in-depth study.

Intrinsic studies are more common in the field of psychology. These reports can also be conducted in healthcare or social work.

These types of studies focus on a unique subject, such as a patient. They can sometimes study groups close to the researcher.

The aim of such studies is to understand the subject better. This requires learning their history. The researcher will also examine how they interact with their environment.

For instance, if the case study below was about a unique brand, it could be an intrinsic study.

Once the study is complete, the researcher will have developed a better understanding of a phenomenon. This phenomenon will likely not have been studied or theorized about before.

Examples of intrinsic case analysis can be found across psychology. For example, Jean Piaget’s theories on cognitive development. He established the theory from intrinsic studies into his own children.

Related: What Disney Villains Can Tell Us About Color Psychology [Infographic]

This is another type of study seen in medical and psychology fields. Instrumental reports are created to examine more than just the primary subject.

When research is conducted for an instrumental study, it is to provide the basis for a larger phenomenon. The subject matter is usually the best example of the phenomenon. This is why it is being studied.

Take the example of the fictional brand below.

Assume it’s examining lead generation strategies. It may want to show that visual marketing is the definitive lead generation tool. The brand can conduct an instrumental case study to examine this phenomenon.

Collective studies are based on instrumental case reports. These types of studies examine multiple reports.

There are a number of reasons why collective reports are created:

• To provide evidence for starting a new study
• To find pattens between multiple instrumental reports
• To find differences in similar types of cases
• Gain a deeper understanding of a complex phenomenon
• Understand a phenomenon from diverse contexts

A researcher could use multiple reports, like the one below, to build a collective case report.

Related: 10+ Case Study Infographic Templates That Convert

What makes a case study a case study?

A case study has a very particular research methodology. They are an in-depth study of a person or a group of individuals. They can also study a community or an organization. Case reports examine real-world phenomena within a set context.

How long should a case study be?

The length of studies depends on the industry. It also depends on the story you’re telling. Most case studies should be at least 500-1500 words long. But you can increase the length if you have more details to share.

What should you ask in a case study?

The one thing you shouldn’t ask is ‘yes’ or ‘no’ questions. Case studies are qualitative. These questions won’t give you the information you need.

Ask your client about the problems they faced. Ask them about solutions they found. Or what they think is the ideal solution. Leave room to ask them follow-up questions. This will help build out the study.

How to present a case study?

When you’re ready to present a case study, begin by providing a summary of the problem or challenge you were addressing. Follow this with an outline of the solution you implemented, and support this with the results you achieved, backed by relevant data. Incorporate visual aids like slides, graphs, and images to make your case study presentation more engaging and impactful.

Now you know what a case study means, you can begin creating one. These reports are a great tool for analyzing brands. They are also useful in a variety of other fields.

Use a visual communication platform like Venngage to design case studies. With Venngage’s templates, you can design easily. Create branded, engaging reports, all without design experience.

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Case Study Research: Methods and Designs

Case study research is a type of qualitative research design. It’s often used in the social sciences because it involves…

Case study research is a type of qualitative research design. It’s often used in the social sciences because it involves observing subjects, or cases, in their natural setting, with minimal interference from the researcher.

In the case study method , researchers pose a specific question about an individual or group to test their theories or hypothesis. This can be done by gathering data from interviews with key informants.

Here’s what you need to know about case study research design .

What Is The Case Study Method?

Main approaches to data collection, case study research methods, how case studies are used, case study model.

Case study research is a great way to understand the nuances of a matter that can get lost in quantitative research methods. A case study is distinct from other qualitative studies in the following ways:

• It’s interested in the effect of a set of circumstances on an individual or group.
• It begins with a specific question about one or more cases.
• It focuses on individual accounts and experiences.

Here are the primary features of case study research:

• Case study research methods typically involve the researcher asking a few questions of one person or a small number of people—known as respondents—to test one hypothesis.
• Case study in research methodology may apply triangulation to collect data, in which the researcher uses several sources, including documents and field data. This is then analyzed and interpreted to form a hypothesis that can be tested through further research or validated by other researchers.
• The case study method requires clear concepts and theories to guide its methods. A well-defined research question is crucial when conducting a case study because the results of the study depend on it. The best approach to answering a research question is to challenge the existing theories, hypotheses or assumptions.
• Concepts are defined using objective language with no reference to preconceived notions that individuals might have about them. The researcher sets out to discover by asking specific questions on how people think or perceive things in their given situation.

They commonly use the case study method in business, management, psychology, sociology, political science and other related fields.

A fundamental requirement of qualitative research is recording observations that provide an understanding of reality. When it comes to the case study method, there are two major approaches that can be used to collect data: document review and fieldwork.

A case study in research methodology also includes literature review, the process by which the researcher collects all data available through historical documents. These might include books, newspapers, journals, videos, photographs and other written material. The researcher may also record information using video cameras to capture events as they occur. The researcher can also go through materials produced by people involved in the case study to gain an insight into their lives and experiences.

Field research involves participating in interviews and observations directly. Observation can be done during telephone interviews, events or public meetings, visits to homes or workplaces, or by shadowing someone for a period of time. The researcher can conduct one-on-one interviews with individuals or group interviews where several people are interviewed at once.

Let’s look now at case study methodology.

The case study method can be divided into three stages: formulation of objectives; collection of data; and analysis and interpretation. The researcher first makes a judgment about what should be studied based on their knowledge. Next, they gather data through observations and interviews. Here are some of the common case study research methods:

One of the most basic methods is the survey. Respondents are asked to complete a questionnaire with open-ended and predetermined questions. It usually takes place through face-to-face interviews, mailed questionnaires or telephone interviews. It can even be done by an online survey.

2. Semi-structured Interview

For case study research a more complex method is the semi-structured interview. This involves the researcher learning about the topic by listening to what others have to say. This usually occurs through one-on-one interviews with the sample. Semi-structured interviews allow for greater flexibility and can obtain information that structured questionnaires can’t.

3. Focus Group Interview

Another method is the focus group interview, where the researcher asks a few people to take part in an open-ended discussion on certain themes or topics. The typical group size is 5–15 people. This method allows researchers to delve deeper into people’s opinions, views and experiences.

4. Participant Observation

Participant observation is another method that involves the researcher gaining insight into an experience by joining in and taking part in normal events. The people involved don’t always know they’re being studied, but the researcher observes and records what happens through field notes.

Case study research design can use one or several of these methods depending on the context.

Case studies are widely used in the social sciences. To understand the impact of socio-economic forces, interpersonal dynamics and other human conditions, sometimes there’s no other way than to study one case at a time and look for patterns and data afterward.

It’s for the same reasons that case studies are used in business. Here are a few uses:

• Case studies can be used as tools to educate and give examples of situations and problems that might occur and how they were resolved. They can also be used for strategy development and implementation.
• Case studies can evaluate the success of a program or project. They can help teams improve their collaboration by identifying areas that need improvements, such as team dynamics, communication, roles and responsibilities and leadership styles.
• Case studies can explore how people’s experiences affect the working environment. Because the study involves observing and analyzing concrete details of life, they can inform theories on how an individual or group interacts with their environment.
• Case studies can evaluate the sustainability of businesses. They’re useful for social, environmental and economic impact studies because they look at all aspects of a business or organization. This gives researchers a holistic view of the dynamics within an organization.
• We can use case studies to identify problems in organizations or businesses. They can help spot problems that are invisible to customers, investors, managers and employees.
• Case studies are used in education to show students how real-world issues or events can be sorted out. This enables students to identify and deal with similar situations in their lives.

And that’s not all. Case studies are incredibly versatile, which is why they’re used so widely.

Human beings are complex and they interact with each other in their everyday life in various ways. The researcher observes a case and tries to find out how the patterns of behavior are created, including their causal relations. Case studies help understand one or more specific events that have been observed. Here are some common methods:

1. Illustrative case study

This is where the researcher observes a group of people doing something. Studying an event or phenomenon this way can show cause-and-effect relationships between various variables.

2. Cumulative case study

A cumulative case study is one that involves observing the same set of phenomena over a period. Cumulative case studies can be very helpful in understanding processes, which are things that happen over time. For example, if there are behavioral changes in people who move from one place to another, the researcher might want to know why these changes occurred.

3. Exploratory case study

An exploratory case study collects information that will answer a question. It can help researchers better understand social, economic, political or other social phenomena.

There are several other ways to categorize case studies. They may be chronological case studies, where a researcher observes events over time. In the comparative case study, the researcher compares one or more groups of people, places, or things to draw conclusions about them. In an intervention case study, the researcher intervenes to change the behavior of the subjects. The study method depends on the needs of the research team.

Deciding how to analyze the information at our disposal is an important part of effective management. An understanding of the case study model can help. With Harappa’s Thinking Critically course, managers and young professionals receive input and training on how to level up their analytic skills. Knowledge of frameworks, reading real-life examples and lived wisdom of faculty come together to create a dynamic and exciting course that helps teams leap to the next level.

Explore Harappa Diaries to learn more about topics such as Objectives Of Research , What are Qualitative Research Methods , How To Make A Problem Statement and How To Improve your Cognitive Skills to upgrade your knowledge and skills.

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Methodology

Research Methods | Definitions, Types, Examples

Research methods are specific procedures for collecting and analyzing data. Developing your research methods is an integral part of your research design . When planning your methods, there are two key decisions you will make.

First, decide how you will collect data . Your methods depend on what type of data you need to answer your research question :

• Qualitative vs. quantitative : Will your data take the form of words or numbers?
• Primary vs. secondary : Will you collect original data yourself, or will you use data that has already been collected by someone else?
• Descriptive vs. experimental : Will you take measurements of something as it is, or will you perform an experiment?

Second, decide how you will analyze the data .

• For quantitative data, you can use statistical analysis methods to test relationships between variables.
• For qualitative data, you can use methods such as thematic analysis to interpret patterns and meanings in the data.

Table of contents

Methods for collecting data, examples of data collection methods, methods for analyzing data, examples of data analysis methods, other interesting articles, frequently asked questions about research methods.

Data is the information that you collect for the purposes of answering your research question . The type of data you need depends on the aims of your research.

Qualitative vs. quantitative data

Your choice of qualitative or quantitative data collection depends on the type of knowledge you want to develop.

For questions about ideas, experiences and meanings, or to study something that can’t be described numerically, collect qualitative data .

If you want to develop a more mechanistic understanding of a topic, or your research involves hypothesis testing , collect quantitative data .

You can also take a mixed methods approach , where you use both qualitative and quantitative research methods.

Primary vs. secondary research

Primary research is any original data that you collect yourself for the purposes of answering your research question (e.g. through surveys , observations and experiments ). Secondary research is data that has already been collected by other researchers (e.g. in a government census or previous scientific studies).

If you are exploring a novel research question, you’ll probably need to collect primary data . But if you want to synthesize existing knowledge, analyze historical trends, or identify patterns on a large scale, secondary data might be a better choice.

Descriptive vs. experimental data

In descriptive research , you collect data about your study subject without intervening. The validity of your research will depend on your sampling method .

In experimental research , you systematically intervene in a process and measure the outcome. The validity of your research will depend on your experimental design .

To conduct an experiment, you need to be able to vary your independent variable , precisely measure your dependent variable, and control for confounding variables . If it’s practically and ethically possible, this method is the best choice for answering questions about cause and effect.

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Your data analysis methods will depend on the type of data you collect and how you prepare it for analysis.

Data can often be analyzed both quantitatively and qualitatively. For example, survey responses could be analyzed qualitatively by studying the meanings of responses or quantitatively by studying the frequencies of responses.

Qualitative analysis methods

Qualitative analysis is used to understand words, ideas, and experiences. You can use it to interpret data that was collected:

• From open-ended surveys and interviews , literature reviews , case studies , ethnographies , and other sources that use text rather than numbers.
• Using non-probability sampling methods .

Qualitative analysis tends to be quite flexible and relies on the researcher’s judgement, so you have to reflect carefully on your choices and assumptions and be careful to avoid research bias .

Quantitative analysis methods

Quantitative analysis uses numbers and statistics to understand frequencies, averages and correlations (in descriptive studies) or cause-and-effect relationships (in experiments).

You can use quantitative analysis to interpret data that was collected either:

• During an experiment .
• Using probability sampling methods .

Because the data is collected and analyzed in a statistically valid way, the results of quantitative analysis can be easily standardized and shared among researchers.

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If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.

• Chi square test of independence
• Statistical power
• Descriptive statistics
• Degrees of freedom
• Pearson correlation
• Null hypothesis
• Double-blind study
• Case-control study
• Research ethics
• Data collection
• Hypothesis testing
• Structured interviews

Research bias

• Hawthorne effect
• Unconscious bias
• Recall bias
• Halo effect
• Self-serving bias
• Information bias

Quantitative research deals with numbers and statistics, while qualitative research deals with words and meanings.

Quantitative methods allow you to systematically measure variables and test hypotheses . Qualitative methods allow you to explore concepts and experiences in more detail.

In mixed methods research , you use both qualitative and quantitative data collection and analysis methods to answer your research question .

A sample is a subset of individuals from a larger population . Sampling means selecting the group that you will actually collect data from in your research. For example, if you are researching the opinions of students in your university, you could survey a sample of 100 students.

In statistics, sampling allows you to test a hypothesis about the characteristics of a population.

The research methods you use depend on the type of data you need to answer your research question .

• If you want to measure something or test a hypothesis , use quantitative methods . If you want to explore ideas, thoughts and meanings, use qualitative methods .
• If you want to analyze a large amount of readily-available data, use secondary data. If you want data specific to your purposes with control over how it is generated, collect primary data.
• If you want to establish cause-and-effect relationships between variables , use experimental methods. If you want to understand the characteristics of a research subject, use descriptive methods.

Methodology refers to the overarching strategy and rationale of your research project . It involves studying the methods used in your field and the theories or principles behind them, in order to develop an approach that matches your objectives.

Methods are the specific tools and procedures you use to collect and analyze data (for example, experiments, surveys , and statistical tests ).

In shorter scientific papers, where the aim is to report the findings of a specific study, you might simply describe what you did in a methods section .

In a longer or more complex research project, such as a thesis or dissertation , you will probably include a methodology section , where you explain your approach to answering the research questions and cite relevant sources to support your choice of methods.

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What the Case Study Method Really Teaches

• Nitin Nohria

Seven meta-skills that stick even if the cases fade from memory.

It’s been 100 years since Harvard Business School began using the case study method. Beyond teaching specific subject matter, the case study method excels in instilling meta-skills in students. This article explains the importance of seven such skills: preparation, discernment, bias recognition, judgement, collaboration, curiosity, and self-confidence.

During my decade as dean of Harvard Business School, I spent hundreds of hours talking with our alumni. To enliven these conversations, I relied on a favorite question: “What was the most important thing you learned from your time in our MBA program?”

• Nitin Nohria is the George F. Baker Jr. and Distinguished Service University Professor. He served as the 10th dean of Harvard Business School, from 2010 to 2020.

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Methodology Series Module 2: Case-control Studies

Maninder singh setia.

Epidemiologist, MGM Institute of Health Sciences, Navi Mumbai, Maharashtra, India

Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same ‘study base’ as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive – particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases – selection bias and recall bias.

Introduction

Case-Control study design is a type of observational study design. In an observational study, the investigator does not alter the exposure status. The investigator measures the exposure and outcome in study participants, and studies their association.

In a case-control study, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. Thus, by design, in a case-control study the outcome has to occur in some of the participants that have been included in the study.

As seen in Figure 1 , at the time of entry into the study (sampling of participants), some of the study participants have the outcome (cases) and others do not have the outcome (controls). During the study procedures, we will examine the exposure of interest in cases as well as controls. We will then study the association between the exposure and outcome in these study participants.

Example of a case-control study

Examples of Case-Control Studies

Smoking and lung cancer study.

In their landmark study, Doll and Hill (1950) evaluated the association between smoking and lung cancer. They included 709 patients of lung carcinoma (defined as cases). They also included 709 controls from general medical and surgical patients. The selected controls were similar to the cases with respect to age and sex. Thus, they included 649 males and 60 females in cases as well as controls.

They found that only 0.3% of males were non-smokers among cases. However, the proportion of non-smokers among controls was 4.2%; the different was statistically significant ( P = 0.00000064). Similarly they found that about 31.7% of the female were non-smokers in cases compared with 53.3% in controls; this difference was also statistically significant (0.01< p <0.02).

Melanoma and tanning (Lazovic et al ., 2010)

The authors conducted a case-control study to study the association between melanoma and tanning. The 1167 cases - individuals with invasive cutaneous melanoma – were selected from Minnesota Cancer Surveillance System. The 1101 controls were selected randomly from Minnesota State Driver's License list; they were matched for age (+/- 5 years) and sex.

The data were collected by self administered questionnaires and telephone interviews. The investigators assessed the use of tanning devices (using photographs), number of years, and frequency of use of these devices. They also collected information on other variables (such as sun exposure; presence of freckles and moles; and colour of skin, hair, among other exposures.

They found that melanoma was higher in individuals who used UVB enhances and primarily UVA-emitting devices. The risk of melanoma also increased with increase in years of use, hours of use, and sessions.

Risk factors for erysipelas (Pitché et al, 2015)

Pitché et al (2015) conducted a case-control study to assess the factors associated with leg erysipelas in sub-Saharan Africa. This was a multi-centre study; the cases and controls were recruited from eight countries in sub-Saharan Africa.

They recruited cases of acute leg cellulitis in these eight countries. They recruited two controls for each case; these were matched for age (+/- 5 years) and sex. Thus, the final study has 364 cases and 728 controls. They found that leg erysipelas was associated with obesity, lympoedema, neglected traumatic wound, toe-web intertrigo, and voluntary cosmetic depigmentation.

We have provided details of all the three studies in the bibliography. We strongly encourage the readers to read the papers to understand some practical aspects of case-control studies.

Selection of Cases and Controls

Selection of cases and controls is an important part of this design. Wacholder and colleagues (1992 a, b, and c) have published wonderful manuscripts on design and conduct of case-control of studies in the American Journal of Epidemiology. The discussion in the next few sections is based on these manuscripts.

Selection of case

The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition.

For example, in the above mentioned Melanoma and Tanning study, the researchers defined their population as any histologic variety of invasive cutaneous melanoma. However, they added another important criterion – these individuals should have a driver's license or State identity card. This probably is not directly related to the clinic condition, so why did they add this criterion? We will discuss this in detail in the next few paragraphs.

Selection of a control

The next important point in designing a case-control study is the selection of control patients.

In fact, Wacholder and colleagues have extensively discussed aspects of design of case control studies and selection of controls in their article.

According to them, an important aspect of selecting a control is that they should be from the same ‘study base’ as that of the cases. Thus, the pool of population from which the cases and controls will be enrolled should be same. For instance, in the Tanning and Melanoma study, the researchers recruited cases from Minnesota Cancer Surveillance System; however, it was also required that these cases should either have a State identity card or Driver's license. This was important since controls were randomly selected from Minnesota State Driver's license list (this also included the list of individuals who have the State identity card).

Another important aspect of a case-control study is that we should measure the exposure similarly in cases and controls. For instance, if we design a research protocol to study the association between metabolic syndrome (exposure) and psoriasis (outcome), we should ensure that we use the same criteria (clinically and biochemically) for evaluating metabolic syndrome in cases and controls. If we use different criteria to measure the metabolic syndrome, then it may cause information bias.

Types of Controls

We can select controls from a variety of groups. Some of them are: General population; relatives or friends; or hospital patients.

Hospital controls

An important source of controls is patients attending the hospital for diseases other than the outcome of interest. These controls are easy to recruit and are more likely to have similar quality of medical records.

However, we have to be careful while recruiting these controls. In the above example of metabolic syndrome and psoriasis, we recruit psoriasis patients from the Dermatology department of the hospital as controls. We recruit patients who do not have psoriasis and present to the Dermatology as controls. Some of these individuals have presented to the Dermatology department with tinea pedis. Do we recruit these individuals as controls for the study? What is the problem if we recruit these patients? Some studies have suggested that diabetes mellitus and obesity are predisposing factors for tinea pedis. As we know, fasting plasma glucose of >100 mg/dl and raised trigylcerides (>=150 mg/dl) are criteria for diagnosis of metabolic syndrome. Thus, it is quite likely that if we recruit many of these tinea pedis patients, the exposure of interest may turn out to be similar in cases and controls; this exposure may not reflect the truth in the population.

Relative and friend controls

Relative controls are relatively easy to recruit. They can be particularly useful when we are interested in trying to ensure that some of the measurable and non-measurable confounders are relatively equally distributed in cases and controls (such as home environment, socio-economic status, or genetic factors).

Another source of controls is a list of friends referred by the cases. These controls are easy to recruit and they are also more likely to be similar to the cases in socio-economic status and other demographic factors. However, they are also more likely to have similar behaviours (alcohol use, smoking etc.); thus, it may not be prudent to use these as controls if we want to study the effect of these exposures on the outcome.

Population controls

These controls can be easily conducted the list of all individuals is available. For example, list from state identity cards, voter's registration list, etc., In the Tanning and melanoma study, the researchers used population controls. They were identified from Minnesota state driver's list.

We may have to use sampling methods (such as random digit dialing or multistage sampling methods) to recruit controls from the population. A main advantage is that these controls are likely to satisfy the ‘study-base’ principle (described above) as suggested by Wacholder and colleagues. However, they can be expensive and time consuming. Furthermore, many of these controls will not be inclined to participate in the study; thus, the response rate may be very low.

Matching in a Case-Control Study

Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics. For example, in the smoking and lung cancer study, the authors selected controls that were similar in age and sex to carcinoma cases. Matching is a useful technique to increase the efficiency of study.

’Individual matching’ is one common technique used in case-control study. For example, in the above mentioned metabolic syndrome and psoriasis, we can decide that for each case enrolled in the study, we will enroll a control that is matched for sex and age (+/- 2 years). Thus, if 40 year male patient with psoriasis is enrolled for the study as a case, we will enroll a 38-42 year male patient without psoriasis (and who will not be excluded for other reason) as controls.

If the study has used ‘individual matching’ procedures, then the data should also reflect the same. For instance, if you have 45 males among cases, you should also have 45 males among controls. If you show 60 males among controls, you should explain the discrepancy.

Even though matching is used to increase the efficiency in case-control studies, it may have its own problems. It may be difficult to fine the exact matching control for the study; we may have to screen many potential enrollees before we are able to recruit one control for each case recruited. Thus, it may increase the time and cost of the study.

Nonetheless, matching may be useful to control for certain types of confounders. For instance, environment variables may be accounted for by matching controls for neighbourhood or area of residence. Household environment and genetic factors may be accounted for by enrolling siblings as controls.

If we use controls from the past (time period when cases did not occur), then the controls are sometimes referred to historic controls. Such controls may be recruited from past hospital records.

Strengths of a Case-Control Study

• Case-Control studies can usually be conducted relatively faster and are inexpensive – particularly when compared with cohort studies (prospective)
• It is useful to study rare outcomes and outcomes with long latent periods. For example, if we wish to study the factors associated with melanoma in India, it will be useful to conduct a case-control study. We will recruit cases of melanoma as cases in one study site or multiple study sites. If we were to conduct a cohort study for this research question, we may to have follow individuals (with the exposure under study) for many years before the occurrence of the outcome
• It is also useful to study multiple exposures in the same outcome. For example, in the metabolic syndrome and psoriasis study, we can study other factors such as Vitamin D levels or genetic markers
• Case-control studies are useful to study the association of risk factors and outcomes in outbreak investigations. For instance, Freeman and colleagues (2015) in a study published in 2015 conducted a case-control study to evaluate the role of proton pump inhibitors in an outbreak of non-typhoidal salmonellosis.

Limitations of a Case-control Study

• The design, in general, is not useful to study rare exposures. It may be prudent to conduct a cohort study for rare exposures

Since the investigator chooses the number of cases and controls, the proportion of cases may not be representative of the proportion in the population. For instance if we choose 50 cases of psoriasis and 50 controls, the prevalence of proportion of psoriasis cases in our study will be 50%. This is not true prevalence. If we had chosen 50 cases of psoriasis and 100 controls, then the proportion of the cases will be 33%.

• The design is not useful to study multiple outcomes. Since the cases are selected based on the outcome, we can only study the association between exposures and that particular outcome
• Sometimes the temporality of the exposure and outcome may not be clearly established in case-control studies
• The case-control studies are also prone to certain biases

If the cases and controls are not selected similarly from the study base, then it will lead to selection bias.

• Odds Ratio: We are able to calculate the odds ratios (OR) from a case-control study. Since we are not able to measure incidence data in case-control study, an odds ratio is a reasonable measure of the relative risk (under some assumptions). Additional details about OR will be discussed in the biostatistics section.

The OR in the above study is 3.5. Since the OR is greater than 1, the outcome is more likely in those exposed (those who are diagnosed with metabolic syndrome) compared with those who are not exposed (those who do are not diagnosed with metabolic syndrome). However, we will require confidence intervals to comment on further interpretation of the OR (This will be discussed in detail in the biostatistics section).

• Other analysis : We can use logistic regression models for multivariate analysis in case-control studies. It is important to note that conditional logistic regressions may be useful for matched case-control studies.

Calculating an Odds Ratio (OR)

Hypothetical study of metabolic syndrome and psoriasis

Additional Points in A Case-Control Study

How many controls can i have for each case.

The most optimum case-to-control ratio is 1:1. Jewell (2004) has suggested that for a fixed sample size, the chi square test for independence is most powerful if the number of cases is same as the number of controls. However, in many situations we may not be able recruit a large number of cases and it may be easier to recruit more controls for the study. It has been suggested that we can increase the number of controls to increase statistical power (if we have limited number of cases) of the study. If data are available at no extra cost, then we may recruit multiple controls for each case. However, if it is expensive to collect exposure and outcome information from cases and controls, then the optimal ratio is 4 controls: 1 case. It has been argued that the increase in statistical power may be limited with additional controls (greater than four) compared with the cost involved in recruiting them beyond this ratio.

I have conducted a randomised controlled trial. I have included a group which received the intervention and another group which did not receive the intervention. Can I call this a case-control study?

A randomised controlled trial is an experimental study. In contrast, case-control studies are observational studies. These are two different groups of studies. One should not use the word case-control study for a randomised controlled trial (even though you have a control group in the study). Every study with a control group is not a case-control study. For a study to be classified as a case-control study, the study should be an observational study and the participants should be recruited based on their outcome status (some have the disease and some do not).

Should I call case-control studies prospective or retrospective studies?

In ‘The Dictionary of Epidemiology’ by Porta (2014), the authors have suggested that even though the term ‘retrospective’ was used for case-control studies, the study participants are often recruited prospectively. In fact, the study on risk factors for erysipelas (Pitché et al ., 2015) was a prospective case case-control study. Thus, it is important to remember that the nature of the study (case-control or cohort) depends on the sampling method. If we sample the study participants based on exposure and move towards the outcome, it is a cohort study. However, if we sample the participants based on the outcome (some with outcome and some do not) and study the exposures in both these groups, it is a case-control study.

In case-control studies, participants are recruited on the basis of disease status. Thus, some of participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. Case-control studies are less expensive and quicker to conduct (compared with prospective cohort studies at least). The measure of association in this type of study is an odds ratio. This type of design is useful for rare outcomes and those with long latent periods. However, they may also be prone to certain biases – selection bias and recall bias.

Financial support and sponsorship

Conflicts of interest.

There are no conflicts of interest.

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• Case Study | Definition, Examples & Methods

Case Study | Definition, Examples & Methods

Published on 5 May 2022 by Shona McCombes . Revised on 30 January 2023.

A case study is a detailed study of a specific subject, such as a person, group, place, event, organisation, or phenomenon. Case studies are commonly used in social, educational, clinical, and business research.

A case study research design usually involves qualitative methods , but quantitative methods are sometimes also used. Case studies are good for describing , comparing, evaluating, and understanding different aspects of a research problem .

Table of contents

When to do a case study, step 1: select a case, step 2: build a theoretical framework, step 3: collect your data, step 4: describe and analyse the case.

A case study is an appropriate research design when you want to gain concrete, contextual, in-depth knowledge about a specific real-world subject. It allows you to explore the key characteristics, meanings, and implications of the case.

Case studies are often a good choice in a thesis or dissertation . They keep your project focused and manageable when you don’t have the time or resources to do large-scale research.

You might use just one complex case study where you explore a single subject in depth, or conduct multiple case studies to compare and illuminate different aspects of your research problem.

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Once you have developed your problem statement and research questions , you should be ready to choose the specific case that you want to focus on. A good case study should have the potential to:

• Provide new or unexpected insights into the subject
• Challenge or complicate existing assumptions and theories
• Propose practical courses of action to resolve a problem
• Open up new directions for future research

Unlike quantitative or experimental research, a strong case study does not require a random or representative sample. In fact, case studies often deliberately focus on unusual, neglected, or outlying cases which may shed new light on the research problem.

If you find yourself aiming to simultaneously investigate and solve an issue, consider conducting action research . As its name suggests, action research conducts research and takes action at the same time, and is highly iterative and flexible. 

However, you can also choose a more common or representative case to exemplify a particular category, experience, or phenomenon.

While case studies focus more on concrete details than general theories, they should usually have some connection with theory in the field. This way the case study is not just an isolated description, but is integrated into existing knowledge about the topic. It might aim to:

• Exemplify a theory by showing how it explains the case under investigation
• Expand on a theory by uncovering new concepts and ideas that need to be incorporated
• Challenge a theory by exploring an outlier case that doesn’t fit with established assumptions

To ensure that your analysis of the case has a solid academic grounding, you should conduct a literature review of sources related to the topic and develop a theoretical framework . This means identifying key concepts and theories to guide your analysis and interpretation.

There are many different research methods you can use to collect data on your subject. Case studies tend to focus on qualitative data using methods such as interviews, observations, and analysis of primary and secondary sources (e.g., newspaper articles, photographs, official records). Sometimes a case study will also collect quantitative data .

The aim is to gain as thorough an understanding as possible of the case and its context.

In writing up the case study, you need to bring together all the relevant aspects to give as complete a picture as possible of the subject.

How you report your findings depends on the type of research you are doing. Some case studies are structured like a standard scientific paper or thesis, with separate sections or chapters for the methods , results , and discussion .

Others are written in a more narrative style, aiming to explore the case from various angles and analyse its meanings and implications (for example, by using textual analysis or discourse analysis ).

In all cases, though, make sure to give contextual details about the case, connect it back to the literature and theory, and discuss how it fits into wider patterns or debates.

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• Open access
• Published: 22 July 2022

Nursing students’ use of social media in their learning: a case study of a Canadian School of Nursing

• Catherine M. Giroux   ORCID: orcid.org/0000-0003-1352-8501 1 &
• Katherine A. Moreau   ORCID: orcid.org/0000-0002-5955-1689 2  

BMC Nursing volume  21 , Article number:  195 ( 2022 ) Cite this article

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Social media has diverse applications for nursing education. Current literature focuses on how nursing faculty use social media in their courses and teaching; less is known about how and why nursing students use social media in support of their learning.

The purpose of this study was to explore how nursing students use social media in their learning formally and informally.

This exploratory qualitative case study of a Canadian School of Nursing reports on the findings of interviews ( n  = 9) with nursing students to explore how they use social media in their learning. Data were analyzed using a combined deductive and inductive coding approach, using three cycles of coding to facilitate category identification.

Results and conclusions

The findings demonstrate that participants use social media for formal and informal learning and specifically, as a third space to support their learning outside of formal institutional structures. Social media plays a role in the learning activities of nursing students studying both face-to-face and by distance. Accordingly, social media use has implications for learning theory and course design, particularly regarding creating space for student learning communities.

Peer Review reports

Social media are online platforms that allow users to connect with other users, curate lists of connections, and interact with each other within the same online platform [ 1 ]. They have applications for both formal and informal learning in health professions education (HPE). Formal learning refers to planned educational experiences, such as courses or assignments [ 2 ] whereas informal learning refers to what is learned through extracurricular activities [ 3 , 4 ]. With social media, formal learning may include such activities as using YouTube videos in class, while informal learning may involve students scrolling through Twitter and finding relevant learning content on their leisure time. Within the HPE literature, social media have been shown to facilitate electronic communication, networking, and real-time collaboration [ 5 , 6 ]. They have also assumed key educational and communicative roles during the COVID-19 pandemic [ 7 , 8 , 9 ]. Furthermore, they continue to allow individuals to engage in independent, informal learning on their own terms and in places of formal education, work, or broader social circles [ 10 ]. Several studies demonstrated how social media can be used to facilitate clinical and professional performance tasks, question-and-answer sessions, and the exploration of complex topics collaboratively; social media can also provide professional learning opportunities and facilitate networking with international practitioners [ 11 , 12 , 13 , 14 ]. Moreover, instructors have used Twitter to provide students with formative feedback in assessment, stimulate reflection and sharing, share daily learning goals, hold journal clubs, notify students of recent topical publications, and orient learners to clinical sites and educational rotations [ 15 , 16 , 17 ]. The literature suggests that the connections that students make using social media can translate to opportunities for mentorship and scholarship [ 18 ]. Moreover, social media may also engage geographically dispersed individuals to create or share content, collaborate in groups, and ultimately form a virtual community [ 19 , 20 ].

Within the nursing education literature, social media is well described as a tool selected by faculty for diverse formal teaching and learning purposes. For instance, several studies described using blogging to facilitate reflections as a teaching strategy for topics such as cultural competence, empathy, the therapeutic relationship, transitions to practice, and self-care [ 21 , 22 , 23 , 24 , 25 ]. The feedback system of the blogging interface provided students with opportunities to practice their reflection and problem-solving skills [ 26 , 27 ]. Some studies used social media to simulate patient encounters or transition experiences for nurses [ 25 , 28 , 29 ]. For example, Thomas et al. used a blog to simulate a new nurse who had just transitioned to practice; the blog was written from the new nurse’s perspective to help final year nursing students consider issues of delegating and supervising, adapting to change, risk and quality management, and legal and ethical issues as they prepared to transition to practice [ 25 ]. Students had to read the blog and post responses. Other studies focused on using Facebook or YouTube as collaborative and interactive tools to help nursing students prepare for examinations like the National Council Licensure Examination (NCLEX) [ 30 , 31 , 32 ]. Still, issues of professionalism arose in the nursing education literature, with some studies noting concerns about students’ online behaviour and potential implications for their reputations and licensure [ 5 , 33 ]. A 2021 narrative review found that learning about digital professionalism concepts as they relate to social media influenced how students behaved online [ 34 ]. Despite these potential professionalism implications, social media appears to be an effective tool to support formal learning in nursing education. A 2018 systematic review explored the effectiveness of using social media in nursing and midwifery education [ 35 ]. The authors found that the collaborative, interactive, and semi-synchronous nature of social media platforms may support knowledge and skill acquisition in nursing students.

Much of the extant undergraduate nursing education literature explores how social media is used in formal learning, specifically from the perspectives of the faculty who select the platforms to suit specific assignments or learning goals. Studies that focus on undergraduate students’ use of social media tended to explore specific platforms used and data analytics (i.e., hashtags used, number of views or shares). Less is known about how and why undergraduate nursing students themselves select social media platforms as an adjunct to their formal and informal learning activities. Thus, this exploratory qualitative case study aimed to address how and why undergraduate nursing students use social media to support their learning.

Theoretical considerations

Social learning theories like social constructivism are appropriate for framing studies involving social media because they view learning as an active and collaborative process [ 36 , 37 , 38 ]. Social constructivism is based on three assumptions: (1) meanings are constructed by humans as they engage with the world they are interpreting; (2) humans engage with their world and make sense of it based on their historical and social perspectives; and (3) the basic generation of meaning is social, arising from the interaction with a human community [ 36 ]. Social constructivism claims knowledge is acquired when subjective meanings are created in interaction with others, drawing on material from previous experiences to guide learning [ 36 , 37 , 38 ]. This study was informed by social constructivism, which influenced our research questions, data collection instruments, and approaches to data analysis.

Research design

The objective of this study was to explore how students at one Canadian School of Nursing used social media to support their learning. We addressed this objective through an exploratory qualitative single case study. Yin [ 39 ] describes a case study as an empirical inquiry that investigates a contemporary phenomenon in depth within its real-world context even when the boundaries between the context and phenomenon may not be evident. Case studies comprise an all-encompassing method, which influences the logic of design, data collection techniques, and approaches to data analyses. Case study research is particularly useful for answering how and why questions; single case studies are appropriate for cases that are critical, unusual, revelatory, and longitudinal [ 39 ]. Our study site represented a critical case since the variety of program delivery methods and modalities were critically aligned with social constructivism. The study site also represented an unusual case, with four distinct program options – including a distance program – for students to achieve a Bachelor of Science in Nursing (BScN) degree. This was a unique program in Canada at the time of the study. The study site did not have any social media policies published to their public-facing website during the time of the study, nor did they have any public-facing references to using social media formally in their programs published on their website.

Case study site and participants

This study took place at a small, relatively northern, Canadian university with a student population of approximately 5,090 students [ 40 ]. The School of Nursing, which includes 1191 students, offers four distinct, English-language, options for students to complete their BScN degree. These options include: 1) a standard four-year direct-entry nursing program; 2) an onsite Registered Practical Nurse (RPN) to BScN bridging program for students who previously obtained an RPN diploma and who are looking to subsequently obtain their BScN degree; 3) a part-time blended learning RPN to BScN bridging program for students currently working as RPNs who are looking to obtain their BScN; and 4) a second entry accelerated program for students who previously obtained an undergraduate degree. Only two of the nursing programs occur at the case study site itself. The second entry program is held in a large city to the south of the case study site. Additionally, students who partake in the RPN to BScN bridging program through blended learning live geographically dispersed throughout the province in which the case study site is located. Given the different program options, the participants in this study consisted of a mixture of face-to-face students and distance students. Additionally, due to the nature of the program options, some participants had pursued their nursing program as their first degree while others were already working as RPNs and had returned to school to obtain their BScN degree.

Participant recruitment and data collection

Participants were purposively recruited from a previous study, which consisted of a digital artifact collection that explored what content nursing students shared to their Twitter, Facebook, and Instagram accounts related to learning [ 41 ]. The twenty-four nursing students who participated in our previous study were contacted by email and invited to participate in this qualitative case study exploring how and why nursing students use social media to support their learning. These students were identified as potential participants because they had confirmed using social media for learning and thus, would be information-rich interviewees for the present study. All potential participants were provided with a Participant Information Letter and Informed Consent form. The data for this study were collected using semi-structured interviews. All interviews were conducted virtually via Zoom in the Fall of 2019, using a semi-structured interview guide that had been developed based on the research questions, our theoretical framework, and the literature (refer to Additional file 1 : Appendix). Prior to using the interview guide, it was piloted with two registered nurses. This pilot involved conducting two mock interviews and debriefing the interview guide with the participants to discuss the feasibility and appropriateness of the interview questions. The average interview length was 32 min, with the shortest being 21 min and the longest being 44 min long. We piloted the interview guide with two registered nurses prior to commencing the study. Each interview was audio-recorded and transcribed verbatim. Interview participation was incentivized with a $20 gift card to a local coffee chain.

Data analysis

We took a combined deductive and inductive approach to coding and analyzing the interview transcripts. We sought to achieve theoretical sufficiency, which is the stage at which codes and categories manage new data without requiring further modification [ 42 ]. To do this, we conducted three cycles of coding in MAXQDA (v.18.2). In the first cycle, a preliminary codebook − which was informed by our research question, theoretical framework, and the literature − facilitated descriptive and process coding [ 43 ]. In the second cycle of coding, we each independently inductively coded the data using both process coding and in vivo coding (i.e., using the participants’ own words) and compared and discussed our coding. In the third cycle of coding, we grouped these summaries into categories, themes, or constructs [ 43 ]. A combination of matrices and networks visually displayed the data and facilitated category identification [ 43 , 44 ].

Reflexivity and trustworthiness

Neither author is a Registered Nurse nor is affiliated with the case study site. Both authors have expertise in conducting educational research within the health professions and were involved in the study conceptualization, data collection, and analysis. We also took steps to ensure that our analyses were credible, dependable, confirmable, and transferable [ 45 , 46 ]. To establish credibility, we engaged in member-checking, wherein we provided the participants a copy of their interview transcripts so that they could ensure that their statements were accurately represented during transcription [ 45 , 47 ]. We also engaged in peer debriefing. In terms of dependability, each of us inductively coded the data, compared our coding, and discussed and resolved any inconsistencies. In addition, we used audit trails as a strategy to ensure confirmability. These audit trails documented each of our decisions made during the research process and would allow an independent auditor to follow our steps and decisions to establish the same conclusions about the data. Lastly, through purposeful sampling and information-rich interviewees, we were able to obtain thick descriptions of how and why the students use social media to support their learning. We also included detailed descriptions of our research processes. This level of description allows others to judge the contextual similarity and transferability of our study findings.

Ethical considerations

The interviews received formal institutional ethical approval (S-08–18-921) and approval from the study site (101916) in August 2019. We reviewed the informed consent form with each participant prior to commencing the interview and addressed any questions that they had. All participants verbally consented to participate in an interview and participants’ consent was recorded using Zoom video conference software, in accordance with our research ethics board approval.

Nine nursing students ( n  = 9) participated in the individual interviews. All participants were female and ranged in age from 18 to 49. Five participants attended classes online in a blended program format that occurred by distance and four participants attended classes face-to-face. The findings demonstrate that participants used social media in numerous ways for both formal and informal learning purposes. Table 1 provides a thematic overview of how the nursing student participants use social media in support of their learning.

Formal learning

Participants reported using social media for a variety of purposes pertaining to formal learning. Table 2 provides exemplary participant quotes outlining their experiences using social media for formal learning purposes.

Sharing and clarifying course content

Several participants reported using social media to share content related to their courses and to clarify course content. Participant 7 explained how “when it comes to having, like, a large quantity of information, I think Facebook’s a better platform for that. Um, you’re able to share different links, you’re able to share pictures, videos, news articles, almost anything, it seems now”. Two participants (Participants 05 and 07) shared contrasting experiences with using social media formally in their distance classes to clarify course concepts. In this instance, a professor had shared YouTube videos in the course. While Participant 7 appreciated the inclusion of videos, Participant 5 found this approach to be lazy, especially since the professor did not create the videos but rather included videos that, according to Participant 5, students would likely search for on their own to assist their learning.

Supplementing university services

Eight participants indicated that Facebook was a good platform to supplement or highlight existing university services. Participant 5 explained how, as a distance student, they used Facebook to learn about the services available to students, like the university’s tutoring service, which Participant 5 found helpful for statistics. Participant 6 described how they used Facebook specifically for sharing course resources, since that platform might be easier at times than the typical learning management system.

Assignments and exams

The participants described using social media as a mechanism to complete their course assignments and to study for course exams and the National Council Licensure Examination (NCLEX). Social media appeared to be involved in the process of completing assignments; it also appeared to be the product of some assignments. Participant 5 described how “any group projects that we have to do would, which in an online program seems a little silly to me to do group projects but, um, we’d have to find a way to collaborate and it was often over Facebook or that sort of thing”. Participant 1 described creating a social media campaign for their community health class to help parents access vision care for their school-age children. Participant 3 shared how they found posts about how to pass the NCLEX the first time shared to social media and Participant 2 explained how they use social media to review for their course exams by dividing course content up amongst a small group of students and sharing review notes and summaries online. Participant 2 also described using social media platforms like Reddit to understand the patient experience based on what patients choose to share to these sites.

Informal learning

Participants indicated that they used social media for diverse informal learning purposes. Table 3 provides an overview of participants’ experiences using social media for informal learning.

Creating community

By far, students shared the value of social media for connecting with peers and the nursing community most frequently. Four participants spoke about how social media promotes connection between distance students. Participant 3 shared how social media “gives you that camaraderie that you’re missing in a classroom environment”. Four out of the five students who identified as an online student cited Facebook groups as being an important mechanism for connecting with their classmates who were spread throughout the province. One participant explained how “there is a group online, uh, [School Name] distance ed students so I use that quite a bit, um, just to get information on classes, um, what to expect from different professors, etc.” Five participants shared how social media helped them combat isolation in their learning. Participant 2 emphasized the importance of social media for connecting distance students, which was important since they did not have the same opportunities to meet their classmates face-to-face. Participant 1 described how participating in Facebook groups helped enhance both the academic and social aspects of their face-to-face learning experience. Participant 4 explained how “we find it’s been really useful, or even like finding little things, like finding rides to clinical and stuff like that. Like obviously not all of us can afford vehicles and stuff like that so just by helping each other out”. In fact, every participant who identified as a face-to-face student ( n  = 4) spoke about the importance of Facebook groups to their learning experience since they contributed to building community and sharing resources.

Similarly, six participants shared how social media connected them with the broader nursing community, outside of their programs and university. Participant 6 described how social media could connect people across the country with experts in the field and the resources they have created. Participant 9 explained how social media could be used to “take my learning outside of the avenues that can be addressed and presented within a program or any program, really. So, it allows you to kind of step outside of that, see what’s happening with other people, how they’re learning…” Participant 1 described how social media allows them to connect with the nursing community on both social and academic levels through sharing memes and experiences on platforms like Instagram and Facebook. Participant 3 shared how social media “probably gives a good, like, um, a good alternative perspective on things, other than the teacher’s”.

‘Behind the scenes’ knowledge sharing

While the participants often spoke about content that was publicly available to them on social media, they also shared how they used social media for informal learning purposes in private or ‘behind the scenes’ ways. Five nursing students reported using social media to buy, sell, and share PDF versions of textbooks. Participant 5 shared how “people share PDFs of textbooks and all that sort of stuff, so it’s definitely saved me several hundred dollars”. Two participants expressed how they prefer social media to textbooks. Participant 9 described how their professors are “not the biggest towards textbooks because they said that the second they are printed they are out of date because of how fast information is changing within healthcare”. In this sense, Participant 9 found social media to be a helpful way to stay up to date with information that textbooks did not provide.

Similarly, three participants described using social media to discuss which professors were the best for each class. Participant 2 explained how “we often talk about which professors are the best for specific courses and so those classes tend to fill up really fast”. Participant 5 described how they use social media to ask questions about the university, share their perceptions of certain professors, and discuss which classes should or should not be taken at the same time. While eight of the nine interview participants actively participated in social media groups, three participants shared that the absence of faculty members in the social media groups could be problematic. Participant 2 suggested using more of the collaborative tools available on the university’s learning management system to eliminate some of the need for the social media groups and better include the faculty members. Participant 5 also found the absence of faculty members in the social media groups to be a problem and recommended involving faculty members in the private groups to correct misinformation and answer questions.

Scaffolding knowledge

In addition to sharing resources, three students indicated that the Facebook groups were essential for giving and receiving support throughout their nursing programs. Similarly, five nursing students shared how they use social media to review their clinical skills. Three participants used social media to review IV insertion. Participant 7 described how “I use Instagram, I follow someone, she, her, her tag is IV Queen or something like that, but she gives a lot of intravenous tips on how to insert IVs and how to care for them”. Participant 3 also described using YouTube videos to review IV compatibility. Participant 1 shared how they used YouTube to practice for their IV therapy lab. Participant 1 also described how “we have used some YouTube videos and tutorials and stuff in our labs where we’re able to view, like, for example just last week we were learning about central lines, um, so we looked at a video about how to do the dressing change for a central line”. Participant 1 also described how they use YouTube to learn about skills like ambulating patients prior to starting their surgical rotation so that they would understand what they were about to do on the rotation.

Why use social media

The study participants presented several reasons to use social media in support of their formal and informal learning activities; similarly, they also presented several reasons to be cautious of using social media for these purposes. Table 4 presents an overview of exemplary participant quotations presented thematically.

Credibility and relevance of sources

Seven participants discussed the credibility and relevance of the sources they found on social media. Participant 7 indicated that they find their friends and followers on social media do not tend to share a lot of content that “I don’t consider real, like the fake news, but it’s a lot of more credible sources, like major journal articles and stuff like that”. Participant 4 expressed that students are taking a risk in depending on social media rather than on their books and their notes. Other students, like Participant 6, emphasized the importance of developing critical thinking skills and being able to filter social media posts so that they could appropriately determine which sources were accurate or credible. Participant 8 indicated that relying on social media links provided by course professors was helpful since “you know if the instructors are posting those videos, then you know that they’re credible sources.”

Professors and professionalism

All nine nursing students shared how their professors, programs, and the importance of professionalism influenced their use of social media. Four participants shared that, perhaps with the exception of YouTube videos, their professors did not use social media in their teaching and discouraged its use by nursing students. Participant 6 explained that “social media is kind of shunned a lot in nursing because of that whole idea of don’t post anything, don’t share your clinical experiences and don’t, you know, breach privacy.” In some instances, participants reported that their professors did not use social media in their teaching but encouraged students to use it to complete course assignments, like learning portfolios. Participant 4 shared that “[the professors] really like the idea of us working together on things and utilizing each other to keep on track”, especially as it related to support during clinical placements.” Other participants described their professors incorporating podcasts, videos, and Reddit into their courses, which encouraged their use of social media for learning. Still, several participants expressed concerns related to professionalism on social media. Participant 3 explained how “I definitely avoid posting about like, things that involve substance use. I feel like there’s added pressure on people in certain, in various professions like healthcare and police that you should avoid because you’re supposed to uphold a certain image of the profession.”

Convenience and accessibility

Several participants discussed the convenience of social media. Two participants shared how it was easier for communication purposes than other methods (i.e., emails, calls, texts). Other participants described how social media provided a central repository for resources that could be easily accessed by classmates. However, Participants 3 and 5 highlighted some challenges to accessibility because of using social media for learning, notably poor internet connection and lack of transcriptions or alternative formats.

Engagement and distraction

Four participants shared how they found social media to be an engaging platform for learning in their nursing education. Participant 4 explained how social media helps highlight major class concepts in a variety of formats, which can be helpful for different learners. Several participants spoke about growing up with social media and how their previous experiences motivated them to use it as a tool to support their nursing education. Participant 6 explained how “I kind of grew up with technology and grew up with social media that I just know how to use it and know how to access it and don’t have a problem filtering out what I don’t need.” Despite how participants felt about social media’s potential for engagement, they also found it potentially distracting. This was a common theme amongst both face-to-face and distance students. Participant 2 described ending up in a “Facebook vortex, where I end up being on it for 2 h, not necessarily on that [program specific] group.”

The nursing student participants described multiple ways of using social media to support their learning. None of the students in this study described using social media for the same creative formal experiences as those published by Thomas et al. [ 25 ] wherein a course instructor developed a simulated student on Facebook for nursing students to interact with online. However, a couple of students outlined their experiences being required to use sites like Reddit to learn about the patient experience. Additionally, some participants described how they used social media to develop patient-oriented health advocacy campaigns for healthcare organizations, effectively demonstrating how social media is being used in their formal nursing education. The ways in which the nursing students use social media to support their formal learning demonstrate social media’s collaborative capacity for knowledge and information exchange for both on-campus and distance students [ 6 , 48 , 49 ]. The study participants used social media creatively to support their formal education; for instance, participants referenced program-specific Facebook groups where they could collectively decide on questions that they needed to ask their professors in class. This finding is consistent with that of Junco et al. [ 50 ], where they found social media to be a low-stress method for students to ask questions of their peers and educators.

Informally, participants indicated using social media to refresh their clinical skills before applying them in lab settings or during clinical rotations. While the findings of this study do not directly touch on the use of social media at the point-of-care, studies like that conducted by Hay et al. [ 51 ] demonstrate social media’s potential utility for enhanced clinical learning and patient safety. In this study, two participants described how they use social media, specifically YouTube videos, to help with patient education at the bedside. Moreover, the participants indicated that they took a cautious approach to using social media in their formal and informal learning out of concern for professionalism implications. Several students indicated that they had been warned about the repercussions of unprofessional online behaviour and had adjusted their behaviour accordingly. This finding is similar to that of a previous conducted narrative review by O’Connor et al. [ 34 ] that found that students were likely to change what content they shared using social media after learning about issues of professionalism.

Importantly, the participants in this study appeared to use social media as a third space. Aaen and Dalsgaard [ 52 ] describe the ‘third space’ as being one that emerges in boundaries or overlaps across spheres; they explain that third spaces emerge from a need for discourses that are unavailable or cannot be filled in existing settings. Participants described creating their own Facebook groups for their classes, cohorts, study groups, clinical groups, and programs. The students explained that faculty members were not present in their Facebook groups, although they did sometimes encourage students to join the groups to stay up to date on information. The participants shared that they used the groups to fill gaps in their education. Others described using the Facebook groups to create a sense of community they felt was missing in their distance learning. In fact, this study found that nursing students use social media in their education in several ways that are often hidden or ‘behind the scenes’. Aaen and Dalsgaard [ 52 ] found that Facebook formed a ‘third space’ that combined elements of academic, personal, and social communication that does not typically take place within conventional university structures or spaces. The findings of this study are similar in the sense that the nursing student participants used social media as a mechanism to collaborate, communicate, teach, and learn when traditional university avenues were unavailable to them.

This study has implications for learning theory in connected teaching and learning. Learning theories – and thus, approaches to teaching – have moved from behaviourist to constructivist in the age of technology [ 53 ]. Indeed, social learning theories like connectivism [ 54 ], Communities of Practice [ 55 ], and social constructivism [ 36 ] can reflect the realities of connected teaching and learning because they focus on collective learning and knowing in both physical and digital spaces. In the present study, social constructivism, specifically Vygotsky’s Zone of Proximal Development, is evident in the participants’ use of social media for formal and informal learning purposes. Vygotsky [ 56 ] defines the Zone of Proximal Development as “the distance between the actual development level as determined by independent problem solving and the level of potential development as determined through problem solving under adult guidance or in collaboration with capable peers” (p. 86). The participants in this study described using online social media groups to share information about course requirements, assignment information, and exam tips. Social media also appeared to be a method for students to consolidate, share, and engage in their learning as part of a larger social process. Several participants described experiences of scaffolding learning for their peers either within their own cohort or in cohorts behind them using social media groups. Scaffolding is a key component of Vygotsky’s Zone of Proximal Development and has applications for online course design; technical scaffolding allows learners to experience just-in-time instruction and be provided with resources to solve problems and generate new learning and understanding collaboratively online [ 57 ]. Thus, the online learning environment should provide learners with the resources, tools, and supports they need to build their own knowledge; scaffolding fades as learners develop their own knowledge and expertise [ 53 ].

Implications for nursing education policy and practice

This study demonstrates that nursing students are using social media in their educational practices both formally and informally. This use of social media has implications for teaching and learning in nursing education. Faculty members must consider the purposes for which nursing students are using social media, especially informally. One finding of this study suggested that nursing students turned to social media to fill perceived gaps – both academic and social – in their learning experience. If faculty members and schools of nursing are aware that social media is being used by nursing students for formal and informal teaching and learning purposes, it can be leveraged to achieve specific competencies and learning objectives. Based on this study, we have highlighted recommendations for nursing education policy and practice.

At the policy level, professional and appropriate social media communication could be included as an educational competency in nursing education programs, if not already stated in guiding curriculum frameworks. The purpose of this recommendation is not to discourage social media use but rather to develop competent online communicators who are equipped to use social media for teaching, learning, advocacy, and knowledge translation purposes. At the institution level, increased training for both faculty members and students on digital literacies, identifying credible online sources, and managing misinformation could help ensure faculty and students feel equipped to use digital tools like social media effectively in their teaching and learning. Finally, at the course level, some participants valued using social media to extend their learning while others were more reluctant to use it; thus, approaching the use of social media with flexibility and allowing for choice is essential. Providing optional opportunities to extend learning may help encourage participation on social media and help students discover how social media platforms can be used as learning tools informally within the nursing profession.

Limitations and future directions

This exploratory qualitative case study included individual semi-structured interviews with nursing students from one Canadian School of Nursing. Despite incentivizing interview participation, we were only able to recruit 9 of the 24 possible participants. It is also probable that those who participated were more interested in social media than those who did not participate. The interviews consisted of self-reported data from the perspectives of the participants. Although participants spoke about how their professors used social media in their courses, the professors’ perspectives were not included in this study, leaving a potential imbalance and area for future research. Moreover, our small qualitative sample did not allow for a stratified analysis based on the program delivery method. This type of analysis would be interesting to conduct with a larger, quantitative dataset. Lastly, while the interview guide included questions about the nursing student participants’ experiences using social media, it did not include questions about their cultural backgrounds. In future, it would be interesting to explore how students’ culture backgrounds influence how and why they use of social media.

Conclusions

The nursing students in this study described and demonstrated using social media to support their formal and informal learning. The participants also used social media as a third space, one that is separate from the traditional confines of the university. Within this space, participants merged their personal and academic discussions to collaborate, share resources, mentor one another, and connect with nursing experts and professional institutions. This use of social media has implications for teaching and learning in nursing education, especially regarding learning theory, scaffolding, and online course design.

Availability of data and materials

Due to the qualitative case study nature of this research, the data generated and analyzed during the current study are not publicly available to maintain the anonymity of the study participants. Data are available from the corresponding author on reasonable request.

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C. G. and K. M. were equally responsible for conceptualizing the study, conducting data collection and analysis, writing the main manuscript text and reviewing the manuscript. All the authors read and approved the final manuscript.

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Giroux, C.M., Moreau, K.A. Nursing students’ use of social media in their learning: a case study of a Canadian School of Nursing. BMC Nurs 21 , 195 (2022). https://doi.org/10.1186/s12912-022-00977-0

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Experiences of medical students and faculty regarding the use of long case as a formative assessment method at a tertiary care teaching hospital in a low resource setting: a qualitative study

• Jacob Kumakech 1 ,
• Ian Guyton Munabi 2 ,
• Aloysius Gonzaga Mubuuke 3 &
• Sarah Kiguli 4  

BMC Medical Education volume  24 , Article number:  621 ( 2024 ) Cite this article

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Introduction

The long case is used to assess medical students’ proficiency in performing clinical tasks. As a formative assessment, the purpose is to offer feedback on performance, aiming to enhance and expedite clinical learning. The long case stands out as one of the primary formative assessment methods for clinical clerkship in low-resource settings but has received little attention in the literature.

To explore the experiences of medical students and faculty regarding the use of the Long Case Study as a formative assessment method at a tertiary care teaching hospital in a low-resource setting.

Methodology

A qualitative study design was used. The study was conducted at Makerere University, a low-resource setting. The study participants were third- and fifth-year medical students as well as lecturers. Purposive sampling was utilized to recruit participants. Data collection comprised six Focus Group Discussions with students and five Key Informant Interviews with lecturers. The qualitative data were analyzed by inductive thematic analysis.

Three themes emerged from the study: ward placement, case presentation, and case assessment and feedback. The findings revealed that students conduct their long cases at patients’ bedside within specific wards/units assigned for the entire clerkship. Effective supervision, feedback, and marks were highlighted as crucial practices that positively impact the learning process. However, challenges such as insufficient orientation to the long case, the super-specialization of the hospital wards, pressure to hunt for marks, and inadequate feedback practices were identified.

The long case offers students exposure to real patients in a clinical setting. However, in tertiary care teaching hospitals, it’s crucial to ensure proper design and implementation of this practice to enable students’ exposure to a variety of cases. Adequate and effective supervision and feedback create valuable opportunities for each learner to present cases and receive corrections.

Peer Review reports

The long case serves as an authentic assessment method for evaluating medical students’ competence in clinical tasks [ 1 ]. This form of assessment requires students to independently spend time with patients taking their medical history, conducting physical examinations, and formulating diagnosis and management plans. Subsequently, students present their findings to senior clinicians for discussion and questioning [ 2 , 3 ]. While developed countries increasingly adopt simulation-based assessments for formative evaluation, logistical challenges hinder the widespread use of such methods in developing countries [ 4 ]. Consequently, the low-resource countries heavily rely on real patient encounters for formative assessment. The long case is one such method predominantly used as a primary formative assessment method during clinical clerkship and offers a great opportunity for feedback [ 5 ]. The assessment grounds students’ learning into practice by providing them with rich opportunities to interact with patients and have the feel of medical practice. The long case thus bridges the gap between theory and practice, immersing students in the real tasks of a physician [ 1 ]. The complexity of clinical scenarios and the anxiety associated with patient encounters may not be well replicated in simulation-based assessments because diseases often have atypical presentations not found in textbooks. Assessment methods should thus utilize authentic learning experiences to provide learners with applications of learning that they would expect to encounter in real life [ 6 ]. This requires medical education and the curriculum to focus attention on assessment because it plays a significant role in driving learning [ 7 ]. The long case thus remains crucial in medical education as one of the best ways of preparing for practice. It exposes the student repeatedly to taking medical history, examining patients, making clinical judgments, deciding treatment plans, and collaborating with senior clinicians.

The long case, however, has faced significant criticism in the medical education literature due to perceived psychometric deficiencies [ 8 , 9 , 10 ]. Consequently, many universities have begun to adopt assessment methods that yield more reliable and easily defensible results [ 2 ] due to concerns over the low reliability, generalizability, and validity of the long case, coupled with rising litigations and student appeals [ 11 , 12 ]. Despite these shortcomings, the long case remains an educationally valuable assessment tool that provides diagnostic feedback essential for the learning process during clinical clerkship [ 13 ]. Teachers can utilize long-case results to pinpoint neglected areas or teaching deficiencies and align with course outcomes.

However, there is a paucity of research into the long case as a formative assessment tool. A few studies conducted in developed countries highlighted its role in promoting a holistic approach to patient care, fostering students’ clinical skills, and a driving force for students to spend time with patients [ 2 , 13 ], . There is a notable absence of literature on the use of long case as a formative assessment method in low-resource countries, and no published work is available at Makerere University where it has been used for decades. This underscores the importance of conducting research in this area to provide insight into the effectiveness, challenges, and potentials for improvement. Therefore, this study aimed to investigate the experiences of medical students and faculty regarding the utilization of the long case as a formative assessment method within the context of a tertiary care teaching hospital in a low-resource setting.

Study design

This was an exploratory qualitative study.

Study setting

The research was conducted at Makerere University within the Department of Internal Medicine. The Bachelor of Medicine and Bachelor of Surgery (MBChB) degree at Makerere University is a five-year program with the first two years for pre-clinical (biomedical Sciences) course and the last three years dedicated to clinical clerkship. Medical students do Internal Medicine clerkships in third- and fifth-year at the two tertiary teaching hospitals namely; Mulago and Kiruddu National Referral Hospitals. The students are introduced to the long case in third-year as Junior Clerks and later in the fifth-year as Senior Clerks. During clerkship, students are assigned to various medical wards, where they interact with patients, take medical history from them, perform physical examinations, and develop diagnosis and management plans. Subsequently, students present their long cases to lecturers or postgraduate students, often in the presence of their peers, followed by feedback and comprehensive case discussions. Students are afforded ample time to prepare and present their cases during ward rounds, at their discretion. The students are formatively assessed and a mark is awarded on a scale of one to ten in the student’s logbook. Each student is required to make a minimum of ten long cases over the seven weeks of clerkship.

Study participants

The study participants were third- and fifth-year medical students who had completed junior and senior clerkship respectively, as well as lecturers who possessed at least five years of experience with the long case. The participants were selected through purposive sampling. The sample size for the study was determined by data saturation.

Data collection

Data were collected through Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs). A total of 36 medical students participated in FGDs, reflecting on their experiences with the long case. Five faculty members participated in individual KIIs. The students were mobilized by their class representative and a brief recruitment presentation was made at the study site while the lecturers were approached via email and telephone invitation.

Six FGDs were conducted, three for junior clerks and three for senior clerks. Each FGD comprised of 5–7 participants with balanced male and female gender representation. Data saturation was achieved by the fifth FGD, at which point no additional new information emerged. A research assistant proficient in qualitative research methods moderated the FGDs. The discussions lasted between 55 min and 1 h 10 min and were audio recorded. The Principal Investigator attended all the FGDs to document interactions and record his perspectives and non-verbal cues of participants.

Semi-structured KIIs were used to collect data from Internal Medicine faculty. Five KIIs were conducted, and data saturation was achieved by the fourth interview, at which point no new theme emerged. The Principal Investigator conducted the KIIs via Zoom. Each interview lasted between 25 and 50 min and all were audio recorded. A research assistant proficient in qualitative methods attended all the Zoom meetings. The data collected were securely stored on a hard drive and Google Drive with password protection to prevent unauthorized access.

Data analysis

Data analysis was done through inductive thematic analysis method. Following each FGD or KII session, the data collection team listened to the recordings to familiarize themselves with the data and develop general ideas regarding the participants’ perspectives. The data were transcribed verbatim by the researchers to generate text data. Two separate transcripts were generated by the Principal Investigator and a research assistant. The transcripts were then compared and manually reviewed by the research team to compare the accuracy with the audio recordings. After transcript harmonization, data cleaning was done for both FGDs and KIIs transcripts.

The transcribed data from both FGDs and KIIs underwent inductive thematic analysis as aggregated data. This involved initial line-by-line coding, followed by focused coding where the relationships between initial codes were explored and similar codes were grouped. Throughout the analysis, the principle of constant comparison was applied, where emerging codes were compared for similarities and differences.

Study results

Socio-demographics.

A total of 36 medical students participated in the FGDs, comprising 18 junior clerks and 19 senior clerks. The participants were aged between 21 and 25 years except two participants who were aged above 25 (30 and 36 years old). Among the third-year students, there were 10 male and 9 female participants while the fifth-year student comprised of 8 male and 10 female participants.

Five lecturers participated in the Key Informant Interviews, three of whom were females and two male participants. They were aged between 40 and 50 years, and all had over 10 years of experience with the long case. The faculty members included one consultant physician, one associate professor, two senior lecturers, and one lecturer.

Themes that emerged

Three themes emerged from the study: ward placement, case presentations, and case assessment and feedback.

Theme 1: Ward placement

The study findings disclosed that medical students are assigned to specific wards for the duration of their clerkship. The specialization of medical wards was found to significantly restrict students’ exposure to limited disease conditions found only in their allocated ward.

With the super-specialization of the units, there is some bias on what they do learn; if a particular group is rotating on the cardiology unit, they will obviously have a bias to learn the history and physical exam related to cardiovascular disease (KII 1).

The students, particularly junior clerks, expressed dissatisfaction with the lack of proper and standardized orientation to the long case on the wards. This deficiency led to wastage of time and a feeling of being unwelcome in the clerkship.

Some orient you when you reach the ward but others you reach and you are supposed to pick up on your own. I expect orientation, then taking data from us, what they expect us to do, and what we expect from them, taking us through the clerkship sessions (FGD 4 Participant 1).

Students’ exposure to cases in other wards poses significant challenges; the study found that as some lecturers facilitate visits to different wards for scheduled teaching sessions, others don’t, resulting in missed learning opportunities. Additionally, some lecturers leave the burden on students’ personal initiative to explore cases in other wards.

We actually encourage them to go through the different specialties because when you are faced with a patient, you will not have to choose which one to see and not to see (KII 4).

Imagine landing on a stroke patient when you have been in the infectious disease ward or getting a patient with renal condition when you have been in the endocrinology ward can create problems (FGD 6 Participant 3).

Theme 2 Case presentation

Medical students present their long case to lecturers and postgraduate students. However, participants revealed variations among lecturers regarding their preferences on how they want students to present their cases. While some prefer to listen to the entire history and examination, others prefer only a summary, and some prefer starting from the diagnosis.

The practice varies depending on the lecturer, as everyone does it their own way. There are some, who listen to your history, examination, and diagnosis, and then they go into basic discussion of the case; others want only a summary. Some lecturers come and tell you to start straight away from your diagnosis, and then they start treating you backward (FGD 6 Participant 3).

The students reported limited observation of their skills due a little emphasis placed by examiners on physical examination techniques, as well as not providing the students with the opportunity to propose treatment plans.

When we are doing these physical examinations on the ward no one is seeing you. You present your physical examination findings, but no one saw how you did it. You may think you are doing the right thing during the ward rotations, but actually your skills are bad (FGD 4 Participant 6).

They don’t give us time to propose management plans. The only time they ask for how you manage a patient is during the summative long case, yet during the ward rotation, they were not giving us the freedom to give our opinion on how we would manage the patient.(FGD 2Participant 6).

Supervision was reportedly dependent on the ward to which the student was allocated. Additionally, the participants believe that the large student-to-lecturer ratio negatively affects the opportunity to present.

My experience was different in years three and five. In year three, we had a specialist every day on the ward, but in year five, we would have a specialist every other day, sometimes even once a week. When I compare year five with year three, I think I was even a better doctor in year three than right now (FGD 1 Participant 1).

Clinical training is like nurturing somebody to behave or conduct themselves in a certain way. Therefore, if the numbers are large, the impacts per person decrease, and the quality decreases (KII 5).

Theme C: Case assessment and feedback

The study found that a student’s long case is assessed both during the case presentation on the ward and through the case write-up, with marks awarded accordingly.

They present to the supervisor and then also write it up, so at a later time you also mark the sheet where they have written up the cases; so they are assessed at presentation and write up (KII 2).

The mark awarded was reportedly a significant motivator for students to visit wards and clerk patients, but students also believe that the pressure to hunt for marks tends to override the goal of the formative assessment.

Your goal there is to learn, but most of us go with the goal of getting signatures; signature-based learning. The learning, you realize probably comes on later if you have the individual morale to go and learn (FGD 1 participant 1).

Feedback is an integral part of any formative assessment. While students receive feedback from lecturers, the participants were concerned about the absence of a formal channel for soliciting feedback from students.

Of course, teachers provide feedback to students because it is a normal part of teaching. However, it is not a common routine to solicit feedback about how teaching has gone. So maybe that is something that needs to be improved so that we know if we have been effective teachers (KII 3).

Whereas the feedback intrigues students to read more to compensate for their knowledge gap, they decried several encounters with demeaning, intimidating, insulting, demotivating, and embarrassing feedback from assessors.

Since we are given a specific target of case presentation we are supposed to make in my training , if I make the ten, I wouldn’t want to present again. Why would I receive other negative comments for nothing? They truly have a personality effect on the student, and students feel low self-esteem (FGD 1, Participant 4).

This study aimed to investigate the experiences of medical students and faculty regarding the use of the long case as a formative assessment method at a tertiary care teaching hospital in a low-resource setting. This qualitative research provides valuable insights into the current practices surrounding the long case as a formative assessment method in such a setting.

The study highlighted the patient bedside as the primary learning environment for medical students. Bedside teaching plays a crucial role in fostering the development of skills such as history-taking and physical examination, as well as modeling professional behaviors and directly observing learners [ 14 , 15 ]. However, the specialization of wards in tertiary hospitals means that students may not be exposed to certain conditions found in other wards. This lack of exposure can lead to issues of case specificity, which has been reported in various literature as a cause of low reliability and generalizability of the long case [ 16 , 17 ]. Participants in the study expressed feeling like pseudo-specialists based on their ward allocations. This is partly attributed to missing scheduled teachings and poor management of opportunities to clerk and present patients on other wards. Addressing these challenges is essential for enhancing the effectiveness of the long case as a formative assessment method in medical education.

Proper orientation at the beginning of a clerkship is crucial for clarifying the structure and organization, defining students’ roles, and providing insights into clinical supervisors’ perspectives [ 18 ]. However, the study revealed that orientation into the long case was unsatisfactory, resulting in time wastage and potentially hindering learning. Effective orientation requires dedicated time and should involve defining expectations and goals, as well as guiding students through the steps of history-taking and physical examination during the initial weeks of the rotation. Contrary to this ideal approach, the medical students reported being taken through systemic examinations when the clerkship was nearing its end, highlighting a significant gap in the orientation process. Proper orientation is very important since previous studies have also documented the positive impact of orientation on student performance [ 19 ]. Therefore, addressing the shortcomings in orientation practices identified in this study is essential for optimizing learning outcomes and ensuring that students are adequately prepared to engage in the long case.

There was reportedly a significant variation in the way students present their long cases, with some lecturers preferring only a case summary, while others expect a complete presentation or begin with a diagnosis. While this diversity in learning styles may expose students to both familiar and unfamiliar approaches, providing a balance of comfort and tension [ 20 ], it’s essential for students to first be exposed to familiar methods before transitioning to less familiar ones to expand their ability to use diverse learning styles. The variation observed in this context may be attributed to time constraints, as lecturers may aim to accommodate the large number of students within the available time. Additionally, a lack of standardized practices could also contribute to this variation. Therefore, there is a pressing need for standardized long-case practices to ensure a consistent experience for students and to meet the desired goals of the assessment. Standardizing the long case practice would not only provide a uniform experience for students but also enhance the reliability, validity, and perception of fairness of the assessment [ 9 , 21 ]. It would ensure that all students are evaluated using the same criteria, reducing potential biases and disparities in grading. Additionally, standardized practices facilitate better alignment with learning objectives and promote more effective feedback mechanisms [ 22 ].

Related to the above, students reported limited observation of skills and little emphasis placed on them to learn physical examination techniques. This finding resonates with the research conducted by Abdalla and Shorbagi in 2018, where many students reported a lack of observation during history-taking and physical examination [ 23 ]. The importance of observation is underscored by the fact that students often avoid conducting physical examinations, as highlighted in Pavlakis & Laurent’s study among postgraduate trainees in 2001 [ 24 ]. This study sheds more light on the critical role of observation in forcing medical students to master clinical assessment and practical skills. The study also uncovered that students are rarely given the opportunity to propose management plans during case presentations, which hampers their confidence and learning of clinical decision-making. These findings likely stem from the large student-to-lecturer ratio and little attention given to these aspects of the long case during the planning of the assessment method. The result is students not receiving the necessary guidance and support to develop their clinical and decision-making skills. Therefore, addressing these issues by putting more emphasis on observation of student-patient interaction, management plan, and having a smaller student group is vital to ensure that medical students receive comprehensive training and are adequately prepared for their future roles as physicians.

The study found that the marks awarded for the long case serve as the primary motivator for students. This finding aligns with previous research indicating that the knowledge that each long case is part of assessment drives students to perform their duties diligently [ 2 , 25 ]. It underscores the crucial role that assessment plays in driving learning processes. However, the pressures to obtain marks and signatures reportedly hinder students’ engagement in learning. This could be attributed to instances where some lecturers relax on supervision or are absent, leaving students to struggle to find someone to assess them. Inadequate supervision by attending physicians has been identified in prior studies as one of the causes of insufficient clinical experience [ 26 ], something that need to be dealt with diligently. While the marks awarded are a motivating factor, it is essential to understand other underlying motivations of medical students to engage in the long case and their impact on the learning process.

Feedback is crucial for the long case to fulfill its role as an assessment for learning. The study participants reported that feedback is provided promptly as students present their cases. This immediate feedback is essential for identifying errors and learning appropriate skills to enhance subsequent performance. However, the feedback process appears to be unilateral, with students receiving feedback from lecturers but lacking a structured mechanism for providing feedback themselves. One reason for the lack of student feedback may be a perceived intimidating approach from lecturers which discourages students from offering their input. It is thus important to establish a conducive environment where students feel comfortable providing feedback without fear of negative repercussions. The study underscores the significance of feedback from students in improving the learning process. This aligns with the findings of Hattie and Timperley (2007), who emphasized that feedback received from learners contributes significantly to improvements in student learning [ 27 ]. Therefore, it is essential to implement strategies to encourage and facilitate bidirectional feedback between students and lecturers in the context of the long case assessment. This could involve creating formal channels for students to provide feedback anonymously or in a structured format, fostering open communication, and addressing any perceived barriers to feedback exchange [ 28 ]. By promoting a culture of feedback reciprocity, educators can enhance the effectiveness of the long case as an assessment tool.

Conclusions

In conclusion, the long case remains a cornerstone of formative assessment during clerkship in many medical schools, particularly in low-resource countries. However, its effectiveness is challenged by limitations such as case specificity in tertiary care hospitals, which can affect the assessment’s reliability and generalizability. The practice of awarding marks in formative assessment serves as a strong motivator for students but also creates tension, especially when there is inadequate contact with lecturers. This can lead to a focus on hunting for marks at the expense of genuine learning. Thus adequate supervision and feedback practices are vital for ensuring the success of the long case as an assessment for learning.

Furthermore, there is a need to foster standardized long case practice to ensure that scheduled learning activities are completed and that all students clerk and present patients with different conditions from various wards. This will promote accountability among both lecturers and students and ensure a consistent and uniform experience with the long case as an assessment for learning, regardless of the ward a student is assigned.

Data availability

The data supporting the study results of this article can be accessed from the Makerere University repository, titled “Perceptions of Medical Students and Lecturers of the Long Case Practices as Formative Assessment in Internal Medicine Clerkship at Makerere University,” available on DSpace. The identifier is http://hdl.handle.net/10570/13032 . Additionally, the raw data are securely stored with the researchers in Google Drive.

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This research was supported by the Fogarty International Centre of the National Institute of Health under award number 1R25TW011213. The content is solely the responsibility of the author and does not necessarily represent the official views of the National Institute of Health.

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JK contributed to the conception and design of the study, as well as the acquisition, analysis, and interpretation of the data. He also drafted the initial version of the work and approved the submitted version. He agrees to be personally accountable for his contribution and to ensure that any questions related to the accuracy or integrity of any part of the work, even those in which he was not personally involved, are appropriately investigated and resolved, with the resolution documented in the literature.IMG contributed to the analysis and interpretation of the data. He also made major corrections to the first draft of the manuscript and approved the submitted version. He agrees to be personally accountable for his contribution and to ensure that any questions related to the accuracy or integrity of any part of the work, even those in which he was not personally involved, are appropriately investigated and resolved, with the resolution documented in the literature.MA contributed to the analysis and interpretation of the data. He made major corrections to the first draft of the manuscript and approved the submitted version. He agrees to be personally accountable for his contribution and to ensure that any questions related to the accuracy or integrity of any part of the work, even those in which he was not personally involved, are appropriately investigated and resolved, with the resolution documented in the literature.SK made major corrections to the first draft and the final corrections for the submitted version of the work. She agrees to be personally accountable for her contribution and to ensure that any questions related to the accuracy or integrity of any part of the work, even those in which she was not personally involved, are appropriately investigated and resolved, with the resolution documented in the literature.

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Kumakech, J., Munabi, I.G., Mubuuke, A.G. et al. Experiences of medical students and faculty regarding the use of long case as a formative assessment method at a tertiary care teaching hospital in a low resource setting: a qualitative study. BMC Med Educ 24 , 621 (2024). https://doi.org/10.1186/s12909-024-05589-7

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2024 Theses Doctoral

Statistically Efficient Methods for Computation-Aware Uncertainty Quantification and Rare-Event Optimization

He, Shengyi

The thesis covers two fundamental topics that are important across the disciplines of operations research, statistics and even more broadly, namely stochastic optimization and uncertainty quantification, with the common theme to address both statistical accuracy and computational constraints. Here, statistical accuracy encompasses the precision of estimated solutions in stochastic optimization, as well as the tightness or reliability of confidence intervals. Computational concerns arise from rare events or expensive models, necessitating efficient sampling methods or computation procedures. In the first half of this thesis, we study stochastic optimization that involves rare events, which arises in various contexts including risk-averse decision-making and training of machine learning models. Because of the presence of rare events, crude Monte Carlo methods can be prohibitively inefficient, as it takes a sample size reciprocal to the rare-event probability to obtain valid statistical information about the rare-event. To address this issue, we investigate the use of importance sampling (IS) to reduce the required sample size. IS is commonly used to handle rare events, and the idea is to sample from an alternative distribution that hits the rare event more frequently and adjusts the estimator with a likelihood ratio to retain unbiasedness. While IS has been long studied, most of its literature focuses on estimation problems and methodologies to obtain good IS in these contexts. Contrary to these studies, the first half of this thesis provides a systematic study on the efficient use of IS in stochastic optimization. In Chapter 2, we propose an adaptive procedure that converts an efficient IS for gradient estimation to an efficient IS procedure for stochastic optimization. Then, in Chapter 3, we provide an efficient IS for gradient estimation, which serves as the input for the procedure in Chapter 2. In the second half of this thesis, we study uncertainty quantification in the sense of constructing a confidence interval (CI) for target model quantities or prediction. We are interested in the setting of expensive black-box models, which means that we are confined to using a low number of model runs, and we also lack the ability to obtain auxiliary model information such as gradients. In this case, a classical method is batching, which divides data into a few batches and then constructs a CI based on the batched estimates. Another method is the recently proposed cheap bootstrap that is constructed on a few resamples in a similar manner as batching. These methods could save computation since they do not need an accurate variability estimator which requires sufficient model evaluations to obtain. Instead, they cancel out the variability when constructing pivotal statistics, and thus obtain asymptotically valid t-distribution-based CIs with only few batches or resamples. The second half of this thesis studies several theoretical aspects of these computation-aware CI construction methods. In Chapter 4, we study the statistical optimality on CI tightness among various computation-aware CIs. Then, in Chapter 5, we study the higher-order coverage errors of batching methods. Finally, Chapter 6 is a related investigation on the higher-order coverage and correction of distributionally robust optimization (DRO) as another CI construction tool, which assumes an amount of analytical information on the model but bears similarity to Chapter 5 in terms of analysis techniques.

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