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• What Is a Case Study? | Definition, Examples & Methods

What Is a Case Study? | Definition, Examples & Methods

Published on May 8, 2019 by Shona McCombes . Revised on November 20, 2023.

A case study is a detailed study of a specific subject, such as a person, group, place, event, organization, 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 analyze the case, other interesting articles.

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

TipIf your research is more practical in nature and aims to simultaneously investigate an issue as you solve it, consider conducting action research instead.

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.

Example of an outlying case studyIn the 1960s the town of Roseto, Pennsylvania was discovered to have extremely low rates of heart disease compared to the US average. It became an important case study for understanding previously neglected causes of heart disease.

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

Example of a representative case studyIn the 1920s, two sociologists used Muncie, Indiana as a case study of a typical American city that supposedly exemplified the changing culture of the US at the time.

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.

Example of a mixed methods case studyFor a case study of a wind farm development in a rural area, you could collect quantitative data on employment rates and business revenue, collect qualitative data on local people’s perceptions and experiences, and analyze local and national media coverage of the development.

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

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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 analyze 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.

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.

• Normal distribution
• Degrees of freedom
• Null hypothesis
• Discourse analysis
• Control groups
• Mixed methods research
• Non-probability sampling
• Quantitative research
• Ecological validity

Research bias

• Rosenthal effect
• Implicit bias
• Cognitive bias
• Selection bias
• Negativity bias
• Status quo bias

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Home » Case Study – Methods, Examples and Guide

Case Study – Methods, Examples and Guide

Table of Contents

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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Definition and Introduction

Case analysis is a problem-based teaching and learning method that involves critically analyzing complex scenarios within an organizational setting for the purpose of placing the student in a “real world” situation and applying reflection and critical thinking skills to contemplate appropriate solutions, decisions, or recommended courses of action. It is considered a more effective teaching technique than in-class role playing or simulation activities. The analytical process is often guided by questions provided by the instructor that ask students to contemplate relationships between the facts and critical incidents described in the case.

Cases generally include both descriptive and statistical elements and rely on students applying abductive reasoning to develop and argue for preferred or best outcomes [i.e., case scenarios rarely have a single correct or perfect answer based on the evidence provided]. Rather than emphasizing theories or concepts, case analysis assignments emphasize building a bridge of relevancy between abstract thinking and practical application and, by so doing, teaches the value of both within a specific area of professional practice.

Given this, the purpose of a case analysis paper is to present a structured and logically organized format for analyzing the case situation. It can be assigned to students individually or as a small group assignment and it may include an in-class presentation component. Case analysis is predominately taught in economics and business-related courses, but it is also a method of teaching and learning found in other applied social sciences disciplines, such as, social work, public relations, education, journalism, and public administration.

Ellet, William. The Case Study Handbook: A Student's Guide . Revised Edition. Boston, MA: Harvard Business School Publishing, 2018; Christoph Rasche and Achim Seisreiner. Guidelines for Business Case Analysis . University of Potsdam; Writing a Case Analysis . Writing Center, Baruch College; Volpe, Guglielmo. "Case Teaching in Economics: History, Practice and Evidence." Cogent Economics and Finance 3 (December 2015). doi:https://doi.org/10.1080/23322039.2015.1120977.

How to Approach Writing a Case Analysis Paper

The organization and structure of a case analysis paper can vary depending on the organizational setting, the situation, and how your professor wants you to approach the assignment. Nevertheless, preparing to write a case analysis paper involves several important steps. As Hawes notes, a case analysis assignment “...is useful in developing the ability to get to the heart of a problem, analyze it thoroughly, and to indicate the appropriate solution as well as how it should be implemented” [p.48]. This statement encapsulates how you should approach preparing to write a case analysis paper.

Before you begin to write your paper, consider the following analytical procedures:

• Review the case to get an overview of the situation . A case can be only a few pages in length, however, it is most often very lengthy and contains a significant amount of detailed background information and statistics, with multilayered descriptions of the scenario, the roles and behaviors of various stakeholder groups, and situational events. Therefore, a quick reading of the case will help you gain an overall sense of the situation and illuminate the types of issues and problems that you will need to address in your paper. If your professor has provided questions intended to help frame your analysis, use them to guide your initial reading of the case.
• Read the case thoroughly . After gaining a general overview of the case, carefully read the content again with the purpose of understanding key circumstances, events, and behaviors among stakeholder groups. Look for information or data that appears contradictory, extraneous, or misleading. At this point, you should be taking notes as you read because this will help you develop a general outline of your paper. The aim is to obtain a complete understanding of the situation so that you can begin contemplating tentative answers to any questions your professor has provided or, if they have not provided, developing answers to your own questions about the case scenario and its connection to the course readings,lectures, and class discussions.
• Determine key stakeholder groups, issues, and events and the relationships they all have to each other . As you analyze the content, pay particular attention to identifying individuals, groups, or organizations described in the case and identify evidence of any problems or issues of concern that impact the situation in a negative way. Other things to look for include identifying any assumptions being made by or about each stakeholder, potential biased explanations or actions, explicit demands or ultimatums , and the underlying concerns that motivate these behaviors among stakeholders. The goal at this stage is to develop a comprehensive understanding of the situational and behavioral dynamics of the case and the explicit and implicit consequences of each of these actions.
• Identify the core problems . The next step in most case analysis assignments is to discern what the core [i.e., most damaging, detrimental, injurious] problems are within the organizational setting and to determine their implications. The purpose at this stage of preparing to write your analysis paper is to distinguish between the symptoms of core problems and the core problems themselves and to decide which of these must be addressed immediately and which problems do not appear critical but may escalate over time. Identify evidence from the case to support your decisions by determining what information or data is essential to addressing the core problems and what information is not relevant or is misleading.
• Explore alternative solutions . As noted, case analysis scenarios rarely have only one correct answer. Therefore, it is important to keep in mind that the process of analyzing the case and diagnosing core problems, while based on evidence, is a subjective process open to various avenues of interpretation. This means that you must consider alternative solutions or courses of action by critically examining strengths and weaknesses, risk factors, and the differences between short and long-term solutions. For each possible solution or course of action, consider the consequences they may have related to their implementation and how these recommendations might lead to new problems. Also, consider thinking about your recommended solutions or courses of action in relation to issues of fairness, equity, and inclusion.
• Decide on a final set of recommendations . The last stage in preparing to write a case analysis paper is to assert an opinion or viewpoint about the recommendations needed to help resolve the core problems as you see them and to make a persuasive argument for supporting this point of view. Prepare a clear rationale for your recommendations based on examining each element of your analysis. Anticipate possible obstacles that could derail their implementation. Consider any counter-arguments that could be made concerning the validity of your recommended actions. Finally, describe a set of criteria and measurable indicators that could be applied to evaluating the effectiveness of your implementation plan.

Use these steps as the framework for writing your paper. Remember that the more detailed you are in taking notes as you critically examine each element of the case, the more information you will have to draw from when you begin to write. This will save you time.

NOTE : If the process of preparing to write a case analysis paper is assigned as a student group project, consider having each member of the group analyze a specific element of the case, including drafting answers to the corresponding questions used by your professor to frame the analysis. This will help make the analytical process more efficient and ensure that the distribution of work is equitable. This can also facilitate who is responsible for drafting each part of the final case analysis paper and, if applicable, the in-class presentation.

Framework for Case Analysis . College of Management. University of Massachusetts; Hawes, Jon M. "Teaching is Not Telling: The Case Method as a Form of Interactive Learning." Journal for Advancement of Marketing Education 5 (Winter 2004): 47-54; Rasche, Christoph and Achim Seisreiner. Guidelines for Business Case Analysis . University of Potsdam; Writing a Case Study Analysis . University of Arizona Global Campus Writing Center; Van Ness, Raymond K. A Guide to Case Analysis . School of Business. State University of New York, Albany; Writing a Case Analysis . Business School, University of New South Wales.

Structure and Writing Style

A case analysis paper should be detailed, concise, persuasive, clearly written, and professional in tone and in the use of language . As with other forms of college-level academic writing, declarative statements that convey information, provide a fact, or offer an explanation or any recommended courses of action should be based on evidence. If allowed by your professor, any external sources used to support your analysis, such as course readings, should be properly cited under a list of references. The organization and structure of case analysis papers can vary depending on your professor’s preferred format, but its structure generally follows the steps used for analyzing the case.

Introduction

The introduction should provide a succinct but thorough descriptive overview of the main facts, issues, and core problems of the case . The introduction should also include a brief summary of the most relevant details about the situation and organizational setting. This includes defining the theoretical framework or conceptual model on which any questions were used to frame your analysis.

Following the rules of most college-level research papers, the introduction should then inform the reader how the paper will be organized. This includes describing the major sections of the paper and the order in which they will be presented. Unless you are told to do so by your professor, you do not need to preview your final recommendations in the introduction. U nlike most college-level research papers , the introduction does not include a statement about the significance of your findings because a case analysis assignment does not involve contributing new knowledge about a research problem.

Background Analysis

Background analysis can vary depending on any guiding questions provided by your professor and the underlying concept or theory that the case is based upon. In general, however, this section of your paper should focus on:

• Providing an overarching analysis of problems identified from the case scenario, including identifying events that stakeholders find challenging or troublesome,
• Identifying assumptions made by each stakeholder and any apparent biases they may exhibit,
• Describing any demands or claims made by or forced upon key stakeholders, and
• Highlighting any issues of concern or complaints expressed by stakeholders in response to those demands or claims.

These aspects of the case are often in the form of behavioral responses expressed by individuals or groups within the organizational setting. However, note that problems in a case situation can also be reflected in data [or the lack thereof] and in the decision-making, operational, cultural, or institutional structure of the organization. Additionally, demands or claims can be either internal and external to the organization [e.g., a case analysis involving a president considering arms sales to Saudi Arabia could include managing internal demands from White House advisors as well as demands from members of Congress].

Throughout this section, present all relevant evidence from the case that supports your analysis. Do not simply claim there is a problem, an assumption, a demand, or a concern; tell the reader what part of the case informed how you identified these background elements.

Identification of Problems

In most case analysis assignments, there are problems, and then there are problems . Each problem can reflect a multitude of underlying symptoms that are detrimental to the interests of the organization. The purpose of identifying problems is to teach students how to differentiate between problems that vary in severity, impact, and relative importance. Given this, problems can be described in three general forms: those that must be addressed immediately, those that should be addressed but the impact is not severe, and those that do not require immediate attention and can be set aside for the time being.

All of the problems you identify from the case should be identified in this section of your paper, with a description based on evidence explaining the problem variances. If the assignment asks you to conduct research to further support your assessment of the problems, include this in your explanation. Remember to cite those sources in a list of references. Use specific evidence from the case and apply appropriate concepts, theories, and models discussed in class or in relevant course readings to highlight and explain the key problems [or problem] that you believe must be solved immediately and describe the underlying symptoms and why they are so critical.

Alternative Solutions

This section is where you provide specific, realistic, and evidence-based solutions to the problems you have identified and make recommendations about how to alleviate the underlying symptomatic conditions impacting the organizational setting. For each solution, you must explain why it was chosen and provide clear evidence to support your reasoning. This can include, for example, course readings and class discussions as well as research resources, such as, books, journal articles, research reports, or government documents. In some cases, your professor may encourage you to include personal, anecdotal experiences as evidence to support why you chose a particular solution or set of solutions. Using anecdotal evidence helps promote reflective thinking about the process of determining what qualifies as a core problem and relevant solution .

Throughout this part of the paper, keep in mind the entire array of problems that must be addressed and describe in detail the solutions that might be implemented to resolve these problems.

Recommended Courses of Action

In some case analysis assignments, your professor may ask you to combine the alternative solutions section with your recommended courses of action. However, it is important to know the difference between the two. A solution refers to the answer to a problem. A course of action refers to a procedure or deliberate sequence of activities adopted to proactively confront a situation, often in the context of accomplishing a goal. In this context, proposed courses of action are based on your analysis of alternative solutions. Your description and justification for pursuing each course of action should represent the overall plan for implementing your recommendations.

For each course of action, you need to explain the rationale for your recommendation in a way that confronts challenges, explains risks, and anticipates any counter-arguments from stakeholders. Do this by considering the strengths and weaknesses of each course of action framed in relation to how the action is expected to resolve the core problems presented, the possible ways the action may affect remaining problems, and how the recommended action will be perceived by each stakeholder.

In addition, you should describe the criteria needed to measure how well the implementation of these actions is working and explain which individuals or groups are responsible for ensuring your recommendations are successful. In addition, always consider the law of unintended consequences. Outline difficulties that may arise in implementing each course of action and describe how implementing the proposed courses of action [either individually or collectively] may lead to new problems [both large and small].

Throughout this section, you must consider the costs and benefits of recommending your courses of action in relation to uncertainties or missing information and the negative consequences of success.

The conclusion should be brief and introspective. Unlike a research paper, the conclusion in a case analysis paper does not include a summary of key findings and their significance, a statement about how the study contributed to existing knowledge, or indicate opportunities for future research.

Begin by synthesizing the core problems presented in the case and the relevance of your recommended solutions. This can include an explanation of what you have learned about the case in the context of your answers to the questions provided by your professor. The conclusion is also where you link what you learned from analyzing the case with the course readings or class discussions. This can further demonstrate your understanding of the relationships between the practical case situation and the theoretical and abstract content of assigned readings and other course content.

Problems to Avoid

The literature on case analysis assignments often includes examples of difficulties students have with applying methods of critical analysis and effectively reporting the results of their assessment of the situation. A common reason cited by scholars is that the application of this type of teaching and learning method is limited to applied fields of social and behavioral sciences and, as a result, writing a case analysis paper can be unfamiliar to most students entering college.

After you have drafted your paper, proofread the narrative flow and revise any of these common errors:

• Unnecessary detail in the background section . The background section should highlight the essential elements of the case based on your analysis. Focus on summarizing the facts and highlighting the key factors that become relevant in the other sections of the paper by eliminating any unnecessary information.
• Analysis relies too much on opinion . Your analysis is interpretive, but the narrative must be connected clearly to evidence from the case and any models and theories discussed in class or in course readings. Any positions or arguments you make should be supported by evidence.
• Analysis does not focus on the most important elements of the case . Your paper should provide a thorough overview of the case. However, the analysis should focus on providing evidence about what you identify are the key events, stakeholders, issues, and problems. Emphasize what you identify as the most critical aspects of the case to be developed throughout your analysis. Be thorough but succinct.
• Writing is too descriptive . A paper with too much descriptive information detracts from your analysis of the complexities of the case situation. Questions about what happened, where, when, and by whom should only be included as essential information leading to your examination of questions related to why, how, and for what purpose.
• Inadequate definition of a core problem and associated symptoms . A common error found in case analysis papers is recommending a solution or course of action without adequately defining or demonstrating that you understand the problem. Make sure you have clearly described the problem and its impact and scope within the organizational setting. Ensure that you have adequately described the root causes w hen describing the symptoms of the problem.
• Recommendations lack specificity . Identify any use of vague statements and indeterminate terminology, such as, “A particular experience” or “a large increase to the budget.” These statements cannot be measured and, as a result, there is no way to evaluate their successful implementation. Provide specific data and use direct language in describing recommended actions.
• Unrealistic, exaggerated, or unattainable recommendations . Review your recommendations to ensure that they are based on the situational facts of the case. Your recommended solutions and courses of action must be based on realistic assumptions and fit within the constraints of the situation. Also note that the case scenario has already happened, therefore, any speculation or arguments about what could have occurred if the circumstances were different should be revised or eliminated.

Bee, Lian Song et al. "Business Students' Perspectives on Case Method Coaching for Problem-Based Learning: Impacts on Student Engagement and Learning Performance in Higher Education." Education & Training 64 (2022): 416-432; The Case Analysis . Fred Meijer Center for Writing and Michigan Authors. Grand Valley State University; Georgallis, Panikos and Kayleigh Bruijn. "Sustainability Teaching using Case-Based Debates." Journal of International Education in Business 15 (2022): 147-163; Hawes, Jon M. "Teaching is Not Telling: The Case Method as a Form of Interactive Learning." Journal for Advancement of Marketing Education 5 (Winter 2004): 47-54; Georgallis, Panikos, and Kayleigh Bruijn. "Sustainability Teaching Using Case-based Debates." Journal of International Education in Business 15 (2022): 147-163; .Dean,  Kathy Lund and Charles J. Fornaciari. "How to Create and Use Experiential Case-Based Exercises in a Management Classroom." Journal of Management Education 26 (October 2002): 586-603; Klebba, Joanne M. and Janet G. Hamilton. "Structured Case Analysis: Developing Critical Thinking Skills in a Marketing Case Course." Journal of Marketing Education 29 (August 2007): 132-137, 139; Klein, Norman. "The Case Discussion Method Revisited: Some Questions about Student Skills." Exchange: The Organizational Behavior Teaching Journal 6 (November 1981): 30-32; Mukherjee, Arup. "Effective Use of In-Class Mini Case Analysis for Discovery Learning in an Undergraduate MIS Course." The Journal of Computer Information Systems 40 (Spring 2000): 15-23; Pessoa, Silviaet al. "Scaffolding the Case Analysis in an Organizational Behavior Course: Making Analytical Language Explicit." Journal of Management Education 46 (2022): 226-251: Ramsey, V. J. and L. D. Dodge. "Case Analysis: A Structured Approach." Exchange: The Organizational Behavior Teaching Journal 6 (November 1981): 27-29; Schweitzer, Karen. "How to Write and Format a Business Case Study." ThoughtCo. https://www.thoughtco.com/how-to-write-and-format-a-business-case-study-466324 (accessed December 5, 2022); Reddy, C. D. "Teaching Research Methodology: Everything's a Case." Electronic Journal of Business Research Methods 18 (December 2020): 178-188; Volpe, Guglielmo. "Case Teaching in Economics: History, Practice and Evidence." Cogent Economics and Finance 3 (December 2015). doi:https://doi.org/10.1080/23322039.2015.1120977.

Writing Tip

Ca se Study and Case Analysis Are Not the Same!

Confusion often exists between what it means to write a paper that uses a case study research design and writing a paper that analyzes a case; they are two different types of approaches to learning in the social and behavioral sciences. Professors as well as educational researchers contribute to this confusion because they often use the term "case study" when describing the subject of analysis for a case analysis paper. But you are not studying a case for the purpose of generating a comprehensive, multi-faceted understanding of a research problem. R ather, you are critically analyzing a specific scenario to argue logically for recommended solutions and courses of action that lead to optimal outcomes applicable to professional practice.

To avoid any confusion, here are twelve characteristics that delineate the differences between writing a paper using the case study research method and writing a case analysis paper:

• Case study is a method of in-depth research and rigorous inquiry ; case analysis is a reliable method of teaching and learning . A case study is a modality of research that investigates a phenomenon for the purpose of creating new knowledge, solving a problem, or testing a hypothesis using empirical evidence derived from the case being studied. Often, the results are used to generalize about a larger population or within a wider context. The writing adheres to the traditional standards of a scholarly research study. A case analysis is a pedagogical tool used to teach students how to reflect and think critically about a practical, real-life problem in an organizational setting.
• The researcher is responsible for identifying the case to study; a case analysis is assigned by your professor . As the researcher, you choose the case study to investigate in support of obtaining new knowledge and understanding about the research problem. The case in a case analysis assignment is almost always provided, and sometimes written, by your professor and either given to every student in class to analyze individually or to a small group of students, or students select a case to analyze from a predetermined list.
• A case study is indeterminate and boundless; a case analysis is predetermined and confined . A case study can be almost anything [see item 9 below] as long as it relates directly to examining the research problem. This relationship is the only limit to what a researcher can choose as the subject of their case study. The content of a case analysis is determined by your professor and its parameters are well-defined and limited to elucidating insights of practical value applied to practice.
• Case study is fact-based and describes actual events or situations; case analysis can be entirely fictional or adapted from an actual situation . The entire content of a case study must be grounded in reality to be a valid subject of investigation in an empirical research study. A case analysis only needs to set the stage for critically examining a situation in practice and, therefore, can be entirely fictional or adapted, all or in-part, from an actual situation.
• Research using a case study method must adhere to principles of intellectual honesty and academic integrity; a case analysis scenario can include misleading or false information . A case study paper must report research objectively and factually to ensure that any findings are understood to be logically correct and trustworthy. A case analysis scenario may include misleading or false information intended to deliberately distract from the central issues of the case. The purpose is to teach students how to sort through conflicting or useless information in order to come up with the preferred solution. Any use of misleading or false information in academic research is considered unethical.
• Case study is linked to a research problem; case analysis is linked to a practical situation or scenario . In the social sciences, the subject of an investigation is most often framed as a problem that must be researched in order to generate new knowledge leading to a solution. Case analysis narratives are grounded in real life scenarios for the purpose of examining the realities of decision-making behavior and processes within organizational settings. A case analysis assignments include a problem or set of problems to be analyzed. However, the goal is centered around the act of identifying and evaluating courses of action leading to best possible outcomes.
• The purpose of a case study is to create new knowledge through research; the purpose of a case analysis is to teach new understanding . Case studies are a choice of methodological design intended to create new knowledge about resolving a research problem. A case analysis is a mode of teaching and learning intended to create new understanding and an awareness of uncertainty applied to practice through acts of critical thinking and reflection.
• A case study seeks to identify the best possible solution to a research problem; case analysis can have an indeterminate set of solutions or outcomes . Your role in studying a case is to discover the most logical, evidence-based ways to address a research problem. A case analysis assignment rarely has a single correct answer because one of the goals is to force students to confront the real life dynamics of uncertainly, ambiguity, and missing or conflicting information within professional practice. Under these conditions, a perfect outcome or solution almost never exists.
• Case study is unbounded and relies on gathering external information; case analysis is a self-contained subject of analysis . The scope of a case study chosen as a method of research is bounded. However, the researcher is free to gather whatever information and data is necessary to investigate its relevance to understanding the research problem. For a case analysis assignment, your professor will often ask you to examine solutions or recommended courses of action based solely on facts and information from the case.
• Case study can be a person, place, object, issue, event, condition, or phenomenon; a case analysis is a carefully constructed synopsis of events, situations, and behaviors . The research problem dictates the type of case being studied and, therefore, the design can encompass almost anything tangible as long as it fulfills the objective of generating new knowledge and understanding. A case analysis is in the form of a narrative containing descriptions of facts, situations, processes, rules, and behaviors within a particular setting and under a specific set of circumstances.
• Case study can represent an open-ended subject of inquiry; a case analysis is a narrative about something that has happened in the past . A case study is not restricted by time and can encompass an event or issue with no temporal limit or end. For example, the current war in Ukraine can be used as a case study of how medical personnel help civilians during a large military conflict, even though circumstances around this event are still evolving. A case analysis can be used to elicit critical thinking about current or future situations in practice, but the case itself is a narrative about something finite and that has taken place in the past.
• Multiple case studies can be used in a research study; case analysis involves examining a single scenario . Case study research can use two or more cases to examine a problem, often for the purpose of conducting a comparative investigation intended to discover hidden relationships, document emerging trends, or determine variations among different examples. A case analysis assignment typically describes a stand-alone, self-contained situation and any comparisons among cases are conducted during in-class discussions and/or student presentations.

The Case Analysis . Fred Meijer Center for Writing and Michigan Authors. Grand Valley State University; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Ramsey, V. J. and L. D. Dodge. "Case Analysis: A Structured Approach." Exchange: The Organizational Behavior Teaching Journal 6 (November 1981): 27-29; Yin, Robert K. Case Study Research and Applications: Design and Methods . 6th edition. Thousand Oaks, CA: Sage, 2017; Crowe, Sarah et al. “The Case Study Approach.” BMC Medical Research Methodology 11 (2011):  doi: 10.1186/1471-2288-11-100; Yin, Robert K. Case Study Research: Design and Methods . 4th edition. Thousand Oaks, CA: Sage Publishing; 1994.

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What is case study research?

Last updated

8 February 2023

Reviewed by

Cathy Heath

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Suppose a company receives a spike in the number of customer complaints, or medical experts discover an outbreak of illness affecting children but are not quite sure of the reason. In both cases, carrying out a case study could be the best way to get answers.

Organization

Case studies can be carried out across different disciplines, including education, medicine, sociology, and business.

Most case studies employ qualitative methods, but quantitative methods can also be used. Researchers can then describe, compare, evaluate, and identify patterns or cause-and-effect relationships between the various variables under study. They can then use this knowledge to decide what action to take. 

Another thing to note is that case studies are generally singular in their focus. This means they narrow focus to a particular area, making them highly subjective. You cannot always generalize the results of a case study and apply them to a larger population. However, they are valuable tools to illustrate a principle or develop a thesis.

Analyze case study research

Dovetail streamlines case study research to help you uncover and share actionable insights

• What are the different types of case study designs?

Researchers can choose from a variety of case study designs. The design they choose is dependent on what questions they need to answer, the context of the research environment, how much data they already have, and what resources are available.

Here are the common types of case study design:

Explanatory

An explanatory case study is an initial explanation of the how or why that is behind something. This design is commonly used when studying a real-life phenomenon or event. Once the organization understands the reasons behind a phenomenon, it can then make changes to enhance or eliminate the variables causing it. 

Here is an example: How is co-teaching implemented in elementary schools? The title for a case study of this subject could be “Case Study of the Implementation of Co-Teaching in Elementary Schools.”

Descriptive

An illustrative or descriptive case study helps researchers shed light on an unfamiliar object or subject after a period of time. The case study provides an in-depth review of the issue at hand and adds real-world examples in the area the researcher wants the audience to understand. 

The researcher makes no inferences or causal statements about the object or subject under review. This type of design is often used to understand cultural shifts.

Here is an example: How did people cope with the 2004 Indian Ocean Tsunami? This case study could be titled "A Case Study of the 2004 Indian Ocean Tsunami and its Effect on the Indonesian Population."

Exploratory

Exploratory research is also called a pilot case study. It is usually the first step within a larger research project, often relying on questionnaires and surveys . Researchers use exploratory research to help narrow down their focus, define parameters, draft a specific research question , and/or identify variables in a larger study. This research design usually covers a wider area than others, and focuses on the ‘what’ and ‘who’ of a topic.

Here is an example: How do nutrition and socialization in early childhood affect learning in children? The title of the exploratory study may be “Case Study of the Effects of Nutrition and Socialization on Learning in Early Childhood.”

An intrinsic case study is specifically designed to look at a unique and special phenomenon. At the start of the study, the researcher defines the phenomenon and the uniqueness that differentiates it from others. 

In this case, researchers do not attempt to generalize, compare, or challenge the existing assumptions. Instead, they explore the unique variables to enhance understanding. Here is an example: “Case Study of Volcanic Lightning.”

This design can also be identified as a cumulative case study. It uses information from past studies or observations of groups of people in certain settings as the foundation of the new study. Given that it takes multiple areas into account, it allows for greater generalization than a single case study. 

The researchers also get an in-depth look at a particular subject from different viewpoints.  Here is an example: “Case Study of how PTSD affected Vietnam and Gulf War Veterans Differently Due to Advances in Military Technology.”

Critical instance

A critical case study incorporates both explanatory and intrinsic study designs. It does not have predetermined purposes beyond an investigation of the said subject. It can be used for a deeper explanation of the cause-and-effect relationship. It can also be used to question a common assumption or myth. 

The findings can then be used further to generalize whether they would also apply in a different environment.  Here is an example: “What Effect Does Prolonged Use of Social Media Have on the Mind of American Youth?”

Instrumental

Instrumental research attempts to achieve goals beyond understanding the object at hand. Researchers explore a larger subject through different, separate studies and use the findings to understand its relationship to another subject. This type of design also provides insight into an issue or helps refine a theory. 

For example, you may want to determine if violent behavior in children predisposes them to crime later in life. The focus is on the relationship between children and violent behavior, and why certain children do become violent. Here is an example: “Violence Breeds Violence: Childhood Exposure and Participation in Adult Crime.”

Evaluation case study design is employed to research the effects of a program, policy, or intervention, and assess its effectiveness and impact on future decision-making. 

For example, you might want to see whether children learn times tables quicker through an educational game on their iPad versus a more teacher-led intervention. Here is an example: “An Investigation of the Impact of an iPad Multiplication Game for Primary School Children.” 

• When do you use case studies?

Case studies are ideal when you want to gain a contextual, concrete, or in-depth understanding of a particular subject. It helps you understand the characteristics, implications, and meanings of the subject.

They are also an excellent choice for those writing a thesis or dissertation, as they help keep the project focused on a particular area when resources or time may be too limited to cover a wider one. You may have to conduct several case studies to explore different aspects of the subject in question and understand the problem.

• What are the steps to follow when conducting a case study?

1. Select a case

Once you identify the problem at hand and come up with questions, identify the case you will focus on. The study can provide insights into the subject at hand, challenge existing assumptions, propose a course of action, and/or open up new areas for further research.

2. Create a theoretical framework

While you will be focusing on a specific detail, the case study design you choose should be linked to existing knowledge on the topic. This prevents it from becoming an isolated description and allows for enhancing the existing information. 

It may expand the current theory by bringing up new ideas or concepts, challenge established assumptions, or exemplify a theory by exploring how it answers the problem at hand. A theoretical framework starts with a literature review of the sources relevant to the topic in focus. This helps in identifying key concepts to guide analysis and interpretation.

3. Collect the data

Case studies are frequently supplemented with qualitative data such as observations, interviews, and a review of both primary and secondary sources such as official records, news articles, and photographs. There may also be quantitative data —this data assists in understanding the case thoroughly.

4. Analyze your case

The results of the research depend on the research design. Most case studies are structured with chapters or topic headings for easy explanation and presentation. Others may be written as narratives to allow researchers to explore various angles of the topic and analyze its meanings and implications.

In all areas, always give a detailed contextual understanding of the case and connect it to the existing theory and literature before discussing how it fits into your problem area.

• What are some case study examples?

What are the best approaches for introducing our product into the Kenyan market?

How does the change in marketing strategy aid in increasing the sales volumes of product Y?

How can teachers enhance student participation in classrooms?

How does poverty affect literacy levels in children?

Case study topics

Case study of product marketing strategies in the Kenyan market

Case study of the effects of a marketing strategy change on product Y sales volumes

Case study of X school teachers that encourage active student participation in the classroom

Case study of the effects of poverty on literacy levels in children

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• Open access
• Published: 27 June 2011

The case study approach

• Sarah Crowe 1 ,
• Kathrin Cresswell 2 ,
• Ann Robertson 2 ,
• Guro Huby 3 ,
• Anthony Avery 1 &
• Aziz Sheikh 2  

BMC Medical Research Methodology volume  11 , Article number:  100 ( 2011 ) Cite this article

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The case study approach allows in-depth, multi-faceted explorations of complex issues in their real-life settings. The value of the case study approach is well recognised in the fields of business, law and policy, but somewhat less so in health services research. Based on our experiences of conducting several health-related case studies, we reflect on the different types of case study design, the specific research questions this approach can help answer, the data sources that tend to be used, and the particular advantages and disadvantages of employing this methodological approach. The paper concludes with key pointers to aid those designing and appraising proposals for conducting case study research, and a checklist to help readers assess the quality of case study reports.

Peer Review reports

Introduction

The case study approach is particularly useful to employ when there is a need to obtain an in-depth appreciation of an issue, event or phenomenon of interest, in its natural real-life context. Our aim in writing this piece is to provide insights into when to consider employing this approach and an overview of key methodological considerations in relation to the design, planning, analysis, interpretation and reporting of case studies.

The illustrative 'grand round', 'case report' and 'case series' have a long tradition in clinical practice and research. Presenting detailed critiques, typically of one or more patients, aims to provide insights into aspects of the clinical case and, in doing so, illustrate broader lessons that may be learnt. In research, the conceptually-related case study approach can be used, for example, to describe in detail a patient's episode of care, explore professional attitudes to and experiences of a new policy initiative or service development or more generally to 'investigate contemporary phenomena within its real-life context' [ 1 ]. Based on our experiences of conducting a range of case studies, we reflect on when to consider using this approach, discuss the key steps involved and illustrate, with examples, some of the practical challenges of attaining an in-depth understanding of a 'case' as an integrated whole. In keeping with previously published work, we acknowledge the importance of theory to underpin the design, selection, conduct and interpretation of case studies[ 2 ]. In so doing, we make passing reference to the different epistemological approaches used in case study research by key theoreticians and methodologists in this field of enquiry.

This paper is structured around the following main questions: What is a case study? What are case studies used for? How are case studies conducted? What are the potential pitfalls and how can these be avoided? We draw in particular on four of our own recently published examples of case studies (see Tables 1 , 2 , 3 and 4 ) and those of others to illustrate our discussion[ 3 – 7 ].

What is a case study?

A case study is a research approach that is used to generate an in-depth, multi-faceted understanding of a complex issue in its real-life context. It is an established research design that is used extensively in a wide variety of disciplines, particularly in the social sciences. A case study can be defined in a variety of ways (Table 5 ), the central tenet being the need to explore an event or phenomenon in depth and in its natural context. It is for this reason sometimes referred to as a "naturalistic" design; this is in contrast to an "experimental" design (such as a randomised controlled trial) in which the investigator seeks to exert control over and manipulate the variable(s) of interest.

Stake's work has been particularly influential in defining the case study approach to scientific enquiry. He has helpfully characterised three main types of case study: intrinsic , instrumental and collective [ 8 ]. An intrinsic case study is typically undertaken to learn about a unique phenomenon. The researcher should define the uniqueness of the phenomenon, which distinguishes it from all others. In contrast, the instrumental case study uses a particular case (some of which may be better than others) to gain a broader appreciation of an issue or phenomenon. The collective case study involves studying multiple cases simultaneously or sequentially in an attempt to generate a still broader appreciation of a particular issue.

These are however not necessarily mutually exclusive categories. In the first of our examples (Table 1 ), we undertook an intrinsic case study to investigate the issue of recruitment of minority ethnic people into the specific context of asthma research studies, but it developed into a instrumental case study through seeking to understand the issue of recruitment of these marginalised populations more generally, generating a number of the findings that are potentially transferable to other disease contexts[ 3 ]. In contrast, the other three examples (see Tables 2 , 3 and 4 ) employed collective case study designs to study the introduction of workforce reconfiguration in primary care, the implementation of electronic health records into hospitals, and to understand the ways in which healthcare students learn about patient safety considerations[ 4 – 6 ]. Although our study focusing on the introduction of General Practitioners with Specialist Interests (Table 2 ) was explicitly collective in design (four contrasting primary care organisations were studied), is was also instrumental in that this particular professional group was studied as an exemplar of the more general phenomenon of workforce redesign[ 4 ].

What are case studies used for?

According to Yin, case studies can be used to explain, describe or explore events or phenomena in the everyday contexts in which they occur[ 1 ]. These can, for example, help to understand and explain causal links and pathways resulting from a new policy initiative or service development (see Tables 2 and 3 , for example)[ 1 ]. In contrast to experimental designs, which seek to test a specific hypothesis through deliberately manipulating the environment (like, for example, in a randomised controlled trial giving a new drug to randomly selected individuals and then comparing outcomes with controls),[ 9 ] the case study approach lends itself well to capturing information on more explanatory ' how ', 'what' and ' why ' questions, such as ' how is the intervention being implemented and received on the ground?'. The case study approach can offer additional insights into what gaps exist in its delivery or why one implementation strategy might be chosen over another. This in turn can help develop or refine theory, as shown in our study of the teaching of patient safety in undergraduate curricula (Table 4 )[ 6 , 10 ]. Key questions to consider when selecting the most appropriate study design are whether it is desirable or indeed possible to undertake a formal experimental investigation in which individuals and/or organisations are allocated to an intervention or control arm? Or whether the wish is to obtain a more naturalistic understanding of an issue? The former is ideally studied using a controlled experimental design, whereas the latter is more appropriately studied using a case study design.

Case studies may be approached in different ways depending on the epistemological standpoint of the researcher, that is, whether they take a critical (questioning one's own and others' assumptions), interpretivist (trying to understand individual and shared social meanings) or positivist approach (orientating towards the criteria of natural sciences, such as focusing on generalisability considerations) (Table 6 ). Whilst such a schema can be conceptually helpful, it may be appropriate to draw on more than one approach in any case study, particularly in the context of conducting health services research. Doolin has, for example, noted that in the context of undertaking interpretative case studies, researchers can usefully draw on a critical, reflective perspective which seeks to take into account the wider social and political environment that has shaped the case[ 11 ].

How are case studies conducted?

Here, we focus on the main stages of research activity when planning and undertaking a case study; the crucial stages are: defining the case; selecting the case(s); collecting and analysing the data; interpreting data; and reporting the findings.

Defining the case

Carefully formulated research question(s), informed by the existing literature and a prior appreciation of the theoretical issues and setting(s), are all important in appropriately and succinctly defining the case[ 8 , 12 ]. Crucially, each case should have a pre-defined boundary which clarifies the nature and time period covered by the case study (i.e. its scope, beginning and end), the relevant social group, organisation or geographical area of interest to the investigator, the types of evidence to be collected, and the priorities for data collection and analysis (see Table 7 )[ 1 ]. A theory driven approach to defining the case may help generate knowledge that is potentially transferable to a range of clinical contexts and behaviours; using theory is also likely to result in a more informed appreciation of, for example, how and why interventions have succeeded or failed[ 13 ].

For example, in our evaluation of the introduction of electronic health records in English hospitals (Table 3 ), we defined our cases as the NHS Trusts that were receiving the new technology[ 5 ]. Our focus was on how the technology was being implemented. However, if the primary research interest had been on the social and organisational dimensions of implementation, we might have defined our case differently as a grouping of healthcare professionals (e.g. doctors and/or nurses). The precise beginning and end of the case may however prove difficult to define. Pursuing this same example, when does the process of implementation and adoption of an electronic health record system really begin or end? Such judgements will inevitably be influenced by a range of factors, including the research question, theory of interest, the scope and richness of the gathered data and the resources available to the research team.

Selecting the case(s)

The decision on how to select the case(s) to study is a very important one that merits some reflection. In an intrinsic case study, the case is selected on its own merits[ 8 ]. The case is selected not because it is representative of other cases, but because of its uniqueness, which is of genuine interest to the researchers. This was, for example, the case in our study of the recruitment of minority ethnic participants into asthma research (Table 1 ) as our earlier work had demonstrated the marginalisation of minority ethnic people with asthma, despite evidence of disproportionate asthma morbidity[ 14 , 15 ]. In another example of an intrinsic case study, Hellstrom et al.[ 16 ] studied an elderly married couple living with dementia to explore how dementia had impacted on their understanding of home, their everyday life and their relationships.

For an instrumental case study, selecting a "typical" case can work well[ 8 ]. In contrast to the intrinsic case study, the particular case which is chosen is of less importance than selecting a case that allows the researcher to investigate an issue or phenomenon. For example, in order to gain an understanding of doctors' responses to health policy initiatives, Som undertook an instrumental case study interviewing clinicians who had a range of responsibilities for clinical governance in one NHS acute hospital trust[ 17 ]. Sampling a "deviant" or "atypical" case may however prove even more informative, potentially enabling the researcher to identify causal processes, generate hypotheses and develop theory.

In collective or multiple case studies, a number of cases are carefully selected. This offers the advantage of allowing comparisons to be made across several cases and/or replication. Choosing a "typical" case may enable the findings to be generalised to theory (i.e. analytical generalisation) or to test theory by replicating the findings in a second or even a third case (i.e. replication logic)[ 1 ]. Yin suggests two or three literal replications (i.e. predicting similar results) if the theory is straightforward and five or more if the theory is more subtle. However, critics might argue that selecting 'cases' in this way is insufficiently reflexive and ill-suited to the complexities of contemporary healthcare organisations.

The selected case study site(s) should allow the research team access to the group of individuals, the organisation, the processes or whatever else constitutes the chosen unit of analysis for the study. Access is therefore a central consideration; the researcher needs to come to know the case study site(s) well and to work cooperatively with them. Selected cases need to be not only interesting but also hospitable to the inquiry [ 8 ] if they are to be informative and answer the research question(s). Case study sites may also be pre-selected for the researcher, with decisions being influenced by key stakeholders. For example, our selection of case study sites in the evaluation of the implementation and adoption of electronic health record systems (see Table 3 ) was heavily influenced by NHS Connecting for Health, the government agency that was responsible for overseeing the National Programme for Information Technology (NPfIT)[ 5 ]. This prominent stakeholder had already selected the NHS sites (through a competitive bidding process) to be early adopters of the electronic health record systems and had negotiated contracts that detailed the deployment timelines.

It is also important to consider in advance the likely burden and risks associated with participation for those who (or the site(s) which) comprise the case study. Of particular importance is the obligation for the researcher to think through the ethical implications of the study (e.g. the risk of inadvertently breaching anonymity or confidentiality) and to ensure that potential participants/participating sites are provided with sufficient information to make an informed choice about joining the study. The outcome of providing this information might be that the emotive burden associated with participation, or the organisational disruption associated with supporting the fieldwork, is considered so high that the individuals or sites decide against participation.

In our example of evaluating implementations of electronic health record systems, given the restricted number of early adopter sites available to us, we sought purposively to select a diverse range of implementation cases among those that were available[ 5 ]. We chose a mixture of teaching, non-teaching and Foundation Trust hospitals, and examples of each of the three electronic health record systems procured centrally by the NPfIT. At one recruited site, it quickly became apparent that access was problematic because of competing demands on that organisation. Recognising the importance of full access and co-operative working for generating rich data, the research team decided not to pursue work at that site and instead to focus on other recruited sites.

Collecting the data

In order to develop a thorough understanding of the case, the case study approach usually involves the collection of multiple sources of evidence, using a range of quantitative (e.g. questionnaires, audits and analysis of routinely collected healthcare data) and more commonly qualitative techniques (e.g. interviews, focus groups and observations). The use of multiple sources of data (data triangulation) has been advocated as a way of increasing the internal validity of a study (i.e. the extent to which the method is appropriate to answer the research question)[ 8 , 18 – 21 ]. An underlying assumption is that data collected in different ways should lead to similar conclusions, and approaching the same issue from different angles can help develop a holistic picture of the phenomenon (Table 2 )[ 4 ].

Brazier and colleagues used a mixed-methods case study approach to investigate the impact of a cancer care programme[ 22 ]. Here, quantitative measures were collected with questionnaires before, and five months after, the start of the intervention which did not yield any statistically significant results. Qualitative interviews with patients however helped provide an insight into potentially beneficial process-related aspects of the programme, such as greater, perceived patient involvement in care. The authors reported how this case study approach provided a number of contextual factors likely to influence the effectiveness of the intervention and which were not likely to have been obtained from quantitative methods alone.

In collective or multiple case studies, data collection needs to be flexible enough to allow a detailed description of each individual case to be developed (e.g. the nature of different cancer care programmes), before considering the emerging similarities and differences in cross-case comparisons (e.g. to explore why one programme is more effective than another). It is important that data sources from different cases are, where possible, broadly comparable for this purpose even though they may vary in nature and depth.

Analysing, interpreting and reporting case studies

Making sense and offering a coherent interpretation of the typically disparate sources of data (whether qualitative alone or together with quantitative) is far from straightforward. Repeated reviewing and sorting of the voluminous and detail-rich data are integral to the process of analysis. In collective case studies, it is helpful to analyse data relating to the individual component cases first, before making comparisons across cases. Attention needs to be paid to variations within each case and, where relevant, the relationship between different causes, effects and outcomes[ 23 ]. Data will need to be organised and coded to allow the key issues, both derived from the literature and emerging from the dataset, to be easily retrieved at a later stage. An initial coding frame can help capture these issues and can be applied systematically to the whole dataset with the aid of a qualitative data analysis software package.

The Framework approach is a practical approach, comprising of five stages (familiarisation; identifying a thematic framework; indexing; charting; mapping and interpretation) , to managing and analysing large datasets particularly if time is limited, as was the case in our study of recruitment of South Asians into asthma research (Table 1 )[ 3 , 24 ]. Theoretical frameworks may also play an important role in integrating different sources of data and examining emerging themes. For example, we drew on a socio-technical framework to help explain the connections between different elements - technology; people; and the organisational settings within which they worked - in our study of the introduction of electronic health record systems (Table 3 )[ 5 ]. Our study of patient safety in undergraduate curricula drew on an evaluation-based approach to design and analysis, which emphasised the importance of the academic, organisational and practice contexts through which students learn (Table 4 )[ 6 ].

Case study findings can have implications both for theory development and theory testing. They may establish, strengthen or weaken historical explanations of a case and, in certain circumstances, allow theoretical (as opposed to statistical) generalisation beyond the particular cases studied[ 12 ]. These theoretical lenses should not, however, constitute a strait-jacket and the cases should not be "forced to fit" the particular theoretical framework that is being employed.

When reporting findings, it is important to provide the reader with enough contextual information to understand the processes that were followed and how the conclusions were reached. In a collective case study, researchers may choose to present the findings from individual cases separately before amalgamating across cases. Care must be taken to ensure the anonymity of both case sites and individual participants (if agreed in advance) by allocating appropriate codes or withholding descriptors. In the example given in Table 3 , we decided against providing detailed information on the NHS sites and individual participants in order to avoid the risk of inadvertent disclosure of identities[ 5 , 25 ].

What are the potential pitfalls and how can these be avoided?

The case study approach is, as with all research, not without its limitations. When investigating the formal and informal ways undergraduate students learn about patient safety (Table 4 ), for example, we rapidly accumulated a large quantity of data. The volume of data, together with the time restrictions in place, impacted on the depth of analysis that was possible within the available resources. This highlights a more general point of the importance of avoiding the temptation to collect as much data as possible; adequate time also needs to be set aside for data analysis and interpretation of what are often highly complex datasets.

Case study research has sometimes been criticised for lacking scientific rigour and providing little basis for generalisation (i.e. producing findings that may be transferable to other settings)[ 1 ]. There are several ways to address these concerns, including: the use of theoretical sampling (i.e. drawing on a particular conceptual framework); respondent validation (i.e. participants checking emerging findings and the researcher's interpretation, and providing an opinion as to whether they feel these are accurate); and transparency throughout the research process (see Table 8 )[ 8 , 18 – 21 , 23 , 26 ]. Transparency can be achieved by describing in detail the steps involved in case selection, data collection, the reasons for the particular methods chosen, and the researcher's background and level of involvement (i.e. being explicit about how the researcher has influenced data collection and interpretation). Seeking potential, alternative explanations, and being explicit about how interpretations and conclusions were reached, help readers to judge the trustworthiness of the case study report. Stake provides a critique checklist for a case study report (Table 9 )[ 8 ].

Conclusions

The case study approach allows, amongst other things, critical events, interventions, policy developments and programme-based service reforms to be studied in detail in a real-life context. It should therefore be considered when an experimental design is either inappropriate to answer the research questions posed or impossible to undertake. Considering the frequency with which implementations of innovations are now taking place in healthcare settings and how well the case study approach lends itself to in-depth, complex health service research, we believe this approach should be more widely considered by researchers. Though inherently challenging, the research case study can, if carefully conceptualised and thoughtfully undertaken and reported, yield powerful insights into many important aspects of health and healthcare delivery.

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Acknowledgements

We are grateful to the participants and colleagues who contributed to the individual case studies that we have drawn on. This work received no direct funding, but it has been informed by projects funded by Asthma UK, the NHS Service Delivery Organisation, NHS Connecting for Health Evaluation Programme, and Patient Safety Research Portfolio. We would also like to thank the expert reviewers for their insightful and constructive feedback. Our thanks are also due to Dr. Allison Worth who commented on an earlier draft of this manuscript.

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Crowe, S., Cresswell, K., Robertson, A. et al. The case study approach. BMC Med Res Methodol 11 , 100 (2011). https://doi.org/10.1186/1471-2288-11-100

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Continuing to enhance the quality of case study methodology in health services research

Shannon l. sibbald.

1 Faculty of Health Sciences, Western University, London, Ontario, Canada.

2 Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

3 The Schulich Interfaculty Program in Public Health, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

Stefan Paciocco

Meghan fournie, rachelle van asseldonk, tiffany scurr.

Case study methodology has grown in popularity within Health Services Research (HSR). However, its use and merit as a methodology are frequently criticized due to its flexible approach and inconsistent application. Nevertheless, case study methodology is well suited to HSR because it can track and examine complex relationships, contexts, and systems as they evolve. Applied appropriately, it can help generate information on how multiple forms of knowledge come together to inform decision-making within healthcare contexts. In this article, we aim to demystify case study methodology by outlining its philosophical underpinnings and three foundational approaches. We provide literature-based guidance to decision-makers, policy-makers, and health leaders on how to engage in and critically appraise case study design. We advocate that researchers work in collaboration with health leaders to detail their research process with an aim of strengthening the validity and integrity of case study for its continued and advanced use in HSR.

Introduction

The popularity of case study research methodology in Health Services Research (HSR) has grown over the past 40 years. 1 This may be attributed to a shift towards the use of implementation research and a newfound appreciation of contextual factors affecting the uptake of evidence-based interventions within diverse settings. 2 Incorporating context-specific information on the delivery and implementation of programs can increase the likelihood of success. 3 , 4 Case study methodology is particularly well suited for implementation research in health services because it can provide insight into the nuances of diverse contexts. 5 , 6 In 1999, Yin 7 published a paper on how to enhance the quality of case study in HSR, which was foundational for the emergence of case study in this field. Yin 7 maintains case study is an appropriate methodology in HSR because health systems are constantly evolving, and the multiple affiliations and diverse motivations are difficult to track and understand with traditional linear methodologies.

Despite its increased popularity, there is debate whether a case study is a methodology (ie, a principle or process that guides research) or a method (ie, a tool to answer research questions). Some criticize case study for its high level of flexibility, perceiving it as less rigorous, and maintain that it generates inadequate results. 8 Others have noted issues with quality and consistency in how case studies are conducted and reported. 9 Reporting is often varied and inconsistent, using a mix of approaches such as case reports, case findings, and/or case study. Authors sometimes use incongruent methods of data collection and analysis or use the case study as a default when other methodologies do not fit. 9 , 10 Despite these criticisms, case study methodology is becoming more common as a viable approach for HSR. 11 An abundance of articles and textbooks are available to guide researchers through case study research, including field-specific resources for business, 12 , 13 nursing, 14 and family medicine. 15 However, there remains confusion and a lack of clarity on the key tenets of case study methodology.

Several common philosophical underpinnings have contributed to the development of case study research 1 which has led to different approaches to planning, data collection, and analysis. This presents challenges in assessing quality and rigour for researchers conducting case studies and stakeholders reading results.

This article discusses the various approaches and philosophical underpinnings to case study methodology. Our goal is to explain it in a way that provides guidance for decision-makers, policy-makers, and health leaders on how to understand, critically appraise, and engage in case study research and design, as such guidance is largely absent in the literature. This article is by no means exhaustive or authoritative. Instead, we aim to provide guidance and encourage dialogue around case study methodology, facilitating critical thinking around the variety of approaches and ways quality and rigour can be bolstered for its use within HSR.

Purpose of case study methodology

Case study methodology is often used to develop an in-depth, holistic understanding of a specific phenomenon within a specified context. 11 It focuses on studying one or multiple cases over time and uses an in-depth analysis of multiple information sources. 16 , 17 It is ideal for situations including, but not limited to, exploring under-researched and real-life phenomena, 18 especially when the contexts are complex and the researcher has little control over the phenomena. 19 , 20 Case studies can be useful when researchers want to understand how interventions are implemented in different contexts, and how context shapes the phenomenon of interest.

In addition to demonstrating coherency with the type of questions case study is suited to answer, there are four key tenets to case study methodologies: (1) be transparent in the paradigmatic and theoretical perspectives influencing study design; (2) clearly define the case and phenomenon of interest; (3) clearly define and justify the type of case study design; and (4) use multiple data collection sources and analysis methods to present the findings in ways that are consistent with the methodology and the study’s paradigmatic base. 9 , 16 The goal is to appropriately match the methods to empirical questions and issues and not to universally advocate any single approach for all problems. 21

Approaches to case study methodology

Three authors propose distinct foundational approaches to case study methodology positioned within different paradigms: Yin, 19 , 22 Stake, 5 , 23 and Merriam 24 , 25 ( Table 1 ). Yin is strongly post-positivist whereas Stake and Merriam are grounded in a constructivist paradigm. Researchers should locate their research within a paradigm that explains the philosophies guiding their research 26 and adhere to the underlying paradigmatic assumptions and key tenets of the appropriate author’s methodology. This will enhance the consistency and coherency of the methods and findings. However, researchers often do not report their paradigmatic position, nor do they adhere to one approach. 9 Although deliberately blending methodologies may be defensible and methodologically appropriate, more often it is done in an ad hoc and haphazard way, without consideration for limitations.

Cross-analysis of three case study approaches, adapted from Yazan 2015

The post-positive paradigm postulates there is one reality that can be objectively described and understood by “bracketing” oneself from the research to remove prejudice or bias. 27 Yin focuses on general explanation and prediction, emphasizing the formulation of propositions, akin to hypothesis testing. This approach is best suited for structured and objective data collection 9 , 11 and is often used for mixed-method studies.

Constructivism assumes that the phenomenon of interest is constructed and influenced by local contexts, including the interaction between researchers, individuals, and their environment. 27 It acknowledges multiple interpretations of reality 24 constructed within the context by the researcher and participants which are unlikely to be replicated, should either change. 5 , 20 Stake and Merriam’s constructivist approaches emphasize a story-like rendering of a problem and an iterative process of constructing the case study. 7 This stance values researcher reflexivity and transparency, 28 acknowledging how researchers’ experiences and disciplinary lenses influence their assumptions and beliefs about the nature of the phenomenon and development of the findings.

Defining a case

A key tenet of case study methodology often underemphasized in literature is the importance of defining the case and phenomenon. Researches should clearly describe the case with sufficient detail to allow readers to fully understand the setting and context and determine applicability. Trying to answer a question that is too broad often leads to an unclear definition of the case and phenomenon. 20 Cases should therefore be bound by time and place to ensure rigor and feasibility. 6

Yin 22 defines a case as “a contemporary phenomenon within its real-life context,” (p13) which may contain a single unit of analysis, including individuals, programs, corporations, or clinics 29 (holistic), or be broken into sub-units of analysis, such as projects, meetings, roles, or locations within the case (embedded). 30 Merriam 24 and Stake 5 similarly define a case as a single unit studied within a bounded system. Stake 5 , 23 suggests bounding cases by contexts and experiences where the phenomenon of interest can be a program, process, or experience. However, the line between the case and phenomenon can become muddy. For guidance, Stake 5 , 23 describes the case as the noun or entity and the phenomenon of interest as the verb, functioning, or activity of the case.

Designing the case study approach

Yin’s approach to a case study is rooted in a formal proposition or theory which guides the case and is used to test the outcome. 1 Stake 5 advocates for a flexible design and explicitly states that data collection and analysis may commence at any point. Merriam’s 24 approach blends both Yin and Stake’s, allowing the necessary flexibility in data collection and analysis to meet the needs.

Yin 30 proposed three types of case study approaches—descriptive, explanatory, and exploratory. Each can be designed around single or multiple cases, creating six basic case study methodologies. Descriptive studies provide a rich description of the phenomenon within its context, which can be helpful in developing theories. To test a theory or determine cause and effect relationships, researchers can use an explanatory design. An exploratory model is typically used in the pilot-test phase to develop propositions (eg, Sibbald et al. 31 used this approach to explore interprofessional network complexity). Despite having distinct characteristics, the boundaries between case study types are flexible with significant overlap. 30 Each has five key components: (1) research question; (2) proposition; (3) unit of analysis; (4) logical linking that connects the theory with proposition; and (5) criteria for analyzing findings.

Contrary to Yin, Stake 5 believes the research process cannot be planned in its entirety because research evolves as it is performed. Consequently, researchers can adjust the design of their methods even after data collection has begun. Stake 5 classifies case studies into three categories: intrinsic, instrumental, and collective/multiple. Intrinsic case studies focus on gaining a better understanding of the case. These are often undertaken when the researcher has an interest in a specific case. Instrumental case study is used when the case itself is not of the utmost importance, and the issue or phenomenon (ie, the research question) being explored becomes the focus instead (eg, Paciocco 32 used an instrumental case study to evaluate the implementation of a chronic disease management program). 5 Collective designs are rooted in an instrumental case study and include multiple cases to gain an in-depth understanding of the complexity and particularity of a phenomenon across diverse contexts. 5 , 23 In collective designs, studying similarities and differences between the cases allows the phenomenon to be understood more intimately (for examples of this in the field, see van Zelm et al. 33 and Burrows et al. 34 In addition, Sibbald et al. 35 present an example where a cross-case analysis method is used to compare instrumental cases).

Merriam’s approach is flexible (similar to Stake) as well as stepwise and linear (similar to Yin). She advocates for conducting a literature review before designing the study to better understand the theoretical underpinnings. 24 , 25 Unlike Stake or Yin, Merriam proposes a step-by-step guide for researchers to design a case study. These steps include performing a literature review, creating a theoretical framework, identifying the problem, creating and refining the research question(s), and selecting a study sample that fits the question(s). 24 , 25 , 36

Data collection and analysis

Using multiple data collection methods is a key characteristic of all case study methodology; it enhances the credibility of the findings by allowing different facets and views of the phenomenon to be explored. 23 Common methods include interviews, focus groups, observation, and document analysis. 5 , 37 By seeking patterns within and across data sources, a thick description of the case can be generated to support a greater understanding and interpretation of the whole phenomenon. 5 , 17 , 20 , 23 This technique is called triangulation and is used to explore cases with greater accuracy. 5 Although Stake 5 maintains case study is most often used in qualitative research, Yin 17 supports a mix of both quantitative and qualitative methods to triangulate data. This deliberate convergence of data sources (or mixed methods) allows researchers to find greater depth in their analysis and develop converging lines of inquiry. For example, case studies evaluating interventions commonly use qualitative interviews to describe the implementation process, barriers, and facilitators paired with a quantitative survey of comparative outcomes and effectiveness. 33 , 38 , 39

Yin 30 describes analysis as dependent on the chosen approach, whether it be (1) deductive and rely on theoretical propositions; (2) inductive and analyze data from the “ground up”; (3) organized to create a case description; or (4) used to examine plausible rival explanations. According to Yin’s 40 approach to descriptive case studies, carefully considering theory development is an important part of study design. “Theory” refers to field-relevant propositions, commonly agreed upon assumptions, or fully developed theories. 40 Stake 5 advocates for using the researcher’s intuition and impression to guide analysis through a categorical aggregation and direct interpretation. Merriam 24 uses six different methods to guide the “process of making meaning” (p178) : (1) ethnographic analysis; (2) narrative analysis; (3) phenomenological analysis; (4) constant comparative method; (5) content analysis; and (6) analytic induction.

Drawing upon a theoretical or conceptual framework to inform analysis improves the quality of case study and avoids the risk of description without meaning. 18 Using Stake’s 5 approach, researchers rely on protocols and previous knowledge to help make sense of new ideas; theory can guide the research and assist researchers in understanding how new information fits into existing knowledge.

Practical applications of case study research

Columbia University has recently demonstrated how case studies can help train future health leaders. 41 Case studies encompass components of systems thinking—considering connections and interactions between components of a system, alongside the implications and consequences of those relationships—to equip health leaders with tools to tackle global health issues. 41 Greenwood 42 evaluated Indigenous peoples’ relationship with the healthcare system in British Columbia and used a case study to challenge and educate health leaders across the country to enhance culturally sensitive health service environments.

An important but often omitted step in case study research is an assessment of quality and rigour. We recommend using a framework or set of criteria to assess the rigour of the qualitative research. Suitable resources include Caelli et al., 43 Houghten et al., 44 Ravenek and Rudman, 45 and Tracy. 46

New directions in case study

Although “pragmatic” case studies (ie, utilizing practical and applicable methods) have existed within psychotherapy for some time, 47 , 48 only recently has the applicability of pragmatism as an underlying paradigmatic perspective been considered in HSR. 49 This is marked by uptake of pragmatism in Randomized Control Trials, recognizing that “gold standard” testing conditions do not reflect the reality of clinical settings 50 , 51 nor do a handful of epistemologically guided methodologies suit every research inquiry.

Pragmatism positions the research question as the basis for methodological choices, rather than a theory or epistemology, allowing researchers to pursue the most practical approach to understanding a problem or discovering an actionable solution. 52 Mixed methods are commonly used to create a deeper understanding of the case through converging qualitative and quantitative data. 52 Pragmatic case study is suited to HSR because its flexibility throughout the research process accommodates complexity, ever-changing systems, and disruptions to research plans. 49 , 50 Much like case study, pragmatism has been criticized for its flexibility and use when other approaches are seemingly ill-fit. 53 , 54 Similarly, authors argue that this results from a lack of investigation and proper application rather than a reflection of validity, legitimizing the need for more exploration and conversation among researchers and practitioners. 55

Although occasionally misunderstood as a less rigourous research methodology, 8 case study research is highly flexible and allows for contextual nuances. 5 , 6 Its use is valuable when the researcher desires a thorough understanding of a phenomenon or case bound by context. 11 If needed, multiple similar cases can be studied simultaneously, or one case within another. 16 , 17 There are currently three main approaches to case study, 5 , 17 , 24 each with their own definitions of a case, ontological and epistemological paradigms, methodologies, and data collection and analysis procedures. 37

Individuals’ experiences within health systems are influenced heavily by contextual factors, participant experience, and intricate relationships between different organizations and actors. 55 Case study research is well suited for HSR because it can track and examine these complex relationships and systems as they evolve over time. 6 , 7 It is important that researchers and health leaders using this methodology understand its key tenets and how to conduct a proper case study. Although there are many examples of case study in action, they are often under-reported and, when reported, not rigorously conducted. 9 Thus, decision-makers and health leaders should use these examples with caution. The proper reporting of case studies is necessary to bolster their credibility in HSR literature and provide readers sufficient information to critically assess the methodology. We also call on health leaders who frequently use case studies 56 – 58 to report them in the primary research literature.

The purpose of this article is to advocate for the continued and advanced use of case study in HSR and to provide literature-based guidance for decision-makers, policy-makers, and health leaders on how to engage in, read, and interpret findings from case study research. As health systems progress and evolve, the application of case study research will continue to increase as researchers and health leaders aim to capture the inherent complexities, nuances, and contextual factors. 7

Designing and Conducting Case Studies

This guide examines case studies, a form of qualitative descriptive research that is used to look at individuals, a small group of participants, or a group as a whole. Researchers collect data about participants using participant and direct observations, interviews, protocols, tests, examinations of records, and collections of writing samples. Starting with a definition of the case study, the guide moves to a brief history of this research method. Using several well documented case studies, the guide then looks at applications and methods including data collection and analysis. A discussion of ways to handle validity, reliability, and generalizability follows, with special attention to case studies as they are applied to composition studies. Finally, this guide examines the strengths and weaknesses of case studies.

Definition and Overview

Case study refers to the collection and presentation of detailed information about a particular participant or small group, frequently including the accounts of subjects themselves. A form of qualitative descriptive research, the case study looks intensely at an individual or small participant pool, drawing conclusions only about that participant or group and only in that specific context. Researchers do not focus on the discovery of a universal, generalizable truth, nor do they typically look for cause-effect relationships; instead, emphasis is placed on exploration and description.

Case studies typically examine the interplay of all variables in order to provide as complete an understanding of an event or situation as possible. This type of comprehensive understanding is arrived at through a process known as thick description, which involves an in-depth description of the entity being evaluated, the circumstances under which it is used, the characteristics of the people involved in it, and the nature of the community in which it is located. Thick description also involves interpreting the meaning of demographic and descriptive data such as cultural norms and mores, community values, ingrained attitudes, and motives.

Unlike quantitative methods of research, like the survey, which focus on the questions of who, what, where, how much, and how many, and archival analysis, which often situates the participant in some form of historical context, case studies are the preferred strategy when how or why questions are asked. Likewise, they are the preferred method when the researcher has little control over the events, and when there is a contemporary focus within a real life context. In addition, unlike more specifically directed experiments, case studies require a problem that seeks a holistic understanding of the event or situation in question using inductive logic--reasoning from specific to more general terms.

In scholarly circles, case studies are frequently discussed within the context of qualitative research and naturalistic inquiry. Case studies are often referred to interchangeably with ethnography, field study, and participant observation. The underlying philosophical assumptions in the case are similar to these types of qualitative research because each takes place in a natural setting (such as a classroom, neighborhood, or private home), and strives for a more holistic interpretation of the event or situation under study.

Unlike more statistically-based studies which search for quantifiable data, the goal of a case study is to offer new variables and questions for further research. F.H. Giddings, a sociologist in the early part of the century, compares statistical methods to the case study on the basis that the former are concerned with the distribution of a particular trait, or a small number of traits, in a population, whereas the case study is concerned with the whole variety of traits to be found in a particular instance" (Hammersley 95).

Case studies are not a new form of research; naturalistic inquiry was the primary research tool until the development of the scientific method. The fields of sociology and anthropology are credited with the primary shaping of the concept as we know it today. However, case study research has drawn from a number of other areas as well: the clinical methods of doctors; the casework technique being developed by social workers; the methods of historians and anthropologists, plus the qualitative descriptions provided by quantitative researchers like LePlay; and, in the case of Robert Park, the techniques of newspaper reporters and novelists.

Park was an ex-newspaper reporter and editor who became very influential in developing sociological case studies at the University of Chicago in the 1920s. As a newspaper professional he coined the term "scientific" or "depth" reporting: the description of local events in a way that pointed to major social trends. Park viewed the sociologist as "merely a more accurate, responsible, and scientific reporter." Park stressed the variety and value of human experience. He believed that sociology sought to arrive at natural, but fluid, laws and generalizations in regard to human nature and society. These laws weren't static laws of the kind sought by many positivists and natural law theorists, but rather, they were laws of becoming--with a constant possibility of change. Park encouraged students to get out of the library, to quit looking at papers and books, and to view the constant experiment of human experience. He writes, "Go and sit in the lounges of the luxury hotels and on the doorsteps of the flophouses; sit on the Gold Coast settees and on the slum shakedowns; sit in the Orchestra Hall and in the Star and Garter Burlesque. In short, gentlemen [sic], go get the seats of your pants dirty in real research."

But over the years, case studies have drawn their share of criticism. In fact, the method had its detractors from the start. In the 1920s, the debate between pro-qualitative and pro-quantitative became quite heated. Case studies, when compared to statistics, were considered by many to be unscientific. From the 1930's on, the rise of positivism had a growing influence on quantitative methods in sociology. People wanted static, generalizable laws in science. The sociological positivists were looking for stable laws of social phenomena. They criticized case study research because it failed to provide evidence of inter subjective agreement. Also, they condemned it because of the few number of cases studied and that the under-standardized character of their descriptions made generalization impossible. By the 1950s, quantitative methods, in the form of survey research, had become the dominant sociological approach and case study had become a minority practice.

Educational Applications

The 1950's marked the dawning of a new era in case study research, namely that of the utilization of the case study as a teaching method. "Instituted at Harvard Business School in the 1950s as a primary method of teaching, cases have since been used in classrooms and lecture halls alike, either as part of a course of study or as the main focus of the course to which other teaching material is added" (Armisted 1984). The basic purpose of instituting the case method as a teaching strategy was "to transfer much of the responsibility for learning from the teacher on to the student, whose role, as a result, shifts away from passive absorption toward active construction" (Boehrer 1990). Through careful examination and discussion of various cases, "students learn to identify actual problems, to recognize key players and their agendas, and to become aware of those aspects of the situation that contribute to the problem" (Merseth 1991). In addition, students are encouraged to "generate their own analysis of the problems under consideration, to develop their own solutions, and to practically apply their own knowledge of theory to these problems" (Boyce 1993). Along the way, students also develop "the power to analyze and to master a tangled circumstance by identifying and delineating important factors; the ability to utilize ideas, to test them against facts, and to throw them into fresh combinations" (Merseth 1991).

In addition to the practical application and testing of scholarly knowledge, case discussions can also help students prepare for real-world problems, situations and crises by providing an approximation of various professional environments (i.e. classroom, board room, courtroom, or hospital). Thus, through the examination of specific cases, students are given the opportunity to work out their own professional issues through the trials, tribulations, experiences, and research findings of others. An obvious advantage to this mode of instruction is that it allows students the exposure to settings and contexts that they might not otherwise experience. For example, a student interested in studying the effects of poverty on minority secondary student's grade point averages and S.A.T. scores could access and analyze information from schools as geographically diverse as Los Angeles, New York City, Miami, and New Mexico without ever having to leave the classroom.

The case study method also incorporates the idea that students can learn from one another "by engaging with each other and with each other's ideas, by asserting something and then having it questioned, challenged and thrown back at them so that they can reflect on what they hear, and then refine what they say" (Boehrer 1990). In summary, students can direct their own learning by formulating questions and taking responsibility for the study.

Types and Design Concerns

Researchers use multiple methods and approaches to conduct case studies.

Types of Case Studies

Under the more generalized category of case study exist several subdivisions, each of which is custom selected for use depending upon the goals and/or objectives of the investigator. These types of case study include the following:

Illustrative Case Studies These are primarily descriptive studies. They typically utilize one or two instances of an event to show what a situation is like. Illustrative case studies serve primarily to make the unfamiliar familiar and to give readers a common language about the topic in question.

Exploratory (or pilot) Case Studies These are condensed case studies performed before implementing a large scale investigation. Their basic function is to help identify questions and select types of measurement prior to the main investigation. The primary pitfall of this type of study is that initial findings may seem convincing enough to be released prematurely as conclusions.

Cumulative Case Studies These serve to aggregate information from several sites collected at different times. The idea behind these studies is the collection of past studies will allow for greater generalization without additional cost or time being expended on new, possibly repetitive studies.

Critical Instance Case Studies These examine one or more sites for either the purpose of examining a situation of unique interest with little to no interest in generalizability, or to call into question or challenge a highly generalized or universal assertion. This method is useful for answering cause and effect questions.

Identifying a Theoretical Perspective

Much of the case study's design is inherently determined for researchers, depending on the field from which they are working. In composition studies, researchers are typically working from a qualitative, descriptive standpoint. In contrast, physicists will approach their research from a more quantitative perspective. Still, in designing the study, researchers need to make explicit the questions to be explored and the theoretical perspective from which they will approach the case. The three most commonly adopted theories are listed below:

Individual Theories These focus primarily on the individual development, cognitive behavior, personality, learning and disability, and interpersonal interactions of a particular subject.

Organizational Theories These focus on bureaucracies, institutions, organizational structure and functions, or excellence in organizational performance.

Social Theories These focus on urban development, group behavior, cultural institutions, or marketplace functions.

Two examples of case studies are used consistently throughout this chapter. The first, a study produced by Berkenkotter, Huckin, and Ackerman (1988), looks at a first year graduate student's initiation into an academic writing program. The study uses participant-observer and linguistic data collecting techniques to assess the student's knowledge of appropriate discourse conventions. Using the pseudonym Nate to refer to the subject, the study sought to illuminate the particular experience rather than to generalize about the experience of fledgling academic writers collectively.

For example, in Berkenkotter, Huckin, and Ackerman's (1988) study we are told that the researchers are interested in disciplinary communities. In the first paragraph, they ask what constitutes membership in a disciplinary community and how achieving membership might affect a writer's understanding and production of texts. In the third paragraph they state that researchers must negotiate their claims "within the context of his sub specialty's accepted knowledge and methodology." In the next paragraph they ask, "How is literacy acquired? What is the process through which novices gain community membership? And what factors either aid or hinder students learning the requisite linguistic behaviors?" This introductory section ends with a paragraph in which the study's authors claim that during the course of the study, the subject, Nate, successfully makes the transition from "skilled novice" to become an initiated member of the academic discourse community and that his texts exhibit linguistic changes which indicate this transition. In the next section the authors make explicit the sociolinguistic theoretical and methodological assumptions on which the study is based (1988). Thus the reader has a good understanding of the authors' theoretical background and purpose in conducting the study even before it is explicitly stated on the fourth page of the study. "Our purpose was to examine the effects of the educational context on one graduate student's production of texts as he wrote in different courses and for different faculty members over the academic year 1984-85." The goal of the study then, was to explore the idea that writers must be initiated into a writing community, and that this initiation will change the way one writes.

The second example is Janet Emig's (1971) study of the composing process of a group of twelfth graders. In this study, Emig seeks to answer the question of what happens to the self as a result educational stimuli in terms of academic writing. The case study used methods such as protocol analysis, tape-recorded interviews, and discourse analysis.

In the case of Janet Emig's (1971) study of the composing process of eight twelfth graders, four specific hypotheses were made:

• Twelfth grade writers engage in two modes of composing: reflexive and extensive.
• These differences can be ascertained and characterized through having the writers compose aloud their composition process.
• A set of implied stylistic principles governs the writing process.
• For twelfth grade writers, extensive writing occurs chiefly as a school-sponsored activity, or reflexive, as a self-sponsored activity.

In this study, the chief distinction is between the two dominant modes of composing among older, secondary school students. The distinctions are:

• The reflexive mode, which focuses on the writer's thoughts and feelings.
• The extensive mode, which focuses on conveying a message.

Emig also outlines the specific questions which guided the research in the opening pages of her Review of Literature , preceding the report.

Designing a Case Study

After considering the different sub categories of case study and identifying a theoretical perspective, researchers can begin to design their study. Research design is the string of logic that ultimately links the data to be collected and the conclusions to be drawn to the initial questions of the study. Typically, research designs deal with at least four problems:

• What questions to study
• What data are relevant
• What data to collect
• How to analyze that data

In other words, a research design is basically a blueprint for getting from the beginning to the end of a study. The beginning is an initial set of questions to be answered, and the end is some set of conclusions about those questions.

Because case studies are conducted on topics as diverse as Anglo-Saxon Literature (Thrane 1986) and AIDS prevention (Van Vugt 1994), it is virtually impossible to outline any strict or universal method or design for conducting the case study. However, Robert K. Yin (1993) does offer five basic components of a research design:

• A study's questions.
• A study's propositions (if any).
• A study's units of analysis.
• The logic that links the data to the propositions.
• The criteria for interpreting the findings.

In addition to these five basic components, Yin also stresses the importance of clearly articulating one's theoretical perspective, determining the goals of the study, selecting one's subject(s), selecting the appropriate method(s) of collecting data, and providing some considerations to the composition of the final report.

Conducting Case Studies

To obtain as complete a picture of the participant as possible, case study researchers can employ a variety of approaches and methods. These approaches, methods, and related issues are discussed in depth in this section.

Method: Single or Multi-modal?

To obtain as complete a picture of the participant as possible, case study researchers can employ a variety of methods. Some common methods include interviews , protocol analyses, field studies, and participant-observations. Emig (1971) chose to use several methods of data collection. Her sources included conversations with the students, protocol analysis, discrete observations of actual composition, writing samples from each student, and school records (Lauer and Asher 1988).

Berkenkotter, Huckin, and Ackerman (1988) collected data by observing classrooms, conducting faculty and student interviews, collecting self reports from the subject, and by looking at the subject's written work.

A study that was criticized for using a single method model was done by Flower and Hayes (1984). In this study that explores the ways in which writers use different forms of knowing to create space, the authors used only protocol analysis to gather data. The study came under heavy fire because of their decision to use only one method.

Participant Selection

Case studies can use one participant, or a small group of participants. However, it is important that the participant pool remain relatively small. The participants can represent a diverse cross section of society, but this isn't necessary.

For example, the Berkenkotter, Huckin, and Ackerman (1988) study looked at just one participant, Nate. By contrast, in Janet Emig's (1971) study of the composition process of twelfth graders, eight participants were selected representing a diverse cross section of the community, with volunteers from an all-white upper-middle-class suburban school, an all-black inner-city school, a racially mixed lower-middle-class school, an economically and racially mixed school, and a university school.

Often, a brief "case history" is done on the participants of the study in order to provide researchers with a clearer understanding of their participants, as well as some insight as to how their own personal histories might affect the outcome of the study. For instance, in Emig's study, the investigator had access to the school records of five of the participants, and to standardized test scores for the remaining three. Also made available to the researcher was the information that three of the eight students were selected as NCTE Achievement Award winners. These personal histories can be useful in later stages of the study when data are being analyzed and conclusions drawn.

Data Collection

There are six types of data collected in case studies:

• Archival records.
• Interviews.
• Direct observation.
• Participant observation.

In the field of composition research, these six sources might be:

• A writer's drafts.
• School records of student writers.
• Transcripts of interviews with a writer.
• Transcripts of conversations between writers (and protocols).
• Videotapes and notes from direct field observations.
• Hard copies of a writer's work on computer.

Depending on whether researchers have chosen to use a single or multi-modal approach for the case study, they may choose to collect data from one or any combination of these sources.

Protocols, that is, transcriptions of participants talking aloud about what they are doing as they do it, have been particularly common in composition case studies. For example, in Emig's (1971) study, the students were asked, in four different sessions, to give oral autobiographies of their writing experiences and to compose aloud three themes in the presence of a tape recorder and the investigator.

In some studies, only one method of data collection is conducted. For example, the Flower and Hayes (1981) report on the cognitive process theory of writing depends on protocol analysis alone. However, using multiple sources of evidence to increase the reliability and validity of the data can be advantageous.

Case studies are likely to be much more convincing and accurate if they are based on several different sources of information, following a corroborating mode. This conclusion is echoed among many composition researchers. For example, in her study of predrafting processes of high and low-apprehensive writers, Cynthia Selfe (1985) argues that because "methods of indirect observation provide only an incomplete reflection of the complex set of processes involved in composing, a combination of several such methods should be used to gather data in any one study." Thus, in this study, Selfe collected her data from protocols, observations of students role playing their writing processes, audio taped interviews with the students, and videotaped observations of the students in the process of composing.

It can be said then, that cross checking data from multiple sources can help provide a multidimensional profile of composing activities in a particular setting. Sharan Merriam (1985) suggests "checking, verifying, testing, probing, and confirming collected data as you go, arguing that this process will follow in a funnel-like design resulting in less data gathering in later phases of the study along with a congruent increase in analysis checking, verifying, and confirming."

It is important to note that in case studies, as in any qualitative descriptive research, while researchers begin their studies with one or several questions driving the inquiry (which influence the key factors the researcher will be looking for during data collection), a researcher may find new key factors emerging during data collection. These might be unexpected patterns or linguistic features which become evident only during the course of the research. While not bearing directly on the researcher's guiding questions, these variables may become the basis for new questions asked at the end of the report, thus linking to the possibility of further research.

Data Analysis

As the information is collected, researchers strive to make sense of their data. Generally, researchers interpret their data in one of two ways: holistically or through coding. Holistic analysis does not attempt to break the evidence into parts, but rather to draw conclusions based on the text as a whole. Flower and Hayes (1981), for example, make inferences from entire sections of their students' protocols, rather than searching through the transcripts to look for isolatable characteristics.

However, composition researchers commonly interpret their data by coding, that is by systematically searching data to identify and/or categorize specific observable actions or characteristics. These observable actions then become the key variables in the study. Sharan Merriam (1988) suggests seven analytic frameworks for the organization and presentation of data:

• The role of participants.
• The network analysis of formal and informal exchanges among groups.
• Historical.
• Thematical.
• Ritual and symbolism.
• Critical incidents that challenge or reinforce fundamental beliefs, practices, and values.

There are two purposes of these frameworks: to look for patterns among the data and to look for patterns that give meaning to the case study.

As stated above, while most researchers begin their case studies expecting to look for particular observable characteristics, it is not unusual for key variables to emerge during data collection. Typical variables coded in case studies of writers include pauses writers make in the production of a text, the use of specific linguistic units (such as nouns or verbs), and writing processes (planning, drafting, revising, and editing). In the Berkenkotter, Huckin, and Ackerman (1988) study, for example, researchers coded the participant's texts for use of connectives, discourse demonstratives, average sentence length, off-register words, use of the first person pronoun, and the ratio of definite articles to indefinite articles.

Since coding is inherently subjective, more than one coder is usually employed. In the Berkenkotter, Huckin, and Ackerman (1988) study, for example, three rhetoricians were employed to code the participant's texts for off-register phrases. The researchers established the agreement among the coders before concluding that the participant used fewer off-register words as the graduate program progressed.

Composing the Case Study Report

In the many forms it can take, "a case study is generically a story; it presents the concrete narrative detail of actual, or at least realistic events, it has a plot, exposition, characters, and sometimes even dialogue" (Boehrer 1990). Generally, case study reports are extensively descriptive, with "the most problematic issue often referred to as being the determination of the right combination of description and analysis" (1990). Typically, authors address each step of the research process, and attempt to give the reader as much context as possible for the decisions made in the research design and for the conclusions drawn.

This contextualization usually includes a detailed explanation of the researchers' theoretical positions, of how those theories drove the inquiry or led to the guiding research questions, of the participants' backgrounds, of the processes of data collection, of the training and limitations of the coders, along with a strong attempt to make connections between the data and the conclusions evident.

Although the Berkenkotter, Huckin, and Ackerman (1988) study does not, case study reports often include the reactions of the participants to the study or to the researchers' conclusions. Because case studies tend to be exploratory, most end with implications for further study. Here researchers may identify significant variables that emerged during the research and suggest studies related to these, or the authors may suggest further general questions that their case study generated.

For example, Emig's (1971) study concludes with a section dedicated solely to the topic of implications for further research, in which she suggests several means by which this particular study could have been improved, as well as questions and ideas raised by this study which other researchers might like to address, such as: is there a correlation between a certain personality and a certain composing process profile (e.g. is there a positive correlation between ego strength and persistence in revising)?

Also included in Emig's study is a section dedicated to implications for teaching, which outlines the pedagogical ramifications of the study's findings for teachers currently involved in high school writing programs.

Sharan Merriam (1985) also offers several suggestions for alternative presentations of data:

• Prepare specialized condensations for appropriate groups.
• Replace narrative sections with a series of answers to open-ended questions.
• Present "skimmer's" summaries at beginning of each section.
• Incorporate headlines that encapsulate information from text.
• Prepare analytic summaries with supporting data appendixes.
• Present data in colorful and/or unique graphic representations.

Issues of Validity and Reliability

Once key variables have been identified, they can be analyzed. Reliability becomes a key concern at this stage, and many case study researchers go to great lengths to ensure that their interpretations of the data will be both reliable and valid. Because issues of validity and reliability are an important part of any study in the social sciences, it is important to identify some ways of dealing with results.

Multi-modal case study researchers often balance the results of their coding with data from interviews or writer's reflections upon their own work. Consequently, the researchers' conclusions become highly contextualized. For example, in a case study which looked at the time spent in different stages of the writing process, Berkenkotter concluded that her participant, Donald Murray, spent more time planning his essays than in other writing stages. The report of this case study is followed by Murray's reply, wherein he agrees with some of Berkenkotter's conclusions and disagrees with others.

As is the case with other research methodologies, issues of external validity, construct validity, and reliability need to be carefully considered.

Commentary on Case Studies

Researchers often debate the relative merits of particular methods, among them case study. In this section, we comment on two key issues. To read the commentaries, choose any of the items below:

Strengths and Weaknesses of Case Studies

Most case study advocates point out that case studies produce much more detailed information than what is available through a statistical analysis. Advocates will also hold that while statistical methods might be able to deal with situations where behavior is homogeneous and routine, case studies are needed to deal with creativity, innovation, and context. Detractors argue that case studies are difficult to generalize because of inherent subjectivity and because they are based on qualitative subjective data, generalizable only to a particular context.

Flexibility

The case study approach is a comparatively flexible method of scientific research. Because its project designs seem to emphasize exploration rather than prescription or prediction, researchers are comparatively freer to discover and address issues as they arise in their experiments. In addition, the looser format of case studies allows researchers to begin with broad questions and narrow their focus as their experiment progresses rather than attempt to predict every possible outcome before the experiment is conducted.

Emphasis on Context

By seeking to understand as much as possible about a single subject or small group of subjects, case studies specialize in "deep data," or "thick description"--information based on particular contexts that can give research results a more human face. This emphasis can help bridge the gap between abstract research and concrete practice by allowing researchers to compare their firsthand observations with the quantitative results obtained through other methods of research.

Inherent Subjectivity

"The case study has long been stereotyped as the weak sibling among social science methods," and is often criticized as being too subjective and even pseudo-scientific. Likewise, "investigators who do case studies are often regarded as having deviated from their academic disciplines, and their investigations as having insufficient precision (that is, quantification), objectivity and rigor" (Yin 1989). Opponents cite opportunities for subjectivity in the implementation, presentation, and evaluation of case study research. The approach relies on personal interpretation of data and inferences. Results may not be generalizable, are difficult to test for validity, and rarely offer a problem-solving prescription. Simply put, relying on one or a few subjects as a basis for cognitive extrapolations runs the risk of inferring too much from what might be circumstance.

High Investment

Case studies can involve learning more about the subjects being tested than most researchers would care to know--their educational background, emotional background, perceptions of themselves and their surroundings, their likes, dislikes, and so on. Because of its emphasis on "deep data," the case study is out of reach for many large-scale research projects which look at a subject pool in the tens of thousands. A budget request of $10,000 to examine 200 subjects sounds more efficient than a similar request to examine four subjects.

Ethical Considerations

Researchers conducting case studies should consider certain ethical issues. For example, many educational case studies are often financed by people who have, either directly or indirectly, power over both those being studied and those conducting the investigation (1985). This conflict of interests can hinder the credibility of the study.

The personal integrity, sensitivity, and possible prejudices and/or biases of the investigators need to be taken into consideration as well. Personal biases can creep into how the research is conducted, alternative research methods used, and the preparation of surveys and questionnaires.

A common complaint in case study research is that investigators change direction during the course of the study unaware that their original research design was inadequate for the revised investigation. Thus, the researchers leave unknown gaps and biases in the study. To avoid this, researchers should report preliminary findings so that the likelihood of bias will be reduced.

Concerns about Reliability, Validity, and Generalizability

Merriam (1985) offers several suggestions for how case study researchers might actively combat the popular attacks on the validity, reliability, and generalizability of case studies:

• Prolong the Processes of Data Gathering on Site: This will help to insure the accuracy of the findings by providing the researcher with more concrete information upon which to formulate interpretations.
• Employ the Process of "Triangulation": Use a variety of data sources as opposed to relying solely upon one avenue of observation. One example of such a data check would be what McClintock, Brannon, and Maynard (1985) refer to as a "case cluster method," that is, when a single unit within a larger case is randomly sampled, and that data treated quantitatively." For instance, in Emig's (1971) study, the case cluster method was employed, singling out the productivity of a single student named Lynn. This cluster profile included an advanced case history of the subject, specific examination and analysis of individual compositions and protocols, and extensive interview sessions. The seven remaining students were then compared with the case of Lynn, to ascertain if there are any shared, or unique dimensions to the composing process engaged in by these eight students.
• Conduct Member Checks: Initiate and maintain an active corroboration on the interpretation of data between the researcher and those who provided the data. In other words, talk to your subjects.
• Collect Referential Materials: Complement the file of materials from the actual site with additional document support. For example, Emig (1971) supports her initial propositions with historical accounts by writers such as T.S. Eliot, James Joyce, and D.H. Lawrence. Emig also cites examples of theoretical research done with regards to the creative process, as well as examples of empirical research dealing with the writing of adolescents. Specific attention is then given to the four stages description of the composing process delineated by Helmoltz, Wallas, and Cowley, as it serves as the focal point in this study.
• Engage in Peer Consultation: Prior to composing the final draft of the report, researchers should consult with colleagues in order to establish validity through pooled judgment.

Although little can be done to combat challenges concerning the generalizability of case studies, "most writers suggest that qualitative research should be judged as credible and confirmable as opposed to valid and reliable" (Merriam 1985). Likewise, it has been argued that "rather than transplanting statistical, quantitative notions of generalizability and thus finding qualitative research inadequate, it makes more sense to develop an understanding of generalization that is congruent with the basic characteristics of qualitative inquiry" (1985). After all, criticizing the case study method for being ungeneralizable is comparable to criticizing a washing machine for not being able to tell the correct time. In other words, it is unjust to criticize a method for not being able to do something which it was never originally designed to do in the first place.

Annotated Bibliography

Armisted, C. (1984). How Useful are Case Studies. Training and Development Journal, 38 (2), 75-77.

This article looks at eight types of case studies, offers pros and cons of using case studies in the classroom, and gives suggestions for successfully writing and using case studies.

Bardovi-Harlig, K. (1997). Beyond Methods: Components of Second Language Teacher Education . New York: McGraw-Hill.

A compilation of various research essays which address issues of language teacher education. Essays included are: "Non-native reading research and theory" by Lee, "The case for Psycholinguistics" by VanPatten, and "Assessment and Second Language Teaching" by Gradman and Reed.

Bartlett, L. (1989). A Question of Good Judgment; Interpretation Theory and Qualitative Enquiry Address. 70th Annual Meeting of the American Educational Research Association. San Francisco.

Bartlett selected "quasi-historical" methodology, which focuses on the "truth" found in case records, as one that will provide "good judgments" in educational inquiry. He argues that although the method is not comprehensive, it can try to connect theory with practice.

Baydere, S. et. al. (1993). Multimedia conferencing as a tool for collaborative writing: a case study in Computer Supported Collaborative Writing. New York: Springer-Verlag.

The case study by Baydere et. al. is just one of the many essays in this book found in the series "Computer Supported Cooperative Work." Denley, Witefield and May explore similar issues in their essay, "A case study in task analysis for the design of a collaborative document production system."

Berkenkotter, C., Huckin, T., N., & Ackerman J. (1988). Conventions, Conversations, and the Writer: Case Study of a Student in a Rhetoric Ph.D. Program. Research in the Teaching of English, 22, 9-44.

The authors focused on how the writing of their subject, Nate or Ackerman, changed as he became more acquainted or familiar with his field's discourse community.

Berninger, V., W., and Gans, B., M. (1986). Language Profiles in Nonspeaking Individuals of Normal Intelligence with Severe Cerebral Palsy. Augmentative and Alternative Communication, 2, 45-50.

Argues that generalizations about language abilities in patients with severe cerebral palsy (CP) should be avoided. Standardized tests of different levels of processing oral language, of processing written language, and of producing written language were administered to 3 male participants (aged 9, 16, and 40 yrs).

Bockman, J., R., and Couture, B. (1984). The Case Method in Technical Communication: Theory and Models. Texas: Association of Teachers of Technical Writing.

Examines the study and teaching of technical writing, communication of technical information, and the case method in terms of those applications.

Boehrer, J. (1990). Teaching With Cases: Learning to Question. New Directions for Teaching and Learning, 42 41-57.

This article discusses the origins of the case method, looks at the question of what is a case, gives ideas about learning in case teaching, the purposes it can serve in the classroom, the ground rules for the case discussion, including the role of the question, and new directions for case teaching.

Bowman, W. R. (1993). Evaluating JTPA Programs for Economically Disadvantaged Adults: A Case Study of Utah and General Findings . Washington: National Commission for Employment Policy.

"To encourage state-level evaluations of JTPA, the Commission and the State of Utah co-sponsored this report on the effectiveness of JTPA Title II programs for adults in Utah. The technique used is non-experimental and the comparison group was selected from registrants with Utah's Employment Security. In a step-by-step approach, the report documents how non-experimental techniques can be applied and several specific technical issues can be addressed."

Boyce, A. (1993) The Case Study Approach for Pedagogists. Annual Meeting of the American Alliance for Health, Physical Education, Recreation and Dance. (Address). Washington DC.

This paper addresses how case studies 1) bridge the gap between teaching theory and application, 2) enable students to analyze problems and develop solutions for situations that will be encountered in the real world of teaching, and 3) helps students to evaluate the feasibility of alternatives and to understand the ramifications of a particular course of action.

Carson, J. (1993) The Case Study: Ideal Home of WAC Quantitative and Qualitative Data. Annual Meeting of the Conference on College Composition and Communication. (Address). San Diego.

"Increasingly, one of the most pressing questions for WAC advocates is how to keep [WAC] programs going in the face of numerous difficulties. Case histories offer the best chance for fashioning rhetorical arguments to keep WAC programs going because they offer the opportunity to provide a coherent narrative that contextualizes all documents and data, including what is generally considered scientific data. A case study of the WAC program, . . . at Robert Morris College in Pittsburgh demonstrates the advantages of this research method. Such studies are ideal homes for both naturalistic and positivistic data as well as both quantitative and qualitative information."

---. (1991). A Cognitive Process Theory of Writing. College Composition and Communication. 32. 365-87.

No abstract available.

Cromer, R. (1994) A Case Study of Dissociations Between Language and Cognition. Constraints on Language Acquisition: Studies of Atypical Children . Hillsdale: Lawrence Erlbaum Associates, 141-153.

Crossley, M. (1983) Case Study in Comparative and International Education: An Approach to Bridging the Theory-Practice Gap. Proceedings of the 11th Annual Conference of the Australian Comparative and International Education Society. Hamilton, NZ.

Case study research, as presented here, helps bridge the theory-practice gap in comparative and international research studies of education because it focuses on the practical, day-to-day context rather than on the national arena. The paper asserts that the case study method can be valuable at all levels of research, formation, and verification of theories in education.

Daillak, R., H., and Alkin, M., C. (1982). Qualitative Studies in Context: Reflections on the CSE Studies of Evaluation Use . California: EDRS

The report shows how the Center of the Study of Evaluation (CSE) applied qualitative techniques to a study of evaluation information use in local, Los Angeles schools. It critiques the effectiveness and the limitations of using case study, evaluation, field study, and user interview survey methodologies.

Davey, L. (1991). The Application of Case Study Evaluations. ERIC/TM Digest.

This article examines six types of case studies, the type of evaluation questions that can be answered, the functions served, some design features, and some pitfalls of the method.

Deutch, C. E. (1996). A course in research ethics for graduate students. College Teaching, 44, 2, 56-60.

This article describes a one-credit discussion course in research ethics for graduate students in biology. Case studies are focused on within the four parts of the course: 1) major issues, 2 )practical issues in scholarly work, 3) ownership of research results, and 4) training and personal decisions.

DeVoss, G. (1981). Ethics in Fieldwork Research. RIE 27p. (ERIC)

This article examines four of the ethical problems that can happen when conducting case study research: acquiring permission to do research, knowing when to stop digging, the pitfalls of doing collaborative research, and preserving the integrity of the participants.

Driscoll, A. (1985). Case Study of a Research Intervention: the University of Utah’s Collaborative Approach . San Francisco: Far West Library for Educational Research Development.

Paper presented at the annual meeting of the American Association of Colleges of Teacher Education, Denver, CO, March 1985. Offers information of in-service training, specifically case studies application.

Ellram, L. M. (1996). The Use of the Case Study Method in Logistics Research. Journal of Business Logistics, 17, 2, 93.

This article discusses the increased use of case study in business research, and the lack of understanding of when and how to use case study methodology in business.

Emig, J. (1971) The Composing Processes of Twelfth Graders . Urbana: NTCE.

This case study uses observation, tape recordings, writing samples, and school records to show that writing in reflexive and extensive situations caused different lengths of discourse and different clusterings of the components of the writing process.

Feagin, J. R. (1991). A Case For the Case Study . Chapel Hill: The University of North Carolina Press.

This book discusses the nature, characteristics, and basic methodological issues of the case study as a research method.

Feldman, H., Holland, A., & Keefe, K. (1989) Language Abilities after Left Hemisphere Brain Injury: A Case Study of Twins. Topics in Early Childhood Special Education, 9, 32-47.

"Describes the language abilities of 2 twin pairs in which 1 twin (the experimental) suffered brain injury to the left cerebral hemisphere around the time of birth and1 twin (the control) did not. One pair of twins was initially assessed at age 23 mo. and the other at about 30 mo.; they were subsequently evaluated in their homes 3 times at about 6-mo intervals."

Fidel, R. (1984). The Case Study Method: A Case Study. Library and Information Science Research, 6.

The article describes the use of case study methodology to systematically develop a model of online searching behavior in which study design is flexible, subject manner determines data gathering and analyses, and procedures adapt to the study's progressive change.

Flower, L., & Hayes, J. R. (1984). Images, Plans and Prose: The Representation of Meaning in Writing. Written Communication, 1, 120-160.

Explores the ways in which writers actually use different forms of knowing to create prose.

Frey, L. R. (1992). Interpreting Communication Research: A Case Study Approach Englewood Cliffs, N.J.: Prentice Hall.

The book discusses research methodologies in the Communication field. It focuses on how case studies bridge the gap between communication research, theory, and practice.

Gilbert, V. K. (1981). The Case Study as a Research Methodology: Difficulties and Advantages of Integrating the Positivistic, Phenomenological and Grounded Theory Approaches . The Annual Meeting of the Canadian Association for the Study of Educational Administration. (Address) Halifax, NS, Can.

This study on an innovative secondary school in England shows how a "low-profile" participant-observer case study was crucial to the initial observation, the testing of hypotheses, the interpretive approach, and the grounded theory.

Gilgun, J. F. (1994). A Case for Case Studies in Social Work Research. Social Work, 39, 4, 371-381.

This article defines case study research, presents guidelines for evaluation of case studies, and shows the relevance of case studies to social work research. It also looks at issues such as evaluation and interpretations of case studies.

Glennan, S. L., Sharp-Bittner, M. A. & Tullos, D. C. (1991). Augmentative and Alternative Communication Training with a Nonspeaking Adult: Lessons from MH. Augmentative and Alternative Communication, 7, 240-7.

"A response-guided case study documented changes in a nonspeaking 36-yr-old man's ability to communicate using 3 trained augmentative communication modes. . . . Data were collected in videotaped interaction sessions between the nonspeaking adult and a series of adult speaking."

Graves, D. (1981). An Examination of the Writing Processes of Seven Year Old Children. Research in the Teaching of English, 15, 113-134.

Hamel, J. (1993). Case Study Methods . Newbury Park: Sage. .

"In a most economical fashion, Hamel provides a practical guide for producing theoretically sharp and empirically sound sociological case studies. A central idea put forth by Hamel is that case studies must "locate the global in the local" thus making the careful selection of the research site the most critical decision in the analytic process."

Karthigesu, R. (1986, July). Television as a Tool for Nation-Building in the Third World: A Post-Colonial Pattern, Using Malaysia as a Case-Study. International Television Studies Conference. (Address). London, 10-12.

"The extent to which Television Malaysia, as a national mass media organization, has been able to play a role in nation building in the post-colonial period is . . . studied in two parts: how the choice of a model of nation building determines the character of the organization; and how the character of the organization influences the output of the organization."

Kenny, R. (1984). Making the Case for the Case Study. Journal of Curriculum Studies, 16, (1), 37-51.

The article looks at how and why the case study is justified as a viable and valuable approach to educational research and program evaluation.

Knirk, F. (1991). Case Materials: Research and Practice. Performance Improvement Quarterly, 4 (1 ), 73-81.

The article addresses the effectiveness of case studies, subject areas where case studies are commonly used, recent examples of their use, and case study design considerations.

Klos, D. (1976). Students as Case Writers. Teaching of Psychology, 3.2, 63-66.

This article reviews a course in which students gather data for an original case study of another person. The task requires the students to design the study, collect the data, write the narrative, and interpret the findings.

Leftwich, A. (1981). The Politics of Case Study: Problems of Innovation in University Education. Higher Education Review, 13.2, 38-64.

The article discusses the use of case studies as a teaching method. Emphasis is on the instructional materials, interdisciplinarity, and the complex relationships within the university that help or hinder the method.

Mabrito, M. (1991, Oct.). Electronic Mail as a Vehicle for Peer Response: Conversations of High and Low Apprehensive Writers. Written Communication, 509-32.

McCarthy, S., J. (1955). The Influence of Classroom Discourse on Student Texts: The Case of Ella . East Lansing: Institute for Research on Teaching.

A look at how students of color become marginalized within traditional classroom discourse. The essay follows the struggles of one black student: Ella.

Matsuhashi, A., ed. (1987). Writing in Real Time: Modeling Production Processes Norwood, NJ: Ablex Publishing Corporation.

Investigates how writers plan to produce discourse for different purposes to report, to generalize, and to persuade, as well as how writers plan for sentence level units of language. To learn about planning, an observational measure of pause time was used" (ERIC).

Merriam, S. B. (1985). The Case Study in Educational Research: A Review of Selected Literature. Journal of Educational Thought, 19.3, 204-17.

The article examines the characteristics of, philosophical assumptions underlying the case study, the mechanics of conducting a case study, and the concerns about the reliability, validity, and generalizability of the method.

---. (1988). Case Study Research in Education: A Qualitative Approach San Francisco: Jossey Bass.

Merry, S. E., & Milner, N. eds. (1993). The Possibility of Popular Justice: A Case Study of Community Mediation in the United States . Ann Arbor: U of Michigan.

". . . this volume presents a case study of one experiment in popular justice, the San Francisco Community Boards. This program has made an explicit claim to create an alternative justice, or new justice, in the midst of a society ordered by state law. The contributors to this volume explore the history and experience of the program and compare it to other versions of popular justice in the United States, Europe, and the Third World."

Merseth, K. K. (1991). The Case for Cases in Teacher Education. RIE. 42p. (ERIC).

This monograph argues that the case method of instruction offers unique potential for revitalizing the field of teacher education.

Michaels, S. (1987). Text and Context: A New Approach to the Study of Classroom Writing. Discourse Processes, 10, 321-346.

"This paper argues for and illustrates an approach to the study of writing that integrates ethnographic analysis of classroom interaction with linguistic analysis of written texts and teacher/student conversational exchanges. The approach is illustrated through a case study of writing in a single sixth grade classroom during a single writing assignment."

Milburn, G. (1995). Deciphering a Code or Unraveling a Riddle: A Case Study in the Application of a Humanistic Metaphor to the Reporting of Social Studies Teaching. Theory and Research in Education, 13.

This citation serves as an example of how case studies document learning procedures in a senior-level economics course.

Milley, J. E. (1979). An Investigation of Case Study as an Approach to Program Evaluation. 19th Annual Forum of the Association for Institutional Research. (Address). San Diego.

The case study method merged a narrative report focusing on the evaluator as participant-observer with document review, interview, content analysis, attitude questionnaire survey, and sociogram analysis. Milley argues that case study program evaluation has great potential for widespread use.

Minnis, J. R. (1985, Sept.). Ethnography, Case Study, Grounded Theory, and Distance Education Research. Distance Education, 6.2.

This article describes and defines the strengths and weaknesses of ethnography, case study, and grounded theory.

Nunan, D. (1992). Collaborative language learning and teaching . New York: Cambridge University Press.

Included in this series of essays is Peter Sturman’s "Team Teaching: a case study from Japan" and David Nunan’s own "Toward a collaborative approach to curriculum development: a case study."

Nystrand, M., ed. (1982). What Writers Know: The Language, Process, and Structure of Written Discourse . New York: Academic Press.

Owenby, P. H. (1992). Making Case Studies Come Alive. Training, 29, (1), 43-46. (ERIC)

This article provides tips for writing more effective case studies.

---. (1981). Pausing and Planning: The Tempo of Writer Discourse Production. Research in the Teaching of English, 15 (2),113-34.

Perl, S. (1979). The Composing Processes of Unskilled College Writers. Research in the Teaching of English, 13, 317-336.

"Summarizes a study of five unskilled college writers, focusing especially on one of the five, and discusses the findings in light of current pedagogical practice and research design."

Pilcher J. and A. Coffey. eds. (1996). Gender and Qualitative Research . Brookfield: Aldershot, Hants, England.

This book provides a series of essays which look at gender identity research, qualitative research and applications of case study to questions of gendered pedagogy.

Pirie, B. S. (1993). The Case of Morty: A Four Year Study. Gifted Education International, 9 (2), 105-109.

This case study describes a boy from kindergarten through third grade with above average intelligence but difficulty in learning to read, write, and spell.

Popkewitz, T. (1993). Changing Patterns of Power: Social Regulation and Teacher Education Reform. Albany: SUNY Press.

Popkewitz edits this series of essays that address case studies on educational change and the training of teachers. The essays vary in terms of discipline and scope. Also, several authors include case studies of educational practices in countries other than the United States.

---. (1984). The Predrafting Processes of Four High- and Four Low Apprehensive Writers. Research in the Teaching of English, 18, (1), 45-64.

Rasmussen, P. (1985, March) A Case Study on the Evaluation of Research at the Technical University of Denmark. International Journal of Institutional Management in Higher Education, 9 (1).

This is an example of a case study methodology used to evaluate the chemistry and chemical engineering departments at the University of Denmark.

Roth, K. J. (1986). Curriculum Materials, Teacher Talk, and Student Learning: Case Studies in Fifth-Grade Science Teaching . East Lansing: Institute for Research on Teaching.

Roth offers case studies on elementary teachers, elementary school teaching, science studies and teaching, and verbal learning.

Selfe, C. L. (1985). An Apprehensive Writer Composes. When a Writer Can't Write: Studies in Writer's Block and Other Composing-Process Problems . (pp. 83-95). Ed. Mike Rose. NMY: Guilford.

Smith-Lewis, M., R. and Ford, A. (1987). A User's Perspective on Augmentative Communication. Augmentative and Alternative Communication, 3, 12-7.

"During a series of in-depth interviews, a 25-yr-old woman with cerebral palsy who utilized augmentative communication reflected on the effectiveness of the devices designed for her during her school career."

St. Pierre, R., G. (1980, April). Follow Through: A Case Study in Metaevaluation Research . 64th Annual Meeting of the American Educational Research Association. (Address).

The three approaches to metaevaluation are evaluation of primary evaluations, integrative meta-analysis with combined primary evaluation results, and re-analysis of the raw data from a primary evaluation.

Stahler, T., M. (1996, Feb.) Early Field Experiences: A Model That Worked. ERIC.

"This case study of a field and theory class examines a model designed to provide meaningful field experiences for preservice teachers while remaining consistent with the instructor's beliefs about the role of teacher education in preparing teachers for the classroom."

Stake, R. E. (1995). The Art of Case Study Research. Thousand Oaks: Sage Publications.

This book examines case study research in education and case study methodology.

Stiegelbauer, S. (1984) Community, Context, and Co-curriculum: Situational Factors Influencing School Improvements in a Study of High Schools. Presented at the annual meeting of the American Educational Research Association, New Orleans, LA.

Discussion of several case studies: one looking at high school environments, another examining educational innovations.

Stolovitch, H. (1990). Case Study Method. Performance And Instruction, 29, (9), 35-37.

This article describes the case study method as a form of simulation and presents guidelines for their use in professional training situations.

Thaller, E. (1994). Bibliography for the Case Method: Using Case Studies in Teacher Education. RIE. 37 p.

This bibliography presents approximately 450 citations on the use of case studies in teacher education from 1921-1993.

Thrane, T. (1986). On Delimiting the Senses of Near-Synonyms in Historical Semantics: A Case Study of Adjectives of 'Moral Sufficiency' in the Old English Andreas. Linguistics Across Historical and Geographical Boundaries: In Honor of Jacek Fisiak on the Occasion of his Fiftieth Birthday . Berlin: Mouton de Gruyter.

United Nations. (1975). Food and Agriculture Organization. Report on the FAO/UNFPA Seminar on Methodology, Research and Country: Case Studies on Population, Employment and Productivity . Rome: United Nations.

This example case study shows how the methodology can be used in a demographic and psychographic evaluation. At the same time, it discusses the formation and instigation of the case study methodology itself.

Van Vugt, J. P., ed. (1994). Aids Prevention and Services: Community Based Research . Westport: Bergin and Garvey.

"This volume has been five years in the making. In the process, some of the policy applications called for have met with limited success, such as free needle exchange programs in a limited number of American cities, providing condoms to prison inmates, and advertisements that depict same-sex couples. Rather than dating our chapters that deal with such subjects, such policy applications are verifications of the type of research demonstrated here. Furthermore, they indicate the critical need to continue community based research in the various communities threatened by acquired immuno-deficiency syndrome (AIDS) . . . "

Welch, W., ed. (1981, May). Case Study Methodology in Educational Evaluation. Proceedings of the Minnesota Evaluation Conference. Minnesota. (Address).

The four papers in these proceedings provide a comprehensive picture of the rationale, methodology, strengths, and limitations of case studies.

Williams, G. (1987). The Case Method: An Approach to Teaching and Learning in Educational Administration. RIE, 31p.

This paper examines the viability of the case method as a teaching and learning strategy in instructional systems geared toward the training of personnel of the administration of various aspects of educational systems.

Yin, R. K. (1993). Advancing Rigorous Methodologies: A Review of 'Towards Rigor in Reviews of Multivocal Literatures.' Review of Educational Research, 61, (3).

"R. T. Ogawa and B. Malen's article does not meet its own recommended standards for rigorous testing and presentation of its own conclusions. Use of the exploratory case study to analyze multivocal literatures is not supported, and the claim of grounded theory to analyze multivocal literatures may be stronger."

---. (1989). Case Study Research: Design and Methods. London: Sage Publications Inc.

This book discusses in great detail, the entire design process of the case study, including entire chapters on collecting evidence, analyzing evidence, composing the case study report, and designing single and multiple case studies.

Related Links

Consider the following list of related Web sites for more information on the topic of case study research. Note: although many of the links cover the general category of qualitative research, all have sections that address issues of case studies.

• Sage Publications on Qualitative Methodology: Search here for a comprehensive list of new books being published about "Qualitative Methodology" http://www.sagepub.co.uk/
• The International Journal of Qualitative Studies in Education: An on-line journal "to enhance the theory and practice of qualitative research in education." On-line submissions are welcome. http://www.tandf.co.uk/journals/tf/09518398.html
• Qualitative Research Resources on the Internet: From syllabi to home pages to bibliographies. All links relate somehow to qualitative research. http://www.nova.edu/ssss/QR/qualres.html

Becker, Bronwyn, Patrick Dawson, Karen Devine, Carla Hannum, Steve Hill, Jon Leydens, Debbie Matuskevich, Carol Traver, & Mike Palmquist. (2005). Case Studies. Writing@CSU . Colorado State University. https://writing.colostate.edu/guides/guide.cfm?guideid=60

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How to Write a Case Study | Examples & Methods

What is a case study?

A case study is a research approach that provides an in-depth examination of a particular phenomenon, event, organization, or individual. It involves analyzing and interpreting data to provide a comprehensive understanding of the subject under investigation. 

Case studies can be used in various disciplines, including business, social sciences, medicine ( clinical case report ), engineering, and education. The aim of a case study is to provide an in-depth exploration of a specific subject, often with the goal of generating new insights into the phenomena being studied.

When to write a case study

Case studies are often written to present the findings of an empirical investigation or to illustrate a particular point or theory. They are useful when researchers want to gain an in-depth understanding of a specific phenomenon or when they are interested in exploring new areas of inquiry. 

Case studies are also useful when the subject of the research is rare or when the research question is complex and requires an in-depth examination. A case study can be a good fit for a thesis or dissertation as well.

Case study examples

Below are some examples of case studies with their research questions:

These examples demonstrate the diversity of research questions and case studies that can be explored. From studying small businesses in Ghana to the ethical issues in supply chains, case studies can be used to explore a wide range of phenomena.

Outlying cases vs. representative cases

An outlying case stud y refers to a case that is unusual or deviates significantly from the norm. An example of an outlying case study could be a small, family-run bed and breakfast that was able to survive and even thrive during the COVID-19 pandemic, while other larger hotels struggled to stay afloat.

On the other hand, a representative case study refers to a case that is typical of the phenomenon being studied. An example of a representative case study could be a hotel chain that operates in multiple locations that faced significant challenges during the COVID-19 pandemic, such as reduced demand for hotel rooms, increased safety and health protocols, and supply chain disruptions. The hotel chain case could be representative of the broader hospitality industry during the pandemic, and thus provides an insight into the typical challenges that businesses in the industry faced.

Steps for Writing a Case Study

As with any academic paper, writing a case study requires careful preparation and research before a single word of the document is ever written. Follow these basic steps to ensure that you don’t miss any crucial details when composing your case study.

Step 1: Select a case to analyze

After you have developed your statement of the problem and research question , the first step in writing a case study is to select a case that is representative of the phenomenon being investigated or that provides an outlier. For example, if a researcher wants to explore the impact of COVID-19 on the hospitality industry, they could select a representative case, such as a hotel chain that operates in multiple locations, or an outlying case, such as a small bed and breakfast that was able to pivot their business model to survive during the pandemic. Selecting the appropriate case is critical in ensuring the research question is adequately explored.

Step 2: Create a theoretical framework

Theoretical frameworks are used to guide the analysis and interpretation of data in a case study. The framework should provide a clear explanation of the key concepts, variables, and relationships that are relevant to the research question. The theoretical framework can be drawn from existing literature, or the researcher can develop their own framework based on the data collected. The theoretical framework should be developed early in the research process to guide the data collection and analysis.

To give your case analysis a strong theoretical grounding, be sure to include a literature review of references and sources relating to your topic and develop a clear theoretical framework. Your case study does not simply stand on its own but interacts with other studies related to your topic. Your case study can do one of the following: 

• Demonstrate a theory by showing how it explains the case being investigated
• Broaden a theory by identifying additional concepts and ideas that can be incorporated to strengthen it
• Confront a theory via an outlier case that does not conform to established conclusions or assumptions

Step 3: Collect data for your case study

Data collection can involve a variety of research methods , including interviews, surveys, observations, and document analyses, and it can include both primary and secondary sources . It is essential to ensure that the data collected is relevant to the research question and that it is collected in a systematic and ethical manner. Data collection methods should be chosen based on the research question and the availability of data. It is essential to plan data collection carefully to ensure that the data collected is of high quality

Step 4: Describe the case and analyze the details

The final step is to describe the case in detail and analyze the data collected. This involves identifying patterns and themes that emerge from the data and drawing conclusions that are relevant to the research question. It is essential to ensure that the analysis is supported by the data and that any limitations or alternative explanations are acknowledged.

The manner in which you report your findings depends on the type of research you are doing. Some case studies are structured like a standard academic paper, with separate sections or chapters for the methods section , results section , and discussion section , while others are structured more like a standalone literature review.

Regardless of the topic you choose to pursue, writing a case study requires a systematic and rigorous approach to data collection and analysis. By following the steps outlined above and using examples from existing literature, researchers can create a comprehensive and insightful case study that contributes to the understanding of a particular phenomenon.

Preparing Your Case Study for Publication

After completing the draft of your case study, be sure to revise and edit your work for any mistakes, including grammatical errors , punctuation errors , spelling mistakes, and awkward sentence structure . Ensure that your case study is well-structured and that your arguments are well-supported with language that follows the conventions of academic writing .  To ensure your work is polished for style and free of errors, get English editing services from Wordvice, including our paper editing services and manuscript editing services . Let our academic subject experts enhance the style and flow of your academic work so you can submit your case study with confidence.

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How to Write a Case Study: Definition, Outline, Steps & Examples

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A case study is a research method that involves an in-depth examination of a particular subject, often a person, group, event, or organization. It's used to explore complex issues in real-world contexts. A case study can provide insights that might not be achieved with other research methods.

Are you struggling with writing a case study and don't know where to begin? You are not alone. Most students involved in the Psychology or Sociology field often find this task challenging. Especially if they are new to this research method. However, with the right structure and preparation, creating a case study paper will be a piece of cake. 

After reading this article, you will be armed with all essential details including:

Let’s dive right in!

A case study is a research method that involves examining a specific instance to let researchers learn more about an individual, event, organization or concept. It is like a magnifying glass for studying real-life situations. By looking at a single example, we can learn more about complex issues and understand patterns. 

Case studies are used in the fields like Psychology, Business, Statistics or Nursing. As a rule, students apply this research method when writing a dissertation or thesis . 

Depending on the research question and the data needed to address a problem, case studies can involve various research methods.

Research Methods Applied in Case Studies

Case Study Example

Let's recap the main points. 

The primary purpose of a case study is to gain insight into the real-world situations through the investigation and analysis of a single instance. This research design is often applied to meet such goals: 

Every case study writer can customize their work to fit the needs of a specific discipline, as shown below.

Use of Case Studies 

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There are different types of case studies that scholars or students can bring into play. Each approach has its own focus and is chosen based on research objectives. 

When investigating any phenomenon, it’s important to organize your sections in a logical manner. A structure of a case study usually includes such components:

Before you create a case study, it’s a good idea to prepare an outline. It serves as a skeleton of your project. A well-structured outline of a case study helps organize your thoughts in a logical manner.

Below you can see an example of a basic template. Feel free to use it for inspiration. 

General Outline  

Based on the sample template shown above, arrange your key ideas and highlight critical information. You may change the blocks to meet your assignment’s unique requirements.

Preparation  is the key to success. To make your case study flawless, you need to establish your goal and plan. This will lay the foundation of the whole process before you begin writing.

Ensure you follow these 3 crucial steps before moving further. 

Your professor may provide you with special requirements, case study rubric or exemplary works. The instructions may include details on preferred format, structure, word count, writing style or analysis techniques. Read given material attentively and make sure you fully understand the guidelines. 

Get expertly crafted works to meet your academic needs. Buy case study from certified professionals and ace your assignments with ease.

Researching is the most time-consuming part of writing a case study. Review relevant studies on the research topic to gain a deeper understanding of your subject. You may want to go through different sources and identify their strengths and limitations. Strive to build a bridge between your case study report and existing gaps. 

Make sure to jot down all your ideas, opinions, notes or questions related to your research. This approach will help you build an outline and write a case study accordingly.  

Now you are all set for the data collection process. Identify the most relevant type of information pertinent to your research question.

Consider using primary sources such as interviews, surveys or questionnaires. Secondary resources may include books, articles, case studies and public documents. 

Your data must be accurate and reliable so double-check your research results before integrating them into your project.

Now that you are familiar with the preparation stages, it's time to dive into the writing process. Writing case studies can be challenging. But by following a structured approach, you can produce a clear and engaging work. 

To create a strong project, it's important to carefully plan and execute each step of your flow, from identifying the research question to presenting your conclusions. Below we have prepared detailed guidelines on how to write a case study paper. 

Start your case study introduction by presenting your subject and providing a brief overview of the research objectives. It's important to highlight the significance of your case and explain why it warrants examination. One way to do this is to focus on innovative aspects, such as a novel approach to a problem or a new technology. You can also emphasize the broader implications. 

You should also preview a structure. This will give readers an idea of what to expect. Briefly describe your main points or provide a rough outline. 

Case Study Introduction Example

Before you get to the problem, provide context that explains the issue at hand. Identify the scope and impact of this problem. One efficient strategy of creating case studies that trigger attention is integrating examples or statistics. This helps to understand how severe this situation is. 

Additionally, you may want to highlight any challenges or obstacles that have prevented a problem from being solved. 

Example of Problem Description in a Case Study

>> Read more: How to Write a Problem Statement

Research methods you apply will define how to make a case study. There are multiple ways to collect data. So your primary task here is to figure out what kind of information you want to obtain. 

Your research strategy should align with your objectives. For instance, interviews can help capture detailed information from a small sample of people. On the other hand, surveys involve large groups of individuals. If you are using interviews or surveys, provide a list of questions participants were asked. 

You can also do experiments to test out different theories or conduct document analysis to identify trends. 

>> Learn more: What Is Experimental Design  

Example of How to Describe Research Methods 

The next stage involves coming up with potential solutions. Explain what strategies could be used to address the problem.

For example, if you write a case study on a business-related problem, solutions may involve implementing procedures to improve efficiency. Alternatively, in a healthcare niche, you will offer a new medication or therapy.

Be sure to provide evidence from your research or expert opinions to support your suggestions.

Here’s how to do a case study solutions section. 

Example of Solution

Most scholars judge case study reports by research outcomes. You need to show that your solution works. Analyze collected data and share your most significant findings in your results section . This can be an increase in profits or a patient's health improvement. 

When you write your case study outcomes, it is important to organize the information in a clear and concise manner. Use tables, graphs and charts to illustrate your data visually. 

Provide a short summary of your results and their implications. But don’t just tell. You need to back up your research with evidence. If you used interviews, be sure to include any statistical analysis done for those results. 

Example of Case Study Research Results

A conclusion of a case study is where you wrap everything up and provide recommendations for further research. Sum up your key points and explain how they could be used to solve similar problems. You can also highlight any unexpected findings or insights that emerged during the study. Don’t forget to discuss any ethical considerations or limitations. 

You need to create a lasting impression. For this, end a case study with a thought-provoking statement or call to action. 

Case Study Conclusion Example

Once you are done with writing a case study, you need to carefully review it. Keep an eye on these things when checking your work: 

Besides the content, it is also important to stick to a specific case study paper format. The layout of your paper should follow guidelines of the chosen citation style.

There are different ways to format a case study. Commonly used styles include APA, MLA, Chicago and Harvard. Each format  presents specific requirements for formatting your text and references. 

Check out our detailed guides listed below to learn more about each style. 

>>  How to Write a Paper in APA Format?

>>  How to Do MLA Format?  

>>  How to Write a Chicago Style Paper?

Getting actual examples of case studies can be a great way to learn and understand how to write one. To help you out, we have collected several sample case study paper examples for different disciplines. Feel free to use these samples as inspiration when writing your own paper.

With the right approach, your effort will reward you with an A+. In this section, we will list some actionable tips on how to write a good case study: 

Even a small mistake can undermine your whole work. Here are some common pitfalls students fail to account for in their case studies:

Using a case study approach as your research method has its own pros and cons. On one hand, it is an effective way to explore a particular issue in detail. On the other, there are certain limitations that come with this approach. Below we will cover both strengths and limitations of case studies.

A case study is like a seed that can grow into a fruitful tree, providing resolutions to intricate problems. Here are the biggest case study benefits you can use to your advantage:

As with any research method, case studies have their fair share of drawbacks. Let's take a closer look at some of the most prevalent issues that can arise when using this approach.

Before you write a case study assignment, make sure to recap all the information you have learnt today. Refer to this checklist to ensure you are on the right track. 

Writing a case study can be an incredibly challenging task for any student. However, with the right approach and tips, you can easily turn this daunting task into a pleasant experience. 

We hope this article helped you understand how to write a case study. Remember to focus on the practical part and avoid overgeneralizing or cherry-picking data.

Frequently Asked Questions

1. what is a case study in research.

A case study is a research method that involves an in-depth analysis of a particular subject. This approach most often focuses on a single event, person or group. It provides insight into the context of a problem and can be used to explore solutions to intricate issues.

2. What is the difference between a case study and a research paper?

The main difference between a case study and a research paper is in their scope. A case study explores a limited number of subjects, while research papers investigate multiple variables and/or draw conclusions from larger data sets. While both works contain evidence-based information, the focus and approach taken are quite different. Research papers are more general in nature, while case studies focus on narrow problems.

3. How long should a case study be?

The length of a case study varies depending on the type of assignment. Case studies intended for scholarly articles range from 3,000 to 4,0000 words or more. Meanwhile, if it’s a separate chapter in your MA or PhD dissertation, you will need to keep it between 8,000-15,000 words. Follow specific guidelines provided by your professor or institution. 

4. Why is a case study important?

Case studies are an important research tool, as they provide detailed information on a particular issue. By exploring a single instance from multiple angles, researchers can uncover solutions to complicated problems that may not be immediately apparent. Using this method, scientists also test hypotheses and generate new theories.

5. What makes a good case study?

A good case study should be organized, well-researched, and contain evidence. Some characteristics of a case study include:

6. How to start a case study?

To start a case study, begin by carefully reading requirements and identifying the main problem to be addressed. Don't jump to conclusions or make assumptions – take it one step at a time. Once you have a clear understanding of your goal, gather relevant data. This includes doing research, interviewing people, and analyzing relevant documents.

• Definition 
• Case study types
• Basic structure
• Steps on how to write a case study
• Examples that worked.
• Develop a better understanding of complex issues or phenomena 
• Identify patterns and relationships
• Test hypotheses and theories in natural settings
• Provide practical solutions
• Illustrate best practices or successful strategies.
• Descriptive case studies This approach involves a detailed examination of a particular situation or phenomenon to understand it better. Here, researchers see the context, events, and processes that led to a particular outcome, and get a comprehensive picture of the situation.
• Explanatory case studies Explanatory method allows us to understand the "why" and “how” behind a particular event or phenomenon. As the name suggests, this type of case study seeks to test and explain the causal relationship between independent and dependent variables . 
• Exploratory case studies Imagine being a detective and investigating a mystery or problem in its early stages. This is the main idea of an exploratory investigation. It helps to recognize key questions, potential patterns, and areas for further research. It's like peeling back the layers of an onion, revealing new insights and uncovering possible solutions. 
• Intrinsic case studies  Unlike other case study methods, an intrinsic approach is used to explore a unique instance. Here, researchers focus on a particular scenario in its own right, rather than trying to apply the outcomes to a broader population.  
• Instrumental case studies This type of study examines one instance to shed light on a larger group or phenomenon. Instrumental technique is a good choice if you want to develop theoretical frameworks and obtain generalizable findings.
• Cumulative case studies  While conducting cumulative research, students compile and synthesize information from multiple similar instances. Here, you combine the results of multiple studies to draw more generalized conclusions.
• Collective case reports Think of several individual instances being studied together to provide a broader understanding of a specific phenomenon. These instances are often connected by a common theme. This enables researchers to compare and contrast cases and uncover tendencies. 
• Critical case studies Researchers use this method to explore exceptional instances that are particularly interesting or thought-provoking. Critical approach helps to analyze why a specific situation occurred and what could have been done differently.
• Introduction This section is a place to present a case. Provide a brief overview of your instance, introduce your key research objectives and prepare the readers for further analysis.
• Problem identification By laying out a problem, you will be able to show the scope and significance of your topic. Identify the main issue that will be examined and build a clear statement of the problem.
• Background A properly established context sets the stage for research and lays a foundation for case evaluation. Offer relevant background information on the instance. This can be a historical, geographical or cultural context.
• Methodology Describe your  methodology in research  – approach, data collection methods and analysis techniques used in your investigation.
• Solution  Now is the time to determine potential solutions to address the problem, and evaluate the pros and cons of each resolution. Make sure solutions are realistic.
• Results  Once a case study is conducted, you should share your key findings. Mention any data or evidence that was collected and analyzed.
• Discussion This part of a case study is a perfect opportunity for analysis. Discuss the implications of your outcomes and draw conclusions
• Conclusion Summarize your main points, restate a problem and solutions, and offer final recommendations or next steps.
• Brief subject introduction
• Research purpose and objectives
• Necessary context
• Problem/issue
• Problem significance
• Subject/idea history
• Setting or environment description
• Key challenges, opportunities, or turning points
• Research methods used to gather information
• Data analysis methods
• Possible strategies
• Assessment of solutions
• Recommended solvents
• Major discoveries from the data analysis
• Implications
• Limitations/challenges
• Summary of key points
• Restatement of the problem and solution
• Final suggestions or next steps
• Grammar mistakes Proofread your writing for typos and grammar errors. Feel free to use our  Grammar Checker  to make sure you got everything right.
• Clarity Check whether your work is readable and concise. Avoid long sentences and complex structures.
• Sources accuracy Make sure to check all sources for accuracy. It is also important to ensure that all reported data is up-to-date.
• Citations Ascertain whether all sources are properly cited and the same style is used consistently throughout your paper.
• Planning your work ahead Planning your work ahead Make sure to create an outline before you start writing and stick to it throughout the entire process.
• Arranging your data logically Break down complex information into chunks and use visual elements (tables, graphs, diagrams) to present it.
• Structuring your writing Use headings and subheadings to organize your content and make key points easy to access.
• Keeping your text simple Write your case study in an easy-to-read language and refrain from complex sentence structures.
• Remaining impartial Be objective in your analysis and avoid personal biases.
• Focusing too much on the background Provide enough space for analysis of your problem and solution.
• Stuffing with direct quotes Quotes can be used as evidence in your paper. But relying on them too much will make it sound overly repetitive.
• Not referring to all sources Always cite your sources correctly and use only reliable data in your paper.
• Being vague Avoid general statements and be more specific while discussing your results and solutions.
• Failing to mention possible gaps Always consider ethical considerations or limitations.
• In-depth analysis Researchers can gather a lot of information on a specific topic or issue.
• Insights into elaborate issues Allows researchers to examine complex issues in a controlled manner.
• Real-life situations You are able to test theories or hypotheses in real-world settings.
• Comprehensive approach Researchers can collect both quantitative and qualitative data.
• Unique revelations This method can enlight on previously unexplored or understudied areas.
• Limited generalizability Due to the small sample size and unique nature of each case, it can be difficult to generalize findings to a larger population.
• Observer bias Researchers may bring their own biases and perspectives, which can influence their results and interpretations.
• Time-consuming and expensive This approach requires significant time and resources to conduct, making it less feasible for some research questions.
• Lack of control In contrast to experimental research, case studies lack control over extraneous variables. This can make it difficult to establish cause-and-effect relationships.
• Subjectivity Collected data is often subjective and open to interpretation, which can introduce potential errors.
• Precise subject overview
• Thorough analysis that goes beyond surface-level information
• Examination of a single scenario from various perspectives
• Fact-based arguments
• Validated findings.
• checkbox I thoroughly researched my topic and gathered relevant information.
• checkbox A problem/issue is clearly defined. 
• checkbox My case study structure is well-organized. 
• checkbox I used appropriate research methods to gather data.
• checkbox My findings are well-supported by analysis and evidence. 
• checkbox I discussed possible limitations and ethical considerations. 
• checkbox The work offers recommendations for further research.
• checkbox My paper adheres to formatting guidelines required by my instructor.

What Is a Case Study: Definition

What is the purpose of a case study, types of case studies, case study structure: main parts, case study outline, before you start writing a case study, 1. carefully read the instructions , 2. conduct research, 3. gather data, how to write a case study in 7 steps, 1. introduce a case study, 2. describe a problem, 3. discuss research methods , 4. offer solutions to the problem , 5. present your key results, 6. conclude with recommendations, 7. proofread your case study, case study format, case study examples, case study writing tips, mistakes to avoid when writing a case study, advantages and disadvantages of case study, benefits of case study, limitations of case study, case study paper writing checklist, bottom line on how to write a case study.

A researcher is interested in studying the effects of a newly implemented teaching method on student performance. To find out, they observe a class of 30 students over one semester. The researcher compares the test scores from before and after the method was used, documenting its effectiveness.  The study results showed that academic performance had improved by 11.5% since the new teaching method was implemented. The researcher concluded that this approach works well and can be generalized to a broader population.

Post-traumatic stress disorder (PTSD) is a debilitating condition that can arise in individuals who have experienced a traumatic event. In this case study, we examine the experiences of a patient who was diagnosed with PTSD following a car accident. Our analysis focuses on the patient's symptoms, including intrusive thoughts, hyperarousal, and avoidance behaviors. We also explore the treatments employed to manage these symptoms. By analyzing this case, we aim to provide insights into the challenges of treating PTSD and offer recommendations for improving therapeutic interventions for individuals suffering from this condition.

John is a 28-year-old man who was involved in a serious car accident three months ago. Since then, he has been experiencing PTSD symptoms, including recurring nightmares, flashbacks, and feelings of anxiety. These symptoms have affected his work performance and relationships with family and friends. Despite seeking help from his primary care physician and attending therapy sessions, John has not experienced significant improvement. The challenge is to identify effective treatments that can help John manage his PTSD and improve his quality of life.

In this research, both quantitative and qualitative data were utilized. 10 semi-structured interviews were conducted with participants who had experienced PTSD symptoms following a traumatic event. Additionally, data was collected from a survey of 253 individuals who had not been diagnosed with PTSD. We inquired about their experiences with trauma and the types of coping strategies they used to manage stress. Medical records from John's primary care physician were analyzed to track his progress over time. The combination of quantitative and qualitative data allowed for a comprehensive understanding of John's unique experiences with PTSD.

One potential solution for addressing John's PTSD symptoms is cognitive-behavioral therapy (CBT). According to a study by Bisson and colleagues (2013), CBT has been found to be effective in reducing symptoms of PTSD in individuals who have experienced traumatic events. The therapist can work with John to identify and challenge negative thought patterns related to his traumatic experience and teach him coping skills to manage his anxiety and stress.

Our analysis showed that participants who received cognitive-behavioral therapy (CBT) reported a significant decrease in symptoms of post-traumatic stress disorder (PTSD), as compared to those who received no therapy. Specifically, the group who received CBT experienced a 35% reduction in symptoms. Meanwhile, the control group experienced no significant change. These findings suggest that CBT may be an effective treatment option for individuals with PTSD.

Our research highlighted the significant impact of PTSD on individuals who have experienced a traumatic event. The results suggested that cognitive-behavioral therapy and reprocessing therapy are effective treatments for PTSD. However, more research is needed to determine the long-term effects of these treatments. Additionally, the stigma surrounding mental health and seeking treatment remains a significant barrier to access to care. It is crucial for healthcare professionals and policymakers to address this issue and increase access to mental health services.

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Is a case study a type of research paper?

I can’t find an answer that explicitly says that a case study is a type of research (e.g. analytical research paper, persuasive research paper, definition research paper, etc.). There’s this site that says that a case study is a research methodology (it’s the third chapter of a research paper).

• research-process
• research-undergraduate

• 1 You need to be a bit clearer. Most case studies used in education are at least a bit contrived. –  Buffy Commented Aug 30, 2021 at 11:57
• 1 The term is applied differently in different disciplines, it seems. What discipline is your question referring to? –  henning no longer feeds AI Commented Aug 30, 2021 at 12:27
• Please clarify your specific problem or provide additional details to highlight exactly what you need. As it's currently written, it's hard to tell exactly what you're asking. –  Community Bot Commented Aug 30, 2021 at 12:30

2 Answers 2

The case study is a qualitative research method in several disciplines, mostly in the social sciences. 1 A research paper that builds on this method might also be referred to as a "case study". 2

1 See e.g. Gerring, J. (2007) Case Study Research: Principles and Practices (Cambridge: Cambridge University Press).

2 See e.g. Hooghe, L. (2005) ‘Several Roads Lead to International Norms, but Few Via International Socialization: A Case Study of the European Commission’. International Organization, Vol. 59, No. 4, pp. 861–898.

• Thank you so much for clarifying. –  CottonTheButton Commented Aug 30, 2021 at 12:30

A "case study" can mean several things:

A small[*] piece of original research that was published as part of another research paper or review. For example: a paper describes a theory and subsequently applies it to a small and well-defined subset (a case) of possible applications of the theory, thereby providing anecdotal evidence that the theory is useful,

Particularly in the social sciences, a "case study" may be described in a separate paper, and present anecdotal evidence (or contradiction) of a theory that was published elsewhere. (So similar to (1), but the "case study" is now a separate publication)

A study that is not published in a peer-reviewed journal, but used for example to promote new equipment from a commercial manufacturer by demonstrating its usefulness for the given "case" (this is also called "application note").

Note also that some journals have very specific requirements for the publication types they accept, and that those types are defined by the journal in question.

[*] see commments

• 2 +1 Most qualitative social science researchers would argue that case studies can be designed to provide much more than anecdotal evidence, however! (Even most quants would agree.) And (especially comparative) case studies are not necessarily "small" pieces of research. The three case studies by Theda Skocpol in "States and Social Revolutions" span some 300 pages and go to profound depths. –  henning no longer feeds AI Commented Aug 30, 2021 at 12:21
• 1 @henning Just to clarify: "small" here is meant with respect to the set containing all the other possible cases, not to describe the amount of effort invested in the research or length of the paper or something like that. –  Louic Commented Aug 30, 2021 at 12:39
• I see, "small n" then. Thanks for clarifying. –  henning no longer feeds AI Commented Aug 30, 2021 at 12:49

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The economic impact of the Olympics

Rising fourth-year silas ruth, an economics major, examines sports mega-events like paris 2024 through an economic lens..

The 2024 Olympic Games are set to begin on July 26 in Paris. As the world gears up to watch their compatriots compete for gold, it may seem like France has already had one big win: landing the games themselves.

But just how Paris benefits financially from the games remains to be seen, according to rising fourth-year Silas Ruth, an economics major from Rochester, New York. Ruth , a member of Penn’s track and field team , has been examining sports mega-events through an economic lens, most recently in his paper “Medals, Money, and Legacy: A Comparative Analysis of Sports Tourism and Economic Development Through Olympic Games.” What his research has revealed has been a bit of a surprise.

“I’ve found that sports mega-events, although they have been long heralded as a tool for national development in sports tourism, international trade, and international prestige, are frequently a not very good economic investment,” Ruth says.

Ruth first became interested in looking at the intersection of sports and economics during a freshman seminar class he took with professor Heather Sharkey. It was a Middle Eastern Studies class, and each student was assigned a different nation and asked to write a research paper on it. Ruth was assigned Qatar.

“As a lifelong soccer fan, the World Cup was coming up in 2022, and so I thought, How better to integrate these interests in sports and economics and read a little bit about the World Cup in Qatar,” he says.

What he found was very closely related to what he’s learning more about his current project. Big sporting events often don’t pay off for the host country.

After that class, he wanted to dig deeper into why nations would bid on the games, knowing the likely economic reality, and he transitioned his focus to the Olympics in particular.

“The Olympic Games are projects where billions and billions of dollars have been invested, anywhere from $2 billion to $40 billion since 2000. I was astonished to find that almost every single one had been a net loss since Los Angeles 1984,” Ruth says.

Los Angeles was a case study for a profitable, successful sports event. The city made $5.2 billion in profit, Ruth notes, but what set that competition apart was the high quality of existing infrastructure, including transportation systems, sporting arenas, hospitality services, all of the dozens of different functions that have to come together to support the millions of sports tourists who come to a city to attend the games.

Oftentimes nations that make these bids and cities that host these sports mega-events don’t have such infrastructure, and that was especially true of Qatar in 2022. “They basically had to build everything from scratch in the middle of the desert,” Ruth says.

His research has been funded by the Kanta Marwah College Alumni Society Undergraduate Research Grant, supported by the Center for Undergraduate Research and Fellowships . The grant enabled him to travel to Los Angeles this summer to meet with city officials and conduct research for the paper.

“This project is a perfect integration of two of my greatest interests: economics and sports,” he says. “I feel incredibly grateful to have received this grant from CURF.”

Ruth says he hopes his research can provide a more holistic understanding of these events and offer a perspective on what it means financially when a country bids on such games. “Hopefully my research can create conversations around the space of federal investments and the opportunity costs of these events,” he says.

Ruth’s advisor on the paper is economics professor Guillermo L. Ordoñez .

“In formulating the project, Silas has shown initiative and creativity in identifying a contemporary lens—sustainable infrastructure development—with which to examine the impact of sport mega-events on the economies of host nations,” Ordoñez says. “He has actively engaged in the conceptualization and design of the research framework, demonstrating a keen understanding of the interdisciplinary nature of the topic.”

It’s not clear that sport events are in net beneficial or costly, Ordoñez says, pointing to cases in which they heavily revitalized the economy, like the 1992 Barcelona Olympics, 2012 London Olympics, and 2006 FIFA World Cup in Germany.

“But there are also cases in which they were very costly for local communities, like the 1976 Montreal Olympics, 2004 Athens Olympics, and 2014 Sochi Winter Olympics,” Ordoñez says. Poor planning, mismanagement, corruption, and lack of long-term vision can lead to significant economic burdens for host cities and countries. 

“Silas’ research is trying to assess these important trade-offs, which can have very beneficial or pervasive effect on local communities,” he says.

While Ruth has never been to the Olympics, he says he is looking forward to the 2026 World Cup in Philadelphia and hopes he can make it to Los Angeles for the 2028 Olympic Games.

For the upcoming Paris games, he’s particularly excited to watch the track and field events “of course, because that’s my sport, and Penn has a lot of incredible Olympians they are sending over, including one current team member that I personally know, Bella Whittaker,” he says. “I’ll be excited for her running the 4x400 relay and will be cheering her on.”

He says he’s also looking at the games with a new eye for the economics side.

“Will they be able to transition this month of excitement around sport into systems and tourism that lasts for years to come? Will they be able to build sporting leagues or youth programming in the systems they created to accommodate the games?” he asks. “The aftermath of the games will be particularly interesting for me to study.”

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Comparison of urban climate change adaptation plans in selected european cities from a legal and spatial perspective.

1. Introduction

• compare solutions between more vulnerable countries and less vulnerable ones [ 16 ];
• contrast approaches in Western European and Central and Eastern European countries [ 17 ].
• Does the content of municipal climate change adaptation plans align with the diagnosis of climate challenges at a broader geographical level and with the scientific discourse?
• How can/do legal and institutional conditions determine the effectiveness of implementing these plans?
• How do provisions within these plans translate into urban spatial planning?

2. Literature Review

• The critical links between urban planning and climate challenges;
• The way city authorities should respond to such challenges institutionally;
• What is the relevance of urban climate change adaptation plans against this background?
• Protecting green open spaces [ 19 , 20 , 21 ];
• Shaping green infrastructure [ 22 , 23 ];
• Expanding environmental protection [ 24 , 25 ];
• Protection against weather hazards [ 26 , 27 , 28 ];
• Water management [ 29 , 30 , 31 ].
• Identify the challenges and aims for climate change adaptation in cities;
• Ensure a holistic view of these goals and challenges, especially from a cross-sectoral policy perspective;
• Provide an opportunity for flexible action, based on in-depth expert analyses.
• Sanchez-Plaza et al. [ 51 ] emphasize the importance of thoroughly evaluating the findings of climate change adaptation plans. Jung et al. [ 52 ] explicitly point out the need for spot-checking the assumptions made in such plans [ 53 ].
• On the other hand, Lee et al. [ 54 ] stress the need for climate change adaptation plans to be based on in-depth, interdisciplinary studies. According to these authors, such studies will facilitate the evaluation of a plan’s provisions.
• spatial plans also include development parameters (building height, building intensity, etc.). Moreover, these parameters can block or enable certain developments [ 74 , 75 ]. In addition, there is a need to include less frequently used parameters in the plans, e.g., forcing the planting of trees or the use of green roofs.
• Facilitate investments in renewable energy sources [ 76 , 77 , 78 , 79 ];
• Prepare areas for the implementation of green infrastructure and in various other ways extend the range of green areas in cities (parks, green roofs, etc.), enabling the widest possible protection of nature in cities [ 80 , 81 , 82 ];
• Set aside space for climate shelters or emergency areas (in the context of sudden weather changes).

3. Materials and Methods

• They are states located in different parts of the same continent. This gives a certain coherence to their legal, political, and social features (manifested, among other things, by the fact that all of them are members of the European Union).
• Despite this consistency, there are also significant differences between them. Spain is a Western European country, Poland is a Central Eastern European country, and Greece is a Southern European country. The differences lie both in the levels of climate challenges and with the approaches to public policies [ 18 ]. Undoubtedly, it is interesting and necessary to compare public policy responses in these countries, especially when studying urban climate change adaptation plans. The countries studied also have varying gross domestic product, with Spain having the highest and Greece the lowest [ 83 ].
• The climate challenges for Athens are extreme heat, urban heat island, energy consumption in municipal buildings and facilities, transportation, densely packed neighborhoods, and pollution—traffic congestion [ 57 ];
• The climate challenges for Barcelona are the need for a reduction in traffic and its emissions, the loss of thermal comfort (especially in summer), the increase in heavy rains, and the increase in the intensity of droughts and problems with urban water supply [ 84 , 85 ];
• The climate challenges for Warsaw include sudden weather changes and the progressive development of the urban heat island effect [ 26 , 86 ];
• It provides insight into how adaptation plans operate in countries with diverse climates and social attitudes towards climate challenges. It also allows for an examination of whether the level of climate risks and societal attitudes impact the use of such plans.
• Additionally, it offers the opportunity to investigate how adaptation plans work in different parts of Europe, considering their varying institutional characteristics.
• In the first step, the team created a questionnaire with common questions about climate challenges and municipal climate change plans (the question sheet can be found at the end of the article). It was based on insights gained from the literature and the previous studies conducted by the authors. The questions were directed to the co-authors—national experts in the field of urban planning and climate challenges in the countries studied (questionnaires were not directed to other people who were not co-authors of the article). The questions from the questionnaire were adapted to the research questions in the article.
• In a second step, representatives of each surveyed country or city answered all questions. It is important to note here that the authors specialize in the national climatic and spatial conditions of these countries.
• In the third step, the team compared responses from each country’s representatives and organized them into a table. The answers were carefully reviewed by all authors. This step was essential to ensure that the diverse land use planning legislation, policies, and administrative structures across the three countries did not hinder the comparability of results. It also made the subsequent analysis clearer and more straightforward.
• In the final and fourth step, the results were aggregated in tabular form (see Table 1 , Table 2 , Table 3 and Table 4 ). The development of these tables was crucial for organizing the information collected in the questionnaire, and it became the basis for preparing the results and writing the Discussion and Conclusions sections.

4.1. Climate Challenges from the Perspective of the Central Documents of the Studied Countries

4.2. legal conditions for the adoption and content of municipal climate change adaptation plans in the countries studied.

4.3. Linking Climate Change Adaptation Plans with Spatial Planning

• They refer to particularly important areas (irrespective of administrative boundaries), which require special regulations;
• Their regulations are implemented swiftly;
• Previously adopted Local Urban Plans need to be adapted to their content.

4.4. Effectiveness of Municipal Climate Change Adaptation Plans

5. discussion, 5.1. key topics addressed in the article.

• Considering supra-local guidelines, particularly those outlined in national strategic documents;
• The legal features of climate change adaptation plans;
• The way and extent to which climate change adaptation plans relate to spatial planning;
• Verifying the potential and actual implementation of climate change adaptation plan provisions, as well as evaluating the implementation process.

5.2. Linking the Content of Surveyed Climate Change Adaptation Plans to Climate Challenges and a Characterization of the Legal Considerations for the Plans

• The details of provisions: Plans cannot be too general and fragmented, like in Warsaw (see Table 2 ). On the one hand, they should set general objectives (linked to the national level); however, these objectives must be translated into detailed, specific guidelines (something done well in Athens). It is also worth highlighting the example of Barcelona, where the guideline plan is formulated to lend itself to rapid evaluation.
• The mechanisms for evaluating provisions: Here, defining them as an obligation for public authorities (public participation included) provides an opportunity for more effective implementation. The literature underscores the importance of ongoing evaluation when implementing climate change adaptation plans. The examples of Barcelona and Athens (see Table 2 ) validate the relevance of this requirement in certain planning contexts. Conversely, the limited evaluation processes in Warsaw highlight that overlooking this aspect can lead to substantial difficulties in implementing climate change adaptation strategies in cities.
• The link between climate change adaptation plans and spatial planning: A major prerequisite for successfully implementing climate change adaptation plans is aligning spatial planning instruments with them. This issue is associated with the third research question, which examines how climate change adaptation objectives intersect with urban spatial policies. This analysis is detailed in Table 3 and Table 4 , which relate climate objectives to urban spatial policies. Countries like Greece and Spain offer two possible approaches: integrating climate guidelines into existing statutory instruments or developing dedicated ‘climate-spatial’ instruments for quicker and more adaptable responses. Adaptation plans should also incorporate specific directives for spatial planning, with the Barcelona plan serving as a notable illustration of this integration.

5.3. Links between Climate Change Adaptation Plans and Spatial Planning Instruments

5.4. limitations of the study.

• Verifying features of climate change adaptation plans in other countries. This comparison seems justified, and the article highlights critical criteria in this respect;
• Considering the possibility of compiling and comparing other acts concerning climate in individual countries. This comparison should also include the regional perspective;
• Identifying “climate-spatial” demands (the example of Barcelona seems most inspiring in this respect) and developing a comprehensive European catalog.

6. Conclusions

• Climate change adaptation plans in Athens and Barcelona are prepared more ambitiously and in a more systemically thought-out manner than the plan for Warsaw. However, in Poland, the government is currently considering changing the regulations on climate change adaptation plans (and taking into account solutions from other countries);
• When translating the content of adaptation plans into the spatial sphere, the solutions are more in-depth in the Spanish and Greek systems (which, of course, does not exclude the possibility of further partial revisions).

Author Contributions

Institutional review board statement, informed consent statement, data availability statement, conflicts of interest.

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Nowak, M.J.; Bera, M.; Lazoglou, M.; Olcina-Cantos, J.; Vagiona, D.G.; Monteiro, R.; Mitrea, A. Comparison of Urban Climate Change Adaptation Plans in Selected European Cities from a Legal and Spatial Perspective. Sustainability 2024 , 16 , 6327. https://doi.org/10.3390/su16156327

Nowak MJ, Bera M, Lazoglou M, Olcina-Cantos J, Vagiona DG, Monteiro R, Mitrea A. Comparison of Urban Climate Change Adaptation Plans in Selected European Cities from a Legal and Spatial Perspective. Sustainability . 2024; 16(15):6327. https://doi.org/10.3390/su16156327

Nowak, Maciej J., Milena Bera, Miltiades Lazoglou, Jorge Olcina-Cantos, Dimitra G. Vagiona, Renato Monteiro, and Andrei Mitrea. 2024. "Comparison of Urban Climate Change Adaptation Plans in Selected European Cities from a Legal and Spatial Perspective" Sustainability 16, no. 15: 6327. https://doi.org/10.3390/su16156327

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• Open access
• Published: 17 July 2024

Experiences and challenges of acute coronary syndrome patients in care provision: a qualitative systematic review

• Daniel Ameen   ORCID: orcid.org/0000-0003-4852-6549 1 ,
• Kate Kynoch 2 &
• Hanan Khalil   ORCID: orcid.org/0000-0002-3302-2009 3  

Systematic Reviews volume  13 , Article number:  184 ( 2024 ) Cite this article

126 Accesses

Metrics details

Coronary artery disease including acute coronary syndrome (ACS) constitutes the most common cause of death in people with cardiovascular disease. Prompt diagnosis and early initiation of treatment significantly impact on patient outcomes. Positive patient experience with their initial care is linked to positive clinical outcomes.

This qualitative review aimed to investigate patients’ experience of care provision and the challenges faced by them during their different stages of care following an ACS.

Searches of four databases - MEDLINE, Embase, CINAHL and PsychINFO - were conducted from inception until July 13, 2022, and were limited to English-language publications. Assessment of methodological quality of studies was performed using the Jonna Briggs Institute (JBI) qualitative assessment and review instrument. Data were extracted using the standardised data extraction tool from JBI. Data synthesis following the JBI approach of meta-aggregation was performed. The level of confidence for each synthesised finding was established based on ConQual.

Overall, from 578 records, 10 studies were included with 39 findings extracted from the included studies. The main synthesised findings were the need to provide tailored information and appropriate management at different stages of care, and that timely management and trust in health care workers are associated with greater patient satisfaction and more positive experiences.

Patients with an ACS experience many challenges during different stages of their care. Clinicians should be aware of the challenges they face and provide tailored information to patients that is appropriate for their different stages of management in order to best optimise patient experience and improve patient outcomes.

Peer Review reports

Introduction

Ischaemic heart disease is associated with the highest comorbidity and mortality globally and account for more than 35% of world-wide death [ 1 ]. Moreover, according to a recent report published by the World Health Organization, 17.9 million people died in 2019 of ischaemic heart disease [ 2 ]. Acute coronary syndrome (ACS), a subset of ischaemic heart disease, describes any condition resulting in an acute disruption of blood flow to the myocardium, potentially resulting in tissue death. ACS constitutes the most common cause of death in people with cardiovascular disease [ 1 ]. Successful management of ACS depends on many factors including prompt diagnosis and early initiation of treatment which may vary significantly due to staffing, resources, adequacy of pain management and hospital environment [ 3 ].

Patient experience and patient satisfaction, while distinct concepts, are closely linked within healthcare and are well recognised and reported indicators for assessing the quality of healthcare [ 4 ]. Patient satisfaction is an outcome measure that impacts directly on a patient’s experience with a healthcare organisation [ 4 ]. Many healthcare providers regard patient experience as a core component of healthcare quality.

Following an ACS, patients’ needs evolve during their care depending on their individual experience, plan of care and the complexity of their condition [ 4 , 5 ]. Studies have explored patient experience following a cardiac event to gain a deeper understanding of the needs and challenges faced by these patients. Several published studies have found that higher patient satisfaction with their management and care was associated with positive clinical outcomes, increased patient safety, and better use of hospital resources [ 6 , 7 , 8 ]. Further research also suggests that other factors such as patients’ expectations, characteristics, understanding of the health care system and the broader society are also contributing factors to their satisfaction and overall experience of their care [ 9 ].

To date, several studies have been published exploring patients’ satisfaction and overall experience with their care and management following an ACS [ 8 , 9 , 10 , 11 , 12 ]. These studies also report on the challenges and barriers patients face during their healthcare journey [ 10 , 11 , 12 , 13 , 14 ]. Healthcare staff can respond to patients' concerns which may result in increased patient satisfaction and an overall positive experience with their care leading to improved health outcomes [ 9 ]. This systematic review investigated patients’ experience of care provision and the challenges faced by them during their different stages of care when experiencing an ACS.

Materials and methods

The review was conducted in accordance with guidance from JBI methodology for systematic reviews of qualitative evidence [ 15 ]. This review was conducted according to a priori protocol registered and published in PROSPERO (CRD42022346910).

Inclusion criteria

Types of participants.

Patients admitted to hospital, regardless of age, due to an ACS (includes unstable angina, non-ST elevation myocardial infarction (NSTEMI), ST elevation myocardial infarction (STEMI))

Patients reported on their experience with the care they were provided in an inpatient setting

Phenomenon of interest

The phenomena of interest for this review were the experiences with the provision of care provided and any challenged faced by them after an acute coronary syndrome.

The context for this review was settings where patients received their initial healthcare following an ACS including their management in hospitals as an inpatient.

Types of studies

The review considered qualitative studies including, but not limited to, designs such as phenomenology, grounded theory and ethnography.

Patient and public involvement

No patient was involved in the design, planning and conception of this study.

Search strategy

The search strategy aimed to find both published and unpublished grey literature. A three-step search strategy was undertaken in this review. An initial limited search of MEDLINE was conducted and followed by analysis of the text words contained in the title and abstract and of the index terms used to describe an article. A second search using all identified keywords and index terms was undertaken across all included databases. We matched the keywords, MeSH terms and thesaurus results related to the concepts of myocardial infarction or ST elevation myocardial infarction or non-ST elevation myocardial infarction or acute coronary syndrome, patients’ experience or satisfaction and health care or medical care or acute care or hospital care or primary care or healthcare services in each database. The full search strategies are provided in Supplementary material. Finally, the reference lists of included articles were hand searched for additional studies. The timeframe for included studies was from the inception of all databases until 13th July 2022. Due to lack of translation resources, only studies published in English language were included.

Information sources

The following databases were searched: MEDLINE, Embase, CINAHL and PsycINFO. The search for grey literature was undertaken in Google Scholar.

Study selection

Following the search, all identified citations were collated and uploaded into EndNote (Version X9 (Clarivate Analytics, PA, USA), The duplicated citations were removed. Two independent reviewers (DA and HK) screened the title and abstract of each paper against the review’s inclusion criteria. Studies identified as potentially eligible or those without an abstract were retrieved for full-text review, and their details were imported into the JBI System for the Unified Management, Assessment and Review of Information (JBI SUMARI) [ 16 ]. Full texts that did not meet the review inclusion criteria were excluded. Any disagreements between the two reviewers were resolved through discussion.

Assessment of methodological quality

Qualitative papers selected for inclusion were assessed by two independent reviewers (DA and HK) according to the 10-item checklist for qualitative research from Lockwood et al. (see Appendix 1 for checklist) [ 15 ]. The assessment evaluated methodology and philosophical perspective of the research, the research objectives, the methods used to collect data, analysis of data and the interpretation of results, if a statement of the influence of the researcher on the research was included and representation of the participants voices. All items were scored as either ‘yes’, ‘no’ or ‘unclear’ All papers were included in the review regardless of methodological quality. Any disagreements that arose between the reviewers were resolved through discussion.

Data extraction

Two reviewers (DA and HK) independently extracted data from papers by using the standardised data extraction tool from JBI SUMARI. The extracted data included specific details about the study population, context, culture, geographical location, study methods and the phenomena of interest relevant to the review question (i.e. experiences of MI patients during provision of care and challenges faced by them). Findings and their illustrations were extracted and assigned a level of credibility [ 15 ].

Data synthesis

Qualitative research findings were aggregated in JBI SUMARI using a meta-aggregation approach. The process to synthesise followed a three-step approach. First, individual extracted study findings were rated as either unequivocal (evidence beyond reasonable doubt), credible (contains illustrations that may be challenged) or unsupported (when findings were not supported) [ 15 , 17 ]. Second, findings of all included studies were extracted and categorised to create a set of categories representing meaningful similarities. Third, similar categories were further synthesised to obtain a comprehensive set of synthesised findings, which were used to develop evidence-based recommendations for practice. Two reviewers independently extracted findings, compared the generated categories and discussed discrepancies until reaching agreement.

Assessing certainty in the finding

The final findings were graded according to the ConQual approach for establishing confidence in the output of research synthesis and presented in a summary of findings [ 17 ]. The ConQual process was used to analyse the level of confidence or trust that exists in the value and level of evidence of each synthesised finding as shown in Supplementary material 1 .

Review results were reported in accordance with the ‘Enhancing Transparency in Reporting the Synthesis of Qualitative Research’ statement, which consists of 21 items and is appropriate for qualitative evidence synthesis (Supplementary file, Appendix 1 ).

Study inclusion

The search strategy yielded 578 studies from MEDLINE, Embase, CINAHL and PsycINFO. A total of 14 articles were removed as they were duplicates which left 564 studies that were imported to JBI SUMARI. These studies were screened for eligibility by titles and abstracts, and 519 studies were excluded as they were not relevant to the topic. The remaining 45 studies were subject to further detailed assessment by examining the full text; 35 studies were excluded for reasons such as wrong phenomenon of interest, population, setting and/or study design. Overall, 10 studies were included in the review as shown in the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) flow chart in Fig.  1 .

PRISMA chart flow diagram for inclusion of studies

Methodological quality

From the assessment method of methodological quality, criteria 1, 3, 4 and 5 are all associated with the philosophical perspective, and congruity between the research methodology and methods used and the representation of analysis of the results were present in 8 of the 10 included studies except for O’Keefe et al. (2014) and Radcliff et al. (2009) as shown in Table  1 [ 11 , 13 ]. Congruity between the research methodology and the research question in criteria 2 was present in all studies but two [ 11 , 13 ]. In criteria 6, a statement locating the researcher culturally and theoretically was not included in three studies [ 10 , 11 , 18 ]. Criteria 7 examined the influence of the researcher on the research was addressed in all studies but one [ 11 ]. Additionally, the assessment of criteria 8 which relates to the representation of the participants voices was addressed in all the studies. Criteria 9 addressed ethics approval which were met in all the included studies. Finally, criteria 10 was associated with congruity between the study conclusion and the analysis and interpretation of the results which was present in all studies.

Characteristics of included studies

The studies included in the review were published between 2008 and 2020, and all of them were from developed countries including the UK, Canada, Denmark, Sweden, Norway, Germany, and Australia. The participants included in the studies were patients who experienced an ACS and a hospital admission as a result of their illness. Patients age ranged between 35 and 80 years old. The sample size of the participants in the individual studies ranged from 4 to 41. A range of qualitative methodologies were used including semi-structured interviews and focus groups. The main phenomenon of interest across the studies was patient’s experience with their treatment following an ACS and management of their symptoms by health-care professionals. Some studies were specific to a particular procedure or aspect of the management of ACS such as angioplasty [ 13 ], pain management [ 11 ] and the remainder of the studies focused on the patients’ overall care experience. The setting of all studies were all metropolitan hospitals with one study set in a rural emergency department setting [ 11 ]. The characteristics of all included studies can be found in Table  2 .

Review findings

From the 10 included studies, 39 findings were extracted. Of these 39 findings, 26 were considered credible evidence, with the remaining 13 assigned as unequivocal evidence. All findings were further assigned to six categories based on their similarity. The categories were trust and professionalism, time taken for treatment, positive outcomes, being informed, evolving nature of decision-making and stressors during treatment. These six categories were then further combined through meta-aggregation into two overarching synthesised findings. The extracted findings for each study are shown in Appendix 1 . The two synthesised findings were as follows: (1) the need to provide tailored information and appropriate management at different stages of care and (2) timely management and trust in health care workers are associated with patient satisfaction. A full overview of the findings linked to categories and synthesised findings can be seen in Figs. 2 and 3 .

Synthesised findings 1

Synthesised findings 2

Synthesised findings 1: The need to provide tailored information and appropriate management at different stages of care

This synthesised finding was generated from the aggregation of three categories, underpinned by 29 extracted findings. The three categories were ‘being informed’, ‘evolving nature of decision making’ and ‘stressors during treatment’. Overall, patients felt stressed during their admission and were overwhelmed with the amount of information being related to them during their stay in hospital. They also appreciated receiving adequate information during their treatment, provided it is appropriate for each stage of their management. The first category ‘being informed’ is derived from 16 findings [ 9 , 10 , 11 , 12 , 13 , 18 , 19 , 20 , 21 , 22 , 23 ]. These findings related to the provision of tailored information. Some of the findings were related to lack of verbal communication in the acute phase, and others were related to fear, anxiety and their expectations of the treatment and the need to know about the plan of their rehabilitation and the information needed to ensure their continuity of care. The second category ‘evolving nature of decision making’ was derived from eight findings [ 13 , 18 , 19 , 20 , 22 ]. These findings were related to some patients feeling that the treatment was being done for them rather than with them. Some patients felt too sick and were incapable of making decisions. The third category ‘stressors during treatment’ was derived from five findings [ 12 , 13 , 23 ]. These findings were related to the stressful environment of the emergency department, the pain and anxiety during manual examination and the procedures patients were undergoing.

Synthesised findings 2: Timely management and trust in health care workers are associated with patient satisfaction

This synthesised finding was generated from the aggregation of three categories, underpinned by 10 extracted findings. These three categories were ‘trust and professionalism’, ‘time taken for treatment’ and ‘positive outcomes’. Overall, patients’ satisfaction was dependent on health care professionals showing compassion, care, time spent with patients, professionalism and the positive outcomes they are experiencing as a result of their management. The first category ‘trust and professionalism’ was derived from four categories related to efficiency, professionalism, compassion and trust [ 18 , 21 ]. These findings capture the appreciation that patients have towards health care professionals when patients feel that they are cared for.

The second category ‘time taken for treatment’ is derived from two findings related to the speed of events and the efficiency of management which results in a dramatic recovery [ 10 , 14 ]. This category captures how patients appreciate the time taken to be managed efficiently by the health care team.

The third category ‘positive outcomes’ is derived from four findings related to positive experiences, positive voices and patients feeling fixed [ 12 , 13 , 14 , 23 ]. These findings capture the positive feelings associated with being well and getting better.

This systematic review detailed patients’ experience and perception with healthcare provision following an ACS. Overall, there were two main synthesised findings generated from the included studies. Firstly, that patients appreciate tailored information being provided during the different stages of care as well as being involved in their management and decisions regarding their care. This includes not only during their initial admission and treatment phase but also for longer term after discharge to ensure continuity of care [ 22 , 24 , 25 ]. The second synthesised finding related to the trust, care, professionalism and time spent with them by the health professionals responding to their needs. This finding highlights the enormous stress patients experience following their initial hospital admission as well as the changing nature of their condition over time. These two findings can be broadly categorised as factors related to the health care professional and the hospital culture [ 7 ]. The professional and personal characteristics of health care professionals included the trust, compassion, knowledge and professionalism that were valued by the patients. The hospital culture included factors such as the efficiency of the system, the information provided to patients and the shared decision-making process employed by the team in managing the patients [ 26 , 27 , 28 ].

Understanding the challenges and needs faced by patients after an ACS, particularly during their hospital admission, is essential to determine the most appropriate patient-centred management plan for each individual patient [ 18 ]. Patient centred and individualised care can improve patient satisfaction and impact on overall patient experience which is important to both health care providers and service providers [ 29 ]. This in turn can contribute to improved care and reduce medical burden and unnecessary treatment [ 29 ]. The provision of hospital service quality is associated with patient satisfaction [ 30 ]. Swain and Kar (2018) identified six main areas through which patients perceive quality of service in hospitals. These included staff attitude, personalised attention, information availability, staff competency, trustworthiness and waiting time as essential to their overall satisfaction with the care they receive [ 31 ]. These areas are important for patients when considering that they are receiving good quality care from a health service provider.

The findings of this review are consistent with other studies investigating patients’ experience and satisfaction with their care. In one study in Singapore, authors undertook an integrative review including both quantitative and qualitative studies and found that patients’ experience and satisfaction were dependent on nurses caring behaviour and the amount of information provided to patients by them for their management [ 32 ]. The authors also found that patients appreciated prompt responses to their needs and appreciated technical information given to them [ 32 ].

Another quantitative systematic review found several factors to be contributing to positive patients experience with their care [ 20 ]. These included specific health care provider factors such as their professionalism, competency and interpersonal care. The authors also found that the physical environment the patients are placed in was another contributing factor to their overall experience. Efficacy and the outcome of the care were also identified as strong predictors of patients’ positive experience [ 33 ]. These findings correspond with the findings reported in this review as patients experiencing positive outcomes of their care showed high satisfaction. Targeting educational interventions to support health care professionals’ behaviours towards patient care and highlighting what issues are important to patients are a major determinant of patient satisfaction [ 12 ]. As for health service providers, initiating policies and guidelines aiming at involving patients in their decision-making and ensuring the provision of timely management to patients is also another important determinant of patient satisfaction with their care [ 10 , 23 ].

This review highlights several important implications for future clinical practice. Clinicans should be aware and carefully consider the delivery of appropiate information to patients during their care and patient involvement in their own management. Additionally, clinicans should aim to create an enviroment of trust and professionalism, where they aim to respond to patients’ needs and concerns in a timely and efficient manner.

A limitation of this review is that the findings may not be generalisable to all countries as all the included studies were undertaken in western countries. Other countries may experience different challenges not mentioned in the included studies. Further research on this topic is needed in non-Western countries.

Conclusions

Patients with acute coronary syndrome experience many challenges during their health care journey. This review has found that patients need tailored information given that is appropriate for their different stages of management. In addition, patients appreciate and want to be involved in their care and be part of the decision-making process. Health care professionals should make time to identify and address patient needs which will result in increased patient satisfaction and a positive patient experience.

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Supplementary Material 1. Search strategy. Database. CINAHL search strategy. JBI Critical Appraisal Checklist for Qualitative Research. Table 1 Summary of the Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement. Table 2. List of Study Findings with Illustrations U-unequivocal, C-credible.

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Ameen, D., Kynoch, K. & Khalil, H. Experiences and challenges of acute coronary syndrome patients in care provision: a qualitative systematic review. Syst Rev 13 , 184 (2024). https://doi.org/10.1186/s13643-024-02578-1

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Organizing Your Social Sciences Research Paper: Writing a Case Study

• Purpose of Guide
• Design Flaws to Avoid
• Independent and Dependent Variables
• Glossary of Research Terms
• Narrowing a Topic Idea
• Broadening a Topic Idea
• Extending the Timeliness of a Topic Idea
• Academic Writing Style
• Choosing a Title
• Making an Outline
• Paragraph Development
• Executive Summary
• The C.A.R.S. Model
• Background Information
• The Research Problem/Question
• Theoretical Framework
• Citation Tracking
• Content Alert Services
• Evaluating Sources
• Reading Research Effectively
• Primary Sources
• Secondary Sources
• Tiertiary Sources
• What Is Scholarly vs. Popular?
• Qualitative Methods
• Quantitative Methods
• Using Non-Textual Elements
• Limitations of the Study
• Common Grammar Mistakes
• Writing Concisely
• Avoiding Plagiarism
• Footnotes or Endnotes?
• Further Readings
• Annotated Bibliography
• Dealing with Nervousness
• Using Visual Aids
• Grading Someone Else's Paper
• Types of Structured Group Activities
• Group Project Survival Skills
• Multiple Book Review Essay
• Reviewing Collected Essays
• Writing a Case Study
• About Informed Consent
• Writing Field Notes
• Writing a Policy Memo
• Writing a Research Proposal
• Bibliography

The term case study refers to both a method of analysis and a specific research design for examining a problem, both of which are used in most circumstances to generalize across populations. This tab focuses on the latter--how to design and organize a research paper in the social sciences that analyzes a specific case.

A case study research paper examines a person, place, event, 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 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 among more than two 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 this writing guide. Review this page because it may help you identify a subject of analysis that can be investigated using a single 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:

• Does the case represent 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.
• Does the case provide 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.
• Does the case challenge and offer 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 practice. A case may offer you 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 the study a case in order 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.
• Does the case provide 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 in order to better warn drivers of an approaching train, particularly when visibility is hindered by heavy rain, fog, or at night.
• Does the case offer a new direction in future research? A case study can be used as a tool for exploratory research that points to a need for further examination of the research 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 Uganda. A case study of how women contribute to saving water in a particular village 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 throughout rural regions of east Africa. The case could also point to the need for scholars to apply 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 was I studying? Describe the research problem and describe the subject of analysis 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 was 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 research 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 include 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 study 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 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 the context of explaining the relevance of the case in addressing the research problem.

III.  Method

In this section, you explain why you selected a particular subject of analysis to study 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 frames 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; c) what were the consequences of the event.

If your subject of analysis is a person. Explain why you selected this particular individual to be studied and describe what experience he or she has had that provides 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 his/her 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 him or her 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.

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, cultural, economic, political, etc.], 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, why study 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 reveals 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? How might knowing the suppliers of these trucks from overseas 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 be linked to the findings from the literature review. Be sure to cite any prior studies that helped you determine that the case you chose was appropriate for investigating the research 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 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 more common to combine a description of the findings 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 to 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 It is important to 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 for 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.

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 needs for further research.

The function of your paper's conclusion is to: 1)  restate the main argument supported by the findings from the analysis of your case; 2) clearly state 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 for you 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 and your professor's preferences, the concluding paragraph may contain your final reflections on the evidence presented applied 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 on 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 differently 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.

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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Hallucinating Law: Legal Mistakes with Large Language Models are Pervasive

A new study finds disturbing and pervasive errors among three popular models on a wide range of legal tasks.

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In May of last year, a Manhattan lawyer became famous for all the wrong reasons. He submitted a legal brief generated largely by ChatGPT. And the judge did not take kindly to the submission. Describing “an unprecedented circumstance,” the judge noted that the brief was littered with “bogus judicial decisions . . . bogus quotes and bogus internal citations.” The story of the “ChatGPT lawyer” went viral as a  New York Times story, sparking none other than  Chief Justice John Roberts to lament the role of “hallucinations” of large language models (LLMs) in his annual report on the federal judiciary. 

Yet how prevalent are such legal hallucinations, really? 

The Legal Transformation  

The legal industry is on the cusp of a major transformation, driven by the emergence of LLMs like ChatGPT, PaLM, Claude, and Llama. These advanced models, equipped with billions of parameters, have the ability not only to process but also to generate extensive, authoritative text on a wide range of topics. Their influence is becoming more evident across various aspects of daily life, including their growing use in legal practices. 

A dizzying number of legal technology startups and law firms are now advertising and leveraging LLM-based tools for a variety of tasks, such as sifting through discovery documents to find relevant evidence, crafting detailed legal memoranda and case briefs, and formulating complex litigation strategies. LLM developers proudly claim that their models can pass the bar exam. But a core problem remains: hallucinations, or the tendency of LLMs to produce content that deviates from actual legal facts or well-established legal principles and precedents. 

Until now, the evidence was largely anecdotal as to the extent of legal hallucinations. Yet the legal system also provides a unique window to systematically study the extent and nature of such hallucinations. 

In a  new preprint study by Stanford RegLab and Institute for Human-Centered AI researchers, we demonstrate that legal hallucinations are pervasive and disturbing: hallucination rates range from 69% to 88% in response to specific legal queries for state-of-the-art language models. Moreover, these models often lack self-awareness about their errors and tend to reinforce incorrect legal assumptions and beliefs. These findings raise significant concerns about the reliability of LLMs in legal contexts, underscoring the importance of careful, supervised integration of these AI technologies into legal practice.

The Correlates of Hallucination

Hallucination rates are alarmingly high for a wide range of verifiable legal facts. Yet the unique structure of the U.S. legal system – with its clear delineations of hierarchy and authority – allowed us to also understand how hallucination rates vary along key dimensions. We designed our study by constructing a number of different tasks, ranging from asking models simple things like the author of an opinion to more complex requests like whether two cases are in tension with one another, a key element of legal reasoning. We tested more than 200,000 queries against each of GPT 3.5, Llama 2, and PaLM 2, stratifying along key dimensions. 

First, we found that performance deteriorates when dealing with more complex tasks that require a nuanced understanding of legal issues or interpretation of legal texts. For instance, in a task measuring the precedential relationship between two different cases, most LLMs do no better than random guessing. And in answering queries about a court’s core ruling (or holding), models hallucinate at least 75% of the time. These findings suggest that LLMs are not yet able to perform the kind of legal reasoning that attorneys perform when they assess the precedential relationship between cases—a core objective of legal research.

Second, case law from lower courts, like district courts, is subject to more frequent hallucinations than case law from higher courts like the Supreme Court. This suggests that LLMs may struggle with localized legal knowledge that is often crucial in lower court cases, and calls into doubt claims that LLMs will reduce longstanding access to justice barriers in the United States. 

Third, LLMs show a tendency to perform better with more prominent cases, particularly those in the Supreme Court. Similarly, performance is best in the influential Second and Ninth Circuits, but worst in circuit courts located in the geographic center of the country. These performance differences could be due to certain cases being more frequently cited and discussed, thus being better represented in the training data of these models. 

Fourth, hallucinations are most common among the Supreme Court’s oldest and newest cases, and least common among later 20th century cases. This suggests that LLMs’ peak performance may lag several years behind current legal doctrine, and that LLMs may fail to internalize case law that is very old but still applicable and relevant law. 

Last, different models exhibit varying degrees of accuracy and biases. For example, GPT 3.5 generally outperforms others but shows certain inclinations, like favoring well-known justices or specific types of cases. When asked who authored an opinion, for instance, GPT 3.5 tends to think Justice Joseph Story wrote far more opinions than he actually did. 

Contrafactual Bias

Another critical danger that we unearth is model susceptibility to what we call “contra-factual bias,” namely the tendency to assume that a factual premise in a query is true, even if it is flatly wrong. For instance, if one queried, “Why did Justice Ruth Bader Ginsburg dissent in  Obergefell ?” (the case that affirmed a right to same-sex marriage), a model might fail to second-guess whether Justice Ginsburg in fact dissented. 

This phenomenon is particularly pronounced in language models like GPT 3.5, which often provide credible responses to queries based on false premises, likely due to its instruction-following training. This tendency escalates in complex legal scenarios or when dealing with lower court cases. Llama 2, on the other hand, frequently rejects false premises, but sometimes mistakenly denies the existence of actual cases or justices.

Relatedly, we also show that models are imperfectly calibrated for legal questions. Model calibration captures whether model confidence is correlated with the correctness of answers. We find some divergence across models: PaLM 2 and ChatGPT (GPT 3.5) show better calibration than Llama 2. Yet, a common thread across all models is a tendency towards overconfidence, irrespective of their actual accuracy. This overconfidence is particularly evident in complex tasks and those pertaining to lower courts, where models often overstate their certainty, especially in well-known or high-profile legal areas.

Implications for the Law  

The implications of these findings are serious. Today, there is much excitement that LLMs will democratize access to justice by providing an easy and low-cost way for members of the public to obtain legal advice. But our findings suggest that the current limitations of LLMs pose a risk of further  deepening existing legal inequalities, rather than alleviating them.

Ideally, LLMs would excel at providing localized legal information, effectively correct users on misguided queries, and qualify their responses with appropriate levels of confidence. However, we find that these capabilities are conspicuously lacking in current models. Thus, the risks of using LLMs for legal research are especially high for:

• Litigants in lower courts or in less prominent jurisdictions,
• Individuals seeking detailed or complex legal information,
• Users formulating questions based on incorrect premises, and 
• Those uncertain about the reliability of LLM responses.

In essence, the users who would benefit the most from legal LLM are precisely those who the LLMs are least well-equipped to serve.

There is also a looming risk of LLMs contributing to legal “ monoculture .” Because LLMs tend to limit users to a narrow judicial perspective, they potentially overlook broader nuances and diversity of legal interpretations. This is substantively alarming, but there is also a version of representational harm: LLMs may systematically erase the contributions of one member of the legal community, such as Justice Ginsburg, by misattributing them to another, such as Justice Story. 

Moving Forward with Caution

Much active technical work is ongoing to address hallucinations in LLMs. Yet addressing  legal hallucinations is not merely a technical problem. We suggest that LLMs face fundamental trade-offs in balancing fidelity to training data, accuracy in responding to user prompts, and adherence to real-world legal facts. Thus, minimizing hallucinations ultimately requires normative judgments about which type of behavior is most important, and transparency in these balancing decisions is critical.

While LLMs hold significant potential for legal practice, the limitations we document in our work warrant significant caution. Responsible integration of AI in legal practice will require more iteration, supervision, and human understanding of AI capabilities and limitations. 

In that respect, our findings underscore the centrality of human-centered AI. Responsible AI integration must augment lawyers, clients, and judges and not, as Chief Justice Roberts put it, risk “dehumanizing the law.” 

Matthew Dahl is a J.D./Ph.D. student at Yale University and graduate student affiliate of Stanford RegLab. 

Varun Magesh is a research fellow at Stanford RegLab. 

Mirac Suzgun is a J.D/Ph.D. student in computer science at Stanford University and a graduate student fellow at Stanford RegLab. 

Daniel E. Ho is the William Benjamin Scott and Luna M. Scott Professor of Law, Professor of Political Science, Professor of Computer Science (by courtesy), Senior Fellow at HAI, Senior Fellow at SIEPR, and Director of the RegLab at Stanford University. 

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