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Case Study vs. Experiment: What's the Difference?

case study v experiment

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Comparison chart, generalization, preferred fields, case study and experiment definitions, when is a case study used, what is an experiment, how do case studies gather data, can case studies be generalized, what fields commonly use case studies, what type of data do experiments produce, can a case study include quantitative data, what is a case study, what is the main purpose of an experiment, is bias a concern in case studies, are experiments replicable, in which fields are experiments predominant, how do experiments impact scientific knowledge, what is a longitudinal case study, can experiments be conducted in natural settings, what is the role of control in experiments, how long can a case study last, what ethical considerations are involved in experiments, can case studies be used to test hypotheses, how is replicability ensured in experiments.

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Case Study vs Experiment: Know the Difference

case study v experiment

A case study and experiment are the two prominent approaches often used at the forefront of scholarly inquiry. While case studies study the complexities of real-life situations, aiming for depth and contextual understanding, experiments seek to uncover causal relationships through controlled manipulation and observation. Both these research methods are indispensable tools in understanding phenomena, yet they diverge significantly in their approaches, aims, and applications.

In this article, we’ll unpack the key differences between case studies and experiments, exploring their strengths, limitations, and the unique insights they offer when working with quantitative data. In the meantime, feel free to use our specialized case study writing service if you seek to streamline your efforts when handling this academic task.

What Is a Case Study?

A case study is a research method that involves an in-depth examination of a particular individual, group, event, or phenomenon within its real-life context. It aims to provide a detailed and comprehensive analysis of the subject under investigation, often using multiple data sources such as interviews, observations, documents, and archival records.

The case study method is used in psychology, sociology, anthropology, education, and business to explore complex issues, understand unique situations, and generate rich, contextualized insights. They allow scholars to explore the intricacies of real-world phenomena, uncovering patterns, relationships, and underlying factors in social sciences that may not be readily apparent through other research methods.

Overall, case studies offer a holistic and nuanced understanding of the subject of interest, facilitating deeper exploration and interpretation of complex social and human phenomena. If you’re struggling with this assignment, simply say, ‘ write my case study for me ,’ and our experts will help you promptly.

What Is an Experiment?

Compared to the case study method, an experiment investigates cause-and-effect relationships by systematically manipulating one or more variables and observing the effects on other variables. In an experiment, students aim to establish causal relationships between an independent variable (the factors being manipulated) and a dependent variable (the outcomes being measured).

Experiments are characterized by their controlled and systematic approach, often involving the random assignment of participants to different experimental conditions to minimize bias and ensure the validity of the findings. They are commonly used in such fields of social sciences as psychology, biology, physics, and medicine to test hypotheses, identify causal mechanisms, and provide empirical evidence for theories.

An experiment method allows scholars to establish causal relationships with high confidence, providing valuable insights into the underlying mechanisms of behavior, natural phenomena, and social processes. Other research methods include:

  • Survey method: Collects research data from individuals through questionnaires or interviews to gather information about attitudes, opinions, behaviors, and characteristics of a population.
  • Observation method: Systematically observes and records behavior, events, or phenomena as they naturally occur in real-life settings to study social interactions, environmental factors, or naturalistic behavior.
  • Qualitative and quantitative research method: Qualitative research explores meanings, perceptions, and experiences using interviews or content analysis, while quantitative research analyzes numerical data to test hypotheses or identify patterns and relationships.
  • Archival research method: Analyzes existing documents, records, or data sources such as historical documents or organizational archives to investigate trends, patterns, or historical events.
  • Action research method: Involves collaboration between scholars and practitioners to identify and address practical problems or challenges within specific organizational or community contexts, aiming to generate actionable knowledge and facilitate positive change.

case study v experiment

Difference Between Case Study and Experiment

Case study and experiment definitions.

A case study method involves a deep investigation into a specific individual, group, event, or phenomenon within its real-life context, aiming to provide rich and detailed insights into complex issues. Learners gather research data from multiple sources, such as interviews, observations, documents, and archival records, to comprehensively understand the subject under study.

Case studies are particularly useful for exploring unique or rare phenomena, offering a holistic view that captures the intricacies and nuances of the situation. However, findings from case studies may be challenging to generalize to broader populations due to the specificity of the case and the lack of experimental control. To learn more about how to write a case study , please refer to our guide.

An experiment is a research method that systematically manipulates one or more variables to observe their effects on other variables, aiming to establish cause-and-effect relationships under controlled conditions. Researchers design experiments with high control over variables, often using standardized procedures and quantitative measures for research data collection.

Experiments are well-suited for testing hypotheses and identifying causal relationships in controlled environments, allowing educatees to conclude the effects of specific interventions or manipulations. However, experiments may lack the depth and contextual richness of case studies, and findings are typically limited to the specific conditions of the experiment.

Case Study and Experiment Characteristic Features

  • In case studies , variables are observed rather than manipulated. Researchers do not typically control variables; instead, they examine how naturally occurring variables interact within the case context.
  • Experiments involve manipulating one or more variables to observe their effects on other variables. Students actively control and manipulate variables to test hypotheses and establish cause-and-effect relationships.
  • Case studies may not always begin with a specific hypothesis. Instead, researchers often seek to generate hypotheses based on the data collected during the study.
  • Experiments are typically conducted to test specific hypotheses. Researchers formulate a hypothesis based on existing theory or observations, and the experiment is designed to confirm or refute this hypothesis.

Case Study vs Experiment

Manipulating Variables

  • Variables are not manipulated in case studies . Instead, researchers observe and analyze how naturally occurring variables influence the phenomenon of interest.
  • In experiments , researchers actively manipulate one independent or dependent variable or more to observe their effects on other variables. This manipulation allows researchers to establish causal relationships between variables.
  • Case studies often involve collecting qualitative data from multiple sources, such as interviews, observations, documents, and archival records. Researchers analyze this research data to provide a detailed and contextualized understanding of the case.
  • Experiments typically involve the collection of quantitative data using standardized procedures and measures. Researchers use statistical analysis to interpret the research data and draw conclusions about the effects of the manipulated variables.

Areas of Implementation

  • Case studies are widely used in social sciences, such as psychology, sociology, anthropology, education, and business, to explore complex issues, understand unique situations, and generate rich, contextualized insights.
  • Experiments are common in fields such as psychology, biology, physics, and medicine, where researchers seek to test hypotheses, identify causal mechanisms, and provide empirical evidence for theories through controlled manipulation and observation.

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case study v experiment

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

case study v experiment

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

Research question

  • Conceptual framework
  • Conceptual vs. theoretical framework

Data collection

  • Qualitative research methods
  • Focus groups
  • Observational research

What is a case study?

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

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

Case studies

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

case study v experiment

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

Definition of a case study

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

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

Characteristics of case studies

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

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

The role of case studies in research

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

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

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

What is the purpose of a case study?

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

Why use case studies in qualitative research?

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

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

The explanatory, exploratory, and descriptive roles of case studies

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

The impact of case studies on knowledge development

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

case study v experiment

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

Types of case studies

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

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

Exploratory case studies

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

Descriptive case studies

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

Explanatory case studies

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

case study v experiment

Intrinsic, instrumental, and collective case studies

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

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

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

Critical information systems research

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

Health research

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

case study v experiment

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

Asthma research studies

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

Other fields

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

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

case study v experiment

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

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

Propositions

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

Units of analysis

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

Argumentation

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

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

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

Defining the research question

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

Selecting and defining the case

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

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

Developing a detailed case study protocol

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

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

Collecting data

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

Analyzing and interpreting data

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

Writing the case study report

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

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

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

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

Observations

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

Documents and artifacts

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

case study v experiment

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

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

Ensuring the quality of data collection

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

Data analysis

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

Organizing the data

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

Categorizing and coding the data

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

Identifying patterns and themes

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

Interpreting the data

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

Verification of the data

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

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

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

Benefits include the following:

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

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

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

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

case study v experiment

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  • Case Study | Definition, Examples & Methods

Case Study | Definition, Examples & Methods

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

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

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

Table of contents

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Methodology or method? A critical review of qualitative case study reports

Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services ( n= 12), social sciences and anthropology ( n= 7), or methods ( n= 15) case studies. The articles were reviewed using an adapted version of established criteria to determine whether adequate methodological justification was present, and if study aims, methods, and reported findings were consistent with a qualitative case study approach. Findings were grouped into five themes outlining key methodological issues: case study methodology or method, case of something particular and case selection, contextually bound case study, researcher and case interactions and triangulation, and study design inconsistent with methodology reported. Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners.

Case study research is an increasingly popular approach among qualitative researchers (Thomas, 2011 ). Several prominent authors have contributed to methodological developments, which has increased the popularity of case study approaches across disciplines (Creswell, 2013b ; Denzin & Lincoln, 2011b ; Merriam, 2009 ; Ragin & Becker, 1992 ; Stake, 1995 ; Yin, 2009 ). Current qualitative case study approaches are shaped by paradigm, study design, and selection of methods, and, as a result, case studies in the published literature vary. Differences between published case studies can make it difficult for researchers to define and understand case study as a methodology.

Experienced qualitative researchers have identified case study research as a stand-alone qualitative approach (Denzin & Lincoln, 2011b ). Case study research has a level of flexibility that is not readily offered by other qualitative approaches such as grounded theory or phenomenology. Case studies are designed to suit the case and research question and published case studies demonstrate wide diversity in study design. There are two popular case study approaches in qualitative research. The first, proposed by Stake ( 1995 ) and Merriam ( 2009 ), is situated in a social constructivist paradigm, whereas the second, by Yin ( 2012 ), Flyvbjerg ( 2011 ), and Eisenhardt ( 1989 ), approaches case study from a post-positivist viewpoint. Scholarship from both schools of inquiry has contributed to the popularity of case study and development of theoretical frameworks and principles that characterize the methodology.

The diversity of case studies reported in the published literature, and on-going debates about credibility and the use of case study in qualitative research practice, suggests that differences in perspectives on case study methodology may prevent researchers from developing a mutual understanding of practice and rigour. In addition, discussion about case study limitations has led some authors to query whether case study is indeed a methodology (Luck, Jackson, & Usher, 2006 ; Meyer, 2001 ; Thomas, 2010 ; Tight, 2010 ). Methodological discussion of qualitative case study research is timely, and a review is required to analyse and understand how this methodology is applied in the qualitative research literature. The aims of this study were to review methodological descriptions of published qualitative case studies, to review how the case study methodological approach was applied, and to identify issues that need to be addressed by researchers, editors, and reviewers. An outline of the current definitions of case study and an overview of the issues proposed in the qualitative methodological literature are provided to set the scene for the review.

Definitions of qualitative case study research

Case study research is an investigation and analysis of a single or collective case, intended to capture the complexity of the object of study (Stake, 1995 ). Qualitative case study research, as described by Stake ( 1995 ), draws together “naturalistic, holistic, ethnographic, phenomenological, and biographic research methods” in a bricoleur design, or in his words, “a palette of methods” (Stake, 1995 , pp. xi–xii). Case study methodology maintains deep connections to core values and intentions and is “particularistic, descriptive and heuristic” (Merriam, 2009 , p. 46).

As a study design, case study is defined by interest in individual cases rather than the methods of inquiry used. The selection of methods is informed by researcher and case intuition and makes use of naturally occurring sources of knowledge, such as people or observations of interactions that occur in the physical space (Stake, 1998 ). Thomas ( 2011 ) suggested that “analytical eclecticism” is a defining factor (p. 512). Multiple data collection and analysis methods are adopted to further develop and understand the case, shaped by context and emergent data (Stake, 1995 ). This qualitative approach “explores a real-life, contemporary bounded system (a case ) or multiple bounded systems (cases) over time, through detailed, in-depth data collection involving multiple sources of information … and reports a case description and case themes ” (Creswell, 2013b , p. 97). Case study research has been defined by the unit of analysis, the process of study, and the outcome or end product, all essentially the case (Merriam, 2009 ).

The case is an object to be studied for an identified reason that is peculiar or particular. Classification of the case and case selection procedures informs development of the study design and clarifies the research question. Stake ( 1995 ) proposed three types of cases and study design frameworks. These include the intrinsic case, the instrumental case, and the collective instrumental case. The intrinsic case is used to understand the particulars of a single case, rather than what it represents. An instrumental case study provides insight on an issue or is used to refine theory. The case is selected to advance understanding of the object of interest. A collective refers to an instrumental case which is studied as multiple, nested cases, observed in unison, parallel, or sequential order. More than one case can be simultaneously studied; however, each case study is a concentrated, single inquiry, studied holistically in its own entirety (Stake, 1995 , 1998 ).

Researchers who use case study are urged to seek out what is common and what is particular about the case. This involves careful and in-depth consideration of the nature of the case, historical background, physical setting, and other institutional and political contextual factors (Stake, 1998 ). An interpretive or social constructivist approach to qualitative case study research supports a transactional method of inquiry, where the researcher has a personal interaction with the case. The case is developed in a relationship between the researcher and informants, and presented to engage the reader, inviting them to join in this interaction and in case discovery (Stake, 1995 ). A postpositivist approach to case study involves developing a clear case study protocol with careful consideration of validity and potential bias, which might involve an exploratory or pilot phase, and ensures that all elements of the case are measured and adequately described (Yin, 2009 , 2012 ).

Current methodological issues in qualitative case study research

The future of qualitative research will be influenced and constructed by the way research is conducted, and by what is reviewed and published in academic journals (Morse, 2011 ). If case study research is to further develop as a principal qualitative methodological approach, and make a valued contribution to the field of qualitative inquiry, issues related to methodological credibility must be considered. Researchers are required to demonstrate rigour through adequate descriptions of methodological foundations. Case studies published without sufficient detail for the reader to understand the study design, and without rationale for key methodological decisions, may lead to research being interpreted as lacking in quality or credibility (Hallberg, 2013 ; Morse, 2011 ).

There is a level of artistic license that is embraced by qualitative researchers and distinguishes practice, which nurtures creativity, innovation, and reflexivity (Denzin & Lincoln, 2011b ; Morse, 2009 ). Qualitative research is “inherently multimethod” (Denzin & Lincoln, 2011a , p. 5); however, with this creative freedom, it is important for researchers to provide adequate description for methodological justification (Meyer, 2001 ). This includes paradigm and theoretical perspectives that have influenced study design. Without adequate description, study design might not be understood by the reader, and can appear to be dishonest or inaccurate. Reviewers and readers might be confused by the inconsistent or inappropriate terms used to describe case study research approach and methods, and be distracted from important study findings (Sandelowski, 2000 ). This issue extends beyond case study research, and others have noted inconsistencies in reporting of methodology and method by qualitative researchers. Sandelowski ( 2000 , 2010 ) argued for accurate identification of qualitative description as a research approach. She recommended that the selected methodology should be harmonious with the study design, and be reflected in methods and analysis techniques. Similarly, Webb and Kevern ( 2000 ) uncovered inconsistencies in qualitative nursing research with focus group methods, recommending that methodological procedures must cite seminal authors and be applied with respect to the selected theoretical framework. Incorrect labelling using case study might stem from the flexibility in case study design and non-directional character relative to other approaches (Rosenberg & Yates, 2007 ). Methodological integrity is required in design of qualitative studies, including case study, to ensure study rigour and to enhance credibility of the field (Morse, 2011 ).

Case study has been unnecessarily devalued by comparisons with statistical methods (Eisenhardt, 1989 ; Flyvbjerg, 2006 , 2011 ; Jensen & Rodgers, 2001 ; Piekkari, Welch, & Paavilainen, 2009 ; Tight, 2010 ; Yin, 1999 ). It is reputed to be the “the weak sibling” in comparison to other, more rigorous, approaches (Yin, 2009 , p. xiii). Case study is not an inherently comparative approach to research. The objective is not statistical research, and the aim is not to produce outcomes that are generalizable to all populations (Thomas, 2011 ). Comparisons between case study and statistical research do little to advance this qualitative approach, and fail to recognize its inherent value, which can be better understood from the interpretive or social constructionist viewpoint of other authors (Merriam, 2009 ; Stake, 1995 ). Building on discussions relating to “fuzzy” (Bassey, 2001 ), or naturalistic generalizations (Stake, 1978 ), or transference of concepts and theories (Ayres, Kavanaugh, & Knafl, 2003 ; Morse et al., 2011 ) would have more relevance.

Case study research has been used as a catch-all design to justify or add weight to fundamental qualitative descriptive studies that do not fit with other traditional frameworks (Merriam, 2009 ). A case study has been a “convenient label for our research—when we ‘can't think of anything ‘better”—in an attempt to give it [qualitative methodology] some added respectability” (Tight, 2010 , p. 337). Qualitative case study research is a pliable approach (Merriam, 2009 ; Meyer, 2001 ; Stake, 1995 ), and has been likened to a “curious methodological limbo” (Gerring, 2004 , p. 341) or “paradigmatic bridge” (Luck et al., 2006 , p. 104), that is on the borderline between postpositivist and constructionist interpretations. This has resulted in inconsistency in application, which indicates that flexibility comes with limitations (Meyer, 2001 ), and the open nature of case study research might be off-putting to novice researchers (Thomas, 2011 ). The development of a well-(in)formed theoretical framework to guide a case study should improve consistency, rigour, and trust in studies published in qualitative research journals (Meyer, 2001 ).

Assessment of rigour

The purpose of this study was to analyse the methodological descriptions of case studies published in qualitative methods journals. To do this we needed to develop a suitable framework, which used existing, established criteria for appraising qualitative case study research rigour (Creswell, 2013b ; Merriam, 2009 ; Stake, 1995 ). A number of qualitative authors have developed concepts and criteria that are used to determine whether a study is rigorous (Denzin & Lincoln, 2011b ; Lincoln, 1995 ; Sandelowski & Barroso, 2002 ). The criteria proposed by Stake ( 1995 ) provide a framework for readers and reviewers to make judgements regarding case study quality, and identify key characteristics essential for good methodological rigour. Although each of the factors listed in Stake's criteria could enhance the quality of a qualitative research report, in Table I we present an adapted criteria used in this study, which integrates more recent work by Merriam ( 2009 ) and Creswell ( 2013b ). Stake's ( 1995 ) original criteria were separated into two categories. The first list of general criteria is “relevant for all qualitative research.” The second list, “high relevance to qualitative case study research,” was the criteria that we decided had higher relevance to case study research. This second list was the main criteria used to assess the methodological descriptions of the case studies reviewed. The complete table has been preserved so that the reader can determine how the original criteria were adapted.

Framework for assessing quality in qualitative case study research.

Adapted from Stake ( 1995 , p. 131).

Study design

The critical review method described by Grant and Booth ( 2009 ) was used, which is appropriate for the assessment of research quality, and is used for literature analysis to inform research and practice. This type of review goes beyond the mapping and description of scoping or rapid reviews, to include “analysis and conceptual innovation” (Grant & Booth, 2009 , p. 93). A critical review is used to develop existing, or produce new, hypotheses or models. This is different to systematic reviews that answer clinical questions. It is used to evaluate existing research and competing ideas, to provide a “launch pad” for conceptual development and “subsequent testing” (Grant & Booth, 2009 , p. 93).

Qualitative methods journals were located by a search of the 2011 ISI Journal Citation Reports in Social Science, via the database Web of Knowledge (see m.webofknowledge.com). No “qualitative research methods” category existed in the citation reports; therefore, a search of all categories was performed using the term “qualitative.” In Table II , we present the qualitative methods journals located, ranked by impact factor. The highest ranked journals were selected for searching. We acknowledge that the impact factor ranking system might not be the best measure of journal quality (Cheek, Garnham, & Quan, 2006 ); however, this was the most appropriate and accessible method available.

International Journal of Qualitative Studies on Health and Well-being.

Search strategy

In March 2013, searches of the journals, Qualitative Health Research , Qualitative Research , and Qualitative Inquiry were completed to retrieve studies with “case study” in the abstract field. The search was limited to the past 5 years (1 January 2008 to 1 March 2013). The objective was to locate published qualitative case studies suitable for assessment using the adapted criterion. Viewpoints, commentaries, and other article types were excluded from review. Title and abstracts of the 45 retrieved articles were read by the first author, who identified 34 empirical case studies for review. All authors reviewed the 34 studies to confirm selection and categorization. In Table III , we present the 34 case studies grouped by journal, and categorized by research topic, including health sciences, social sciences and anthropology, and methods research. There was a discrepancy in categorization of one article on pedagogy and a new teaching method published in Qualitative Inquiry (Jorrín-Abellán, Rubia-Avi, Anguita-Martínez, Gómez-Sánchez, & Martínez-Mones, 2008 ). Consensus was to allocate to the methods category.

Outcomes of search of qualitative methods journals.

In Table III , the number of studies located, and final numbers selected for review have been reported. Qualitative Health Research published the most empirical case studies ( n= 16). In the health category, there were 12 case studies of health conditions, health services, and health policy issues, all published in Qualitative Health Research . Seven case studies were categorized as social sciences and anthropology research, which combined case study with biography and ethnography methodologies. All three journals published case studies on methods research to illustrate a data collection or analysis technique, methodological procedure, or related issue.

The methodological descriptions of 34 case studies were critically reviewed using the adapted criteria. All articles reviewed contained a description of study methods; however, the length, amount of detail, and position of the description in the article varied. Few studies provided an accurate description and rationale for using a qualitative case study approach. In the 34 case studies reviewed, three described a theoretical framework informed by Stake ( 1995 ), two by Yin ( 2009 ), and three provided a mixed framework informed by various authors, which might have included both Yin and Stake. Few studies described their case study design, or included a rationale that explained why they excluded or added further procedures, and whether this was to enhance the study design, or to better suit the research question. In 26 of the studies no reference was provided to principal case study authors. From reviewing the description of methods, few authors provided a description or justification of case study methodology that demonstrated how their study was informed by the methodological literature that exists on this approach.

The methodological descriptions of each study were reviewed using the adapted criteria, and the following issues were identified: case study methodology or method; case of something particular and case selection; contextually bound case study; researcher and case interactions and triangulation; and, study design inconsistent with methodology. An outline of how the issues were developed from the critical review is provided, followed by a discussion of how these relate to the current methodological literature.

Case study methodology or method

A third of the case studies reviewed appeared to use a case report method, not case study methodology as described by principal authors (Creswell, 2013b ; Merriam, 2009 ; Stake, 1995 ; Yin, 2009 ). Case studies were identified as a case report because of missing methodological detail and by review of the study aims and purpose. These reports presented data for small samples of no more than three people, places or phenomenon. Four studies, or “case reports” were single cases selected retrospectively from larger studies (Bronken, Kirkevold, Martinsen, & Kvigne, 2012 ; Coltart & Henwood, 2012 ; Hooghe, Neimeyer, & Rober, 2012 ; Roscigno et al., 2012 ). Case reports were not a case of something, instead were a case demonstration or an example presented in a report. These reports presented outcomes, and reported on how the case could be generalized. Descriptions focussed on the phenomena, rather than the case itself, and did not appear to study the case in its entirety.

Case reports had minimal in-text references to case study methodology, and were informed by other qualitative traditions or secondary sources (Adamson & Holloway, 2012 ; Buzzanell & D'Enbeau, 2009 ; Nagar-Ron & Motzafi-Haller, 2011 ). This does not suggest that case study methodology cannot be multimethod, however, methodology should be consistent in design, be clearly described (Meyer, 2001 ; Stake, 1995 ), and maintain focus on the case (Creswell, 2013b ).

To demonstrate how case reports were identified, three examples are provided. The first, Yeh ( 2013 ) described their study as, “the examination of the emergence of vegetarianism in Victorian England serves as a case study to reveal the relationships between boundaries and entities” (p. 306). The findings were a historical case report, which resulted from an ethnographic study of vegetarianism. Cunsolo Willox, Harper, Edge, ‘My Word’: Storytelling and Digital Media Lab, and Rigolet Inuit Community Government (2013) used “a case study that illustrates the usage of digital storytelling within an Inuit community” (p. 130). This case study reported how digital storytelling can be used with indigenous communities as a participatory method to illuminate the benefits of this method for other studies. This “case study was conducted in the Inuit community” but did not include the Inuit community in case analysis (Cunsolo Willox et al., 2013 , p. 130). Bronken et al. ( 2012 ) provided a single case report to demonstrate issues observed in a larger clinical study of aphasia and stroke, without adequate case description or analysis.

Case study of something particular and case selection

Case selection is a precursor to case analysis, which needs to be presented as a convincing argument (Merriam, 2009 ). Descriptions of the case were often not adequate to ascertain why the case was selected, or whether it was a particular exemplar or outlier (Thomas, 2011 ). In a number of case studies in the health and social science categories, it was not explicit whether the case was of something particular, or peculiar to their discipline or field (Adamson & Holloway, 2012 ; Bronken et al., 2012 ; Colón-Emeric et al., 2010 ; Jackson, Botelho, Welch, Joseph, & Tennstedt, 2012 ; Mawn et al., 2010 ; Snyder-Young, 2011 ). There were exceptions in the methods category ( Table III ), where cases were selected by researchers to report on a new or innovative method. The cases emerged through heuristic study, and were reported to be particular, relative to the existing methods literature (Ajodhia-Andrews & Berman, 2009 ; Buckley & Waring, 2013 ; Cunsolo Willox et al., 2013 ; De Haene, Grietens, & Verschueren, 2010 ; Gratton & O'Donnell, 2011 ; Sumsion, 2013 ; Wimpenny & Savin-Baden, 2012 ).

Case selection processes were sometimes insufficient to understand why the case was selected from the global population of cases, or what study of this case would contribute to knowledge as compared with other possible cases (Adamson & Holloway, 2012 ; Bronken et al., 2012 ; Colón-Emeric et al., 2010 ; Jackson et al., 2012 ; Mawn et al., 2010 ). In two studies, local cases were selected (Barone, 2010 ; Fourie & Theron, 2012 ) because the researcher was familiar with and had access to the case. Possible limitations of a convenience sample were not acknowledged. Purposeful sampling was used to recruit participants within the case of one study, but not of the case itself (Gallagher et al., 2013 ). Random sampling was completed for case selection in two studies (Colón-Emeric et al., 2010 ; Jackson et al., 2012 ), which has limited meaning in interpretive qualitative research.

To demonstrate how researchers provided a good justification for the selection of case study approaches, four examples are provided. The first, cases of residential care homes, were selected because of reported occurrences of mistreatment, which included residents being locked in rooms at night (Rytterström, Unosson, & Arman, 2013 ). Roscigno et al. ( 2012 ) selected cases of parents who were admitted for early hospitalization in neonatal intensive care with a threatened preterm delivery before 26 weeks. Hooghe et al. ( 2012 ) used random sampling to select 20 couples that had experienced the death of a child; however, the case study was of one couple and a particular metaphor described only by them. The final example, Coltart and Henwood ( 2012 ), provided a detailed account of how they selected two cases from a sample of 46 fathers based on personal characteristics and beliefs. They described how the analysis of the two cases would contribute to their larger study on first time fathers and parenting.

Contextually bound case study

The limits or boundaries of the case are a defining factor of case study methodology (Merriam, 2009 ; Ragin & Becker, 1992 ; Stake, 1995 ; Yin, 2009 ). Adequate contextual description is required to understand the setting or context in which the case is revealed. In the health category, case studies were used to illustrate a clinical phenomenon or issue such as compliance and health behaviour (Colón-Emeric et al., 2010 ; D'Enbeau, Buzzanell, & Duckworth, 2010 ; Gallagher et al., 2013 ; Hooghe et al., 2012 ; Jackson et al., 2012 ; Roscigno et al., 2012 ). In these case studies, contextual boundaries, such as physical and institutional descriptions, were not sufficient to understand the case as a holistic system, for example, the general practitioner (GP) clinic in Gallagher et al. ( 2013 ), or the nursing home in Colón-Emeric et al. ( 2010 ). Similarly, in the social science and methods categories, attention was paid to some components of the case context, but not others, missing important information required to understand the case as a holistic system (Alexander, Moreira, & Kumar, 2012 ; Buzzanell & D'Enbeau, 2009 ; Nairn & Panelli, 2009 ; Wimpenny & Savin-Baden, 2012 ).

In two studies, vicarious experience or vignettes (Nairn & Panelli, 2009 ) and images (Jorrín-Abellán et al., 2008 ) were effective to support description of context, and might have been a useful addition for other case studies. Missing contextual boundaries suggests that the case might not be adequately defined. Additional information, such as the physical, institutional, political, and community context, would improve understanding of the case (Stake, 1998 ). In Boxes 1 and 2 , we present brief synopses of two studies that were reviewed, which demonstrated a well bounded case. In Box 1 , Ledderer ( 2011 ) used a qualitative case study design informed by Stake's tradition. In Box 2 , Gillard, Witt, and Watts ( 2011 ) were informed by Yin's tradition. By providing a brief outline of the case studies in Boxes 1 and 2 , we demonstrate how effective case boundaries can be constructed and reported, which may be of particular interest to prospective case study researchers.

Article synopsis of case study research using Stake's tradition

Ledderer ( 2011 ) used a qualitative case study research design, informed by modern ethnography. The study is bounded to 10 general practice clinics in Denmark, who had received federal funding to implement preventative care services based on a Motivational Interviewing intervention. The researcher question focussed on “why is it so difficult to create change in medical practice?” (Ledderer, 2011 , p. 27). The study context was adequately described, providing detail on the general practitioner (GP) clinics and relevant political and economic influences. Methodological decisions are described in first person narrative, providing insight on researcher perspectives and interaction with the case. Forty-four interviews were conducted, which focussed on how GPs conducted consultations, and the form, nature and content, rather than asking their opinion or experience (Ledderer, 2011 , p. 30). The duration and intensity of researcher immersion in the case enhanced depth of description and trustworthiness of study findings. Analysis was consistent with Stake's tradition, and the researcher provided examples of inquiry techniques used to challenge assumptions about emerging themes. Several other seminal qualitative works were cited. The themes and typology constructed are rich in narrative data and storytelling by clinic staff, demonstrating individual clinic experiences as well as shared meanings and understandings about changing from a biomedical to psychological approach to preventative health intervention. Conclusions make note of social and cultural meanings and lessons learned, which might not have been uncovered using a different methodology.

Article synopsis of case study research using Yin's tradition

Gillard et al. ( 2011 ) study of camps for adolescents living with HIV/AIDs provided a good example of Yin's interpretive case study approach. The context of the case is bounded by the three summer camps of which the researchers had prior professional involvement. A case study protocol was developed that used multiple methods to gather information at three data collection points coinciding with three youth camps (Teen Forum, Discover Camp, and Camp Strong). Gillard and colleagues followed Yin's ( 2009 ) principles, using a consistent data protocol that enhanced cross-case analysis. Data described the young people, the camp physical environment, camp schedule, objectives and outcomes, and the staff of three youth camps. The findings provided a detailed description of the context, with less detail of individual participants, including insight into researcher's interpretations and methodological decisions throughout the data collection and analysis process. Findings provided the reader with a sense of “being there,” and are discovered through constant comparison of the case with the research issues; the case is the unit of analysis. There is evidence of researcher immersion in the case, and Gillard reports spending significant time in the field in a naturalistic and integrated youth mentor role.

This case study is not intended to have a significant impact on broader health policy, although does have implications for health professionals working with adolescents. Study conclusions will inform future camps for young people with chronic disease, and practitioners are able to compare similarities between this case and their own practice (for knowledge translation). No limitations of this article were reported. Limitations related to publication of this case study were that it was 20 pages long and used three tables to provide sufficient description of the camp and program components, and relationships with the research issue.

Researcher and case interactions and triangulation

Researcher and case interactions and transactions are a defining feature of case study methodology (Stake, 1995 ). Narrative stories, vignettes, and thick description are used to provoke vicarious experience and a sense of being there with the researcher in their interaction with the case. Few of the case studies reviewed provided details of the researcher's relationship with the case, researcher–case interactions, and how these influenced the development of the case study (Buzzanell & D'Enbeau, 2009 ; D'Enbeau et al., 2010 ; Gallagher et al., 2013 ; Gillard et al., 2011 ; Ledderer, 2011 ; Nagar-Ron & Motzafi-Haller, 2011 ). The role and position of the researcher needed to be self-examined and understood by readers, to understand how this influenced interactions with participants, and to determine what triangulation is needed (Merriam, 2009 ; Stake, 1995 ).

Gillard et al. ( 2011 ) provided a good example of triangulation, comparing data sources in a table (p. 1513). Triangulation of sources was used to reveal as much depth as possible in the study by Nagar-Ron and Motzafi-Haller ( 2011 ), while also enhancing confirmation validity. There were several case studies that would have benefited from improved range and use of data sources, and descriptions of researcher–case interactions (Ajodhia-Andrews & Berman, 2009 ; Bronken et al., 2012 ; Fincham, Scourfield, & Langer, 2008 ; Fourie & Theron, 2012 ; Hooghe et al., 2012 ; Snyder-Young, 2011 ; Yeh, 2013 ).

Study design inconsistent with methodology

Good, rigorous case studies require a strong methodological justification (Meyer, 2001 ) and a logical and coherent argument that defines paradigm, methodological position, and selection of study methods (Denzin & Lincoln, 2011b ). Methodological justification was insufficient in several of the studies reviewed (Barone, 2010 ; Bronken et al., 2012 ; Hooghe et al., 2012 ; Mawn et al., 2010 ; Roscigno et al., 2012 ; Yeh, 2013 ). This was judged by the absence, or inadequate or inconsistent reference to case study methodology in-text.

In six studies, the methodological justification provided did not relate to case study. There were common issues identified. Secondary sources were used as primary methodological references indicating that study design might not have been theoretically sound (Colón-Emeric et al., 2010 ; Coltart & Henwood, 2012 ; Roscigno et al., 2012 ; Snyder-Young, 2011 ). Authors and sources cited in methodological descriptions were inconsistent with the actual study design and practices used (Fourie & Theron, 2012 ; Hooghe et al., 2012 ; Jorrín-Abellán et al., 2008 ; Mawn et al., 2010 ; Rytterström et al., 2013 ; Wimpenny & Savin-Baden, 2012 ). This occurred when researchers cited Stake or Yin, or both (Mawn et al., 2010 ; Rytterström et al., 2013 ), although did not follow their paradigmatic or methodological approach. In 26 studies there were no citations for a case study methodological approach.

The findings of this study have highlighted a number of issues for researchers. A considerable number of case studies reviewed were missing key elements that define qualitative case study methodology and the tradition cited. A significant number of studies did not provide a clear methodological description or justification relevant to case study. Case studies in health and social sciences did not provide sufficient information for the reader to understand case selection, and why this case was chosen above others. The context of the cases were not described in adequate detail to understand all relevant elements of the case context, which indicated that cases may have not been contextually bounded. There were inconsistencies between reported methodology, study design, and paradigmatic approach in case studies reviewed, which made it difficult to understand the study methodology and theoretical foundations. These issues have implications for methodological integrity and honesty when reporting study design, which are values of the qualitative research tradition and are ethical requirements (Wager & Kleinert, 2010a ). Poorly described methodological descriptions may lead the reader to misinterpret or discredit study findings, which limits the impact of the study, and, as a collective, hinders advancements in the broader qualitative research field.

The issues highlighted in our review build on current debates in the case study literature, and queries about the value of this methodology. Case study research can be situated within different paradigms or designed with an array of methods. In order to maintain the creativity and flexibility that is valued in this methodology, clearer descriptions of paradigm and theoretical position and methods should be provided so that study findings are not undervalued or discredited. Case study research is an interdisciplinary practice, which means that clear methodological descriptions might be more important for this approach than other methodologies that are predominantly driven by fewer disciplines (Creswell, 2013b ).

Authors frequently omit elements of methodologies and include others to strengthen study design, and we do not propose a rigid or purist ideology in this paper. On the contrary, we encourage new ideas about using case study, together with adequate reporting, which will advance the value and practice of case study. The implications of unclear methodological descriptions in the studies reviewed were that study design appeared to be inconsistent with reported methodology, and key elements required for making judgements of rigour were missing. It was not clear whether the deviations from methodological tradition were made by researchers to strengthen the study design, or because of misinterpretations. Morse ( 2011 ) recommended that innovations and deviations from practice are best made by experienced researchers, and that a novice might be unaware of the issues involved with making these changes. To perpetuate the tradition of case study research, applications in the published literature should have consistencies with traditional methodological constructions, and deviations should be described with a rationale that is inherent in study conduct and findings. Providing methodological descriptions that demonstrate a strong theoretical foundation and coherent study design will add credibility to the study, while ensuring the intrinsic meaning of case study is maintained.

The value of this review is that it contributes to discussion of whether case study is a methodology or method. We propose possible reasons why researchers might make this misinterpretation. Researchers may interchange the terms methods and methodology, and conduct research without adequate attention to epistemology and historical tradition (Carter & Little, 2007 ; Sandelowski, 2010 ). If the rich meaning that naming a qualitative methodology brings to the study is not recognized, a case study might appear to be inconsistent with the traditional approaches described by principal authors (Creswell, 2013a ; Merriam, 2009 ; Stake, 1995 ; Yin, 2009 ). If case studies are not methodologically and theoretically situated, then they might appear to be a case report.

Case reports are promoted by university and medical journals as a method of reporting on medical or scientific cases; guidelines for case reports are publicly available on websites ( http://www.hopkinsmedicine.org/institutional_review_board/guidelines_policies/guidelines/case_report.html ). The various case report guidelines provide a general criteria for case reports, which describes that this form of report does not meet the criteria of research, is used for retrospective analysis of up to three clinical cases, and is primarily illustrative and for educational purposes. Case reports can be published in academic journals, but do not require approval from a human research ethics committee. Traditionally, case reports describe a single case, to explain how and what occurred in a selected setting, for example, to illustrate a new phenomenon that has emerged from a larger study. A case report is not necessarily particular or the study of a case in its entirety, and the larger study would usually be guided by a different research methodology.

This description of a case report is similar to what was provided in some studies reviewed. This form of report lacks methodological grounding and qualities of research rigour. The case report has publication value in demonstrating an example and for dissemination of knowledge (Flanagan, 1999 ). However, case reports have different meaning and purpose to case study, which needs to be distinguished. Findings of our review suggest that the medical understanding of a case report has been confused with qualitative case study approaches.

In this review, a number of case studies did not have methodological descriptions that included key characteristics of case study listed in the adapted criteria, and several issues have been discussed. There have been calls for improvements in publication quality of qualitative research (Morse, 2011 ), and for improvements in peer review of submitted manuscripts (Carter & Little, 2007 ; Jasper, Vaismoradi, Bondas, & Turunen, 2013 ). The challenging nature of editor and reviewers responsibilities are acknowledged in the literature (Hames, 2013 ; Wager & Kleinert, 2010b ); however, review of case study methodology should be prioritized because of disputes on methodological value.

Authors using case study approaches are recommended to describe their theoretical framework and methods clearly, and to seek and follow specialist methodological advice when needed (Wager & Kleinert, 2010a ). Adequate page space for case study description would contribute to better publications (Gillard et al., 2011 ). Capitalizing on the ability to publish complementary resources should be considered.

Limitations of the review

There is a level of subjectivity involved in this type of review and this should be considered when interpreting study findings. Qualitative methods journals were selected because the aims and scope of these journals are to publish studies that contribute to methodological discussion and development of qualitative research. Generalist health and social science journals were excluded that might have contained good quality case studies. Journals in business or education were also excluded, although a review of case studies in international business journals has been published elsewhere (Piekkari et al., 2009 ).

The criteria used to assess the quality of the case studies were a set of qualitative indicators. A numerical or ranking system might have resulted in different results. Stake's ( 1995 ) criteria have been referenced elsewhere, and was deemed the best available (Creswell, 2013b ; Crowe et al., 2011 ). Not all qualitative studies are reported in a consistent way and some authors choose to report findings in a narrative form in comparison to a typical biomedical report style (Sandelowski & Barroso, 2002 ), if misinterpretations were made this may have affected the review.

Case study research is an increasingly popular approach among qualitative researchers, which provides methodological flexibility through the incorporation of different paradigmatic positions, study designs, and methods. However, whereas flexibility can be an advantage, a myriad of different interpretations has resulted in critics questioning the use of case study as a methodology. Using an adaptation of established criteria, we aimed to identify and assess the methodological descriptions of case studies in high impact, qualitative methods journals. Few articles were identified that applied qualitative case study approaches as described by experts in case study design. There were inconsistencies in methodology and study design, which indicated that researchers were confused whether case study was a methodology or a method. Commonly, there appeared to be confusion between case studies and case reports. Without clear understanding and application of the principles and key elements of case study methodology, there is a risk that the flexibility of the approach will result in haphazard reporting, and will limit its global application as a valuable, theoretically supported methodology that can be rigorously applied across disciplines and fields.

Conflict of interest and funding

The authors have not received any funding or benefits from industry or elsewhere to conduct this study.

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Organizing Your Social Sciences Research Assignments

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

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

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

How to Approach Writing a Case Study Research Paper

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

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

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

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

Structure and Writing Style

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

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

I.  Introduction

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

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

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

II.  Literature Review

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

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

III.  Method

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

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

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

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

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

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

IV.  Discussion

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

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

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

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

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

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

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

V.  Conclusion

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

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

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

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

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

Problems to Avoid

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

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

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

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

Writing Tip

At Least Five Misconceptions about Case Study Research

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

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

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

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

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case study v experiment

Distinguishing Between Case Studies & Experiments

Maria Nguyen

Case Study vs Experiment

Case studies and experiments are two distinct research methods used across various disciplines, providing researchers with the ability to study and analyze a subject through different approaches. This variety in research methods allows the researcher to gather both qualitative and quantitative data, cross-check the data, and assign greater validity to the conclusions and overall findings of the research. A case study is a research method in which the researcher explores the subject in depth, while an experiment is a research method where two specific groups or variables are used to test a hypothesis. This article will examine the differences between case study and experiment further.

What is a Case Study?

A case study is a research method where an individual, event, or significant place is studied in depth. In the case of an individual, the researcher studies the person’s life history, which can include important days or special experiences. The case study method is used in various social sciences such as sociology, anthropology, and psychology. Through a case study, the researcher can identify and understand the subjective experiences of an individual regarding a specific topic. For example, a researcher studying the impact of second rape on the lives of rape victims can conduct several case studies to understand the subjective experiences of individuals and social mechanisms that contribute to this phenomenon. The case study is a qualitative research method that can be subjective.

What is an Experiment?

An experiment, unlike a case study, can be classified as a quantitative research method, as it provides statistically significant data and an objective, empirical approach. Experiments are primarily used in natural sciences, as they allow the scientist to control variables. In social sciences, controlling variables can be challenging and may lead to faulty conclusions. In an experiment, there are mainly two variables: the independent variable and the dependent variable. The researcher tries to test their hypothesis by manipulating these variables. There are different types of experiments, such as laboratory experiments (conducted in laboratories where conditions can be strictly controlled) and natural experiments (which take place in real-life settings). As seen, case study methods and experiments are very different from one another. However, most researchers prefer to use triangulation when conducting research to minimize biases.

Key Takeaways

  • Case studies are in-depth explorations of a subject, providing qualitative data, while experiments test hypotheses by manipulating variables, providing quantitative data.
  • Experiments are primarily used in natural sciences, whereas case studies are primarily used in social sciences.
  • Experiments involve testing the correlation between two variables (independent and dependent), while case studies focus on exploring a subject in depth without testing correlations between variables.

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Difference between power & authority, distinguishing could of & could have, distinguishing pixie & bob haircuts, distinguishing between debate & discussion, distinguishing between dialogue & conversation, distinguishing between a present & a gift, distinguishing between will & can, distinguishing between up & upon.

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The Oxford Handbook of Qualitative Research

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The Oxford Handbook of Qualitative Research

22 Case Study Research: In-Depth Understanding in Context

Helen Simons, School of Education, University of Southampton

  • Published: 01 July 2014
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This chapter explores case study as a major approach to research and evaluation. After first noting various contexts in which case studies are commonly used, the chapter focuses on case study research directly Strengths and potential problematic issues are outlined and then key phases of the process. The chapter emphasizes how important it is to design the case, to collect and interpret data in ways that highlight the qualitative, to have an ethical practice that values multiple perspectives and political interests, and to report creatively to facilitate use in policy making and practice. Finally, it explores how to generalize from the single case. Concluding questions center on the need to think more imaginatively about design and the range of methods and forms of reporting requiredto persuade audiences to value qualitative ways of knowing in case study research.

Introduction

This chapter explores case study as a major approach to research and evaluation using primarily qualitative methods, as well as documentary sources, contemporaneous or historical. However, this is not the only way in which case study can be conceived. No one has a monopoly on the term. While sharing a focus on the singular in a particular context, case study has a wide variety of uses, not all associated with research. A case study, in common parlance, documents a particular situation or event in detail in a specific sociopolitical context. The particular can be a person, a classroom, an institution, a program, or a policy. Below I identify different ways in which case study is used before focusing on qualitative case study research in particular. However, first I wish to indicate how I came to advocate and practice this form of research. Origins, context, and opportunity often shape the research processes we endorse. It is helpful for the reader, I think, to know how I came to the perspective I hold.

The Beginnings

I first came to appreciate and enjoy the virtues of case study research when I entered the field of curriculum evaluation and research in the 1970s. The dominant research paradigm for educational research at that time was experimental or quasi- experimental, cost-benefit, or systems analysis, and the dominant curriculum model was aims and objectives ( House, 1993 ). The field was dominated, in effect, by a psychometric view of research in which quantitative methods were preeminent. But the innovative projects we were asked to evaluate (predominantly, but not exclusively, in the humanities) were not amenable to such methodologies. The projects were challenging to the status quo of institutions, involved people interpreting the policy and programs, were implemented differently in different contexts and regions, and had many unexpected effects.

We had no choice but to seek other ways to evaluate these complex programs, and case study was the methodology we found ourselves exploring, in order to understand how the projects were being implemented, why they had positive effects in some regions of the country and not others, and what the outcomes meant in different sociopolitical and cultural contexts. What better way to do this than to talk with people to see how they interpreted the “new” curriculum; to watch how teachers and students put it into practice; to document transactions, outcomes, and unexpected consequences; and to interpret all in the specific context of the case ( Simons, 1971 , 1987 , pp. 55–89). From this point on and in further studies, case study in educational research and evaluation came to be a major methodology for understanding complex educational and social programs. It also extended to other practice professions, such as nursing, health, and social care ( Zucker, 2001 ; Greenhalgh & Worrall, 1997 ; Shaw & Gould, 2001 ). For further details of the evolution of the case study approach and qualitative methodologies in evaluation, see House, 1993 , pp. 2–3; Greene, 2000 ; Simons, 2009 , pp. 14–18; Simons & McCormack, 2007 , pp. 292–311).

This was not exactly the beginning of case study, of course. It has a long history in many disciplines ( Simons, 1980; Ragin, 1992; Gomm, Hammersley, & Foster, 2004 ; Platt, 2007 ), many aspects of which form part of case study practice to this day. But its evolution in the context just described was a major move in the contemporary evolution of the logic of evaluative inquiry ( House, 1980 ). It also coincided with movement toward the qualitative in other disciplines, such as sociology and psychology. This was all part of what Denzin & Lincoln (1994) termed “a quiet methodological revolution” (p. ix) in qualitative inquiry that had been evolving over the course of forty years.

There is a further reason why I continue to advocate and practice case study research and evaluation to this day and that is my personal predilection for trying to understand and represent complexity, for puzzling through the ambiguities that exist in many contexts and programs and for presenting and negotiating different values and interests in fair and just ways.

Put more simply, I like interacting with people, listening to their stories, trials and tribulations—giving them a voice in understanding the contexts and projects with which they are involved, and finding ways to share these with a range of audiences. In other words, the move toward case study methodology described here suited my preference for how I learn.

Concepts and Purposes of Case Study

Before exploring case study as it has come to be established in educational research and evaluation over the past forty years, I wish to acknowledge other uses of case study. More often than not, these relate to purpose, and appropriately so in their different contexts, but many do not have a research intention. For a study to count as research, it would need to be a systematic investigation generating evidence that leads to “new” knowledge that is made public and open to scrutiny. There are many ways to conduct research stemming from different traditions and disciplines, but they all, in different ways, involve these characteristics.

Everyday Usage: Stories We Tell

The most common of these uses of case study is the everyday reference to a person, an anecdote or story illustrative of a particular incident, event, or experience of that person. It is often a short, reported account commonly seen in journalism but also in books exploring a phenomenon, such as recovery from serious accidents or tragedies, where the author chooses to illustrate the story or argument with a “lived” example. This is sometimes written by the author and sometimes by the person whose tale it is. “Let me share with you a story,” is a phrase frequently heard

The spirit behind this common usage and its power to connect can be seen in a report by Tim Adams of the London Olympics opening ceremony’s dramatization by Danny Boyle.

It was the point when we suddenly collectively wised up to the idea that what we are about to receive over the next two weeks was not only about “legacy collateral” and “targeted deliverables,” not about G4S failings and traffic lanes and branding opportunities, but about the second-by-second possibilities of human endeavour and spirit and communality, enacted in multiple places and all at the same time. Stories in other words. ( Adams, 2012 )

This was a collective story, of course, not an individual one, but it does convey some of the major characteristics of case study—that richness of detail, time, place, multiple happenings and experiences—that are also manifest in case study research, although carefully evidenced in the latter instance. We can see from this common usage how people have come to associate case study with story. I return to this thread in the reporting section.

Professions Individual Cases

In professional settings, in health and social care, case studies, often called case histories , are used to accurately record a person’s health or social care history and his or her current symptoms, experience, and treatment. These case histories include facts but also judgments and observations about the person’s reaction to situations or medication. Usually these are confidential. Not dissimilar is the detailed documentation of a case in law, often termed a case precedent when referred to in a court case to support an argument being made. However in law there is a difference in that such case precedents are publicly documented.

Case Studies in Teaching

Exemplars of practice.

In education, but also in health and social care training contexts, case studies have long been used as exemplars of practice. These are brief descriptions with some detail of a person or project’s experience in an area of practice. Though frequently reported accounts, they are based on a person’s experience and sometimes on previous research.

Case scenarios

Management studies are a further context in which case studies are often used. Here, the case is more like a scenario outlining a particular problem situation for the management student to resolve. These scenarios may be based on research but frequently are hypothetical situations used to raise issues for discussion and resolution. What distinguishes these case scenarios and the case exemplars in education from case study research is the intention to use them for teaching purposes.

Country Case Studies

Then there are case studies of programs, projects, and even countries, as in international development, where a whole-country study might be termed a case study or, in the context of the Organization for Economic Co-operation and Development (OECD), where an exploration is conducted of the state of the art of a subject, such as education or environmental science in one or several countries. This may be a contemporaneous study and/or what transpired in a program over a period of time. Such studies often do have a research base but frequently are reported accounts that do not detail the design, methodology, and analysis of the case, as a research case study would do, or report in ways that give readers a vicarious experience of what it was like to be there. Such case studies tend to be more knowledge and information-focused than experiential.

Case Study as History

Closer to a research context is case study as history—what transpired at a certain time in a certain place. This is likely to be supported by documentary evidence but not primary data gathering unless it is an oral history. In education, in the late 1970s, Stenhouse (1978) experimented with a case study archive. Using contemporaneous data gathering, primarily through interviewing, he envisaged this database, which he termed a “case record,” forming an archive from which different individuals,, at some later date, could write a “case study.” This approach uses case study as a documentary source to begin to generate a history of education, as the subtitle of Stenhouse’s 1978 paper indicates “Towards a contemporary history of education.”

Case Study Research

From here on, my focus is on case study research per se, adopting for this purpose the following definition:

Case study is an in-depth exploration from multiple perspectives of the complexity and uniqueness of a particular project, policy, institution or system in a “real-life” context. It is research based, inclusive of different methods and is evidence-led. ( Simons, 2009 , p. 21).

For further related definitions of case study, see Stake (1995) , Merriam (1998), and Chadderton & Torrance (2011) . And for definitions from a slightly different perspective, see Yin (2004) and Thomas (2011a) .

Not Defined by Method or Perspective

The inclusion of different methods in the definition quoted above definition signals that case study research is not defined by methodology or method. What defines case study is its singularity and the concept and boundary of the case. It is theoretically possible to conduct a case study using primarily quantitative data if this is the best way of providing evidence to inform the issues the case is exploring. It is equally possible to conduct case study that is mainly qualitative, to engage people with the experience of the case or to provide a rich portrayal of an event, project, or program.

Or one can design the case using mixed methods. This increases the options for learning from different ways of knowing and is sometimes preferred by stakeholders who believe it provides a firmer basis for informing policy. This is not necessarily the case but is beyond the scope of this chapter to explore. For further discussion of the complexities of mixing methods and the virtue of using qualitative methods and case study in a mixed method design, see Greene (2007) .

Case study research may also be conducted from different standpoints—realist, interpretivist, or constructivist, for example. My perspective falls within a constructivist, interpretivist framework. What interests me is how I and those in the case perceive and interpret what we find and how we construct or co-construct understandings of the case. This not only suits my predilection for how I see the world, but also my preferred phenomenological approach to interviewing and curiosity about people and how they act in social and professional life.

Qualitative Case Study Research

Qualitative case study research shares many characteristics with other forms of qualitative research, such as narrative, oral history, life history, ethnography, in-depth interview, and observational studies that utilize qualitative methods. However, its focus, purpose, and origins, in educational research at least, are a little different.

The focus is clearly the study of the singular. The purpose is to portray an in-depth view of the quality and complexity of social/educational programs or policies as they are implemented in specific sociopolitical contexts. What makes it qualitative is its emphasis on subjective ways of knowing, particularly the experiential, practical, and presentational rather than the propositional ( Heron, 1992 , 1999 ) to comprehend and communicate what transpired in the case.

Characteristic Features and Advantages

Case study research is not method dependent, as noted earlier, nor is it constrained by resources or time. Although it can be conducted over several years, which provides an opportunity to explore the process of change and explain how and why things happened, it can equally be carried out contemporaneously in a few days, weeks, or months. This flexibility is extremely useful in many contexts, particularly when a change in policy or unforeseen issues in the field require modifying the design.

Flexibility extends to reporting. The case can be written up in different lengths and forms to meet different audience needs and to maximize use (see the section on Reporting). Using the natural language of participants and familiar methods (like interview, observation, oral history) also enables participants to engage in the research process, thereby contributing significantly to the generation of knowledge of the case. As I have indicated elsewhere ( Simons, 2009 ), “This is both a political and epistemological point. It signals a potential shift in the power base of who controls knowledge and recognizes the importance of co-constructing perceived reality through the relationships and joint understandings we create in the field” (p. 23).

Possible Disadvantages

If one is an advocate, identifying advantages of a research approach is easier than pointing out its disadvantages, something detractors are quite keen to do anyway! But no approach is perfect, and here are some of the issues that often trouble people about case study research. The “sample of one” is an obvious issue that worries those convinced that only large samples can constitute valid research and especially if this is to inform policy. Understanding complexity in depth may not be a sufficient counterargument, and I suspect there is little point in trying to persuade otherwise For frequently, this perception is one of epistemological and methodological, if not ideological, preference.

However, there are some genuine concerns that many case researchers face: the difficulty of processing a mass of data; of “telling the truth” in contexts where people may be identifiable; personal involvement, when the researcher is the main instrument of data gathering; and writing reports that are data-based, yet readable in style and length. But one issue that concerns advocates and nonadvocates alike is how inferences are drawn from the single case.

Answers to some of these issues are covered in the sections that follow. Whether they convince may again be a question of preference. However, it is worth noting here that I do not think we should seek to justify these concerns in terms identified by other methodologies. Many of them are intrinsic to the nature and strength of qualitative case study research.

Subjectivity, for instance, both of participants and researcher is inevitable, as it is in many other qualitative methodologies. This is often the basis on which we act. Rather than see this as bias or something to counter, it is an intelligence that is essential to understanding and interpreting the experience of participants and stakeholders. Such subjectivity needs to be disciplined, of course, through procedures that examine both the validity of individuals’ representations of “their truth”, and demonstrate how the researcher took a reflexive approach to monitoring how his or her own values and predilections may have unduly influenced the data.

Types of Case Study

There are numerous types of case study, too many to categorize, I think, as there are overlaps between them. However, attempts have been made to do this and, for those who value typologies, I refer them to Bassey (1999) and, for a more extended typology, to Thomas (2011b) . A slightly different approach is taken by Gomm, Hammersley, and Foster (2004) in annotating the different emphases in major texts on case study. What I prefer to do here is to highlight a few familiar types to focus the discussion that follows on the practice of case study research.

Stake (1995) offers a threefold distinction that is helpful when it comes to practice, he says, because it influences the methods we choose to gather data (p. 4). He distinguishes between an intrinsic case study , one that is studied to learn about the particular case itself and an instrumental case study , in which we choose a case to gain insight into a particular issue (i.e., the case is instrumental to understanding something else; p. 3). The collective case study is what its name suggests: an extension of the instrumental to several cases.

Theory-led or theory-generated case study is similarly self-explanatory, the first starting from a specific theory that is tested through the case; the second constructing a theory through interpretation of data generated in the case. In other words, one ends rather than begins with a theory. In qualitative case study research, this is the more familiar route. The theory of the case becomes the argument or story you will tell.

Evaluation case study requires a slightly longer description as this is my context of practice, one which has influenced the way I conduct case study and what I choose to emphasize in this chapter. An evaluation case study has three essential features: to determine the value of the case, to include and balance different interests and values, and to report findings to a range of stakeholders in ways that they can use. The reasons for this may be found in the interlude that follows, which offers a brief characterization of the social and ethical practice of evaluation and why qualitative methods are so important in this practice.

Interlude: Social and Ethical Practice of Evaluation

Evaluation is a social practice that documents, portrays, and seeks to understand the value of a particular project, program, or policy. This can be determined by different evaluation methodologies, of course. But the value of qualitative case study is that it is possible to discern this value without decontextualizing the data. While the focus of the case is usually a project, program, policy, or some unit within, studies of key individuals, what I term case profiles , may be embedded within the overall case. In some instances, these profiles, or even shorter cameos of individuals, may be quite prominent. For it is through the perceptions, interpretations, and interactions of people that we learn how policies and programs are enacted ( Kushner, 2000 , p. 12). The program is still the main focus of analysis, but, in exploring how individuals play out their different roles in the program, we get closer to the actual experience and meaning of the program in practice.

Case study evaluation is often commissioned from an external source (government department or other agency) keen to know the worth of publicly funded programs and policies to inform future decision making. It needs to be responsive to issues or questions identified by stakeholders, who often have different values and interests in the expected outcomes and appreciate different perspectives of the program in action. The context also is often highly politicized, and interests can conflict. The task of the evaluator in such situations becomes one of including and balancing all interests and values in the program fairly and justly.

This is an inherently political process and requires an ethical practice that offers participants some protection over the personal data they give as part of the research and agreed audiences access to the findings, presented in ways they can understand. Negotiating what information becomes public can be quite difficult in singular settings where people are identifiable and intricate or problematic transactions have been documented. The consequences that ensue from making knowledge public that hitherto was private may be considerable for those in the case. It may also be difficult to portray some of the contextual detail that would enhance understanding for readers.

The ethical stance that underpins the case study research and evaluation I conduct stems from a theory of ethics that emphasizes the centrality of relationships in the specific context and the consequences for individuals, while remaining aware of the research imperative to publicly report. It is essentially an independent democratic process based on the concepts of fairness and justice, in which confidentiality, negotiation, and accessibility are key principles ( MacDonald, 1976 ; Simons, 2009 , pp. 96–111; and Simons 2010 ). The principles are translated into specific procedures to guide the collection, validation, and dissemination of data in the field. These include:

engaging participants and stakeholders in identifying issues to explore and sometimes also in interpreting the data;

documenting how different people interpret and value the program;

negotiating what data becomes public respecting both the individual’s “right to privacy” and the public’s “right to know”;

offering participants opportunities to check how their data are used in the context of reporting;

reporting in language and forms accessible to a wide range of audiences;

disseminating to audiences within and beyond the case.

For further discussion of the ethics of democratic case study evaluation and examples of their use in practice, see Simons (2000 , 2006 , 2009 , chapter 6, 2010 ).

Designing Case Study Research

Design issues in case study sometimes take second place to those of data gathering, the more exciting task perhaps in starting research. However, it is critical to consider the design at the outset, even if changes are required in practice due to the reality of what is encountered in the field. In this sense, the design of case study is emergent, rather than preordinate, shaped and reshaped as understanding of the significance of foreshadowed issues emerges and more are discovered.

Before entering the field, there are a myriad of planning issues to think about related to stakeholders, participants, and audiences. These include whose values matter, whether to engage them in data gathering and interpretation, the style of reporting appropriate for each, and the ethical guidelines that will underpin data collection and reporting. However, here I emphasize only three: the broad focus of the study, what the case is a case of, and framing questions/issues. These are steps often ignored in an enthusiasm to gather data, resulting in a case study that claims to be research but lacks the basic principles required for generation of valid, public knowledge.

Conceptualize the Topic

First, it is important that the topic of the research is conceptualized in a way that it can be researched (i.e., it is not too wide). This seems an obvious point to make, but failure to think through precisely what it is about your research topic you wish to investigate will have a knock-on effect on the framing of the case, data gathering, and interpretation and may lead, in some instances, to not gathering or analyzing data that actually informs the topic. Further conceptualization or reconceptualization may be necessary as the study proceeds, but it is critical to have a clear focus at the outset.

What Constitutes the Case

Second, I think it is important to decide what would constitute the case (i.e., what it is a case of) and where the boundaries of this lie. This often proves more difficult than first appears. And sometimes, partly because of the semifluid nature of the way the case evolves, it is only possible to finally establish what the case is a case of at the end. Nevertheless, it is useful to identify what the case and its boundaries are at the outset to help focus data collection while maintaining an awareness that these may shift. This is emergent design in action.

In deciding the boundary of the case, there are several factors to bear in mind. Is it bounded by an institution or a unit within an institution, by people within an institution, by region, or by project, program or policy,? If we take a school as an example, the case could be comprised of the principal, teachers, and students, or the boundary could be extended to the cleaners, the caretaker, the receptionist, people who often know a great deal about the subnorms and culture of the institution.

If the case is a policy or particular parameter of a policy, the considerations may be slightly different. People will still be paramount—those who generated the policy and those who implemented it—but there is likely also to be a political culture surrounding the policy that had an influence on the way the policy evolved. Would this be part of the case?

Whatever boundary is chosen, this may change in the course of conducting the study when issues arise that can only be understood by going to another level. What transpires in a classroom, for example, if this is the case, is often partly dependent on the support of the school leadership and culture of the institution and this, in turn, to some extent is dependent on what resources are allocated from the local education administration. Much like a series of Russian dolls, one context inside the other.

Unit of analysis

Thinking about what would constitute the unit of analysis— a classroom, an institution, a program, a region—may help in setting the boundaries of the case, and it will certainly help when it comes to analysis. But this is a slightly different issue from deciding what the case is a case of. Taking a health example, the case may be palliative care support, but the unit of analysis the palliative care ward or wards. If you took the palliative care ward as the unit of analysis this would be as much about how palliative care was exercised in this or that ward than issues about palliative care support in general. In other words, you would need to have specific information and context about how this ward was structured and managed to understand how palliative care was conducted in this particular ward. Here, as in the school example above, you would need to consider which of the many people who populate the ward form part of the case—nurses, interns, or doctors only, or does it extend to patients, cleaners, nurse aides, and medical students?

Framing Questions and Issues

The third most important consideration is how to frame the study, and you are likely to do this once you have selected the site or sites for study. There are at least four approaches. You could start with precise questions, foreshadowed issues ( Smith & Pohland, 1974 ), theories, or a program logic. To some extent, your choice will be dictated by the type of case you have chosen, but also by your personal preference for how to conduct it—in either a structured or open way.

Initial questions give structure; foreshadowed issues more freedom to explore. In qualitative case study, foreshadowed issues are more common, allowing scope for issues to change as the study evolves, guided by participants’ perspectives and events in the field. With this perspective, it is more likely that you will generate a theory of the case toward the end, through your interpretation and analysis.

If you are conducting an instrumental case study, staying close to the questions or foreshadowed issues is necessary to be sure you gain data that will illuminate the central focus of the study. This is critical if you are exploring issues across several cases, although it is possible to do a cross-case analysis from cases that have each followed a different route to discovering significant issues.

Opting to start with a theoretical framework provides a basis for formulating questions and issues, but it can also constrain the study to only those questions/issues that fit the framework. The same is true with using program logic to frame the case. This is an approach frequently adopted in evaluation case study where the evaluator, individually or with stakeholders, examines how the aims and objectives of the program relate to the activities designed to promote it and the outcomes and impacts expected. It provides direction, although it can lead to simply confirming what was anticipated, rather than documenting what transpired in the case.

Whichever approach you choose to frame the case, it is useful to think about the rationale or theory for each question and what methods would best enable you to gain an understanding of them. This will not only start a reflexive process of examining your choices—an important aspect of the process of data gathering and interpretation—it will also aid analysis and interpretation further down the track.

Methodology and Methods

Qualitative case study research, as already noted, appeals to subjective ways of knowing and to a primarily qualitative methodology, that captures experiential understanding ( Stake, 2010 , pp. 56–70). It follows that the main methods of data gathering to access this way of knowing will be qualitative. Interviewing, observation, and document analysis are the primary three, often supported by critical incidents, focus groups, cameos, vignettes, diaries/journals, and photographs. Before gathering any primary data, however, it is useful to search relevant existing sources (written or visual) to learn about the antecedents and context of a project, program, or policy as a backdrop to the case. This can sharpen framing questions, avoid unnecessary data gathering, and shorten the time needed in the field.

Given that there are excellent texts on qualitative methods (see, for example, Denzin & Lincoln, 1994 ; Seale, 1999 ; Silverman, 2000 , 2004 ), I will not discuss all potential relevant methods here, but simply focus on the qualities of the primary methods that are particularly appropriate for case study research.

Primary Qualitative Data Gathering Methods

Interviewing.

The most effective style of interviewing in qualitative case study research to gain in-depth data, document multiple perspectives and experiences and explore contested issues is the unstructured interview, active listening and open questioning are paramount, whatever prequestions or foreshadowed issues have been identified. This can include photographs—a useful starting point with certain cultural groups and the less articulate, to encourage them to tell their story through connecting or identifying with something in the image.

The flexibility of unstructured interviewing has three further advantages for understanding participants’ experiences. First, through questioning, probing, listening, and, above all, paying attention to the silences and what they mean, you can get closer to the meaning of participants’ experiences. It is not always what they say.

Second, unstructured interviewing is useful for engaging participants in the process of research. Instead of starting with questions and issues, invite participants to tell their stories or reflect on specific issues, to conduct their own self-evaluative interview, in fact. Not only will they contribute their particular perspective to the case, they will also learn about themselves, thereby making the process of research educative for them as well as for the audiences of the research.

Third, the open-endedness of this style of interviewing has the potential for creating a dialogue between participants and the researcher and between the researcher and the public, if enough of the dialogue is retained in the publication ( Bellah, Madsen, Sullivan, Swidler, & Tipton, 1985 ).

Observations

Observations in case study research are likely to be close-up descriptions of events, activities, and incidents that detail what happens in a particular context. They will record time, place, specific incidents, transactions, and dialogue, and note characteristics of the setting and of people in it without preconceived categories or judgment. No description is devoid of some judgment in selection, of course, but, on the whole, the intent is to describe the scene or event “as it is,” providing a rich, textured description to give readers a sense of what it was like to be there or provide a basis for later interpretation.

Take the following excerpt from a study of the West Bromwich Operatic Society. It is the first night of a new production, The Producers , by this amateur operatic society. This brief excerpt is from a much longer observation of the overture to the first evening’s performance, detailing exactly what the production is, where it is, and why there is such a tremendous sense of atmosphere and expectation surrounding the event. Space prevents including the whole observation, but I hope you can get a glimmer of the passion and excitement that precedes the performance:

Birmingham, late November, 2011, early evening.... Bars and restaurants spruce up for the evening’s trade. There is a chill in the air but the party season is just starting....

A few hundred yards away, past streaming traffic on Suffolk Street, Queensway, an audience is gathering at the New Alexandra Theatre. The foyer windows shine in the orange sodium night. Above each one is the rubric: WORLD CLASS THEATRE.

Inside the preparatory rituals are being observed; sweets chosen, interval drinks ordered and programmes bought. People swap news and titbits about the production.... The bubble of anticipation grows as the 5-minute warning sounds. People make their way to the auditorium. There have been so many nights like this in the past 110 years since a man named William Coutts invested £10,000 to build this palace of dreams.... So many fantasies have been played under this arch: melodramas and pantomimes, musicals and variety.... So many audiences, settling down in their tip-up seats, wanting to be transported away from work, from ordinariness and private troubles.... The dimming lights act like a mother’s hush. You could touch the silence. Boinnng! A spongy thump on a bass drum, and the horns pipe up that catchy, irrepressible, tasteless tune and already you’re singing under your breath, ‘Springtime for Hitler and Germany....’ The orchestra is out of sight in the pit. There’s just the velvet curtain to watch as your fingers tap along. What’s waiting behind? Then it starts it to move. Opening night.... It’s opening night! ( Matarasso, 2012 , pp. 1–2)

For another and different example—a narrative observation of an everyday but unique incident that details date, time, place, and experience—see Simons (2009 , p. 60).

Such naturalistic observations are also useful in contexts where we cannot understand what is going on through interviewing alone—in cultures with which we are less familiar or where key actors may not share our language or have difficulty expressing it. Careful description in these situations can help identify key issues, discover the norms and values that exist in the culture, and, if sufficiently detailed, allow others to cross corroborate what significance we draw from these observations. This last point is very important to avoid the danger in observation of ascribing motivations to people and meanings to transactions.

Finally, naturalistic observations are very important in highly politicized environments, often the case in commissioned evaluation case study, where individuals in interview may try to elude the “truth” or press on you that their view is the “right” view of the situation. In these contexts, naturalistic observations not only enable you to document interactions as you perceive them, but they also provide a cross-check on the veracity of information obtained in interviews.

Document analysis

Analysis of documents, as already intimated, is useful for establishing what historical antecedents might exist to provide a springboard for contemporaneous data gathering. In most cases, existing documents are also extremely pertinent for understanding the policy context.

In a national policy case study I conducted on a major curriculum change, the importance of preexisting documentation was brought home to me sharply when certain documentation initially proved elusive to obtain. It was difficult to believe that it did not exist, as the evolution of the innovation involved several parties who had not worked together before. There was bound, I thought, to be minuted meetings sharing progress and documentation of the “new” curriculum. In the absence of some crucial documents, I began to piece together the story through interviewing. Only there were gaps, and certain issues did not make sense.

It was only when I presented two versions of what I discerned had transpired in the development of this initiative in an interim report eighteen months into the study that things started to change. Subsequent to the meeting at which the report was presented, the “missing” documents started to appear. Suddenly found. What lay behind the “missing documents,” something I suspected from what certain individuals did and did not say in interview, was a major difference of view about how the innovation evolved, who was key in the process, and whose voice was more important in the context. Political differences, in other words, that some stakeholders were trying to keep from me. The emergence of the documents enabled me to finally produce an accurate and fair account.

This is an example of the importance of having access to all relevant documents relating to a program or policy in order to study it fairly. The other major way in which document analysis is useful in case study is for understanding the values, explicit and hidden, in policy and program documents and in the organization where the program or policy is implemented. Not to be ignored as documents are photographs, and these, too, can form the basis of a cultural and value analysis of an organization ( Prosser, 2000 ).

Creative artistic approaches

Increasingly, some case study researchers are employing creative approaches associated with the arts as a means of data gathering and analysis. Artistic approaches have often been used in representing findings, but less frequently in data gathering and interpretation ( Simons & McCormack, 2007 ). A major exception is the work of Richardson (1994) , who sees the very process of writing as an interpretative act, and of Cancienne and Snowber (2003) , who argue for movement as method.

The most familiar of these creative and artistic forms are written—narratives and short stories ( Clandinin & Connelly, 2000 ; Richardson, 1994 ; Sparkes, 2002 ), poems or poetic form ( Butler-Kisber, 2010 ; Duke, 2007 ; Richardson, 1997 ; Sparkes & Douglas, 2007 ), cameos of people, or vignettes of situations. These can be written by participants or by the researcher or developed in partnership. They can also be shared with participants to further interpret the data. But photographs also have a long history in qualitative research for presenting and constructing understanding ( Butler-Kisber, 2010 ; Collier, 1967 ; Prosser, 2000 ; Rugang, 2006 ; Walker, 1993 ).

Less common are other visual forms of gathering data, such as “draw and write” ( Sewell, 2011 ), artefacts, drawings, sketches, paintings, and collages, although all forms are now on the increase. For examples of the use of collage in data gathering, see Duke (2007) and Butler-Kisber (2010) , and for charcoal drawing, Elliott (2008) .

In qualitative inquiry broadly, these creative approaches are now quite common. And in the context of arts and health in particular (see, for example, Frank, 1997 ; Liamputtong & Rumbold, 2008 ; Spouse, 2000 ), we can see how artistic approaches illuminate in-depth understanding. However, in case study research to date, I think narrative forms have tended to be most prominent.

Finally, for capturing the quality and essence of peoples’ experience, nothing could be more revealing than a recording of their voices. Video diaries—self-evaluative portrayals by individuals of their perspectives, feelings, or experience of an event or situation—are a most potent way both of gaining understanding and communicating that to others. It is rather more difficult to gain access for observational videos, but they are useful for documentation and have the potential to engage participants and stakeholders in the interpretation.

Getting It All Together

Case study is so often associated with story or with a report of some event or program that it is easy to forget that much analysis and interpretation has gone on before we reach this point. In many case study reports, this process is hidden, leaving the reader with little evidence on which to assess the validity of the findings and having to trust the one who wrote the tale.

This section briefly outlines possibilities, first, for analyzing and interpreting data, and second, for how to communicate the findings to others. However it is useful to think of these together and indeed, at the start, because decisions about how you report may influence how you choose to make sense of the data. Your choice may also vary according to the context of the study—what is expected or acceptable—and your personal predilections, whether you prefer a more rational than intuitive mode of analysis, for example, or a formal or informal style of writing up that includes images, metaphor, narratives, or poetic forms.

Analyzing and Interpreting Data

When it comes to making sense of data, I make a distinction between analysis—a formal inductive process that seeks to explain—and interpretation, a more intuitive process that gains understanding and insight from a holistic grasp of data, although these may interact and overlap at different stages.

The process, whichever emphasis you choose, is one of reducing or transforming a large amount of data to themes that can encapsulate the overarching meaning in the data. This involves sorting, refining, and refocusing data until they make sense. It starts at the beginning with preliminary hunches, sometimes called “interpretative asides” or “working hypotheses,” later moving to themes, analytic propositions, or a theory of the case.

There are many ways to conduct this process. Two strategies often employed are concept mapping —a means of representing data visually to explore links between related concepts—and progressive focusing ( Parlett & Hamilton, 1976 ), the gradual reframing of initially identified issues into themes that are then further interpreted to generate findings. Each of these strategies tends to have three stages: initial sense making, identification of themes, and examination of patterns and relationships between them.

If taking a formal analytic approach to the task, the data would likely be broken down into segments or datasets (coded and categorized) and then reordered and explored for themes, patterns, and possible propositions. If adopting a more intuitive process, you might focus on identifying insights through metaphors and images, lateral thinking, or puzzling over paradoxes and ambiguities in the data, after first immersing yourself in the total dataset, reading and re-reading interview scripts, observations and field notes to get a sense of the whole. Trying out different forms of making sense through poetry, vignettes, cameos, narratives, collages, and drawing are further creative ways to interpret data, as are photographs taken in the case arranged to explain or tell the story of the case.

Reporting Case Study Research

Narrative structure and story.

As indicated in the introduction, telling a story is often associated with case study and some think this is what a case study is. In one sense, it is and, given that story is the natural way in which we learn ( Okri, 1997 ), it is a useful framework both for gathering data and for communicating case study findings. Not any story will do however. To count as research, it must be authentic, grounded in data, interpreted and analyzed to convey the meaning of the case.

There are several senses in which story is appropriate in qualitative case study: in capturing stories participants tell, in generating a narrative structure that makes sense of the case (i.e., the story you will tell), and in deciding how you communicate this narrative (i.e., in story form). If you choose a written story form (and advice here can be sought from Harrington (2003) and Caulley (2008) ), it needs to be clearly structured, well written, and contain only the detail that is necessary to give readers the vicarious experience of what it was like in the case. If the story is to be communicated in other ways, through, for example, audio or videotape, or computer or personal interaction, the same applies, substituting visual and interpersonal skill for written.

Matching forms of reporting to audience

The art of reporting is strongly connected to usability, so forms of reporting need to connect to the audiences we hope to inform: how they learn, what kind of evidence they value, and what kind of reporting maximizes the chances they will use the findings to promote policies and programs in the interests of beneficiaries. As Okri (1997) further reminds us, the writer only does half the work; the reader does the other (p. 41).

There may be other considerations as well: how open are commissioners to receiving stories of difficulties, as well as success stories? What might they need to hear beyond what is sought in the technical brief? And through what style of reporting would you try and persuade them? If conducting noncommissioned case study research, the scope for different forms of reporting is wider. In academia, for instance, many institutions these days accept creative and artistic forms of reporting when supported by supervisors and appreciated by examiners.

Styles of Reporting

The most obvious form of reporting is linear, often starting with a short executive summary and a brief description of focus and context, followed by methodology, the case study or thematic analysis, findings, and conclusions or implications. Conclusion-led reporting is similar in terms of its formality, but simply starts the other way around. From the conclusions drawn from the analyzed data, it works backward to tell the story through narrative, verbatim, and observational data of how these conclusions were reached. Both have a strong story line. The intent is analytic and explanatory.

Quite a different approach is to engage the reader in the experience and veracity of the case. Rather like constructing a portrait or editing a documentary film, this involves the sifting, constructing, re-ordering of frames, events and episodes to tell a coherent story primarily through interview excerpts, observations, vignettes, and critical incidents that depict what transpired in the case. Interpretation is indirect through the weaving of the data. The story can start at any point provided the underlying narrative structure is maintained to establish coherence ( House, 1980 , p. 116).

Different again, and from the other end of a continuum, is a highly interpretative account that may use similar ways of presenting data but weaves a story from the outset that is highly interpretative. Engaging metaphor, images, short stories, contradictions, paradoxes, and puzzles, it is invariably interesting to read and can be most persuasive. However, the evidence is less visible and therefore less open to alternative interpretations.

Even more persuasive is a case study that uses artistic forms to communicate the story of the case. Paintings, poetic form, drawings, photography, collage, and movement can all be adopted to report findings, whether the data was acquired using these forms or by other means. The arts-based inquiry movement ( Mullen & Finley, 2003 ) has contributed hugely to the validation and legitimation of artistic and creative ways of representing qualitative research findings. The journal Qualitative Inquiry contains many good examples, but see also Liamputtong & Rumbold (2008) . Such artistic forms of representation may not be for everyone or appropriate in some contexts, but they do have the power to engage an audience and the potential to facilitate use.

Generalization in Case Study Research

One of the potential limitations of case study often proposed is that it is impossible to generalize. This is not so. However, the way in which one generalizes from a case is different from that adopted in traditional forms of social science research that utilize large samples (randomly selected) and statistical procedures and which assume regularities in the social world that allow cause and effect to be determined. In this form of research inferences from data are stated as formal propositions that apply to all in the target population. See Donmoyer (1990) for an argument on the restricted nature of this form of generalization when considering single-case studies.

Making inferences from cases with a qualitative data set arises more from a process of interpretation in context, appealing to tacit and situated understanding for acceptance of their validity. Such inferences are possible where the context and experience of the case is richly described so the reader can recognize and connect with the events and experiences portrayed. There are two ways to examine how to reach these generalized understandings. One is to generalize from the case to other cases of a similar or dissimilar nature. The other is to see what we learn in-depth from the uniqueness of the single case itself.

Generalizing from the Single Case

A common approach to generalization and one most akin to a propositional form is cross-case generalization. In a collective or multi-site case study, each case is explored to see if issues that arise in one case also exist in other cases and what interconnecting themes there are between them. This kind of generalization has a degree of abstraction and potential for theorizing and is often welcomed by commissioners of research concerned that findings from the single case do not provide an adequate or “safe” basis for policy determination.

However, there are four additional ways to generalize from the single case, all of which draw more on tacit knowledge and recognition of context, although in different ways. In naturalistic generalization , first proposed by Stake (1978) , generalization is reached on the basis of recognition of similarities and differences to cases with which we are familiar. To enable such recognition, the case needs to feature rich description; people’s voices; and enough detail of time, place, and context to provide a vicarious experience to help readers discern what is similar and dissimilar to their own context ( Stake, 1978 ).

Situated generalization ( Simons, Kushner, Jones, & James, 2003 ) is close to the concept of naturalistic generalization in relying for its generality on retaining a connectedness with the context in which it first evolved. However, it has an extra dimension in a practice context. This notion of generalization was identified in an evaluation of a research project that engaged teachers in and with research. Here, in addition to the usual validity criteria to establish the warrant for the findings, the generalization was seen as dependable if trust existed between those who conducted the research (teachers, in this example) and those thinking about using it (other teachers). In other words, beyond the technical validity of the research, teachers considered using the findings in their own practice because they had confidence in those who generated them. This is a useful way to think about generalization if we wish research findings to improve professional practice.

The next two concepts of generalization— concept and process generalization —relate more to what you discover in making sense of the case. As you interpret and analyze, you begin to generate a theory of the case that makes sense of the whole. Concepts may be identified that make sense in the one case but have equal significance in other cases of a similar kind, even if the contexts are different.

It is the concept that generalizes, not the specific content or context. This may be similar to the process Donmoyer (2008) identifies of “intellectual generalization” (quoted by Butler-Kisber, 2010 , p. 15) to indicate the cognitive understanding one can gain from qualitative accounts even if settings are quite different.

The same is true for generalization of a process. It is possible to identify a significant process in one case (or several cases) that is transferable to other contexts, irrespective of the precise content and contexts of those other cases. An example here is the collaborative model for sustainable school self-evaluation I identified in researching school self-evaluation in a number of schools and countries ( Simons, 2002 ). Schools that successfully sustained school self-evaluation had an infrastructure that was collaborative at all stages of the evaluation process from design to conduct of the study, to analyzing the results and to reporting the findings. This ensured that the whole school was involved and that results were discussed and built into the ongoing development of school policies and practice. In other cases, different processes may be discovered that have applicability in a range of contexts. As with concept generalization, it is the process that generalizes not the substantive content or specific context.

Particularization

The forms of generalization discussed above are useful when we have to justify case study in a research or policy context. But the overarching justification for how we learn from case study is particularization —a rich portrayal of insights and understandings interpreted in the particular context. Several authors have made this point ( Stake, 1995 ; Flyvberg, 2006 ; Simons 2009 ). Stake puts it most sharply when he observes that “The real business of case study is particularization, not generalization” (p. 8), referring here to the main reason for studying the singular, which is to understand the uniqueness of the case itself.

My perspective (explored further in Simons, 1996 ; Simons, 2009 , p. 239; Simons & McCormack, 2007 ) is similar in that I believe the “real” strength of case study lies in the insights we gain from in-depth study of the particular. But I also argue for the universality of such insights—if we get it “right.” By which I mean that if we are able to capture and report the uniqueness, the essence, of the case in all its particularity and present this in a way we can all recognize, we will discover something of universal significance. This is something of a paradox. The more you learn in depth about the particularity of one person, situation, or context, the more likely you are to discover something universal. This process of reaching understanding has support both from the way in which many discoveries are made in science and in how we learn from artists, poets, and novelists, who reach us by communicating a recognizable truth about individuals, human relationships, and/or social contexts.

This concept of particularization is far from new, as the quotation from a preface to a book written in 1908 attests. Stephen Reynolds, the author of A Poor Man’s House , notes that the substance of the book was first recorded in a journal, kept for purposes of fiction, and in letters to one of his friends, but fiction proved an inappropriate medium. He felt that the life and the people were so much better than anything he could invent. The book therefore consists of the journal and letters drawn together to present a picture of a typical poor man’s house and life, much as we might draw together a range of data to present a case study. It is not the substance of the book that concerns us here but the methodological relevance to case study research. Reynolds notes that the conclusions expressed are tentative and possibly go beyond this man’s life, so he thought some explanation of the way he arrived at them was needed:

Educated people usually deal with the poor man’s life deductively; they reason from the general to the particular; and, starting with a theory, religious, philanthropic, political, or what not, they seek, and too easily find, among the millions of poor, specimens—very frequently abnormal—to illustrate their theories. With anything but human beings, that is an excellent method. Human beings, unfortunately, have individualities. They do what, theoretically, they ought not to do, and leave undone those things they ought to do. They are even said to possess souls—untrustworthy things beyond the reach of sociologists. The inductive method—reasoning from the particular to the general... should at least help to counterbalance the psychological superficiality of the deductive method. ( Reynolds, 1908 : preface) 1

Slightly overstated perhaps, but the point is well made. In our search for general laws, we not only lose sight of the uniqueness and humanity of individuals, but reduce them in the process, failing to present their experience in any “real” sense. What is astonishing about the quotation is that it was written over a century ago and yet many still argue today that you cannot generalize from the particular.

Going even further back, in 1798, Blake proclaimed that “To Generalize is to be an Idiot. To Particularize is the Alone Distinction of Merit.” In research, we may not wish to make such a strong distinction: these processes both have their uses in different kinds of research. But there is a major point here for the study of the particular that Wilson (2008) notes in commenting on Blake’s perception when he says: “Favouring the abstract over the concrete, one ‘sees all things only thro’ the narrow chinks of his cavern”’ (referring here to Blake’s The Marriage of Heaven and Hell [1793]; in Wilson, 2008 , p. 62). The danger Wilson is pointing to here is that abstraction relies heavily on what we know from our past understanding of things, and this may prevent us experiencing a concrete event directly or “apprehend[ing] a particular moment” ( Wilson, 2008 , p. 63).

Blake had a different mission, of course, than case researchers, and he was not himself free from abstractions, as Wilson points out, although he fought hard “to break through mental barriers to something unique and living” ( Wilson, 2008 , p. 65). It is this search for the “unique and living” and experiencing the “isness” of the particular that we should take from the Blake example to remind ourselves of the possibility of discovering something “new,” beyond our current understanding of the way things are.

Focusing on particularization does not diminish the usefulness of case study research for policy makers or practitioners. Grounded in recognizable experience, the potential is there to reach a range of audiences and to facilitate use of the findings. It may be more difficult for those who seek formal generalizations that seem to offer a safe basis for policy making to accept case study reports. However, particular stories often hold the key to why policies have or have not worked well in the past. It is not necessary to present long cases—a criticism frequently levelled—to demonstrate the story of the case. Such case stories can be most insightful for policy makers who, like many of us in everyday life, often draw inferences from a single instance or case, whatever the formal evidence presented. “I am reminded of the story of....”

The case for studying the particular to inform practice in professional contexts needs less persuasion because practitioners can recognize the content and context quite readily and make the inference to their own particular context ( Simons et al., 2003 ). In both sets of circumstances—policy and practice—it is more a question of whether the readers of our case research accept the validity of findings determined in this way, how they choose to learn, and our skill in telling the case study story.

Conclusion and Future Directions

In this chapter, I have presented an argument for case study research, making the case, in particular, for using qualitative methods to highlight what it is that qualitative case study research can bring to the study of social and educational programs. I outlined the various ways in which case study is commonly used before focusing directly on case study as a major mode of research inquiry, noting characteristics it shares with other qualitative methodologies, as well as itsdifference and the difficulties it is sometimes perceived to have. The chapter emphasizes the importance of thinking through what the case is, to be sure that the issues explored and the data generated do illuminate this case and not any other.

But there is still more to be done. In particular, I think we need to be more adventurous in how we craft and report the case. I suspect we may have been too cautious in the past in how we justified case study research, borrowing concepts from other disciplines and forms of educational research. More than 40 years on, it is time to take a greater risk—in demonstrating the intrinsic nature of case study and what it can offer to our understanding of human and social situations.

I have already drawn attention to the need to design the case, although this could be developed further to accentuate the uniqueness of the particular case. One way to do this is to feature individuals more in the design itself, not only to explore programs and policies through perspectives of key actors or groups and transactions between them, which to some extent happens already, but also to get them to characterize what makes the context unique. This is the reversal of many a design framework that starts with the logic of a program and takes forward the argument for personal evaluation ( Kushner, 2000 ), noted in the interlude on evaluation. Apart from this attention to design, there are three other issues I think we need to explore further: the warrant for creative methods in case study, more imaginative reporting; and how we learn from a study of the singular.

Warrant for More Creative Methods in Case Study Research

The promise that creative methods have for eliciting in-depth understanding and capturing the unusual, the idiosyncratic, the uniqueness of the case, was mentioned in the methods section. Yet, in case study research, particularly in program and policy contexts, we have few good examples of the use of artistic approaches for eliciting and interpreting data, although more, as acknowledged later, for presenting it. This may be because case study research is often conducted in academic or policy environments, where propositional ways of knowing are more valued.

Using creative and artistic forms in generating and interpreting case study data offers a form of evidence that acknowledges experiential understanding in illuminating the uniqueness of the case. The question is how to establish the warrant for this way of knowing and persuade others of its virtue. The answer is simple. By demonstrating the use of these methods in action, by arguing for a different form of validity that matches the intrinsic nature of the method, and, above all, by good examples.

Representing Findings to Engage Audiences in Learning

In evaluative and research policy contexts, where case study is often the main mode of inquiry or part of a broader study, case study reports often take a formal structure or sometimes, where the context is receptive, a portrayal or interpretative form. But, too often, the qualitative is an add-on to a story told by other means or reduced to issues in which the people who gave rise to the data are no longer seen. However, there are many ways to put them center stage.

Tell good stories and tell them well. Or, let key actors tell their own stories. Explore the different ways technology can help. Make video clips that demonstrate events in context, illustrate interactions between people, give voice to participants—show the reality of the program, in other words. Use graphics to summarize key issues and interactive, cartoon technology, as seen on some TED presentations, to summarize and visually show the complexity of the case. Video diaries were mentioned in the methods section: seeing individuals tell their tales directly is a powerful way of communicating, unhindered by “our” sense making. Tell photo stories. Let the photos convey the narrative, but make sure the structure of the narrative is evident to ensure coherence. These are just the beginnings. Those skilled in information technology could no doubt stretch our imagination further.

One problem and a further question concerns our audiences. Will they accept these modes of communication? Maybe not, in some contexts. However, there are three points I wish to leave you with. First, do not presume that they won’t. If people are fully present in the story and the complexity is not diminished, those reading, watching, or hearing about the case will get the message. If you are worried about how commissioners might respond, remember that they are no different from any other stakeholder or participant when it comes to how they learn from human experience. Witness the reference to Okri (1997) earlier about how we learn.

Second, when you detect that the context requires a more formal presentation of findings, respond according to expectation but also include elements of other forms of presentation. Nudge a little in the direction of creativity. Third, simply take a chance, that risk I spoke about earlier. Challenge the status quo. Find situations and contexts where you can fully represent the qualitative nature of the experience in the cases you study with creative forms of interpretation and representation. And let the audience decide.

Learning from a Study of the Singular

Finally, to return to the issue of “generalization” in case study that worries some audiences. I pointed out in the generalization section several ways in which it is possible to generalize from case study research, not in a formal propositional sense or from a case to a population, but by retaining a connection with the context in which the generalization first arose—that is, to realize in-depth understanding in context in different circumstances and situations. However, I also emphasized that, in many instances, it is particularization from which we learn. That is the point of the singular case study, and it is an art to perceive and craft the case in ways that we can.

Acknowledgments

Parts of this chapter build on ideas first explored in Simons, 2009 .

I am grateful to Bob Williams for pointing out the relevance of this quotation from Reynolds to remind us that “there is nothing new under the sun” and that we sometimes continue to engage endlessly in debates that have been well rehearsed before.

Adams, T. ( 2012 ) ‘ Olympics 2012: Team GB falters but London shines bright on opening day ’, Observer, 29.07.12.

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What is case study research?

Last updated

8 February 2023

Reviewed by

Cathy Heath

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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Writing a Case Study

Hands holding a world globe

What is a case study?

A Map of the world with hands holding a pen.

A Case study is: 

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

What are the different types of case studies?

Man and woman looking at a laptop

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

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

Who are your case study participants?

Boys looking through a camera

What is triangulation ? 

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

Triangulation image with examples

How to write a Case Study?

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

Man holding his hand out to show five fingers.

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What Is a Case Study?

Weighing the pros and cons of this method of research

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

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Cara Lustik is a fact-checker and copywriter.

case study v experiment

Verywell / Colleen Tighe

  • Pros and Cons

What Types of Case Studies Are Out There?

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

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

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

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

At a Glance

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

What Are the Benefits and Limitations of Case Studies?

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

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

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

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

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

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

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

Case Study Examples

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

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

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

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

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

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

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

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

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

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

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

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

Section 1: A Case History

This section will have the following structure and content:

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

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

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

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

Section 2: Treatment Plan

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

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

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

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

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

Need More Tips?

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

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

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

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

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

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

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

Case Study Research Method in Psychology

Saul Mcleod, PhD

Editor-in-Chief for Simply Psychology

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

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

Learn about our Editorial Process

Olivia Guy-Evans, MSc

Associate Editor for Simply Psychology

BSc (Hons) Psychology, MSc Psychology of Education

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

On This Page:

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

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

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

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

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

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

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

case study

 Famous Case Studies

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

Clinical Case Studies

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

Child Psychology Case Studies

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

Types of Case Studies

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

Where Do You Find Data for a Case Study?

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

1. Primary sources

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

2. Secondary sources

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

3. Archival records

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

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

4. Organizational records

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

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

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

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

How do I Write a Case Study in Psychology?

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

1. Introduction

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

2. Case Presentation

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

3. Management and Outcome

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

4. Discussion

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

5. Additional Items

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

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

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

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

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

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

Limitations

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Further Information

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

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Home » Case Study – Methods, Examples and Guide

Case Study – Methods, Examples and Guide

Table of Contents

Case Study Research

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.

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Case Study vs. Single-Case Experimental Designs

What's the difference.

Case study and single-case experimental designs are both research methods used in psychology and other social sciences to investigate individual cases or subjects. However, they differ in their approach and purpose. Case studies involve in-depth examination of a single case, such as an individual, group, or organization, to gain a comprehensive understanding of the phenomenon being studied. On the other hand, single-case experimental designs focus on studying the effects of an intervention or treatment on a single subject over time. These designs use repeated measures and control conditions to establish cause-and-effect relationships. While case studies provide rich qualitative data, single-case experimental designs offer more rigorous experimental control and allow for the evaluation of treatment effectiveness.

Further Detail

Introduction.

When conducting research in various fields, it is essential to choose the appropriate study design to answer research questions effectively. Two commonly used designs are case study and single-case experimental designs. While both approaches aim to provide valuable insights into specific phenomena, they differ in several key attributes. This article will compare and contrast the attributes of case study and single-case experimental designs, highlighting their strengths and limitations.

Definition and Purpose

A case study is an in-depth investigation of a particular individual, group, or event. It involves collecting and analyzing qualitative or quantitative data to gain a comprehensive understanding of the subject under study. Case studies are often used to explore complex phenomena, generate hypotheses, or provide detailed descriptions of unique cases.

On the other hand, single-case experimental designs are a type of research design that focuses on studying a single individual or a small group over time. These designs involve manipulating an independent variable and measuring its effects on a dependent variable. Single-case experimental designs are particularly useful for examining cause-and-effect relationships and evaluating the effectiveness of interventions or treatments.

Data Collection and Analysis

In terms of data collection, case studies rely on various sources such as interviews, observations, documents, and artifacts. Researchers often employ multiple methods to gather rich and diverse data, allowing for a comprehensive analysis of the case. The data collected in case studies are typically qualitative in nature, although quantitative data may also be included.

In contrast, single-case experimental designs primarily rely on quantitative data collection methods. Researchers use standardized measures and instruments to collect data on the dependent variable before, during, and after the manipulation of the independent variable. This allows for a systematic analysis of the effects of the intervention or treatment on the individual or group being studied.

Generalizability

One of the key differences between case studies and single-case experimental designs is their generalizability. Case studies are often conducted on unique or rare cases, making it challenging to generalize the findings to a larger population. The focus of case studies is on providing detailed insights into specific cases rather than making broad generalizations.

On the other hand, single-case experimental designs aim to establish causal relationships and can provide evidence for generalizability. By systematically manipulating the independent variable and measuring its effects on the dependent variable, researchers can draw conclusions about the effectiveness of interventions or treatments that may be applicable to similar cases or populations.

Internal Validity

Internal validity refers to the extent to which a study accurately measures the cause-and-effect relationship between variables. In case studies, establishing internal validity can be challenging due to the lack of control over extraneous variables. The presence of multiple data sources and the potential for subjective interpretation may also introduce bias.

In contrast, single-case experimental designs prioritize internal validity by employing rigorous control over extraneous variables. Researchers carefully design the intervention or treatment, implement it consistently, and measure the dependent variable under controlled conditions. This allows for a more confident determination of the causal relationship between the independent and dependent variables.

Time and Resources

Case studies often require significant time and resources due to their in-depth nature. Researchers need to spend considerable time collecting and analyzing data from various sources, conducting interviews, and immersing themselves in the case. Additionally, case studies may involve multiple researchers or a research team, further increasing the required resources.

On the other hand, single-case experimental designs can be more time and resource-efficient. Since they focus on a single individual or a small group, data collection and analysis can be more streamlined. Researchers can also implement interventions or treatments in a controlled manner, reducing the time and resources needed for data collection.

Ethical Considerations

Both case studies and single-case experimental designs require researchers to consider ethical implications. In case studies, researchers must ensure the privacy and confidentiality of the individuals or groups being studied. Informed consent and ethical guidelines for data collection and analysis should be followed to protect the rights and well-being of the participants.

Similarly, in single-case experimental designs, researchers must consider ethical considerations when implementing interventions or treatments. The well-being and safety of the individual or group being studied should be prioritized, and informed consent should be obtained. Additionally, researchers should carefully monitor and evaluate the potential risks and benefits associated with the intervention or treatment.

Case studies and single-case experimental designs are valuable research approaches that offer unique insights into specific phenomena. While case studies provide in-depth descriptions and exploratory analyses of individual cases, single-case experimental designs focus on establishing causal relationships and evaluating interventions or treatments. Researchers should carefully consider the attributes and goals of their study when choosing between these two designs, ensuring that the selected approach aligns with their research questions and objectives.

Comparisons may contain inaccurate information about people, places, or facts. Please report any issues.

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6.1 Experiment Basics

Learning objectives.

  • Explain what an experiment is and recognize examples of studies that are experiments and studies that are not experiments.
  • Explain what internal validity is and why experiments are considered to be high in internal validity.
  • Explain what external validity is and evaluate studies in terms of their external validity.
  • Distinguish between the manipulation of the independent variable and control of extraneous variables and explain the importance of each.
  • Recognize examples of confounding variables and explain how they affect the internal validity of a study.

What Is an Experiment?

As we saw earlier in the book, an experiment is a type of study designed specifically to answer the question of whether there is a causal relationship between two variables. Do changes in an independent variable cause changes in a dependent variable? Experiments have two fundamental features. The first is that the researchers manipulate, or systematically vary, the level of the independent variable. The different levels of the independent variable are called conditions. For example, in Darley and Latané’s experiment, the independent variable was the number of witnesses that participants believed to be present. The researchers manipulated this independent variable by telling participants that there were either one, two, or five other students involved in the discussion, thereby creating three conditions. The second fundamental feature of an experiment is that the researcher controls, or minimizes the variability in, variables other than the independent and dependent variable. These other variables are called extraneous variables. Darley and Latané tested all their participants in the same room, exposed them to the same emergency situation, and so on. They also randomly assigned their participants to conditions so that the three groups would be similar to each other to begin with. Notice that although the words manipulation and control have similar meanings in everyday language, researchers make a clear distinction between them. They manipulate the independent variable by systematically changing its levels and control other variables by holding them constant.

Internal and External Validity

Internal validity.

Recall that the fact that two variables are statistically related does not necessarily mean that one causes the other. “Correlation does not imply causation.” For example, if it were the case that people who exercise regularly are happier than people who do not exercise regularly, this would not necessarily mean that exercising increases people’s happiness. It could mean instead that greater happiness causes people to exercise (the directionality problem) or that something like better physical health causes people to exercise and be happier (the third-variable problem).

The purpose of an experiment, however, is to show that two variables are statistically related and to do so in a way that supports the conclusion that the independent variable caused any observed differences in the dependent variable. The basic logic is this: If the researcher creates two or more highly similar conditions and then manipulates the independent variable to produce just one difference between them, then any later difference between the conditions must have been caused by the independent variable. For example, because the only difference between Darley and Latané’s conditions was the number of students that participants believed to be involved in the discussion, this must have been responsible for differences in helping between the conditions.

An empirical study is said to be high in internal validity if the way it was conducted supports the conclusion that the independent variable caused any observed differences in the dependent variable. Thus experiments are high in internal validity because the way they are conducted—with the manipulation of the independent variable and the control of extraneous variables—provides strong support for causal conclusions.

External Validity

At the same time, the way that experiments are conducted sometimes leads to a different kind of criticism. Specifically, the need to manipulate the independent variable and control extraneous variables means that experiments are often conducted under conditions that seem artificial or unlike “real life” (Stanovich, 2010). In many psychology experiments, the participants are all college undergraduates and come to a classroom or laboratory to fill out a series of paper-and-pencil questionnaires or to perform a carefully designed computerized task. Consider, for example, an experiment in which researcher Barbara Fredrickson and her colleagues had college students come to a laboratory on campus and complete a math test while wearing a swimsuit (Fredrickson, Roberts, Noll, Quinn, & Twenge, 1998). At first, this might seem silly. When will college students ever have to complete math tests in their swimsuits outside of this experiment?

The issue we are confronting is that of external validity. An empirical study is high in external validity if the way it was conducted supports generalizing the results to people and situations beyond those actually studied. As a general rule, studies are higher in external validity when the participants and the situation studied are similar to those that the researchers want to generalize to. Imagine, for example, that a group of researchers is interested in how shoppers in large grocery stores are affected by whether breakfast cereal is packaged in yellow or purple boxes. Their study would be high in external validity if they studied the decisions of ordinary people doing their weekly shopping in a real grocery store. If the shoppers bought much more cereal in purple boxes, the researchers would be fairly confident that this would be true for other shoppers in other stores. Their study would be relatively low in external validity, however, if they studied a sample of college students in a laboratory at a selective college who merely judged the appeal of various colors presented on a computer screen. If the students judged purple to be more appealing than yellow, the researchers would not be very confident that this is relevant to grocery shoppers’ cereal-buying decisions.

We should be careful, however, not to draw the blanket conclusion that experiments are low in external validity. One reason is that experiments need not seem artificial. Consider that Darley and Latané’s experiment provided a reasonably good simulation of a real emergency situation. Or consider field experiments that are conducted entirely outside the laboratory. In one such experiment, Robert Cialdini and his colleagues studied whether hotel guests choose to reuse their towels for a second day as opposed to having them washed as a way of conserving water and energy (Cialdini, 2005). These researchers manipulated the message on a card left in a large sample of hotel rooms. One version of the message emphasized showing respect for the environment, another emphasized that the hotel would donate a portion of their savings to an environmental cause, and a third emphasized that most hotel guests choose to reuse their towels. The result was that guests who received the message that most hotel guests choose to reuse their towels reused their own towels substantially more often than guests receiving either of the other two messages. Given the way they conducted their study, it seems very likely that their result would hold true for other guests in other hotels.

A second reason not to draw the blanket conclusion that experiments are low in external validity is that they are often conducted to learn about psychological processes that are likely to operate in a variety of people and situations. Let us return to the experiment by Fredrickson and colleagues. They found that the women in their study, but not the men, performed worse on the math test when they were wearing swimsuits. They argued that this was due to women’s greater tendency to objectify themselves—to think about themselves from the perspective of an outside observer—which diverts their attention away from other tasks. They argued, furthermore, that this process of self-objectification and its effect on attention is likely to operate in a variety of women and situations—even if none of them ever finds herself taking a math test in her swimsuit.

Manipulation of the Independent Variable

Again, to manipulate an independent variable means to change its level systematically so that different groups of participants are exposed to different levels of that variable, or the same group of participants is exposed to different levels at different times. For example, to see whether expressive writing affects people’s health, a researcher might instruct some participants to write about traumatic experiences and others to write about neutral experiences. The different levels of the independent variable are referred to as conditions , and researchers often give the conditions short descriptive names to make it easy to talk and write about them. In this case, the conditions might be called the “traumatic condition” and the “neutral condition.”

Notice that the manipulation of an independent variable must involve the active intervention of the researcher. Comparing groups of people who differ on the independent variable before the study begins is not the same as manipulating that variable. For example, a researcher who compares the health of people who already keep a journal with the health of people who do not keep a journal has not manipulated this variable and therefore not conducted an experiment. This is important because groups that already differ in one way at the beginning of a study are likely to differ in other ways too. For example, people who choose to keep journals might also be more conscientious, more introverted, or less stressed than people who do not. Therefore, any observed difference between the two groups in terms of their health might have been caused by whether or not they keep a journal, or it might have been caused by any of the other differences between people who do and do not keep journals. Thus the active manipulation of the independent variable is crucial for eliminating the third-variable problem.

Of course, there are many situations in which the independent variable cannot be manipulated for practical or ethical reasons and therefore an experiment is not possible. For example, whether or not people have a significant early illness experience cannot be manipulated, making it impossible to do an experiment on the effect of early illness experiences on the development of hypochondriasis. This does not mean it is impossible to study the relationship between early illness experiences and hypochondriasis—only that it must be done using nonexperimental approaches. We will discuss this in detail later in the book.

In many experiments, the independent variable is a construct that can only be manipulated indirectly. For example, a researcher might try to manipulate participants’ stress levels indirectly by telling some of them that they have five minutes to prepare a short speech that they will then have to give to an audience of other participants. In such situations, researchers often include a manipulation check in their procedure. A manipulation check is a separate measure of the construct the researcher is trying to manipulate. For example, researchers trying to manipulate participants’ stress levels might give them a paper-and-pencil stress questionnaire or take their blood pressure—perhaps right after the manipulation or at the end of the procedure—to verify that they successfully manipulated this variable.

Control of Extraneous Variables

An extraneous variable is anything that varies in the context of a study other than the independent and dependent variables. In an experiment on the effect of expressive writing on health, for example, extraneous variables would include participant variables (individual differences) such as their writing ability, their diet, and their shoe size. They would also include situation or task variables such as the time of day when participants write, whether they write by hand or on a computer, and the weather. Extraneous variables pose a problem because many of them are likely to have some effect on the dependent variable. For example, participants’ health will be affected by many things other than whether or not they engage in expressive writing. This can make it difficult to separate the effect of the independent variable from the effects of the extraneous variables, which is why it is important to control extraneous variables by holding them constant.

Extraneous Variables as “Noise”

Extraneous variables make it difficult to detect the effect of the independent variable in two ways. One is by adding variability or “noise” to the data. Imagine a simple experiment on the effect of mood (happy vs. sad) on the number of happy childhood events people are able to recall. Participants are put into a negative or positive mood (by showing them a happy or sad video clip) and then asked to recall as many happy childhood events as they can. The two leftmost columns of Table 6.1 “Hypothetical Noiseless Data and Realistic Noisy Data” show what the data might look like if there were no extraneous variables and the number of happy childhood events participants recalled was affected only by their moods. Every participant in the happy mood condition recalled exactly four happy childhood events, and every participant in the sad mood condition recalled exactly three. The effect of mood here is quite obvious. In reality, however, the data would probably look more like those in the two rightmost columns of Table 6.1 “Hypothetical Noiseless Data and Realistic Noisy Data” . Even in the happy mood condition, some participants would recall fewer happy memories because they have fewer to draw on, use less effective strategies, or are less motivated. And even in the sad mood condition, some participants would recall more happy childhood memories because they have more happy memories to draw on, they use more effective recall strategies, or they are more motivated. Although the mean difference between the two groups is the same as in the idealized data, this difference is much less obvious in the context of the greater variability in the data. Thus one reason researchers try to control extraneous variables is so their data look more like the idealized data in Table 6.1 “Hypothetical Noiseless Data and Realistic Noisy Data” , which makes the effect of the independent variable is easier to detect (although real data never look quite that good).

Table 6.1 Hypothetical Noiseless Data and Realistic Noisy Data

One way to control extraneous variables is to hold them constant. This can mean holding situation or task variables constant by testing all participants in the same location, giving them identical instructions, treating them in the same way, and so on. It can also mean holding participant variables constant. For example, many studies of language limit participants to right-handed people, who generally have their language areas isolated in their left cerebral hemispheres. Left-handed people are more likely to have their language areas isolated in their right cerebral hemispheres or distributed across both hemispheres, which can change the way they process language and thereby add noise to the data.

In principle, researchers can control extraneous variables by limiting participants to one very specific category of person, such as 20-year-old, straight, female, right-handed, sophomore psychology majors. The obvious downside to this approach is that it would lower the external validity of the study—in particular, the extent to which the results can be generalized beyond the people actually studied. For example, it might be unclear whether results obtained with a sample of younger straight women would apply to older gay men. In many situations, the advantages of a diverse sample outweigh the reduction in noise achieved by a homogeneous one.

Extraneous Variables as Confounding Variables

The second way that extraneous variables can make it difficult to detect the effect of the independent variable is by becoming confounding variables. A confounding variable is an extraneous variable that differs on average across levels of the independent variable. For example, in almost all experiments, participants’ intelligence quotients (IQs) will be an extraneous variable. But as long as there are participants with lower and higher IQs at each level of the independent variable so that the average IQ is roughly equal, then this variation is probably acceptable (and may even be desirable). What would be bad, however, would be for participants at one level of the independent variable to have substantially lower IQs on average and participants at another level to have substantially higher IQs on average. In this case, IQ would be a confounding variable.

To confound means to confuse, and this is exactly what confounding variables do. Because they differ across conditions—just like the independent variable—they provide an alternative explanation for any observed difference in the dependent variable. Figure 6.1 “Hypothetical Results From a Study on the Effect of Mood on Memory” shows the results of a hypothetical study, in which participants in a positive mood condition scored higher on a memory task than participants in a negative mood condition. But if IQ is a confounding variable—with participants in the positive mood condition having higher IQs on average than participants in the negative mood condition—then it is unclear whether it was the positive moods or the higher IQs that caused participants in the first condition to score higher. One way to avoid confounding variables is by holding extraneous variables constant. For example, one could prevent IQ from becoming a confounding variable by limiting participants only to those with IQs of exactly 100. But this approach is not always desirable for reasons we have already discussed. A second and much more general approach—random assignment to conditions—will be discussed in detail shortly.

Figure 6.1 Hypothetical Results From a Study on the Effect of Mood on Memory

Hypothetical Results From a Study on the Effect of Mood on Memory

Because IQ also differs across conditions, it is a confounding variable.

Key Takeaways

  • An experiment is a type of empirical study that features the manipulation of an independent variable, the measurement of a dependent variable, and control of extraneous variables.
  • Studies are high in internal validity to the extent that the way they are conducted supports the conclusion that the independent variable caused any observed differences in the dependent variable. Experiments are generally high in internal validity because of the manipulation of the independent variable and control of extraneous variables.
  • Studies are high in external validity to the extent that the result can be generalized to people and situations beyond those actually studied. Although experiments can seem “artificial”—and low in external validity—it is important to consider whether the psychological processes under study are likely to operate in other people and situations.
  • Practice: List five variables that can be manipulated by the researcher in an experiment. List five variables that cannot be manipulated by the researcher in an experiment.

Practice: For each of the following topics, decide whether that topic could be studied using an experimental research design and explain why or why not.

  • Effect of parietal lobe damage on people’s ability to do basic arithmetic.
  • Effect of being clinically depressed on the number of close friendships people have.
  • Effect of group training on the social skills of teenagers with Asperger’s syndrome.
  • Effect of paying people to take an IQ test on their performance on that test.

Cialdini, R. (2005, April). Don’t throw in the towel: Use social influence research. APS Observer . Retrieved from http://www.psychologicalscience.org/observer/getArticle.cfm?id=1762 .

Fredrickson, B. L., Roberts, T.-A., Noll, S. M., Quinn, D. M., & Twenge, J. M. (1998). The swimsuit becomes you: Sex differences in self-objectification, restrained eating, and math performance. Journal of Personality and Social Psychology, 75 , 269–284.

Stanovich, K. E. (2010). How to think straight about psychology (9th ed.). Boston, MA: Allyn & Bacon.

Research Methods in Psychology Copyright © 2016 by University of Minnesota is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

AI on Trial: Legal Models Hallucinate in 1 out of 6 Queries

A new study reveals the need for benchmarking and public evaluations of AI tools in law.

Scales of justice illustrated in code

Artificial intelligence (AI) tools are rapidly transforming the practice of law. Nearly  three quarters of lawyers plan on using generative AI for their work, from sifting through mountains of case law to drafting contracts to reviewing documents to writing legal memoranda. But are these tools reliable enough for real-world use?

Large language models have a documented tendency to “hallucinate,” or make up false information. In one highly-publicized case, a New York lawyer  faced sanctions for citing ChatGPT-invented fictional cases in a legal brief;  many similar cases have since been reported. And our  previous study of general-purpose chatbots found that they hallucinated between 58% and 82% of the time on legal queries, highlighting the risks of incorporating AI into legal practice. In his  2023 annual report on the judiciary , Chief Justice Roberts took note and warned lawyers of hallucinations. 

Across all areas of industry, retrieval-augmented generation (RAG) is seen and promoted as the solution for reducing hallucinations in domain-specific contexts. Relying on RAG, leading legal research services have released AI-powered legal research products that they claim  “avoid” hallucinations and guarantee  “hallucination-free” legal citations. RAG systems promise to deliver more accurate and trustworthy legal information by integrating a language model with a database of legal documents. Yet providers have not provided hard evidence for such claims or even precisely defined “hallucination,” making it difficult to assess their real-world reliability.

AI-Driven Legal Research Tools Still Hallucinate

In a new preprint study by  Stanford RegLab and  HAI researchers, we put the claims of two providers, LexisNexis and Thomson Reuters (the parent company of Westlaw), to the test. We show that their tools do reduce errors compared to general-purpose AI models like GPT-4. That is a substantial improvement and we document instances where these tools can spot mistaken premises. But even these bespoke legal AI tools still hallucinate an alarming amount of the time: these systems produced incorrect information more than 17% of the time—one in every six queries.

Read the full study, Hallucination-Free? Assessing the Reliability of Leading AI Legal Research Tools

To conduct our study, we manually constructed a pre-registered dataset of over 200 open-ended legal queries, which we designed to probe various aspects of these systems’ performance.

Broadly, we investigated (1) general research questions (questions about doctrine, case holdings, or the bar exam); (2) jurisdiction or time-specific questions (questions about circuit splits and recent changes in the law); (3) false premise questions (questions that mimic a user having a mistaken understanding of the law); and (4) factual recall questions (questions about simple, objective facts that require no legal interpretation).

Bar chart showing rate of hallucinations and incomplete responses from three different tools

Figure 1: Comparison of hallucinated (red) and incomplete (yellow) answers across generative legal research tools.

These systems can hallucinate in one of two ways. First, a response from an AI tool might just be  incorrect —it describes the law incorrectly or makes a factual error. Second, a response might be  misgrounded —the AI tool describes the law correctly, but cites a source which does not in fact support its claims.

Given the critical importance of authoritative sources in legal research and writing, the second type of hallucination may be even more pernicious than the outright invention of legal cases. A citation might be “hallucination-free” in the narrowest sense that the citation  exists , but that is not the only thing that matters. The core promise of legal AI is that it can streamline the time-consuming process of identifying relevant legal sources. If a tool provides sources that  seem authoritative but are in reality irrelevant or contradictory, users could be misled. They may place undue trust in the tool's output, potentially leading to erroneous legal judgments and conclusions.

Examples of incorrect responses to legal queries from various AI tools

Figure 2:  Left: Example of a hallucinated response by Thomson Reuters’s Ask Practical Law AI. The system fails to correct the user's mistaken premise—in reality, Justice Ginsburg joined the Court's landmark decision legalizing same-sex marriage—and instead provides additional false information about the case. Right: Example of a hallucinated response by LexisNexis’s Lexis+ AI.  Casey and its undue burden standard were overruled by the Supreme Court in  Dobbs v. Jackson Women's Health Organization , 597 U.S. 215 (2022); the correct answer is rational basis review.

RAG Is Not a Panacea

a chart showing an overview of the retrieval-augmentation generation (RAG) process.

Figure 3: An overview of the retrieval-augmentation generation (RAG) process. Given a user query (left), the typical process consists of two steps: (1) retrieval (middle), where the query is embedded with natural language processing and a retrieval system takes embeddings and retrieves the relevant documents (e.g., Supreme Court cases); and (2) generation (right), where the retrieved texts are fed to the language model to generate the response to the user query. Any of the subsidiary steps may introduce error and hallucinations into the generated response. (Icons are courtesy of FlatIcon.)

Under the hood, these new legal AI tools use retrieval-augmented generation (RAG) to produce their results, a method that many tout as a potential solution to the hallucination problem. In theory, RAG allows a system to first  retrieve the relevant source material and then use it to  generate the correct response. In practice, however, we show that even RAG systems are not hallucination-free. 

We identify several challenges that are particularly unique to RAG-based legal AI systems, causing hallucinations. 

First, legal retrieval is hard. As any lawyer knows, finding the appropriate (or best) authority can be no easy task. Unlike other domains, the law is not entirely composed of verifiable  facts —instead, law is built up over time by judges writing  opinions . This makes identifying the set of documents that definitively answer a query difficult, and sometimes hallucinations occur for the simple reason that the system’s retrieval mechanism fails.

Second, even when retrieval occurs, the document that is retrieved can be an inapplicable authority. In the American legal system, rules and precedents differ across jurisdictions and time periods; documents that might be relevant on their face due to semantic similarity to a query may actually be inapposite for idiosyncratic reasons that are unique to the law. Thus, we also observe hallucinations occurring when these RAG systems fail to identify the truly binding authority. This is particularly problematic as areas where the law is in flux is precisely where legal research matters the most. One system, for instance, incorrectly recited the “undue burden” standard for abortion restrictions as good law, which was overturned in  Dobbs (see Figure 2). 

Third, sycophancy—the tendency of AI to agree with the user's incorrect assumptions—also poses unique risks in legal settings. One system, for instance, naively agreed with the question’s premise that Justice Ginsburg dissented in  Obergefell , the case establishing a right to same-sex marriage, and answered that she did so based on her views on international copyright. (Justice Ginsburg did not dissent in  Obergefell and, no, the case had nothing to do with copyright.) Notwithstanding that answer, here there are optimistic results. Our tests showed that both systems generally navigated queries based on false premises effectively. But when these systems do agree with erroneous user assertions, the implications can be severe—particularly for those hoping to use these tools to increase access to justice among  pro se and under-resourced litigants.

Responsible Integration of AI Into Law Requires Transparency

Ultimately, our results highlight the need for rigorous and transparent benchmarking of legal AI tools. Unlike other domains, the use of AI in law remains alarmingly opaque: the tools we study provide no systematic access, publish few details about their models, and report no evaluation results at all.

This opacity makes it exceedingly challenging for lawyers to procure and acquire AI products. The big law firm  Paul Weiss spent nearly a year and a half testing a product, and did not develop “hard metrics” because checking the AI system was so involved that it “makes any efficiency gains difficult to measure.” The absence of rigorous evaluation metrics makes responsible adoption difficult, especially for practitioners that are less resourced than Paul Weiss. 

The lack of transparency also threatens lawyers’ ability to comply with ethical and professional responsibility requirements. The bar associations of  California ,  New York , and  Florida have all recently released guidance on lawyers’ duty of supervision over work products created with AI tools. And as of May 2024,  more than 25 federal judges have issued standing orders instructing attorneys to disclose or monitor the use of AI in their courtrooms.

Without access to evaluations of the specific tools and transparency around their design, lawyers may find it impossible to comply with these responsibilities. Alternatively, given the high rate of hallucinations, lawyers may find themselves having to verify each and every proposition and citation provided by these tools, undercutting the stated efficiency gains that legal AI tools are supposed to provide.

Our study is meant in no way to single out LexisNexis and Thomson Reuters. Their products are far from the only legal AI tools that stand in need of transparency—a slew of startups offer similar products and have  made   similar   claims , but they are available on even more restricted bases, making it even more difficult to assess how they function. 

Based on what we know, legal hallucinations have not been solved and the legal profession should turn to public benchmarking and rigorous evaluations of AI tools. 

Paper authors: Varun Magesh is a research fellow at Stanford RegLab. Faiz Surani is a research fellow at Stanford RegLab. Matthew Dahl is a joint JD/PhD student in political science at Yale University and graduate student affiliate of Stanford RegLab. Mirac Suzgun is a joint JD/PhD student in computer science at Stanford University and a graduate student fellow at Stanford RegLab. Christopher D. Manning is Thomas M. Siebel Professor of Machine Learning, Professor of Linguistics and Computer Science, and Senior Fellow at HAI. 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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Organizational learning starting points and presuppositions: a case study from a hospital’s surgical department.

Jaakkola M, Lemmetty S, Collin K, et al. Organizational learning starting points and presuppositions: a case study from a hospital’s surgical department. Learn Org. 2024;31(3):337-357. doi:10.1108/tlo-12-2022-0160.

Organizational learning is a continuous process of integrating data and knowledge to ensure improvement. This qualitative study focuses on the starting points and presuppositions of organizational learning within a surgical department. Starting points for individual learning were informal and based on day-to-day work (e.g., solving a specific problem) and organizational learning encompassed more formal and intentional practices. Factors presupposing and framing the learning process can be divided into four categories: leadership and roles, practices and resources, collaboration and climate, and motivation and activity.

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Addressing mistreatment of providers by patients and family members as a patient safety event. February 16, 2022

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This paper is in the following e-collection/theme issue:

Published on 23.5.2024 in Vol 8 (2024)

Barriers to Implementing Registered Nurse–Driven Clinical Decision Support for Antibiotic Stewardship: Retrospective Case Study

Authors of this article:

Author Orcid Image

Original Paper

  • Elizabeth R Stevens 1 , MPH, PhD   ; 
  • Lynn Xu 1 , MPH   ; 
  • JaeEun Kwon 1 , MPP   ; 
  • Sumaiya Tasneem 1 , MPH   ; 
  • Natalie Henning 1 , MPH   ; 
  • Dawn Feldthouse 1 , RN-BC, MSN   ; 
  • Eun Ji Kim 2 , MSc, MS, MD   ; 
  • Rachel Hess 3, 4 , MS, MD   ; 
  • Katherine L Dauber-Decker 2 , PhD   ; 
  • Paul D Smith 5 , MD   ; 
  • Wendy Halm 6, 7 , DNP   ; 
  • Pranisha Gautam-Goyal 2 , MD   ; 
  • David A Feldstein 6 , MD   ; 
  • Devin M Mann 1, 8 , MS, MD  

1 Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States

2 Northwell, New Hyde Park, NY, United States

3 Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States

4 Department of Internal Medicine, University of Utah, Salt Lake City, UT, United States

5 Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States

6 Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States

7 University of Wisconsin-Madison School of Nursing, Madison, WI, United States

8 Department of Medicine, New York University Langone, New York, NY, United States

Corresponding Author:

Elizabeth R Stevens, MPH, PhD

Department of Population Health

New York University Grossman School of Medicine

180 Madison Ave

New York, NY, 10016

United States

Phone: 1 6465012558

Email: [email protected]

Background: Up to 50% of antibiotic prescriptions for upper respiratory infections (URIs) are inappropriate. Clinical decision support (CDS) systems to mitigate unnecessary antibiotic prescriptions have been implemented into electronic health records, but their use by providers has been limited.

Objective: As a delegation protocol, we adapted a validated electronic health record–integrated clinical prediction rule (iCPR) CDS-based intervention for registered nurses (RNs), consisting of triage to identify patients with low-acuity URI followed by CDS-guided RN visits. It was implemented in February 2022 as a randomized controlled stepped-wedge trial in 43 primary and urgent care practices within 4 academic health systems in New York, Wisconsin, and Utah. While issues were pragmatically addressed as they arose, a systematic assessment of the barriers to implementation is needed to better understand and address these barriers.

Methods: We performed a retrospective case study, collecting quantitative and qualitative data regarding clinical workflows and triage-template use from expert interviews, study surveys, routine check-ins with practice personnel, and chart reviews over the first year of implementation of the iCPR intervention. Guided by the updated CFIR (Consolidated Framework for Implementation Research), we characterized the initial barriers to implementing a URI iCPR intervention for RNs in ambulatory care. CFIR constructs were coded as missing, neutral, weak, or strong implementation factors.

Results: Barriers were identified within all implementation domains. The strongest barriers were found in the outer setting, with those factors trickling down to impact the inner setting. Local conditions driven by COVID-19 served as one of the strongest barriers, impacting attitudes among practice staff and ultimately contributing to a work infrastructure characterized by staff changes, RN shortages and turnover, and competing responsibilities. Policies and laws regarding scope of practice of RNs varied by state and institutional application of those laws, with some allowing more clinical autonomy for RNs. This necessitated different study procedures at each study site to meet practice requirements, increasing innovation complexity. Similarly, institutional policies led to varying levels of compatibility with existing triage, rooming, and documentation workflows. These workflow conflicts were compounded by limited available resources, as well as an implementation climate of optional participation, few participation incentives, and thus low relative priority compared to other clinical duties.

Conclusions: Both between and within health care systems, significant variability existed in workflows for patient intake and triage. Even in a relatively straightforward clinical workflow, workflow and cultural differences appreciably impacted intervention adoption. Takeaways from this study can be applied to other RN delegation protocol implementations of new and innovative CDS tools within existing workflows to support integration and improve uptake. When implementing a system-wide clinical care intervention, considerations must be made for variability in culture and workflows at the state, health system, practice, and individual levels.

Trial Registration: ClinicalTrials.gov NCT04255303; https://clinicaltrials.gov/ct2/show/NCT04255303

Introduction

Antibiotic resistance is a major public health risk, with more than 35,000 deaths each year in the United States due to antibiotic-resistant bacterial infections [ 1 , 2 ]. Overprescribing and misuse of antibiotics for upper respiratory infections (URIs) remain the most significant combined factors causing antibiotic resistance [ 3 , 4 ]. In the United States, up to 50% of all outpatient antibiotic prescriptions for URIs are inappropriate [ 5 , 6 ].

An estimated 80%-90% of antibiotic prescribing occurs in outpatient settings, such as doctors’ offices, urgent care facilities, and emergency departments [ 7 - 9 ]. From 1996 to 2010, 72% of adult patients in primary care with a diagnosis of acute bronchitis received antibiotics contrary to guideline recommendations against antibiotic treatment, and prescription rates actually increased during this time frame [ 10 ]. Patients with sore throats received antibiotics 61% of the time when the prevalence of group A streptococcus, the only clear indication for antibiotics, was only 10% in adults [ 11 ].

By providing real-time evidence-based data to assist providers (physicians, nurse practitioners, and physician assistants) in estimating the likelihood of a patient having either pneumococcal pneumonia or group A streptococcus, electronic health record (EHR)–integrated clinical prediction rules (iCPRs) can help address prescriber-level barriers to antibiotic stewardship and reduce antibiotic prescribing for URIs in primary care [ 12 - 15 ]. Indeed, CPRs have already been validated to successfully distinguish between viral and bacterial respiratory infections [ 16 - 18 ].

While potentially effective, there is low uptake of the iCPR tools among physicians in primary care practices, thus indicating implementation barriers to antibiotic stewardship iCPRs among physicians [ 19 ]. This outcome is consistent with other literature, indicating that physicians perceive antibiotic stewardship as onerous and would require substantial assistance to change their antibiotic prescribing behaviors [ 20 ]. Due to these limitations associated with the physician-driven iCPR implementation model, such as “alert fatigue” and time constraints [ 21 , 22 ], the iCPR intervention was adapted so antibiotic stewardship tasks could be delegated to other qualified members of the medical team.

A registered nurse (RN)–driven implementation model of iCPR for low-acuity URIs has the potential to be an effective alternative to the physician-driven implementation model. RNs have demonstrated equivalent symptom resolution compared to physicians when using protocols to improve ambulatory care across a number of chronic diseases [ 23 ] as well as the treatment of acute minor illnesses [ 24 , 25 ]. Therefore, the iCPR intervention was adapted for RNs to include the identification of patients with low-acuity URI followed by clinical decision support (CDS)–guided RN visits. The intervention was implemented in February 2022 as a stepped-wedge trial in primary and urgent care practices within 4 academic health systems in New York, Wisconsin, and Utah [ 26 ].

Despite a seemingly straightforward URI clinical workflow, the RN-driven iCPR intervention encountered significant barriers early on during implementation. While these issues were pragmatically addressed as they arose during study implementation, a systematic assessment of the barriers to implementation is needed to better understand and address these barriers. The CFIR (Consolidated Framework for Implementation Research) [ 27 ] has been widely used to guide the systematic assessment of multilevel implementation contexts to identify contextual determinants of implementation success [ 28 ]. Using the updated CFIR as a guide [ 29 ], we sought to identify and categorize the barriers experienced during the implementation of the RN-driven antibiotic stewardship “iCPR3” intervention.

We performed a retrospective case study, collecting quantitative and qualitative data from expert interviews, study surveys, routine check-ins with practice personnel, and chart reviews over the first year of implementation of the iCPR3 intervention. We used the updated CFIR [ 29 ] to characterize the initial barriers to adapting a URI iCPR intervention for RNs in ambulatory care.

Ethical Considerations

The study protocol and procedures were approved by the NYU Langone Health institutional review board, which served as the study’s single institutional review board (NYULH Study: i19-01222). Informed consent was received from all participants. Documentation of consent was waived for this study. All study data reported in this manuscript are deidentified. Compensation was not provided for participation.

Study Intervention

The study intervention consists of triage followed by an in-person iCPR–guided RN visit for patients with low-acuity URIs ( Figure 1 ). RNs perform telephone triage (or in urgent care, an RN or medical assistant performs a similar assessment through a rooming protocol) for patients reporting cough or sore throat symptoms to assess acuity, need for primary care, urgent care, or ED visit, and appropriateness for an in-person iCPR–guided RN visit. In the urgent care setting, the assessment is dichotomous as either a need for a provider visit or appropriateness for an iCPR-guided RN visit. The triage tool consists of a prepopulated note template integrated into the EHR system designed to document patient symptoms and their severity and determine the most appropriate level of care. Triage algorithms were based on institutional triage resources for decisions about ED or urgent care visits, primary care visits, and home care [ 30 ].

Patients triaged as low acuity and appropriate for an RN visit are invited for an in-person RN visit that replaces the standard of care provider visit. During the RN visit, guided by iCPR tools, the RN evaluates a patient to determine their risk of bacterial infections of strep pharyngitis (sore throat) or pneumonia (cough). Prepopulated note template EHR tools lead RNs through a focused history and physical examination. Once an RN completes the patient history and physical examination, they use an iCPR tool specific to cough or sore throat to calculate the risk of bacterial infection based on the patient’s vitals, symptoms, and pertinent history [ 26 ]. The iCPR tools are informed by the CPRs [ 17 , 18 , 31 ] used in the iCPR1 and iCPR2 studies [ 12 , 19 ], which were validated in prior studies among patients with acute respiratory illnesses [ 17 , 18 , 31 ]. The CPRs are integrated into the EHR, and upon completion of the calculator, the level of risk with an approximate probability of having either strep pharyngitis or pneumonia is displayed. After completion of the risk calculator, the RN is linked by the EHR to an order set specific to the level of risk, along with relevant patient education.

case study v experiment

Setting and Participants

The iCPR3 intervention study was implemented in February 2022, as a randomized controlled stepped-wedge trial, in 43 primary and urgent care practices associated with 4 academic medical centers including 2 in New York, 1 in Wisconsin, and 1 in Utah. To be eligible for participation, a practice must include general internal medicine, family medicine, or urgent care practices. Furthermore, practices must have at least 1 RN full-time equivalent capable of performing triage within the EHR and in-person RN visits.

For this case study, purposive sampling was used to select experts with key knowledge and insight on study implementation from members of the research team and study practices. This sample included research study team members engaged in the implementation of the iCPR3 study (ie, research coordinators, research assistants, and investigators) and study practice personnel (ie, RNs, RN or practice managers, and providers) from each study site (academic medical center). At least 2 research study team members per site participated in semistructured interviews, with those experts determining which practice personnel to include in their data collection. All RNs participating in the iCPR3 intervention were included in study acceptability surveys and routine implementation check-ins with study staff.

Of note, approximately 8 months into iCPR3 implementation, 1 New York–based study site withdrew from the intervention study due to limited practice recruitment and insurmountable barriers to implementing the intervention. Interviews were still performed with site personnel and their comments are included in these analyses.

Data Collection

A semistructured interview guide containing questions based on the 5 domains of CFIR [ 27 , 29 ] was developed. The CFIR constructs supported the research team in defining topics for the interviews and ensured that all major domains in the framework that influence implementation were addressed. Interview questions did not explicitly name or ask participants to name the CFIR domains or constructs. The interviews were performed via in-depth email interviews [ 32 ], in which research study team interviewees were asked questions to identify which of the 48 CFIR constructs were perceived as current barriers to iCPR3 implementation and provided detailed descriptions of the identified barriers and strategies that have already been used by the iCPR3 research study team.

Surveys and Routine Check-Ins

The perspectives of practice personnel were incorporated into the case study based on notes from surveys; individual interviews; or written feedback from RNs, providers, and RN and practice managers collected over the implementation period as routine intervention study procedures. As this was a pragmatic study, study staff routinely elicited informal feedback from practice personnel throughout intervention implementation to identify barriers and improve intervention implementation.

At 6 and 12 months post-RN visit implementation, participating RNs completed a short survey that asked about burnout, job satisfaction, and comfort levels with performing tasks related to treating patients reporting cough and sore throat. The survey also collected information on ease of use of the EHR tools as well as feedback on elements of the intervention, such as training, and recommendations.

Chart Review

Clinical workflows and EHR note templates (triage and RN visits) use in the first 12 months of implementation were collected via chart review. A subset of EHR template uses initiated was evaluated for appropriateness and completeness. To determine the total number of potential patients in a practice eligible for triage template use, patients with visits resulting in a diagnosis code for cough or sore throat were documented ( International Classification of Diseases-10 [ ICD-10 ] codes: R05, R07.0, J20.9, J06.9, and J18.9). The EHR records related to the visit were reviewed to determine patient eligibility for triage and document the workflow leading to the patient visit (ie, how the appointment was scheduled, by whom, and whether appointment notes were present).

CFIR Domains and Constructs

The CFIR was used to retrospectively describe the implementation process of the iCPR3 intervention to identify determinants in this process. Only the determinants relevant to the iCPR3 intervention implementation process were described. The CFIR is composed of 48 constructs sorted into 5 major domains including innovation, outer setting, inner setting, individuals, and implementation process [ 27 , 29 ]. Operationalization of CFIR domains for this study are shown in Table 1 .

a iCPR3: integrated clinical prediction rule 3.

b RN: registered nurse.

Data Coding and Analysis

Insights gathered from the surveys, chart reviews, and formal and informal check-ins with study practice personnel helped inform research study team members’ responses to the semistructured interview guide. The written responses and notes collected from the email interviews were analyzed using techniques of qualitative content analysis, inspired by a deductive-directed approach, deemed applicable because the data were analyzed in light of an existing framework [ 33 ]. The analysis was performed by 3 authors (ERS, LX, and JK) in a stepwise interactive process. The first step in the analysis, after reading all transcripts, notes, and written responses to obtain an understanding of the whole, was to develop initial coding nodes and subnodes based on the domains and constructs of the CFIR [ 29 ].

In the second step, units of analysis, such as sentences or sections of thought, were deductively coded into the nodes and subnodes. Third, the coded text was rated based on the recommended method described by the authors of CFIR, Damschroder and Lowery [ 34 ]. In the rating process, a consensus process was used to assign a rating to each construct obtained from each study site. The ratings reflected the positive or negative influence and the strength of each construct that emerged based on the coded text. When all constructs obtained from all study sites were rated, we compared and compiled ratings for each construct across study sites. Constructs were coded as missing, not distinguishing between positive or negative implementation factors (0), or weakly (+1/–1), or strongly (+2/–2) distinguishing low from high implementation factors ( Table 2 ).

a CFIR: Consolidated Framework for Implementation Research.

b iCPR3: integrated clinical prediction rule intervention.

Barriers and facilitators to implementation were identified within the CFIR domains and constructs and are presented within the frame of CFIR domains including innovation, outer and inner settings, individuals, and implementation process ( Table 3 ).

c Construct lettering and numbers correspond with Damschroder et al [ 27 ].

d Only constructs applicable to the iCPR implementation are cited.

e –2: strong negative influence; –1: weak negative influence; 0: neutral influence; 0 (mix): mixed positive and negative influences, which balanced each other; +1: weak positive influence; +2: strong positive influence; missing: not asked or miscoded.

Outer Setting

Local conditions , primarily driven by the COVID-19 pandemic, served as one of the strongest barriers to implementation as COVID-19 impacted nearly every aspect of implementation from changes in workflows and staffing availability to patient volume and URI care protocols. There were observed changes to URI care protocols including shifts from in-office care to telehealth and redirection to urgent care, driven by COVID-19–testing requirements and hesitancy from both patients and practices to have on-site care. Furthermore, COVID-19 affected local attitudes among practice staff as health issues and burnout led to staff shortages, turnover, and shifting of responsibilities. These barriers were further compounded by regional nursing shortages and financial incentives that drew RNs out of primary care practices.

Policies and laws, such as state regulatory laws and institutional policies, also had a strong impact on the study procedures and implementation. RN scope-of-practice varied by state and between institutions. Wisconsin has existing RN delegation protocols, allowing for more clinical autonomy among RNs than at institutions in New York and Utah. This required additional training and modification to the RN visit portion of the intervention at institutions, where RNs had a more limited scope of practice and could not function autonomously. For example, the New York sites were required to adopt a “co-visit” structure to ensure that providers could oversee RN visits. This created additional scheduling constraints and complexity, as well as an unanticipated burden for providers. Multimedia Appendix 1 shows the analysis of performance measurement pressure and the innovation construct.

Inner Setting

Within the construct of structural characteristics , work infrastructure served as a strong barrier to the intervention implementation as practices across institutions experienced staff changes, RN shortages and turnover, and competing responsibilities that all hindered their ability to effectively participate in the study. Notably, at practices with only 1 RN, implementation was negatively impacted as clinic participation was dependent on 1 individual, whereas at other practices, study responsibilities were distributed across multiple RNs. Within the culture construct, a norm of limited deliverer centeredness , related to the prioritization of the needs and desires of RNs, served as a barrier to the implementation of this RN-focused intervention. As patient ( recipient centeredness ) and provider preferences were prioritized over RN activities, the innovation activities that would have been performed by the RNs were overridden. For example, to ensure patient autonomy, if a patient preferred to see a provider, they were not scheduled for an RN visit even if they were eligible. Similarly, at most institutions (except those with more RN autonomy), RNs tended to defer to providers in terms of preference and final decisions. Therefore, if the provider preferred seeing a patient themselves, the patient, even if eligible for an RN visit, would not be seen by an RN.

Overall, relational connections , specifically the RN-provider dynamic, negatively affected implementation. RNs in the study did not always have open bidirectional communication with providers, thus limiting the self-efficacy of RNs to explain or justify intervention-related activities. As observed within the culture construct, many practices had limited deliverer centeredness , typically deferring to providers to make final decisions, and therefore RNs were hesitant to push these boundaries or make decisions that were contrary to a provider’s preferences. In particular, some sites mentioned some practices having poor relationships among practice staff, even requiring team-building training in some instances. On the other hand, this was less of a barrier at practices, where RNs had more clinical autonomy or had developed stronger relationships within the practice.

Communications culture within practices served as a barrier to effectively implementing aspects of the study; for example, some practices did not have a culture of communicating with patients prior to visits in the form of triage or lacked formalized documentation as information was often conveyed informally (eg, verbal, secure chat message, and free-text note). In some practices, a strong communication system between RNs (ie, a chat channel used by most RNs) served as a facilitator to innovation implementation by allowing RNs to support and answer each other’s questions.

The intervention’s compatibility , or lack thereof, with existing workflows was a strong barrier to implementation, as the necessary intervention-specific workflow adaptions required great effort on the part of the practice if not already in place (eg, front desk forwarding eligible patients for triage, RNs performing triage after appointments had been scheduled, and filling out EHR note templates as opposed to free text). As the new study workflow required changes to the status quo, tension for change also served as a barrier since practices perceived little anticipated benefit from the study as compared to the difficulty of change. Relatedly, relative priority of the intervention was a strong barrier as competing clinical responsibilities and the voluntary nature of the study meant staff would not prioritize study-related tasks.

Overall, there was a lack of incentive systems in place related to study activities, which hindered RN participation. While gift card incentives for RNs performing triage were used, these tended to incentivize the same RNs already using the tools as opposed to encouraging new RNs to participate. Additionally, at institutions where RNs were unable to bill for visits and did not receive any other recognition for their efforts, this lack of incentives was a strong barrier to participation. One institution was able to reduce the influence of this barrier by providing incentives to RNs through continuing education credits, an employee recognition fund, and paid time for training.

Multimedia Appendix 1 presents the analyses of physical infrastructure, IT infrastructure, access to knowledge and information, available resources, learning-centeredness, and mission alignment.

Individuals: Characteristics Subdomain

Both capability and motivation were barriers to implementation. As these tools were new to many of the participating RNs, they were less confident in their skills and required continuous feedback, training, and support. In addition, RNs were not motivated to participate in the study largely due to competing priorities, lack of a strong incentive, and COVID-19–related stress and burnout. Opportunity was also a strong barrier, as RNs did not have many opportunities to use the innovation tools. Conflicting responsibilities, staff shortages, workflow barriers, patient volume, and patient eligibility were observed as contributors to this barrier.

Multimedia Appendix 1 shows the analyses of roles subdomain constructs high-level leaders, mid-level leaders, opinion leaders, innovation deliverers, innovation recipients, implementation facilitators, implementation leaders, and implementation team members. Multimedia Appendix 1 shows the analyses of the implementation process domain constructs assessing context and assessing needs, innovation deliverers, doing, planning and tailoring strategies, teaming, engaging the innovation deliverers, reflecting and evaluating, and adapting.

Principal Findings

This case study identified numerous barriers to the successful implementation of iCPR3, an RN-driven antibiotic stewardship intervention. Many of the identified barriers are consistent with those observed in other interventions that sought to alter nursing responsibilities and workflows within primary care [ 35 , 36 ]. The most impactful barriers were noted within the outer setting, and these conditions were observed to influence the inner setting constructs. The effects of COVID-19 served as an overarching barrier that impacted nearly all implementation constructs, shifting the culture and conditions at many participating practices as well as decreasing the capacity of practices to engage in activities perceived as nonessential. These barriers, however, were less prevalent within clinics that had previously established workflows with patient care within the RN role description. Takeaways from this study can be applied to support integration and improve uptake during the implementation of other RN delegation protocols involving CDS tools into existing workflows.

Policies impacting innovation deliverers’ (RNs) clinical autonomy at both the state and institutional levels need to be considered when developing RN delegation protocols as they can impact implementation depending on compatibility with existing workflows. As a multisite study with implementation spanning 3 states, the differing state regulatory laws and institutional policies dictating RN scope-of-practice had a substantial impact on the compatibility of the iCPR3 implementation at each site. This was evident in the higher rate of RN visits occurring in practices in Wisconsin compared to New York. At the Wisconsin study site, there were established delegation protocols for RNs to see patients with minimal provider supervision. In contrast, for the 2 New York study sites, a more complex “covisit” design was developed, which involved joint scheduling of the iCPR3 RN visit followed immediately by a visit for the provider to see the patient and confirm the RN plan of care. The addition of a provider visit component increased the intervention’s dependency on already limited provider availability, thus inhibiting the ability to schedule the iCPR3 RN visits even when a patient was appropriate and willing and an RN was available to conduct the visit. As observed in other RN delegation protocols, considerations for local regulations must be made when assessing the viability of implementing these types of interventions [ 36 ].

Consideration of practice-level culture and work infrastructure is also essential for the successful implementation of an intervention that includes RN delegation protocols. This implementation study revealed impactful differences in existing workflow expectations that affected RN capability and intervention complexity. One unexpected barrier was the influence of practice personnel who were part of the local workflow but were not directly involved in the implementation of the iCPR tools. For example, at one institution, successful implementation of the intervention was reliant on administrative staff to forward patients reporting cough and sore throat to participating RNs for triage. Implementation planning with greater efforts to clarify practice-level workflows, identifying potential stakeholders early on, and engaging these personnel who ultimately support the innovation deliverers can support a successful implementation.

Similarly, when delegating provider tasks to RNs, it is important to secure provider buy-in early on in the implementation process, even with a seemingly RN-focused intervention. Consistent with previous research demonstrating the importance of RN-provider relationships in job satisfaction [ 37 ], this study showed that power dynamics between providers and RNs can serve as a barrier to RN intervention engagement. With a culture of deference to providers, many RNs did not want to overstep these boundaries and would not engage with the intervention if there was any perceived resistance from practice providers. Barriers experienced due to this power structure were further compounded when poor relations existed between RNs and providers. Furthermore, as seen in other clinical academic partnerships, future implementation efforts would benefit from more active engagement of leadership at all levels [ 38 ].

Future clinical delegation interventions may also need to consider alternate care mechanisms to account for unexpected shifts in clinic workflows. Due to the timing of the implementation, one of the largest observed barriers to implementation was the COVID-19 pandemic, which amplified nearly all other barriers and created additional unique challenges. As an intervention specifically designed for in-person care, the shift toward telemedicine driven by the pandemic [ 39 ] had a particularly negative impact on implementation. One study institution piloted a program to divert all patients with URI to telemedicine visits with a centrally employed nurse practitioner, which bypassed all potential points of intervention for the iCPR study. Further diverting potentially eligible patients away from primary care practices was the increased popularity of urgent care centers [ 40 ], which served as an expedient solution for patients with URI seeking to avoid long wait times at many primary care practices. Incorporating alternate care mechanisms to provide agility in the intervention may support the success of study implementation. Similarly, integrating CDS tools with existing EHR tools and templates can help minimize changes in workflow, thereby allowing interventions to be resilient in the face of unforeseen events.

As observed in this case study, the pandemic also directly impacted practice staff and their ability to participate in activities beyond the essential, including research. Practices across all study institutions experienced nursing staff shortages due to RNs themselves being sick, covering for others who are sick, or leaving the practice altogether, thus resulting in a redistribution of responsibilities. An increased workload, along with outside stressors, led to increased reported stress and burnout among practice staff [ 41 ], making it difficult for them to view the study as a daily priority. The voluntary nature of the study and these conflicting responsibilities greatly reduced the opportunity for RNs to use the innovation and participate fully. This was particularly evident in practices that required greater workflow modifications. Practices with existing expectations of note documentation and template use facilitated implementation; however, in other practices, the lack of RN familiarity with these EHR functions required the creation of additional training and workflow modification efforts, as well as a greater perceived effort burden on the part of RNs.

Future implementation should consider the value of face-to-face communication in encouraging engagement and team building during the implementation process [ 42 ]. In addition to its impact at the institutional and practice level, the effects of COVID-19 hindered the implementation process itself, especially early in the planning phase by limiting in-person interactions and creating communication barriers [ 43 ]. With nearly all communication occurring remotely, interactions to collect practice workflow information and engage stakeholders were perceived as less efficient, requiring additional follow-up meetings and hindering the development of relationships of the study team with leadership and innovation deliverers. When in-person practice visits by the research team became feasible, an improvement in practice responsiveness and innovation uptake was observed [ 42 ].

This study had several limitations. First, the use of an emailed in-depth interview hindered the study team’s ability to probe respondents for further information at the moment, potentially limiting the collection of further details that may have impacted the interpretation of interview responses. However, the emailed format increased the feasibility of conducting a long interview and created an opportunity for study sites to compile perspectives from multiple team members, thus improving the richness of information provided. Second, the reported barriers and facilitators were self-reported and not directly observed and are therefore based on the perceptions of the study site research teams. Similarly, as the data collection was primarily retrospective, it may be subject to recall bias. We attempted to mitigate this by conducting semistructured interviews during the implementation process. Finally, this analysis was performed prior to the completion of implementation at all sites and analysis of the primary intervention effectiveness outcomes. Therefore, it was not possible to link perceived implementation constructs to intervention outcome measures, and additional implementation construct influences may have been missed.

Conclusions

Both between and within health care systems, significant variability exists in workflows for patient intake and triage. Even in a relatively straightforward clinical workflow, seemingly nuanced workflow and culture differences appreciably impacted successful intervention adoption. Barriers to intervention adoption existed within multiple constructs and domains. When implementing a system-wide clinical care intervention, stakeholders should consider the variability in workflow policy and culture at the health system, practice, and individual levels, as well as create accommodations for changing care patterns.

Acknowledgments

This work was funded by NIAID 5R01AI108680 (PI Mann). Generative AI was not used in the writing of this manuscript.

Data Availability

The data sets used and analyzed during this study contain personally identifiable information and are therefore not made publicly available. Data are available from the corresponding author upon reasonable request.

Authors' Contributions

ERS wrote the original draft and contributed to conceptualization, methodology, data collection, and analysis; LX contributed to writing the original draft, methodology, data collection, and analysis; JK contributed to writing the original draft, methodology, data collection, and analysis; ST contributed to data collection and project administration; NH contributed to data collection and writing editing; DF contributed to data collection and writing editing; EJK contributed to data collection and writing editing; RH contributed to data collection and writing editing; KLD-D contributed to data collection and writing editing; PDS contributed to data collection and writing editing; WH contributed to data collection and writing editing; PG-G contributed to data collection and writing editing; DAF contributed to the conceptualization, funding acquisition, and writing editing; DMM contributed to the conceptualization, funding acquisition, and writing editing. All authors reviewed and approved the final manuscript draft.

Conflicts of Interest

None declared.

Consolidated Framework for Implementation Research domain barrier analysis results.

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Abbreviations

Edited by A Mavragani; submitted 30.11.23; peer-reviewed by R Hillard; comments to author 21.02.24; revised version received 13.03.24; accepted 15.03.24; published 23.05.24.

©Elizabeth R Stevens, Lynn Xu, JaeEun Kwon, Sumaiya Tasneem, Natalie Henning, Dawn Feldthouse, Eun Ji Kim, Rachel Hess, Katherine L Dauber-Decker, Paul D Smith, Wendy Halm, Pranisha Gautam-Goyal, David A Feldstein, Devin M Mann. Originally published in JMIR Formative Research (https://formative.jmir.org), 23.05.2024.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on https://formative.jmir.org, as well as this copyright and license information must be included.

medRxiv

Persistent symptoms and clinical findings in adults with post-acute sequelae of COVID-19/post-COVID-19 syndrome in the second year after acute infection: population-based, nested case-control study

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Objective: To assess risk factors for persistence vs improvement and to describe clinical characteristics and diagnostic evaluation of subjects with post-acute sequelae of COVID-19/post-COVID-19 syndrome (PCS) persisting for more than one year. Design: Nested population-based case-control study. Setting: Comprehensive outpatient assessment, including neurocognitive, cardiopulmonary exercise, and laboratory testing in four university health centres in southwestern Germany (2022). Participants: PCS cases aged 18 to 65 years with (n=982) and age and sex-matched controls without PCS (n=576) according to an earlier population-based questionnaire study (six to 12 months after acute infection, phase 1) consenting to provide follow-up information and to undergo clinical diagnostic assessment (phase 2, another 8.5 months [median] after phase 1). Main outcome measures: Relative frequencies of symptoms and health problems and distribution of symptom scores and diagnostic test results between persistent cases and controls. Additional analysis included predictors of changing case or control status over time with adjustments for potentially confounding variables. Results: At the time of clinical examination (phase 2), 67.6% of the initial cases (phase 1) remained cases, whereas 78.5% of the controls continued to report no health problems related to PCS. In adjusted analyses, predictors of improvement among cases were mild acute index infection, previous full-time employment, educational status, and no specialist consultation and not attending a rehabilitation programme. Among controls, predictors of new symptoms or worsening with PCS development were an intercurrent secondary SARS-CoV-2 infection and educational status. At phase 2, persistent cases were less frequently never smokers, had higher values for BMI and body fat, and had lower educational status than controls. Fatigue/exhaustion, neurocognitive disturbance, chest symptoms/breathlessness and anxiety/depression/sleep problems remained the predominant symptom clusters, and exercise intolerance with post-exertional malaise for >14 h (PEM) and symptoms compatible with ME/CFS (according to Canadian consensus criteria) were reported by 35.6% and 11.6% of persistent cases, respectively. In adjusted analyses, significant differences between persistent cases and stable controls (at phase 2) were observed for neurocognitive test performances, scores for perceived stress and subjective cognitive disturbances, symptoms indicating dysautonomia, depression and anxiety, sleep quality, fatigue, and quality of life. In persistent cases, handgrip strength, maximal oxygen consumption, and ventilator efficiency were significantly reduced. However, there were no differences in measures of systolic and diastolic cardiac function, in the level of pro-BNP blood levels or other laboratory measurements (including complement activity, serological markers of EBV reactivation, inflammatory and coagulation markers, cortisol, ACTH and DHEA-S serum levels). Screening for viral persistence (based on PCR in stool samples and SARS-CoV-2 spike antigen levels in plasma in a subgroup of the cases) was negative. Sensitivity analyses (pre-existing illness/comorbidity, obesity, PEM, medical care of the index acute infection) revealed similar findings and showed that persistent cases with PEM reported more pain symptoms and had worse results in almost all tests. Conclusions: This nested population-based case-control study demonstrates that the majority of PCS cases do not recover in the second year of their illness, with patterns of reported symptoms remaining essentially similar, nonspecific and dominated by fatigue, exercise intolerance and cognitive complaints. We found objective signs of cognitive deficits and reduced exercise capacity likely to be unrelated to primary cardiac or pulmonary dysfunction in some of the cases, but there was no major pathology in laboratory investigations. A history of PEM >14 h which was associated with more severe symptoms as well as with more objective signs of disease may be a pragmatic means to stratify cases for disease severity.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This work was funded by the Baden-Wuerttemberg Federal State Ministry of Science and Art (grant number MR/S028188/1).

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval was obtained from the Ethics Committee of the University of Freiburg, Engelberger Strasse 21, D-79106 Freiburg/Germany (#21/1484_1), the Ethics Committee of the Medical Faculty of Heidelberg University, Alte Glockengiesserei 11/1, D-69115 Heidelberg/Germany (#S-846/2021), the Ethics Committee at the Medical Faculty of the Eberhard-Karls-University and at the University Hospital of Tuebingen, Gartenstrasse 47, D-72074 Tuebingen/Germany (#845/2021BO2), and the Ethic Committee of the University of Ulm, Oberberghof 7, D-89081 Ulm/Germany (#337/21).

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Data Availability

All data produced in the present study are available upon reasonable request to the authors.

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How NASA Tracked the Most Intense Solar Storm in Decades

May 2024 has already proven to be a particularly stormy month for our Sun. During the first full week of May, a barrage of large solar flares and coronal mass ejections (CMEs) launched clouds of charged particles and magnetic fields toward Earth, creating the strongest solar storm to reach Earth in two decades — and possibly one of the strongest displays of auroras on record in the past 500 years.

We’ll be studying this event for years. It will help us test the limits of our models and understanding of solar storms.

Teresa Nieves-Chinchilla

Teresa Nieves-Chinchilla

Acting Director of NASA’s Moon to Mars (M2M) Space Weather Analysis Office

“We’ll be studying this event for years,” said Teresa Nieves-Chinchilla, acting director of NASA’s Moon to Mars (M2M) Space Weather Analysis Office. “It will help us test the limits of our models and understanding of solar storms.”

The first signs of the solar storm started late on May 7 with two strong solar flares. From May 7 – 11, multiple strong solar flares and at least seven CMEs stormed toward Earth. Eight of the flares in this period were the most powerful type, known as X-class, with the strongest peaking with a rating of X5.8. (Since then, the same solar region has released many more large flares, including an X8.7 flare — the most powerful flare seen this solar cycle — on May 14.)

Traveling at speeds up to 3 million mph, the CMEs bunched up in waves that reached Earth starting May 10, creating a long-lasting geomagnetic storm that reached a rating of G5 — the highest level on the geomagnetic storm scale, and one that hasn’t been seen since 2003.

“The CMEs all arrived largely at once, and the conditions were just right to create a really historic storm,” said Elizabeth MacDonald, NASA heliophysics citizen science lead and a space scientist at NASA’s Goddard Space Flight Center in Greenbelt, Maryland.

When the storm reached Earth, it created brilliant auroras seen around the globe. Auroras were even visible at unusually low latitudes, including the southern U.S. and northern India. The strongest auroras were seen the night of May 10, and they continued to illuminate night skies throughout the weekend. Thousands of reports submitted to the NASA-funded Aurorasaurus citizen science site are helping scientists study the event to learn more about auroras.

“Cameras — even standard cell phone cameras — are much more sensitive to the colors of the aurora than they were in the past,” MacDonald said. “By collecting photos from around the world, we have a huge opportunity to learn more about auroras through citizen science.”

Red and green streaks of an aurora radiate out from the center of the photo. Black silhouettes of trees line the edge.

By one measure of geomagnetic storm strength, called the disturbance storm time index which dates back to 1957, this storm was similar to historic storms in 1958 and 2003. And with reports of auroras visible to as low as 26 degrees magnetic latitude, this recent storm may compete with some of the lowest-latitude aurora sightings on record over the past five centuries, though scientists are still assessing this ranking.

“It’s a little hard to gauge storms over time because our technology is always changing,” said Delores Knipp, a research professor in the Smead Aerospace Engineering Science Department and a senior research associate at the NCAR High Altitude Observatory, in Boulder, Colorado. “Aurora visibility is not the perfect measure, but it allows us to compare over centuries.”

MacDonald encourages people to continue submitting aurora reports to Aurorasaurus.org , noting that even non-sightings are valuable for helping scientists understand the extent of the event.

Leading up to the storm, the National Oceanic and Atmospheric Administration’s Space Weather Prediction Center, which is responsible for forecasting solar storm impacts, sent notifications to operators of power grids and commercial satellites to help them mitigate potential impacts.

Warnings helped many NASA missions brace for the storm, with some spacecraft preemptively powering down certain instruments or systems to avoid issues. NASA's ICESat-2 — which studies polar ice sheets — entered safe mode, likely because of increased drag due to the storm.  

Looking Forward

Better data on how solar events influence Earth's upper atmosphere is crucial to understanding space weather's impact on satellites, crewed missions, and Earth- and space-based infrastructure. To date, only a few limited direct measurements exist in this region. But more are coming. Future missions, such as NASA’s Geospace Dynamics Constellation (GDC) and Dynamical Neutral Atmosphere-Ionosphere Coupling (DYNAMIC), will be able to see and measure exactly how Earth’s atmosphere responds to the energy influxes that occur during solar storms like this one. Such measurements will also be valuable as NASA sends astronauts to the Moon with the Artemis missions and, later, to Mars.

An image of the Sun shows a bright flash in the bottom right side where a solar flare erupts.

The solar region responsible for the recent stormy weather is now turning around the backside of the Sun, where its impacts can’t reach Earth. However, that doesn’t mean the storm is over. NASA’s Solar TErrestrial RElations Observatory (STEREO), currently located at about 12 degrees ahead of Earth in its orbit, will continue watching the active region an additional day after it is no longer visible from Earth.

“The active region is just starting to come into view of Mars,” said Jamie Favors, director for the NASA Space Weather Program at NASA Headquarters in Washington. “We’re already starting to capture some data at Mars, so this story only continues.”

By Mara Johnson-Groh NASA’s Goddard Space Flight Center, Greenbelt, Md.

Media Contact: Sarah Frazier NASA’s Goddard Space Flight Center, Greenbelt, Md.

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A close-up view of a spiral galaxy fills most of the scene. It has a bright, glowing spot at its core, broad spiral arms that hold many dark threads of dust, and pink glowing spots across the disk that mark areas of star formation. A faint halo that bleeds into the dark background surrounds the galaxy’s disk.

Hubble Captures a Bright Spiral in the Queen’s Hair

This illustration is awash in bright blues, with only areas of the black background of space peeking out near the edges. Just above center is a large white spiral galaxy that is forming within a large cloud of blue gas. Its spiral arms twirl clockwise. Immediately around the galaxy’s edges are larger light blue dots. The gas appears thicker and brighter blue below the galaxy and toward the bottom left in what looks like a loose, extended column. Other wispy blue gas appears all around the galaxy, extending to every edge of the illustration. There are two additional spiral galaxies, though they are about half the size of the one at the center. They appear toward the top left and bottom right, and both are connected to regions of blue gas. Several bright knots dot the brightest blue areas near the center, and toward the top right. The background is clearer and more obviously black along a wider area at the left edge, a sliver along the top right, and in triangles toward the bottom right corner.

Galaxies Actively Forming in Early Universe Caught Feeding on Cold Gas

Space scene of a thin atmosphere version of Gliese 12 b

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Americans overwhelmingly say access to IVF is a good thing

The political debate around access to in vitro fertilization (IVF) intensified this year,  following an Alabama Supreme Court decision in February that frozen embryos could be considered children .

A pie chart showing that more than two-thirds of Americans say having access to IVF is a good thing.

An April Pew Research Center survey finds that Americans overwhelmingly say people having access to IVF is a good thing.

Seven-in-ten adults say IVF access is a good thing. Just 8% say it is a bad thing, while 22% are unsure.

There are only modest differences in views of IVF access across most demographic and partisan groups.

Related: Broad Public Support for Legal Abortion Persists 2 Years After Dobbs

Pew Research Center asked about Americans’ views of in vitro fertilization (IVF) as part of a larger study exploring their social and political attitudes. Questions covered Americans’ views on the legality of abortion and their perceptions of abortion access.

We surveyed 8,709 U.S. adults from April 8 to 14, 2024. Everyone who took part in this survey is a member of the Center’s American Trends Panel (ATP), an online survey panel that is recruited through national, random sampling of residential addresses. This way nearly all U.S. adults have a chance of selection. The survey is weighted to be representative of the U.S. adult population by gender, race, ethnicity, partisan affiliation, education and other categories. Read more about the ATP’s methodology .

Here are the questions used for this analysis , along with responses, and its methodology .

Views by gender

A bar chart showing that more adults say IVF access is a good thing than a bad thing, including those who oppose abortion access.

Women (70%) and men (69%) are about equally likely to say IVF access is a good thing.

Views by religious affiliation

Across religious groups, far more people say IVF access is a good thing than a bad thing.

White nonevangelical Protestants and religiously unaffiliated Americans are particularly likely to say IVF access is a good thing (78% each). Clear majorities of White evangelicals (63%), Black Protestants (69%) and Catholics (65%) also say this.

Views by partisanship

About six-in-ten Republicans and Republican-leaning independents (63%) say IVF access is a good thing while one-in-ten say it’s a bad thing. Another 27% are not sure.

By comparison, Democrats and Democratic leaners are more likely to say IVF access is a good thing (79%) and somewhat less likely to say it is a bad thing (5%) or that they are unsure (16%).

Views by opinion on abortion

Regardless of their support for or opposition to legal abortion, clear majorities say having access to IVF is good.

Those who say abortion should be legal in all (82%) or most (76%) cases are particularly likely to say IVF access is a good thing.

But even those who say abortion should be illegal in most cases generally view IVF access positively (60% say it’s good). And while views of IVF are least positive among those who say abortion should always be illegal, this group is still twice as likely to say having access to IVF is good (40%) as to say it’s bad (20%). An additional 40% say they are not sure.

Views by beliefs about when life begins

When considering Americans’ views about when life begins, there is a similar pattern.

A bar chart showing that people who say human life begins at conception mostly view access to IVF as a good thing.

Overall, about a third of Americans say the statement “human life begins at conception, so an embryo is a person with rights” describes their views extremely or very well. Among those who express this view, 59% say IVF access is a good thing, while just 13% say it is a bad thing.

Among those who say the statement describes their views somewhat well, 61% say IVF access is a good thing.

A larger share (82%) of those who do not hold the view that life begins at conception have a positive view of IVF access.

Note: Here are the questions used for this analysis , along with responses, and its methodology .

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Gabriel Borelli is a research associate focusing on U.S. politics and policy at Pew Research Center .

Broad Public Support for Legal Abortion Persists 2 Years After Dobbs

Few east asian adults believe women have an obligation to society to have children, public has mixed views on the modern american family, the modern american family, with a potential ‘baby bust’ on the horizon, key facts about fertility in the u.s. before the pandemic, most popular.

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COMMENTS

  1. Case Study vs. Experiment

    A case study involves in-depth analysis of a particular individual, group, or situation, aiming to provide a detailed understanding of a specific phenomenon. On the other hand, an experiment involves manipulating variables and observing the effects on a sample population, aiming to establish cause-and-effect relationships.

  2. Case Study vs. Experiment: What's the Difference?

    Key Differences. Case studies involve a detailed examination of a specific subject, providing rich qualitative data. Experiments are structured to test hypotheses, involving variable control and manipulation. 15. In case studies, data is gathered from real-world observations, interviews, and documents. Experiments rely on quantitative data from ...

  3. Case Study vs Experiment: Definition, Characteristics, & Usage

    Eugene Webb. A case study and experiment are the two prominent approaches often used at the forefront of scholarly inquiry. While case studies study the complexities of real-life situations, aiming for depth and contextual understanding, experiments seek to uncover causal relationships through controlled manipulation and observation.

  4. Case Study Method: A Step-by-Step Guide for Business Researchers

    Although case studies have been discussed extensively in the literature, little has been written about the specific steps one may use to conduct case study research effectively (Gagnon, 2010; Hancock & Algozzine, 2016).Baskarada (2014) also emphasized the need to have a succinct guideline that can be practically followed as it is actually tough to execute a case study well in practice.

  5. What is a Case Study?

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

  6. PDF Comparing the Five Approaches

    interviews in phenomenology, multiple forms in case study research to provide the in-depth case picture). At the data analysis stage, the differences are most pronounced. Not only is the distinction one of specificity of the analysis phase (e.g., grounded the-ory most specific, narrative research less defined) but the number of steps to be under-

  7. What Is a Case Study?

    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 ...

  8. Case Study vs. Research

    Case study and research are both methods used in academic and professional settings to gather information and gain insights. However, they differ in their approach and purpose. A case study is an in-depth analysis of a specific individual, group, or situation, aiming to understand the unique characteristics and dynamics involved.

  9. Case Study

    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: Mixed methods case study. For a case study of a wind farm development in a ...

  10. Methodology or method? A critical review of qualitative case study

    Case studies are designed to suit the case and research question and published case studies demonstrate wide diversity in study design. There are two popular case study approaches in qualitative research. The first, proposed by Stake ( 1995) and Merriam ( 2009 ), is situated in a social constructivist paradigm, whereas the second, by Yin ( 2012 ...

  11. 23 Case Study Research: In-Depth Understanding in Context

    This chapter explores case study as a major approach to research and evaluation using primarily qualitative methods, as well as documentary sources, contemporaneous or historical. However, this is not the only way in which case study can be conceived. No one has a monopoly on the term. While sharing a focus on the singular in a particular context, case study has a wide variety of uses, not all ...

  12. Writing a Case Study

    A case study is a research method that involves an in-depth analysis of a real-life phenomenon or situation. Learn how to write a case study for your social sciences research assignments with this helpful guide from USC Library. Find out how to define the case, select the data sources, analyze the evidence, and report the results.

  13. Distinguishing Between Case Studies & Experiments

    A case study is a research method in which the researcher explores the subject in depth, while an experiment is a research method where two specific groups or variables are used to test a hypothesis. This article will examine the differences between case study and experiment further.

  14. 22 Case Study Research: In-Depth Understanding in Context

    Abstract. This chapter explores case study as a major approach to research and evaluation. After first noting various contexts in which case studies are commonly used, the chapter focuses on case study research directly Strengths and potential problematic issues are outlined and then key phases of the process.

  15. How to Use Case Studies in Research: Guide and Examples

    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.

  16. LibGuides: Research Writing and Analysis: Case Study

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

  17. Case Study Methodology of Qualitative Research: Key Attributes and

    A case study is one of the most commonly used methodologies of social research. This article attempts to look into the various dimensions of a case study research strategy, the different epistemological strands which determine the particular case study type and approach adopted in the field, discusses the factors which can enhance the effectiveness of a case study research, and the debate ...

  18. Case Study: Definition, Examples, Types, and How to Write

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

  19. Case Study Research Method in Psychology

    Case studies are in-depth investigations of a person, group, event, or community. Typically, data is gathered from various sources using several methods (e.g., observations & interviews). The case study research method originated in clinical medicine (the case history, i.e., the patient's personal history). In psychology, case studies are ...

  20. Case Study

    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.

  21. Case Study vs. Single-Case Experimental Designs

    A case study is an in-depth investigation of a particular individual, group, or event. It involves collecting and analyzing qualitative or quantitative data to gain a comprehensive understanding of the subject under study. Case studies are often used to explore complex phenomena, generate hypotheses, or provide detailed descriptions of unique ...

  22. 6.1 Experiment Basics

    Experiments have two fundamental features. The first is that the researchers manipulate, or systematically vary, the level of the independent variable. The different levels of the independent variable are called conditions. For example, in Darley and Latané's experiment, the independent variable was the number of witnesses that participants ...

  23. AI on Trial: Legal Models Hallucinate in 1 out of 6 Queries

    And our previous study of general-purpose chatbots found that they hallucinated between 58% and 82% of the time on legal queries, highlighting the risks of incorporating AI into legal practice. In his 2023 annual report on the judiciary, Chief Justice Roberts took note and warned lawyers of hallucinations.

  24. Organizational learning starting points and presuppositions: a case

    Organizational learning is a continuous process of integrating data and knowledge to ensure improvement. This qualitative study focuses on the starting points and presuppositions of organizational learning within a surgical department. Starting points for individual learning were informal and based on day-to-day work (e.g., solving a specific problem) and organizational learning encompassed ...

  25. JMIR Formative Research

    Methods: We performed a retrospective case study, collecting quantitative and qualitative data regarding clinical workflows and triage-template use from expert interviews, study surveys, routine check-ins with practice personnel, and chart reviews over the first year of implementation of the iCPR intervention.

  26. What the results of Wegovy's longest clinical trial yet show about

    The study also looked at how many people maintained at least 80% of the weight loss after the initial 36 weeks, and while many more who continued on the drug did - almost 90% - almost 17% of ...

  27. Persistent symptoms and clinical findings in adults with post-acute

    Objective: To assess risk factors for persistence vs improvement and to describe clinical characteristics and diagnostic evaluation of subjects with post-acute sequelae of COVID-19/post-COVID-19 syndrome (PCS) persisting for more than one year. Design: Nested population-based case-control study. Setting: Comprehensive outpatient assessment, including neurocognitive, cardiopulmonary exercise ...

  28. How NASA Tracked the Most Intense Solar Storm in Decades

    On May 14, 2024, the Sun emitted a strong solar flare. This solar flare is the largest of Solar Cycle 25 and is classified as an X8.7 flare. NASA's Goddard Space Flight Center. Traveling at speeds up to 3 million mph, the CMEs bunched up in waves that reached Earth starting May 10, creating a long-lasting geomagnetic storm that reached a rating ...

  29. Case study

    A case study is an in-depth, detailed examination of a particular case (or cases) within a real-world context. For example, case studies in medicine may focus on an individual patient or ailment; case studies in business might cover a particular firm's strategy or a broader market; similarly, case studies in politics can range from a narrow happening over time like the operations of a specific ...

  30. IVF access overwhelmingly seen as a good thing in the US

    An April Pew Research Center survey finds that Americans overwhelmingly say people having access to IVF is a good thing. Seven-in-ten adults say IVF access is a good thing. Just 8% say it is a bad thing, while 22% are unsure. There are only modest differences in views of IVF access across most demographic and partisan groups.