Resources for Case Studies A case study is a research method common in social science. This article defends case study methodology as an appropriate methodology, giving a description, the process and its strengths and weaknesses. Case Studies Explained A fairly lengthy explanation of case studies from G. Illustrative case studies serve primarily to make the unfamiliar familiar and to give readers a common language about the topic in question.
Exploratory or pilot Case Studies These are condensed case studies performed before implementing a large scale investigation. Their basic function is to help identify questions and select types of measurement prior to the main investigation. The primary pitfall of this type of study is that initial findings may seem convincing enough to be released prematurely as conclusions. Cumulative Case Studies These serve to aggregate information from several sites collected at different times.
The idea behind these studies is the collection of past studies will allow for greater generalization without additional cost or time being expended on new, possibly repetitive studies. Critical Instance Case Studies These examine one or more sites for either the purpose of examining a situation of unique interest with little to no interest in generalizability, or to call into question or challenge a highly generalized or universal assertion. This method is useful for answering cause and effect questions.
If a researcher wanted to study uncontacted Indian tribes, and could only observe the subjects, what type of observations should be made? Location — This type of study focuses on a place, and how and why people use the place. For example, many case studies have been done about Siberia, and the people who live there.
Siberia is a cold and barren place in northern Russia, and it is considered the most difficult place to live in the world. Studying the location, and it's weather and people can help other people learn how to live with extreme weather and isolation. Location studies can also be done on locations that are facing some kind of change. For example, a case study could be done on Alaska, and whether the state is seeing the effects of climate change. Another type of study that could be done in Alaska is how the environment changes as population increases.
Geographers and those interested in population growth often do these case studies. This could include the people who work for the company, or an event that occurred at the organization. An excellent example of this type of case study is Enron. Enron was one of the largest energy company's in the United States, when it was discovered that executives at the company were fraudulently reporting the company's accounting numbers. Once the fraud was uncovered, investigators discovered willful and systematic corruption that caused the collapse of Enron, as well as their financial auditors, Arthur Andersen.
The fraud was so severe that the top executives of the company were sentenced to prison. This type of case study is used by accountants, auditors, financiers, as well as business students, in order to learn how such a large company could get away with committing such a serious case of corporate fraud for as long as they did.
It can also be looked at from a psychological standpoint, as it is interesting to learn why the executives took the large risks that they took. Most company or organization case studies are done for business purposes. In fact, in many business schools, such as Harvard Business School, students learn by the case method, which is the study of case studies.
They learn how to solve business problems by studying the cases of businesses that either survived the same problem, or one that didn't survive the problem. Event — This type of study focuses on an event, whether cultural or societal, and how it affects those that are affected by it. An example would be the Tylenol cyanide scandal.
To this day, when a company experiences a large public relations scandal, they look to the Tylenol case study to learn how they managed to survive the scandal. A very popular topic for case studies was the events of September 11 th. There were studies in almost all of the different types of research studies. Obviously the event itself was a very popular topic. It was important to learn what lead up to the event, and how best to proven it from happening in the future. These studies are not only important to the U.
You have decided that you want to research and write a case study. Now what? In this section you will learn how to plan and organize a research case study. The first step is to choose the subject, topic or case.
You will want to choose a topic that is interesting to you, and a topic that would be of interest to your potential audience. Ideally you have a passion for the topic, as then you will better understand the issues surrounding the topic, and which resources would be most successful in the study.
You also must choose a topic that would be of interest to a large number of people. You want your case study to reach as large an audience as possible, and a topic that is of interest to just a few people will not have a very large reach.
One of the goals of a case study is to reach as many people as possible. Are you trying to reach the layperson? Or are you trying to reach other professionals in your field?
Your audience will help determine the topic you choose. If you are writing a case study that is looking for ways to lower rates of child obesity, who is your audience? If you are writing a psychology case study, you must consider whether your audience will have the intellectual skills to understand the information in the case. Does your audience know the vocabulary of psychology? Do they understand the processes and structure of the field? You want your audience to have as much general knowledge as possible.
When it comes time to write the case study, you may have to spend some time defining and explaining terms that might be unfamiliar to the audience. Lastly, when selecting a topic you do not want to choose a topic that is very old.
Current topics are always the most interesting, so if your topic is more than years old, you might want to consider a newer topic. If you choose an older topic, you must ask yourself what new and valuable information do you bring to the older topic, and is it relevant and necessary.
An illustrative case study will examine an unfamiliar case in order to help others understand it. For example, a case study of a veteran with PTSD can be used to help new therapists better understand what veterans experience.
An exploratory case study is a preliminary project that will be the precursor to a larger study in the future. For example, a case study could be done challenging the efficacy of different therapy methods for vets with PTSD. Once the study is complete, a larger study could be done on whichever method was most effective. A critical instance case focuses on a unique case that doesn't have a predetermined purpose. For example, a vet with an incredibly severe case of PTSD could be studied to find ways to treat his condition.
Ethics are a large part of the case study process, and most case studies require ethical approval. This approval usually comes from the institution or department the researcher works for. Many universities and research institutions have ethics oversight departments. They will require you to prove that you will not harm your study subjects or participants.
This should be done even if the case study is on an older subject. Sometimes publishing new studies can cause harm to the original participants. Regardless of your personal feelings, it is essential the project is brought to the ethics department to ensure your project can proceed safely. Once you have your topic, it is time to start planning and developing the study. Whilst such a schema can be conceptually helpful, it may be appropriate to draw on more than one approach in any case study, particularly in the context of conducting health services research.
Doolin has, for example, noted that in the context of undertaking interpretative case studies, researchers can usefully draw on a critical, reflective perspective which seeks to take into account the wider social and political environment that has shaped the case[ 11 ].
Here, we focus on the main stages of research activity when planning and undertaking a case study; the crucial stages are: defining the case; selecting the case s ; collecting and analysing the data; interpreting data; and reporting the findings.
Carefully formulated research question s , informed by the existing literature and a prior appreciation of the theoretical issues and setting s , are all important in appropriately and succinctly defining the case[ 8 , 12 ]. Crucially, each case should have a pre-defined boundary which clarifies the nature and time period covered by the case study i.
A theory driven approach to defining the case may help generate knowledge that is potentially transferable to a range of clinical contexts and behaviours; using theory is also likely to result in a more informed appreciation of, for example, how and why interventions have succeeded or failed[ 13 ].
Example of a checklist for rating a case study proposal[ 8 ]. Our focus was on how the technology was being implemented. However, if the primary research interest had been on the social and organisational dimensions of implementation, we might have defined our case differently as a grouping of healthcare professionals e.
The precise beginning and end of the case may however prove difficult to define. Pursuing this same example, when does the process of implementation and adoption of an electronic health record system really begin or end? Such judgements will inevitably be influenced by a range of factors, including the research question, theory of interest, the scope and richness of the gathered data and the resources available to the research team.
The decision on how to select the case s to study is a very important one that merits some reflection. In an intrinsic case study, the case is selected on its own merits[ 8 ]. The case is selected not because it is representative of other cases, but because of its uniqueness, which is of genuine interest to the researchers.
In another example of an intrinsic case study, Hellstrom et al. For an instrumental case study, selecting a "typical" case can work well[ 8 ]. In contrast to the intrinsic case study, the particular case which is chosen is of less importance than selecting a case that allows the researcher to investigate an issue or phenomenon.
For example, in order to gain an understanding of doctors' responses to health policy initiatives, Som undertook an instrumental case study interviewing clinicians who had a range of responsibilities for clinical governance in one NHS acute hospital trust[ 17 ]. Sampling a "deviant" or "atypical" case may however prove even more informative, potentially enabling the researcher to identify causal processes, generate hypotheses and develop theory.
In collective or multiple case studies, a number of cases are carefully selected. Choosing a "typical" case may enable the findings to be generalised to theory i. Yin suggests two or three literal replications i. However, critics might argue that selecting 'cases' in this way is insufficiently reflexive and ill-suited to the complexities of contemporary healthcare organisations.
The selected case study site s should allow the research team access to the group of individuals, the organisation, the processes or whatever else constitutes the chosen unit of analysis for the study. Access is therefore a central consideration; the researcher needs to come to know the case study site s well and to work cooperatively with them.
Selected cases need to be not only interesting but also hospitable to the inquiry [ 8 ] if they are to be informative and answer the research question s. Case study sites may also be pre-selected for the researcher, with decisions being influenced by key stakeholders.
This prominent stakeholder had already selected the NHS sites through a competitive bidding process to be early adopters of the electronic health record systems and had negotiated contracts that detailed the deployment timelines. It is also important to consider in advance the likely burden and risks associated with participation for those who or the site s which comprise the case study. Of particular importance is the obligation for the researcher to think through the ethical implications of the study e.
The outcome of providing this information might be that the emotive burden associated with participation, or the organisational disruption associated with supporting the fieldwork, is considered so high that the individuals or sites decide against participation.
In our example of evaluating implementations of electronic health record systems, given the restricted number of early adopter sites available to us, we sought purposively to select a diverse range of implementation cases among those that were available[ 5 ].
We chose a mixture of teaching, non-teaching and Foundation Trust hospitals, and examples of each of the three electronic health record systems procured centrally by the NPfIT. At one recruited site, it quickly became apparent that access was problematic because of competing demands on that organisation. Recognising the importance of full access and co-operative working for generating rich data, the research team decided not to pursue work at that site and instead to focus on other recruited sites.
In order to develop a thorough understanding of the case, the case study approach usually involves the collection of multiple sources of evidence, using a range of quantitative e. The use of multiple sources of data data triangulation has been advocated as a way of increasing the internal validity of a study i. Brazier and colleagues used a mixed-methods case study approach to investigate the impact of a cancer care programme[ 22 ].
Here, quantitative measures were collected with questionnaires before, and five months after, the start of the intervention which did not yield any statistically significant results. Qualitative interviews with patients however helped provide an insight into potentially beneficial process-related aspects of the programme, such as greater, perceived patient involvement in care.
The authors reported how this case study approach provided a number of contextual factors likely to influence the effectiveness of the intervention and which were not likely to have been obtained from quantitative methods alone.
In collective or multiple case studies, data collection needs to be flexible enough to allow a detailed description of each individual case to be developed e.
It is important that data sources from different cases are, where possible, broadly comparable for this purpose even though they may vary in nature and depth. Making sense and offering a coherent interpretation of the typically disparate sources of data whether qualitative alone or together with quantitative is far from straightforward.
Repeated reviewing and sorting of the voluminous and detail-rich data are integral to the process of analysis. In collective case studies, it is helpful to analyse data relating to the individual component cases first, before making comparisons across cases. Attention needs to be paid to variations within each case and, where relevant, the relationship between different causes, effects and outcomes[ 23 ].
Data will need to be organised and coded to allow the key issues, both derived from the literature and emerging from the dataset, to be easily retrieved at a later stage. An initial coding frame can help capture these issues and can be applied systematically to the whole dataset with the aid of a qualitative data analysis software package.
Theoretical frameworks may also play an important role in integrating different sources of data and examining emerging themes. Case study findings can have implications both for theory development and theory testing.
They may establish, strengthen or weaken historical explanations of a case and, in certain circumstances, allow theoretical as opposed to statistical generalisation beyond the particular cases studied[ 12 ].
These theoretical lenses should not, however, constitute a strait-jacket and the cases should not be "forced to fit" the particular theoretical framework that is being employed. When reporting findings, it is important to provide the reader with enough contextual information to understand the processes that were followed and how the conclusions were reached.
In a collective case study, researchers may choose to present the findings from individual cases separately before amalgamating across cases. Care must be taken to ensure the anonymity of both case sites and individual participants if agreed in advance by allocating appropriate codes or withholding descriptors. The case study approach is, as with all research, not without its limitations. The volume of data, together with the time restrictions in place, impacted on the depth of analysis that was possible within the available resources.
This highlights a more general point of the importance of avoiding the temptation to collect as much data as possible; adequate time also needs to be set aside for data analysis and interpretation of what are often highly complex datasets. Case study research has sometimes been criticised for lacking scientific rigour and providing little basis for generalisation i. There are several ways to address these concerns, including: the use of theoretical sampling i.
Transparency can be achieved by describing in detail the steps involved in case selection, data collection, the reasons for the particular methods chosen, and the researcher's background and level of involvement i. Seeking potential, alternative explanations, and being explicit about how interpretations and conclusions were reached, help readers to judge the trustworthiness of the case study report. Stake's checklist for assessing the quality of a case study report[ 8 ].
The case study approach allows, amongst other things, critical events, interventions, policy developments and programme-based service reforms to be studied in detail in a real-life context.
It should therefore be considered when an experimental design is either inappropriate to answer the research questions posed or impossible to undertake. Considering the frequency with which implementations of innovations are now taking place in healthcare settings and how well the case study approach lends itself to in-depth, complex health service research, we believe this approach should be more widely considered by researchers.
Though inherently challenging, the research case study can, if carefully conceptualised and thoughtfully undertaken and reported, yield powerful insights into many important aspects of health and healthcare delivery. AS conceived this article. SC and AS are guarantors. We are grateful to the participants and colleagues who contributed to the individual case studies that we have drawn on.
We would also like to thank the expert reviewers for their insightful and constructive feedback. Our thanks are also due to Dr.
Allison Worth who commented on an earlier draft of this manuscript. National Center for Biotechnology Information , U. Published online Jun
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