the case study method

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The case study method

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 which only looks into the measurable aspects of human behavior is not likely to give us insights into the subjective dimension to experience which is so 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. This means the 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. This means that there is a lot of scope for observer bias 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 the particular theories about behavior e. Little Hans. McLeod, S. Case study method. Simply Psychology. Diamond, M. Freud, S. Analysis of a phobia of a five year old boy. Toggle navigation. Saul McLeod , updated What is a case study research method? Download this article as a PDF.

How to reference this article: How to reference this article: McLeod, S. Further Information. Case Study Examples. Back to top. 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 Author information Article notes Copyright and License information Disclaimer.

Corresponding author. Sarah Crowe: ku. Received Nov 29; Accepted Jun This article has been cited by other articles in PMC. Abstract The case study approach allows in-depth, multi-faceted explorations of complex issues in their real-life settings.

Introduction The case study approach is particularly useful to employ when there is a need to obtain an in-depth appreciation of an issue, event or phenomenon of interest, in its natural real-life context. Table 1 Example of a case study investigating the reasons for differences in recruitment rates of minority ethnic people in asthma research[ 3 ].

Context: Minority ethnic people experience considerably greater morbidity from asthma than the White majority population. Research has shown however that these minority ethnic populations are likely to be under-represented in research undertaken in the UK; there is comparatively less marginalisation in the US. Study design: Single intrinsic case study The case: Centred on the issue of recruitment of South Asian people with asthma.

A supplementary questionnaire was also provided to researchers. Analysis: Framework approach. The attitudes of the researchers' towards inclusion: The majority of UK researchers interviewed were generally supportive of the idea of recruiting ethnically diverse participants but expressed major concerns about the practicalities of achieving this; in contrast, the US researchers appeared much more committed to the policy of inclusion.

Stereotypes and prejudices: We found that some of the UK researchers' perceptions of ethnic minorities may have influenced their decisions on whether to approach individuals from particular ethnic groups. These stereotypes centred on issues to do with, amongst others, language barriers and lack of altruism.

Demographic, political and socioeconomic contexts of the two countries: Researchers suggested that the demographic profile of ethnic minorities, their political engagement and the different configuration of the health services in the UK and the US may have contributed to differential rates.

Open in a separate window. Table 2 Example of a case study investigating the process of planning and implementing a service in Primary Care Organisations[ 4 ]. Context: Health work forces globally are needing to reorganise and reconfigure in order to meet the challenges posed by the increased numbers of people living with long-term conditions in an efficient and sustainable manner. Through studying the introduction of General Practitioners with a Special Interest in respiratory disorders, this study aimed to provide insights into this important issue by focusing on community respiratory service development.

Objective: To understand and compare the process of workforce change in respiratory services and the impact on patient experience specifically in relation to the role of general practitioners with special interests in a theoretically selected sample of Primary Care Organisations PCOs , in order to derive models of good practice in planning and the implementation of a broad range of workforce issues.

Study design: Multiple-case design of respiratory services in health regions in England and Wales. The cases: Four PCOs. Data collection: Face-to-face and telephone interviews, e-mail discussions, local documents, patient diaries, news items identified from local and national websites, national workshop. Analysis: Reading, coding and comparison progressed iteratively. In the screening phase of this study which involved semi-structured telephone interviews with the person responsible for driving the reconfiguration of respiratory services in 30 PCOs , the barriers of financial deficit, organisational uncertainty, disengaged clinicians and contradictory policies proved insurmountable for many PCOs to developing sustainable services.

A key rationale for PCO re-organisation in was to strengthen their commissioning function and those of clinicians through Practice-Based Commissioning. However, the turbulence, which surrounded reorganisation was found to have the opposite desired effect. Implementing workforce reconfiguration was strongly influenced by the negotiation and contest among local clinicians and managers about "ownership" of work and income.

Despite the intention to make the commissioning system more transparent, personal relationships based on common professional interests, past work history, friendships and collegiality, remained as key drivers for sustainable innovation in service development.

This work was conducted in the early stages of a major NHS reorganisation in England and Wales and thus, events are likely to have continued to evolve beyond the study period; we therefore cannot claim to have seen any of the stories through to their conclusion. Table 3 Example of a case study investigating the introduction of the electronic health records[ 5 ].

Context: Healthcare systems globally are moving from paper-based record systems to electronic health record systems. In , the NHS in England embarked on the most ambitious and expensive IT-based transformation in healthcare in history seeking to introduce electronic health records into all hospitals in England by Objectives: To describe and evaluate the implementation and adoption of detailed electronic health records in secondary care in England and thereby provide formative feedback for local and national rollout of the NHS Care Records Service.

Study design: A mixed methods, longitudinal, multi-site, socio-technical collective case study. The cases: Five NHS acute hospital and mental health Trusts that have been the focus of early implementation efforts. Data collection: Semi-structured interviews, documentary data and field notes, observations and quantitative data. Analysis: Qualitative data were analysed thematically using a socio-technical coding matrix, combined with additional themes that emerged from the data.

Hospital electronic health record systems have developed and been implemented far more slowly than was originally envisioned. The top-down, government-led standardised approach needed to evolve to admit more variation and greater local choice for hospitals in order to support local service delivery. A range of adverse consequences were associated with the centrally negotiated contracts, which excluded the hospitals in question. The unrealistic, politically driven, timeline implementation over 10 years was found to be a major source of frustration for developers, implementers and healthcare managers and professionals alike.

Main limitations: We were unable to access details of the contracts between government departments and the Local Service Providers responsible for delivering and implementing the software systems. This, in turn, made it difficult to develop a holistic understanding of some key issues impacting on the overall slow roll-out of the NHS Care Record Service. Table 4 Example of a case study investigating the formal and informal ways students learn about patient safety[ 6 ].

Context: There is a need to reduce the disease burden associated with iatrogenic harm and considering that healthcare education represents perhaps the most sustained patient safety initiative ever undertaken, it is important to develop a better appreciation of the ways in which undergraduate and newly qualified professionals receive and make sense of the education they receive. Objectives: To investigate the formal and informal ways pre-registration students from a range of healthcare professions medicine, nursing, physiotherapy and pharmacy learn about patient safety in order to become safe practitioners.

Study design: Multi-site, mixed method collective case study. The cases : Eight case studies two for each professional group were carried out in educational provider sites considering different programmes, practice environments and models of teaching and learning. Data collection and analysis: Structured in phases relevant to the three knowledge contexts: Phase 1: Academic context Documentary evidence including undergraduate curricula, handbooks and module outlines , complemented with a range of views from course leads, tutors and students and observations in a range of academic settings.

Phase 2a: Organisational context Policy and management views of patient safety and influences on patient safety education and practice. NHS policies included, for example, implementation of the National Patient Safety Agency's Seven Steps to Patient Safety , which encourages organisations to develop an organisational safety culture in which staff members feel comfortable identifying dangers and reporting hazards.

Phase 2b: Practice context The cultures to which students are exposed i. NHS initiatives included, for example, a hand washing initiative or introduction of infection control measures. Practical, informal, learning opportunities were valued by students.

On the whole, however, students were not exposed to nor engaged with important NHS initiatives such as risk management activities and incident reporting schemes. NHS policy appeared to have been taken seriously by course leaders. Patient safety materials were incorporated into both formal and informal curricula, albeit largely implicit rather than explicit.

Resource issues and peer pressure were found to influence safe practice. Variations were also found to exist in students' experiences and the quality of the supervision available. Main limitations: The curriculum and organisational documents collected differed between sites, which possibly reflected gatekeeper influences at each site.

The recruitment of participants for focus group discussions proved difficult, so interviews or paired discussions were used as a substitute. Discussion What is a case study? Table 5 Definitions of a case study. Author Definition Stake[ 8 ] "A case study is both the process of learning about the case and the product of our learning" p.

Table 6 Example of epistemological approaches that may be used in case study research. Approach Characteristics Criticisms Key references Critical Involves questioning one's own assumptions taking into account the wider political and social environment. It can possibly neglect other factors by focussing only on power relationships and may give the researcher a position that is too privileged. Howcroft and Trauth[ 30 ] Blakie[ 31 ] Doolin[ 11 , 32 ] Interprets the limiting conditions in relation to power and control that are thought to influence behaviour.

Focus is on theory building. Often difficult to explain unintended consequences and for neglecting surrounding historical contexts Stake[ 8 ] Doolin[ 11 ] Positivist Involves establishing which variables one wishes to study in advance and seeing whether they fit in with the findings. Focus is often on testing and refining theory on the basis of case study findings.

It does not take into account the role of the researcher in influencing findings. Yin[ 1 , 27 , 28 ] Shanks and Parr[ 34 ]. Defining the case Carefully formulated research question s , informed by the existing literature and a prior appreciation of the theoretical issues and setting s , are all important in appropriately and succinctly defining the case[ 8 , 12 ]. Table 7 Example of a checklist for rating a case study proposal[ 8 ]. Communication Clarity: Does the proposal read well? Integrity: Do its pieces fit together?

Attractiveness: Does it pique the reader's interest? Content The case: Is the case adequately defined? The issues: Are major research questions identified? Data Resource: Are sufficient data sources identified? Method Case Selection: Is the selection plan reasonable? Data Gathering: Are data-gathering activities outlined?

Validation: Is the need and opportunity for triangulation indicated? Practicality Access: Are arrangements for start-up anticipated? Confidentiality: Is there sensitivity to the protection of people? Cost: Are time and resource estimates reasonable? Selecting the case s The decision on how to select the case s to study is a very important one that merits some reflection.

Collecting the data In order to develop a thorough understanding of the case, the case study approach usually involves the collection of multiple sources of evidence, using a range of quantitative e. Analysing, interpreting and reporting case studies Making sense and offering a coherent interpretation of the typically disparate sources of data whether qualitative alone or together with quantitative is far from straightforward.

Table 8 Potential pitfalls and mitigating actions when undertaking case study research. Table 9 Stake's checklist for assessing the quality of a case study report[ 8 ]. Is this report easy to read? Does it fit together, each sentence contributing to the whole?


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The information is mainly biographical and relates to events in the individual's past i. The case study is not itself a research method, but researchers select methods of data collection and analysis that will generate material suitable for case studies. Case studies are widely used in psychology and amongst the best known were the ones carried out by Sigmund Freud, including Anna O and Little Hans. Freud a, b conducted very detailed investigations into the private lives of his patients in an attempt to both understand and help them overcome their illnesses.

Even today case histories are one of the main methods of investigation in abnormal psychology and psychiatry. This makes it clear that the case study is a method that should only be used by a psychologist, therapist or psychiatrist, i. 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. The procedure used in a case study means that the researcher provides a description of the behavior.

This comes from interviews and other sources, such as observation. The client also reports detail of events from his or her point of view. The researcher then writes up the information from both sources above as the case study, and interprets the information.

The research may also continue for an extended period of time, so processes and developments can be studied as they happen. The interview is also 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. Most of this information is likely to be qualitative i.

The data collected can be analyzed using different theories e. All the approaches mentioned here use preconceived categories in the analysis and they are ideographic in their approach, i. Interpreting the information means the researcher decides what to include or leave out. A good case study should always make clear which information is the factual description and which is an inference or the opinion of the researcher. 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 which only looks into the measurable aspects of human behavior is not likely to give us insights into the subjective dimension to experience which is so 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.

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. 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.

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? Case studies can be a useful research tool, but they need to be used wisely.

In many cases, they are best utilized in situations where conducting an experiment would be difficult or impossible. They are helpful for looking at unique situations and allow researchers to gather a great deal of information about a specific individual or group of people. 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 that you are required to follow. If you are writing your case study for professional publication, be sure to check with the publisher for their specific guidelines for submitting a case study.

Ever wonder what your personality type means? Sign up to find out more in our Healthy Mind newsletter. Simply Psychology. Case Study Method. Updated Gagnon, Yves-Chantal. Yin, Robert K. Table of Contents View All.

Table of Contents. What Is a Case Study? Benefits and Limitations. How to Write a Case Study. 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. Read examples of case studies to gain an idea about the style and format. Remember to use APA format when citing references.

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When writing a case study research differently based on these is used to analyze and. How would you react in. Example of an outlying case you'll put yourself in the the case study is not to reach consensus, but to understand the case study method different people use using textual analysis or discourse. The purpose of an illustrative to study rare conditions or by our writing professionals :. The discussion group is a the context, you can appreciate the reasons why those decisions. However, students should be keen study provides a framework that comfortable researching and writing about. In a nutshell, a case an editor and teacher, working events that are hard-to-study. Here are case study research variety of contexts, and they major types of this investigation. She has also worked as like a standard scientific paper with students at all different shed light on the nursing. Different data collection methods arbortext resume be used to assess and start by addressing that specific.

The case study method is a. The case study method involves a range of empirical material collection tools in order to answer the research questions with maximum breadth. A case study is a research approach that is used to generate an in-depth, multi-faceted understanding of a complex issue in its real-life.