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

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

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

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

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

Table of contents

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Research bias

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

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Research Method

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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research case study process

Designing and Conducting Case Studies

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

Definition and Overview

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

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

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

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

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

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

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

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

Educational Applications

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

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

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

Types and Design Concerns

Researchers use multiple methods and approaches to conduct case studies.

Types of Case Studies

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

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

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

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

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

Identifying a Theoretical Perspective

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

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

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

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

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

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

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

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

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

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

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

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

Designing a Case Study

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

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

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

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

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

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

Conducting Case Studies

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

Method: Single or Multi-modal?

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

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

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

Participant Selection

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

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

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

Data Collection

There are six types of data collected in case studies:

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

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

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

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

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

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

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

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

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

Data Analysis

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

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

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

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

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

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

Composing the Case Study Report

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

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

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

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

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

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

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

Issues of Validity and Reliability

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

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

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

Commentary on Case Studies

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

Strengths and Weaknesses of Case Studies

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

Flexibility

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

Emphasis on Context

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

Inherent Subjectivity

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

High Investment

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

Ethical Considerations

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

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

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

Concerns about Reliability, Validity, and Generalizability

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

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

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

Annotated Bibliography

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No abstract available.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

This article provides tips for writing more effective case studies.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Related Links

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

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

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

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 | 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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Shona McCombes

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  • v.107(1); 2019 Jan

Distinguishing case study as a research method from case reports as a publication type

The purpose of this editorial is to distinguish between case reports and case studies. In health, case reports are familiar ways of sharing events or efforts of intervening with single patients with previously unreported features. As a qualitative methodology, case study research encompasses a great deal more complexity than a typical case report and often incorporates multiple streams of data combined in creative ways. The depth and richness of case study description helps readers understand the case and whether findings might be applicable beyond that setting.

Single-institution descriptive reports of library activities are often labeled by their authors as “case studies.” By contrast, in health care, single patient retrospective descriptions are published as “case reports.” Both case reports and case studies are valuable to readers and provide a publication opportunity for authors. A previous editorial by Akers and Amos about improving case studies addresses issues that are more common to case reports; for example, not having a review of the literature or being anecdotal, not generalizable, and prone to various types of bias such as positive outcome bias [ 1 ]. However, case study research as a qualitative methodology is pursued for different purposes than generalizability. The authors’ purpose in this editorial is to clearly distinguish between case reports and case studies. We believe that this will assist authors in describing and designating the methodological approach of their publications and help readers appreciate the rigor of well-executed case study research.

Case reports often provide a first exploration of a phenomenon or an opportunity for a first publication by a trainee in the health professions. In health care, case reports are familiar ways of sharing events or efforts of intervening with single patients with previously unreported features. Another type of study categorized as a case report is an “N of 1” study or single-subject clinical trial, which considers an individual patient as the sole unit of observation in a study investigating the efficacy or side effect profiles of different interventions. Entire journals have evolved to publish case reports, which often rely on template structures with limited contextualization or discussion of previous cases. Examples that are indexed in MEDLINE include the American Journal of Case Reports , BMJ Case Reports, Journal of Medical Case Reports, and Journal of Radiology Case Reports . Similar publications appear in veterinary medicine and are indexed in CAB Abstracts, such as Case Reports in Veterinary Medicine and Veterinary Record Case Reports .

As a qualitative methodology, however, case study research encompasses a great deal more complexity than a typical case report and often incorporates multiple streams of data combined in creative ways. Distinctions include the investigator’s definitions and delimitations of the case being studied, the clarity of the role of the investigator, the rigor of gathering and combining evidence about the case, and the contextualization of the findings. Delimitation is a term from qualitative research about setting boundaries to scope the research in a useful way rather than describing the narrow scope as a limitation, as often appears in a discussion section. The depth and richness of description helps readers understand the situation and whether findings from the case are applicable to their settings.

CASE STUDY AS A RESEARCH METHODOLOGY

Case study as a qualitative methodology is an exploration of a time- and space-bound phenomenon. As qualitative research, case studies require much more from their authors who are acting as instruments within the inquiry process. In the case study methodology, a variety of methodological approaches may be employed to explain the complexity of the problem being studied [ 2 , 3 ].

Leading authors diverge in their definitions of case study, but a qualitative research text introduces case study as follows:

Case study research is defined as a qualitative approach in which the investigator explores a real-life, contemporary bounded system (a case) or multiple bound systems (cases) over time, through detailed, in-depth data collection involving multiple sources of information, and reports a case description and case themes. The unit of analysis in the case study might be multiple cases (a multisite study) or a single case (a within-site case study). [ 4 ]

Methodologists writing core texts on case study research include Yin [ 5 ], Stake [ 6 ], and Merriam [ 7 ]. The approaches of these three methodologists have been compared by Yazan, who focused on six areas of methodology: epistemology (beliefs about ways of knowing), definition of cases, design of case studies, and gathering, analysis, and validation of data [ 8 ]. For Yin, case study is a method of empirical inquiry appropriate to determining the “how and why” of phenomena and contributes to understanding phenomena in a holistic and real-life context [ 5 ]. Stake defines a case study as a “well-bounded, specific, complex, and functioning thing” [ 6 ], while Merriam views “the case as a thing, a single entity, a unit around which there are boundaries” [ 7 ].

Case studies are ways to explain, describe, or explore phenomena. Comments from a quantitative perspective about case studies lacking rigor and generalizability fail to consider the purpose of the case study and how what is learned from a case study is put into practice. Rigor in case studies comes from the research design and its components, which Yin outlines as (a) the study’s questions, (b) the study’s propositions, (c) the unit of analysis, (d) the logic linking the data to propositions, and (e) the criteria for interpreting the findings [ 5 ]. Case studies should also provide multiple sources of data, a case study database, and a clear chain of evidence among the questions asked, the data collected, and the conclusions drawn [ 5 ].

Sources of evidence for case studies include interviews, documentation, archival records, direct observations, participant-observation, and physical artifacts. One of the most important sources for data in qualitative case study research is the interview [ 2 , 3 ]. In addition to interviews, documents and archival records can be gathered to corroborate and enhance the findings of the study. To understand the phenomenon or the conditions that created it, direct observations can serve as another source of evidence and can be conducted throughout the study. These can include the use of formal and informal protocols as a participant inside the case or an external or passive observer outside of the case [ 5 ]. Lastly, physical artifacts can be observed and collected as a form of evidence. With these multiple potential sources of evidence, the study methodology includes gathering data, sense-making, and triangulating multiple streams of data. Figure 1 shows an example in which data used for the case started with a pilot study to provide additional context to guide more in-depth data collection and analysis with participants.

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Key sources of data for a sample case study

VARIATIONS ON CASE STUDY METHODOLOGY

Case study methodology is evolving and regularly reinterpreted. Comparative or multiple case studies are used as a tool for synthesizing information across time and space to research the impact of policy and practice in various fields of social research [ 9 ]. Because case study research is in-depth and intensive, there have been efforts to simplify the method or select useful components of cases for focused analysis. Micro-case study is a term that is occasionally used to describe research on micro-level cases [ 10 ]. These are cases that occur in a brief time frame, occur in a confined setting, and are simple and straightforward in nature. A micro-level case describes a clear problem of interest. Reporting is very brief and about specific points. The lack of complexity in the case description makes obvious the “lesson” that is inherent in the case; although no definitive “solution” is necessarily forthcoming, making the case useful for discussion. A micro-case write-up can be distinguished from a case report by its focus on briefly reporting specific features of a case or cases to analyze or learn from those features.

DATABASE INDEXING OF CASE REPORTS AND CASE STUDIES

Disciplines such as education, psychology, sociology, political science, and social work regularly publish rich case studies that are relevant to particular areas of health librarianship. Case reports and case studies have been defined as publication types or subject terms by several databases that are relevant to librarian authors: MEDLINE, PsycINFO, CINAHL, and ERIC. Library, Information Science & Technology Abstracts (LISTA) does not have a subject term or publication type related to cases, despite many being included in the database. Whereas “Case Reports” are the main term used by MEDLINE’s Medical Subject Headings (MeSH) and PsycINFO’s thesaurus, CINAHL and ERIC use “Case Studies.”

Case reports in MEDLINE and PsycINFO focus on clinical case documentation. In MeSH, “Case Reports” as a publication type is specific to “clinical presentations that may be followed by evaluative studies that eventually lead to a diagnosis” [ 11 ]. “Case Histories,” “Case Studies,” and “Case Study” are all entry terms mapping to “Case Reports”; however, guidance to indexers suggests that “Case Reports” should not be applied to institutional case reports and refers to the heading “Organizational Case Studies,” which is defined as “descriptions and evaluations of specific health care organizations” [ 12 ].

PsycINFO’s subject term “Case Report” is “used in records discussing issues involved in the process of conducting exploratory studies of single or multiple clinical cases.” The Methodology index offers clinical and non-clinical entries. “Clinical Case Study” is defined as “case reports that include disorder, diagnosis, and clinical treatment for individuals with mental or medical illnesses,” whereas “Non-clinical Case Study” is a “document consisting of non-clinical or organizational case examples of the concepts being researched or studied. The setting is always non-clinical and does not include treatment-related environments” [ 13 ].

Both CINAHL and ERIC acknowledge the depth of analysis in case study methodology. The CINAHL scope note for the thesaurus term “Case Studies” distinguishes between the document and the methodology, though both use the same term: “a review of a particular condition, disease, or administrative problem. Also, a research method that involves an in-depth analysis of an individual, group, institution, or other social unit. For material that contains a case study, search for document type: case study.” The ERIC scope note for the thesaurus term “Case Studies” is simple: “detailed analyses, usually focusing on a particular problem of an individual, group, or organization” [ 14 ].

PUBLICATION OF CASE STUDY RESEARCH IN LIBRARIANSHIP

We call your attention to a few examples published as case studies in health sciences librarianship to consider how their characteristics fit with the preceding definitions of case reports or case study research. All present some characteristics of case study research, but their treatment of the research questions, richness of description, and analytic strategies vary in depth and, therefore, diverge at some level from the qualitative case study research approach. This divergence, particularly in richness of description and analysis, may have been constrained by the publication requirements.

As one example, a case study by Janke and Rush documented a time- and context-bound collaboration involving a librarian and a nursing faculty member [ 15 ]. Three objectives were stated: (1) describing their experience of working together on an interprofessional research team, (2) evaluating the value of the librarian role from librarian and faculty member perspectives, and (3) relating findings to existing literature. Elements that signal the qualitative nature of this case study are that the authors were the research participants and their use of the term “evaluation” is reflection on their experience. This reads like a case study that could have been enriched by including other types of data gathered from others engaging with this team to broaden the understanding of the collaboration.

As another example, the description of the academic context is one of the most salient components of the case study written by Clairoux et al., which had the objectives of (1) describing the library instruction offered and learning assessments used at a single health sciences library and (2) discussing the positive outcomes of instruction in that setting [ 16 ]. The authors focus on sharing what the institution has done more than explaining why this institution is an exemplar to explore a focused question or understand the phenomenon of library instruction. However, like a case study, the analysis brings together several streams of data including course attendance, online material page views, and some discussion of results from surveys. This paper reads somewhat in between an institutional case report and a case study.

The final example is a single author reporting on a personal experience of creating and executing the role of research informationist for a National Institutes of Health (NIH)–funded research team [ 17 ]. There is a thoughtful review of the informationist literature and detailed descriptions of the institutional context and the process of gaining access to and participating in the new role. However, the motivating question in the abstract does not seem to be fully addressed through analysis from either the reflective perspective of the author as the research participant or consideration of other streams of data from those involved in the informationist experience. The publication reads more like a case report about this informationist’s experience than a case study that explores the research informationist experience through the selection of this case.

All of these publications are well written and useful for their intended audiences, but in general, they are much shorter and much less rich in depth than case studies published in social sciences research. It may be that the authors have been constrained by word counts or page limits. For example, the submission category for Case Studies in the Journal of the Medical Library Association (JMLA) limited them to 3,000 words and defined them as “articles describing the process of developing, implementing, and evaluating a new service, program, or initiative, typically in a single institution or through a single collaborative effort” [ 18 ]. This definition’s focus on novelty and description sounds much more like the definition of case report than the in-depth, detailed investigation of a time- and space-bound problem that is often examined through case study research.

Problem-focused or question-driven case study research would benefit from the space provided for Original Investigations that employ any type of quantitative or qualitative method of analysis. One of the best examples in the JMLA of an in-depth multiple case study that was authored by a librarian who published the findings from her doctoral dissertation represented all the elements of a case study. In eight pages, she provided a theoretical basis for the research question, a pilot study, and a multiple case design, including integrated data from interviews and focus groups [ 19 ].

We have distinguished between case reports and case studies primarily to assist librarians who are new to research and critical appraisal of case study methodology to recognize the features that authors use to describe and designate the methodological approaches of their publications. For researchers who are new to case research methodology and are interested in learning more, Hancock and Algozzine provide a guide [ 20 ].

We hope that JMLA readers appreciate the rigor of well-executed case study research. We believe that distinguishing between descriptive case reports and analytic case studies in the journal’s submission categories will allow the depth of case study methodology to increase. We also hope that authors feel encouraged to pursue submitting relevant case studies or case reports for future publication.

Editor’s note: In response to this invited editorial, the Journal of the Medical Library Association will consider manuscripts employing rigorous qualitative case study methodology to be Original Investigations (fewer than 5,000 words), whereas manuscripts describing the process of developing, implementing, and assessing a new service, program, or initiative—typically in a single institution or through a single collaborative effort—will be considered to be Case Reports (formerly known as Case Studies; fewer than 3,000 words).

research case study process

Case Study Research: Methods and Designs

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

Case Study Method

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

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

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

What Is The Case Study Method?

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

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

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

Here are the primary features of case study research:

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

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

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

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

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

Let’s look now at case study methodology.

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

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

2. Semi-structured Interview

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

3. Focus Group Interview

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

4. Participant Observation

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

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

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

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

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

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

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

1. Illustrative case study

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

2. Cumulative case study

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

3. Exploratory case study

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

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

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

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

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A Quick Guide to Case Study with Examples

Published by Alvin Nicolas at August 14th, 2021 , Revised On August 29, 2023

A case study is a documented history and detailed analysis of a situation concerning organisations, industries, and markets.

A case study:

  • Focuses on discovering new facts of the situation under observation.
  • Includes data collection from multiple sources over time.
  • Widely used in social sciences to study the underlying information, organisation, community, or event.
  • It does not provide any solution to the problem .

When to Use Case Study? 

You can use a case study in your research when:

  • The focus of your study is to find answers to how and why questions .
  • You don’t have enough time to conduct extensive research; case studies are convenient for completing your project successfully.
  • You want to analyse real-world problems in-depth, then you can use the method of the case study.

You can consider a single case to gain in-depth knowledge about the subject, or you can choose multiple cases to know about various aspects of your  research problem .

What are the Aims of the Case Study?

  • The case study aims at identifying weak areas that can be improved.
  • This method is often used for idiographic research (focuses on individual cases or events).
  • Another aim of the case study is nomothetic research (aims to discover new theories through data analysis of multiple cases).

Types of Case Studies

There are different types of case studies that can be categorised based on the purpose of the investigation.

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How to Conduct a Case Study?

  • Select the Case to Investigate
  • Formulate the Research Question
  • Review of Literature
  • Choose the Precise Case to Use in your Study
  • Select Data Collection and Analysis Techniques
  • Collect the Data
  • Analyse the Data
  • Prepare the Report

Step1: Select the Case to Investigate

The first step is to select a case to conduct your investigation. You should remember the following points.

  • Make sure that you perform the study in the available timeframe.
  • There should not be too much information available about the organisation.
  • You should be able to get access to the organisation.
  • There should be enough information available about the subject to conduct further research.

Step2: Formulate the Research Question

It’s necessary to  formulate a research question  to proceed with your case study. Most of the research questions begin with  how, why, what, or what can . 

You can also use a research statement instead of a research question to conduct your research which can be conditional or non-conditional. 

Step 3: Review of Literature

Once you formulate your research statement or question, you need to extensively  review the documentation about the existing discoveries related to your research question or statement.

Step 4: Choose the Precise Case to Use in your Study

You need to select a specific case or multiple cases related to your research. It would help if you treated each case individually while using multiple cases. The outcomes of each case can be used as contributors to the outcomes of the entire study.  You can select the following cases. 

  • Representing various geographic regions
  • Cases with various size parameters
  • Explaining the existing theories or assumptions
  • Leading to discoveries
  • Providing a base for future research.

Step 5: Select Data Collection and Analysis Techniques

You can choose both  qualitative or quantitative approaches  for  collecting the data . You can use  interviews ,  surveys , artifacts, documentation, newspapers, and photographs, etc. To avoid biased observation, you can triangulate  your research to provide different views of your case. Even if you are focusing on a single case, you need to observe various case angles. It would help if you constructed validity, internal and external validity, as well as reliability.

Example: Identifying the impacts of contaminated water on people’s health and the factors responsible for it. You need to gather the data using qualitative and quantitative approaches to understand the case in such cases.

Construct validity:  You should select the most suitable measurement tool for your research. 

Internal validity:   You should use various methodological tools to  triangulate  the data. Try different methods to study the same hypothesis.

External validity:  You need to effectively apply the data beyond the case’s circumstances to more general issues.

Reliability:   You need to be confident enough to formulate the new direction for future studies based on your findings.

Also Read:  Reliability and Validity

Step 6: Collect the Data

Beware of the following when collecting data:

  • Information should be gathered systematically, and the collected evidence from various sources should contribute to your research objectives.
  • Don’t collect your data randomly.
  • Recheck your research questions to avoid mistakes.
  • You should save the collected data in any popular format for clear understanding.
  • While making any changes to collecting information, make sure to record the changes in a document.
  • You should maintain a case diary and note your opinions and thoughts evolved throughout the study.

Step 7: Analyse the Data

The research data identifies the relationship between the objects of study and the research questions or statements. You need to reconfirm the collected information and tabulate it correctly for better understanding. 

Step 8: Prepare the Report

It’s essential to prepare a report for your case study. You can write your case study in the form of a scientific paper or thesis discussing its detail with supporting evidence. 

A case study can be represented by incorporating  quotations,  stories, anecdotes,  interview transcripts , etc., with empirical data in the result section. 

You can also write it in narrative styles using  textual analysis  or   discourse analysis . Your report should also include evidence from published literature, and you can put it in the discussion section.

Advantages and Disadvantages of Case Study

Frequently asked questions, what is the case study.

A case study is a research method where a specific instance, event, or situation is deeply examined to gain insights into real-world complexities. It involves detailed analysis of context, data, and variables to understand patterns, causes, and effects, often used in various disciplines for in-depth exploration.

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Chapter 11 Case Research

Case research, also called case study, is a method of intensively studying a phenomenon over time within its natural setting in one or a few sites. Multiple methods of data collection, such as interviews, observations, prerecorded documents, and secondary data, may be employed and inferences about the phenomenon of interest tend to be rich, detailed, and contextualized. Case research can be employed in a positivist manner for the purpose of theory testing or in an interpretive manner for theory building. This method is more popular in business research than in other social science disciplines.

Case research has several unique strengths over competing research methods such as experiments and survey research. First, case research can be used for either theory building or theory testing, while positivist methods can be used for theory testing only. In interpretive case research, the constructs of interest need not be known in advance, but may emerge from the data as the research progresses. Second, the research questions can be modified during the research process if the original questions are found to be less relevant or salient. This is not possible in any positivist method after the data is collected. Third, case research can help derive richer, more contextualized, and more authentic interpretation of the phenomenon of interest than most other research methods by virtue of its ability to capture a rich array of contextual data. Fourth, the phenomenon of interest can be studied from the perspectives of multiple participants and using multiple levels of analysis (e.g., individual and organizational).

At the same time, case research also has some inherent weaknesses. Because it involves no experimental control, internal validity of inferences remain weak. Of course, this is a common problem for all research methods except experiments. However, as described later, the problem of controls may be addressed in case research using “natural controls”. Second, the quality of inferences derived from case research depends heavily on the integrative powers of the researcher. An experienced researcher may see concepts and patterns in case data that a novice researcher may miss. Hence, the findings are sometimes criticized as being subjective. Finally, because the inferences are heavily contextualized, it may be difficult to generalize inferences from case research to other contexts or other organizations.

It is important to recognize that case research is different from case descriptions such as Harvard case studies discussed in business classes. While case descriptions typically describe an organizational problem in rich detail with the goal of stimulating classroom discussion and critical thinking among students, or analyzing how well an organization handled a specific problem, case research is a formal research technique that involves a scientific method to derive explanations of organizational phenomena.

Case research is a difficult research method that requires advanced research skills on the part of the researcher, and is therefore, often prone to error. Benbasat et al. (1987) [8] describe five problems frequently encountered in case research studies. First, many case research studies start without specific research questions, and therefore end up without having any specific answers or insightful inferences. Second, case sites are often chosen based on access and convenience, rather than based on the fit with the research questions, and are therefore cannot adequately address the research questions of interest. Third, researchers often do not validate or triangulate data collected using multiple means, which may lead to biased interpretation based on responses from biased interviewees. Fourth, many studies provide very little details on how data was collected (e.g., what interview questions were used, which documents were examined, what are the organizational positions of each interviewee, etc.) or analyzed, which may raise doubts about the reliability of the inferences. Finally, despite its strength as a longitudinal research method, many case research studies do not follow through a phenomenon in a longitudinal manner, and hence present only a cross-sectional and limited view of organizational processes and phenomena that are temporal in nature.

Key Decisions in Case Research

Several key decisions must be made by a researcher when considering a case research method. First, is this the right method for the research questions being studied? The case research method is particularly appropriate for exploratory studies for discovering relevant constructs in areas where theory building at the formative stages, for studies where the experiences of participants and context of actions are critical, and for studies aimed at understanding complex, temporal processes (why and how of a phenomenon) rather than factors or causes (what). This method is well-suited for studying complex organizational processes that involve multiple participants and interacting sequences of events, such as organizational change and large-scale technology implementation projects.

Second, what is the appropriate unit of analysis for a case research study? Since case research can simultaneously examine multiple units of analyses, the researcher must decide whether she wishes to study a phenomenon at the individual, group, and organizational level or at multiple levels. For instance, a study of group decision making or group work may combine individual-level constructs such as individual participation in group activities with group-level constructs, such as group cohesion and group leadership, to derive richer understanding than that can be achieved from a single level of analysis.

Third, should the researcher employ a single-case or multiple-case design? The single case design is more appropriate at the outset of theory generation, if the situation is unique or extreme, if it is revelatory (i.e., the situation was previously inaccessible for scientific investigation), or if it represents a critical or contrary case for testing a well-formulated theory. The multiple case design is more appropriate for theory testing, for establishing generalizability of inferences, and for developing richer and more nuanced interpretations of a phenomenon. Yin (1984) [9] recommends the use of multiple case sites with replication logic, viewing each case site as similar to one experimental study, and following rules of scientific rigor similar to that used in positivist research.

Fourth, what sites should be chosen for case research? Given the contextualized nature of inferences derived from case research, site selection is a particularly critical issue because selecting the wrong site may lead to the wrong inferences. If the goal of the research is to test theories or examine generalizability of inferences, then dissimilar case sites should be selected to increase variance in observations. For instance, if the goal of the research is to understand the process of technology implementation in firms, a mix of large, mid-sized, and small firms should be selected to examine whether the technology implementation process differs with firm size. Site selection should not be opportunistic or based on convenience, but rather based on the fit with research questions through a process called “theoretical sampling.”

Fifth, what techniques of data collection should be used in case research? Although interview (either open-ended/unstructured or focused/structured) is by far the most popular data collection technique for case research, interview data can be supplemented or corroborated with other techniques such as direct observation (e.g., attending executive meetings, briefings, and planning sessions), documentation (e.g., internal reports, presentations, and memoranda, as well as external accounts such as newspaper reports), archival records (e.g., organization charts, financial records, etc.), and physical artifacts (e.g., devices, outputs, tools). Furthermore, the researcher should triangulate or validate observed data by comparing responses between interviewees.

Conducting Case Research

Most case research studies tend to be interpretive in nature. Interpretive case research is an inductive technique where evidence collected from one or more case sites is systematically analyzed and synthesized to allow concepts and patterns to emerge for the purpose of building new theories or expanding existing ones. Eisenhardt (1989) [10] propose a “roadmap” for building theories from case research, a slightly modified version of which is described below. For positivist case research, some of the following stages may need to be rearranged or modified; however sampling, data collection, and data analytic techniques should generally remain the same.

Define research questions. Like any other scientific research, case research must also start with defining research questions that are theoretically and practically interesting, and identifying some intuitive expectations about possible answers to those research questions or preliminary constructs to guide initial case design. In positivist case research, the preliminary constructs are based on theory, while no such theory or hypotheses should be considered ex ante in interpretive research. These research questions and constructs may be changed in interpretive case research later on, if needed, but not in positivist case research.

Select case sites. The researcher should use a process of “theoretical sampling” (not random sampling) to identify case sites. In this approach, case sites are chosen based on theoretical, rather than statistical, considerations, for instance, to replicate previous cases, to extend preliminary theories, or to fill theoretical categories or polar types. Care should be taken to ensure that the selected sites fit the nature of research questions, minimize extraneous variance or noise due to firm size, industry effects, and so forth, and maximize variance in the dependent variables of interest. For instance, if the goal of the research is to examine how some firms innovate better than others, the researcher should select firms of similar size within the same industry to reduce industry or size effects, and select some more innovative and some less innovative firms to increase variation in firm innovation. Instead of cold-calling or writing to a potential site, it is better to contact someone at executive level inside each firm who has the authority to approve the project or someone who can identify a person of authority. During initial conversations, the researcher should describe the nature and purpose of the project, any potential benefits to the case site, how the collected data will be used, the people involved in data collection (other researchers, research assistants, etc.), desired interviewees, and the amount of time, effort, and expense required of the sponsoring organization. The researcher must also assure confidentiality, privacy, and anonymity of both the firm and the individual respondents.

Create instruments and protocols. Since the primary mode of data collection in case research is interviews, an interview protocol should be designed to guide the interview process. This is essentially a list of questions to be asked. Questions may be open-ended (unstructured) or closed-ended (structured) or a combination of both. The interview protocol must be strictly followed, and the interviewer must not change the order of questions or skip any question during the interview process, although some deviations are allowed to probe further into respondent’s comments that are ambiguous or interesting. The interviewer must maintain a neutral tone, not lead respondents in any specific direction, say by agreeing or disagreeing with any response. More detailed interviewing techniques are discussed in the chapter on surveys. In addition, additional sources of data, such as internal documents and memorandums, annual reports, financial statements, newspaper articles, and direct observations should be sought to supplement and validate interview data.

Select respondents. Select interview respondents at different organizational levels, departments, and positions to obtain divergent perspectives on the phenomenon of interest. A random sampling of interviewees is most preferable; however a snowball sample is acceptable, as long as a diversity of perspectives is represented in the sample. Interviewees must be selected based on their personal involvement with the phenomenon under investigation and their ability and willingness to answer the researcher’s questions accurately and adequately, and not based on convenience or access.

Start data collection . It is usually a good idea to electronically record interviews for future reference. However, such recording must only be done with the interviewee’s consent. Even when interviews are being recorded, the interviewer should take notes to capture important comments or critical observations, behavioral responses (e.g., respondent’s body language), and the researcher’s personal impressions about the respondent and his/her comments. After each interview is completed, the entire interview should be transcribed verbatim into a text document for analysis.

Conduct within-case data analysis. Data analysis may follow or overlap with data collection. Overlapping data collection and analysis has the advantage of adjusting the data collection process based on themes emerging from data analysis, or to further probe into these themes. Data analysis is done in two stages. In the first stage (within-case analysis), the researcher should examine emergent concepts separately at each case site and patterns between these concepts to generate an initial theory of the problem of interest. The researcher can interview data subjectively to “make sense” of the research problem in conjunction with using her personal observations or experience at the case site. Alternatively, a coding strategy such as Glasser and Strauss’ (1967) grounded theory approach, using techniques such as open coding, axial coding, and selective coding, may be used to derive a chain of evidence and inferences. These techniques are discussed in detail in a later chapter. Homegrown techniques, such as graphical representation of data (e.g., network diagram) or sequence analysis (for longitudinal data) may also be used. Note that there is no predefined way of analyzing the various types of case data, and the data analytic techniques can be modified to fit the nature of the research project.

Conduct cross-case analysis. Multi-site case research requires cross-case analysis as the second stage of data analysis. In such analysis, the researcher should look for similar concepts and patterns between different case sites, ignoring contextual differences that may lead to idiosyncratic conclusions. Such patterns may be used for validating the initial theory, or for refining it (by adding or dropping concepts and relationships) to develop a more inclusive and generalizable theory. This analysis may take several forms. For instance, the researcher may select categories (e.g., firm size, industry, etc.) and look for within-group similarities and between-group differences (e.g., high versus low performers, innovators versus laggards). Alternatively, she can compare firms in a pair-wise manner listing similarities and differences across pairs of firms.

Build and test hypotheses. Based on emergent concepts and themes that are generalizable across case sites, tentative hypotheses are constructed. These hypotheses should be compared iteratively with observed evidence to see if they fit the observed data, and if not, the constructs or relationships should be refined. Also the researcher should compare the emergent constructs and hypotheses with those reported in the prior literature to make a case for their internal validity and generalizability. Conflicting findings must not be rejected, but rather reconciled using creative thinking to generate greater insight into the emergent theory. When further iterations between theory and data yield no new insights or changes in the existing theory, “theoretical saturation” is reached and the theory building process is complete.

Write case research report. In writing the report, the researcher should describe very clearly the detailed process used for sampling, data collection, data analysis, and hypotheses development, so that readers can independently assess the reasonableness, strength, and consistency of the reported inferences. A high level of clarity in research methods is needed to ensure that the findings are not biased by the researcher’s preconceptions.

Interpretive Case Research Exemplar

Perhaps the best way to learn about interpretive case research is to examine an illustrative example. One such example is Eisenhardt’s (1989) [11] study of how executives make decisions in high-velocity environments (HVE). Readers are advised to read the original paper published in Academy of Management Journal before reading the synopsis in this chapter. In this study, Eisenhardt examined how executive teams in some HVE firms make fast decisions, while those in other firms cannot, and whether faster decisions improve or worsen firm performance in such environments. HVE was defined as one where demand, competition, and technology changes so rapidly and discontinuously that the information available is often inaccurate, unavailable or obsolete. The implicit assumptions were that (1) it is hard to make fast decisions with inadequate information in HVE, and (2) fast decisions may not be efficient and may result in poor firm performance.

Reviewing the prior literature on executive decision -making, Eisenhardt found several patterns, although none of these patterns were specific to high-velocity environments. The literature suggested that in the interest of expediency, firms that make faster decisions obtain input from fewer sources, consider fewer alternatives, make limited analysis, restrict user participation in decision-making, centralize decision-making authority, and has limited internal conflicts. However, Eisenhardt contended that these views may not necessarily explain how decision makers make decisions in high-velocity environments, where decisions must be made quickly and with incomplete information, while maintaining high decision quality.

To examine this phenomenon, Eisenhardt conducted an inductive study of eight firms in the personal computing industry. The personal computing industry was undergoing dramatic changes in technology with the introduction of the UNIX operating system, RISC architecture, and 64KB random access memory in the 1980’s, increased competition with the entry of IBM into the personal computing business, and growing customer demand with double-digit demand growth, and therefore fit the profile of the high-velocity environment. This was a multiple case design with replication logic, where each case was expected to confirm or disconfirm inferences from other cases. Case sites were selected based on their access and proximity to the researcher; however, all of these firms operated in the high-velocity personal computing industry in California’s Silicon Valley area. The collocation of firms in the same industry and the same area ruled out any “noise” or variance in dependent variables (decision speed or performance) attributable to industry or geographic differences.

The study employed an embedded design with multiple levels of analysis: decision (comparing multiple strategic decisions within each firm), executive teams (comparing different teams responsible for strategic decisions), and the firm (overall firm performance). Data was collected from five sources:

  • Initial interviews with Chief Executive Officers: CEOs were asked questions about their firm’s competitive strategy, distinctive competencies, major competitors, performance, and recent/ongoing major strategic decisions. Based on these interviews, several strategic decisions were selected in each firm for further investigation. Four criteria were used to select decisions: (1) the decisions involved the firm’s strategic positioning,

(2) the decisions had high stakes, (3) the decisions involved multiple functions, and (4) the decisions were representative of strategic decision-making process in that firm.

  • Interviews with divisional heads: Each divisional head was asked sixteen open-ended questions, ranging from their firm’s competitive strategy, functional strategy, top management team members, frequency and nature of interaction with team, typical decision making processes, how each of the previously identified decision was made, and how long it took them to make those decisions. Interviews lasted between 1.5 and 2 hours, and sometimes extended to 4 hours. To focus on facts and actual events rather than respondents’ perceptions or interpretations, a “courtroom” style questioning was employed, such as when did this happen, what did you do, etc. Interviews were conducted by two people, and the data was validated by cross-checking facts and impressions made by the interviewer and note-taker. All interview data was recorded, however notes were also taken during each interview, which ended with the interviewer’s overall impressions. Using a “24-hour rule”, detailed field notes were completed within 24 hours of the interview, so that some data or impressions were not lost to recall.
  • Questionnaires: Executive team members at each firm were completed a survey questionnaire that captured quantitative data on the extent of conflict and power distribution in their firm.
  • Secondary data: Industry reports and internal documents such as demographics of the executive teams (responsible for strategic decisions), financial performance of firms, and so forth, were examined.
  • Personal observation: Lastly, the researcher attended a 1-day strategy session and a weekly executive meeting at two firms in her sample.

Data analysis involved a combination of quantitative and qualitative techniques. Quantitative data on conflict and power were analyzed for patterns across firms/decisions. Qualitative interview data was combined into decision climate profiles, using profile traits (e.g., impatience) mentioned by more than one executive. For within-case analysis, decision stories were created for each strategic decision by combining executive accounts of the key decision events into a timeline. For cross-case analysis, pairs of firms were compared for similarities and differences, categorized along variables of interest such as decision speed and firm performance. Based on these analyses, tentative constructs and propositions were derived inductively from each decision story within firm categories. Each decision case was revisited to confirm the proposed relationships. The inferred propositions were compared with findings from the existing literature to reconcile examine differences with the extant literature and to generate new insights from the case findings. Finally, the validated propositions were synthesized into an inductive theory of strategic decision-making by firms in high-velocity environments.

Inferences derived from this multiple case research contradicted several decision-making patterns expected from the existing literature. First, fast decision makers in high-velocity environments used more information, and not less information as suggested by the previous literature. However, these decision makers used more real-time information (an insight not available from prior research), which helped them identify and respond to problems, opportunities, and changing circumstances faster. Second, fast decision makers examined more (not fewer) alternatives. However, they considered these multiple alternatives in a simultaneous manner, while slower decision makers examined fewer alternatives in a sequential manner. Third, fast decision makers did not centralize decision making or restrict inputs from others, as the literature suggested. Rather, these firms used a two-tiered decision process in which experienced counselors were asked for inputs in the first stage, following by a rapid comparison and decision selection in the second stage. Fourth, fast decision makers did not have less conflict, as expected from the literature, but employed better conflict resolution techniques to reduce conflict and improve decision-making speed. Finally, fast decision makers exhibited superior firm performance by virtue of their built-in cognitive, emotional, and political processes that led to rapid closure of major decisions.

Positivist Case Research Exemplar

Case research can also be used in a positivist manner to test theories or hypotheses. Such studies are rare, but Markus (1983) [12] provides an exemplary illustration in her study of technology implementation at the Golden Triangle Company (a pseudonym). The goal of this study was to understand why a newly implemented financial information system (FIS), intended to improve the productivity and performance of accountants at GTC was supported by accountants at GTC’s corporate headquarters but resisted by divisional accountants at GTC branches. Given the uniqueness of the phenomenon of interest, this was a single-case research study.

To explore the reasons behind user resistance of FIS, Markus posited three alternative explanations: (1) system-determined theory: resistance was caused by factors related to an inadequate system, such as its technical deficiencies, poor ergonomic design, or lack of user friendliness, (2) people-determined theory: resistance was caused by factors internal to users, such as the accountants’ cognitive styles or personality traits that were incompatible with using the system, and (3) interaction theory: resistance was not caused not by factors intrinsic to the system or the people, but by the interaction between the two set of factors. Specifically, interaction theory suggested that the FIS engendered a redistribution of intra-organizational power, and accountants who lost organizational status, relevance, or power as a result of FIS implementation resisted the system while those gaining power favored it.

In order to test the three theories, Markus predicted alternative outcomes expected from each theoretical explanation and analyzed the extent to which those predictions matched with her observations at GTC. For instance, the system-determined theory suggested that since user resistance was caused by an inadequate system, fixing the technical problems of the system would eliminate resistance. The computer running the FIS system was subsequently upgraded with a more powerful operating system, online processing (from initial batch processing, which delayed immediate processing of accounting information), and a simplified software for new account creation by managers. One year after these changes were made, the resistant users were still resisting the system and felt that it should be replaced. Hence, the system-determined theory was rejected.

The people-determined theory predicted that replacing individual resistors or co-opting them with less resistant users would reduce their resistance toward the FIS. Subsequently, GTC started a job rotation and mobility policy, moving accountants in and out of the resistant divisions, but resistance not only persisted, but in some cases increased! In one specific instance, one accountant, who was one of the system’s designers and advocates when he worked for corporate accounting, started resisting the system after he was moved to the divisional controller’s office. Failure to realize the predictions of the people-determined theory led to the rejection of this theory.

Finally, the interaction theory predicted that neither changing the system or the people (i.e., user education or job rotation policies) will reduce resistance as long as the power imbalance and redistribution from the pre-implementation phase were not addressed. Before FIS implementation, divisional accountants at GTC felt that they owned all accounting data related to their divisional operations. They maintained this data in thick, manual ledger books, controlled others’ access to the data, and could reconcile unusual accounting events before releasing those reports. Corporate accountants relied heavily on divisional accountants for access to the divisional data for corporate reporting and consolidation. Because the FIS system automatically collected all data at source and consolidated them into a single corporate database, it obviated the need for divisional accountants, loosened their control and autonomy over their division’s accounting data, and making their job somewhat irrelevant. Corporate accountants could now query the database and access divisional data directly without going through the divisional accountants, analyze and compare the performance of individual divisions, and report unusual patterns and activities to the executive committee, resulting in further erosion of the divisions’ power. Though Markus did not empirically test this theory, her observations about the redistribution of organizational power, coupled with the rejection of the two alternative theories, led to the justification of interaction theory.

Comparisons with Traditional Research

Positivist case research, aimed at hypotheses testing, is often criticized by natural science researchers as lacking in controlled observations, controlled deductions, replicability, and generalizability of findings – the traditional principles of positivist research. However, these criticisms can be overcome through appropriate case research designs. For instance, the problem of controlled observations refers to the difficulty of obtaining experimental or statistical control in case research. However, case researchers can compensate for such lack of controls by employing “natural controls.” This natural control in Markus’ (1983) study was the corporate accountant who was one of the system advocates initially, but started resisting it once he moved to controlling division. In this instance, the change in his behavior may be attributed to his new divisional position. However, such natural controls cannot be anticipated in advance, and case researchers may overlook then unless they are proactively looking for such controls. Incidentally, natural controls are also used in natural science disciplines such as astronomy, geology, and human biology, such as wait for comets to pass close enough to the earth in order to make inferences about comets and their composition.

The problem of controlled deduction refers to the lack of adequate quantitative evidence to support inferences, given the mostly qualitative nature of case research data. Despite the lack of quantitative data for hypotheses testing (e.g., t-tests), controlled deductions can still be obtained in case research by generating behavioral predictions based on theoretical considerations and testing those predictions over time. Markus employed this strategy in her study by generating three alternative theoretical hypotheses for user resistance, and rejecting two of those predictions when they did not match with actual observed behavior. In this case, the hypotheses were tested using logical propositions rather than using mathematical tests, which are just as valid as statistical inferences since mathematics is a subset of logic.

Third, the problem of replicability refers to the difficulty of observing the same phenomenon given the uniqueness and idiosyncrasy of a given case site. However, using Markus’ three theories as an illustration, a different researcher can test the same theories at a different case site, where three different predictions may emerge based on the idiosyncratic nature of the new case site, and the three resulting predictions may be tested accordingly. In other words, it is possible to replicate the inferences of case research, even if the case research site or context may not be replicable.

Fourth, case research tends to examine unique and non-replicable phenomena that may not be generalized to other settings. Generalizability in natural sciences is established through additional studies. Likewise, additional case studies conducted in different contexts with different predictions can establish generalizability of findings if such findings are observed to be consistent across studies.

Lastly, British philosopher Karl Popper described four requirements of scientific theories: (1) theories should be falsifiable, (2) they should be logically consistent, (3) they should have adequate predictive ability, and (4) they should provide better explanation than rival theories. In case research, the first three requirements can be increased by increasing the degrees of freedom of observed findings, such as by increasing the number of case sites, the number of alternative predictions, and the number of levels of analysis examined. This was accomplished in Markus’ study by examining the behavior of multiple groups (divisional accountants and corporate accountants) and providing multiple (three) rival explanations.

Popper’s fourth condition was accomplished in this study when one hypothesis was found to match observed evidence better than the two rival hypotheses.

[8] Benbasat, I., Goldstein, D. K., and Mead, M. (1987). “The Case Research Strategy in Studies of Information Systems,” MIS Quarterly (11:3), 369-386.

[9] Yin, R. K. (2002), Case Study Research: Design and Methods . Thousand Oaks, CA: Sage Publications.

[10] Eisenhardt, K. M. (1989). “Building Theories from Case Research,” Academy of Management Review

(14:4), 532-550.

[11] Eisenhardt, K. M. (1989). “Making Fast Strategic Decisions in High-Velocity Environments,” Academy of Management Journal (32:3), 543-576.

[12] Markus, M. L. (1983). “Power, Politics, and MIS Implementation,” Communications of the ACM (26:6), 430-444.

  • Social Science Research: Principles, Methods, and Practices. Authored by : Anol Bhattacherjee. Provided by : University of South Florida. Located at : http://scholarcommons.usf.edu/oa_textbooks/3/ . License : CC BY-NC-SA: Attribution-NonCommercial-ShareAlike

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

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Olivia Guy-Evans, MSc

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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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Case Study Research and Applications

Case Study Research and Applications Design and Methods

  • Robert K. Yin - COSMOS Corporation
  • Description

Winner of the 2019 McGuffey Longevity Award from the Textbook & Academic Authors Association (TAA)

Recognized as one of the most cited methodology books in the social sciences, the Sixth Edition of Robert K. Yin's bestselling text provides a complete portal to the world of case study research. With the integration of 11 applications in this edition, the book gives readers access to exemplary case studies drawn from a wide variety of academic and applied fields. Ultimately, Case Study Research and Applications will guide students in the successful use and application of the case study research method.

See what’s new to this edition by selecting the Features tab on this page. Should you need additional information or have questions regarding the HEOA information provided for this title, including what is new to this edition, please email [email protected] . Please include your name, contact information, and the name of the title for which you would like more information. For information on the HEOA, please go to http://ed.gov/policy/highered/leg/hea08/index.html .

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Supplements

Password-protected Instructor Resources include the following:

  • An expanded glossary provided by the author in the form of downloadable Briefs.
  • Additional tutorials written by the author which correspond to Chapters 1, 2, 3, 5, and 6.
  • A selection of author Robert Yin's SAGE journal articles.
  • Tables and figures from the book available for download.

“The book is filled with tips to the researcher on how to master the craft of doing research overall and specifically how to account for multi-layered cases.”

“Yin covers all of the basic and advanced knowledge for conducting case study and why they are useful for specific research studies without getting lost in the weeds.”

“The applications enhance the original material because it gives the reader concrete examples.”

“Yin is much more in-depth on case study methods both within a general qualitative text and any other case study text I have seen.”

On demand used as recommendation for basic literature for case study research

An essential reading for people doing case studies.

very thoruogh introduction

Very good introduction to Case Study design. I have used case study approach for my PhD study. I would recommend this book for an indepth understanding of case study design for research projects.

Dr Siew Lee School of Nursing, Midwifery and Paramedic Practice Robert Gordon University, Aberdeen.

The book is a really good introduction to case study research and is full of useful examples. I will recommend as the definitive source for students interested in pursuing this further in their projects.

In our Doctor of Ministerial Leadership (DML), Case Study is the Methodology that is required in this program. Robert Yin's book provides the foundational knowledge needed to conduct research using his Case Study design.

NEW TO THIS EDITION:

  • Includes 11 in-depth applications that show how researchers have implemented case study methods successfully.
  • Increases reference to relativist and constructivist approaches to case study research, as well as how case studies can be part of mixed methods projects.
  • Places greater emphasis on using plausible rival explanations to bolster case study quality.
  • Discusses synthesizing findings across case studies in a multiple-case study in more detail.
  • Adds an expanded list of 15 fields that have text or texts devoted to case study research.
  • Sharpens discussion of distinguishing research from non-research case studies.
  • The author brings to light at least three remaining gaps to be filled in the future:
  • how rival explanations can become more routinely integrated into all case study research;
  • the difference between case-based and variable-based approaches to designing and analyzing case studies; and
  • the relationship between case study research and qualitative research.

KEY FEATURES:

  • Numerous conceptual exercises, illustrative exhibits, vignettes, and a glossary make the book eminently accessible.
  • Boxes throughout offer more in-depth real-world examples of research.
  • Short, sidebar tips help succinctly explain concepts and allow students to check their understanding.
  • Exercises throughout offer students the chance to immediately apply their knowledge.

Sample Materials & Chapters

Preface: Spotlighting "Case Study Research"

Chapter 1: Getting Started

For instructors

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Case Study Methods

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  • Case Study Research
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What is a case study?

A case study is a type of research method. In case studies, the unit of analysis is a case . The case typically provides a detailed account of a situation that usually focuses on a conflict or complexity that one might encounter in the workplace.

  • Case studies help explain the process by which a unit (a person, department, business, organization, industry, country, etc.) deals with the issue or problem confronting it, and offers possible solutions that can be applied to other units facing similar situations.
  • The information presented in case studies is usually qualitative in nature - gathered through methods such as interview, observation, and document collection.
  • There are different types of case study, including  intrinsic, instrumental, naturalistic,  and  pragmatic.

This research guide will assist you in finding individual case studies, as well as providing information on designing case studies. If you need assistance locating information, please Ask a Librarian .

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You are ready to start researching your case study. You have your topic and your hypothesis. What is next? It is time to start researching for your case study. This research can include many different things, but usually focuses on interviews and observations.

The heart of the case study is the research notebook. Every researcher must have a physical notebook to record all finding, notes and observations. While some computer programs and other technological advances can be used, nothing can replace the original research notebook.

Preliminary Research

Once you have chosen your topic, you must do preliminary research to determine whether the topic is viable or not. To do this, you can review newspapers, databases, industry websites, and other previously published case studies. With some topics you might even want to discuss your idea with other people in your field.

You must be certain that you have access to enough information to accurately determine whether or not the topic is viable. It is always a good idea to have one or two backup ideas in the event your first idea doesn't pan out.

Once you have your topic, you must choose which perspective the story should be told.

From what perspective will the reader see the case?

Who is the decision maker in the case?

When will the story begin and when will it end?

You want the case study to be a readable story, so you want to make sure you include enough background so the reader is invested in the story and the study. You want to include enough background that your readers get invested in the story, but not so much they are overwhelmed with too much information.

Make a Timeline

Constructing a timeline is the next step. This timeline should list all events in chronological order, and can be several pages long. However, it will help both you and the reader to understand the time frame, and be able to keep the people and events straight. It can be easy to forget what happened and when without a detailed timeline.

It is also important to set your own timeline. When do you want the case study completed by? If you have one year to complete the study, you must determine how much time you have to conduct background information, do interviews, have time to analyze the findings, and writing the report. Using a timeline can help you stay on task.

Detail Key Players in the Study

Make a list of all the important people in the study, and list them alphabetically using their name and role in the study. You will need to explain to your readers who each person is, and what their background is.

For example, the "Genie" case study has very heavy background information for all of people related to Genie. Her immediate family, her father, mother, and brother all have extremely detailed backgrounds, as that information is essential to Genie's story.

The background information about Genie's father went back to his childhood, as researchers wanted to know what caused her father to be so abusive. Same for her mother, researchers wanted to know why exactly she was willing to sit by and allow her husband to abuse Genie.

When the researchers obtained all this information, they did so with some paper research, but mostly interviews. Since Genie's father committed suicide soon after she was discovered, they were unable to interview him. Therefore, they had to interview those who knew of him. Researchers were surprised to find that most people who knew Genie's father had no idea that he even had a daughter.

Identify Critical Issues

List all critical issues in the case, and rank them based on importance. This information is for you, the researcher, and not your reader. Next to each issue write why the issue is important, and why it is necessary for the study.

Check off each issue as you handle them, and list any resources attached to the issue. You must have a source for everything used in your study. Make sure each issue is accurate, and backed by verifiable research. If you cannot corroborate information, then you must cross it off of the list.

In the Genie case, there were many critical issues. The case study was about acquiring language skills, of which Genie had almost none of when found. The study was going to be an attempt to see whether Genie could acquire language skills as a teenager.

But the Genie case was not that simple. Yes there were language issues. But there were other serious issues as well, such as her behavior, medical issues, and emotional problems. All of these issues had o be identified and dealt with as the study progressed.

Perform Background Research

If the case study is about a person or people, it will be necessary to research their backgrounds for any relevant information that could be useful in the study. This could include medical history, including medical history of the subject's family.

When performing research, you want to use basic academic research strategies. This includes knowing the difference between primary and secondary research.

Primary research – Primary research is original research done by the researcher. This means that the research is new, and doesn't appear in any other case study.

Secondary research – Secondary research is research done by reading publications from other experts in your field. This research can be used to reach conclusions on your own ideas.

Performing Obtrusive Observation

In case studies that use human subjects, you cannot overtly "spy" on your subjects. This means you must use obtrusive observation, which means your subjects are aware that you are observing them.

In this type of study, you can speak with your subjects and make them feel comfortable about the study. Just remember that your presence will affect your subject's behavior, regardless of the type of relationship you have with them.

The best way to observe your subjects in less inhibited behavior is to establish trust with them. You want to be friendly, while not becoming too close. You want to maintain a level of professionalism. Also, people will be less inhibited in natural environments, such as their home or workplace.

Using questionnaires are a great way to conduct obtrusive research. Your subjects will know they are being watched, but it is an easy way to obtain general information.

Take Notes! When conducting any type of research, it is essential to take as many notes as possible. When possible, some researchers use a tape recorder and speak their observations. This usually isn't possible with observational research, so you will have to take extensive notes.

In some cases, you might need to ask your participants to keep diaries so they can record their personal experiences.

With the Genie case, all of her sessions were videotaped, and in some instances, other researchers sat in on her sessions. Her mother gave authorization for the sessions to be videotaped, but in retrospect, many child development specialists and other professionals had an issue with the ethics surrounding the videotaping.

The researchers who would sit in on the sessions would write down all observations about Genie, such as how she looked, her behavior, whether she was ill, and how she was responding to the interviews done by the lead researcher. They would also record observations of the main researcher. For instance, if the main researcher was tired or ill, did that affect how they worked with Genie that day. Since the Genie case couldn't be ethically recreated, it was important that every possible observation be made.

The Interview Process

This is often the backbone of the case study, and the single most important way to get information from your study participants. Depending on the size of the study, interviews could be conducted weekly or monthly. You will want to use the questions you developed in the planning stage, and then dig deeper if necessary.

When asking questions to your subjects, keep your focus on the following:

1. Describe the experience – When interviewing the subject ask them what it's like to participate in the study.

2. Describe the meaning – When interviewing the subject ask them what the study means to them, and what, if anything, they will take from the experience.

3. The focus – As the interview progresses be certain to keep the focus on the study, while keeping an open mind to any newly developing questions or ideas.

When asking questions, you want a balance of open-ended and close-ended questions. For example, a researcher studying PTSD in veterans could have the following set of questions:

1. Which event of war did you find most upsetting when they happened?

2. When you have nightmares, what are they about?

3. Based on a scale of 1-10, where do you rank the sound of gunfire?

4. Based on a scale on 1-10, where do you rank the image of an injured child?

5. When you think of an injured child, how do you feel?

As you can see, these questions require the subject to speak about his experiences, but some questions are quantitative, such as ranking triggers on a scale of 1-10.

Stay Rigorous!

Case studies are not as data-driven as medical or scientific trials or large studies. But that doesn't mean you can lose or relax attention to detail. The study methodology must remain strict.

If you have multiple interview subjects, make sure you spend equal time with all subjects. You may find yourself drawn to certain subjects, especially if their results are helping or proving your case. However, keep interviewing and observing your typical subjects as well. You won't be able to judge the veracity of their responses until after the interview period is over, and you begin to review you notes.

Collecting and Analyzing Data

Once the interviews have been completed, it is time to analyze all of the information you gained during the interview process. How you do this will depend on how many people you interviewed, and the depth and length of those interviews.

Qualitative Data

Qualitative data is a measurement expressed in terms of language, not numbers. Data expressed in numbers is called quantitative data.

There are two main ways to analyze qualitative data, and these are deductive and inductive.

The deductive method uses structured and predetermined framework to analyze the data. This means the researcher sets the standards using his own ideas or theories, and uses them to analyze the interview transcripts.

This type of approach is best for situations when the researcher is already aware of possible subject responses. For example, if veterans state that certain wartime activities cause PTSD, the researcher may know which activities these are. When it comes to analyzing the data, the researcher can completed the data assessment marking which veteran experienced which negative wartime activity.

The deductive method can also be faulty, especially if the researcher doesn't do enough background research. If the researcher has never been to war, or fought combat, there are things that occur that the researcher may not be privy to. Without knowing this, the researcher could be leaving out a major trigger of PTSD.

The inductive method analyzes data based on zero predetermined notions. A researcher using this method goes into the study blind, and uses the data obtained in the study to determine the solutions.

For example, a researcher studying the triggers for PTSD would conduct all of the interviews, and then use the results to determine what was the biggest trigger. Some vets may say that gunfire is a trigger; others might say that seeing an injured child is a trigger. The researcher will record every possible trigger mentioned by the vets, and then will mark down each time of the vets mentioned the particular trigger.

The inductive method is the most common form of data analysis used in case studies.

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  • Open access
  • Published: 27 June 2011

The case study approach

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

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

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

Peer Review reports

Introduction

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

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

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

What is a case study?

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

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

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

What are case studies used for?

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

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

How are case studies conducted?

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

Defining the case

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

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

Selecting the case(s)

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

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

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

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

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

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

Collecting the data

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

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

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

Analysing, interpreting and reporting case studies

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

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

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

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

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

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

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

Conclusions

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

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Acknowledgements

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

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AS conceived this article. SC, KC and AR wrote this paper with GH, AA and AS all commenting on various drafts. SC and AS are guarantors.

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Implementing a tobacco-free workplace program at a substance use treatment center: a case study

  • Anastasia Rogova 1 , 2 ,
  • Isabel Martinez Leal 1 , 2 ,
  • Maggie Britton 1 , 2 ,
  • Tzuan A. Chen 2 ,
  • Lisa M. Lowenstein 1 ,
  • Bryce Kyburz 3 ,
  • Kathleen Casey 3 ,
  • Kim Skeene 3 ,
  • Teresa Williams 3 &
  • Lorraine R. Reitzel 1 , 2  

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People with substance use disorders smoke cigarettes at much higher rates than the general population in the United States and are disproportionately affected by tobacco-related diseases. Many substance use treatment centers do not provide evidence-based tobacco cessation treatment or maintain comprehensive tobacco-free workplace policies. The goal of the current work is to identify barriers and facilitators to a successful and sustainable implementation of a tobacco-free workplace program, which includes a comprehensive tobacco-free policy and evidence-based cessation treatment services, in a substance use treatment center.

This study is based on an ethnographic approach and uses a qualitative case study design. Data were collected via interviews with staff ( n  = 6) and clients ( n  = 16) at the substance use treatment center and site visits ( n  = 8). Data were analyzed using thematic analysis guided by the extended Normalization Process Theory designed to inform the implementation of innovations in healthcare practice.

Staff at the substance use treatment center supported the implementation of the program and shared a good understanding of the purpose of the intervention and its potential benefits. However, the study identified significant challenges faced by the center during implementation, including widespread tobacco use among clients, contributing to attitudes among staff that tobacco cessation was a low-priority problem due to a perceived lack of interest in quitting and inability to quit among their clients. We identified several factors that contributed to changing this attitude, including provision of tobacco training to staff, active leadership support, low number of staff members who smoked, and access to material resources, including nicotine replacement products. The implementation and active enforcement of a comprehensive tobacco-free workplace program contributed to a gradual change in attitudes and improved the provision of evidence-based tobacco cessation care at the substance use treatment center.

Conclusions

Substance use treatment centers can integrate tobacco cessation practices in their daily operations, despite multiple challenges they face due to the complex behavioral health and socioeconomic needs of their clients. With proper support, substance use treatment centers can provide much needed tobacco cessation care to their clients who are disproportionately affected by tobacco-related health conditions and systemic health inequities.

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According to data from the Centers for Disease Control and Prevention, 12.5% of the US adults aged ≥ 18 years reported current use of cigarettes in 2020 [ 1 ]. While this figure represents a substantial decrease from over 40% of the adult population smoking in the 1960s, tobacco use is still the leading preventable cause of death in the US [ 2 ] with annual deaths directly attributable to tobacco use estimated to be at least 480,000 [ 3 ]. However, these devastating effects of tobacco use do not equally impact all population groups. The proportion of people who use tobacco products is dramatically elevated among the often intersecting groups of people experiencing socioeconomic disadvantage, who are medically underserved, and/or people living with comorbid mental health and non-nicotine substance use disorders [ 4 ]. These health disparity populations have disproportionately high smoking rates; for example, over 65% of adults with substance use disorders (and up to 90% according to some sources) are active smokers [ 5 , 6 , 7 ]. As a result, adults with substance use disorders are disproportionately affected by tobacco-related disease compared to the general population [ 7 , 8 ].

There is an overwhelming body of evidence that adults with substance use disorders are interested in and capable of quitting with appropriate support [ 9 , 10 ]. Current clinical guidelines recommend that all clients be provided with evidence-based cessation care, which includes behavioral interventions such as tobacco use assessment, brief cessation advice, individual or group counseling, and pharmacotherapy such as nicotine replacement therapy or non-nicotine medication (bupropion and varenicline) [ 11 , 12 ]. Moreover, the adoption of system-level policies, including comprehensive tobacco-free workplace policies, which prohibit the use of any form of tobacco inside buildings and on the grounds of behavioral health treatment centers, are also shown to be effective in improving quit rates [ 13 ]. Despite their proven effectiveness, however, evidence-based practices and policies remain underutilized, and tobacco use treatment is given a low priority in substance use treatment centers. For example, according to a 2016 nationwide study, only 64.0% of substance use treatment centers reported screening clients for tobacco use, 47.4% offered tobacco cessation counseling, 26.2% offered nicotine replacement therapy, and 34.5% had tobacco-free policies [ 4 ]. Furthermore, although not reported, it is possible that some proportion of these centers had tobacco-free workplace policies that may have been non-comprehensive in product coverage (e.g., not extending to e-cigarettes/vaping) or workplace area coverage (e.g., allowing smoking areas), which are known to be less effective than their comprehensive policy counterparts [ 14 , 15 , 16 ]. Consequently, there is a missed opportunity for substance use treatment centers to comply with clinical care guidelines [ 11 , 12 ] and to intervene to reduce tobacco use and related health disparities among their clients.

There are several previously identified barriers to providing tobacco cessation treatment at substance use treatment centers, including limited training, limited resources, time restraints, and cultural norms [ 9 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. Additionally, available treatment opportunities that take little time or training, such as referral to a state tobacco cessation quitline, are often unknown by staff at substance use treatment centers [ 23 ]. Our use of “staff” here refers to both clinical employees, those providing direct services to clients, and nonclinical employees. Moreover, despite evidence to the contrary, staff may believe that treating tobacco use and substance use disorders simultaneously will jeopardize substance use treatment and recovery [ 25 ]. Together, these barriers and others may contribute to the known translational lag whereby any type of evidence-based practice takes a long time (e.g., up to 17 years) to be implemented into practice to reach the intended population and ensure the improvement of clients’ health [ 26 , 27 ]. While this translational lag is detrimental for all clients and communities, the negative consequences of these delays are even worse for populations who experience health disparities, such as individuals living with substance use disorders.

Together, the previously described evidence-based tobacco cessation practices and policies, such as tobacco use assessment, brief cessation advice, individual or group counseling, pharmacotherapy, tobacco-free policies, form the core components of a comprehensive tobacco-free workplace program [ 28 , 29 ]. Academic-community partnerships can assist substance use treatment centers in implementing comprehensive tobacco-free programs and reducing the translational gap that affects health disparities among their clients [ 29 , 30 , 31 , 32 ]. This study describes the implementation of a tobacco-free workplace program at a substance use treatment center in Houston, Texas, which included a comprehensive tobacco-free workplace policy implementation, education and specialized training support, and the provision of resources to support tobacco cessation care. The goal of the study was to identify barriers and facilitators to successful integration of tobacco-free workplace policy and cessation practices into a substance use treatment center. The current study was based on an ethnographic approach and uses a case study design, which is considered an efficient way to present qualitative ethnographic findings [ 33 , 34 ]. Case study design has been found to be particularly useful in implementation research, as it allows for an in-depth analysis of complex interventions in combination with a participatory approach in a real-life context [ 35 , 36 , 37 , 38 ]. Prior research has shown the importance of studying interventions in close connection with the context of dynamic environments that can have an extensive influence on the implementation process [ 37 ]. In the case of complex interventions, such as comprehensive tobacco-free programs, this is particularly relevant, given their dependence on contextual elements for their effectiveness [ 39 ]. Intervention and context cannot be easily separated in this situation, and there is an urgent need to better understand the relationship between these two core elements of implementation to ensure that research evidence can meaningfully impact policy and healthcare organizational culture [ 38 ]. By applying a case study design, this work contributes to the existing research on implementing tobacco-free workplace programs at substance use treatment centers [ 32 ] by providing an in-depth qualitative description of program implementation in the setting of a nonprofit outpatient substance use treatment center serving diverse clients, most of whom belong to socioeconomically disadvantaged and medically underserved groups. Additionally, this study represents both staff, clinical and nonclinical alike, including leadership, and clients’ perspectives on this program, the latter of which were not included in prior work [ 32 ]. The findings presented in this study can be used by other substance use treatment centers that serve similar populations and seek to implement a comprehensive tobacco-free program in the most sustainable way.

Case description

This initiative was undertaken as a part of the Taking Texas Tobacco Free (TTTF) program, which is a multicomponent, evidence-based comprehensive tobacco-free workplace program that was designed to address tobacco dependence within healthcare treatment settings, including substance use treatment settings [ 30 , 32 ]. TTTF includes (1) tobacco-free policy development and implementation and/or refreshment for comprehensiveness or quality assurance; (2) education and specialized training for staff on tobacco use and cessation, screening practices, and treatment provision; and (3) resource provision, including free nicotine replacement therapy, signage, and passive dissemination materials. Throughout the implementation process, TTTF team members, comprising an academic-community collaboration, provide ongoing technical assistance and support (for more information on the TTTF program, see previously published studies [ 28 , 30 , 31 , 32 , 40 , 41 , 42 , 43 , 44 ]).

To ensure the privacy of the research participants, we refer to the field research location as the “Center” herein. The Center is located in a Houston, Texas, zip code that is among the Centers for Medicare and Medicaid Services-designated low-income and health professional shortage areas. It is a small Center that employs 7 staff (including clinical and nonclinical staff) and serves approximately 1,000 unique clients each year. One of these staff members was designated the TTTF program champion to serve as the main point of contact for all aspects of the tobacco-free workplace program implementation process. This staff member was not financially compensated for accepting this role, but they received additional week-long full-time training to become a Tobacco Treatment Specialist. The financial compensation for this role was not a part of the current program, and the expectation was that the Center’s leadership incorporates this role in the regular scope of work for their staff to ensure the sustainability of the program.

The Center serves a diverse group of clients, with 90% of their clients having histories of incarceration or another form of engagement in the criminal justice system, many of whom come from low socioeconomic backgrounds and/or have been diagnosed with comorbid behavioral health (i.e., mental health or substance use disorders) and physical health conditions. The Center estimated that approximately 80% of their clients smoked conventional cigarettes and 30% used other tobacco products, including e-cigarettes (there is an overlap, as some clients might be dual or multiple product users). Most clients participate in the Center’s substance use treatment program for 90 days. The Center introduced a tobacco-free policy in 2000, which prohibited the use of tobacco products of any type both indoors and outdoors; however, they had not provided any tobacco cessation services to their clients beyond the requirement not to use tobacco on their property prior to their enrollment in the TTTF program. The tobacco-free workplace program implementation components and the Center’s timeline are presented in Table  1 .

This project was approved by the Internal Review Board of the University of Houston and the Quality Improvement Assessment Board at the University of Texas MD Anderson Cancer Center. Oral informed consent was received from all participants prior to participation in qualitative study procedures. The aims of the project and interviews were discussed with participants who were given an opportunity to ask any questions about the interview process and the nature of the study. Additionally, all participants gave oral permission to audio-record the interview; they were given the option to remain anonymous and not use their names or other identifying information in any written summary of the collected data. Participants were informed that their participation was voluntary, that they could decline to answer any questions and stop participating in the interview at any time.

Data collection instruments

Data for this qualitative case study were collected via group and individual interviews with staff and clients at the Center, as well as site visits and participant observations. Data include interview transcripts and fieldnotes. We conducted one pre- and one post-implementation focus group with clients ( n  = 16), two pre-implementation semi-structured interviews with staff ( n  = 2), two individual interviews with staff during the implementation process ( n  = 2), and one post-implementation group interview with staff ( n  = 2). Interview guides were used for interviews and focus groups, which lasted 60–90 min (see Additional file 1 : Interview Guides). Pre-implementation interview questions for staff focused on any Center-specific needs for the program rollout, populations they served, their personal experience with tobacco use, their knowledge of and attitudes toward tobacco use and cessation among their clients, and implementation barriers and facilitators they anticipated. Staff post-implementation interview questions addressed experiences with implementing the program, interventions that were successful and less successful, changes in their practices addressing tobacco dependence, and any challenges they experienced. Focus groups with clients addressed their experiences with tobacco use and cessation, their knowledge of the tobacco-free program at the Center, their attitudes toward and interest in this program, and their experiences with and results of receiving any tobacco cessation support at the Center. In addition, we undertook several site visits ( n  = 8), when A.R. (the 1st author) and I.M.L. (the 2nd author), both cultural anthropologists who worked as qualitative research specialists on the project, conducted observations and made fieldnotes using a free-form approach. The site visits (1 to 2 h long) incorporated both direct and indirect observations. The collected observational data were not subjected to standalone analysis but served to inform the interview questions, gain a more nuanced understanding of how the Center was implementing various parts of the program, and provide further details about the study’s context and setting.

Two authors (A.R. and I.M.L.) moderated the focus groups and completed the interviews. Audio-recordings of focus groups and interviews were transcribed verbatim by a professional transcription service and analyzed using thematic analysis to initially inductively code and identify themes within the dataset. Data analysis was conducted iteratively using constant comparison, and themes were drawn directly from the data. The process of constant comparison provided analytic rigor and ensured accurate accounting of all the data, identifying appropriate selection of categories and themes [ 45 ]. At the next stage of the analysis, the concepts of the extended Normalization Process Theory (discussed in detail below) were applied to these themes to more effectively analyze and evaluate the implementation process.

Approach: extended normalization process theory

When exploring the implementation process, the application of a theoretical framework enhances understanding of the process and highlights barriers to and facilitators of the implementation. Implementation scientists have developed several major frameworks and theories to describe and evaluate the implementation process [ 26 , 46 , 47 , 48 , 49 ]. For this analysis, we followed the extended Normalization Process Theory (eNPT) [ 46 , 47 ], which is a sociological theory that informs the implementation of innovations in healthcare practice, focusing on bridging the translational gap between evidence-based practices and their implementation [ 50 ]. This theory approaches the implementation process as a series of interactions between people’s actions (their ‘agency’) and the context within which the intervention is implemented [ 46 , 50 ].

The eNPT identifies and explains key elements that contribute to or impede normalization of complex interventions within a social system, including four core constructs, two of which are focused on context (potential and capacity) and two of which address agency (capability and contribution, see Fig.  1 for details) [ 46 ]. The identification of these major constructs helps researchers guide and understand the implementation process and provide a systematic description [ 46 ]. The eNPT has been effectively utilized at all stages of research projects, both during the planning stages and the post-implementation analysis, as in this case, where this theory helps to frame emergent themes and consider their implications for further research and implementation practice [ 51 ]. The application of the eNPT as a theoretical framework enhances stakeholders’ ability to improve design for more successful implementation in the future and to enhance the application and normalization of interventions within organizations by community adopters and researchers [ 50 ].

figure 1

Concepts and Constructs of the Extended Normalization Process Theory (eNPT, adapted from May 2013 [ 46 ])

The two constructs of the eNPT that characterize the context of implementation are potential and capacity . Participants’ potential is expressed through individual intentions and collective commitment to participate in the intervention [ 52 ]. Capacity, which is another crucial element of context, is defined as the availability of material and cognitive resources, as well as existing social norms and social roles. Attention to these contextual elements ensures a better understanding of the implementation process and its outcomes, as they shape agents’ ability to effectively cooperate with each other to bring about change [ 46 ]. Capability and contribution are two constructs that characterize the agency of the participants involved in the implementation process. Capability refers to how workable the complex intervention is, as well as to the possibility of integrating it in everyday practice. Contribution refers to the actions of the agents who are involved in the implementation process [ 46 ]. This construct focuses on how the agents, including individuals and groups, enact potential and capacity by undertaking actions to make things happen and ensure that new processes and practices become “the way we do things here.” [ 46 ] Each of these constructs is further divided into categories used to understand and evaluate the implementation process (see Table  2 ).

After conducting the initial coding, the emerged themes were systematized and organized in relation to the major concepts and constructs of the eNPT theory. Table  2 shows the identified themes from the case study data and how they are related to the eNPT constructs and dimensions. In the section below, we present our results in relation to these theoretical constructs.

Context: potential

The Center’s CEO initiated the Center’s participation in the tobacco-free workplace program and continuously expressed their personal support and commitment to implement and maintain the program. The Center’s staff were also enthusiastic about the tobacco-free program and expressed commitment to its implementation. Most participants welcomed this forthcoming change and expansion of tobacco cessation services and agreed that it was necessary and beneficial for the Center’s working environment and for their clients’ needs and well-being. This collective commitment was supported and reinforced during the preparation phase of the implementation process, when all staff received training provided by the TTTF program:

I think one of the biggest things in preparation for implementing the program was when we had our staff retreat. Bryce [B.K.] actually flew in, and he participated in the retreat and helped train our staff prior to us actually implementing the program. So, he did a workshop with us, and that gave us an opportunity to ask him questions […] So, everybody was ready. Everybody was pumped and ready because we knew what to do. We knew what the problem was about . (Staff post-implementation interview)

The number of staff who used tobacco products themselves was very low at the Center. The only staff member who said that she smoked cigarettes participated in the program herself and, at the time of the interview, reported a successful quit attempt and being tobacco-free. In the pre- and post-implementation interviews, staff members shared their negative attitudes towards smoking related to health concerns and their readiness to facilitate tobacco cessation efforts at their center:

I grew up as an athlete, and so smoking is something that was not encouraged in my field. I didn’t partake when I was around people that did such as my mom who later on in life actually stopped smoking. (Staff pre-implementation interview)

Context: capacity

One of the major barriers to the implementation of the tobacco-free workplace program at the Center was associated with the widespread practice of tobacco use among the Center’s clients and within their immediate environment. There are two closely interrelated aspects of this problem: clients’ lived experiences with tobacco being an innate part of their everyday life and staff attitudes and expectations of their clients’ interest in and ability to quit tobacco, both of which are discussed below.

Most of the Center’s clients grew up in an environment where smoking had been normalized for years. They shared their experiences of having parents, older siblings, grandparents, neighbors, and friends who had smoked on a regular basis for most of their lives:

Kind of like I think started smoking from– because I would light cigarettes for my daddy or whatever, so he was smoking. (Client focus group, pre-implementation) Me growing up around my grandfather and stuff, he smokes. […] Mine started just with social. Got out of high school, my own place. All my friends, they bring over rum […] and cigarettes and everything. (Client focus group, pre-implementation)

Some of the clients reported a lack of interest in quitting or their perceived inability to quit:

So officially, once I turned 18 or the age to buy a pack of cigarettes, I bought a pack of cigarettes and since then it’s been– I never had the urge to quit, never tried to quit. Just always adapted to it. (Client focus group, pre-implementation) They [clients] point-blank told me that they feel that if they stop smoking, that they’ll latch back onto something else that is not as legal. (Staff post-implementation interview)

However, these experiences do not mean that none of the clients problematized tobacco use practices and were interested in quitting tobacco. Some clients reported varied attitudes toward quitting. For example, one of the clients who participated in a focus group shared her motivation to quit smoking:

I didn’t want him [her son] to - when he’s picking up pieces of paper towel and putting it to his mouth like a cigarette, it bothers me. I don’t want him to […] also, my baby’s father wasn’t a smoker. It’s a shame thing. I was ashamed. (Client focus group, post-implementation)

In the interviews with the Center’s staff members, they generally revealed that tobacco cessation treatment was a low-priority problem, related partly to a perceived lack of interest in quitting among their clients. Staff shared expectations that clients must be proactive in expressing their interest in quitting and seeking support. Staff at the Center repeatedly expressed the idea that if their clients were interested in quitting tobacco use, they had to ask for help to proactively demonstrate that they were interested in and committed to quitting. As the Center’s program champion said during a conversation with one of the researchers:

I see some of the guys who signed up for the program, but they go out and smoke with other guys outside. I walk by, I see him, but I am not going to say anything to him. It must be his decision, he is an adult, and he must take responsibility. I cannot do it for them. (fieldnotes, conversation with program champion, May 2022)

In a similar way, one of the clinicians at the Center shared during the interview:

I guess if they ask me, if they would like the patches, if they want to participate, I guess that’s when I’ll bring it up […] I think it’s ultimately really up to the client if they really want to make that change. That’s what I love. Some of the clients really want to commit strongly about making the change to stop smoking. (Staff post-implementation interview)

Tobacco education trainings were offered to all Center staff at the beginning of implementation, which were designed to mitigate these barriers (e.g., by providing information about how to proactively address tobacco use with clients) and enhance the implementation capacity by ensuring that they had the knowledge and skills required to implement the program. One of the staff evaluated this training as being very important to help them to be able to deliver tobacco cessation services:

Teaching us about pharmacology, motivational interviewing […]. That thing that was really helpful for us to learn and to be able to explain it to the clients if questions were to come up. (Staff post-implementation interview)

The capacity to implement the program also depends on the availability of material resources. One of most important and expensive resources, nicotine replacement therapy products, were provided to the Center free of charge as a part of the active implementation process. The availability of the nicotine replacement products was widely discussed by the Center’s staff and evaluated as one of the central elements of the program implementation at the Center:

We actually not only have “No Smoking” sign posted up, but we’re able to say, “Here, we have products, nicotine replacement products, that we could give you to help you stop smoking.” (Staff post-implementation interview).

Agency: capability

The Center’s capability to implement the program was evaluated by assessing the implementation’s workability and integration with the everyday workflow and preexisting work processes, following the eNPT framework concepts.

The Center already had a standard tobacco-free policy in place prior to the involvement in the project, and while the TTTF presented them with a much more comprehensive program, the initial buy-in was facilitated by the level of familiarity with the intervention by both staff and clients:

We weren’t really implementing anything. It [tobacco-free policy] was there. It was understood, but this gave us a fuller picture of a way to implement, how to introduce it, a guideline to follow . (Staff post-implementation interview)

One element of the program that contributed to the increased workability was the introduction of the program champion role into the program:

I think the best thing is to have a point person. Because we have a point person, that point person stays on top of all the policy procedures, regulation, inventory, whatever we have going on. (Staff pre-implementation interview)

The Center’s CEO and staff also emphasized that the support they received from the TTTF program increased the workability of the intervention. In addition to regular practical and informational support, they were able to contact program staff with any ongoing questions and requests for assistance. They shared that the focus groups that were conducted with clients also contributed to the program implementation success by increasing clients’ interest in the program:

You guys come in here and working with those guys, because you legitimize the process as a third-party source, and the guys come in to see and you do the surveys [focus group] with them. I think that’s very helpful. (Staff post-implementation interview)

New aspects of the program were reported to be well integrated into the everyday workflow, and while their implementation needed certain changes in practices and attitudes among staff and clients, these changes were not particularly disruptive or time consuming, according to staff who participated in post-implementation interviews:

It’s good to have it embedded into the program that you already have, immerse into what you have going and make it a part of the process, not as something separate, but just this is our program. This is included in the program. I think it’s welcomed a little bit more. (Staff post-implementation interview)

Agency: contribution

Most staff members shared a clear understanding of the purpose of the intervention and its potential benefits. They evaluated the program as important, saw the value of this program for their clients, and shared positive experiences of being involved in its implementation:

I love the program because it gives the clients an opportunity to work on solving that problem of addiction in a positive manner. (Staff post-implementation interview) I felt like it was a great idea to come into play here at the facility. (Staff post-implementation interview)

All staff were well aware of the program being implemented and what new practices and routines were introduced at the Center. They reported very little disagreement about a shared understanding of the need to implement this program:

Everybody was clear on what the mission was, how we would present it, and the way it would be implemented . (Staff post-implementation interview)

One example of effective engagement with the program was one of the staff members quitting smoking herself:

When I came in, he was doing a class and I sat in on it and I’m like, “Hey, I want to do this.” […] we talked about it and I signed up to do it. It’s worked very good for me. (Staff post-implementation interview)

In the interviews, staff at the Center discussed how their engagement in the program and enacting it in their everyday practices contributed to their deeper sense of belonging:

I have the feeling like you can’t disrespect the facility [ by smoking ]. This is our facility and we need to respect her. (Staff post-implementation interview)

Staff members shared a commitment to serving their clients and supporting each other, which was further reinforced by their increased capacity to provide tobacco cessation support to their clients:

That sign right there says we are community, and that’s what we promote, that we are a community center, and this community center has many different programs in it that can provide assistance and this is one of the additional programs that we have that can provide assistance. (Staff post-implementation interview)

Various program components were implemented with different degrees of commitment. The tobacco-free policy was the component that staff reported to be implemented most consistently. The tobacco-free policy has been routinely maintained and reinforced by both the Center’s staff and clients themselves:

They are not allowed to smoke within the facility area. So, that’s worked pretty good. (Staff post-implementation interview) We were always like, “You can’t smoke in here. You got to walk outside.” I think that they just pretty much are just like, “Okay, we got to do the right thing.” […] So yes, they respect it, I think . (Staff post-implementation interview)

However, as A.R. and I.M.L. observed when they visited the Center, clients were often smoking outside. While they were not violating the policy as they were technically outside the property and were smoking while on a public road, they remained physically close to the building, and whoever was leaving or entering the property had to go past a group of clients smoking to enter through the only door to the Center. The Center’s leadership has not found a solution to this problem, as they said they did not have control over the territory and could not prohibit tobacco use beyond their property. This location-specific issue led to a situation in which the tobacco-free policy was technically enforced; however, clients were still able to smoke in the vicinity of the Center, visitors were exposed to secondhand smoke, and this practice was not challenged by leadership or staff, either pre-implementation or after.

Tobacco screenings were reported to be implemented on a regular basis, although there were some discrepancies in the participants’ accounts of screening practices and their regularity. All clients were reportedly screened for all forms of tobacco use during intake, but the follow-up screenings of those clients who reported using tobacco were less consistent. There seemed to be a lack of clear understanding and agreement among staff who was responsible for these screenings, which resulted in a lack of consistency and depended on a specific staff member’s practice rather than established and clearly understood guidelines:

Each time we do an intake on a form, there is an assessment that asks the client if they do smoke, and if they do smoke, do they smoke cigarettes, or do they smoke e-cigarettes? We do offer the NRT [nicotine replacement therapy, and if they want to participate, they would need to say yes or no. Let the counsellor know. […] The individual counsellors, after 30 days in their sessions, ask them again. (Staff post-implementation interview)

However, in individual interviews with staff, at least one of them said that they did not conduct any follow-up screenings unless their clients brought this up and asked about the tobacco cessation program themselves.

As one of the central elements of the program implementation, the program champion provided regular information sessions to inform their clients on the Center’s participation in the program and available support and resources for clients who were interested in quitting tobacco. All clients were expected to attend at least one of these sessions, as these presentations were performed during their mandatory group counseling sessions. Clients were made aware of the resources and support available to them at the Center if they decided to make a quit attempt, as well as given a brief educational presentation on the harms of smoking and the benefits of quitting. These presentations were seen as an effective tool to get clients interested in the program, provide them an opportunity to ask for more information, and engage in conversations about quitting:

People have changed their minds, actually. They initially said no, but then once they heard [the program champion] and people talk about it, they come back and say, well, yes, they would like to. There’s been a couple of guys that have done it, that I know personally, that have done that. (Staff post-implementation interview)

The actual engagement of clients and motivating them to make a quit attempt was the most challenging part of the implementation process for the Center. The overall number of participants who made a quit attempt was 17 clients and two staff members by the end of the implementation period. While the reach of the program is larger than immediate client participation in cessation treatment, there were also some clients’ accounts of inconsistency in support they received during their time at the Center regarding their tobacco use:

Nobody has ever asked me anything [about tobacco use], except you. (Client focus group, post-implementation)

While staff supported the implementation of the program from the beginning, there were some concerns about how well this program might be accepted by their clients. In the post-implementation interview, a counselor shared an observation that their clients were more interested in quitting than they anticipated:

I guess I’m just surprised that I feel like I’m getting some yes’s now instead of a whole bunch of no’s. So, I think that’s actually a good thing because I feel like now that the program has been implemented here, that we’re getting quite a few yes’s. So, that’s definitely something to feel good about, that makes me feel good. (Staff post-implementation interview)

While we observed a variation in the degree to which tobacco cessation intervention services were provided in practice, there was a shared understanding that some of the services needed to be improved:

To be honest, it’s a question [tobacco use and interest in quitting] I feel like I need to ask them more. I haven’t been asking them about it, but I feel like I do need to ask them . […]So, that’s something I could work on. (Staff post-implementation interview)

In the quote above, the counsellor acknowledges that they should ask their clients about their smoking habits and interest in quitting more proactively, which is a positive example of reflexive monitoring of their own actions and practices and could ultimately lead to better outcomes of the intervention.

Staff also demonstrated their involvement by critically evaluating the program delivery and expressing suggestions for improvement:

[We say] “We’re going to have smoking cessation group today and this is going to be the only one for the month.” Well, why can’t we bring it up every meeting? Look, we have three meetings a week, let’s bring it up every time. […] I think there should be a smoking class […] for the whole group at least once a month. (Staff post-implementation interview)

Staff reflected on how this program changed their Center, and they reported a positive change, creating an opportunity to provide more meaningful and involved support and services to their clients:

It’s positively changed or impacted our facility because it gives us some legitimacy behind not only just having a no smoking sign just posted like every public place you see, but actually giving some type of support, nicotine replacement therapy. […] (Staff post-implementation interview).

This case study discusses the implementation of a tobacco-free workplace program at a substance use treatment center serving a diverse group of clients, including many from low socioeconomic backgrounds. This analysis and consideration of the interplay between context and emergent agency, facilitated by the application of the eNPT framework, contribute to the existing knowledge on implementing similar programs in substance use treatment settings that serve marginalized and medically underserved populations facing socioeconomic and health challenges. The findings from this study offer insights that can guide other substance use treatment centers with similar populations in implementing sustainable tobacco-free programs effectively.

A key barrier associated with the context of the implementation, as defined by the eNPT framework, was the widespread tobacco use among clients and within their immediate environment. Prior research has indicated that individuals with substance use disorders are often interested in quitting smoking [ 16 ], but they tend to have lower success rates [ 53 , 54 ]. These contextual barriers to achieving success in tobacco cessation efforts among this population require an exceptionally high level of commitment from the staff working at substance use treatment centers to provide continuous, robust support to their clients [ 55 , 56 ]. As our findings suggest, it is essential to acknowledge and consider the difficulties faced by these individuals when they are trying to quit smoking. While these challenges should not deter clinicians from motivating their clients to quit smoking, it is crucial that they are prepared to approach the situation with sensitivity and awareness of the contextual factors and lived experiences of the clients, which is also emphasized in the principles of trauma-informed care.

Other contextual categories, defined by the eNPT, which we addressed in our study to evaluate the Center’s potential to implement the program, include individual intentions and collective commitment shared by staff and leadership. Most of the staff expressed a strong commitment to participate in the program and provide cessation services to the clients. However, we also encountered attitudes indicating that staff, including clinicians, were doubtful about their clients’ interest in quitting and ability to do so. Given their expertise and supportive roles as addiction treatment specialists, clinicians’ attitudes can greatly affect those of their clients; moreover, clinicians’ beliefs and attitudes are often cited as one of the major barriers to effectively implementing tobacco-free programs within substance use treatment settings [ 4 , 22 , 25 , 57 ]. Training given as a part of the program implementation provided staff with information on evidence-based tobacco cessation practices and addressed some of these attitudes to better prepare staff to provide cessation care to their clients. Such training programs are particularly important for successful implementation and can be further enhanced by placing a stronger emphasis on motivational interviewing techniques, providing practitioners with a better understanding of the nature of ambivalence toward behavior change and the diverse factors influencing clients’ readiness to quit tobacco use.

The capacity to successfully implement and maintain the tobacco-free workplace program is also dependent on access to material resources and, specifically, nicotine replacement therapy products. While two shipments of nicotine replacement products were provided free of charge by the TTTF program, ensuring a continuous supply of these products is anticipated to be challenging for the Center. While individual clients can access free nicotine replacement products through services such as the Texas Tobacco Quitline [ 58 ], the availability of these products on-site and the ability to distribute them immediately and at no cost has been emphasized by the Center’s staff as a crucial component of the program. To address this challenge, the TTTF staff provided informational resources to the Center’s leadership and program champion, highlighting the support available in the community to secure additional funding for the ongoing purchase of nicotine replacement products. However, it remains uncertain at this stage whether the Center will be able to secure the necessary funding to sustain the provision of free nicotine replacement products to their clients and how the availability of these products will impact the long-term sustainability of the tobacco-free program. This is a limitation of this study, as it was conducted during the active phase of implementation and shortly after its completion, lacking data on the program’s long-term maintenance and outcomes. Therefore, further investigation specifically focusing on the long-term sustainability of tobacco-free programs at substance-use treatment centers would be valuable to address this gap and provide insights into ensuring ongoing access to nicotine replacement therapy products for patients. We suggest, however, that it is important to maintain communication with centers after the program implementation is completed, highlighting specific local funding opportunities, as well as sharing examples of successful programs maintained by other centers as a mechanism to support collaboration and pursue additional resources.

Analysis of the themes reflecting the expressions of agency, another major eNPT concept, showed a gradual positive change in tobacco treatment practices at the Center following the implementation of the program, including the enforcement of policies and staff quitting smoking. However, the findings also show that these changes did not immediately affect the provision of smoking cessation care to clients at the Center. Tobacco cessation treatment remained a problem of a lower priority, even for staff who had negative experiences with smoking associated with health concerns, did not use tobacco themselves and were overall very supportive of the program and excited about helping their clients to quit. Rather, this seemed closely related to a persistent perception that their clients were not genuinely interested in or capable of quitting, which was also revealed in the expectations shared by staff that clients had to be proactive in expressing their interest in quitting and seeking support.

We suggest that the expectation of clients proactively seeking support shared by the Center’s staff is associated, at least partially, with their understanding of the existing standards of client-clinician communication, which emphasizes the importance of “sharing power” equally with clients and involving them in the decision-making process [ 59 ]. The concept of patient-centered care, designed to improve healthcare provision and outcomes, is often regarded as a matter of ethical and moral healthcare practice, and it assumes patients’ involvement in their care [ 60 , 61 ]. It is important to consider, however, that these expectations might not work as planned with vulnerable populations, including clients who experience socioeconomic disadvantage, limited access to healthcare services, lower literacy levels and/or limited English proficiency [ 62 ]. These individuals’ ability to take a proactive stance and advocate for their health and well-being may be further hindered by systemic inequalities and structural racism disproportionately experienced by minoritized and underserved groups, and these factors have to be considered to improve the delivery of patient-centered care to these clients and ensure that the care they receive is tailored to their specific needs. Taking Texas Tobacco Free program has developed multiple training videos on smoking cessation support to special population groups [ 63 ], which can be used to provide continuing education on working with diverse groups to ensure that healthcare professionals are equipped with knowledge and skills needed to provide such care.

It is important to acknowledge that concerns about promoting smoking cessation are not entirely unfounded, as clinicians’ advice can have various consequences beyond the client simply following or not following it [ 64 ], and prior research has shown that avoidance of hearing specific recommendations to change behavior, including smoking, is reported as one of the reasons why people avoid seeking medical care [ 65 ]. However, these findings should not discourage health care providers from asking their clients about tobacco use, as this practice is associated with increased quit attempts and is recommended by The US Public Health Service Clinical Practice Guideline [ 66 ]. The potential risk of inadvertently stigmatizing clients who may already feel shame and guilt regarding their tobacco use and inability to quit might be avoided if clinicians use non-stigmatizing approaches identified in prior research [ 67 , 68 , 69 , 70 , 71 ]. It is particularly important to address these concerns in tobacco cessation trainings and educate staff on non-stigmatizing approaches. It is important to incorporate motivational interviewing in these trainings as this approach highlights the importance of displaying unconditional positive regard toward clients, which may increase client resilience in the face of behavioral change advice offered and minimize perceived stigma. It is crucial to find a balance between being sensitive to clients’ choices and priorities and providing the healthcare necessary to alleviate the consequences of systemic health inequities among minoritized and medically underserved groups.

One of the limitation of the study is the limited data on clients’ quit attempts and their outcomes. While the Center attempted to collect these data, they had difficulties following up with their clients after they left the program (most of the clients attended a 90-day program), which created difficulties in evaluating outcomes of those clients who initiated a quit attempt while being treated at the Center. While a more detailed analysis of client outcomes would enhance the evaluation of the intervention, the focus of this study has been on the implementation outcomes, including changes in provider behavior regarding assessing and treating tobacco dependence rather than assessing its direct impact on clients’ tobacco use and cessation [ 72 ]. Future research is needed to delve into evaluating the effects of the intervention on clients’ outcomes, which would provide valuable insights for further refining and optimizing the program.

While the Center’s staff exhibited strong potential and capacity to implement the program, our findings indicate that the actual change in practice has been less successful than anticipated based on the overall support of the program, high potential, and capability. Tobacco cessation treatment had not yet become a routine practice for all staff members by the end of the implementation process. However, despite encountering significant barriers, there is evidence that the program has led to a change in attitudes, including a better understanding of the need and improved ability to provide evidence-based tobacco cessation treatment to their patients. The staff at the Center have started to integrate tobacco treatment into their routine practices, informing clients about the available support, including nicotine replacement therapy products, providing personalized assistance, and assessing patients who may not be ready to quit. Although there are areas for improvement, the program has effectively initiated change in practices, normalizing tobacco cessation treatment and incorporating it as a routine practice at the Center.

The results of this study suggest that substance use treatment centers can maintain tobacco-free workplace policies and integrate evidence-based tobacco cessation practices in their daily operations, but they face extreme challenges due to the complex behavioral health needs and socioeconomic needs of their clients. Understanding the complex interplay between social norms, social roles, and limited resources within such settings is paramount for the success of tobacco cessation efforts. These organizations need extensive support, including a longer implementation period, as well as additional material resources, informational and educational support, and assistance in preparing and maintaining local policies. Regular training of staff, including implementing a train-the-trainer program, would allow to promote and sustain local expertise on evidence-based tobacco cessation interventions for minoritized and medically underserved populations. With proper support, substance use treatment settings have the potential to play a crucial role in addressing tobacco use and provide much needed cessation services to their clients who are disproportionately affected by tobacco-related health conditions and systemic health inequities.

Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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This project was supported by funding from the Cancer Prevention & Research Institute of Texas (grant #PP210003 to L.R.R.). A.R.’s time and effort for manuscript drafting was supported in part by MD Anderson’s Tobacco Settlement Funds and by Halliburton Employees Fellowship in Cancer Prevention Fund from The University of Texas MD Anderson Cancer Center. Publication was supported by start-up funds provided by MD Anderson to L.R.R. The funders had no role in the design of the study, the collection, analyses or interpretation of the data, the writing of the manuscript or the decision to publish the results.

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AR, LRR, IML conceptualized the research question and design of the case study; AR and IML completed the collection, analysis, and interpretation of qualitative data; TC completed the analysis of survey data; AR drafted the manuscript text; IML, LRR, MB, LML substantively revised it; MB, BK, KS, KC, TW administered the project and contributed to data collection. All authors reviewed and approved the manuscript.

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Rogova, A., Leal, I.M., Britton, M. et al. Implementing a tobacco-free workplace program at a substance use treatment center: a case study. BMC Health Serv Res 24 , 201 (2024). https://doi.org/10.1186/s12913-024-10629-5

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ORIGINAL RESEARCH article

Research on an evaluation rubric for promoting user’s continuous usage intention: a case study of serious games for chinese cultural heritage.

Pingting Mao

  • 1 Department of Design and Manufacturing Engineering, Jeonbuk National University, Jeonju-si, Republic of Korea
  • 2 Department of Industrial Design, Jeonbuk National University, Jeonju, Republic of Korea

The sustainable development of serious games dedicated to Chinese cultural heritage faces challenges due to the lack of prolonged user engagement and iterative optimization based on long-term user feedback. This situation not only hinders the sustainable growth of these games but also limits the transmission of Chinese cultural heritage, a problem that demands urgent attention yet remains under-acknowledged. This study synthesizes literature to unearth user needs from three dimensions: motivational use, quality requirements of games, and continuous usage intention. It identifies 14 influential factors, including cognitive satisfaction, immersion satisfaction, and achievement satisfaction. Drawing from the User Experience Rubric for Educational Games-CH (UEREG-CH) evaluation rubric and the Delphi method, these factors are expanded into an evaluation system model comprising six primary indicators, 14 secondary indicators, and 38 tertiary indicators. The analytic hierarchy process (AHP) is utilized for expert scoring to assign weights to each indicator. This is combined with the fuzzy comprehensive evaluation method to arrive at a final user score of Z = 3.4228, indicating that the evaluation rubric is close to ‘good’ and has received positive user feedback. Ultimately, this generates an evaluation rubric tailored to the specific context of serious games for cultural heritage. By integrating qualitative and quantitative methods, this paper confirms the scientific and rational nature of the evaluation rubric. The study aims to establish a user-approved rubric that encourages continuous usage intention, thereby providing effective guidance for game developers and assisting users in selecting appropriate games, while also addressing the theoretical gap in the field of evaluation for serious games related to cultural heritage.

1 Introduction

This research focuses on Serious Games for Cultural Heritage, which are games developed through the integration of cultural heritage and serious gaming. The primary purpose of these games is to protect and disseminate a specific theme of cultural heritage, primarily through digital interactive formats. They often simulate and emulate traditional cultural skills. In this study, they are abbreviated as CH-SGs ( Zhou and Xu, 2017 ). The interest in the cultural heritage domain within serious games arises from the current social context, where protecting and inheriting cultural heritage is a crucial historical mission for the national defense of independence and sovereignty. Many Chinese cultural heritage projects have been lost due to historical reasons and the complexity of their forms. Therefore, there is an urgent need to broaden the channels for disseminating cultural heritage and to find carriers for its living inheritance and innovation ( Teng, 2019 ). CH-SGs, with their unique functional attributes, make cultural heritage knowledge and skills more accessible to users through digital network technologies and entertaining gaming methods, thereby stimulating their autonomous learning ( Qin, 2017 ). Thus, CH-SGs play an essential role in preserving the authenticity of cultural heritage, enriching its presentation forms, lowering the barriers for user engagement, and assuming the crucial responsibility for the transformative development of cultural heritage. Hence, this paper emphasizes the importance of optimizing and improving CH-SGs for significant social relevance ( Cai, 2020 ). Although CH-SGs possess positive social value and have become a new medium for presenting Chinese traditional culture to the world, supported strongly by the state, their practical development is not optimistic. Their development and usage in the Chinese gaming market are relatively scarce ( Chen and Liu, 2019 ). To date, only about twenty games have been developed by renowned companies like Tencent Games and the Palace Museum ( Figure 1 ). These games only offer a “one-time” experience of cultural heritage, sparking only brief interest in users and failing to elicit long-term usage feedback and real, objective evaluation standards to effectively improve game quality ( Li, 2023 ). Likewise, theoretical research on these games is also scarce. In previous literature, the Chinese scholar Xu Haifeng focused on the Shenyang Imperial Palace’s material culture as a theme, emphasizing the game’s functional and aesthetic attributes to enhance user experience ( Xu H. F., 2019 ). Li Haishi, through an analysis of games for intangible cultural heritage, summarized three design transformation paths, emphasizing the design expression of intangible cultural heritage, its visual transformation, and experience design ( Li, 2019 ). Yang Xiao took Shaman culture as a starting point to analyze the factors influencing cognition to behavior in serious games, proving that games play a more effective role in the dissemination of intangible heritage ( Yang, 2020 ). Previous literature has focused on CH-SGs’ cultural themes, game element design, and dissemination impact, but lacks consideration on how to promote continuous usage intention and exploration of user evaluation of such games.

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Figure 1 . Serious games for Chinese cultural heritage.

The current evaluation theories for serious games generally adopt Gardner and Hatch, (1989) and Krathwohl et al. (1956) . These evaluations focus on curriculum standards and the educational attributes of educations ( Shen, 2015 ). However, established serious game evaluations are mostly limited to educational and medical fields, and their applicability in the cultural heritage domain remains unverified. Therefore, the research on a CH-SGs evaluation rubric in this paper aims to fill this gap, promoting the development of both theoretical and empirical research on CH-SGs evaluation. It also aids other types of serious games in exploring suitable evaluation indicators and assessment tools. This study posits that with the guidance of evaluation rubrics, the design process of CH-SGs is akin to having a measuring ruler and a direction, leading to breakthroughs in research on design, development, and application evaluations of CH-SGs ( Wang et al., 2019a ). An evaluation rubric is a scoring tool that includes standards for assessing a task, encompassing various indicators each with its specific weight and assessment criteria. It is a scoring tool that can present indicators in the form of charts or tables. The Chinese scholar Li and Zhu (2017) considers rubrics as structured quantitative evaluation tools, useful for assessing student digital works with strong operability and accuracy, allowing evaluations by teachers, students, and peers ( Li and Zhu, 2017 ). The evaluation rubric in this paper includes various levels of indicators based on theoretical foundations, representing a comprehensive set of evaluation indicators. It revolves around the needs of CH-SGs users, serving as a reference for designers. Establishing a CH-SGs evaluation rubric requires more than a single theoretical construction; it necessitates examination from the user’s perspective ( Xu L. Q., 2019 ). However, it is observed that the existing evaluation rubrics are predominantly used by teachers, designers, and parents, with few specifically formulated for users. The primary evaluators of these games are educators and developers, not the learners or users. This study argues that the users are the true evaluators of serious games, which requires developers to consider game content that matches user needs right from the design stage ( Shen and Zhang, 2014 ). However, accurately grasping user needs is challenging, and past qualitative evaluations based on user experience have overly relied on the evaluators’ quality, often being subjective and lacking scientific rigor ( Jin and Yang, 2017 ). Therefore, this study attempts a multidimensional exploration of user need indicators and a multi-method validation of the evaluation rubric.

In summary, this research focuses on two main questions: how to construct a multi-dimensional CH-SG evaluation rubric that meets user needs, and whether the constructed CH-SG evaluation rubric is accepted by users. This article summarizes 14 user demand factors through literature induction, from the perspectives of usage motivation, game quality, and continuous usage intention; refers to the User Experience Rubric for Educational Games-CH (UEREG-CH) evaluation scale to initially form a CH-SG evaluation system model with 6 primary indicators, 14 secondary indicators, and 32 tertiary indicators; revises and perfects this model in terms of dimensions and semantics through the Delphi expert consultation method, expanding the original 32 tertiary indicators to 38; then conducts Analytic Hierarchy Process (AHP) hierarchical analysis with expert scoring to assign weights to each indicator of the model; subsequently, through user questionnaire surveys, scores are assigned to this model, combined with the weights given by experts to perform fuzzy comprehensive calculations, obtaining the final user evaluation value to determine whether users accept the CH-SG evaluation scale ( Figure 2 ).

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Figure 2 . Research flowchart.

This study constructs the evaluation rubric for Cultural Heritage Serious Games (CH-SGs) from three dimensions: usage motivation, game quality, and continuous usage intention. Initially, one issue with CH-SGs is that they fail to prioritize users’ motivational needs ( Tang, 2022 ). Instead, from design to content, these games often align with the aesthetics of designers and professionals, as evidenced by games like “Tenon and Mortise,” awarded as an excellent app by the Apple App Store in 2014, “Folding Fan” winning the “2018 Zcool Award - Interface Design Category” special award, and “Nishan Shaman” receiving the “ Lina and Haifeng, 2020 China Best Sound Effect Award” among others. While these games are recognized in the industry, they struggle to captivate users, often described as “one-time games” or “beautiful but useless,” indicating that designers are not fully aware of the real motivations of users. In terms of usage motivation literature, Chinese research on game users, especially focusing on the psychological motivations of adolescents using online games, is limited ( Chen, 2023 ). The scholar Zhong Zhijin found that players engaged in online games are influenced by different motivations like personal achievement, enjoying a social life, and immersing in virtual worlds to escape reality, all significantly boosting game duration and stickiness ( Zhong, 2011 ). Research by Ye Na, involving an empirical survey of 546 college students playing online games, showed that the relationship between achievement satisfaction and online game addiction was the strongest ( Ye et al., 2009 ). This study references Zhang Wenmin’s research on Multiplayer online battle arena (MOBA) mobile game users’ continuous usage intentions, which posits that social, competitive, immersive, and cognitive motivations significantly impact users’ continued usage ( Zhang, 2019 ). Furthermore, the scholar Holbrook noted that the product provided by online games is virtual, offering psychological and emotional satisfaction through emotional interaction with others, leading to leisure enjoyment ( Holbrook and Hirschman, 1982 ). In her empirical study on the relationship between customer perceived value, satisfaction, and loyalty in online games, Hu (2013) also found that leisure enjoyment positively impacts customer retention. Therefore, based on the above discussions, this study incorporates cognitive satisfaction, immersive satisfaction, achievement satisfaction, social satisfaction, and leisure satisfaction into the user motivation indicators for measurement, defined as follows:

1. Cognitive satisfaction: Kahn believes this involves helping users develop specific intellectual abilities through games.

2. Immersive satisfaction: Yee defines this as the behavior or psychological state where users immerse themselves in the virtual world of the game, escaping reality.

3. Achievement satisfaction: This refers to the user’s strong desire to achieve victory in the game.

4. Social satisfaction: Yee sees this as the user’s expectation to achieve social activities on the gaming platform.

5. Leisure satisfaction: Holbrook suggests that through emotional interaction in online games, customers experience a sense of well-being in their consciousness, meeting their psychological and emotional needs and expectations.

Secondly, as products of the internet era, CH-SGs require support from various sectors of the industry chain, from pre-launch advertising by game operators, provision of downloads by distributors, and stable service from service providers to continuous updates and optimization by developers ( Jiang, 2011 ). Users may choose to continue or abandon a game due to various factors such as server quality and system stability. A prominent issue in the current design of CH-SGs is the simplicity of their mechanism design, lacking in gameplay and intrigue, and their weak playability. Additionally, the integration of educational elements with gameplay is insufficient ( Lei and Feng, 2020 ). For instance, games like “Tenon and Mortise” and “Folding Fan” by Tag Design team are termed as “serious games,” but they focus more on conveying the artistry of cultural heritage, with more emphasis on aesthetics than on interactive gaming, failing to convey information through game mechanics or narratives, which points to a deficiency in the game quality of CH-SGs ( Zhang S. Y., 2023 ). Among the literature related to game quality, many scholars view games as a new type of information system and have incorporated the revised model of information system success into studies on game user engagement, confirming that system quality, information quality, and service quality influence user participation ( Wang, 2010 ). This study refers to the scholar Zhang (2016) , who analyzed mobile game user churn and attributed game factors to system quality, service quality, game design, and brand image, demonstrating significant impacts on the perceived usefulness and ease of use by game users ( Fang, 2023 ). Furthermore, CH-SGs differ from traditional online games in that they are primarily designed to address real-world social and industrial problems. They are not solely for entertainment but are meant to achieve at least one additional goal, namely, the learning objective, without compromising the user’s gaming experience ( Peng and Liu, 2020 ). Many studies have explored different quality standards for serious games, including effectiveness and attractiveness, but have not fully considered the dual mission of serious games, i.e., achieving both functional and gaming aspects. High-quality serious games must balance functionality and gaming; they must systematically support users in achieving learning goals (functional part) and must engage and maintain entertainment objectives (gaming part). These two aspects should be perfectly matched and integrated, rather than being addressed in isolation ( Caserman et al., 2020 ). Therefore, this paper also considers learning and entertainment objectives as factors in game quality, defined as follows:

1. System quality: This refers to the stability and usability of the game system, essential for ensuring a normal gaming experience for users.

2. Service quality: This assesses the quality of services provided by companies to users, ensuring a comfortable and enjoyable gaming experience.

3. Game design: This involves the rational organization and arrangement of various elements of a game product, creation through game engines, and the final formation of the game product.

4. Brand image: The perceived influence of the game brand by users, including the brand image of the game itself and the company’s reputation.

5. Learning objectives: The learning objectives of CH-SGs should be closely related to their application fields. The learning or training effect should remain the focus throughout the game process, always supporting users in achieving this purpose, with game elements not interfering with the learning or training process.

6. Entertainment objectives: High-quality CH-SGs should be engaging and enjoyable, focusing on user involvement, positive gameplay experiences, fluidity, and feeling of control, as well as supporting social interaction to ensure users find enjoyment in the game.

Additionally, this study emphasizes the promotion of continued usage of CH-SGs. Parthasarathy once noted in the context of information systems that retaining an existing customer costs five times less than acquiring a new one ( Yu and Cheng, 2012 ). Long-term user feedback helps understand the ever-changing needs of users, improving and innovating game products. Continued usage intention is defined as the subjective desire of users to continue using an information system after initial use ( Niu, 2020 ). In the field of continued usage intention, the technology acceptance model (TAM) has been widely applied and has become one of the most mature theories in this area ( Sun, 2023 ). As online games, fundamentally, belong to the category of information systems ( Li, 2011 ), many scholars have used the TAM model in their studies of online game users’ continuous usage ( Min, 2018 ). The TAM model predicts the degree to which a person accepts, uses, or rejects information technology, effectively explaining the behavior of users in adopting new technologies and its influencing factors ( Sun and Guo, 2023 ), and is the most concise and universal model for studying the initial intention and continuous intention to adopt technology ( Yao, 2023 ). Davis (1989) first proposed the TAM model while studying users’ acceptance of computers. He suggested that perceived usefulness is an extent indicator, reflecting the individual’s perception of how an information system enhances their work efficiency. Higher perceived usefulness increases the likelihood of taking actions; perceived ease of use reflects the individual’s perceived difficulty in using the system, with higher ease of use leading to more likely user behavior ( Jia, 2019 ). Later in 2000, Davis and Venkatesh revised the TAM to include subjective norms based on numerous studies ( Dong, 2017 ). Scholars like Sun Shaojun integrated the TAM and Stimulus-Organism-Response (SOR) models to establish a continuous usage behavior model for game live streaming ( Sun and Zhang, 2017 ); Wu Xuanying integrated the TAM model and flow theory to construct a stickiness influence model for mobile game users ( Wu, 2019 ); Zhang Di combined the SOR, TAM, information success model, and immersion theory to build a model for mobile game user churn factors ( Zhang, 2016 ). These studies confirmed the positive impact of perceived usefulness, ease of use, and subjective norms on continuous usage. Therefore, this study incorporates these three variables into the continuous usage indicators, defined as follows:

1. Perceived usefulness: The degree to which a user perceives that using a particular information system will help them perform tasks better or gain other benefits. When users perceive that using such games meets their expected benefits, they will feel satisfied and continue using the games.

2. Perceived ease of use: The degree to which a user perceives the ease or difficulty of using a particular information system. If users encounter difficulties when experiencing a game, they may feel dissatisfied and abandon it, whereas if they find the game easy to operate, they will feel satisfied and continue using it.

3. Subjective norms: The degree to which a user’s behavior is influenced by group dynamics, such as conformity, suggestion, and obedience. Therefore, an individual’s behavior is often influenced by the group. If users perceive that no one in their social circle is using the game, they may feel that the game is futile and abandon it due to a lack of positive gaming experience.

2 Methodology

2.1 constructing the ch-sg evaluation system model.

This study posits that only by establishing an evaluation rubric fitting the CH-SG context can effective assessments be conducted in all aspects, referencing the UEREG-CH evaluation scale with high similarity prior to construction ( Table 1 ). This scale was developed by the team at the Educational Game Center of Nanjing Normal University. It is guided theoretically by Hartmann’s improved model of user experience influencing factors, reviews the current state of research on factors influencing user experience, and analyzes the characteristics and elements of serious game user experiences. The rubric identifies key terms in user experience evaluation through user testing, and then refines the primary and secondary indicators of the index system through two rounds of expert consultation, thus ultimately determining this evaluation rubric ( Shen, 2015 ).

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Table 1 . The UEREG-CH evaluation rubric.

This paper, based on literature research, identifies 14 influencing factors: ‘Intellectual satisfaction, Immersion satisfaction, Achievement satisfaction, Social satisfaction, Pleasure satisfaction, System quality, Service quality, Game design, Brand image, Learning objectives, Entertainment objectives, Perceived usefulness, Perceived ease of use, and Subjective norms’. These factors are used as secondary indicators in the CH-SG evaluation system model. Referring to the dimensions in the UEREG-CH evaluation rubrics, these 14 secondary indicators are categorized into 6 primary indicators and further expanded into 32 tertiary indicators, thereby preliminarily forming the CH-SG evaluation system model ( Liu et al., 2021 ) ( Table 2 ).

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Table 2 . Initial establishment of the CH-SG evaluation system model.

2.2 The Delphi method

The Delphi method is a group decision-making behavior that involves a series of concentrated expert surveys. Based on the collective professional knowledge and experience of experts, supplemented by controlled feedback of opinions, the process aims to achieve the greatest consensus among a group of experts ( Dai, 2023 ). The advantage of the Delphi method is that it avoids direct confrontation between experts and structures the discussion process of the expert group, making them more effective when discussing complex issues ( Liu et al., 2021 ). It is not only used in the field of prediction but also widely used in the establishment of various evaluation systems and the determination of specific indicators ( Liu et al., 2011 ). The 10 experts who filled out the questionnaire on game studies were strictly selected and all had at least 2–3 years of research experience in serious games, educational games, and online games, with at least 2 years of game testing experience and at least one experience in educational game evaluation ( Liu et al., 2023 ).

Ten experts were consulted over two rounds regarding the initially established CH-SGs evaluation system model, using both electronic mail and paper questionnaires to collect expert opinions and to add, delete, or modify indicators. The specific process included: clarifying evaluation objectives, selecting experts, issuing questions, experts’ assessment of questions, and revising based on expert feedback ( Liu et al., 2011 ). The first round of questionnaires involved experts’ familiarity with each level of indicators, suggestions for additional or deletable indicators, and other questions or recommendations. Based on expert suggestions, similar indicators in the CH-SG evaluation system model were merged, unreasonable ones were deleted or broken down, and missing indicators were added ( Dong, 2013 ). In the first round of questionnaire consultation, the primary indicator “Identity dimension” was not described accurately and was loosely connected logically with the secondary indicators “Brand image” and “Subjective norms,” hence it was changed to “Social dimension.” The secondary indicator “Game design” was too broad and encompassed too much, so it was changed to “Interface design” based on the tertiary indicators. Complex descriptions in tertiary indicators were further refined, such as “D1 Game interface operation setting is reasonable, with the characteristics of the cultural heritage theme,” which was split into “D1 Interface design features cultural heritage theme” and “D2 Interface menu layout is reasonable and orderly” for easier understanding and scoring by experts or users. “D4 Immersed in the game’s artistic roles, creating one’s own story background” was simplified to “D5 Immersion in creating one’s story with artistic roles,” etc. Other less comprehensive descriptions were expanded, thus increasing the original 32 tertiary indicators to 38. Overall, the experts acknowledged the feasibility of the indicators, with minimal modifications made ( Table 3 ).

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Table 3 . Revised CH-SG evaluation system model.

The revised CH-SG evaluation system model consists of 6 primary indicators, 14 secondary indicators, and 38 tertiary indicators. In the second round of questionnaire surveys, the opinions of the experts converged, with the agreement rate for each level of indicators reaching 100%. Therefore, no further modifications were needed, and the CH-SG evaluation system model was finally determined to be used as the AHP for the next phase of research.

2.3 AHP hierarchical analysis

The AHP is a decision-making method for complex and vague issues, particularly suitable for issues difficult to be fully quantified. It is a flexible, convenient, and practical multi-criteria decision-making method ( Zhang et al., 2014 ). The principle of AHP is to organize and hierarchize problems, constructing a structured model with various levels. Complex issues are decomposed into elements, which are then grouped according to their characteristics and certain rules into several levels. Elements within each level have approximately the same status. An orderly, step-by-step hierarchy is established based on the affiliation relationships between levels, where elements of a higher level dominate related elements of the next lower level ( Dong, 2013 ). In this step-by-step hierarchical model, decision-makers score the importance of each level quantitatively based on their judgment of certain objective facts. This is done by determining the relative importance of elements within each level through pairwise comparison and quantitatively expressing this importance, thereby establishing judgment matrices. Mathematical models are then used to calculate the relative importance weights of each indicator within the judgment matrices of each level. Finally, the relative importance weights of all indicators concerning the evaluation objective are calculated through corresponding operations ( Xu, 2009 ). In the CH-SG hierarchical model of this paper, the relationship between primary, secondary, and tertiary indicators is one of containment and being contained, also known as the upper and lower level relationship in the decision-making field. In the hierarchical model, “CH-SG Evaluation System Model” A is the goal layer, B1-B6 are primary indicators, C1-C14 secondary indicators are criterion layers, and D1-D38 tertiary indicators are the scheme layer. Experts compare and score the indicators in the evaluation system ( Table 4 ), generate judgment matrices, and calculate the weight values of each indicator.

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Table 4 . Expert questionnaire scoring 1–9 scale method.

Steps for calculating weights using the AH involve the hypothetical judgment matrix A:

The calculation steps for the root method are as follows:

(1) Calculate the product of the elements in each row of the judgment matrix A:

(2) Calculate the nth root of mi;

(3) Normalize the vector W ∗ = w 1 ∗ w 2 ∗ ⋯ w n ∗ T

The weights obtained are the desired weight vector, w1, w2,..., wn, which corresponds to the weight value of each element.

Matrix consistency test method:

(4) Calculate the consistency index

The calculation formula for the largest eigenvalue is: λ max

(5) Look up the corresponding Average Random Consistency Index RI.

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(6) Average Consistency Ratio (CR).

When CR is less than 0.1, the consistency of the judgment matrix A is considered acceptable; otherwise, some adjustments to the judgment matrix are required ( Zhu et al., 2020 ) (Refer to the appendix for the detailed calculation process).

Based on the scoring from 10 experts, a judgment matrix is constructed, and the results of the weight calculation using the AHP are as follows:

Table 5 shows that the CR value is <0.1, passing the consistency test. The smaller the CR value, the better the consistency of the judgment matrix, indicating the rationality of this weight determination method. There is no need to modify the judgment matrix. The derived weight set can reflect the importance of each indicator, and the weight distribution is reasonable ( Li and Guo, 2004 ).

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Table 5 . Results of the consistency test.

Through the above research, the weight coefficients of each level of indicators for the CH-SGs evaluation were determined ( Table 6 ), forming a complete evaluation system. Subsequently, the fuzzy comprehensive evaluation method will be used by users to assess the overall quality of this system ( Zhang X. W., 2023 ).

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Table 6 . Weight values of each indicator in the CH-SG evaluation system model.

2.4 Fuzzy comprehensive calculation

Fuzzy comprehensive calculation is based on fuzzy mathematics and applies the principle of fuzzy relation synthesis to quantify factors with unclear boundaries and difficult quantification, conducting a comprehensive evaluation of the belonging level of an entity under evaluation from multiple factors ( Ge and Sun, 2014 ). The basic procedure is to first determine the factor domain of the evaluation object, i.e., the number of indicators, and second to determine the evaluation level domain, typically taking integers, and for the convenience of expert judgment, the levels are divided as finely as possible ( Li and Deng, 2019 ). This study adopts an evaluation set of levels: poor, below average, average, good, and excellent. Finally, the weights of each indicator obtained from the AHP are combined to calculate the final fuzzy evaluation result ( Wang, 2017 ). The fuzzy comprehensive calculation is as follows:

1 First, determine the factor domain of the evaluation object (i.e., the fuzzy factor set): let there be p evaluation indicators, U = {u1, u2,..., up}.

2 Determine the weight vector of evaluation factors and the evaluation level domain (i.e., the evaluation set): in fuzzy comprehensive evaluation, determine the weight vector of evaluation factors: W = {a1, a2,..., ap}. The relative importance order of evaluation indicators is usually determined using the AHP or other methods to establish the weight coefficients, and normalize them before synthesis. Let the evaluation level domain (i.e., the evaluation set) be V = {v1, v2,..., vm}, with each level corresponding to a fuzzy subset, i.e., the level set.

3 Establish a fuzzy relation matrix (i.e., the membership degree matrix): after constructing the level fuzzy subsets, quantify the evaluated entity from each factor ui (i = 1, 2,..., p), i.e., determine the membership degree of the evaluated entity to the level fuzzy subsets (R|ui). Through survey questionnaires, obtain the scoring of each person for each level of the indicator, with the proportion of the number of people scoring each evaluation level to the total number of experts as the membership degree, thereby establishing the single factor fuzzy comprehensive evaluation matrix.

The membership degree matrix for a single element (R|ui) = (ri1, ri2,..., rim), where for each level of a single element, the membership degree is: r i j = c i j c .

Cij represents the number of people who chose level vj for indicator i, and c represents the total number of experts participating in the evaluation.

Calculate the membership degree for p evaluation indicators to obtain the overall fuzzy relation matrix, as follows:

In this element, the element rij in the ith row and jth column represents the membership degree of a certain evaluated entity ui in terms of the factor to the level vj fuzzy subset.

4 Synthesize the fuzzy comprehensive evaluation result vector: combine W with the overall fuzzy relation matrix R of each evaluated entity to obtain the fuzzy comprehensive evaluation vector B for each evaluated entity, i.e.:

B=W*R = (a1,a2,…,ap)* r 11 r 12 … r 1 m r 21 r 22 … r 2 m … … … … r p 1 r p 2 … r pm =(b1,b2,…,bm).

bi represents the degree of membership of the evaluated entity to the level vj fuzzy subset from an overall perspective.

5 Analyze the fuzzy comprehensive evaluation result vector: the most commonly used method in practice is the principle of the maximum degree of membership. However, in some cases, its use can be forced, leading to the loss of a lot of information, and even producing unreasonable evaluation results. This paper uses the method of weighted average to determine the membership level, allowing for the ranking of multiple evaluated entities according to their level positions (refer to the appendix for the detailed calculation process).

To verify the scientific and practical nature of the CH-SG evaluation system model discussed earlier, this paper utilizes the weights of indicators determined by the AHP and applies fuzzy comprehensive calculation to evaluate the comprehensive score of this system. For this purpose, a questionnaire targeted at users of CH-SGs is designed (refer to the appendix for details). Evaluators simply need to select the corresponding levels for each indicator on the scale based on their judgment ( Zhang, 2015 ). A total of 400 questionnaires were distributed, with 392 valid responses collected. To ensure the reliability and validity of the questionnaire, the sample data was analyzed using the Cronbach’s alpha coefficient in SPSS, yielding an overall Cronbach’s alpha of α = 0.962, indicating good internal consistency. Exploratory factor analysis was also conducted, with a Kaiser-Meyer-Olkin (KMO) value of 0.978 and a significant level of Bartlett’s test of sphericity at 0.000, indicating significant correlations between variables and passing the test of reliability and validity. This paper analyzes the collected questionnaires, calculating the frequency of each level—poor, below average, average, good, and excellent—and the corresponding values of each indicator for fuzzy comprehensive calculation. Through these calculations, the fuzzy evaluation values of each level of indicators in the CH-SGs evaluation system are derived, providing reference for further analysis of the evaluation rubric.

The fuzzy comprehensive calculation resulted in the evaluation values for each level of indicators in the CH-SG evaluation rubric ( Table 7 ). The overall primary level fuzzy comprehensive evaluation value was 3.4228, indicating an overall level between average and good. This suggests that the evaluation rubric is recognized by users, and the descriptions of evaluations in these games closely align with user experiences ( Liang, 2019 ). According to the data, the primary indicators are ranked by their importance as follows: B4 Gamification at 3.5371 > B5 Demand at 3.4546 > B6 Social dimension at 3.4473 > B3 Educational value at 3.4307 > B1 Artistic dimension at 3.4223 > B2 Usability at 3.2355. The B2 Usability at 3.2355 is notably lower than the overall evaluation value of 3.4228, indicating that this indicator is not ideal and suggests a mismatch between expert and user standards in evaluating the game.

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Table 7 . Fuzzy evaluation values of each indicator in the CH-SG Evaluation Rubric.

The primary indicator B4 Gamification at 3.5371 is higher than the overall comprehensive evaluation value, indicating that enhancing gameplay positively impacts the evaluation of the game and that users are most concerned with the gameplay aspect of CH-SGs. In the secondary indicators, C8 Perceived ease of use at 3.6105 and C10 Pleasure satisfaction at 3.5510 are higher than the gamification indicators, enhancing the gamification. In the tertiary indicators, D21 Easy download, installation, payment for the game at 3.6301, D22 Easy learning and operation of the game at 3.5714, D23 Establishing multi-modal experiences such as graphics, sound effects, and tactile at 3.7883, and D29 Participation in offline experiences and purchasing cultural peripheral products at 3.6633 are all higher than the gamification, having a positive impact. Designers should consider how to make the game user-friendly, aligning with the characteristics of CH-SGs as light-function games, requiring minimal time and effort from users, facilitating knowledge acquisition, character cultivation, enjoyment, and mental pleasure, and providing different experiences in sound effects, tactile modes, and offline activities, all of which will effectively increase users’ willingness to continue using the game ( Gong and Liang, 2018 ).

The primary indicator B5 Needs at 3.4546 is higher than the overall evaluation value, positively impacting it. In its secondary indicators, C12 Achievement satisfaction at 3.4719 is slightly higher than the demand dimension. In the tertiary indicators, D31 Making many friends through cooperation and communication with other users at 3.4745, D32 Long-term contact with other users and feeling care among friends at 3.8954, and D33 The desire to win in challenges and competitions at 3.5434 are all higher than the demand dimension, positively impacting it. Designers should focus on expanding users’ social pathways and convenience, fully satisfying users’ desires for social interaction and emotional communication, and increasing the game’s competitiveness and positive feedback to stimulate users’ sense of achievement, thereby promoting their willingness to continue using the game ( Chang, 2015 ).

The primary indicator B6 Social dimension at 3.4473 is higher than the overall evaluation value, positively impacting it. In its secondary indicators, C13 Brand image at 3.5485 is higher than the social dimension indicator. In the tertiary indicators, D36 Production companies with high recognition or liked experts and stars at 3.7474 and D35 High recognition or liked cultural IP themes at 3.4490 are both higher than the primary indicator. This indicates that production companies with high recognition are a guarantee of high-quality games for users. Choosing well-known experts and stars for advertising endorsements can effectively attract users’ attention. Alternatively, choosing popular, well-received IPs for game development can arouse users’ curiosity and encourage continued use ( Wang, 2022 ).

The primary indicator B3 Educational value at 3.4307 is slightly higher than the overall evaluation value, also having a promotive effect. In its secondary indicators, C5 Learning objectives at 3.5879 and C6 Intellectual satisfaction at 3.6956, are higher than the primary indicator. In the tertiary indicators, D12 Continuous and systematic learning content at 3.7908, D15 Accurate and reliable cultural heritage knowledge in various forms at 3.8316, D16 Level design conforming to learning rules and user cognitive level at 3.4413, D17 Enhancing the ability to complete tasks and cooperate intellectually with others at 3.6939, and D18 Stimulating curiosity in learning traditional culture at 3.6990, all these indicators are higher than the primary indicator. The educational value is where serious games differ from other entertainment games in value, thus gaining more attention from users ( Li and Sun, 2019 ). Designers, while developing the educational goals of the game, must first ensure that the integrated cultural heritage knowledge is accurate and diverse, maintaining users’ freshness toward knowledge. Secondly, they must consider whether the designed cultural knowledge and skills are systematic, enabling users to learn progressively rather than a one-time experience that cannot be sustained. They must also consider whether the knowledge broken down into stages of task levels conforms to the users’ cognitive level, ensuring that users can overcome the task with some effort or seeking help, without feeling a sense of failure and giving up. Finally, users should gain from the use and learning of the game, either through increased positive rewards or by setting stage-wise tasks and evaluation rewards, ensuring that users have gains at every stage after completing tasks or cooperating with other users, and developing new cognition and curiosity about cultural heritage. These aspects can effectively stimulate users to continue using the game ( Huang, 2023 ).

The primary indicator B1 Artistic dimension at 3.4223 is close to the overall evaluation value. In its secondary indicators, C2 Immersion satisfaction at 3.6786 is higher than the artistic dimension, positively impacting it. In the tertiary indicators, D4 High clarity, exquisite realism, and interesting visual scenes at 3.6709, D5 Immersion in creating one’s own artistic characters and stories at 3.6378, and D6 Helps to forget problems and stresses of real life at 3.8010, all these indicators are higher than the primary indicator value. This suggests that users hope to immerse themselves in a virtual world through the game, temporarily escaping life’s troubles for mental rest. To achieve such immersion ( Wang et al., 2019b ), designers need to enhance the visual effects of game scenes and endow characters with artistry, strongly attracting users’ attention, and giving them more control to create their own characters and stories ( Zhang, 2018 ). Stimulating these aspects can enhance users’ willingness to continue using such games.

The primary indicator B2 Usability at 3.2355 is below the overall evaluation value, indicating that this indicator is not ideal and that there is a mismatch between experts’ and users’ standards in evaluating the game. In its secondary indicators, C4 Service quality at 3.5000 is higher than both the primary indicator and the overall evaluation value, suggesting that users are more concerned about the service attitude and quality of the game production company. In its tertiary indicators, D10 Conducting promotional activities and fulfilling promises to users at 3.4745 and D11 Customer service staff being competent and promptly resolving user issues at 3.5510, these indicators indicate that if game production companies deceive users during use or fail to fulfill various promotional promises, or if customer service staff have a poor attitude, lack professional competence, or do not promptly resolve users’ issues in the game, it will lead to user dissatisfaction and the desire to quit the game.

4 Discussion

4.1 comparative analysis of ch-sgs and uereg-ch setting principles.

This section compares and analyzes the CH-SGs evaluation model and UEREG-CH based on three principles of rubric setting: purposefulness, systematicity, and measurability. Purposefulness is the fundamental basis for establishing evaluation rubrics and directly affects the conduct of evaluation activities. Systematicity requires that the evaluation rubric should comprehensively reflect the requirements of the evaluation objective, without missing any significantly important indicators. Additionally, indicators should be mutually independent, without causal or overlapping relationships, clearly hierarchical, and collectively form an organic whole. Measurability demands that specific indicators should be defined in operationalizable language, allowing for conclusions to be drawn through actual observation or measurement. This principle concretizes and quantifies abstract evaluation objectives, and is one of the basic conditions for the practical application of evaluation rubrics and the generation of reliability ( Shen, 2015 ).

Purposefulness: The UEREG-CH primarily reflects the sensory experiences and real needs of serious game users, including students and teachers. The purpose of the evaluation is to select educational games that meet the autonomous learning needs of learners and adapt to different learning styles. The CH-SGs in this study primarily focuses on user needs and experiences to promote continued use. It provides scientific and reasonable guidance and evaluation standards for designers and developers of these games and assists users and learners in selecting suitable CH-SGs.

Systematicity: The UEREG-CH, centered on user experience as the evaluation objective, sets up 5 primary indicators, 22 secondary indicators, and corresponding descriptions and weights, with a tightly interconnected hierarchical relationship. For example, under “Gamification,” there are secondary indicators like “Appropriate challenge” and “Reasonable incentives.” However, a shortcoming is the similarity or lack of distinction between some secondary indicators, such as “Organized interface menu” and “Clear interface design”; and “Easy to remember” and “Easy to learn.” CH-SGs in this study sets up 6 primary indicators, 14 secondary indicators, and 38 tertiary indicators, assigning weights to each. Focusing on user experience, it emphasizes promoting continued use and includes content related to user motivation and game quality. The considered range of indicators is broader, deeper, and more detailed, with each level of indicators being interrelated yet distinct and easy to differentiate.

Measurability: Both the UEREG-CH and CH-SGs achieve clarity and conciseness in the design of indicator descriptions. In designing the scale method, descriptive terms like “excellent,” “good,” “average,” “poor,” and “below average” are used. Evaluators score according to the degree to which the last level of indicators meets the description.

4.2 Comparative analysis of CH-SGs and UEREG-CH indicator dimensions

4.2.1 gamification.

The UEREG-CH breaks down “Gamification” into five secondary indicators: challenge, reward, content, plot, and rules, which lacks comprehensive consideration. This study dissects the “Gamification” into “Perceived ease of use,” “Entertainment objective,” and “Pleasure satisfaction,” along with nine tertiary indicators from D21 to D29 ( Table 8 ). It posits that the prerequisite for user engagement in a game is its perceived ease of use, as simple operability leads users to further explore the game’s entertainment aspects. The “Entertainment objective” involves users empathizing with characters, controlling the game’s direction, achieving self-realization, and immersing in the experience, leading to the satisfaction of pleasure and making the game a part of their life. This study views gamification as a distinguishing feature of CH-SGs compared to other educational games, necessitating a multi-faceted consideration of users’ actual operational needs.

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Table 8 . Comparison of indicator dimensions.

4.2.2 Demand

The UEREG-CH decomposes “Demand” into two aspects: “Game learning content meets or exceeds learner needs” and “Game functionality meets or exceeds learner needs.” This study finds this approach overly simplistic and lacking a clear distinction from “Educational” aspects. CH-SGs categorizes the “Demand dimension” into “Social satisfaction” and “Achievement satisfaction,” with five tertiary indicators from D30 to D34 ( Table 8 ). It believes that users’ intrinsic demands stem from two sources: achievement satisfaction through winning in the game mechanics, and social satisfaction from connections made with other users. These needs are interdependent, as victory in the game leads to a desire for social display and sharing, while collaboration and communication with others facilitate winning.

4.2.3 Social aspect

The UEREG-CH does not set this indicator ( Table 8 ). However, this study argues that games, as products, have strong social attributes, encompassing both users’ social attributes and the game’s societal aspects. CH-SG users often belong to culturally and economically higher echelons, greatly influenced by social norms, and their actions are affected by others in society. If close friends or experts recommend such games, users are likely to try them. The “Brand image” represents the game product’s social attribute. If the game’s production company is well-known, endorsed by celebrities or experts, or developed from a well-known IP, it tends to be favored and sought after by users.

4.2.4 Educational aspect

In the UEREG-CH, “Educational value” is divided into five secondary indicators: “Clear and timely knowledge feedback,” “Levels compliant with learning rules,” “Reliable content with flexible and diverse forms,” “Clear learning objectives,” and “Balanced skills and challenges.” This categorization appears somewhat generic and necessitates further detailed expansion. CH-SGs decompose the “Educational value” into three secondary indicators: “Learning objectives,” “Intellectual satisfaction,” and “Perceived usefulness,” along with nine tertiary indicators from D12 to D20 ( Table 8 ). “Learning objectives” play a crucial role in the quality aspect of CH-SGs games and serve as a distinctive feature differentiating them from other games. Users experience intellectual satisfaction only after completing tasks set by the “Learning objectives.” This sense of intellectual satisfaction, being one of the primary motives for initial game usage, leads to the perception of usefulness, thereby encouraging users to continue using the game. Thus, the relationship among these three indicators is interlinked, each supporting and leading into the next, collectively embodying the educational aspect from multiple perspectives.

4.2.5 Artistic aspect

The UEREG-CH deconstructs “Perceived aesthetics” into interface design, menu, elements, production, etc., which this study believes lacks an overall requirement for the game’s artistry and attention to users’ perception of art. CH-SGs breaks down “Artistic aspect” into two secondary indicators: “Interface design” and “Immersive satisfaction,” along with six tertiary indicators from D1 to D6 ( Table 8 ). This study suggests that the artistic indicators should reflect cultural heritage themes and emphasize creativity more than other educational games. Only when users perceive a unique artistic atmosphere in the interface can they immerse themselves in their game characters and forget the stresses of life.

4.2.6 Usability

The UEREG-CH decomposes “Usability” into indicators such as ease of memorization, operation, learning, absence of faults, and timely feedback. However, these indicators are subjective and semantically vague, overlapping with others. This study breaks down “Usability” into “System quality” and “Service quality,” with five tertiary indicators from D7 to D11 ( Table 8 ). A game’s usability is first judged by system quality; a game is considered usable only when the system is stable, frequently optimized, and has good guidance and synchronous feedback. Additionally, customer service’s timely problem resolution and fulfillment of promises to users are essential; otherwise, users may develop negative perceptions of the game’s usability and abandon it.

4.3 Comparative analysis of indicator weights in CH-SGs and UEREG-CH

4.3.1 weight structure.

Both the UEREG-CH and CH-SGs have tree-like indicator systems, but the former does not highlight the characteristics of various serious games as effectively as the latter, which is tailored for CH-SGs. Regarding the method of weight determination, the UEREG-CH uses group AHP cluster analysis, while the CH-SG combines the Delphi method, AHP, and fuzzy comprehensive calculation, blending qualitative and quantitative research ( Table 9 ).

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Table 9 . Comparison of indicator weights.

4.3.2 Important indicator weights

In the UEREG-CH, “Usability” ranks first, followed by “Educational value,” “Demand,” “Gamification,” and “Perceived aesthetics.” This prioritization shows that serious games in China focus more on basic user needs, emphasizing usability and educational aspects but are weaker in gamification and artistic aspects, lacking a balance between learning and gaming. In CH-SGs, “Gamification” ranks first, followed by “Demand,” “Social aspect,” “Educational value,” “Artistic dimension,” and “Usability.” This suggests that CH-SGs users prioritize leisure and entertainment in games, personal needs fulfillment, and social interaction. However, the educational aspect is less emphasized, possibly because CH-SGs, while educational, are perceived as weaker in function compared to pure educational games. This perception might stem from the games’ design issues that fail to emphasize learning objectives through game mechanics, leading to the impression that their educational function is weak. The lesser importance of the artistic aspect could be due to the convergence of artistic styles in current CH-SGs, predominantly adopting traditional Chinese styles and lacking in diversity and innovation. Usability ranks last because system quality generally meets users’ needs in current CH-SGs, and service quality has a minor impact on user experience, thus receiving less attention from users ( Table 9 ).

5 Conclusion and limitations

This study confirms that an effective and comprehensive evaluation rubric for CH-SGs can be constructed by focusing on usage motivation, game quality, and continuous usage. Previous research on serious games has focused on the educational aspect and the improvement of learners’ outcomes. However, empirical studies primarily aimed at collecting evidence of learning effectiveness have design flaws, leading to a shift in the research trend beyond just educational aspects. This study observes that the educational function of CH-SGs in China is relatively weak and needs to be integrated into the game mechanics to achieve learning objectives. Compared to other serious games, CH-SGs have a distinct cultural and artistic attribute. Therefore, evaluation rubrics developed for other serious games are not suitable for CH-SGs. To reflect the characteristics of CH-SGs and the needs of their user group, this study distinguishes them from other serious games across six dimensions: “Artistic,” “Usability,” “Educational value,” “Gamification,” “Demand,” and “Social aspect.” The secondary and tertiary indicators emphasize cultural heritage elements, such as breaking down the “Educational value” dimension into technical indicators like “Learning objectives” and non-technical indicators like “Intellectual satisfaction” and “Perceived usefulness,” with tertiary indicators reflecting elements of cultural heritage, such as “Accurate and reliable cultural heritage knowledge in various forms,” “Stimulating curiosity in learning traditional culture,” and “Enhancing the level of traditional cultural knowledge and skills.” Empirical research has revealed a departure from the traditional approach in serious game studies, which often emphasizes a balance between educational and gameplay aspects. It was found that users of CH-SGs tend to favor “Gamification” more, with “Educational” factors ranking only fourth in terms of importance. Therefore, it is recommended that designers of CH-SGs tailor the balance between gaming and learning aspects according to the specific theme and type of each game, rather than uniformly pursuing a balance between the two.

This study also validates that the CH-SGs evaluation rubric is recognized by users, not just experts. Involving users in the evaluation process is crucial, as they have the right to assess the games. Therefore, the evaluation rubric is developed around users’ diverse needs, formed through expert consultations and the AHP method, and further validated by user surveys and fuzzy comprehensive calculations. This approach ensures significant user participation. The study also believes that a game’s true appreciation by users depends on their continued use and the lasting, long-term impact it has on them. Thus, the rubric differs from previous studies by including long-term indicators, focusing on users’ experiences, attitudes, enthusiasm, persistence, and other non-technical aspects ( Yu, 2016 ). Starting from the theory of continued usage intention, the study sets “Perceived usefulness,” “Perceived ease of use,” and “Subjective norms” as secondary indicators, and “Continuous and systematic learning content,” “Long-term contact with other users and feeling care among friends,” etc., as tertiary indicators to assess the long-term impact of CH-SGs on users. True feedback for game iterative improvement can only be obtained through long-term usage by users.

This study also has limitations in its research methodology. Although user needs and evaluations were incorporated in the fuzzy calculation process of establishing the evaluation rubric, there are shortcomings in the composition of the user sample data collected. The survey respondents were all users who had experienced CH-SGs, but many potential users were not surveyed. Additionally, the user groups need further segmentation, as different groups may have varying evaluations of serious games, leading to instability in results. The methods for collecting user needs should also be expanded beyond questionnaires, including in-depth interviews and group discussions for a more detailed understanding of user needs, thus improving the accuracy of the evaluation results. In the Delphi and AHP methods, the study included opinions from an expert panel, which was not fully comprehensive, being predominantly from the field of game studies. This led to subjectivity and bias in the evaluation system and weightings. The inclusion of experts from educational sciences, cultural heritage inheritors, game industry professionals, and other cultural institutions is needed for a more balanced perspective. Moreover, the indicators in the evaluation rubric are not fully comprehensive, with many derived from educational game evaluations. Regarding the design scales for evaluation indicators, this study used a 5-point rating scale, and the scoring of each indicator primarily relied on subjective user perceptions without more detailed criteria. Therefore, how to delineate evaluation levels more finely and completely is a topic for future discussion. Lastly, as the CH-SGs evaluation rubric developed in this study has significant cultural specificity within the serious games domain, whether it can serve as a referable and extendable evaluation paradigm for other types of serious games requires continuous validation in future research.

Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Author contributions

PM: Writing – original draft. DC: Writing – review & editing.

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Supplementary material

The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpsyg.2024.1300686/full#supplementary-material

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Keywords: serious games, cultural heritage, continuous usage intention, evaluation rubric, Delphi method, analytic hierarchy process, fuzzy comprehensive evaluation method

Citation: Mao P and Cho DM (2024) Research on an evaluation rubric for promoting user’s continuous usage intention: a case study of serious games for Chinese cultural heritage. Front. Psychol . 15:1300686. doi: 10.3389/fpsyg.2024.1300686

Received: 17 October 2023; Accepted: 15 January 2024; Published: 15 February 2024.

Reviewed by:

Copyright © 2024 Mao and Cho. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Pingting Mao, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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Informed Consent Helps Patients Understand Their Rights and Responsibilities as a Clinical Trial Participant

Informed Consent Helps Patients Understand Their Rights and Responsibilities as a Clinical Trial Participant

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A comprehensive, ongoing process that involves providing potential and enrolled research participants with adequate information about a clinical trial’s purpose, procedures, risks, and benefits, informed consent helps individuals make sure they fully understand the implications when deciding whether they want to participate. 

Informed consent is more than just obtaining a patient’s signature on a document; it’s a continuous process that involves answering participants’ questions and providing information as the study progresses or as the subject or situation requires. Nurses have a responsibility to facilitate informed consent and ensure that participants fully comprehend the trial information and their role as clinical trial participants. 

The U.S. Food and Drug Administration has an overview of the basic elements of informed consent.  

Protecting Patients’ Rights 

Informed consent respects and upholds clinical trial participants’ rights to:  

  • Receive detailed information about the trial, including its purpose, procedures, risks, and benefits, in a language that they can understand  
  • Ask questions if they do not understand something 
  • Withdraw from the trial at any time without facing any consequences 

However, researchers conducting an extensive systematic review and meta-analysis spanning studies published over three decades found that only 52.1%–75.8% of participants in clinical trials understood different components of informed consent—and those numbers didn’t budge at all in the 30-year time span. Specifically , approximately: 

  • 75% understood the nature of study, potential benefits, and that they had the freedom to withdraw at any time. 
  • 65%–70% understood the study’s purpose, potential risks, and side effects; confidentiality; availability of alternative treatment if they withdraw; and treatments being compared. 
  • 50% understood the concepts of placebo and randomization. 

As oncology nurses, we have a duty to provide comprehensive education to people with cancer. When their cancer treatment is part of a clinical trial, our patient education duties include providing clinical trial information and decision-making support throughout their participation.  

According to the Health Insurance Portability and Accountability Act (HIPAA), participants also have the right to privacy and confidentiality and access to medical care. As nurses, it is our responsibility to maintain the highest standards of our patient’s privacy throughout the clinical trial and to advocate for their well-being to ensure that they receive the care and support that they need. 

Defining Participants’ Responsibilities 

After they agree to participate in a clinical trial, patients have responsibilities such as attending scheduled visits, adhering to the clinical trial protocol, complying with their medication schedule, and reporting adverse events. Nurses should inform patients about their responsibilities during the informed consent process and emphasize the importance of meeting the requirements during their participation. 

Informed consent is an essential component of clinical trials. As nurses, we play an important role in explaining the process, providing information, and advocating for the well-being of those who choose to participate. By keeping patients well-informed and supported throughout a clinical trial, we can help them make informed decisions about their participation. 

Implications for Oncology Nurses: Case Study 

Using Jane, a newly diagnosed patient with cancer, as an example, here’s one way oncology nurses can include informed consent as an ongoing process throughout a patient’s participation in a clinical trial.  

Jane is enrolled in a phase II oncology clinical trial during her clinic visit. At this visit, the oncology nurse and physician conduct a thorough informed consent by explaining the elements included in the document. At each of Jane’s future return visits during the trial, the oncology nurse assesses gaps in Jane’s understanding of the trial, addresses her questions, any emerging safety concerns, and updates her about modifications to the trial protocol and relevant protocol findings.   

During cycle 3, Jane’s creatinine clearance level is less than 50 ml/min. According to the clinical trial protocol, that level requires a dose reduction of the investigational product. The oncology nurse ensures Jane’s comprehension about the need for a dose reduction and her willingness to continue participating in the trial. 

Six months into the trial, the data and safety monitoring board identifies a new potential side effect based on interim results analysis which warrants an update to the informed consent. The nurse collaborates with the physician to discuss the updated side effects with Jane, answers any questions she has, and assists in reconsenting her with the most updated informed consent document. During the reconsent process, the nurse conducts intermittent comprehension assessments to ensure that Jane understands the updated information. 

By diligently continuing to ensure Jane fully understands the study and her rights and responsibilities at every visit throughout the trial, the oncology nurse is providing comprehensive informed consent for her as a participant. 

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7 Strategies to Get Your Employees On Board with GenAI

  • Tomas Chamorro-Premuzic

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A culture that accepts this new technology can also learn how to innovate with it.

As with any aspect of digital transformation, the effective deployment of generative AI will depend less on technological capability than on human adaptability. Indeed, the human factor — people and culture — will drive the adoption of AI, or lack thereof. Looking at scientific research and real-world case studies, there are seven generalizable lessons for improving your ability to adopt GenAI, and any novel technology, at an organizational level: innovation boosts your organization’s immunity, focus on the problem, less is more, intuition is the common enemy, everyone loves change until they have to do it, process eats culture for lunch, and be proactive about ethical concerns.

Despite record rapid adoption and persistent media hype — ranging from dystopian to utopian coverage — generative AI is more of an area of intellectual promise or concern for businesses than an operational reality. Amidst estimates of an AI market that could reach almost $670 billion by 2030, adding up to $4.4 trillion in productivity, business leaders are still wondering what exactly to do with AI, how to leverage it, and how exactly it will deliver the advertised economic benefits. And there is no shortage of hope or belief in AI’s potential, especially during turbulent economic times.

research case study process

  • Tomas Chamorro-Premuzic is the Chief Innovation Officer at ManpowerGroup, a professor of business psychology at University College London and at Columbia University, co-founder of  deepersignals.com , and an associate at Harvard’s Entrepreneurial Finance Lab. He is the author of  Why Do So Many Incompetent Men Become Leaders? (and How to Fix It ) , upon which his  TEDx talk  was based. His latest book is I, Human: AI, Automation, and the Quest to Reclaim What Makes Us Unique.   Find him at  www.drtomas.com . drtcp

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    Introduction. The popularity of case study research methodology in Health Services Research (HSR) has grown over the past 40 years. 1 This may be attributed to a shift towards the use of implementation research and a newfound appreciation of contextual factors affecting the uptake of evidence-based interventions within diverse settings. 2 Incorporating context-specific information on the ...

  10. Distinguishing case study as a research method from case reports as a

    Case study as a qualitative methodology is an exploration of a time- and space-bound phenomenon. As qualitative research, case studies require much more from their authors who are acting as instruments within the inquiry process. In the case study methodology, a variety of methodological approaches may be employed to explain the complexity of ...

  11. Case Study Research: Methods and Designs

    The case study method can be divided into three stages: formulation of objectives; collection of data; and analysis and interpretation. The researcher first makes a judgment about what should be studied based on their knowledge. Next, they gather data through observations and interviews. Here are some of the common case study research methods: 1.

  12. A Quick Guide to Case Study with Examples

    Learn More How to Conduct a Case Study? Select the Case to Investigate Formulate the Research Question Review of Literature Choose the Precise Case to Use in your Study Select Data Collection and Analysis Techniques Collect the Data Analyse the Data Prepare the Report Step1: Select the Case to Investigate

  13. PDF DEFINING THE CASE STUDY

    1. question: case studies most useful for answering how, why. 2. propositions, if any to help problematize your question (e.g., organizations collaborate because they derive mutual benefit). 3. units of analysis (a neighborhood or a small group; a new technology or an innovation process?)

  14. PDF PREPARING A CASE STUDY: A Guide for Designing and Conducting a Case

    A case study is a story about something unique, special, or interesting—stories can be about individuals, organizations, processes, programs, neighborhoods, institutions, and even events.1 The case study gives the story behind the result by capturing what happened to bring it about, and can be a good opportunity to highlight a project's success,...

  15. Chapter 11 Case Research

    Chapter 11 Case Research. Case research, also called case study, is a method of intensively studying a phenomenon over time within its natural setting in one or a few sites. Multiple methods of data collection, such as interviews, observations, prerecorded documents, and secondary data, may be employed and inferences about the phenomenon of ...

  16. (PDF) Case Study Research

    This study employed a qualitative case study methodology. The case study method is a research strategy that aims to gain an in-depth understanding of a specific phenomenon by collecting and ...

  17. Case Study Research Method in Psychology

    Procedure 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.

  18. Case Study Research and Applications

    Ultimately, Case Study Research and Applications will guide students in the successful use and application of the case study research method. Available Formats. ISBN: 9781506336169. Paperback. Suggested Retail Price: $85.00. Bookstore Price: $68.00. ISBN: 9781506336176. Electronic Version. Suggested Retail Price: $65.25.

  19. Research Guides: Case Study Research: What is a Case Study?

    A case study is a type of research method. In case studies, the unit of analysis is a case. The case typically provides a detailed account of a situation that usually focuses on a conflict or complexity that one might encounter in the workplace. ... Case studies help explain the process by which a unit (a person, department, business ...

  20. The research process for case studies

    ... this article, the research process for case studies is presented through eight different phases. Figure 1 shows the eight phases for case research based on the literature review of...

  21. The Process of Researching A Case Study

    The heart of the case study is the research notebook. Every researcher must have a physical notebook to record all finding, notes and observations. ... The Interview Process. This is often the backbone of the case study, and the single most important way to get information from your study participants. Depending on the size of the study ...

  22. Beyond Convenience: A Case and Method for Purposive Sampling in

    When designing a study, the sampling method for selecting research participants is an important decision with a host of considerations. When designing a professional development (PD) program with a limited number of spaces, the method of choosing participants from the applicants is also important. When research and professional development are entwined, sets of sampling criteria could conflict ...

  23. The case study approach

    The case study approach allows in-depth, multi-faceted explorations of complex issues in their real-life settings. The value of the case study approach is well recognised in the fields of business, law and policy, but somewhat less so in health services research.

  24. Abductive Cross-Case Comparison in Qualitative Research: Methodological

    The authors call this abductive cross-case comparison and illustrate it by way of a collective study of how professional boundary work is changing under transnational conditions. In this study, the authors faced a common challenge in qualitative-comparative research: what to do when initial observations generate "surprises" that seem to ...

  25. Implementing a tobacco-free workplace program at a substance use

    By applying a case study design, this work contributes to the existing research on implementing tobacco-free workplace programs at substance use treatment centers by providing an in-depth qualitative description of program implementation in the setting of a nonprofit outpatient substance use treatment center serving diverse clients, most of ...

  26. Frontiers

    This study posits that with the guidance of evaluation rubrics, the design process of CH-SGs is akin to having a measuring ruler and a direction, leading to breakthroughs in research on design, development, and application evaluations of CH-SGs (Wang et al., 2019a). An evaluation rubric is a scoring tool that includes standards for assessing a ...

  27. Informed Consent Helps Patients Understand Their Rights and

    Implications for Oncology Nurses: Case Study . Using Jane, a newly diagnosed patient with cancer, as an example, here's one way oncology nurses can include informed consent as an ongoing process throughout a patient's participation in a clinical trial. Jane is enrolled in a phase II oncology clinical trial during her clinic visit.

  28. 7 Strategies to Get Your Employees On Board with GenAI

    Looking at scientific research and real-world case studies, there are seven generalizable lessons for improving your ability to adopt GenAI, and any novel technology, at an organizational level ...