Case Study Research Design - How to conduct a Case Study

 

case study of research methodology

PDF | Commenting on the lack of case studies published in modern psychotherapy publications, the author reviews the strengths of case study methodology and responds to common criticisms, before Author: Mark Widdowson. Qualitative Case Study Methodology: Study Design and Implementation for Novice Researchers Abstract Qualitative case study methodology provides tools for researchers to study complex phenomena within their contexts. When the approach is applied correctly, it Cited by: Volume 18, No. 1, Art. 19 – January Case Study Research: Foundations and Methodological Orientations. Helena Harrison, Melanie Birks, Richard Franklin & Jane Mills. Abstract: Over the last forty years, case study research has undergone substantial methodological pillsreviewi.gq evolution has resulted in a pragmatic, flexible research approach, capable of providing comprehensive in Cited by:


The case study approach | BMC Medical Research Methodology | Full Text


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.

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, case study of research methodology.

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 case study of research methodology 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 case study of research methodology structured around the following main questions: What is a case study? What case study of research methodology 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 123 and 4 and those of others to illustrate our discussion[ 3 — 7 ].

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 5the 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: intrinsicinstrumental 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 case study of research methodology 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 1we 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 23 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 studiedis was also instrumental in that this particular professional group was studied as an exemplar of the more general phenomenon of workforce redesign[ 4 ].

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 3for example [ 1 ]. In contrast to experimental designs, case study of research methodology, 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 [ 610 ]. 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' assumptionsinterpretivist trying to understand individual and shared social case study of research methodology 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, case study of research methodology in the context of conducting health services research. Doolin has, for example, noted that in the context of undertaking interpretative case studies, researchers can usefully draw on a critical, reflective perspective which seeks to take into account the wider social and political environment that has shaped the case[ 11 ].

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

Carefully formulated research question sinformed by the existing literature and a prior appreciation of the theoretical issues and setting sare all important in appropriately and succinctly defining the case[ 812 ].

Crucially, case study of research methodology, each case should have a pre-defined boundary which clarifies the nature and time period covered by the case study i.

A theory driven approach to defining the case may help generate knowledge that is potentially transferable to a range of clinical contexts and behaviours; using theory is also likely to result in a more informed appreciation of, for example, how and why interventions have succeeded or failed[ 13 ]. For example, in our evaluation of the introduction of electronic health records in English hospitals Table 3we 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 case study of research methodology our case differently as a grouping of healthcare professionals e.

The precise beginning and end of the case may however prove difficult to define. Pursuing this same example, when does the process of implementation and adoption of an electronic health record system really begin or end? Such judgements will inevitably be influenced by a range of factors, including the research question, theory of interest, case study of research methodology, the scope and richness of the gathered data and the resources available to the research team, case study of research methodology.

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 case study of research methodology, but because of its uniqueness, which is of genuine interest to case study of research methodology 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[ 1415 ]. In another example of an intrinsic case study, Hellstrom et al. For an instrumental case study, selecting case study of research methodology "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, case study of research methodology.

For example, in order to gain an understanding of doctors' responses to health policy initiatives, case study of research methodology, Som undertook an instrumental case study interviewing clinicians who had a range of responsibilities for clinical governance in one NHS acute hospital trust[ 17 ]. Sampling a "deviant" or "atypical" case may however prove even more informative, potentially enabling the researcher to identify causal processes, generate hypotheses and develop theory.

In collective or multiple case studies, a number of cases are carefully selected. Choosing a "typical" case may enable the findings to be generalised to theory i. Yin suggests two or three literal replications i. However, case study of research methodology, 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.

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, case study of research methodology, and examples of each of the three electronic health record systems procured centrally by the NPfIT. At one recruited site, case study of research methodology, it quickly became apparent that access was problematic because of competing demands case study of research methodology that organisation.

Recognising the importance of full access and co-operative working for generating rich data, the research team decided not to pursue work at that site and instead to focus on other recruited sites. In order to develop a thorough understanding of the case, the case study approach usually involves the collection of multiple sources of evidence, using a range of quantitative e.

Case study of research methodology use of multiple sources of data data triangulation has been advocated as a way of increasing the internal validity of a study i. 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 case study of research methodology 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 case study of research methodology e.

It is important that data sources from different cases are, where possible, broadly comparable for this purpose even though they may vary in nature and depth. Making sense and offering a coherent interpretation of the typically disparate sources of data whether qualitative alone or together with quantitative is far from straightforward. Repeated reviewing and sorting of the voluminous and detail-rich data are integral to the process of analysis.

In collective case studies, it is helpful to analyse data relating to the individual component cases first, before making comparisons across cases. Attention needs to be paid to variations within each case and, where relevant, the relationship between different causes, effects and outcomes[ 23 ].

Data will need to be organised and coded to allow the key issues, both derived from the literature and emerging case study of research methodology 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 interpretationcase study of research methodology, 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 [ 324 ].

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.

 

Case Studies - Research-Methodology

 

case study of research methodology

 

PDF | Commenting on the lack of case studies published in modern psychotherapy publications, the author reviews the strengths of case study methodology and responds to common criticisms, before Author: Mark Widdowson. Qualitative Case Study Methodology: Study Design and Implementation for Novice Researchers Abstract Qualitative case study methodology provides tools for researchers to study complex phenomena within their contexts. When the approach is applied correctly, it Cited by: Case studies are a popular research method in business area. Case studies aim to analyze specific issues within the boundaries of a specific environment, situation or organization. According to its design, case studies in business research can be divided into three categories: explanatory.