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Teaching by the Case Method

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Case Method in Practice

Chris Christensen described case method teaching as "the art of managing uncertainty"—a process in which the instructor serves as "planner, host, moderator, devil's advocate, fellow-student, and judge," all in search of solutions to real-world problems and challenges.

Unlike lectures, case method classes unfold without a detailed script. Successful instructors simultaneously manage content and process, and they must prepare rigorously for both. Case method teachers learn to balance planning and spontaneity. In practice, they pursue opportunities and "teachable moments" that emerge throughout the discussion, and deftly guide students toward discovery and learning on multiple levels. The principles and techniques are developed, Christensen says, "through collaboration and cooperation with friends and colleagues, and through self-observation and reflection."

This section of the Christensen Center website explores the Case Method in Practice along the following dimensions:

• Providing Assessment and Feedback

Each subsection provides perspectives and guidance through a written overview, supplemented by video commentary from experienced case method instructors. Where relevant, links are included to downloadable documents produced by the Christensen Center or Harvard Business School Publishing. References for further reading are provided as well.

An additional subsection, entitled Resources, appears at the end. It combines references from throughout the Case Method in Practice section with additional information on published materials and websites that may be of interest to prospective, new, and experienced case method instructors.

Note: We would like to thank Harvard Business School Publishing for permission to incorporate the video clips that appear in the Case Method in Practice section of our website. The clips are drawn from video excerpts included in Participant-Centered Learning and the Case Method: A DVD Case Teaching Tool (HBSP, 2003).

Christensen Center Tip Sheets

• Characteristics of Effective Case Method Teaching
• Elements of Effective Class Preparation
• Guidelines for Effective Observation of Case Instructors
• In-Class Assessment of Discussion-Based Teaching
• Questions for Class Discussions
• Teaching Quantitative Material
• Strategies and Tactics for Sensitive Topics

Curriculum Innovation

The case method has evolved so students may act as decision-makers in new engaging formats:

Game Simulations

Multimedia cases, ideo: human-centered service design.

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What the Case Study Method Really Teaches

• Nitin Nohria

Seven meta-skills that stick even if the cases fade from memory.

It’s been 100 years since Harvard Business School began using the case study method. Beyond teaching specific subject matter, the case study method excels in instilling meta-skills in students. This article explains the importance of seven such skills: preparation, discernment, bias recognition, judgement, collaboration, curiosity, and self-confidence.

During my decade as dean of Harvard Business School, I spent hundreds of hours talking with our alumni. To enliven these conversations, I relied on a favorite question: “What was the most important thing you learned from your time in our MBA program?”

• Nitin Nohria is the George F. Baker Jr. and Distinguished Service University Professor. He served as the 10th dean of Harvard Business School, from 2010 to 2020.

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• Teaching with Cases

At professional schools (like Harvard’s Law, Business, Education, or Medical Schools), courses often adopt the so-called "case method" of teaching , in which students are confronted with real-world problems or scenarios involving multiple stakeholders and competing priorities. Most of the cases which faculty use with their students are written by professionals who have expertise in researching and writing in that genre, and for good reason—writing a truly masterful case, one which can engage students in hours of debate and deliberation, takes a lot of time and effort. It can be effective, nevertheless, for you to try implementing some aspects of the case-teaching approach in your class. Among the benefits which accrue to using case studies are the following:

• the fact that it gives your students the opportunity to "practice" a real-world application;
• the fact that it compels them (and you!) to reconstruct all of the divergent and convergent perspectives which different parties might bring to the scenario;
• the fact that it motivates your students to anticipate a wide range of possible responses which a reader might have; and
• the fact that it invites your students to indulge in metacognition as they revisit the process by which they became more knowledgeable about the scenario.

Features of an Effective Teaching Case

While no two case studies will be exactly alike, here are some of those principles:

• The case should illustrate what happens when a concept from the course could be, or has been, applied in the real world. Depending on the course, a “concept” might mean any one among a range of things, including an abstract principle, a theory, a tension, an issue, a method, an approach, or simply a way of thinking characteristic of an academic field. Whichever you choose, you should make sure to “ground” the case in a realistic setting early in the narrative, so that participants understand their role in the scenario.
• The case materials should include enough factual content and context to allow students to explore multiple perspectives. In order for participants to feel that they are encountering a real-world application of the course material, and that they have some freedom and agency in terms of how they interpret it, they need to be able to see the issue or problem from more than one perspective. Moreover, those perspectives need to seem genuine, and to be sketched in enough detail to seem complex. (In fact, it’s not a bad idea to include some “extraneous” information about the stakeholders involved in the case, so that students have to filter out things that seem relevant or irrelevant to them.) Otherwise, participants may fall back on picking obvious “winners” and “losers” rather than seeking creative, negotiated solutions that satisfy multiple stakeholders.
• The case materials should confront participants with a range of realistic constraints, hard choices, and authentic outcomes. If the case presumes that participants will all become omniscient, enjoy limitless resources, and succeed, they won’t learn as much about themselves as team-members and decision-makers as if they are forced to confront limitations, to make tough decisions about priorities, and to be prepared for unexpected results. These constraints and outcomes can be things which have been documented in real life, but they can also be things which the participants themselves surface in their deliberations.

• The activity should include space to reflect upon the decision-making process and the lessons of the case. Writing a case offers an opportunity to engage in multiple layers of reflection. For you, as the case writer, it is an occasion to anticipate how you (if you were the instructor) might create scenarios that are aligned with, and likely to meet the learning objectives of, a given unit of your course. For the participants whom you imagine using your case down the road, the case ideally should help them (1) to understand their own hidden assumptions, priorities, values, and biases better; and (2) to close the gap between their classroom learning and its potential real-world applications.

For more information...

Kim, Sara et al. 2006. "A Conceptual Framework for Developing Teaching Cases: A Review and Synthesis of the Literature across Disciplines." Medical Education 40: 867–876.

Herreid, Clyde Freeman. 2011. "Case Study Teaching." New Directions for Teaching and Learning 128: 31–40.

Nohria, Nitin. 2021. "What the Case Study Method Really Teaches." Harvard Business Review .

Swiercz, Paul Michael. "SWIF Learning: A Guide to Student Written-Instructor Facilitated Case Writing."

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The Case Study Teaching Method

It is easy to get confused between the case study method and the case method , particularly as it applies to legal education. The case method in legal education was invented by Christopher Columbus Langdell, Dean of Harvard Law School from 1870 to 1895. Langdell conceived of a way to systematize and simplify legal education by focusing on previous case law that furthered principles or doctrines. To that end, Langdell wrote the first casebook, entitled A Selection of Cases on the Law of Contracts , a collection of settled cases that would illuminate the current state of contract law. Students read the cases and came prepared to analyze them during Socratic question-and-answer sessions in class.

The Harvard Business School case study approach grew out of the Langdellian method. But instead of using established case law, business professors chose real-life examples from the business world to highlight and analyze business principles. HBS-style case studies typically consist of a short narrative (less than 25 pages), told from the point of view of a manager or business leader embroiled in a dilemma. Case studies provide readers with an overview of the main issue; background on the institution, industry, and individuals involved; and the events that led to the problem or decision at hand. Cases are based on interviews or public sources; sometimes, case studies are disguised versions of actual events or composites based on the faculty authors’ experience and knowledge of the subject. Cases are used to illustrate a particular set of learning objectives; as in real life, rarely are there precise answers to the dilemma at hand.

Our suite of free materials offers a great introduction to the case study method. We also offer review copies of our products free of charge to educators and staff at degree-granting institutions.

For more information on the case study teaching method, see:

• Martha Minow and Todd Rakoff: A Case for Another Case Method
• HLS Case Studies Blog: Legal Education’s 9 Big Ideas
• Teaching Units: Problem Solving , Advanced Problem Solving , Skills , Decision Making and Leadership , Professional Development for Law Firms , Professional Development for In-House Counsel
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Watch this informative video about the Problem-Solving Workshop:

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What is Teaching with the Case Method?

The case method combines two elements: the case itself and the discussion of that case. A teaching case is a rich narrative in which individuals or groups must make a decision or solve a problem. A teaching case is not a "case study" of the type used in academic research. Teaching cases provide information, but neither analysis nor conclusions. The analytical work of explaining the relationships among events in the case, identifying options, evaluating choices and predicting the effects of actions is the work done by students during the classroom discussion.

What are Cases?

Cases are narratives that contain information and invite analysis. Participants are put in the position of making decisions or evaluations based on the information available. Cases can be acquired from the formal, purpose written material available from such sources as the Harvard Business School and the Kennedy School or constructed by faculty members from newspaper articles, cartoons, radio stories and even grocery store coupons and fliers. (See the examples collection .)

Cases can involve situations in which decisions must be made or problems solved, or they can involve evaluation or reconsideration of existing policies, practices or proposals. Effective cases are usually based on real events, but can be drawn from both the present and the past, even the distant past. Cases require students to make choices about what theory or concepts to apply in conducting the analysis, which is distinct from the one to one correspondence between theory and application that they see in their textbooks or hear in lectures.

How do Cases differ from other kinds of examples?

Unlike examples from textbooks or those we insert in lectures, cases include information but provide no analysis. Cases present students with complex, unstructured problems that may include extraneous or irrelevant information and often don't include every piece of information an analyst would like to have. Unlike problem sets, they do not break the problem down into clear steps, and frequently have no single "right" answer. Cases provide a rich contextual way to introduce new material and create opportunities for students to apply the material they have just learned. The same overarching case can even can be used several times in the same course, as students return to the story of the case with new analytical techniques and tools. Cases require students to make choices about what theory or concepts to apply in conducting the analysis, which is distinct from the one to one correspondence between theory and application that they see in their textbooks or hear in lectures.

What happens in a Case Method classroom?

In classroom discussion, students analyze the information in the case and use it to solve the problem set up by the case. The discussion can take many forms, including closely directed questioning by faculty to help students draw out the information from the case and identify the central decisions or evaluations that need to be made, more open-ended questions and discussions as students evaluate options and weigh the evidence, and small group work by students focused on specific analytical tasks. Many faculty members use role-play as a technique to put students completely in the case environment. Ideally, case method discussions involve mostly conversation between and among students, rather than discussion centered on direct participation by the faculty member. Many case method teachers describe their role as conductor, facilitator, or guide, drawing attention to their role in setting up discussion in which students are the primary participants.

In what contexts are cases used?

Faculty members use cases in any environment in which they can effectively manage discussion. There are faculty members using it successfully in very large courses (Steve Lamy at USC teaches cases to as many as 300 introductory IR students) and others who use it in very small graduate classes, though very large classes and very small classes can pose particular challenges in generating sufficient participation, focusing attention, or producing the diverse viewpoints that make discussion rich. Cases are used effectively to teach critical thinking and quantitative reasoning, and have been successfully applied in a wide range of disciplines including political science, economics , law, business, chemistry, history, and linguistics, and in both undergraduate and graduate classrooms.

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Case Method Teaching and Learning

What is the case method? How can the case method be used to engage learners? What are some strategies for getting started? This guide helps instructors answer these questions by providing an overview of the case method while highlighting learner-centered and digitally-enhanced approaches to teaching with the case method. The guide also offers tips to instructors as they get started with the case method and additional references and resources.

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What is case method teaching.

• Case Method at Columbia

Why use the Case Method?

Case method teaching approaches, how do i get started.

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The CTL is here to help!

For support with implementing a case method approach in your course, email [email protected] to schedule your 1-1 consultation .

Cite this resource: Columbia Center for Teaching and Learning (2019). Case Method Teaching and Learning. Columbia University. Retrieved from [today’s date] from https://ctl.columbia.edu/resources-and-technology/resources/case-method/  

Case method 1 teaching is an active form of instruction that focuses on a case and involves students learning by doing 2 3 . Cases are real or invented stories 4  that include “an educational message” or recount events, problems, dilemmas, theoretical or conceptual issue that requires analysis and/or decision-making.

Case-based teaching simulates real world situations and asks students to actively grapple with complex problems 5 6 This method of instruction is used across disciplines to promote learning, and is common in law, business, medicine, among other fields. See Table 1 below for a few types of cases and the learning they promote.

Table 1: Types of cases and the learning they promote.

For a more complete list, see Case Types & Teaching Methods: A Classification Scheme from the National Center for Case Study Teaching in Science.

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Case Method Teaching and Learning at Columbia

The case method is actively used in classrooms across Columbia, at the Morningside campus in the School of International and Public Affairs (SIPA), the School of Business, Arts and Sciences, among others, and at Columbia University Irving Medical campus.

Faculty Spotlight:

Professor Mary Ann Price on Using Case Study Method to Place Pre-Med Students in Real-Life Scenarios

Read more  

Professor De Pinho on Using the Case Method in the Mailman Core

Case method teaching has been found to improve student learning, to increase students’ perception of learning gains, and to meet learning objectives 8 9 . Faculty have noted the instructional benefits of cases including greater student engagement in their learning 10 , deeper student understanding of concepts, stronger critical thinking skills, and an ability to make connections across content areas and view an issue from multiple perspectives 11 . 

Through case-based learning, students are the ones asking questions about the case, doing the problem-solving, interacting with and learning from their peers, “unpacking” the case, analyzing the case, and summarizing the case. They learn how to work with limited information and ambiguity, think in professional or disciplinary ways, and ask themselves “what would I do if I were in this specific situation?”

The case method bridges theory to practice, and promotes the development of skills including: communication, active listening, critical thinking, decision-making, and metacognitive skills 12 , as students apply course content knowledge, reflect on what they know and their approach to analyzing, and make sense of a case. 

Though the case method has historical roots as an instructor-centered approach that uses the Socratic dialogue and cold-calling, it is possible to take a more learner-centered approach in which students take on roles and tasks traditionally left to the instructor. 

Cases are often used as “vehicles for classroom discussion” 13 . Students should be encouraged to take ownership of their learning from a case. Discussion-based approaches engage students in thinking and communicating about a case. Instructors can set up a case activity in which students are the ones doing the work of “asking questions, summarizing content, generating hypotheses, proposing theories, or offering critical analyses” 14 . 

The role of the instructor is to share a case or ask students to share or create a case to use in class, set expectations, provide instructions, and assign students roles in the discussion. Student roles in a case discussion can include: 

• discussion “starters” get the conversation started with a question or posing the questions that their peers came up with; 
• facilitators listen actively, validate the contributions of peers, ask follow-up questions, draw connections, refocus the conversation as needed; 
• recorders take-notes of the main points of the discussion, record on the board, upload to CourseWorks, or type and project on the screen; and 
• discussion “wrappers” lead a summary of the main points of the discussion. 

Prior to the case discussion, instructors can model case analysis and the types of questions students should ask, co-create discussion guidelines with students, and ask for students to submit discussion questions. During the discussion, the instructor can keep time, intervene as necessary (however the students should be doing the talking), and pause the discussion for a debrief and to ask students to reflect on what and how they learned from the case activity. 

Note: case discussions can be enhanced using technology. Live discussions can occur via video-conferencing (e.g., using Zoom ) or asynchronous discussions can occur using the Discussions tool in CourseWorks (Canvas) .

Table 2 includes a few interactive case method approaches. Regardless of the approach selected, it is important to create a learning environment in which students feel comfortable participating in a case activity and learning from one another. See below for tips on supporting student in how to learn from a case in the “getting started” section and how to create a supportive learning environment in the Guide for Inclusive Teaching at Columbia . 

Table 2. Strategies for Engaging Students in Case-Based Learning

Approaches to case teaching should be informed by course learning objectives, and can be adapted for small, large, hybrid, and online classes. Instructional technology can be used in various ways to deliver, facilitate, and assess the case method. For instance, an online module can be created in CourseWorks (Canvas) to structure the delivery of the case, allow students to work at their own pace, engage all learners, even those reluctant to speak up in class, and assess understanding of a case and student learning. Modules can include text, embedded media (e.g., using Panopto or Mediathread ) curated by the instructor, online discussion, and assessments. Students can be asked to read a case and/or watch a short video, respond to quiz questions and receive immediate feedback, post questions to a discussion, and share resources. 

For more information about options for incorporating educational technology to your course, please contact your Learning Designer .

To ensure that students are learning from the case approach, ask them to pause and reflect on what and how they learned from the case. Time to reflect  builds your students’ metacognition, and when these reflections are collected they provides you with insights about the effectiveness of your approach in promoting student learning.

Well designed case-based learning experiences: 1) motivate student involvement, 2) have students doing the work, 3) help students develop knowledge and skills, and 4) have students learning from each other.  

Designing a case-based learning experience should center around the learning objectives for a course. The following points focus on intentional design. 

Identify learning objectives, determine scope, and anticipate challenges. 

• Why use the case method in your course? How will it promote student learning differently than other approaches? 
• What are the learning objectives that need to be met by the case method? What knowledge should students apply and skills should they practice? 
• What is the scope of the case? (a brief activity in a single class session to a semester-long case-based course; if new to case method, start small with a single case). 
• What challenges do you anticipate (e.g., student preparation and prior experiences with case learning, discomfort with discussion, peer-to-peer learning, managing discussion) and how will you plan for these in your design? 
• If you are asking students to use transferable skills for the case method (e.g., teamwork, digital literacy) make them explicit. 

Determine how you will know if the learning objectives were met and develop a plan for evaluating the effectiveness of the case method to inform future case teaching. 

• What assessments and criteria will you use to evaluate student work or participation in case discussion? 
• How will you evaluate the effectiveness of the case method? What feedback will you collect from students? 
• How might you leverage technology for assessment purposes? For example, could you quiz students about the case online before class, accept assignment submissions online, use audience response systems (e.g., PollEverywhere) for formative assessment during class? 

Select an existing case, create your own, or encourage students to bring course-relevant cases, and prepare for its delivery

• Where will the case method fit into the course learning sequence? 
• Is the case at the appropriate level of complexity? Is it inclusive, culturally relevant, and relatable to students? 
• What materials and preparation will be needed to present the case to students? (e.g., readings, audiovisual materials, set up a module in CourseWorks). 

Plan for the case discussion and an active role for students

• What will your role be in facilitating case-based learning? How will you model case analysis for your students? (e.g., present a short case and demo your approach and the process of case learning) (Davis, 2009). 
• What discussion guidelines will you use that include your students’ input? 
• How will you encourage students to ask and answer questions, summarize their work, take notes, and debrief the case? 
• If students will be working in groups, how will groups form? What size will the groups be? What instructions will they be given? How will you ensure that everyone participates? What will they need to submit? Can technology be leveraged for any of these areas? 
• Have you considered students of varied cognitive and physical abilities and how they might participate in the activities/discussions, including those that involve technology? 

Student preparation and expectations

• How will you communicate about the case method approach to your students? When will you articulate the purpose of case-based learning and expectations of student engagement? What information about case-based learning and expectations will be included in the syllabus?
• What preparation and/or assignment(s) will students complete in order to learn from the case? (e.g., read the case prior to class, watch a case video prior to class, post to a CourseWorks discussion, submit a brief memo, complete a short writing assignment to check students’ understanding of a case, take on a specific role, prepare to present a critique during in-class discussion).

Andersen, E. and Schiano, B. (2014). Teaching with Cases: A Practical Guide . Harvard Business Press. 

Bonney, K. M. (2015). Case Study Teaching Method Improves Student Performance and Perceptions of Learning Gains†. Journal of Microbiology & Biology Education , 16 (1), 21–28. https://doi.org/10.1128/jmbe.v16i1.846

Davis, B.G. (2009). Chapter 24: Case Studies. In Tools for Teaching. Second Edition. Jossey-Bass. 

Garvin, D.A. (2003). Making the Case: Professional Education for the world of practice. Harvard Magazine. September-October 2003, Volume 106, Number 1, 56-107.

Golich, V.L. (2000). The ABCs of Case Teaching. International Studies Perspectives. 1, 11-29. 

Golich, V.L.; Boyer, M; Franko, P.; and Lamy, S. (2000). The ABCs of Case Teaching. Pew Case Studies in International Affairs. Institute for the Study of Diplomacy. 

Heath, J. (2015). Teaching & Writing Cases: A Practical Guide. The Case Center, UK. 

Herreid, C.F. (2011). Case Study Teaching. New Directions for Teaching and Learning. No. 128, Winder 2011, 31 – 40. 

Herreid, C.F. (2007). Start with a Story: The Case Study Method of Teaching College Science . National Science Teachers Association. Available as an ebook through Columbia Libraries. 

Herreid, C.F. (2006). “Clicker” Cases: Introducing Case Study Teaching Into Large Classrooms. Journal of College Science Teaching. Oct 2006, 36(2). https://search.proquest.com/docview/200323718?pq-origsite=gscholar  

Krain, M. (2016). Putting the Learning in Case Learning? The Effects of Case-Based Approaches on Student Knowledge, Attitudes, and Engagement. Journal on Excellence in College Teaching. 27(2), 131-153. 

Lundberg, K.O. (Ed.). (2011). Our Digital Future: Boardrooms and Newsrooms. Knight Case Studies Initiative. 

Popil, I. (2011). Promotion of critical thinking by using case studies as teaching method. Nurse Education Today, 31(2), 204–207. https://doi.org/10.1016/j.nedt.2010.06.002

Schiano, B. and Andersen, E. (2017). Teaching with Cases Online . Harvard Business Publishing. 

Thistlethwaite, JE; Davies, D.; Ekeocha, S.; Kidd, J.M.; MacDougall, C.; Matthews, P.; Purkis, J.; Clay D. (2012). The effectiveness of case-based learning in health professional education: A BEME systematic review . Medical Teacher. 2012; 34(6): e421-44. 

Yadav, A.; Lundeberg, M.; DeSchryver, M.; Dirkin, K.; Schiller, N.A.; Maier, K. and Herreid, C.F. (2007). Teaching Science with Case Studies: A National Survey of Faculty Perceptions of the Benefits and Challenges of Using Cases. Journal of College Science Teaching; Sept/Oct 2007; 37(1). 

Weimer, M. (2013). Learner-Centered Teaching: Five Key Changes to Practice. Second Edition. Jossey-Bass.

Additional resources 

Teaching with Cases , Harvard Kennedy School of Government. 

Features “what is a teaching case?” video that defines a teaching case, and provides documents to help students prepare for case learning, Common case teaching challenges and solutions, tips for teaching with cases. 

Promoting excellence and innovation in case method teaching: Teaching by the Case Method , Christensen Center for Teaching & Learning. Harvard Business School. 

National Center for Case Study Teaching in Science . University of Buffalo. 

A collection of peer-reviewed STEM cases to teach scientific concepts and content, promote process skills and critical thinking. The Center welcomes case submissions. Case classification scheme of case types and teaching methods:

• Different types of cases: analysis case, dilemma/decision case, directed case, interrupted case, clicker case, a flipped case, a laboratory case. 
• Different types of teaching methods: problem-based learning, discussion, debate, intimate debate, public hearing, trial, jigsaw, role-play. 

Columbia Resources

Resources available to support your use of case method: The University hosts a number of case collections including: the Case Consortium (a collection of free cases in the fields of journalism, public policy, public health, and other disciplines that include teaching and learning resources; SIPA’s Picker Case Collection (audiovisual case studies on public sector innovation, filmed around the world and involving SIPA student teams in producing the cases); and Columbia Business School CaseWorks , which develops teaching cases and materials for use in Columbia Business School classrooms.

Center for Teaching and Learning

The Center for Teaching and Learning (CTL) offers a variety of programs and services for instructors at Columbia. The CTL can provide customized support as you plan to use the case method approach through implementation. Schedule a one-on-one consultation. 

Office of the Provost

The Hybrid Learning Course Redesign grant program from the Office of the Provost provides support for faculty who are developing innovative and technology-enhanced pedagogy and learning strategies in the classroom. In addition to funding, faculty awardees receive support from CTL staff as they redesign, deliver, and evaluate their hybrid courses.

The Start Small! Mini-Grant provides support to faculty who are interested in experimenting with one new pedagogical strategy or tool. Faculty awardees receive funds and CTL support for a one-semester period.

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• The origins of this method can be traced to Harvard University where in 1870 the Law School began using cases to teach students how to think like lawyers using real court decisions. This was followed by the Business School in 1920 (Garvin, 2003). These professional schools recognized that lecture mode of instruction was insufficient to teach critical professional skills, and that active learning would better prepare learners for their professional lives. ↩
• Golich, V.L. (2000). The ABCs of Case Teaching. International Studies Perspectives. 1, 11-29. ↩
• Herreid, C.F. (2007). Start with a Story: The Case Study Method of Teaching College Science . National Science Teachers Association. Available as an ebook through Columbia Libraries. ↩
• Davis, B.G. (2009). Chapter 24: Case Studies. In Tools for Teaching. Second Edition. Jossey-Bass. ↩
• Andersen, E. and Schiano, B. (2014). Teaching with Cases: A Practical Guide . Harvard Business Press. ↩
• Lundberg, K.O. (Ed.). (2011). Our Digital Future: Boardrooms and Newsrooms. Knight Case Studies Initiative. ↩
• Heath, J. (2015). Teaching & Writing Cases: A Practical Guide. The Case Center, UK. ↩
• Bonney, K. M. (2015). Case Study Teaching Method Improves Student Performance and Perceptions of Learning Gains†. Journal of Microbiology & Biology Education , 16 (1), 21–28. https://doi.org/10.1128/jmbe.v16i1.846 ↩
• Krain, M. (2016). Putting the Learning in Case Learning? The Effects of Case-Based Approaches on Student Knowledge, Attitudes, and Engagement. Journal on Excellence in College Teaching. 27(2), 131-153. ↩
• Thistlethwaite, JE; Davies, D.; Ekeocha, S.; Kidd, J.M.; MacDougall, C.; Matthews, P.; Purkis, J.; Clay D. (2012). The effectiveness of case-based learning in health professional education: A BEME systematic review . Medical Teacher. 2012; 34(6): e421-44. ↩
• Yadav, A.; Lundeberg, M.; DeSchryver, M.; Dirkin, K.; Schiller, N.A.; Maier, K. and Herreid, C.F. (2007). Teaching Science with Case Studies: A National Survey of Faculty Perceptions of the Benefits and Challenges of Using Cases. Journal of College Science Teaching; Sept/Oct 2007; 37(1). ↩
• Popil, I. (2011). Promotion of critical thinking by using case studies as teaching method. Nurse Education Today, 31(2), 204–207. https://doi.org/10.1016/j.nedt.2010.06.002 ↩
• Weimer, M. (2013). Learner-Centered Teaching: Five Key Changes to Practice. Second Edition. Jossey-Bass. ↩
• Herreid, C.F. (2006). “Clicker” Cases: Introducing Case Study Teaching Into Large Classrooms. Journal of College Science Teaching. Oct 2006, 36(2). https://search.proquest.com/docview/200323718?pq-origsite=gscholar ↩

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Teaching History Through the Case Method

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T he case method is typically synonymous with business school curriculum. Through active case discussion, students put themselves in the proverbial shoes of a case protagonist, often a manager or leader of a company or organization facing a difficult business challenge. Students apply critical thinking skills to work through complicated problems and process contending points of view, then engage with their classmates in developing a solution together. This intellectual energy is the pedagogical “magic” instructors strive for.

Perhaps a lesser-known power of the case method, however, is in its applicability across a variety of topics and student levels. Take, for instance, history, government, civics, and democracy—topics that feel particularly pertinent given the roller-coaster US election and other polarizing political events around the world.

In an effort to bring these important topics, particularly American history, to life, historian David Moss, the Paul Whiton Cherington Professor of Business Administration at Harvard Business School (HBS), has taken the case method’s magic from the business school to the high school. In 2015, Moss launched a pilot program in 11 public, charter, and private high schools across the United States. He provided 23 history and civics teachers with historical cases that showcase the foundations of US democracy—as well as worksheets, assignment questions, and teaching plans. He then made the cases available for free to high school students to encourage case teaching among this group.

The goal of this program, called the Case Method Project , is to demonstrate that teaching with cases can strengthen high school and college education as well as ensure “a more exciting, relevant, and effective experience for students and teachers across a range of subjects,” according to its site.

“The results [of the Case Method Project] have been incredibly positive, especially in terms of strengthening students’ critical thinking, their retention and understanding of course material, and their civic interest and engagement.” David Moss

Since its initial launch, the program has grown considerably. Today Moss is working with over 350 teachers in more than 250 high schools across 45 states and the District of Columbia. “We’ve now reached well over 30,000 students as part of the initial pilot,” he says. “The project has grown considerably over the last several years, and the results have been incredibly positive, especially in terms of strengthening students’ critical thinking, their retention and understanding of course material, and their civic interest and engagement. Because of this success, we’re aiming to reach much larger numbers of teachers and students going forward through the new Case Method Institute for Education and Democracy, which started up this summer.”

The case method has proven remarkably effective in teaching high schoolers the critical thinking skills that the world’s future leaders so greatly need. Here, to help educators see the different ways and venues in which case teaching can be used, we showcase the collection of cases Moss authored and provided in support of this effort.

Democracy Cases to Use in Class

Here is a list of Moss’s cases , which you can use to engage students in conversations about US history and democracy. We hope you find these cases helpful.

James Madison, the ‘Federal Negative,’ and the Making of the U.S. Constitution (1787) and as a supplement: In Detail: Debt and Paper Money in Rhode Island (1786)

Battle Over a Bank: Defining the Limits of Federal Power Under a New Constitution (1791)

Democracy, Sovereignty, and the Struggle over Cherokee Removal (1836)

Banking and Politics in Antebellum New York (1838)

Property, Suffrage, and the "Right of Revolution" in Rhode Island, 1842

Debt and Democracy: The New York Constitutional Convention of 1846

The Struggle Over Public Education in Early America (1851)

A Nation Divided: The United States and the Challenge of Secession (1861)

Reconstruction A: The Crisis of 1877

Reconstruction B: Jury Rights in Virginia, 1877-1880

An Australian Ballot for California? (1891)

Labor, Capital, and Government: The Anthracite Coal Strike of 1902

The Jungle and the Debate over Federal Meat Inspection in 1906

The Battle Over the Initiative and Referendum in Massachusetts (1918)

Regulating Radio in the Age of Broadcasting (1927)

The Pecora Hearings (1932-34)

Martin Luther King and the Struggle for Black Voting Rights (1965)

Democracy and Women’s Rights in America: The Fight over the ERA (1982)

Manufacturing Constituencies: Race and Redistricting in North Carolina, 1993

Leadership and Independence at the Federal Reserve (2009)

Citizens United and Corporate Speech (2010)

Do you use the case method to spark discussion and debate on topics outside of business disciplines? Let us know .

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• Case Teaching Resources

Teaching With Cases

Included here are resources to learn more about case method and teaching with cases.

What Is A Teaching Case?

This video explores the definition of a teaching case and introduces the rationale for using case method.

Narrated by Carolyn Wood, former director of the HKS Case Program

Learning by the Case Method

Questions for class discussion, common case teaching challenges and possible solutions, teaching with cases tip sheet, teaching ethics by the case method.

The case method is an effective way to increase student engagement and challenge students to integrate and apply skills to real-world problems. In these videos,  Using the Case Method to Teach Public Policy , you'll find invaluable insights into the art of case teaching from one of HKS’s most respected professors, Jose A. Gomez-Ibanez.

Chapter 1: Preparing for Class (2:29)

Chapter 2: How to begin the class and structure the discussion blocks (1:37)

Chapter 3: How to launch the discussion (1:36)

Chapter 4: Tools to manage the class discussion (2:23)

Chapter 5: Encouraging participation and acknowledging students' comments (1:52)

Chapter 6: Transitioning from one block to the next / Importance of body (2:05)

Chapter 7: Using the board plan to feed the discussion (3:33)

Chapter 8: Exploring the richness of the case (1:42)

Chapter 9: The wrap-up. Why teach cases? (2:49)

Center for Teaching

Case studies.

Print Version

Case studies are stories that are used as a teaching tool to show the application of a theory or concept to real situations. Dependent on the goal they are meant to fulfill, cases can be fact-driven and deductive where there is a correct answer, or they can be context driven where multiple solutions are possible. Various disciplines have employed case studies, including humanities, social sciences, sciences, engineering, law, business, and medicine. Good cases generally have the following features: they tell a good story, are recent, include dialogue, create empathy with the main characters, are relevant to the reader, serve a teaching function, require a dilemma to be solved, and have generality.

Instructors can create their own cases or can find cases that already exist. The following are some things to keep in mind when creating a case:

• What do you want students to learn from the discussion of the case?
• What do they already know that applies to the case?
• What are the issues that may be raised in discussion?
• How will the case and discussion be introduced?
• What preparation is expected of students? (Do they need to read the case ahead of time? Do research? Write anything?)
• What directions do you need to provide students regarding what they are supposed to do and accomplish?
• Do you need to divide students into groups or will they discuss as the whole class?
• Are you going to use role-playing or facilitators or record keepers? If so, how?
• What are the opening questions?
• How much time is needed for students to discuss the case?
• What concepts are to be applied/extracted during the discussion?
• How will you evaluate students?

To find other cases that already exist, try the following websites:

• The National Center for Case Study Teaching in Science , University of Buffalo. SUNY-Buffalo maintains this set of links to other case studies on the web in disciplines ranging from engineering and ethics to sociology and business
• A Journal of Teaching Cases in Public Administration and Public Policy , University of Washington

For more information:

• World Association for Case Method Research and Application

Book Review :  Teaching and the Case Method , 3rd ed., vols. 1 and 2, by Louis Barnes, C. Roland (Chris) Christensen, and Abby Hansen. Harvard Business School Press, 1994; 333 pp. (vol 1), 412 pp. (vol 2).

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• v.16(1); 2015 May

Case Study Teaching Method Improves Student Performance and Perceptions of Learning Gains †

Associated data.

• Appendix 1: Example assessment questions used to assess the effectiveness of case studies at promoting learning
• Appendix 2: Student learning gains were assessed using a modified version of the SALG course evaluation tool

Following years of widespread use in business and medical education, the case study teaching method is becoming an increasingly common teaching strategy in science education. However, the current body of research provides limited evidence that the use of published case studies effectively promotes the fulfillment of specific learning objectives integral to many biology courses. This study tested the hypothesis that case studies are more effective than classroom discussions and textbook reading at promoting learning of key biological concepts, development of written and oral communication skills, and comprehension of the relevance of biological concepts to everyday life. This study also tested the hypothesis that case studies produced by the instructor of a course are more effective at promoting learning than those produced by unaffiliated instructors. Additionally, performance on quantitative learning assessments and student perceptions of learning gains were analyzed to determine whether reported perceptions of learning gains accurately reflect academic performance. The results reported here suggest that case studies, regardless of the source, are significantly more effective than other methods of content delivery at increasing performance on examination questions related to chemical bonds, osmosis and diffusion, mitosis and meiosis, and DNA structure and replication. This finding was positively correlated to increased student perceptions of learning gains associated with oral and written communication skills and the ability to recognize connections between biological concepts and other aspects of life. Based on these findings, case studies should be considered as a preferred method for teaching about a variety of concepts in science courses.

INTRODUCTION

The case study teaching method is a highly adaptable style of teaching that involves problem-based learning and promotes the development of analytical skills ( 8 ). By presenting content in the format of a narrative accompanied by questions and activities that promote group discussion and solving of complex problems, case studies facilitate development of the higher levels of Bloom’s taxonomy of cognitive learning; moving beyond recall of knowledge to analysis, evaluation, and application ( 1 , 9 ). Similarly, case studies facilitate interdisciplinary learning and can be used to highlight connections between specific academic topics and real-world societal issues and applications ( 3 , 9 ). This has been reported to increase student motivation to participate in class activities, which promotes learning and increases performance on assessments ( 7 , 16 , 19 , 23 ). For these reasons, case-based teaching has been widely used in business and medical education for many years ( 4 , 11 , 12 , 14 ). Although case studies were considered a novel method of science education just 20 years ago, the case study teaching method has gained popularity in recent years among an array of scientific disciplines such as biology, chemistry, nursing, and psychology ( 5 – 7 , 9 , 11 , 13 , 15 – 17 , 21 , 22 , 24 ).

Although there is now a substantive and growing body of literature describing how to develop and use case studies in science teaching, current research on the effectiveness of case study teaching at meeting specific learning objectives is of limited scope and depth. Studies have shown that working in groups during completion of case studies significantly improves student perceptions of learning and may increase performance on assessment questions, and that the use of clickers can increase student engagement in case study activities, particularly among non-science majors, women, and freshmen ( 7 , 21 , 22 ). Case study teaching has been shown to improve exam performance in an anatomy and physiology course, increasing the mean score across all exams given in a two-semester sequence from 66% to 73% ( 5 ). Use of case studies was also shown to improve students’ ability to synthesize complex analytical questions about the real-world issues associated with a scientific topic ( 6 ). In a high school chemistry course, it was demonstrated that the case study teaching method produces significant increases in self-reported control of learning, task value, and self-efficacy for learning and performance ( 24 ). This effect on student motivation is important because enhanced motivation for learning activities has been shown to promote student engagement and academic performance ( 19 , 24 ). Additionally, faculty from a number of institutions have reported that using case studies promotes critical thinking, learning, and participation among students, especially in terms of the ability to view an issue from multiple perspectives and to grasp the practical application of core course concepts ( 23 ).

Despite what is known about the effectiveness of case studies in science education, questions remain about the functionality of the case study teaching method at promoting specific learning objectives that are important to many undergraduate biology courses. A recent survey of teachers who use case studies found that the topics most often covered in general biology courses included genetics and heredity, cell structure, cells and energy, chemistry of life, and cell cycle and cancer, suggesting that these topics should be of particular interest in studies that examine the effectiveness of the case study teaching method ( 8 ). However, the existing body of literature lacks direct evidence that the case study method is an effective tool for teaching about this collection of important topics in biology courses. Further, the extent to which case study teaching promotes development of science communication skills and the ability to understand the connections between biological concepts and everyday life has not been examined, yet these are core learning objectives shared by a variety of science courses. Although many instructors have produced case studies for use in their own classrooms, the production of novel case studies is time-consuming and requires skills that not all instructors have perfected. It is therefore important to determine whether case studies published by instructors who are unaffiliated with a particular course can be used effectively and obviate the need for each instructor to develop new case studies for their own courses. The results reported herein indicate that teaching with case studies results in significantly higher performance on examination questions about chemical bonds, osmosis and diffusion, mitosis and meiosis, and DNA structure and replication than that achieved by class discussions and textbook reading for topics of similar complexity. Case studies also increased overall student perceptions of learning gains and perceptions of learning gains specifically related to written and oral communication skills and the ability to grasp connections between scientific topics and their real-world applications. The effectiveness of the case study teaching method at increasing academic performance was not correlated to whether the case study used was authored by the instructor of the course or by an unaffiliated instructor. These findings support increased use of published case studies in the teaching of a variety of biological concepts and learning objectives.

Student population

This study was conducted at Kingsborough Community College, which is part of the City University of New York system, located in Brooklyn, New York. Kingsborough Community College has a diverse population of approximately 19,000 undergraduate students. The student population included in this study was enrolled in the first semester of a two-semester sequence of general (introductory) biology for biology majors during the spring, winter, or summer semester of 2014. A total of 63 students completed the course during this time period; 56 students consented to the inclusion of their data in the study. Of the students included in the study, 23 (41%) were male and 33 (59%) were female; 40 (71%) were registered as college freshmen and 16 (29%) were registered as college sophomores. To normalize participant groups, the same student population pooled from three classes taught by the same instructor was used to assess both experimental and control teaching methods.

Course material

The four biological concepts assessed during this study (chemical bonds, osmosis and diffusion, mitosis and meiosis, and DNA structure and replication) were selected as topics for studying the effectiveness of case study teaching because they were the key concepts addressed by this particular course that were most likely to be taught in a number of other courses, including biology courses for both majors and nonmajors at outside institutions. At the start of this study, relevant existing case studies were freely available from the National Center for Case Study Teaching in Science (NCCSTS) to address mitosis and meiosis and DNA structure and replication, but published case studies that appropriately addressed chemical bonds and osmosis and diffusion were not available. Therefore, original case studies that addressed the latter two topics were produced as part of this study, and case studies produced by unaffiliated instructors and published by the NCCSTS were used to address the former two topics. By the conclusion of this study, all four case studies had been peer-reviewed and accepted for publication by the NCCSTS ( http://sciencecases.lib.buffalo.edu/cs/ ). Four of the remaining core topics covered in this course (macromolecules, photosynthesis, genetic inheritance, and translation) were selected as control lessons to provide control assessment data.

To minimize extraneous variation, control topics and assessments were carefully matched in complexity, format, and number with case studies, and an equal amount of class time was allocated for each case study and the corresponding control lesson. Instruction related to control lessons was delivered using minimal slide-based lectures, with emphasis on textbook reading assignments accompanied by worksheets completed by students in and out of the classroom, and small and large group discussion of key points. Completion of activities and discussion related to all case studies and control topics that were analyzed was conducted in the classroom, with the exception of the take-home portion of the osmosis and diffusion case study.

Data collection and analysis

This study was performed in accordance with a protocol approved by the Kingsborough Community College Human Research Protection Program and the Institutional Review Board (IRB) of the City University of New York (CUNY IRB reference 539938-1; KCC IRB application #: KCC 13-12-126-0138). Assessment scores were collected from regularly scheduled course examinations. For each case study, control questions were included on the same examination that were similar in number, format, point value, and difficulty level, but related to a different topic covered in the course that was of similar complexity. Complexity and difficulty of both case study and control questions were evaluated using experiential data from previous iterations of the course; the Bloom’s taxonomy designation and amount of material covered by each question, as well as the average score on similar questions achieved by students in previous iterations of the course was considered in determining appropriate controls. All assessment questions were scored using a standardized, pre-determined rubric. Student perceptions of learning gains were assessed using a modified version of the Student Assessment of Learning Gains (SALG) course evaluation tool ( http://www.salgsite.org ), distributed in hardcopy and completed anonymously during the last week of the course. Students were presented with a consent form to opt-in to having their data included in the data analysis. After the course had concluded and final course grades had been posted, data from consenting students were pooled in a database and identifying information was removed prior to analysis. Statistical analysis of data was conducted using the Kruskal-Wallis one-way analysis of variance and calculation of the R 2 coefficient of determination.

Teaching with case studies improves performance on learning assessments, independent of case study origin

To evaluate the effectiveness of the case study teaching method at promoting learning, student performance on examination questions related to material covered by case studies was compared with performance on questions that covered material addressed through classroom discussions and textbook reading. The latter questions served as control items; assessment items for each case study were compared with control items that were of similar format, difficulty, and point value ( Appendix 1 ). Each of the four case studies resulted in an increase in examination performance compared with control questions that was statistically significant, with an average difference of 18% ( Fig. 1 ). The mean score on case study-related questions was 73% for the chemical bonds case study, 79% for osmosis and diffusion, 76% for mitosis and meiosis, and 70% for DNA structure and replication ( Fig. 1 ). The mean score for non-case study-related control questions was 60%, 54%, 60%, and 52%, respectively ( Fig. 1 ). In terms of examination performance, no significant difference between case studies produced by the instructor of the course (chemical bonds and osmosis and diffusion) and those produced by unaffiliated instructors (mitosis and meiosis and DNA structure and replication) was indicated by the Kruskal-Wallis one-way analysis of variance. However, the 25% difference between the mean score on questions related to the osmosis and diffusion case study and the mean score on the paired control questions was notably higher than the 13–18% differences observed for the other case studies ( Fig. 1 ).

Case study teaching method increases student performance on examination questions. Mean score on a set of examination questions related to lessons covered by case studies (black bars) and paired control questions of similar format and difficulty about an unrelated topic (white bars). Chemical bonds, n = 54; Osmosis and diffusion, n = 54; Mitosis and meiosis, n = 51; DNA structure and replication, n = 50. Error bars represent the standard error of the mean (SEM). Asterisk indicates p < 0.05.

Case study teaching increases student perception of learning gains related to core course objectives

Student learning gains were assessed using a modified version of the SALG course evaluation tool ( Appendix 2 ). To determine whether completing case studies was more effective at increasing student perceptions of learning gains than completing textbook readings or participating in class discussions, perceptions of student learning gains for each were compared. In response to the question “Overall, how much did each of the following aspects of the class help your learning?” 82% of students responded that case studies helped a “good” or “great” amount, compared with 70% for participating in class discussions and 58% for completing textbook reading; only 4% of students responded that case studies helped a “small amount” or “provided no help,” compared with 2% for class discussions and 22% for textbook reading ( Fig. 2A ). The differences in reported learning gains derived from the use of case studies compared with class discussion and textbook readings were statistically significant, while the difference in learning gains associated with class discussion compared with textbook reading was not statistically significant by a narrow margin ( p = 0.051).

The case study teaching method increases student perceptions of learning gains. Student perceptions of learning gains are indicated by plotting responses to the question “How much did each of the following activities: (A) Help your learning overall? (B) Improve your ability to communicate your knowledge of scientific concepts in writing? (C) Improve your ability to communicate your knowledge of scientific concepts orally? (D) Help you understand the connections between scientific concepts and other aspects of your everyday life?” Reponses are represented as follows: Helped a great amount (black bars); Helped a good amount (dark gray bars); Helped a moderate amount (medium gray bars); Helped a small amount (light gray bars); Provided no help (white bars). Asterisk indicates p < 0.05.

To elucidate the effectiveness of case studies at promoting learning gains related to specific course learning objectives compared with class discussions and textbook reading, students were asked how much each of these methods of content delivery specifically helped improve skills that were integral to fulfilling three main course objectives. When students were asked how much each of the methods helped “improve your ability to communicate knowledge of scientific concepts in writing,” 81% of students responded that case studies help a “good” or “great” amount, compared with 63% for class discussions and 59% for textbook reading; only 6% of students responded that case studies helped a “small amount” or “provided no help,” compared with 8% for class discussions and 21% for textbook reading ( Fig. 2B ). When the same question was posed about the ability to communicate orally, 81% of students responded that case studies help a “good” or “great” amount, compared with 68% for class discussions and 50% for textbook reading, while the respective response rates for helped a “small amount” or “provided no help,” were 4%, 6%, and 25% ( Fig. 2C ). The differences in learning gains associated with both written and oral communication were statistically significant when completion of case studies was compared with either participation in class discussion or completion of textbook readings. Compared with textbook reading, class discussions led to a statistically significant increase in oral but not written communication skills.

Students were then asked how much each of the methods helped them “understand the connections between scientific concepts and other aspects of your everyday life.” A total of 79% of respondents declared that case studies help a “good” or “great” amount, compared with 70% for class discussions and 57% for textbook reading ( Fig. 2D ). Only 4% stated that case studies and class discussions helped a “small amount” or “provided no help,” compared with 21% for textbook reading ( Fig. 2D ). Similar to overall learning gains, the use of case studies significantly increased the ability to understand the relevance of science to everyday life compared with class discussion and textbook readings, while the difference in learning gains associated with participation in class discussion compared with textbook reading was not statistically significant ( p = 0.054).

Student perceptions of learning gains resulting from case study teaching are positively correlated to increased performance on examinations, but independent of case study author

To test the hypothesis that case studies produced specifically for this course by the instructor were more effective at promoting learning gains than topically relevant case studies published by authors not associated with this course, perceptions of learning gains were compared for each of the case studies. For both of the case studies produced by the instructor of the course, 87% of students indicated that the case study provided a “good” or “great” amount of help to their learning, and 2% indicated that the case studies provided “little” or “no” help ( Table 1 ). In comparison, an average of 85% of students indicated that the case studies produced by an unaffiliated instructor provided a “good” or “great” amount of help to their learning, and 4% indicated that the case studies provided “little” or “no” help ( Table 1 ). The instructor-produced case studies yielded both the highest and lowest percentage of students reporting the highest level of learning gains (a “great” amount), while case studies produced by unaffiliated instructors yielded intermediate values. Therefore, it can be concluded that the effectiveness of case studies at promoting learning gains is not significantly affected by whether or not the course instructor authored the case study.

Case studies positively affect student perceptions of learning gains about various biological topics.

Finally, to determine whether performance on examination questions accurately predicts student perceptions of learning gains, mean scores on examination questions related to case studies were compared with reported perceptions of learning gains for those case studies ( Fig. 3 ). The coefficient of determination (R 2 value) was 0.81, indicating a strong, but not definitive, positive correlation between perceptions of learning gains and performance on examinations, suggesting that student perception of learning gains is a valid tool for assessing the effectiveness of case studies ( Fig. 3 ). This correlation was independent of case study author.

Perception of learning gains but not author of case study is positively correlated to score on related examination questions. Percentage of students reporting that each specific case study provided “a great amount of help” to their learning was plotted against the point difference between mean score on examination questions related to that case study and mean score on paired control questions. Positive point differences indicate how much higher the mean scores on case study-related questions were than the mean scores on paired control questions. Black squares represent case studies produced by the instructor of the course; white squares represent case studies produced by unaffiliated instructors. R 2 value indicates the coefficient of determination.

The purpose of this study was to test the hypothesis that teaching with case studies produced by the instructor of a course is more effective at promoting learning gains than using case studies produced by unaffiliated instructors. This study also tested the hypothesis that the case study teaching method is more effective than class discussions and textbook reading at promoting learning gains associated with four of the most commonly taught topics in undergraduate general biology courses: chemical bonds, osmosis and diffusion, mitosis and meiosis, and DNA structure and replication. In addition to assessing content-based learning gains, development of written and oral communication skills and the ability to connect scientific topics with real-world applications was also assessed, because these skills were overarching learning objectives of this course, and classroom activities related to both case studies and control lessons were designed to provide opportunities for students to develop these skills. Finally, data were analyzed to determine whether performance on examination questions is positively correlated to student perceptions of learning gains resulting from case study teaching.

Compared with equivalent control questions about topics of similar complexity taught using class discussions and textbook readings, all four case studies produced statistically significant increases in the mean score on examination questions ( Fig. 1 ). This indicates that case studies are more effective than more commonly used, traditional methods of content delivery at promoting learning of a variety of core concepts covered in general biology courses. The average increase in score on each test item was equivalent to nearly two letter grades, which is substantial enough to elevate the average student performance on test items from the unsatisfactory/failing range to the satisfactory/passing range. The finding that there was no statistical difference between case studies in terms of performance on examination questions suggests that case studies are equally effective at promoting learning of disparate topics in biology. The observations that students did not perform significantly less well on the first case study presented (chemical bonds) compared with the other case studies and that performance on examination questions did not progressively increase with each successive case study suggests that the effectiveness of case studies is not directly related to the amount of experience students have using case studies. Furthermore, anecdotal evidence from previous semesters of this course suggests that, of the four topics addressed by cases in this study, DNA structure and function and osmosis and diffusion are the first and second most difficult for students to grasp. The lack of a statistical difference between case studies therefore suggests that the effectiveness of a case study at promoting learning gains is not directly proportional to the difficulty of the concept covered. However, the finding that use of the osmosis and diffusion case study resulted in the greatest increase in examination performance compared with control questions and also produced the highest student perceptions of learning gains is noteworthy and could be attributed to the fact that it was the only case study evaluated that included a hands-on experiment. Because the inclusion of a hands-on kinetic activity may synergistically enhance student engagement and learning and result in an even greater increase in learning gains than case studies that lack this type of activity, it is recommended that case studies that incorporate this type of activity be preferentially utilized.

Student perceptions of learning gains are strongly motivating factors for engagement in the classroom and academic performance, so it is important to assess the effect of any teaching method in this context ( 19 , 24 ). A modified version of the SALG course evaluation tool was used to assess student perceptions of learning gains because it has been previously validated as an efficacious tool ( Appendix 2 ) ( 20 ). Using the SALG tool, case study teaching was demonstrated to significantly increase student perceptions of overall learning gains compared with class discussions and textbook reading ( Fig. 2A ). Case studies were shown to be particularly useful for promoting perceived development of written and oral communication skills and for demonstrating connections between scientific topics and real-world issues and applications ( Figs. 2B–2D ). Further, student perceptions of “great” learning gains positively correlated with increased performance on examination questions, indicating that assessment of learning gains using the SALG tool is both valid and useful in this course setting ( Fig. 3 ). These findings also suggest that case study teaching could be used to increase student motivation and engagement in classroom activities and thus promote learning and performance on assessments. The finding that textbook reading yielded the lowest student perceptions of learning gains was not unexpected, since reading facilitates passive learning while the class discussions and case studies were both designed to promote active learning.

Importantly, there was no statistical difference in student performance on examinations attributed to the two case studies produced by the instructor of the course compared with the two case studies produced by unaffiliated instructors. The average difference between the two instructor-produced case studies and the two case studies published by unaffiliated instructors was only 3% in terms of both the average score on examination questions (76% compared with 73%) and the average increase in score compared with paired control items (14% compared with 17%) ( Fig. 1 ). Even when considering the inherent qualitative differences of course grades, these differences are negligible. Similarly, the effectiveness of case studies at promoting learning gains was not significantly affected by the origin of the case study, as evidenced by similar percentages of students reporting “good” and “great” learning gains regardless of whether the case study was produced by the course instructor or an unaffiliated instructor ( Table 1 ).

The observation that case studies published by unaffiliated instructors are just as effective as those produced by the instructor of a course suggests that instructors can reasonably rely on the use of pre-published case studies relevant to their class rather than investing the considerable time and effort required to produce a novel case study. Case studies covering a wide range of topics in the sciences are available from a number of sources, and many of them are free access. The National Center for Case Study Teaching in Science (NCCSTS) database ( http://sciencecases.lib.buffalo.edu/cs/ ) contains over 500 case studies that are freely available to instructors, and are accompanied by teaching notes that provide logistical advice and additional resources for implementing the case study, as well as a set of assessment questions with a password-protected answer key. Case study repositories are also maintained by BioQUEST Curriculum Consortium ( http://www.bioquest.org/icbl/cases.php ) and the Science Case Network ( http://sciencecasenet.org ); both are available for use by instructors from outside institutions.

It should be noted that all case studies used in this study were rigorously peer-reviewed and accepted for publication by the NCCSTS prior to the completion of this study ( 2 , 10 , 18 , 25 ); the conclusions of this study may not apply to case studies that were not developed in accordance with similar standards. Because case study teaching involves skills such as creative writing and management of dynamic group discussion in a way that is not commonly integrated into many other teaching methods, it is recommended that novice case study teachers seek training or guidance before writing their first case study or implementing the method. The lack of a difference observed in the use of case studies from different sources should be interpreted with some degree of caution since only two sources were represented in this study, and each by only two cases. Furthermore, in an educational setting, quantitative differences in test scores might produce meaningful qualitative differences in course grades even in the absence of a p value that is statistically significant. For example, there is a meaningful qualitative difference between test scores that result in an average grade of C− and test scores that result in an average grade of C+, even if there is no statistically significant difference between the two sets of scores.

In the future, it could be informative to confirm these findings using a larger cohort, by repeating the study at different institutions with different instructors, by evaluating different case studies, and by directly comparing the effectiveness of the case studying teaching method with additional forms of instruction, such as traditional chalkboard and slide-based lecturing, and laboratory-based activities. It may also be informative to examine whether demographic factors such as student age and gender modulate the effectiveness of the case study teaching method, and whether case studies work equally well for non-science majors taking a science course compared with those majoring in the subject. Since the topical material used in this study is often included in other classes in both high school and undergraduate education, such as cell biology, genetics, and chemistry, the conclusions of this study are directly applicable to a broad range of courses. Presently, it is recommended that the use of case studies in teaching undergraduate general biology and other science courses be expanded, especially for the teaching of capacious issues with real-world applications and in classes where development of written and oral communication skills are key objectives. The use of case studies that involve hands-on activities should be emphasized to maximize the benefit of this teaching method. Importantly, instructors can be confident in the use of pre-published case studies to promote learning, as there is no indication that the effectiveness of the case study teaching method is reliant on the production of novel, customized case studies for each course.

SUPPLEMENTAL MATERIALS

Acknowledgments.

This article benefitted from a President’s Faculty Innovation Grant, Kingsborough Community College. The author declares that there are no conflicts of interest.

† Supplemental materials available at http://jmbe.asm.org

• Our Mission

Making Learning Relevant With Case Studies

The open-ended problems presented in case studies give students work that feels connected to their lives.

To prepare students for jobs that haven’t been created yet, we need to teach them how to be great problem solvers so that they’ll be ready for anything. One way to do this is by teaching content and skills using real-world case studies, a learning model that’s focused on reflection during the problem-solving process. It’s similar to project-based learning, but PBL is more focused on students creating a product.

Case studies have been used for years by businesses, law and medical schools, physicians on rounds, and artists critiquing work. Like other forms of problem-based learning, case studies can be accessible for every age group, both in one subject and in interdisciplinary work.

You can get started with case studies by tackling relatable questions like these with your students:

• How can we limit food waste in the cafeteria?
• How can we get our school to recycle and compost waste? (Or, if you want to be more complex, how can our school reduce its carbon footprint?)
• How can we improve school attendance?
• How can we reduce the number of people who get sick at school during cold and flu season?

Addressing questions like these leads students to identify topics they need to learn more about. In researching the first question, for example, students may see that they need to research food chains and nutrition. Students often ask, reasonably, why they need to learn something, or when they’ll use their knowledge in the future. Learning is most successful for students when the content and skills they’re studying are relevant, and case studies offer one way to create that sense of relevance.

Teaching With Case Studies

Ultimately, a case study is simply an interesting problem with many correct answers. What does case study work look like in classrooms? Teachers generally start by having students read the case or watch a video that summarizes the case. Students then work in small groups or individually to solve the case study. Teachers set milestones defining what students should accomplish to help them manage their time.

During the case study learning process, student assessment of learning should be focused on reflection. Arthur L. Costa and Bena Kallick’s Learning and Leading With Habits of Mind gives several examples of what this reflection can look like in a classroom: 

Journaling: At the end of each work period, have students write an entry summarizing what they worked on, what worked well, what didn’t, and why. Sentence starters and clear rubrics or guidelines will help students be successful. At the end of a case study project, as Costa and Kallick write, it’s helpful to have students “select significant learnings, envision how they could apply these learnings to future situations, and commit to an action plan to consciously modify their behaviors.”

Interviews: While working on a case study, students can interview each other about their progress and learning. Teachers can interview students individually or in small groups to assess their learning process and their progress.

Student discussion: Discussions can be unstructured—students can talk about what they worked on that day in a think-pair-share or as a full class—or structured, using Socratic seminars or fishbowl discussions. If your class is tackling a case study in small groups, create a second set of small groups with a representative from each of the case study groups so that the groups can share their learning.

4 Tips for Setting Up a Case Study

1. Identify a problem to investigate: This should be something accessible and relevant to students’ lives. The problem should also be challenging and complex enough to yield multiple solutions with many layers.

2. Give context: Think of this step as a movie preview or book summary. Hook the learners to help them understand just enough about the problem to want to learn more.

3. Have a clear rubric: Giving structure to your definition of quality group work and products will lead to stronger end products. You may be able to have your learners help build these definitions.

4. Provide structures for presenting solutions: The amount of scaffolding you build in depends on your students’ skill level and development. A case study product can be something like several pieces of evidence of students collaborating to solve the case study, and ultimately presenting their solution with a detailed slide deck or an essay—you can scaffold this by providing specified headings for the sections of the essay.

Problem-Based Teaching Resources

There are many high-quality, peer-reviewed resources that are open source and easily accessible online.

• The National Center for Case Study Teaching in Science at the University at Buffalo built an online collection of more than 800 cases that cover topics ranging from biochemistry to economics. There are resources for middle and high school students.
• Models of Excellence , a project maintained by EL Education and the Harvard Graduate School of Education, has examples of great problem- and project-based tasks—and corresponding exemplary student work—for grades pre-K to 12.
• The Interdisciplinary Journal of Problem-Based Learning at Purdue University is an open-source journal that publishes examples of problem-based learning in K–12 and post-secondary classrooms.
• The Tech Edvocate has a list of websites and tools related to problem-based learning.

In their book Problems as Possibilities , Linda Torp and Sara Sage write that at the elementary school level, students particularly appreciate how they feel that they are taken seriously when solving case studies. At the middle school level, “researchers stress the importance of relating middle school curriculum to issues of student concern and interest.” And high schoolers, they write, find the case study method “beneficial in preparing them for their future.”

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Using Case Studies to Teach

Why Use Cases?

Many students are more inductive than deductive reasoners, which means that they learn better from examples than from logical development starting with basic principles. The use of case studies can therefore be a very effective classroom technique.

Case studies are have long been used in business schools, law schools, medical schools and the social sciences, but they can be used in any discipline when instructors want students to explore how what they have learned applies to real world situations. Cases come in many formats, from a simple “What would you do in this situation?” question to a detailed description of a situation with accompanying data to analyze. Whether to use a simple scenario-type case or a complex detailed one depends on your course objectives.

Most case assignments require students to answer an open-ended question or develop a solution to an open-ended problem with multiple potential solutions. Requirements can range from a one-paragraph answer to a fully developed group action plan, proposal or decision.

Common Case Elements

Most “full-blown” cases have these common elements:

• A decision-maker who is grappling with some question or problem that needs to be solved.
• A description of the problem’s context (a law, an industry, a family).
• Supporting data, which can range from data tables to links to URLs, quoted statements or testimony, supporting documents, images, video, or audio.

Case assignments can be done individually or in teams so that the students can brainstorm solutions and share the work load.

The following discussion of this topic incorporates material presented by Robb Dixon of the School of Management and Rob Schadt of the School of Public Health at CEIT workshops. Professor Dixon also provided some written comments that the discussion incorporates.

Advantages to the use of case studies in class

A major advantage of teaching with case studies is that the students are actively engaged in figuring out the principles by abstracting from the examples. This develops their skills in:

• Problem solving
• Analytical tools, quantitative and/or qualitative, depending on the case
• Decision making in complex situations
• Coping with ambiguities

Guidelines for using case studies in class

In the most straightforward application, the presentation of the case study establishes a framework for analysis. It is helpful if the statement of the case provides enough information for the students to figure out solutions and then to identify how to apply those solutions in other similar situations. Instructors may choose to use several cases so that students can identify both the similarities and differences among the cases.

Depending on the course objectives, the instructor may encourage students to follow a systematic approach to their analysis.  For example:

• What is the issue?
• What is the goal of the analysis?
• What is the context of the problem?
• What key facts should be considered?
• What alternatives are available to the decision-maker?
• What would you recommend — and why?

An innovative approach to case analysis might be to have students  role-play the part of the people involved in the case. This not only actively engages students, but forces them to really understand the perspectives of the case characters. Videos or even field trips showing the venue in which the case is situated can help students to visualize the situation that they need to analyze.

Accompanying Readings

Case studies can be especially effective if they are paired with a reading assignment that introduces or explains a concept or analytical method that applies to the case. The amount of emphasis placed on the use of the reading during the case discussion depends on the complexity of the concept or method. If it is straightforward, the focus of the discussion can be placed on the use of the analytical results. If the method is more complex, the instructor may need to walk students through its application and the interpretation of the results.

Leading the Case Discussion and Evaluating Performance

Decision cases are more interesting than descriptive ones. In order to start the discussion in class, the instructor can start with an easy, noncontroversial question that all the students should be able to answer readily. However, some of the best case discussions start by forcing the students to take a stand. Some instructors will ask a student to do a formal “open” of the case, outlining his or her entire analysis.  Others may choose to guide discussion with questions that move students from problem identification to solutions.  A skilled instructor steers questions and discussion to keep the class on track and moving at a reasonable pace.

In order to motivate the students to complete the assignment before class as well as to stimulate attentiveness during the class, the instructor should grade the participation—quantity and especially quality—during the discussion of the case. This might be a simple check, check-plus, check-minus or zero. The instructor should involve as many students as possible. In order to engage all the students, the instructor can divide them into groups, give each group several minutes to discuss how to answer a question related to the case, and then ask a randomly selected person in each group to present the group’s answer and reasoning. Random selection can be accomplished through rolling of dice, shuffled index cards, each with one student’s name, a spinning wheel, etc.

Tips on the Penn State U. website: http://tlt.its.psu.edu/suggestions/cases/

If you are interested in using this technique in a science course, there is a good website on use of case studies in the sciences at the University of Buffalo.

Dunne, D. and Brooks, K. (2004) Teaching with Cases (Halifax, NS: Society for Teaching and Learning in Higher Education), ISBN 0-7703-8924-4 (Can be ordered at http://www.bookstore.uwo.ca/ at a cost of $15.00)

Want to create or adapt books like this? Learn more about how Pressbooks supports open publishing practices.

Teaching with Case Studies

The Case Study method is based on focused stories, rooted in reality, and provides contextual information such as background, characters, setting, and enough specific details to provide some guidance. Cases can be used to illustrate, remediate, and practice critical thinking, teamwork, research, and communication skills. Classroom applications of the case study method include:

• Socratic cross examination
• Directed discussion or research teams
• Public hearings or trials
• Dialogue paper (e.g., 10 exchanges between two characters from opposing sides of an issue that finish with a personal opinion or reflection)

At the Fifth Annual Conference on Case Study Teaching in Science hosted by the University of Buffalo-SUNY, two broad categories of case studies were identified (recognizing potential overlap):

• Open or Closed: Open cases are left to one’s interpretation and may have multiple correct or valid answers depending on the rationale and facts presented in the case analysis. Closed cases have specific, correct answers or processes that must be followed in order to arrive at the correct analysis.
• Analysis or Dilemma: Analysis Cases (Issues Cases) are a general account of “what happened.” Dilemma Cases (Decision Cases) require students to make a decision or take action given certain information.

Case Study Analysis Process

Based on a variety of different case study analysis models, we have identified four basic stages students follow in analyzing a case study. This process may vary depending on discipline and if case studies are being used as part of a problem-based learning exercise.

• Observe the facts and issues that are present without interpretation (“what do we know”).
• Develop hypotheses/questions, formulate predictions, and provide explanations or justifications based on the known information (“what do we need to know”).
• Collect and explore relevant data to answer open questions, reinforce/refute hypotheses, and formulate new hypotheses and questions.
• Communicate findings including citations and documentation.

How to Write a Case Study

Effective case studies tell a story, have compelling and identifiable characters, contain depth and complexity, and have dilemmas that are not easily resolved. The following steps provide a general guide for use in identifying the various issues and criteria comprising a good case study.

• Identify a course and list the teachable principles, topics, and issues (often a difficult or complex concept students just don’t “get”).
• List any relevant controversies and subtopics that further describe your topics.
• Identify stakeholders or those affected by the issue (from that list, consider choosing one central character on which to base the case study).
• Identify teaching methods that might be used (team project, dialogue paper, debate, etc.) as well as the most appropriate assessment method (peer or team assessments, participation grade, etc.).
• Decide what materials and resources will be provided to students.
• Identify and describe the deliverables students will produce (paper, presentation, etc.).
• Select the category of case study (open or closed/analysis or dilemma) that best fits your topic, scenario, learning outcomes, teaching method, and assessment strategy. Write your case study and include teaching notes outlining the critical elements identified above.
• Teach the case and subsequently make any necessary revisions.

Problem-Based Learning (PBL)

PBL uses case studies in a slightly different way by providing a more specific structure for learning. The medical field uses this approach extensively. According to Barrows & Tamblyn (1980), the case problem is presented first in the learning sequence, before any background preparation has occurred. The case study analysis process outlined above is used with PBL; the main difference being that cases are presented in pieces, with increasing amounts of specific detail provided in each layer of the case (e.g., part one of the case may simply be a patient admission form, part two may provide a summary of patient examination notes, part three may contain specific medical test results, and so on).

The problem-based learning approach encourages student-directed learning and allows the instructor to serve as a facilitator. Students frame and identify problems and continually identify and test hypotheses. During group tutorials, case-related questions arise that students are unable to answer. These questions form the basis for learning issues that students will study independently between sessions. This method requires an alert and actively involved instructor to facilitate.

Guide to Teaching with Technology Copyright © 2019 by Centre for Pedagogical Innovation is licensed under a Creative Commons Attribution 4.0 International License , except where otherwise noted.

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Case Study Teaching and Learning

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• Shalini Ramdeo 2  

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This chapter is the first of three chapters that explore case studies in OD. This chapter presents the fundamentals of case method teaching and learning. It is important to understand such fundamentals before presenting OD cases to readers. In OD and other related fields, the case approach is widely used as a pedagogy for learning by making decisions on information about an issue or problem. Case method teaching and learning strategies attempt to bridge the gap between theoretical and practical applications in any field of study. The chapter also presents the reader with the basics of case method approaches, provides an explanation of its importance in OD, describes how students should approach case method learning, and outlines how they can approach case analysis and discussion.

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Singh, R., Ramdeo, S. (2020). Case Study Teaching and Learning. In: Leading Organizational Development and Change. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-39123-2_21

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NCCSTS Case Collection • Teaching Resources

The publications listed below have been produced by the National Center for Case Study Teaching in Science.

Start with a Story: The Case Study Method of Teaching College Science , edited by Clyde Freeman Herreid, originally published in 2006 by NSTA Press; reprinted by the National Center for Case Study Teaching in Science (NCCSTS) in 2013. Collection of 40+ essays examining every aspect of the case study method and its use in the science classroom. The book is available for purchase through NSTA .

Science Stories You Can Count On: 51 Case Studies with Quantitative Reasoning in Biology , edited by Clyde Freeman Herreid, Nancy A. Schiller, and Ky F. Herreid, NSTA Press, 2014. Includes case studies as well as tips and techniques for promoting quantitative reasoning in biology. The book is available for purchase through NSTA or from Amazon .

Science Stories: Using Case Studies to Teach Critical Thinking , edited by Clyde Freeman Herreid, Nancy A. Schiller, and Ky F. Herreid, NSTA Press, 2012. A compilation of case studies with questions and teaching notes that can be used to help develop STEM students’ critical thinking skills. The book is available for purchase through NSTA or from Amazon .

The NCCSTS has produced two training videos with supporting brochures on the case method and its use in science education.

Use of Case Studies and Group Discussion in Science Education This hands-on video shows the classical method of running a case study class used by Harvard law and business school professors for almost 100 years—the art of using successful group discussion. In 26 minutes you will learn how to ensure that your large group discussion is not a free-for-all or an exercise in futility as you try to get students to say something intelligent. Preparation and control are the key ingredients. For preparation students must read a case study ahead of time. But it is more than that. In this video, which focuses on a case study involving genetically modified food, you will see how an actual class is given a “warm-up” by breaking into small groups to discuss the reading they’ve done ahead of time. Then you will see how a large group discussion is successfully controlled. It’s the important, yet subtle, use of appropriate questions, body language, blackboard planning, and summarization that makes it all work. Video on YouTube | Access the video booklet (PDF)

Team Learning: Cooperative Learning in the Science Classroom Having students work in small groups is arguably the best way to teach science and this includes teaching science using cases. But how can we run a classroom this way? Here is one answer using a method called Team Learning. This 26-minute video shows you how to establish groups, how to set up a grading system that encourages group participation, how to answer students’ questions and, most importantly, why this is a superior method of teaching. Video on YouTube | Access the video booklet (PDF)

Bibliographies

• Bibliography on Case Study Teaching in Science compiled by Nancy A. Schiller and Clyde Freeman Herreid.

Selected Articles by Clyde F. Herreid and other members of the NCCSTS

Getting started.

• Case Studies in Science: A Novel Method of Science Education
• What is a Case? Bringing to Science Education the Established Teaching Tool of Law and Medicine
• My Favorite Case and What Makes It So
• What Makes a Good Case? Some Basic Rules of Good Storytelling Help Teachers Generate Student Excitement in the Classroom
• Sorting Potatoes for Miss Bonner: Bringing Order to Case Study Methodology Through a Classification Scheme
• Can Case Studies Be Used to Teach Critical Thinking?
• A Peek Behind the Curtain of Tenure and Promotion

Writing Cases

• Cooking With Betty Crocker: A Recipe for Case Writing
• The Way of Flesch: The Art of Writing Readable Cases
• Twixt Fact and Fiction: A Case Writer’s Dilemma
• Let’s Get Personal: Putting Personality into your Cases
• Puttin’ on the Ritz: How to Put Science into Cases
• Putting Words in Their Mouth: Writing Dialogue for Case Studies
• And All That Jazz: An Essay Extolling the Virtues of Writing Case Teaching Notes
• Exercises in Style: Is There a Best Way to Write a Case Study?
• The Chef Returns: A Recipe for Writing Great Case Studies
• Creating a Video Case Study

Teaching with Cases

• Don't! What Not to Do When Teaching Cases
• Return to Mars: How Not to Teach a Case Study
• Assembling a Case Study Tool Kit: 10 Tools for Teaching With Cases
• The Interrupted Case Method
• Case Studies and the Flipped Classroom
• A Chat with the Survey Monkey: Case Studies and the Flipped Classroom
• Intimate Debate Technique
• "Clicker" Cases: Introducing Case Study Teaching into Large Classrooms
• Structured Controversy: A Case Study Strategy
• Trigger Cases Versus Capstone Cases
• The Boy Scouts Said Its Best: Some Advice on Case Study Teaching and Student Prepara-tion
• Naming Names
• Science, Pseudoscience, and Nonsense

Cases and Cooperative Learning

• The Bee and the Groundhog: Lessons in Cooperative Learning
• I Never Knew Joe Paterno: An Essay on Teamwork and Love
• The Wisdom of Groups

Grading Case Work

• When Justice Peeks: Evaluating Students in Case Study Teaching

Start with a Story: The Case Study Method of Teaching College Science

Edited by Clyde Freeman Herreid

Originally published in 2006 by NSTA Press; reprinted by the National Center for Case Study Teaching in Science (NCCSTS) in 2013. Collection of 40+ essays examining every aspect of the case study method and its use in the science classroom. The book is available for purchase through NSTA .

Science Stories You Can Count On: 51 Case Studies with Quantitative Reasoning in Biology

Edited by Clyde Freeman Herreid, Nancy A. Schiller, and Ky F. Herreid, NSTA Press, 2014.

Includes case studies as well as tips and techniques for promoting quantitative reasoning in biology. The book is available for purchase through NSTA or from Amazon .

Science Stories: Using Case Studies to Teach Critical Thinking

Edited by Clyde Freeman Herreid, Nancy A. Schiller, and Ky F. Herreid, NSTA Press, 2012.

A compilation of case studies with questions and teaching notes that can be used to help develop STEM students’ critical thinking skills. The book is available for purchase through NSTA or from Amazon .

Use of Case Studies and Group Discussion in Science Education

This hands-on video shows the classical method of running a case study class used by Harvard law and business school professors for almost 100 years—the art of using successful group discussion. In 26 minutes you will learn how to ensure that your large group discussion is not a free-for-all or an exercise in futility as you try to get students to say something intelligent. Preparation and control are the key ingredients. For preparation students must read a case study ahead of time. But it is more than that. In this video, which focuses on a case study involving genetically modified food, you will see how an actual class is given a “warm-up” by breaking into small groups to discuss the reading they’ve done ahead of time. Then you will see how a large group discussion is successfully controlled. It’s the important, yet subtle, use of appropriate questions, body language, blackboard planning, and summarization that makes it all work.

Video on YouTube | Access the video booklet (PDF)

Team Learning: Cooperative Learning in the Science Classroom

Having students work in small groups is arguably the best way to teach science and this includes teaching science using cases. But how can we run a classroom this way? Here is one answer using a method called Team Learning. This 26-minute video shows you how to establish groups, how to set up a grading system that encourages group participation, how to answer students’ questions and, most importantly, why this is a superior method of teaching.

The articles listed below are selected by Clyde F. Herreid and other members of the NCCSTS.

Smart. Open. Grounded. Inventive. Read our Ideas Made to Matter.

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Teaching Resources Library

Case studies.

The teaching business case studies available here are narratives that facilitate class discussion about a particular business or management issue. Teaching cases are meant to spur debate among students rather than promote a particular point of view or steer students in a specific direction.  Some of the case studies in this collection highlight the decision-making process in a business or management setting. Other cases are descriptive or demonstrative in nature, showcasing something that has happened or is happening in a particular business or management environment. Whether decision-based or demonstrative, case studies give students the chance to be in the shoes of a protagonist. With the help of context and detailed data, students can analyze what they would and would not do in a particular situation, why, and how.

Case Studies By Category

• Open access
• Published: 05 June 2024

Current status and ongoing needs for the teaching and assessment of clinical reasoning – an international mixed-methods study from the students` and teachers` perspective

• F. L Wagner 1 ,
• M. Sudacka 2 ,
• A. A Kononowicz 3 ,
• M. Elvén 4 , 5 ,
• S. J Durning 6 ,
• I. Hege 7 &
• S. Huwendiek 1  

BMC Medical Education volume  24 , Article number:  622 ( 2024 ) Cite this article

46 Accesses

Metrics details

Clinical reasoning (CR) is a crucial ability that can prevent errors in patient care. Despite its important role, CR is often not taught explicitly and, even when it is taught, typically not all aspects of this ability are addressed in health professions education. Recent research has shown the need for explicit teaching of CR for both students and teachers. To further develop the teaching and learning of CR we need to improve the understanding of students' and teachers' needs regarding content as well as teaching and assessment methods for a student and trainer CR curriculum.

Parallel mixed-methods design that used web-surveys and semi-structured interviews to gather data from both students (n survey  = 100; n interviews  = 13) and teachers (n survey  = 112; n interviews  = 28). The interviews and surveys contained similar questions to allow for triangulation of the results. This study was conducted as part of the EU-funded project DID-ACT ( https://did-act.eu ).

Both the surveys and interview data emphasized the need for content in a clinical reasoning (CR) curriculum such as “gathering, interpreting and synthesizing patient information”, “generating differential diagnoses”, “developing a diagnostic and a treatment plan” and “collaborative and interprofessional aspects of CR”. There was high agreement that case-based learning and simulations are most useful for teaching CR. Clinical and oral examinations were favored for the assessment of CR. The preferred format for a train-the-trainer (TTT)-course was blended learning. There was also some agreement between the survey and interview participants regarding contents of a TTT-course (e.g. teaching and assessment methods for CR). The interviewees placed special importance on interprofessional aspects also for the TTT-course.

Conclusions

We found some consensus on needed content, teaching and assessment methods for a student and TTT-course in CR. Future research could investigate the effects of CR curricula on desired outcomes, such as patient care.

Peer Review reports

Introduction

Clinical reasoning (CR) is a universal ability that mobilizes integration of necessary fundamental knowledge while delivering high-quality patient care in a variety of contexts in a timely and effective way [ 1 , 2 ]. Daniel et al. [ 3 ] define it as a “skill, process or outcome wherein clinicians observe, collect, and interpret data to diagnose and treat patients”. CR encompasses health professionals thinking and acting in patient assessment, diagnostic, and management processes in clinical situations, taking into account the patient ‘s specific circumstances and preferences [ 4 ]. How CR is defined can vary between health professions, but there are also similarities [ 5 ]. Poor CR is associated with low-quality patient care and increases the risk of medical errors [ 6 ]. Berner and Graber [ 7 ] suggested that the rate of diagnostic error is around 15%, underlining the threat that insufficient CR ability poses to patient safety as well as increasing healthcare costs [ 8 ]. Despite the importance of CR, it appears to be rarely taught or assessed explicitly, often only parts of the CR process are covered in existing curricula, and there seems to be a lack of progression throughout curricula (e.g. [ 9 , 10 , 11 , 12 , 13 , 14 ].). Moreover, teachers are often not trained to explicitly teach CR, including explaining their own reasoning to others [ 10 , 11 , 12 ] although this appears to be an important factor in the implementation of a CR curriculum [ 15 ]. Some teachers even question whether CR can be explicitly taught [ 16 ]. Considering these findings, efforts should be made to incorporate explicit teaching of CR into health care professions curricula and training for teachers should be established based on best evidence. However, to date, little is known about what a longitudinal CR curriculum should incorporate to meet the needs of teachers and students.

Insights regarding teaching CR were provided from a global survey by Kononowicz et al. [ 10 ], who reported a need for a longitudinal CR curriculum. However, the participants in their study were mainly health professions educators, leaving the needs of students for a CR curriculum largely unknown. As students are future participants of a CR curriculum, their needs should also be investigated. Kononowicz et al. [ 10 ] also identified a lack of qualified faculty to teach CR. A train-the-trainer course for CR could help reduce this barrier to teaching CR. To the best of our knowledge, in addition to the work by Kononowicz et al. [ 10 ], no research exists yet that addresses the needs of teachers for such a course, and Kononowicz et al. [ 10 ] did not investigate their needs beyond course content. Recently, Gupta et al. [ 12 ] and Gold et al. [ 13 ] conducted needs analyses regarding clinical reasoning instruction from the perspective of course directors at United States medical schools, yet a European perspective is missing. Thus, our research questions were the following:

What aspects of clinical reasoning are currently taught and how important are they in a clinical reasoning curriculum according to teachers and students?

What methods are currently used to teach and assess clinical reasoning and which methods would be ideal according to teachers and students?

In what study year does the teaching of clinical reasoning currently begin and when should it ideally begin according to teachers and students?

How should a train-the-trainer course for teachers of clinical reasoning be constructed regarding content and format?

In this study, we used a convergent parallel mixed-methods design [ 17 ] within a pragmatic constructivist case study approach [ 18 ]. We simultaneously collected data from students and educators using online questionnaires and semi-structured interviews to gain deeper insight into their needs on one particular situation [ 19 ]– the development of a clinical reasoning curriculum—to address our research questions. To help ensure that the results of the survey and the interviews could be compared and integrated, we constructed the questions for the survey and the interviews similarly with the exception that in the interviews, the questions were first asked openly. The design was parallel both in that we collected data simultaneously and also constructed the survey and interviews to cover similar topics. We chose this approach to obtain comprehensive answers to the research questions and to facilitate later triangulation [ 17 ] of the results.

Context of this study

We conducted this study within the EU-funded (Erasmus + program) project DID-ACT (“Developing, implementing, and disseminating an adaptive clinical reasoning curriculum for healthcare students and educators”; https://did-act.eu ). Institutions from six European countries (Augsburg University, Germany; Jagiellonian University in Kraków, Poland; Maribor University, Slovenia; Örebro University, Sweden; University of Bern, Switzerland; EDU, a higher medical education institution based in Malta, Instruct GmbH, Munich, Germany) with the support of associate partners (e.g., Prof. Steven Durning, Uniformed Services University of the Health Sciences, USA; Mälardalen University, Sweden.) were part of this project. For further information, see https://did-act.eu/team-overview/team/ . In this project, we developed an interprofessional longitudinal clinical reasoning curriculum for students in healthcare education and a train-the-trainer course for health profession educators. The current curriculum (for a description of the curriculum, see Hege et al. [ 20 ]) was also informed by this study. This study was part of the Erasmus + Knowledge Alliance DID-ACT (612,454-EPP-1–2019-1-DE-EPPKA2-KA).

Target groups

We identified two relevant target groups for this study, teachers and students, which are potential future users and participants of a train—the—trainer (TTT-) course and a clinical reasoning curriculum, respectively. The teacher group also included individuals who were considered knowledgeable regarding the current status of clinical reasoning teaching and assessment at their institutions (e.g. curriculum managers). These specific participants were individually selected by the DID-ACT project team to help ensure that they had the desired level of expertise. The target groups included different health professions from a large number of countries (see Table  1 ), as we wanted to gather insights that are not restricted to one profession.

Development of data collection instruments

Development of questions.

The questions in this study addressed the current status and needs regarding content, teaching, and assessment of clinical reasoning (CR). They were based on the questions used by Kononowicz et al. [ 10 ] and were expanded to obtain more detailed information. Specifically, regarding CR content, we added additional aspects (see Table 8 in the Appendix for details). The contents covered in this part of the study also align with the five domains of CR education (clinical reasoning concepts, history and physical examination, choosing and interpreting diagnostic tests, problem identification and management and shared decision-making) that were reported by Cooper et al. [ 14 ]. It has been shown that there are similarities between professions regarding the definition of CR (e.g. history taking or an emphasis on clinical skills), while nurses placed greater importance on a patient-centered approach [ 5 ]. We aimed to cover as many aspects of CR in the contents as possible to represent these findings. We expanded the questions on CR teaching formats to cover a broader range of formats. Furthermore, two additional assessment methods were added to the respective questions. Finally, one aspect was added to the content questions for a train-the-trainer course (see Table 8 in the Appendix ). As a lack of qualified faculty to teach CR was identified in the study by Kononowicz et al. [ 10 ], we added additional questions on the specific needs for the design of a CR train-the-trainer course beyond content. Table 8 in the Appendix shows the adaptations that we made in detail.

We discussed the questions within the interprofessional DID-ACT project team and adapted them in several iterative cycles until the final versions of the survey questionnaire and the interview guide were obtained and agreed upon. We tested the pre-final versions with think-alouds [ 21 ] to ensure that the questions were understandable and interpreted as intended, which led to a few changes. The survey questionnaires and interview-guides can be found at https://did-act.eu/results/ and accessed via links in table sections D1.1a (survey questions) and D1.1b (interview guides), respectively. Of these questions, we included only those relevant to the research questions addressed in this study. The questions included in this study can be found in the Appendix in Table8.

Teachers were asked questions about all content areas, but only the expert subgroup was asked to answer questions on the current situation regarding the teaching and assessment of clinical reasoning at their institutions, as they were considered the best informed group on the matter. Furthermore, students were not asked questions on the train-the-trainer course. Using the abovementioned procedures, we also hoped to improve the response rate as longer surveys were found to be associated with lower response rates [ 22 ].

We created two different versions of the interview guide, one for teachers and one for students. The student interview guide did not contain questions on the current status of clinical reasoning teaching and assessment or questions about the train-the-trainer course. The interview guides were prepared with detailed instructions to ensure that the interviews were conducted in a comparable manner at all locations. By using interviews, we intended to obtain a broad picture of existing needs. Individual interviews further allowed participants to speak their own languages and thus to express themselves naturally and as precisely as possible.

Reflexivity statement

Seven researchers representing different perspectives and professions form the study team. MS has been a PhD candidate representing the junior researcher perspective, while also experienced researchers with a broad background in clinical reasoning and qualitative as well as quantitative research are part of the team (SD, SH, AK, IH, ME, FW). ME represents the physiotherapist perspective, SD, SH, and MS represent the medical perspective. We discussed all steps of the study in the team and made joint decisions.

Data collection and analysis

The survey was created using LimeSurvey software (LimeSurvey GmbH). The survey links were distributed via e-mail (individual invitations, posts to institutional mailing lists, newsletters) by the DID-ACT project team and associate partners (the target groups received specific links to the online-survey). The e-mail contained information on the project and its goals. By individually contacting persons in the local language, we hoped to increase the likelihood of participation. The survey was anonymous. The data were collected from March to July 2020.

Potential interview participants were contacted personally by the DID-ACT project team members in their respective countries. We used a convenience sampling approach by personally contacting potential interview partners in the local language to motivate as many participants as possible. With this approach we also hoped to increase the likelihood of participation. The interviews were conducted in the local languages also to avoid language barriers and were audio-recorded to help with the analysis and for documentation purposes. Most interviews were conducted using online meeting services (e.g. Skype or Zoom) because of restrictions due to the ongoing coronavirus pandemic that occurred with the start of data collection at the beginning of the DID-ACT project. The data were collected from March to July 2020. All interview partners provided informed consent.

Ethics approval and consent to participate

We asked the Bern Ethics Committee to approve this multi-institutional study. This type of study was regarded as exempt from formal ethical approval according to the regulations of the Bern Ethics Committee (‘Kantonale Ethikkommission Bern’, decision Req-2020–00074). All participants voluntarily participated and provided informed consent before taking part in this study.

Data analysis

Descriptive analyses were performed using SPSS statistics software (version 28, 2021). Independent samples t-tests were computed for comparisons between teachers and students. When the variances of the two groups were unequal, Welch’s test was used. Bonferroni correction of significance levels was used to counteract alpha error accumulation in repeated tests. The answers to the free text questions were screened for recurring themes. There were very few free-text comments, typically repeating aspects from the closed questions, hence, no meaningful analysis was possible. For this reason, the survey comments are mentioned only where they made a unique contribution to the results.

The interviews were translated into English by the partners. An overarching summarizing qualitative content analysis [ 23 ] of the data was conducted. A summarizing content analysis is particularly useful when the content level of the material is of interest. Its goal is to reduce the material to manageable short texts in a way that retains the essential meaning [ 23 ]. The analysis was conducted first by two of the authors of the study (FW, SH) and then discussed by the entire author team. The analysis was carried out as an iterative process until a complete consensus was reached within the author team.

The results from the surveys and interviews were compared and are presented together in the results section. The qualitative data are reported in accordance with the standards for reporting qualitative research (SRQR, O’Brien et al. [ 24 ]).

Table 1 shows the professional background and country of the interviewees and survey samples. The survey was opened by 857 persons, 212 (25%) of whom answered the questions included in this study. The expert sub-group of teachers who answered the questions on the current status of clinical reasoning teaching and assessment encompassed 45 individuals.

Content of a clinical reasoning curriculum for students

The survey results show that “Gathering, interpreting, and synthesizing patient information”, is currently most extensively taught, while “Theories of clinical reasoning” are rarely taught (see Table  2 ). In accordance with these findings, “Gathering, interpreting, and synthesizing patient information” received the highest mean importance rating for a clinical reasoning curriculum while “Theories of clinical reasoning” received the lowest importance rating. Full results can be found in Table 9 in the Appendix .

Teachers and students differed significantly in their importance ratings of two content areas, “Gathering, interpreting, and synthesizing patient information” ( t (148.32) = 4.294, p  < 0.001, d  = 0.609) and “Developing a problem formulation/hypothesis” ( t (202) = 4.006, p  < 0.001, d  = 0.561), with teachers assigning greater importance to both of these content areas.

The results from the interviews are in line with those from the survey. Details can be found in Table 12 in the Appendix .

Clinical reasoning teaching methods

The survey participants reported that, most often, case-based learning is currently applied in the teaching of clinical reasoning (CR). This format was also rated as most important for teaching CR (see Table  3 ). Full results can be found in Table 10 in the Appendix .

Teachers and students differed significantly in their importance ratings of Team-based learning ( t (202) = 3.079, p  = 0.002, d  = 0.431), with teachers assigning greater importance to this teaching format.

Overall, the interviewees provided very similar judgements to the survey participants. Next to the teaching formats shown in Table  3 , some of them would employ blended learning, and clinical teaching formats such as bedside teaching and internships were also mentioned. Details can be found in the Appendix in Table 13. In addition to the importance of each individual teaching format, it was also argued that all of the formats can be useful because they all are meant to reach different objectives and that there is not one single best format for teaching CR.

Start of clinical reasoning teaching in curricula

Most teachers (52.5%) reported that currently, the teaching of clinical reasoning (CR) starts in the first year of study. Most often (46.4%) the participants also chose the first study year as the optimal year for starting the teaching CR. In accordance with the survey results, the interviewees also advocated for an early start of the teaching of CR. Some interview participants who advocated for a later start of CR teaching suggested that the students first need a solid knowledge base and that once the clinical/practical education starts, explicit teaching of CR should begin.

Assessment of clinical reasoning

The survey results suggest that currently written tests or clinical examinations are most often used, while Virtual Patients are used least often (see Table  4 ). Despite written tests being the most common current assessment format, they received the lowest importance rating for a future longitudinal CR curriculum. Full results can be found in Table 11 in the Appendix .

Teachers and students differed significantly in their importance ratings of clinical examinations ( t (161.81) = 2.854, p  = 0.005, d  = 0.413) and workplace-based assessments ( t (185) = 2.640, p = 0.009, d  = 0.386) with teachers assigning greater importance to both of these assessment formats.

The interviewees also placed importance on all assessment methods but found it difficult to assess CR with written assessment methods. The students seemed to associate clinical examinations more with practical skills than with CR. Details can be found in the Appendix in Table 14. Two of the interview participants mentioned that CR is currently not assessed at their institutions, and one person mentioned that students are asked to self-reflect on their interactions with patients and on potential improvements.

Train-the-trainer course

The following sections highlight the results from the needs analysis regarding a train-the-trainer (TTT-) course. The questions presented here were posed only to the teachers.

Most survey participants reported that there is currently no TTT- course on clinical reasoning at their institution but that they think such a course is necessary (see Table  5 ). The same was also true for the interviewees (no TTT- course on clinical reasoning existing but need for one).

In the interviews, 22 participants (78.6%) answered that a TTT-course is necessary for healthcare educators, two participants answered that no such course was necessary, and two other participants were undecided about its necessity. At none of the institutions represented by the interviewees, a TTT-course for teaching clinical reasoning exists.

When asked what the best format for a clinical reasoning TTT- course would be (single answer question), the majority of the survey participants favored a blended learning / flipped classroom approach, a combination of e-learning and face-to-face meetings. (see Table  6 ).

In the survey comments it was noted that blended-learning encompasses the benefits of both self-directed learning and discussion/learning from others. It would further allow teachers to gather knowledge about CR first in an online learning phase where they can take the time they need before coming to a face-to-face meeting.

The interviewees also found a blended-learning approach particularly suitable for a TTT-course. An e-learning course only was seen as more critical because teachers may lack motivation to participate in an online-only setting, while a one-time face-to-face meeting would not provide enough time. In some interviews, it was emphasized that teachers should experience themselves what they are supposed to teach to the students and also that the trainers for the teachers need to have solid education and knowledge on clinical reasoning.

Table 7 shows the importance ratings of potential content of a TTT-course generated from the survey. To elaborate on this content, comments by the interviewees were added. On average, all content was seen as (somewhat) important with teaching methods on the ward and/or clinic receiving the highest ratings. Some interviewees also mentioned the importance of interprofessional aspects and interdisciplinary understanding of CR. In the survey comments, some participants further expressed their interest in such a course.

Finally, the interviewees were asked about the ideal length of a clinical reasoning TTT-course. The answers varied greatly from 2–3 hours to a two-year educational program, with a tendency toward 1–2 days. Several interviewees commented that the time teachers are able to spend on a TTT-course is limited. This should be considered in the planning of such a course to make participation feasible for teachers.

In this study, we investigated the current status of and suggestions for teaching and assessment of clinical reasoning (CR) in a longitudinal curriculum as well as suggestions for a train-the-trainer (TTT-) course for CR. Teachers and students were invited to participate in online-surveys as well as semi-structured interviews to derive answers to our research questions. Regarding the contents of a CR curriculum for students, the results of the surveys and interviews were comparable and favoured content such as gathering, interpreting, and synthesizing patient information, generating differential diagnoses, and developing a diagnostic and a treatment plan. In the interviews, high importance was additionally placed on collaborative and interprofessional aspects of CR. Case-based learning and simulations were seen as the most useful methods for teaching CR, and clinical and oral examinations were favoured for the assessment of CR. The preferred format for a TTT-course was blended learning. In terms of course content, teaching and assessment methods for CR were emphasized. In addition to research from the North American region [ 11 ], this study provides results from predominantly European countries that support the existing findings.

Content of a clinical reasoning curriculum

Our results revealed that there are still aspects of clinical reasoning (CR), such as “Errors in the clinical reasoning process and strategies to avoid them” or “Interprofessional aspects of CR” that are rarely taught despite their high importance, corroborating the findings of Kononowicz et al. [ 10 ]. According to the interviewees, students should have basic knowledge of CR before they are taught about errors in the CR process and strategies to avoid them. The lack of teaching of errors in CR may also stem from a lack of institutional culture regarding how to manage failures in a constructive way (e.g. [ 16 , 25 ]), making it difficult to explicitly address errors and strategies to avoid them. Although highly relevant in the everyday practice of healthcare professions and underpinned by CR theoretical frameworks (e.g., distributed cognition [ 26 ]), interprofessional and collaborative aspects of CR are currently rarely considered in the teaching of CR. The interviews suggested that hierarchical distance and cultural barriers may contribute to this finding. Sudacka et al. [ 16 ] also reported cultural barriers as one reason for a lack of CR teaching. Generally, the interviewees seemed to place greater importance on interprofessional and collaborative aspects than did the survey-participants This may have been due to differences in the professions represented in the two modalities (e.g., a greater percentage of nurses among the interview participants, who tend to define CR more broadly than physicians [ 5 ]).

“Self-reflection on clinical reasoning performance and strategies for future improvement”, “Developing a problem formulation/hypothesis” and “Aspects of patient-participation in CR” were rated as important but are currently rarely taught, a finding not previously reported. The aspect “Self-reflection on clinical reasoning performance and strategies for future improvement”, received high importance ratings, but only 25% of the survey-participants answered that it is currently taught to a great extent. The interviewees agreed that self-reflection is important and added that ideally, it should be guided by specific questions. Ogdie et al. [ 27 ] found that reflective writing exercises helped students identify errors in their reasoning and biases that contributed to these errors.

“Gathering, interpreting, and synthesizing patient information” and “Developing a problem formulation/hypothesis” were rated significantly more important by teachers than by students. It appears that students may be less aware yet of the importance of gathering, interpreting, and synthesizing patient information in the clinical reasoning process. There was some indication in the interviews that the students may not have had enough experience yet with “Developing a problem formulation/hypothesis” or associate this aspect with research, possibly contributing to the observed difference.

Overall, our results on the contents of a CR curriculum suggest that all content is important and should be included in a CR curriculum, starting with basic theoretical knowledge and data gathering to more advanced aspects such as errors in CR and collaboration. Two other recent surveys conducted in the United States among pre-clerkship clinical skills course directors [ 12 ] and members of clerkship organizations [ 13 ] came to similar conclusions regarding the inclusion of clinical reasoning content at various stages of medical curricula. How to fit the content into already dense study programs, however, can still be a challenge [ 16 ].

In addition to case-based learning and clinical teaching, human simulated patients and Team-based learning also received high importance ratings for teaching clinical reasoning (CR), a finding not previously reported. Lectures, on the other hand, are seen as the least important to teach CR (see also Kononowicz et al. [ 10 ]), as they mainly deliver factual knowledge according to the interviewees. High-fidelity simulations (mannequins) and Virtual Patients (VPs) are rarely used to teach CR at the moment and are rated less important compared to other teaching formats. Some interviewees see high-fidelity simulations as more useful for teaching practical skills. The lower importance rating of VPs was surprising given that this format is case-based, provides a safe environment for learning, and is described in the literature as a well-suited tool for teaching CR [ 28 , 29 ]. Considering that VPs seemed to be used less often at the institutions involved in this study, the lack of experience with this format may have led to this result.

Teachers rated Team-based learning as significantly more important for teaching clinical reasoning than students. In the interviews, many students seemed not to be familiar with Team-based learning, possibly explaining the lower ratings the students gave this format in the survey.

Taken together, our results suggest that there is not one best format for teaching all aspects of clinical reasoning but rather that the use of all teaching formats is justified depending on the specific content to be taught and goals to be achieved. However, there was agreement that a safe learning environment where no patients can be harmed is preferred for teaching clinical reasoning, and that discussions should be possible.

There was wide agreement that clinical reasoning (CR) teaching should start in the first year of study in the curriculum. However, a few participants of this study argued that students first need to develop some general knowledge before CR is taught. Rencic et al. [ 11 ] reported that according to internal medicine clerkship directors, CR should be taught throughout all years of medical school, with a particular focus during the clinical teaching years. A similar remark was made by participants in a survey among pre-clerkship clinical skills course directors by Gupta et al. [ 12 ] where the current structure of some curricula (e.g. late introduction of the pathophysiology) was regarded as a barrier to introducing CR from the first year of study on [ 12 ].

Our results show that the most important format for assessing clinical reasoning (CR) that is also currently used to the greatest extent are clinical examinations (e.g. OSCE), consistent with Kononowicz et al. [ 10 ]. The interviewees emphasized that CR should ideally be assessed in a conversation or discussion where the learners can explain their reasoning. Given this argument, all assessment formats enabling a conversation are suitable for assessing CR. This is reflected in our survey results, where assessment formats that allow for a discussion with the learner received the most favourable importance ratings, including oral examinations. In agreement with Kononowicz et al. [ 10 ], we also found that written tests are currently used most often to assess CR but are rated as least important and suitable only for the assessment of some aspects of CR. Daniel et al. [ 3 ] argued that written exams such as MCQs, where correct answers have to be selected from a list of choices, are not the best representation of real practical CR ability. Thus, there still seems to be potential for improvement in the way CR is assessed.

Teachers rated clinical examinations and workplace-based assessments significantly higher than students. Based on the interviews, the students seemed to associate clinical examinations such as OSCEs more with a focus on practical skills than CR, potentially explaining their lower ratings of this format.

What a clinical reasoning train-the-trainer course should look like

Our results show a clear need for a clinical reasoning (CR) train-the-trainer course (see also Singh et al. [ 15 ]), which currently does not exist at most institutions represented in this study, corroborating findings by Kononowicz et al. [ 10 ]. A lack of adequately trained teachers is a common barrier to the introduction of CR content into curricula [ 12 , 16 ]. According to our results such a course should follow a blended learning/flipped classroom approach or consist of a series of face-to-face meetings. A blended-learning course would combine the benefits of both self-directed learning and the possibility for trainers to discuss with and learn from their peers, which could also increase their motivation to participate in such a course. An e-learning only course or a one-time face-to-face meeting were considered insufficient. The contents “Clinical reasoning strategies” and “Common errors in the clinical reasoning process” were given greater importance for the trainer-curriculum than for the students-curriculum, possibly reflecting higher expectations of trainers as “CR experts” compared with students. There was some agreement in the interviews that ideally, the course should not be too time-consuming, with participants tending towards an overall duration of 1–2 days, considering that most teachers usually have many duties and may not be able or willing to attend the course if it were too long. Lack of time was also identified as a barrier to attending teacher training [ 12 , 13 , 16 ].

Strengths and limitations

The strengths of this study include its international and interprofessional participants. Furthermore, we explicitly included teachers and students as target groups in the same study, which enables a comparison of different perspectives. Members of the target groups not only participated in a survey but were also interviewed to gain in-depth knowledge. A distinct strength of this study is its mixed-methods design. The two data collection methods employed in parallel provided convergent results, with responses from the web survey indicating global needs and semi-structured interviews contributing to a deeper understanding of the stakeholder groups’ nuanced expectations and perspectives on CR education.

This study is limited in that most answers came from physicians, making the results potentially less generalizable to other professions. Furthermore, there were participants from a great variety of countries, with some countries overrepresented. Because of the way the survey-invitations were distributed, the exact number of recipients is unknown, making it impossible to compute an exact response rate. Also, the response rate of the survey was rather low for individuals who opened the survey. Because the survey was anonymous, it cannot completely be ruled out that some individuals participated in both interviews and survey. Finally, there could have been some language issues in the interview analysis, as the data were translated to English at the local partner institutions before they were submitted for further analysis.

Our study provides evidence of an existing need for explicit clinical reasoning (CR) longitudinal teaching and dedicated CR teacher training. More specifically, there are aspects of CR that are rarely taught that our participants believe should be given priority, such as self-reflection on clinical reasoning performance and strategies for future improvement and aspects of patient participation in CR that have not been previously reported. Case-based learning and clinical teaching methods were again identified as the most important formats for teaching CR, while lectures were considered relevant only for certain aspects of CR. To assess CR, students should have to explain their reasoning, and assessment formats should be chosen accordingly. There was also still a clear need for a CR train-the-trainer course. In addition to existing research, our results show that such a course should ideally have a blended-learning format and should not be too time-consuming. The most important contents of the train-the-trainer course were confirmed to be teaching methods, CR strategies, and strategies to avoid errors in the CR process. Examples exist for what a longitudinal CR curriculum for students and a corresponding train-the-trainer course could look like and how these components could be integrated into existing curricula (e.g. DID-ACT curriculum [ 20 ], https://did-act.eu/integration-guide/ or the described curriculum of Singh et al. [ 15 ]). Further research should focus on whether and to what extent the intended outcomes of such a curriculum are actually reached, including the potential impact on patient care.

Availability of data and materials

All materials described in this manuscript generated during the current study are available from the corresponding author on reasonable request without breaching participant confidentiality.

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Acknowledgements

We want to thank all participants of the interviews and survey who took their time to contribute to this study despite the ongoing pandemic in 2020. Furthermore, we thank the members of the DID-ACT project team who supported collection and analysis of survey and interview data.

The views expressed herein are those of the authors and not necessarily those of the Department of Defense, the Uniformed Services University or other Federal Agencies.

This study was partially supported by the Erasmus + Knowledge Alliance DID-ACT (612454-EPP-1–2019-1-DE-EPPKA2-KA).

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Institute for Medical Education, Department for Assessment and Evaluation, University of Bern, Bern, Switzerland

F. L Wagner & S. Huwendiek

Center of Innovative Medical Education, Department of Medical Education, Jagiellonian University, Kraków, Poland

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A. A Kononowicz

School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden

Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden

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FW and SH wrote the first draft of the manuscript. All authors critically revised the manu-script in several rounds and approved the final manuscript.

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This type of study was regarded as exempt from formal ethical approval according to the regulations of the Bern Ethics Committee (‘Kantonale Ethikkommission Bern’, decision Req-2020–00074). All participants voluntarily participated and provided informed consent before taking part in this study.

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Wagner, F., Sudacka, M., Kononowicz, A. et al. Current status and ongoing needs for the teaching and assessment of clinical reasoning – an international mixed-methods study from the students` and teachers` perspective. BMC Med Educ 24 , 622 (2024). https://doi.org/10.1186/s12909-024-05518-8

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DOI : https://doi.org/10.1186/s12909-024-05518-8

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After a trip to meet with the Dalai Lama, an Ed.L.D. student says we do

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June 2024 Newsletter

Congratulations to the Class of 2024!

Congratulations to all our graduates! Nearly four hundred graduates were recognized on Friday, May 17 to join nearly one thousand Master's and doctoral students who earned their degrees in August 2023, January 2024, and May 2024! May your next journeys continue to be amazing!

Coverage of Commencement

Later this summer, videos of both our diploma ceremony and Convocation (held on Wednesday, May 15) will be posted to the University's YouTube channel. If you got your picture taken by the professional photographers during Commencement,  GradImages  will be reaching out to you in the coming weeks.

Register for Summer and Fall Classes!

If you haven't yet, register now for Summer and Fall through  SIS ! Be sure to talk with your advisor and check SIS for any holds that may prevent registration.

Summer 2024 Graduation

Are you almost ready to graduate? The deadline to apply to graduate this summer is Friday, June 7. You can find graduation information with  detailed requirements here .  All final materials  are due July 19 and degrees will be awarded on August 16. Students who graduate in August will be invited to return for Commencement in May 2025.

Please note : If you applied to graduate in spring 2024 but did not complete all requirements you  must  apply again this semester.

Summer Waiver of Registration

Missed last semester's deadline to apply to graduate? If you've completed all graduation requirements, but did not meet the spring graduation deadline, you may be eligible to waive class registration for summer. Here's how: 

• Submit all final materials for your degree as  listed here , including the Waiver of Registration form (included in the downloadable file).
• International students must have the waiver of registration electronically signed by  International Student Services  (ISS).

The waiver of registration deadline is Friday, June 7. Once completed and signed please email the form along with all your other final graduation materials to your program coordinator in SGS directly or to  [email protected] .

Summer Course Withdrawal

If you are enrolled in a course this summer and need to withdraw, review the  Summer 2024 Enrollment Dates + Deadlines page  (scroll down to the Grad section) to confirm the last possible day to do so. For most classes, a withdrawal is to be done in  SIS . See the University Registrar's page on  class registration  ( start at #20 ) for instructions.

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Changes to Tech Access After Graduating

Make sure to review  changes to your access of University technologies  after graduation so you can make plans now to ensure your work will be still available. For 180 days after the date of degree conferral, graduating students will retain access to Google Workspace (Gmail, drives, etc), Microsoft 365, Qualtrics, and GitHub. Access to Adobe products will expire on July 1. Access to CWRU's Zoom (including recordings and whiteboards) ended immediately upon graduation.

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QUANTIFYING AND IDENTIFYING CAUSES OF ABSENTEEISM IN MARITIME STUDIES: A CASE STUDY AT BARCELONA SCHOOL OF NAUTICAL STUDIES

• Marcel·la Castells Sanabra
• CLAUDIA BARAHONA-FUENTES Universitat Politècnica de Catalunya https://orcid.org/0000-0001-8599-8188
• CLARA BORÉN Universitat Politècnica de Catalunya https://orcid.org/0000-0001-7666-2279
• ROSA M. FERNANDEZ-CANTI Universitat Politècnica de Catalunya https://orcid.org/0000-0002-9381-6601
• ANNA MUJAL-COLILLES Universitat Politècnica de Catalunya https://orcid.org/0000-0003-0139-3849
• ROGER CASTELLS-MARTÍNEZ Universitat Politècnica de Catalunya
• ELISABET MAS DE LES VALLS Universitat Politècnica de Catalunya https://orcid.org/0000-0003-0134-0325

Absenteeism at the university level can be attributed to a multitude of factors. Some of these factors are academic self-perception, attitudes towards teachers, or academic performance. Others are more closely associated with work-related absenteeism, including stress, group size, commitment, and job satisfaction. In Spain, an increase of absenteeism has been noted at university level, particularly after the Covid crisis, making it one of the primary challenges that require attention. Due to the particularities and specific requirements of the Maritime Education and Training (MET) system, this study aims to quantify the current level of absenteeism and identify its main causes at the Barcelona School of Nautical Studies (FNB-UPC). This study represents the initial phase of the teaching innovation project ASAP-UPC, which focuses on redesigning teaching methodologies to minimise absenteeism in polytechnic study programs. Students and lecturers are asked about their interest in attending classes, skill development throughout their FNB-UPC experience, and their perception of the skills required for a maritime career. Information is gathered through both online surveys and in-person interviews. Results indicate that absenteeism occurs not only in class attendance but also in participation in various university activities, partly due to the change in habits caused by the pandemic. A significant number of students express dissatisfaction with in-person classes, claiming that they are overly theoretical and lack the expected balance between theory, experimental practice, and problem-solving components. These findings hold significance for FNB-UPC lecturers and decision-making bodies, as they highlight areas that can be improved to offer a more useful experience to our students. Moreover, the outcomes of this research can potentially be applied to other Maritime Education and Training Institutions (METIs).

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Teacher Degree Apprenticeships: how they work and when to apply

Trainee teachers will soon be able to gain a degree through an apprenticeship, instead of through the traditional university route into the profession.

Degree apprenticeships are growing in popularity as they offer the chance for people to earn while they learn, and gain a degree without student debt.

They are already on offer in professions including nursing, law and even space engineering , and a new Teacher Degree Apprenticeship (TDA) will soon become available.

It will enable schools across the country to recruit thousands more teachers into classrooms and will open opportunities for more people to get into teaching.

The new apprenticeships will be offered alongside the university route, so aspirational teachers will be able to choose the path that works best for them.

What are Teacher Degree Apprenticeships?

Normally, teacher training courses require candidates to already have a degree to be eligible.

With a TDA, you’ll work in a school while you gain qualified teacher status (QTS), which you need in order to teach in most schools in England. At the same time, you’ll be studying for a degree.

It means trainees won’t take on student debt and will earn while they learn, supporting those who may not have the financial means to do a traditional university-based teacher training programme.

It will be available for people to train as both primary and secondary teachers.

When can I apply for a Teacher Degree Apprenticeship?

Subject to final approval, schools will be able to start recruiting apprentices from autumn 2024, with the first trainees beginning the programme in 2025.

How do I apply for a Teacher Degree Apprenticeship?

We expect applications to open from autumn 2024 for training to start in autumn 2025.

Who is eligible and what qualifications do I need?

The TDA will be available both to those beginning their careers and those currently in employment who are interested in pursuing a career in teaching, including teaching assistants and career changers.

Candidates won’t need to already have a degree.

Further information on eligibility criteria will be provided at a later date.

How much will trainees earn?

Trainees will start working in the classroom from day one. As they develop skills to become excellent teachers, they will gradually scale up their teaching practice.

Salaries will reflect trainee responsibilities at each stage of their course. Details of exact earnings will be announced at a later date.

On top of receiving a salary, their training and qualifications will be fully funded.

How is this different to other teaching qualifications?

Currently, except for fee-funded undergraduate initial teacher training, all routes into teaching require trainees to already have a degree or undertake full time, fee-funded study.

The TDA will be an exciting and unique route into teaching that builds on the existing Postgraduate Teaching Apprenticeship (PGTA) and will be the only route that provides a salary as well as the training to get both a degree and QTS.

Will this lower teaching standards?

No. On completion, TDA trainees will have the same qualifications as someone who has qualified as a teacher through any other teacher training route.

This doesn’t mean trainees will be treated as qualified teachers from the beginning. They will work under supervision at an appropriate level that is suitable to their stage of training.

What other routes are there into teaching?

There are several routes to gaining QTS, including through university study, school-led training, or charitable organisations like Teach First.

Find out more via Get Into Teaching .

You may also be interested in:

• Degree apprenticeships: How you could get a degree for free
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• NHS doctor apprenticeships: Everything you need to know

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Teaching Award Spotlight: Amanda Murphy, Department of Statistics

When it comes time to sign up for classes, statistics students at the University of South Carolina often tell each other, “You want to sign up for Murphy’s class!” 

That’s according to David Hitchcock, interim chair of the Department of Statistics, who nominated his colleague Amanda Murphy for the 2024 Professional Track Teaching Award from the College of Arts and Sciences. 

“She’s the type of teacher that introductory statistics students feel lucky to get,” he writes. 

A senior instructor in the department, Murphy earned her reputation – and this year’s award – for her dedication and her teaching, which engages students and ensures their understanding. She also provides valuable mentorship for other instructors and teaching assistants, especially in support of Statistics 201, a course that requires students to conduct their own statistical experiments. 

“Amanda Murphy makes the Statistics department a better place through her teaching excellence in the classroom, her drive to improve the student experience in our introductory courses, her mentoring of other instructors and graduate TAs, and her collegial willingness to serve the department,” Hitchock writes. 

In recognition of her achievement, we asked Murphy to share a few thoughts about her approach to teaching. 

What inspired you to become an educator?    

I think I have always wanted to be an educator. In high school I enjoyed helping other students in math classes try to understand materials they thought were too hard to get. In graduate school, I really enjoyed being a teaching assistant and teaching Elementary Statistics. 

How do you approach teaching, and what should students expect when they enroll in one of your classes?  

I have been fortunate to have some exceptional teachers in the past, and I have used many of their methods to help me be a better educator. Good educators are those that emulate other good educators. Students who enroll in my class should expect to work outside of the classroom to practice the concepts covered in the lectures. Practice will help the materials make more sense to students with no background of the subject. My lectures break down the concepts so they are easier to understand, and my assignments reinforce the materials.  

What are some of the moments or accomplishments that make you most proud of your work at USC?  

As an instructor, I have always enjoyed hearing from students about how much they enjoyed the course, especially those who thought they would struggle in the beginning. However, something that makes me most proud has been my work with graduate students teaching a class for the first time. It is important to help new educators get started strong and have confidence. I really enjoy when a graduate student, who did not plan to go into teaching, tells me they really liked teaching.  

What do you hope your students remember about you and your courses in 10 years?  

I hope students remember that hard work on their part can make anything possible. I want students to look back after 10 years and be impressed that they could do statistical analysis that led to meaningful findings. Additionally, I hope students can see statistics presented in the real world and have an understanding of the information provided.  

Who at USC has been a role model or mentor for you and your teaching?  

I am fortunate to work in a department that has very good communication and collaboration. I have discussed teaching techniques with almost all of my colleagues. While the Department of Statistics has many faculty members that have helped me along the way, Maureen Petkewich and Gail Ward-Besser have been my role models. 

Professor Petkewich was instrumental in helping me get started when I joined the Department of Statistics. Ward-Besser, also an instructor, helped me learn how to work with large class sizes and has been a constant reference when I have needed help or another opinion about how to handle a given situation.  

Challenge the conventional. Create the exceptional. No Limits.