a case study and review of literature

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What is a Literature Review? How to Write It (with Examples)

A literature review is a critical analysis and synthesis of existing research on a particular topic. It provides an overview of the current state of knowledge, identifies gaps, and highlights key findings in the literature. 1 The purpose of a literature review is to situate your own research within the context of existing scholarship, demonstrating your understanding of the topic and showing how your work contributes to the ongoing conversation in the field. Learning how to write a literature review is a critical tool for successful research. Your ability to summarize and synthesize prior research pertaining to a certain topic demonstrates your grasp on the topic of study, and assists in the learning process.

What is the purpose of literature review?
a. Habitat Loss and Species Extinction:
b. Range Shifts and Phenological Changes:
c. Ocean Acidification and Coral Reefs:
d. Adaptive Strategies and Conservation Efforts:
How to write a good literature review
Choose a Topic and Define the Research Question:
Decide on the Scope of Your Review:
Select Databases for Searches:
Conduct Searches and Keep Track:
Review the Literature:
Organize and Write Your Literature Review:
Frequently asked questions

What is a literature review?

A well-conducted literature review demonstrates the researcher’s familiarity with the existing literature, establishes the context for their own research, and contributes to scholarly conversations on the topic. One of the purposes of a literature review is also to help researchers avoid duplicating previous work and ensure that their research is informed by and builds upon the existing body of knowledge.

What is the purpose of literature review?

A literature review serves several important purposes within academic and research contexts. Here are some key objectives and functions of a literature review: 2

Contextualizing the Research Problem: The literature review provides a background and context for the research problem under investigation. It helps to situate the study within the existing body of knowledge.
Identifying Gaps in Knowledge: By identifying gaps, contradictions, or areas requiring further research, the researcher can shape the research question and justify the significance of the study. This is crucial for ensuring that the new research contributes something novel to the field.
Understanding Theoretical and Conceptual Frameworks: Literature reviews help researchers gain an understanding of the theoretical and conceptual frameworks used in previous studies. This aids in the development of a theoretical framework for the current research.
Providing Methodological Insights: Another purpose of literature reviews is that it allows researchers to learn about the methodologies employed in previous studies. This can help in choosing appropriate research methods for the current study and avoiding pitfalls that others may have encountered.
Establishing Credibility: A well-conducted literature review demonstrates the researcher’s familiarity with existing scholarship, establishing their credibility and expertise in the field. It also helps in building a solid foundation for the new research.
Informing Hypotheses or Research Questions: The literature review guides the formulation of hypotheses or research questions by highlighting relevant findings and areas of uncertainty in existing literature.

Literature review example

Let’s delve deeper with a literature review example: Let’s say your literature review is about the impact of climate change on biodiversity. You might format your literature review into sections such as the effects of climate change on habitat loss and species extinction, phenological changes, and marine biodiversity. Each section would then summarize and analyze relevant studies in those areas, highlighting key findings and identifying gaps in the research. The review would conclude by emphasizing the need for further research on specific aspects of the relationship between climate change and biodiversity. The following literature review template provides a glimpse into the recommended literature review structure and content, demonstrating how research findings are organized around specific themes within a broader topic.

Literature Review on Climate Change Impacts on Biodiversity:

Climate change is a global phenomenon with far-reaching consequences, including significant impacts on biodiversity. This literature review synthesizes key findings from various studies:

a. Habitat Loss and Species Extinction:

Climate change-induced alterations in temperature and precipitation patterns contribute to habitat loss, affecting numerous species (Thomas et al., 2004). The review discusses how these changes increase the risk of extinction, particularly for species with specific habitat requirements.

b. Range Shifts and Phenological Changes:

Observations of range shifts and changes in the timing of biological events (phenology) are documented in response to changing climatic conditions (Parmesan & Yohe, 2003). These shifts affect ecosystems and may lead to mismatches between species and their resources.

c. Ocean Acidification and Coral Reefs:

The review explores the impact of climate change on marine biodiversity, emphasizing ocean acidification’s threat to coral reefs (Hoegh-Guldberg et al., 2007). Changes in pH levels negatively affect coral calcification, disrupting the delicate balance of marine ecosystems.

d. Adaptive Strategies and Conservation Efforts:

Recognizing the urgency of the situation, the literature review discusses various adaptive strategies adopted by species and conservation efforts aimed at mitigating the impacts of climate change on biodiversity (Hannah et al., 2007). It emphasizes the importance of interdisciplinary approaches for effective conservation planning.

How to write a good literature review

Writing a literature review involves summarizing and synthesizing existing research on a particular topic. A good literature review format should include the following elements.

Introduction: The introduction sets the stage for your literature review, providing context and introducing the main focus of your review.

Opening Statement: Begin with a general statement about the broader topic and its significance in the field.
Scope and Purpose: Clearly define the scope of your literature review. Explain the specific research question or objective you aim to address.
Organizational Framework: Briefly outline the structure of your literature review, indicating how you will categorize and discuss the existing research.
Significance of the Study: Highlight why your literature review is important and how it contributes to the understanding of the chosen topic.
Thesis Statement: Conclude the introduction with a concise thesis statement that outlines the main argument or perspective you will develop in the body of the literature review.

Body: The body of the literature review is where you provide a comprehensive analysis of existing literature, grouping studies based on themes, methodologies, or other relevant criteria.

Organize by Theme or Concept: Group studies that share common themes, concepts, or methodologies. Discuss each theme or concept in detail, summarizing key findings and identifying gaps or areas of disagreement.
Critical Analysis: Evaluate the strengths and weaknesses of each study. Discuss the methodologies used, the quality of evidence, and the overall contribution of each work to the understanding of the topic.
Synthesis of Findings: Synthesize the information from different studies to highlight trends, patterns, or areas of consensus in the literature.
Identification of Gaps: Discuss any gaps or limitations in the existing research and explain how your review contributes to filling these gaps.
Transition between Sections: Provide smooth transitions between different themes or concepts to maintain the flow of your literature review.

Conclusion: The conclusion of your literature review should summarize the main findings, highlight the contributions of the review, and suggest avenues for future research.

Summary of Key Findings: Recap the main findings from the literature and restate how they contribute to your research question or objective.
Contributions to the Field: Discuss the overall contribution of your literature review to the existing knowledge in the field.
Implications and Applications: Explore the practical implications of the findings and suggest how they might impact future research or practice.
Recommendations for Future Research: Identify areas that require further investigation and propose potential directions for future research in the field.
Final Thoughts: Conclude with a final reflection on the importance of your literature review and its relevance to the broader academic community.

Conducting a literature review

Conducting a literature review is an essential step in research that involves reviewing and analyzing existing literature on a specific topic. It’s important to know how to do a literature review effectively, so here are the steps to follow: 1

Choose a Topic and Define the Research Question:

Select a topic that is relevant to your field of study.
Clearly define your research question or objective. Determine what specific aspect of the topic do you want to explore?

Decide on the Scope of Your Review:

Determine the timeframe for your literature review. Are you focusing on recent developments, or do you want a historical overview?
Consider the geographical scope. Is your review global, or are you focusing on a specific region?
Define the inclusion and exclusion criteria. What types of sources will you include? Are there specific types of studies or publications you will exclude?

Select Databases for Searches:

Identify relevant databases for your field. Examples include PubMed, IEEE Xplore, Scopus, Web of Science, and Google Scholar.
Consider searching in library catalogs, institutional repositories, and specialized databases related to your topic.

Conduct Searches and Keep Track:

Develop a systematic search strategy using keywords, Boolean operators (AND, OR, NOT), and other search techniques.
Record and document your search strategy for transparency and replicability.
Keep track of the articles, including publication details, abstracts, and links. Use citation management tools like EndNote, Zotero, or Mendeley to organize your references.

Review the Literature:

Evaluate the relevance and quality of each source. Consider the methodology, sample size, and results of studies.
Organize the literature by themes or key concepts. Identify patterns, trends, and gaps in the existing research.
Summarize key findings and arguments from each source. Compare and contrast different perspectives.
Identify areas where there is a consensus in the literature and where there are conflicting opinions.
Provide critical analysis and synthesis of the literature. What are the strengths and weaknesses of existing research?

Organize and Write Your Literature Review:

Literature review outline should be based on themes, chronological order, or methodological approaches.
Write a clear and coherent narrative that synthesizes the information gathered.
Use proper citations for each source and ensure consistency in your citation style (APA, MLA, Chicago, etc.).
Conclude your literature review by summarizing key findings, identifying gaps, and suggesting areas for future research.

The literature review sample and detailed advice on writing and conducting a review will help you produce a well-structured report. But remember that a literature review is an ongoing process, and it may be necessary to revisit and update it as your research progresses.

Frequently asked questions

A literature review is a critical and comprehensive analysis of existing literature (published and unpublished works) on a specific topic or research question and provides a synthesis of the current state of knowledge in a particular field. A well-conducted literature review is crucial for researchers to build upon existing knowledge, avoid duplication of efforts, and contribute to the advancement of their field. It also helps researchers situate their work within a broader context and facilitates the development of a sound theoretical and conceptual framework for their studies.

Literature review is a crucial component of research writing, providing a solid background for a research paper’s investigation. The aim is to keep professionals up to date by providing an understanding of ongoing developments within a specific field, including research methods, and experimental techniques used in that field, and present that knowledge in the form of a written report. Also, the depth and breadth of the literature review emphasizes the credibility of the scholar in his or her field.

Before writing a literature review, it’s essential to undertake several preparatory steps to ensure that your review is well-researched, organized, and focused. This includes choosing a topic of general interest to you and doing exploratory research on that topic, writing an annotated bibliography, and noting major points, especially those that relate to the position you have taken on the topic.

Literature reviews and academic research papers are essential components of scholarly work but serve different purposes within the academic realm. 3 A literature review aims to provide a foundation for understanding the current state of research on a particular topic, identify gaps or controversies, and lay the groundwork for future research. Therefore, it draws heavily from existing academic sources, including books, journal articles, and other scholarly publications. In contrast, an academic research paper aims to present new knowledge, contribute to the academic discourse, and advance the understanding of a specific research question. Therefore, it involves a mix of existing literature (in the introduction and literature review sections) and original data or findings obtained through research methods.

Literature reviews are essential components of academic and research papers, and various strategies can be employed to conduct them effectively. If you want to know how to write a literature review for a research paper, here are four common approaches that are often used by researchers. Chronological Review: This strategy involves organizing the literature based on the chronological order of publication. It helps to trace the development of a topic over time, showing how ideas, theories, and research have evolved. Thematic Review: Thematic reviews focus on identifying and analyzing themes or topics that cut across different studies. Instead of organizing the literature chronologically, it is grouped by key themes or concepts, allowing for a comprehensive exploration of various aspects of the topic. Methodological Review: This strategy involves organizing the literature based on the research methods employed in different studies. It helps to highlight the strengths and weaknesses of various methodologies and allows the reader to evaluate the reliability and validity of the research findings. Theoretical Review: A theoretical review examines the literature based on the theoretical frameworks used in different studies. This approach helps to identify the key theories that have been applied to the topic and assess their contributions to the understanding of the subject. It’s important to note that these strategies are not mutually exclusive, and a literature review may combine elements of more than one approach. The choice of strategy depends on the research question, the nature of the literature available, and the goals of the review. Additionally, other strategies, such as integrative reviews or systematic reviews, may be employed depending on the specific requirements of the research.

The literature review format can vary depending on the specific publication guidelines. However, there are some common elements and structures that are often followed. Here is a general guideline for the format of a literature review: Introduction: Provide an overview of the topic. Define the scope and purpose of the literature review. State the research question or objective. Body: Organize the literature by themes, concepts, or chronology. Critically analyze and evaluate each source. Discuss the strengths and weaknesses of the studies. Highlight any methodological limitations or biases. Identify patterns, connections, or contradictions in the existing research. Conclusion: Summarize the key points discussed in the literature review. Highlight the research gap. Address the research question or objective stated in the introduction. Highlight the contributions of the review and suggest directions for future research.

Both annotated bibliographies and literature reviews involve the examination of scholarly sources. While annotated bibliographies focus on individual sources with brief annotations, literature reviews provide a more in-depth, integrated, and comprehensive analysis of existing literature on a specific topic. The key differences are as follows:

References

Denney, A. S., & Tewksbury, R. (2013). How to write a literature review.  Journal of criminal justice education ,  24 (2), 218-234.
Pan, M. L. (2016).  Preparing literature reviews: Qualitative and quantitative approaches . Taylor & Francis.
Cantero, C. (2019). How to write a literature review.  San José State University Writing Center .

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Organizing Your Social Sciences Research Paper: Writing a Case Study

Purpose of Guide
Design Flaws to Avoid
Independent and Dependent Variables
Glossary of Research Terms
Narrowing a Topic Idea
Broadening a Topic Idea
Extending the Timeliness of a Topic Idea
Academic Writing Style
Choosing a Title
Making an Outline
Paragraph Development
Executive Summary
The C.A.R.S. Model
Background Information
The Research Problem/Question
Theoretical Framework
Citation Tracking
Content Alert Services
Evaluating Sources
Reading Research Effectively
Primary Sources
Secondary Sources
Tiertiary Sources
What Is Scholarly vs. Popular?
Qualitative Methods
Quantitative Methods
Using Non-Textual Elements
Limitations of the Study
Common Grammar Mistakes
Writing Concisely
Avoiding Plagiarism
Footnotes or Endnotes?
Further Readings
Annotated Bibliography
Dealing with Nervousness
Using Visual Aids
Grading Someone Else's Paper
Types of Structured Group Activities
Group Project Survival Skills
Multiple Book Review Essay
Reviewing Collected Essays
Writing a Case Study
About Informed Consent
Writing Field Notes
Writing a Policy Memo
Writing a Research Proposal
Bibliography

The term case study refers to both a method of analysis and a specific research design for examining a problem, both of which are used in most circumstances to generalize across populations. This tab focuses on the latter--how to design and organize a research paper in the social sciences that analyzes a specific case.

A case study research paper examines a person, place, event, phenomenon, or other type of subject of analysis in order to extrapolate key themes and results that help predict future trends, illuminate previously hidden issues that can be applied to practice, and/or provide a means for understanding an important research problem with greater clarity. A case study paper usually examines a single subject of analysis, but case study papers can also be designed as a comparative investigation that shows relationships between two or among more than two subjects. The methods used to study a case can rest within a quantitative, qualitative, or mixed-method investigative paradigm.

Case Studies . Writing@CSU. Colorado State University; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010 ; “What is a Case Study?” In Swanborn, Peter G. Case Study Research: What, Why and How? London: SAGE, 2010.

How to Approach Writing a Case Study Research Paper

General information about how to choose a topic to investigate can be found under the " Choosing a Research Problem " tab in this writing guide. Review this page because it may help you identify a subject of analysis that can be investigated using a single case study design.

However, identifying a case to investigate involves more than choosing the research problem . A case study encompasses a problem contextualized around the application of in-depth analysis, interpretation, and discussion, often resulting in specific recommendations for action or for improving existing conditions. As Seawright and Gerring note, practical considerations such as time and access to information can influence case selection, but these issues should not be the sole factors used in describing the methodological justification for identifying a particular case to study. Given this, selecting a case includes considering the following:

Does the case represent an unusual or atypical example of a research problem that requires more in-depth analysis? Cases often represent a topic that rests on the fringes of prior investigations because the case may provide new ways of understanding the research problem. For example, if the research problem is to identify strategies to improve policies that support girl's access to secondary education in predominantly Muslim nations, you could consider using Azerbaijan as a case study rather than selecting a more obvious nation in the Middle East. Doing so may reveal important new insights into recommending how governments in other predominantly Muslim nations can formulate policies that support improved access to education for girls.
Does the case provide important insight or illuminate a previously hidden problem? In-depth analysis of a case can be based on the hypothesis that the case study will reveal trends or issues that have not been exposed in prior research or will reveal new and important implications for practice. For example, anecdotal evidence may suggest drug use among homeless veterans is related to their patterns of travel throughout the day. Assuming prior studies have not looked at individual travel choices as a way to study access to illicit drug use, a case study that observes a homeless veteran could reveal how issues of personal mobility choices facilitate regular access to illicit drugs. Note that it is important to conduct a thorough literature review to ensure that your assumption about the need to reveal new insights or previously hidden problems is valid and evidence-based.
Does the case challenge and offer a counter-point to prevailing assumptions? Over time, research on any given topic can fall into a trap of developing assumptions based on outdated studies that are still applied to new or changing conditions or the idea that something should simply be accepted as "common sense," even though the issue has not been thoroughly tested in practice. A case may offer you an opportunity to gather evidence that challenges prevailing assumptions about a research problem and provide a new set of recommendations applied to practice that have not been tested previously. For example, perhaps there has been a long practice among scholars to apply a particular theory in explaining the relationship between two subjects of analysis. Your case could challenge this assumption by applying an innovative theoretical framework [perhaps borrowed from another discipline] to the study a case in order to explore whether this approach offers new ways of understanding the research problem. Taking a contrarian stance is one of the most important ways that new knowledge and understanding develops from existing literature.
Does the case provide an opportunity to pursue action leading to the resolution of a problem? Another way to think about choosing a case to study is to consider how the results from investigating a particular case may result in findings that reveal ways in which to resolve an existing or emerging problem. For example, studying the case of an unforeseen incident, such as a fatal accident at a railroad crossing, can reveal hidden issues that could be applied to preventative measures that contribute to reducing the chance of accidents in the future. In this example, a case study investigating the accident could lead to a better understanding of where to strategically locate additional signals at other railroad crossings in order to better warn drivers of an approaching train, particularly when visibility is hindered by heavy rain, fog, or at night.
Does the case offer a new direction in future research? A case study can be used as a tool for exploratory research that points to a need for further examination of the research problem. A case can be used when there are few studies that help predict an outcome or that establish a clear understanding about how best to proceed in addressing a problem. For example, after conducting a thorough literature review [very important!], you discover that little research exists showing the ways in which women contribute to promoting water conservation in rural communities of Uganda. A case study of how women contribute to saving water in a particular village can lay the foundation for understanding the need for more thorough research that documents how women in their roles as cooks and family caregivers think about water as a valuable resource within their community throughout rural regions of east Africa. The case could also point to the need for scholars to apply feminist theories of work and family to the issue of water conservation.

Eisenhardt, Kathleen M. “Building Theories from Case Study Research.” Academy of Management Review 14 (October 1989): 532-550; Emmel, Nick. Sampling and Choosing Cases in Qualitative Research: A Realist Approach . Thousand Oaks, CA: SAGE Publications, 2013; Gerring, John. “What Is a Case Study and What Is It Good for?” American Political Science Review 98 (May 2004): 341-354; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Seawright, Jason and John Gerring. "Case Selection Techniques in Case Study Research." Political Research Quarterly 61 (June 2008): 294-308.

Structure and Writing Style

The purpose of a paper in the social sciences designed around a case study is to thoroughly investigate a subject of analysis in order to reveal a new understanding about the research problem and, in so doing, contributing new knowledge to what is already known from previous studies. In applied social sciences disciplines [e.g., education, social work, public administration, etc.], case studies may also be used to reveal best practices, highlight key programs, or investigate interesting aspects of professional work. In general, the structure of a case study research paper is not all that different from a standard college-level research paper. However, there are subtle differences you should be aware of. Here are the key elements to organizing and writing a case study research paper.

I. Introduction

As with any research paper, your introduction should serve as a roadmap for your readers to ascertain the scope and purpose of your study . The introduction to a case study research paper, however, should not only describe the research problem and its significance, but you should also succinctly describe why the case is being used and how it relates to addressing the problem. The two elements should be linked. With this in mind, a good introduction answers these four questions:

What was I studying? Describe the research problem and describe the subject of analysis you have chosen to address the problem. Explain how they are linked and what elements of the case will help to expand knowledge and understanding about the problem.
Why was this topic important to investigate? Describe the significance of the research problem and state why a case study design and the subject of analysis that the paper is designed around is appropriate in addressing the problem.
What did we know about this topic before I did this study? Provide background that helps lead the reader into the more in-depth literature review to follow. If applicable, summarize prior case study research applied to the research problem and why it fails to adequately address the research problem. Describe why your case will be useful. If no prior case studies have been used to address the research problem, explain why you have selected this subject of analysis.
How will this study advance new knowledge or new ways of understanding? Explain why your case study will be suitable in helping to expand knowledge and understanding about the research problem.

Each of these questions should be addressed in no more than a few paragraphs. Exceptions to this can be when you are addressing a complex research problem or subject of analysis that requires more in-depth background information.

II. Literature Review

The literature review for a case study research paper is generally structured the same as it is for any college-level research paper. The difference, however, is that the literature review is focused on providing background information and enabling historical interpretation of the subject of analysis in relation to the research problem the case is intended to address . This includes synthesizing studies that help to:

Place relevant works in the context of their contribution to understanding the case study being investigated . This would include summarizing studies that have used a similar subject of analysis to investigate the research problem. If there is literature using the same or a very similar case to study, you need to explain why duplicating past research is important [e.g., conditions have changed; prior studies were conducted long ago, etc.].
Describe the relationship each work has to the others under consideration that informs the reader why this case is applicable . Your literature review should include a description of any works that support using the case to study the research problem and the underlying research questions.
Identify new ways to interpret prior research using the case study . If applicable, review any research that has examined the research problem using a different research design. Explain how your case study design may reveal new knowledge or a new perspective or that can redirect research in an important new direction.
Resolve conflicts amongst seemingly contradictory previous studies . This refers to synthesizing any literature that points to unresolved issues of concern about the research problem and describing how the subject of analysis that forms the case study can help resolve these existing contradictions.
Point the way in fulfilling a need for additional research . Your review should examine any literature that lays a foundation for understanding why your case study design and the subject of analysis around which you have designed your study may reveal a new way of approaching the research problem or offer a perspective that points to the need for additional research.
Expose any gaps that exist in the literature that the case study could help to fill . Summarize any literature that not only shows how your subject of analysis contributes to understanding the research problem, but how your case contributes to a new way of understanding the problem that prior research has failed to do.
Locate your own research within the context of existing literature [very important!] . Collectively, your literature review should always place your case study within the larger domain of prior research about the problem. The overarching purpose of reviewing pertinent literature in a case study paper is to demonstrate that you have thoroughly identified and synthesized prior studies in the context of explaining the relevance of the case in addressing the research problem.

III. Method

In this section, you explain why you selected a particular subject of analysis to study and the strategy you used to identify and ultimately decide that your case was appropriate in addressing the research problem. The way you describe the methods used varies depending on the type of subject of analysis that frames your case study.

If your subject of analysis is an incident or event . In the social and behavioral sciences, the event or incident that represents the case to be studied is usually bounded by time and place, with a clear beginning and end and with an identifiable location or position relative to its surroundings. The subject of analysis can be a rare or critical event or it can focus on a typical or regular event. The purpose of studying a rare event is to illuminate new ways of thinking about the broader research problem or to test a hypothesis. Critical incident case studies must describe the method by which you identified the event and explain the process by which you determined the validity of this case to inform broader perspectives about the research problem or to reveal new findings. However, the event does not have to be a rare or uniquely significant to support new thinking about the research problem or to challenge an existing hypothesis. For example, Walo, Bull, and Breen conducted a case study to identify and evaluate the direct and indirect economic benefits and costs of a local sports event in the City of Lismore, New South Wales, Australia. The purpose of their study was to provide new insights from measuring the impact of a typical local sports event that prior studies could not measure well because they focused on large "mega-events." Whether the event is rare or not, the methods section should include an explanation of the following characteristics of the event: a) when did it take place; b) what were the underlying circumstances leading to the event; c) what were the consequences of the event.

If your subject of analysis is a person. Explain why you selected this particular individual to be studied and describe what experience he or she has had that provides an opportunity to advance new understandings about the research problem. Mention any background about this person which might help the reader understand the significance of his/her experiences that make them worthy of study. This includes describing the relationships this person has had with other people, institutions, and/or events that support using him or her as the subject for a case study research paper. It is particularly important to differentiate the person as the subject of analysis from others and to succinctly explain how the person relates to examining the research problem.

If your subject of analysis is a place. In general, a case study that investigates a place suggests a subject of analysis that is unique or special in some way and that this uniqueness can be used to build new understanding or knowledge about the research problem. A case study of a place must not only describe its various attributes relevant to the research problem [e.g., physical, social, cultural, economic, political, etc.], but you must state the method by which you determined that this place will illuminate new understandings about the research problem. It is also important to articulate why a particular place as the case for study is being used if similar places also exist [i.e., if you are studying patterns of homeless encampments of veterans in open spaces, why study Echo Park in Los Angeles rather than Griffith Park?]. If applicable, describe what type of human activity involving this place makes it a good choice to study [e.g., prior research reveals Echo Park has more homeless veterans].

If your subject of analysis is a phenomenon. A phenomenon refers to a fact, occurrence, or circumstance that can be studied or observed but with the cause or explanation to be in question. In this sense, a phenomenon that forms your subject of analysis can encompass anything that can be observed or presumed to exist but is not fully understood. In the social and behavioral sciences, the case usually focuses on human interaction within a complex physical, social, economic, cultural, or political system. For example, the phenomenon could be the observation that many vehicles used by ISIS fighters are small trucks with English language advertisements on them. The research problem could be that ISIS fighters are difficult to combat because they are highly mobile. The research questions could be how and by what means are these vehicles used by ISIS being supplied to the militants and how might supply lines to these vehicles be cut? How might knowing the suppliers of these trucks from overseas reveal larger networks of collaborators and financial support? A case study of a phenomenon most often encompasses an in-depth analysis of a cause and effect that is grounded in an interactive relationship between people and their environment in some way.

NOTE: The choice of the case or set of cases to study cannot appear random. Evidence that supports the method by which you identified and chose your subject of analysis should be linked to the findings from the literature review. Be sure to cite any prior studies that helped you determine that the case you chose was appropriate for investigating the research problem.

IV. Discussion

The main elements of your discussion section are generally the same as any research paper, but centered around interpreting and drawing conclusions about the key findings from your case study. Note that a general social sciences research paper may contain a separate section to report findings. However, in a paper designed around a case study, it is more common to combine a description of the findings with the discussion about their implications. The objectives of your discussion section should include the following:

Reiterate the Research Problem/State the Major Findings Briefly reiterate the research problem you are investigating and explain why the subject of analysis around which you designed the case study were used. You should then describe the findings revealed from your study of the case using direct, declarative, and succinct proclamation of the study results. Highlight any findings that were unexpected or especially profound.

Explain the Meaning of the Findings and Why They are Important Systematically explain the meaning of your case study findings and why you believe they are important. Begin this part of the section by repeating what you consider to be your most important or surprising finding first, then systematically review each finding. Be sure to thoroughly extrapolate what your analysis of the case can tell the reader about situations or conditions beyond the actual case that was studied while, at the same time, being careful not to misconstrue or conflate a finding that undermines the external validity of your conclusions.

Relate the Findings to Similar Studies No study in the social sciences is so novel or possesses such a restricted focus that it has absolutely no relation to previously published research. The discussion section should relate your case study results to those found in other studies, particularly if questions raised from prior studies served as the motivation for choosing your subject of analysis. This is important because comparing and contrasting the findings of other studies helps to support the overall importance of your results and it highlights how and in what ways your case study design and the subject of analysis differs from prior research about the topic.

Consider Alternative Explanations of the Findings It is important to remember that the purpose of social science research is to discover and not to prove. When writing the discussion section, you should carefully consider all possible explanations for the case study results, rather than just those that fit your hypothesis or prior assumptions and biases. Be alert to what the in-depth analysis of the case may reveal about the research problem, including offering a contrarian perspective to what scholars have stated in prior research.

Acknowledge the Study's Limitations You can state the study's limitations in the conclusion section of your paper but describing the limitations of your subject of analysis in the discussion section provides an opportunity to identify the limitations and explain why they are not significant. This part of the discussion section should also note any unanswered questions or issues your case study could not address. More detailed information about how to document any limitations to your research can be found here .

Suggest Areas for Further Research Although your case study may offer important insights about the research problem, there are likely additional questions related to the problem that remain unanswered or findings that unexpectedly revealed themselves as a result of your in-depth analysis of the case. Be sure that the recommendations for further research are linked to the research problem and that you explain why your recommendations are valid in other contexts and based on the original assumptions of your study.

V. Conclusion

As with any research paper, you should summarize your conclusion in clear, simple language; emphasize how the findings from your case study differs from or supports prior research and why. Do not simply reiterate the discussion section. Provide a synthesis of key findings presented in the paper to show how these converge to address the research problem. If you haven't already done so in the discussion section, be sure to document the limitations of your case study and needs for further research.

The function of your paper's conclusion is to: 1) restate the main argument supported by the findings from the analysis of your case; 2) clearly state the context, background, and necessity of pursuing the research problem using a case study design in relation to an issue, controversy, or a gap found from reviewing the literature; and, 3) provide a place for you to persuasively and succinctly restate the significance of your research problem, given that the reader has now been presented with in-depth information about the topic.

Consider the following points to help ensure your conclusion is appropriate:

If the argument or purpose of your paper is complex, you may need to summarize these points for your reader.
If prior to your conclusion, you have not yet explained the significance of your findings or if you are proceeding inductively, use the conclusion of your paper to describe your main points and explain their significance.
Move from a detailed to a general level of consideration of the case study's findings that returns the topic to the context provided by the introduction or within a new context that emerges from your case study findings.

Note that, depending on the discipline you are writing in and your professor's preferences, the concluding paragraph may contain your final reflections on the evidence presented applied to practice or on the essay's central research problem. However, the nature of being introspective about the subject of analysis you have investigated will depend on whether you are explicitly asked to express your observations in this way.

Problems to Avoid

Overgeneralization One of the goals of a case study is to lay a foundation for understanding broader trends and issues applied to similar circumstances. However, be careful when drawing conclusions from your case study. They must be evidence-based and grounded in the results of the study; otherwise, it is merely speculation. Looking at a prior example, it would be incorrect to state that a factor in improving girls access to education in Azerbaijan and the policy implications this may have for improving access in other Muslim nations is due to girls access to social media if there is no documentary evidence from your case study to indicate this. There may be anecdotal evidence that retention rates were better for girls who were on social media, but this observation would only point to the need for further research and would not be a definitive finding if this was not a part of your original research agenda.

Failure to Document Limitations No case is going to reveal all that needs to be understood about a research problem. Therefore, just as you have to clearly state the limitations of a general research study , you must describe the specific limitations inherent in the subject of analysis. For example, the case of studying how women conceptualize the need for water conservation in a village in Uganda could have limited application in other cultural contexts or in areas where fresh water from rivers or lakes is plentiful and, therefore, conservation is understood differently than preserving access to a scarce resource.

Failure to Extrapolate All Possible Implications Just as you don't want to over-generalize from your case study findings, you also have to be thorough in the consideration of all possible outcomes or recommendations derived from your findings. If you do not, your reader may question the validity of your analysis, particularly if you failed to document an obvious outcome from your case study research. For example, in the case of studying the accident at the railroad crossing to evaluate where and what types of warning signals should be located, you failed to take into consideration speed limit signage as well as warning signals. When designing your case study, be sure you have thoroughly addressed all aspects of the problem and do not leave gaps in your analysis.

Case Studies . Writing@CSU. Colorado State University; Gerring, John. Case Study Research: Principles and Practices . New York: Cambridge University Press, 2007; Merriam, Sharan B. Qualitative Research and Case Study Applications in Education . Rev. ed. San Francisco, CA: Jossey-Bass, 1998; Miller, Lisa L. “The Use of Case Studies in Law and Social Science Research.” Annual Review of Law and Social Science 14 (2018): TBD; Mills, Albert J., Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Putney, LeAnn Grogan. "Case Study." In Encyclopedia of Research Design , Neil J. Salkind, editor. (Thousand Oaks, CA: SAGE Publications, 2010), pp. 116-120; Simons, Helen. Case Study Research in Practice . London: SAGE Publications, 2009; Kratochwill, Thomas R. and Joel R. Levin, editors. Single-Case Research Design and Analysis: New Development for Psychology and Education . Hilldsale, NJ: Lawrence Erlbaum Associates, 1992; Swanborn, Peter G. Case Study Research: What, Why and How? London : SAGE, 2010; Yin, Robert K. Case Study Research: Design and Methods . 6th edition. Los Angeles, CA, SAGE Publications, 2014; Walo, Maree, Adrian Bull, and Helen Breen. “Achieving Economic Benefits at Local Events: A Case Study of a Local Sports Event.” Festival Management and Event Tourism 4 (1996): 95-106.

Writing Tip

At Least Five Misconceptions about Case Study Research

Social science case studies are often perceived as limited in their ability to create new knowledge because they are not randomly selected and findings cannot be generalized to larger populations. Flyvbjerg examines five misunderstandings about case study research and systematically "corrects" each one. To quote, these are:

Misunderstanding 1 : General, theoretical [context-independent knowledge is more valuable than concrete, practical (context-dependent) knowledge. Misunderstanding 2 : One cannot generalize on the basis of an individual case; therefore, the case study cannot contribute to scientific development. Misunderstanding 3 : The case study is most useful for generating hypotheses; that is, in the first stage of a total research process, whereas other methods are more suitable for hypotheses testing and theory building. Misunderstanding 4 : The case study contains a bias toward verification, that is, a tendency to confirm the researcher’s preconceived notions. Misunderstanding 5 : It is often difficult to summarize and develop general propositions and theories on the basis of specific case studies [p. 221].

While writing your paper, think introspectively about how you addressed these misconceptions because to do so can help you strengthen the validity and reliability of your research by clarifying issues of case selection, the testing and challenging of existing assumptions, the interpretation of key findings, and the summation of case outcomes. Think of a case study research paper as a complete, in-depth narrative about the specific properties and key characteristics of your subject of analysis applied to the research problem.

Flyvbjerg, Bent. “Five Misunderstandings About Case-Study Research.” Qualitative Inquiry 12 (April 2006): 219-245.

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What is a Literature Review? | Guide, Template, & Examples

What is a Literature Review? | Guide, Template, & Examples

Published on 22 February 2022 by Shona McCombes . Revised on 7 June 2022.

What is a literature review? A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research.

There are five key steps to writing a literature review:

Search for relevant literature
Evaluate sources
Identify themes, debates and gaps
Outline the structure
Write your literature review

A good literature review doesn’t just summarise sources – it analyses, synthesises, and critically evaluates to give a clear picture of the state of knowledge on the subject.

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Why write a literature review, examples of literature reviews, step 1: search for relevant literature, step 2: evaluate and select sources, step 3: identify themes, debates and gaps, step 4: outline your literature review’s structure, step 5: write your literature review, frequently asked questions about literature reviews, introduction.

Quick Run-through
Step 1 & 2

When you write a dissertation or thesis, you will have to conduct a literature review to situate your research within existing knowledge. The literature review gives you a chance to:

Demonstrate your familiarity with the topic and scholarly context
Develop a theoretical framework and methodology for your research
Position yourself in relation to other researchers and theorists
Show how your dissertation addresses a gap or contributes to a debate

You might also have to write a literature review as a stand-alone assignment. In this case, the purpose is to evaluate the current state of research and demonstrate your knowledge of scholarly debates around a topic.

The content will look slightly different in each case, but the process of conducting a literature review follows the same steps. We’ve written a step-by-step guide that you can follow below.

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Writing literature reviews can be quite challenging! A good starting point could be to look at some examples, depending on what kind of literature review you’d like to write.

Example literature review #1: “Why Do People Migrate? A Review of the Theoretical Literature” ( Theoretical literature review about the development of economic migration theory from the 1950s to today.)
Example literature review #2: “Literature review as a research methodology: An overview and guidelines” ( Methodological literature review about interdisciplinary knowledge acquisition and production.)
Example literature review #3: “The Use of Technology in English Language Learning: A Literature Review” ( Thematic literature review about the effects of technology on language acquisition.)
Example literature review #4: “Learners’ Listening Comprehension Difficulties in English Language Learning: A Literature Review” ( Chronological literature review about how the concept of listening skills has changed over time.)

You can also check out our templates with literature review examples and sample outlines at the links below.

Download Word doc Download Google doc

Before you begin searching for literature, you need a clearly defined topic .

If you are writing the literature review section of a dissertation or research paper, you will search for literature related to your research objectives and questions .

If you are writing a literature review as a stand-alone assignment, you will have to choose a focus and develop a central question to direct your search. Unlike a dissertation research question, this question has to be answerable without collecting original data. You should be able to answer it based only on a review of existing publications.

Make a list of keywords

Start by creating a list of keywords related to your research topic. Include each of the key concepts or variables you’re interested in, and list any synonyms and related terms. You can add to this list if you discover new keywords in the process of your literature search.

Social media, Facebook, Instagram, Twitter, Snapchat, TikTok
Body image, self-perception, self-esteem, mental health
Generation Z, teenagers, adolescents, youth

Search for relevant sources

Use your keywords to begin searching for sources. Some databases to search for journals and articles include:

Your university’s library catalogue
Google Scholar
Project Muse (humanities and social sciences)
Medline (life sciences and biomedicine)
EconLit (economics)
Inspec (physics, engineering and computer science)

You can use boolean operators to help narrow down your search:

Read the abstract to find out whether an article is relevant to your question. When you find a useful book or article, you can check the bibliography to find other relevant sources.

To identify the most important publications on your topic, take note of recurring citations. If the same authors, books or articles keep appearing in your reading, make sure to seek them out.

You probably won’t be able to read absolutely everything that has been written on the topic – you’ll have to evaluate which sources are most relevant to your questions.

For each publication, ask yourself:

What question or problem is the author addressing?
What are the key concepts and how are they defined?
What are the key theories, models and methods? Does the research use established frameworks or take an innovative approach?
What are the results and conclusions of the study?
How does the publication relate to other literature in the field? Does it confirm, add to, or challenge established knowledge?
How does the publication contribute to your understanding of the topic? What are its key insights and arguments?
What are the strengths and weaknesses of the research?

Make sure the sources you use are credible, and make sure you read any landmark studies and major theories in your field of research.

You can find out how many times an article has been cited on Google Scholar – a high citation count means the article has been influential in the field, and should certainly be included in your literature review.

The scope of your review will depend on your topic and discipline: in the sciences you usually only review recent literature, but in the humanities you might take a long historical perspective (for example, to trace how a concept has changed in meaning over time).

Remember that you can use our template to summarise and evaluate sources you’re thinking about using!

Take notes and cite your sources

As you read, you should also begin the writing process. Take notes that you can later incorporate into the text of your literature review.

It’s important to keep track of your sources with references to avoid plagiarism . It can be helpful to make an annotated bibliography, where you compile full reference information and write a paragraph of summary and analysis for each source. This helps you remember what you read and saves time later in the process.

You can use our free APA Reference Generator for quick, correct, consistent citations.

Prevent plagiarism, run a free check.

To begin organising your literature review’s argument and structure, you need to understand the connections and relationships between the sources you’ve read. Based on your reading and notes, you can look for:

Trends and patterns (in theory, method or results): do certain approaches become more or less popular over time?
Themes: what questions or concepts recur across the literature?
Debates, conflicts and contradictions: where do sources disagree?
Pivotal publications: are there any influential theories or studies that changed the direction of the field?
Gaps: what is missing from the literature? Are there weaknesses that need to be addressed?

This step will help you work out the structure of your literature review and (if applicable) show how your own research will contribute to existing knowledge.

Most research has focused on young women.
There is an increasing interest in the visual aspects of social media.
But there is still a lack of robust research on highly-visual platforms like Instagram and Snapchat – this is a gap that you could address in your own research.

There are various approaches to organising the body of a literature review. You should have a rough idea of your strategy before you start writing.

Depending on the length of your literature review, you can combine several of these strategies (for example, your overall structure might be thematic, but each theme is discussed chronologically).

Chronological

The simplest approach is to trace the development of the topic over time. However, if you choose this strategy, be careful to avoid simply listing and summarising sources in order.

Try to analyse patterns, turning points and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred.

If you have found some recurring central themes, you can organise your literature review into subsections that address different aspects of the topic.

For example, if you are reviewing literature about inequalities in migrant health outcomes, key themes might include healthcare policy, language barriers, cultural attitudes, legal status, and economic access.

Methodological

If you draw your sources from different disciplines or fields that use a variety of research methods , you might want to compare the results and conclusions that emerge from different approaches. For example:

Look at what results have emerged in qualitative versus quantitative research
Discuss how the topic has been approached by empirical versus theoretical scholarship
Divide the literature into sociological, historical, and cultural sources

Theoretical

A literature review is often the foundation for a theoretical framework . You can use it to discuss various theories, models, and definitions of key concepts.

You might argue for the relevance of a specific theoretical approach, or combine various theoretical concepts to create a framework for your research.

Like any other academic text, your literature review should have an introduction , a main body, and a conclusion . What you include in each depends on the objective of your literature review.

The introduction should clearly establish the focus and purpose of the literature review.

If you are writing the literature review as part of your dissertation or thesis, reiterate your central problem or research question and give a brief summary of the scholarly context. You can emphasise the timeliness of the topic (“many recent studies have focused on the problem of x”) or highlight a gap in the literature (“while there has been much research on x, few researchers have taken y into consideration”).

Depending on the length of your literature review, you might want to divide the body into subsections. You can use a subheading for each theme, time period, or methodological approach.

As you write, make sure to follow these tips:

Summarise and synthesise: give an overview of the main points of each source and combine them into a coherent whole.
Analyse and interpret: don’t just paraphrase other researchers – add your own interpretations, discussing the significance of findings in relation to the literature as a whole.
Critically evaluate: mention the strengths and weaknesses of your sources.
Write in well-structured paragraphs: use transitions and topic sentences to draw connections, comparisons and contrasts.

In the conclusion, you should summarise the key findings you have taken from the literature and emphasise their significance.

If the literature review is part of your dissertation or thesis, reiterate how your research addresses gaps and contributes new knowledge, or discuss how you have drawn on existing theories and methods to build a framework for your research. This can lead directly into your methodology section.

A literature review is a survey of scholarly sources (such as books, journal articles, and theses) related to a specific topic or research question .

It is often written as part of a dissertation , thesis, research paper , or proposal .

There are several reasons to conduct a literature review at the beginning of a research project:

To familiarise yourself with the current state of knowledge on your topic
To ensure that you’re not just repeating what others have already done
To identify gaps in knowledge and unresolved problems that your research can address
To develop your theoretical framework and methodology
To provide an overview of the key findings and debates on the topic

Writing the literature review shows your reader how your work relates to existing research and what new insights it will contribute.

The literature review usually comes near the beginning of your dissertation . After the introduction , it grounds your research in a scholarly field and leads directly to your theoretical framework or methodology .

Cite this Scribbr article

If you want to cite this source, you can copy and paste the citation or click the ‘Cite this Scribbr article’ button to automatically add the citation to our free Reference Generator.

McCombes, S. (2022, June 07). What is a Literature Review? | Guide, Template, & Examples. Scribbr. Retrieved 22 April 2024, from https://www.scribbr.co.uk/thesis-dissertation/literature-review/

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CC0006 Basics of Report Writing

Structure of a report (case study, literature review or survey).

Structure of report (Site visit)
Citing Sources
Tips and Resources

The information in the report has to be organised in the best possible way for the reader to understand the issue being investigated, analysis of the findings and recommendations or implications that relate directly to the findings. Given below are the main sections of a standard report. Click on each section heading to learn more about it.

Tells the reader what the report is about
Informative, short, catchy

Example - Sea level rise in Singapore : Causes, Impact and Solution

The title page must also include group name, group members and their matriculation numbers.

Content s Page

Has headings and subheadings that show the reader where the various sections of the report are located
Written on a separate page
Includes the page numbers of each section
Briefly summarises the report, the process of research and final conclusions
Provides a quick overview of the report and describes the main highlights
Short, usually not more than 150 words in length
Mention briefly why you choose this project, what are the implications and what kind of problems it will solve

Usually, the abstract is written last, ie. after writing the other sections and you know the key points to draw out from these sections. Abstracts allow readers who may be interested in the report to decide whether it is relevant to their purposes.

Introduction

Discusses the background and sets the context
Introduces the topic, significance of the problem, and the purpose of research
Gives the scope ie shows what it includes and excludes

In the introduction, write about what motivates your project, what makes it interesting, what questions do you aim to answer by doing your project. The introduction lays the foundation for understanding the research problem and should be written in a way that leads the reader from the general subject area of the topic to the particular topic of research.

Literature Review

Helps to gain an understanding of the existing research in that topic
To develop on your own ideas and build your ideas based on the existing knowledge
Prevents duplication of the research done by others

Search the existing literature for information. Identify the data pertinent to your topic. Review, extract the relevant information for eg how the study was conducted and the findings. Summarise the information. Write what is already known about the topic and what do the sources that you have reviewed say. Identify conflicts in previous studies, open questions, or gaps that may exist. If you are doing

Case study - look for background information and if any similar case studies have been done before.
Literature review - find out from literature, what is the background to the questions that you are looking into
Site visit - use the literature review to read up and prepare good questions before hand.
Survey - find out if similar surveys have been done before and what did they find?

Keep a record of the source details of any information you want to use in your report so that you can reference them accurately.

Methodology

Methodology is the approach that you take to gather data and arrive at the recommendation(s). Choose a method that is appropriate for the research topic and explain it in detail.

In this section, address the following: a) How the data was collected b) How it was analysed and c) Explain or justify why a particular method was chosen.

Usually, the methodology is written in the past tense and can be in the passive voice. Some examples of the different methods that you can use to gather data are given below. The data collected provides evidence to build your arguments. Collect data, integrate the findings and perspectives from different studies and add your own analysis of its feasibility.

Explore the literature/news/internet sources to know the topic in depth
Give a description of how you selected the literature for your project
Compare the studies, and highlight the findings, gaps or limitations.
An in-depth, detailed examination of specific cases within a real-world context.
Enables you to examine the data within a specific context.
Examine a well defined case to identify the essential factors, process and relationship.
Write the case description, the context and the process involved.
Make sense of the evidence in the case(s) to answer the research question
Gather data from a predefined group of respondents by asking relevant questions
Can be conducted in person or online
Why you chose this method (questionnaires, focus group, experimental procedure, etc)
How you carried out the survey. Include techniques and any equipment you used
If there were participants in your research, who were they? How did you select them and how may were there?
How the survey questions address the different aspects of the research question
Analyse the technology / policy approaches by visiting the required sites
Make a detailed report on its features and your understanding of it

Results and Analysis

Present the results of the study. You may consider visualising the results in tables and graphs, graphics etc.
Analyse the results to obtain answer to the research question.
Provide an analysis of the technical and financial feasibility, social acceptability etc

Discussion, Limitation(s) and Implication(s)

Discuss your interpretations of the analysis and the significance of your findings
Explain any new understanding or insights that emerged as a result of your research
Consider the different perspectives (social, economic and environmental)in the discussion
Explain the limitation(s)
Explain how could what you found be used to make a difference for sustainability

Conclusion and Recommendations

Summarise the significance and outcome of the study highlighting the key points.
Come up with alternatives and propose specific actions based on the alternatives
Describe the result or improvement it would achieve
Explain how it will be implemented

Recommendations should have an innovative approach and should be feasible. It should make a significant difference in solving the issue under discussion.

List the sources you have referred to in your writing
Use the recommended citation style consistently in your report

Appendix (if necessary/any)

Include any material relating to the report and research that does not fit in the body of the report, in the appendix. For example, you may include survey questionnaire and results in the appendix.

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A Review of the Literature on Case Study Research

This paper presents a review of the literature on case study research and comments on the ongoing debate of the value of case study. A research paradigm and its theoretical framework is described. This review focuses extensively on the positions of

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Extension of theory using a multiple-case study design can contribute value to a particular theoretical perspective and further define the boundaries of the original theory. Most organizations today operate in volatile economic and social environments. Qualitative research plays an essential role in the investigation of leadership and management problems, given that they remain complex social enigmas. The multiple case study design is a valuable qualitative research tool in studying the links between the personal, social, behavioral, psychological, organizational, cultural, and environmental factors that guide managerial and leadership development. Multiple-case studies can be used by both novice and experienced qualitative researchers to contribute original qualitative data to extant theory. Multiple-case study research is particularly suitable for responding to "how" and "why" and what Eisenhardt terms as "big picture" research questions that remain unanswered in the extant leadership and management literature.

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Case study research though increasingly popular in social sciences for positivist and intrepretivist research, a kind of confusion is prevalent when it is used ignoring its philosophical position. Arguably, the case study research is considered more appropriate for qualitative research because of its foremost strength ˗ the in-depth study of complex issues. This paper, drawing from the literature, discusses the philosophical position of case study research and argues that qualitative case study research is appropriate for theory building. For theory building, this paper follows the inductive approach guided by qualitative research paradigm and argues that it is not appropriate to assess theory building from the perspective of quantitative research. Very similar to other research methods, it is natural that the case study research has certain challenges; however, most of the challenges and misunderstandings overlap causing difficulty to understand the role of case study research. Hence, this paper aims to contribute to the understandings of the challenges and misunderstandings associated with the theory building from case study research. This paper argues that most of the challenges associated with theory building from case study can be addressed employing appropriate research strategies particularly clear understanding of philosophical stance and selection of appropriate case. The misunderstandings, on the other hand, are arisen due to the differences in the researcher's perspectives particularly positivistic thinking of them rather than the shortcomings inherent in the qualitative case study research design.

Florian Kohlbacher

This paper aims at exploring and discus sing the possibilities of applying qualitative content analysis as a (text) interpretation method in case study research. First, case study research as a research strategy within qualitative social research is briefly presented. Then, a basic introduction to (qualitative) content analysis as an interpretation method for qualitative interviews and other data material is given.

Assessment of Qualitative

15th NCVER conference

John Guenther

milton malaya

Lesley Bartlett

casestudies journal

Qualitative case-study research has experienced an upsurge in business management fields of inquiry in the recent past. A methodology is selection, justification and sequential arranging of activities, procedures and tasks in a research project. Research methodology can no longer be confined to a set of universally applicable rules, conventions and traditions. A research paradigm is a set of propositions that explains how the world is perceived. There are three basic paradigms: positivist, interpretive and critical. Qualitative " approaches to research " , " strategies of inquiry " and " varieties of methodologies " classified into five " types " or " traditions " namely; biography, phenomenology, grounded theory, ethnography and case study. The major criticism made of qualitative methods is that they are impressionistic and non-verifiable, post-positivists who reject this charge claiming that qualitative data is auditable and therefore dependable. The less structured qualitative methodologies reject many of the positivists " constructions over what constitutes rigour, favouring instead the flexibility, creativity and otherwise inaccessible insights afforded by alternative routes of inquiry that embrace storytelling, recollection, and dialogue. Case study research is not really a " methodology " or a method, rather an approach to research. Case studies can be ethnographic or not and some scholars identified it as a strategy of social inquiry. It is argued that, case studies are more appropriate to investigate causal relationships prevailing both in the business field as well as in wider society in general.

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

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

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

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

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

CASE STUDY AS A RESEARCH METHODOLOGY

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

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

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

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

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

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

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Key sources of data for a sample case study

VARIATIONS ON CASE STUDY METHODOLOGY

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

DATABASE INDEXING OF CASE REPORTS AND CASE STUDIES

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

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

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

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

PUBLICATION OF CASE STUDY RESEARCH IN LIBRARIANSHIP

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

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

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

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

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

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

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

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

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

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Database search tip : Add the phrase "literature review" to your search to find published literature reviews.

While at the GSD, you may be asked to conduct a literature review for research courses or if you are writing a thesis or dissertation.

What is a literature review?

It is a survey of relevant or foundational texts about a particular topic, theory, or research question. A literature review

May provide the background for larger work, or it may stand on its own.

Is more than a simple list of sources; an effective literature review analyzes and synthesizes information about key themes or issues.

Contains a set of themes fundamental enough to be considered a reasonable mode of entry into the field along with the relevant, foundational texts of that field or sub-field.

Coheres around a chronological, geographic, technical, and/or cultural structure.

Is thorough but not comprehensive; it is impossible to reach an exhaustive knowledge of a field, especially as a graduate student.

How do you conduct a literature review?

Gather Sources through preliminary research

This step allows you to discover what has been written about in the field
Focus your topic: A literature review aims to cover all of the research on a given topic. If the topic is too large, there will be too much material to cover it adequately.

The GSD’s guidelines for doctoral literature reviews offers helpful examples of feasible topics:

A research area usually covers a relatively broad field like the ‘history of architecture from 1800 to the present,’ the ‘theories of urbanization in the nineteenth and twentieth centuries,’ or ‘digital fabrication.’ More focused major fields are of course possible and could include studies of ‘Decorative Art, Design and the Object: History, Theory, and Debate: 1850-1930,’ ‘Modernity and Modernism in Latin America,’ or ‘Life Cycle Design.’

Read with a purpose: Although you will need to briefly summarize sources, a good literature review requires that you isolate key themes or issues related to your own research interests.

Evaluate Sources

Conduct a critical appraisal to evaluate the literature and what has been done already to see the gaps in the field, thus what still needs to be done in one’s own research

For each book or article consider: Is the author an expert? Does the evidence support the conclusion? Is the argument or evidence complete?

Does all research arrive at the same conclusion or are there differing opinions? What evidence or reasoning are the differences based on? What questions are raised by the literature? Are there any gaps or omissions?

Write an Introduction

The introduction should identify your topic, some discussion of the significance of that topic and a thesis statement that outlines what conclusion you will draw from your analysis and synthesis of the literature. If your literature review is part of a larger work, explain the importance of the review to your research question.
Focus on the organizing principles of your literature review. How have you organized your sources?

Have you organized it by theme? This is the most common way to organize literature reviews as it relates each source back to the field.

Have you organized it by methodology? This is often used when discussing interdisciplinary approaches to a topic or when discussing a number of studies with a different approach.

Have you organized it by chronology? This method is helpful when historical changes are central to explaining the topic.

Write the body

The body will be comprised of your findings from evaluating the sources. In the body, discuss and assess the research according to the specific organizational principles above.
Focus on the relationship of sources to each other: how do these sources constitute a field?
Return to your evaluations and critical appraisals of the texts. Include these appraisals in the body of your literature review.
Articulate the relevance of these sources to your research question.
Demonstrate that your research and source selection is sufficient to constitute a reasonable mode of entry into the particular field where you what to conduct subsequent research.

Write the conclusion

This section is perhaps the most important: you should briefly outline all gaps in the field and assess what is lacking in the current field of literature. Thus, you establish the value of your research and where you will situate your research within the context that you have explored in the body.
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Published: 19 April 2024

Person-centered care assessment tool with a focus on quality healthcare: a systematic review of psychometric properties

Lluna Maria Bru-Luna 1 ,
Manuel Martí-Vilar 2 ,
César Merino-Soto 3 ,
José Livia-Segovia 4 ,
Juan Garduño-Espinosa 5 &
Filiberto Toledano-Toledano 5 , 6 , 7

BMC Psychology volume 12 , Article number: 217 ( 2024 ) Cite this article

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Metrics details

The person-centered care (PCC) approach plays a fundamental role in ensuring quality healthcare. The Person-Centered Care Assessment Tool (P-CAT) is one of the shortest and simplest tools currently available for measuring PCC. The objective of this study was to conduct a systematic review of the evidence in validation studies of the P-CAT, taking the “Standards” as a frame of reference.

First, a systematic literature review was conducted following the PRISMA method. Second, a systematic descriptive literature review of validity tests was conducted following the “Standards” framework. The search strategy and information sources were obtained from the Cochrane, Web of Science (WoS), Scopus and PubMed databases. With regard to the eligibility criteria and selection process, a protocol was registered in PROSPERO (CRD42022335866), and articles had to meet criteria for inclusion in the systematic review.

A total of seven articles were included. Empirical evidence indicates that these validations offer a high number of sources related to test content, internal structure for dimensionality and internal consistency. A moderate number of sources pertain to internal structure in terms of test-retest reliability and the relationship with other variables. There is little evidence of response processes, internal structure in measurement invariance terms, and test consequences.

The various validations of the P-CAT are not framed in a structured, valid, theory-based procedural framework like the “Standards” are. This can affect clinical practice because people’s health may depend on it. The findings of this study show that validation studies continue to focus on the types of validity traditionally studied and overlook interpretation of the scores in terms of their intended use.

Peer Review reports

Person-centered care (PCC)

Quality care for people with chronic diseases, functional limitations, or both has become one of the main objectives of medical and care services. The person-centered care (PCC) approach is an essential element not only in achieving this goal but also in providing high-quality health maintenance and medical care [ 1 , 2 , 3 ]. In addition to guaranteeing human rights, PCC provides numerous benefits to both the recipient and the provider [ 4 , 5 ]. Additionally, PCC includes a set of necessary competencies for healthcare professionals to address ongoing challenges in this area [ 6 ]. PCC includes the following elements [ 7 ]: an individualized, goal-oriented care plan based on individuals’ preferences; an ongoing review of the plan and the individual’s goals; support from an interprofessional team; active coordination among all medical and care providers and support services; ongoing information exchange, education and training for providers; and quality improvement through feedback from the individual and caregivers.

There is currently a growing body of literature on the application of PCC. A good example of this is McCormack’s widely known mid-range theory [ 8 ], an internationally recognized theoretical framework for PCC and how it is operationalized in practice. This framework forms a guide for care practitioners and researchers in hospital settings. This framework is elaborated in PCC and conceived of as “an approach to practice that is established through the formation and fostering of therapeutic relationships between all care providers, service users, and others significant to them, underpinned by values of respect for persons, [the] individual right to self-determination, mutual respect, and understanding” [ 9 ].

Thus, as established by PCC, it is important to emphasize that reference to the person who is the focus of care refers not only to the recipient but also to everyone involved in a care interaction [ 10 , 11 ]. PCC ensures that professionals are trained in relevant skills and methodology since, as discussed above, carers are among the agents who have the greatest impact on the quality of life of the person in need of care [ 12 , 13 , 14 ]. Furthermore, due to the high burden of caregiving, it is essential to account for caregivers’ well-being. In this regard, studies on professional caregivers are beginning to suggest that the provision of PCC can produce multiple benefits for both the care recipient and the caregiver [ 15 ].

Despite a considerable body of literature and the frequent inclusion of the term in health policy and research [ 16 ], PCC involves several complications. There is no standard consensus on the definition of this concept [ 17 ], which includes problematic areas such as efficacy assessment [ 18 , 19 ]. In addition, the difficulty of measuring the subjectivity involved in identifying the dimensions of the CPC and the infrequent use of standardized measures are acute issues [ 20 ]. These limitations and purposes motivated the creation of the Person-Centered Care Assessment Tool (P-CAT; [ 21 ]), which emerged from the need for a brief, economical, easily applied, versatile and comprehensive assessment instrument to provide valid and reliable measures of PCC for research purposes [ 21 ].

Person-centered care assessment tool (P-CAT)

There are several instruments that can measure PCC from different perspectives (i.e., the caregiver or the care recipient) and in different contexts (e.g., hospitals and nursing homes). However, from a practical point of view, the P-CAT is one of the shortest and simplest tools and contains all the essential elements of PCC described in the literature. It was developed in Australia to measure the approach of long-term residential settings to older people with dementia, although it is increasingly used in other healthcare settings, such as oncology units [ 22 ] and psychiatric hospitals [ 23 ].

Due to the brevity and simplicity of its application, the versatility of its use in different medical and care contexts, and its potential emic characteristics (i.e., constructs that can be cross-culturally applicable with reasonable and similar structure and interpretation; [ 24 ]), the P-CAT is one of the most widely used tests by professionals to measure PCC [ 25 , 26 ]. It has expanded to several countries with cultural and linguistic differences. Since its creation, it has been adapted in countries separated by wide cultural and linguistic differences, such as Norway [ 27 ], Sweden [ 28 ], China [ 29 ], South Korea [ 30 ], Spain [ 25 ], and Italy [ 31 ].

The P-CAT comprises 13 items rated on a 5-point ordinal scale (from “strongly disagree” to “strongly agree”), with high scores indicating a high degree of person-centeredness. The scale consists of three dimensions: person-centered care (7 items), organizational support (4 items) and environmental accessibility (2 items). In the original study ( n = 220; [ 21 ]), the internal consistency of the instrument yielded satisfactory values for the total scale ( α = 0.84) and good test-retest reliability ( r =.66) at one-week intervals. A reliability generalization study conducted in 2021 [ 32 ] that estimated the internal consistency of the P-CAT and analyzed possible factors that could affect the it revealed that the mean α value for the 25 meta-analysis samples (some of which were part of the validations included in this study) was 0.81, and the only variable that had a statistically significant relationship with the reliability coefficient was the mean age of the sample. With respect to internal structure validity, three factors (56% of the total variance) were obtained, and content validity was assessed by experts, literature reviews and stakeholders [ 33 ].

Although not explicitly stated, the apparent commonality between validation studies of different versions of the P-CAT may be influenced by an influential decades-old validity framework that differentiates three categories: content validity, construct validity, and criterion validity [ 34 , 35 ]. However, a reformulation of the validity of the P-CAT within a modern framework, which would provide a different definition of validity, has not been performed.

Scale validity

Traditionally, validation is a process focused on the psychometric properties of a measurement instrument [ 36 ]. In the early 20th century, with the frequent use of standardized measurement tests in education and psychology, two definitions emerged: the first defined validity as the degree to which a test measures what it intends to measure, while the second described the validity of an instrument in terms of the correlation it presents with a variable [ 35 ].

However, in the past century, validity theory has evolved, leading to the understanding that validity should be based on specific interpretations for an intended purpose. It should not be limited to empirically obtained psychometric properties but should also be supported by the theory underlying the construct measured. Thus, to speak of classical or modern validity theory suggests an evolution in the classical or modern understanding of the concept of validity. Therefore, a classical approach (called classical test theory, CTT) is specifically differentiated from a modern approach. In general, recent concepts associated with a modern view of validity are based on (a) a unitary conception of validity and (b) validity judgments based on inferences and interpretations of the scores of a measure [ 37 , 38 ]. This conceptual advance in the concept of validity led to the creation of a guiding framework to for obtaining evidence to support the use and interpretation of the scores obtained by a measure [ 39 ].

This purpose is addressed by the Standards for Educational and Psychological Testing (“Standards”), a guide created by the American Educational Research Association (AERA), the American Psychological Association (APA) and the National Council on Measurement in Education (NCME) in 2014 with the aim of providing guidelines to assess the validity of the interpretations of scores of an instrument based on their intended use. Two conceptual aspects stand out in this modern view of validity: first, validity is a unitary concept centered on the construct; second, validity is defined as “the degree to which evidence and theory support the interpretations of test scores for proposed uses of tests” [ 37 ]. Thus, the “Standards” propose several sources that serve as a reference for assessing different aspects of validity. The five sources of valid evidence are as follows [ 37 ]: test content, response processes, internal structure, relations to other variables and consequences of testing. According to AERA et al. [ 37 ], test content validity refers to the relationship of the administration process, subject matter, wording and format of test items to the construct they are intended to measure. It is measured predominantly with qualitative methods but without excluding quantitative approaches. The validity of the responses is based on analysis of the cognitive processes and interpretation of the items by respondents and is measured with qualitative methods. Internal structure validity is based on the interrelationship between the items and the construct and is measured by quantitative methods. Validity in terms of the relationship with other variables is based on comparison between the variable that the instrument intends to measure and other theoretically relevant external variables and is measured by quantitative methods. Finally, validity based on the results of the test analyses consequences, both intended and unintended, that may be due to a source of invalidity. It is measured mainly by qualitative methods.

Thus, although validity plays a fundamental role in providing a strong scientific basis for interpretations of test scores, validation studies in the health field have traditionally focused on content validity, criterion validity and construct validity and have overlooked the interpretation and use of scores [ 34 ].

“Standards” are considered a suitable validity theory-based procedural framework for reviewing the validity of questionnaires due to its ability to analyze sources of validity from both qualitative and quantitative approaches and its evidence-based method [ 35 ]. Nevertheless, due to a lack of knowledge or the lack of a systematic description protocol, very few instruments to date have been reviewed within the framework of the “Standards” [ 39 ].

Current study

Although the P-CAT is one of the most widely used instruments by professionals and has seven validations [ 25 , 27 , 28 , 29 , 30 , 31 , 40 ], no analysis has been conducted of its validity within the framework of the “Standards”. That is, empirical evidence of the validity of the P-CAT has not been obtained in a way that helps to develop a judgment based on a synthesis of the available information.

A review of this type is critical given that some methodological issues seem to have not been resolved in the P-CAT. For example, although the multidimensionality of the P-CAT was identified in the study that introduced it, Bru-Luna et al. [ 32 ] recently stated that in adaptations of the P-CAT [ 25 , 27 , 28 , 29 , 30 , 40 ], the total score is used for interpretation and multidimensionality is disregarded. Thus, the multidimensionality of the original study was apparently not replicated. Bru-Luna et al. [ 32 ] also indicated that the internal structure validity of the P-CAT is usually underreported due to a lack of sufficiently rigorous approaches to establish with certainty how its scores are calculated.

The validity of the P-CAT, specifically its internal structure, appears to be unresolved. Nevertheless, substantive research and professional practice point to this measure as relevant to assessing PCC. This perception is contestable and judgment-based and may not be sufficient to assess the validity of the P-CAT from a cumulative and synthetic angle based on preceding validation studies. An adequate assessment of validity requires a model to conceptualize validity followed by a review of previous studies of the validity of the P-CAT using this model.

Therefore, the main purpose of this study was to conduct a systematic review of the evidence provided by P-CAT validation studies while taking the “Standards” as a framework.

The present study comprises two distinct but interconnected procedures. First, a systematic literature review was conducted following the PRISMA method ( [ 41 ]; Additional file 1; Additional file 2) with the aim of collecting all validations of the P-CAT that have been developed. Second, a systematic description of the validity evidence for each of the P-CAT validations found in the systematic review was developed following the “Standards” framework [ 37 ]. The work of Hawkins et al. [ 39 ], the first study to review validity sources according to the guidelines proposed by the “Standards”, was also used as a reference. Both provided conceptual and pragmatic guidance for organizing and classifying validity evidence for the P-CAT.

The procedure conducted in the systematic review is described below, followed by the procedure for examining the validity studies.

Systematic review

Search strategy and information sources.

Initially, the Cochrane database was searched with the aim of identifying systematic reviews of the P-CAT. When no such reviews were found, subsequent preliminary searches were performed in the Web of Science (WoS), Scopus and PubMed databases. These databases play a fundamental role in recent scientific literature since they are the main sources of published articles that undergo high-quality content and editorial review processes [ 42 ]. The search formula was as follows. The original P-CAT article [ 21 ] was located, after which all articles that cited it through 2021 were identified and analyzed. This approach ensured the inclusion of all validations. No articles were excluded on the basis of language to avoid language bias [ 43 ]. Moreover, to reduce the effects of publication bias, a complementary search in Google Scholar was also performed to allow the inclusion of “gray” literature [ 44 ]. Finally, a manual search was performed through a review of the references of the included articles to identify other articles that met the search criteria but were not present in any of the aforementioned databases.

This process was conducted by one of the authors and corroborated by another using the Covidence tool [ 45 ]. A third author was consulted in case of doubt.

Eligibility criteria and selection process

The protocol was registered in PROSPERO, and the search was conducted according to these criteria. The identification code is CRD42022335866.

The articles had to meet the following criteria for inclusion in the systematic review: (a) a methodological approach to P-CAT validations, (b) an experimental or quasiexperimental studies, (c) studies with any type of sample, and (d) studies in any language. We discarded studies that met at least one of the following exclusion criteria: (a) systematic reviews or bibliometric reviews of the instrument or meta-analyses or (b) studies published after 2021.

Data collection process

After the articles were selected, the most relevant information was extracted from each article. Fundamental data were recorded in an Excel spreadsheet for each of the sections: introduction, methodology, results and discussion. Information was also recorded about the limitations mentioned in each article as well as the practical implications and suggestions for future research.

Given the aim of the study, information was collected about the sources of validity of each study, including test content (judges’ evaluation, literature review and translation), response processes, internal structure (factor analysis, design, estimator, factor extraction method, factors and items, interfactor R, internal replication, effect of the method, and factor loadings), and relationships with other variables (convergent, divergent, concurrent and predictive validity) and consequences of measurement.

Description of the validity study

To assess the validity of the studies, an Excel table was used. Information was recorded for the seven articles included in the systematic review. The data were extracted directly from the texts of the articles and included information about the authors, the year of publication, the country where each P-CAT validation was produced and each of the five standards proposed in the “Standards” [ 37 ].

The validity source related to internal structure was divided into three sections to record information about dimensionality (e.g., factor analysis, design, estimator, factor extraction method, factors and items, interfactor R, internal replication, effect of the method, and factor loadings), reliability expression (i.e., internal consistency and test-retest) and the study of factorial invariance according to the groups into which it was divided (e.g., sex, age, profession) and the level of study (i.e., metric, intercepts). This approach allowed much more information to be obtained than relying solely on source validity based on internal structure. This division was performed by the same researcher who performed the previous processes.

Study selection and study characteristics

The systematic review process was developed according to the PRISMA methodology [ 41 ].

The WoS, Scopus, PubMed and Google Scholar databases were searched on February 12, 2022 and yielded a total of 485 articles. Of these, 111 were found in WoS, 114 in Scopus, 43 in PubMed and 217 in Google Scholar. In the first phase, the title and abstracts of all the articles were read. In this first screening, 457 articles were eliminated because they did not include studies with a methodological approach to P-CAT validation and one article was excluded because it was the original P-CAT article. This resulted in a total of 27 articles, 19 of which were duplicated in different databases and, in the case of Google Scholar, within the same database. This process yielded a total of eight articles that were evaluated for eligibility by a complete reading of the text. In this step, one of the articles was excluded due to a lack of access to the full text of the study [ 31 ] (although the original manuscript was found, it was impossible to access the complete content; in addition, the authors of the manuscript were contacted, but no reply was received). Finally, a manual search was performed by reviewing the references of the seven studies, but none were considered suitable for inclusion. Thus, the review was conducted with a total of seven articles.

Of the seven studies, six were original validations in other languages. These included Norwegian [ 27 ], Swedish [ 28 ], Chinese (which has two validations [ 29 , 40 ]), Spanish [ 25 ], and Korean [ 30 ]. The study by Selan et al. [ 46 ] included a modification of the Swedish version of the P-CAT and explored the psychometric properties of both versions (i.e., the original Swedish version and the modified version).

The item selection and screening process are illustrated in detail in Fig. 1 .

PRISMA 2020 flow diagram for new systematic reviews including database searches

Validity analysis

To provide a clear overview of the validity analyses, Table 1 descriptively shows the percentages of items that provide information about the five standards proposed by the “Standards” guide [ 37 ].

The table shows a high number of validity sources related to test content and internal structure in relation to dimensionality and internal consistency, followed by a moderate number of sources for test-retest and relationship with other variables. A rate of 0% is observed for validity sources related to response processes, invariance and test consequences. Below, different sections related to each of the standards are shown, and the information is presented in more detail.

Evidence based on test content

The first standard, which focused on test content, was met for all items (100%). Translation, which refers to the equivalence of content between the original language and the target language, was met in the six articles that conducted validation in another language and/or culture. These studies reported that the validations were translated by bilingual experts and/or experts in the area of care. In addition, three studies [ 25 , 29 , 40 ] reported that the translation process followed International Test Commission guidelines, such as those of Beaton et al. [ 47 ], Guillemin [ 48 ], Hambleton et al. [ 49 ], and Muñiz et al. [ 50 ]. Evaluation by judges, who referred to the relevance, clarity and importance of the content, was divided into two categories: expert evaluation (a panel of expert judges for each of the areas to consider in the evaluation instrument) and experiential evaluation (potential participants testing the test). The first type of evaluation occurred in three of the articles [ 28 , 29 , 46 ], while the other occurred in two [ 25 , 40 ]. Only one of the items [ 29 ] reported that the scale contained items that reflected the dimension described in the literature. The validity evidence related to the test content presented in each article can be found in Table 2 .

Evidence based on response processes

The second standard, related to the validity of the response process, was obtained according to the “Standards” from the analysis of individual responses: “questioning test takers about their performance strategies or response to particular items (…), maintaining records that monitor the development of a response to a writing task (…), documentation of other aspects of performance, like eye movement or response times…” [ 37 ] (p. 15). According to the analysis of the validity of the response processes, none of the articles complied with this evidence.

Evidence based on internal structure

The third standard, validity related to internal structure, was divided into three sections. First, the dimensionality of each study was examined in terms of factor analysis, design, estimator, factor extraction method, factors and items, interfactor R, internal replication, effect of the method, and factor loadings. Le et al. [ 40 ] conducted an exploratory-confirmatory design while Sjögren et al. [ 28 ] conducted a confirmatory-exploratory design to assess construct validity using confirmatory factor analysis (CFA) and investigated it further using exploratory factor analysis (EFA). The remaining articles employed only a single form of factor analysis: three employed EFA, and two employed CFA. Regarding the next point, only three of the articles reported the factor extraction method used, including Kaiser’s eigenvalue, criterion, scree plot test, parallel analysis and Velicer’s MAP test. Instrument validations yielded a total of two factors in five of the seven articles, while one yielded a single dimension [ 25 ] and the other yielded three dimensions [ 29 ], as in the original instrument. The interfactor R was reported only in the study by Zhong and Lou [ 29 ], whereas in the study by Martínez et al. [ 25 ], it could be easily obtained since it consisted of only one dimension. Internal replication was also calculated in the Spanish validation by randomly splitting the sample into two to test the correlations between factors. The effectiveness of the method was not reported in any of the articles. This information is presented in Table 3 in addition to a summary of the factor loadings.

The second section examined reliability. All the studies presented measures of internal consistency conducted in their entirety with Cronbach’s α coefficient for both the total scale and the subscales. The ω coefficient of McDonald was not used in any case. Four of the seven articles performed a test-retest test. Martínez et al. [ 25 ] conducted a test-retest after a period of seven days, while Le et al. [ 40 ] and Rokstad et al. [ 27 ] performed it between one and two weeks later and Sjögren et al. [ 28 ] allowed approximately two weeks to pass after the initial test.

The third section analyzes the calculation of invariance, which was not reported in any of the studies.

Evidence based on relationships with other variables

In the fourth standard, based on validity according to the relationship with other variables, the articles that reported it used only convergent validity (i.e., it was hypothesized that the variables related to the construct measured by the test—in this case, person-centeredness—were positively or negatively related to another construct). Discriminant validity hypothesizes that the variables related to the PCC construct are not correlated in any way with any other variable studied. No article (0%) measured discriminant evidence, while four (57%) measured convergent evidence [ 25 , 29 , 30 , 46 ]. Convergent validity was obtained through comparisons with instruments such as the Person-Centered Climate Questionnaire–Staff Version (PCQ-S), the Staff-Based Measures of Individualized Care for Institutionalized Persons with Dementia (IC), the Caregiver Psychological Elder Abuse Behavior Scale (CPEAB), the Organizational Climate (CLIOR) and the Maslach Burnout Inventory (MBI). In the case of Selan et al. [ 46 ], convergent validity was assessed on two items considered by the authors as “crude measures of person-centered care (i.e., external constructs) giving an indication of the instruments’ ability to measure PCC” (p. 4). Concurrent validity, which measures the degree to which the results of one test are or are not similar to those of another test conducted at more or less the same time with the same participants, and predictive validity, which allows predictions to be established regarding behavior based on comparison between the values of the instrument and the criterion, were not reported in any of the studies.

Evidence based on the consequences of testing

The fifth and final standard was related to the consequences of the test. It analyzed the consequences, both intended and unintended, of applying the test to a given sample. None of the articles presented explicit or implicit evidence of this.

The last two sources of validity can be seen in Table 4 .

Table 5 shows the results of the set of validity tests for each study according to the described standards.

The main purpose of this article is to analyze the evidence of validity in different validation studies of the P-CAT. To gather all existing validations, a systematic review of all literature citing this instrument was conducted.

The publication of validation studies of the P-CAT has been constant over the years. Since the publication of the original instrument in 2010, seven validations have been published in other languages (taking into account the Italian version by Brugnolli et al. [ 31 ], which could not be included in this study) as well as a modification of one of these versions. The very unequal distribution of validations between languages and countries is striking. A recent systematic review [ 51 ] revealed that in Europe, the countries where the PCC approach is most widely used are the United Kingdom, Sweden, the Netherlands, Northern Ireland, and Norway. It has also been shown that the neighboring countries seem to exert an influence on each other due to proximity [ 52 ] such that they tend to organize healthcare in a similar way, as is the case for Scandinavian countries. This favors the expansion of PCC and explains the numerous validations we found in this geographical area.

Although this approach is conceived as an essential element of healthcare for most governments [ 53 ], PCC varies according to the different definitions and interpretations attributed to it, which can cause confusion in its application (e.g., between Norway and the United Kingdom [ 54 ]). Moreover, facilitators of or barriers to implementation depend on the context and level of development of each country, and financial support remains one of the main factors in this regard [ 53 ]. This fact explains why PCC is not globally widespread among all territories. In countries where access to healthcare for all remains out of reach for economic reasons, the application of this approach takes a back seat, as does the validation of its assessment tools. In contrast, in a large part of Europe or in countries such as China or South Korea that have experienced decades of rapid economic development, patients are willing to be involved in their medical treatment and enjoy more satisfying and efficient medical experiences and environments [ 55 ], which facilitates the expansion of validations of instruments such as the P-CAT.

Regarding validity testing, the guidelines proposed by the “Standards” [ 37 ] were followed. According to the analysis of the different validations of the P-CAT instrument, none of the studies used a structured validity theory-based procedural framework for conducting validation. The most frequently reported validity tests were on the content of the test and two of the sections into which the internal structure was divided (i.e., dimensionality and internal consistency).

In the present article, the most cited source of validity in the studies was the content of the test because most of the articles were validations of the P-CAT in other languages, and the authors reported that the translation procedure was conducted by experts in all cases. In addition, several of the studies employed International Test Commission guidelines, such as those by Beaton et al. [ 47 ], Guillemin [ 48 ], Hambleton et al. [ 49 ], and Muñiz et al. [ 50 ]. Several studies also assessed the relevance, clarity and importance of the content.

The third source of validity, internal structure, was the next most often reported, although it appeared unevenly among the three sections into which this evidence was divided. Dimensionality and internal consistency were reported in all studies, followed by test-retest consistency. In relation to the first section, factor analysis, a total of five EFAs and four CFAs were presented in the validations. Traditionally, EFA has been used in research to assess dimensionality and identify key psychological constructs, although this approach involves a number of inconveniences, such as difficulty testing measurement invariance and incorporating latent factors into subsequent analyses [ 56 ] or the major problem of factor loading matrix rotation [ 57 ]. Studies eventually began to employ CFA, a technique that overcame some of these obstacles [ 56 ] but had other drawbacks; for example, the strict requirement of zero cross-loadings often does not fit the data well, and misspecification of zero loadings tends to produce distorted factors [ 57 ]. Recently, exploratory structural equation modeling (ESEM) has been proposed. This technique is widely recommended both conceptually and empirically to assess the internal structure of psychological tools [ 58 ] since it overcomes the limitations of EFA and CFA in estimating their parameters [ 56 , 57 ].

The next section, reliability, reports the total number of items according to Cronbach’s α reliability coefficient. Reliability is defined as a combination of systematic and random influences that determine the observed scores on a psychological test. Reporting the reliability measure ensures that item-based scores are consistent, that the tool’s responses are replicable and that they are not modified solely by random noise [ 59 , 60 ]. Currently, the most commonly employed reliability coefficient in studies with a multi-item measurement scale (MIMS) is Cronbach’s α [ 60 , 61 ].

Cronbach’s α [ 62 ] is based on numerous strict assumptions (e.g., the test must be unidimensional, factor loadings must be equal for all items and item errors should not covary) to estimate internal consistency. These assumptions are difficult to meet, and their violation may produce small reliability estimates [ 60 ]. One of the alternative measures to α that is increasingly recommended by the scientific literature is McDonald’s ω [ 63 ], a composite reliability measure. This coefficient is recommended for congeneric scales in which tau equivalence is not assumed. It has several advantages. For example, estimates of ω are usually robust when the estimated model contains more factors than the true model, even with small samples, or when skewness in univariate item distributions produces lower biases than those found when using α [ 59 ].

The test-retest method was the next most commonly reported internal structure section in these studies. This type of reliability considers the consistency of the scores of a test between two measurements separated by a period [ 64 ]. It is striking that test-retest consistency does not have a prevalence similar to that of internal consistency since, unlike internal consistency, test-retest consistency can be assessed for practically all types of patient-reported outcomes. It is even considered by some measurement experts to report reliability with greater relevance than internal consistency since it plays a fundamental role in the calculation of parameters for health measures [ 64 ]. However, the literature provides little guidance regarding the assessment of this type of reliability.

The internal structure section that was least frequently reported in the studies in this review was invariance. A lack of invariance refers to a difference between scores on a test that is not explained by group differences in the structure it is intended to measure [ 65 ]. The invariance of the measure should be emphasized as a prerequisite in comparisons between groups since “if scale invariance is not examined, item bias may not be fully recognized and this may lead to a distorted interpretation of the bias in a particular psychological measure” [ 65 ].

Evidence related to other variables was the next most reported source of validity in the studies included in this review. Specifically, the four studies that reported this evidence did so according to convergent validity and cited several instruments. None of the studies included evidence of discriminant validity, although this may be because there are currently several obstacles related to the measurement of this type of validity [ 66 ]. On the one hand, different definitions are used in the applied literature, which makes its evaluation difficult; on the other hand, the literature on discriminant validity focuses on techniques that require the use of multiple measurement methods, which often seem to have been introduced without sufficient evidence or are applied randomly.

Validity related to response processes was not reported by any of the studies. There are several methods to analyze this validity. These methods can be divided into two groups: “those that directly access the psychological processes or cognitive operations (think aloud, focus group, and interviews), compared to those which provide indirect indicators which in turn require additional inference (eye tracking and response times)” [ 38 ]. However, this validity evidence has traditionally been reported less frequently than others in most studies, perhaps because there are fewer clear and accepted practices on how to design or report these studies [ 67 ].

Finally, the consequences of testing were not reported in any of the studies. There is debate regarding this source of validity, with two main opposing streams of thought. On the one hand [ 68 , 69 ]) suggests that consequences that appear after the application of a test should not derive from any source of test invalidity and that “adverse consequences only undermine the validity of an assessment if they can be attributed to a problem of fit between the test and the construct” (p. 6). In contrast, Cronbach [ 69 , 70 ] notes that adverse social consequences that may result from the application of a test may call into question the validity of the test. However, the potential risks that may arise from the application of a test should be minimized in any case, especially in regard to health assessments. To this end, it is essential that this aspect be assessed by instrument developers and that the experiences of respondents be protected through the development of comprehensive and informed practices [ 39 ].

This work is not without limitations. First, not all published validation studies of the P-CAT, such as the Italian version by Brugnolli et al. [ 31 ], were available. These studies could have provided relevant information. Second, many sources of validity could not be analyzed because the studies provided scant or no data, such as response processes [ 25 , 27 , 28 , 29 , 30 , 40 , 46 ], relationships with other variables [ 27 , 28 , 40 ], consequences of testing [ 25 , 27 , 28 , 29 , 30 , 40 , 46 ], or invariance [ 25 , 27 , 28 , 29 , 30 , 40 , 46 ] in the case of internal structure and interfactor R [ 27 , 28 , 30 , 40 , 46 ], internal replication [ 27 , 28 , 29 , 30 , 40 , 46 ] or the effect of the method [ 25 , 27 , 28 , 29 , 30 , 40 , 46 ] in the case of dimensionality. In the future, it is hoped that authors will become aware of the importance of validity, as shown in this article and many others, and provide data on unreported sources so that comprehensive validity studies can be performed.

The present work also has several strengths. The search was extensive, and many studies were obtained using three different databases, including WoS, one of the most widely used and authoritative databases in the world. This database includes a large number and variety of articles and is not fully automated due to its human team [ 71 , 72 , 73 ]. In addition, to prevent publication bias, gray literature search engines such as Google Scholar were used to avoid the exclusion of unpublished research [ 44 ]. Finally, linguistic bias was prevented by not limiting the search to articles published in only one or two languages, thus avoiding the overrepresentation of studies in one language and underrepresentation in others [ 43 ].

Conclusions

Validity is understood as the degree to which tests and theory support the interpretations of instrument scores for their intended use [ 37 ]. From this perspective, the various validations of the P-CAT are not presented in a structured, valid, theory-based procedural framework like the “Standards” are. After integration and analysis of the results, it was observed that these validation reports offer a high number of sources of validity related to test content, internal structure in dimensionality and internal consistency, a moderate number of sources for internal structure in terms of test-retest reliability and the relationship with other variables, and a very low number of sources for response processes, internal structure in terms of invariance, and test consequences.

Validity plays a fundamental role in ensuring a sound scientific basis for test interpretations because it provides evidence of the extent to which the data provided by the test are valid for the intended purpose. This can affect clinical practice as people’s health may depend on it. In this sense, the “Standards” are considered a suitable and valid theory-based procedural framework for studying this modern conception of questionnaire validity, which should be taken into account in future research in this area.

Although the P-CAT is one of the most widely used instruments for assessing PCC, as shown in this study, PCC has rarely been studied. The developers of measurement tests applied to the health care setting, on which the health and quality of life of many people may depend, should use this validity framework to reflect the clear purpose of the measurement. This approach is important because the equity of decision making by healthcare professionals in daily clinical practice may depend on the source of validity. Through a more extensive study of validity that includes the interpretation of scores in terms of their intended use, the applicability of the P-CAT, an instrument that was initially developed for long-term care homes for elderly people, could be expanded to other care settings. However, the findings of this study show that validation studies continue to focus on traditionally studied types of validity and overlook the interpretation of scores in terms of their intended use.

Data availability

All data relevant to the study were included in the article or uploaded as additional files. Additional template data extraction forms are available from the corresponding author upon reasonable request.

Abbreviations

American Educational Research Association

American Psychological Association

Confirmatory factor analysis

Organizational Climate

Caregiver Psychological Elder Abuse Behavior Scale

Exploratory factor analysis

Exploratory structural equation modeling

Staff-based Measures of Individualized Care for Institutionalized Persons with Dementia

Maslach Burnout Inventory

Multi-item measurement scale

Maximum likelihood

National Council on Measurement in Education

Person-Centered Care Assessment Tool

Person-centered care

Person-Centered Climate Questionnaire–Staff Version

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

International Register of Systematic Review Protocols

Standards for Educational and Psychological Testing

weighted least square mean and variance adjusted

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Acknowledgements

The authors thank the casual helpers for their aid in information processing and searching.

This work is one of the results of research project HIM/2015/017/SSA.1207, “Effects of mindfulness training on psychological distress and quality of life of the family caregiver”. Main researcher: Filiberto Toledano-Toledano Ph.D. The present research was funded by federal funds for health research and was approved by the Commissions of Research, Ethics and Biosafety (Comisiones de Investigación, Ética y Bioseguridad), Hospital Infantil de México Federico Gómez, National Institute of Health. The source of federal funds did not control the study design, data collection, analysis, or interpretation, or decisions regarding publication.

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Lluna Maria Bru-Luna

Departamento de Psicología Básica, Universitat de València, Blasco Ibáñez Avenue, 21, 46010, Valencia, Spain

Manuel Martí-Vilar

Departamento de Psicología, Instituto de Investigación de Psicología, Universidad de San Martín de Porres, Tomás Marsano Avenue 242, Lima 34, Perú

César Merino-Soto

Instituto Central de Gestión de la Investigación, Universidad Nacional Federico Villarreal, Carlos Gonzalez Avenue 285, 15088, San Miguel, Perú

José Livia-Segovia

Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez Instituto Nacional de Salud, Dr. Márquez 162, 06720, Doctores, Cuauhtémoc, Mexico

Juan Garduño-Espinosa & Filiberto Toledano-Toledano

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Filiberto Toledano-Toledano

Dirección de Investigación y Diseminación del Conocimiento, Instituto Nacional de Ciencias e Innovación para la Formación de Comunidad Científica, INDEHUS, Periférico Sur 4860, Arenal de Guadalupe, 14389, Tlalpan, Mexico City, Mexico

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L.M.B.L. conceptualized the study, collected the data, performed the formal anal- ysis, wrote the original draft, and reviewed and edited the subsequent drafts. M.M.V. collected the data and reviewed and edited the subsequent drafts. C.M.S. collected the data, performed the formal analysis, wrote the original draft, and reviewed and edited the subsequent drafts. J.L.S. collected the data, wrote the original draft, and reviewed and edited the subsequent drafts. J.G.E. collected the data and reviewed and edited the subsequent drafts. F.T.T. conceptualized the study and reviewed and edited the subsequent drafts. L.M.B.L. conceptualized the study and reviewed and edited the subsequent drafts. M.M.V. conceptualized the study and reviewed and edited the subsequent drafts. C.M.S. reviewed and edited the subsequent drafts. J.G.E. reviewed and edited the subsequent drafts. F.T.T. conceptualized the study; provided resources, software, and supervision; wrote the original draft; and reviewed and edited the subsequent drafts.

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Bru-Luna, L.M., Martí-Vilar, M., Merino-Soto, C. et al. Person-centered care assessment tool with a focus on quality healthcare: a systematic review of psychometric properties. BMC Psychol 12 , 217 (2024). https://doi.org/10.1186/s40359-024-01716-7

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Cauda equina neuroendocrine tumor: a report of three cases and review of the literature with focus on differential diagnosis and postoperative management

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Published: 17 April 2024
Volume 47 , article number 166 , ( 2024 )

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L. Fabbrocini ORCID: orcid.org/0009-0009-0291-2920 1 ,
K. Keyvani 2 &
F. H. Ebner 1

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Introduction

Cauda equina neuroendocrine tumors (CENETs), previously described as cauda equina paragangliomas (PGLs) are rare and well-vascularized benign entities which can be often misdiagnosed with other intradural tumors more common in this anatomical site, such as ependymomas and neurinomas. We describe three cases of CENETs observed at our institution with particular focus on differential diagnosis and postoperative management. Since the lack of guidelines, we performed a literature review to identify factors that can predict recurrence and influence postoperative decision making.

Case report and literature review

We report on three patients, two of them presenting with a clinical history of lower back pain and sciatica. In all cases magnetic resonance imaging (MRI) of the lumbosacral spine with and without Gd-DTPA revealed an intradural lesion with strong contrast enhancement, first described as atypical ependymoma or schwannoma. A complete tumor resection was achieved in all cases, the histopathological diagnosis classified the tumors as CENETs.

In our literature review, a total of 688 articles were screened and 162 patients were included. Patients demographic data, clinical symptoms, resection and recurrence were recorded.

Differential diagnosis between CENETs and other more common tumors affecting cauda equina region, such as ependymomas or schwannomas (neurinomas), is still very challenging. Due to the lack of specific clinical or radiological characteristics, a correct preoperative diagnosis is almost impossible. With this paper we want to point out that CENETs must be considered in the differential diagnosis, most of all in case of entities with atypical radiological features. According to the literature, tumor recurrence after gross total resection is unlikely, while a long-term follow-up is recommended in case of subtotal resection or local aggressive behavior.

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Fabbrocini, L., Zin, F., Keyvani, K. et al. Cauda equina neuroendocrine tumor: a report of three cases and review of the literature with focus on differential diagnosis and postoperative management. Neurosurg Rev 47 , 166 (2024). https://doi.org/10.1007/s10143-024-02405-0

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Review Article
Open access
Published: 23 April 2024

Research on flipped classrooms in foreign language teaching in Chinese higher education

Wen Kong 1 ,
Di Li 2 &
Quanjiang Guo ORCID: orcid.org/0000-0002-7846-1363 3

Humanities and Social Sciences Communications volume 11 , Article number: 525 ( 2024 ) Cite this article

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Language and linguistics

This review examines 233 articles published in Chinese academic journals between 2011 and 2021, documenting the state of research concerning flipped classrooms (FCs) in foreign language teaching within the context of higher education in China. Employing the methodological approach of a scoping review, the investigation is underpinned by the five-stage framework articulated by Arksey and O’Malley. The results reveal a notable surge in FC-related studies between 2013 and 2017, with a subsequent decline in scholarly attention. The majority of the reviewed studies on FCs focused on English instruction at the college level, with a conspicuous dearth of inquiry into the application of FCs in the teaching of other foreign languages. All studies were categorized as either empirical or non-empirical, and the most frequently used instruments for data collection were surveys and interviews; case studies were underrepresented in the literature. Early studies focused on the introduction of the new model, while more recent investigations focused on the impact of its implementation. The findings of the in-depth content analysis unearthed a prevailing trend of high learner satisfaction with the FC model, along with favorable direct and indirect educational outcomes. Noteworthy factors influencing the efficacy of FCs included learners’ foreign language proficiency and their self-regulation or self-discipline abilities. The paper concludes with a discussion of the challenges in FC implementation and a call for future research on this promising pedagogy.

The implementation of a flipped classroom approach at a UK dental school

Effectiveness of the flipped classroom model on students’ self-reported motivation and learning during the COVID-19 pandemic

Content validity of the Constructivist Learning in Higher Education Settings (CLHES) scale in the context of the flipped classroom in higher education

Introduction.

The flipped classroom (FC), also known as the “inverted classroom”, is a pedagogical approach that first emerged in the 1980s and came into more widespread use in the 2000s (Baker, 2000 ; Bergmann and Sams, 2012 ; Khan, 2012 ). It has gained prominence as advances in technology afford increasing opportunities for ubiquitous access to a variety of online resources. The FC model removes in-class lectures, freeing up classroom time for more in-depth exploration of topics through discussion with peers or problem-solving activities facilitated by instructors. The removed content is often delivered to learners through pre-class materials like video recordings. As a result, in the FC, learning activities that are active and social occur inside the classroom while most information transmission occurs outside the classroom. Today, the FC has been implemented in many different disciplines and in schools and universities around the world (Akcayir and Akcayir, 2018 ).

Proponents of the FC assert its pedagogical merits on several fronts. First, it alleviates the constraints associated with requiring all learning to happen at the same time and place, furnishing learners with an individualized education that enables flexible online study at their own pace as long as an internet connection is available (Hung, 2014 ). Second, it allocates class time to the cultivation of learners’ higher-order cognitive skills, emphasizing application, analysis, and evaluation, as opposed to lower-order skills such as knowledge and comprehension (Brinks-Lockwood, 2014 ; Lee and Wallace, 2018 ). Third, in contrast to traditional lecturing, the FC is a student-centered approach emphasizing engagement and active learning (Steen-Utheim and Foldnes, 2018 ), fostering students’ autonomy by endowing them with heightened responsibility for their learning (Brinks-Lockwood, 2014 ; O’Flaherty and Philips, 2015 ).

Vygotsky’s social constructivism ( 1978 ) has frequently been adopted as a theoretical foundation for designing learning experiences in technologically rich environments (Marzouki et al., 2017 ), and this framework highlights the particular benefits of technology-enhanced FC pedagogy (Jarvis et al., 2014 ). As mentioned above, in an FC model, learners can watch pre-recorded videos in their own time before class to remember basic information and understand concepts as they prepare for classroom activities, while the higher-order skills of analyzing, applying, evaluating, and creating can be collaborative and interactive, taking place in class with the guidance of a teacher, and thus facilitating progression within the learners’ proximal developmental zone.

Since its introduction in foreign language teaching (FLT) in China in 2011, the FC has attracted increasing research attention and has been welcomed by foreign language teachers (Yan and Zhou, 2021 ). Over the past decade, the Ministry of Education of the People’s Republic of China has exerted increasing pressure on higher education institutions to transition from traditional teacher-centered lecture-style approaches to innovative methods integrating technology and the internet, with the goals of enhancing learning, sustaining student engagement, and improving student satisfaction (Ministry of Education of People’s Republic China, 2021 ). The FC model, combined with traditional face-to-face teaching and personalized online learning, has emerged as a popular strategy in China to meet ministry requirements while delivering cost-effective and learner-centered curricula in response to the increasing student enrollment in higher education.

Despite the wide adoption of FCs in FLT in China, literature reviews about their implementation and effects have been notably scarce in the last decade. A search of the China National Knowledge Infrastructure (CNKI), the largest national research and information publishing company housing China’s most extensive academic database, revealed only three reviews—by Deng ( 2016 ), Qu ( 2019 ), and Su et al. ( 2019 )—published prior to the end of 2021. These reviews primarily focused on FCs in the context of English as a foreign language (EFL) education, overlooking most of the over 100 foreign languages taught in Chinese higher education. As a result, these reviews fell short of delivering a comprehensive analysis of research pertaining to FCs, and the reliability and generalizability of their findings in non-EFL contexts are questionable. Moreover, Deng ( 2016 ) and Su et al.’s (2019) reviews included all published papers without establishing clear inclusion and exclusion criteria. For example, they did not exclude articles that made a passing or token reference to the FC model, short papers of only one or two pages in length, book reviews, or editorials. Qu’s study ( 2019 ), on the other hand, was constrained in scope to articles within the Chinese Social Sciences Citation Index (CSSCI), a sub-database developed by Nanjing University of China Academy of Social Sciences Research Evaluation Center and the Hong Kong University of Science and Technology, and thus omitted relevant contributions from other academic journals. The CNKI incorporates both the CSSCI and the Core Journals of China (CJC), an equally significant sub-database overseen by the Peking University Library and experts from relevant institutions. Given the exclusion of the latter, a reevaluation of the scope and potential limitations of Qu’s study is warranted.

Thus, there persists an imperative for a comprehensive synthesis of the extant studies on FCs in FLT within Chinese higher education over the past decade. The restricted visibility of studies conducted in China, owing to their publication in Chinese and confinement to Chinese academic journals, makes it difficult for international researchers and practitioners to access and comprehend this body of literature. Such understanding among the global academic community is necessary for exploring both the strengths and limitations of FCs in diverse cultural and linguistic contexts.

Research method

The current study adopts a scoping review approach based on the methodological framework developed by Arksey and O’Malley ( 2005 ) to provide both quantitative and qualitative data for researchers and practitioners.

A scoping review is a relatively new approach to synthesizing research data which has been gaining popularity in many disciplines (Davis et al., 2009 ; Daudt et al., 2013 ). It is often undertaken as an independent project when a research area is complex, and no review of that area has previously been made available. A scoping review serves to highlight the relevant literature to researchers with the aim of rapidly mapping the key concepts characterizing a research area and the main sources and types of evidence available (Arksey and O’Malley, 2005 ; Mays et al., 2005 ; Levac et al., 2010 ). According to Arksey and O’Malley ( 2005 ), this kind of review addresses four goals: to examine the extent, range, and nature of research activity; to determine the value of undertaking a full systematic review; to summarize and disseminate research findings; and to identify research gaps in the existing literature. The scoping review is increasingly being employed in the field of foreign language education to provide a comprehensive view of FLT studies, identify implications for theory and pedagogy, or inform subsequent in-depth reviews and empirical studies (Chan et al., 2022 ; Hillman et al., 2020 ; Tullock and Ortega, 2017 ).

The difference between a scoping review and a narrative or traditional literature review lies in the transparency of the review process. A narrative review usually depends on the author’s own knowledge or experience to describe the studies reviewed and uses an implicit process to provide evidence (Garg et al., 2008 ). The reader cannot determine how much literature has been consulted or whether certain studies have been ignored due to contradictory findings. A scoping review, in contrast, uses an explicit, rigorous, and systematic approach to retrieve relevant articles to ensure the transparency and replicability of the data extraction process. For example, the methodological framework adopted by Arksey and O’Malley ( 2005 ) for conducting a scoping study comprises five stages: identifying the research questions; identifying relevant studies; selecting studies for inclusion; charting the data; and collating, summarizing, and reporting the results. By presenting the process and results in an accessible and summarized format, reviewers are in a position to illustrate the field of interest in terms of the volume, nature, and characteristics of the primary research, enabling researchers, practitioners, and policymakers to make effective use of the findings.

Figure 1 presents the process of the scoping review in the current study based on the five-stage methodological framework developed by Arksey and O’Malley ( 2005 ).

Process of the scoping review.

Process of the scoping review

Identifying research questions.

This scoping review is driven by four research questions:

RQ1. What is the current state of FC research in FLT within the context of higher education in China?

RQ2. What research methods and instruments have been employed in the included FC studies?

RQ3. What research foci and trends are displayed in the included FC studies?

RQ4. What are the major findings of the included FC studies?

RQ1 aims to provide an overview of studies on FCs in FLT in Chinese higher education by providing details about the basic information about existing publications, such as the number of publications per year and the distribution of publications by foreign language context. RQ2 leads to a classification of the research methods and instruments used to collect data in FC research. RQ3 explores the topics and trends in FC research over the past decade with the help of the literature visualization and analysis tool CiteSpace5.8R3. RQ4 reveals the effects of the FC model on direct and indirect educational outcomes, learners’ satisfaction with FCs, and the factors influencing the impact of FCs, as documented in the reviewed sources.

Searching for relevant studies

To be as comprehensive as possible in identifying primary evidence and to ensure the quality of the published articles, we searched both CSSCI and CJC in the CNKI database. The key search terms were developed and categorized based on two dimensions according to the purpose of the review. One dimension related to teaching or learning in FCs, while the other dimension related to the types of foreign languages. The key search terms and search methods are listed in Table 1 .

As the FC approach was introduced into FLT in China in 2011, the search included articles published between 2011 and 2021. Further inclusion and exclusion criteria were developed to focus on the scope of the review; these are outlined in Table 2 .

Study selection

Figure 2 shows a process diagram of the study selection process, which consisted of four phases: searching the databases; identifying the total number of articles in each database; screening titles, abstracts, and full texts; and selecting eligible articles for inclusion.

Flowchart diagram for article selection.

The final database search was conducted on January 16, 2022, and resulted in the identification of a total of 333 articles. Subsequently, all potentially relevant articles went through a three-step screening process. The first step excluded 9 duplicates. The second step excluded irrelevant articles by screening titles and abstracts; 37 articles were removed at this stage as they were book reviews, conference proceedings, reports, editorials, or other non-refereed publications. The third step filtered articles by screening full texts; 54 articles were excluded because they made only passing reference to the FC or were not related to higher education. This meticulous selection yielded a corpus of 233 articles suitable for in-depth analysis, each of which was scrutinized by the authors to confirm its suitability for inclusion. During the selection process, the 233 articles were also systematically categorized into two groups: 131 non-empirical and 102 empirical studies. The non-empirical studies were further divided into two subcategories. The first type was literature reviews; the second type was those drawing on personal observations, reflections on current events, or the authority or experience of the author (Dan, 2021 ). The empirical studies used a variety of systematic methods of collecting materials and analyzing data, including quantitative methods (e.g., survey, correlational research, experimental research) and/or qualitative methods (e.g., interview, case study, record keeping, observation, ethnographic research) (Dan, 2021 ).

Data charting and collation

The fourth stage of Arksey and O’Malley’s scoping review framework is the charting of the selected articles. Summaries of each study were developed. for all studies, these summaries included the author, year of publication, citations per year, foreign language taught, and a brief description of the outcomes. For empirical sources, details related to the research design, study population, and sample size were also provided. Tables 3 and 4 list the top ten most-cited non-empirical and empirical sources. In Table 4 , which references experimental and control groups in results summaries, the experimental group (EG) was the group that took courses in the FC model, while the control group (CG) took courses in a traditional classroom.

Results and analysis

In accordance with the fifth stage of Arksey and O’Malley’s framework for a scoping review, the findings from the 233 included studies are summarized and discussed in the following three sections. Section 4.1 summarizes basic information regarding the included studies; section 4.2 presents a holistic analysis of the research foci and trends over time using keyword clustering analysis and keyword burst analysis; and section 4.3 offers an in-depth content analysis focusing on the categorization of the included studies and discussion of the major findings.

Basic information on the included studies

Distribution by year of publication.

As Fig. 3 shows, the first studies on FCs in the field of FLT in China emerged in 2013. The number of such studies began to steadily increase and reached a peak in 2016 and 2017. Although there was some decrease after that, the FC model has continued to attract research attention, in line with global trends. According to Akçayir and Akçayir’s (2018) review of the literature on FCs published in Social Sciences Citation Index (SSCI) journals as of 31 December 2016, the first article about the FC was published in 2000, but the second was not published until more than a decade later, in 2012; 2013 was also the year that FC studies became popular among scholars. A possible explanation for this increase in interest is the growing availability of internet technologies and the popularity of online learning platforms, such as MOOCs and SPOCs (Small Private Online Courses), along with the view of the FC as a promising model that can open doors to new approaches in higher education in the new century.

Number of articles published by year.

Distribution by foreign language

Figure 4 shows the distribution of foreign languages discussed in the FC literature. The FC model was mainly implemented in EFL teaching (93%), which reflects the dominance of English in FLT in Chinese higher education. Only five articles discussed the use of FC models in Japanese teaching, while one article was related to French teaching. Ten non-empirical studies (4%) reported the feasibility of FC models in FLT without mentioning a specific foreign language.

Distribution by foreign language type.

Research methods of the included studies

Figure 5 shows a breakdown of the methodologies adopted by the studies included in our review. Among the 131 non-empirical studies, three were literature reviews, while the remaining 128 (55%) were descriptive studies based on the introduction of the FC model, including descriptions of its strengths and associated challenges and discussions of its design and implementation in FLT.

Methodological paradigms.

Of the 102 empirical studies, 60 (26%) used quantitative methods for data collection, eight (3%) used qualitative methods, and 34 (15%) used mixed methods. It is interesting to note that although quantitative methods are more common in FC studies, seven of the top ten most-cited empirical studies (as listed above in Table 4 ) used mixed methods. A potential reason may be that research findings collected with triangulation from various data sources or methods are seen as more reliable and valid and, hence, more accepted by scholars.

A breakdown of the data collection approaches used in the 102 reviewed empirical studies is displayed in Table 5 . It is important to note that most studies used more than one instrument, and therefore, it is possible for percentages to add up to more than 100%. The survey, as a convenient, cost-effective, and reliable research method, was the tool most frequently used to gain a comprehensive picture of the attitudes and characteristics of a large group of learners. Surveys were used in 79 of the 102 studies—73 times with learners and six times with teachers—to explore students’ learning experiences, attitudes, and emotions, as well as teachers’ opinions. Some studies used paper-based surveys, while others used online ones. Interviews with learners were used in 33 studies to provide in-depth information; one study used interviews with teachers. Surveys and interviews were combined in 24 studies to obtain both quantitative and qualitative data. Other research approaches included comparing the test scores between experimental and control groups (used in 25 studies) or using the results of course assessments (17 studies) to investigate the effects of the FC on academic performance. Learners’ self-reports (9 studies) were also used to capture the effects of the FC on learners’ experience and cognitive changes that could not be obtained in other ways, while one study used a case study for a similar purpose. Teachers’ class observations and reflections were used in eight studies to evaluate students’ engagement, interaction, activities, and learning performance.

Holistic analysis of the research foci and the changing trends of the included studies

A holistic analysis of the research foci in studies of FCs in China was conducted using CiteSpace5.8.R3, a software developed by Chaomei Chen ( http://cluster.cis.drexel.edu/~cchen/citespace/ , accessed on 20 February 2022), to conduct a visual analysis of the literature. This software can help conduct co-citation analysis, keyword co-occurrence analysis, keyword clustering analysis, keyword burst analysis, and social network analysis (Chen, 2016 ). In this study, keyword clustering analysis and keyword burst analysis were chosen to capture important themes and reveal changing trends in FC research.

Keyword clustering analysis primarily serves to identify core topics in a corpus. Figure 6 presents a graph of the top ten keyword clusters identified in the included studies. In this graph, the lower the ID number of a given cluster, the more keywords are in that cluster. As shown in the top left corner of Fig. 6 , the value of modularity q is 0.8122, which is greater than the critical value of 0.3, indicating that the clustering effect is good; the mean silhouette value is 0.9412, which is >0.5, indicating that the clustering results are significant and can accurately represent hot spots and topics in FC research (Hu and Song, 2021 ). The top ten keyword clusters include #0翻转课堂 (flipped classroom), #1大学英语 (college English), #2 MOOC, #3教学模式 (teaching model), #4元认知 (metacognition), #5微课 (micro lecture), #6微课设计 (micro lecture design), #7英语教学 (English teaching), #8 SPOC, and #9 POA (production-oriented approach).

The graph of the top ten keyword clusters.

Keyword burst analysis is used to showcase the changes in keyword frequencies over a given period of time. By analyzing the rise and decline of keywords, and in particular, the years in which some keywords suddenly become significantly more prevalent (“burst”), we can identify emerging trends in the evolution of FC research. Figure 7 displays the 11 keywords with the strongest citation bursts. We can roughly divide the evolution of FC research documented in Fig. 7 into two periods. The first period (2014 to 2017) focused on the introduction of the new model and the analysis of its feasibility in FLT. The keywords that underwent bursts in this period included “MOOC”, “自主学习” (independent learning), “模式” (model), “学习模式” (learning model), “教师话语” (teacher discourse), “茶文化” (tea culture), and “可行性” (feasibility). The reason for the appearance of the keyword “tea culture” lies in the fact that three articles discussing the use of FCs in teaching tea culture in an EFL environment were published in the same journal, entitled Tea in Fujian , during this period. The second period (2018–2021) focused on the investigation of the effect of FCs and the design of micro lectures. Keywords undergoing bursts during this period included “互联网+” (internet plus), “课堂环境” (classroom environment), “教学效果” (teaching effect), and “微课设计” (micro lecture design). The latter two topics (“teaching effect” and “micro lecture design”) may continue to be prevalent in the coming years.

Top 11 keywords with the strongest citation bursts.

In-depth content analysis of the included studies

Along with the findings from the keyword clustering analysis and keyword burst analysis, an open coding system was created to categorize the research topics and contents of the 233 articles for in-depth analysis. Non-empirical and empirical studies were classified further into detailed sub-categories based on research foci and findings. It is important to note that some studies reported more than one research focus. For such studies, more than one sub-category or more than one code was applied; therefore, it is possible for percentages to add up to more than 100%. The findings for each category are discussed in detail in the following sections.

Non-empirical studies

The 131 non-empirical studies can be roughly divided into two categories, as shown in Table 6 . The first category, literature reviews, has no sub-categories. The second, descriptive studies, includes discussions of how to use FCs in FLT; descriptions of the process of implementing the FC in FLT; and comparisons between FCs and traditional classes or comparisons of FCs in Chinese and American educational contexts.

The sub-categories of “introduction and discussion” and “introduction and description” in Table 6 comprise 91.6% of the non-empirical studies included in our review. The difference between them lies in that the former is based on the introduction of the FC literature, while the latter is based both on the introduction of the FC literature and exploration of researchers’ teaching experience; the latter might have become qualitative studies if researchers had gone further in providing systematic methods of collecting information or an analysis of the impact of FCs.

Empirical studies

The 102 empirical studies were divided into four categories based on the domain of their reported findings: the effect of FCs on learners; learners’ satisfaction with FCs; factors influencing FCs; or other research foci. Each group was further classified into more detailed sub-categories.

Effect of FCs on learners

Studies on the effect of FCs on learners were divided into two types, as presented in Table 7 : those concerned with the direct effect of FCs on learning performance and those exploring the indirect effect on learners’ perceptions. Eight codes were applied to categorize the direct effect of FCs on learning performance, which was usually evaluated through test scores; 14 codes were used to categorize the indirect effect of FCs on learners’ perceptions, which were usually investigated through surveys or questionnaires. We do not provide percentages for each code in Tables 7 – 9 because, given that the total number of empirical studies is 102, the percentages are almost identical to the frequencies.

The results shown in Table 7 reveal that 84 studies of direct educational outcomes reported that FCs had a positive effect on basic language skills, content knowledge, and foreign language proficiency. Of these, 64 were concerned with the positive effect of FCs on foreign language proficiency, speaking skills, or listening skills. This result might be explained by the features of FCs. The main difference between FCs and traditional classrooms is that the teaching of content in FCs has been removed from the classes themselves and is often delivered to the students through video recordings, which can be viewed repeatedly outside of the class. In-class time can thus be used for discussion, presentations, or the extension of the knowledge provided in the videos. It is evident that students have more opportunities to practice listening and speaking in FCs, and foreign language proficiency is naturally expected. Only three studies reported that FCs had no effect or a negative effect on the development of foreign language proficiency, speaking, listening, and writing skills. Yan and Zhou ( 2021 ) found that after the FC model had been in place for one semester, college students’ reading abilities improved significantly, while there was no significant improvement in their listening and writing abilities. Yin ( 2016 ) reported that after FC had been implemented for one semester, there was no significant difference in college students’ speaking scores.

A total of 96 studies reported positive effects on indirect educational outcomes, including: boosting learners’ motivation, interest, or confidence; enhancing engagement, interaction, cooperation, creativity, independent learning ability, or critical thinking ability; fostering information literacy, learning strategies, learning efficiency, or self-efficacy; or relieving stress or anxiety. The most frequently documented indirect effect of FCs is improvement in students’ independent learning ability. Only one study found that the FC did not significantly increase student interest in the course (Wang, 2015 ). Similarly, only one study found that students’ anxiety in the FC was significantly higher than that in a traditional class (Gao and Li, 2016 ).

Learners’ satisfaction with FCs

Table 8 presents the results regarding learners’ satisfaction with FCs. Nine codes were used to categorize the different aspects of learners’ satisfaction investigated in the 102 empirical studies. Some researchers represented learner satisfaction using the percentage of students choosing each answer on a five-point Likert scale from 1 (not at all satisfied) to 5 (very satisfied), while others used average scores based on Likert scale values. For the purposes of our synthesis of findings, if the percentage is above 60% or the average score is above 3, the finding is categorized as satisfied; otherwise, it is categorized as not satisfied.

The results in Table 8 show that among the nine aspects investigated, teaching approach and learning outcomes were most frequently asked about in the research, and learners were generally satisfied with both. Only one study (Li and Cao, 2015 ) reported significant dissatisfaction; in this case, 76.19% of students were not satisfied with the videos used in college English teaching due to their poor quality.

Factors influencing the effect of FCs

Eleven factors were found to influence the effect of FCs; these are categorized in Table 9 .

The results shown in Table 9 indicate that learners’ foreign language proficiency and self-regulation or self-discipline abilities are two important factors influencing the effect of FCs. Learners with high foreign language proficiency benefited more from FCs than those with low foreign language proficiency (Lv and Wang, 2016 ; Li and Cao, 2015 ; Wang and Zhang, 2014 ; Qu and Miu, 2016 ; Wang and Zhang, 2013 ; Cheng, 2016 ; Jia et al., 2016 ; Liu, 2016 ), and learners with good self-regulation and self-discipline abilities benefited more than those with limited abilities (Wang and Zhang, 2014 ; Lu, 2014 ; Lv and Wang, 2016 ; Dai and Chen 2016 ; Jia et al. 2016 ; Ling, 2018 ). It is interesting to note that two studies explored the relationship between gender and FCs (Wang and Zhang, 2014 ; Zhang and He, 2020 ), and both reported that girls benefited more from FCs because they were generally more self-disciplined than boys.

Studies with other research foci

There were six studies with other research foci, three of which investigated teachers’ attitudes toward FCs (Liao and Zou, 2019 ; Zhang and Xu, 2018 ; Zhang et al., 2015 ). The results of the surveys in these three studies showed that teachers generally held positive attitudes towards FCs and felt that the learning outcomes were better than those of traditional classes. However, some problems were also revealed in these studies. First, 56% of teachers expressed the desire to receive training before using FCs due to a lack of theoretical and practical expertise regarding this new model. Second, 87% of teachers thought that the FC increased their workload, as they were spending a significant amount of time learning to use new technology and preparing online videos or materials, yet no policy was implemented in the schools to encourage them to undertake this work. Third, 72% of teachers felt that the FC increased the academic burden students faced in their spare time (Zhang and Xu, 2018 ; Zhang et al., 2015 ). The final three studies include Cheng’s ( 2016 ) investigation of the mediative functions of college EFL teachers in the FC, Wang and Ma’s ( 2017 ) construction of a model for assessing the teaching quality of classes using the FC model, and Luo’s ( 2018 ) evaluation of the learning environment of an FC-model college English MOOC.

Discussion and conclusions

This investigation employed literature visualization to systematically analyze 233 research papers sourced from CSSCI and CJC in the CNKI database, thereby conducting a scoping review delineating the landscape of FC research within the domain of FLT in the context of higher education in China.

Our findings in relation to RQ1 highlight a substantial surge in the number of articles relating to FCs in FLT between 2013 and 2017, followed by a discernible, albeit moderate, decrease. Despite this trend, FC studies continue to be of significant interest to foreign language educators and researchers. This may be attributed to Chinese government policies encouraging higher education reform, increased internet access among educators and learners, and the burgeoning popularity of online courses such as MOOCs and SPOCs. However, the majority of the reviewed FC studies were conducted in college English classes, with only 6 studies on classes teaching foreign languages other than English. It seems that foreign language education in China (and in much of the world) has become synonymous with the teaching and learning of English, with other languages occupying a marginal position, struggling to find space in educational programs. In a multilingual world in which each language offers different possibilities for understanding others, their cultures, their epistemologies, and their experiences, this monolingual approach to FLT is dangerous (Liddicoat, 2022 ). The promotion of linguistic diversity in foreign language education policies and research is thus imperative. Another gap that needs to be addressed is the paucity of studies on the implementation of FCs in adult education. The FC model is expected to be potentially effective for teaching adult learners because it is similar in some respects to online distance learning.

In answer to RQ2, we found that the commonly used research methods and instruments in studies of the FC model include surveys, interviews, comparisons of academic measures between EGs and CGs, and course assessments. The case study is the least used method, likely due to limitations such as time demand, researcher bias, and the fact that it provides little basis for the generalization of results to the wider population. However, more case studies are needed in future research on FCs because they can provide detailed and insightful qualitative information that cannot be gathered in other ways.

Our findings regarding RQ3 show that research foci within the FC domain have evolved over time from initial exploration and feasibility discussions to a subsequent focus on the design of FCs incorporating micro-lectures based on MOOC or SPOC structures, and then to the present focus on the examination of FCs’ impacts on learners. The results of the keyword burst analysis indicate that these thematic areas are likely to persist as prominent subjects of research interest for the foreseeable future.

In response to RQ4, our in-depth content analysis found that FCs, on the whole, yield positive outcomes, although isolated studies identify limited negative impacts. FCs are most frequently associated with enhancements in student learning performance, fostering independent learning, promoting engagement and cooperation, and mitigating stress or anxiety. The results of this study suggest that well-designed FCs present a significant opportunity for foreign language educators to revolutionize instructional approaches. Furthermore, well-structured FCs can facilitate the development of learners’ potential while concurrently enabling the seamless integration of digital technology into FLT.

Most learners are satisfied with FCs, particularly with the innovative pedagogical approach of reversing traditional classes. FCs are perceived as beneficial for improving learning outcomes, creating an environment conducive to peer interaction, and gaining immediate teacher feedback and support. In addition, students’ interest in classes is enhanced by the rich and diverse online learning materials uploaded by teachers, which can be accessed conveniently at any time in any place. Furthermore, the dynamic and formative online assessment approach is also welcomed by students because it provides immediate feedback and the ability to discuss any problems they have with teachers or peers online or offline.

However, it is worth noting that most of the reviewed studies on FCs focused on one course, usually over only one semester. Students’ increase in motivation or improvements in learning outcomes might, therefore, be a result of the Hawthorne effect. Compared with the traditional didactic lecture format, the novelty of FCs, when used for the first time, might generate excitement among students, thus increasing their attention and enhancing learning outcomes, but such benefits will diminish over time. Therefore, there is a need to examine whether this model is suitable for large-scale implementation and whether its effects might be sustained over longer periods of implementation.

Learners’ foreign language proficiency and self-regulation or self-discipline abilities are the two key factors influencing the effect of FCs. These two factors are closely related; self-regulation or self-discipline is a prerequisite for successful foreign language learning in FC contexts and plays a crucial role in students’ success in the pre-class sessions for which they are personally responsible. In addition, factors such as learners’ attitudes, expectations of and adaptability to the FC model, the learning tasks and learning environment, the teaching organization and assessment methods, and the learner’s gender also have some impact on the effect of FCs. However, due to the limited number of studies, there is not sufficient evidence to warrant the generalization of any of these effects.

This scoping review highlights some potential challenges that need to be addressed for the effective implementation of FCs.

First, despite the benefits of the FC model, FCs are not equally advantageous to all students due to the self-regulated nature of the model. Many learners have reported difficulties in completing their individual online tasks outside the classroom (Yoon et al., 2021 ). The non-traditional configuration of FCs poses a formidable challenge, particularly for students less inclined to engage in pre-class online activities characterized by a lack of interactivity and for those who are less self-disciplined. Consequentially, students may attend class without having assimilated the pre-assigned material, thereby diminishing the efficacy of this instructional approach. To address this issue, additional support or prompts for students should be provided to remind them of the need to self-regulate their learning. For example, Park and Jo ( 2015 ) employed a learning analytics dashboard displaying visual representations of students’ learning patterns derived from login traces, such as login frequency and interval regularity, within the course’s learning management system. These visual indicators allowed students to monitor their learning engagement and performance in comparison to those of their peers.

Second, a persistent problem with FCs is the inability of students to interact with their peers or receive prompt feedback from instructors after completing independent online learning activities. While some researchers identified a need for teachers to provide immediate online feedback or opportunities for peer discussion, our review of the literature shows that scant attention has been given to this issue. Researchers note that under-stimulation, low perceived control over tasks, and delayed or insufficient feedback in online learning contribute significantly to learner boredom or absenteeism (Yazdanmehr et al., 2021 ; Tao and Gao, 2022 ). Online pedagogical innovations are needed to solve these new problems. For instance, the establishment of online groups employing chat software like QQ or WeChat could facilitate instantaneous feedback or peer interaction through text-based communication, thereby enhancing learners’ satisfaction with FC courses.

Third, despite recognizing the value of FCs in enhancing the learning experience for students, teachers often lack the requisite training to implement FCs effectively. Insights derived from interviews with teachers, as noted in several of the reviewed studies, reveal a pronounced desire for increased opportunities to learn about the underlying theories of FCs and acquire the skills necessary for the translation of FC concepts into pedagogical practice. Specifically, teachers express a need for guidance in creating engaging instructional videos, determining optimal video length to sustain learner interest, and ascertaining the ideal duration for online quizzes to foster optimal learner performance. Further research is required on strategies and technologies that can help teachers produce high-quality videos despite limited time and technical skills. Support from professional communities, institutions, and technology specialists is thus essential for the provision of effective hybrid offline and online instruction.

Fourth, additional research is required to determine whether workloads for students and teachers are increased by the use of FCs. If this is the case, as found in some of the reviewed studies, then the compelling benefits of FCs would be offset by the extra time needed, making it difficult to draw the conclusion that FCs are more efficient than traditional classes. The majority of language teachers, due to limited skills in technology, online environment management, and online interaction, feel too physically and emotionally overworked to expend more time and energy on enhancing teaching effectiveness. With few teachers having excess spare time, the thought of designing and creating new content might discourage even the most enthusiastic teachers.

Finally, robust empirical evidence is needed to evaluate whether FCs can facilitate students’ higher-order thinking through the use of creative technologies and assessment approaches. Constructs such as creativity and critical thinking are not always easily reduced to measurable items on survey instruments or scores on examinations (Haladyna et al., 2002 ).

In conclusion, the insights garnered from this study have the potential to enrich the global discourse on the benefits and limitations of FCs in diverse cultural and linguistic contexts. Our review included literature accessible through CSSCI and CJC in the CNKI database, and while this provides a thorough selection of the Chinese literature on the subject, our search approach may have excluded valuable FC-related papers published in other languages and countries. Consequently, different search criteria might yield different selection and data results. Future researchers are encouraged to undertake more comprehensive literature reviews encompassing broader databases to fill the gaps in our work and to augment the depth and breadth of knowledge in this domain.

Data availability

The raw data for this paper were collected from articles in Chinese Social Sciences Citation Index (CSSCI) journals and A Guide to the Core Journals of China of Peking University (PKU journals) in the database of China National Knowledge Infrastructure (CNKI) ( https://www.cnki.net/ ). The raw data used to support the findings of this study are available from the corresponding author upon request.

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Acknowledgements

This research was funded by The 14th Five-year Plan for Education Science of Jiangsu Province (Grant number: D/2021/01/79), Changzhou University (Grant number: GJY2021013), and Department of Education of Zhejiang Province, China (Project of Ideological and Political Construction of Courses 2021-337).

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Conceptualization, WK and Q-JG; methodology, WK; software, DL; validation, WK, DL, and Q-JG; formal analysis, WK and Q-JG; investigation, WK and Q-JG; resources, DL; data curation, DL; writing—original draft preparation, WK and Q-JG; writing—review and editing, WK and Q-JG; visualization, WK and Q-JG; supervision, WK; project administration, WK; funding acquisition, WK and Q-JG. All authors have read and agreed to the published version of the manuscript.

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Kong, W., Li, D. & Guo, Q. Research on flipped classrooms in foreign language teaching in Chinese higher education. Humanit Soc Sci Commun 11 , 525 (2024). https://doi.org/10.1057/s41599-024-03019-z

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This article is part of the research topic.

Using Case Study and Narrative Pedagogy to Guide Students Through the Process of Science

Molecular Storytelling: A Conceptual Framework for Teaching and Learning with Molecular Case Studies Provisionally Accepted

1 School of Interdisciplinary Arts and Sciences, University of Washington Bothell, United States
2 Institute for Quantitative Biomedicine, Rutgers, The State University of New Jersey, United States
3 Research Collaboratory for Structural Bioinformatics Protein Data Bank, Rutgers, The State University of New Jersey,, United States

The final, formatted version of the article will be published soon.

Molecular case studies (MCSs) provide educational opportunities to explore biomolecular structure and function using data from public bioinformatics resources. The conceptual basis for the design of MCSs has yet to be fully discussed in the literature, so we present molecular storytelling as a conceptual framework for teaching with case studies. Whether the case study aims to understand the biology of a specific disease and design its treatments or track the evolution of a biosynthetic pathway, vast amounts of structural and functional data, freely available in public bioinformatics resources, can facilitate rich explorations in atomic detail. To help biology and chemistry educators use these resources for instruction, a community of scholars collaborated to create the Molecular CaseNet. This community uses storytelling to explore biomolecular structure and function while teaching biology and chemistry. In this article, we define the structure of an MCS and present an example. Then, we articulate the evolution of a conceptual framework for developing and using MCSs. Finally, we related our framework to the development of technological, pedagogical, and content knowledge (TPCK) for educators in the Molecular CaseNet. The report conceptualizes an interdisciplinary framework for teaching about the molecular world and informs lesson design and education research.

Keywords: Molecular education, Case studies, Technological pedagogical and content knowledge (TPCK), Molecular structure and function, molecular visualization, Bioinformatics education, conceptual modeling

Received: 31 Jan 2024; Accepted: 23 Apr 2024.

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

* Correspondence: Prof. Caleb M. Trujillo, University of Washington Bothell, School of Interdisciplinary Arts and Sciences, Bothell, United States

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Complicated Treatment Course of Severe Asymptomatic Hypertriglyceridemia: A Case Report and Literature Review

Affiliations.

1 Department of Internal Medicine, Saint Michael's Medical Center, Newark, NJ, USA.
2 Department of Internal Medicine, Division of Gastroenterology and Hepatology, Saint Michael's Medical Center, Newark, NJ, USA.
3 Department of Medicine, Medical College Jordan University of Science and Technology, Irbid, Jordan.
4 Department of Medicine, Medical College Mutah University, Karak, Jordan.
PMID: 38620025
PMCID: PMC11034391
DOI: 10.12659/AJCR.943858

BACKGROUND Close observation, statins, fibrate treatment, and lifestyle changes can safely manage asymptomatic individuals with severe hypertriglyceridemia (HTG) and minimal risk of symptom development. However, the risk of medication-induced liver injury in patients taking statin-fibrate makes management more challenging, and may require hospital admission and close monitoring with follow-up. CASE REPORT We present a rare case of a 43-year-old man with asymptomatic severe HTG exceeding 11.370 mg/dL with mixed hyperlipidemia, managed initially with high-intensity statins and fibrate. However, due to the concurrent use of statin and fibrates, the patient subsequently developed an acute liver injury. Hence, the oral medications had to be stopped, and the patient was admitted to the hospital for an insulin drip. Even during the hospital course, the patient's triglyceride (TG) levels showed resistance to the recommended dose of insulin and he required a higher insulin dose. He was discharged on fenofibrate and subcutaneous insulin to keep the TG level under 500. Fibrate was stopped, and high-intensity statin was used as primary prevention with lifestyle modifications. CONCLUSIONS This instance highlights the necessity of increased cognizance and cooperative endeavors in handling severe asymptomatic HTG. Our results highlight the significance of further research into the management of severe asymptomatic HTG in cases of injury to the liver. This work adds essential knowledge to the ongoing discussion about managing a rare case complicated by acute liver injury.

Publication types

Case Reports
Fenofibrate* / therapeutic use
Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use
Hyperlipidemias* / complications
Hypertriglyceridemia* / complications
Hypertriglyceridemia* / drug therapy
Insulins* / therapeutic use
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Fenofibrate

Organizing Your Social Sciences Research Assignments

Annotated Bibliography
Analyzing a Scholarly Journal Article
Group Presentations
Dealing with Nervousness
Using Visual Aids
Grading Someone Else's Paper
Types of Structured Group Activities
Group Project Survival Skills
Leading a Class Discussion
Multiple Book Review Essay
Reviewing Collected Works
Writing a Case Analysis Paper
Writing a Case Study
About Informed Consent
Writing Field Notes
Writing a Policy Memo
Writing a Reflective Paper
Writing a Research Proposal
Generative AI and Writing
Acknowledgments

A case study research paper examines a person, place, event, condition, phenomenon, or other type of subject of analysis in order to extrapolate key themes and results that help predict future trends, illuminate previously hidden issues that can be applied to practice, and/or provide a means for understanding an important research problem with greater clarity. A case study research paper usually examines a single subject of analysis, but case study papers can also be designed as a comparative investigation that shows relationships between two or more subjects. The methods used to study a case can rest within a quantitative, qualitative, or mixed-method investigative paradigm.

Case Studies. Writing@CSU. Colorado State University; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010 ; “What is a Case Study?” In Swanborn, Peter G. Case Study Research: What, Why and How? London: SAGE, 2010.

How to Approach Writing a Case Study Research Paper

General information about how to choose a topic to investigate can be found under the " Choosing a Research Problem " tab in the Organizing Your Social Sciences Research Paper writing guide. Review this page because it may help you identify a subject of analysis that can be investigated using a case study design.

The case represents an unusual or atypical example of a research problem that requires more in-depth analysis? Cases often represent a topic that rests on the fringes of prior investigations because the case may provide new ways of understanding the research problem. For example, if the research problem is to identify strategies to improve policies that support girl's access to secondary education in predominantly Muslim nations, you could consider using Azerbaijan as a case study rather than selecting a more obvious nation in the Middle East. Doing so may reveal important new insights into recommending how governments in other predominantly Muslim nations can formulate policies that support improved access to education for girls.
The case provides important insight or illuminate a previously hidden problem? In-depth analysis of a case can be based on the hypothesis that the case study will reveal trends or issues that have not been exposed in prior research or will reveal new and important implications for practice. For example, anecdotal evidence may suggest drug use among homeless veterans is related to their patterns of travel throughout the day. Assuming prior studies have not looked at individual travel choices as a way to study access to illicit drug use, a case study that observes a homeless veteran could reveal how issues of personal mobility choices facilitate regular access to illicit drugs. Note that it is important to conduct a thorough literature review to ensure that your assumption about the need to reveal new insights or previously hidden problems is valid and evidence-based.
The case challenges and offers a counter-point to prevailing assumptions? Over time, research on any given topic can fall into a trap of developing assumptions based on outdated studies that are still applied to new or changing conditions or the idea that something should simply be accepted as "common sense," even though the issue has not been thoroughly tested in current practice. A case study analysis may offer an opportunity to gather evidence that challenges prevailing assumptions about a research problem and provide a new set of recommendations applied to practice that have not been tested previously. For example, perhaps there has been a long practice among scholars to apply a particular theory in explaining the relationship between two subjects of analysis. Your case could challenge this assumption by applying an innovative theoretical framework [perhaps borrowed from another discipline] to explore whether this approach offers new ways of understanding the research problem. Taking a contrarian stance is one of the most important ways that new knowledge and understanding develops from existing literature.
The case provides an opportunity to pursue action leading to the resolution of a problem? Another way to think about choosing a case to study is to consider how the results from investigating a particular case may result in findings that reveal ways in which to resolve an existing or emerging problem. For example, studying the case of an unforeseen incident, such as a fatal accident at a railroad crossing, can reveal hidden issues that could be applied to preventative measures that contribute to reducing the chance of accidents in the future. In this example, a case study investigating the accident could lead to a better understanding of where to strategically locate additional signals at other railroad crossings so as to better warn drivers of an approaching train, particularly when visibility is hindered by heavy rain, fog, or at night.
The case offers a new direction in future research? A case study can be used as a tool for an exploratory investigation that highlights the need for further research about the problem. A case can be used when there are few studies that help predict an outcome or that establish a clear understanding about how best to proceed in addressing a problem. For example, after conducting a thorough literature review [very important!], you discover that little research exists showing the ways in which women contribute to promoting water conservation in rural communities of east central Africa. A case study of how women contribute to saving water in a rural village of Uganda can lay the foundation for understanding the need for more thorough research that documents how women in their roles as cooks and family caregivers think about water as a valuable resource within their community. This example of a case study could also point to the need for scholars to build new theoretical frameworks around the topic [e.g., applying feminist theories of work and family to the issue of water conservation].

Structure and Writing Style

In general, the structure of a case study research paper is not all that different from a standard college-level research paper. However, there are subtle differences you should be aware of. Here are the key elements to organizing and writing a case study research paper.

I. Introduction

What is being studied? Describe the research problem and describe the subject of analysis [the case] you have chosen to address the problem. Explain how they are linked and what elements of the case will help to expand knowledge and understanding about the problem.
Why is this topic important to investigate? Describe the significance of the research problem and state why a case study design and the subject of analysis that the paper is designed around is appropriate in addressing the problem.
What did we know about this topic before I did this study? Provide background that helps lead the reader into the more in-depth literature review to follow. If applicable, summarize prior case study research applied to the research problem and why it fails to adequately address the problem. Describe why your case will be useful. If no prior case studies have been used to address the research problem, explain why you have selected this subject of analysis.
How will this study advance new knowledge or new ways of understanding? Explain why your case study will be suitable in helping to expand knowledge and understanding about the research problem.

II. Literature Review

Place relevant works in the context of their contribution to understanding the case study being investigated . This would involve summarizing studies that have used a similar subject of analysis to investigate the research problem. If there is literature using the same or a very similar case to study, you need to explain why duplicating past research is important [e.g., conditions have changed; prior studies were conducted long ago, etc.].
Describe the relationship each work has to the others under consideration that informs the reader why this case is applicable . Your literature review should include a description of any works that support using the case to investigate the research problem and the underlying research questions.
Identify new ways to interpret prior research using the case study . If applicable, review any research that has examined the research problem using a different research design. Explain how your use of a case study design may reveal new knowledge or a new perspective or that can redirect research in an important new direction.
Resolve conflicts amongst seemingly contradictory previous studies . This refers to synthesizing any literature that points to unresolved issues of concern about the research problem and describing how the subject of analysis that forms the case study can help resolve these existing contradictions.
Point the way in fulfilling a need for additional research . Your review should examine any literature that lays a foundation for understanding why your case study design and the subject of analysis around which you have designed your study may reveal a new way of approaching the research problem or offer a perspective that points to the need for additional research.
Expose any gaps that exist in the literature that the case study could help to fill . Summarize any literature that not only shows how your subject of analysis contributes to understanding the research problem, but how your case contributes to a new way of understanding the problem that prior research has failed to do.
Locate your own research within the context of existing literature [very important!] . Collectively, your literature review should always place your case study within the larger domain of prior research about the problem. The overarching purpose of reviewing pertinent literature in a case study paper is to demonstrate that you have thoroughly identified and synthesized prior studies in relation to explaining the relevance of the case in addressing the research problem.

III. Method

In this section, you explain why you selected a particular case [i.e., subject of analysis] and the strategy you used to identify and ultimately decide that your case was appropriate in addressing the research problem. The way you describe the methods used varies depending on the type of subject of analysis that constitutes your case study.

If your subject of analysis is a person. Explain why you selected this particular individual to be studied and describe what experiences they have had that provide an opportunity to advance new understandings about the research problem. Mention any background about this person which might help the reader understand the significance of their experiences that make them worthy of study. This includes describing the relationships this person has had with other people, institutions, and/or events that support using them as the subject for a case study research paper. It is particularly important to differentiate the person as the subject of analysis from others and to succinctly explain how the person relates to examining the research problem [e.g., why is one politician in a particular local election used to show an increase in voter turnout from any other candidate running in the election]. Note that these issues apply to a specific group of people used as a case study unit of analysis [e.g., a classroom of students].

If your subject of analysis is a place. In general, a case study that investigates a place suggests a subject of analysis that is unique or special in some way and that this uniqueness can be used to build new understanding or knowledge about the research problem. A case study of a place must not only describe its various attributes relevant to the research problem [e.g., physical, social, historical, cultural, economic, political], but you must state the method by which you determined that this place will illuminate new understandings about the research problem. It is also important to articulate why a particular place as the case for study is being used if similar places also exist [i.e., if you are studying patterns of homeless encampments of veterans in open spaces, explain why you are studying Echo Park in Los Angeles rather than Griffith Park?]. If applicable, describe what type of human activity involving this place makes it a good choice to study [e.g., prior research suggests Echo Park has more homeless veterans].

If your subject of analysis is a phenomenon. A phenomenon refers to a fact, occurrence, or circumstance that can be studied or observed but with the cause or explanation to be in question. In this sense, a phenomenon that forms your subject of analysis can encompass anything that can be observed or presumed to exist but is not fully understood. In the social and behavioral sciences, the case usually focuses on human interaction within a complex physical, social, economic, cultural, or political system. For example, the phenomenon could be the observation that many vehicles used by ISIS fighters are small trucks with English language advertisements on them. The research problem could be that ISIS fighters are difficult to combat because they are highly mobile. The research questions could be how and by what means are these vehicles used by ISIS being supplied to the militants and how might supply lines to these vehicles be cut off? How might knowing the suppliers of these trucks reveal larger networks of collaborators and financial support? A case study of a phenomenon most often encompasses an in-depth analysis of a cause and effect that is grounded in an interactive relationship between people and their environment in some way.

NOTE: The choice of the case or set of cases to study cannot appear random. Evidence that supports the method by which you identified and chose your subject of analysis should clearly support investigation of the research problem and linked to key findings from your literature review. Be sure to cite any studies that helped you determine that the case you chose was appropriate for examining the problem.

IV. Discussion

The main elements of your discussion section are generally the same as any research paper, but centered around interpreting and drawing conclusions about the key findings from your analysis of the case study. Note that a general social sciences research paper may contain a separate section to report findings. However, in a paper designed around a case study, it is common to combine a description of the results with the discussion about their implications. The objectives of your discussion section should include the following:

Relate the Findings to Similar Studies No study in the social sciences is so novel or possesses such a restricted focus that it has absolutely no relation to previously published research. The discussion section should relate your case study results to those found in other studies, particularly if questions raised from prior studies served as the motivation for choosing your subject of analysis. This is important because comparing and contrasting the findings of other studies helps support the overall importance of your results and it highlights how and in what ways your case study design and the subject of analysis differs from prior research about the topic.

Consider Alternative Explanations of the Findings Remember that the purpose of social science research is to discover and not to prove. When writing the discussion section, you should carefully consider all possible explanations revealed by the case study results, rather than just those that fit your hypothesis or prior assumptions and biases. Be alert to what the in-depth analysis of the case may reveal about the research problem, including offering a contrarian perspective to what scholars have stated in prior research if that is how the findings can be interpreted from your case.

V. Conclusion

The function of your paper's conclusion is to: 1) reiterate the main argument supported by the findings from your case study; 2) state clearly the context, background, and necessity of pursuing the research problem using a case study design in relation to an issue, controversy, or a gap found from reviewing the literature; and, 3) provide a place to persuasively and succinctly restate the significance of your research problem, given that the reader has now been presented with in-depth information about the topic.

Consider the following points to help ensure your conclusion is appropriate:

If the argument or purpose of your paper is complex, you may need to summarize these points for your reader.
If prior to your conclusion, you have not yet explained the significance of your findings or if you are proceeding inductively, use the conclusion of your paper to describe your main points and explain their significance.
Move from a detailed to a general level of consideration of the case study's findings that returns the topic to the context provided by the introduction or within a new context that emerges from your case study findings.

Note that, depending on the discipline you are writing in or the preferences of your professor, the concluding paragraph may contain your final reflections on the evidence presented as it applies to practice or on the essay's central research problem. However, the nature of being introspective about the subject of analysis you have investigated will depend on whether you are explicitly asked to express your observations in this way.

Problems to Avoid

Overgeneralization One of the goals of a case study is to lay a foundation for understanding broader trends and issues applied to similar circumstances. However, be careful when drawing conclusions from your case study. They must be evidence-based and grounded in the results of the study; otherwise, it is merely speculation. Looking at a prior example, it would be incorrect to state that a factor in improving girls access to education in Azerbaijan and the policy implications this may have for improving access in other Muslim nations is due to girls access to social media if there is no documentary evidence from your case study to indicate this. There may be anecdotal evidence that retention rates were better for girls who were engaged with social media, but this observation would only point to the need for further research and would not be a definitive finding if this was not a part of your original research agenda.

Failure to Document Limitations No case is going to reveal all that needs to be understood about a research problem. Therefore, just as you have to clearly state the limitations of a general research study , you must describe the specific limitations inherent in the subject of analysis. For example, the case of studying how women conceptualize the need for water conservation in a village in Uganda could have limited application in other cultural contexts or in areas where fresh water from rivers or lakes is plentiful and, therefore, conservation is understood more in terms of managing access rather than preserving access to a scarce resource.

Case Studies. Writing@CSU. Colorado State University; Gerring, John. Case Study Research: Principles and Practices . New York: Cambridge University Press, 2007; Merriam, Sharan B. Qualitative Research and Case Study Applications in Education . Rev. ed. San Francisco, CA: Jossey-Bass, 1998; Miller, Lisa L. “The Use of Case Studies in Law and Social Science Research.” Annual Review of Law and Social Science 14 (2018): TBD; Mills, Albert J., Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Putney, LeAnn Grogan. "Case Study." In Encyclopedia of Research Design , Neil J. Salkind, editor. (Thousand Oaks, CA: SAGE Publications, 2010), pp. 116-120; Simons, Helen. Case Study Research in Practice . London: SAGE Publications, 2009; Kratochwill, Thomas R. and Joel R. Levin, editors. Single-Case Research Design and Analysis: New Development for Psychology and Education . Hilldsale, NJ: Lawrence Erlbaum Associates, 1992; Swanborn, Peter G. Case Study Research: What, Why and How? London : SAGE, 2010; Yin, Robert K. Case Study Research: Design and Methods . 6th edition. Los Angeles, CA, SAGE Publications, 2014; Walo, Maree, Adrian Bull, and Helen Breen. “Achieving Economic Benefits at Local Events: A Case Study of a Local Sports Event.” Festival Management and Event Tourism 4 (1996): 95-106.

Writing Tip

At Least Five Misconceptions about Case Study Research

Misunderstanding 1 : General, theoretical [context-independent] knowledge is more valuable than concrete, practical [context-dependent] knowledge. Misunderstanding 2 : One cannot generalize on the basis of an individual case; therefore, the case study cannot contribute to scientific development. Misunderstanding 3 : The case study is most useful for generating hypotheses; that is, in the first stage of a total research process, whereas other methods are more suitable for hypotheses testing and theory building. Misunderstanding 4 : The case study contains a bias toward verification, that is, a tendency to confirm the researcher’s preconceived notions. Misunderstanding 5 : It is often difficult to summarize and develop general propositions and theories on the basis of specific case studies [p. 221].

Flyvbjerg, Bent. “Five Misunderstandings About Case-Study Research.” Qualitative Inquiry 12 (April 2006): 219-245.

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How to Write a Literature Review
Examples of literature reviews. Step 1 - Search for relevant literature. Step 2 - Evaluate and select sources. Step 3 - Identify themes, debates, and gaps. Step 4 - Outline your literature review's structure. Step 5 - Write your literature review.
What is a Literature Review? How to Write It (with Examples)
A literature review is a critical analysis and synthesis of existing research on a particular topic. It provides an overview of the current state of knowledge, identifies gaps, and highlights key findings in the literature. 1 The purpose of a literature review is to situate your own research within the context of existing scholarship ...
Writing a Case Study
The literature review for a case study research paper is generally structured the same as it is for any college-level research paper. The difference, however, is that the literature review is focused on providing background information and enabling historical interpretation of the subject of analysis in relation to the research problem the case ...
Writing a literature review
A formal literature review is an evidence-based, in-depth analysis of a subject. There are many reasons for writing one and these will influence the length and style of your review, but in essence a literature review is a critical appraisal of the current collective knowledge on a subject. Rather than just being an exhaustive list of all that ...
Case Study Methodology of Qualitative Research: Key Attributes and
A case study is one of the most commonly used methodologies of social research. This article attempts to look into the various dimensions of a case study research strategy, the different epistemological strands which determine the particular case study type and approach adopted in the field, discusses the factors which can enhance the effectiveness of a case study research, and the debate ...
What is a Literature Review?
A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research. There are five key steps to writing a literature review: Search for relevant literature. Evaluate sources. Identify themes, debates and gaps.
The Case Study in Educational Research: a Review of Selected Literature
A REVIEW OF SELECTED LITERATURE Case study has a long history of use in medicine, law, anthropology, political science, psychol ogy, and social work. More recently, education has recognized the advantage of using a case study approach for better understanding the process or dynamics of certain aspects of practice. All levels
Case Study Method: A Step-by-Step Guide for Business Researchers
Although case studies have been discussed extensively in the literature, little has been written about the specific steps one may use to conduct case study research effectively (Gagnon, 2010; Hancock & Algozzine, 2016).Baskarada (2014) also emphasized the need to have a succinct guideline that can be practically followed as it is actually tough to execute a case study well in practice.
Methodology or method? A critical review of qualitative case study reports
Study design. The critical review method described by Grant and Booth (Citation 2009) was used, which is appropriate for the assessment of research quality, and is used for literature analysis to inform research and practice.This type of review goes beyond the mapping and description of scoping or rapid reviews, to include "analysis and conceptual innovation" (Grant & Booth, Citation 2009 ...
A Review of the Literature on Case Study Research
This paper presents a review of the literature on case study research and comments on the ongoing debate of the value of case study. A research paradigm and its theoretical framework is described. This review focuses extensively on the positions of Merriam (1998), Yin (1981, 1984, 1994, 1999, 2003a, 2003b, 2005), and Stake (1978/2000, 1994, 1995, 2005, 2008) as foundational writers in the area ...
How much Literature Review is enough for a Case Report?
The number of references should be limited to maximum of 30 for journal of orthopaedic case reports. This will again require authors to review select the most relevant articles from the literature search. Try and include the most recent articles and also from the most relevant authors and medical centres.
Structure of a report (Case study, Literature review or Survey
Literature review Explore the literature/news/internet sources to know the topic in depth; Give a description of how you selected the literature for your project; Compare the studies, and highlight the findings, gaps or limitations. Case study An in-depth, detailed examination of specific cases within a real-world context.
The Case Study in Educational Research: A Review of Selected Literature
The Case Study in Educational Research: A Review of Selected Literature. Case study has a long history of use in medicine, law, anthropology, political science, psychol ogy, and social work. More recently, education has recognized the advantage of using a case study approach for better understanding the process or dynamics of certain aspects of ...
A Review of the Literature on Case Study Research
Ricardo D'Ávila. This paper presents a review of the literature on case study research and comments on the ongoing debate of the value of case study. A research paradigm and its theoretical framework is described. This review focuses extensively on the positions of. See Full PDF.
Distinguishing case study as a research method from case reports as a
A previous editorial by Akers and Amos about improving case studies addresses issues that are more common to case reports; for example, not having a review of the literature or being anecdotal, not generalizable, and prone to various types of bias such as positive outcome bias . However, case study research as a qualitative methodology is ...
Pulmonary Hypertension in COPD: A Case Study and Review of the Literature
In-depth workup of underlying pulmonary hypertension and use of pulmonary vasodilator medications may be appropriate on an individual basis. We present a case study and a review and discussion of the pertinent literature on this topic. Keywords: PH-COPD; chronic obstructive pulmonary disease; pulmonary hypertension.
Research Guides: Write and Cite: Literature Review
This step allows you to discover what has been written about in the field. Focus your topic: A literature review aims to cover all of the research on a given topic. If the topic is too large, there will be too much material to cover it adequately. The GSD's guidelines for doctoral literature reviews offers helpful examples of feasible topics:
Open Innovation Practices: A Literature Review of Case Studies
PDF | On Jan 1, 2015, Leidy Tatiana Rodriguez Torres and others published Open Innovation Practices: A Literature Review of Case Studies | Find, read and cite all the research you need on ResearchGate
citations
Jan 3, 2019 at 19:13. To copy and paste it as it is, word for word. Then reference it. - Sambo. Jan 3, 2019 at 19:29. I don't know about your field, but in mine, case studies are full-length articles. These you couldn't cite verbatim from beginning to end. - henning. Jan 3, 2019 at 20:28.
Determinant on Economic Growth in Developing Country: A Special Case
Our comprehensive literature review identifies a pressing need for a more profound analysis that transcends the conventional employment of broad economic models, thereby addressing the first identified gap. ... An investigation on Innokids as a case study. Daffodil International University Journal of Business and Entrepreneurship, 16(1), ...
Person-centered care assessment tool with a focus on quality healthcare
The present study comprises two distinct but interconnected procedures. First, a systematic literature review was conducted following the PRISMA method ( []; Additional file 1; Additional file 2) with the aim of collecting all validations of the P-CAT that have been developed.Second, a systematic description of the validity evidence for each of the P-CAT validations found in the systematic ...
Malignant peritoneal mesothelioma presenting with bilateral
This study aimed to provide clinical evidence for the diagnosis, treatment, and prognosis of rare MPM. Case presentation ... (2024) Malignant peritoneal mesothelioma presenting with bilateral hydronephrosis and renal insufficiency: a case report and literature review. Front. Surg. 11:1342657. doi: 10.3389/fsurg.2024.1342657. Received: 22 ...
Cauda equina neuroendocrine tumor: a report of three cases and review
We describe three cases of CENETs observed at our institution with particular focus on differential diagnosis and postoperative management. Since the lack of guidelines, we performed a literature review to identify factors that can predict recurrence and influence postoperative decision making. Case report and literature review
Research on flipped classrooms in foreign language teaching in ...
Figure 5 shows a breakdown of the methodologies adopted by the studies included in our review. Among the 131 non-empirical studies, three were literature reviews, while the remaining 128 (55% ...
Case Study as a Research Method in Hospitality and Tourism Research: A
Case studies are, therefore, useful, and their units of analysis can largely be comprised of a broad range of elements; persons, social communities, organizations, and institutions could become the subject of a case analysis (Flick, 2009; Yin, 2003).Case study research is preferred by researchers when (a) the main research questions are "how" or "why" questions; (b) the researcher has ...
Molecular Storytelling: A Conceptual Framework for Teaching and
Molecular case studies (MCSs) provide educational opportunities to explore biomolecular structure and function using data from public bioinformatics resources. The conceptual basis for the design of MCSs has yet to be fully discussed in the literature, so we present molecular storytelling as a conceptual framework for teaching with case studies. Whether the case study aims to understand the ...
Complicated Treatment Course of Severe Asymptomatic
Complicated Treatment Course of Severe Asymptomatic Hypertriglyceridemia: A Case Report and Literature Review Am J Case Rep. 2024 Apr 15 ... CASE REPORT We present a rare case of a 43-year-old man with asymptomatic severe HTG exceeding 11.370 mg/dL with mixed hyperlipidemia, managed initially with high-intensity statins and fibrate. However ...
Prosthetic Joint Infections Caused by Mycobacterium tuberculosis ...
Purpose: While tuberculosis remains a significant global health concern, prosthetic joint infections (PJIs) caused by members of the Mycobacterium tuberculosis complex are exceptionally rare. Our objective is to perform a retrospective search of new cases of this disease and analyze all cases available in the literature of tuberculous PJIs, aiming to detect factors that may influence patient ...
Writing a Case Study
The literature review for a case study research paper is generally structured the same as it is for any college-level research paper. The difference, however, is that the literature review is focused on providing background information and enabling historical interpretation of the subject of analysis in relation to the research problem the case ...

What is a Literature Review? How to Write It (with Examples)

Table of Contents

What is a literature review?

What is the purpose of literature review?

Literature review example

Literature Review on Climate Change Impacts on Biodiversity:

a. Habitat Loss and Species Extinction:

b. Range Shifts and Phenological Changes:

c. Ocean Acidification and Coral Reefs:

d. Adaptive Strategies and Conservation Efforts:

How to write a good literature review

Conducting a literature review

Choose a Topic and Define the Research Question:

Decide on the Scope of Your Review:

Select Databases for Searches:

Conduct Searches and Keep Track:

Review the Literature:

Organize and Write Your Literature Review:

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Shona McCombes

CC0006 Basics of Report Writing

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Introduction

Literature Review

Methodology

Results and Analysis

Discussion, Limitation(s) and Implication(s)

Conclusion and Recommendations

Appendix (if necessary/any)

A Review of the Literature on Case Study Research

Related Papers

RELATED PAPERS

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

CASE STUDY AS A RESEARCH METHODOLOGY

VARIATIONS ON CASE STUDY METHODOLOGY

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PUBLICATION OF CASE STUDY RESEARCH IN LIBRARIANSHIP

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Person-centered care assessment tool with a focus on quality healthcare: a systematic review of psychometric properties

Person-centered care (PCC)

Person-centered care assessment tool (P-CAT)

Scale validity

Current study

Systematic review

Eligibility criteria and selection process

Data collection process

Description of the validity study

Study selection and study characteristics

Validity analysis

Evidence based on test content

Evidence based on response processes

Evidence based on internal structure

Evidence based on relationships with other variables

Evidence based on the consequences of testing

Conclusions

Data availability

Abbreviations

Acknowledgements

Author information

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