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Case Study – Methods, Examples and Guide

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A case study is a research method that involves an in-depth examination and analysis of a particular phenomenon or case, such as an individual, organization, community, event, or situation.

It is a qualitative research approach that aims to provide a detailed and comprehensive understanding of the case being studied. Case studies typically involve multiple sources of data, including interviews, observations, documents, and artifacts, which are analyzed using various techniques, such as content analysis, thematic analysis, and grounded theory. The findings of a case study are often used to develop theories, inform policy or practice, or generate new research questions.

Types of Case Study

Types and Methods of Case Study are as follows:

Single-Case Study

A single-case study is an in-depth analysis of a single case. This type of case study is useful when the researcher wants to understand a specific phenomenon in detail.

For Example , A researcher might conduct a single-case study on a particular individual to understand their experiences with a particular health condition or a specific organization to explore their management practices. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of a single-case study are often used to generate new research questions, develop theories, or inform policy or practice.

Multiple-Case Study

A multiple-case study involves the analysis of several cases that are similar in nature. This type of case study is useful when the researcher wants to identify similarities and differences between the cases.

For Example, a researcher might conduct a multiple-case study on several companies to explore the factors that contribute to their success or failure. The researcher collects data from each case, compares and contrasts the findings, and uses various techniques to analyze the data, such as comparative analysis or pattern-matching. The findings of a multiple-case study can be used to develop theories, inform policy or practice, or generate new research questions.

Exploratory Case Study

An exploratory case study is used to explore a new or understudied phenomenon. This type of case study is useful when the researcher wants to generate hypotheses or theories about the phenomenon.

For Example, a researcher might conduct an exploratory case study on a new technology to understand its potential impact on society. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as grounded theory or content analysis. The findings of an exploratory case study can be used to generate new research questions, develop theories, or inform policy or practice.

Descriptive Case Study

A descriptive case study is used to describe a particular phenomenon in detail. This type of case study is useful when the researcher wants to provide a comprehensive account of the phenomenon.

For Example, a researcher might conduct a descriptive case study on a particular community to understand its social and economic characteristics. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of a descriptive case study can be used to inform policy or practice or generate new research questions.

Instrumental Case Study

An instrumental case study is used to understand a particular phenomenon that is instrumental in achieving a particular goal. This type of case study is useful when the researcher wants to understand the role of the phenomenon in achieving the goal.

For Example, a researcher might conduct an instrumental case study on a particular policy to understand its impact on achieving a particular goal, such as reducing poverty. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of an instrumental case study can be used to inform policy or practice or generate new research questions.

Case Study Data Collection Methods

Here are some common data collection methods for case studies:

Interviews involve asking questions to individuals who have knowledge or experience relevant to the case study. Interviews can be structured (where the same questions are asked to all participants) or unstructured (where the interviewer follows up on the responses with further questions). Interviews can be conducted in person, over the phone, or through video conferencing.

Observations

Observations involve watching and recording the behavior and activities of individuals or groups relevant to the case study. Observations can be participant (where the researcher actively participates in the activities) or non-participant (where the researcher observes from a distance). Observations can be recorded using notes, audio or video recordings, or photographs.

Documents can be used as a source of information for case studies. Documents can include reports, memos, emails, letters, and other written materials related to the case study. Documents can be collected from the case study participants or from public sources.

Surveys involve asking a set of questions to a sample of individuals relevant to the case study. Surveys can be administered in person, over the phone, through mail or email, or online. Surveys can be used to gather information on attitudes, opinions, or behaviors related to the case study.

Artifacts are physical objects relevant to the case study. Artifacts can include tools, equipment, products, or other objects that provide insights into the case study phenomenon.

How to conduct Case Study Research

Conducting a case study research involves several steps that need to be followed to ensure the quality and rigor of the study. Here are the steps to conduct case study research:

• Define the research questions: The first step in conducting a case study research is to define the research questions. The research questions should be specific, measurable, and relevant to the case study phenomenon under investigation.
• Select the case: The next step is to select the case or cases to be studied. The case should be relevant to the research questions and should provide rich and diverse data that can be used to answer the research questions.
• Collect data: Data can be collected using various methods, such as interviews, observations, documents, surveys, and artifacts. The data collection method should be selected based on the research questions and the nature of the case study phenomenon.
• Analyze the data: The data collected from the case study should be analyzed using various techniques, such as content analysis, thematic analysis, or grounded theory. The analysis should be guided by the research questions and should aim to provide insights and conclusions relevant to the research questions.
• Draw conclusions: The conclusions drawn from the case study should be based on the data analysis and should be relevant to the research questions. The conclusions should be supported by evidence and should be clearly stated.
• Validate the findings: The findings of the case study should be validated by reviewing the data and the analysis with participants or other experts in the field. This helps to ensure the validity and reliability of the findings.
• Write the report: The final step is to write the report of the case study research. The report should provide a clear description of the case study phenomenon, the research questions, the data collection methods, the data analysis, the findings, and the conclusions. The report should be written in a clear and concise manner and should follow the guidelines for academic writing.

Examples of Case Study

Here are some examples of case study research:

• The Hawthorne Studies : Conducted between 1924 and 1932, the Hawthorne Studies were a series of case studies conducted by Elton Mayo and his colleagues to examine the impact of work environment on employee productivity. The studies were conducted at the Hawthorne Works plant of the Western Electric Company in Chicago and included interviews, observations, and experiments.
• The Stanford Prison Experiment: Conducted in 1971, the Stanford Prison Experiment was a case study conducted by Philip Zimbardo to examine the psychological effects of power and authority. The study involved simulating a prison environment and assigning participants to the role of guards or prisoners. The study was controversial due to the ethical issues it raised.
• The Challenger Disaster: The Challenger Disaster was a case study conducted to examine the causes of the Space Shuttle Challenger explosion in 1986. The study included interviews, observations, and analysis of data to identify the technical, organizational, and cultural factors that contributed to the disaster.
• The Enron Scandal: The Enron Scandal was a case study conducted to examine the causes of the Enron Corporation’s bankruptcy in 2001. The study included interviews, analysis of financial data, and review of documents to identify the accounting practices, corporate culture, and ethical issues that led to the company’s downfall.
• The Fukushima Nuclear Disaster : The Fukushima Nuclear Disaster was a case study conducted to examine the causes of the nuclear accident that occurred at the Fukushima Daiichi Nuclear Power Plant in Japan in 2011. The study included interviews, analysis of data, and review of documents to identify the technical, organizational, and cultural factors that contributed to the disaster.

Application of Case Study

Case studies have a wide range of applications across various fields and industries. Here are some examples:

Business and Management

Case studies are widely used in business and management to examine real-life situations and develop problem-solving skills. Case studies can help students and professionals to develop a deep understanding of business concepts, theories, and best practices.

Case studies are used in healthcare to examine patient care, treatment options, and outcomes. Case studies can help healthcare professionals to develop critical thinking skills, diagnose complex medical conditions, and develop effective treatment plans.

Case studies are used in education to examine teaching and learning practices. Case studies can help educators to develop effective teaching strategies, evaluate student progress, and identify areas for improvement.

Social Sciences

Case studies are widely used in social sciences to examine human behavior, social phenomena, and cultural practices. Case studies can help researchers to develop theories, test hypotheses, and gain insights into complex social issues.

Law and Ethics

Case studies are used in law and ethics to examine legal and ethical dilemmas. Case studies can help lawyers, policymakers, and ethical professionals to develop critical thinking skills, analyze complex cases, and make informed decisions.

Purpose of Case Study

The purpose of a case study is to provide a detailed analysis of a specific phenomenon, issue, or problem in its real-life context. A case study is a qualitative research method that involves the in-depth exploration and analysis of a particular case, which can be an individual, group, organization, event, or community.

The primary purpose of a case study is to generate a comprehensive and nuanced understanding of the case, including its history, context, and dynamics. Case studies can help researchers to identify and examine the underlying factors, processes, and mechanisms that contribute to the case and its outcomes. This can help to develop a more accurate and detailed understanding of the case, which can inform future research, practice, or policy.

Case studies can also serve other purposes, including:

• Illustrating a theory or concept: Case studies can be used to illustrate and explain theoretical concepts and frameworks, providing concrete examples of how they can be applied in real-life situations.
• Developing hypotheses: Case studies can help to generate hypotheses about the causal relationships between different factors and outcomes, which can be tested through further research.
• Providing insight into complex issues: Case studies can provide insights into complex and multifaceted issues, which may be difficult to understand through other research methods.
• Informing practice or policy: Case studies can be used to inform practice or policy by identifying best practices, lessons learned, or areas for improvement.

Advantages of Case Study Research

There are several advantages of case study research, including:

• In-depth exploration: Case study research allows for a detailed exploration and analysis of a specific phenomenon, issue, or problem in its real-life context. This can provide a comprehensive understanding of the case and its dynamics, which may not be possible through other research methods.
• Rich data: Case study research can generate rich and detailed data, including qualitative data such as interviews, observations, and documents. This can provide a nuanced understanding of the case and its complexity.
• Holistic perspective: Case study research allows for a holistic perspective of the case, taking into account the various factors, processes, and mechanisms that contribute to the case and its outcomes. This can help to develop a more accurate and comprehensive understanding of the case.
• Theory development: Case study research can help to develop and refine theories and concepts by providing empirical evidence and concrete examples of how they can be applied in real-life situations.
• Practical application: Case study research can inform practice or policy by identifying best practices, lessons learned, or areas for improvement.
• Contextualization: Case study research takes into account the specific context in which the case is situated, which can help to understand how the case is influenced by the social, cultural, and historical factors of its environment.

Limitations of Case Study Research

There are several limitations of case study research, including:

• Limited generalizability : Case studies are typically focused on a single case or a small number of cases, which limits the generalizability of the findings. The unique characteristics of the case may not be applicable to other contexts or populations, which may limit the external validity of the research.
• Biased sampling: Case studies may rely on purposive or convenience sampling, which can introduce bias into the sample selection process. This may limit the representativeness of the sample and the generalizability of the findings.
• Subjectivity: Case studies rely on the interpretation of the researcher, which can introduce subjectivity into the analysis. The researcher’s own biases, assumptions, and perspectives may influence the findings, which may limit the objectivity of the research.
• Limited control: Case studies are typically conducted in naturalistic settings, which limits the control that the researcher has over the environment and the variables being studied. This may limit the ability to establish causal relationships between variables.
• Time-consuming: Case studies can be time-consuming to conduct, as they typically involve a detailed exploration and analysis of a specific case. This may limit the feasibility of conducting multiple case studies or conducting case studies in a timely manner.
• Resource-intensive: Case studies may require significant resources, including time, funding, and expertise. This may limit the ability of researchers to conduct case studies in resource-constrained settings.

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What is case study research?

Last updated

8 February 2023

Reviewed by

Cathy Heath

Suppose a company receives a spike in the number of customer complaints, or medical experts discover an outbreak of illness affecting children but are not quite sure of the reason. In both cases, carrying out a case study could be the best way to get answers.

Organization

Case studies can be carried out across different disciplines, including education, medicine, sociology, and business.

Most case studies employ qualitative methods, but quantitative methods can also be used. Researchers can then describe, compare, evaluate, and identify patterns or cause-and-effect relationships between the various variables under study. They can then use this knowledge to decide what action to take. 

Another thing to note is that case studies are generally singular in their focus. This means they narrow focus to a particular area, making them highly subjective. You cannot always generalize the results of a case study and apply them to a larger population. However, they are valuable tools to illustrate a principle or develop a thesis.

Analyze case study research

Dovetail streamlines case study research to help you uncover and share actionable insights

• What are the different types of case study designs?

Researchers can choose from a variety of case study designs. The design they choose is dependent on what questions they need to answer, the context of the research environment, how much data they already have, and what resources are available.

Here are the common types of case study design:

Explanatory

An explanatory case study is an initial explanation of the how or why that is behind something. This design is commonly used when studying a real-life phenomenon or event. Once the organization understands the reasons behind a phenomenon, it can then make changes to enhance or eliminate the variables causing it. 

Here is an example: How is co-teaching implemented in elementary schools? The title for a case study of this subject could be “Case Study of the Implementation of Co-Teaching in Elementary Schools.”

Descriptive

An illustrative or descriptive case study helps researchers shed light on an unfamiliar object or subject after a period of time. The case study provides an in-depth review of the issue at hand and adds real-world examples in the area the researcher wants the audience to understand. 

The researcher makes no inferences or causal statements about the object or subject under review. This type of design is often used to understand cultural shifts.

Here is an example: How did people cope with the 2004 Indian Ocean Tsunami? This case study could be titled "A Case Study of the 2004 Indian Ocean Tsunami and its Effect on the Indonesian Population."

Exploratory

Exploratory research is also called a pilot case study. It is usually the first step within a larger research project, often relying on questionnaires and surveys . Researchers use exploratory research to help narrow down their focus, define parameters, draft a specific research question , and/or identify variables in a larger study. This research design usually covers a wider area than others, and focuses on the ‘what’ and ‘who’ of a topic.

Here is an example: How do nutrition and socialization in early childhood affect learning in children? The title of the exploratory study may be “Case Study of the Effects of Nutrition and Socialization on Learning in Early Childhood.”

An intrinsic case study is specifically designed to look at a unique and special phenomenon. At the start of the study, the researcher defines the phenomenon and the uniqueness that differentiates it from others. 

In this case, researchers do not attempt to generalize, compare, or challenge the existing assumptions. Instead, they explore the unique variables to enhance understanding. Here is an example: “Case Study of Volcanic Lightning.”

This design can also be identified as a cumulative case study. It uses information from past studies or observations of groups of people in certain settings as the foundation of the new study. Given that it takes multiple areas into account, it allows for greater generalization than a single case study. 

The researchers also get an in-depth look at a particular subject from different viewpoints.  Here is an example: “Case Study of how PTSD affected Vietnam and Gulf War Veterans Differently Due to Advances in Military Technology.”

Critical instance

A critical case study incorporates both explanatory and intrinsic study designs. It does not have predetermined purposes beyond an investigation of the said subject. It can be used for a deeper explanation of the cause-and-effect relationship. It can also be used to question a common assumption or myth. 

The findings can then be used further to generalize whether they would also apply in a different environment.  Here is an example: “What Effect Does Prolonged Use of Social Media Have on the Mind of American Youth?”

Instrumental

Instrumental research attempts to achieve goals beyond understanding the object at hand. Researchers explore a larger subject through different, separate studies and use the findings to understand its relationship to another subject. This type of design also provides insight into an issue or helps refine a theory. 

For example, you may want to determine if violent behavior in children predisposes them to crime later in life. The focus is on the relationship between children and violent behavior, and why certain children do become violent. Here is an example: “Violence Breeds Violence: Childhood Exposure and Participation in Adult Crime.”

Evaluation case study design is employed to research the effects of a program, policy, or intervention, and assess its effectiveness and impact on future decision-making. 

For example, you might want to see whether children learn times tables quicker through an educational game on their iPad versus a more teacher-led intervention. Here is an example: “An Investigation of the Impact of an iPad Multiplication Game for Primary School Children.” 

• When do you use case studies?

Case studies are ideal when you want to gain a contextual, concrete, or in-depth understanding of a particular subject. It helps you understand the characteristics, implications, and meanings of the subject.

They are also an excellent choice for those writing a thesis or dissertation, as they help keep the project focused on a particular area when resources or time may be too limited to cover a wider one. You may have to conduct several case studies to explore different aspects of the subject in question and understand the problem.

• What are the steps to follow when conducting a case study?

1. Select a case

Once you identify the problem at hand and come up with questions, identify the case you will focus on. The study can provide insights into the subject at hand, challenge existing assumptions, propose a course of action, and/or open up new areas for further research.

2. Create a theoretical framework

While you will be focusing on a specific detail, the case study design you choose should be linked to existing knowledge on the topic. This prevents it from becoming an isolated description and allows for enhancing the existing information. 

It may expand the current theory by bringing up new ideas or concepts, challenge established assumptions, or exemplify a theory by exploring how it answers the problem at hand. A theoretical framework starts with a literature review of the sources relevant to the topic in focus. This helps in identifying key concepts to guide analysis and interpretation.

3. Collect the data

Case studies are frequently supplemented with qualitative data such as observations, interviews, and a review of both primary and secondary sources such as official records, news articles, and photographs. There may also be quantitative data —this data assists in understanding the case thoroughly.

4. Analyze your case

The results of the research depend on the research design. Most case studies are structured with chapters or topic headings for easy explanation and presentation. Others may be written as narratives to allow researchers to explore various angles of the topic and analyze its meanings and implications.

In all areas, always give a detailed contextual understanding of the case and connect it to the existing theory and literature before discussing how it fits into your problem area.

• What are some case study examples?

What are the best approaches for introducing our product into the Kenyan market?

How does the change in marketing strategy aid in increasing the sales volumes of product Y?

How can teachers enhance student participation in classrooms?

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Case study topics

Case study of product marketing strategies in the Kenyan market

Case study of the effects of a marketing strategy change on product Y sales volumes

Case study of X school teachers that encourage active student participation in the classroom

Case study of the effects of poverty on literacy levels in children

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What Is a Case Study?

Weighing the pros and cons of this method of research

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Cara Lustik is a fact-checker and copywriter.

Verywell / Colleen Tighe

• Pros and Cons

What Types of Case Studies Are Out There?

Where do you find data for a case study, how do i write a psychology case study.

A case study is an in-depth study of one person, group, or event. In a case study, nearly every aspect of the subject's life and history is analyzed to seek patterns and causes of behavior. Case studies can be used in many different fields, including psychology, medicine, education, anthropology, political science, and social work.

The point of a case study is to learn as much as possible about an individual or group so that the information can be generalized to many others. Unfortunately, case studies tend to be highly subjective, and it is sometimes difficult to generalize results to a larger population.

While case studies focus on a single individual or group, they follow a format similar to other types of psychology writing. If you are writing a case study, we got you—here are some rules of APA format to reference.  

At a Glance

A case study, or an in-depth study of a person, group, or event, can be a useful research tool when used wisely. In many cases, case studies are best used in situations where it would be difficult or impossible for you to conduct an experiment. They are helpful for looking at unique situations and allow researchers to gather a lot of˜ information about a specific individual or group of people. However, it's important to be cautious of any bias we draw from them as they are highly subjective.

What Are the Benefits and Limitations of Case Studies?

A case study can have its strengths and weaknesses. Researchers must consider these pros and cons before deciding if this type of study is appropriate for their needs.

One of the greatest advantages of a case study is that it allows researchers to investigate things that are often difficult or impossible to replicate in a lab. Some other benefits of a case study:

• Allows researchers to capture information on the 'how,' 'what,' and 'why,' of something that's implemented
• Gives researchers the chance to collect information on why one strategy might be chosen over another
• Permits researchers to develop hypotheses that can be explored in experimental research

On the other hand, a case study can have some drawbacks:

• It cannot necessarily be generalized to the larger population
• Cannot demonstrate cause and effect
• It may not be scientifically rigorous
• It can lead to bias

Researchers may choose to perform a case study if they want to explore a unique or recently discovered phenomenon. Through their insights, researchers develop additional ideas and study questions that might be explored in future studies.

It's important to remember that the insights from case studies cannot be used to determine cause-and-effect relationships between variables. However, case studies may be used to develop hypotheses that can then be addressed in experimental research.

Case Study Examples

There have been a number of notable case studies in the history of psychology. Much of  Freud's work and theories were developed through individual case studies. Some great examples of case studies in psychology include:

• Anna O : Anna O. was a pseudonym of a woman named Bertha Pappenheim, a patient of a physician named Josef Breuer. While she was never a patient of Freud's, Freud and Breuer discussed her case extensively. The woman was experiencing symptoms of a condition that was then known as hysteria and found that talking about her problems helped relieve her symptoms. Her case played an important part in the development of talk therapy as an approach to mental health treatment.
• Phineas Gage : Phineas Gage was a railroad employee who experienced a terrible accident in which an explosion sent a metal rod through his skull, damaging important portions of his brain. Gage recovered from his accident but was left with serious changes in both personality and behavior.
• Genie : Genie was a young girl subjected to horrific abuse and isolation. The case study of Genie allowed researchers to study whether language learning was possible, even after missing critical periods for language development. Her case also served as an example of how scientific research may interfere with treatment and lead to further abuse of vulnerable individuals.

Such cases demonstrate how case research can be used to study things that researchers could not replicate in experimental settings. In Genie's case, her horrific abuse denied her the opportunity to learn a language at critical points in her development.

This is clearly not something researchers could ethically replicate, but conducting a case study on Genie allowed researchers to study phenomena that are otherwise impossible to reproduce.

There are a few different types of case studies that psychologists and other researchers might use:

• Collective case studies : These involve studying a group of individuals. Researchers might study a group of people in a certain setting or look at an entire community. For example, psychologists might explore how access to resources in a community has affected the collective mental well-being of those who live there.
• Descriptive case studies : These involve starting with a descriptive theory. The subjects are then observed, and the information gathered is compared to the pre-existing theory.
• Explanatory case studies : These   are often used to do causal investigations. In other words, researchers are interested in looking at factors that may have caused certain things to occur.
• Exploratory case studies : These are sometimes used as a prelude to further, more in-depth research. This allows researchers to gather more information before developing their research questions and hypotheses .
• Instrumental case studies : These occur when the individual or group allows researchers to understand more than what is initially obvious to observers.
• Intrinsic case studies : This type of case study is when the researcher has a personal interest in the case. Jean Piaget's observations of his own children are good examples of how an intrinsic case study can contribute to the development of a psychological theory.

The three main case study types often used are intrinsic, instrumental, and collective. Intrinsic case studies are useful for learning about unique cases. Instrumental case studies help look at an individual to learn more about a broader issue. A collective case study can be useful for looking at several cases simultaneously.

The type of case study that psychology researchers use depends on the unique characteristics of the situation and the case itself.

There are a number of different sources and methods that researchers can use to gather information about an individual or group. Six major sources that have been identified by researchers are:

• Archival records : Census records, survey records, and name lists are examples of archival records.
• Direct observation : This strategy involves observing the subject, often in a natural setting . While an individual observer is sometimes used, it is more common to utilize a group of observers.
• Documents : Letters, newspaper articles, administrative records, etc., are the types of documents often used as sources.
• Interviews : Interviews are one of the most important methods for gathering information in case studies. An interview can involve structured survey questions or more open-ended questions.
• Participant observation : When the researcher serves as a participant in events and observes the actions and outcomes, it is called participant observation.
• Physical artifacts : Tools, objects, instruments, and other artifacts are often observed during a direct observation of the subject.

If you have been directed to write a case study for a psychology course, be sure to check with your instructor for any specific guidelines you need to follow. If you are writing your case study for a professional publication, check with the publisher for their specific guidelines for submitting a case study.

Here is a general outline of what should be included in a case study.

Section 1: A Case History

This section will have the following structure and content:

Background information : The first section of your paper will present your client's background. Include factors such as age, gender, work, health status, family mental health history, family and social relationships, drug and alcohol history, life difficulties, goals, and coping skills and weaknesses.

Description of the presenting problem : In the next section of your case study, you will describe the problem or symptoms that the client presented with.

Describe any physical, emotional, or sensory symptoms reported by the client. Thoughts, feelings, and perceptions related to the symptoms should also be noted. Any screening or diagnostic assessments that are used should also be described in detail and all scores reported.

Your diagnosis : Provide your diagnosis and give the appropriate Diagnostic and Statistical Manual code. Explain how you reached your diagnosis, how the client's symptoms fit the diagnostic criteria for the disorder(s), or any possible difficulties in reaching a diagnosis.

Section 2: Treatment Plan

This portion of the paper will address the chosen treatment for the condition. This might also include the theoretical basis for the chosen treatment or any other evidence that might exist to support why this approach was chosen.

• Cognitive behavioral approach : Explain how a cognitive behavioral therapist would approach treatment. Offer background information on cognitive behavioral therapy and describe the treatment sessions, client response, and outcome of this type of treatment. Make note of any difficulties or successes encountered by your client during treatment.
• Humanistic approach : Describe a humanistic approach that could be used to treat your client, such as client-centered therapy . Provide information on the type of treatment you chose, the client's reaction to the treatment, and the end result of this approach. Explain why the treatment was successful or unsuccessful.
• Psychoanalytic approach : Describe how a psychoanalytic therapist would view the client's problem. Provide some background on the psychoanalytic approach and cite relevant references. Explain how psychoanalytic therapy would be used to treat the client, how the client would respond to therapy, and the effectiveness of this treatment approach.
• Pharmacological approach : If treatment primarily involves the use of medications, explain which medications were used and why. Provide background on the effectiveness of these medications and how monotherapy may compare with an approach that combines medications with therapy or other treatments.

This section of a case study should also include information about the treatment goals, process, and outcomes.

When you are writing a case study, you should also include a section where you discuss the case study itself, including the strengths and limitiations of the study. You should note how the findings of your case study might support previous research. 

In your discussion section, you should also describe some of the implications of your case study. What ideas or findings might require further exploration? How might researchers go about exploring some of these questions in additional studies?

Need More Tips?

Here are a few additional pointers to keep in mind when formatting your case study:

• Never refer to the subject of your case study as "the client." Instead, use their name or a pseudonym.
• Read examples of case studies to gain an idea about the style and format.
• Remember to use APA format when citing references .

Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach .  BMC Med Res Methodol . 2011;11:100.

Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach . BMC Med Res Methodol . 2011 Jun 27;11:100. doi:10.1186/1471-2288-11-100

Gagnon, Yves-Chantal.  The Case Study as Research Method: A Practical Handbook . Canada, Chicago Review Press Incorporated DBA Independent Pub Group, 2010.

Yin, Robert K. Case Study Research and Applications: Design and Methods . United States, SAGE Publications, 2017.

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

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• Knowledge Base
• Methodology
• Case Study | Definition, Examples & Methods

Case Study | Definition, Examples & Methods

Published on 5 May 2022 by Shona McCombes . Revised on 30 January 2023.

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

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

Table of contents

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

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

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

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

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

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

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

If you find yourself aiming to simultaneously investigate and solve an issue, consider conducting action research . As its name suggests, action research conducts research and takes action at the same time, and is highly iterative and flexible. 

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

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

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

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

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

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

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

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

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

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

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The Ultimate Guide to Qualitative Research - Part 1: The Basics

• Introduction and overview
• What is qualitative research?
• What is qualitative data?
• Examples of qualitative data
• Qualitative vs. quantitative research
• Mixed methods
• Qualitative research preparation
• Theoretical perspective
• Theoretical framework
• Literature reviews

Research question

• Conceptual framework
• Conceptual vs. theoretical framework

Data collection

• Qualitative research methods
• Focus groups
• Observational research

What is a case study?

Applications for case study research, what is a good case study, process of case study design, benefits and limitations of case studies.

• Ethnographical research
• Ethical considerations
• Confidentiality and privacy
• Power dynamics
• Reflexivity

Case studies

Case studies are essential to qualitative research , offering a lens through which researchers can investigate complex phenomena within their real-life contexts. This chapter explores the concept, purpose, applications, examples, and types of case studies and provides guidance on how to conduct case study research effectively.

Whereas quantitative methods look at phenomena at scale, case study research looks at a concept or phenomenon in considerable detail. While analyzing a single case can help understand one perspective regarding the object of research inquiry, analyzing multiple cases can help obtain a more holistic sense of the topic or issue. Let's provide a basic definition of a case study, then explore its characteristics and role in the qualitative research process.

Definition of a case study

A case study in qualitative research is a strategy of inquiry that involves an in-depth investigation of a phenomenon within its real-world context. It provides researchers with the opportunity to acquire an in-depth understanding of intricate details that might not be as apparent or accessible through other methods of research. The specific case or cases being studied can be a single person, group, or organization – demarcating what constitutes a relevant case worth studying depends on the researcher and their research question .

Among qualitative research methods , a case study relies on multiple sources of evidence, such as documents, artifacts, interviews , or observations , to present a complete and nuanced understanding of the phenomenon under investigation. The objective is to illuminate the readers' understanding of the phenomenon beyond its abstract statistical or theoretical explanations.

Characteristics of case studies

Case studies typically possess a number of distinct characteristics that set them apart from other research methods. These characteristics include a focus on holistic description and explanation, flexibility in the design and data collection methods, reliance on multiple sources of evidence, and emphasis on the context in which the phenomenon occurs.

Furthermore, case studies can often involve a longitudinal examination of the case, meaning they study the case over a period of time. These characteristics allow case studies to yield comprehensive, in-depth, and richly contextualized insights about the phenomenon of interest.

The role of case studies in research

Case studies hold a unique position in the broader landscape of research methods aimed at theory development. They are instrumental when the primary research interest is to gain an intensive, detailed understanding of a phenomenon in its real-life context.

In addition, case studies can serve different purposes within research - they can be used for exploratory, descriptive, or explanatory purposes, depending on the research question and objectives. This flexibility and depth make case studies a valuable tool in the toolkit of qualitative researchers.

Remember, a well-conducted case study can offer a rich, insightful contribution to both academic and practical knowledge through theory development or theory verification, thus enhancing our understanding of complex phenomena in their real-world contexts.

What is the purpose of a case study?

Case study research aims for a more comprehensive understanding of phenomena, requiring various research methods to gather information for qualitative analysis . Ultimately, a case study can allow the researcher to gain insight into a particular object of inquiry and develop a theoretical framework relevant to the research inquiry.

Why use case studies in qualitative research?

Using case studies as a research strategy depends mainly on the nature of the research question and the researcher's access to the data.

Conducting case study research provides a level of detail and contextual richness that other research methods might not offer. They are beneficial when there's a need to understand complex social phenomena within their natural contexts.

The explanatory, exploratory, and descriptive roles of case studies

Case studies can take on various roles depending on the research objectives. They can be exploratory when the research aims to discover new phenomena or define new research questions; they are descriptive when the objective is to depict a phenomenon within its context in a detailed manner; and they can be explanatory if the goal is to understand specific relationships within the studied context. Thus, the versatility of case studies allows researchers to approach their topic from different angles, offering multiple ways to uncover and interpret the data .

The impact of case studies on knowledge development

Case studies play a significant role in knowledge development across various disciplines. Analysis of cases provides an avenue for researchers to explore phenomena within their context based on the collected data.

This can result in the production of rich, practical insights that can be instrumental in both theory-building and practice. Case studies allow researchers to delve into the intricacies and complexities of real-life situations, uncovering insights that might otherwise remain hidden.

Types of case studies

In qualitative research , a case study is not a one-size-fits-all approach. Depending on the nature of the research question and the specific objectives of the study, researchers might choose to use different types of case studies. These types differ in their focus, methodology, and the level of detail they provide about the phenomenon under investigation.

Understanding these types is crucial for selecting the most appropriate approach for your research project and effectively achieving your research goals. Let's briefly look at the main types of case studies.

Exploratory case studies

Exploratory case studies are typically conducted to develop a theory or framework around an understudied phenomenon. They can also serve as a precursor to a larger-scale research project. Exploratory case studies are useful when a researcher wants to identify the key issues or questions which can spur more extensive study or be used to develop propositions for further research. These case studies are characterized by flexibility, allowing researchers to explore various aspects of a phenomenon as they emerge, which can also form the foundation for subsequent studies.

Descriptive case studies

Descriptive case studies aim to provide a complete and accurate representation of a phenomenon or event within its context. These case studies are often based on an established theoretical framework, which guides how data is collected and analyzed. The researcher is concerned with describing the phenomenon in detail, as it occurs naturally, without trying to influence or manipulate it.

Explanatory case studies

Explanatory case studies are focused on explanation - they seek to clarify how or why certain phenomena occur. Often used in complex, real-life situations, they can be particularly valuable in clarifying causal relationships among concepts and understanding the interplay between different factors within a specific context.

Intrinsic, instrumental, and collective case studies

These three categories of case studies focus on the nature and purpose of the study. An intrinsic case study is conducted when a researcher has an inherent interest in the case itself. Instrumental case studies are employed when the case is used to provide insight into a particular issue or phenomenon. A collective case study, on the other hand, involves studying multiple cases simultaneously to investigate some general phenomena.

Each type of case study serves a different purpose and has its own strengths and challenges. The selection of the type should be guided by the research question and objectives, as well as the context and constraints of the research.

The flexibility, depth, and contextual richness offered by case studies make this approach an excellent research method for various fields of study. They enable researchers to investigate real-world phenomena within their specific contexts, capturing nuances that other research methods might miss. Across numerous fields, case studies provide valuable insights into complex issues.

Critical information systems research

Case studies provide a detailed understanding of the role and impact of information systems in different contexts. They offer a platform to explore how information systems are designed, implemented, and used and how they interact with various social, economic, and political factors. Case studies in this field often focus on examining the intricate relationship between technology, organizational processes, and user behavior, helping to uncover insights that can inform better system design and implementation.

Health research

Health research is another field where case studies are highly valuable. They offer a way to explore patient experiences, healthcare delivery processes, and the impact of various interventions in a real-world context.

Case studies can provide a deep understanding of a patient's journey, giving insights into the intricacies of disease progression, treatment effects, and the psychosocial aspects of health and illness.

Asthma research studies

Specifically within medical research, studies on asthma often employ case studies to explore the individual and environmental factors that influence asthma development, management, and outcomes. A case study can provide rich, detailed data about individual patients' experiences, from the triggers and symptoms they experience to the effectiveness of various management strategies. This can be crucial for developing patient-centered asthma care approaches.

Other fields

Apart from the fields mentioned, case studies are also extensively used in business and management research, education research, and political sciences, among many others. They provide an opportunity to delve into the intricacies of real-world situations, allowing for a comprehensive understanding of various phenomena.

Case studies, with their depth and contextual focus, offer unique insights across these varied fields. They allow researchers to illuminate the complexities of real-life situations, contributing to both theory and practice.

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Understanding the key elements of case study design is crucial for conducting rigorous and impactful case study research. A well-structured design guides the researcher through the process, ensuring that the study is methodologically sound and its findings are reliable and valid. The main elements of case study design include the research question , propositions, units of analysis, and the logic linking the data to the propositions.

The research question is the foundation of any research study. A good research question guides the direction of the study and informs the selection of the case, the methods of collecting data, and the analysis techniques. A well-formulated research question in case study research is typically clear, focused, and complex enough to merit further detailed examination of the relevant case(s).

Propositions

Propositions, though not necessary in every case study, provide a direction by stating what we might expect to find in the data collected. They guide how data is collected and analyzed by helping researchers focus on specific aspects of the case. They are particularly important in explanatory case studies, which seek to understand the relationships among concepts within the studied phenomenon.

Units of analysis

The unit of analysis refers to the case, or the main entity or entities that are being analyzed in the study. In case study research, the unit of analysis can be an individual, a group, an organization, a decision, an event, or even a time period. It's crucial to clearly define the unit of analysis, as it shapes the qualitative data analysis process by allowing the researcher to analyze a particular case and synthesize analysis across multiple case studies to draw conclusions.

Argumentation

This refers to the inferential model that allows researchers to draw conclusions from the data. The researcher needs to ensure that there is a clear link between the data, the propositions (if any), and the conclusions drawn. This argumentation is what enables the researcher to make valid and credible inferences about the phenomenon under study.

Understanding and carefully considering these elements in the design phase of a case study can significantly enhance the quality of the research. It can help ensure that the study is methodologically sound and its findings contribute meaningful insights about the case.

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Conducting a case study involves several steps, from defining the research question and selecting the case to collecting and analyzing data . This section outlines these key stages, providing a practical guide on how to conduct case study research.

Defining the research question

The first step in case study research is defining a clear, focused research question. This question should guide the entire research process, from case selection to analysis. It's crucial to ensure that the research question is suitable for a case study approach. Typically, such questions are exploratory or descriptive in nature and focus on understanding a phenomenon within its real-life context.

Selecting and defining the case

The selection of the case should be based on the research question and the objectives of the study. It involves choosing a unique example or a set of examples that provide rich, in-depth data about the phenomenon under investigation. After selecting the case, it's crucial to define it clearly, setting the boundaries of the case, including the time period and the specific context.

Previous research can help guide the case study design. When considering a case study, an example of a case could be taken from previous case study research and used to define cases in a new research inquiry. Considering recently published examples can help understand how to select and define cases effectively.

Developing a detailed case study protocol

A case study protocol outlines the procedures and general rules to be followed during the case study. This includes the data collection methods to be used, the sources of data, and the procedures for analysis. Having a detailed case study protocol ensures consistency and reliability in the study.

The protocol should also consider how to work with the people involved in the research context to grant the research team access to collecting data. As mentioned in previous sections of this guide, establishing rapport is an essential component of qualitative research as it shapes the overall potential for collecting and analyzing data.

Collecting data

Gathering data in case study research often involves multiple sources of evidence, including documents, archival records, interviews, observations, and physical artifacts. This allows for a comprehensive understanding of the case. The process for gathering data should be systematic and carefully documented to ensure the reliability and validity of the study.

Analyzing and interpreting data

The next step is analyzing the data. This involves organizing the data , categorizing it into themes or patterns , and interpreting these patterns to answer the research question. The analysis might also involve comparing the findings with prior research or theoretical propositions.

Writing the case study report

The final step is writing the case study report . This should provide a detailed description of the case, the data, the analysis process, and the findings. The report should be clear, organized, and carefully written to ensure that the reader can understand the case and the conclusions drawn from it.

Each of these steps is crucial in ensuring that the case study research is rigorous, reliable, and provides valuable insights about the case.

The type, depth, and quality of data in your study can significantly influence the validity and utility of the study. In case study research, data is usually collected from multiple sources to provide a comprehensive and nuanced understanding of the case. This section will outline the various methods of collecting data used in case study research and discuss considerations for ensuring the quality of the data.

Interviews are a common method of gathering data in case study research. They can provide rich, in-depth data about the perspectives, experiences, and interpretations of the individuals involved in the case. Interviews can be structured , semi-structured , or unstructured , depending on the research question and the degree of flexibility needed.

Observations

Observations involve the researcher observing the case in its natural setting, providing first-hand information about the case and its context. Observations can provide data that might not be revealed in interviews or documents, such as non-verbal cues or contextual information.

Documents and artifacts

Documents and archival records provide a valuable source of data in case study research. They can include reports, letters, memos, meeting minutes, email correspondence, and various public and private documents related to the case.

These records can provide historical context, corroborate evidence from other sources, and offer insights into the case that might not be apparent from interviews or observations.

Physical artifacts refer to any physical evidence related to the case, such as tools, products, or physical environments. These artifacts can provide tangible insights into the case, complementing the data gathered from other sources.

Ensuring the quality of data collection

Determining the quality of data in case study research requires careful planning and execution. It's crucial to ensure that the data is reliable, accurate, and relevant to the research question. This involves selecting appropriate methods of collecting data, properly training interviewers or observers, and systematically recording and storing the data. It also includes considering ethical issues related to collecting and handling data, such as obtaining informed consent and ensuring the privacy and confidentiality of the participants.

Data analysis

Analyzing case study research involves making sense of the rich, detailed data to answer the research question. This process can be challenging due to the volume and complexity of case study data. However, a systematic and rigorous approach to analysis can ensure that the findings are credible and meaningful. This section outlines the main steps and considerations in analyzing data in case study research.

Organizing the data

The first step in the analysis is organizing the data. This involves sorting the data into manageable sections, often according to the data source or the theme. This step can also involve transcribing interviews, digitizing physical artifacts, or organizing observational data.

Categorizing and coding the data

Once the data is organized, the next step is to categorize or code the data. This involves identifying common themes, patterns, or concepts in the data and assigning codes to relevant data segments. Coding can be done manually or with the help of software tools, and in either case, qualitative analysis software can greatly facilitate the entire coding process. Coding helps to reduce the data to a set of themes or categories that can be more easily analyzed.

Identifying patterns and themes

After coding the data, the researcher looks for patterns or themes in the coded data. This involves comparing and contrasting the codes and looking for relationships or patterns among them. The identified patterns and themes should help answer the research question.

Interpreting the data

Once patterns and themes have been identified, the next step is to interpret these findings. This involves explaining what the patterns or themes mean in the context of the research question and the case. This interpretation should be grounded in the data, but it can also involve drawing on theoretical concepts or prior research.

Verification of the data

The last step in the analysis is verification. This involves checking the accuracy and consistency of the analysis process and confirming that the findings are supported by the data. This can involve re-checking the original data, checking the consistency of codes, or seeking feedback from research participants or peers.

Like any research method , case study research has its strengths and limitations. Researchers must be aware of these, as they can influence the design, conduct, and interpretation of the study.

Understanding the strengths and limitations of case study research can also guide researchers in deciding whether this approach is suitable for their research question . This section outlines some of the key strengths and limitations of case study research.

Benefits include the following:

• Rich, detailed data: One of the main strengths of case study research is that it can generate rich, detailed data about the case. This can provide a deep understanding of the case and its context, which can be valuable in exploring complex phenomena.
• Flexibility: Case study research is flexible in terms of design , data collection , and analysis . A sufficient degree of flexibility allows the researcher to adapt the study according to the case and the emerging findings.
• Real-world context: Case study research involves studying the case in its real-world context, which can provide valuable insights into the interplay between the case and its context.
• Multiple sources of evidence: Case study research often involves collecting data from multiple sources , which can enhance the robustness and validity of the findings.

On the other hand, researchers should consider the following limitations:

• Generalizability: A common criticism of case study research is that its findings might not be generalizable to other cases due to the specificity and uniqueness of each case.
• Time and resource intensive: Case study research can be time and resource intensive due to the depth of the investigation and the amount of collected data.
• Complexity of analysis: The rich, detailed data generated in case study research can make analyzing the data challenging.
• Subjectivity: Given the nature of case study research, there may be a higher degree of subjectivity in interpreting the data , so researchers need to reflect on this and transparently convey to audiences how the research was conducted.

Being aware of these strengths and limitations can help researchers design and conduct case study research effectively and interpret and report the findings appropriately.

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28 Case Study Examples Every Marketer Should See

Published: March 08, 2023

Putting together a compelling case study is one of the most powerful strategies for showcasing your product and attracting future customers. But it's not easy to create case studies that your audience can’t wait to read.

In this post, we’ll go over the definition of a case study and the best examples to inspire you.

What is a case study?

A case study is a detailed story of something your company did. It includes a beginning — often discussing a conflict, an explanation of what happened next, and a resolution that explains how the company solved or improved on something.

A case study proves how your product has helped other companies by demonstrating real-life results. Not only that, but marketing case studies with solutions typically contain quotes from the customer. This means that they’re not just ads where you praise your own product. Rather, other companies are praising your company — and there’s no stronger marketing material than a verbal recommendation or testimonial. A great case study is also filled with research and stats to back up points made about a project's results.

There are myriad ways to use case studies in your marketing strategy . From featuring them on your website to including them in a sales presentation, a case study is a strong, persuasive tool that shows customers why they should work with you — straight from another customer. Writing one from scratch is hard, though, which is why we’ve created a collection of case study templates for you to get started.

Fill out the form below to access the free case study templates.

Free Case Study Templates

Showcase your company's success using these three free case study templates.

• Data-Driven Case Study Template
• Product-Specific Case Study Template
• General Case Study Template

You're all set!

Click this link to access this resource at any time.

There’s no better way to generate more leads than by writing case studies . But without case study examples to draw inspiration from, it can be difficult to write impactful studies that convince visitors to submit a form.

Marketing Case Study Examples

To help you create an attractive and high-converting case study, we've put together a list of some of our favorites. This list includes famous case studies in marketing, technology, and business.

These studies can show you how to frame your company offers in a way that is both meaningful and useful to your audience. So, take a look, and let these examples inspire your next brilliant case study design.

These marketing case studies with solutions show the value proposition of each product. They also show how each company benefited in both the short and long term using quantitative data. In other words, you don’t get just nice statements, like "This company helped us a lot." You see actual change within the firm through numbers and figures.

You can put your learnings into action with HubSpot's Free Case Study Templates . Available as custom designs and text-based documents, you can upload these templates to your CMS or send them to prospects as you see fit.

1. " How Handled Scaled from Zero to 121 Locations with the Help of HubSpot ," by HubSpot

What's interesting about this case study is the way it leads with the customer. That reflects a major HubSpot cornerstone, which is to always solve for the customer first. The copy leads with a brief description of why the CEO of Handled founded the company and why he thought Handled could benefit from adopting a CRM. The case study also opens up with one key data point about Handled’s success using HubSpot, namely that it grew to 121 locations.

Notice that this case study uses mixed media. Yes, there is a short video, but it's elaborated upon in the other text on the page. So while your case studies can use one or the other, don't be afraid to combine written copy with visuals to emphasize the project's success.

Key Learnings from the HubSpot Case Study Example

• Give the case study a personal touch by focusing on the CEO rather than the company itself.
• Use multimedia to engage website visitors as they read the case study.

2. " The Whole Package ," by IDEO

Here's a design company that knows how to lead with simplicity in its case studies. As soon as the visitor arrives at the page, they’re greeted with a big, bold photo and the title of the case study — which just so happens to summarize how IDEO helped its client. It summarizes the case study in three snippets: The challenge, the impact, and the outcome.

Immediately, IDEO communicates its impact — the company partnered with H&M to remove plastic from its packaging — but it doesn't stop there. As the user scrolls down, the challenge, impact, and progress are elaborated upon with comprehensive (but not overwhelming) copy that outlines what that process looked like, replete with quotes and intriguing visuals.

Key Learnings from the IDEO Case Study Example

• Split up the takeaways of your case studies into bite-sized sections.
• Always use visuals and images to enrich the case study experience, especially if it’s a comprehensive case study.

3. " Rozum Robotics intensifies its PR game with Awario ," by Awario

In this case study, Awario greets the user with a summary straight away — so if you’re feeling up to reading the entire case study, you can scan the snapshot and understand how the company serves its customers. The case study then includes jump links to several sections, such as "Company Profile," "Rozum Robotics' Pains," "Challenge," "Solution," and "Results and Improvements."

The sparse copy and prominent headings show that you don’t need a lot of elaborate information to show the value of your products and services. Like the other case study examples on this list, it includes visuals and quotes to demonstrate the effectiveness of the company’s efforts. The case study ends with a bulleted list that shows the results.

Key Learnings from the Awario Robotics Case Study Example

• Create a table of contents to make your case study easier to navigate.
• Include a bulleted list of the results you achieved for your client.

4. " Chevrolet DTU ," by Carol H. Williams

If you’ve worked with a company that’s well-known, use only the name in the title — like Carol H. Williams, one of the nation’s top advertising agencies, does here. The "DTU," stands for "Discover the Unexpected." It generates interest because you want to find out what the initials mean.

They keep your interest in this case study by using a mixture of headings, images, and videos to describe the challenges, objectives, and solutions of the project. The case study closes with a summary of the key achievements that Chevrolet’s DTU Journalism Fellows reached during the project.

Key Learnings from the Carol H. Williams Case Study Example

• If you’ve worked with a big brand before, consider only using the name in the title — just enough to pique interest.
• Use a mixture of headings and subheadings to guide users through the case study.

5. " How Fractl Earned Links from 931 Unique Domains for Porch.com in a Single Year ," by Fractl

Fractl uses both text and graphic design in their Porch.com case study to immerse the viewer in a more interesting user experience. For instance, as you scroll, you'll see the results are illustrated in an infographic-design form as well as the text itself.

Further down the page, they use icons like a heart and a circle to illustrate their pitch angles, and graphs to showcase their results. Rather than writing which publications have mentioned Porch.com during Fractl’s campaign, they incorporated the media outlets’ icons for further visual diversity.

Key Learnings from the Fractl Case Study Example

• Let pictures speak for you by incorporating graphs, logos, and icons all throughout the case study.
• Start the case study by right away stating the key results, like Fractl does, instead of putting the results all the way at the bottom.

6. " The Met ," by Fantasy

What's the best way to showcase the responsiveness and user interface of a website? Probably by diving right into it with a series of simple showcases— which is exactly what Fantasy does on their case study page for the Metropolitan Museum of Art. They keep the page simple and clean, inviting you to review their redesign of the Met’s website feature-by-feature.

Each section is simple, showing a single piece of the new website's interface so that users aren’t overwhelmed with information and can focus on what matters most.

If you're more interested in text, you can read the objective for each feature. Fantasy understands that, as a potential customer, this is all you need to know. Scrolling further, you're greeted with a simple "Contact Us" CTA.

Key Learnings from the Fantasy Case Study Example

• You don’t have to write a ton of text to create a great case study. Focus on the solution you delivered itself.
• Include a CTA at the bottom inviting visitors to contact you.

7. " Rovio: How Rovio Grew Into a Gaming Superpower ," by App Annie

If your client had a lot of positive things to say about you, take a note from App Annie’s Rovio case study and open up with a quote from your client. The case study also closes with a quote, so that the case study doesn’t seem like a promotion written by your marketing team but a story that’s taken straight from your client’s mouth. It includes a photo of a Rovio employee, too.

Another thing this example does well? It immediately includes a link to the product that Rovio used (namely, App Annie Intelligence) at the top of the case study. The case study closes with a call-to-action button prompting users to book a demo.

Key Learnings from the App Annie Case Study Example

• Feature quotes from your client at the beginning and end of the case study.
• Include a mention of the product right at the beginning and prompt users to learn more about the product.

8. " Embracing first-party data: 3 success stories from HubSpot ," by Think with Google

Google takes a different approach to text-focused case studies by choosing three different companies to highlight.

The case study is clean and easily scannable. It has sections for each company, with quotes and headers that clarify the way these three distinct stories connect. The simple format also uses colors and text that align with the Google brand.

Another differentiator is the focus on data. This case study is less than a thousand words, but it's packed with useful data points. Data-driven insights quickly and clearly show how the value of leveraging first-party data while prioritizing consumer privacy.

Key Learnings from the Think with Google Case Study Example

• A case study doesn’t need to be long or complex to be powerful.
• Clear data points are a quick and effective way to prove value.

9. " In-Depth Performance Marketing Case Study ," by Switch

Switch is an international marketing agency based in Malta that knocks it out of the park with this case study. Its biggest challenge is effectively communicating what it did for its client without ever revealing the client’s name. It also effectively keeps non-marketers in the loop by including a glossary of terms on page 4.

The PDF case study reads like a compelling research article, including titles like "In-Depth Performance Marketing Case Study," "Scenario," and "Approach," so that readers get a high-level overview of what the client needed and why they approached Switch. It also includes a different page for each strategy. For instance, if you’d only be interested in hiring Switch for optimizing your Facebook ads, you can skip to page 10 to see how they did it.

The PDF is fourteen pages long but features big fonts and plenty of white space, so viewers can easily skim it in only a few minutes.

Key Learnings from the Switch Case Study Example

• If you want to go into specialized information, include a glossary of terms so that non-specialists can easily understand.
• Close with a CTA page in your case study PDF and include contact information for prospective clients.

10. " Gila River ," by OH Partners

Let pictures speak for you, like OH Partners did in this case study. While you’ll quickly come across a heading and some text when you land on this case study page, you’ll get the bulk of the case study through examples of actual work OH Partners did for its client. You will see OH Partners’ work in a billboard, magazine, and video. This communicates to website visitors that if they work with OH Partners, their business will be visible everywhere.

And like the other case studies here, it closes with a summary of what the firm achieved for its client in an eye-catching way.

Key Learnings from the OH Partners Case Study Example

• Let the visuals speak by including examples of the actual work you did for your client — which is especially useful for branding and marketing agencies.
• Always close out with your achievements and how they impacted your client.

11. " Facing a Hater ," by Digitas

Digitas' case study page for Sprite’s #ILOVEYOUHATER campaign keeps it brief while communicating the key facts of Digitas’ work for the popular soda brand. The page opens with an impactful image of a hundred people facing a single man. It turns out, that man is the biggest "bully" in Argentina, and the people facing him are those whom he’s bullied before.

Scrolling down, it's obvious that Digitas kept Sprite at the forefront of their strategy, but more than that, they used real people as their focal point. They leveraged the Twitter API to pull data from Tweets that people had actually tweeted to find the identity of the biggest "hater" in the country. That turned out to be @AguanteElCofler, a Twitter user who has since been suspended.

Key Learnings from the Digitas Case Study Example

• If a video was part of your work for your client, be sure to include the most impactful screenshot as the heading.
• Don’t be afraid to provide details on how you helped your client achieve their goals, including the tools you leveraged.

12. " Better Experiences for All ," by HermanMiller

HermanMiller sells sleek, utilitarian furniture with no frills and extreme functionality, and that ethos extends to its case study page for a hospital in Dubai.

What first attracted me to this case study was the beautiful video at the top and the clean user experience. User experience matters a lot in a case study. It determines whether users will keep reading or leave. Another notable aspect of this case study is that the video includes closed-captioning for greater accessibility, and users have the option of expanding the CC and searching through the text.

HermanMiller’s case study also offers an impressive amount of information packed in just a few short paragraphs for those wanting to understand the nuances of their strategy. It closes out with a quote from their client and, most importantly, the list of furniture products that the hospital purchased from the brand.

Key Learnings from the HermanMiller Case Study Example

• Close out with a list of products that users can buy after reading the case study.
• Include accessibility features such as closed captioning and night mode to make your case study more user-friendly.

13. " Capital One on AWS ," by Amazon

Do you work continuously with your clients? Consider structuring your case study page like Amazon did in this stellar case study example. Instead of just featuring one article about Capital One and how it benefited from using AWS, Amazon features a series of articles that you can then access if you’re interested in reading more. It goes all the way back to 2016, all with different stories that feature Capital One’s achievements using AWS.

This may look unattainable for a small firm, but you don’t have to go to extreme measures and do it for every single one of your clients. You could choose the one you most wish to focus on and establish a contact both on your side and your client’s for coming up with the content. Check in every year and write a new piece. These don’t have to be long, either — five hundred to eight hundred words will do.

Key Learnings from the Amazon AWS Case Study Example

• Write a new article each year featuring one of your clients, then include links to those articles in one big case study page.
• Consider including external articles as well that emphasize your client’s success in their industry.

14. " HackReactor teaches the world to code #withAsana ," by Asana

While Asana's case study design looks text-heavy, there's a good reason. It reads like a creative story, told entirely from the customer's perspective.

For instance, Asana knows you won't trust its word alone on why this product is useful. So, they let Tony Phillips, HackReactor CEO, tell you instead: "We take in a lot of information. Our brains are awful at storage but very good at thinking; you really start to want some third party to store your information so you can do something with it."

Asana features frequent quotes from Phillips to break up the wall of text and humanize the case study. It reads like an in-depth interview and captivates the reader through creative storytelling. Even more, Asana includes in-depth detail about how HackReactor uses Asana. This includes how they build templates and workflows:

"There's a huge differentiator between Asana and other tools, and that’s the very easy API access. Even if Asana isn’t the perfect fit for a workflow, someone like me— a relatively mediocre software engineer—can add functionality via the API to build a custom solution that helps a team get more done."

Key Learnings from the Asana Example

• Include quotes from your client throughout the case study.
• Provide extensive detail on how your client worked with you or used your product.

15. " Rips Sewed, Brand Love Reaped ," by Amp Agency

Amp Agency's Patagonia marketing strategy aimed to appeal to a new audience through guerrilla marketing efforts and a coast-to-coast road trip. Their case study page effectively conveys a voyager theme, complete with real photos of Patagonia customers from across the U.S., and a map of the expedition. I liked Amp Agency's storytelling approach best. It captures viewers' attention from start to finish simply because it's an intriguing and unique approach to marketing.

Key Learnings from the Amp Agency Example

• Open up with a summary that communicates who your client is and why they reached out to you.
• Like in the other case study examples, you’ll want to close out with a quantitative list of your achievements.

16. " NetApp ," by Evisort

Evisort opens up its NetApp case study with an at-a-glance overview of the client. It’s imperative to always focus on the client in your case study — not on your amazing product and equally amazing team. By opening up with a snapshot of the client’s company, Evisort places the focus on the client.

This case study example checks all the boxes for a great case study that’s informative, thorough, and compelling. It includes quotes from the client and details about the challenges NetApp faced during the COVID pandemic. It closes out with a quote from the client and with a link to download the case study in PDF format, which is incredibly important if you want your case study to be accessible in a wider variety of formats.

Key Learnings from the Evisort Example

• Place the focus immediately on your client by including a snapshot of their company.
• Mention challenging eras, such as a pandemic or recession, to show how your company can help your client succeed even during difficult times.

17. " Copernicus Land Monitoring – CLC+ Core ," by Cloudflight

Including highly specialized information in your case study is an effective way to show prospects that you’re not just trying to get their business. You’re deep within their industry, too, and willing to learn everything you need to learn to create a solution that works specifically for them.

Cloudflight does a splendid job at that in its Copernicus Land Monitoring case study. While the information may be difficult to read at first glance, it will capture the interest of prospects who are in the environmental industry. It thus shows Cloudflight’s value as a partner much more effectively than a general case study would.

The page is comprehensive and ends with a compelling call-to-action — "Looking for a solution that automates, and enhances your Big Data system? Are you struggling with large datasets and accessibility? We would be happy to advise and support you!" The clean, whitespace-heavy page is an effective example of using a case study to capture future leads.

Key Learnings from the Cloudflight Case Study Example

• Don’t be afraid to get technical in your explanation of what you did for your client.
• Include a snapshot of the sales representative prospects should contact, especially if you have different sales reps for different industries, like Cloudflight does.

18. " Valvoline Increases Coupon Send Rate by 76% with Textel’s MMS Picture Texting ," by Textel

If you’re targeting large enterprises with a long purchasing cycle, you’ll want to include a wealth of information in an easily transferable format. That’s what Textel does here in its PDF case study for Valvoline. It greets the user with an eye-catching headline that shows the value of using Textel. Valvoline saw a significant return on investment from using the platform.

Another smart decision in this case study is highlighting the client’s quote by putting it in green font and doing the same thing for the client’s results because it helps the reader quickly connect the two pieces of information. If you’re in a hurry, you can also take a look at the "At a Glance" column to get the key facts of the case study, starting with information about Valvoline.

Key Learnings from the Textel Case Study Example

• Include your client’s ROI right in the title of the case study.
• Add an "At a Glance" column to your case study PDF to make it easy to get insights without needing to read all the text.

19. " Hunt Club and Happeo — a tech-enabled love story ," by Happeo

In this blog-post-like case study, Happeo opens with a quote from the client, then dives into a compelling heading: "Technology at the forefront of Hunt Club's strategy." Say you’re investigating Happeo as a solution and consider your firm to be technology-driven. This approach would spark your curiosity about why the client chose to work with Happeo. It also effectively communicates the software’s value proposition without sounding like it’s coming from an in-house marketing team.

Every paragraph is a quote written from the customer’s perspective. Later down the page, the case study also dives into "the features that changed the game for Hunt Club," giving Happeo a chance to highlight some of the platform’s most salient features.

Key Learnings from the Happeo Case Study Example

• Consider writing the entirety of the case study from the perspective of the customer.
• Include a list of the features that convinced your client to go with you.

20. " Red Sox Season Campaign ," by CTP Boston

What's great about CTP's case study page for their Red Sox Season Campaign is their combination of video, images, and text. A video automatically begins playing when you visit the page, and as you scroll, you'll see more embedded videos of Red Sox players, a compilation of print ads, and social media images you can click to enlarge.

At the bottom, it says "Find out how we can do something similar for your brand." The page is clean, cohesive, and aesthetically pleasing. It invites viewers to appreciate the well-roundedness of CTP's campaign for Boston's beloved baseball team.

Key Learnings from the CTP Case Study Example

• Include a video in the heading of the case study.
• Close with a call-to-action that makes leads want to turn into prospects.

21. " Acoustic ," by Genuine

Sometimes, simple is key. Genuine's case study for Acoustic is straightforward and minimal, with just a few short paragraphs, including "Reimagining the B2B website experience," "Speaking to marketers 1:1," and "Inventing Together." After the core of the case study, we then see a quote from Acoustic’s CMO and the results Genuine achieved for the company.

The simplicity of the page allows the reader to focus on both the visual aspects and the copy. The page displays Genuine's brand personality while offering the viewer all the necessary information they need.

• You don’t need to write a lot to create a great case study. Keep it simple.
• Always include quantifiable data to illustrate the results you achieved for your client.

22. " Using Apptio Targetprocess Automated Rules in Wargaming ," by Apptio

Apptio’s case study for Wargaming summarizes three key pieces of information right at the beginning: The goals, the obstacles, and the results.

Readers then have the opportunity to continue reading — or they can walk away right then with the information they need. This case study also excels in keeping the human interest factor by formatting the information like an interview.

The piece is well-organized and uses compelling headers to keep the reader engaged. Despite its length, Apptio's case study is appealing enough to keep the viewer's attention. Every Apptio case study ends with a "recommendation for other companies" section, where the client can give advice for other companies that are looking for a similar solution but aren’t sure how to get started.

Key Learnings from the Apptio Case Study Example

• Put your client in an advisory role by giving them the opportunity to give recommendations to other companies that are reading the case study.
• Include the takeaways from the case study right at the beginning so prospects quickly get what they need.

23. " Airbnb + Zendesk: building a powerful solution together ," by Zendesk

Zendesk's Airbnb case study reads like a blog post, and focuses equally on Zendesk and Airbnb, highlighting a true partnership between the companies. To captivate readers, it begins like this: "Halfway around the globe is a place to stay with your name on it. At least for a weekend."

The piece focuses on telling a good story and provides photographs of beautiful Airbnb locations. In a case study meant to highlight Zendesk's helpfulness, nothing could be more authentic than their decision to focus on Airbnb's service in such great detail.

Key Learnings from the Zendesk Case Study Example

• Include images of your client’s offerings — not necessarily of the service or product you provided. Notice how Zendesk doesn’t include screenshots of its product.
• Include a call-to-action right at the beginning of the case study. Zendesk gives you two options: to find a solution or start a trial.

24. " Biobot Customer Success Story: Rollins College, Winter Park, Florida ," by Biobot

Like some of the other top examples in this list, Biobot opens its case study with a quote from its client, which captures the value proposition of working with Biobot. It mentions the COVID pandemic and goes into detail about the challenges the client faced during this time.

This case study is structured more like a news article than a traditional case study. This format can work in more formal industries where decision-makers need to see in-depth information about the case. Be sure to test different methods and measure engagement .

Key Learnings from the Biobot Case Study Example

• Mention environmental, public health, or economic emergencies and how you helped your client get past such difficult times.
• Feel free to write the case study like a normal blog post, but be sure to test different methods to find the one that best works for you.

25. " Discovering Cost Savings With Efficient Decision Making ," by Gartner

You don't always need a ton of text or a video to convey your message — sometimes, you just need a few paragraphs and bullet points. Gartner does a fantastic job of quickly providing the fundamental statistics a potential customer would need to know, without boggling down their readers with dense paragraphs. The case study closes with a shaded box that summarizes the impact that Gartner had on its client. It includes a quote and a call-to-action to "Learn More."

Key Learnings from the Gartner Case Study Example

• Feel free to keep the case study short.
• Include a call-to-action at the bottom that takes the reader to a page that most relates to them.

26. " Bringing an Operator to the Game ," by Redapt

This case study example by Redapt is another great demonstration of the power of summarizing your case study’s takeaways right at the start of the study. Redapt includes three easy-to-scan columns: "The problem," "the solution," and "the outcome." But its most notable feature is a section titled "Moment of clarity," which shows why this particular project was difficult or challenging.

The section is shaded in green, making it impossible to miss. Redapt does the same thing for each case study. In the same way, you should highlight the "turning point" for both you and your client when you were working toward a solution.

Key Learnings from the Redapt Case Study Example

• Highlight the turning point for both you and your client during the solution-seeking process.
• Use the same structure (including the same headings) for your case studies to make them easy to scan and read.

27. " Virtual Call Center Sees 300% Boost In Contact Rate ," by Convoso

Convoso’s PDF case study for Digital Market Media immediately mentions the results that the client achieved and takes advantage of white space. On the second page, the case study presents more influential results. It’s colorful and engaging and closes with a spread that prompts readers to request a demo.

Key Learnings from the Convoso Case Study Example

• List the results of your work right at the beginning of the case study.
• Use color to differentiate your case study from others. Convoso’s example is one of the most colorful ones on this list.

28. " Ensuring quality of service during a pandemic ," by Ericsson

Ericsson’s case study page for Orange Spain is an excellent example of using diverse written and visual media — such as videos, graphs, and quotes — to showcase the success a client experienced. Throughout the case study, Ericsson provides links to product and service pages users might find relevant as they’re reading the study.

For instance, under the heading "Preloaded with the power of automation," Ericsson mentions its Ericsson Operations Engine product, then links to that product page. It closes the case study with a link to another product page.

Key Learnings from the Ericsson Case Study Example

• Link to product pages throughout the case study so that readers can learn more about the solution you offer.
• Use multimedia to engage users as they read the case study.

Start creating your case study.

Now that you've got a great list of examples of case studies, think about a topic you'd like to write about that highlights your company or work you did with a customer.

A customer’s success story is the most persuasive marketing material you could ever create. With a strong portfolio of case studies, you can ensure prospects know why they should give you their business.

Editor's note: This post was originally published in August 2018 and has been updated for comprehensiveness.

Don't forget to share this post!

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Blog Graphic Design

15+ Professional Case Study Examples [Design Tips + Templates]

By Alice Corner , Jan 12, 2023

Have you ever bought something — within the last 10 years or so — without reading its reviews or without a recommendation or prior experience of using it?

If the answer is no — or at least, rarely — you get my point.

Positive reviews matter for selling to regular customers, and for B2B or SaaS businesses, detailed case studies are important too.

Wondering how to craft a compelling case study ? No worries—I’ve got you covered with 15 marketing case study templates , helpful tips, and examples to ensure your case study converts effectively.

Click to jump ahead:

• What is a Case Study?

Business Case Study Examples

Simple case study examples.

• Marketing Case Study Examples

Sales Case Study Examples

• Case Study FAQs

What is a case study?

A case study is an in-depth, detailed analysis of a specific real-world situation. For example, a case study can be about an individual, group, event, organization, or phenomenon. The purpose of a case study is to understand its complexities and gain insights into a particular instance or situation.

In the context of a business, however, case studies take customer success stories and explore how they use your product to help them achieve their business goals.

As well as being valuable marketing tools , case studies are a good way to evaluate your product as it allows you to objectively examine how others are using it.

It’s also a good way to interview your customers about why they work with you.

Related: What is a Case Study? [+6 Types of Case Studies]

Marketing Case Study Template

A marketing case study showcases how your product or services helped potential clients achieve their business goals. You can also create case studies of internal, successful marketing projects. A marketing case study typically includes:

• Company background and history
• The challenge
• How you helped
• Specific actions taken
• Visuals or Data
• Client testimonials

Here’s an example of a marketing case study template:

Whether you’re a B2B or B2C company, business case studies can be a powerful resource to help with your sales, marketing, and even internal departmental awareness.

Business and business management case studies should encompass strategic insights alongside anecdotal and qualitative findings, like in the business case study examples below.

Conduct a B2B case study by researching the company holistically

When it comes to writing a case study, make sure you approach the company holistically and analyze everything from their social media to their sales.

Think about every avenue your product or service has been of use to your case study company, and ask them about the impact this has had on their wider company goals.

In business case study examples like the one above, we can see that the company has been thought about holistically simply by the use of icons.

By combining social media icons with icons that show in-person communication we know that this is a well-researched and thorough case study.

This case study report example could also be used within an annual or end-of-year report.

Highlight the key takeaway from your marketing case study

To create a compelling case study, identify the key takeaways from your research. Use catchy language to sum up this information in a sentence, and present this sentence at the top of your page.

This is “at a glance” information and it allows people to gain a top-level understanding of the content immediately. 

You can use a large, bold, contrasting font to help this information stand out from the page and provide interest.

Learn  how to choose fonts  effectively with our Venngage guide and once you’ve done that.

Upload your fonts and  brand colors  to Venngage using the  My Brand Kit  tool and see them automatically applied to your designs.

The heading is the ideal place to put the most impactful information, as this is the first thing that people will read.

In this example, the stat of “Increase[d] lead quality by 90%” is used as the header. It makes customers want to read more to find out how exactly lead quality was increased by such a massive amount.

If you’re conducting an in-person interview, you could highlight a direct quote or insight provided by your interview subject.

Pick out a catchy sentence or phrase, or the key piece of information your interview subject provided and use that as a way to draw a potential customer in.

Use charts to visualize data in your business case studies

Charts are an excellent way to visualize data and to bring statistics and information to life. Charts make information easier to understand and to illustrate trends or patterns.

Making charts is even easier with Venngage.

In this consulting case study example, we can see that a chart has been used to demonstrate the difference in lead value within the Lead Elves case study.

Adding a chart here helps break up the information and add visual value to the case study. 

Using charts in your case study can also be useful if you’re creating a project management case study.

You could use a Gantt chart or a project timeline to show how you have managed the project successfully.

Use direct quotes to build trust in your marketing case study

To add an extra layer of authenticity you can include a direct quote from your customer within your case study.

According to research from Nielsen , 92% of people will trust a recommendation from a peer and 70% trust recommendations even if they’re from somebody they don’t know.

So if you have a customer or client who can’t stop singing your praises, make sure you get a direct quote from them and include it in your case study.

You can either lift part of the conversation or interview, or you can specifically request a quote. Make sure to ask for permission before using the quote.

This design uses a bright contrasting speech bubble to show that it includes a direct quote, and helps the quote stand out from the rest of the text.

This will help draw the customer’s attention directly to the quote, in turn influencing them to use your product or service.

Less is often more, and this is especially true when it comes to creating designs. Whilst you want to create a professional-looking, well-written and design case study – there’s no need to overcomplicate things.

These simple case study examples show that smart clean designs and informative content can be an effective way to showcase your successes.

Use colors and fonts to create a professional-looking case study

Business case studies shouldn’t be boring. In fact, they should be beautifully and professionally designed.

This means the normal rules of design apply. Use fonts, colors, and icons to create an interesting and visually appealing case study.

In this case study example, we can see how multiple fonts have been used to help differentiate between the headers and content, as well as complementary colors and eye-catching icons.

Marketing case study examples

Marketing case studies are incredibly useful for showing your marketing successes. Every successful marketing campaign relies on influencing a consumer’s behavior, and a great case study can be a great way to spotlight your biggest wins.

In the marketing case study examples below, a variety of designs and techniques to create impactful and effective case studies.

Show off impressive results with a bold marketing case study

Case studies are meant to show off your successes, so make sure you feature your positive results prominently. Using bold and bright colors as well as contrasting shapes, large bold fonts, and simple icons is a great way to highlight your wins.

In well-written case study examples like the one below, the big wins are highlighted on the second page with a bright orange color and are highlighted in circles.

Making the important data stand out is especially important when attracting a prospective customer with marketing case studies.

Use a simple but clear layout in your case study

Using a simple layout in your case study can be incredibly effective, like in the example of a case study below.

Keeping a clean white background, and using slim lines to help separate the sections is an easy way to format your case study.

Making the information clear helps draw attention to the important results, and it helps improve the  accessibility of the design .

Business case study examples like this would sit nicely within a larger report, with a consistent layout throughout.

Use visuals and icons to create an engaging and branded business case study

Nobody wants to read pages and pages of text — and that’s why Venngage wants to help you communicate your ideas visually.

Using icons, graphics, photos, or patterns helps create a much more engaging design. 

With this Blue Cap case study icons, colors, and impactful pattern designs have been used to create an engaging design that catches your eye.

Use a monochromatic color palette to create a professional and clean case study

Let your research shine by using a monochromatic and minimalistic color palette.

By sticking to one color, and leaving lots of blank space you can ensure your design doesn’t distract a potential customer from your case study content.

In this case study on Polygon Media, the design is simple and professional, and the layout allows the prospective customer to follow the flow of information.

The gradient effect on the left-hand column helps break up the white background and adds an interesting visual effect.

Did you know you can generate an accessible color palette with Venngage? Try our free accessible color palette generator today and create a case study that delivers and looks pleasant to the eye:

Add long term goals in your case study

When creating a case study it’s a great idea to look at both the short term and the long term goals of the company to gain the best understanding possible of the insights they provide.

Short-term goals will be what the company or person hopes to achieve in the next few months, and long-term goals are what the company hopes to achieve in the next few years.

Check out this modern pattern design example of a case study below:

In this case study example, the short and long-term goals are clearly distinguished by light blue boxes and placed side by side so that they are easy to compare.

Use a strong introductory paragraph to outline the overall strategy and goals before outlining the specific short-term and long-term goals to help with clarity.

This strategy can also be handy when creating a consulting case study.

Use data to make concrete points about your sales and successes

When conducting any sort of research stats, facts, and figures are like gold dust (aka, really valuable).

Being able to quantify your findings is important to help understand the information fully. Saying sales increased 10% is much more effective than saying sales increased.

While sales dashboards generally tend it make it all about the numbers and charts, in sales case study examples, like this one, the key data and findings can be presented with icons. This contributes to the potential customer’s better understanding of the report.

They can clearly comprehend the information and it shows that the case study has been well researched.

Use emotive, persuasive, or action based language in your marketing case study

Create a compelling case study by using emotive, persuasive and action-based language when customizing your case study template.

In this well-written case study example, we can see that phrases such as “Results that Speak Volumes” and “Drive Sales” have been used.

Using persuasive language like you would in a blog post. It helps inspire potential customers to take action now.

Keep your potential customers in mind when creating a customer case study for marketing

82% of marketers use case studies in their marketing  because it’s such an effective tool to help quickly gain customers’ trust and to showcase the potential of your product.

Why are case studies such an important tool in content marketing?

By writing a case study you’re telling potential customers that they can trust you because you’re showing them that other people do.

Not only that, but if you have a SaaS product, business case studies are a great way to show how other people are effectively using your product in their company.

In this case study, Network is demonstrating how their product has been used by Vortex Co. with great success; instantly showing other potential customers that their tool works and is worth using.

Related: 10+ Case Study Infographic Templates That Convert

Case studies are particularly effective as a sales technique.

A sales case study is like an extended customer testimonial, not only sharing opinions of your product – but showcasing the results you helped your customer achieve.

Make impactful statistics pop in your sales case study

Writing a case study doesn’t mean using text as the only medium for sharing results.

You should use icons to highlight areas of your research that are particularly interesting or relevant, like in this example of a case study:

Icons are a great way to help summarize information quickly and can act as visual cues to help draw the customer’s attention to certain areas of the page.

In some of the business case study examples above, icons are used to represent the impressive areas of growth and are presented in a way that grabs your attention.

Use high contrast shapes and colors to draw attention to key information in your sales case study

Help the key information stand out within your case study by using high contrast shapes and colors.

Use a complementary or contrasting color, or use a shape such as a rectangle or a circle for maximum impact.

This design has used dark blue rectangles to help separate the information and make it easier to read.

Coupled with icons and strong statistics, this information stands out on the page and is easily digestible and retainable for a potential customer.

Case Study Examples Summary

Once you have created your case study, it’s best practice to update your examples on a regular basis to include up-to-date statistics, data, and information.

You should update your business case study examples often if you are sharing them on your website .

It’s also important that your case study sits within your brand guidelines – find out how Venngage’s My Brand Kit tool can help you create consistently branded case study templates.

Case studies are important marketing tools – but they shouldn’t be the only tool in your toolbox. Content marketing is also a valuable way to earn consumer trust.

Case Study FAQ

Why should you write a case study.

Case studies are an effective marketing technique to engage potential customers and help build trust.

By producing case studies featuring your current clients or customers, you are showcasing how your tool or product can be used. You’re also showing that other people endorse your product.

In addition to being a good way to gather positive testimonials from existing customers , business case studies are good educational resources and can be shared amongst your company or team, and used as a reference for future projects.

How should you write a case study?

To create a great case study, you should think strategically. The first step, before starting your case study research, is to think about what you aim to learn or what you aim to prove.

You might be aiming to learn how a company makes sales or develops a new product. If this is the case, base your questions around this.

You can learn more about writing a case study  from our extensive guide.

Related: How to Present a Case Study like a Pro (With Examples)

Some good questions you could ask would be:

• Why do you use our tool or service?
• How often do you use our tool or service?
• What does the process of using our product look like to you?
• If our product didn’t exist, what would you be doing instead?
• What is the number one benefit you’ve found from using our tool?

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• 12 Essential Consulting Templates For Marketing, Planning and Branding
• Best Marketing Strategies for Consultants and Freelancers in 2019 [Study + Infographic]

Research Writing and Analysis

• NVivo Group and Study Sessions
• SPSS This link opens in a new window
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• Using Qualtrics
• Dissertation and Data Analysis Group Sessions
• Defense Schedule - Commons Calendar This link opens in a new window
• Research Process Flow Chart
• Research Alignment Chapter 1 This link opens in a new window
• Step 1: Seek Out Evidence
• Step 2: Explain
• Step 3: The Big Picture
• Step 4: Own It
• Step 5: Illustrate
• Annotated Bibliography
• Literature Review This link opens in a new window
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• How to Synthesize and Analyze
• Synthesis and Analysis Practice
• Synthesis and Analysis Group Sessions
• Problem Statement
• Purpose Statement
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Writing a Case Study

What is a case study?

A Case study is: 

• An in-depth research design that primarily uses a qualitative methodology but sometimes​​ includes quantitative methodology.
• Used to examine an identifiable problem confirmed through research.
• Used to investigate an individual, group of people, organization, or event.
• Used to mostly answer "how" and "why" questions.

What are the different types of case studies?

Note: These are the primary case studies. As you continue to research and learn

about case studies you will begin to find a robust list of different types. 

Who are your case study participants?

What is triangulation ? 

Validity and credibility are an essential part of the case study. Therefore, the researcher should include triangulation to ensure trustworthiness while accurately reflecting what the researcher seeks to investigate.

How to write a Case Study?

When developing a case study, there are different ways you could present the information, but remember to include the five parts for your case study.

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Writing A Case Study

Case Study Examples

Brilliant Case Study Examples and Templates For Your Help

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A Complete Case Study Writing Guide With Examples

Simple Case Study Format for Students to Follow

Understand the Types of Case Study Here

It’s no surprise that writing a case study is one of the most challenging academic tasks for students. You’re definitely not alone here!

Most people don't realize that there are specific guidelines to follow when writing a case study. If you don't know where to start, it's easy to get overwhelmed and give up before you even begin.

Don't worry! Let us help you out!

We've collected over 25 free case study examples with solutions just for you. These samples with solutions will help you win over your panel and score high marks on your case studies.

So, what are you waiting for? Let's dive in and learn the secrets to writing a successful case study.

• 1. An Overview of Case Studies
• 2. Case Study Examples for Students
• 3. Business Case Study Examples
• 4. Medical Case Study Examples
• 5. Psychology Case Study Examples 
• 6. Sales Case Study Examples
• 7. Interview Case Study Examples
• 8. Marketing Case Study Examples
• 9. Tips to Write a Good Case Study

An Overview of Case Studies

A case study is a research method used to study a particular individual, group, or situation in depth. It involves analyzing and interpreting data from a variety of sources to gain insight into the subject being studied. 

Case studies are often used in psychology, business, and education to explore complicated problems and find solutions. They usually have detailed descriptions of the subject, background info, and an analysis of the main issues.

The goal of a case study is to provide a comprehensive understanding of the subject. Typically, case studies can be divided into three parts, challenges, solutions, and results. 

Here is a case study sample PDF so you can have a clearer understanding of what a case study actually is:

Case Study Sample PDF

How to Write a Case Study Examples

Learn how to write a case study with the help of our comprehensive case study guide.

Case Study Examples for Students

Quite often, students are asked to present case studies in their academic journeys. The reason instructors assign case studies is for students to sharpen their critical analysis skills, understand how companies make profits, etc.

Below are some case study examples in research, suitable for students:

Case Study Example in Software Engineering

Qualitative Research Case Study Sample

Software Quality Assurance Case Study

Social Work Case Study Example

Ethical Case Study

Case Study Example PDF

These examples can guide you on how to structure and format your own case studies.

Struggling with formatting your case study? Check this case study format guide and perfect your document’s structure today.

Business Case Study Examples

A business case study examines a business’s specific challenge or goal and how it should be solved. Business case studies usually focus on several details related to the initial challenge and proposed solution. 

To help you out, here are some samples so you can create case studies that are related to businesses: 

Here are some more business case study examples:

Business Case Studies PDF

Business Case Studies Example

Typically, a business case study discovers one of your customer's stories and how you solved a problem for them. It allows your prospects to see how your solutions address their needs. 

Medical Case Study Examples

Medical case studies are an essential part of medical education. They help students to understand how to diagnose and treat patients. 

Here are some medical case study examples to help you.

Medical Case Study Example

Nursing Case Study Example

Want to understand the various types of case studies? Check out our types of case study blog to select the perfect type.

Psychology Case Study Examples 

Case studies are a great way of investigating individuals with psychological abnormalities. This is why it is a very common assignment in psychology courses. 

By examining all the aspects of your subject’s life, you discover the possible causes of exhibiting such behavior. 

For your help, here are some interesting psychology case study examples:

Psychology Case Study Example

Mental Health Case Study Example

Sales Case Study Examples

Case studies are important tools for sales teams’ performance improvement. By examining sales successes, teams can gain insights into effective strategies and create action plans to employ similar tactics.

By researching case studies of successful sales campaigns, sales teams can more accurately identify challenges and develop solutions.

Sales Case Study Example

Interview Case Study Examples

Interview case studies provide businesses with invaluable information. This data allows them to make informed decisions related to certain markets or subjects.

Interview Case Study Example

Marketing Case Study Examples

Marketing case studies are real-life stories that showcase how a business solves a problem. They typically discuss how a business achieves a goal using a specific marketing strategy or tactic.

They typically describe a challenge faced by a business, the solution implemented, and the results achieved.

This is a short sample marketing case study for you to get an idea of what an actual marketing case study looks like.

 Here are some more popular marketing studies that show how companies use case studies as a means of marketing and promotion:

“Chevrolet Discover the Unexpected” by Carol H. Williams

This case study explores Chevrolet's “ DTU Journalism Fellows ” program. The case study uses the initials “DTU” to generate interest and encourage readers to learn more. 

Multiple types of media, such as images and videos, are used to explain the challenges faced. The case study concludes with an overview of the achievements that were met.

Key points from the case study include:

• Using a well-known brand name in the title can create interest.
• Combining different media types, such as headings, images, and videos, can help engage readers and make the content more memorable.
• Providing a summary of the key achievements at the end of the case study can help readers better understand the project's impact.

“The Met” by Fantasy

“ The Met ” by Fantasy is a fictional redesign of the Metropolitan Museum of Art in New York City, created by the design studio Fantasy. The case study clearly and simply showcases the museum's website redesign.

The Met emphasizes the website’s features and interface by showcasing each section of the interface individually, allowing the readers to concentrate on the significant elements.

For those who prefer text, each feature includes an objective description. The case study also includes a “Contact Us” call-to-action at the bottom of the page, inviting visitors to contact the company.

Key points from this “The Met” include:

• Keeping the case study simple and clean can help readers focus on the most important aspects.
• Presenting the features and solutions with a visual showcase can be more effective than writing a lot of text.
• Including a clear call-to-action at the end of the case study can encourage visitors to contact the company for more information.

“Better Experiences for All” by Herman Miller

Herman Miller's minimalist approach to furniture design translates to their case study, “ Better Experiences for All ”, for a Dubai hospital. The page features a captivating video with closed-captioning and expandable text for accessibility.

The case study presents a wealth of information in a concise format, enabling users to grasp the complexities of the strategy with ease. It concludes with a client testimonial and a list of furniture items purchased from the brand.

Key points from the “Better Experiences” include:

• Make sure your case study is user-friendly by including accessibility features like closed captioning and expandable text.
• Include a list of products that were used in the project to guide potential customers.

“NetApp” by Evisort 

Evisort's case study on “ NetApp ” stands out for its informative and compelling approach. The study begins with a client-centric overview of NetApp, strategically directing attention to the client rather than the company or team involved.

The case study incorporates client quotes and explores NetApp’s challenges during COVID-19. Evisort showcases its value as a client partner by showing how its services supported NetApp through difficult times. 

• Provide an overview of the company in the client’s words, and put focus on the customer. 
• Highlight how your services can help clients during challenging times.
• Make your case study accessible by providing it in various formats.

“Red Sox Season Campaign,” by CTP Boston

The “ Red Sox Season Campaign ” showcases a perfect blend of different media, such as video, text, and images. Upon visiting the page, the video plays automatically, there are videos of Red Sox players, their images, and print ads that can be enlarged with a click.

The page features an intuitive design and invites viewers to appreciate CTP's well-rounded campaign for Boston's beloved baseball team. There’s also a CTA that prompts viewers to learn how CTP can create a similar campaign for their brand.

Some key points to take away from the “Red Sox Season Campaign”: 

• Including a variety of media such as video, images, and text can make your case study more engaging and compelling.
• Include a call-to-action at the end of your study that encourages viewers to take the next step towards becoming a customer or prospect.

“Airbnb + Zendesk” by Zendesk

The case study by Zendesk, titled “ Airbnb + Zendesk : Building a powerful solution together,” showcases a true partnership between Airbnb and Zendesk. 

The article begins with an intriguing opening statement, “Halfway around the globe is a place to stay with your name on it. At least for a weekend,” and uses stunning images of beautiful Airbnb locations to captivate readers.

Instead of solely highlighting Zendesk's product, the case study is crafted to tell a good story and highlight Airbnb's service in detail. This strategy makes the case study more authentic and relatable.

Some key points to take away from this case study are:

• Use client's offerings' images rather than just screenshots of your own product or service.
• To begin the case study, it is recommended to include a distinct CTA. For instance, Zendesk presents two alternatives, namely to initiate a trial or seek a solution.

“Influencer Marketing” by Trend and WarbyParker

The case study "Influencer Marketing" by Trend and Warby Parker highlights the potential of influencer content marketing, even when working with a limited budget. 

The “Wearing Warby” campaign involved influencers wearing Warby Parker glasses during their daily activities, providing a glimpse of the brand's products in use. 

This strategy enhanced the brand's relatability with influencers' followers. While not detailing specific tactics, the case study effectively illustrates the impact of third-person case studies in showcasing campaign results.

Key points to take away from this case study are:

• Influencer marketing can be effective even with a limited budget.
• Showcasing products being used in everyday life can make a brand more approachable and relatable.
• Third-person case studies can be useful in highlighting the success of a campaign.

Marketing Case Study Example

Marketing Case Study Template

Now that you have read multiple case study examples, hop on to our tips.

Tips to Write a Good Case Study

Here are some note-worthy tips to craft a winning case study 

• Define the purpose of the case study This will help you to focus on the most important aspects of the case. The case study objective helps to ensure that your finished product is concise and to the point.
• Choose a real-life example. One of the best ways to write a successful case study is to choose a real-life example. This will give your readers a chance to see how the concepts apply in a real-world setting.
• Keep it brief. This means that you should only include information that is directly relevant to your topic and avoid adding unnecessary details.
• Use strong evidence. To make your case study convincing, you will need to use strong evidence. This can include statistics, data from research studies, or quotes from experts in the field.
• Edit and proofread your work. Before you submit your case study, be sure to edit and proofread your work carefully. This will help to ensure that there are no errors and that your paper is clear and concise.

There you go!

We’re sure that now you have secrets to writing a great case study at your fingertips! This blog teaches the key guidelines of various case studies with samples. So grab your pen and start crafting a winning case study right away!

Having said that, we do understand that some of you might be having a hard time writing compelling case studies.

But worry not! Our expert case study writing service is here to take all your case-writing blues away! 

With 100% thorough research guaranteed, our professional essay writing service can craft an amazing case study within 6 hours! 

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Dr. Barbara is a highly experienced writer and author who holds a Ph.D. degree in public health from an Ivy League school. She has worked in the medical field for many years, conducting extensive research on various health topics. Her writing has been featured in several top-tier publications.

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All You Wanted to Know About How to Write a Case Study

What do you study in your college? If you are a psychology, sociology, or anthropology student, we bet you might be familiar with what a case study is. This research method is used to study a certain person, group, or situation. In this guide from our dissertation writing service , you will learn how to write a case study professionally, from researching to citing sources properly. Also, we will explore different types of case studies and show you examples — so that you won’t have any other questions left.

What Is a Case Study?

A case study is a subcategory of research design which investigates problems and offers solutions. Case studies can range from academic research studies to corporate promotional tools trying to sell an idea—their scope is quite vast.

What Is the Difference Between a Research Paper and a Case Study?

While research papers turn the reader’s attention to a certain problem, case studies go even further. Case study guidelines require students to pay attention to details, examining issues closely and in-depth using different research methods. For example, case studies may be used to examine court cases if you study Law, or a patient's health history if you study Medicine. Case studies are also used in Marketing, which are thorough, empirically supported analysis of a good or service's performance. Well-designed case studies can be valuable for prospective customers as they can identify and solve the potential customers pain point.

Case studies involve a lot of storytelling – they usually examine particular cases for a person or a group of people. This method of research is very helpful, as it is very practical and can give a lot of hands-on information. Most commonly, the length of the case study is about 500-900 words, which is much less than the length of an average research paper.

The structure of a case study is very similar to storytelling. It has a protagonist or main character, which in your case is actually a problem you are trying to solve. You can use the system of 3 Acts to make it a compelling story. It should have an introduction, rising action, a climax where transformation occurs, falling action, and a solution.

Here is a rough formula for you to use in your case study:

Problem (Act I): > Solution (Act II) > Result (Act III) > Conclusion.

Types of Case Studies

The purpose of a case study is to provide detailed reports on an event, an institution, a place, future customers, or pretty much anything. There are a few common types of case study, but the type depends on the topic. The following are the most common domains where case studies are needed:

• Historical case studies are great to learn from. Historical events have a multitude of source info offering different perspectives. There are always modern parallels where these perspectives can be applied, compared, and thoroughly analyzed.
• Problem-oriented case studies are usually used for solving problems. These are often assigned as theoretical situations where you need to immerse yourself in the situation to examine it. Imagine you’re working for a startup and you’ve just noticed a significant flaw in your product’s design. Before taking it to the senior manager, you want to do a comprehensive study on the issue and provide solutions. On a greater scale, problem-oriented case studies are a vital part of relevant socio-economic discussions.
• Cumulative case studies collect information and offer comparisons. In business, case studies are often used to tell people about the value of a product.
• Critical case studies explore the causes and effects of a certain case.
• Illustrative case studies describe certain events, investigating outcomes and lessons learned.

Need a compelling case study? EssayPro has got you covered. Our experts are ready to provide you with detailed, insightful case studies that capture the essence of real-world scenarios. Elevate your academic work with our professional assistance.

Case Study Format

The case study format is typically made up of eight parts:

• Executive Summary. Explain what you will examine in the case study. Write an overview of the field you’re researching. Make a thesis statement and sum up the results of your observation in a maximum of 2 sentences.
• Background. Provide background information and the most relevant facts. Isolate the issues.
• Case Evaluation. Isolate the sections of the study you want to focus on. In it, explain why something is working or is not working.
• Proposed Solutions. Offer realistic ways to solve what isn’t working or how to improve its current condition. Explain why these solutions work by offering testable evidence.
• Conclusion. Summarize the main points from the case evaluations and proposed solutions. 6. Recommendations. Talk about the strategy that you should choose. Explain why this choice is the most appropriate.
• Implementation. Explain how to put the specific strategies into action.
• References. Provide all the citations.

How to Write a Case Study

Let's discover how to write a case study.

Setting Up the Research

When writing a case study, remember that research should always come first. Reading many different sources and analyzing other points of view will help you come up with more creative solutions. You can also conduct an actual interview to thoroughly investigate the customer story that you'll need for your case study. Including all of the necessary research, writing a case study may take some time. The research process involves doing the following:

• Define your objective. Explain the reason why you’re presenting your subject. Figure out where you will feature your case study; whether it is written, on video, shown as an infographic, streamed as a podcast, etc.
• Determine who will be the right candidate for your case study. Get permission, quotes, and other features that will make your case study effective. Get in touch with your candidate to see if they approve of being part of your work. Study that candidate’s situation and note down what caused it.
• Identify which various consequences could result from the situation. Follow these guidelines on how to start a case study: surf the net to find some general information you might find useful.
• Make a list of credible sources and examine them. Seek out important facts and highlight problems. Always write down your ideas and make sure to brainstorm.
• Focus on several key issues – why they exist, and how they impact your research subject. Think of several unique solutions. Draw from class discussions, readings, and personal experience. When writing a case study, focus on the best solution and explore it in depth. After having all your research in place, writing a case study will be easy. You may first want to check the rubric and criteria of your assignment for the correct case study structure.

Read Also: ' WHAT IS A CREDIBLE SOURCES ?'

Although your instructor might be looking at slightly different criteria, every case study rubric essentially has the same standards. Your professor will want you to exhibit 8 different outcomes:

• Correctly identify the concepts, theories, and practices in the discipline.
• Identify the relevant theories and principles associated with the particular study.
• Evaluate legal and ethical principles and apply them to your decision-making.
• Recognize the global importance and contribution of your case.
• Construct a coherent summary and explanation of the study.
• Demonstrate analytical and critical-thinking skills.
• Explain the interrelationships between the environment and nature.
• Integrate theory and practice of the discipline within the analysis.

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Case Study Outline

Let's look at the structure of an outline based on the issue of the alcoholic addiction of 30 people.

Introduction

• Statement of the issue: Alcoholism is a disease rather than a weakness of character.
• Presentation of the problem: Alcoholism is affecting more than 14 million people in the USA, which makes it the third most common mental illness there.
• Explanation of the terms: In the past, alcoholism was commonly referred to as alcohol dependence or alcohol addiction. Alcoholism is now the more severe stage of this addiction in the disorder spectrum.
• Hypotheses: Drinking in excess can lead to the use of other drugs.
• Importance of your story: How the information you present can help people with their addictions.
• Background of the story: Include an explanation of why you chose this topic.
• Presentation of analysis and data: Describe the criteria for choosing 30 candidates, the structure of the interview, and the outcomes.
• Strong argument 1: ex. X% of candidates dealing with anxiety and depression...
• Strong argument 2: ex. X amount of people started drinking by their mid-teens.
• Strong argument 3: ex. X% of respondents’ parents had issues with alcohol.
• Concluding statement: I have researched if alcoholism is a disease and found out that…
• Recommendations: Ways and actions for preventing alcohol use.

Writing a Case Study Draft

After you’ve done your case study research and written the outline, it’s time to focus on the draft. In a draft, you have to develop and write your case study by using: the data which you collected throughout the research, interviews, and the analysis processes that were undertaken. Follow these rules for the draft:

• Your draft should contain at least 4 sections: an introduction; a body where you should include background information, an explanation of why you decided to do this case study, and a presentation of your main findings; a conclusion where you present data; and references.
• In the introduction, you should set the pace very clearly. You can even raise a question or quote someone you interviewed in the research phase. It must provide adequate background information on the topic. The background may include analyses of previous studies on your topic. Include the aim of your case here as well. Think of it as a thesis statement. The aim must describe the purpose of your work—presenting the issues that you want to tackle. Include background information, such as photos or videos you used when doing the research.
• Describe your unique research process, whether it was through interviews, observations, academic journals, etc. The next point includes providing the results of your research. Tell the audience what you found out. Why is this important, and what could be learned from it? Discuss the real implications of the problem and its significance in the world.
• Include quotes and data (such as findings, percentages, and awards). This will add a personal touch and better credibility to the case you present. Explain what results you find during your interviews in regards to the problem and how it developed. Also, write about solutions which have already been proposed by other people who have already written about this case.
• At the end of your case study, you should offer possible solutions, but don’t worry about solving them yourself.

Use Data to Illustrate Key Points in Your Case Study

Even though your case study is a story, it should be based on evidence. Use as much data as possible to illustrate your point. Without the right data, your case study may appear weak and the readers may not be able to relate to your issue as much as they should. Let's see the examples from essay writing service :

‍ With data: Alcoholism is affecting more than 14 million people in the USA, which makes it the third most common mental illness there. Without data: A lot of people suffer from alcoholism in the United States.

Try to include as many credible sources as possible. You may have terms or sources that could be hard for other cultures to understand. If this is the case, you should include them in the appendix or Notes for the Instructor or Professor.

Finalizing the Draft: Checklist

After you finish drafting your case study, polish it up by answering these ‘ask yourself’ questions and think about how to end your case study:

• Check that you follow the correct case study format, also in regards to text formatting.
• Check that your work is consistent with its referencing and citation style.
• Micro-editing — check for grammar and spelling issues.
• Macro-editing — does ‘the big picture’ come across to the reader? Is there enough raw data, such as real-life examples or personal experiences? Have you made your data collection process completely transparent? Does your analysis provide a clear conclusion, allowing for further research and practice?

Problems to avoid:

• Overgeneralization – Do not go into further research that deviates from the main problem.
• Failure to Document Limitations – 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.
• 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.

How to Create a Title Page and Cite a Case Study

Let's see how to create an awesome title page.

Your title page depends on the prescribed citation format. The title page should include:

• A title that attracts some attention and describes your study
• The title should have the words “case study” in it
• The title should range between 5-9 words in length
• Your name and contact information
• Your finished paper should be only 500 to 1,500 words in length.With this type of assignment, write effectively and avoid fluff

Here is a template for the APA and MLA format title page:

There are some cases when you need to cite someone else's study in your own one – therefore, you need to master how to cite a case study. A case study is like a research paper when it comes to citations. You can cite it like you cite a book, depending on what style you need.

Citation Example in MLA ‍ Hill, Linda, Tarun Khanna, and Emily A. Stecker. HCL Technologies. Boston: Harvard Business Publishing, 2008. Print.

Citation Example in APA ‍ Hill, L., Khanna, T., & Stecker, E. A. (2008). HCL Technologies. Boston: Harvard Business Publishing.

Citation Example in Chicago Hill, Linda, Tarun Khanna, and Emily A. Stecker. HCL Technologies.

Case Study Examples

To give you an idea of a professional case study example, we gathered and linked some below.

Eastman Kodak Case Study

Case Study Example: Audi Trains Mexican Autoworkers in Germany

To conclude, a case study is one of the best methods of getting an overview of what happened to a person, a group, or a situation in practice. It allows you to have an in-depth glance at the real-life problems that businesses, healthcare industry, criminal justice, etc. may face. This insight helps us look at such situations in a different light. This is because we see scenarios that we otherwise would not, without necessarily being there. If you need custom essays , try our research paper writing services .

Get Help Form Qualified Writers

Crafting a case study is not easy. You might want to write one of high quality, but you don’t have the time or expertise. If you’re having trouble with your case study, help with essay request - we'll help. EssayPro writers have read and written countless case studies and are experts in endless disciplines. Request essay writing, editing, or proofreading assistance from our custom case study writing service , and all of your worries will be gone.

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What Is A Case Study?

How to cite a case study in apa, how to write a case study, related articles.

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• Acknowledgments

Definition and Introduction

Case analysis is a problem-based teaching and learning method that involves critically analyzing complex scenarios within an organizational setting for the purpose of placing the student in a “real world” situation and applying reflection and critical thinking skills to contemplate appropriate solutions, decisions, or recommended courses of action. It is considered a more effective teaching technique than in-class role playing or simulation activities. The analytical process is often guided by questions provided by the instructor that ask students to contemplate relationships between the facts and critical incidents described in the case.

Cases generally include both descriptive and statistical elements and rely on students applying abductive reasoning to develop and argue for preferred or best outcomes [i.e., case scenarios rarely have a single correct or perfect answer based on the evidence provided]. Rather than emphasizing theories or concepts, case analysis assignments emphasize building a bridge of relevancy between abstract thinking and practical application and, by so doing, teaches the value of both within a specific area of professional practice.

Given this, the purpose of a case analysis paper is to present a structured and logically organized format for analyzing the case situation. It can be assigned to students individually or as a small group assignment and it may include an in-class presentation component. Case analysis is predominately taught in economics and business-related courses, but it is also a method of teaching and learning found in other applied social sciences disciplines, such as, social work, public relations, education, journalism, and public administration.

Ellet, William. The Case Study Handbook: A Student's Guide . Revised Edition. Boston, MA: Harvard Business School Publishing, 2018; Christoph Rasche and Achim Seisreiner. Guidelines for Business Case Analysis . University of Potsdam; Writing a Case Analysis . Writing Center, Baruch College; Volpe, Guglielmo. "Case Teaching in Economics: History, Practice and Evidence." Cogent Economics and Finance 3 (December 2015). doi:https://doi.org/10.1080/23322039.2015.1120977.

How to Approach Writing a Case Analysis Paper

The organization and structure of a case analysis paper can vary depending on the organizational setting, the situation, and how your professor wants you to approach the assignment. Nevertheless, preparing to write a case analysis paper involves several important steps. As Hawes notes, a case analysis assignment “...is useful in developing the ability to get to the heart of a problem, analyze it thoroughly, and to indicate the appropriate solution as well as how it should be implemented” [p.48]. This statement encapsulates how you should approach preparing to write a case analysis paper.

Before you begin to write your paper, consider the following analytical procedures:

• Review the case to get an overview of the situation . A case can be only a few pages in length, however, it is most often very lengthy and contains a significant amount of detailed background information and statistics, with multilayered descriptions of the scenario, the roles and behaviors of various stakeholder groups, and situational events. Therefore, a quick reading of the case will help you gain an overall sense of the situation and illuminate the types of issues and problems that you will need to address in your paper. If your professor has provided questions intended to help frame your analysis, use them to guide your initial reading of the case.
• Read the case thoroughly . After gaining a general overview of the case, carefully read the content again with the purpose of understanding key circumstances, events, and behaviors among stakeholder groups. Look for information or data that appears contradictory, extraneous, or misleading. At this point, you should be taking notes as you read because this will help you develop a general outline of your paper. The aim is to obtain a complete understanding of the situation so that you can begin contemplating tentative answers to any questions your professor has provided or, if they have not provided, developing answers to your own questions about the case scenario and its connection to the course readings,lectures, and class discussions.
• Determine key stakeholder groups, issues, and events and the relationships they all have to each other . As you analyze the content, pay particular attention to identifying individuals, groups, or organizations described in the case and identify evidence of any problems or issues of concern that impact the situation in a negative way. Other things to look for include identifying any assumptions being made by or about each stakeholder, potential biased explanations or actions, explicit demands or ultimatums , and the underlying concerns that motivate these behaviors among stakeholders. The goal at this stage is to develop a comprehensive understanding of the situational and behavioral dynamics of the case and the explicit and implicit consequences of each of these actions.
• Identify the core problems . The next step in most case analysis assignments is to discern what the core [i.e., most damaging, detrimental, injurious] problems are within the organizational setting and to determine their implications. The purpose at this stage of preparing to write your analysis paper is to distinguish between the symptoms of core problems and the core problems themselves and to decide which of these must be addressed immediately and which problems do not appear critical but may escalate over time. Identify evidence from the case to support your decisions by determining what information or data is essential to addressing the core problems and what information is not relevant or is misleading.
• Explore alternative solutions . As noted, case analysis scenarios rarely have only one correct answer. Therefore, it is important to keep in mind that the process of analyzing the case and diagnosing core problems, while based on evidence, is a subjective process open to various avenues of interpretation. This means that you must consider alternative solutions or courses of action by critically examining strengths and weaknesses, risk factors, and the differences between short and long-term solutions. For each possible solution or course of action, consider the consequences they may have related to their implementation and how these recommendations might lead to new problems. Also, consider thinking about your recommended solutions or courses of action in relation to issues of fairness, equity, and inclusion.
• Decide on a final set of recommendations . The last stage in preparing to write a case analysis paper is to assert an opinion or viewpoint about the recommendations needed to help resolve the core problems as you see them and to make a persuasive argument for supporting this point of view. Prepare a clear rationale for your recommendations based on examining each element of your analysis. Anticipate possible obstacles that could derail their implementation. Consider any counter-arguments that could be made concerning the validity of your recommended actions. Finally, describe a set of criteria and measurable indicators that could be applied to evaluating the effectiveness of your implementation plan.

Use these steps as the framework for writing your paper. Remember that the more detailed you are in taking notes as you critically examine each element of the case, the more information you will have to draw from when you begin to write. This will save you time.

NOTE : If the process of preparing to write a case analysis paper is assigned as a student group project, consider having each member of the group analyze a specific element of the case, including drafting answers to the corresponding questions used by your professor to frame the analysis. This will help make the analytical process more efficient and ensure that the distribution of work is equitable. This can also facilitate who is responsible for drafting each part of the final case analysis paper and, if applicable, the in-class presentation.

Framework for Case Analysis . College of Management. University of Massachusetts; Hawes, Jon M. "Teaching is Not Telling: The Case Method as a Form of Interactive Learning." Journal for Advancement of Marketing Education 5 (Winter 2004): 47-54; Rasche, Christoph and Achim Seisreiner. Guidelines for Business Case Analysis . University of Potsdam; Writing a Case Study Analysis . University of Arizona Global Campus Writing Center; Van Ness, Raymond K. A Guide to Case Analysis . School of Business. State University of New York, Albany; Writing a Case Analysis . Business School, University of New South Wales.

Structure and Writing Style

A case analysis paper should be detailed, concise, persuasive, clearly written, and professional in tone and in the use of language . As with other forms of college-level academic writing, declarative statements that convey information, provide a fact, or offer an explanation or any recommended courses of action should be based on evidence. If allowed by your professor, any external sources used to support your analysis, such as course readings, should be properly cited under a list of references. The organization and structure of case analysis papers can vary depending on your professor’s preferred format, but its structure generally follows the steps used for analyzing the case.

Introduction

The introduction should provide a succinct but thorough descriptive overview of the main facts, issues, and core problems of the case . The introduction should also include a brief summary of the most relevant details about the situation and organizational setting. This includes defining the theoretical framework or conceptual model on which any questions were used to frame your analysis.

Following the rules of most college-level research papers, the introduction should then inform the reader how the paper will be organized. This includes describing the major sections of the paper and the order in which they will be presented. Unless you are told to do so by your professor, you do not need to preview your final recommendations in the introduction. U nlike most college-level research papers , the introduction does not include a statement about the significance of your findings because a case analysis assignment does not involve contributing new knowledge about a research problem.

Background Analysis

Background analysis can vary depending on any guiding questions provided by your professor and the underlying concept or theory that the case is based upon. In general, however, this section of your paper should focus on:

• Providing an overarching analysis of problems identified from the case scenario, including identifying events that stakeholders find challenging or troublesome,
• Identifying assumptions made by each stakeholder and any apparent biases they may exhibit,
• Describing any demands or claims made by or forced upon key stakeholders, and
• Highlighting any issues of concern or complaints expressed by stakeholders in response to those demands or claims.

These aspects of the case are often in the form of behavioral responses expressed by individuals or groups within the organizational setting. However, note that problems in a case situation can also be reflected in data [or the lack thereof] and in the decision-making, operational, cultural, or institutional structure of the organization. Additionally, demands or claims can be either internal and external to the organization [e.g., a case analysis involving a president considering arms sales to Saudi Arabia could include managing internal demands from White House advisors as well as demands from members of Congress].

Throughout this section, present all relevant evidence from the case that supports your analysis. Do not simply claim there is a problem, an assumption, a demand, or a concern; tell the reader what part of the case informed how you identified these background elements.

Identification of Problems

In most case analysis assignments, there are problems, and then there are problems . Each problem can reflect a multitude of underlying symptoms that are detrimental to the interests of the organization. The purpose of identifying problems is to teach students how to differentiate between problems that vary in severity, impact, and relative importance. Given this, problems can be described in three general forms: those that must be addressed immediately, those that should be addressed but the impact is not severe, and those that do not require immediate attention and can be set aside for the time being.

All of the problems you identify from the case should be identified in this section of your paper, with a description based on evidence explaining the problem variances. If the assignment asks you to conduct research to further support your assessment of the problems, include this in your explanation. Remember to cite those sources in a list of references. Use specific evidence from the case and apply appropriate concepts, theories, and models discussed in class or in relevant course readings to highlight and explain the key problems [or problem] that you believe must be solved immediately and describe the underlying symptoms and why they are so critical.

Alternative Solutions

This section is where you provide specific, realistic, and evidence-based solutions to the problems you have identified and make recommendations about how to alleviate the underlying symptomatic conditions impacting the organizational setting. For each solution, you must explain why it was chosen and provide clear evidence to support your reasoning. This can include, for example, course readings and class discussions as well as research resources, such as, books, journal articles, research reports, or government documents. In some cases, your professor may encourage you to include personal, anecdotal experiences as evidence to support why you chose a particular solution or set of solutions. Using anecdotal evidence helps promote reflective thinking about the process of determining what qualifies as a core problem and relevant solution .

Throughout this part of the paper, keep in mind the entire array of problems that must be addressed and describe in detail the solutions that might be implemented to resolve these problems.

Recommended Courses of Action

In some case analysis assignments, your professor may ask you to combine the alternative solutions section with your recommended courses of action. However, it is important to know the difference between the two. A solution refers to the answer to a problem. A course of action refers to a procedure or deliberate sequence of activities adopted to proactively confront a situation, often in the context of accomplishing a goal. In this context, proposed courses of action are based on your analysis of alternative solutions. Your description and justification for pursuing each course of action should represent the overall plan for implementing your recommendations.

For each course of action, you need to explain the rationale for your recommendation in a way that confronts challenges, explains risks, and anticipates any counter-arguments from stakeholders. Do this by considering the strengths and weaknesses of each course of action framed in relation to how the action is expected to resolve the core problems presented, the possible ways the action may affect remaining problems, and how the recommended action will be perceived by each stakeholder.

In addition, you should describe the criteria needed to measure how well the implementation of these actions is working and explain which individuals or groups are responsible for ensuring your recommendations are successful. In addition, always consider the law of unintended consequences. Outline difficulties that may arise in implementing each course of action and describe how implementing the proposed courses of action [either individually or collectively] may lead to new problems [both large and small].

Throughout this section, you must consider the costs and benefits of recommending your courses of action in relation to uncertainties or missing information and the negative consequences of success.

The conclusion should be brief and introspective. Unlike a research paper, the conclusion in a case analysis paper does not include a summary of key findings and their significance, a statement about how the study contributed to existing knowledge, or indicate opportunities for future research.

Begin by synthesizing the core problems presented in the case and the relevance of your recommended solutions. This can include an explanation of what you have learned about the case in the context of your answers to the questions provided by your professor. The conclusion is also where you link what you learned from analyzing the case with the course readings or class discussions. This can further demonstrate your understanding of the relationships between the practical case situation and the theoretical and abstract content of assigned readings and other course content.

Problems to Avoid

The literature on case analysis assignments often includes examples of difficulties students have with applying methods of critical analysis and effectively reporting the results of their assessment of the situation. A common reason cited by scholars is that the application of this type of teaching and learning method is limited to applied fields of social and behavioral sciences and, as a result, writing a case analysis paper can be unfamiliar to most students entering college.

After you have drafted your paper, proofread the narrative flow and revise any of these common errors:

• Unnecessary detail in the background section . The background section should highlight the essential elements of the case based on your analysis. Focus on summarizing the facts and highlighting the key factors that become relevant in the other sections of the paper by eliminating any unnecessary information.
• Analysis relies too much on opinion . Your analysis is interpretive, but the narrative must be connected clearly to evidence from the case and any models and theories discussed in class or in course readings. Any positions or arguments you make should be supported by evidence.
• Analysis does not focus on the most important elements of the case . Your paper should provide a thorough overview of the case. However, the analysis should focus on providing evidence about what you identify are the key events, stakeholders, issues, and problems. Emphasize what you identify as the most critical aspects of the case to be developed throughout your analysis. Be thorough but succinct.
• Writing is too descriptive . A paper with too much descriptive information detracts from your analysis of the complexities of the case situation. Questions about what happened, where, when, and by whom should only be included as essential information leading to your examination of questions related to why, how, and for what purpose.
• Inadequate definition of a core problem and associated symptoms . A common error found in case analysis papers is recommending a solution or course of action without adequately defining or demonstrating that you understand the problem. Make sure you have clearly described the problem and its impact and scope within the organizational setting. Ensure that you have adequately described the root causes w hen describing the symptoms of the problem.
• Recommendations lack specificity . Identify any use of vague statements and indeterminate terminology, such as, “A particular experience” or “a large increase to the budget.” These statements cannot be measured and, as a result, there is no way to evaluate their successful implementation. Provide specific data and use direct language in describing recommended actions.
• Unrealistic, exaggerated, or unattainable recommendations . Review your recommendations to ensure that they are based on the situational facts of the case. Your recommended solutions and courses of action must be based on realistic assumptions and fit within the constraints of the situation. Also note that the case scenario has already happened, therefore, any speculation or arguments about what could have occurred if the circumstances were different should be revised or eliminated.

Bee, Lian Song et al. "Business Students' Perspectives on Case Method Coaching for Problem-Based Learning: Impacts on Student Engagement and Learning Performance in Higher Education." Education & Training 64 (2022): 416-432; The Case Analysis . Fred Meijer Center for Writing and Michigan Authors. Grand Valley State University; Georgallis, Panikos and Kayleigh Bruijn. "Sustainability Teaching using Case-Based Debates." Journal of International Education in Business 15 (2022): 147-163; Hawes, Jon M. "Teaching is Not Telling: The Case Method as a Form of Interactive Learning." Journal for Advancement of Marketing Education 5 (Winter 2004): 47-54; Georgallis, Panikos, and Kayleigh Bruijn. "Sustainability Teaching Using Case-based Debates." Journal of International Education in Business 15 (2022): 147-163; .Dean,  Kathy Lund and Charles J. Fornaciari. "How to Create and Use Experiential Case-Based Exercises in a Management Classroom." Journal of Management Education 26 (October 2002): 586-603; Klebba, Joanne M. and Janet G. Hamilton. "Structured Case Analysis: Developing Critical Thinking Skills in a Marketing Case Course." Journal of Marketing Education 29 (August 2007): 132-137, 139; Klein, Norman. "The Case Discussion Method Revisited: Some Questions about Student Skills." Exchange: The Organizational Behavior Teaching Journal 6 (November 1981): 30-32; Mukherjee, Arup. "Effective Use of In-Class Mini Case Analysis for Discovery Learning in an Undergraduate MIS Course." The Journal of Computer Information Systems 40 (Spring 2000): 15-23; Pessoa, Silviaet al. "Scaffolding the Case Analysis in an Organizational Behavior Course: Making Analytical Language Explicit." Journal of Management Education 46 (2022): 226-251: Ramsey, V. J. and L. D. Dodge. "Case Analysis: A Structured Approach." Exchange: The Organizational Behavior Teaching Journal 6 (November 1981): 27-29; Schweitzer, Karen. "How to Write and Format a Business Case Study." ThoughtCo. https://www.thoughtco.com/how-to-write-and-format-a-business-case-study-466324 (accessed December 5, 2022); Reddy, C. D. "Teaching Research Methodology: Everything's a Case." Electronic Journal of Business Research Methods 18 (December 2020): 178-188; Volpe, Guglielmo. "Case Teaching in Economics: History, Practice and Evidence." Cogent Economics and Finance 3 (December 2015). doi:https://doi.org/10.1080/23322039.2015.1120977.

Writing Tip

Ca se Study and Case Analysis Are Not the Same!

Confusion often exists between what it means to write a paper that uses a case study research design and writing a paper that analyzes a case; they are two different types of approaches to learning in the social and behavioral sciences. Professors as well as educational researchers contribute to this confusion because they often use the term "case study" when describing the subject of analysis for a case analysis paper. But you are not studying a case for the purpose of generating a comprehensive, multi-faceted understanding of a research problem. R ather, you are critically analyzing a specific scenario to argue logically for recommended solutions and courses of action that lead to optimal outcomes applicable to professional practice.

To avoid any confusion, here are twelve characteristics that delineate the differences between writing a paper using the case study research method and writing a case analysis paper:

• Case study is a method of in-depth research and rigorous inquiry ; case analysis is a reliable method of teaching and learning . A case study is a modality of research that investigates a phenomenon for the purpose of creating new knowledge, solving a problem, or testing a hypothesis using empirical evidence derived from the case being studied. Often, the results are used to generalize about a larger population or within a wider context. The writing adheres to the traditional standards of a scholarly research study. A case analysis is a pedagogical tool used to teach students how to reflect and think critically about a practical, real-life problem in an organizational setting.
• The researcher is responsible for identifying the case to study; a case analysis is assigned by your professor . As the researcher, you choose the case study to investigate in support of obtaining new knowledge and understanding about the research problem. The case in a case analysis assignment is almost always provided, and sometimes written, by your professor and either given to every student in class to analyze individually or to a small group of students, or students select a case to analyze from a predetermined list.
• A case study is indeterminate and boundless; a case analysis is predetermined and confined . A case study can be almost anything [see item 9 below] as long as it relates directly to examining the research problem. This relationship is the only limit to what a researcher can choose as the subject of their case study. The content of a case analysis is determined by your professor and its parameters are well-defined and limited to elucidating insights of practical value applied to practice.
• Case study is fact-based and describes actual events or situations; case analysis can be entirely fictional or adapted from an actual situation . The entire content of a case study must be grounded in reality to be a valid subject of investigation in an empirical research study. A case analysis only needs to set the stage for critically examining a situation in practice and, therefore, can be entirely fictional or adapted, all or in-part, from an actual situation.
• Research using a case study method must adhere to principles of intellectual honesty and academic integrity; a case analysis scenario can include misleading or false information . A case study paper must report research objectively and factually to ensure that any findings are understood to be logically correct and trustworthy. A case analysis scenario may include misleading or false information intended to deliberately distract from the central issues of the case. The purpose is to teach students how to sort through conflicting or useless information in order to come up with the preferred solution. Any use of misleading or false information in academic research is considered unethical.
• Case study is linked to a research problem; case analysis is linked to a practical situation or scenario . In the social sciences, the subject of an investigation is most often framed as a problem that must be researched in order to generate new knowledge leading to a solution. Case analysis narratives are grounded in real life scenarios for the purpose of examining the realities of decision-making behavior and processes within organizational settings. A case analysis assignments include a problem or set of problems to be analyzed. However, the goal is centered around the act of identifying and evaluating courses of action leading to best possible outcomes.
• The purpose of a case study is to create new knowledge through research; the purpose of a case analysis is to teach new understanding . Case studies are a choice of methodological design intended to create new knowledge about resolving a research problem. A case analysis is a mode of teaching and learning intended to create new understanding and an awareness of uncertainty applied to practice through acts of critical thinking and reflection.
• A case study seeks to identify the best possible solution to a research problem; case analysis can have an indeterminate set of solutions or outcomes . Your role in studying a case is to discover the most logical, evidence-based ways to address a research problem. A case analysis assignment rarely has a single correct answer because one of the goals is to force students to confront the real life dynamics of uncertainly, ambiguity, and missing or conflicting information within professional practice. Under these conditions, a perfect outcome or solution almost never exists.
• Case study is unbounded and relies on gathering external information; case analysis is a self-contained subject of analysis . The scope of a case study chosen as a method of research is bounded. However, the researcher is free to gather whatever information and data is necessary to investigate its relevance to understanding the research problem. For a case analysis assignment, your professor will often ask you to examine solutions or recommended courses of action based solely on facts and information from the case.
• Case study can be a person, place, object, issue, event, condition, or phenomenon; a case analysis is a carefully constructed synopsis of events, situations, and behaviors . The research problem dictates the type of case being studied and, therefore, the design can encompass almost anything tangible as long as it fulfills the objective of generating new knowledge and understanding. A case analysis is in the form of a narrative containing descriptions of facts, situations, processes, rules, and behaviors within a particular setting and under a specific set of circumstances.
• Case study can represent an open-ended subject of inquiry; a case analysis is a narrative about something that has happened in the past . A case study is not restricted by time and can encompass an event or issue with no temporal limit or end. For example, the current war in Ukraine can be used as a case study of how medical personnel help civilians during a large military conflict, even though circumstances around this event are still evolving. A case analysis can be used to elicit critical thinking about current or future situations in practice, but the case itself is a narrative about something finite and that has taken place in the past.
• Multiple case studies can be used in a research study; case analysis involves examining a single scenario . Case study research can use two or more cases to examine a problem, often for the purpose of conducting a comparative investigation intended to discover hidden relationships, document emerging trends, or determine variations among different examples. A case analysis assignment typically describes a stand-alone, self-contained situation and any comparisons among cases are conducted during in-class discussions and/or student presentations.

The Case Analysis . Fred Meijer Center for Writing and Michigan Authors. Grand Valley State University; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Ramsey, V. J. and L. D. Dodge. "Case Analysis: A Structured Approach." Exchange: The Organizational Behavior Teaching Journal 6 (November 1981): 27-29; Yin, Robert K. Case Study Research and Applications: Design and Methods . 6th edition. Thousand Oaks, CA: Sage, 2017; Crowe, Sarah et al. “The Case Study Approach.” BMC Medical Research Methodology 11 (2011):  doi: 10.1186/1471-2288-11-100; Yin, Robert K. Case Study Research: Design and Methods . 4th edition. Thousand Oaks, CA: Sage Publishing; 1994.

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14 Market Research Examples

This article was originally published in the MarketingSherpa email newsletter .

Example #1: National bank’s A/B testing

You can learn what customers want by conducting experiments on real-life customer decisions using A/B testing. When you ensure your tests do not have any validity threats, the information you garner can offer very reliable insights into customer behavior.

Here’s an example from Flint McGlaughlin, CEO of MarketingSherpa and MECLABS Institute, and the creator of its  online marketing course .

A national bank was working with MECLABS to discover how to increase the number of sign-ups for new checking accounts.

Customers who were interested in checking accounts could click on an “Open in Minutes” link on the bank’s homepage.

Creative Sample #1: Anonymized bank homepage

After clicking on the homepage link, visitors were taken to a four-question checking account selector tool.

Creative Sample #2: Original checking account landing page — account recommendation selector tool

After filling out the selector tool, visitors were taken to a results page that included a suggested package (“Best Choice”) along with a secondary option (“Second Choice”). The results page had several calls to action (CTAs). Website visitors were able to select an account and begin pre-registration (“Open Now”) or find out more information about the account (“Learn More”), go back and change their answers (“Go back and change answers”), or manually browse other checking options (“Other Checking Options”).

Creative Sample #3: Original checking account landing page — account recommendation selector tool results page

After going through the experience, the MECLABS team hypothesized that the selector tool wasn’t really delivering on the expectation the customer had after clicking on the “Open in Minutes” CTA. They created two treatments (new versions) and tested them against the control experience.

In the first treatment, the checking selector tool was removed, and instead, customers were directly presented with three account options in tabs from which customers could select.

Creative Sample #4: Checking account landing page Treatment #1

The second treatment’s landing page focused on a single product and had only one CTA. The call-to-action was similar to the CTA customers clicked on the homepage to get to this page — “Open Now.”

Creative Sample #5: Checking account landing page Treatment #2

Both treatments increased account applications compared to the control landing page experience, with Treatment #2 generating 65% more applicants at a 98% level of confidence.

Creative Sample #6: Results of bank experiment that used A/B testing

You’ll note the Level of Confidence in the results. With any research tactic or tool you use to learn about customers, you have to consider whether the information you’re getting really represents most customers, or if you’re just seeing outliers or random chance.

With a high Level of Confidence like this, it is more likely the results actually represent a true difference between the control and treatment landing pages and that the results aren’t just a random event.

The other factor to consider is — testing in and of itself will not produce results. You have to use testing as research to actually learn about the customer and then make changes to better serve the customer.

In the video How to Discover Exactly What the Customer Wants to See on the Next Click: 3 critical skills every marketer must master , McGlaughlin discussed this national bank experiment and explained how to use prioritization, identification and deduction to discover what your customers want.

This example was originally published in Marketing Research: 5 examples of discovering what customers want .

Example #2: Consumer Reports’ market intelligence research from third-party sources

The first example covers A/B testing. But keep in mind, ill-informed A/B testing isn’t market research, it’s just hoping for insights from random guesses.

In other words, A/B testing in a vacuum does not provide valuable information about customers. What you are testing is crucial, and then A/B testing is a means to help better understand whether insights you have about the customer are either validated or refuted by actual customer behavior. So it’s important to start with some research into potential customers and competitors to inform your A/B tests.

For example, when MECLABS and MarketingExperiments (sister publisher to MarketingSherpa) worked with Consumer Reports on a public, crowdsourced A/B test, we provided a market intelligence report to our audience to help inform their test suggestions.

Every successful marketing test should confirm or deny an assumption about the customer. You need enough knowledge about the customer to create marketing messages you think will be effective.

For this public experiment to help marketers improve their split testing abilities, we had a real customer to work with — donors to Consumer Reports.

To help our audience better understand the customer, the MECLABS Marketing Intelligence team created the 26-page ConsumerReports Market Intelligence Research document (which you can see for yourself at that link).

This example was originally published in Calling All Writers and Marketers: Write the most effective copy for this Consumer Reports email and win a MarketingSherpa Summit package and Consumer Reports Value Proposition Test: What you can learn from a 29% drop in clickthrough .

Example #3: Virtual event company’s conversation

What if you don’t have the budget for A/B testing? Or any of the other tactics in this article?

Well, if you’re like most people you likely have some relationships with other human beings. A significant other, friends, family, neighbors, co-workers, customers, a nemesis (“Newman!”). While conducting market research by talking to these people has several validity threats, it at least helps you get out of your own head and identify some of your blind spots.

WebBabyShower.com’s lead magnet is a PDF download of a baby shower thank you card ‘swipe file’ plus some extras. “Women want to print it out and have it where they are writing cards, not have a laptop open constantly,” said Kurt Perschke, owner, WebBabyShower.com.

That is not a throwaway quote from Perschke. That is a brilliant insight, so I want to make sure we don’t overlook it. By better understanding customer behavior, you can better serve customers and increase results.

However, you are not your customer. So you must bridge the gap between you and them.

Often you hear marketers or business leaders review an ad or discuss a marketing campaign and say, “Well, I would never read that entire ad” or “I would not be interested in that promotion.” To which I say … who cares? Who cares what you would do? If you are not in the ideal customer set, sorry to dent your ego, but you really don’t matter. Only the customer does.

Perschke is one step ahead of many marketers and business leaders because he readily understands this. “Owning a business whose customers are 95% women has been a great education for me,” he said.

So I had to ask him, how did he get this insight into his customers’ behavior? Frankly, it didn’t take complex market research. He was just aware of this disconnect he had with the customer, and he was alert for ways to bridge the gap. “To be honest, I first saw that with my wife. Then we asked a few customers, and they confirmed it’s what they did also. Writing notes by hand is viewed as a ‘non-digital’ activity and reading from a laptop kinda spoils the mood apparently,” he said.

Back to WebBabyShower. “We've seen a [more than] 100% increase in email signups using this method, which was both inexpensive and evergreen,” Perschke said.

This example was originally published in Digital Marketing: Six specific examples of incentives that worked .

Example #4: Spiceworks Ziff Davis’ research-informed content marketing

Marketing research isn’t just to inform products and advertising messages. Market research can also give your brand a leg up in another highly competitive space – content marketing.

Don’t just jump in and create content expecting it to be successful just because it’s “free.” Conducting research beforehand can help you understand what your potential audience already receives and where they might need help but are currently being served.

When Spiceworks Ziff Davis (SWZD) published its annual State of IT report, it invested months in conducting primary market research, analyzing year-over-year trends, and finally producing the actual report.

“Before getting into the nuts and bolts of writing an asset, look at market shifts and gaps that complement your business and marketing objectives. Then, you can begin to plan, research, write, review and finalize an asset,” said Priscilla Meisel, Content Marketing Director, SWZD.

This example was originally published in Marketing Writing: 3 simple tips that can help any marketer improve results (even if you’re not a copywriter) .

Example #5: Business travel company’s guerilla research

There are many established, expensive tactics you can use to better understand customers.

But if you don’t have the budget for those tactics, and don’t know any potential customers, you might want to brainstorm creative ways you can get valuable information from the right customer target set.

Here’s an example from a former client of Mitch McCasland, Founding Partner and Director, Brand Inquiry Partners. The company sold a product related to frequent business flyers and was interested in finding out information on people who travel for a living. They needed consumer feedback right away.

“I suggested that they go out to the airport with a bunch of 20-dollar bills and wait outside a gate for passengers to come off their flight,” McCasland said. When people came off the flight, they were politely asked if they would answer a few questions in exchange for the incentive (the $20). By targeting the first people off the flight they had a high likelihood of reaching the first-class passengers.

This example was originally published in Guerrilla Market Research Expert Mitch McCasland Tells How You Can Conduct Quick (and Cheap) Research .

Example #6: Intel’s market research database

When conducting market research, it is crucial to organize your data in a way that allows you to easily and quickly report on it. This is especially important for qualitative studies where you are trying to do more than just quantify the data, but need to manage it so it is easier to analyze.

Anne McClard, Senior Researcher, Doxus worked with Shauna Pettit-Brown of Intel on a research project to understand the needs of mobile application developers throughout the world.

Intel needed to be able to analyze the data from several different angles, including segment and geography, a daunting task complicated by the number of interviews, interviewers, and world languages.

“The interviews were about an hour long, and pretty substantial,” McClard says. So, she needed to build a database to organize the transcripts in a way that made sense.

Different types of data are useful for different departments within a company; once your database is organized you can sort it by various threads.

The Intel study had three different internal sponsors. "When it came to doing the analysis, we ended up creating multiple versions of the presentation targeted to individual audiences," Pettit-Brown says.

The organized database enabled her to go back into the data set to answer questions specific to the interests of the three different groups.

This example was originally published in 4 Steps to Building a Qualitative Market Research Database That Works Better .

Example #7: National security survey’s priming

When conducting market research surveys, the way you word your questions can affect customers’ response. Even the way you word previous questions can put customers in a certain mindset that will skew their answers.

For example, when people were asked if they thought the U.S. government should spend money on an anti-missile shield, the results appeared fairly conclusive. Sixty-four percent of those surveyed thought the country should and only six percent were unsure, according to Opinion Makers: An Insider Exposes the Truth Behind the Polls .

But when pollsters added the option, "...or are you unsure?" the level of uncertainty leaped from six percent to 33 percent. When they asked whether respondents would be upset if the government took the opposite course of action from their selection, 59 percent either didn’t have an opinion or didn’t mind if the government did something differently.

This is an example of how the way you word questions can change a survey’s results. You want survey answers to reflect customer’s actual sentiments that are as free of your company’s previously held biases as possible.

This example was originally published in Are Surveys Misleading? 7 Questions for Better Market Research .

Example #8: Visa USA’s approach to getting an accurate answer

As mentioned in the previous example, the way you ask customers questions can skew their responses with your own biases.

However, the way you ask questions to potential customers can also illuminate your understanding of them. Which is why companies field surveys to begin with.

“One thing you learn over time is how to structure questions so you have a greater likelihood of getting an accurate answer. For example, when we want to find out if people are paying off their bills, we'll ask them to think about the card they use most often. We then ask what the balance was on their last bill after they paid it,” said Michael Marx, VP Research Services, Visa USA.

This example was originally published in Tips from Visa USA's Market Research Expert Michael Marx .

Example #9: Hallmark’s private members-only community

Online communities are a way to interact with and learn from customers. Hallmark created a private members-only community called Idea Exchange (an idea you could replicate with a Facebook or LinkedIn Group).

The community helped the greeting cards company learn the customer’s language.

“Communities…let consumers describe issues in their own terms,” explained Tom Brailsford, Manager of Advancing Capabilities, Hallmark Cards. “Lots of times companies use jargon internally.”

At Hallmark they used to talk internally about “channels” of distribution. But consumers talk about stores, not channels. It is much clearer to ask consumers about the stores they shop in than what channels they shop.

For example, Brailsford clarified, “We say we want to nurture, inspire, and lift one’s spirits. We use those terms, and the communities have defined those terms for us. So we have learned how those things play out in their lives. It gives us a much richer vocabulary to talk about these things.”

This example was originally published in Third Year Results from Hallmark's Online Market Research Experiment .

Example #10: L'Oréal’s social media listening

If you don’t want the long-term responsibility that comes with creating an online community, you can use social media listening to understand how customers talking about your products and industry in their own language.

In 2019, L'Oréal felt the need to upgrade one of its top makeup products – L'Oréal Paris Alliance Perfect foundation. Both the formula and the product communication were outdated – multiple ingredients had emerged on the market along with competitive products made from those ingredients.

These new ingredients and products were overwhelming consumers. After implementing new formulas, the competitor brands would advertise their ingredients as the best on the market, providing almost magical results.

So the team at L'Oréal decided to research their consumers’ expectations instead of simply crafting a new formula on their own. The idea was to understand not only which active ingredients are credible among the audience, but also which particular words they use while speaking about foundations in general.

The marketing team decided to combine two research methods: social media listening and traditional questionnaires.

“For the most part, we conduct social media listening research when we need to find out what our customers say about our brand/product/topic and which words they use to do it. We do conduct traditional research as well and ask questions directly. These surveys are different because we provide a variety of readymade answers that respondents choose from. Thus, we limit them in terms of statements and their wording,” says Marina Tarandiuk, marketing research specialist, L'Oréal Ukraine.

“The key value of social media listening (SML) for us is the opportunity to collect people’s opinions that are as ‘natural’ as possible. When someone leaves a review online, they are in a comfortable environment, they use their ‘own’ language to express themselves, there is no interviewer standing next to them and potentially causing shame for their answer. The analytics of ‘natural’ and honest opinions of our customers enables us to implement the results in our communication and use the same language as them,” Tarandiuk said.

The team worked with a social media listening tool vendor to identify the most popular, in-demand ingredients discussed online and detect the most commonly used words and phrases to create a “consumer glossary.”

Questionnaires had to confirm all the hypotheses and insights found while monitoring social media. This part was performed in-house with the dedicated team. They created custom questionnaires aiming to narrow down all the data to a maximum of three variants that could become the base for the whole product line.

“One of our recent studies had a goal to find out which words our clients used to describe positive and negative qualities of [the] foundation. Due to a change in [the] product’s formula, we also decided to change its communication. Based on the opinions of our customers, we can consolidate the existing positive ideas that our clients have about the product,” Tarandiuk said.

To find the related mentions, the team monitored not only the products made by L'Oréal but also the overall category. “The search query contained both brand names and general words like foundation, texture, smell, skin, pores, etc. The problem was that this approach ended up collecting thousands of mentions, not all of which were relevant to the topic,” said Elena Teselko, content marketing manager, YouScan (L'Oréal’s social media listening tool).

So the team used artificial intelligence-based tagging that divided mentions according to the category, features, or product type.

This approach helped the team discover that customers valued such foundation features as not clogging pores, a light texture, and not spreading. Meanwhile, the most discussed and appreciated cosmetics component was hyaluronic acid.

These exact phrases, found with the help of social media monitoring, were later used for marketing communication.

Creative Sample #7: Marketing communicating for personal care company with messaging based on discoveries from market research

“Doing research and detecting audience’s interests BEFORE starting a campaign is an approach that dramatically lowers any risks and increases chances that the campaign would be appreciated by customers,” Teselko said.

This example was originally published in B2C Branding: 3 quick case studies of enhancing the brand with a better customer experience .

Example #11: Levi’s ethnographic research

In a focus group or survey, you are asking customers to explain something they may not even truly understand. Could be why they bought a product. Or what they think of your competitor.

Ethnographic research is a type of anthropology in which you go into customers’ homes or places of business and observe their actual behavior, behavior they may not understand well enough to explain to you.

While cost prohibitive to many brands, and simply unfeasible for others, it can elicit new insights into your customers.

Michael Perman, Senior Director Cultural Insights, Levi Strauss & Co. uses both quantitative and qualitative research on a broad spectrum, but when it comes to gathering consumer insight, he focuses on in-depth ethnographic research provided by partners who specialize in getting deep into the “nooks and crannies of consumer life in America and around the world.” For example, his team spends time in consumers’ homes and in their closets. They shop with consumers, looking for the reality of a consumer’s life and identifying themes that will enable designers and merchandisers to better understand and anticipate consumer needs.

Perman then puts together multi-sensory presentations that illustrate the findings of research. For example, “we might recreate a teenager’s bedroom and show what a teenage girl might have on her dresser.”

This example was originally published in How to Get Your Company to Pay Attention to Market Research Results: Tips from Levi Strauss .

Example #12: eBags’ ethnographic research

Ethnographic research isn’t confined to a physical goods brand like Levi’s. Digital brands can engage in this form of anthropology as well.

While usability testing in a lab is useful, it does miss some of the real-world environmental factors that play a part in the success of a website. Usability testing alone didn’t create a clear enough picture for Gregory Casey, User Experience Designer and Architect, eBags.

“After we had designed our mobile and tablet experience, I wanted to run some contextual user research, which basically meant seeing how people used it in the wild, seeing how people are using it in their homes. So that’s exactly what I did,” Gregory said.

He found consumers willing to open their home to him and be tested in their normal environment. This meant factors like the television, phone calls and other family members played a part in how they experienced the eBags mobile site.

“During these interview sessions, a lot of times we were interrupted by, say, a child coming over and the mother having to do something for the kid … The experience isn’t sovereign. It’s not something where they just sit down, work through a particular user flow and complete their interaction,” Gregory said.

By watching users work through the site as they would in their everyday life, Gregory got to see what parts of the site they actually use.

This example was originally published in Mobile Marketing: 4 takeaways on how to improve your mobile shopping experience beyond just responsive design .

Example #13: John Deere’s shift from product-centric market research to consumer-centric research

One of the major benefits of market research is to overcome company blind spots. However, if you start with your blind spots – i.e., a product focus – you will blunt the effectiveness of your market research.

In the past, “they’d say, Here’s the product, find out how people feel about it,” explained David van Nostrand, Manager, John Deere's Global Market Research. “A lot of companies do that.” Instead, they should be saying, “Let's start with the customers: what do they want, what do they need?”

The solution? A new in-house program called “Category Experts” brings the product-group employees over as full team members working on specific research projects with van Nostrand’s team.

These staffers handle items that don’t require a research background: scheduling, meetings, logistics, communication and vendor management. The actual task they handle is less important than the fact that they serve as human cross-pollinators, bringing consumer-centric sensibility back to their product- focused groups.

For example, if van Nostrand’s team is doing research about a vehicle, they bring in staffers from the Vehicles product groups. “The information about vehicle consumers needs to be out there in the vehicle marketing groups, not locked in here in the heads of the researchers.”

This example was originally published in How John Deere Increased Mass Consumer Market Share by Revamping its Market Research Tactics .

Example #14: LeapFrog’s market research involvement throughout product development (not just at the beginning and the end)

Market research is sometimes thought of as a practice that can either inform the development of a product, or research consumer attitudes about developed products. But what about the middle?

Once the creative people begin working on product designs, the LeapFrog research department stays involved.

They have a lab onsite where they bring moms and kids from the San Francisco Bay area to test preliminary versions of the products. “We do a lot of hands-on, informal qualitative work with kids,” said Craig Spitzer, VP Marketing Research, LeapFrog. “Can they do what they need to do to work the product? Do they go from step A to B to C, or do they go from A to C to B?”

When designing the LeapPad Learning System, for example, the prototype went through the lab “a dozen times or so,” he says.

A key challenge for the research department is keeping and building the list of thousands of families who have agreed to be on call for testing. “We've done everything from recruiting on the Internet to putting out fliers in local schools, working through employees whose kids are in schools, and milking every connection we have,” Spitzer says.

Kids who test products at the lab are compensated with a free, existing product rather than a promise of the getting the product they're testing when it is released in the future.

This example was originally published in How LeapFrog Uses Marketing Research to Launch New Products .

Related resources

The Marketer’s Blind Spot: 3 ways to overcome the marketer’s greatest obstacle to effective messaging

Get Your Free Test Discovery Tool to Help Log all the Results and Discoveries from Your Company’s Marketing Tests

Marketing Research: 5 examples of discovering what customers want

Online Marketing Tests: How do you know you’re really learning anything?

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Gender pay gap in U.S. hasn’t changed much in two decades

The gender gap in pay has remained relatively stable in the United States over the past 20 years or so. In 2022, women earned an average of 82% of what men earned, according to a new Pew Research Center analysis of median hourly earnings of both full- and part-time workers. These results are similar to where the pay gap stood in 2002, when women earned 80% as much as men.

As has long been the case, the wage gap is smaller for workers ages 25 to 34 than for all workers 16 and older. In 2022, women ages 25 to 34 earned an average of 92 cents for every dollar earned by a man in the same age group – an 8-cent gap. By comparison, the gender pay gap among workers of all ages that year was 18 cents.

While the gender pay gap has not changed much in the last two decades, it has narrowed considerably when looking at the longer term, both among all workers ages 16 and older and among those ages 25 to 34. The estimated 18-cent gender pay gap among all workers in 2022 was down from 35 cents in 1982. And the 8-cent gap among workers ages 25 to 34 in 2022 was down from a 26-cent gap four decades earlier.

The gender pay gap measures the difference in median hourly earnings between men and women who work full or part time in the United States. Pew Research Center’s estimate of the pay gap is based on an analysis of Current Population Survey (CPS) monthly outgoing rotation group files ( IPUMS ) from January 1982 to December 2022, combined to create annual files. To understand how we calculate the gender pay gap, read our 2013 post, “How Pew Research Center measured the gender pay gap.”

The COVID-19 outbreak affected data collection efforts by the U.S. government in its surveys, especially in 2020 and 2021, limiting in-person data collection and affecting response rates. It is possible that some measures of economic outcomes and how they vary across demographic groups are affected by these changes in data collection.

In addition to findings about the gender wage gap, this analysis includes information from a Pew Research Center survey about the perceived reasons for the pay gap, as well as the pressures and career goals of U.S. men and women. The survey was conducted among 5,098 adults and includes a subset of questions asked only for 2,048 adults who are employed part time or full time, from Oct. 10-16, 2022. Everyone who took part is a member of the Center’s American Trends Panel (ATP), an online survey panel that is recruited through national, random sampling of residential addresses. This way nearly all U.S. adults have a chance of selection. The survey is weighted to be representative of the U.S. adult population by gender, race, ethnicity, partisan affiliation, education and other categories. Read more about the ATP’s methodology .

Here are the questions used in this analysis, along with responses, and its methodology .

The  U.S. Census Bureau has also analyzed the gender pay gap, though its analysis looks only at full-time workers (as opposed to full- and part-time workers). In 2021, full-time, year-round working women earned 84% of what their male counterparts earned, on average, according to the Census Bureau’s most recent analysis.

Much of the gender pay gap has been explained by measurable factors such as educational attainment, occupational segregation and work experience. The narrowing of the gap over the long term is attributable in large part to gains women have made in each of these dimensions.

Related: The Enduring Grip of the Gender Pay Gap

Even though women have increased their presence in higher-paying jobs traditionally dominated by men, such as professional and managerial positions, women as a whole continue to be overrepresented in lower-paying occupations relative to their share of the workforce. This may contribute to gender differences in pay.

Other factors that are difficult to measure, including gender discrimination, may also contribute to the ongoing wage discrepancy.

Perceived reasons for the gender wage gap

When asked about the factors that may play a role in the gender wage gap, half of U.S. adults point to women being treated differently by employers as a major reason, according to a Pew Research Center survey conducted in October 2022. Smaller shares point to women making different choices about how to balance work and family (42%) and working in jobs that pay less (34%).

There are some notable differences between men and women in views of what’s behind the gender wage gap. Women are much more likely than men (61% vs. 37%) to say a major reason for the gap is that employers treat women differently. And while 45% of women say a major factor is that women make different choices about how to balance work and family, men are slightly less likely to hold that view (40% say this).

Parents with children younger than 18 in the household are more likely than those who don’t have young kids at home (48% vs. 40%) to say a major reason for the pay gap is the choices that women make about how to balance family and work. On this question, differences by parental status are evident among both men and women.

Views about reasons for the gender wage gap also differ by party. About two-thirds of Democrats and Democratic-leaning independents (68%) say a major factor behind wage differences is that employers treat women differently, but far fewer Republicans and Republican leaners (30%) say the same. Conversely, Republicans are more likely than Democrats to say women’s choices about how to balance family and work (50% vs. 36%) and their tendency to work in jobs that pay less (39% vs. 30%) are major reasons why women earn less than men.

Democratic and Republican women are more likely than their male counterparts in the same party to say a major reason for the gender wage gap is that employers treat women differently. About three-quarters of Democratic women (76%) say this, compared with 59% of Democratic men. And while 43% of Republican women say unequal treatment by employers is a major reason for the gender wage gap, just 18% of GOP men share that view.

Pressures facing working women and men

Family caregiving responsibilities bring different pressures for working women and men, and research has shown that being a mother can reduce women’s earnings , while fatherhood can increase men’s earnings .

Employed women and men are about equally likely to say they feel a great deal of pressure to support their family financially and to be successful in their jobs and careers, according to the Center’s October survey. But women, and particularly working mothers, are more likely than men to say they feel a great deal of pressure to focus on responsibilities at home.

About half of employed women (48%) report feeling a great deal of pressure to focus on their responsibilities at home, compared with 35% of employed men. Among working mothers with children younger than 18 in the household, two-thirds (67%) say the same, compared with 45% of working dads.

When it comes to supporting their family financially, similar shares of working moms and dads (57% vs. 62%) report they feel a great deal of pressure, but this is driven mainly by the large share of unmarried working mothers who say they feel a great deal of pressure in this regard (77%). Among those who are married, working dads are far more likely than working moms (60% vs. 43%) to say they feel a great deal of pressure to support their family financially. (There were not enough unmarried working fathers in the sample to analyze separately.)

About four-in-ten working parents say they feel a great deal of pressure to be successful at their job or career. These findings don’t differ by gender.

Gender differences in job roles, aspirations

Overall, a quarter of employed U.S. adults say they are currently the boss or one of the top managers where they work, according to the Center’s survey. Another 33% say they are not currently the boss but would like to be in the future, while 41% are not and do not aspire to be the boss or one of the top managers.

Men are more likely than women to be a boss or a top manager where they work (28% vs. 21%). This is especially the case among employed fathers, 35% of whom say they are the boss or one of the top managers where they work. (The varying attitudes between fathers and men without children at least partly reflect differences in marital status and educational attainment between the two groups.)

In addition to being less likely than men to say they are currently the boss or a top manager at work, women are also more likely to say they wouldn’t want to be in this type of position in the future. More than four-in-ten employed women (46%) say this, compared with 37% of men. Similar shares of men (35%) and women (31%) say they are not currently the boss but would like to be one day. These patterns are similar among parents.

Note: This is an update of a post originally published on March 22, 2019. Anna Brown and former Pew Research Center writer/editor Amanda Barroso contributed to an earlier version of this analysis. Here are the questions used in this analysis, along with responses, and its methodology .

What is the gender wage gap in your metropolitan area? Find out with our pay gap calculator

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• Published: 15 April 2024

What is quality in long covid care? Lessons from a national quality improvement collaborative and multi-site ethnography

• Trisha Greenhalgh   ORCID: orcid.org/0000-0003-2369-8088 1 ,
• Julie L. Darbyshire 1 ,
• Cassie Lee 2 ,
• Emma Ladds 1 &
• Jenny Ceolta-Smith 3  

BMC Medicine volume  22 , Article number:  159 ( 2024 ) Cite this article

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Metrics details

Long covid (post covid-19 condition) is a complex condition with diverse manifestations, uncertain prognosis and wide variation in current approaches to management. There have been calls for formal quality standards to reduce a so-called “postcode lottery” of care. The original aim of this study—to examine the nature of quality in long covid care and reduce unwarranted variation in services—evolved to focus on examining the reasons why standardizing care was so challenging in this condition.

In 2021–2023, we ran a quality improvement collaborative across 10 UK sites. The dataset reported here was mostly but not entirely qualitative. It included data on the origins and current context of each clinic, interviews with staff and patients, and ethnographic observations at 13 clinics (50 consultations) and 45 multidisciplinary team (MDT) meetings (244 patient cases). Data collection and analysis were informed by relevant lenses from clinical care (e.g. evidence-based guidelines), improvement science (e.g. quality improvement cycles) and philosophy of knowledge.

Participating clinics made progress towards standardizing assessment and management in some topics; some variation remained but this could usually be explained. Clinics had different histories and path dependencies, occupied a different place in their healthcare ecosystem and served a varied caseload including a high proportion of patients with comorbidities. A key mechanism for achieving high-quality long covid care was when local MDTs deliberated on unusual, complex or challenging cases for which evidence-based guidelines provided no easy answers. In such cases, collective learning occurred through idiographic (case-based) reasoning , in which practitioners build lessons from the particular to the general. This contrasts with the nomothetic reasoning implicit in evidence-based guidelines, in which reasoning is assumed to go from the general (e.g. findings of clinical trials) to the particular (management of individual patients).

Not all variation in long covid services is unwarranted. Largely because long covid’s manifestations are so varied and comorbidities common, generic “evidence-based” standards require much individual adaptation. In this complex condition, quality improvement resources may be productively spent supporting MDTs to optimise their case-based learning through interdisciplinary discussion. Quality assessment of a long covid service should include review of a sample of individual cases to assess how guidelines have been interpreted and personalized to meet patients’ unique needs.

Study registration

NCT05057260, ISRCTN15022307.

Peer Review reports

The term “long covid” [ 1 ] means prolonged symptoms following SARS-CoV-2 infection not explained by an alternative diagnosis [ 2 ]. It embraces the US term “post-covid conditions” (symptoms beyond 4 weeks) [ 3 ], the UK terms “ongoing symptomatic covid-19” (symptoms lasting 4–12 weeks) and “post covid-19 syndrome” (symptoms beyond 12 weeks) [ 4 ] and the World Health Organization’s “post covid-19 condition” (symptoms occurring beyond 3 months and persisting for at least 2 months) [ 5 ]. Long covid thus defined is extremely common. In UK, for example, 1.8 million of a population of 67 million met the criteria for long covid in early 2023 and 41% of these had been unwell for more than 2 years [ 6 ].

Long covid is characterized by a constellation of symptoms which may include breathlessness, fatigue, muscle and joint pain, chest pain, memory loss and impaired concentration (“brain fog”), sleep disturbance, depression, anxiety, palpitations, dizziness, gastrointestinal problems such as diarrhea, skin rashes and allergy to food or drugs [ 2 ]. These lead to difficulties with essential daily activities such as washing and dressing, impaired exercise tolerance and ability to work, and reduced quality of life [ 2 , 7 , 8 ]. Symptoms typically cluster (e.g. in different patients, long covid may be dominated by fatigue, by breathlessness or by palpitations and dizziness) [ 9 , 10 ]. Long covid may follow a fairly constant course or a relapsing and remitting one, perhaps with specific triggers [ 11 ]. Overlaps between fatigue-dominant subtypes of long covid, myalgic encephalomyelitis and chronic fatigue syndrome have been hypothesized [ 12 ] but at the time of writing remain unproven.

Long covid has been a contested condition from the outset. Whilst long-term sequelae following other coronavirus (SARS and MERS) infections were already well-documented [ 13 ], SARS-CoV-2 was originally thought to cause a short-lived respiratory illness from which the patient either died or recovered [ 14 ]. Some clinicians dismissed protracted or relapsing symptoms as due to anxiety or deconditioning, especially if the patient had not had laboratory-confirmed covid-19. People with long covid got together in online groups and shared accounts of their symptoms and experiences of such “gaslighting” in their healthcare encounters [ 15 , 16 ]. Some groups conducted surveys on their members, documenting the wide range of symptoms listed in the previous paragraph and showing that whilst long covid is more commonly a sequel to severe acute covid-19, it can (rarely) follow a mild or even asymptomatic acute infection [ 17 ].

Early publications on long covid depicted a post-pneumonia syndrome which primarily affected patients who had been hospitalized (and sometimes ventilated) [ 18 , 19 ]. Later, covid-19 was recognized to be a multi-organ inflammatory condition (the pneumonia, for example, was reclassified as pneumonitis ) and its long-term sequelae attributed to a combination of viral persistence, dysregulated immune response (including auto-immunity), endothelial dysfunction and immuno-thrombosis, leading to damage to the lining of small blood vessels and (thence) interference with transfer of oxygen and nutrients to vital organs [ 20 , 21 , 22 , 23 , 24 ]. But most such studies were highly specialized, laboratory-based and written primarily for an audience of fellow laboratory researchers. Despite demonstrating mean differences in a number of metabolic variables, they failed to identify a reliable biomarker that could be used routinely in the clinic to rule a diagnosis of long covid in or out. Whilst the evidence base from laboratory studies grew rapidly, it had little influence on clinical management—partly because most long covid clinics had been set up with impressive speed by front-line clinical teams to address an immediate crisis, with little or no input from immunologists, virologists or metabolic specialists [ 25 ].

Studies of the patient experience revealed wide geographical variation in whether any long covid services were provided and (if they were) which patients were eligible for these and what tests and treatments were available [ 26 ]. An interim UK clinical guideline for long covid had been produced at speed and published in December 2020 [ 27 ], but it was uncertain about diagnostic criteria, investigations, treatments and prognosis. Early policy recommendations for long covid services in England, based on wide consultation across UK, had proposed a tiered service with “tier 1” being supported self-management, “tier 2” generalist assessment and management in primary care, “tier 3” specialist rehabilitation or respiratory follow-up with oversight from a consultant physician and “tier 4” tertiary care for patients with complications or complex needs [ 28 ]. In 2021, ring-fenced funding was allocated to establish 90 multidisciplinary long covid clinics in England [ 29 ]; some clinics were also set up with local funding in Scotland and Wales. These clinics varied widely in eligibility criteria, referral pathways, staffing mix (some had no doctors at all) and investigations and treatments offered. A further policy document on improving long covid services was published in 2022 [ 30 ]; it recommended that specialist long covid clinics should continue, though the long-term funding of these services remains uncertain [ 31 ]. To build the evidence base for delivering long covid services, major programs of publicly funded research were commenced in both UK [ 32 ] and USA [ 33 ].

In short, at the time this study began (late 2021), there appeared to be much scope for a program of quality improvement which would capture fast-emerging research findings, establish evidence-based standards and ensure these were rapidly disseminated and consistently adopted across both specialist long covid services and in primary care.

Quality improvement collaboratives

The quality improvement movement in healthcare was born in the early 1980s when clinicians and policymakers US and UK [ 34 , 35 , 36 , 37 ] began to draw on insights from outside the sector [ 38 , 39 , 40 ]. Adapting a total quality management approach that had previously transformed the Japanese car industry, they sought to improve efficiency, reduce waste, shift to treating the upstream causes of problems (hence preventing disease) and help all services approach the standards of excellence achieved by the best. They developed an approach based on (a) understanding healthcare as a complex system (especially its key interdependencies and workflows), (b) analysing and addressing variation within the system, (c) learning continuously from real-world data and (d) developing leaders who could motivate people and help them change structures and processes [ 41 , 42 , 43 , 44 ].

Quality improvement collaboratives (originally termed “breakthrough collaboratives” [ 45 ]), in which representatives from different healthcare organizations come together to address a common problem, identify best practice, set goals, share data and initiate and evaluate improvement efforts [ 46 ], are one model used to deliver system-wide quality improvement. It is widely assumed that these collaboratives work because—and to the extent that—they identify, interpret and implement high-quality evidence (e.g. from randomized controlled trials).

Research on why quality improvement collaboratives succeed or fail has produced the following list of critical success factors: taking a whole-system approach, selecting a topic and goal that fits with organizations’ priorities, fostering a culture of quality improvement (e.g. that quality is everyone’s job), engagement of everyone (including the multidisciplinary clinical team, managers, patients and families) in the improvement effort, clearly defining people’s roles and contribution, engaging people in preliminary groundwork, providing organizational-level support (e.g. chief executive endorsement, protected staff time, training and support for teams, resources, quality-focused human resource practices, external facilitation if needed), training in specific quality improvement techniques (e.g. plan-do-study-act cycle), attending to the human dimension (including cultivating trust and working to ensure shared vision and buy-in), continuously generating reliable data on both processes (e.g. current practice) and outcomes (clinical, satisfaction) and a “learning system” infrastructure in which knowledge that is generated feeds into individual, team and organizational learning [ 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ].

The quality improvement collaborative approach has delivered many successes but it has been criticized at a theoretical level for over-simplifying the social science of human motivation and behaviour and for adopting a somewhat mechanical approach to the study of complex systems [ 55 , 56 ]. Adaptations of the original quality improvement methodology (e.g. from Sweden [ 57 , 58 ]) have placed greater emphasis on human values and meaning-making, on the grounds that reducing the complexities of a system-wide quality improvement effort to a set of abstract and generic “success factors” will miss unique aspects of the case such as historical path dependencies, personalities, framing and meaning-making and micropolitics [ 59 ].

Perhaps this explains why, when the abovementioned factors are met, a quality improvement collaborative’s success is more likely but is not guaranteed, as a systematic review demonstrated [ 60 ]. Some well-designed and well-resourced collaboratives addressing clear knowledge gaps produced few or no sustained changes in key outcome measures [ 49 , 53 , 60 , 61 , 62 ]. To identify why this might be, a detailed understanding of a service’s history, current challenges and contextual constraints is needed. This explains our decision, part-way through the study reported here, to collect rich contextual data on participating sites so as to better explain success or failure of our own collaborative.

Warranted and unwarranted variation in clinical practice

A generation ago, Wennberg described most variation in clinical practice as “unwarranted” (which he defined as variation in the utilization of health care services that cannot be explained by variation in patient illness or patient preferences) [ 63 ]. Others coined the term “postcode lottery” to depict how such variation allegedly impacted on health outcomes [ 64 ]. Wennberg and colleagues’ Atlas of Variation , introduced in 1999 [ 65 ], and its UK equivalent, introduced in 2010 [ 66 ], described wide regional differences in the rates of procedures from arthroscopy to hysterectomy, and were used to prompt services to identify and address examples of under-treatment, mis-treatment and over-treatment. Numerous similar initiatives, mostly based on hospital activity statistics, have been introduced around the world [ 66 , 67 , 68 , 69 ]. Sutherland and Levesque’s proposed framework for analysing variation, for example, has three domains: capacity (broadly, whether sufficient resources are allocated at organizational level and whether individuals have the time and headspace to get involved), evidence (the extent to which evidence-based guidelines exist and are followed), and agency (e.g. whether clinicians are engaged with the issue and the effect of patient choice) [ 70 ].

Whilst it is clearly a good idea to identify unwarranted variation in practice, it is also important to acknowledge that variation can be warranted . The very act of measuring and describing variation carries great rhetorical power, since revealing geographical variation in any chosen metric effectively frames this as a problem with a conceptually simple solution (reducing variation) that will appeal to both politicians and the public [ 71 ]. The temptation to expose variation (e.g. via visualizations such as maps) and address it in mechanistic ways should be resisted until we have fully understood the reasons why it exists, which may include perverse incentives, insufficient opportunities to discuss cases with colleagues, weak or absent feedback on practice, unclear decision processes, contested definitions of appropriate care and professional challenges to guidelines [ 72 ].

Research question, aims and objectives

Research question.

What is quality in long covid care and how can it best be achieved?

To identify best practice and reduce unwarranted variation in UK long covid services.

To explain aspects of variation in long covid services that are or may be warranted.

Our original objectives were to:

Establish a quality improvement collaborative for 10 long covid clinics across UK.

Use quality improvement methods in collaboration with patients and clinic staff to prioritize aspects of care to improve. For each priority topic, identify best (evidence-informed) clinical practice, measure performance in each clinic, compare performance with a best practice benchmark and improve performance.

Produce organizational case studies of participating long covid clinics to explain their origins, evolution, leadership, ethos, population served, patient pathways and place in the wider healthcare ecosystem.

Examine these case studies to explain variation in practice, especially in topics where the quality improvement cycle proves difficult to follow or has limited impact.

The LOCOMOTION study

LOCOMOTION (LOng COvid Multidisciplinary consortium Optimising Treatments and services across the NHS) was a 30-month multi-site case study of 10 long covid clinics (8 in England, 1 in Wales and 1 in Scotland), beginning in 2021, which sought to optimise long covid care. Each clinic offered multidisciplinary care to patients referred from primary or secondary care (and, in some cases, self-referred), and held regular multidisciplinary team (MDT) meetings, mostly online via Microsoft Teams, to discuss cases. A study protocol for LOCOMOTION, with details of ethical approvals, management, governance and patient involvement has been published [ 25 ]. The three main work packages addressed quality improvement, technology-supported patient self-management and phenotyping and symptom clustering. This paper reports on the first work package, focusing mainly on qualitative findings.

Setting up the quality improvement collaborative

We broadly followed standard methodology for “breakthrough” quality improvement collaboratives [ 44 , 45 ], with two exceptions. First, because of geographical distance, continuing pandemic precautions and developments in videoconferencing technology, meetings were held online. Second, unlike in the original breakthrough model, patients were included in the collaborative, reflecting the cultural change towards patient partnerships since the model was originally proposed 40 years ago.

Each site appointed a clinical research fellow (doctor, nurse or allied health professional) funded partly by the LOCOMOTION study and partly with clinical sessions; some were existing staff who were backfilled to take on a research role whilst others were new appointments. The quality improvement meetings were held approximately every 8 weeks on Microsoft Teams and lasted about 2 h; there was an agenda and a chair, and meetings were recorded with consent. The clinical research fellow from each clinic attended, sometimes joined by the clinical lead for that site. In the initial meeting, the group proposed and prioritized topics before merging their consensus with the list of priority topics generated separately by patients (there was much overlap but also some differences).

In subsequent meetings, participants attempted to reach consensus on how to define, measure and achieve quality for each priority topic in turn, implement this approach in their own clinic and monitor its impact. Clinical leads prepared illustrative clinical cases and summaries of the research evidence, which they presented using Microsoft Powerpoint; the group then worked towards consensus on the implications for practice through general discussion. Clinical research fellows assisted with literature searches, collected baseline data from their own clinic, prepared and presented anonymized case examples, and contributed to collaborative goal-setting for improvement. Progress on each topic was reviewed at a later meeting after an agreed interval.

An additional element of this work package was semi-structured interviews with 29 patients, recruited from 9 of the 10 participating sites, about their clinic experiences with a view to feeding into service improvement (in the other site, no patient volunteered).

Our patient advisory group initially met separately from the quality improvement collaborative. They designed a short survey of current practice and sent it to each clinic; the results of this informed a prioritization exercise for topics where they considered change was needed. The patient-generated list was tabled at the quality improvement collaborative discussions, but patients were understandably keen to join these discussions directly. After about 9 months, some patient advisory group members joined the regular collaborative meetings. This dynamic was not without its tensions, since sharing performance data requires trust and there were some concerns about confidentiality when real patient cases were discussed with other patients present.

How evidence-informed quality targets were set

At the time the study began, there were no published large-scale randomized controlled trials of any interventions for long covid. We therefore followed a model used successfully in other quality improvement efforts where research evidence was limited or absent or it did not translate unambiguously into models for current services. In such circumstances, the best evidence may be custom and practice in the best-performing units. The quality improvement effort becomes oriented to what one group of researchers called “potentially better practices”—that is, practices that are “developed through analysis of the processes of care, literature review, and site visits” (page 14) [ 73 ]. The idea was that facilitated discussion among clinical teams, drawing on published research where available but also incorporating clinical experience, established practice and systematic analysis of performance data across participating clinics would surface these “potentially better practices”—an approach which, though not formally tested in controlled trials, appears to be associated with improved outcomes [ 46 , 73 ].

Adding an ethnographic component

Following limited progress made on some topics that had been designated high priority, we interviewed all 10 clinical research fellows (either individually or, in two cases, with a senior clinician present) and 18 other clinic staff (five individually plus two groups of 5 and 8), along with additional informal discussions, to explore the challenges of implementing the changes that had been agreed. These interviews were not audiotaped but detailed notes were made and typed up immediately afterwards. It became evident that some aspects of what the collaborative had deemed “evidence-informed” care were contested by front-line clinic staff, perceived as irrelevant to the service they were delivering, or considered impossible to implement. To unpack these issues further, the research protocol was amended to include an ethnographic component.

TG and EL (academic general practitioners) and JLD (a qualitative researcher with a PhD in the patient experience) attended a total of 45 MDT meetings in participating clinics (mostly online or hybrid). Staff were informed in advance that there would be an observer present; nobody objected. We noted brief demographic and clinical details of cases discussed (but no identifying data), dilemmas and uncertainties on which discussions focused, and how different staff members contributed.

TG made 13 in-person visits to participating long covid clinics. Staff were notified in advance; all were happy to be observed. Visits lasted between 5 and 8 h (54 h in total). We observed support staff booking patients in and processing requests and referrals, and shadowed different clinical staff in turn as they saw patients. Patients were informed of our presence and its purpose beforehand and given the opportunity to decline (three of 53 patients approached did). We discussed aspects of each case with the clinician after the patient left. When invited, we took breaks with staff and used these as an opportunity to ask them informally what it was like working in the clinic.

Ethnographic observation, analysis and reporting was geared to generating a rich interpretive account of the clinical, operational and interpersonal features of each clinic—what Van Maanen calls an “impressionist tales” [ 74 ]. Our work was also guided by the principles set out by Golden-Biddle and Locke, namely authenticity (spending time in the field and basing interpretations on these direct observations), plausibility (creating a plausible account through rich persuasive description) and criticality (e.g. reflexively examining our own assumptions) [ 75 ]. Our collection and analysis of qualitative data was informed by our own professional backgrounds (two general practitioners, one physical therapist, two non-clinicians).

In both MDTs and clinics, we took contemporaneous notes by hand and typed these up immediately afterwards.

Data management and analysis

Typed interview notes and field notes from clinics were collated in a set of Word documents, one for each clinic attended. They were analysed thematically [ 76 ] with attention to the literature on quality improvement and variation (see “ Background ”). Interim summaries were prepared on each clinic, setting out the narrative of how it had been established, its ethos and leadership, setting and staffing, population served and key links with other parts of the local healthcare ecosystem.

Minutes and field notes from the quality improvement collaborative meetings were summarized topic by topic, including initial data collected by the researchers-in-residence, improvement actions taken (or attempted) in that clinic, and any follow-up data shared. Progress or lack of it was interpreted in relation to the contextual case summary for that clinic.

Patient cases seen in clinic, and those discussed by MDTs, were summarized as brief case narratives in Word documents. Using the constant comparative method [ 77 ], we produced an initial synthesis of the clinical picture and principles of management based on the first 10 patient cases seen, and refined this as each additional case was added. Demographic and brief clinical and social details were also logged on Excel spreadsheets. When writing up clinical cases, we used the technique of composite case construction (in which we drew on several actual cases to generate a fictitious one, thereby protecting anonymity whilst preserving key empirical findings [ 78 ]); any names reported in this paper are pseudonyms.

Member checking

A summary was prepared for each clinic, including a narrative of the clinic’s own history and a summary of key quality issues raised across the ten clinics. These summaries included examples from real cases in our dataset. These were shared with the clinical research fellow and a senior clinician from the clinic, and amended in response to feedback. We also shared these summaries with representatives from the patient advisory group.

Overview of dataset

This study generated three complementary datasets. First, the video recordings, minutes, and field notes of 12 quality improvement collaborative meetings, along with the evidence summaries prepared for these meetings and clinic summaries (e.g. descriptions of current practice, audits) submitted by the clinical research fellows. This dataset illustrated wide variation in practice, and (in many topics) gaps or ambiguities in the evidence base.

Second, interviews with staff ( n  = 30) and patients ( n  = 29) from the clinics, along with ethnographic field notes (approximately 100 pages) from 13 in-person clinic visits (54 h), including notes on 50 patient consultations (40 face-to-face, 6 telephone, 4 video). This dataset illustrated the heterogeneity among the ten participating clinics.

Third, field notes (approximately 100 pages), including discussions on 244 clinical cases from the 45 MDT meetings (49 h) that we observed. This dataset revealed further similarities and contrasts among clinics in how patients were managed. In particular, it illustrated how, for the complex patients whose cases were presented at these meetings, teams made sense of, and planned for, each case through multidisciplinary dialogue. This dialogue typically began with one staff member presenting a detailed clinical history along with a narrative of how it had affected the patient’s life and what was at stake for them (e.g. job loss), after which professionals from various backgrounds (nursing, physical therapy, occupational therapy, psychology, dietetics, and different medical specialties) joined in a discussion about what to do.

The ten participating sites are summarized in Table  1 .

In the next two sections, we explore two issues—difficulty defining best practice and the heterogeneous nature of the clinics—that were key to explaining why quality, when pursued in a 10-site collaborative, proved elusive. We then briefly summarize patients’ accounts of their experience in the clinics and give three illustrative examples of the elusiveness of quality improvement using selected topics that were prioritized in our collaborative: outcome measures, investigation of palpitations and management of fatigue. In the final section of the results, we describe how MDT deliberations proved crucial for local quality improvement. Further detail on clinical priority topics will be presented in a separate paper.

“Best practice” in long covid: uncertainty and conflict

The study period (September 2021 to December 2023) corresponded with an exponential increase in published research on long covid. Despite this, the quality improvement collaborative found few unambiguous recommendations for practice. This gap between what the research literature offered and what clinical practice needed was partly ontological (relating what long covid is ). One major bone of contention between patients and clinicians (also evident in discussions with our patient advisory group), for example, was how far (and in whom) clinicians should look for and attempt to treat the various metabolic abnormalities that had been documented in laboratory research studies. The literature on this topic was extensive but conflicting [ 20 , 21 , 22 , 23 , 24 , 79 , 80 , 81 , 82 ]; it was heavy on biological detail but light on clinical application.

Patients were often aware of particular studies that appeared to offer plausible molecular or cellular explanations for symptom clusters along with a drug (often repurposed and off-label) whose mechanism of action appeared to be a good fit with the metabolic chain of causation. In one clinic, for example, we were shown an email exchange between a patient (not medically qualified) and a consultant, in which the patient asked them to reconsider their decision not to prescribe low-dose naltrexone, an opioid receptor antagonist with anti-inflammatory properties. The request included a copy of a peer-reviewed academic paper describing a small, uncontrolled pre-post study (i.e. a weak study design) in which this drug appeared to improve symptoms and functional performance in patients with long covid, as well as a mechanistic argument explaining why the patient felt this drug was a plausible choice in their own case.

This patient’s clinician, in common with most clinicians delivering front-line long covid services, considered that the evidence for such mechanism-based therapies was weak. Clinicians generally felt that this evidence, whilst promising, did not yet support routine measurement of clotting factors, antibodies, immune cells or other biomarkers or the prescription of mechanism-based therapies such as antivirals, anti-inflammatories or anticoagulants. Low-dose naltroxone, for example, is currently being tested in at least one randomized controlled trial (see National Clinical Trials Registry NCT05430152), which had not reported at the time of our observations.

Another challenge to defining best practice was the oft-repeated phrase that long covid is a “diagnosis by exclusion”, but the high prevalence of comorbidities meant that the “pure” long covid patient untainted by other potential explanations for their symptoms was a textbook ideal. In one MDT, for example, we observed a discussion about a patient who had had both swab-positive covid-19 and erythema migrans (a sign of Lyme disease) in the weeks before developing fatigue, yet local diagnostic criteria for each condition required the other to be excluded.

The logic of management in most participating clinics was pragmatic: prompt multidisciplinary assessment and treatment with an emphasis on obtaining a detailed clinical history (including premorbid health status), excluding serious complications (“red flags”), managing specific symptom clusters (for example, physical therapy for breathing pattern disorder), treating comorbidities (for example, anaemia, diabetes or menopause) and supporting whole-person rehabilitation [ 7 , 83 ]. The evidentiary questions raised in MDT discussions (which did not include patients) addressed the practicalities of the rehabilitation model (for example, whether cognitive therapy for neurocognitive complications is as effective when delivered online as it is when delivered in-person) rather than the molecular or cellular mechanisms of disease. For example, the question of whether patients with neurocognitive impairment should be tested for micro-clots or treated with anticoagulants never came up in the MDTs we observed, though we did visit a tertiary referral clinic (the tier 4 clinic in site H), whose lead clinician had a research interest in inflammatory coagulopathies and offered such tests to selected patients.

Because long covid typically produces dozens of symptoms that tend to be uniquely patterned in each patient, the uncertainties on which MDT discussions turned were rarely about general evidence of the kind that might be found in a guideline (e.g. how should fatigue be managed?). Rather they concerned particular case-based clinical decisions (e.g. how should this patient’s fatigue be managed, given the specifics of this case?). An example from our field notes illustrates this:

Physical therapist presents the case of a 39-year-old woman who works as a cleaner on an overnight ferry. Has had long covid for 2 years. Main symptoms are shortness of breath and possible anxiety attacks, especially when at work. She has had a course of physical therapy to teach diaphragmatic breathing but has found that focusing on her breathing makes her more anxious. Patient has to do a lot of bending in her job (e.g. cleaning toilets and under seats), which makes her dizzy, but Active Stand Test was normal. She also has very mild tricuspid incompetence [someone reads out a cardiology report—not hemodynamically significant].

Rehabilitation guidelines (e.g. WHO) recommend phased return to work (e.g. with reduced hours) and frequent breaks. “Tricky!” says someone. The job is intense and busy, and the patient can’t afford not to work. Discussion on whether all her symptoms can be attributed to tension and anxiety. Physical therapist who runs the breathing group says, “No, it’s long covid”, and describes severe initial covid-19 episode and results of serial chest X-rays which showed gradual clearing of ground glass shadows. Team discussion centers on how to negotiate reduced working hours in this particular job, given the overnight ferry shifts. --MDT discussion, Site D

This example raises important considerations about the nature of clinical knowledge in long covid. We return to it in the final section of the “ Results ” and in the “ Discussion ”.

Long covid clinics: a heterogeneous context for quality improvement

Most participating clinics had been established in mid-2020 to follow up patients who had been hospitalized (and perhaps ventilated) for severe acute covid-19. As mass vaccination reduced the severity of acute covid-19 for most people, the patient population in all clinics progressively shifted to include fewer “post-ICU [intensive care unit]” patients (in whom respiratory symptoms almost always dominated), and more people referred by their general practitioners or other secondary care specialties who had not been hospitalized for their acute covid-19 infection, and in whom fatigue, brain fog and palpitations were often the most troubling symptoms. Despite these similarities, the ten clinics had very different histories, geographical and material settings, staffing structures, patient pathways and case mix, as Table  1 illustrates. Below, we give more detail on three example sites.

Site C was established as a generalist “assessment-only” service by a general practitioner with an interest in infectious diseases. It is led jointly by that general practitioner and an occupational therapist, assisted by a wide range of other professionals including speech and language therapy, dietetics, clinical psychology and community-based physical therapy and occupational therapy. It has close links with a chronic fatigue service and a pain clinic that have been running in the locality for over 20 years. The clinic, which is entirely virtual (staff consult either from home or from a small side office in the community trust building), is physically located in a low-rise building on the industrial outskirts of a large town, sharing office space with various community-based health and social care services. Following a 1-h telephone consultation by one of the clinical leads, each patient is discussed at the MDT and then either discharged back to their general practitioner with a detailed management plan or referred on to one of the specialist services. This arrangement evolved to address a particular problem in this locality—that many patients with long covid were being referred by their general practitioner to multiple specialties (e.g. respiratory, neurology, fatigue), leading to a fragmented patient experience, unnecessary specialist assessments and wasteful duplication. The generalist assessment by telephone is oriented to documenting what is often a complex illness narrative (including pre-existing physical and mental comorbidities) and working with the patient to prioritize which symptoms or problems to pursue in which order.

Site E, in a well-regarded inner-city teaching hospital, had been set up in 2020 by a respiratory physician. Its initial ethos and rationale had been “respiratory follow-up”, with strong emphasis on monitoring lung damage via repeated imaging and lung function tests and in ensuring that patients received specialist physical therapy to “re-learn” efficient breathing techniques. Over time, this site has tried to accommodate a more multi-system assessment, with the introduction of a consultant-led infectious disease clinic for patients without a dominant respiratory component, reflecting the shift towards a more fatigue-predominant case mix. At the time of our fieldwork, each patient was seen in turn by a physician, psychologist, occupational therapist and respiratory physical therapist (half an hour each) before all four staff reconvened in a face-to-face MDT meeting to form a plan for each patient. But whilst a wide range of patients with diverse symptoms were discussed at these meetings, there remained a strong focus on respiratory pathology (e.g. tracking improvements in lung function and ensuring that coexisting asthma was optimally controlled).

Site F, one of the first long covid clinics in UK, was set up by a rehabilitation consultant who had been drafted to work on the ICU during the first wave of covid-19 in early 2020. He had a longstanding research interest in whole-patient rehabilitation, especially the assessment and management of chronic fatigue and pain. From the outset, clinic F was more oriented to rehabilitation, including vocational rehabilitation to help patients return to work. There was less emphasis on monitoring lung function or pursuing respiratory comorbidities. At the time of our fieldwork, clinic F offered both a community-based service (“tier 2”) led by an occupational therapist, supported by a respiratory physical therapist and psychologist, and a hospital-based service (“tier 3”) led by the rehabilitation consultant, supported by a wider MDT. Staff in both tiers emphasized that each patient needs a full physical and mental assessment and help to set and work towards achievable goals, whilst staying within safe limits so as to avoid post-exertional symptom exacerbation. Because of the research interest of the lead physician, clinic F adapted well to the growing numbers of patients with fatigue and quickly set up research studies on this cohort [ 84 ].

Details of the other seven sites are shown in Table  1 . Broadly speaking, sites B, E, G and H aligned with the “respiratory follow-up” model and sites F and I aligned with the “rehabilitation” model. Sites A and J had a high-volume, multi-tiered service whose community tier aligned with the “holistic GP assessment” model (site C above) and which also offered a hospital-based, rehabilitation-focused tier. The small service in Scotland (site D) had evolved from an initial respiratory focus to become part of the infectious diseases (ME/CFS) service; Lyme disease (another infectious disease whose sequelae include chronic fatigue) was also prevalent in this region.

The patient experience

Whilst the 10 participating clinics were very diverse in staffing, ethos and patient flows, the 29 patient interviews described remarkably consistent clinic experiences. Almost all identified the biggest problem to be the extended wait of several months before they were seen and the limited awareness (when initially referred) of what long covid clinics could provide. Some talked of how they cried with relief when they finally received an appointment. When the quality improvement collaborative was initially established, waiting times and bottlenecks were patients’ the top priority for quality improvement, and this ranking was shared by clinic staff, who were very aware of how much delays and uncertainties in assessment and treatment compounded patients’ suffering. This issue resolved to a large extent over the study period in all clinics as the referral backlog cleared and the incidence of new cases of long covid fell [ 85 ]; it will be covered in more detail in a separate publication.

Most patients in our sample were satisfied with the care they received when they were finally seen in clinic, especially how they finally felt “heard” after a clinician took a full history. They were relieved to receive affirmation of their experience, a diagnosis of what was wrong and reassurance that they were believed. They were grateful for the input of different members of the multidisciplinary teams and commented on the attentiveness, compassion and skill of allied professionals in particular (“she was wonderful, she got me breathing again”—patient BIR145 talking about a physical therapist). One or two patient participants expressed confusion about who exactly they had seen and what advice they had been given, and some did not realize that a telephone assessment had been an actual clinical consultation. A minority expressed disappointment that an expected investigation had not been ordered (one commented that they had not had any blood tests at all). Several had assumed that the help and advice from the long covid clinic would continue to be offered until they were better and were disappointed that they had been discharged after completing the various courses on offer (since their clinic had been set up as an “assessment only” service).

In the next sections, we give examples of topics raised in the quality improvement collaborative and how they were addressed.

Example quality topic 1: Outcome measures

The first topic considered by the quality improvement collaborative was how (that is, using which measures and metrics) to assess and monitor patients with long covid. In the absence of a validated biomarker, various symptom scores and quality of life scales—both generic and disease-specific—were mooted. Site F had already developed and validated a patient-reported outcome measure (PROM), the C19-YRS (Covid-19 Yorkshire Rehabilitation Scale) and used it for both research and clinical purposes [ 86 ]. It was quickly agreed that, for the purposes of generating comparative research findings across the ten clinics, the C19-YRS should be used at all sites and completed by patients three-monthly. A commercial partner produced an electronic version of this instrument and an app for patient smartphones. The quality improvement collaborative also agreed that patients should be asked to complete the EUROQOL EQ5D, a widely used generic health-related quality of life scale [ 87 ], in order to facilitate comparisons between long covid and other chronic conditions.

In retrospect, the discussions which led to the unopposed adoption of these two measures as a “quality” initiative in clinical care were somewhat aspirational. A review of progress at a subsequent quality improvement meeting revealed considerable variation among clinics, with a wide variety of measures used in different clinics to different degrees. Reasons for this variation were multiple. First, although our patient advisory group were keen that we should gather as much data as possible on the patient experience of this new condition, many clinic patients found the long questionnaires exhausting to complete due to cognitive impairment and fatigue. In addition, whilst patients were keen to answer questions on symptoms that troubled them, many had limited patience to fill out repeated surveys on symptoms that did not trouble them (“it almost felt as if I’ve not got long covid because I didn’t feel like I fit the criteria as they were laying it out”—patient SAL001). Staff assisted patients in completing the measures when needed, but this was time-consuming (up to 45 min per instrument) and burdensome for both staff and patients. In clinics where a high proportion of patients required assistance, staff time was the rate-limiting factor for how many instruments got completed. For some patients, one short instrument was the most that could be asked of them, and the clinician made a judgement on which one would be in their best interests on the day.

The second reason for variation was that the clinical diagnosis and management of particular features, complications and comorbidities of long covid required more nuance than was provided by these relatively generic instruments, and the level of detail sought varied with the specialist interest of the clinic (and the clinician). The modified C19-YRS [ 88 ], for example, contained 19 items, of which one asked about sleep quality. But if a patient had sleep difficulties, many clinicians felt that these needed to be documented in more detail—for example using the 8-item Epworth Sleepiness Scale, originally developed for conditions such as narcolepsy and obstructive sleep apnea [ 89 ]. The “Epworth score” was essential currency for referrals to some but not all specialist sleep services. Similarly, the C19-YRS had three items relating to anxiety, depression and post-traumatic stress disorder, but in clinics where there was a strong focus on mental health (e.g. when there was a resident psychologist), patients were usually invited to complete more specific tools (e.g. the Patient Health Questionnaire 9 [ 90 ], a 9-item questionnaire originally designed to assess severity of depression).

The third reason for variation was custom and practice. Ethnographic visits revealed that paper copies of certain instruments were routinely stacked on clinicians’ desks in outpatient departments and also (in some cases) handed out by administrative staff in waiting areas so that patients could complete them before seeing the clinician. These familiar clinic artefacts tended to be short (one-page) instruments that had a long tradition of use in clinical practice. They were not always fit for purpose. For example, the Nijmegen questionnaire was developed in the 1980s to assess hyperventilation; it was validated against a longer, “gold standard” instrument for that condition [ 91 ]. It subsequently became popular in respiratory clinics to diagnose or exclude breathing pattern disorder (a condition in which the normal physiological pattern of breathing becomes replaced with less efficient, shallower breathing [ 92 ]), so much so that the researchers who developed the instrument published a paper to warn fellow researchers that it had not been validated for this purpose [ 93 ]. Whilst a validated 17-item instrument for breathing pattern disorder (the Self-Evaluation of Breathing Questionnaire [ 94 ]) does exist, it is not in widespread clinical use. Most clinics in LOCOMOTION used Nijmegen either on all patients (e.g. as part of a comprehensive initial assessment, especially if the service had begun as a respiratory follow-up clinic) or when breathing pattern disorder was suspected.

In sum, the use of outcome measures in long covid clinics was a compromise between standardization and contingency. On the one hand, all clinics accepted the need to use “validated” instruments consistently. On the other hand, there were sometimes good reasons why they deviated from agreed practice, including mismatch between the clinic’s priorities as a research site, its priorities as a clinical service, and the particular clinical needs of a patient; the clinic’s—and the clinician’s—specialist focus; and long-held traditions of using particular instruments with which staff and patients were familiar.

Example quality topic 2: Postural orthostatic tachycardia syndrome (POTS)

Palpitations (common in long covid) and postural orthostatic tachycardia syndrome (POTS, a disproportionate acceleration in heart rate on standing, the assumed cause of palpitations in many long covid patients) was the top priority for quality improvement identified by our patient advisory group. Reflecting discussions and evidence (of various kinds) shared in online patient communities, the group were confident that POTS is common in long covid patients and that many cases remain undetected (perhaps misdiagnosed as anxiety). Their request that all long covid patients should be “screened” for POTS prompted a search for, and synthesis of, evidence (which we published in the BMJ [ 95 ]). In sum, that evidence was sparse and contested, but, combined with standard practice in specialist clinics, broadly supported the judicious use of the NASA Lean Test [ 96 ]. This test involves repeated measurements of pulse and blood pressure with the patient first lying and then standing (with shoulders resting against a wall).

The patient advisory group’s request that the NASA Lean Test should be conducted on all patients met with mixed responses from the clinics. In site F, the lead physician had an interest in autonomic dysfunction in chronic fatigue and was keen; he had already published a paper on how to adapt the NASA Lean Test for self-assessment at home [ 97 ]. Several other sites were initially opposed. Staff at site E, for example, offered various arguments:

The test is time-consuming, labor-intensive, and takes up space in the clinic which has an opportunity cost in terms of other potential uses;

The test is unvalidated and potentially misleading (there is a high incidence of both false negative and false positive results);

There is no proven treatment for POTS, so there is no point in testing for it;

It is a specialist test for a specialist condition, so it should be done in a specialist clinic where its benefits and limitations are better understood;

Objective testing does not change clinical management since what we treat is the patient’s symptoms (e.g. by a pragmatic trial of lifestyle measures and medication);

People with symptoms suggestive of dysautonomia have already been “triaged out” of this clinic (that is, identified in the initial telephone consultation and referred directly to neurology or cardiology);

POTS is a manifestation of the systemic nature of long covid; it does not need specific treatment but will improve spontaneously as the patient goes through standard interventions such as active pacing, respiratory physical therapy and sleep hygiene;

Testing everyone, even when asymptomatic, runs counter to the ethos of rehabilitation, which is to “de-medicalize” patients so as to better orient them to their recovery journey.

When clinics were invited to implement the NASA Lean Test on a consecutive sample of patients to resolve a dispute about the incidence of POTS (from “we’ve only seen a handful of people with it since the clinic began” to “POTS is common and often missed”), all but one site agreed to participate. The tertiary POTS centre linked to site H was already running the NASA Lean Test as standard on all patients. Site C, which operated entirely virtually, passed the work to the referring general practitioner by making this test a precondition for seeing the patient; site D, which was largely virtual, sent instructions for patients to self-administer the test at home.

The NASA Lean Test study has been published separately [ 98 ]. In sum, of 277 consecutive patients tested across the eight clinics, 20 (7%) had a positive NASA Lean Test for POTS and a further 28 (10%) a borderline result. Six of 20 patients who met the criteria for POTS on testing had no prior history of orthostatic intolerance. The question of whether this test should be used to “screen” all patients was not answered definitively. But the experience of participating in the study persuaded some sceptics that postural changes in heart rate could be severe in some long covid patients, did not appear to be fully explained by their previously held theories (e.g. “functional”, anxiety, deconditioning), and had likely been missed in some patients. The outcome of this particular quality improvement cycle was thus not a wholescale change in practice (for which the evidence base was weak) but a more subtle increase in clinical awareness, a greater willingness to consider testing for POTS and a greater commitment to contribute to research into this contested condition.

More generally, the POTS audit prompted some clinicians to recognize the value of quality improvement in novel clinical areas. One physician who had initially commented that POTS was not seen in their clinic, for example, reflected:

“ Our clinic population is changing. […] Overall there’s far fewer post-ICU patients with ECMO [extra-corporeal membrane oxygenation] issues and far more long covid from the community, and this is the bit our clinic isn’t doing so well on. We’re doing great on breathing pattern disorder; neuro[logists] are helping us with the brain fogs; our fatigue and occupational advice is ok but some of the dysautonomia symptoms that are more prevalent in the people who were not hospitalized – that’s where we need to improve .” -Respiratory physician, site G (from field visit 6.6.23)

Example quality topic 3: Management of fatigue

Fatigue was the commonest symptom overall and a high priority among both patients and clinicians for quality improvement. It often coexisted with the cluster of neurocognitive symptoms known as brain fog, with both conditions relapsing and remitting in step. Clinicians were keen to systematize fatigue management using a familiar clinical framework oriented around documenting a full clinical history, identifying associated symptoms, excluding or exploring comorbidities and alternative explanations (e.g. poor sleep patterns, depression, menopause, deconditioning), assessing how fatigue affects physical and mental function, implementing a program of physical and cognitive therapy that was sensitive to the patient’s condition and confidence level, and monitoring progress using validated patient-reported outcome measures and symptom diaries.

The underpinning logic of this approach, which broadly reflected World Health Organization guidance [ 99 ], was that fatigue and linked cognitive impairment could be a manifestation of many—perhaps interacting—conditions but that a whole-patient (body and mind) rehabilitation program was the cornerstone of management in most cases. Discussion in the quality improvement collaborative focused on issues such as whether fatigue was so severe that it produced safety concerns (e.g. in a person’s job or with childcare), the pros and cons of particular online courses such as yoga, relaxation and mindfulness (many were viewed positively, though the evidence base was considered weak), and the extent to which respiratory physical therapy had a crossover impact on fatigue (systematic reviews suggested that it may do, but these reviews also cautioned that primary studies were sparse, methodologically flawed, and heterogeneous [ 100 , 101 ]). They also debated the strengths and limitations of different fatigue-specific outcome measures, each of which had been developed and validated in a different condition, with varying emphasis on cognitive fatigue, physical fatigue, effect on daily life, and motivation. These instruments included the Modified Fatigue Impact Scale; Fatigue Severity Scale [ 102 ]; Fatigue Assessment Scale; Functional Assessment Chronic Illness Therapy—Fatigue (FACIT-F) [ 103 ]; Work and Social Adjustment Scale [ 104 ]; Chalder Fatigue Scale [ 105 ]; Visual Analogue Scale—Fatigue [ 106 ]; and the EQ5D [ 87 ]. In one clinic (site F), three of these scales were used in combination for reasons discussed below.

Some clinicians advocated melatonin or nutritional supplements (such as vitamin D or folic acid) for fatigue on the grounds that many patients found them helpful and formal placebo-controlled trials were unlikely ever to be conducted. But neurostimulants used in other fatigue-predominant conditions (e.g. brain injury, stroke), which also lacked clinical trial evidence in long covid, were viewed as inappropriate in most patients because of lack of evidence of clear benefit and hypothetical risk of harm (e.g. adverse drug reactions, polypharmacy).

Whilst the patient advisory group were broadly supportive of a whole-patient rehabilitative approach to fatigue, their primary concern was fatiguability , especially post-exertional symptom exacerbation (PESE, also known as “crashes”). In these, the patient becomes profoundly fatigued some hours or days after physical or mental exertion, and this state can last for days or even weeks [ 107 ]. Patients viewed PESE as a “red flag” symptom which they felt clinicians often missed and sometimes caused. They wanted the quality improvement effort to focus on ensuring that all clinicians were aware of the risks of PESE and acted accordingly. A discussion among patients and clinicians at a quality improvement collaborative meeting raised a new research hypothesis—that reducing the number of repeated episodes of PESE may improve the natural history of long covid.

These tensions around fatigue management played out differently in different clinics. In site C (the GP-led virtual clinic run from a community hub), fatigue was viewed as one manifestation of a whole-patient condition. The lead general practitioner used the metaphor of untangling a skein of wool: “you have to find the end and then gently pull it”. The underlying problem in a fatigued patient, for example, might be an undiagnosed physical condition such as anaemia, disturbed sleep, or inadequate pacing. These required (respectively) the chronic fatigue service (comprising an occupational therapist and specialist psychologist and oriented mainly to teaching the techniques of goal-setting and pacing), a “tiredness” work-up (e.g. to exclude anaemia or menopause), investigation of poor sleep (which, not uncommonly, was due to obstructive sleep apnea), and exploration of mental health issues.

In site G (a hospital clinic which had evolved from a respiratory service), patients with fatigue went through a fatigue management program led by the occupational therapist with emphasis on pacing, energy conservation, avoidance of PESE and sleep hygiene. Those without ongoing respiratory symptoms were often discharged back to their general practitioner once they had completed this; there was no consultant follow-up of unresolved fatigue.

In site F (a rehabilitation clinic which had a longstanding interest in chronic fatigue even before the pandemic), active interdisciplinary management of fatigue was commenced at or near the patient’s first visit, on the grounds that the earlier this began, the more successful it would be. In this clinic, patients were offered a more intensive package: a similar occupational therapy-led fatigue course as those in site G, plus input from a dietician to advise on regular balanced meals and caffeine avoidance and a group-based facilitated peer support program which centred on fatigue management. The dietician spoke enthusiastically about how improving diet in longstanding long covid patients often improved fatigue (e.g. because they had often lost muscle mass and tended to snack on convenience food rather than make meals from scratch), though she agreed there was no evidence base from trials to support this approach.

Pursuing local quality improvement through MDTs

Whilst some long covid patients had “textbook” symptoms and clinical findings, many cases were unique and some were fiendishly complex. One clinician commented that, somewhat paradoxically, “easy cases” were often the post-ICU follow-ups who had resolving chest complications; they tended to do well with a course of respiratory physical therapy and a return-to-work program. Such cases were rarely brought to MDT meetings. “Difficult cases” were patients who had not been hospitalized for their acute illness but presented with a months- or years-long history of multiple symptoms with fatigue typically predominant. Each one was different, as the following example (some details of which have been fictionalized to protect anonymity) illustrates.

The MDT is discussing Mrs Fermah, a 65-year-old homemaker who had covid-19 a year ago. She has had multiple symptoms since, including fluctuating fatigue, brain fog, breathlessness, retrosternal chest pain of burning character, dry cough, croaky voice, intermittent rashes (sometimes on eating), lips going blue, ankle swelling, orthopnoea, dizziness with the room spinning which can be triggered by stress, low back pain, aches and pains in the arms and legs and pins and needles in the fingertips, loss of taste and smell, palpitations and dizziness (unclear if postural, but clear association with nausea), headaches on waking, and dry mouth. She is somewhat overweight (body mass index 29) and admits to low mood. Functionally, she is mostly confined to the house and can no longer manage the stairs so has begun to sleep downstairs. She has stumbled once or twice but not fallen. Her social life has ceased and she rarely has the energy to see her grandchildren. Her 70-year-old husband is retired and generally supportive, though he spends most evenings at his club. Comorbidities include glaucoma which is well controlled and overseen by an ophthalmologist, mild club foot (congenital) and stage 1 breast cancer 20 years ago. Various tests, including a chest X-ray, resting and exercise oximetry and a blood panel, were normal except for borderline vitamin D level. Her breathing questionnaire score suggests she does not have breathing pattern disorder. ECG showed first-degree atrioventricular block and left axis deviation. No clinician has witnessed the blue lips. Her current treatment is online group respiratory physical therapy; a home visit is being arranged to assess her climbing stairs. She has declined a psychologist assessment. The consultant asks the nurse who assessed her: “Did you get a feel if this is a POTS-type dizziness or an ENT-type?” She sighs. “Honestly it was hard to tell, bless her.”—Site A MDT

This patient’s debilitating symptoms and functional impairments could all be due to long covid, yet “evidence-based” guidance for how to manage her complex suffering does not exist and likely never will exist. The question of which (if any) additional blood or imaging tests to do, in what order of priority, and what interventions to offer the patient will not be definitively answered by consulting clinical trials involving hundreds of patients, since (even if these existed) the decision involves weighing this patient’s history and the multiple factors and uncertainties that are relevant in her case. The knowledge that will help the MDT provide quality care to Mrs Fermah is case-based knowledge—accumulated clinical experience and wisdom from managing and deliberating on multiple similar cases. We consider case-based knowledge further in the “ Discussion ”.

Summary of key findings

This study has shown that a quality improvement collaborative of UK long covid clinics made some progress towards standardizing assessment and management in some topics, but some variation remained. This could be explained in part by the fact that different clinics had different histories and path dependencies, occupied a different place in the local healthcare ecosystem, served different populations, were differently staffed, and had different clinical interests. Our patient advisory group and clinicians in the quality improvement collaborative broadly prioritized the same topics for improvement but interpreted them somewhat differently. “Quality” long covid care had multiple dimensions, relating to (among other things) service set-up and accessibility, clinical provision appropriate to the patient’s need (including options for referral to other services locally), the human qualities of clinical and support staff, how knowledge was distributed across (and accessible within) the system, and the accumulated collective wisdom of local MDTs in dealing with complex cases (including multiple kinds of specialist expertise as well as relational knowledge of what was at stake for the patient). Whilst both staff and patients were keen to contribute to the quality improvement effort, the burden of measurement was evident: multiple outcome measures, used repeatedly, were resource-intensive for staff and exhausting for patients.

Strengths and limitations of this study

To our knowledge, we are the first to report both a quality improvement collaborative and an in-depth qualitative study of clinical work in long covid. Key strengths of this work include the diverse sampling frame (with sites from three UK jurisdictions and serving widely differing geographies and demographics); the use of documents, interviews and reflexive interpretive ethnography to produce meaningful accounts of how clinics emerged and how they were currently organized; the use of philosophical concepts to analyse data on how MDTs produced quality care on a patient-by-patient basis; and the close involvement of patient co-researchers and coauthors during the research and writing up.

Limitations of the study include its exclusive UK focus (the external validity of findings to other healthcare systems is unknown); the self-selecting nature of participants in a quality improvement collaborative (our patient advisory group suggested that the MDTs observed in this study may have represented the higher end of a quality spectrum, hence would be more likely than other MDTs to adhere to guidelines); and the particular perspective brought by the researchers (two GPs, a physical therapist and one non-clinical person) in ethnographic observations. Hospital specialists or organizational scholars, for example, may have noticed different things or framed what they observed differently.

Explaining variation in long covid care

Sutherland and Levesque’s framework mentioned in the “ Background ” section does not explain much of the variation found in our study [ 70 ]. In terms of capacity, at the time of this study most participating clinics benefited from ring-fenced resources. In terms of evidence, guidelines existed and were not greatly contested, but as illustrated by the case of Mrs Fermah above, many patients were exceptions to the guideline because of complex symptomatology and relevant comorbidities. In terms of agency, clinicians in most clinics were passionately engaged with long covid (they were pioneers who had set up their local clinic and successfully bid for national ring-fenced resources) and were generally keen to support patient choice (though not if the patient requested tests which were unavailable or deemed not indicated).

Astma et al.’s list of factors that may explain variation in practice (see “ Background ”) includes several that may be relevant to long covid, especially that the definition of appropriate care in this condition remains somewhat contested. But lack of opportunity to discuss cases was not a problem in the clinics in our sample. On the contrary, MDT meetings in each locality gave clinicians multiple opportunities to discuss cases with colleagues and reflect collectively on whether and how to apply particular guidelines.

The key problem was not that clinicians disputed the guidelines for managing long covid or were unaware of them; it was that the guidelines were not self-interpreting . Rather, MDTs had to deliberate on the balance of benefits and harms in different aspects of individual cases. In patients whose symptoms suggested a possible diagnosis of POTS (or who suspected themselves of having POTS), for example, these deliberations were sometimes lengthy and nuanced. Should a test result that is not technically in the abnormal range but close to it be treated as diagnostic, given that symptoms point to this diagnosis? If not, should the patient be told that the test excludes POTS or that it is equivocal? If a cardiology opinion has stated firmly that the patient does not have POTS but the cardiologist is not known for their interest in this condition, should a second specialist opinion be sought? If the gold standard “tilt test” [ 108 ] for POTS (usually available only in tertiary centres) is not available locally, does this patient merit a costly out-of-locality referral? Should the patient’s request for a trial of off-label medication, reflecting discussions in an online support group, be honoured? These are the kinds of questions on which MDTs deliberated at length.

The fact that many cases required extensive deliberation does not necessarily justify variation in practice among clinics. But taking into account the clinics’ very different histories, set-up, and local referral pathways, the variation begins to make sense. A patient who is being assessed in a clinic that functions as a specialist chronic fatigue centre and attracts referrals which reflect this interest (e.g. site F in our sample) will receive different management advice from one that functions as a telephone-only generalist assessment centre and refers on to other specialties (site C in our sample). The wide variation in case mix, coupled with the fact that a different proportion of these cases were highly complex in each clinic (and in different ways), suggests that variation in practice may reflect appropriate rather than inappropriate care.

Our patient advisory group affirmed that many of the findings reported here resonated with their own experience, but they raised several concerns. These included questions about patient groups who may have been missed in our sample because they were rarely discussed in MDTs. The decision to take a case to MDT discussion is taken largely by a clinician, and there was evidence from online support groups that some patients’ requests for their case to be taken to an MDT had been declined (though not, to our knowledge, in the clinics participating in the LOCOMOTION study).

We began this study by asking “what is quality in long covid care?”. We initially assumed that this question referred to a generalizable evidence base, which we felt we could identify, and we believed that we could then determine whether long covid clinics were following the evidence base through conventional audits of structure, process, and outcome. In retrospect, these assumptions were somewhat naïve. On the basis of our findings, we suggest that a better (and more individualized) research question might be “to what extent does each patient with long covid receive evidence-based care appropriate to their needs?”. This question would require individual case review on a sample of cases, tracking each patient longitudinally including cross-referrals, and also interviewing the patient.

Nomothetic versus idiographic knowledge

In a series of lectures first delivered in the 1950s and recently republished [ 109 ], psychiatrist Dr Maurice O’Connor Drury drew on the later philosophy of his friend and mentor Ludwig Wittgenstein to challenge what he felt was a concerning trend: that the nomothetic (generalizable, abstract) knowledge from randomized controlled trials (RCTs) was coming to over-ride the idiographic (personal, situated) knowledge about particular patients. Based on Wittgenstein’s writings on the importance of the particular, Drury predicted—presciently—that if implemented uncritically, RCTs would result in worse, not better, care for patients, since it would go hand-in-hand with a downgrading of experience, intuition, subjective judgement, personal reflection, and collective deliberation.

Much conventional quality improvement methodology is built on an assumption that nomothetic knowledge (for example, findings from RCTs and systematic reviews) is a higher form of knowing than idiographic knowledge. But idiographic, case-based reasoning—despite its position at the very bottom of evidence-based medicine’s hierarchy of evidence [ 110 ]—is a legitimate and important element of medical practice. Bioethicist Kathryn Montgomery, drawing on Aristotle’s notion of praxis , considers clinical practice to be an example of case-based reasoning [ 111 ]. Medicine is governed not by hard and fast laws but by competing maxims or rules of thumb ; the essence of judgement is deciding which (if any) rule should be applied in a particular circumstance. Clinical judgement incorporates science (especially the results of well-conducted research) and makes use of available tools and technologies (including guidelines and decision-support algorithms that incorporate research findings). But rather than being determined solely by these elements, clinical judgement is guided both by the scientific evidence and by the practical and ethical question “what is it best to do, for this individual, given these circumstances?”.

In this study, we observed clinical management of, and MDT deliberations on, hundreds of clinical cases. In the more straightforward ones (for example, recovering pneumonitis), guideline-driven care was not difficult to implement and such cases were rarely brought to the MDT. But cases like Mrs Fermah (see last section of “ Results ”) required much discussion on which aspects of which guideline were in the patient’s best interests to bring into play at any particular stage in their illness journey.

Conclusions

One systematic review on quality improvement collaboratives concluded that “ [those] reporting success generally addressed relatively straightforward aspects of care, had a strong evidence base and noted a clear evidence-practice gap in an accepted clinical pathway or guideline” (page 226) [ 60 ]. The findings from this study suggest that to the extent that such collaboratives address clinical cases that are not straightforward, conventional quality improvement methods may be less useful and even counterproductive.

The question “what is quality in long covid care?” is partly a philosophical one. Our findings support an approach that recognizes and values idiographic knowledge —including establishing and protecting a safe and supportive space for deliberation on individual cases to occur and to value and draw upon the collective learning that occurs in these spaces. It is through such deliberation that evidence-based guidelines can be appropriately interpreted and applied to the unique needs and circumstances of individual patients. We suggest that Drury’s warning about the limitations of nomothetic knowledge should prompt a reassessment of policies that rely too heavily on such knowledge, resulting in one-size-fits-all protocols. We also cautiously hypothesize that the need to centre the quality improvement effort on idiographic rather than nomothetic knowledge is unlikely to be unique to long covid. Indeed, such an approach may be particularly important in any condition that is complex, unpredictable, variable in presentation and clinical course, and associated with comorbidities.

Availability of data and materials

Selected qualitative data (ensuring no identifiable information) will be made available to formal research teams on reasonable request to Professor Greenhalgh at the University of Oxford, on condition that they have research ethics approval and relevant expertise. The quantitative data on NASA Lean Test have been published in full in a separate paper [ 98 ].

Abbreviations

Chronic fatigue syndrome

Intensive care unit

Jenny Ceolta-Smith

Julie Darbyshire

LOng COvid Multidisciplinary consortium Optimising Treatments and services across the NHS

Multidisciplinary team

Myalgic encephalomyelitis

Middle East Respiratory Syndrome

National Aeronautics and Space Association

Occupational therapy/ist

Post-exertional symptom exacerbation

Postural orthostatic tachycardia syndrome

Speech and language therapy

Severe Acute Respiratory Syndrome

Trisha Greenhalgh

United Kingdom

United States

World Health Organization

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Acknowledgements

We are grateful to clinic staff for allowing us to study their work and to patients for allowing us to sit in on their consultations. We also thank the funder of LOCOMOTION (National Institute for Health Research) and the patient advisory group for lived experience input.

This research is supported by National Institute for Health Research (NIHR) Long Covid Research Scheme grant (Ref COV-LT-0016).

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Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Rd, Oxford, OX2 6GG, UK

Trisha Greenhalgh, Julie L. Darbyshire & Emma Ladds

Imperial College Healthcare NHS Trust, London, UK

LOCOMOTION Patient Advisory Group and Lived Experience Representative, London, UK

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Contributions

TG conceptualized the overall study, led the empirical work, supported the quality improvement meetings, conducted the ethnographic visits, led the data analysis, developed the theorization and wrote the first draft of the paper. JLD organized and led the quality improvement meetings, supported site-based researchers to collect and analyse data on their clinic, collated and summarized data on quality topics, and liaised with the patient advisory group. CL conceptualized and led the quality topic on POTS, including exploring reasons for some clinics’ reluctance to conduct testing and collating and analysing the NASA Lean Test data across all sites. EL assisted with ethnographic visits, data analysis, and theorization. JCS contributed lived experience of long covid and also clinical experience as an occupational therapist; she liaised with the wider patient advisory group, whose independent (patient-led) audit of long covid clinics informed the quality improvement prioritization exercise. All authors provided extensive feedback on drafts and contributed to discussions and refinements. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Trisha Greenhalgh .

Ethics declarations

Ethics approval and consent to participate.

LOng COvid Multidisciplinary consortium Optimising Treatments and servIces acrOss the NHS study is sponsored by the University of Leeds and approved by Yorkshire & The Humber—Bradford Leeds Research Ethics Committee (ref: 21/YH/0276) and subsequent amendments.

Patient participants in clinic were approached by the clinician (without the researcher present) and gave verbal informed consent for a clinically qualified researcher to observe the consultation. If they consented, the researcher was then invited to sit in. A written record was made in field notes of this verbal consent. It was impractical to seek consent from patients whose cases were discussed (usually with very brief clinical details) in online MDTs. Therefore, clinical case examples from MDTs presented in the paper are fictionalized cases constructed from multiple real cases and with key clinical details changed (for example, comorbidities were replaced with different conditions which would produce similar symptoms). All fictionalized cases were checked by our patient advisory group to check that they were plausible to lived experience experts.

Consent for publication

No direct patient cases are reported in this manuscript. For details of how the fictionalized cases were constructed and validated, see “Consent to participate” above.

Competing interests

TG was a member of the UK National Long Covid Task Force 2021–2023 and on the Oversight Group for the NICE Guideline on Long Covid 2021–2022. She is a member of Independent SAGE.

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Greenhalgh, T., Darbyshire, J.L., Lee, C. et al. What is quality in long covid care? Lessons from a national quality improvement collaborative and multi-site ethnography. BMC Med 22 , 159 (2024). https://doi.org/10.1186/s12916-024-03371-6

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Received : 04 December 2023

Accepted : 26 March 2024

Published : 15 April 2024

DOI : https://doi.org/10.1186/s12916-024-03371-6

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• Post-covid-19 syndrome
• Quality improvement
• Breakthrough collaboratives
• Warranted variation
• Unwarranted variation
• Improvement science
• Ethnography
• Idiographic reasoning
• Nomothetic reasoning

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