how to use case study as a teaching strategy

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Making Learning Relevant With Case Studies

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

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

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

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

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

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

Teaching With Case Studies

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

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

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

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

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

4 Tips for Setting Up a Case Study

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

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

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

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

Problem-Based Teaching Resources

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

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

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

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Case Method Teaching and Learning

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

On this page:

What is case method teaching.

• Case Method at Columbia

Why use the Case Method?

Case method teaching approaches, how do i get started.

• Additional Resources

The CTL is here to help!

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

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

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

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

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

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

Back to Top

Case Method Teaching and Learning at Columbia

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

Faculty Spotlight:

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

Read more  

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Identify learning objectives, determine scope, and anticipate challenges. 

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

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

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

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

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

Plan for the case discussion and an active role for students

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

Student preparation and expectations

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Additional resources 

Teaching with Cases , Harvard Kennedy School of Government. 

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

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

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

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

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

Columbia Resources

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

Center for Teaching and Learning

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

Office of the Provost

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

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

Explore our teaching resources.

• Blended Learning
• Contemplative Pedagogy
• Inclusive Teaching Guide
• FAQ for Teaching Assistants
• Metacognition

CTL resources and technology for you.

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

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Case-Based Learning

This guide explores what case studies are, the value of using case studies as teaching tools, and how to implement them in your teaching.

What are case studies?

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

How to use cases for teaching and learning

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

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

To find other cases that already exist, try the following websites (if you know of other examples, please let us know and we will add them to this resource) :

• The National Center for Case Study Teaching in Science , University of Buffalo. SUNY-Buffalo maintains this set of links to other case studies on the web in disciplines ranging from engineering and ethics to sociology and business
• A Journal of Teaching Cases in Public Administration and Public Policy, University of Washington
• The American Anthropological Association’s Handbook on Ethical Issues in Anthropology , Chapter 3: Cases & Solutions  provides cases  in a format that asks the reader to solve each dilemma and includes the solutions used by the actual anthropologists. Comments by anthropologists who disagreed with the “solution” are also provided.

Additional information

• Teaching with Cases , Harvard Kennedy School
• World Association for Case Method Research and Application
• Case-Based Teaching & Problem-Based Learning , UMich
• What is Case-Based Learning , Queens University

You may also be interested in:

Project-based learning, game-based learning & gamification, student engagement part 2: ensuring deep learning, udl learning community 2023, experiential learning, safety, curiosity, and the joy of learning, embodied learning: teaching and learning with reacting to the past, universal design for learning: an introduction.

• Case Teaching Resources

Teaching With Cases

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

What Is A Teaching Case?

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

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

Learning by the Case Method

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

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

Chapter 1: Preparing for Class (2:29)

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

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

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

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

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

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

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

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

• Harvard Business School →
• Christensen Center →

Teaching by the Case Method

• Preparing to Teach
• Leading in the Classroom
• Providing Assessment & Feedback
• Sample Class

Case Method in Practice

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

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

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

• Providing Assessment and Feedback

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

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

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

Christensen Center Tip Sheets

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

Curriculum Innovation

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

Game Simulations

Multimedia cases, ideo: human-centered service design.

• Utility Menu

GA4 tagging code

• Demonstrating Moves Live
• Raw Clips Library
• Facilitation Guide

Case Teaching

The professional real world is complex and filled with uncertainty. Rather than avoiding this complexity, case-based instruction centers around cases that tell the stories of real-life protagonists facing difficult decisions. Cases often end with a straightforward question: Which path should the protagonist take? To answer this question, students carefully read the case and its documents before class. They then spend class time discussing the context, analyzing the data, and debating potential courses of action the protagonist could take. As a facilitator of the conversation, the case instructor tracks and guides the conversation, pushing students to further clarify their ideas, teasing out disagreements, and introducing useful frameworks for analyzing the case. The end of a case discussion usually involves a "reveal," where the actual outcome is shared and students have an opportunity to reflect on their predictions. For these reasons, case-based discussion classrooms are an exciting mix: they are intensely grounded in specifics yet centered around an open-ended question. Effective case teaching instructors prepare intensely for sessions but try to always follow their students’ lead as well. 

How do you plan a case-session that will cover the key concepts but is flexible enough to follow a spontaneous conversation? How can instructors effectively follow up with students to ensure their students’ ideas have been clearly articulated and explored? How can student disagreement be harnessed for deeper understanding? How can instructors make sure that all students have an opportunity to be heard in the classroom discussion? In these videos, featured instructor Julie Battilana discusses her approach and strategies for using case teaching with graduate students across the university.

Building Structure and Flexibility into Case Lesson Plans

Engaging in Extended Dialogue with Students

Using Boards to Organize and Structure Class Thinking

Probing Student Disagreement to Achieve Deeper Understanding

Introducing Frameworks to Connect Case Specifics to Broader Concepts

Using Movement to Increase Intimacy, Energy, and Visibility

Referring Back to Student Comments as Discussion Touchstones

Tracking Student Participation to Ensure All Students Contribute

What does the research say.

• Merseth provides the historical context behind the case-based teaching method ( 1991 )

Seen from the lens of constructivism, the use of case studies requires active engagement from students. Because constructivism posits that students actively construct their understanding, instructors using case studies should consider how to build flexibility into their lessons to allow for active student engagement ( Sudzina, 1997 )

Case teaching is linked to student learning gains and positive student perceptions about their learning ( Bonney, 2015 )

• Further Print Resources
• Further Online Resources

Zakrajsek, T. D., and Nilson, L. B. (2023). Teaching at Its Best: A Research-Based Resource for College Instructors, 5th Ed. John Wiley & Sons.

Chapter 19 provides an overview of the case method and offers guidance to instructors hoping to design cases and integrate them into their teaching.

McKeachie, W., & Svinicki, M. (2014). McKeachie's teaching tips. United Kingdom: Cengage Learning.

Chapter 17 provides several tips about how to best facilitate the case method in your classroom.

•  Harvard Business School has developed a wealth of resources on case-method teaching including tips for planning an effective case session .
•  The Science Education Resource Center (SERC) at Carleton College has helpful, step-by-step instructions for how to teach a case no matter the discipline.
•  The opening question in a case is often one that generates opportunities to follow-up with students. This Harvard Business Publishing article explains the elements of a “perfect opening question” for case discussion .

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What the Case Study Method Really Teaches

• Nitin Nohria

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

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

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

• Nitin Nohria is the George F. Baker Jr. Professor at Harvard Business School and the former dean of HBS.

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Case studies.

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

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

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

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

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

For more information:

• World Association for Case Method Research and Application

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

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Case-based learning.

Case-based learning (CBL) is an established approach used across disciplines where students apply their knowledge to real-world scenarios, promoting higher levels of cognition (see Bloom’s Taxonomy ). In CBL classrooms, students typically work in groups on case studies, stories involving one or more characters and/or scenarios.  The cases present a disciplinary problem or problems for which students devise solutions under the guidance of the instructor. CBL has a strong history of successful implementation in medical, law, and business schools, and is increasingly used within undergraduate education, particularly within pre-professional majors and the sciences (Herreid, 1994). This method involves guided inquiry and is grounded in constructivism whereby students form new meanings by interacting with their knowledge and the environment (Lee, 2012).

There are a number of benefits to using CBL in the classroom. In a review of the literature, Williams (2005) describes how CBL: utilizes collaborative learning, facilitates the integration of learning, develops students’ intrinsic and extrinsic motivation to learn, encourages learner self-reflection and critical reflection, allows for scientific inquiry, integrates knowledge and practice, and supports the development of a variety of learning skills.

CBL has several defining characteristics, including versatility, storytelling power, and efficient self-guided learning.  In a systematic analysis of 104 articles in health professions education, CBL was found to be utilized in courses with less than 50 to over 1000 students (Thistlethwaite et al., 2012). In these classrooms, group sizes ranged from 1 to 30, with most consisting of 2 to 15 students.  Instructors varied in the proportion of time they implemented CBL in the classroom, ranging from one case spanning two hours of classroom time, to year-long case-based courses. These findings demonstrate that instructors use CBL in a variety of ways in their classrooms.

The stories that comprise the framework of case studies are also a key component to CBL’s effectiveness. Jonassen and Hernandez-Serrano (2002, p.66) describe how storytelling:

Is a method of negotiating and renegotiating meanings that allows us to enter into other’s realms of meaning through messages they utter in their stories,

Helps us find our place in a culture,

Allows us to explicate and to interpret, and

Facilitates the attainment of vicarious experience by helping us to distinguish the positive models to emulate from the negative model.

Neurochemically, listening to stories can activate oxytocin, a hormone that increases one’s sensitivity to social cues, resulting in more empathy, generosity, compassion and trustworthiness (Zak, 2013; Kosfeld et al., 2005). The stories within case studies serve as a means by which learners form new understandings through characters and/or scenarios.

CBL is often described in conjunction or in comparison with problem-based learning (PBL). While the lines are often confusingly blurred within the literature, in the most conservative of definitions, the features distinguishing the two approaches include that PBL involves open rather than guided inquiry, is less structured, and the instructor plays a more passive role. In PBL multiple solutions to the problem may exit, but the problem is often initially not well-defined. PBL also has a stronger emphasis on developing self-directed learning. The choice between implementing CBL versus PBL is highly dependent on the goals and context of the instruction.  For example, in a comparison of PBL and CBL approaches during a curricular shift at two medical schools, students and faculty preferred CBL to PBL (Srinivasan et al., 2007). Students perceived CBL to be a more efficient process and more clinically applicable. However, in another context, PBL might be the favored approach.

In a review of the effectiveness of CBL in health profession education, Thistlethwaite et al. (2012), found several benefits:

Students enjoyed the method and thought it enhanced their learning,

Instructors liked how CBL engaged students in learning,

CBL seemed to facilitate small group learning, but the authors could not distinguish between whether it was the case itself or the small group learning that occurred as facilitated by the case.

Other studies have also reported on the effectiveness of CBL in achieving learning outcomes (Bonney, 2015; Breslin, 2008; Herreid, 2013; Krain, 2016). These findings suggest that CBL is a vehicle of engagement for instruction, and facilitates an environment whereby students can construct knowledge.

Science – Students are given a scenario to which they apply their basic science knowledge and problem-solving skills to help them solve the case. One example within the biological sciences is two brothers who have a family history of a genetic illness. They each have mutations within a particular sequence in their DNA. Students work through the case and draw conclusions about the biological impacts of these mutations using basic science. Sample cases: You are Not the Mother of Your Children ; Organic Chemisty and Your Cellphone: Organic Light-Emitting Diodes ;   A Light on Physics: F-Number and Exposure Time

Medicine – Medical or pre-health students read about a patient presenting with specific symptoms. Students decide which questions are important to ask the patient in their medical history, how long they have experienced such symptoms, etc. The case unfolds and students use clinical reasoning, propose relevant tests, develop a differential diagnoses and a plan of treatment. Sample cases: The Case of the Crying Baby: Surgical vs. Medical Management ; The Plan: Ethics and Physician Assisted Suicide ; The Haemophilus Vaccine: A Victory for Immunologic Engineering

Public Health – A case study describes a pandemic of a deadly infectious disease. Students work through the case to identify Patient Zero, the person who was the first to spread the disease, and how that individual became infected.  Sample cases: The Protective Parent ; The Elusive Tuberculosis Case: The CDC and Andrew Speaker ; Credible Voice: WHO-Beijing and the SARS Crisis

Law – A case study presents a legal dilemma for which students use problem solving to decide the best way to advise and defend a client. Students are presented information that changes during the case.  Sample cases: Mortgage Crisis Call (abstract) ; The Case of the Unpaid Interns (abstract) ; Police-Community Dialogue (abstract)

Business – Students work on a case study that presents the history of a business success or failure. They apply business principles learned in the classroom and assess why the venture was successful or not. Sample cases: SELCO-Determining a path forward ; Project Masiluleke: Texting and Testing to Fight HIV/AIDS in South Africa ; Mayo Clinic: Design Thinking in Healthcare

Humanities - Students consider a case that presents a theater facing financial and management difficulties. They apply business and theater principles learned in the classroom to the case, working together to create solutions for the theater. Sample cases: David Geffen School of Drama

Recommendations

Finding and Writing Cases

Consider utilizing or adapting open access cases - The availability of open resources and databases containing cases that instructors can download makes this approach even more accessible in the classroom. Two examples of open databases are the Case Center on Public Leadership and Harvard Kennedy School (HKS) Case Program , which focus on government, leadership and public policy case studies.

• Consider writing original cases - In the event that an instructor is unable to find open access cases relevant to their course learning objectives, they may choose to write their own. See the following resources on case writing: Cooking with Betty Crocker: A Recipe for Case Writing ; The Way of Flesch: The Art of Writing Readable Cases ;   Twixt Fact and Fiction: A Case Writer’s Dilemma ; And All That Jazz: An Essay Extolling the Virtues of Writing Case Teaching Notes .

Implementing Cases

Take baby steps if new to CBL - While entire courses and curricula may involve case-based learning, instructors who desire to implement on a smaller-scale can integrate a single case into their class, and increase the number of cases utilized over time as desired.

Use cases in classes that are small, medium or large - Cases can be scaled to any course size. In large classes with stadium seating, students can work with peers nearby, while in small classes with more flexible seating arrangements, teams can move their chairs closer together. CBL can introduce more noise (and energy) in the classroom to which an instructor often quickly becomes accustomed. Further, students can be asked to work on cases outside of class, and wrap up discussion during the next class meeting.

Encourage collaborative work - Cases present an opportunity for students to work together to solve cases which the historical literature supports as beneficial to student learning (Bruffee, 1993). Allow students to work in groups to answer case questions.

Form diverse teams as feasible - When students work within diverse teams they can be exposed to a variety of perspectives that can help them solve the case. Depending on the context of the course, priorities, and the background information gathered about the students enrolled in the class, instructors may choose to organize student groups to allow for diversity in factors such as current course grades, gender, race/ethnicity, personality, among other items.  

Use stable teams as appropriate - If CBL is a large component of the course, a research-supported practice is to keep teams together long enough to go through the stages of group development: forming, storming, norming, performing and adjourning (Tuckman, 1965).

Walk around to guide groups - In CBL instructors serve as facilitators of student learning. Walking around allows the instructor to monitor student progress as well as identify and support any groups that may be struggling. Teaching assistants can also play a valuable role in supporting groups.

Interrupt strategically - Only every so often, for conversation in large group discussion of the case, especially when students appear confused on key concepts. An effective practice to help students meet case learning goals is to guide them as a whole group when the class is ready. This may include selecting a few student groups to present answers to discussion questions to the entire class, asking the class a question relevant to the case using polling software, and/or performing a mini-lesson on an area that appears to be confusing among students.  

Assess student learning in multiple ways - Students can be assessed informally by asking groups to report back answers to various case questions. This practice also helps students stay on task, and keeps them accountable. Cases can also be included on exams using related scenarios where students are asked to apply their knowledge.

Barrows HS. (1996). Problem-based learning in medicine and beyond: a brief overview. New Directions for Teaching and Learning, 68, 3-12.  

Bonney KM. (2015). Case Study Teaching Method Improves Student Performance and Perceptions of Learning Gains. Journal of Microbiology and Biology Education, 16(1): 21-28.

Breslin M, Buchanan, R. (2008) On the Case Study Method of Research and Teaching in Design.  Design Issues, 24(1), 36-40.

Bruffee KS. (1993). Collaborative learning: Higher education, interdependence, and authority of knowledge. Johns Hopkins University Press, Baltimore, MD.

Herreid CF. (2013). Start with a Story: The Case Study Method of Teaching College Science, edited by Clyde Freeman Herreid. Originally published in 2006 by the National Science Teachers Association (NSTA); reprinted by the National Center for Case Study Teaching in Science (NCCSTS) in 2013.

Herreid CH. (1994). Case studies in science: A novel method of science education. Journal of Research in Science Teaching, 23(4), 221–229.

Jonassen DH and Hernandez-Serrano J. (2002). Case-based reasoning and instructional design: Using stories to support problem solving. Educational Technology, Research and Development, 50(2), 65-77.  

Kosfeld M, Heinrichs M, Zak PJ, Fischbacher U, Fehr E. (2005). Oxytocin increases trust in humans. Nature, 435, 673-676.

Krain M. (2016) Putting the learning in case learning? The effects of case-based approaches on student knowledge, attitudes, and engagement. Journal on Excellence in College Teaching, 27(2), 131-153.

Lee V. (2012). What is Inquiry-Guided Learning?  New Directions for Learning, 129:5-14.

Nkhoma M, Sriratanaviriyakul N. (2017). Using case method to enrich students’ learning outcomes. Active Learning in Higher Education, 18(1):37-50.

Srinivasan et al. (2007). Comparing problem-based learning with case-based learning: Effects of a major curricular shift at two institutions. Academic Medicine, 82(1): 74-82.

Thistlethwaite JE et al. (2012). The effectiveness of case-based learning in health professional education. A BEME systematic review: BEME Guide No. 23.  Medical Teacher, 34, e421-e444.

Tuckman B. (1965). Development sequence in small groups. Psychological Bulletin, 63(6), 384-99.

Williams B. (2005). Case-based learning - a review of the literature: is there scope for this educational paradigm in prehospital education? Emerg Med, 22, 577-581.

Zak, PJ (2013). How Stories Change the Brain. Retrieved from: https://greatergood.berkeley.edu/article/item/how_stories_change_brain

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Case-based Teaching and Problem-based Learning

Case-based teaching.

With case-based teaching, students develop skills in analytical thinking and reflective judgment by reading and discussing complex, real-life scenarios. The articles in this section explain how to use cases in teaching and provide case studies for the natural sciences, social sciences, and other disciplines.

Teaching with Case Studies (Stanford University)

This article from the Stanford Center for Teaching and Learning describes the rationale for using case studies, the process for choosing appropriate cases, and tips for how to implement them in college courses.

The Case Method (University of Illinois)

Tips for teachers on how to be successful using the Case Method in the college/university classroom. Includes information about the Case Method values, uses, and additional resource links.

National Center for Case Study Teaching in Science (National Science Teaching Association)

This site offers resources and examples specific to teaching in the sciences. This includes the “UB Case Study Collection,” an extensive list of ready-to-use cases in a variety of science disciplines. Each case features a PDF handout describing the case, as well as teaching notes.

The Michigan Sustainability Cases Initiative (CRLT Occasional Paper)

This paper describes the Michigan Sustainability Cases Initiative, including links to the full library of cases, and it offers advice both for writing cases and facilitating case discussions effectively.

The Case Method and the Interactive Classroom (Foran, 2001, NEA Higher Education Journal)

First-person account of how a sociology faculty member at University of California, Santa Barbara began using case studies in his teaching and how his methods have evolved over time as a professor.

Problem-based Learning

Problem-based learning (PBL) is both a teaching method and an approach to the curriculum. It consists of carefully designed problems that challenge students to use problem solving techniques, self-directed learning strategies, team participation skills, and disciplinary knowledge. The articles and links in this section describe the characteristics and objectives of PBL and the process for using PBL. There is also a list of printed and web resources.

Problem-Based Learning Network (Illinois Mathematics and Science Academy)

Site includes an interactive PBL Model, Professional Development links, and video vignettes to illustrate how to effectively use problem-based learning in the classroom. The goals of IMSA's PBLNetwork are to mentor educators in all disciplines, to explore problem-based learning strategies, and to connect PBL educators to one another.

Problem-Based Learning: An Introduction (Rhem, 1998, National Teaching and Learning Forum)

This piece summarizes the benefits of using problem-based learning, its historical origins, and the faculty/student roles in PBL. Overall, this is an easy to read introduction to problem-based learning.

Problem-Based Learning (Stanford University, 2001)

This issue of Speaking of Teaching identifies the central features of PBL, provides some guidelines for planning a PBL course, and discusses the impact of PBL on student learning and motivation.

Problem-Based Learning Clearinghouse (University of Delaware)

Collection of peer reviewed problems and articles to assist educators in using problem-based learning. Teaching notes and supplemental materials accompany each problem, providing insights and strategies that are innovative and classroom-tested. Free registration is required to view and download the Clearinghouse’s resources.

See also: The International Journal of Problem-Based Learning

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• Instructional Strategies

Case-Based Learning

What is case-based learning.

Using a case-based approach engages students in discussion of specific scenarios that resemble or typically are real-world examples. This method is learner-centered with intense interaction between participants as they build their knowledge and work together as a group to examine the case. The instructor's role is that of a facilitator while the students collaboratively analyze and address problems and resolve questions that have no single right answer.

Clyde Freeman Herreid provides eleven basic rules for case-based learning.

• Tells a story.
• Focuses on an interest-arousing issue.
• Set in the past five years
• Creates empathy with the central characters.
• Includes quotations. There is no better way to understand a situation and to gain empathy for the characters
• Relevant to the reader.
• Must have pedagogic utility.
• Conflict provoking.
• Decision forcing.
• Has generality.

Why Use Case-Based Learning?

To provide students with a relevant opportunity to see theory in practice. Real world or authentic contexts expose students to viewpoints from multiple sources and see why people may want different outcomes. Students can also see how a decision will impact different participants, both positively and negatively.

To require students to analyze data in order to reach a conclusion. Since many assignments are open-ended, students can practice choosing appropriate analytic techniques as well. Instructors who use case-based learning say that their students are more engaged, interested, and involved in the class.

To develop analytic, communicative and collaborative skills along with content knowledge. In their effort to find solutions and reach decisions through discussion, students sort out factual data, apply analytic tools, articulate issues, reflect on their relevant experiences, and draw conclusions they can relate to new situations. In the process, they acquire substantive knowledge and develop analytic, collaborative, and communication skills.

Many faculty also use case studies in their curriculum to teach content, connect students with real life data, or provide opportunities for students to put themselves in the decision maker's shoes.

Teaching Strategies for Case-Based Learning

By bringing real world problems into student learning, cases invite active participation and innovative solutions to problems as they work together to reach a judgment, decision, recommendation, prediction or other concrete outcome.

The Campus Instructional Consulting unit at Indiana University has created a great resource for case-based learning. The following is from their website which we have permission to use.

Formats for Cases

• “Finished” cases based on facts: for analysis only, since the solution is indicated or alternate solutions are suggested.
• “Unfinished” open-ended cases: the results are not yet clear (either because the case has not come to a factual conclusion in real life, or because the instructor has eliminated the final facts.) Students must predict, make choices and offer suggestions that will affect the outcome.
• Fictional cases: entirely written by the instructor—can be open-ended or finished. Cautionary note: the case must be both complex enough to mimic reality, yet not have so many “red herrings” as to obscure the goal of the exercise.
• Original documents: news articles, reports with data and statistics, summaries, excerpts from historical writings, artifacts, literary passages, video and audio recordings, ethnographies, etc. With the right questions, these can become problem-solving opportunities. Comparison between two original documents related to the same topic or theme is a strong strategy for encouraging both analysis and synthesis. This gives the opportunity for presenting more than one side of an argument, making the conflicts more complex.

Managing a Case Assignment

• Design discussions for small groups. 3-6 students are an ideal group size for setting up a discussion on a case.
• Design the narrative or situation such that it requires participants to reach a judgment, decision, recommendation, prediction or other concrete outcome. If possible, require each group to reach a consensus on the decision requested.
• Structure the discussion. The instructor should provide a series of written questions to guide small group discussion. Pay careful attention to the sequencing of the questions. Early questions might ask participants to make observations about the facts of the case. Later questions could ask for comparisons, contrasts, and analyses of competing observations or hypotheses. Final questions might ask students to take a position on the matter. The purpose of these questions is to stimulate, guide or prod (but not dictate) participants’ observations and analyses. The questions should be impossible to answer with a simple yes or no.
• Debrief the discussion to compare group responses. Help the whole class interprets and understand the implications of their solutions.
• Allow groups to work without instructor interference. The instructor must be comfortable with ambiguity and with adopting the non-traditional roles of witness and resource, rather than authority.

Designing Case Study Questions

Cases can be more or less “directed” by the kinds of questions asked. These kinds of questions can be appended to any case, or could be a handout for participants unfamiliar with case studies on how to approach one.

• What is the situation—what do you actually know about it from reading the case? (Distinguishes between fact and assumptions under critical understanding)
• What issues are at stake? (Opportunity for linking to theoretical readings)
• What questions do you have—what information do you still need? Where/how could you find it?
• What problem(s) need to be solved? (Opportunity to discuss communication versus conflict, gaps between assumptions, sides of the argument)
• What are all the possible options? What are the pros/cons of each option?
• What are the underlying assumptions for [person X] in the case—where do you see them?
• What criteria should you use when choosing an option? What does that mean about your assumptions?

Managing Discussion and Debate Effectively

• Delay the problem-solving part until the rest of the discussion has had time to develop. Start with expository questions to clarify the facts, then move to analysis, and finally to evaluation, judgment, and recommendations.
• Shift points of view: “Now that we’ve seen it from [W’s] standpoint, what’s happening here from [Y’s] standpoint?” What evidence would support Y’s position? What are the dynamics between the two positions?
• Shift levels of abstraction: if the answer to the question above is “It’s just a bad situation for her,” quotations help: When [Y] says “_____,” what are her assumptions? Or seek more concrete explanations: Why does she hold this point of view?”
• Ask for benefits/disadvantages of a position; for all sides.
• Shift time frame— not just to “What’s next?” but also to “How could this situation have been different?” What could have been done earlier to head off this conflict and turn it into a productive conversation? Is it too late to fix this? What are possible leverage points for a more productive discussion? What good can come of the existing situation?
• Shift to another context: We see how a person who thinks X would see the situation. How would a person who thinks Y see it? We see what happened in the Johannesburg news, how could this be handled in [your town/province]? How might [insert person, organization] address this problem?
• Follow-up questions: “What do you mean by ___?” Or, “Could you clarify what you said about ___?” (even if it was a pretty clear statement—this gives students time for thinking, developing different views, and exploration in more depth). Or “How would you square that observation with what [name of person] pointed out?”
• Point out and acknowledge differences in discussion— “that’s an interesting difference from what Sam just said, Sarah. Let’s look at where the differences lie.” (let sides clarify their points before moving on).

Herreid, C. F. (2007). Start with a story: The case study method of teaching college science. NSTA Press.

Select Books available through the Queen's Library

Crosling, G. & Webb, G. (2002). Supporting Student Learning: Case Studies, Experience and Practice from Higher Education. London: Kogan Page

Edwards, H., Smith, B., & Webb, G. (Eds.) (2001). Lecturing: Case Studies, Experience and Practice. London: Kogan Page.

Ellington, H. & Earl, S. (1998). Using Games, Simulations and Interactive Case Studies. Birmingham: Staff and Educational Development Association

Wassermann, S. (1994). Introduction to Case Method Teaching: A Guide to the Galaxy. New York: Teachers College Press, Columbia University.

Online Articles

Bieron, J. & Dinan, F. (1999). Case Studies Across a Science Curriculum. Department of Chemistry and Biochemistry, Canisius College in Buffalo, NY.

Walters. M. R. (1999). Case-stimulated learning within endocrine physiology lectures: An approach applicable to other disciplines. Advances in Physiology Education, 276, 74-78.

Websites and Online Case Collections

The Center for Teaching Excellence at the University of Medicine and Dentistry in New Jersey offers a wide variety of references including 21 links to case repositories in the Health Sciences.

The National Center for Case Study Teaching in Science provides an award-winning library of over 410 cases and case materials while promoting the development and dissemination of innovative materials and sound educational practices for case teaching in the sciences.

Houghton and Mifflin provide an excellent resource for students including on analyzing and writing the case.

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

Teaching with Case Studies

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

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

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

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

Case Study Analysis Process

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

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

How to Write a Case Study

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

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

Problem-Based Learning (PBL)

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

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

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

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The Case Study Teaching Method

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

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

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

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

• Martha Minow and Todd Rakoff: A Case for Another Case Method
• HLS Case Studies Blog: Legal Education’s 9 Big Ideas
• Teaching Units: Problem Solving , Advanced Problem Solving , Skills , Decision Making and Leadership , Professional Development for Law Firms , Professional Development for In-House Counsel
• Educator Community: Tips for Teachers

Watch this informative video about the Problem-Solving Workshop:

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Teaching with Case Studies to Develop Clinical Reasoning

By Ann Horigan 

• Owen, M.I. (2017). A case study scavenger hunt for senior nursing students. Journal of Nursing Education, 56(3), 191. doi: 10.3928/01484834-20170222-13.  Describes the use of a case study and simulation used with a group of senior nursing students in a synthesis seminar. The purpose of the exercise in this course was to provide students with a standardized method of analyzing and synthesizing content from previous courses to help prepare them for the RN licensure exam.  Good example of using a case study with low fidelity simulation and demonstrates that students benefit from this type of exercise. However, this was done in a sim lab setting in small groups of students and does not delve into issues of using case studies in a didactic setting to establish and further clinical reasoning.
• Peery, A. (2015). Use of the unfolding case study in teaching nurse educator master of science in nursing students. Journal of Nursing Education, 54(3), 180. doi: 10.3928/01484834-20150217-11 . Course for nurse educator MSN students done in an online format which uses an unfolding case study to work through challenging issues that a nurse educator is likely to encounter. Unfolding cases promote inquiry among students and should be believable and relevant to the class. Four steps to developing an unfolding case study are discussed. Students found the exercise useful and made them aware of situations they otherwise may not have been aware of in education. It is a dynamic and engaging method for teaching and preparing for real-life scenarios. This article is helpful as it notes the steps in devising an unfolding case study and the benefits of using this type of exercise. It would be more helpful if this had been set up as a formal inquiry with specific measures of application and synthesis pre and post. As it is, it describes an experience and innovative method which is helpful.
• Kaylor, S. and Strickland, H. (2015). Unfolding case studies as a formative teaching methodology for novice nursing students.  Journal of Nursing Education, 54(2), 106-110. doi:10.3928/01484834-20150120-06. Describes a way in which unfolding case studies can be used to teach undergraduate nursing, novice students evidence based practice information rather than the case study acting as a summative evaluation of knowledge. Unfolding case studies develop over time and are unpredictable to the learner. If well done, promotes experiential education and imagination. Students picture themselves as part of the scenario. Enables students to practice making decisions and evaluating the effects of those decisions in a non-threatening environment. When this is done in small groups, students are developing decision making, communication, clinical judgment and problem solving. Helps students connect dots between theory and practice. Authors recommend that this is not the only method of active learning used throughout the semester and should be used several times but not exhaustively.  Excellent article that presents a unique active learning method with benefits, barriers, lessons learned. Would be interesting to see what students thought of it as a learning method.
• Dudas, K. (2012). Podcast and unfolding case study to promote active learning. Journal of Nursing Education, 51(8), 476. DOI:10.3928/01484834-20120719-02. Describes the use of a pre-class podcast used to give information for an unfolding case study on a patient with a neuromuscular disorder completed in class. Information from the podcast was reviewed at the beginning of class and then students were given the unfolding case study. Class reconvened and answers to the case study reviewed. Students reported feeling actively involved in learning and that clinical decision making skills improved. Students wanted these more frequently in the course. Authors state that while unfolding case studies are time consuming to prepare, the benefits from active learning outweigh the time needed.
• Utterback, V., Davenport, D. Gallegos, B. & Boyd, E. (2012). The critical difference assignment: An innovative instructional method. Journal of Nursing Education, 51(1), 42-45. DOI:10.3928/01484834-20111116-03. Describes an assignment called the Critical Difference assignment where two case studies are given to students who must use reasoning to differentiate between the 2 cases. The cases have similar patient presentations but have differing and unknown underlying pathophysiologies. Students must compare and contrast symptoms, lab results, diagnostic studies to come to an understanding of the critical difference between the 2 cases and then develop a plan of care for each case based on the similarities and differences in the cases. These studies are called companion case studies and are purposely constructed so that students must discriminate between 2 similarly presenting patient problems. The outcomes from this type of learning are that the learner can learn by themselves, learn with others, share information, and make decisions. This mirrors the ability to work with others in the clinical setting. Excellent example of how to move students thinking to the next level. Again, would be interesting to see what students thought of experience as well as any objective measures of how this has helped initiate clinical judgment or improve abilities in clinical judgment.
• Priddy, K. & Crow, M. (2011). Clinical imagination: Dynamic cast studies using an attribute listing matrix. Journal of Nursing Education, 50(10), 591-594. DOI:10.3928/01484834-20110630-03. Describes how to develop and use a matrix for choosing elements of a case study so that they are randomly generated and students have differing elements with different outcomes. It allows for more opportunities to role model and richer discussion. The number of choices on the matrix can be based on the context and the problem at hand. This can be done based on developmental level of students and where they are in the nursing curriculum. It describes the steps of how to implement this in class in detail which is very helpful. The variety of options possible gives opportunity for great discussion and generation of nursing knowledge. Great example of what can be done in smaller groups as formative or summative evaluation. Would be difficult to do in a large lecture course. Again, no objective measures of how this has pushed students to think and engage.
• Bennett, C., Kennedy, S. & Donato, A. (2011). Preparing NP’s for primary care: Unraveling complexity with unfolding cases. Journal of Nursing Education, 50(6), 328-331. doi:10.3928/01484834-20110228-05. Describes the use of Backward Design (identifying desired results, identifying evidence of learning and developing teaching methods) to design a course for nurse practitioners in a behavioral health therapeutics course. Faculty developed cases that included an initial patient encounter and follow up encounter which were video taped with actors and complications of treatment or new problems were added at follow up visits. In the final step of Backward Design, creating teaching methods, the authors used Zull’s model of learning as brain change, which encourage innovative strategies to teach in context. There is an emphasis on reflection and iterative knowledge development. The authors found that students’ iterative thought processes advanced as they were able to practice as independent clinicians in a safe and collaborative environment. Course evaluations were done based on university requirements and therefore did not evaluate this method specifically, but they state that written feedback was overwhelmingly positive. Would be nice to see objective measures of advancement of clinical thinking, maybe samples of how grades improved over the semester or how pass rates on certification exams improved.
• Beyer, D. (2011). Reverse case study: To think like a nurse. Journal of Nursing Education, 50(1), 48-50.  doi:10.3928/01484834-20101029-06. Describes combining two active learning strategies, case studies and concept mapping into a reverse case study to promote critical thinking and problem solving. The article outlines a process for creating a reverse case study to be used in small groups. They are given a blank concept map with elements of the nursing process and patient history on it, but with no specific information other than a list of medications. Students work backward from that point to devise a list of anticipated medical problems the patient probably experiences and the care for these problems. The complexity of the cases can be manipulated by the number and type of medications. Groups then present their cases and priorities. This is a unique twist on the traditional case study. It could be done at every level of nursing education and development. A lab or discussion course would probably be best, not a class of 100+ students.
• Tanner, C. (2009). The case for cases: A pedagogy for developing habits of thought. Journal of Nursing Education, 48(6), 299-300.  An editorial that argues that the use of case based learning as a method that supports experiential thinking, clinical judgment and encourages students to “think like a nurse”. No information on actual work done in classroom.
• Sandstom, S. (2006). Use of case studies to teach diabetes and other chronic illnesses to nursing students. Journal of Nursing Education, 45(6), 229-232. Case studies increase learning by “placing” them in a situation where they must use or apply knowledge learned in the classroom. They are in a real world situation with decisions to make. The use of the example case study is done in the laboratory setting about diabetes as students are learning to draw up insulin and monitor blood glucose. Discusses 2 other assignments related to diabetes content that students are assigned. The article lacks depth about how the case studies are developed and why. No objective findings of student evaluation or learning other than the author’s recitation of what has been said in lab.
• Schlenker, E. & Kerber, C. (2006). The CARE case study method for teaching community health nursing. Journal of Nursing Education, 45(4), 144. Stands for Case study, Application, Research, Evaluation. Goal of this method is to facilitate understanding of theoretical content, foster interaction between faculty and students and knowledge sharing, give opportunities to apply knowledge in the classroom. Case studies are developed based on current topics in community health nursing and introduced during class time. Students work in small groups to answer clinical questions. The authors state that this has been well received by students who are motivated and excited to come to class and have done the prep work. There is no description of how the case studies are generated other than by choosing current topics in community health nursing, there is also no further discussion of how this method is used but a generic description. More detail would be helpful.
• Loving, G. & Siow, P. (2005). Use of an online case study template in nursing education. Journal of Nursing Education, 44(8), 387-388. The authors created a template to be used in online nursing courses that was based on interactivity and feedback for faculty to use in the design of case studies. It is a set of online forms that allows faculty to enter information. Students also work through this case study and click on multiple choice answers where feedback is given. This isn’t particularly helpful information. It doesn’t inform how the body of the case should be created, the elements, whether they should unfold and how or how the students interface with the case study in detail. 
• Tarcinale, M. (1987). The case study as a vicarious learning technique. Journal of Nursing Education, 26(8), 340-341. Discusses vicarious learning or learning through imagination, which I think now 30 years later would be experiential, or situational learning. The learner will use information from previous experiences to help solve current situational problems. Components of a case study are discussed (very helpful and one of only a few articles that do this). The placement of the case study in class depends on what it would be used for. Helpful information, but I think that the case study method has evolved quite a bit over time to include the reverse and unfolding case studies. However this is a good summary of how a basic case study can be used to bring abstract concepts to more concrete understanding.
• Page, J., Kowlowitz, V. & Alden, K. (2010). Development of a scripted unfolding case study focusing on delirium in older adults. The Journal of Continuing Education in Nursing, 41(5), 225-230. DOI:10.3928/00220124-20100423-05. The article begins by talking about how simulation is an important piece of practice based learning and that continuing education for nurses should incorporate more of it. The article then goes on to describe how to develop an unfolding case study. (might be splitting hairs, but case studies and simulation are not the same, many times simulation will use a case study, but sometimes it doesn’t. And not all uses of case studies are simulation. They don’t do a good job of connecting the two in the article) The steps for developing a case study for use are outlined as well as how to review it before implementing it. The authors present data on evaluation of the case by nurses who were involved in the continuing education. This is good information, detailed in the description of how the case can be developed, presented and evaluated.
• Jones, D. & Sheridan, M., (1999). A case study approach: Developing critical thinking skills in novice pediatric nurses. The Journal of Continuing Education in Nursing, 30(2), 75-78. Key component of nursing is problem solving, but not all nurses are good at it. The use of case studies promotes problem solving and critical thinking. They can be done with real or hypothetical situations. Provides an opportunity to enact in decision making when a real clinical situation isn’t available. In novice pediatric nurses, case studies reinforce what was learned in school but also introduce them to unique situations in family focused nursing. The article goes on to describe that case studies should include certain elements and gives and example. The article does not present data on how case studies have improved novice nurses comfort level or competence in working with families and children or if novice nurses found them useful during an orientation period.
• Smallheer, B. (2016). Reverse case study: A new perspective on an existing teaching strategy. Nurse Educator, 41(1), 7-8. DOI: 10.1097/NNE.0000000000000186. Traditional case studies can be limited to utilizing the lower portion of Blooms taxonomy, remembering, understanding, applying.  The reverse case study can engage students in higher parts of taxonomy: analyzing evaluating and creating. Students actually develop the scenario which means they must analyze and evaluate material in creating the materials and data for the case study. The article gives an example of a graded reverse case study done in a nursing pharmacology class. During the session, faculty observed collaboration, team work, prioritization and critical thinking. This type of case study refocuses students from being task oriented to being thinkers and planners. Would be an excellent process for lab or seminar group, clinical post conference group. May be difficult to do in a large class without splitting into groups. Again, wonder if there are any objective measures regarding student outcomes.
• Porter-Wenzlaff, L. (2013). Unfolding multicourse case study: Developing students administrative competencies. Nurse Educator, 38(6), 241-245. DOI: 10.1097/01.NNE.0000435263.15495.9f. The articles describes an unfolding case study that is done over 2 semesters in 2 courses. This is done in 2 graduate level nurse executive courses that are leveled. Students work in teams as the nurse executive of a fictional facility and must work through administrative complexities such as physician relations, resource allocation etc. Students are to do individual pieces of projects and come together and use the work in the larger objective. The projects progress across semesters and ideally students teams are the same as semesters change. The author recognized that students felt over whelmed and unprepared for this learning (and probably would have no matter the format) but found ways to help them work through by validating their concerns, having help available and that learning is an ongoing process. This paper does a great job of reporting anecdotal feedback from students, although it acknowledges there were no formal pre and post measures of implementation of this case study format.
• Harrison, E., (2012). How to develop well written case studies: The essential elements. Nurse Educator, 37(2), 67-70. DOI: 10.1097/NNE.0b013e3182461ba2. Briefly discusses the history of the use of case studies as educational tool in nursing. Suggests that case studies, much like narratives, should have a setting, characters, plot and elements of style that come together to create a mystery, a puzzle to be solved by the information given and knowing what additional information is needed. Students identify important data from that data that may be superfluous or not essential to the case. This is a unique way to describe a case study and how to create elements that nurses may forget, or not emphasize in their creation of case studies. Would be helpful to know if this paradigm has been used by others and if they found it effective.
• Henning, J.E., Nielsen, L.E. & Hauschildt, J.A. (2006). Implementing case study methodology in critical care nursing: a discourse analysis. Nurse Educator, 31(4):153-8. Describes a change in content delivery technique based on student feedback that lectures were boring and they wanted to experience more patient scenarios. Case study approach was adopted to increase interaction between teacher and students. Used method by Stepien et al. to analyze the case.  A model for discussion was then used with the case method which uses 3 types of discussion, 1. Frame the discussion where interest is generated and background information is given. 2. Conceptual discussion – teacher guides students in grasping concept 3. Application discussions where students discuss newly acquired knowledge is discussed as applied to scenarios. Using this method required that the teacher learn a new way to talk with or to students; had to learn how to elicit information from students and respond to them.  Student participation increased significantly with each addition of the next level of discussion where the teacher adjusted their questioning/cuing of students to elicit more response. They found that students spoke 2x as much as professor and both students and teacher seemed to become more comfortable with their new role as discussions went on. Very helpful in describing a way in which a classroom discussion can take place, one that elicits student participation and lets students guide the learning and morphs into a review discussion where the teacher makes sure that students understand the material accurately and use their discussion to apply newly acquired material.
• Ciesielka, D. (2003). Clues for clinicians: a case study approach to educating the renaissance nurse. Nurse Educator, 28(1), 3-4. Describes a way to integrate the humanities into a rigorous graduate curriculum already packed with science in order to prepare nurses to be able to work with patients of all cultures and social status. Developed Clues for Clinicians and used in the first clinical reasoning/clinical judgment course in nurse practitioner program. Instead of deriving cases from standard everyday clinical practice, cases were developed based on historical accounts. Faculty guided students in problem solving and students found themselves discussing the medical issue while also investigating a part of medical history.. Feedback was unanimously positive. I’m not convinced that this infuses humanities to the extent that the authors think it does, but it does keep interest and encourages student participation and reasoning as well as gives students something memorable to hang the information on. 
• Dowd, S.B. & Davidhizar, R. (1999). Using case studies to teach clinical problem-solving. Nurse Educator, 24(5), 42-6. Discusses advantages of using case studies to as well as preparation for faculty. Lists ways to prepare the case studies and how case studies can be solved.  Case studies connect theory to practice. They require preparation on the part of faculty and flexibility in allowing students to solve the case.
• Summary of findings: Most studies lack any data regarding student performance in clinical reasoning or judgment pre/post implementation of this method. While there is evidence that students find this method useful and engaging, no study presents findings that demonstrate that the case study method does what it’s purported to do. Studies discuss the preparation that must go into the case study development, that there are different ways of using the case study method (traditional, unfolding, reverse) and that students find them beneficial as well as how thinking is transformed to reach higher levels of Blooms Taxonomy. Almost all studies discuss case studies used in small groups or large classes broken into groups. None discuss how to lead a large class through a case and if/how this can engage students as well as improve their clinical reasoning. Only one articles discusses the use of an ongoing case that continues to the next semester, and this is for graduate students who are at a very different level of processing information than undergraduate students.

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• v.19(3); Fall 2020

Value of Case-Based Learning within STEM Courses: Is It the Method or Is It the Student?

Ashley rhodes.

† Division of Biology, Kansas State University, Manhattan, KS 66506

Abigail Wilson

Timothy rozell.

‡ Department of Animal Sciences and Industry, Kansas State University, Manhattan, KS 66506

Associated Data

Undergraduate attrition from science, technology, engineering, and mathematics is well documented and generally intensifies during intermediate years of college. Many contributing factors exist; however, a mismatch between timing of certain pedagogical approaches, such as case-based learning, and the level of students’ cognitive abilities plays a crucial role. Using cognitive load theory as a foundation, we examined relationships between case-based learning versus a traditional lecture and learning gains of undergraduates within an intermediate physiology course. We hypothesized instruction via a case study would provide greater learning benefits over a traditional lecture, with gains possibly tempered by student characteristics like academic preparation, as measured by ACT scores, and academic age, as measured by credit hours completed. Results were surprising. Case-based learning did not guarantee improved learning gains compared with a traditional lecture for all equally. Students with lower ACT scores or fewer credit hours completed had lower learning gains with a case study compared with a traditional lecture. As suggested by cognitive load theory, the amount of extraneous load potentially presented by case-based learning might overwhelm the cognitive abilities of inexperienced students.

INTRODUCTION

Increasing the number of students completing a postsecondary degree within the science, technology, engineering, and mathematics (STEM) fields is crucial for building and maintaining a strong workforce, yet loss of students from these fields during their undergraduate years continues to be problematic ( President’s Council of Advisors on Science and Technology, 2012 ; Graham et al. , 2013 ; Freeman et al. , 2014 ; Vilorio, 2014 ; Chen, 2015 ). Attrition from STEM fields may be caused by a number of complex factors that challenge both educators and students alike. For example, attrition has been linked to large classroom sizes; rapid pace of information delivery; a competitive atmosphere; uninspiring pedagogy that is seemingly irrelevant to the lives of students, causing a loss of interest; inability to see presented information as a cohesive whole; or simply feeling that they do not belong in STEM ( Jozefowicz, 1994 ; Herreid et al. , 2012 ; President’s Council of Advisors on Science and Technology [PCAST], 2012 ; Graham et al. , 2013 ; Freeman et al. , 2014 ; Scott et al. , 2017 ; Fisher et al. , 2019 ). However, it is also possible that a mismatch in the timing of pedagogical tools used and the individual learning needs of students could also cause attrition from STEM fields. For example, Wood (2009) suggested that superior [SIC] students will progress from introductory to upper-level courses during their undergraduate years regardless of the teaching method used. However, students considered to be less academically oriented or self-motivated who leave STEM fields early in their college careers might do so because the curricular methods used are often seen as nothing more than a large collection of disconnected facts that rarely have much relevance to their daily lives and will soon be forgotten ( Wood, 2009 ). Wood (2009) concluded that, for this group of students, the issue lies not in what we teach but in how we teach. This conclusion is both encouraging and yet perhaps a little puzzling for educators, many of whom go to great lengths to help all students within their courses succeed. While some suggestions for helping to alleviate the dissonance between academic preparation and success within STEM courses have been made, they sometimes appear ambiguous or perhaps too complex for educators to tackle. For example, improving student preparation during junior high and high school could translate to better success in college ( Ejiwale, 2013 ). Additionally, improving STEM instructor preparation at multiple levels could be helpful ( Goldhaber and Brewer, 1998 ; Ingersoll and Perda, 2010 ; PCAST, 2012 ). Also, adding more engaging activities within STEM courses could be beneficial for helping underprepared students see connections between in-class learning and real-life applications ( Villanueva and Hand, 2011 ; Kennedy and Odell, 2014 ).

In contrast to some of these more open-ended suggestions, one solution that has been promoted for increasing student success in STEM is the use of active-learning approaches such as case-based learning ( Lundeberg, 2008 ; Kaddoura, 2011 ; McRae, 2012 ; Herreid and Schiller, 2013 ; Greenwald and Quitadamo, 2014 ; Stains et al. , 2018 ). Case-based learning encourages students to use techniques that help them integrate, synthesize, and apply newly learned information to a broader context, both to help them see the value of what they are learning and to foster critical-thinking skills ( Jozefowicz, 1994 ; Graham et al. , 2013 ; Greenwald and Quitadamo, 2014 ).

Case-based learning can take many forms but generally relies upon the use of a case study that describes a specific situation or clinical case and requires students to work through the information to generate solutions and solve problems ( Herreid, 2006 ; Wood, 2009 ; Popil, 2011 ; Savery, 2015 ; McLean, 2016 ). Case studies can vary substantially in length, format, delivery, and the type of media included. Cases may emphasize problem solving, debates, flexible thinking, development of alternative strategies, and even the use of skepticism ( Herreid, 2004 ). Implementing cases within courses can also vary, but according to Herreid (1998) , four major classifications exist in regard to what students do: participate in small-group activities, participate in discussions, listen to a lecture, or work alone completing an individual assignment. Thus, when or how a case study is delivered to students, the responsibilities of students, interactions between students, and even case study assignments that entail students working individually or in groups all vary ( Popil, 2011 ; Thistlethwaite et al. , 2012 ).

Comparing case-based learning to more traditional forms of learning has resulted in reports of increased learning gains ( Kaddoura, 2011 ; Bonney, 2015 ), decreased learning gains ( Andrews et al. , 2011 ; Thistlethwaite et al. , 2012 ), and no significant changes ( Dochy et al. , 2003 ; Halstead and Billings, 2005 ; Hoag et al. , 2005 ; Terry, 2007 ; Kulak and Newton, 2014 ). Some researchers have also reported that case-based learning is effective, but only if supported by supplementary didactic lectures that structured student understanding of the material ( Cliff, 2006 ; Baeten et al. , 2013 ), or that case-based learning improved student attitudes but not always student learning ( Wilke, 2003 ). This disparity could be caused by several factors. For example, it is not currently known how much background knowledge or preparation students should have before they can effectively engage with case-based activities ( McLean, 2016 ), when and how instructors should deliver these activities ( Lundeberg, 2008 ), and how much instructor guidance is required ( McRae, 2012 ).

It is possible that the existing uncertainty regarding who exactly benefits from case-based learning in comparison to other teaching methods could be due to the number of studies primarily relying upon survey data to make conclusions as to the value of this approach ( Cliff and Wright, 1996 ; Knight et al. , 2008 ; McLean, 2016 ; Kaur et al. , 2019 ) and the number of studies that did not use a control and thus lacked a true experimental design ( Greenwald, and Quitadamo, 2014 ; Kulak and Newton, 2014 ). Furthermore, few authors have specifically investigated the utility and potential benefits of case-based learning in regard to certain undergraduate student characteristics or provided clear guidance regarding when and how to use case-based learning within undergraduate courses ( Lundeberg, 2008 ; Kulak and Newton, 2014 ; McLean, 2016 ). Thus, we believe our overarching research question is important when using case-based learning within undergraduate STEM courses: For whom is it useful?

Theoretical Framework

Cognitive load theory (CLT) serves as the foundation for this research, as it provides guidance for investigating relationships between instructional design and student learning gains ( Paas et al. , 2003a ). According to CLT, cognitive processes, and thus learning, are impacted by three types of cognitive loads: extraneous load, intrinsic load, and germane load. These loads are additive and must be appropriately managed for optimal learning, but how they are managed differs based on student characteristics such as previous academic experiences, prior knowledge, and learning preferences. For example, extraneous loads, defined as superfluous information that does not directly relate to learning objectives, should be minimized wherever possible. This is especially true for novice learners, whose ability to take in new information can quickly be overloaded, even when completing common tasks such as searching for and applying information to solve a problem ( Paas et al. , 2003a ). In contrast, intrinsic loads, defined as the degree of difficulty inherent to a discipline, can be more difficult for instructors to manage. Intrinsic load must be supported by appropriately scaffolding information, but should never be minimized, as simplification could give an artificial impression of the discipline and potentially erode the ability to critically think about the information in future contexts ( Paas et al. , 2003a ). However, the degree of scaffolding required is unique for each learner; thus, designing a curriculum or even an individual activity that appropriately manages intrinsic load becomes difficult, especially in large courses with diverse enrollment. According to Paas et al. (2003a ), the key to successfully managing intrinsic load is to consider element interactivity, or the number of interacting items, that must be simultaneously managed to understand a concept. If this number is high, which is often the case within STEM courses, then additional instructional support is often required; for novices, the recommendation is to omit all but the most essential interacting elements. Germane loads, defined as the amount of effort a learner is willing to expend to understand a concept, can be positively impacted by instructional design, but only if the needs of the learner are matched and supported by the way in which information is presented. For example, learners who have little background in a subject, and thus underdeveloped abilities to synthesize and use new information, benefit from instructional tools that present information directly and do not require searching for or synthesis of abstract ideas, while the opposite is true for learners who have prior and positive experiences with the subject ( Paas et al. , 2003a , b ; Sweller et al. , 2011 ; Young et al. , 2014 ).

Conceptual Framework

Using CLT as a theoretical framework, we explored potential relationships between comprehension of complex information that had a high intrinsic load, the experience of learners based upon individual characteristics such as level of academic preparation, and two distinct instructional formats that varied in amount of extrinsic load yet contained the same content. One instructional format included the use of an interactive case study that was designed to engage students with a story and scaffold their nascent understanding of the information presented by chunking information into manageable sections, each one containing explanatory text, interactive graphics, and critical-thinking questions. While carefully designed and aligned with suggestions on case study development, this format did carry a higher extrinsic load due to the number of interacting elements that had to be considered in order to understand the information.

The second instructional format represented a more traditional teaching method and included a didactic lecture using bulleted PowerPoint slides that also included the same graphics presented within the case study; however, the lecture format was devoid of interactive activities and questions and involved only a lecture during which students mostly listened but were allowed to ask questions at any time. This format had a lower extrinsic load due to the decreased number of interacting elements that needed to be considered at any given time to understand the information.

These two instructional formats were used within a large, intermediate-level undergraduate physiology course with a diverse student body that varied in age and academic preparation. However, all were majoring in a STEM discipline, and many aspired to matriculate into a professional school upon graduation. Thus, while variation did exist within the population, we believe it is an accurate portrayal of the natural variation found within most large STEM courses at this level.

To examine the utility of case-based learning and the benefits it may provide in regard to specific student characteristics in comparison to a more conventional format of learning, we investigated the following two research questions:

• Compared with a conventional learning format such as a traditional lecture, how do student learning gains differ when using a case study?
• How do student characteristics such as general academic preparation and credit hours completed relate to learning gains derived from the use a case study?

Setting and Participants

This study took place at a large, midwestern, land-grant university with an admissions acceptance rate of 94%. Participants were recruited from an intermediate (300 level at a university in which undergraduate courses start at 100 and go through 600) physiology course offered within a biology department. During the semester in which the study was conducted, the course was open to all students who had completed introductory biology and chemistry courses and received a “B” or better in both. Furthermore, this course was an 8 credit-hour course that included several components such as lecture, laboratory, and cadaver dissection; thus, most students were very committed to learning, as their grades would have had a significant impact on their overall grade point averages. Applications of course material on exams and quizzes tended to be focused on human health and applications to allied health professions. The average ACT score of students was 26.6. Of the 134 students enrolled, all chose to participate, although only 122 completed all portions of the study due to absences. The final distribution of students completing all components of the study represented a mixture of 34 sophomores, 59 juniors, and 29 seniors. Information related to gender and ethnicity was not tracked.

Participation in the study was voluntary, and all activities were approved by our Institutional Review Board (IRB protocol no. 7028). Students were awarded a small amount of extra credit for participating. Students were provided the option of an alternative assignment if they did not want to participate; however, none selected this option.

Development of Case Study and Conventional Lecture Treatments

Both the case study and conventional lecture were created by the authors to specifically deliver information about insulin resistance and its progression to type II diabetes. Not only do these topics encompass suggestions by Michael et al. (2017) about pertinent concepts that should be taught within undergraduate physiology courses, such as flow-down gradients between blood and interstitial fluid and details of cell membranes, but they also align well with suggestions made by Allen et al. (1996) regarding topic selection for the design of critical-thinking activities. The case study was created using a design-based research process that entailed four iterations. Each iteration was reviewed by graduate teaching assistants as well as three STEM instructors. After each iteration, feedback was used to revise and improve the case study. The final iteration of the case study authored by Wilson et al. (2017) was peer reviewed and published by the National Center for Case Study Teaching in Science.

The case study included a short story about an individual who, through diet and lack of exercise, proceeded through the stages of insulin resistance and pre-diabetes and eventually developed type II diabetes. Immediately following each section about this individual’s story, accompanying informational text as well as interactive figures and graphics describing the physiology of what was occurring were presented. The story, text, and graphics were presented in small sections, a strategy known as chunking, which is encouraged when presenting complex information that has multiple interacting elements ( Mayer and Moreno, 2003 ). The interactive figures and graphics, which displayed the same information presented within the text, required students to apply what they had just read to complete them as described by carefully written instructions. And finally, critical-thinking questions were placed at the end of each section or chunk, and students were asked to think about what they had just learned before moving to the next section. Figure 1 provides a sample of the case study design features.

Typical features of the case study design. This particular portion was taken midway through the case study after students had been presented with information about the basics of carbohydrate breakdown in the digestive system. Specific features related to chunking and scaffolding include a short story, a small amount of explanatory text, and instructions explaining how to interact with a graphical feature designed to help students visualize the information. Additionally, the explanatory text and visuals were placed very close to each other, and vocabulary used in the explanatory text matched vocabulary used in the visual in order to reduce cognitive load.

Students in the lecture treatment, which consisted of a traditional lecture with PowerPoint slides and accompanying handouts of the slides, received the same physiological information presented in the case study. For example, the lecture and handouts included static versions of the figures and graphics found in the case study, and these were described directly to students by the instructor. This presentation was also subjected to four iterations of review and improvement by graduate students and other STEM instructors. Thus, the major differences between the case study and conventional lecture treatment groups were that students in the latter group were not presented with a story or required to complete activities associated with the graphics. In short, the conventional lecture contained little to no extraneous information.

Implementation of Treatments

Both treatments were administered during regularly scheduled lab periods within a single week of the semester and before any presentation of glucose homeostasis by the primary instructor in either lecture or lab. At the beginning of each treatment, the same instructor provided a brief overview of the activities and goals. For the case study group, this also included instructions on how to work through the case and specifically how to interact with the graphics. This instructor was the lead author of the case study and conventional lecture treatment and was also a lab instructor for the course; thus, comfort level with techniques, delivery, students, and content was high.

Students in both treatments were instructed to work alone, as one of our main objectives was to correlate student characteristics such as academic preparation and experience with learning gains when extrinsic load was varied between treatments. Thus, we purposefully did not allow students to work in groups, as this would have made our data difficult to interpret in regard to individual student gains. However, students in both treatments were told several times they could ask the instructor questions at any time while working through the case study or listening to the lecture.

Experimental Design

Using the pretest/posttest comparison group design ( Campbell and Stanley, 1963 ), we assessed differences in student learning gains resulting from the use of a case study versus a conventional lecture over the same concepts. Participants were recruited using a convenience sampling method, with 122 completing all components of the study, which included a prior knowledge assessment (PKA; Rhodes and Rozell, 2017 ), a modified version of the Student Approach to Learning (SAL) survey ( Marsh et al. , 2006 ; Rhodes and Rozell, 2017 ), a pretest, a learning treatment, and a posttest. Experimental design components and schedule are described in Figure 2 .

Experimental design. Students completed the PKA and SAL survey on the first day of class, then a topic-specific pretest was given a week before randomizing participants into either the case study or conventional lecture treatment. A posttest, which was identical to the pretest, was given immediately after each treatment. Not shown in this graphic is the collection of ACT scores, which occurred at the end of the semester after final grades had been submitted.

The PKA was used to assess the background knowledge of students about core physiological concepts and was administered on the first day of class. The PKA (Appendix A in the Supplemental Material) consisted of 10 multiple-choice questions, with each question potentially having multiple correct answers. To receive the full point(s) for each question, students had to have selected all the correct answers and none of the incorrect answers on this assessment. This grading procedure was used to reduce awarding points for guessing. Students received 1 extra credit point for completing the PKA that was not dependent on the score. The PKA was created and refined over a period of several years within this specific course before being used in this study.

For evaluating how students approach learning new information presented to them in a formal course setting, a modified version of the SAL survey was used (Appendix B in the Supplemental Material). This survey was designed to assesses a variety of student characteristics, such as self-regulated learning strategies, motivation, confidence, and learning preferences ( Marsh et al. , 2006 ). For this study, we only selected questions from the SAL that evaluated the self-regulated learning strategies of students, specifically memorization and elaboration, and generated an individual SAL metric for each student, as previously described by Rhodes and Rozell (2017) . This metric could then be used to quantify and compare results from the SAL with other components of the study.

Pretest and Posttest

Both the pretest and posttest (Appendix C in the Supplemental Material) consisted of 10 multiple-choice questions that could have multiple correct answers. Full points for each question were awarded only if every correct answer had to be selected and none of the incorrect answers selected. As with the PKA, this all-or-nothing grading scheme was used to reduce the chance of receiving full credit due to guessing.

To ensure that questions asked on the posttest were appropriate and understandable for students after receiving either treatment, we applied an item difficulty index (IDI) before analyzing statistical results related to the research questions. As discussed by Tavakol and Dennick (2011) , this metric can be used to determine whether a question effectively measured comprehension by students after receiving a particular form of instruction. The following formula was used to calculate the IDI, where R is the number of students who answered the question correctly; N is the number of total responses, including those that were correct, incorrect, or left blank; and i refers to the question number:

While the IDI can range from 0 to 1, with very difficult questions having a score nearing 0 and very easy questions have a score approaching 1, the IDI of each question should have ideally ranged between 0.3 and 0.8 ( Tavakol and Dennick, 2011 ). The IDI for question 10 on the posttest was outside the ideal range, possibly due to the complexity of the question. Statistical analyses were performed both with and without question 10, but results did not change. Results of the IDI are shown in Table 1 .

Results of the Item Difficulty Index.

The ACT College Readiness Assessment

The ACT is a standardized college entrance exam that assesses college readiness and is often a prerequisite when applying to colleges. After gaining permission from student participants and our IRB, ACT scores were collected from the university’s online information system after the semester was over.

Credit Hours Completed

The number of total credit hours completed at the start of the study was collected and used as a metric of academic age or experience. After gaining permission from student participants and our IRB, information was retrieved via the online university information system.

Statistical Analyses

All data were analyzed using IBM’s SPSS v. 26. Differences between means were evaluated using one-way analysis of variance (ANOVA). Correlations between variables for student data were calculated using Spearman’s rank-order correlation test. This test was selected as it is slightly more conservative than Pearson’s, our data were monotonic, and we included more than one outlier for each correlation performed. Statistical significance was defined as p ≤ 0.05.

Our analyses yielded several noteworthy and unexpected results. In regard to our first research question, “Compared with a conventional learning format such as a traditional lecture, how do student learning gains differ when using a case study?,” we found no differences by treatment ( Figure 3 ). Using a one-way ANOVA, we found that the means of posttest scores for students in the case study group were not statistically different from students in the conventional lecture group, F (1, 119) = 0.025, p = 0.874. Furthermore, learning gains of students in the case study group were not statistically different from those of students in the conventional lecture group, F (1, 119) = 0.027, p = 0.946.

Results of pretest, posttest, and learning gains by treatment. Values on the y-axis are points earned on the identical pretest and posttest assessments, with potential scores ranging from 0 to 10. Both pretests and posttests were graded “all or none” to avoid guessing. For each student, the pretest score was subtracted from the posttest score to calculate learning gains. Bars shown are means plus or minus SD. No statistical differences were found between means for any of the parameters tested ( p ≥ 0.05).

For further verification, learning gains by treatments were also analyzed using the average normalized gain equation for estimating the impacts of case-based learning as developed by Hake ( 1998a , b ), where (Post − Pre)/(10 − Pre). Normalized learning gain was 0.40 for the case study treatment and 0.39 for the conventional lecture group, corroborating that no statistical differences existed in learning gains by treatments.

In regard to our second research question, “How do student characteristics such as general academic preparation and credit hours completed relate to learning gains derived from the use of a case study?,” we found that the benefit of case-based learning was correlated with certain student characteristics. The use of a case study did not automatically translate to higher learning gains for all. Instead, it appears as though certain student characteristics predicted learning gains when case-based learning was used but this was not true when traditional didactic lectures were used. For example, as displayed in Figures 4A through ​ through7A, 7A , positive and significant correlations existed between learning gains from the use of a case study and prior knowledge levels, r (59) = 0.275, p = 0.034; preferences for elaboration over memorization as measured by the SAL metric, r (59) = 0.270, p = 0.039; ACT scores, r (53) = 0.479, p = 0.000; and college credit hours completed, r (61) = 0.299, p = 0.019. However, as shown in Figures 3B through ​ through7B, 7 B, no relationships existed between learning gains from the use of a traditional lecture and student characteristics such as prior knowledge levels, r (60) = 0.012, p = 0.872; preference for elaboration over memorization as measured by the SAL metric, r (56) = −0.056, p = 0.680; or college credit hours completed, r (60) = −0.024, p = 0.855. A positive and significant correlation did exist between ACT scores and learning gains from a traditional lecture, r (52) = 0.276, p = 0.047.

Effect of prior knowledge on learning gains. Participants were given a prior knowledge quiz that consisted of 10 multiple-choice questions with multiple potential correct answers, graded all or none. Identical pretest and posttest quizzes over the specific topics covered by the case study (A) or lecture (B) treatments consisted of 10 multiple-choice questions with multiple potential correct answers, graded all or none. Learning gains were calculated by subtracting pretest score from posttest score for each participant. A Spearman’s rank-order correlation test was used to determine relationships between prior physiology knowledge and learning gains, and correlations were considered to be significant at p ≤ 0.05.

Effect of academic experience on learning gains. The number of credit hours completed was collected for participants with their permission. Identical pretest and posttest quizzes over the specific topics covered by the case study (A) or lecture (B) treatments consisted of 10 multiple-choice questions with multiple potential correct answers, graded all or none. Learning gains were calculated by subtracting pretest score from posttest score for each participant. A Spearman’s rank-order correlation test was used to determine relationships between college credits completed and learning gains, and correlations were considered to be significant at p ≤ 0.05.

Effect of participant’s approach to learning on learning gains. Participants were given a survey (the SAL) that assessed their preferred approach to learning on a five-point Likert scale, and a calculated SAL metric was used to quantify whether the preferred approach was memorization (SAL metric scores) or elaboration (higher SAL metric scores). Identical pretests and posttests over the specific topics covered by the case study (A) or lecture (B) treatments consisted of 10 multiple-choice questions with multiple potential correct answers, graded all or none. Learning gains were calculated by subtracting pretest score from posttest score for each participant. A Spearman’s rank-order correlation test was used to determine relationships between SAL metric scores and learning gains, and correlations were considered to be significant at p ≤ 0.05.

Effect of standardized test performance on learning gains. Scores from the ACT exam taken before college entrance were collected with permission of the participants. Identical pretest and posttest quizzes over the specific topics covered by the case study (A) or lecture (B) treatments consisted of 10 multiple-choice questions with multiple potential correct answers, graded all or none. Learning gains were calculated by subtracting pretest score from posttest score for each participant. A Spearman’s rank-order correlation test was used to determine relationships between ACT scores and learning gains, and correlations were considered to be significant at p ≤ 0.05.

CONCLUSION AND DISCUSSION

The overarching purpose of this study was to investigate the relationship between the use of case-based learning within an intermediate-level undergraduate STEM course and correlate specific student characteristics such as academic preparation and experience with learning gains. We were specifically interested to see whether case-based learning represented a beneficial and equitable form of learning for all participants, or, as predicted by CLT, whether some students perhaps benefited more from a traditional lecture due to its simpler structure and reduced cognitive load. We were also interested in providing realistic suggestions to other educators who may be considering the use of case-based learning in their courses in piecemeal manner to replace certain lectures or perhaps a laboratory activity but are unable to replace an entire semester’s curriculum given the resources required ( Colliver, 2000 ). As explained by Aikens and Dolan (2014) and Albanese (2000) , replacing single lessons or activities is more realistic when trying something different in most courses. Also, given the findings of Stains et al. (2018) , most STEM instructors naturally move between different teaching formats, even within a single teaching period. Thus, providing evidence-based guidance on when to use certain formats and with which population of students may help direct the timing and implementation of certain activities.

In regard to our first research question, “Compared with a conventional learning format such as a traditional lecture, how do student learning gains differ when using a case study?,” we found no differences between treatments. Our findings were consistent with those of other authors such as Hoag et al. (2005) , who found no difference in learning gains between the use of a case study compared with a didactic lecture for students enrolled in an undergraduate immunology course when assessing critical-thinking skills via a multiple-choice test. Similarly, Terry (2007) assessed introductory biology students’ critical-thinking skills using the Watson-Glaser Critical Thinking assessment and found no differences between students in a case-based learning group versus a traditional lecture group. Furthermore, in a study conducted by Baeten et al. (2013) , which compared case-based learning with traditional lectures, it was found that case-based learning did not produce deeper learning unless supplemented with a well-structured didactic lecture first, so that students could understand the content discussed in the case study before attempting to complete it. This finding was similar to that described by Cliff (2006) , who reported that, if case-based learning was used in an undergraduate STEM course, additional supplementation with well-structured material was often required to help students understand content. And finally, Dochy et al. (2003) conducted a meta-analysis comparing case-based learning to learning via traditional lectures in a clinical skills course for medical students and found that, while application of knowledge and higher-order thinking for professional students using case-based learning was higher immediately after the case-based learning experience, there were no differences between groups when given multiple-choice posttests measuring accumulated and retained knowledge at a later point.

For our second research question we asked, “How do student characteristics such as general academic preparation and credit hours completed relate to learning gains derived from the use of a case study?,” and attempted to isolate case-based learning benefits by certain student characteristics. This question was not only driven by the lack of information specifically addressing who benefits from case-based learning within undergraduate STEM courses, but also by other authors such as Lundeberg (2008) and Yadav et al. (2007) who questioned how much background students should have to be successful when using case-based learning. We found that success with case-based learning is likely predicted by certain student characteristics, such as having a stronger academic background coming out of high school, as indicated by the correlations between ACT scores and learning gains, or having more college experience, as indicated by the correlations in our study between college credit hours completed and learning gains. Our results were consistent with other authors investigating similar questions with undergraduate students. For example, Halstead and Billings (2005) found that case-based learning may become frustrating for less-prepared students or those who are used to more traditional methods. Similarly, McRae (2012) stated that “case studies can cause confusion and cognitive frustration if students do not have the prerequisite knowledge to handle the information” (p. 1175).

Our results, as well as those reported by Halstead and Billings (2005) and McRae (2012) , can perhaps be explained by CLT, which provides a framework for understanding the relationship between cognitive processes of learners and the structure of information ( Paas et al. , 2003a ). According to this theory, when novice learners are attempting to comprehend complex information consisting of multiple interacting elements, especially for the first time, extraneous details should be minimized, as they can quickly overload novice learners’ cognitive abilities. Although we did not directly test for this, it is likely that the story, explanatory text, and interactive graphics that were part of the case study presented too much extraneous detail for some students. It is also possible the interactive graphics themselves, which required a student to have a certain level of reading comprehension to extract pertinent information from the story and apply it correctly to a graphic, were too overwhelming. In comparison, the traditional learning format used in this study, which consisted of a basic PowerPoint presentation and didactic lecture, contained little to no extraneous information and required a much lower level of reading comprehension. Perhaps as a student gains more experience and his or her cognitive abilities evolve, the addition of extraneous details can be beneficial, as it makes the information more interesting and challenging and encourages the student to see how elements interact. This notion was also supported by Paas et al. (2003a ), who suggested the addition of previously omitted details can foster a deeper level of understanding for more advanced learners, and is also reinforced by McParland et al. (2004) , who found that older students were less likely to use surface learning approaches, such as memorization, and were thus more likely to be able to make meaning from complex activities.

Summarizing our findings in light of outcomes reported by other authors, we believe our results provide several novel additions to the field of case-based learning. First, the use of a case study by itself might not always yield increased learning gains compared with more traditional teaching methods, especially if students are asked to work through the case study individually. This is more likely to be true if students have less background and academic preparation or have less college experience in general. It is also more likely to be true if students rely upon memorization when learning new information and are unsure of how to assimilate information, as indicated by our correlations, which show relationships between student approach to learning and learning gains with a case study versus a lecture. In large-enrollment courses, where there is likely to be variation regarding student abilities, it is possible that a more traditional form of teaching such as a lecture, at least initially, might represent a more equitable form of learning. After the playing field has been leveled, so to speak, case-based learning may become more useful to more students. This is consistent with work by McLean (2016) , who concluded that advance preparation of the student was necessary for case-based learning to be effective and after that cases could be a powerful stimulant for learning. Second, our study provides helpful insights into the benefits and drawbacks of using case-based learning with an often-overlooked population of students: intermediate-level undergraduates. Given that attrition rates from STEM often intensify during this time, especially for lower-performing students ( Strenta et al. , 1994 ; Seymour and Hewitt, 1997 ; Maltese and Tai, 2010 ; PCAST, 2012 ), having some information about which teaching tools to use or avoid at certain time points could be beneficial.

We would like to acknowledge that many studies supporting case-based learning have been reported with nursing students ( Kaddoura, 2011 ; Popil, 2011 ), medical students ( Wood, 2009 ; Nair et al. , 2013 ; McLean, 2016 ; Kaur et al. , 2019 ), graduate students ( McRae, 2012 ), and even vetted upper-level undergraduates enrolled in a majors course ( Cliff and Wright, 1996 ; Knight et al. , 2008 ; Greenwald and Quitadamo, 2014 ). In fact, according to McLean (2016) , medicine represented almost 73% of published studies, followed by dentistry at 5%, pharmacy at 5%, and nursing at 3%, while published studies detailing the use of case-based learning in mixed, undergraduate courses represented 1.4% of the articles published globally (p. 41). Clearly, fewer researchers have examined when and how to use case-based learning with intermediate-level undergraduates, leaving many questions for educators who teach at this level.

As with any study, this one was not without limitations. For example, we specifically wanted to examine relationships between individual students and case-based learning versus a more traditional form of learning, and to do this, we had students work by themselves in both treatments. Typically, case-based learning is done with students working in groups. However, group work can often mask the performance of lower-achieving students, as a small minority of students can dominate group work ( Lundeberg, 2008 ). This idea was also supported by McRae (2012) , who reported that, when students worked in groups as part of case-based learning, lower-performing students often rode the coattails of better-performing students and may have learned less than they appeared to learn. Additionally, it is possible that students with lower reading comprehension gained less when learning with a case study compared with a traditional lecture. We did not collect or assess reading comprehension scores, but it would be something to consider for the future, given the typical reliance upon reading skills when learning from a case study. Furthermore, empirically assessing the value of different types of activities within a case study, such as multimedia or other interactive features that help students scaffold their nascent understanding of the information provided by the case study, would be a helpful addition to the literature. It is very possible that case studies could become a powerful tool to help engage underprepared students if the right supportive features were included. And finally, we would like to acknowledge that learning gains in both treatments used in this study were lower than we had hoped and perhaps indicate that the concepts presented were too difficult for students at this level, and this could have impacted our results.

In conclusion, while case-based learning increased learning gains for some students, it is possible that these gains may not be equally achievable by all students within large undergraduate courses due to the diversity of student characteristics. The advantages of case-based learning are likely more tangible for students who have stronger academic backgrounds and are better equipped to assimilate information from multiple sources when learning new concepts as opposed to relying upon memorization and for those with more college experience. In large, diverse, undergraduate courses, we believe it is important to provide a more equitable form of learning for all students, and in these instances, we suggest supporting case-based learning activities with other pedagogical tools, including didactic lectures. It is possible that the provision of complex information, made upfront or ahead of time in a more simplified and scaffolded format, could reduce the cognitive load some students may experience while trying to navigate and learn from a case study. And finally, we suggest measuring and carefully considering the current level of development of students when selecting tools such as case studies for use in undergraduate courses; matching the timing of certain educational approaches with the current cognitive load capacity of students is likely key to effective learning.

Supplementary Material

Acknowledgments.

Publication of this article was funded in part by the Kansas State University Open Access Publishing Fund.

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