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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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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.

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Case Method Teaching and Learning at Columbia

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

Faculty Spotlight:

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

Read more  

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Identify learning objectives, determine scope, and anticipate challenges. 

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

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

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

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

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

Plan for the case discussion and an active role for students

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

Student preparation and expectations

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Additional resources 

Teaching with Cases , Harvard Kennedy School of Government. 

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

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

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

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

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

Columbia Resources

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

Center for Teaching and Learning

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

Office of the Provost

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

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

Explore our teaching resources.

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• Inclusive Teaching Guide
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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

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.

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Case-Based Collaborative Learning

Learning conceptual material in the abstract works for some students. For others, traditional lectures and textbook learning can be alienating. By contrast, Case-Based Collaborative Learning (CBCL) provides a structured, student-centered approach to learning challenging material within realistic scenarios from the field. In the CBCL classroom, students identify and wrestle with concepts as they appear in reality. In the true-to-life, well-crafted case, these concepts may be buried amid relevant and/or irrelevant details. In the field, concepts rarely surface in “textbook” form, and problems of practice are increasingly confronted by teams of professionals who bring different levels of expertise to a given situation. Accordingly, Case-Based Collaborative Learning presents student groups with relevant field-specific puzzles and affords them a clear structure for solving these puzzles. Students work through complex material together, apply the concepts they gleaned individually the night before, and reach new understandings as a group. 

How do we craft cases and structure students’ experiences of them in a way that avoids straightforward answers, invites debate, and encourages collaboration? Given that cases are likely to stimulate many questions from students, how do we help them to progress in a case without quelling their curiosity and enthusiasm? How do we foster safe learning environments that value students’ diverse academic backgrounds and afford them the flexibility to wrestle with course material in context? In these videos, featured instructor Dr. Barbara Cockrill discusses her approach and strategies for using case-based collaborative learning with first-year medical students.

Using Cases in the Case-Based Collaborative Learning Classroom

Circulating the Room During Small Group Case Discussions

Designing a Case-Based Collaborative Learning Case

Sharing Relevant Experiences from the Field

Structuring the Case Discussion

Moving Class Forward While Honoring Curiosity Spurred by the Case

Experiencing the Case as a Student Team

Channeling Expertise in the Room to Enhance the Case

What does the research say.

• Merseth provides the historical context behind the case-based teaching method ( 1991 ) 
• The benefits of working in groups are due to pooled knowledge, opportunities for explanation and argumentation, a decrease in memory load, and increased opportunities for observational learning ( Nokes-Malach et al., 2015 ) 
• Research conducted by Krain confirms increased recall and deeper theoretical and conceptual understanding among students when using case-based materials in a pre- and post-test ( 2016 )
• Instructor scaffolding is critical for effective case-based learning ( Ramaekers et al., 2011 )
• Further Print Resources
• Further Online Resources

Kolodner, J. (2014). Case-based reasoning . Morgan Kaufmann.

Kolodner offers an extensive examination of case-based reasoning and its use in the classroom

Barkley, Elizabeth F., K. Patricia Cross, and Claire H. Major. (2014). Collaborative learning techniques: A handbook for college faculty. John Wiley & Sons.

Barkley, Cross, and Major provide a broad overview of student-centered collaborative learning activities for the classroom

The Case Center contains a large repository of cases from many disciplines for the higher education setting

This comprehensive resource on “The ABCs of Case Teaching” provides helpful tips for planning and “running” your case .

Harvard Medical School provides a rubric to self-assess your own CBCL facilitation, or collaborate with colleagues to conduct peer observations and evaluations.

Suggested Next Page: Case Teaching

Using Case Studies to Teach

Why Use Cases?

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

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

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

Common Case Elements

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

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

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

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

Advantages to the use of case studies in class

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

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

Guidelines for using case studies in class

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

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

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

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

Accompanying Readings

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

Leading the Case Discussion and Evaluating Performance

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

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

Tips on the Penn State U. website: https://sites.psu.edu/pedagogicalpractices/case-studies/

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

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

Associated data.

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

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

INTRODUCTION

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

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

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

Student population

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

Course material

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

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

Data collection and analysis

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

SUPPLEMENTAL MATERIALS

Acknowledgments.

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

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

Create a Case Method Group Activity to Engage Students in Critical Thinking

The case method group activity is an instructional design strategy that involves faculty members providing one or more case studies to which groups of students respond. The case(s) could be a real-life case or simulation. It could be description of key concept(s) applied, a story or scenario, an actual case study, a problem or mystery, a performance, a visual, or an example.

The case method in online learning as an intervention presents students with ill-structured, real-world derived problems with multiple solutions (Choi & Lee, 2009). In a group activity this case method has the potential to harnesses the effectiveness of collaborative learning (Kolb, 1984) and group activities provide a space for collaborative problem solving, fostering a constructivist learning environment with potential to build a community of learning (Jonassen, 1997). The teaching facilitator can influence learners’ engagement in and adoption of the activity by communicating the relative advantage of key features of the online environment (Karamanos & Gibbs, 2012), as well as mapping and intervening in the group interactions to keep students focused on the problem (Etmer & Koehler, 2014). This mapping creates a plan for instructors to scaffold (or build in techniques to progressively support students to greater levels of learning independence and effective group interactions). Introduction of scaffolds and learning resources, perhaps additional readings and activities, presented at later stages of problem solving were associated with deep meaningful learning and critical thinking (Choi & Lee, 2009).

Because the case reflects a real-life situation, as the group members interact with each other, they should uncover multiple solutions, perspectives, or methods of analyzing the situation, with no single right answer. This divergence is important to encourage for fostering deeper levels of learning and critical thinking (Choi & Lee, 2009). A guiding question for the lesson can offer some parameters for faculty to map and scaffold activities, guiding students’ interactions as they engage with others in their groups about the case. This guiding question should depend on the purpose of the instruction (University of Illinois, 2015). The process of a faculty member scaffolding activities should result in more than one individual or group deliverable associated with it and a corresponding timeline for each. Consider, too, whether each component will have a group or individual grade (Carnegie Mellon University, 2015).

Link to example artifact(s)

As an example of the case method group activity, a faculty member teaching an industrial/organizational psychology course divided the students into groups based on time zones and created a discussion forum for each group. They completed a learning team charter to establish their group covenant. The parameters for the group activity were well-defined: students completed a group charter to agree on expectations for each member’s contribution to the group, the faculty provided an explanation of the purpose of the group activity for learning the material and succeeding in the course. The faculty explicitly stated how the quality of interactions and ideas derived from the group conversation and supported with evidence could contribute to the success of individual assignments.

The faculty provided the same case scenario across each group discussion forum. The case described in writing a company whose strict hierarchy and “us” (management) versus “them” (workers) mentality had led to a dysfunctional workplace environment with punitive acts from management and passive aggressive behaviors from employees. The faculty prompted students to analyze the situation using management and leadership approaches and theories from the course as a group by midway through the course, brainstorm as a group solutions to remedy the situation by applying key course concepts from middle to the end of the course, and submit an individual solution to the problem the case presented as the final assignment.

The faculty member interacted with each group several times throughout the course in their discussion forums, guiding them to consider important motivational and management theories (like Maslow’s hierarchy of needs and McGregor’s theory x and y) to analyze the behavioral dynamics of management and the employees in the case. Additionally, a rubric was associated with each component presented prior to the assignment to set expectations and utilized by the faculty member for grading. To assess critical thinking, elements from the AASU Value rubric were incorporated into the individual solution activity rubric (2017). Students were graded individually even though they were interacting as a group for their mid-course analysis of the scenario, as a group on the solution brainstorming activity for a group grade, and individually on their submissions of their individual solution to the case.

Students’ critical thinking improvements and favorable reaction provided good evidence for the success of the case scenario activities in this course. During the discussion, students often related the scenario to their own real-life experiences in workplace settings. As the discussions progressed, students began identifying these experiences with key concepts, referring and citing course content, and this habit transferred to their individual solutions to the case presented in their papers. Some students developed a clear thesis for their perspectives, recounting nuances of the situation in the scenario (such as the organizational structure and emerging management styles) to substantiate their position. Even fewer students gave multiple solutions and explained why one is better than another. Students generally responded positively to the course and case scenario format. They indicated that they appreciated the real-life examples from other students and expressed that the group discussion contributed development of their individual submissions. Satisfaction with the course, as indicated on students’ end-of-course reviews, was high to very high.

Applying this case method group activity strategy to other disciplines should result in similar success, strengthening students’ critical thinking skills. This strategy is definitely generalizable, as the aim is for students’ collaboration for achieving the course or module objective(s) associated with the activity/assignment (University of Illinois, 2015), guiding students to:

• Identify key concepts reflected by a case, • Situate a case within a given system, • Summarize or recapitulate a case, • Generalize patterns or symbolic representations within a case, • Generate plausible causes that result in a case, • Analyze the components of a case, • Assess or judge the appropriate application presented in a case scenario, • Solve a problem that the case presents or that the faculty presents about the case Any discipline where students would benefit cognitively from collaboration to achieve one of the above objectives could apply this strategy: create a case method group activity to engage students in critical thinking.

Individual Paper Case Study Rubric

Case Study Rubric for Group Collaboration Discussion

Instructor: Revathi Viswanathan Course: Biotechnology

Students were asked to discuss case studies relating to their subject, and Edmodo was used as a learning platform for handling them. The purpose of integrating the technological tool was to encourage students to actively participate in the teaching and learning process even beyond their classroom. Besides this, Edmodo, as an application could be accessed both in a computer and a mobile, which in turn helps teachers to post resources, initiate discussions, create small groups, and enroll students to do collaborative tasks.

As part of the classroom based research, the students were put in small groups, and inputs for case study was posted as video files and reading texts to each group in the Edmodo page. Each group was given guidance on holding case study discussions. The preliminary discussion was initiated through brainstorming questions, which encouraged students to get to the important issue or aspect of the case study. For example, the following questions were posted related to the case study on ‘ Regenerative medicine- Current therapies and future directions’:

• What do you know about regenerative medicine?
• How does it help common man?

Similarly, one of the groups discussed ‘Genetic Engineering of Animals: ethical issues, including welfare concerns’ and the following questions were asked:

• Discuss how ‘deletion of genes, or the manipulation of genes already present’ affects the animals.
• What do you think about this as a biotechnology student?

After a few dialogues online, it was felt that most of the students could not identify the main aspect of the case study and the teacher researcher had to intervene by posting guidelines for discussing a case study (Source: https://plato.acadiau.ca/courses/Busi/IntroBus/CASEMETHOD.html#CASEMETHOD ). They were told about the process by which a case study has to be analysed. They were asked to look for issues that are stated in the case study, critically read and see how the issue is handled in depth. Then, they had to look for opening paragraph, background information, specific area of interest covered, specific problem stated, alternatives given and the conclusion drawn from the discussion, in the case study.

Besides posting these tips for handling case studies, the teacher explained the components of a case study (stated above) in the class. It was felt that this online collaborative activity had to be handled by following the online collaborative theory advocated by Harasim (2012). According to her, a teacher plays an important role (in an online collaborative learning scenario) in the process of knowledge construction among students, by providing inputs and integrating the core concept along with the subject domain. In this context, it must be stated that the teacher researcher had already brought in the integration of biotechnology related case studies for discussion. However, considering the extent to which they could use the subject knowledge for discussing the given case study, it was evident that the students expected teacher’s intervention. In other words, the teacher had to draw their attention to the main issue of the case study by posting a few specific (case study related) questions.

For example, the group which was working on the case study, ‘Genetic engineering of animals’, were asked to focus on the specific concepts. The following question was posted in Edmodo group page:

• How does it affect an animal when it is genetically modified or genetically altered or genetically manipulated or transgenic, and biotechnology-derived
• How will the animal cope with when it is modified?

The extent to which the students of respective groups (group A & B) could discuss the case study by using their subject knowledge was evaluated by comparing two groups (both before-the-intervention and after-the-intervention of the teacher) using Causal-Comparative method. The analysis of performance of the group members was done with the help of the rubrics, ‘Undergraduate Case Analysis Rubrics’ (Source https://www.onlineethics.org/File.aspx?id=31203&v=859a7ffb ). The frequency polygon drawn for both groups (Figures 1 and 2) and the ANOVA test scores evaluated showed variation, particularly in group A’s performance (ie before and after teacher’s intervention).

It was evident that students’ application of subject knowledge in their discussion had promoted communicative ability. Further, it proved the application of online collaborative theory in encouraging students to contribute to online discussions.

Link to scholarly references

Association of American Colleges & Universities (2017). Critical thinking VALUE rubric. Retrieved from  https://www.aacu.org/value/rubrics/critical-thinking

Carnegie Mellon University Eberly Center (2015). How can I assess group work? Retrieved from  https://www.cmu.edu/teaching/designteach/design/instructionalstrategies/groupprojects/assess.html

Choi, I., & Lee, K. (2009). Designing and implementing a case-based learning environment for enhancing ill-structured problem solving: Classroom management problems for prospective teachers. Educational Technology Research and Development , 57( 1 ), 99-129.  https://doi.org/10.1007/s11423-008-9089-2

David, H. J. (1997). Instructional design models for well-structured and ill-structured problem-solving learning outcomes. Educational Technology Research and Development , 45( 1 ). Retrieved from  http://www.webkelley.com/HBS/ID%20Models%20for%20Well-Structured.pdf

Ertmer, P. A., & Koehler, A. A. (2014). Online case-based discussions: Examining coverage of the afforded problem space. Educational Technology Research and Development , 62( 5 ), 617-636.  https://doi.org/10.1007/s11423-014-9350-9

Jonassen, D. H. (1999). Designing constructivist learning environments. In C. M. Reigeluth I nstructional-design theories and models: Volume II (pp. 215-239). Mahwah, N.J: Lawrence Erlbaum Associates. Retrieved from  https://www.savoiabenincasa.gov.it/wp-content/uploads/2016/04/1999-Jonassen.pdf

Karamanos, N., & Gibbs, P. (2012). A model for student adoption of online interactivity. Research in Post-Compulsory Education , 17( 3 ), 321-334.  https://doi.org/10.1080/13596748.2012.700108

Kolb, D. (1984). Experiential learning: Experience as the source of learning and development . Englewood Cliffs, NJ: Prentice Hall. Retrieved from  https://www.pearson.com/us/higher-education/program/Kolb-Experiential-Learning-Experience-as-the-Source-of-Learning-and-Development-2nd-Edition/PGM183903.html

University of Illinois. (2015). Online teaching activity index: Case study or case based index. Retrieved from  www.ion.uillinois.edu%2Fresources%2Fotai%2Fcasestudies.asp&token=yz%2BG1QALcwhrBLaVIIOV1qkwVJCS27mZAH624RoGdAc%3D

Major, A.,  & Viswanathan, R.  (2019). Create a case method group activity to engage students in critical thinking. In A. deNoyelles, A. Albrecht, S. Bauer, & S. Wyatt (Eds.),  Teaching Online Pedagogical Repository . Orlando, FL: University of Central Florida Center for Distributed Learning.  https://topr.online.ucf.edu/create-case-method-group-activity-engage-students-critical-thinking/ .

Center for Teaching Innovation

Resource library, examples of collaborative learning or group work activities.

• Getting Started with Designing Group Work Assignments
• Getting Started with Evaluating Group Work
• Team-Based Learning Collaborative

Stump Your Partner

• Students take a minute to create a challenging question based on the lecture content up to that point.
• Students pose the question to the person sitting next to them.
• To take this activity a step further, ask students to write down their questions and hand them in. These questions can be used to create tests or exams. They can also be reviewed to gauge student understanding.

Think-Pair-Share/Write-Pair-Share

• The instructor poses a question that demands analysis, evaluation, or synthesis.
• Students take a few minutes to think through an appropriate response.
• Students turn to a partner (or small groups) and share their responses. Take this a step further by asking students to find someone who arrived at an answer different from their own and convince their partner to change their mind.
• Student responses are shared within larger teams or with the entire class during a follow-up discussion.
• Stop at a transition point in your lecture.
• Have students turn to a partner or work in small groups to compare notes and ask clarifying questions.
• After a few minutes, open the floor to a few questions.

Fishbowl Debate

• Ask students to sit in groups of three.
• Assign roles. For example, the person on left takes one position on a topic for debate, the person on right takes the opposite position, and the person in the middle takes notes and decides which side is the most convincing and provides an argument for his or her choice.
• Debrief by calling on a few groups to summarize their discussions.
• Create four to five case studies of similar difficulty.
• Have students work in groups of four or five to work through and analyze their case study.
• Provide 10-15 minutes (or adequate time) to work through the cases.
• Walk around and address any questions.
• Call on groups randomly and ask that students share their analysis. Continue until each case study has been addressed.

Team-Based Learning

• Start a course unit by giving students some tasks to complete, such as reading or lab assignments. Consider assigning these to be completed before class.
• Check students' comprehension of the material with a quick multiple-choice quiz. Have students submit their answers.
• Assign students to groups and have them review their answers with group members to reach consensus. Have each group submit one answered quiz.
• Record both the individual student assessment scores and the final group assessment score (both of which are used toward each student's course grade).
• Deliver a lecture that specially targets any misconceptions or gaps in knowledge the assessments reveal.
• Give groups a challenging assignment, such as solving a problem or applying a theory to a real-world situation.
• Find more information on this strategy at   the Team-Based Learning Collaborative .

Group Problem-Solving

There are many instructional strategies that involve students working together to solve a problem, including inquiry-based learning, authentic learning, and discovery learning. While they each have their own unique characteristics, they fundamentally involve:

• Presenting students with a problem.
• Providing some structure or guidance toward solving the problem. Note however, that they are all student-centered activities in which the instructor may have a very minimal role.
• Reaching a final outcome or solution.

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• Creating Effective Scenarios, Case Studies and Role Plays

Creating effective scenarios, case studies and role plays

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Scenarios, case studies and role plays are examples of active and collaborative teaching techniques that research confirms are effective for the deep learning needed for students to be able to remember and apply concepts once they have finished your course. See  Research Findings on University Teaching Methods .

Typically you would use case studies, scenarios and role plays for higher-level learning outcomes that require application, synthesis, and evaluation (see  Writing Outcomes or Learning Objectives ; scroll down to the table).

The point is to increase student interest and involvement, and have them practice application by making choices and receive feedback on them, and refine their understanding of concepts and practice in your discipline.

These types of activities provide the following research-based benefits: (Shaw, 3-5)

• They provide concrete examples of abstract concepts, facilitate the development through practice of analytical skills, procedural experience, and decision making skills through application of course concepts in real life situations. This can result in deep learning and the appreciation of differing perspectives.
• They can result in changed perspectives, increased empathy for others, greater insights into challenges faced by others, and increased civic engagement.
• They tend to increase student motivation and interest, as evidenced by increased rates of attendance, completion of assigned readings, and time spent on course work outside of class time.
• Studies show greater/longer retention of learned materials.
• The result is often better teacher/student relations and a more relaxed environment in which the natural exchange of ideas can take place. Students come to see the instructor in a more positive light.
• They often result in better understanding of complexity of situations. They provide a good forum for a large volume of orderly written analysis and discussion.

There are benefits for instructors as well, such as keeping things fresh and interesting in courses they teach repeatedly; providing good feedback on what students are getting and not getting; and helping in standing and promotion in institutions that value teaching and learning.

Outcomes and learning activity alignment

The learning activity should have a clear, specific skills and/or knowledge development purpose that is evident to both instructor and students. Students benefit from knowing the purpose of the exercise, learning outcomes it strives to achieve, and evaluation methods. The example shown in the table below is for a case study, but the focus on demonstration of what students will know and can do, and the alignment with appropriate learning activities to achieve those abilities applies to other learning activities.

(Smith, 18)

What’s the difference?

Scenarios are typically short and used to illustrate or apply one main concept. The point is to reinforce concepts and skills as they are taught by providing opportunity to apply them. Scenarios can also be more elaborate, with decision points and further scenario elaboration (multiple storylines), depending on responses. CETL has experience developing scenarios with multiple decision points and branching storylines with UNB faculty using PowerPoint and online educational software.

Case studies

Case studies are typically used to apply several problem-solving concepts and skills to a detailed situation with lots of supporting documentation and data. A case study is usually more complex and detailed than a scenario. It often involves a real-life, well documented situation and the students’ solutions are compared to what was done in the actual case. It generally includes dialogue, creates identification or empathy with the main characters, depending on the discipline. They are best if the situations are recent, relevant to students, have a problem or dilemma to solve, and involve principles that apply broadly.

Role plays can be short like scenarios or longer and more complex, like case studies, but without a lot of the documentation. The idea is to enable students to experience what it may be like to see a problem or issue from many different perspectives as they assume a role they may not typically take, and see others do the same.

Foundational considerations

Typically, scenarios, case studies and role plays should focus on real problems, appropriate to the discipline and course level.

They can be “well-structured” or “ill-structured”:

• Well-structured  case studies, problems and scenarios can be simple or complex or anything in-between, but they have an optimal solution and only relevant information is given, and it is usually labelled or otherwise easily identified.
• Ill-structured  case studies, problems and scenarios can also be simple or complex, although they tend to be complex. They have relevant and irrelevant information in them, and part of the student’s job is to decide what is relevant, how it is relevant, and to devise an evidence-based solution to the problem that is appropriate to the context and that can be defended by argumentation that draws upon the student’s knowledge of concepts in the discipline.

Well-structured problems would be used to demonstrate understanding and application. Higher learning levels of analysis, synthesis and evaluation are better demonstrated by ill-structured problems.

Scenarios, case studies and role plays can be  authentic  or  realistic :

• Authentic  scenarios are actual events that occurred, usually with personal details altered to maintain anonymity. Since the events actually happened, we know that solutions are grounded in reality, not a fictionalized or idealized or simplified situation. This makes them “low transference” in that, since we are dealing with the real world (although in a low-stakes, training situation, often with much more time to resolve the situation than in real life, and just the one thing to work on at a time), not much after-training adjustment to the real world is necessary.
• By contrast,  realistic  scenarios are often hypothetical situations that may combine aspects of several real-world events, but are artificial in that they are fictionalized and often contain ideal or simplified elements that exist differently in the real world, and some complications are missing. This often means they are easier to solve than real-life issues, and thus are “high transference” in that some after-training adjustment is necessary to deal with the vagaries and complexities of the real world.

Scenarios, case studies and role plays can be  high  or  low fidelity :

High vs. low fidelity:  Fidelity has to do with how much a scenario, case study or role play is like its corresponding real world situation. Simplified, well-structured scenarios or problems are most appropriate for beginners. These are low-fidelity, lacking a lot of the detail that must be struggled with in actual practice. As students gain experience and deeper knowledge, the level of complexity and correspondence to real-world situations can be increased until they can solve high fidelity, ill-structured problems and scenarios.

Further details for each

Scenarios can be used in a very wide range of learning and assessment activities. Use in class exercises, seminars, as a content presentation method, exam (e.g., tell students the exam will have four case studies and they have to choose two—this encourages deep studying). Scenarios help instructors reflect on what they are trying to achieve, and modify teaching practice.

For detailed working examples of all types, see pages 7 – 25 of the  Psychology Applied Learning Scenarios (PALS) pdf .

The contents of case studies should: (Norton, 6)

• Connect with students’ prior knowledge and help build on it.
• Be presented in a real world context that could plausibly be something they would do in the discipline as a practitioner (e.g., be “authentic”).
• Provide some structure and direction but not too much, since self-directed learning is the goal. They should contain sufficient detail to make the issues clear, but with enough things left not detailed that students have to make assumptions before proceeding (or explore assumptions to determine which are the best to make). “Be ambiguous enough to force them to provide additional factors that influence their approach” (Norton, 6).
• Should have sufficient cues to encourage students to search for explanations but not so many that a lot of time is spent separating relevant and irrelevant cues. Also, too many storyline changes create unnecessary complexity that makes it unnecessarily difficult to deal with.
• Be interesting and engaging and relevant but focus on the mundane, not the bizarre or exceptional (we want to develop skills that will typically be of use in the discipline, not for exceptional circumstances only). Students will relate to case studies more if the depicted situation connects to personal experiences they’ve had.
• Help students fill in knowledge gaps.

Role plays generally have three types of participants: players, observers, and facilitator(s). They also have three phases, as indicated below:

Briefing phase:  This stage provides the warm-up, explanations, and asks participants for input on role play scenario. The role play should be somewhat flexible and customizable to the audience. Good role descriptions are sufficiently detailed to let the average person assume the role but not so detailed that there are so many things to remember that it becomes cumbersome. After role assignments, let participants chat a bit about the scenarios and their roles and ask questions. In assigning roles, consider avoiding having visible minorities playing “bad guy” roles. Ensure everyone is comfortable in their role; encourage students to play it up and even overact their role in order to make the point.

Play phase:  The facilitator makes seating arrangements (for players and observers), sets up props, arranges any tech support necessary, and does a short introduction. Players play roles, and the facilitator keeps things running smoothly by interjecting directions, descriptions, comments, and encouraging the participation of all roles until players keep things moving without intervention, then withdraws. The facilitator provides a conclusion if one does not arise naturally from the interaction.

Debriefing phase:  Role players talk about their experience to the class, facilitated by the instructor or appointee who draws out the main points. All players should describe how they felt and receive feedback from students and the instructor. If the role play involved heated interaction, the debriefing must reconcile any harsh feelings that may otherwise persist due to the exercise.

Five Cs of role playing  (AOM, 3)

Control:  Role plays often take on a life of their own that moves them in directions other than those intended. Rehearse in your mind a few possible ways this could happen and prepare possible intervention strategies. Perhaps for the first role play you can play a minor role to give you and “in” to exert some control if needed. Once the class has done a few role plays, getting off track becomes less likely. Be sensitive to the possibility that students from different cultures may respond in unforeseen ways to role plays. Perhaps ask students from diverse backgrounds privately in advance for advice on such matters. Perhaps some of these students can assist you as co-moderators or observers.

Controversy:  Explain to students that they need to prepare for situations that may provoke them or upset them, and they need to keep their cool and think. Reiterate the learning goals and explain that using this method is worth using because it draws in students more deeply and helps them to feel, not just think, which makes the learning more memorable and more likely to be accessible later. Set up a “safety code word” that students may use at any time to stop the role play and take a break.

Command of details:  Students who are more deeply involved may have many more detailed and persistent questions which will require that you have a lot of additional detail about the situation and characters. They may also question the value of role plays as a teaching method, so be prepared with pithy explanations.

Can you help?  Students may be concerned about how their acting will affect their grade, and want assistance in determining how to play their assigned character and need time to get into their role. Tell them they will not be marked on their acting. Say there is no single correct way to play a character. Prepare for slow starts, gaps in the action, and awkward moments. If someone really doesn’t want to take a role, let them participate by other means—as a recorder, moderator, technical support, observer, props…

Considered reflection:  Reflection and discussion are the main ways of learning from role plays. Players should reflect on what they felt, perceived, and learned from the session. Review the key events of the role play and consider what people would do differently and why. Include reflections of observers. Facilitate the discussion, but don’t impose your opinions, and play a neutral, background role. Be prepared to start with some of your own feedback if discussion is slow to start.

An engineering role play adaptation

Boundary objects (e.g., storyboards) have been used in engineering and computer science design projects to facilitate collaboration between specialists from different disciplines (Diaz, 6-80). In one instance, role play was used in a collaborative design workshop as a way of making computer scientist or engineering students play project roles they are not accustomed to thinking about, such as project manager, designer, user design specialist, etc. (Diaz 6-81).

References:

Academy of Management. (Undated).  Developing a Role playing Case Study as a Teaching Tool. 

Diaz, L., Reunanen, M., & Salimi, A. (2009, August).  Role Playing and Collaborative Scenario Design Development. Paper presented at the International Conference of Engineering Design, Stanford University, California.

Norton, L. (2004).  Psychology Applied Learning Scenarios (PALS): A practical introduction to problem-based learning using vignettes for psychology lecturers .  Liverpool Hope University College. 

Shaw, C. M. (2010). Designing and Using Simulations and Role-Play Exercises in  The International Studies Encyclopedia,  eISBN: 9781444336597

Smith, A. R. & Evanstone, A. (Undated).  Writing Effective Case Studies in the Sciences: Backward Design and Global Learning Outcomes.  Institute for Biological Education, University of Wisconsin-Madison. 

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Knowledge Base

Collaborative (group) learning, example uses and supporting technologies.

Last revised: 05/12/2021 by JP

Collaborative learning, also known as group learning, is an opportunity for students to develop higher-order cognitive skills; promote connection and community; innovate; and engage with different perspectives. There are a handful of UConn supported technologies that enable student collaboration in online courses. Beyond those, there are many applications that faculty can use for free or purchase a single-use educational license and integrate with their HuskyCT site via Learning Tool Interoperability (LTI). This article shares examples of both.

Planning Online Collaborative (Group) Learning

Before incorporating collaborative (group) learning activities and selecting technologies, answer the following questions:

• What are your course’s learning objectives ?
• How will collaborative learning help your students meet one or more of your learning objectives? (This is the principle of alignment . Also see Quality Matters HE Rubric .)
• How will you configure your groups ? Should you use group contracts ? (See example group contract template .)
• How does collaborative learning connect to your discipline and the work performed by professionals in it? In other words, how will it benefit your students?
• Should collaborative learning be asynchronous, synchronous or a combination? Consider if there are any synchronous limitations for your students, such as working adults, or University Mode of Instruction designation (Online, Distance Learning, Hybrid/Blended etc.) restrictions.

Using the answers to your questions, consider which of the following technologies align best with your course and student needs.

Technologies for Collaboration with Example Uses

The following is not an exhaustive list; however it includes common online collaborative applications used in UConn courses, as well some unique uses and examples.

*Indicates technologies supported by UConn ITS and/or Educational Technologies as of November 2020, where Educational Technologies’ main support focus is helping faculty with HuskyCT, Collaborate and Webex.  For technologies not identified with an asterisk, please use the vendor’s main help/support resources.

Facilitating Effective Online Collaborative Activities

• Explain to students why (benefits) and how (procedures and group formation) collaborative learning will be used in the course. Introduce it on the syllabus and within your course orientation.
• Break down the collaborative process into easy to understand steps and provide instructional guidance about working in groups. Consider using group contracts for larger collaborative projects.
• Build in required technology practice at the beginning of the course. Be careful not to cognitively overload students with too many different technologies. Also, inform students about all used technologies’ privacy policies on your syllabus.  (For example, HuskyCT/ Blackboard Privacy Policy ; Microsoft Privacy Statement , etc.)
• Integrate incremental instructor check-ins to provide formative feedback to groups and create a contingency plan for potential group issues, such as student add/drops, complaints, etc.
• Explain how group work will be assessed/graded.
• Evaluate the collaborative activities from both the student and instructor perspectives.  Consider including anonymous student surveys.

Other Collaborative Technologies

A few other technologies used by UConn faculty include, Discord and Slack .  These technologies are geared towards social/community building, but with intentional design, they could also be used for collaborative learning.  Note: UConn does not currently offer technical support for faculty and students using these applications.

• Barshay, J. (2020, September 28). Improving college exams during remote learning: A bicoastal experiment in administering collaborative two-stage exams via Zoom shows promise .  Hechinger Report .
• Brame, C.J. and Biel, R. (2015). Setting up and facilitating group work: Using cooperative learning groups effectively. Retrieved [October 22, 2020] from http://cft.vanderbilt.edu/guides-sub-pages/setting-up-and-facilitating-group-work-using-cooperative-learning-groups-effectively/ .
• Chapter 2 – Concepts of Online Collaborative Learning in Chih-Hsiun Tu. (2004). Online Collaborative Learning Communities: Twenty-One Designs to Building an Online Collaborative Learning Community.
• Cornell University’s Center for Teaching Innovation. Collaborative Learning .
• Hesterman, S. (2016).  The Digital Handshake: A Group Contract for Authentic eLearning in Higher Education , Journal of University Teaching & Learning Practice , 13(3).
• Liberman, M. (2018, April 25). Online Students Don’t Have to Work Solo . Inside Higher Ed .
• Morrison, D. (2012, March 24). Why we need group work in Online Learning .  Online Learning Insights .
• Romaniuk, S. (2018, March 24). Collaborative and Active Learning In Higher Education Classrooms . eLearning Industry .
• Smith Budhai, Stephanie. (Jan. 29, 2016).  Designing Effective Team Projects in Online Courses .
• UNSW’s Teaching and Learning. Group Work .

Related Posts:

• Alternatives for Online Discussions
• An Overview of Perusall
• Developing Engaging Online Discussions
• Facilitating Online Discussions

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The Case for College in the Era of Online Learning

• Robert Walker

In-person education provides valuable experiences, opportunities, and skills that can’t be replicated online.

Does pursuing a college education still make sense in the age of online learning and AI — when we have access to information for free via the internet? The problem with this question is that it frames college as an information gatekeeper, misunderstanding much of its value. For many, higher education institutions offer more than that: a transformative journey where students can network and develop transferable soft skills that require teamwork and repetition. You can maximize your college experience by leaning into these opportunities while simultaneously staying up to date with the latest technological trends. By being agile, networking vigorously, cultivating problem-solving skills, and seeking learning opportunities in the real world while in school, you can prepare yourself for a successful career.

Today, we have access to more information than ever before. YouTube and TikTok can provide us with in-depth learning opportunities for free — from professional development tips to AI tutorials . In more recent years, large language models like ChatGPT and Gemini have shown they can answer almost any question that comes to mind with an increasing level of accuracy .

• RW Robert Walker is the director of high school admissions at University of Advancing Technology. Walker has over 12 years of in-depth experience in recruitment and technology, has a genuine passion helping others achieve their educations dream,s and holds advanced degrees in technology leadership and cyber security.  

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Doctoral Dissertations and Projects

Exploring the role of innovation across social and academic integration for first-generation caribbean undergraduate persistence.

Angelina Natasha Carvalhal , Liberty University Follow

School of Education

Doctor of Philosophy

Sharon Farrell

first-generation, Caribbean undergraduates, innovation, active learning, persistence

Disciplines

Curriculum and Instruction | Educational Methods

Recommended Citation

Carvalhal, Angelina Natasha, "Exploring the Role of Innovation Across Social and Academic Integration for First-generation Caribbean Undergraduate Persistence" (2024). Doctoral Dissertations and Projects . 5869. https://digitalcommons.liberty.edu/doctoral/5869

The purpose of this intrinsic case study was to understand how innovation across social and academic integration among first-generation Caribbean Undergraduates supports persistence at three public universities in the Northeast. The theory underpinning this study was Tinto’s dropout theory and theory of institutional departure. Tinto’s theory connected to this study of how supporting innovation through social and academic integration supports the persistence of first-generation Caribbean Undergraduates. The central research question guiding this study was: How has innovative academic content delivery affected the retention of first-generation Caribbean Undergraduates? Purposeful sampling was applied to interview students on-site, while random sampling was applied to select students for participation in a focus group to gain an understanding of how students interpret innovative content delivery. Letter writing from the students themselves was analyzed to compare how their ideas about innovation evolved over time. Themes of endurance, educational expectation, educational aspiration, and enriched motivation, and the sub-themes of continuity, accessibility and convenience, collaboration and engagement, efficiency, increased motivation, professional development, building community, academic resources, social resources, and stress management were identified. The results of this study indicated innovative content delivery for first-generation Caribbean Undergraduates supports persistence. Innovation takes on various forms due to the academic freedom of the faculty, supporting active learning that inherently promotes social and academic integration.

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• Open access
• Published: 08 August 2024

Medical students’ experience and learning outcomes of overseas community involvement project: a qualitative study

• Gayathri Devi Nadarajan 1 , 2 ,
• Kumaran Rasappan 3 ,
• Jonathan Shen You Ng 4 ,
• Melvin Lim Junchen 4 &
• Sungwon Yoon 5  

BMC Medical Education volume  24 , Article number:  854 ( 2024 ) Cite this article

112 Accesses

Metrics details

Medical students in Singapore engage in short term medical missions, locally known as Overseas Community Involvement Projects (OCIPs). Little is known about the learning outcomes of an OCIP and how this complements their medical education back home. Understanding this can help the medical educators structure the OCIP to optimise its learning value.

This study aims to gain an in-depth understanding of the experiences and learning outcomes of the medical students who participated in the OCIP.

This was a qualitative study involving Singaporean students from one medical school travelling to Nepal. Data was collected from reflective journals, overall group reflections and two focus group discussions. The data was thematically analysed using the Accreditation Council for Graduate Medical (ACGME) core competencies for medical professionals.

The data could be classified under various themes within the six domains of the ACGME framework. The study revealed themes of: humanism, socioeconomic and cultural determinants of health under the domain of patient care, application of medical knowledge, investigating and evaluating the needs of a population and feedback to drive improvement under the domain of practice-based learning and improvement, use of non-verbal cues and communicating across language barriers under the domain of interpersonal and communication skills, healthcare systems and delivery, resourcefulness and adaptability, health equity and accessibility under the domain of systems-based practice, ethics, role-modelling, teamwork and leadership skills, interprofessional skills and resilience under the domain of professionalism. Understanding the students’ motivations, utilising reflections, and following the patients’ journey facilitated attainment of these outcomes.

Conclusions

This OCIP experience translated to learning outcomes aligned with the ACGME framework. There is great potential for the experiential learning from a well-structured OCIP to help with personal and professional development and global health education.

Peer Review reports

Introduction

Globalisation provides opportunities and challenges to medical education. There is an increasing interest in overseas service trips and global health education where medical students engage in Overseas Community Involvement Project (OCIP). These trips involve medical students, usually from high income regions, travelling to a lower resource setting. The trips, ranging from 1 week to 3 weeks in duration, are student-led, supervised by a physician mentor who may not necessarily accompany them. Such trips were more common prior to the COVID-19 pandemic related travel restrictions. Currently, it is picking up pace once again as the world is steadily recovering from the pandemic.

As this overseas service activity begins to resume, it is time to re-think how it can be approached. These trips raise ethical issues such as sustainability of student involvement or a lack of follow-up of patients after a diagnosis of a chronic illness during the trip [ 1 , 2 , 3 , 4 ]. In addition, when students volunteer, significant resources are dedicated to this activity including time, money and even utilisation of the receiving countries’ scarce resources. Safety of all involved is also an issue as there are no regulations about personal protective equipment or operating protocols should the students encounter an infectious disease outbreak. Hence, it is now more important than ever to be clear on the risks and benefits of such trips.

If the risks and benefits are well taken into consideration when planning an OCIP, these trips may have the potential to benefit the community in low-income settings through collaborative partnerships [ 5 , 6 ]. For the students, the OCIP may serve as an educational tool or pedagogy in medical education. The experience can be very rich and may stimulate learning of important but often neglected topics within medical education which are also challenging to teach such as health systems and socioeconomic and cultural determinants of health [ 7 , 8 , 9 ]. The OCIP also provides students with early exposure to community health [ 10 ] and may potentially be a valuable source of experiential learning.

While a few studies [ 11 , 12 , 13 ] described the benefits and issues around volunteerisms in global health, very little medical education research has been conducted to demonstrate the possible learning outcomes of an OCIP. Specifically, there is a gap in understanding how the OCIP experience relates to medical education competencies. Furthermore, the literature on the experience of Asian medical students volunteering in overseas community projects is sparse. As global health issues are increasingly incorporated into medical education with growing interest in OCIP, it is important to understand what Asian medical students learn and how this complements their medical education back home. This in turn can help the medical educators structure the OCIP to optimise its learning value. Therefore, the aim of this study is to gain an in-depth understanding of the experiences and learning outcomes of the medical students who participated in the OCIP.

Study design

A qualitative study design was chosen as the study requires an in-depth understanding of students’ experiences.

Setting and participants

This study was based in one medical school in Singapore, a metropolitan city state. Each of the three medical schools in Singapore have multiple OCIPs which are student-led with physician oversight. Such OCIPs have been in existence in each of these schools since their setup and is voluntary. It is currently not part of the medical curriculum but is available for anyone to join in medical school. The term OCIP is used rather than short term experiences in global health (STEGH) because the objective of such trips is to provide service to an underserved community rather than a ‘global health experience’. The OCIP group usually revisits the same location to ensure continuity of care. The OCIP activities typically include screening camps, health education or training to equip the community with a certain set of skills. Project Aasha is an annual OCIP where participants spend two weeks in the rural, mountainous region of Nepal. Landlocked between India and China in Asia, Nepal has a population of about 30 million, spread across the valley of Kathmandu (its capital) and unique terrains comprising of the world’s highest mountains and terai (lowland region). Though healthcare is heavily subsidised for the poor, the challenging terrains affects accessibility, and the poor health literacy and volatile politics makes implementation of policies difficult. Hence, universal health coverage and equitable health provision is still a struggle. The trip was based in Bung village in the Himalaya mountains in North-eastern Nepal at an elevation of 1800 m and Biratnagar city, a terai in Eastern Nepal. The health service consisted of first aid training and women’s health education for school students, health screening and cataract surgery for the villagers. This trip rooted from the local community leaders approaching the physician mentor of Project Aasha. They were concerned of the general poor state of health of the villagers- where many of them do not continue with follow up care for their chronic conditions, there was poor health literacy and there was a major concern about injuries and the lack of first aid knowledge as the nearest hospital was a day’s walk away. Following contact with the community leader, and prior to this trip, Project Aasha members did a separate trip for a needs analysis (by performing a door-to-door survey) and also proceeded to apply for permits to allow the team to practice in the village of Bung.

The OCIP team consisted of a physiotherapy group (four students and a mentor) an ultrasonographer, five doctors (from specialties of Ophthalmology, Emergency Medicine, Orthopaedics and Surgery), fourteen medical students and two Nepalese student translators. Pre-trip, the students were involved in researching about the community they would be visiting in Nepal, preparing the logistics for the team’s stay, trip itinerary, medical equipment, medications and training materials for the community. There was also a sharing session in which the teams that had previously went to Nepal shared their experiences. Once in Nepal, the team reached their destination by jeep on partially built gravel roads and trekking through the mountainous terrain. The team took the same route that the villagers would take to reach secondary and tertiary healthcare facilities. This gave them the opportunity to meet the various stakeholders in the clinics and hospitals, with the aim of understanding the local health system. The mentors accompanying the students utilised reflections [ 14 ] to consolidate students’ daily experiences. Reflective learning, where a deliberate attempt is made to share and reflect on one’s experiences from the day [ 15 ] is key to Project Aasha as it helps shape the experiences into learning moments. Participants for this study were 14 medical students who took part in the trip.

Data collection

At the start, the students were asked to share verbally within the group and in a reflective log on their motivations to participate in the OCIP. On each of the four service days, they were also asked to fill a personal daily reflective log. The end of each service day consisted of a daily debrief, where operational issues of the day will be discussed followed by a group reflective session, where the supervising seniors (doctors and physiotherapists in this trip) also shared their reflections. The reflective log asked all the students to pen down their experience and learning points for the day while the group reflective session asked some of them to share their experiences from the day. This was recorded and transcribed verbatim. At the end of the trip, two focus group discussions (FGD) were conducted on-site where the students were asked to share their overall experience from the trip and what they have learnt. They were audio-recorded and transcribed verbatim. Hence, the data collection comprised three different sources- reflective journals, overall group reflections and the two FGDs.

Data analysis

The transcribed data and written materials were thematically analysed by two coders (GN, MN). GN and MN are both medical doctors with public health training. Disagreements were resolved by a third coder (SY) who is an academic faculty member with expertise in global health and health services research through iterative meetings. Following the initial thematic analysis, compiled themes and sub-themes were subsequently mapped onto the ‘Accreditation Council for Graduate Medical (ACGME) core competencies for medical professionals’ since it is a commonly used framework to measure the competencies of the medical doctors in Singapore. Themes and sub-themes that did not fall within the ACGME categories but emerged from data were also compiled. Therefore, our analysis involved both inductive and deductive approaches. To bolster the strength of our qualitative analysis, we employed data triangulation by incorporating multiple data sources including on-site reflective journals, recorded group reflections and focus groups. These sources allowed us to capture comprehensive exploration of students’ experiences. The analysis involved two independent coders, each responsible for examining the three sources of data. By comparing interpretations of the coding, we assessed the extent of convergence across various data and between coders while also identifying any divergences. This approach ensured a rigorous examination of the experiences and learning outcomes. Through analysis, a conceptual diagram for the learning outcomes from OCIP was generated.

The study was declared to have exempt status and ethical waiver by the SingHealth Centralised Institutional Review Board (Ref no. 2018/3226).

Table  1 shows the characteristics of participants and their motivations to join the trip. There was a balanced number of male and female participants from both year one and two of the same medical school, with an average age of 20 years old. Approximately three quarters (75%) did not have a prior OCIP experience. The majority of students (50%) stated that the experience of healthcare in a low resource setting was the main motivation to join the trip, followed by the experience of healthcare within a different culture, learning how to plan for medical mission trips, wanting to join a sustainable OCIP project and an interest in serving an underserved population.

Learning points during the preparation phase of the trip

Table  2 shows what participants learnt during the pre-trip preparation phase. Three themes were identified – organisational skills, teaching skills and the ability to take into context the culture of the recipient community when developing health education materials. As this is a student-led trip, the students organised all aspects of the trip for the team as well as for the Nepalese community. Consequently, many reflected on acquisition of organisational skills during the preparation phase.

The students also prepared teaching materials for first aid, hand hygiene and women’s health under the physician’s guidance. The initial teaching materials were adopted from the internet, which lacked localisation and thus appeared to be unsuitable for the villagers. For example, for menstrual hygiene, the menstrual cup was seen to be too invasive and culturally inappropriate, and the sanitary napkins were viewed as environmentally unfriendly as compared to using a cloth. Through feedback from the physicians as well as sharing from their predecessors who had visited the village the year before, they learnt to tailor the teaching materials accordingly to the local culture, beliefs and practices.

OCIP experience and learning outcomes according to ACGME framework

Participants’ experiences and reflections engendered various themes under the six domains of the ACGME framework. These quotes for the themes are summarised in Table  3 .

Patient care (PC)

Their reflections depicted the experience of humanism . Besides attending to the patients, the students observed how the doctors, translators and physiotherapists interacted with the patients. This allowed them to appreciate different facets of patient care such as understanding patients’ unique concerns besides the medical complaints and seeing them as an individual rather than a collection of symptoms and signs. Socioeconomic and cultural determinants of health were another two emerging themes of this domain. As one student reflected, “an elderly couple with social issues that greatly outweighed their medical ones, leading me to rethink how to we treat patients”. Seeing them in-situ within their villages and communities allowed the students to appreciate how their lifestyle, habitat and beliefs could influence their presenting medical complaints and health behaviors. For example, students noticed that despite medical advances and awareness, villagers preferred to follow the practice of being isolated during the menstrual cycle or deliver at home instead of using a birthing center due to their own cultural beliefs.

Medical knowledge (MK)

Besides clerking for the patients, the students took on the roles of a pharmacist and a triage nurse which helped them improve the understanding of the patient’s healthcare journey and narratives. Students also worked closely with the doctors who would supervise all the cases they saw. This opportunity allowed them to “use medical knowledge to correlate the clinical presentation with the disease” and apply their medical knowledge in a safe, protected environment.

Practice based learning and improvement (PBLI)

Interactions with the stakeholders especially enabled the students to appreciate the role of PBLI in striving for quality care for the villagers. As this OCIP doesn’t involve any NGOs, the students had the chance to directly interact with the village leaders and clinic leads to understand the healthcare issues in the village and brainstorm on solutions. Through conversations with these stakeholders, they were able to “understand the situation better and design programmes that will benefit the communities the most.” In this process, they learnt how best to investigate and evaluate the needs of the population and the importance of regular feedback to improve the system .

Interpersonal and communication skills

During the OCIP, the patients mainly spoke the Nepali language which indeed created a challenging language barrier . When the students had to work around this barrier, it allowed them to appreciate the importance of non-verbal communication as well as accuracy in understanding the patients’ narrative when taking a history from them. As one student described, students learned “how to make patients feel engaged and connected to you even though I was speaking through a translator.” During the daily reflections sharing, the physicians shared their communication challenges back in multiracial Singapore where knowing English alone is insufficient as each of the elderly patients speak their ethnic dialect. This reflection allowed the students to relate the experience to the situation In Singapore and reflect on how they would communicate across language barriers .

Systems based practice (SBP)

This OCIP was designed in a way that the team has to trek through the mountains from the nearest town to reach the villages for medical service provision and training. This follows the villagers’ journey should they need to travel to a tertiary hospital as the roads are not conducive for vehicular travel. The experience made the students realize how such a system can especially impact the speed of treatment in times of emergencies. During reflections, the physicians also shared that although Singapore is a developed country, for an elderly or disabled patient, their frequents trips to the hospital for multiple medical appointments is comparable. Hence, an ideal situation may be to have a strong primary healthcare facility near their homes, staffed by health professionals who have built a good rapport with the villagers and can manage common chronic conditions. It was commonly reflected that such experiences and sharing enabled them to understand healthcare delivery in low resource settings and relate it back to practice at home. Many reflected on health inequity as they saw how those living in the mountains were disadvantaged due to inaccessibility by virtue of the terrain or when they were unable to afford transport via helicopter to reach a tertiary hospital when time critical care is needed. In addition, the health post at these mountainous villages were often left unattended unlike those along more popular trekking routes like the Everest Base Camp trek or in the city. This created an unreliable system and affected the confidence the villagers have on the healthcare providers. Birthing centres were also present, but they were located on the top of a hill which was challenging for pregnant ladies to travel to. Hence people defaulted antenatal follow-ups and delivered at home. Such experiences brought about reflections on healthcare systems, accessibility and delivery. Specifically, students highlighted the importance of “understanding the bigger picture of the healthcare system in the management of patients.”

Professionalism

Many themes emerged under the domain of professionalism, such as the ethics around such short-term mission trips as well as role modelling when the students saw how the local doctors worked hard for the underprivileged population. Students reflected that healthcare is all “about heart” and they should “always reach out to those in need of greater help.” Experiencing healthcare in a low-income setting also brought about a sense of gratitude . Concurrently, organizing and conducting the trip together with different healthcare professionals provided the platform for the development of teamwork, leadership and interprofessional skills . Lastly, through their experience and reflections, the students reflected on their self-resilience as well as the resilience of the Nepalese people in managing with the minimum. Students observed that witnessing how Nepalese people navigate challenges despite limitations in healthcare infrastructure provided them with “a better insight into what it means to be resilient and how to cope with difficult situations.”

The ACGME framework is broad enough to encompass the various themes from the students’ reflections. Interestingly, these themes refer to the soft or non-technical skills (NTS) in the medical curriculum. These themes also fall within the domains of global health education (socioeconomic and cultural determinants of health, PBLI, SBP), personal (teamwork & leadership skills, resilience) and professional (humanism, MK, ICS, interprofessional skills) development. Teaching the NTS is challenging and may sometimes be perceived as less important by the students. Hence, we propose an alternative conceptual model (Fig.  1 ) to highlight learning outcomes from OCIPs. It aims to help the facilitator and learner in reflecting on their experiences, converting them into learning moments and effectively consolidating learning outcomes in an OCIP. Our framework takes the form of a pyramid, with “Personal Development” forming its base, “Professional Development” building upon that foundation and ultimately capped with “Global Health Awareness”. It is structured as such because it is imperative for the learner to develop personal competencies and attributes to be in a comfortable zone, to glean the higher-order professional and global health skills offered by an OCIP experience. For example, without addressing personal competencies such as teamwork or adaptability to the challenging environment, students may struggle to progress to the next stage of learning professional competencies. Only by adequately addressing these two foundational skills, can students develop a deeper appreciation for global health principles, such as social determinants of health. Understanding the students’ motivations pre-trip can set the learners’ agendas and shape the experiential learning outcomes. Lastly, reflections during the trip and a healthcare journey approach can meaningfully contribute to reaching these outcomes.

Framework for OCIP learning outcomes

This study sought to understand Singaporean medical students experience and learning outcomes of the OCIP. While findings from this study echo the benefits of global health experience published elsewhere [ 8 , 10 , 16 ], this is the first study to show how the OCIP experience could translate to various facets of ACGME domains. Our results demonstrate that OCIP is relevant to undergraduate medical education and could be a pedagogical tool for acquiring ACGME competencies as well as skills relevant to their personal, professional development and global health understanding.

The OCIP provides the opportunity to utilize both experiential learning [ 17 , 18 ] and reflections, which are powerful pedagogical tools in medical education and part of the Kolb’s learning cycle. It provides the space to experience medicine in a more relaxed setting. The dedicated sharing time allows them to reflect and conceptualise the experience and eventually test out what they have learnt the following day [ 17 ]. The experience, reflection, abstract conceptualisation and experimentation are all part of the Kolb’s cycle.

The OCIP also contributes to the transformative learning process [ 19 ]. The students had certain assumptions at the start of the OCIP, which were challenged during the trip. Some of the self and group reflections evoked deep discussions which brought about a change in their perspectives. This is similar to studies which show that critical reflection of experiences serve as a pedagogical approach to learn complex concepts [ 20 , 21 ]. For example, a successful physician is seen as one who can diagnose a patient’s problem and prescribe the appropriate management. However, in the low-resource setting, there was the realization that such skill would not suffice in the optimal long-term management, due to the scarcity of treatment or the inability of villagers to travel regularly to tertiary hospital for continued treatment. Thus, a “health systems” thinking process would be required to address the patient’s problems. Upstream problems (e.g., sanitation, diet) need to be addressed and active effort needs to be made for effective health education and preventative health. Allied healthcare may need to be stationed at the village health posts. The physician should be able to effectively communicate a diagnosis to the villagers and help them understand the impact of illness and treatment noncompliance on their lives such that they follow up on their treatment. And most importantly there should be a system to ensure continuity of care after the departure of overseas physicians. From this experience, it became evident that a successful physician should possess strong leadership skills and ability to bring all of these together.

Such an experience showed the students that a successful physician also needs to have NTS. The Lancet Commissions have proposed a new approach in medical education that focuses on teaching NTS to address health inequity [ 22 ]. These topics are also important to develop a future generation of doctors who are community and socially responsible [ 20 , 23 ]. However, these are challenging topics to teach. The OCIP experience generated the importance of NTS - such as PC, ICS, SBP and professionalism. A well designed OCIP can facilitate the learning of these challenging concepts [ 24 ].

Findings from this study can pave the way for adoption of more relevant competencies to measure the impact of an OCIP. For example, cultural competence or humility has been one of the commonly used learning outcomes. However, the limitations of using this term as a learning outcome are being recognised, as it has not succeeded in reducing health disparities. In response, some have proposed a transnational [ 23 , 24 ] approach to medical education and a global health curriculum to complement OCIPs. The transnational approach comprises both of medical and social competencies that allow the physician to manage patients in various settings. Some of the learning themes identified in this study fall within the transnational framework [ 24 ] and hence, these outcomes (e.g., health systems understanding) may be used to measure the educational effectiveness of an OCIP. Adopting a transnational approach may potentially result in incorporating new competencies into medical education to cultivate socially responsible physicians.

Our findings underscore the need to develop a curriculum for physicians leading OCIPs on how to facilitate the experiential learning through reflections [ 20 ]. A curriculum covering topics relevant to the practical and medical education aspects of an OCIP is much needed [ 4 ]. Although there are existing guidelines on global health ethics [ 2 ], infectious diseases, tropical and travel medicine, currently, there is no guideline on how to facilitate the experiential learning process of medical students during an OCIP. Our findings serve to act as an impetus to develop a more structured approach to OCIPs to ensure that its educational benefits are appropriately assessed.

This study has a few limitations. The study was based on a single OCIP group in Singapore which may limit the transferability of the findings. The physician leads of the OCIP group utilized reflections to facilitate learnings from the OCIP experience and hence there is uncertainty if similar learning outcomes will be achieved if an OCIP didn’t consist of reflective practice. This study explored the OCIP’s benefits solely from the perspectives of the medical student volunteers, leaving the viewpoints of local translators or local population unaccounted for. Further research work is warranted to include the perspectives of the community receiving help [ 25 ] to understand the OCIP’s experiential learning in a more holistic manner.

The rich experience of an OCIP can provide valuable lessons that classroom or bedside teaching may not achieve. In today’s globalized world, as patient care becomes more complex, it is essential to be an all-rounded physician. The experiential learning from OCIPs can facilitate this development. Future steps should focus on how to make such trips more impactful and relevant for the community it serves and to develop a pre-trip checklist of competencies that encompasses the essential NTS required for such trips.

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Data availability

All relevant data are within the manuscript.

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Acknowledgements

We would like to thank the Project Aasha students who participated in this study.

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Gayathri Devi Nadarajan

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Gayathri Devi Nadarajan (GDN) and Sungwoon Yoon (SY) conceptualised the article, contributed to article sections, and reviewed and revised manuscript based on suggestions from the other authors. GDN, SY and Melvin Lim Junchen (ML) undertook the thematic analysis and contributed to the result section. Kumaran Rasappan and Jonathan Shen You Ng contributed to the article sections. All the authors have read and approved the final manuscript. GDN takes full responsibility for the article.

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Nadarajan, G.D., Rasappan, K., Ng, J.S.Y. et al. Medical students’ experience and learning outcomes of overseas community involvement project: a qualitative study. BMC Med Educ 24 , 854 (2024). https://doi.org/10.1186/s12909-024-05560-6

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DOI : https://doi.org/10.1186/s12909-024-05560-6

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