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5 Benefits of Learning Through the Case Study Method

• 28 Nov 2023

While several factors make HBS Online unique —including a global Community and real-world outcomes —active learning through the case study method rises to the top.

In a 2023 City Square Associates survey, 74 percent of HBS Online learners who also took a course from another provider said HBS Online’s case method and real-world examples were better by comparison.

Here’s a primer on the case method, five benefits you could gain, and how to experience it for yourself.

Access your free e-book today.

What Is the Harvard Business School Case Study Method?

The case study method , or case method , is a learning technique in which you’re presented with a real-world business challenge and asked how you’d solve it. After working through it yourself and with peers, you’re told how the scenario played out.

HBS pioneered the case method in 1922. Shortly before, in 1921, the first case was written.

“How do you go into an ambiguous situation and get to the bottom of it?” says HBS Professor Jan Rivkin, former senior associate dean and chair of HBS's master of business administration (MBA) program, in a video about the case method . “That skill—the skill of figuring out a course of inquiry to choose a course of action—that skill is as relevant today as it was in 1921.”

Originally developed for the in-person MBA classroom, HBS Online adapted the case method into an engaging, interactive online learning experience in 2014.

In HBS Online courses , you learn about each case from the business professional who experienced it. After reviewing their videos, you’re prompted to take their perspective and explain how you’d handle their situation.

You then get to read peers’ responses, “star” them, and comment to further the discussion. Afterward, you learn how the professional handled it and their key takeaways.

Learn more about HBS Online's approach to the case method in the video below, and subscribe to our YouTube channel for more.

HBS Online’s adaptation of the case method incorporates the famed HBS “cold call,” in which you’re called on at random to make a decision without time to prepare.

“Learning came to life!” said Sheneka Balogun , chief administration officer and chief of staff at LeMoyne-Owen College, of her experience taking the Credential of Readiness (CORe) program . “The videos from the professors, the interactive cold calls where you were randomly selected to participate, and the case studies that enhanced and often captured the essence of objectives and learning goals were all embedded in each module. This made learning fun, engaging, and student-friendly.”

If you’re considering taking a course that leverages the case study method, here are five benefits you could experience.

5 Benefits of Learning Through Case Studies

1. take new perspectives.

The case method prompts you to consider a scenario from another person’s perspective. To work through the situation and come up with a solution, you must consider their circumstances, limitations, risk tolerance, stakeholders, resources, and potential consequences to assess how to respond.

Taking on new perspectives not only can help you navigate your own challenges but also others’. Putting yourself in someone else’s situation to understand their motivations and needs can go a long way when collaborating with stakeholders.

2. Hone Your Decision-Making Skills

Another skill you can build is the ability to make decisions effectively . The case study method forces you to use limited information to decide how to handle a problem—just like in the real world.

Throughout your career, you’ll need to make difficult decisions with incomplete or imperfect information—and sometimes, you won’t feel qualified to do so. Learning through the case method allows you to practice this skill in a low-stakes environment. When facing a real challenge, you’ll be better prepared to think quickly, collaborate with others, and present and defend your solution.

3. Become More Open-Minded

As you collaborate with peers on responses, it becomes clear that not everyone solves problems the same way. Exposing yourself to various approaches and perspectives can help you become a more open-minded professional.

When you’re part of a diverse group of learners from around the world, your experiences, cultures, and backgrounds contribute to a range of opinions on each case.

On the HBS Online course platform, you’re prompted to view and comment on others’ responses, and discussion is encouraged. This practice of considering others’ perspectives can make you more receptive in your career.

“You’d be surprised at how much you can learn from your peers,” said Ratnaditya Jonnalagadda , a software engineer who took CORe.

In addition to interacting with peers in the course platform, Jonnalagadda was part of the HBS Online Community , where he networked with other professionals and continued discussions sparked by course content.

“You get to understand your peers better, and students share examples of businesses implementing a concept from a module you just learned,” Jonnalagadda said. “It’s a very good way to cement the concepts in one's mind.”

4. Enhance Your Curiosity

One byproduct of taking on different perspectives is that it enables you to picture yourself in various roles, industries, and business functions.

“Each case offers an opportunity for students to see what resonates with them, what excites them, what bores them, which role they could imagine inhabiting in their careers,” says former HBS Dean Nitin Nohria in the Harvard Business Review . “Cases stimulate curiosity about the range of opportunities in the world and the many ways that students can make a difference as leaders.”

Through the case method, you can “try on” roles you may not have considered and feel more prepared to change or advance your career .

5. Build Your Self-Confidence

Finally, learning through the case study method can build your confidence. Each time you assume a business leader’s perspective, aim to solve a new challenge, and express and defend your opinions and decisions to peers, you prepare to do the same in your career.

According to a 2022 City Square Associates survey , 84 percent of HBS Online learners report feeling more confident making business decisions after taking a course.

“Self-confidence is difficult to teach or coach, but the case study method seems to instill it in people,” Nohria says in the Harvard Business Review . “There may well be other ways of learning these meta-skills, such as the repeated experience gained through practice or guidance from a gifted coach. However, under the direction of a masterful teacher, the case method can engage students and help them develop powerful meta-skills like no other form of teaching.”

How to Experience the Case Study Method

If the case method seems like a good fit for your learning style, experience it for yourself by taking an HBS Online course. Offerings span eight subject areas, including:

• Business essentials
• Leadership and management
• Entrepreneurship and innovation
• Digital transformation
• Finance and accounting
• Business in society

No matter which course or credential program you choose, you’ll examine case studies from real business professionals, work through their challenges alongside peers, and gain valuable insights to apply to your career.

Are you interested in discovering how HBS Online can help advance your career? Explore our course catalog and download our free guide —complete with interactive workbook sections—to determine if online learning is right for you and which course to take.

About the Author

What the Case Study Method Really Teaches

by Nitin Nohria

Summary .   

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

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

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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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Center for Excellence in Teaching and Learning

• Case Based Learning

What is the case method?

In case-based learning, students learn to interact with and manipulate basic foundational knowledge by working with situations resembling specific real-world scenarios.

How does it work?

Case studies encourage students to use critical thinking skills to identify and narrow an issue, develop and evaluate alternatives, and offer a solution.  In fact, Nkhoma (2016), who studied the value of developing case-based learning activities based on Bloom’s Taxonomy of thinking skills, suggests that this approach encourages deep learning through critical thinking:

Sherfield (2004) confirms this, asserting that working through case studies can begin to build and expand these six critical thinking strategies:

• Emotional restraint
• Questioning
• Distinguishing fact from fiction
• Searching for ambiguity

What makes a good case?

Case-based learning can focus on anything from a one-sentence physics word problem to a textbook-sized nursing case or a semester-long case in a law course.  Though we often assume that a case is a “problem,” Ellet (2007) suggests that most cases entail one of four types of situations:

• Evaluations
• What are the facts you know about the case?
• What are some logical assumptions you can make about the case?
• What are the problems involved in the case as you see it?
• What is the root problem (the main issue)?
• What do you estimate is the cause of the root problem?
• What are the reasons that the root problem exists?
• What is the solution to the problem?
• Are there any moral or ethical considerations to your solution?
• What are the real-world implications for this case?
• How might the lives of the people in the case study be changed because of your proposed solution?
• Where in your world (campus/town/country) might a problem like this occur?
• Where could someone get help with this problem?
• What personal advice would you give to the person or people concerned?

Adapted from Sherfield’s Case Studies for the First Year (2004)

Some faculty buy prepared cases from publishers, but many create their own based on their unique course needs.  When introducing case-based learning to students, be sure to offer a series of guidelines or questions to prompt deep thinking.  One option is to provide a scenario followed by questions; for example, questions designed for a first year experience problem might include these:

Before you begin, take a look at what others are doing with cases in your field.  Pre-made case studies are available from various publishers, and you can find case-study templates online.

• Choose scenarios carefully
• Tell a story from beginning to end, including many details
• Create real-life characters and use quotes when possible
• Write clearly and concisely and format the writing simply
• Ask students to reflect on their learning—perhaps identifying connections between the lesson and specific course learning outcomes—after working a case

Additional Resources

• Barnes, Louis B. et al. Teaching and the Case Method , 3 rd (1994). Harvard, 1994.
• Campoy, Renee. Case Study Analysis in the Classroom: Becoming a Reflective Teacher . Sage Publications, 2005.
• Ellet, William. The Case Study Handbook . Harvard, 2007.
• Herreid, Clyde Freeman, ed. Start with a Story: The Case Study Method of Teaching College Science . NSTA, 2007.
• Herreid, Clyde Freeman, et al. Science Stories: Using Case Studies to Teach Critical Thinking . NSTA, 2012.
• Nkhoma, M., Lam, et al. Developing case-based learning activities based on the revised Bloom’s Taxonomy . Proceedings of Informing Science & IT Education Conference (In SITE) 2016, 85-93. 2016.
• Rolls, Geoff. Classic Case Studies in Psychology , 3 rd Hodder Education, Bookpoint, 2014.
• Sherfield, Robert M., et al. Case Studies for the First Year . Pearson, 2004.
• Shulman, Judith H., ed. Case Methods in Teacher Education . Teacher’s College, 1992.

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Using Case Studies to Teach

Why Use Cases?

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

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

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

Common Case Elements

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

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

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

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

Advantages to the use of case studies in class

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

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

Guidelines for using case studies in class

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

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

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

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

Accompanying Readings

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

Leading the Case Discussion and Evaluating Performance

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

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

Tips on the Penn State U. website: 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.

Learning and skills at work

Our report and case studies examine how learning and development practices and the overall L&D landscape transformed during the COVID-19 pandemic

The COVID-19 pandemic has caused unprecedented upheaval over the past year. As organisations went into survival mode during lockdown, learning and development (L&D) functions were presented with significant challenges. Many faced reduced budgets, changing demands, and not least the sudden switch to full digital delivery as face-to-face learning became restricted.

However, for some organisations and their learning teams, the crisis has proved to be an opportunity: to refresh their alignment with organisational needs, examine the enablers of collaboration and learning, to embrace digital technology and support employee reskilling and redeployment at a time of ongoing workforce disruption.

In this still uncertain climate, our research underscores the need for organisations to be curious, to step outside of their comfort zones and embrace new ways of delivering learning with impact for the digital age.

While these findings are based on UK data, the broader trends and implications should be of interest wherever you are based. 

Explore the research findings

Download our  survey report  for full details of our findings and recommendations. Complementing the report is a set of  case studies  of seven high-profile organisations and their L&D journey through the pandemic. Their experiences will serve as helpful examples for those looking to steer their course through what may be a protracted and complex post-pandemic recovery.

Report: Learning and skills at work 2021

Case studies: learning and skills at work 2021.

The past year created a unique climate where often siloed business functions are now working together to solve critical business challenges. Now is the time to build forward and leverage that momentum to improve individual, team and organisational learning."

Key findings

• Around a third of organisations report reductions in budgets, L&D headcount and use of external consultants. Organisations who had been more severely impacted by the pandemic have had to make greater cuts to learning budgets.
• Only 18% of organisations think that their learning strategy, investment and resourcing will go back to what it was before the pandemic.
• Despite the seismic shift to digital learning, take-up of technologies that have the potential to make learning more engaging and effective, remains low. The proportion using mobile apps, chatbots, VR and AR animations or games is largely unchanged from last year.
• Organisations that adopt a more sophisticated approach to technology create a virtuous circle, generating an increased appetite for learning.
• Compared with last year, a greater proportion say their learning strategy is aligned with business priorities and the vast majority report that they are clear about the way learning adds value in their organisation.
• The switch from traditional forms of learning to digital has in some cases improved the way individuals support each other; there has been a significant upswing in the proportion of organisations saying they develop and maintain a climate of trust, as well as a rise in those that say employees are supporting each other to learn.
• Since last year, a greater proportion of organisations say they have assessed the impact of automation and how to redeploy employees affected (51%) as well as how roles are changing and how to reskill to meet these needs (64%).
• Organisations are more confident about their ability to address current skills gaps, with 72% reporting that they are able to effectively tackle skills gaps.
• While more organisations had online facilitator roles in place, only a minority had design roles, such as learning technologist/product owner (11%), digital asset creator (7%) and instructional designers (11%).
• Only a third of L&D professionals say they are proactive in identifying performance issues before recommending a solution, and only a quarter design and make recommendations using evidence-informed principles to address those issues. 

Recommendations

In light of the survey findings, and acknowledging the huge impact of the pandemic on organisations, we set out a number of calls to action for practitioners:

• Reflect on what has worked well during the pandemic and what can be adapted to build back better.
• Embrace digital innovation – define your technology strategy in line with your learning strategy. Start small and experiment before scaling up.
• Co-create organisational value through continued cross-team working and cultivate collaboration between business and learning leaders.
• Harness the wider learning environment by agreeing the role of line managers in the L&D context, encouraging peer-to-peer connections and supporting individuals to apply their learning.
• Plan for the future skills your people and organisation need. Encourage continual learning, create the clear learning pathways and career choices.
• Be evidence-based: define your desired outcomes, engage key stakeholders, gather evidence and measure learning impact on performance.

About the research

We collected our research sample via a YouGov panel, supplemented by insights drawn from L&D professionals taken from across the CIPD’s network. Fieldwork took place in February 2021, with more than 1,200 people responding. The survey was specifically aimed at people working in HR/L&D or occupying senior roles, as the questions required specific knowledge on L&D practices and policy.

Access our earlier report and case studies

Report: Learning and skills at work 2020

Case studies: Learning and skills at work 2020

Accenture  is a leading global professional services company, providing a broad range of services in strategy and consulting, interactive, technology and operations, with digital capabilities across all of these services. We combine unmatched experience and specialised capabilities across more than 40 industries – powered by the world’s largest network of Advanced Technology and Intelligent Operations centers. With 509,000 people serving clients in more than 120 countries, Accenture brings continuous innovation to help clients improve their performance and create lasting value across their enterprises. 

We unlock the potential of people and organisations to lead disruption that advances industry and society. Using objective diagnostics and data insights, we create real-time learning to equip employees with the right skills that help organisations pivot at speed and scale. We help clients reskill and new skill workforces through on-demand, continuous, and customised digital experiences.

Tackling barriers to work today whilst creating inclusive workplaces of tomorrow.

Bullying and harassment

Discover our practice guidance and recommendations to tackle bullying and harassment in the workplace.

More on this topic

Evidence-based L&D - Learning at the point of need

Podcast 211: Outside the workplace we’re blessed with an abundance of tools to learn at the point of need. But what can we achieve in the workplace?

Learn about the influence of theories on how people learn and the shift away from simplistic learning styles theory

Outlines different learning methods and what to consider when choosing between them

Review approaches for evaluating learning and gain insights for consideration

More reports

The CIPD examines the state of innovation in the UK and its connection with productivity to inform policy-making and investment

Read our latest Labour Market Outlook report for analysis on employers’ recruitment, redundancy and pay intentions

A Northern Ireland summary of the CIPD Good Work Index 2024 survey report

A Wales summary of the CIPD Good Work Index 2024 survey report

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Case Method Teaching and Learning

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

On this page:

What is case method teaching.

• Case Method at Columbia

Why use the Case Method?

Case method teaching approaches, how do i get started.

• Additional Resources

The CTL is here to help!

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

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

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

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

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

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

Back to Top

Case Method Teaching and Learning at Columbia

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

Faculty Spotlight:

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

Read more  

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Identify learning objectives, determine scope, and anticipate challenges. 

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

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

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

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

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

Plan for the case discussion and an active role for students

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

Student preparation and expectations

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Additional resources 

Teaching with Cases , Harvard Kennedy School of Government. 

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

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

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

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

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

Columbia Resources

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

Center for Teaching and Learning

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

Office of the Provost

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

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

Explore our teaching resources.

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

CTL resources and technology for you.

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

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Case Studies: Bringing Learning to Life and Making Knowledge Stick

Learning by doing is a highly effective and proven strategy for knowledge retention. But sometimes, learning about others who have “done”—using case studies, for example—can be an excellent addition to or replacement for hands-on learning. Case studies―a vital tool in the problem-based learning toolkit—can turbocharge lessons in any subject, but they are particularly useful teaching aids in subjects like Medicine, Law or Forensic Science , where hands-on experiences may not initially be possible.

Here’s a look at how this type of problem-based learning functions to make learning stick and how any faculty member can use them to facilitate deeper, richer learning experiences:

Case studies complement theoretical information 

Reading about scientific principles in a textbook challenges students to think deductively and use their imagination to apply what they’re learning to real-world scenarios. It’s an important skill set. Not all information can or should be packaged up and handed to students, pre-formed; we want students to become critical thinkers and smart decision-makers who are capable of forming their own insights and opinions. 

However, the strategic use of case studies, as a companion to required reading, can help students see theoretical information in a new light, and often for the first time. In short, a case study can bring to life what is often dry and difficult material, transforming it into something powerful, and inspiring students to keep learning. Furthermore, the ability to select or create case studies can give students greater agency in their learning experiences, helping them steer their educational experiences towards topics they find interesting and meaningful. 

What does the research show about using case studies in educational settings? For one, when used in group settings, the use of case studies is proven to promote collaboration while promoting the application of theory. Furthermore, case studies are proven to promote the consideration of diverse cultures, perspectives, and ideas. Beyond that? They help students to broaden their professional acumen —a vitally necessary part of the higher education experience. 

Case studies can be what you want them to be, but they should follow a formula  

Faculty may choose to use case studies in any number of ways, including asking students to read existing case studies, or even challenging them to build their own case studies based on real or hypothetical situations. This can be done individually or in a group. It may be done in the classroom, at home, or in a professional setting. Case studies can take on a wide variety of formats. They may be just a few paragraphs or 30 pages long. They may be prescriptive and challenge readers to create a takeaway or propose a different way of doing things. Or, they may simply ask readers to understand how things were done in a specific case. Beyond written case studies, videos or slide decks can be equally compelling formats. One faculty member even asks students to get theatrical and act out a solution in their sociology class.  

Regardless of format, a case study works best when it roughly follows an arc of problem, solution and results. All case studies must present a problem that doesn’t have an immediately clear solution or result. For example, a medical student may read a case study detailing the hospital admission of a 42-year-old woman who presents to the emergency room with persistent and severe calf pain, but has normal blood tests and ultrasound imaging. What should the physician consider next? A law student might read a case study about an elderly man involved in a car accident who denies any memory of the event. What legal angles should be considered?

Case studies – get started

Are you eager to use case studies with your students? Cengage higher education titles typically contain case studies and real-world examples that bring learning to life and help knowledge stick. Below are some learning materials, spanning a range of subjects, that can help your students reap the proven benefits of case study learning:

Accounting, 29e

Award-winning authors Carl Warren, Jefferson P. Jones and William B. Tayler offer students the opportunity to analyze real-world business decisions and show how accounting is used by real companies.

Guide to Computer Forensics and Investigations, 7e

“Guide to Computer Forensics and Investigations” by Bill Nelson, Amelia Phillips, Christopher Steuart and Robert S. Wilson includes case projects aimed at providing practical implementation experience, as well as practice in applying critical thinking skills.

Business Ethics: Case Studies and Selected Readings, 10e

Marianne M. Jennings’ best-selling “Business Ethics: Case Studies and Selected Readings, 10e” explores a proven process for analyzing ethical dilemmas and creating stronger values.

Anatomy & Physiology, 1e

Author Dr. Liz Co includes a chapter composed entirely of case studies to give students additional practice in critical thinking. The cases can be assigned at the end of the semester or at intervals as the instructor chooses.

Psychopathology and Life: A Dimensional Approach, 11e

Christopher Kearney offers a concise, contemporary and science-based view of psychopathology that emphasizes the individual first. Geared toward cases to which most college students can relate, helping them understand that symptoms of psychological problems occur in many people in different ways.

Understanding Psychological Disorders Enhanced, 12e

In “Understanding Psychological Disorders Enhanced” by David Sue, Derald Sue, Diane M. Sue and Stanley Sue, students can explore current events, real-world case studies and the latest developments from the field.

Policing in the US: Past, Present, and Future, 1e

This comprehensive and timely text by Lorenzo M. Boyd, Melissa S. Morabito and Larry J. Siegel examines the current state of American policing, offering a fresh and balanced look at contemporary issues in law enforcement. Each chapter opens with a real-life case or incident.

Public Speaking: The Evolving Art, 5e

With a student-centered approach, “Public Speaking: The Evolving Art” by Stephanie J. Coopman and James Lull includes innovative solutions to current issues, including critically assessing the credibility of information sources. A diverse collection of sample student and professional presentations encourage students to consider chapter concepts in the context of real speeches.

Theory and Practice of Counseling and Psychotherapies, 11e

Dr. Gerald Corey’s best-selling text helps readers compare and contrast the therapeutic models expressed in counseling theories.

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Use Case Studies Online to Facilitate Critical Thinking Skills

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Bill Brandon

Editor, Learning Solutions, The Learning Guild

The human-machine division of labor is changing rapidly. It will come as a surprise to nobody that the pandemic slowed the growth of automation and modified expectations of the amount of change to that ratio in the next few years. This article suggests that the case study method, one of many experiential approaches to learning, can facilitate the development of essential cognitive skills, particularly in a remote learning setting. 

Responding to disruption 

According to survey responses collected by the World Economic Forum ( “The Future of Jobs Report 2020” ), in 2020 respondents expected 47% of business tasks would be automated in the following five years.  However, today machines just manage to perform 34% of all business-related tasks. This represents only a 1% increase in the level of automation since the 2020 edition of the Future of Jobs Survey. The expectations in the Future of Jobs Report 2023 are that 42% of business tasks will be automated by 2027. In some organizations the percentage will be much greater than that, but overall the improvement is falling short of expectations. 

Supporting those lowered expectations will still require accommodation in the learning and development (L&D) plans of enterprise and government organizations. On top of that, automation will continue to grow and human performance skills required for employment—including thinking skills—will increase substantially as actual jobs change. This shift will very likely show up in gaps in skill sets that employers who responded to the Future of Jobs survey in 2023 said they expect employees to have. Some skills will turn out to be best turned over to machines by 2027, while other skills for which people are better suited will remain at their current levels or progress more slowly. In addition, we can expect to discover new skill requirements for humans. These new skills will include, for example, the ability to work effectively with artificial intelligence (AI) applications. The net result is the disruption of many jobs, including changes to methods of skilling, upskilling, and reskilling, along with the plans of L&D organizations to support skill development at scale. 

Fortunately, learning design professionals and academic institutions have innovated methods and modalities in recent years to meet this challenge.  It is important to consider how to apply these innovations to meet the skill gaps in the best time possible.

Case studies are not the only approach that instructional designers can apply to this kind of development. My intention in coming months is to explore other opportunities such as virtual reality, games, simulations, microlearning, and web-based interactive computing platforms among many others. 

Skill set evolution 2023 to 2027 

According to The Future of Jobs Report 2023, analytical thinking and creative thinking are the most important skills for workers, beginning in 2023 as organizations evolve over the next five years. Analytical thinking is considered a core skill by more companies than any other skill. Creative thinking ranks second.  

Cognitive skills, the category that includes analytical thinking and creative thinking, are growing in importance more quickly than other kinds of skills. The increasing importance of problem-solving ability drives this. According to the World Economic Forum 2023 survey, creative thinking is growing in importance a bit more rapidly than analytical thinking. Notwithstanding that difference, analytical thinking is expected to account for 10% of training initiatives across all the responses to the survey, making it the higher priority of the two skill sets from 2023 to 2027. Creative thinking accounts for 8% of upskilling activity in that period, making it the second workforce development priority.  How can changes to the default approaches to teaching and learning have a positive improvement on solving this challenge?

Learning by doing

Didactic teaching and experiential teaching are two different approaches to teaching and learning. Didactic teaching is familiar to many people due to its extensive use in primary and secondary education. It is also the default that organizational leaders and decision-makers may expect, accept, and sometimes insist upon for teaching and learning. Didactic teaching is primarily lecture-based and assumes that learning is the product of teachers imparting knowledge to students.

Experiential learning takes the approach that people learn best through hands-on experiences. Experiential learning encourages learners to take an active role in their own learning process. As a way to build cognitive skills, experiential learning works, and the didactic approach is far less effective, if it works at all. Adopting the experiential model requires moving away from didactic teaching, but we can expect resistance to the change from organizational leadership, legislative bodies, and from learners themselves.

Cognitive skills grow with experience and maturity, and they can be sharpened through appropriate adoption of improved teaching and learning methods, mental exercises, and feedback. There are experiential methods that provide situational simulations of sufficient fidelity to support learning a skill safely, to provide necessary competence, and to give the learners the opportunity to practice the necessary analysis and performance. One of those methods is the Harvard Case Study Method, more simply referred to as the case study method. 

Introduction to the case study method 

Most readers are probably familiar with the way that case study exercises are conducted in classroom settings. There are links to some resources at the end of this article for readers who need them.

The instructor’s job for this method begins with inviting participants to online sessions for case study exercise. The instructor is also responsible for providing the case materials to participants in their respective locations, making sure that all of the participants are able to connect to the events, and organizing the total group into subgroups to facilitate the sessions. The details of these duties will depend on the online meeting software selected for use. 

The case study method uses narratives or stories (cases) that put the learners in a role requiring them to make a decision. Each case requires learners to consume a case narrative and some supporting information to discuss the case with other learners in their subgroup, to identify and analyze the problem in the case, to develop recommendations to address the issues, and to discuss the recommendations with other learners in the larger group. There may be ambiguity in the information provided to the learners. The decisions will involve a certain amount of difficulty. These are not obstacles to learning: the objective is to improve the learners' approach to collaborative problem solving and development of consensus skills. The objective is not to create conformance to canonical dictates.

Unlike other teaching methods, instructors must not reveal their opinions about the case, its analysis, or the recommendation. The instructor’s job is to ask students to devise, describe, and defend solutions to the problems presented by the case. The case study and instructions may be written to meet the requirements of the instructional situation as to details such as organizing the group into small groups, and the amount of time permitted for discussion. 

The case method asks learners to work together as quickly as they can to make sense of a complex problem, to arrive at a reasonable solution, and to communicate that solution in an effective way.  

Case materials  

Case materials provide learners with the information needed by the students to support learning. Participants in the session will need a copy of the case information (“the case”). You can purchase the information in booklet form by choosing a relevant case from any of the publishers listed in the next section of this article. 

You can also create a case based on your own curated clippings from business publications. As required by your organization’s policies, have your legal department review the clippings and your created case study based on them.  

As the facilitator, you are required to provide each learner with the case materials.  

Published case materials  

A number of organizations publish case materials. These organizations include: 

• Blavatnik School of Government  
• Harvard Business School  
• Stanford Graduate School of Business  
• Columbia Business School  

Here are resources for further reading on case study methods and critical thinking. 

• Ellet, W. (2007). The Case Study Handbook: How to Read, Discuss, and Write Persuasively About Cases . Boston, MA: Harvard Business School Press. Link  
• Herreid, C. F., & Schiller, N. A. (2013). Case studies and the flipped classroom. Journal of College Science Teaching , 42(5), 62-66. Link
• Nohria, Nitin. (2021) “What the case study method really teaches.” Harvard Business Review. December 21, 2021.  Link  
• Rebeiz, Karim S. (2011) “An Insider Perspective on Implementing the Harvard Case Study Method in Business Teaching.” Retrieved September 4, 2032 at ED527670.pdf  

At the time of this writing, none of those resources was behind a paywall.

September 7, 2023

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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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Home » Blog » 15 Active Learning Strategies and Examples

15 Active Learning Strategies and Examples

This paradigm shift from traditional teaching to active learning underscores the learner’s role in constructing knowledge. Rather than being just a recipient of information, the learner becomes an active participant in a two-way process, whereby learning is imprinted through memorable, interactive activities and challenges.

With today’s dynamic global environment, active learning has become more critical in L&D than ever before. This teaching approach encourages employees to play an active role in their own education, fostering a culture of continuous learning and adaptability, vital in the ever-evolving world of work.

What is Active Learning and How Does it Work?

First defined in 1991 by educational theorists Charles C. Bonwell and James A. Eison , the method includes “anything that involves students in doing things and thinking about the things they are doing.” It’s a reciprocal process where cognition and demonstration combine to reinforce key learning points.

A recent study conducted at Carnegie Mellon University’s Human-Computer Interaction Institute concluded that “active learning can put students in the driver’s seat of their lessons. Active learning techniques encourage students to produce thoughts and get feedback through interactive settings rather than passively receiving information as is common in pervasive approaches to education like lectures and readings.”

Active learning allows students to analyse, synthesise and apply knowledge rather than passively receive information. It fosters learner engagement , interaction, and deeper understanding, moving beyond the memorization of facts to cultivate higher-order thinking skills.

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Key components of active learning strategies.

At the heart of active learning are three fundamental components: Engagement , Reflection, and Application. Learners actively engage with the material, reflect on the content’s relevance and meaning, and apply what they’ve learned in practical, often collaborative, situations.

Here’s how those three components work in more detail:

Engagement : This aspect describes a mix of concentration and interest. Students focus on the topic in hand because it is taught in a manner that makes it intrinsically interesting.

Reflection : Students are asked to consciously reflect on the subjects they have been learning. This helps personalise and imprint the knowledge, and the repetition of key points helps fix them in memory.

Application : This aspect focuses on the practical use of key pieces of learning. By making the topic practical, students learn how useful the subject can be, motivating them to remember and focus.

Another key element of active learning is that it’s frequently collaborative. Not only do learners benefit from interaction with the educator, but they join forces in team exercises, or share their opinions and experiences in group discussion.

Benefits of Active Learning

Active learning has a plethora of benefits, some of which include:

Boosting Retention

Active learning strategies help learners retain information better. When learners actively engage with content—discussing, debating, teaching, or applying it—they’re more likely to remember it. Part of the reason for this is that activities help personalise the learning content, creating appreciation and some of the positive emotions that make an experience memorable. Information Processing Theory explains retention in three stages – sensory memory, short-term memory, and long-term memory.

Critical Thinking

Active learning cultivates critical thinking skills. Learners don’t just absorb information; they analyse, evaluate, and synthesise it, fostering problem-solving and decision-making skills. Critical thinking is considered a soft skill and is essential to any modern educational programme, from social science to the humanities, hard science, and vocational subjects.

Collaboration

Active learning often involves teamwork and collaboration. Through group activities and discussions, learners develop interpersonal skills and learn to work effectively as a team. This is particularly helpful in workplace settings where learners can support one another in the shared goal of picking up new skills they can use at work.

Increasing Engagement

Active learning increases learner engagement. Interactive activities stimulate interest and motivate learners, contributing to a more enjoyable and effective learning experience. By creating engaging interactive content, you can avoid the glazed eyes or after-lunch slump of less involving courses!

15 Active Learning Examples

Now that we understand active learning and its benefits, let’s delve into some practical strategies to implement this learning approach.

1. Think-Pair-Share

Think-Pair-Share encourages collaboration and peer learning. Learners think about a question or problem individually, pair up to discuss their thoughts, then share their insights with the larger group. This method combines social learning activities like collaboration and reflection in a way that draws out the strengths of both modalities.

2. Three-Step Interviews

Three-Step interviews allow learners to apply different questioning strategies and reflect on understanding. They take turns acting as the interviewer, interviewee, and observer, promoting active engagement and deep reflection. This kind of active learning works particularly well for courses emphasising social and negotiation skills, including hospitality, politics, journalism, and sales.

3. Case Studies

Using case studies enables learners to apply concepts to real-world scenarios. This strategy fosters critical thinking and problem-solving skills, linking theoretical learning to practical application. Case studies should be designed to chime with course participants’ lives and experiences, allowing them to offer their own personal insights. This allows them to become emotionally and intellectually involved in the subject under discussion, and the learning is likely to stick.

4. Role-Play

Role-play enhances empathy and problem-solving skills. By acting out scenarios, learners gain insights into different perspectives and learn to navigate complex situations. It can be particularly instructive to ask learners to inhabit both sides of an interaction, for instance, a police officer and suspect, or sales professional and buyer. Not all students will be comfortable in such a performative exercise, however.

5. Flipped Classroom

In a flipped classroom, learners explore content independently before class, freeing up classroom time for active discussions and problem-solving activities. This method works best in a highly motivated educational setting, such as vocational training resulting in professional qualifications. An obvious drawback is that, if students don’t prepare, they’ll get very little out of the class-based content. It’s also important for participants to reflect on in-class discussions after each session.

6. The Muddiest Point

The Muddiest Point requires learners to reflect on challenging areas, providing invaluable feedback for the educator. The educator will typically ask “what didn’t you understand?” or “what point did you find most complex?” and then follow up with a focused session exploring that concept. This technique helps identify misconceptions and knowledge gaps, as well as improving future iterations of course content.

7. Problem-Based Learning

Problem-Based Learning cultivates critical thinking and decision-making skills. Learners tackle real-world problems, applying knowledge and skills in a practical context. Rather than the theoretical situations covered in a typical case study, problem-based learning might take a story from the news or social media and explore it under the lens of the topic in hand. This makes the subject feel more relevant to the students, and more useful.

8. Simulations and Gamification

Simulations and gamification create immersive learning experiences. These methods engage learners in an interactive, competitive environment, enhancing motivation and learning outcomes. Such games could involve anything from quizzes to physical games or puzzles to be solved by teams. Some subjects will lend themselves to this better than others, and competitive workplaces , such as sales teams, may prove more comfortable with such challenges.

9. Peer Teaching

Peer teaching reinforces understanding and builds confidence in knowledge. By teaching their peers, learners gain a deeper understanding and consolidate their learning. The classic American “show and tell” in junior school is an example of this, but adult learners can also benefit from sharing their experiences or explaining a point with reference to an example from their own working lives.

10. Debates and Discussions

Debates and discussions encourage active participation and analysis. They foster critical thinking and the ability to articulate and defend viewpoints. Although a little out of favour in modern schools, nevertheless this classic strategy serves to imprint key issues in social, cultural, and political thinking. It’s possible to reduce the antagonistic elements of debates by imposing strict discourse rules (such as addressing the chair or avoiding ad hominem attacks).

11. Interactive Quizzes and Polls

Interactive quizzes and polls engage learners and assess knowledge. They make learning fun, while also serving as valuable tools for instant feedback. These can work just as well in-person as they might online, or in blended learning settings. They are essential as part of any eLearning Platform that offers online courses – as both a measurement tool and a method of monitoring progress and content effectiveness.

12. Experiential Learning

Experiential learning involves hands-on activities for practical skill development. Learners gain practical experience, increasing the transfer of learning to real-world situations. For situations in which site visits are impossible, bringing pieces of the subject into the classroom can be highly instructive. First aid lessons require this aspect, and children love this aspect of learning. It’s worth not neglecting this for adult learners of any subject, however.

13. Brainstorming Sessions

Brainstorming sessions stimulate creativity and idea generation. They foster open-mindedness, encouraging learners to consider various possibilities and solutions. When brainstorming, it’s vital not to make any value judgments on suggestions, but simply to group and list student ideas. Once everyone has had their say, the educator and class can begin to identify common themes and recurring ideas.

14. Field Trips and Site Visits

Field trips and site visits connect learning to real-world situations. They enhance understanding and contextualization of knowledge. Site visits are fun and instructive and add much-needed variety to an in-person course. They often introduce students to hands-on skills they might pursue in greater depth, or to potential workplaces or causes they can become invested in.

15. Learning Circles and Communities

Learning circles and communities help foster collaboration and knowledge sharing. They create a supportive learning environment where learners can learn from one another, share insights, and collaboratively solve problems. With digital courses, it’s often important to create a forum for learners where mutual encouragement and support can occur. When classes are held in-person, students can be encouraged to help one another with coursework and collaborative projects.

Implementing Active Learning Strategies

Key considerations.

When incorporating active learning strategies, consider the learning objectives , the learners’ characteristics and needs, and the available resources. It’s also important to ask what students want to get out of the course (rather than any objective need for certification or qualification).

The right blend of active learning strategies can enhance the learning experience, making it more engaging, meaningful, and effective.

For instance, you’ll need a very different approach with a community of language learners from different countries, with varying levels of proficiency, than you would teaching an established workplace group where the main variable is seniority.

Let’s break these variables down a little:

Student Objectives: What would each student like to get out of the class, in terms of educational purpose and enhancement of their working or home life?

Student Characteristics: What proficiency and understanding level are your students at? If it’s a workplace course, what level of seniority do they have (how easily can the effect change)? If you have shy students, how can you involve them in activities without undue pressure?

Student Needs: What is the practical outcome supposed to be? It could be a qualification, a certificate, or simply a better understanding of a topic. It’s also worth asking, going into a class, if anyone has any additional needs, since you may have students with dyslexia, ADHD, or other learning challenges.

Available Resources: Do you provide paper and pens, devices, calculators? Do you invite guest speakers? Are their physical challenges and hands-on experiences? Do you provide meals? All these ingredients could affect the success of your course.

Challenges of Active Learning Strategies

Active learning strategies, while beneficial, pose certain challenges. They require time, resources, and planning. They also require students to buy into a style of learning that some may not be familiar with.

Let’s unpack three more common challenges of active learning in a little more detail:

Student Hesitancy: To make active learning inviting, it’s best to design courses so that students come to expect and are prepared for this style of education from day one. Begin with simple exercises like a current knowledge quiz or simple pair exercises, and then progress to more involved exercises.

It’s also important to be clear with instructions and allow time for students to get used to being active rather than passive participants. Explain why you’re using these methods, rather than more rote methods of learning. If students believe it’s in their best interests to participate, they will.

Lack of Collaboration: Before you can expect a group of disparate individuals to work together, they must feel comfortable together. Begin with simple introductory exercises, so students get to know one another before being asked to share more personal experiences. Where students are too shy to choose partners, it’s okay to assign partners for them, so long as you attend to any obvious signs of discomfort.

Running out of Time: This is very common. When students are engaged, they can lose track of time. It’s often a good sign!

However, to avoid your course running out of control, make sure you do time trials of collaborative exercises, and be very upfront with any timescales you impose. You can even use a bell or whistle to warn students when they have five or two minutes left to finish up an exercise.

All these challenges can be overcome through careful design, strategic planning, scene setting, and the use of technology to streamline and support the learning process.

Remember that active learning is often a process of trial and error. What works well with one group may not prove so successful with another. It’s worth having alternative exercises to hand in case it becomes obvious that you need to pivot to a different approach.

Measuring the Impact of Active Learning Strategies

Methods to measure the effectiveness of active learning include surveys, assessments, observation, and feedback. Make sure you incorporate a bit of time for learners to complete satisfaction surveys or training feedback forms and make it as easy as possible to do so anonymously. Don’t make these too lengthy but do allow space for comments.

It’s essential to evaluate not only engagement and knowledge acquisition but also the development of skills and attitudes and the transfer of learning to real-world scenarios. Ideally, whoever has commissioned the course will have some method for following up and measuring KPIs after some weeks or months have passed. Ask if you can receive a copy of this information too.

Final Insights

Active learning, with its focus on engagement, reflection, and application, offers numerous benefits. It boosts retention, enhances critical thinking, fosters collaboration, and increases engagement.

At Skillshub, we fully commit to active learning, and incorporate many of its strategies into our learning solutions, creating eLearning content which is engaging, active and involving.

Our offerings are designed to facilitate active learning, equipping learners with the knowledge, skills, and attitudes necessary to thrive in today’s dynamic world.

If you’re ready to incorporate active learning into your L&D strategy with the help of an eLearning company , get in touch with us today!

Sean McPheat

Sean is the CEO of Skillshub. He’s a published author and has been featured on CNN, BBC and ITV as a leading authority in the learning and development industry. Sean is responsible for the vision and strategy at Skillshub, helping to ensure innovation within the company.

Updated on: 4 October, 2023

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• Open access
• Published: 12 September 2024

A combination of case-based learning with flipped classroom improved performance of medical students in nephrology bedside teaching

• Bibi Hu 1 ,
• Li Wang 2 ,
• Junxia Wu 3 ,
• Lina Zhu 3 &
• Zhida Chen 3  

BMC Medical Education volume  24 , Article number:  995 ( 2024 ) Cite this article

Metrics details

Bedside teaching remains a challenging endeavor for clinical doctors and medical students, as the students often encounter difficulties in applying their knowledge to clinical situations. This study aims to evaluate the efficacy of combining case-based learning (CBL) with a flipped classroom (FC) approach in nephrology bedside teaching.

A total of 92 medical students were enrolled in this study, including clerks and interns. The students were assigned into two groups. The CBL/FC group students received the combined teaching approach of CBL and FC (CBL/FC). Students who received the traditional lecture-based teaching (LBT) approach were treated as the control group. General knowledge tests, clinical case scenarios, and questionnaires were used to evaluate the teaching efficacy.

Ninety-two students were included in this study. Overall, 46 students were assigned to the CBL/FC group, while the other 46 students were assigned to the LBT group. The students in both groups showed comparable performance in the knowledge test. However, in clinical case scenarios, students in the CBL/FC group demonstrated superior performance compared to those in the LBT group. Additionally, the analysis of questionnaires revealed that the CBL/FC group students expressed more positive attitudes toward their proficiency in medical history taking, physical examination, medical record documentation, clinical reasoning, and consideration for patients’ welfare. Moreover, the students from the CBL/FC group regarded the CBL/FC teaching approach as an effective and satisfying method without increasing the learning burden.

This study reveals that the CBL/FC combined teaching approach shows promise in nephrology education and provides an effective and alternative format for medical teaching.

Peer Review reports

Introduction

Towards the end of their undergraduate education, medical students face a transition from students to interns, requiring them to apply their problem-solving skills in a clinical setting [ 1 ]. The factors that cause human diseases are complex and medicine is a highly practical discipline; hence, the basic medical knowledge acquired from school is insufficient to meet the requirements of clinical practice. New interns are often confused about managing clinical problems, as they are faced with the challenge of applying theoretical knowledge to clinical practice [ 2 ]. Bedside teaching is an effective mode of medical education, helping interns to apply their knowledge to real-world clinical work [ 3 ]. However, the traditional instructional approach emphasizes the delivery of core knowledge to students and overlooks the development of clinical thinking and problem-solving. Therefore, students cannot integrate theoretical knowledge with clinical knowledge. Moreover, long-term passive acquisition of knowledge that is poorly applied to clinical practice dampens students’ enthusiasm for learning [ 4 , 5 ].

Traditionally, lecture-based teaching (LBT) has been the most common method of teaching. This approach is commonly used in teaching medical knowledge and clinical skills and represents an easy and effective method to show the students general knowledge and concepts. However, during clinical teaching, LBT does not effectively engage students in developing critical reasoning skills. In addition, LBT is teacher-centered, so the knowledge transmission depends highly on the teachers [ 6 , 7 ].

In contrast, case-based learning (CBL) is a learner-centered method that promotes interaction among participants as they collaborate to build their knowledge and examine the case together as a group. CBL has been widely used around the world for medical education [ 8 ]. CBL facilitates the development of students’ clinical performance and teamwork, encouraging them to solve clinical problems with their theoretical knowledge and critical thinking. It is a student-centered teaching methodology that exposes students to real-world scenarios [ 9 ]. Previous studies comparing the CBL method to the traditional teaching method in medical students have demonstrated that CBL is more effective in improving students’ problem-solving skills [ 10 , 11 ].

Flipped classroom (FC) is another student-centered teaching approach that is widely used in medical education. The FC approach allows students to watch instructional videos online before class. In class, teachers and students primarily interact and converse, and teachers answer questions to enable learners to internalize their lessons [ 12 ]. By freely managing their time while learning online and repeatedly learning complex knowledge, students maximize the efficiency of classroom learning [ 13 ]. The most recent research revealed that students in FCs consistently exhibited higher levels of satisfaction, motivation, and engagement, as well as more positive academic outcomes compared to traditional lecture-based learning (LBL) [ 14 , 15 ].

Both the CBL approach and the FC approach are beneficial to student learning, while the effects of the combined usage of CBL and FC in nephrology education remain poorly understood. Therefore, this randomized control study investigated 92 medical students to evaluate the effectiveness and acceptability of the combined approach (CBL/FC). This study compared the performance in general knowledge tests, clinical case scenarios, and questionnaires between students who received the CBL/FC approach and LBT approach. The CBL/FC approach was compared with traditional LBT teaching in undergraduate students and evaluated the advantages of this teaching model to provide new strategies for undergraduate medical education.

Participants

A total of 92 undergraduate students were included in this study, who all majored in clinical medicine at Zhejiang University, School of Medicine. The students undertook a clinical rotation in the Department of Nephrology, Second Affiliated Hospital of Zhejiang University, between January 2022 and January 2023.

The inclusion criteria were (1) attended the hospital for pre-clerkship or clerkship training, (2) first time to attend the clinical rotation in the Department of Nephrology, and (3) having a presence of over 90% over the training period. The exclusion criteria were (1) refusing participation, (2) an absence rate of 10% or more over the training period, and (3) dropping out for other reasons.

All students enrolled in this study have attended the nephrology lectures taught by the same instructors beforehand. Before the study enrolment, the participants were required to take examinations containing a general knowledge test and clinical case scenarios related to nephrology. The students’ baseline performance was assessed according to the results of the examination. The students were randomly assigned to two groups based on their year of grade in the school. Students in Group A received the CBL and FC combined approach, while students in Group B received the traditional LBT approach as a control group. General knowledge tests, clinical case scenarios, and questionnaires were used to evaluate the teaching efficacy.

All the teachers participating in this study were voluntarily included. They were experienced teachers in clinical teaching and were trained before teaching.

Study design

All students received the CBL/FC approach or LBT approach between January 2022 and January 2023. The study flow is displayed in Fig.  1 . In brief, the teachers prepared the same topic for the two groups. In Group A (CBL/FC group), students were divided into small groups comprised of 4 or 5 persons. Teachers were required to prepare topic-related materials (including related cases, PowerPoint materials, and handouts), which were delivered to the students one week before the class. The students were requested to preview the topic-associated materials and prepare slides for a case presentation. The class began with the teachers introducing the topic, and the students presented their case, followed by a discussion. Students placed themselves in the role of the decision-maker and identified the problems they faced using the knowledge they learned. Next, students performed the necessary analysis, including the clinical diagnosis, differential diagnosis, further examination, and therapeutic regimen. Finally, the teachers answered the questions raised by students and summarized the corresponding pitfalls and pearls. After the class, the teachers assigned after-school thinking questions to the students and prepared the case for the next class. Students were requested to review the textbook and prepare for the exam. In Group B (LBT group), the teachers prepared slides about the class topic by themselves, while students were not informed in advance about the new content for the next class. During class, the teachers lectured about the class topic and answered the students’ questions. At the end of the class, the teachers provided a summary of the topic and left some homework for the students. The study design was approved by the Institutional Review Board and Ethics Committee of the Second Affiliated Hospital of Zhejiang University School of Medicine. All students involved in the study signed informed consent forms.

Schematic representation of the interventions. A : Schematic representation of the CBL/FC approach; B : Schematic representation of the LBT approach. CBL, case-based learning; FC, flipped classroom; TBL, lecture-based teaching

To evaluate the outcomes of the intervention, the students from the two groups were assessed by a general knowledge test and clinical case scenario on their last day in our department. The general knowledge test was composed of multiple-choice questions, with each question bearing the same weight. The students were required to participate in clinical practice as doctors do in clinical case scenarios, including medical history collection, physical examination, record writing, clinical thinking, and care for patients. The scenarios used for assessment were never presented in the teaching process for students in the CBL/FC group. Moreover, we had provided specialized training to familiarize both groups of students with the format of the exam. The clinical case scenarios used for assessment were the same between the two groups. Finally, the students were scored according to their performance. All students from both groups were required to complete a questionnaire, which was used to understand the perspectives and experiences of the students regarding the teaching models using a five-point Likert scale. The items covered questions about improving the ability of medical history collection, physical examination, record writing, clinical thinking, and care for patients, as well as the time spent for the class, the satisfaction with the teaching method, and recommendation of this method. The questionnaire was modified from Paul Ramsden’s Course Experience Questionnaire and Biggs’ Study Process questionnaire with verified reliability and validity [ 2 , 16 , 17 ]. The questionnaire is listed in the Supplementary Materials.

All methods were carried out in accordance with relevant guidelines and regulations.

Statistical analysis

All data were presented as mean ± standard deviation of mean (SD) and analyzed on GraphPad Prism 9.0. The independent sample t- test was performed to compare exam scores between groups. In addition, the chi-square test was performed to compare the gender distribution between the two groups. The Mann-Whitney test was performed to compare the age and questionnaire outcomes between groups. In this study, P  < 0.05 was considered statistically significant.

Participant characteristics

A total of 48 of the students were in their fourth grade of medical school, and 44 were in Grade 5. The ages of the students ranged from 20 to 22 years old. At the start of the study, 46 students were randomly assigned to the CBL/FC group, and the other 46 students were assigned to the LBT group. As displayed in Table  1 , the average age, male/female, and grade showed no significant difference between the two groups.

Students’ performance in the exam

Before the interventions, the students’ baseline performance was assessed. The scores of the examination were analyzed and the results revealed no significant difference between these two groups (Fig.  2 A and B). In the general knowledge test, the average score in the CBL/FC group was 94.07 ± 4.86, while the score was 93.04 ± 5.33 in the LBT group, revealing a similar performance in both groups ( P  > 0.05, Fig.  3 A). However, in the clinical case scenarios, the students in the CBL/FC group demonstrated a superior performance to that of the LBT group ( P  < 0.05), as shown in Fig.  3 B.

The performance of students before the interventions. A/B : The performance of students in Grade 4 before the interventions. A : The students in the two groups showed similar performance in general knowledge test, 83.96 ± 4.63 vs. 84.12 ± 4.87, P  = 0.90. B : The students in the two groups showed similar performance in clinical case scenarios, 55.46 ± 14.86 vs. 55.88 ± 13.12, P  = 0.92. C/D : The performance of students in Grade 5 before the interventions. C : The students in the two groups showed similar performance in general knowledge test, 87.41 ± 4.68 vs. 87.73 ± 4.05, P  = 0.81. D : The students in the two groups showed similar performance in clinical case scenarios, 71.09 ± 11.49 vs. 69.82 ± 13.86, P  = 0.74. Data are presented as mean ± SD. NS, no statistical significance

The performance of students after the interventions. A : General knowledge test scores. The students in the two groups showed similar performance, 94.07 ± 4.86 vs. 93.04 ± 5.33, P  = 0.34. B : Clinical case scenarios. The students in the CBL/FC group scored higher than students in the LBT group, 80.39 ± 15.05 vs. 71.43 ± 15.61, P  = 0.01. Data are presented as mean ± SD. * P  < 0.05; NS, no statistical significance

All the students in the same grade were pooled together, indicating that students in Grade 4 performed better in the general knowledge test (Grade 4: 96.67 ± 4.42 vs. Grade 5: 90.16 ± 3.33, P  < 0.01), whereas students in Grade 5 performed better in the clinical case scenarios tests (Grade4: 70.50 ± 16.02 vs. Grade 5: 81.82 ± 13.64, P  < 0.01). Additionally, the same trend was observed when comparing the test scores of the students in different grades (Fig.  4 A and B).

The performance of students after the interventions in different groups. A : Students in Grade 4 performed better in the general knowledge test compared to students in Grade 5, 96.67 ± 4.42 vs. 90.16 ± 3.33, P  < 0.01. Similar results were found in subgroups based on the teaching method: in the CBL/FC group, Grade 4: 97.08 ± 3.88 vs. Grade 5: 90.77 ± 3.53, P  < 0.01; in the LBT group, Grade 4: 96.25 ± 4.94 vs. Grade 5: 89.55 ± 3.08, P  < 0.01. B : Students in Grade 5 performed better in clinical case scenarios than students in Grade 4, 70.50 ± 16.02 vs. 81.82 ± 13.64, P  < 0.01. Similar results were found in subgroups based on the teaching method: in the CBL/FC group, Grade 4: 75.13 ± 16.63 vs. Grade 5: 86.14 ± 10.79, P  = 0.01; in the LBT group, Grade4: 65.88 ± 14.26 vs. Grade 5: 77.50 ± 15.02, P  = 0.01. Data are presented as mean ± SD. * P  < 0.05, ** P  < 0.01

Students’ experience survey.

Students’ perceptions and experiences were evaluated using a questionnaire. All the students in this study were required to complete the questionnaire. The Cronbach’s alpha for positive items of the questionnaire was calculated as 0.84, which indicated the satisfactory internal consistency and reliability of the questionnaire. The students in Grade 4 in the CBL/FC group provided a more positive perception of improving the ability of medical history collection (4.25 ± 0.79 vs. 3.25 ± 0.74, P  < 0.01), physical examination (4.29 ± 0.75 vs. 3.29 ± 0.75, P  < 0.01), record writing (4.63 ± 0.49 vs. 3.63 ± 0.82, P  < 0.01), clinical thinking (4.33 ± 0.70 vs. 3.79 ± 0.72, P  = 0.01), and support for patients (4.38 ± 0.65 vs. 3.25 ± 0.85, P  < 0.01) compared to the LBT group. The time spent before the class showed no difference between the two groups (2.92 ± 0.28 vs. 3.17 ± 0.96, P  = 0.23). However, the CBL/FC group students were more satisfied with the class (4.21 ± 0.72 vs. 3.54 ± 0.83, P  < 0.01). Similarly, the students in Grade 5 in the CBL/FC group also held a more positive perception of improving the ability of medical history collection (4.68 ± 0.48 vs. 3.91 ± 0.75, P  < 0.01), physical examination (4.55 ± 0.60 vs. 3.73 ± 0.70, P  < 0.01), record writing (4.59 ± 0.59 vs. 3.36 ± 0.85, P  < 0.01), clinical thinking (4.64 ± 0.49 vs. 3.55 ± 0.91, P  < 0.01), and support for patients (4.68 ± 0.48 vs. 3.86 ± 0.83, P  < 0.01) compared to the LBT group. The time spent before the class showed no difference between the two groups (3.18 ± 1.14 vs. 3.14 ± 0.64, P  = 0.87). However, the CBL/FC group students were more satisfied with the class (4.27 ± 0.55 vs. 3.09 ± 0.97, P  < 0.01) (Fig.  5 A and B).

The students’ perspectives on the teaching modality. A : Experience survey of students in grade 4. B : Experience survey of students in grade 5. The students in the CBL/FC group reported a more positive perception of improving the ability of medical history collection, physical examination, record writing, clinical thinking, and support for patients ( P  < 0.05). The time spent before the class showed no significant difference between groups ( P  > 0.05). However, the CBL/FC group students were more satisfied with the class ( P  < 0.05). Data are presented as mean ± SD. * P  < 0.05, ** P  < 0.01; NS, no statistical significance

Clinical learning during an internship remains a challenge for medical students. Traditional clinical teaching methods such as LBT do not fulfill the requirements for current medical education [ 18 , 19 ]. Thus, new strategies should be explored to improve the medical students’ clinical thinking ability and problem-solving ability.

Compared to simple FC teaching, a previous study revealed that case-based and team-based learning (CTBL) combined with FC (FC/CTBL) was superior in teaching residents, effectively improving their teamwork, clinical thinking, and confidence to solve problems by themselves [ 20 ]. The results indicate that a combination of multiple teaching methods could improve the student’s performance and learning efficiency. The CBL approach is a long-established pedagogical method, which aims to help students link theoretical knowledge with clinical practice. In this approach, instructors show the clinical history of patients with typical symptoms and students place themselves in the role of the decision-maker, applying the knowledge they learned [ 21 ]. The FC approach is a student-centered active learning strategy, which allows students to review instructional content outside the classroom and take part in interactive learning under the teacher’s guidance, allowing students to internalize their lessons. The FC approach has shown greater academic achievement for higher-level learning outcomes compared to traditional LBT and students considered FC beneficial to comprehension, critical thinking, and teamwork [ 22 ]. Overall, the CBL approach motivates students and facilitates the association between student learning and real-life situations. Furthermore, the FC approach emphasizes the initiative of students and promotes the development of the students’ abilities to analyze and solve problems. Hence, the present study combined FC with CBL. This study’s findings suggested that students in the CBL/FC group performed better in clinical case scenarios and felt more motivated to learn compared to those in the traditional LBT group.

This study demonstrated that students in the CBL/FC group scored higher than those in the LBT group for the tests of clinical case scenarios. However, the students from both groups achieved similar scores in the general knowledge tests. These results were consistent with those of previous studies. The CBL approach has been considered to provide a relaxed, non-threatening environment, which introduces students to clinical skills in a way that fosters their confidence for future clinical practice [ 23 , 24 ]. Moreover, the FC approach cultivates high-order cognitive abilities and improves students’ skills, which can be attributed to students being encouraged to utilize their knowledge to solve specific problems and to absorb new ideas through debate or discussion [ 14 , 25 ]. Notably, the baseline performance between both groups before intervention was comparable. Collectively, the CBL/FC approach combines the advantages of the CBL and FC approaches and improves the students’ ability to transition knowledge from textbooks to real-world clinical settings.

Interestingly, the students in the fifth-year grade obtained higher scores in clinical case scenarios in both the CBL/FC group and the LBT group, while they scored lower in the general knowledge test. This result may be attributed to the students in grade 5 having obtained more experience from their clinical rotations, as they received training in other departments. Meanwhile, students in Grade 4 were still studying clinical medicine courses, while students in Grade 5 had finished their courses and participated in clinical work [ 26 ]. Thus, students in Grade 4 may remember more theoretical knowledge compared to their Grade 5 counterparts, which is critical in scoring higher on the general knowledge test.

Subsequently, feedback was collected from students regarding the CBL/FC approach in nephrology teaching. The assessment of questionnaires revealed that the students gave positive perceptions of the CBL/FC. The students felt that the CBL/FC approach helped them to improve their medical history taking, physical examination, medical record documentation, and clinical reasoning skills, as well as consideration for patients’ welfare. Additionally, the students learned to search academic publications and improved their critical thinking by discussing with their classmates. During the CBL/FC processing, the students developed some essential abilities for their science writing and presenting, which may be applicable to their academic careers. In contrast, the LBT method did not provide much motivation. Previous studies have demonstrated similar outcomes, with students showing greater satisfaction with the CBL approach and the FC approach, reporting that both teaching approaches resulted in a deeper understanding [ 21 , 22 , 24 , 27 ]. Intriguingly, several studies found that students gave negative feedback about extra burden and pressure when receiving the CBL approach or the FC approach [ 21 , 28 ]. However, the students enrolled in the CBL/FC group in the present study showed they did not spend an excessive amount of time on their preparation and felt satisfied with this teaching approach. This may be partly attributed to the study having a longer intervention period and students gradually adapting to this learning mode. Moreover, students can feel their progress when using the CBL/FC approach, thereby creating a positive feedback effect. These findings should encourage teachers to consider using the CBL/FC approach in nephrology education since it is very effective in cultivating students’ abilities without extra pressure.

The present study is the first to evaluate the effectiveness of the CBL/FC approach in nephrology bedside teaching. Moreover, this study carried out a long-term intervention and assessed the effect of the CBL/FC approach in different grades. Nevertheless, the limitations of the present study should be acknowledged. Firstly, the present study did not include the CBL group or the FC group due to the limited number of participants. This limits the conclusion about which approach yields the best teaching efficacy. Secondly, the study was limited to the Department of Nephrology, and teaching approaches are generally somewhat different in various departments, especially between surgery and internal medicine. Thirdly, new assessment systems should be created to evaluate the effectiveness of the CBL/FC approach in detail and accurately. Finally, all students participated in the training in the Nephrology Department for only one month, which did not allow for a crossover study, and might potentially introduce bias in the study.

Conclusions

In conclusion, the CBL/FC approach could be a better option than the traditional LBT approach in nephrology education. The CBL/FC method motivates students to learn and cultivates their problem-solving abilities, as well as clinical skills. Our study suggests that the CBL/FC approach is an effective teaching approach, which may promote new strategies for undergraduate medical education.

Data availability

The dataset supporting the conclusions of this article are included within the article.

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Acknowledgements

We want to thank the participating clinical teachers and students.

This work was supported by the Teaching Reform and Cultivation Project of the Second Clinical Medical College of Zhejiang University (20210209, 20230242), the 2023 General Research Project of the zhejiang Provincial Department of Education (Y202351977).

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Conceptualization: Z.D.C.; Acquisition, analysis, or interpretation of data: B.B.H., L.N.Z., L.W., J.X.W.; Drafting the work: B.B.H.; Supervised the entire project: Z.D.C. All authors reviewed the manuscript.

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Hu, B., Wang, L., Wu, J. et al. A combination of case-based learning with flipped classroom improved performance of medical students in nephrology bedside teaching. BMC Med Educ 24 , 995 (2024). https://doi.org/10.1186/s12909-024-05973-3

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Received : 06 March 2024

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DOI : https://doi.org/10.1186/s12909-024-05973-3

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