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Case Study – Methods, Examples and Guide

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

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

Types of Case Study

Types and Methods of Case Study are as follows:

Single-Case Study

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

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

Multiple-Case Study

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

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

Exploratory Case Study

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

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

Descriptive Case Study

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

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

Instrumental Case Study

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

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

Case Study Data Collection Methods

Here are some common data collection methods for case studies:

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

Observations

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

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

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

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

How to conduct Case Study Research

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

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

Examples of Case Study

Here are some examples of case study research:

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

Application of Case Study

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

Business and Management

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

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

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

Social Sciences

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

Law and Ethics

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

Purpose of Case Study

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

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

Case studies can also serve other purposes, including:

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

Advantages of Case Study Research

There are several advantages of case study research, including:

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

Limitations of Case Study Research

There are several limitations of case study research, including:

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

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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Writing a Case Study

What is a case study?

A Case study is: 

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

What are the different types of case studies?

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

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

Who are your case study participants?

What is triangulation ? 

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

How to write a Case Study?

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

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• Case Study | Definition, Examples & Methods

Case Study | Definition, Examples & Methods

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

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

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

Table of contents

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

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

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

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

Prevent plagiarism, run a free check.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Methodology or method? A critical review of qualitative case study reports

Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services ( n= 12), social sciences and anthropology ( n= 7), or methods ( n= 15) case studies. The articles were reviewed using an adapted version of established criteria to determine whether adequate methodological justification was present, and if study aims, methods, and reported findings were consistent with a qualitative case study approach. Findings were grouped into five themes outlining key methodological issues: case study methodology or method, case of something particular and case selection, contextually bound case study, researcher and case interactions and triangulation, and study design inconsistent with methodology reported. Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners.

Case study research is an increasingly popular approach among qualitative researchers (Thomas, 2011 ). Several prominent authors have contributed to methodological developments, which has increased the popularity of case study approaches across disciplines (Creswell, 2013b ; Denzin & Lincoln, 2011b ; Merriam, 2009 ; Ragin & Becker, 1992 ; Stake, 1995 ; Yin, 2009 ). Current qualitative case study approaches are shaped by paradigm, study design, and selection of methods, and, as a result, case studies in the published literature vary. Differences between published case studies can make it difficult for researchers to define and understand case study as a methodology.

Experienced qualitative researchers have identified case study research as a stand-alone qualitative approach (Denzin & Lincoln, 2011b ). Case study research has a level of flexibility that is not readily offered by other qualitative approaches such as grounded theory or phenomenology. Case studies are designed to suit the case and research question and published case studies demonstrate wide diversity in study design. There are two popular case study approaches in qualitative research. The first, proposed by Stake ( 1995 ) and Merriam ( 2009 ), is situated in a social constructivist paradigm, whereas the second, by Yin ( 2012 ), Flyvbjerg ( 2011 ), and Eisenhardt ( 1989 ), approaches case study from a post-positivist viewpoint. Scholarship from both schools of inquiry has contributed to the popularity of case study and development of theoretical frameworks and principles that characterize the methodology.

The diversity of case studies reported in the published literature, and on-going debates about credibility and the use of case study in qualitative research practice, suggests that differences in perspectives on case study methodology may prevent researchers from developing a mutual understanding of practice and rigour. In addition, discussion about case study limitations has led some authors to query whether case study is indeed a methodology (Luck, Jackson, & Usher, 2006 ; Meyer, 2001 ; Thomas, 2010 ; Tight, 2010 ). Methodological discussion of qualitative case study research is timely, and a review is required to analyse and understand how this methodology is applied in the qualitative research literature. The aims of this study were to review methodological descriptions of published qualitative case studies, to review how the case study methodological approach was applied, and to identify issues that need to be addressed by researchers, editors, and reviewers. An outline of the current definitions of case study and an overview of the issues proposed in the qualitative methodological literature are provided to set the scene for the review.

Definitions of qualitative case study research

Case study research is an investigation and analysis of a single or collective case, intended to capture the complexity of the object of study (Stake, 1995 ). Qualitative case study research, as described by Stake ( 1995 ), draws together “naturalistic, holistic, ethnographic, phenomenological, and biographic research methods” in a bricoleur design, or in his words, “a palette of methods” (Stake, 1995 , pp. xi–xii). Case study methodology maintains deep connections to core values and intentions and is “particularistic, descriptive and heuristic” (Merriam, 2009 , p. 46).

As a study design, case study is defined by interest in individual cases rather than the methods of inquiry used. The selection of methods is informed by researcher and case intuition and makes use of naturally occurring sources of knowledge, such as people or observations of interactions that occur in the physical space (Stake, 1998 ). Thomas ( 2011 ) suggested that “analytical eclecticism” is a defining factor (p. 512). Multiple data collection and analysis methods are adopted to further develop and understand the case, shaped by context and emergent data (Stake, 1995 ). This qualitative approach “explores a real-life, contemporary bounded system (a case ) or multiple bounded systems (cases) over time, through detailed, in-depth data collection involving multiple sources of information … and reports a case description and case themes ” (Creswell, 2013b , p. 97). Case study research has been defined by the unit of analysis, the process of study, and the outcome or end product, all essentially the case (Merriam, 2009 ).

The case is an object to be studied for an identified reason that is peculiar or particular. Classification of the case and case selection procedures informs development of the study design and clarifies the research question. Stake ( 1995 ) proposed three types of cases and study design frameworks. These include the intrinsic case, the instrumental case, and the collective instrumental case. The intrinsic case is used to understand the particulars of a single case, rather than what it represents. An instrumental case study provides insight on an issue or is used to refine theory. The case is selected to advance understanding of the object of interest. A collective refers to an instrumental case which is studied as multiple, nested cases, observed in unison, parallel, or sequential order. More than one case can be simultaneously studied; however, each case study is a concentrated, single inquiry, studied holistically in its own entirety (Stake, 1995 , 1998 ).

Researchers who use case study are urged to seek out what is common and what is particular about the case. This involves careful and in-depth consideration of the nature of the case, historical background, physical setting, and other institutional and political contextual factors (Stake, 1998 ). An interpretive or social constructivist approach to qualitative case study research supports a transactional method of inquiry, where the researcher has a personal interaction with the case. The case is developed in a relationship between the researcher and informants, and presented to engage the reader, inviting them to join in this interaction and in case discovery (Stake, 1995 ). A postpositivist approach to case study involves developing a clear case study protocol with careful consideration of validity and potential bias, which might involve an exploratory or pilot phase, and ensures that all elements of the case are measured and adequately described (Yin, 2009 , 2012 ).

Current methodological issues in qualitative case study research

The future of qualitative research will be influenced and constructed by the way research is conducted, and by what is reviewed and published in academic journals (Morse, 2011 ). If case study research is to further develop as a principal qualitative methodological approach, and make a valued contribution to the field of qualitative inquiry, issues related to methodological credibility must be considered. Researchers are required to demonstrate rigour through adequate descriptions of methodological foundations. Case studies published without sufficient detail for the reader to understand the study design, and without rationale for key methodological decisions, may lead to research being interpreted as lacking in quality or credibility (Hallberg, 2013 ; Morse, 2011 ).

There is a level of artistic license that is embraced by qualitative researchers and distinguishes practice, which nurtures creativity, innovation, and reflexivity (Denzin & Lincoln, 2011b ; Morse, 2009 ). Qualitative research is “inherently multimethod” (Denzin & Lincoln, 2011a , p. 5); however, with this creative freedom, it is important for researchers to provide adequate description for methodological justification (Meyer, 2001 ). This includes paradigm and theoretical perspectives that have influenced study design. Without adequate description, study design might not be understood by the reader, and can appear to be dishonest or inaccurate. Reviewers and readers might be confused by the inconsistent or inappropriate terms used to describe case study research approach and methods, and be distracted from important study findings (Sandelowski, 2000 ). This issue extends beyond case study research, and others have noted inconsistencies in reporting of methodology and method by qualitative researchers. Sandelowski ( 2000 , 2010 ) argued for accurate identification of qualitative description as a research approach. She recommended that the selected methodology should be harmonious with the study design, and be reflected in methods and analysis techniques. Similarly, Webb and Kevern ( 2000 ) uncovered inconsistencies in qualitative nursing research with focus group methods, recommending that methodological procedures must cite seminal authors and be applied with respect to the selected theoretical framework. Incorrect labelling using case study might stem from the flexibility in case study design and non-directional character relative to other approaches (Rosenberg & Yates, 2007 ). Methodological integrity is required in design of qualitative studies, including case study, to ensure study rigour and to enhance credibility of the field (Morse, 2011 ).

Case study has been unnecessarily devalued by comparisons with statistical methods (Eisenhardt, 1989 ; Flyvbjerg, 2006 , 2011 ; Jensen & Rodgers, 2001 ; Piekkari, Welch, & Paavilainen, 2009 ; Tight, 2010 ; Yin, 1999 ). It is reputed to be the “the weak sibling” in comparison to other, more rigorous, approaches (Yin, 2009 , p. xiii). Case study is not an inherently comparative approach to research. The objective is not statistical research, and the aim is not to produce outcomes that are generalizable to all populations (Thomas, 2011 ). Comparisons between case study and statistical research do little to advance this qualitative approach, and fail to recognize its inherent value, which can be better understood from the interpretive or social constructionist viewpoint of other authors (Merriam, 2009 ; Stake, 1995 ). Building on discussions relating to “fuzzy” (Bassey, 2001 ), or naturalistic generalizations (Stake, 1978 ), or transference of concepts and theories (Ayres, Kavanaugh, & Knafl, 2003 ; Morse et al., 2011 ) would have more relevance.

Case study research has been used as a catch-all design to justify or add weight to fundamental qualitative descriptive studies that do not fit with other traditional frameworks (Merriam, 2009 ). A case study has been a “convenient label for our research—when we ‘can't think of anything ‘better”—in an attempt to give it [qualitative methodology] some added respectability” (Tight, 2010 , p. 337). Qualitative case study research is a pliable approach (Merriam, 2009 ; Meyer, 2001 ; Stake, 1995 ), and has been likened to a “curious methodological limbo” (Gerring, 2004 , p. 341) or “paradigmatic bridge” (Luck et al., 2006 , p. 104), that is on the borderline between postpositivist and constructionist interpretations. This has resulted in inconsistency in application, which indicates that flexibility comes with limitations (Meyer, 2001 ), and the open nature of case study research might be off-putting to novice researchers (Thomas, 2011 ). The development of a well-(in)formed theoretical framework to guide a case study should improve consistency, rigour, and trust in studies published in qualitative research journals (Meyer, 2001 ).

Assessment of rigour

The purpose of this study was to analyse the methodological descriptions of case studies published in qualitative methods journals. To do this we needed to develop a suitable framework, which used existing, established criteria for appraising qualitative case study research rigour (Creswell, 2013b ; Merriam, 2009 ; Stake, 1995 ). A number of qualitative authors have developed concepts and criteria that are used to determine whether a study is rigorous (Denzin & Lincoln, 2011b ; Lincoln, 1995 ; Sandelowski & Barroso, 2002 ). The criteria proposed by Stake ( 1995 ) provide a framework for readers and reviewers to make judgements regarding case study quality, and identify key characteristics essential for good methodological rigour. Although each of the factors listed in Stake's criteria could enhance the quality of a qualitative research report, in Table I we present an adapted criteria used in this study, which integrates more recent work by Merriam ( 2009 ) and Creswell ( 2013b ). Stake's ( 1995 ) original criteria were separated into two categories. The first list of general criteria is “relevant for all qualitative research.” The second list, “high relevance to qualitative case study research,” was the criteria that we decided had higher relevance to case study research. This second list was the main criteria used to assess the methodological descriptions of the case studies reviewed. The complete table has been preserved so that the reader can determine how the original criteria were adapted.

Framework for assessing quality in qualitative case study research.

Adapted from Stake ( 1995 , p. 131).

Study design

The critical review method described by Grant and Booth ( 2009 ) was used, which is appropriate for the assessment of research quality, and is used for literature analysis to inform research and practice. This type of review goes beyond the mapping and description of scoping or rapid reviews, to include “analysis and conceptual innovation” (Grant & Booth, 2009 , p. 93). A critical review is used to develop existing, or produce new, hypotheses or models. This is different to systematic reviews that answer clinical questions. It is used to evaluate existing research and competing ideas, to provide a “launch pad” for conceptual development and “subsequent testing” (Grant & Booth, 2009 , p. 93).

Qualitative methods journals were located by a search of the 2011 ISI Journal Citation Reports in Social Science, via the database Web of Knowledge (see m.webofknowledge.com). No “qualitative research methods” category existed in the citation reports; therefore, a search of all categories was performed using the term “qualitative.” In Table II , we present the qualitative methods journals located, ranked by impact factor. The highest ranked journals were selected for searching. We acknowledge that the impact factor ranking system might not be the best measure of journal quality (Cheek, Garnham, & Quan, 2006 ); however, this was the most appropriate and accessible method available.

International Journal of Qualitative Studies on Health and Well-being.

Search strategy

In March 2013, searches of the journals, Qualitative Health Research , Qualitative Research , and Qualitative Inquiry were completed to retrieve studies with “case study” in the abstract field. The search was limited to the past 5 years (1 January 2008 to 1 March 2013). The objective was to locate published qualitative case studies suitable for assessment using the adapted criterion. Viewpoints, commentaries, and other article types were excluded from review. Title and abstracts of the 45 retrieved articles were read by the first author, who identified 34 empirical case studies for review. All authors reviewed the 34 studies to confirm selection and categorization. In Table III , we present the 34 case studies grouped by journal, and categorized by research topic, including health sciences, social sciences and anthropology, and methods research. There was a discrepancy in categorization of one article on pedagogy and a new teaching method published in Qualitative Inquiry (Jorrín-Abellán, Rubia-Avi, Anguita-Martínez, Gómez-Sánchez, & Martínez-Mones, 2008 ). Consensus was to allocate to the methods category.

Outcomes of search of qualitative methods journals.

In Table III , the number of studies located, and final numbers selected for review have been reported. Qualitative Health Research published the most empirical case studies ( n= 16). In the health category, there were 12 case studies of health conditions, health services, and health policy issues, all published in Qualitative Health Research . Seven case studies were categorized as social sciences and anthropology research, which combined case study with biography and ethnography methodologies. All three journals published case studies on methods research to illustrate a data collection or analysis technique, methodological procedure, or related issue.

The methodological descriptions of 34 case studies were critically reviewed using the adapted criteria. All articles reviewed contained a description of study methods; however, the length, amount of detail, and position of the description in the article varied. Few studies provided an accurate description and rationale for using a qualitative case study approach. In the 34 case studies reviewed, three described a theoretical framework informed by Stake ( 1995 ), two by Yin ( 2009 ), and three provided a mixed framework informed by various authors, which might have included both Yin and Stake. Few studies described their case study design, or included a rationale that explained why they excluded or added further procedures, and whether this was to enhance the study design, or to better suit the research question. In 26 of the studies no reference was provided to principal case study authors. From reviewing the description of methods, few authors provided a description or justification of case study methodology that demonstrated how their study was informed by the methodological literature that exists on this approach.

The methodological descriptions of each study were reviewed using the adapted criteria, and the following issues were identified: case study methodology or method; case of something particular and case selection; contextually bound case study; researcher and case interactions and triangulation; and, study design inconsistent with methodology. An outline of how the issues were developed from the critical review is provided, followed by a discussion of how these relate to the current methodological literature.

Case study methodology or method

A third of the case studies reviewed appeared to use a case report method, not case study methodology as described by principal authors (Creswell, 2013b ; Merriam, 2009 ; Stake, 1995 ; Yin, 2009 ). Case studies were identified as a case report because of missing methodological detail and by review of the study aims and purpose. These reports presented data for small samples of no more than three people, places or phenomenon. Four studies, or “case reports” were single cases selected retrospectively from larger studies (Bronken, Kirkevold, Martinsen, & Kvigne, 2012 ; Coltart & Henwood, 2012 ; Hooghe, Neimeyer, & Rober, 2012 ; Roscigno et al., 2012 ). Case reports were not a case of something, instead were a case demonstration or an example presented in a report. These reports presented outcomes, and reported on how the case could be generalized. Descriptions focussed on the phenomena, rather than the case itself, and did not appear to study the case in its entirety.

Case reports had minimal in-text references to case study methodology, and were informed by other qualitative traditions or secondary sources (Adamson & Holloway, 2012 ; Buzzanell & D'Enbeau, 2009 ; Nagar-Ron & Motzafi-Haller, 2011 ). This does not suggest that case study methodology cannot be multimethod, however, methodology should be consistent in design, be clearly described (Meyer, 2001 ; Stake, 1995 ), and maintain focus on the case (Creswell, 2013b ).

To demonstrate how case reports were identified, three examples are provided. The first, Yeh ( 2013 ) described their study as, “the examination of the emergence of vegetarianism in Victorian England serves as a case study to reveal the relationships between boundaries and entities” (p. 306). The findings were a historical case report, which resulted from an ethnographic study of vegetarianism. Cunsolo Willox, Harper, Edge, ‘My Word’: Storytelling and Digital Media Lab, and Rigolet Inuit Community Government (2013) used “a case study that illustrates the usage of digital storytelling within an Inuit community” (p. 130). This case study reported how digital storytelling can be used with indigenous communities as a participatory method to illuminate the benefits of this method for other studies. This “case study was conducted in the Inuit community” but did not include the Inuit community in case analysis (Cunsolo Willox et al., 2013 , p. 130). Bronken et al. ( 2012 ) provided a single case report to demonstrate issues observed in a larger clinical study of aphasia and stroke, without adequate case description or analysis.

Case study of something particular and case selection

Case selection is a precursor to case analysis, which needs to be presented as a convincing argument (Merriam, 2009 ). Descriptions of the case were often not adequate to ascertain why the case was selected, or whether it was a particular exemplar or outlier (Thomas, 2011 ). In a number of case studies in the health and social science categories, it was not explicit whether the case was of something particular, or peculiar to their discipline or field (Adamson & Holloway, 2012 ; Bronken et al., 2012 ; Colón-Emeric et al., 2010 ; Jackson, Botelho, Welch, Joseph, & Tennstedt, 2012 ; Mawn et al., 2010 ; Snyder-Young, 2011 ). There were exceptions in the methods category ( Table III ), where cases were selected by researchers to report on a new or innovative method. The cases emerged through heuristic study, and were reported to be particular, relative to the existing methods literature (Ajodhia-Andrews & Berman, 2009 ; Buckley & Waring, 2013 ; Cunsolo Willox et al., 2013 ; De Haene, Grietens, & Verschueren, 2010 ; Gratton & O'Donnell, 2011 ; Sumsion, 2013 ; Wimpenny & Savin-Baden, 2012 ).

Case selection processes were sometimes insufficient to understand why the case was selected from the global population of cases, or what study of this case would contribute to knowledge as compared with other possible cases (Adamson & Holloway, 2012 ; Bronken et al., 2012 ; Colón-Emeric et al., 2010 ; Jackson et al., 2012 ; Mawn et al., 2010 ). In two studies, local cases were selected (Barone, 2010 ; Fourie & Theron, 2012 ) because the researcher was familiar with and had access to the case. Possible limitations of a convenience sample were not acknowledged. Purposeful sampling was used to recruit participants within the case of one study, but not of the case itself (Gallagher et al., 2013 ). Random sampling was completed for case selection in two studies (Colón-Emeric et al., 2010 ; Jackson et al., 2012 ), which has limited meaning in interpretive qualitative research.

To demonstrate how researchers provided a good justification for the selection of case study approaches, four examples are provided. The first, cases of residential care homes, were selected because of reported occurrences of mistreatment, which included residents being locked in rooms at night (Rytterström, Unosson, & Arman, 2013 ). Roscigno et al. ( 2012 ) selected cases of parents who were admitted for early hospitalization in neonatal intensive care with a threatened preterm delivery before 26 weeks. Hooghe et al. ( 2012 ) used random sampling to select 20 couples that had experienced the death of a child; however, the case study was of one couple and a particular metaphor described only by them. The final example, Coltart and Henwood ( 2012 ), provided a detailed account of how they selected two cases from a sample of 46 fathers based on personal characteristics and beliefs. They described how the analysis of the two cases would contribute to their larger study on first time fathers and parenting.

Contextually bound case study

The limits or boundaries of the case are a defining factor of case study methodology (Merriam, 2009 ; Ragin & Becker, 1992 ; Stake, 1995 ; Yin, 2009 ). Adequate contextual description is required to understand the setting or context in which the case is revealed. In the health category, case studies were used to illustrate a clinical phenomenon or issue such as compliance and health behaviour (Colón-Emeric et al., 2010 ; D'Enbeau, Buzzanell, & Duckworth, 2010 ; Gallagher et al., 2013 ; Hooghe et al., 2012 ; Jackson et al., 2012 ; Roscigno et al., 2012 ). In these case studies, contextual boundaries, such as physical and institutional descriptions, were not sufficient to understand the case as a holistic system, for example, the general practitioner (GP) clinic in Gallagher et al. ( 2013 ), or the nursing home in Colón-Emeric et al. ( 2010 ). Similarly, in the social science and methods categories, attention was paid to some components of the case context, but not others, missing important information required to understand the case as a holistic system (Alexander, Moreira, & Kumar, 2012 ; Buzzanell & D'Enbeau, 2009 ; Nairn & Panelli, 2009 ; Wimpenny & Savin-Baden, 2012 ).

In two studies, vicarious experience or vignettes (Nairn & Panelli, 2009 ) and images (Jorrín-Abellán et al., 2008 ) were effective to support description of context, and might have been a useful addition for other case studies. Missing contextual boundaries suggests that the case might not be adequately defined. Additional information, such as the physical, institutional, political, and community context, would improve understanding of the case (Stake, 1998 ). In Boxes 1 and 2 , we present brief synopses of two studies that were reviewed, which demonstrated a well bounded case. In Box 1 , Ledderer ( 2011 ) used a qualitative case study design informed by Stake's tradition. In Box 2 , Gillard, Witt, and Watts ( 2011 ) were informed by Yin's tradition. By providing a brief outline of the case studies in Boxes 1 and 2 , we demonstrate how effective case boundaries can be constructed and reported, which may be of particular interest to prospective case study researchers.

Article synopsis of case study research using Stake's tradition

Ledderer ( 2011 ) used a qualitative case study research design, informed by modern ethnography. The study is bounded to 10 general practice clinics in Denmark, who had received federal funding to implement preventative care services based on a Motivational Interviewing intervention. The researcher question focussed on “why is it so difficult to create change in medical practice?” (Ledderer, 2011 , p. 27). The study context was adequately described, providing detail on the general practitioner (GP) clinics and relevant political and economic influences. Methodological decisions are described in first person narrative, providing insight on researcher perspectives and interaction with the case. Forty-four interviews were conducted, which focussed on how GPs conducted consultations, and the form, nature and content, rather than asking their opinion or experience (Ledderer, 2011 , p. 30). The duration and intensity of researcher immersion in the case enhanced depth of description and trustworthiness of study findings. Analysis was consistent with Stake's tradition, and the researcher provided examples of inquiry techniques used to challenge assumptions about emerging themes. Several other seminal qualitative works were cited. The themes and typology constructed are rich in narrative data and storytelling by clinic staff, demonstrating individual clinic experiences as well as shared meanings and understandings about changing from a biomedical to psychological approach to preventative health intervention. Conclusions make note of social and cultural meanings and lessons learned, which might not have been uncovered using a different methodology.

Article synopsis of case study research using Yin's tradition

Gillard et al. ( 2011 ) study of camps for adolescents living with HIV/AIDs provided a good example of Yin's interpretive case study approach. The context of the case is bounded by the three summer camps of which the researchers had prior professional involvement. A case study protocol was developed that used multiple methods to gather information at three data collection points coinciding with three youth camps (Teen Forum, Discover Camp, and Camp Strong). Gillard and colleagues followed Yin's ( 2009 ) principles, using a consistent data protocol that enhanced cross-case analysis. Data described the young people, the camp physical environment, camp schedule, objectives and outcomes, and the staff of three youth camps. The findings provided a detailed description of the context, with less detail of individual participants, including insight into researcher's interpretations and methodological decisions throughout the data collection and analysis process. Findings provided the reader with a sense of “being there,” and are discovered through constant comparison of the case with the research issues; the case is the unit of analysis. There is evidence of researcher immersion in the case, and Gillard reports spending significant time in the field in a naturalistic and integrated youth mentor role.

This case study is not intended to have a significant impact on broader health policy, although does have implications for health professionals working with adolescents. Study conclusions will inform future camps for young people with chronic disease, and practitioners are able to compare similarities between this case and their own practice (for knowledge translation). No limitations of this article were reported. Limitations related to publication of this case study were that it was 20 pages long and used three tables to provide sufficient description of the camp and program components, and relationships with the research issue.

Researcher and case interactions and triangulation

Researcher and case interactions and transactions are a defining feature of case study methodology (Stake, 1995 ). Narrative stories, vignettes, and thick description are used to provoke vicarious experience and a sense of being there with the researcher in their interaction with the case. Few of the case studies reviewed provided details of the researcher's relationship with the case, researcher–case interactions, and how these influenced the development of the case study (Buzzanell & D'Enbeau, 2009 ; D'Enbeau et al., 2010 ; Gallagher et al., 2013 ; Gillard et al., 2011 ; Ledderer, 2011 ; Nagar-Ron & Motzafi-Haller, 2011 ). The role and position of the researcher needed to be self-examined and understood by readers, to understand how this influenced interactions with participants, and to determine what triangulation is needed (Merriam, 2009 ; Stake, 1995 ).

Gillard et al. ( 2011 ) provided a good example of triangulation, comparing data sources in a table (p. 1513). Triangulation of sources was used to reveal as much depth as possible in the study by Nagar-Ron and Motzafi-Haller ( 2011 ), while also enhancing confirmation validity. There were several case studies that would have benefited from improved range and use of data sources, and descriptions of researcher–case interactions (Ajodhia-Andrews & Berman, 2009 ; Bronken et al., 2012 ; Fincham, Scourfield, & Langer, 2008 ; Fourie & Theron, 2012 ; Hooghe et al., 2012 ; Snyder-Young, 2011 ; Yeh, 2013 ).

Study design inconsistent with methodology

Good, rigorous case studies require a strong methodological justification (Meyer, 2001 ) and a logical and coherent argument that defines paradigm, methodological position, and selection of study methods (Denzin & Lincoln, 2011b ). Methodological justification was insufficient in several of the studies reviewed (Barone, 2010 ; Bronken et al., 2012 ; Hooghe et al., 2012 ; Mawn et al., 2010 ; Roscigno et al., 2012 ; Yeh, 2013 ). This was judged by the absence, or inadequate or inconsistent reference to case study methodology in-text.

In six studies, the methodological justification provided did not relate to case study. There were common issues identified. Secondary sources were used as primary methodological references indicating that study design might not have been theoretically sound (Colón-Emeric et al., 2010 ; Coltart & Henwood, 2012 ; Roscigno et al., 2012 ; Snyder-Young, 2011 ). Authors and sources cited in methodological descriptions were inconsistent with the actual study design and practices used (Fourie & Theron, 2012 ; Hooghe et al., 2012 ; Jorrín-Abellán et al., 2008 ; Mawn et al., 2010 ; Rytterström et al., 2013 ; Wimpenny & Savin-Baden, 2012 ). This occurred when researchers cited Stake or Yin, or both (Mawn et al., 2010 ; Rytterström et al., 2013 ), although did not follow their paradigmatic or methodological approach. In 26 studies there were no citations for a case study methodological approach.

The findings of this study have highlighted a number of issues for researchers. A considerable number of case studies reviewed were missing key elements that define qualitative case study methodology and the tradition cited. A significant number of studies did not provide a clear methodological description or justification relevant to case study. Case studies in health and social sciences did not provide sufficient information for the reader to understand case selection, and why this case was chosen above others. The context of the cases were not described in adequate detail to understand all relevant elements of the case context, which indicated that cases may have not been contextually bounded. There were inconsistencies between reported methodology, study design, and paradigmatic approach in case studies reviewed, which made it difficult to understand the study methodology and theoretical foundations. These issues have implications for methodological integrity and honesty when reporting study design, which are values of the qualitative research tradition and are ethical requirements (Wager & Kleinert, 2010a ). Poorly described methodological descriptions may lead the reader to misinterpret or discredit study findings, which limits the impact of the study, and, as a collective, hinders advancements in the broader qualitative research field.

The issues highlighted in our review build on current debates in the case study literature, and queries about the value of this methodology. Case study research can be situated within different paradigms or designed with an array of methods. In order to maintain the creativity and flexibility that is valued in this methodology, clearer descriptions of paradigm and theoretical position and methods should be provided so that study findings are not undervalued or discredited. Case study research is an interdisciplinary practice, which means that clear methodological descriptions might be more important for this approach than other methodologies that are predominantly driven by fewer disciplines (Creswell, 2013b ).

Authors frequently omit elements of methodologies and include others to strengthen study design, and we do not propose a rigid or purist ideology in this paper. On the contrary, we encourage new ideas about using case study, together with adequate reporting, which will advance the value and practice of case study. The implications of unclear methodological descriptions in the studies reviewed were that study design appeared to be inconsistent with reported methodology, and key elements required for making judgements of rigour were missing. It was not clear whether the deviations from methodological tradition were made by researchers to strengthen the study design, or because of misinterpretations. Morse ( 2011 ) recommended that innovations and deviations from practice are best made by experienced researchers, and that a novice might be unaware of the issues involved with making these changes. To perpetuate the tradition of case study research, applications in the published literature should have consistencies with traditional methodological constructions, and deviations should be described with a rationale that is inherent in study conduct and findings. Providing methodological descriptions that demonstrate a strong theoretical foundation and coherent study design will add credibility to the study, while ensuring the intrinsic meaning of case study is maintained.

The value of this review is that it contributes to discussion of whether case study is a methodology or method. We propose possible reasons why researchers might make this misinterpretation. Researchers may interchange the terms methods and methodology, and conduct research without adequate attention to epistemology and historical tradition (Carter & Little, 2007 ; Sandelowski, 2010 ). If the rich meaning that naming a qualitative methodology brings to the study is not recognized, a case study might appear to be inconsistent with the traditional approaches described by principal authors (Creswell, 2013a ; Merriam, 2009 ; Stake, 1995 ; Yin, 2009 ). If case studies are not methodologically and theoretically situated, then they might appear to be a case report.

Case reports are promoted by university and medical journals as a method of reporting on medical or scientific cases; guidelines for case reports are publicly available on websites ( http://www.hopkinsmedicine.org/institutional_review_board/guidelines_policies/guidelines/case_report.html ). The various case report guidelines provide a general criteria for case reports, which describes that this form of report does not meet the criteria of research, is used for retrospective analysis of up to three clinical cases, and is primarily illustrative and for educational purposes. Case reports can be published in academic journals, but do not require approval from a human research ethics committee. Traditionally, case reports describe a single case, to explain how and what occurred in a selected setting, for example, to illustrate a new phenomenon that has emerged from a larger study. A case report is not necessarily particular or the study of a case in its entirety, and the larger study would usually be guided by a different research methodology.

This description of a case report is similar to what was provided in some studies reviewed. This form of report lacks methodological grounding and qualities of research rigour. The case report has publication value in demonstrating an example and for dissemination of knowledge (Flanagan, 1999 ). However, case reports have different meaning and purpose to case study, which needs to be distinguished. Findings of our review suggest that the medical understanding of a case report has been confused with qualitative case study approaches.

In this review, a number of case studies did not have methodological descriptions that included key characteristics of case study listed in the adapted criteria, and several issues have been discussed. There have been calls for improvements in publication quality of qualitative research (Morse, 2011 ), and for improvements in peer review of submitted manuscripts (Carter & Little, 2007 ; Jasper, Vaismoradi, Bondas, & Turunen, 2013 ). The challenging nature of editor and reviewers responsibilities are acknowledged in the literature (Hames, 2013 ; Wager & Kleinert, 2010b ); however, review of case study methodology should be prioritized because of disputes on methodological value.

Authors using case study approaches are recommended to describe their theoretical framework and methods clearly, and to seek and follow specialist methodological advice when needed (Wager & Kleinert, 2010a ). Adequate page space for case study description would contribute to better publications (Gillard et al., 2011 ). Capitalizing on the ability to publish complementary resources should be considered.

Limitations of the review

There is a level of subjectivity involved in this type of review and this should be considered when interpreting study findings. Qualitative methods journals were selected because the aims and scope of these journals are to publish studies that contribute to methodological discussion and development of qualitative research. Generalist health and social science journals were excluded that might have contained good quality case studies. Journals in business or education were also excluded, although a review of case studies in international business journals has been published elsewhere (Piekkari et al., 2009 ).

The criteria used to assess the quality of the case studies were a set of qualitative indicators. A numerical or ranking system might have resulted in different results. Stake's ( 1995 ) criteria have been referenced elsewhere, and was deemed the best available (Creswell, 2013b ; Crowe et al., 2011 ). Not all qualitative studies are reported in a consistent way and some authors choose to report findings in a narrative form in comparison to a typical biomedical report style (Sandelowski & Barroso, 2002 ), if misinterpretations were made this may have affected the review.

Case study research is an increasingly popular approach among qualitative researchers, which provides methodological flexibility through the incorporation of different paradigmatic positions, study designs, and methods. However, whereas flexibility can be an advantage, a myriad of different interpretations has resulted in critics questioning the use of case study as a methodology. Using an adaptation of established criteria, we aimed to identify and assess the methodological descriptions of case studies in high impact, qualitative methods journals. Few articles were identified that applied qualitative case study approaches as described by experts in case study design. There were inconsistencies in methodology and study design, which indicated that researchers were confused whether case study was a methodology or a method. Commonly, there appeared to be confusion between case studies and case reports. Without clear understanding and application of the principles and key elements of case study methodology, there is a risk that the flexibility of the approach will result in haphazard reporting, and will limit its global application as a valuable, theoretically supported methodology that can be rigorously applied across disciplines and fields.

Conflict of interest and funding

The authors have not received any funding or benefits from industry or elsewhere to conduct this study.

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Qualitative study design: Case Studies

• Qualitative study design
• Phenomenology
• Grounded theory
• Ethnography
• Narrative inquiry
• Action research

Case Studies

• Field research
• Focus groups
• Observation
• Surveys & questionnaires
• Study Designs Home

In depth description of the experience of a single person, a family, a group, a community or an organisation.

An example of a qualitative case study is a life history which is the story of one specific person.  A case study may be done to highlight a specific issue by telling a story of one person or one group. 

• Oral recording

Ability to explore and describe, in depth, an issue or event. 

Develop an understanding of health, illness and health care in context. 

Single case can be used to develop or disprove a theory. 

Can be used as a model or prototype .  

Limitations

Labour intensive and generates large diverse data sets which can be hard to manage. 

Case studies are seen by many as a weak methodology because they only look at one person or one specific group and aren’t as broad in their participant selection as other methodologies. 

Example questions

This methodology can be used to ask questions about a specific drug or treatment and its effects on an individual.

• Does thalidomide cause birth defects?
• Does exposure to a pesticide lead to cancer?

Example studies

• Choi, T. S. T., Walker, K. Z., & Palermo, C. (2018). Diabetes management in a foreign land: A case study on Chinese Australians. Health & Social Care in the Community, 26(2), e225-e232. 
• Reade, I., Rodgers, W., & Spriggs, K. (2008). New Ideas for High Performance Coaches: A Case Study of Knowledge Transfer in Sport Science.  International Journal of Sports Science & Coaching , 3(3), 335-354. 
• Wingrove, K., Barbour, L., & Palermo, C. (2017). Exploring nutrition capacity in Australia's charitable food sector.  Nutrition & Dietetics , 74(5), 495-501. 
• Green, J., & Thorogood, N. (2018). Qualitative methods for health research (4th ed.). London: SAGE. 
• University of Missouri-St. Louis. Qualitative Research Designs. Retrieved from http://www.umsl.edu/~lindquists/qualdsgn.html   
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Designing and Conducting Case Studies

This guide examines case studies, a form of qualitative descriptive research that is used to look at individuals, a small group of participants, or a group as a whole. Researchers collect data about participants using participant and direct observations, interviews, protocols, tests, examinations of records, and collections of writing samples. Starting with a definition of the case study, the guide moves to a brief history of this research method. Using several well documented case studies, the guide then looks at applications and methods including data collection and analysis. A discussion of ways to handle validity, reliability, and generalizability follows, with special attention to case studies as they are applied to composition studies. Finally, this guide examines the strengths and weaknesses of case studies.

Definition and Overview

Case study refers to the collection and presentation of detailed information about a particular participant or small group, frequently including the accounts of subjects themselves. A form of qualitative descriptive research, the case study looks intensely at an individual or small participant pool, drawing conclusions only about that participant or group and only in that specific context. Researchers do not focus on the discovery of a universal, generalizable truth, nor do they typically look for cause-effect relationships; instead, emphasis is placed on exploration and description.

Case studies typically examine the interplay of all variables in order to provide as complete an understanding of an event or situation as possible. This type of comprehensive understanding is arrived at through a process known as thick description, which involves an in-depth description of the entity being evaluated, the circumstances under which it is used, the characteristics of the people involved in it, and the nature of the community in which it is located. Thick description also involves interpreting the meaning of demographic and descriptive data such as cultural norms and mores, community values, ingrained attitudes, and motives.

Unlike quantitative methods of research, like the survey, which focus on the questions of who, what, where, how much, and how many, and archival analysis, which often situates the participant in some form of historical context, case studies are the preferred strategy when how or why questions are asked. Likewise, they are the preferred method when the researcher has little control over the events, and when there is a contemporary focus within a real life context. In addition, unlike more specifically directed experiments, case studies require a problem that seeks a holistic understanding of the event or situation in question using inductive logic--reasoning from specific to more general terms.

In scholarly circles, case studies are frequently discussed within the context of qualitative research and naturalistic inquiry. Case studies are often referred to interchangeably with ethnography, field study, and participant observation. The underlying philosophical assumptions in the case are similar to these types of qualitative research because each takes place in a natural setting (such as a classroom, neighborhood, or private home), and strives for a more holistic interpretation of the event or situation under study.

Unlike more statistically-based studies which search for quantifiable data, the goal of a case study is to offer new variables and questions for further research. F.H. Giddings, a sociologist in the early part of the century, compares statistical methods to the case study on the basis that the former are concerned with the distribution of a particular trait, or a small number of traits, in a population, whereas the case study is concerned with the whole variety of traits to be found in a particular instance" (Hammersley 95).

Case studies are not a new form of research; naturalistic inquiry was the primary research tool until the development of the scientific method. The fields of sociology and anthropology are credited with the primary shaping of the concept as we know it today. However, case study research has drawn from a number of other areas as well: the clinical methods of doctors; the casework technique being developed by social workers; the methods of historians and anthropologists, plus the qualitative descriptions provided by quantitative researchers like LePlay; and, in the case of Robert Park, the techniques of newspaper reporters and novelists.

Park was an ex-newspaper reporter and editor who became very influential in developing sociological case studies at the University of Chicago in the 1920s. As a newspaper professional he coined the term "scientific" or "depth" reporting: the description of local events in a way that pointed to major social trends. Park viewed the sociologist as "merely a more accurate, responsible, and scientific reporter." Park stressed the variety and value of human experience. He believed that sociology sought to arrive at natural, but fluid, laws and generalizations in regard to human nature and society. These laws weren't static laws of the kind sought by many positivists and natural law theorists, but rather, they were laws of becoming--with a constant possibility of change. Park encouraged students to get out of the library, to quit looking at papers and books, and to view the constant experiment of human experience. He writes, "Go and sit in the lounges of the luxury hotels and on the doorsteps of the flophouses; sit on the Gold Coast settees and on the slum shakedowns; sit in the Orchestra Hall and in the Star and Garter Burlesque. In short, gentlemen [sic], go get the seats of your pants dirty in real research."

But over the years, case studies have drawn their share of criticism. In fact, the method had its detractors from the start. In the 1920s, the debate between pro-qualitative and pro-quantitative became quite heated. Case studies, when compared to statistics, were considered by many to be unscientific. From the 1930's on, the rise of positivism had a growing influence on quantitative methods in sociology. People wanted static, generalizable laws in science. The sociological positivists were looking for stable laws of social phenomena. They criticized case study research because it failed to provide evidence of inter subjective agreement. Also, they condemned it because of the few number of cases studied and that the under-standardized character of their descriptions made generalization impossible. By the 1950s, quantitative methods, in the form of survey research, had become the dominant sociological approach and case study had become a minority practice.

Educational Applications

The 1950's marked the dawning of a new era in case study research, namely that of the utilization of the case study as a teaching method. "Instituted at Harvard Business School in the 1950s as a primary method of teaching, cases have since been used in classrooms and lecture halls alike, either as part of a course of study or as the main focus of the course to which other teaching material is added" (Armisted 1984). The basic purpose of instituting the case method as a teaching strategy was "to transfer much of the responsibility for learning from the teacher on to the student, whose role, as a result, shifts away from passive absorption toward active construction" (Boehrer 1990). Through careful examination and discussion of various cases, "students learn to identify actual problems, to recognize key players and their agendas, and to become aware of those aspects of the situation that contribute to the problem" (Merseth 1991). In addition, students are encouraged to "generate their own analysis of the problems under consideration, to develop their own solutions, and to practically apply their own knowledge of theory to these problems" (Boyce 1993). Along the way, students also develop "the power to analyze and to master a tangled circumstance by identifying and delineating important factors; the ability to utilize ideas, to test them against facts, and to throw them into fresh combinations" (Merseth 1991).

In addition to the practical application and testing of scholarly knowledge, case discussions can also help students prepare for real-world problems, situations and crises by providing an approximation of various professional environments (i.e. classroom, board room, courtroom, or hospital). Thus, through the examination of specific cases, students are given the opportunity to work out their own professional issues through the trials, tribulations, experiences, and research findings of others. An obvious advantage to this mode of instruction is that it allows students the exposure to settings and contexts that they might not otherwise experience. For example, a student interested in studying the effects of poverty on minority secondary student's grade point averages and S.A.T. scores could access and analyze information from schools as geographically diverse as Los Angeles, New York City, Miami, and New Mexico without ever having to leave the classroom.

The case study method also incorporates the idea that students can learn from one another "by engaging with each other and with each other's ideas, by asserting something and then having it questioned, challenged and thrown back at them so that they can reflect on what they hear, and then refine what they say" (Boehrer 1990). In summary, students can direct their own learning by formulating questions and taking responsibility for the study.

Types and Design Concerns

Researchers use multiple methods and approaches to conduct case studies.

Types of Case Studies

Under the more generalized category of case study exist several subdivisions, each of which is custom selected for use depending upon the goals and/or objectives of the investigator. These types of case study include the following:

Illustrative Case Studies These are primarily descriptive studies. They typically utilize one or two instances of an event to show what a situation is like. Illustrative case studies serve primarily to make the unfamiliar familiar and to give readers a common language about the topic in question.

Exploratory (or pilot) Case Studies These are condensed case studies performed before implementing a large scale investigation. Their basic function is to help identify questions and select types of measurement prior to the main investigation. The primary pitfall of this type of study is that initial findings may seem convincing enough to be released prematurely as conclusions.

Cumulative Case Studies These serve to aggregate information from several sites collected at different times. The idea behind these studies is the collection of past studies will allow for greater generalization without additional cost or time being expended on new, possibly repetitive studies.

Critical Instance Case Studies These examine one or more sites for either the purpose of examining a situation of unique interest with little to no interest in generalizability, or to call into question or challenge a highly generalized or universal assertion. This method is useful for answering cause and effect questions.

Identifying a Theoretical Perspective

Much of the case study's design is inherently determined for researchers, depending on the field from which they are working. In composition studies, researchers are typically working from a qualitative, descriptive standpoint. In contrast, physicists will approach their research from a more quantitative perspective. Still, in designing the study, researchers need to make explicit the questions to be explored and the theoretical perspective from which they will approach the case. The three most commonly adopted theories are listed below:

Individual Theories These focus primarily on the individual development, cognitive behavior, personality, learning and disability, and interpersonal interactions of a particular subject.

Organizational Theories These focus on bureaucracies, institutions, organizational structure and functions, or excellence in organizational performance.

Social Theories These focus on urban development, group behavior, cultural institutions, or marketplace functions.

Two examples of case studies are used consistently throughout this chapter. The first, a study produced by Berkenkotter, Huckin, and Ackerman (1988), looks at a first year graduate student's initiation into an academic writing program. The study uses participant-observer and linguistic data collecting techniques to assess the student's knowledge of appropriate discourse conventions. Using the pseudonym Nate to refer to the subject, the study sought to illuminate the particular experience rather than to generalize about the experience of fledgling academic writers collectively.

For example, in Berkenkotter, Huckin, and Ackerman's (1988) study we are told that the researchers are interested in disciplinary communities. In the first paragraph, they ask what constitutes membership in a disciplinary community and how achieving membership might affect a writer's understanding and production of texts. In the third paragraph they state that researchers must negotiate their claims "within the context of his sub specialty's accepted knowledge and methodology." In the next paragraph they ask, "How is literacy acquired? What is the process through which novices gain community membership? And what factors either aid or hinder students learning the requisite linguistic behaviors?" This introductory section ends with a paragraph in which the study's authors claim that during the course of the study, the subject, Nate, successfully makes the transition from "skilled novice" to become an initiated member of the academic discourse community and that his texts exhibit linguistic changes which indicate this transition. In the next section the authors make explicit the sociolinguistic theoretical and methodological assumptions on which the study is based (1988). Thus the reader has a good understanding of the authors' theoretical background and purpose in conducting the study even before it is explicitly stated on the fourth page of the study. "Our purpose was to examine the effects of the educational context on one graduate student's production of texts as he wrote in different courses and for different faculty members over the academic year 1984-85." The goal of the study then, was to explore the idea that writers must be initiated into a writing community, and that this initiation will change the way one writes.

The second example is Janet Emig's (1971) study of the composing process of a group of twelfth graders. In this study, Emig seeks to answer the question of what happens to the self as a result educational stimuli in terms of academic writing. The case study used methods such as protocol analysis, tape-recorded interviews, and discourse analysis.

In the case of Janet Emig's (1971) study of the composing process of eight twelfth graders, four specific hypotheses were made:

• Twelfth grade writers engage in two modes of composing: reflexive and extensive.
• These differences can be ascertained and characterized through having the writers compose aloud their composition process.
• A set of implied stylistic principles governs the writing process.
• For twelfth grade writers, extensive writing occurs chiefly as a school-sponsored activity, or reflexive, as a self-sponsored activity.

In this study, the chief distinction is between the two dominant modes of composing among older, secondary school students. The distinctions are:

• The reflexive mode, which focuses on the writer's thoughts and feelings.
• The extensive mode, which focuses on conveying a message.

Emig also outlines the specific questions which guided the research in the opening pages of her Review of Literature , preceding the report.

Designing a Case Study

After considering the different sub categories of case study and identifying a theoretical perspective, researchers can begin to design their study. Research design is the string of logic that ultimately links the data to be collected and the conclusions to be drawn to the initial questions of the study. Typically, research designs deal with at least four problems:

• What questions to study
• What data are relevant
• What data to collect
• How to analyze that data

In other words, a research design is basically a blueprint for getting from the beginning to the end of a study. The beginning is an initial set of questions to be answered, and the end is some set of conclusions about those questions.

Because case studies are conducted on topics as diverse as Anglo-Saxon Literature (Thrane 1986) and AIDS prevention (Van Vugt 1994), it is virtually impossible to outline any strict or universal method or design for conducting the case study. However, Robert K. Yin (1993) does offer five basic components of a research design:

• A study's questions.
• A study's propositions (if any).
• A study's units of analysis.
• The logic that links the data to the propositions.
• The criteria for interpreting the findings.

In addition to these five basic components, Yin also stresses the importance of clearly articulating one's theoretical perspective, determining the goals of the study, selecting one's subject(s), selecting the appropriate method(s) of collecting data, and providing some considerations to the composition of the final report.

Conducting Case Studies

To obtain as complete a picture of the participant as possible, case study researchers can employ a variety of approaches and methods. These approaches, methods, and related issues are discussed in depth in this section.

Method: Single or Multi-modal?

To obtain as complete a picture of the participant as possible, case study researchers can employ a variety of methods. Some common methods include interviews , protocol analyses, field studies, and participant-observations. Emig (1971) chose to use several methods of data collection. Her sources included conversations with the students, protocol analysis, discrete observations of actual composition, writing samples from each student, and school records (Lauer and Asher 1988).

Berkenkotter, Huckin, and Ackerman (1988) collected data by observing classrooms, conducting faculty and student interviews, collecting self reports from the subject, and by looking at the subject's written work.

A study that was criticized for using a single method model was done by Flower and Hayes (1984). In this study that explores the ways in which writers use different forms of knowing to create space, the authors used only protocol analysis to gather data. The study came under heavy fire because of their decision to use only one method.

Participant Selection

Case studies can use one participant, or a small group of participants. However, it is important that the participant pool remain relatively small. The participants can represent a diverse cross section of society, but this isn't necessary.

For example, the Berkenkotter, Huckin, and Ackerman (1988) study looked at just one participant, Nate. By contrast, in Janet Emig's (1971) study of the composition process of twelfth graders, eight participants were selected representing a diverse cross section of the community, with volunteers from an all-white upper-middle-class suburban school, an all-black inner-city school, a racially mixed lower-middle-class school, an economically and racially mixed school, and a university school.

Often, a brief "case history" is done on the participants of the study in order to provide researchers with a clearer understanding of their participants, as well as some insight as to how their own personal histories might affect the outcome of the study. For instance, in Emig's study, the investigator had access to the school records of five of the participants, and to standardized test scores for the remaining three. Also made available to the researcher was the information that three of the eight students were selected as NCTE Achievement Award winners. These personal histories can be useful in later stages of the study when data are being analyzed and conclusions drawn.

Data Collection

There are six types of data collected in case studies:

• Archival records.
• Interviews.
• Direct observation.
• Participant observation.

In the field of composition research, these six sources might be:

• A writer's drafts.
• School records of student writers.
• Transcripts of interviews with a writer.
• Transcripts of conversations between writers (and protocols).
• Videotapes and notes from direct field observations.
• Hard copies of a writer's work on computer.

Depending on whether researchers have chosen to use a single or multi-modal approach for the case study, they may choose to collect data from one or any combination of these sources.

Protocols, that is, transcriptions of participants talking aloud about what they are doing as they do it, have been particularly common in composition case studies. For example, in Emig's (1971) study, the students were asked, in four different sessions, to give oral autobiographies of their writing experiences and to compose aloud three themes in the presence of a tape recorder and the investigator.

In some studies, only one method of data collection is conducted. For example, the Flower and Hayes (1981) report on the cognitive process theory of writing depends on protocol analysis alone. However, using multiple sources of evidence to increase the reliability and validity of the data can be advantageous.

Case studies are likely to be much more convincing and accurate if they are based on several different sources of information, following a corroborating mode. This conclusion is echoed among many composition researchers. For example, in her study of predrafting processes of high and low-apprehensive writers, Cynthia Selfe (1985) argues that because "methods of indirect observation provide only an incomplete reflection of the complex set of processes involved in composing, a combination of several such methods should be used to gather data in any one study." Thus, in this study, Selfe collected her data from protocols, observations of students role playing their writing processes, audio taped interviews with the students, and videotaped observations of the students in the process of composing.

It can be said then, that cross checking data from multiple sources can help provide a multidimensional profile of composing activities in a particular setting. Sharan Merriam (1985) suggests "checking, verifying, testing, probing, and confirming collected data as you go, arguing that this process will follow in a funnel-like design resulting in less data gathering in later phases of the study along with a congruent increase in analysis checking, verifying, and confirming."

It is important to note that in case studies, as in any qualitative descriptive research, while researchers begin their studies with one or several questions driving the inquiry (which influence the key factors the researcher will be looking for during data collection), a researcher may find new key factors emerging during data collection. These might be unexpected patterns or linguistic features which become evident only during the course of the research. While not bearing directly on the researcher's guiding questions, these variables may become the basis for new questions asked at the end of the report, thus linking to the possibility of further research.

Data Analysis

As the information is collected, researchers strive to make sense of their data. Generally, researchers interpret their data in one of two ways: holistically or through coding. Holistic analysis does not attempt to break the evidence into parts, but rather to draw conclusions based on the text as a whole. Flower and Hayes (1981), for example, make inferences from entire sections of their students' protocols, rather than searching through the transcripts to look for isolatable characteristics.

However, composition researchers commonly interpret their data by coding, that is by systematically searching data to identify and/or categorize specific observable actions or characteristics. These observable actions then become the key variables in the study. Sharan Merriam (1988) suggests seven analytic frameworks for the organization and presentation of data:

• The role of participants.
• The network analysis of formal and informal exchanges among groups.
• Historical.
• Thematical.
• Ritual and symbolism.
• Critical incidents that challenge or reinforce fundamental beliefs, practices, and values.

There are two purposes of these frameworks: to look for patterns among the data and to look for patterns that give meaning to the case study.

As stated above, while most researchers begin their case studies expecting to look for particular observable characteristics, it is not unusual for key variables to emerge during data collection. Typical variables coded in case studies of writers include pauses writers make in the production of a text, the use of specific linguistic units (such as nouns or verbs), and writing processes (planning, drafting, revising, and editing). In the Berkenkotter, Huckin, and Ackerman (1988) study, for example, researchers coded the participant's texts for use of connectives, discourse demonstratives, average sentence length, off-register words, use of the first person pronoun, and the ratio of definite articles to indefinite articles.

Since coding is inherently subjective, more than one coder is usually employed. In the Berkenkotter, Huckin, and Ackerman (1988) study, for example, three rhetoricians were employed to code the participant's texts for off-register phrases. The researchers established the agreement among the coders before concluding that the participant used fewer off-register words as the graduate program progressed.

Composing the Case Study Report

In the many forms it can take, "a case study is generically a story; it presents the concrete narrative detail of actual, or at least realistic events, it has a plot, exposition, characters, and sometimes even dialogue" (Boehrer 1990). Generally, case study reports are extensively descriptive, with "the most problematic issue often referred to as being the determination of the right combination of description and analysis" (1990). Typically, authors address each step of the research process, and attempt to give the reader as much context as possible for the decisions made in the research design and for the conclusions drawn.

This contextualization usually includes a detailed explanation of the researchers' theoretical positions, of how those theories drove the inquiry or led to the guiding research questions, of the participants' backgrounds, of the processes of data collection, of the training and limitations of the coders, along with a strong attempt to make connections between the data and the conclusions evident.

Although the Berkenkotter, Huckin, and Ackerman (1988) study does not, case study reports often include the reactions of the participants to the study or to the researchers' conclusions. Because case studies tend to be exploratory, most end with implications for further study. Here researchers may identify significant variables that emerged during the research and suggest studies related to these, or the authors may suggest further general questions that their case study generated.

For example, Emig's (1971) study concludes with a section dedicated solely to the topic of implications for further research, in which she suggests several means by which this particular study could have been improved, as well as questions and ideas raised by this study which other researchers might like to address, such as: is there a correlation between a certain personality and a certain composing process profile (e.g. is there a positive correlation between ego strength and persistence in revising)?

Also included in Emig's study is a section dedicated to implications for teaching, which outlines the pedagogical ramifications of the study's findings for teachers currently involved in high school writing programs.

Sharan Merriam (1985) also offers several suggestions for alternative presentations of data:

• Prepare specialized condensations for appropriate groups.
• Replace narrative sections with a series of answers to open-ended questions.
• Present "skimmer's" summaries at beginning of each section.
• Incorporate headlines that encapsulate information from text.
• Prepare analytic summaries with supporting data appendixes.
• Present data in colorful and/or unique graphic representations.

Issues of Validity and Reliability

Once key variables have been identified, they can be analyzed. Reliability becomes a key concern at this stage, and many case study researchers go to great lengths to ensure that their interpretations of the data will be both reliable and valid. Because issues of validity and reliability are an important part of any study in the social sciences, it is important to identify some ways of dealing with results.

Multi-modal case study researchers often balance the results of their coding with data from interviews or writer's reflections upon their own work. Consequently, the researchers' conclusions become highly contextualized. For example, in a case study which looked at the time spent in different stages of the writing process, Berkenkotter concluded that her participant, Donald Murray, spent more time planning his essays than in other writing stages. The report of this case study is followed by Murray's reply, wherein he agrees with some of Berkenkotter's conclusions and disagrees with others.

As is the case with other research methodologies, issues of external validity, construct validity, and reliability need to be carefully considered.

Commentary on Case Studies

Researchers often debate the relative merits of particular methods, among them case study. In this section, we comment on two key issues. To read the commentaries, choose any of the items below:

Strengths and Weaknesses of Case Studies

Most case study advocates point out that case studies produce much more detailed information than what is available through a statistical analysis. Advocates will also hold that while statistical methods might be able to deal with situations where behavior is homogeneous and routine, case studies are needed to deal with creativity, innovation, and context. Detractors argue that case studies are difficult to generalize because of inherent subjectivity and because they are based on qualitative subjective data, generalizable only to a particular context.

Flexibility

The case study approach is a comparatively flexible method of scientific research. Because its project designs seem to emphasize exploration rather than prescription or prediction, researchers are comparatively freer to discover and address issues as they arise in their experiments. In addition, the looser format of case studies allows researchers to begin with broad questions and narrow their focus as their experiment progresses rather than attempt to predict every possible outcome before the experiment is conducted.

Emphasis on Context

By seeking to understand as much as possible about a single subject or small group of subjects, case studies specialize in "deep data," or "thick description"--information based on particular contexts that can give research results a more human face. This emphasis can help bridge the gap between abstract research and concrete practice by allowing researchers to compare their firsthand observations with the quantitative results obtained through other methods of research.

Inherent Subjectivity

"The case study has long been stereotyped as the weak sibling among social science methods," and is often criticized as being too subjective and even pseudo-scientific. Likewise, "investigators who do case studies are often regarded as having deviated from their academic disciplines, and their investigations as having insufficient precision (that is, quantification), objectivity and rigor" (Yin 1989). Opponents cite opportunities for subjectivity in the implementation, presentation, and evaluation of case study research. The approach relies on personal interpretation of data and inferences. Results may not be generalizable, are difficult to test for validity, and rarely offer a problem-solving prescription. Simply put, relying on one or a few subjects as a basis for cognitive extrapolations runs the risk of inferring too much from what might be circumstance.

High Investment

Case studies can involve learning more about the subjects being tested than most researchers would care to know--their educational background, emotional background, perceptions of themselves and their surroundings, their likes, dislikes, and so on. Because of its emphasis on "deep data," the case study is out of reach for many large-scale research projects which look at a subject pool in the tens of thousands. A budget request of $10,000 to examine 200 subjects sounds more efficient than a similar request to examine four subjects.

Ethical Considerations

Researchers conducting case studies should consider certain ethical issues. For example, many educational case studies are often financed by people who have, either directly or indirectly, power over both those being studied and those conducting the investigation (1985). This conflict of interests can hinder the credibility of the study.

The personal integrity, sensitivity, and possible prejudices and/or biases of the investigators need to be taken into consideration as well. Personal biases can creep into how the research is conducted, alternative research methods used, and the preparation of surveys and questionnaires.

A common complaint in case study research is that investigators change direction during the course of the study unaware that their original research design was inadequate for the revised investigation. Thus, the researchers leave unknown gaps and biases in the study. To avoid this, researchers should report preliminary findings so that the likelihood of bias will be reduced.

Concerns about Reliability, Validity, and Generalizability

Merriam (1985) offers several suggestions for how case study researchers might actively combat the popular attacks on the validity, reliability, and generalizability of case studies:

• Prolong the Processes of Data Gathering on Site: This will help to insure the accuracy of the findings by providing the researcher with more concrete information upon which to formulate interpretations.
• Employ the Process of "Triangulation": Use a variety of data sources as opposed to relying solely upon one avenue of observation. One example of such a data check would be what McClintock, Brannon, and Maynard (1985) refer to as a "case cluster method," that is, when a single unit within a larger case is randomly sampled, and that data treated quantitatively." For instance, in Emig's (1971) study, the case cluster method was employed, singling out the productivity of a single student named Lynn. This cluster profile included an advanced case history of the subject, specific examination and analysis of individual compositions and protocols, and extensive interview sessions. The seven remaining students were then compared with the case of Lynn, to ascertain if there are any shared, or unique dimensions to the composing process engaged in by these eight students.
• Conduct Member Checks: Initiate and maintain an active corroboration on the interpretation of data between the researcher and those who provided the data. In other words, talk to your subjects.
• Collect Referential Materials: Complement the file of materials from the actual site with additional document support. For example, Emig (1971) supports her initial propositions with historical accounts by writers such as T.S. Eliot, James Joyce, and D.H. Lawrence. Emig also cites examples of theoretical research done with regards to the creative process, as well as examples of empirical research dealing with the writing of adolescents. Specific attention is then given to the four stages description of the composing process delineated by Helmoltz, Wallas, and Cowley, as it serves as the focal point in this study.
• Engage in Peer Consultation: Prior to composing the final draft of the report, researchers should consult with colleagues in order to establish validity through pooled judgment.

Although little can be done to combat challenges concerning the generalizability of case studies, "most writers suggest that qualitative research should be judged as credible and confirmable as opposed to valid and reliable" (Merriam 1985). Likewise, it has been argued that "rather than transplanting statistical, quantitative notions of generalizability and thus finding qualitative research inadequate, it makes more sense to develop an understanding of generalization that is congruent with the basic characteristics of qualitative inquiry" (1985). After all, criticizing the case study method for being ungeneralizable is comparable to criticizing a washing machine for not being able to tell the correct time. In other words, it is unjust to criticize a method for not being able to do something which it was never originally designed to do in the first place.

Annotated Bibliography

Armisted, C. (1984). How Useful are Case Studies. Training and Development Journal, 38 (2), 75-77.

This article looks at eight types of case studies, offers pros and cons of using case studies in the classroom, and gives suggestions for successfully writing and using case studies.

Bardovi-Harlig, K. (1997). Beyond Methods: Components of Second Language Teacher Education . New York: McGraw-Hill.

A compilation of various research essays which address issues of language teacher education. Essays included are: "Non-native reading research and theory" by Lee, "The case for Psycholinguistics" by VanPatten, and "Assessment and Second Language Teaching" by Gradman and Reed.

Bartlett, L. (1989). A Question of Good Judgment; Interpretation Theory and Qualitative Enquiry Address. 70th Annual Meeting of the American Educational Research Association. San Francisco.

Bartlett selected "quasi-historical" methodology, which focuses on the "truth" found in case records, as one that will provide "good judgments" in educational inquiry. He argues that although the method is not comprehensive, it can try to connect theory with practice.

Baydere, S. et. al. (1993). Multimedia conferencing as a tool for collaborative writing: a case study in Computer Supported Collaborative Writing. New York: Springer-Verlag.

The case study by Baydere et. al. is just one of the many essays in this book found in the series "Computer Supported Cooperative Work." Denley, Witefield and May explore similar issues in their essay, "A case study in task analysis for the design of a collaborative document production system."

Berkenkotter, C., Huckin, T., N., & Ackerman J. (1988). Conventions, Conversations, and the Writer: Case Study of a Student in a Rhetoric Ph.D. Program. Research in the Teaching of English, 22, 9-44.

The authors focused on how the writing of their subject, Nate or Ackerman, changed as he became more acquainted or familiar with his field's discourse community.

Berninger, V., W., and Gans, B., M. (1986). Language Profiles in Nonspeaking Individuals of Normal Intelligence with Severe Cerebral Palsy. Augmentative and Alternative Communication, 2, 45-50.

Argues that generalizations about language abilities in patients with severe cerebral palsy (CP) should be avoided. Standardized tests of different levels of processing oral language, of processing written language, and of producing written language were administered to 3 male participants (aged 9, 16, and 40 yrs).

Bockman, J., R., and Couture, B. (1984). The Case Method in Technical Communication: Theory and Models. Texas: Association of Teachers of Technical Writing.

Examines the study and teaching of technical writing, communication of technical information, and the case method in terms of those applications.

Boehrer, J. (1990). Teaching With Cases: Learning to Question. New Directions for Teaching and Learning, 42 41-57.

This article discusses the origins of the case method, looks at the question of what is a case, gives ideas about learning in case teaching, the purposes it can serve in the classroom, the ground rules for the case discussion, including the role of the question, and new directions for case teaching.

Bowman, W. R. (1993). Evaluating JTPA Programs for Economically Disadvantaged Adults: A Case Study of Utah and General Findings . Washington: National Commission for Employment Policy.

"To encourage state-level evaluations of JTPA, the Commission and the State of Utah co-sponsored this report on the effectiveness of JTPA Title II programs for adults in Utah. The technique used is non-experimental and the comparison group was selected from registrants with Utah's Employment Security. In a step-by-step approach, the report documents how non-experimental techniques can be applied and several specific technical issues can be addressed."

Boyce, A. (1993) The Case Study Approach for Pedagogists. Annual Meeting of the American Alliance for Health, Physical Education, Recreation and Dance. (Address). Washington DC.

This paper addresses how case studies 1) bridge the gap between teaching theory and application, 2) enable students to analyze problems and develop solutions for situations that will be encountered in the real world of teaching, and 3) helps students to evaluate the feasibility of alternatives and to understand the ramifications of a particular course of action.

Carson, J. (1993) The Case Study: Ideal Home of WAC Quantitative and Qualitative Data. Annual Meeting of the Conference on College Composition and Communication. (Address). San Diego.

"Increasingly, one of the most pressing questions for WAC advocates is how to keep [WAC] programs going in the face of numerous difficulties. Case histories offer the best chance for fashioning rhetorical arguments to keep WAC programs going because they offer the opportunity to provide a coherent narrative that contextualizes all documents and data, including what is generally considered scientific data. A case study of the WAC program, . . . at Robert Morris College in Pittsburgh demonstrates the advantages of this research method. Such studies are ideal homes for both naturalistic and positivistic data as well as both quantitative and qualitative information."

---. (1991). A Cognitive Process Theory of Writing. College Composition and Communication. 32. 365-87.

No abstract available.

Cromer, R. (1994) A Case Study of Dissociations Between Language and Cognition. Constraints on Language Acquisition: Studies of Atypical Children . Hillsdale: Lawrence Erlbaum Associates, 141-153.

Crossley, M. (1983) Case Study in Comparative and International Education: An Approach to Bridging the Theory-Practice Gap. Proceedings of the 11th Annual Conference of the Australian Comparative and International Education Society. Hamilton, NZ.

Case study research, as presented here, helps bridge the theory-practice gap in comparative and international research studies of education because it focuses on the practical, day-to-day context rather than on the national arena. The paper asserts that the case study method can be valuable at all levels of research, formation, and verification of theories in education.

Daillak, R., H., and Alkin, M., C. (1982). Qualitative Studies in Context: Reflections on the CSE Studies of Evaluation Use . California: EDRS

The report shows how the Center of the Study of Evaluation (CSE) applied qualitative techniques to a study of evaluation information use in local, Los Angeles schools. It critiques the effectiveness and the limitations of using case study, evaluation, field study, and user interview survey methodologies.

Davey, L. (1991). The Application of Case Study Evaluations. ERIC/TM Digest.

This article examines six types of case studies, the type of evaluation questions that can be answered, the functions served, some design features, and some pitfalls of the method.

Deutch, C. E. (1996). A course in research ethics for graduate students. College Teaching, 44, 2, 56-60.

This article describes a one-credit discussion course in research ethics for graduate students in biology. Case studies are focused on within the four parts of the course: 1) major issues, 2 )practical issues in scholarly work, 3) ownership of research results, and 4) training and personal decisions.

DeVoss, G. (1981). Ethics in Fieldwork Research. RIE 27p. (ERIC)

This article examines four of the ethical problems that can happen when conducting case study research: acquiring permission to do research, knowing when to stop digging, the pitfalls of doing collaborative research, and preserving the integrity of the participants.

Driscoll, A. (1985). Case Study of a Research Intervention: the University of Utah’s Collaborative Approach . San Francisco: Far West Library for Educational Research Development.

Paper presented at the annual meeting of the American Association of Colleges of Teacher Education, Denver, CO, March 1985. Offers information of in-service training, specifically case studies application.

Ellram, L. M. (1996). The Use of the Case Study Method in Logistics Research. Journal of Business Logistics, 17, 2, 93.

This article discusses the increased use of case study in business research, and the lack of understanding of when and how to use case study methodology in business.

Emig, J. (1971) The Composing Processes of Twelfth Graders . Urbana: NTCE.

This case study uses observation, tape recordings, writing samples, and school records to show that writing in reflexive and extensive situations caused different lengths of discourse and different clusterings of the components of the writing process.

Feagin, J. R. (1991). A Case For the Case Study . Chapel Hill: The University of North Carolina Press.

This book discusses the nature, characteristics, and basic methodological issues of the case study as a research method.

Feldman, H., Holland, A., & Keefe, K. (1989) Language Abilities after Left Hemisphere Brain Injury: A Case Study of Twins. Topics in Early Childhood Special Education, 9, 32-47.

"Describes the language abilities of 2 twin pairs in which 1 twin (the experimental) suffered brain injury to the left cerebral hemisphere around the time of birth and1 twin (the control) did not. One pair of twins was initially assessed at age 23 mo. and the other at about 30 mo.; they were subsequently evaluated in their homes 3 times at about 6-mo intervals."

Fidel, R. (1984). The Case Study Method: A Case Study. Library and Information Science Research, 6.

The article describes the use of case study methodology to systematically develop a model of online searching behavior in which study design is flexible, subject manner determines data gathering and analyses, and procedures adapt to the study's progressive change.

Flower, L., & Hayes, J. R. (1984). Images, Plans and Prose: The Representation of Meaning in Writing. Written Communication, 1, 120-160.

Explores the ways in which writers actually use different forms of knowing to create prose.

Frey, L. R. (1992). Interpreting Communication Research: A Case Study Approach Englewood Cliffs, N.J.: Prentice Hall.

The book discusses research methodologies in the Communication field. It focuses on how case studies bridge the gap between communication research, theory, and practice.

Gilbert, V. K. (1981). The Case Study as a Research Methodology: Difficulties and Advantages of Integrating the Positivistic, Phenomenological and Grounded Theory Approaches . The Annual Meeting of the Canadian Association for the Study of Educational Administration. (Address) Halifax, NS, Can.

This study on an innovative secondary school in England shows how a "low-profile" participant-observer case study was crucial to the initial observation, the testing of hypotheses, the interpretive approach, and the grounded theory.

Gilgun, J. F. (1994). A Case for Case Studies in Social Work Research. Social Work, 39, 4, 371-381.

This article defines case study research, presents guidelines for evaluation of case studies, and shows the relevance of case studies to social work research. It also looks at issues such as evaluation and interpretations of case studies.

Glennan, S. L., Sharp-Bittner, M. A. & Tullos, D. C. (1991). Augmentative and Alternative Communication Training with a Nonspeaking Adult: Lessons from MH. Augmentative and Alternative Communication, 7, 240-7.

"A response-guided case study documented changes in a nonspeaking 36-yr-old man's ability to communicate using 3 trained augmentative communication modes. . . . Data were collected in videotaped interaction sessions between the nonspeaking adult and a series of adult speaking."

Graves, D. (1981). An Examination of the Writing Processes of Seven Year Old Children. Research in the Teaching of English, 15, 113-134.

Hamel, J. (1993). Case Study Methods . Newbury Park: Sage. .

"In a most economical fashion, Hamel provides a practical guide for producing theoretically sharp and empirically sound sociological case studies. A central idea put forth by Hamel is that case studies must "locate the global in the local" thus making the careful selection of the research site the most critical decision in the analytic process."

Karthigesu, R. (1986, July). Television as a Tool for Nation-Building in the Third World: A Post-Colonial Pattern, Using Malaysia as a Case-Study. International Television Studies Conference. (Address). London, 10-12.

"The extent to which Television Malaysia, as a national mass media organization, has been able to play a role in nation building in the post-colonial period is . . . studied in two parts: how the choice of a model of nation building determines the character of the organization; and how the character of the organization influences the output of the organization."

Kenny, R. (1984). Making the Case for the Case Study. Journal of Curriculum Studies, 16, (1), 37-51.

The article looks at how and why the case study is justified as a viable and valuable approach to educational research and program evaluation.

Knirk, F. (1991). Case Materials: Research and Practice. Performance Improvement Quarterly, 4 (1 ), 73-81.

The article addresses the effectiveness of case studies, subject areas where case studies are commonly used, recent examples of their use, and case study design considerations.

Klos, D. (1976). Students as Case Writers. Teaching of Psychology, 3.2, 63-66.

This article reviews a course in which students gather data for an original case study of another person. The task requires the students to design the study, collect the data, write the narrative, and interpret the findings.

Leftwich, A. (1981). The Politics of Case Study: Problems of Innovation in University Education. Higher Education Review, 13.2, 38-64.

The article discusses the use of case studies as a teaching method. Emphasis is on the instructional materials, interdisciplinarity, and the complex relationships within the university that help or hinder the method.

Mabrito, M. (1991, Oct.). Electronic Mail as a Vehicle for Peer Response: Conversations of High and Low Apprehensive Writers. Written Communication, 509-32.

McCarthy, S., J. (1955). The Influence of Classroom Discourse on Student Texts: The Case of Ella . East Lansing: Institute for Research on Teaching.

A look at how students of color become marginalized within traditional classroom discourse. The essay follows the struggles of one black student: Ella.

Matsuhashi, A., ed. (1987). Writing in Real Time: Modeling Production Processes Norwood, NJ: Ablex Publishing Corporation.

Investigates how writers plan to produce discourse for different purposes to report, to generalize, and to persuade, as well as how writers plan for sentence level units of language. To learn about planning, an observational measure of pause time was used" (ERIC).

Merriam, S. B. (1985). The Case Study in Educational Research: A Review of Selected Literature. Journal of Educational Thought, 19.3, 204-17.

The article examines the characteristics of, philosophical assumptions underlying the case study, the mechanics of conducting a case study, and the concerns about the reliability, validity, and generalizability of the method.

---. (1988). Case Study Research in Education: A Qualitative Approach San Francisco: Jossey Bass.

Merry, S. E., & Milner, N. eds. (1993). The Possibility of Popular Justice: A Case Study of Community Mediation in the United States . Ann Arbor: U of Michigan.

". . . this volume presents a case study of one experiment in popular justice, the San Francisco Community Boards. This program has made an explicit claim to create an alternative justice, or new justice, in the midst of a society ordered by state law. The contributors to this volume explore the history and experience of the program and compare it to other versions of popular justice in the United States, Europe, and the Third World."

Merseth, K. K. (1991). The Case for Cases in Teacher Education. RIE. 42p. (ERIC).

This monograph argues that the case method of instruction offers unique potential for revitalizing the field of teacher education.

Michaels, S. (1987). Text and Context: A New Approach to the Study of Classroom Writing. Discourse Processes, 10, 321-346.

"This paper argues for and illustrates an approach to the study of writing that integrates ethnographic analysis of classroom interaction with linguistic analysis of written texts and teacher/student conversational exchanges. The approach is illustrated through a case study of writing in a single sixth grade classroom during a single writing assignment."

Milburn, G. (1995). Deciphering a Code or Unraveling a Riddle: A Case Study in the Application of a Humanistic Metaphor to the Reporting of Social Studies Teaching. Theory and Research in Education, 13.

This citation serves as an example of how case studies document learning procedures in a senior-level economics course.

Milley, J. E. (1979). An Investigation of Case Study as an Approach to Program Evaluation. 19th Annual Forum of the Association for Institutional Research. (Address). San Diego.

The case study method merged a narrative report focusing on the evaluator as participant-observer with document review, interview, content analysis, attitude questionnaire survey, and sociogram analysis. Milley argues that case study program evaluation has great potential for widespread use.

Minnis, J. R. (1985, Sept.). Ethnography, Case Study, Grounded Theory, and Distance Education Research. Distance Education, 6.2.

This article describes and defines the strengths and weaknesses of ethnography, case study, and grounded theory.

Nunan, D. (1992). Collaborative language learning and teaching . New York: Cambridge University Press.

Included in this series of essays is Peter Sturman’s "Team Teaching: a case study from Japan" and David Nunan’s own "Toward a collaborative approach to curriculum development: a case study."

Nystrand, M., ed. (1982). What Writers Know: The Language, Process, and Structure of Written Discourse . New York: Academic Press.

Owenby, P. H. (1992). Making Case Studies Come Alive. Training, 29, (1), 43-46. (ERIC)

This article provides tips for writing more effective case studies.

---. (1981). Pausing and Planning: The Tempo of Writer Discourse Production. Research in the Teaching of English, 15 (2),113-34.

Perl, S. (1979). The Composing Processes of Unskilled College Writers. Research in the Teaching of English, 13, 317-336.

"Summarizes a study of five unskilled college writers, focusing especially on one of the five, and discusses the findings in light of current pedagogical practice and research design."

Pilcher J. and A. Coffey. eds. (1996). Gender and Qualitative Research . Brookfield: Aldershot, Hants, England.

This book provides a series of essays which look at gender identity research, qualitative research and applications of case study to questions of gendered pedagogy.

Pirie, B. S. (1993). The Case of Morty: A Four Year Study. Gifted Education International, 9 (2), 105-109.

This case study describes a boy from kindergarten through third grade with above average intelligence but difficulty in learning to read, write, and spell.

Popkewitz, T. (1993). Changing Patterns of Power: Social Regulation and Teacher Education Reform. Albany: SUNY Press.

Popkewitz edits this series of essays that address case studies on educational change and the training of teachers. The essays vary in terms of discipline and scope. Also, several authors include case studies of educational practices in countries other than the United States.

---. (1984). The Predrafting Processes of Four High- and Four Low Apprehensive Writers. Research in the Teaching of English, 18, (1), 45-64.

Rasmussen, P. (1985, March) A Case Study on the Evaluation of Research at the Technical University of Denmark. International Journal of Institutional Management in Higher Education, 9 (1).

This is an example of a case study methodology used to evaluate the chemistry and chemical engineering departments at the University of Denmark.

Roth, K. J. (1986). Curriculum Materials, Teacher Talk, and Student Learning: Case Studies in Fifth-Grade Science Teaching . East Lansing: Institute for Research on Teaching.

Roth offers case studies on elementary teachers, elementary school teaching, science studies and teaching, and verbal learning.

Selfe, C. L. (1985). An Apprehensive Writer Composes. When a Writer Can't Write: Studies in Writer's Block and Other Composing-Process Problems . (pp. 83-95). Ed. Mike Rose. NMY: Guilford.

Smith-Lewis, M., R. and Ford, A. (1987). A User's Perspective on Augmentative Communication. Augmentative and Alternative Communication, 3, 12-7.

"During a series of in-depth interviews, a 25-yr-old woman with cerebral palsy who utilized augmentative communication reflected on the effectiveness of the devices designed for her during her school career."

St. Pierre, R., G. (1980, April). Follow Through: A Case Study in Metaevaluation Research . 64th Annual Meeting of the American Educational Research Association. (Address).

The three approaches to metaevaluation are evaluation of primary evaluations, integrative meta-analysis with combined primary evaluation results, and re-analysis of the raw data from a primary evaluation.

Stahler, T., M. (1996, Feb.) Early Field Experiences: A Model That Worked. ERIC.

"This case study of a field and theory class examines a model designed to provide meaningful field experiences for preservice teachers while remaining consistent with the instructor's beliefs about the role of teacher education in preparing teachers for the classroom."

Stake, R. E. (1995). The Art of Case Study Research. Thousand Oaks: Sage Publications.

This book examines case study research in education and case study methodology.

Stiegelbauer, S. (1984) Community, Context, and Co-curriculum: Situational Factors Influencing School Improvements in a Study of High Schools. Presented at the annual meeting of the American Educational Research Association, New Orleans, LA.

Discussion of several case studies: one looking at high school environments, another examining educational innovations.

Stolovitch, H. (1990). Case Study Method. Performance And Instruction, 29, (9), 35-37.

This article describes the case study method as a form of simulation and presents guidelines for their use in professional training situations.

Thaller, E. (1994). Bibliography for the Case Method: Using Case Studies in Teacher Education. RIE. 37 p.

This bibliography presents approximately 450 citations on the use of case studies in teacher education from 1921-1993.

Thrane, T. (1986). On Delimiting the Senses of Near-Synonyms in Historical Semantics: A Case Study of Adjectives of 'Moral Sufficiency' in the Old English Andreas. Linguistics Across Historical and Geographical Boundaries: In Honor of Jacek Fisiak on the Occasion of his Fiftieth Birthday . Berlin: Mouton de Gruyter.

United Nations. (1975). Food and Agriculture Organization. Report on the FAO/UNFPA Seminar on Methodology, Research and Country: Case Studies on Population, Employment and Productivity . Rome: United Nations.

This example case study shows how the methodology can be used in a demographic and psychographic evaluation. At the same time, it discusses the formation and instigation of the case study methodology itself.

Van Vugt, J. P., ed. (1994). Aids Prevention and Services: Community Based Research . Westport: Bergin and Garvey.

"This volume has been five years in the making. In the process, some of the policy applications called for have met with limited success, such as free needle exchange programs in a limited number of American cities, providing condoms to prison inmates, and advertisements that depict same-sex couples. Rather than dating our chapters that deal with such subjects, such policy applications are verifications of the type of research demonstrated here. Furthermore, they indicate the critical need to continue community based research in the various communities threatened by acquired immuno-deficiency syndrome (AIDS) . . . "

Welch, W., ed. (1981, May). Case Study Methodology in Educational Evaluation. Proceedings of the Minnesota Evaluation Conference. Minnesota. (Address).

The four papers in these proceedings provide a comprehensive picture of the rationale, methodology, strengths, and limitations of case studies.

Williams, G. (1987). The Case Method: An Approach to Teaching and Learning in Educational Administration. RIE, 31p.

This paper examines the viability of the case method as a teaching and learning strategy in instructional systems geared toward the training of personnel of the administration of various aspects of educational systems.

Yin, R. K. (1993). Advancing Rigorous Methodologies: A Review of 'Towards Rigor in Reviews of Multivocal Literatures.' Review of Educational Research, 61, (3).

"R. T. Ogawa and B. Malen's article does not meet its own recommended standards for rigorous testing and presentation of its own conclusions. Use of the exploratory case study to analyze multivocal literatures is not supported, and the claim of grounded theory to analyze multivocal literatures may be stronger."

---. (1989). Case Study Research: Design and Methods. London: Sage Publications Inc.

This book discusses in great detail, the entire design process of the case study, including entire chapters on collecting evidence, analyzing evidence, composing the case study report, and designing single and multiple case studies.

Related Links

Consider the following list of related Web sites for more information on the topic of case study research. Note: although many of the links cover the general category of qualitative research, all have sections that address issues of case studies.

• Sage Publications on Qualitative Methodology: Search here for a comprehensive list of new books being published about "Qualitative Methodology" http://www.sagepub.co.uk/
• The International Journal of Qualitative Studies in Education: An on-line journal "to enhance the theory and practice of qualitative research in education." On-line submissions are welcome. http://www.tandf.co.uk/journals/tf/09518398.html
• Qualitative Research Resources on the Internet: From syllabi to home pages to bibliographies. All links relate somehow to qualitative research. http://www.nova.edu/ssss/QR/qualres.html

Becker, Bronwyn, Patrick Dawson, Karen Devine, Carla Hannum, Steve Hill, Jon Leydens, Debbie Matuskevich, Carol Traver, & Mike Palmquist. (2005). Case Studies. Writing@CSU . Colorado State University. https://writing.colostate.edu/guides/guide.cfm?guideid=60

What Is a Research Design? | Definition, Types & Guide

Introduction

Parts of a research design, types of research methodology in qualitative research, narrative research designs, phenomenological research designs, grounded theory research designs.

• Ethnographic research designs

Case study research design

Important reminders when designing a research study.

A research design in qualitative research is a critical framework that guides the methodological approach to studying complex social phenomena. Qualitative research designs determine how data is collected, analyzed, and interpreted, ensuring that the research captures participants' nuanced and subjective perspectives. Research designs also recognize ethical considerations and involve informed consent, ensuring confidentiality, and handling sensitive topics with the utmost respect and care. These considerations are crucial in qualitative research and other contexts where participants may share personal or sensitive information. A research design should convey coherence as it is essential for producing high-quality qualitative research, often following a recursive and evolving process.

Theoretical concepts and research question

The first step in creating a research design is identifying the main theoretical concepts. To identify these concepts, a researcher should ask which theoretical keywords are implicit in the investigation. The next step is to develop a research question using these theoretical concepts. This can be done by identifying the relationship of interest among the concepts that catch the focus of the investigation. The question should address aspects of the topic that need more knowledge, shed light on new information, and specify which aspects should be prioritized before others. This step is essential in identifying which participants to include or which data collection methods to use. Research questions also put into practice the conceptual framework and make the initial theoretical concepts more explicit. Once the research question has been established, the main objectives of the research can be specified. For example, these objectives may involve identifying shared experiences around a phenomenon or evaluating perceptions of a new treatment.

Methodology

After identifying the theoretical concepts, research question, and objectives, the next step is to determine the methodology that will be implemented. This is the lifeline of a research design and should be coherent with the objectives and questions of the study. The methodology will determine how data is collected, analyzed, and presented. Popular qualitative research methodologies include case studies, ethnography , grounded theory , phenomenology, and narrative research . Each methodology is tailored to specific research questions and facilitates the collection of rich, detailed data. For example, a narrative approach may focus on only one individual and their story, while phenomenology seeks to understand participants' lived common experiences. Qualitative research designs differ significantly from quantitative research, which often involves experimental research, correlational designs, or variance analysis to test hypotheses about relationships between two variables, a dependent variable and an independent variable while controlling for confounding variables.

Literature review

After the methodology is identified, conducting a thorough literature review is integral to the research design. This review identifies gaps in knowledge, positioning the new study within the larger academic dialogue and underlining its contribution and relevance. Meta-analysis, a form of secondary research, can be particularly useful in synthesizing findings from multiple studies to provide a clear picture of the research landscape.

Data collection

The sampling method in qualitative research is designed to delve deeply into specific phenomena rather than to generalize findings across a broader population. The data collection methods—whether interviews, focus groups, observations, or document analysis—should align with the chosen methodology, ethical considerations, and other factors such as sample size. In some cases, repeated measures may be collected to observe changes over time.

Data analysis

Analysis in qualitative research typically involves methods such as coding and thematic analysis to distill patterns from the collected data. This process delineates how the research results will be systematically derived from the data. It is recommended that the researcher ensures that the final interpretations are coherent with the observations and analyses, making clear connections between the data and the conclusions drawn. Reporting should be narrative-rich, offering a comprehensive view of the context and findings.

Overall, a coherent qualitative research design that incorporates these elements facilitates a study that not only adds theoretical and practical value to the field but also adheres to high quality. This methodological thoroughness is essential for achieving significant, insightful findings. Examples of well-executed research designs can be valuable references for other researchers conducting qualitative or quantitative investigations. An effective research design is critical for producing robust and impactful research outcomes.

Each qualitative research design is unique, diverse, and meticulously tailored to answer specific research questions, meet distinct objectives, and explore the unique nature of the phenomenon under investigation. The methodology is the wider framework that a research design follows. Each methodology in a research design consists of methods, tools, or techniques that compile data and analyze it following a specific approach.

The methods enable researchers to collect data effectively across individuals, different groups, or observations, ensuring they are aligned with the research design. The following list includes the most commonly used methodologies employed in qualitative research designs, highlighting how they serve different purposes and utilize distinct methods to gather and analyze data.

The narrative approach in research focuses on the collection and detailed examination of life stories, personal experiences, or narratives to gain insights into individuals' lives as told from their perspectives. It involves constructing a cohesive story out of the diverse experiences shared by participants, often using chronological accounts. It seeks to understand human experience and social phenomena through the form and content of the stories. These can include spontaneous narrations such as memoirs or diaries from participants or diaries solicited by the researcher. Narration helps construct the identity of an individual or a group and can rationalize, persuade, argue, entertain, confront, or make sense of an event or tragedy. To conduct a narrative investigation, it is recommended that researchers follow these steps:

Identify if the research question fits the narrative approach. Its methods are best employed when a researcher wants to learn about the lifestyle and life experience of a single participant or a small number of individuals.

Select the best-suited participants for the research design and spend time compiling their stories using different methods such as observations, diaries, interviewing their family members, or compiling related secondary sources.

Compile the information related to the stories. Narrative researchers collect data based on participants' stories concerning their personal experiences, for example about their workplace or homes, their racial or ethnic culture, and the historical context in which the stories occur.

Analyze the participant stories and "restore" them within a coherent framework. This involves collecting the stories, analyzing them based on key elements such as time, place, plot, and scene, and then rewriting them in a chronological sequence (Ollerenshaw & Creswell, 2000). The framework may also include elements such as a predicament, conflict, or struggle; a protagonist; and a sequence with implicit causality, where the predicament is somehow resolved (Carter, 1993).

Collaborate with participants by actively involving them in the research. Both the researcher and the participant negotiate the meaning of their stories, adding a credibility check to the analysis (Creswell & Miller, 2000).

A narrative investigation includes collecting a large amount of data from the participants and the researcher needs to understand the context of the individual's life. A keen eye is needed to collect particular stories that capture the individual experiences. Active collaboration with the participant is necessary, and researchers need to discuss and reflect on their own beliefs and backgrounds. Multiple questions could arise in the collection, analysis, and storytelling of individual stories that need to be addressed, such as: Whose story is it? Who can tell it? Who can change it? Which version is compelling? What happens when narratives compete? In a community, what do the stories do among them? (Pinnegar & Daynes, 2006).

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A research design based on phenomenology aims to understand the essence of the lived experiences of a group of people regarding a particular concept or phenomenon. Researchers gather deep insights from individuals who have experienced the phenomenon, striving to describe "what" they experienced and "how" they experienced it. This approach to a research design typically involves detailed interviews and aims to reach a deep existential understanding. The purpose is to reduce individual experiences to a description of the universal essence or understanding the phenomenon's nature (van Manen, 1990). In phenomenology, the following steps are usually followed:

Identify a phenomenon of interest . For example, the phenomenon might be anger, professionalism in the workplace, or what it means to be a fighter.

Recognize and specify the philosophical assumptions of phenomenology , for example, one could reflect on the nature of objective reality and individual experiences.

Collect data from individuals who have experienced the phenomenon . This typically involves conducting in-depth interviews, including multiple sessions with each participant. Additionally, other forms of data may be collected using several methods, such as observations, diaries, art, poetry, music, recorded conversations, written responses, or other secondary sources.

Ask participants two general questions that encompass the phenomenon and how the participant experienced it (Moustakas, 1994). For example, what have you experienced in this phenomenon? And what contexts or situations have typically influenced your experiences within the phenomenon? Other open-ended questions may also be asked, but these two questions particularly focus on collecting research data that will lead to a textural description and a structural description of the experiences, and ultimately provide an understanding of the common experiences of the participants.

Review data from the questions posed to participants . It is recommended that researchers review the answers and highlight "significant statements," phrases, or quotes that explain how participants experienced the phenomenon. The researcher can then develop meaningful clusters from these significant statements into patterns or key elements shared across participants.

Write a textual description of what the participants experienced based on the answers and themes of the two main questions. The answers are also used to write about the characteristics and describe the context that influenced the way the participants experienced the phenomenon, called imaginative variation or structural description. Researchers should also write about their own experiences and context or situations that influenced them.

Write a composite description from the structural and textural description that presents the "essence" of the phenomenon, called the essential and invariant structure.

A phenomenological approach to a research design includes the strict and careful selection of participants in the study where bracketing personal experiences can be difficult to implement. The researcher decides how and in which way their knowledge will be introduced. It also involves some understanding and identification of the broader philosophical assumptions.

Grounded theory is used in a research design when the goal is to inductively develop a theory "grounded" in data that has been systematically gathered and analyzed. Starting from the data collection, researchers identify characteristics, patterns, themes, and relationships, gradually forming a theoretical framework that explains relevant processes, actions, or interactions grounded in the observed reality. A grounded theory study goes beyond descriptions and its objective is to generate a theory, an abstract analytical scheme of a process. Developing a theory doesn't come "out of nothing" but it is constructed and based on clear data collection. We suggest the following steps to follow a grounded theory approach in a research design:

Determine if grounded theory is the best for your research problem . Grounded theory is a good design when a theory is not already available to explain a process.

Develop questions that aim to understand how individuals experienced or enacted the process (e.g., What was the process? How did it unfold?). Data collection and analysis occur in tandem, so that researchers can ask more detailed questions that shape further analysis, such as: What was the focal point of the process (central phenomenon)? What influenced or caused this phenomenon to occur (causal conditions)? What strategies were employed during the process? What effect did it have (consequences)?

Gather relevant data about the topic in question . Data gathering involves questions that are usually asked in interviews, although other forms of data can also be collected, such as observations, documents, and audio-visual materials from different groups.

Carry out the analysis in stages . Grounded theory analysis begins with open coding, where the researcher forms codes that inductively emerge from the data (rather than preconceived categories). Researchers can thus identify specific properties and dimensions relevant to their research question.

Assemble the data in new ways and proceed to axial coding . Axial coding involves using a coding paradigm or logic diagram, such as a visual model, to systematically analyze the data. Begin by identifying a central phenomenon, which is the main category or focus of the research problem. Next, explore the causal conditions, which are the categories of factors that influence the phenomenon. Specify the strategies, which are the actions or interactions associated with the phenomenon. Then, identify the context and intervening conditions—both narrow and broad factors that affect the strategies. Finally, delineate the consequences, which are the outcomes or results of employing the strategies.

Use selective coding to construct a "storyline" that links the categories together. Alternatively, the researcher may formulate propositions or theory-driven questions that specify predicted relationships among these categories.

Develop and visually present a matrix that clarifies the social, historical, and economic conditions influencing the central phenomenon. This optional step encourages viewing the model from the narrowest to the broadest perspective.

Write a substantive-level theory that is closely related to a specific problem or population. This step is optional but provides a focused theoretical framework that can later be tested with quantitative data to explore its generalizability to a broader sample.

Allow theory to emerge through the memo-writing process, where ideas about the theory evolve continuously throughout the stages of open, axial, and selective coding.

The researcher should initially set aside any preconceived theoretical ideas to allow for the emergence of analytical and substantive theories. This is a systematic research approach, particularly when following the methodological steps outlined by Strauss and Corbin (1990). For those seeking more flexibility in their research process, the approach suggested by Charmaz (2006) might be preferable.

One of the challenges when using this method in a research design is determining when categories are sufficiently saturated and when the theory is detailed enough. To achieve saturation, discriminant sampling may be employed, where additional information is gathered from individuals similar to those initially interviewed to verify the applicability of the theory to these new participants. Ultimately, its goal is to develop a theory that comprehensively describes the central phenomenon, causal conditions, strategies, context, and consequences.

Ethnographic research design

An ethnographic approach in research design involves the extended observation and data collection of a group or community. The researcher immerses themselves in the setting, often living within the community for long periods. During this time, they collect data by observing and recording behaviours, conversations, and rituals to understand the group's social dynamics and cultural norms. We suggest following these steps for ethnographic methods in a research design:

Assess whether ethnography is the best approach for the research design and questions. It's suitable if the goal is to describe how a cultural group functions and to delve into their beliefs, language, behaviours, and issues like power, resistance, and domination, particularly if there is limited literature due to the group’s marginal status or unfamiliarity to mainstream society.

Identify and select a cultural group for your research design. Choose one that has a long history together, forming distinct languages, behaviours, and attitudes. This group often might be marginalized within society.

Choose cultural themes or issues to examine within the group. Analyze interactions in everyday settings to identify pervasive patterns such as life cycles, events, and overarching cultural themes. Culture is inferred from the group members' words, actions, and the tension between their actual and expected behaviours, as well as the artifacts they use.

Conduct fieldwork to gather detailed information about the group’s living and working environments. Visit the site, respect the daily lives of the members, and collect a diverse range of materials, considering ethical aspects such as respect and reciprocity.

Compile and analyze cultural data to develop a set of descriptive and thematic insights. Begin with a detailed description of the group based on observations of specific events or activities over time. Then, conduct a thematic analysis to identify patterns or themes that illustrate how the group functions and lives. The final output should be a comprehensive cultural portrait that integrates both the participants (emic) and the researcher’s (etic) perspectives, potentially advocating for the group’s needs or suggesting societal changes to better accommodate them.

Researchers engaging in ethnography need a solid understanding of cultural anthropology and the dynamics of sociocultural systems, which are commonly explored in ethnographic research. The data collection phase is notably extensive, requiring prolonged periods in the field. Ethnographers often employ a literary, quasi-narrative style in their narratives, which can pose challenges for those accustomed to more conventional social science writing methods.

Another potential issue is the risk of researchers "going native," where they become overly assimilated into the community under study, potentially jeopardizing the objectivity and completion of their research. It's crucial for researchers to be aware of their impact on the communities and environments they are studying.

The case study approach in a research design focuses on a detailed examination of a single case or a small number of cases. Cases can be individuals, groups, organizations, or events. Case studies are particularly useful for research designs that aim to understand complex issues in real-life contexts. The aim is to provide a thorough description and contextual analysis of the cases under investigation. We suggest following these steps in a case study design:

Assess if a case study approach suits your research questions . This approach works well when you have distinct cases with defined boundaries and aim to deeply understand these cases or compare multiple cases.

Choose your case or cases. These could involve individuals, groups, programs, events, or activities. Decide whether an individual or collective, multi-site or single-site case study is most appropriate, focusing on specific cases or themes (Stake, 1995; Yin, 2003).

Gather data extensively from diverse sources . Collect information through archival records, interviews, direct and participant observations, and physical artifacts (Yin, 2003).

Analyze the data holistically or in focused segments . Provide a comprehensive overview of the entire case or concentrate on specific aspects. Start with a detailed description including the history of the case and its chronological events then narrow down to key themes. The aim is to delve into the case's complexity rather than generalize findings.

Interpret and report the significance of the case in the final phase . Explain what insights were gained, whether about the subject of the case in an instrumental study or an unusual situation in an intrinsic study (Lincoln & Guba, 1985).

The investigator must carefully select the case or cases to study, recognizing that multiple potential cases could illustrate a chosen topic or issue. This selection process involves deciding whether to focus on a single case for deeper analysis or multiple cases, which may provide broader insights but less depth per case. Each choice requires a well-justified rationale for the selected cases. Researchers face the challenge of defining the boundaries of a case, such as its temporal scope and the events and processes involved. This decision in a research design is crucial as it affects the depth and value of the information presented in the study, and therefore should be planned to ensure a comprehensive portrayal of the case.

Qualitative and quantitative research designs are distinct in their approach to data collection and data analysis. Unlike quantitative research, which focuses on numerical data and statistical analysis, qualitative research prioritizes understanding the depth and richness of human experiences, behaviours, and interactions.

Qualitative methods in a research design have to have internal coherence, meaning that all elements of the research project—research question, data collection, data analysis, findings, and theory—are well-aligned and consistent with each other. This coherence in the research study is especially crucial in inductive qualitative research, where the research process often follows a recursive and evolving path. Ensuring that each component of the research design fits seamlessly with the others enhances the clarity and impact of the study, making the research findings more robust and compelling. Whether it is a descriptive research design, explanatory research design, diagnostic research design, or correlational research design coherence is an important element in both qualitative and quantitative research.

Finally, a good research design ensures that the research is conducted ethically and considers the well-being and rights of participants when managing collected data. The research design guides researchers in providing a clear rationale for their methodologies, which is crucial for justifying the research objectives to the scientific community. A thorough research design also contributes to the body of knowledge, enabling researchers to build upon past research studies and explore new dimensions within their fields. At the core of the design, there is a clear articulation of the research objectives. These objectives should be aligned with the underlying concepts being investigated, offering a concise method to answer the research questions and guiding the direction of the study with proper qualitative methods.

Carter, K. (1993). The place of a story in the study of teaching and teacher education. Educational Researcher, 22(1), 5-12, 18.

Charmaz, K. (2006). Constructing grounded theory. London: Sage.

Creswell, J. W., & Miller, D. L. (2000). Determining validity in qualitative inquiry. Theory Into Practice, 39(3), 124-130.

Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Newbury Park, CA: Sage.

Moustakas, C. (1994). Phenomenological research methods. Thousand Oaks, CA: Sage.

Ollerenshaw, J. A., & Creswell, J. W. (2000, April). Data analysis in narrative research: A comparison of two “restoring” approaches. Paper presented at the annual meeting of the American Educational Research Association, New Orleans, LA.

Stake, R. E. (1995). The art of case study research. Thousand Oaks, CA: Sage.

Strauss, A., & Corbin, J. (1990). Basics of qualitative research: Grounded theory procedures and techniques. Newbury Park, CA: Sage.

van Manen, M. (1990). Researching lived experience: Human science for an action sensitive pedagogy. Ontario, Canada: University of Western Ontario.

Yin, R. K. (2003). Case study research: Design and methods (3rd ed.). Thousand Oaks, CA: Sage

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6 Qualitative data examples for thorough market researchers

Types of qualitative data in market research, 6 qualitative data examples, get nuanced insights from qualitative market research.

There are plenty of ways to gather consumer insights for fresh campaigns and better products, but qualitative research is up there with the best sources of insight.

This guide is packed with examples of how to turn qualitative data into actionable insights, to spark your creativity and sharpen your research strategy. You’ll see how qualitative data, especially through surveys, opens doors to deeper understanding by inviting consumers to share their experiences and thoughts freely, in their own words — and how qualitative data can transform your brand.

Before we dig into some examples of how qualitative data can empower your teams to make focused, confident and quick decisions on anything from product to marketing, let’s go back to basics. We can categorize qualitative data into roughly three categories: binary, nominal and ordinal data. Here’s how each of them is used in qualitative data analysis.

Binary data

Binary data represents a choice between two distinct options, like ‘yes’ or ‘no’. In market research, this type of qualitative data is useful for filtering responses or making clear distinctions in consumer preferences.

Binary data in qualitative research is great for straightforward insights, but has its limits. Here’s a quick guide on when to use it and when to opt for qualitative data that is more detailed:

Binary data is great for:

• Quick Yes/No questions : like “Have you used our app? Yes or No.”
• Initial screening : to quickly sort participants for further studies.
• Clear-cut answers : absolute factors, such as ownership or usage.

Avoid binary data for:

• Understanding motivations : it lacks the depth to explore why behind actions.
• Measuring intensity : can’t show how much someone likes or uses something.
• Detail needed for product development : misses the nuanced feedback necessary for innovations.

Nominal data

Nominal data categorizes responses without implying any order. For example, when survey respondents choose their favorite brand from a list, the data collected is nominal, offering insights into brand preferences among different demographics.

Some other examples of qualitative data that can be qualified as nominal are asking participants to name their primary information source about products in categories like social media, friends, or online reviews. Or in focus groups, discussing brand perceptions could classify brands into categories such as luxury, budget-friendly, or eco-conscious, based on participant descriptions.

Nominal data is great for:

• Categorizing responses : such as types of consumer complaints (product quality, customer service, delivery issues).
• Identifying preferences : like favorite product categories (beverages, electronics, apparel).
• Segmentation : grouping participants based on attributes (first-time buyers, loyal customers).

Nominal data is not for:

• Measuring quantities : it can’t quantify how much more one category is preferred over another.
• Ordering or ranking responses : it doesn’t indicate which category is higher or lower in any hierarchy.
• Detailed behavioral analysis : While it can group behaviors, it doesn’t delve into the frequency or intensity of those behaviors.

Ordinal data

Ordinal data introduces a sense of order, ranking preferences or satisfaction levels. In qualitative analysis, it’s particularly useful for understanding how consumers prioritize features or products, giving researchers a clearer picture of market trends.

Other examples of qualitative data analyses that use ordinal data, are for instance a study on consumer preferences for coffee flavors, participants might rank flavors in order of preference, providing insights into flavor trends. You can also get ordinal data from focus groups on things like customer satisfaction surveys or app usability, by asking users to rate their ease of use or happiness on an ordinal scale.

Ordinal data is great for:

• Ranking preferences : asking participants to rank product features from most to least important.
• Measuring satisfaction levels : using scales like “very satisfied,” “satisfied,” “neutral,” “dissatisfied,” “very dissatisfied.”
• Assessing Agreement : with statements on a scale from “strongly agree” to “strongly disagree.”

Ordinal data is not for:

• Quantifying differences : it doesn’t show how much more one rank is preferred over another, just the order.
• Precise measurements : can’t specify the exact degree of satisfaction or agreement, only relative positions.

This mix of qualitative and quantitative data will give you a well-rounded view of participant attitudes and preferences.

The things you can do with qualitative data are endless. But this article shouldn’t turn into a work of literature, so we’ll highlight six ways to collect qualitative data and give you examples of how to use these qualitative research methods to get actionable results.

How to get qual insights with Attest

You can get to the heart of what your target customers think, with reliable qualitative insights from Attest Video Responses

1. Highlighting brand loyalty drivers with open-ended surveys and questionnaires

Open-ended surveys and questionnaires are great at finding out what makes customers choose and stick with a brand. Here’s why this qualitative data analysis tool is so good for gathering qualitative data on things like brand loyalty and customer experience:

Straight from the source

Open-ended survey responses show the actual thoughts and feelings of your target audience in their own words, while still giving you structure in your data analysis.

Understanding ‘why’

Numbers can show us how many customers are loyal; open-ended survey responses explain why they are. You can also easily add thematic analysis to the mix by counting certain keywords or phrases.

Guiding decisions

The insights from these surveys can help a brand decide where to focus its efforts, from making sure their marketing highlights what customers love most to improving parts of their product.

Surveys are one of the most versatile and efficient qualitative data collection methods out there. We want to bring the power of qualitative data analysis to every business and make it easy to gather qualitative data from the people who matter most to your brand. Check out our survey templates to hit the ground running. And you’re not limited to textual data as your only data source — we also enable you to gather video responses to get additional context from non verbal cues and more.

2. Trend identification with observation notes

Observation notes are a powerful qualitative data analysis tool for spotting trends as they naturally unfold in real-world settings. Here’s why they’re particularly valuable insights and effective for identifying new trends:

Real behavior

Observing people directly shows us how they actually interact with products or services, not just how they say they do. This can highlight emerging trends in consumer behavior or preferences before people can even put into words what they are doing and why.

Immediate insights

By watching how people engage with different products, we can quickly spot patterns or changes in behavior. This immediate feedback is invaluable for catching trends as they start.

Context matters

Observations give you context. You can see not just what people do, but where and how they do it. This context can be key to understanding why a trend is taking off.

Unprompted reactions

Since people don’t know they’re being observed for these purposes, their actions are genuine. This leads to authentic insights about what’s really catching on.

3. Understanding consumer sentiments through semi-structured interviews

Semi-structured interviews for qualitative data analysis are an effective method for data analysts to get a deep understanding of consumer sentiments. It provides a structured yet flexible approach to gather in-depth insights. Here’s why they’re particularly useful for this type of research question:

Personal connection

These interviews create a space for a real conversation, allowing consumers to share their feelings, experiences, and opinions about a brand or product in a more personal setting.

Flexibility

The format lets the interviewer explore interesting points that come up during the conversation, diving deeper into unexpected areas of discussion. This flexibility uncovers richer insights than strictly structured interviews.

Depth of understanding

By engaging in detailed discussions, brands can understand not just what consumers think but why they think that way and what stations their train of thought passes by.

Structure and surprise

Semi-structured interviews can be tailored to explore specific areas of interest while still allowing for new insights to emerge.

4. Using focus groups for informing market entry strategies

Using a focus group to inform market entry strategies provides a dynamic way to discover your potential customers’ needs, preferences, and perceptions before launching a product or entering a new market. Here’s how focus groups can be particularly effective for this kind of research goal:

Real conversations

Focus groups allow for real-time, interactive discussions, giving you a front-row seat to hear what your potential customers think and feel about your product or service idea.

Diverse Perspectives

By bringing together people from various backgrounds, a focus group can offer a wide range of views and insights, highlighting different consumer needs and contextual information that you might miss out on in a survey.

Spotting opportunities and challenges

The dynamic nature of focus groups can help uncover unique market opportunities or potential challenges that might not be evident through other research methods, like cultural nuances.

Testing ideas

A focus group is a great way to test and compare reactions to different market entry strategies, from pricing models to distribution channels, providing clear direction on what approach might work best.

5. Case studies to gain a nuanced understanding of consumers on a broad level

Case studies in qualitative research zoom in on specific stories from customers or groups using a product or service, great for gaining a nuanced understanding of consumers at a broad level. Here’s why case studies are a particularly effective qualitative data analysis tool for this type of research goal:

In-depth analysis

Case studies can provide a 360-degree look at the consumer experience, from initial awareness to post-purchase feelings.

This depth of insight reveals not just what consumers do, but why they do it, uncovering motivations, influences, and decision-making processes.

Longitudinal insight

Case studies can track changes in consumer behavior or satisfaction over time, offering a dynamic view of how perceptions evolve.

This longitudinal perspective is crucial for giving context to the lifecycle of consumer engagement with a brand.

Storytelling power

The narrative nature of case studies — when done right — makes them powerful tools for communicating complex consumer insights in an accessible and engaging way, which can be especially useful for internal strategy discussions or external marketing communications.

6. Driving product development with diary studies

Diary studies are a unique qualitative research method that involves participants recording their thoughts, experiences, or behaviors over a period of time, related to using a product or service. This qualitative data analysis method is especially valuable for driving product development for several reasons:

Real-time insights

Diary studies capture real-time user experiences and feedback as they interact with a product in their daily lives.

This ongoing documentation provides a raw, unfiltered view of how a product fits into the user’s routine, highlighting usability issues or unmet needs that might not be captured in a one-time survey or interview.

Realistic user journey mapping

By analyzing diary entries, you can map out the entire user journey, identifying critical touch points where users feel delighted, frustrated, or indifferent.

This then enables you to implement targeted improvements and innovations at the moments that matter most.

Identifying patterns

Over the course of a diary study, patterns in behavior, preferences, and challenges can emerge, which is great for thematic analysis.

It can guide product developers to prioritize features or fixes that will have the most significant impact on user satisfaction, which is especially great if they don’t know what areas to focus on first.

Qualitative research brings your consumers’ voices directly to your strategy table. The examples we’ve explored show how qualitative data analysis methods like surveys, interviews, and case studies illuminate the ‘why’ behind consumer choices, guiding more informed decisions. Using these insights means crafting products and messages that resonate deeply, ensuring your brand not only meets but exceeds consumer expectations.

Customer Research Manager 

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This cross-sectional case study ( n  = 20) took place in Qatar over a 3-month period spanning from September until the end of November in 2021. It examined the impacts of a post-COVID classroom arrangement that incorporated preventive measures like social distancing and the use of face coverings. Using the case study methodology, we employed two qualitative research methods, namely non-participant observation and semi-structured interviews, to gather primary data. We also conducted an extensive literature review to identify the key themes for investigation in the field. The primary focus of our study was on proxemics (personal space and crowding), technology (Zoom), non-verbal communication, and ergonomics (lighting and acoustics). Our study uncovered new areas for future research, particularly in how proxemics change in socially distanced classrooms, affecting personal space and perceptions of crowding. Additionally, it highlighted themes in post-pandemic classroom design, emphasizing the impact of factors like seating arrangements and available amenities (e.g., pinup walls) on student engagement, especially in design-studio classrooms. The study also revealed unexpected challenges, such as issues with microphone usage due to users’ lack of familiarity with their operation. In summary, the research underscores the ongoing importance of adaptable learning methods and communication strategies, particularly in response to preventive measures like social distancing and face-covering, which have reshaped our concept of personal space and emphasized the crucial role of telecommunication in crisis resilience for communities and organizations.

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Introduction.

The COVID-19 pandemic, caused by the novel coronavirus (SARS-CoV-2), was declared a global pandemic by the World Health Organization (WHO) due to its rapid spread to multiple countries ( WHO Director-General’s Opening Remarks at the Media Briefing on COVID-19 - 11 March 2020 , 2020 ). It is important to note that COVID-19 is not an isolated event in history, as previous pandemics like the 1918 American Polio epidemic, the 1918 Spanish flu, the 1957 Asian flu, the 1981 AIDS pandemic, the 2009 H1N1 Swine flu, the 2014 West African Ebola, and the 2014 Zika Virus epidemic have occurred (Cennimo, 2020 ; Jarus, 2023 ). COVID-19 can have severe health consequences, particularly for the elderly and those with pre-existing health conditions (World Health Organization, n.d. ) .

Preventing the transmission of COVID-19 involves a combination of physical and medical interventions. The WHO recommends physical measures such as handwashing, social distancing, and wearing face coverings (Centers for Disease Control and Prevention, n.d. ). Medical interventions include vaccines, although their long-term effectiveness is still being studied (Frequently Asked Questions about COVID-19 Vaccination, 2023 ). Vaccines have proven effective in reducing hospitalization rates by 92–96% (Robson, 2021 ), but ongoing research is examining their long-term impacts.

The COVID-19 pandemic led to significant changes in the operations of various institutions, including educational establishments. Measures like remote work and restricted access to buildings were implemented, and as vaccines were developed, some restrictions were lifted. In Qatar, strict COVID-19 measures included travel bans and public place closures, and the use of the Ehteraz app for exposure alerts (Al Khal et al., 2020 ). Mandatory face masks, protective equipment distribution, and clear public communication highlighted preventive measures, linking access to public facilities with a healthy Ehteraz status during the lockdown (Al Khal et al., 2020 ). The gradual reopening and removal of restrictions occurred in four phases, commencing on May 21, 2021 (Government Communications Office, 2020 ). Our study coincided with the second phase, marked by the partial lifting of restrictions, enabling a return to campus within designated daily hours and specific building capacities that varied across different structures.

The transition back to in-person learning has brought challenges in ensuring safety in alignment with WHO guidelines, including social distancing measures within classrooms. Given the mixed sentiments surrounding the reopening, communication within the classroom under setups adhering to WHO guidelines was unforeseen and unfamiliar to everyone. With varied opinions on the reopening, communication within classrooms following WHO guidelines was unexpected. Hence, our research study aimed to explore classroom communication post-online learning during the pandemic, as there is limited existing research on the effects of preventive measures on this aspect.

Student engagement is related to academic performance, and a conducive learning environment plays a crucial role in fostering effective communication and learning (Shernoff et al., 2016 , as cited in Kelly, 2008; Kopec, 2012 ). Therefore, this study aims to investigate the effects of preventive measures like face-covering and social distancing on classroom communication in a post-pandemic, socially-distanced classroom setting. In essence, our study seeks to answer the research question: “What impact do preventive measures have on classroom communication within a post-pandemic classroom environment?” This study was conducted on two interconnected classrooms, which were intentionally furnished to comply with social distancing requirements and create a cohesive socially distanced learning environment, prompting further exploration of this phenomenon.

Literature review

To investigate how preventive measures might impact classroom communication dynamics, our study conducted a review of the literature to identify and extract certain themes from this body of work. These predetermined themes were integral to addressing the aforementioned research question. Out of more than 50 studies examined, only 29 were selected to form the basis of the literature review for this study. Additional sources were incorporated for specific definitions and concepts. The literature selection criteria included original works in environmental design pertaining to proxemics, exploration of blended learning and technology use, considerations in classroom design, and aspects of verbal and non-verbal communication in classrooms.

Personal space

Due to the physical nature of the social distancing measure, literature on personal space was reviewed to better understand the impact of the changing proxemics. The first scholar to introduce the concept of personal space was Edward Hall in 1959 (Beaulieu, 2004 , p. 794). Hall defined personal space as “an invisible three-dimensional zone surrounding a person, which allows that person to regulate his interactions with the outside world” (Beaulieu, 2004 , p. 294). Research shows that “the idea of personal space is actually an interpersonal phenomenon” (Kopec, 2012 ). In other words, it requires the existence of others in order to occur. This was the definition pertaining to the psychological nature of this entity. However, it is also defined based on its physical characteristics as the variable and subjective distance at which one person feels comfortable talking to another ( Dictionary.com | Meanings & Definitions of English Words , 2021 ).

According to Hall ( 1990 ), the hidden boundaries of personal space are not fixed and can vary from one culture to another, as culture plays an important role in defining personal space. Nevertheless, in a socially distanced classroom, personal space that was long referred to as an invisible bubble has become well-identified with its visible physical boundaries after the COVID-19 pandemic. Spacing mechanisms used in design, in general, and in a socially distanced classroom, in particular, serve to maintain one’s perception of their personal space (Kopec, 2012 ).

The importance of the concept of personal space lies in regulating communication and human interaction. Research shows that “the concept of personal space is viewed as variable and permeable in different settings” (Beaulieu, 2004 , p. 297). According to Hall ( 1990 ), interpersonal distance zones, which govern our interactions, can be categorized into four zones. The first category is the intimate, which ranges from 0 to 18”, typically reserved for individuals with close relationships, such as family members or individuals in deeply connected interpersonal bonds (Kopec, 2012 ). The second interpersonal zone is the personal which can range from 18” up to 4’ (Kopec, 2012 , p. 78). This zone is usually used in casual interactions between friends and acquaintances (Kopec, 2012 ). The third level is social , which is usually maintained in business relations between coworkers (Beaulieu, 2004 ) and ranges from 4’ to 12’ (Kopec, 2012 , p. 78). Lastly, the public zone which is usually used by people in public places where they find themselves surrounded by a number of strangers (Kopec, 2012 ). This zone varies from 12’ to 25’ (Kopec, 2012 . p. 78). In a recent study, Mehta ( 2020 ) investigated Hall’s proxemics in urban settings, focusing on changes in street and public space dynamics in residential areas during COVID-19. The research highlighted how residents in mid- to low-density areas repurpose spaces, fostering sociability despite social distancing measures.

In our study, we chose to explore the personal space perceived by participants in an attempt to analyze the various elements that define this concept within the new classroom setup. Our study was mostly exploratory and was not focused on a certain type of interpersonal distance.

Crowding concept

We also explored another concept in environmental psychology that is closely related to personal space, which is Crowding. In normal situations, the occupant load, which is “the number of people that a building code assumes will occupy a given building or a portion of a building”, is based on the building classification (Ballast, 2013 ). The number, placement, and capacity of exits are based on more than just occupant load. The type of occupancy and use, travel distance and remoteness or separation of exits are examples of other factors typically considered when designing a building.

As Kopec ( 2012 , p. 77) indicated, “spacing mechanisms used in design serve to help maintain an individual’s sense of personal space”. To put it differently, the use of physical boundaries such as partitions, furniture and layout allows the individual to identify their own personal space. Crowding, on the other hand, is defined as the “psychological tension produced in environments of high population density, especially when individuals feel that the amount of space available to them is insufficient for their needs” (American Psychological Association, n.d. ). In that sense, it can be argued that implementing social distancing in a classroom can potentially eliminate any sensation of crowding. However, our study examines this concept further, as the perception of crowding can be subjective in nature.

Some researchers such as Evans and Wener ( 2007 ) analyzed the concept of personal space and crowding in trains. According to their review of the literature, incursions into personal space by unfamiliar individuals lead to greater stress compared to those committed by individuals with positive interpersonal relationships. Evans and Wener ( 2007 ) suggested that crowding occurs when the regulation of social interaction fails, leading to a higher level of social interaction than desired. Worchel and Teddie ( 1976 ) also asserted that a feeling of overcrowding is associated with violations of personal space. Crowding can have negative impacts on mental health, causing decreased performance on complex tasks, stress aftermaths, and increased physiological stress (American Psychological Association, n.d. ). The lack of control over social interaction (i.e. privacy) and the decline of socially supportive relationships are considered to be two key mechanisms that contribute to crowding (American Psychological Association, n.d. ).

Upon reviewing the existing literature, specific inquiries emerge concerning the concept of crowding. Our principal emphasis lies in examining how the notion of crowding, closely intertwined with the concept of personal space, has evolved within a socially distanced classroom environment.

Communication

According to Wahyuni ( 2018 ), teachers are required to excel in specific nonverbal communication skills, which encompass body language, the utilization of eye contact, maintaining appropriate distance from students, and the use of touch. Wahyuni ( 2018 ), who further cited Darn (Darn, n.d. ), noted that nearly 75% of classroom management relies on nonverbal communication. In this research, our objective was to investigate the alterations in both verbal and nonverbal communication within the new setup. This change was prompted by the introduction of social distancing measures through the rearrangement of furniture and the adoption of Zoom as an auxiliary tool to facilitate communication between two interconnected classrooms.

Non-verbal communication

It is evident that nonverbal communication plays an important role in classroom interaction (Hall et al., 1977 ). French ( 1977 ) described the non-verbal experience as a multi-dimensional, multi-sensory experience. In his study, French ( 1977 ) emphasized the need for incorporating the non-verbal experience into curriculum development. “The non-verbal experience focused both on self and others”, which requires “an active engagement rather than a passive one” (French, 1977 , p. 176). French’s ( 1977 ) findings resonate well with Astin’s ( 1984 ) regarding the degree of student involvement. Astin ( 1984 ) defines student involvement as the extent of physical and psychological energy invested in the college experience, including academic absorption, extracurricular participation, and interaction with faculty. Education literature distinguishes between student engagement and involvement. Engagement , according to Campus Intelligence (Gay, 2019 ), entails dedicating time and effort to educationally purposeful activities, surpassing mere involvement. Engaged students actively pursue endeavors that contribute to their educational goals, going beyond classroom actions like note-taking and questioning. In their recent research, Walker and Koralesky ( 2021 ) employed the definition of student engagement found in various scholarly reviews, indicating that student engagement is a multi-dimensional construct with three interconnected dimensions: affective, behavioral, and cognitive engagement (Walker and Koralesky, 2021 ; as cited in Chapman, 2002; Fredricks et al., 2004 ; Mandernach, 2015 ; Trowler, 2010 ). Our comprehension of the distinction between these two terms aided us in pinpointing the themes of observation. This is because engagement, in this context, is not the behavior we are focusing on; instead, we are interested in examining classroom dynamics and communication.

Hall et al. ( 1977 ) indicated that non-verbal communication involves a sender and a recipient. Hall et al. ( 1977 ) highlighted that there are some variables that make this sending-receiving type of interaction more effective. Among those variables that Hall et al. ( 1977 ) listed is the “climate”, which refers to how friendly the teacher is in interacting with students. Students are encouraged to actively participate in class discussions if they receive these cues about friendliness and positivity through the sender’s facial expressions and voice tone (Hall et al., 1977 ). This coincides with Zeki’s ( 2009 ) findings that the teacher’s non-verbal communication creates a comfortable and relaxing climate, which consequently enables the students to effectively and confidently engage in class discussions.

In the literature, we discovered another element that affects the student’s engagement in class, which is the locus of control (Astin, 1984 ; Richmond and McCroskey, 2012 , p. 13). According to Astin ( 1984 ), “students’ degree of involvement in learning tasks can be influenced by whether they believe that their behavior is controlled by internal or by external factors.” This is related to belief systems, which are often rooted in one’s locus of control (Kopec, 2012 ). Those who have “a strong external locus of control believe that they are controlled by external forces” (Kopec, 2012 , p. 98). On the other hand, people who have an “internal locus of control believe that their actions, choices, and pursuits control their destiny” (Kopec, 2012 , p. 98). This can be an indicative measure of the student’s level of motivation (Zeki, 2009 ). A number of studies (Zeki, 2009 ; Kopec, 2012 ; Hall, 1959 ) stated that the components of non-verbal communication include, but are not limited to; facial expressions (i.e. mimics), eye contact, angulation, and gestures (i.e. body language). The amount of information one receives from their surroundings comes from all senses but mainly from the eyes and ears (Zeki, 2009 ). This highlights the importance of visual and auditory environmental cues in a classroom.

Verbal communication

Additionally, we sought to comprehend the influence of the new environment on verbal communication. Consequently, we delved into the literature pertaining to physical ergonomics, such as classroom layout, acoustics, and lighting within the field of environmental design.

Classroom layout

Through an examination of early literature centered on the physical ergonomics of classroom configurations, we came across a notable study conducted by Sommer ( 1977 ) that underscored the significance of classroom layout as a means of non-verbal communication. Sommer emphasized that a classroom should not be viewed as a single homogeneous space but rather as a collection of interconnected micro-environments. Elements such as windows, lighting, heating vents, blackboards, and display equipment were identified as factors influencing interactions within the classroom. Additionally, the arrangement of classroom furniture was found to impact body angulation, which in turn affects nonverbal communication (Kopec, 2012 ).

In the realm of classroom design, the establishment of structures known as “affordances” gives rise to opportunities for engagement or limitations in that regard (Metzger and Langley, 2020 ). Affordances pertain to both the perceived and tangible characteristics of objects or surroundings, influencing how they can be employed (Metzger and Langley, 2020 , as cited in Gibson, 1979). In other words, these affordances represent resources within an environment for those who perceive and interact with them. In the context of our study, affordances are represented by movable chairs, movable tables, Zoom technology, and microphones. These affordances are meant to enhance communication while also imposing limitations on social proximity.

Verbal communication in a classroom involves the teacher conveying speech to students through a combination of direct and reflected sound (Berg et al., 1996 ). Effective acoustics are achieved when the reflected sound enhances the quality of the direct sound (Berg et al., 1996 ). Sound within the classroom space exhibits three behaviors: reflection off obstacles, diffraction around obstacles, and transmission into obstacles or new media (Timeline: Sound Wave, n.d. ). Reflected sound can lead to two issues: echoes or reverberation (Timeline: Sound Wave, n.d. ). An echo occurs when a reflected sound wave reaches the ear more than 0.1 s after the original sound wave was heard (Timeline: Sound Wave, n.d. ). On the other hand, reverberation is the prolongation of sound as it repeatedly bounces off hard surfaces (Ballast, 2013 ). Reverberation is generally preferred in classroom acoustics as it enhances speech intelligibility in the interior environment (Ballast, 2013 ). To achieve good acoustics in a classroom, a well-designed space includes an appropriate combination of absorbent, reflective, and diffusive materials (Berg et al., 1996 ).

Classroom acoustics can be affected by sound transmission through barriers, such as HVAC systems and external noise from corridors or streets (Ballast, 2013 ). Research efforts have been directed towards exploring issues such as listening problems among special students, student disengagement, the teacher’s voice, and teacher fatigue (Berg et al., 1996 ). This information is relevant to our study as it pertains to the investigation of a socially distanced classroom setup. We also aimed to investigate acoustics because of its significant impact on both verbal and nonverbal communication, especially when considering the use of face coverings.

Daytime light exposure, particularly from sunlight, full-spectrum LEDs, and digital screens, is significant for learning as it affects both vision and a non-visual system tied to sleep-wake cycles and cognitive performance. Blue light has the most powerful impact on alertness and reduced sleepiness compared to other wavelengths, influencing hormonal secretion in the non-visual system (Uncapher, 2016 ).

In their case study, Tureková et al. ( 2018 ) aimed to show how the school environment significantly affects students’ academic performance. They found that factors like accurate lighting influence visual comfort and fatigue during visual tasks. Assessing the daylight factor in a university classroom revealed insufficient values, prompting the design of a potential software-based alternative to improve visual comfort. They also highlighted that natural light’s impact goes beyond academics, influencing physiological, psychological, and behavioral aspects of both students and workers (Tureková et al., 2018 ).

Al-Sallal ( 2010 ) studied daylighting in UAE classrooms, analyzing visual performance and quality. His research involved data collection from architectural drawings, compliance documents, site visits, and photography. Crucial design issues affecting visual quality, such as space size, depth-to-height ratio, window orientation, lighting direction, and desk position, were investigated through simulation. The study revealed design issues impacting daylighting and visual quality, including depth, glazing area, orientation, and daylighting direction. Visual discomfort was found due to contrasting luminance, high window brightness, and uneven daylight distribution. Mitigation strategies discussed focused on solar shading, glare protection, and daylight redirection, considering UAE climate design requirements. This study holds great relevance to our research because Qatar and the UAE share a similar climate. Our objective was to investigate whether there are any unexpected issues related to lighting in the new setup.

Joia and Lorenzo ( 2021 ) investigated the effectiveness of using Zoom, a popular choice for virtual communication during the pandemic (Joia and Lorenzo, 2021 ). The study’s findings emphasize the importance of a teacher’s digital proficiency on the platform and the availability of metacognitive support within the digital environment as key factors in achieving successful pedagogical objectives. Additionally, the research highlights that disciplines involving hard skills are more prone to not meeting their educational goals when transitioning to technology-mediated environments compared to soft skill disciplines undergoing a similar transition (Joia and Lorenzo, 2021 ).

Another study highlighted the benefits of video communication platforms, including expanding educational reach and enabling multimedia-based pedagogy (Earon, n.d. ). Online learning via Zoom showed satisfactory student levels in a study conducted in Pakistan (Minhas et al., 2021 ), but some students reported dissatisfaction due to technical issues (Kim, 2020 ). While online learning cannot replace face-to-face instruction (Ramadani and Xhaferi, 2020 ; Alawamleh et al., 2020 ), instructors’ digital competence and metacognitive support on Zoom can enhance the online experience (Joia and Lorenzo, 2021 ). The potential of using Zoom in a socially distanced classroom requires further exploration, given the COVID-19 pandemic’s impact and new social distancing measures. In our study, we aim to explore the use of Zoom as a supplementary communication medium in socially distanced classrooms.

To bridge the research gap on socially distanced classrooms that are specific to the context of Qatar, we embraced the philosophy of Epistemic Contextualism, asserting that knowledge attribution varies based on context (Rysiew, 2021 ). Following Morgan et al.’s ( 2016 ) recommendation, we adopted the case study methodology, drawing inspiration from the Case Study Observational Research (CSOR) approach. This approach entails conducting observations before interviews to delve deeper into aspects within the contextual framework. Our choice of a case study methodology aligns with qualitative research principles, suitable for exploring new fields or theorizing important issues (Jamshed, 2014 ). Consequently, we employed two data collection methods: observations followed by semi-structured interviews. Semi-structured interviews, rooted in the belief in socially constructed reality, offer flexibility for cross-verification within and between interviews (Azungah, 2018 ). The main objective was to investigate the impact of socially distanced classrooms on student engagement and classroom communication. This cross-sectional study was conducted within a three-month timeframe. Data were analyzed using thematic analysis (Lawless and Chen, 2018 ) for both the observation and interviews. The study was conducted in a unique setting. Prior to the COVID-19 pandemic, the classroom was designed as a studio for a single group, separated into two interconnected classrooms, illustrated in Fig. 1 as Classroom A and Classroom B. Additionally, two vestibules were designated as break areas for students. Classroom A had a dual function, serving as both a studio space and a location where students assembled their tables in the center for lectures. However, in response to the COVID-19 pandemic, social distancing measures were implemented, mandating that each student remain in their assigned seat even during lectures. In other words, students were assigned to design-studio classrooms A and B. The instructor’s workstation, which contained all the necessary equipment, was located in classroom A. As a result, Classroom A was equipped with a TV screen for presentations, while Classroom B was equipped with a projector. Both the screen and the projector were connected to the audio/speakers’ area that was located next to the instructor’s workstation in Classroom A (see Fig. 2 ).

This figure demonstrates Pre- and Post-COVID layouts showcasing a floor plan of the two design-studio classrooms (A and B) interconnected by two vestibules, forming a unified socially distanced classroom. It also illustrates the locations of screens and instructor’s workstation in both classrooms.

A floor plan depicting the layout of design-studio classrooms A and B , along with four perspectives from both classrooms viewed from various camera angles (angles A , B , C , and D ).

Non-participant observations

Observational documentation spanned three months, from September to November, commencing at the start of the semester before obtaining Institutional Review Board (IRB) approval for interviews, as no direct participant contact was required. Field notes encompassed written observations, hand sketches, and circulation maps, providing visual representations of classroom communications. The observer, the second researcher, attended the bi-weekly class sessions for approximately 60 min, ensuring comprehensive consideration of any potential confounding variables. The observation method was guided by findings from the literature review, shaping the framework for the study.

The observations involved observing students without actively participating, providing an overview of the setting and narrowing focus to specific elements of interest (Non-participant Observation, n.d. ). Students were closely monitored in their natural environments, with observations aligned with several themes derived from the literature review mentioned earlier. Field notes were recorded, specifically focusing on non-verbal communication aspects like angulation, body language, and gestures. Additionally, the observer examined any unanticipated data that had not been emphasized in the literature review. The aim of this method was to examine our predetermined themes extracted from the literature review and explore the emerging themes resulting from the new setup. Data were collected through field notes, sketches, and movement mapping over a period of three months.

Access to the classrooms was granted by both the Interim Chair of the Department and the Research Department. The first author served as the instructor for a lecture-based course during the research period, while the second author conducted the non-participant observations and subsequent semi-structured interviews. To maintain confidentiality, only data that had been de-identified and coded were provided to the first author for the purpose of data analysis.

It’s important to mention that we initially piloted a participant-observation method at the start of the semester, involving observations from both researchers. However, this proved impractical as the first researcher was also the course instructor, heavily engaged in fulfilling teaching obligations. Consequently, we opted for a non-participant observation approach, allowing one researcher to fully immerse in observing and documenting the identified variables from the literature review. Generally, “observational data can be integrated as auxiliary or confirmatory research” (Jamshed, 2014 , p. 88). Essentially, the use of observational data is intended to confirm the applicability of the predetermined themes identified in our literature review and to identify any unforeseen themes.

Semi-structured interviews

The second method utilized involved the conducting of face-to-face semi-structured interviews with college students who were pursuing a major in interior design. This was carried out following the approval granted by a national Institutional Review Board. Data was collected from a group of students ( n  = 20) aged between 18 and 20 years old. Ultimately, a total of 17 interviews were conducted, with three participants choosing to withdraw due to scheduling conflicts that arose during the final weeks of the semester. The inclusion and exclusion criteria can be found below in Table 1 .

Interviews were recorded and transcribed verbatim, with each session lasting approximately 30 min (Jamshed, 2014 ). The interview questions, derived from the literature review and observations, were intentionally designed as semi-structured to provide participants with the opportunity to elaborate on their responses. The inquiries primarily consisted of open-ended questions, aiming to delve into participants’ authentic feelings and attitudes regarding the new setup. However, close-ended questions were also incorporated to ensure clarity and consistency in responses.

The interviewing process employed a funnel approach, focusing on building trust and rapport and presenting questions in an unbiased manner to minimize biases from both the interviewer and interviewee (Azungah, 2018 ).

Data analysis

We adopted the inductive/deductive hybrid thematic analysis approach. According to Proudfoot ( 2022 ), thematic analysis that combines elements of both inductive and deductive approaches presents promising prospects for researchers. We initiated the coding process with a deductive approach, employing pre-established themes crafted before engaging with the collected data. These themes were formulated based on the literature review findings, detailed in Tables 2 and 3 . As we analyzed the interview data, we identified new themes that emerged from the study. Consequently, we adopted an inductive coding approach to highlight these additional insights.

Observations

During a 3-month period, the various movements of communication behaviors were captured with sketches. Video or audio recordings were not viable options due to cultural considerations. The outcomes of the non-participant observations align with the previously identified findings from literature review as shown below in Table 2 .

Based on our field observations, the instructor’s position within the room has a significant impact on student engagement. When the instructor is physically present in the room, it positively influences student-instructor interaction. Some students actively participate in class discussions and take notes only when the instructor is within their line of sight. However, there are other students who seem eager to participate regardless of the instructor’s location. While this observation might seem apparent, it proved valuable as it allowed us to connect it to the concept of locus of control. We were particularly interested in exploring whether student engagement stemmed from an internal or external source. Although this observation didn’t offer in-depth information, it provided an insight into how some students might possess an internal locus of control, motivating them to participate actively in class discussions regardless of classroom conditions or arrangements.

Additionally, our observations highlight that establishing eye contact plays a significant role in enhancing verbal communication and increasing student engagement. It is quite normal to see students eagerly joining classroom discussions by raising their hands, especially when they are in a position where the instructor can easily see them. In instances where students cannot recall technical terms for architectural concepts (e.g., forms, shapes, etc.), they resort to using hand gestures to convey their ideas. However, this might pose a challenge for those participating in the class discussion through Zoom from the adjacent room (classroom A or B), as they may not be able to see or interpret these hand gestures effectively. Body language encompasses a broad spectrum of non-verbal cues involving different parts of the body. Emphasizing the significance of hands in particular, they play a pivotal role in enhancing the effectiveness of verbal communication. Our observations also reveal that students commonly adjust their body position, specifically their angulation, to enhance their ability to actively engage in classroom discussions. This adjustment often involves orienting themselves towards key focal points within the classroom, which typically include the instructor’s position or the screen/display, particularly in lecture-style classes. This angulation adjustment may have potential musculoskeletal consequences, which is an aspect we aimed to explore further during the interviews.

This setup is relatively novel and has yet to receive attention in the existing literature. Our field observations underscore the significance of technology utilization in a socially distanced classroom setting. It notably reduces the time spent on communication between two separate rooms. Without the aid of microphones and speakers, instructors are required to repeat discussions for both rooms, effectively duplicating their verbal communication efforts. This duplication of effort can lead to fatigue, occasionally diminishing the instructor’s overall productivity in a socially distanced classroom. Conversely, the positioning of the microphone held significant importance for student engagement. Students seated in closer proximity to the microphone or those with unobstructed access to it demonstrated higher levels of participation in class activities and discussions as illustrated in the mapping diagram (Fig. 3 ).

A mapping diagram that layers the instructor’s movement and students’ movement in the classrooms. In this diagram, the instructor’s movement frequency is highlighted with purple hexagons, while student movements are depicted with green hexagons.The dark microphone symbol denotes the primary location of the microphone, while the gray microphone symbol indicates changes in its position based on student movement.

Personal space and crowding

We also aimed to investigate the concept of crowding concerning personal space within the socially distanced setup. Most responses indicated that this feeling was barely experienced within the new arrangement. It appears that some students confused the psychological meaning of crowding with the physical aspects of overcrowding, and a follow-up question might have been helpful to clarify the investigation’s focus. Nonetheless, we suggest that the absence of the feeling of crowding could be attributed to individual personality traits, particularly whether one is a screener or non-screener (Kopec, 2012 ). Screeners are skilled at filtering out irrelevant stimuli and are less easily distracted or upset (“The Oxford Dictionary of Sports Science & Medicine,” 2006 ), while non-screeners have difficulty shifting attention and tend to experience higher levels of anxiety and empathy ( Nonscreener , n.d. ). Participant 4 exhibited a generally calm demeanor and a resilience to the influence of environmental factors. This disposition may shed light on the coping strategy that was observed, which includes either texting or stepping outside the classroom as a response to feeling overwhelmed. This coping strategy was also highlighted by participant 17.

Participant 17: “I actually try to take a break and try to go to the toilet or get a coffee, just a five-minute break, try to look to my phone to distract myself” .

Regarding the concept of personal space, the majority of participants perceived it positively in the socially distanced classroom. They appreciated the spaciousness of the setup and the generous size of their workspace, aligning with existing literature findings related to the concept of personal space as indicated below in Table 3 .

Furniture arrangement was generally perceived positively by 11 out of 20 participants, who appreciated the spacious personal space it provided in studio classes. However, some participants found the layout inconvenient, especially during lecture classes. The availability of a personal pin-up wall was appreciated by some students, but those sitting in the middle of the classroom, such as participant 13, felt disadvantaged due to the lack of this feature. Socially distanced classrooms were better tolerated in studio classes than in lecture classes, with students enjoying the increased personal space regardless of their location in the classroom.

Participant 13: “It is good, but at the same time I feel I don’t like it. I need a corner to sit in, in my area I sit in the middle, so I don’t have a pin up wall. Like in the Junior studio, I feel it is better because they have more corners, their tables are arranged in a U-shape, so most of them have corners and the area in the middle is empty. Having our tables in the middle, ok it is good for me to concentrate during the lecture classes, but in the studio classes it is uncomfortable” .

One drawback of this layout was the limited number of electrical outlets, which could become crowded when students needed to charge their laptops simultaneously. Another concern raised was the L-shaped table setup, which provided more space but required students to frequently turn their bodies and necks to view the screen during lectures, leading to potential musculoskeletal problems as emphasized by participant 14.

Participant 14: “The L-shape table setup is nice, because it gives us more space. However, the layout is not good, because we are not facing the screen, so we have to turn our bodies and neck in order to see the screen, which is very tiring. To open the laptop, take notes, following the lectures on the big screen with a layout that is not comfortable makes me lose focus” .

Instructors moving between the two rooms during class meetings to ensure equal engagement posed a distraction for some participants. They described maintaining two classrooms simultaneously as overwhelming for the instructor. Furthermore, some students found communication with instructors more convenient through Zoom compared to the socially distanced setup.

Nonverbal communication

Body language significantly influences a student’s attentiveness, as highlighted by 16 participants who emphasized that they are more focused when the instructor is physically present in the same classroom. Participant 14 expressed that seeing the instructor’s body language and personality creates a more engaging experience compared to feeling like they are listening to a machine, which helps them concentrate better. The term “focus” was used by those 16 participants to describe their level of engagement in class. Regardless of whether the interactions are one-way or two-way conversations, most students indicated that body language plays a vital role in keeping them attentive during class. However, it is essential to note that in-class participation does not always imply complete engagement with the class content. Rather, it is a term we used to assess the effectiveness of communication within this setting.

Participant 14: “Because focusing makes me understand the class materials, for example, if he or she (referring to the instructor) is here, I will be able to focus and understand, however, if they are in the other room, I try to listen to them but I cannot focus much “ .

Participant 13 emphasized the significance of body language, especially eye contact, in enhancing vocal communication. She mentioned that being able to see the instructor in front of her helps her understand the class materials better compared to when the instructor is in another room, and she struggles to maintain focus. This aligns with the observation that students tend to be more engaged when the instructor is within their line of sight.

Non-verbal communication or body language encompasses various aspects such as eye contact, gestures, voice, facial expressions, touch, space, and body movement/posture (Segal et al., 2023 ). Among these elements, the eyes and ears are the most utilized in any form of vocal communication, whether in one-way or two-way conversations. Hall’s ( 1966 ) findings indicate that the unaided ear’s effective coverage is limited, making visual cues crucial for effective communication.

Participant 14 mentioned relying more on visual cues than auditory ones, suggesting that visual learners may find it challenging to adapt to socially distanced classroom environments, especially when they cannot consistently see the speaker. This lack of human connection, as described by Participant 16, can hinder effective communication between the speaker and the audience.

Participant 10 emphasized the significance of visual access provided by Zoom in a socially distanced classroom. She expressed that when the instructor makes eye contact with the camera, it creates a sense of direct connection and engagement. To her, establishing eye contact is essential for comprehending lessons and establishing a connection with the instructor. She also noted that recalling the instructor’s body language while reviewing PowerPoint slides after class enhances information retention compared to audio-only classes, where relying on notes is necessary.

Additionally, Participant 10 highlighted the importance of eye contact, even in virtual settings, through the Zoom camera. When the instructor looks directly at the camera, it gives the remote audience the impression of maintained eye contact. This effort allows visually inaccessible students to stay involved and potentially engaged with the class content. Furthermore, the participant mentioned that body language helps in mentally noting information for better retention.

Participant 10: “somehow it does work, especially if the instructor is making eye contact with the camera or something. It makes me feel she is directed towards the students and she is looking at us. And for me eye contact is very important in communication, especially when it comes to understanding a lesson. Also, it is like having a relationship with the instructor, it is not just audio, but it is visual as well. Sometimes, when I go over the PowerPoint slides again after class to study, I sort of remember the instructor’s body language and it is like remembering the information that was said during the class. I feel I retain the information better, however, if it was only audio, I feel I will need to go back to my notes to remember and to refresh my memories.”

Participant 1 mentioned the advantage of immediate interaction in studio or graphics classes, where movement and questions are encouraged. However, there was confusion between audience etiquette and lack of participation, as remaining silent during a lecture is expected to avoid distractions. Questions were facilitated through raised hands, achieved by sharing screens via Zoom to connect both rooms. The perception of student engagement may have been skewed because of the room’s dual function (serving as both a studio and a lecture room), potentially causing some misinterpretation.

Three participants mentioned that the socially distanced setup facilitated effective communication with their classmates within the same classroom more than with those in other classrooms. Participant 6 expressed developing stronger relationships and feeling comfortable talking to nearby classmates, whereas communication with students in the other room was less frequent. This sentiment was shared by other participants, highlighting that student-to-student communication was confined within microenvironments, typically within a 1-m radius.

The type of course, whether studio-based or lecture-based, played a significant role in defining student-to-student communication. Studio classes held in those classrooms allowed for more walking around and talking, leading to increased interactions among students. On the other hand, lecture courses tended to limit communication to those sitting nearby or using microphones for questions.

Participant 10 acknowledged the ease of communication within their class but found it challenging to interact with students in the other room. However, efforts were made to maintain personal connections and engage in group discussions, even with students in the adjacent room. Similar experiences were shared by other participants, who expressed greater communication with those sitting closer to them, particularly in lecture classes.

Student location

The quality of a student’s learning experience is correlated with their location in the classroom, as indicated by several responses. Participants mentioned that being closer to the instructor’s position resulted in a better learning experience, allowing for comfortable, conversational distance and improved concentration.

Apart from proximity to the instructor, students also considered other factors when choosing their seats, such as adequate daylighting. Some preferred corner spots for privacy, storage space, and access to pinup walls, while middle spots were perceived as lacking privacy due to the absence of vertical partitions. However, certain desk locations led to musculoskeletal issues for students as they tried to adjust their positions to see the screen or instructor clearly. Participants 5 and 17 pointed out that poor ergonomics could result in disengagement from class activities.

Participant 17: “As a social distance I have no issues. But after the midterms I changed my location because I got neck issues. My table was facing the wall, so I had to twist my whole body to follow the lecture on the screen and that was very tiring”. She added, “…. and after the midterms, I did not like my grades, they were average but I did not like them. So, I felt I had to change, I had to be more comfortable, so I can focus more. Then I found another available place” .

Participant 6 indicated that the instructors’ movement between classrooms was influenced by the layout, with the primary workstation attracting them to stay longer in that room. This affected student engagement and communication with the instructor during class.

Participant 6 said, “Now that I think about it, I mainly talk with people sitting closer to me. However, my location is near the junior partition, which is annoying because I can hear everything through a little crack in the partition—their lectures, jokes, fights, everything.” The external noise from adjacent rooms with similar setups poses additional distractions, especially for students sitting on the wall-side. Despite having absorptive materials (fabric) on the pinup walls, the doors in between the classrooms require further treatment to address noise issues, considering the use of microphones and speakers as part of the socially distanced setup. Acoustics are significantly impacted by the flooring in the classroom, and footsteps and flooring noises can also contribute to distractions.

Circulation

Some participants described the circulation as tight, with Participant 1 stating, “I think the circulation is a bit tight, but overall it is good.” This perception may be attributed to the limited pathways intentionally designed to restrict each student’s space and minimize potential areas of congregation. On the other hand, other participants found the circulation to be convenient for their work and overall smooth. Participant 5 expressed appreciation for the circulation, particularly the provision of two desks for each student, which was beneficial for their work and required ample space. They also found the circulation easy to navigate, with no challenges in moving around the classroom.

Upon analyzing the layout and comparing the seating positions of Participant 1 and Participant 5, we observed that both locations were unobstructed and conveniently accessible from the classroom entrance. Both participants were equidistant from the instructor’s position and the TV screen. However, it is worth mentioning that while Participant 5 was seated near a window, Participant 1 occupied a seat in the middle of classroom A. Despite this difference, they were still relatively close to each other. This variation in seating may have influenced their perceptions of the room’s overall circulation, with the window-side location potentially contributing to a greater sense of spaciousness.

Participant 1 expressed a preference for dimmer environments during lecture courses, stating, “Sometimes when I see it is dark there, I wish I was in the other room. My side has too much light.” This suggests that there is a variation in lighting preferences among students in a classroom setting. The proximity to windows is considered a privilege by some students, providing them with a view and the ability to control daylight, as described by Participant 1. Participant 14, on the other hand, mentioned being situated far from the window and lacking direct sunlight. Additionally, she found the artificial lighting in her class to be either excessively bright or too dim. As someone who enjoys natural light, she expressed a desire for more sunlight in her space. The quality of light, whether natural or artificial, significantly impacts students’ perceptions of the environment. For instance, Participant 14 attributed feelings of lethargy and tiredness during afternoon classes to the absence of sunlight. She believed that more windows would increase her energy and alertness. Participant 5 indicated that having her desk somehow close to the window and receiving sunlight in the morning helps awaken her, suggesting a positive association between productivity and good daylighting. However, Participant 12 pointed out that sitting near windows could be overwhelming in hot weather, expressing a preference for blinds to regulate natural light and maintain a comfortable temperature. Surprisingly, glare was not as problematic as initially thought, as students found ways to adjust their seating to avoid it, utilizing the spacious workspaces provided. In fact, several participants, including Participant 1, stated they had no glare issues due to the L-shaped tables, which allowed them to adjust their laptops accordingly.

While many participants appreciated the adequate amount of daylight in their classroom, they felt that the artificial lighting was inadequate and, to some extent, contributed to feelings of drowsiness. For instance, Participant 16 mentioned that the artificial light in her class (referring to classroom B) was low and dull. Furthermore, Participant 6, who occupies a seat in classroom B, found screen light during presentations or lectures to be bothersome for her eyes despite not receiving direct sunlight due to her window being closed. The room’s darkness and strong light from the screen caused discomfort and eye irritation for her.

The placement of microphones and their limited number discouraged several students from actively participating in class discussions during lecture-based courses. Participant 14 expressed frustration, describing walking to the fixed microphone location as a “nightmare.” A significant issue, pointed out by 12 participants, is the challenging distance between their desks and the microphone, which hinders their ability to engage in class discussions effectively. Participants used terms like “time-consuming” and “waste of time” to describe the inconvenience of walking to the microphone, which can impact the overall communication in the class.

Some students prefer to participate in discussions while remaining seated, especially if the microphone’s location is prominently visible in the room. Shyness was identified as a reason for some students’ hesitance to use the fixed microphone. It is speculated that shyness may stem from cultural factors or personality traits, but further investigation is required to understand the underlying reasons behind this sentiment.

Another theme that emerged from the interviews is that students intentionally refrain from participating due to spatial and technical challenges. For example, participant 4 explained that she holds back from answering questions because she believes others in the second room will reach the microphone faster or the instructor will notice them first. As a result, she remains silent and stays in her place. Participant 10 echoed a similar sentiment, stating that sometimes it takes the instructor time to realize that they want to ask or answer a question, leading to a reluctance to disturb the class or interrupt the instructor. The time required to walk to the microphone makes them hesitant, as by the time they reach there, the instructor might have moved on to the next topic. This situation can be embarrassing for students, as they do not want to interrupt the lecture inadvertently.

Participant 6 shared a similar experience, stating that she refrained from participating altogether during lecture classes due to the effort and stress involved. The process of walking to the microphone, ensuring it works, and repeating herself to those in the other room feels overwhelming. Participant 12 also acknowledged this challenge, indicating that she often weighs whether her question or comment is worth the time and potential disruption to the class.

Participant 3 expressed that she avoids participation due to the lengthy process involved in a socially distanced classroom. She feels that someone else will answer, so she does not need to speak up. Similarly, Participant 4 chooses not to participate in certain situations, believing that others will answer before her.

We propose that this pattern of hesitating to participate may be linked to a concept known as “learned helplessness.” This phenomenon occurs when individuals are repeatedly exposed to uncontrollable stressors, leading them to develop a belief that they lack control over their environment. Thus, this diminished sense of control can reduce their motivation to take action or attempt to change the situation ( APA Dictionary of Psychology , n.d.)

Microphone manners

One emerging sub-theme from the study is the intimidation some users, especially students, experience when using microphones. Instructors are also not effectively trained in microphone usage. Participants reported instances where they could not hear the instructor clearly due to audio volume fluctuations. This was attributed to instructors holding the microphone too far away or pointing it at their chin instead of their mouth, causing acoustic issues for students in the other classroom. Consequently, students tended to zone out when unable to hear clearly, impacting their engagement in class discussions.

Participant 5 mentioned that although instructors were generally audible, there were instances of sound cut-offs or distractions when the microphone was too close to the professor’s mouth, picking up unwanted sounds like breathing. Participant 7 also noted that some students had soft voices even when using the microphone, affecting clarity.

Zoom was deliberately chosen to visually connect people in both rooms for this study, as the transition from full online learning for two years made it a suitable platform. However, interview results revealed two main perspectives on using Zoom in a socially distanced classroom. Some participants found Zoom distracting, perceiving it as a reminder of online classes, while others appreciated its usefulness, especially visual learners who could easily view lecture slides through the sharing feature.

Distraction emerged as a recurring concern among several participants, particularly related to visual and auditory stimuli. These distractions encompassed factors such as noise originating from neighboring classrooms, the movements of the instructor, and technical issues. Notably, some students, like Participant 14, disclosed that they had Attention Deficit Hyperactivity Disorder (ADHD) and experienced heightened sensitivity to various forms of movement, which made both virtual and in-person classes equally challenging in terms of maintaining focus. Conversely, some participants held a positive perspective regarding Zoom’s role in enhancing communication between the two interconnected classrooms. For example, participant 10 expressed gratitude for the opportunity to observe the lecturer’s body language, which contributed to a sense of human interaction, even within a semi-virtual learning environment.

Technical issues occasionally led to student disengagement, but Zoom proved helpful for those in the no-instructor classroom. Students utilized Zoom’s sharing feature to follow lecture slides and virtually raise their hands for participation. However, overall, students preferred face-to-face interaction over Zoom communication, finding the latter tiring and distracting. Observations during the study supported this preference for face-to-face interaction.

Locus of control

Four participants indicated that they had little control over their classroom location and settled for what was available. However, some, like Participant 5, displayed an internal locus of control, stating she could teach herself and adapt to any situation. Participant 5 emphasized that the physical presence of the instructor was not crucial for her learning, indicating a strong internal strength and adaptability.

Conversely, Participant 17 exhibited a blend of external and internal locus of control. Initially, her seat choice was influenced by the location of her friends, reflecting an external factor. However, she later opted to change her seat with the goal of “improving her grades,” indicating a degree of internal control in her decision-making process.

Participant 17: “At the beginning I was just walking with my friends, and they sat so I sat. So, we sat and we were chatting, then I realized oh ok this is my place. But then I felt I cannot continue, and after the midterms, I did not like my grades, they were average but I did not like them. So, I felt I had to change, I had to be more comfortable, so I can focus more. Then I found another available place” .

Participant 15, on the other hand, favored keeping her laptop active during lectures, utilizing Zoom’s sharing feature to manage slides and search for answers when necessary. In doing so, she demonstrated an external locus of control, relying on available resources such as Zoom to address technical and acoustic challenges.

To our knowledge, this study is the first exploration of post-pandemic classroom design and its effects on classroom communication and student engagement under preventive measures such as face covering and social distancing. To investigate the research question in this case study, a thorough examination of both old and recent literature was methodically undertaken. This approach serves as both a limitation and a strength. The absence of pertinent studies prior to the research in 2021 posed a significant challenge. Nevertheless, delving into well-established older literature proved instrumental in overcoming this hurdle and establishing the groundwork for this exploratory research.

With the implementation of social distancing and the redefined proxemics, our study aimed to investigate the variations in the concept of personal space in this context. Hall’s work provided the foundation for our research in this specific area. While reviewing several studies referencing proxemics theory, none closely resembled ours. Thus, we utilized the original work as a starting point for exploration. This approach mirrors Mehta’s study ( 2020 ), which explored the impact of COVID-19 measures in urban settings, noting the transformation of spaces in response to social distancing. Mehta’s findings on sociable spaces resonated with our results regarding furniture arrangement and classroom layout. Our findings on the redefined proxemics in the new setup reveal that the post-pandemic classroom was widely praised for its redefined personal space. A majority of 11 out of 17 participants expressed positive sentiments about the spaciousness and convenience of the newly defined personal space (Table 3 ). Crowding, a psychological concept associated with personal space, was seldom experienced in the new setup. Some participants mentioned that crowding was only felt when there was limited access to charging outlets for their laptops. Additionally, individuals who experienced any form of stress in class identified checking their phones or taking short breaks as coping strategies.

Our findings also show that the furniture arrangement of the post-pandemic classroom is key in facilitating class communication. While being in close proximity to the instructor in the front or middle of the classroom is deemed conducive to student engagement, as it enables close and direct communication that helps students stay on task (Berg et al., 1996 ; as cited by Gullup, 1986), our study reveals that these middle seats do not cater to the spatial requirements of design students in studio classes, mainly due to the absence of pin-up walls. The findings indicate insufficient attention to the needs of students situated in the middle, exposing them to more visibility and diminished privacy compared to their counterparts along the perimeter. This situation is akin to the airplane aisle and window seats’ dilemma. While middle-seat students benefit from being close to the lecturer as a source of information, wall-side students enjoy privacy, access to a pin-up wall, and window advantages. A socio-petal (Mehta, 2020 ) furniture arrangement is recommended as it can provide equal opportunities and amenities for art and design students while facilitating communication in a socially distanced classroom.

The results of interviews and observations highlight the substantial influence of the instructor’s positioning in the classroom on communication with students, encompassing both verbal and non-verbal aspects. The students are more inclined to engage in class discussion if the instructor’s location in the classroom, as well as their body language are visually accessible. This highlights Kopec’s insights about the benefits of a rectangular classroom layout and how it supports the instructor’s capacity to establish eye contact with students since they fall within “the instructor’s primary visual field” (Kopec, 2012 , p. 224). Moreover, our research shows that 80% of the interview responses highlight the positive impact of body language on students’ attentiveness and engagement. This finding is consistent with the established literature, specifically Zeki’s ( 2009 ), emphasizing the significance of body language in non-verbal communication within the classroom. Put differently, the arrangement of the classroom is pivotal for both verbal and non-verbal communication, both in a general classroom setting and specifically in the post-pandemic classroom. Our study contributes to the existing knowledge by examining the utilization of Zoom to enhance body language, including eye contact, in a scenario involving the coordination of two or more classrooms simultaneously, necessitated by insufficient space in the facility. Fifteen percent of our sample expressed positive perceptions of using Zoom as an alternative to face-to-face communication to address spatial challenges in this context (Table 3 ). Based on these findings, we propose that new hidden dimensions arise, shaping communication and interactions within socially distanced classrooms. The noted expansion of personal, social, and public spheres, with the public sphere arguably encompassing the use of Zoom, prompts further exploration in these settings. The distances between students and instructors have the potential to redefine proxemics in post-pandemic classroom arrangements.

Our investigation explored lighting aspects, revealing that they had the least impact on the socially distanced classroom setup. Students’ main concerns revolved around having more control over lighting levels in their designated spaces. Responses showed diverse preferences for lighting conditions, with some favoring dim lighting and others opting for brighter classrooms. The L-shaped workspace effectively addressed glare issues, allowing students to adjust their positions for control if the problem arose. In a prior UAE study (Al-Sallal, 2010 ), it was observed that simulation runs revealed three key issues causing visual discomfort: sharp contrasts in luminance between the task surface (e.g., whiteboard) and nearby surfaces, excessive brightness from windows and uneven distribution of daylight in the space. In his study, the student’s sitting location was identified as a crucial factor influencing visual quality. The most problematic location was reported to be “the rear, opposite side of the windows” (Al-Sallal, 2010 , p. 208) in terms of acceptable luminance. While our study primarily addressed lighting preferences and emerging behaviors impacting post-pandemic classroom communications, certain findings resonate with Al-Sallal’s ( 2010 ), especially those related to student location. Six out of 17 students favored daylighting and found glare issues insignificant, attributing this to their ability to adjust positions within the spacious workspace. Additionally, four out of 17 participants expressed a preference for more control and the ability to adjust lighting levels according to their individual needs to enhance attention and focus (Table 3 ). Some participants positively associated proximity to windows with productivity, as highlighted in the lighting results subsection. To prioritize confidentiality, our study analyzed responses without linking them to specific student locations, resulting in a lack of specificity in our results. This limitation is acknowledged, but the decision was made to safeguard confidentiality, especially since one researcher served as the course instructor, creating a potential challenge in handling information related to student locations. This aspect is worth exploring in future research to understand the correlation between lighting and student location in post-pandemic classrooms.

In addition, we investigated acoustics in this distinctive setup utilizing technology to facilitate the operation of two classrooms simultaneously, aiming to improve verbal communication. Our research focused on exploring the consequences of preventive measures on classroom communication in a post-pandemic setting. Considering earlier research in the field, notably Berg et al.’s ( 1996 ) review article, which synthesized results from diverse studies, emphasizing the influence of noisy classrooms on students’ effective listening, impacting task engagement, discipline, and cooperation. They highlighted that teachers adjust their vocal approach, exhibiting variations in strength (Berg et al., 1996 ; as cited in Gallup, 1986; Ray, 1990). While some effectively project their voices, individuals with weaker voices may encounter stress when elevating their vocal levels (Berg et al., 1996 ; as cited in Berg, 1993). These findings proved valuable as we sought to comprehend the challenges faced by instructors in both general and specific settings. Our findings show that the adoption of microphones eliminated the need for vocal exertion by instructors. One of the acoustic concerns pointed out by some participants was noise. In this setup, noise primarily originated from adjacent classrooms and internal sources, such as speakers’ echoing sound and unwanted noise resulting from improper microphone use (e.g., instructor breathing). Seven out of 17 interviewees expressed more concern about noise related to technical issues, while three out of 17 interviewees identified external noise as more distracting (Table 3 ). For instance, participant 6 mentioned that her location is mainly distracting due to external noise from the neighboring classroom. These findings emphasize emerging challenges in temporary arrangements for socially distanced classrooms, suggesting areas for further exploration, such as the impact of using speakers in acoustically unprepared lecture spaces during emergencies.

This research uncovered novel findings not present in existing literature. One such discovery is the concept of microphone etiquette, an aspect not previously addressed in the specific context of our study. This introduces a new avenue for exploration by researchers and designers. The intentional inclusion of microphones in this setting aimed to improve verbal communication between two interconnected classrooms. Further investigation into blended learning or hybrid approaches utilizing microphones could be valuable, potentially mitigating challenges during local or global outbreaks.

An aspect warranting future exploration in research is students’ perceptions of microphone usage. Approximately 70.6% of participants indicated that microphone location affected their level of engagement in class. Three out of 17 participants explicitly reported abstaining from engagement due to recurrent technical issues, leading to delayed verbal communication. Students refrained from participating due to shyness, as they had to walk to the microphone location and their apprehension that technical problems might arise (Table 3 ). Arguably, this behavior can be attributed to learned helplessness, which is defined as “occurring when an individual continuously faces a negative, uncontrollable situation and stops trying to change their circumstances, even when they have the ability to do so” (Psychology Today, n.d. ). This finding resonates with Polat’s study ( 2022 , p. 95), which suggests that the students’ “individual uncertainties” can lead to learned helplessness, diminishing motivation and resulting in decreased academic performance and passive behaviors. However, given the sample’s size and homogeneity, it remains challenging to definitively associate learned helplessness with the socially-distanced setup or other variables in this case study. Additional data is needed to establish this as a dependent variable specific to this context. The locus of control was also identified within the responses, as outlined in the results section. A more comprehensive understanding of the data regarding locus of control could have been achieved with a larger sample and the incorporation of additional qualitative methods, such as surveys. The four responses collected in this aspect may be influenced by unanticipated variables specific to this context beyond the locus of control.

It is essential to recognize that the findings derived from this case study are highly contextual. If a similar setup is implemented in a different context or country, the results, especially concerning student attitudes toward microphone usage and privacy concerns, may vary. The transferability of our findings may be constrained both geographically and across disciplines. Since the study exclusively targeted interior design students, its relevance to other fields in the hard sciences may be restricted due to the unique nature of their work. It is noteworthy that cultural aspects were not explicitly addressed within the scope of this research.

It is worth mentioning that the non-participant observation method proved valuable in aligning predetermined themes from the literature review with the research question. Given this unprecedented environmental context, we opted for deductive coding to stay within the scope of this research study on classroom communication post-pandemic. However, the semi-structured interviews revealed unexpected themes, providing opportunities for further research, as mentioned earlier. Hence, we utilized a hybrid approach, incorporating both deductive and inductive coding, to identify patterns in the interview responses. This method facilitated the emergence of new themes, including the consideration of microphone etiquette.

In addressing potential biases arising from observations, we took measures to clearly delineate the role of each researcher (Glesne, 2011 ) to ensure transparency and maintain participant data confidentiality. Throughout the study, we consistently practiced reflexivity ( Reflexivity , n.d. ), allowing us to continually scrutinize our own biases and perspectives during data collection and analysis. The decision to employ a single observer was influenced by regulations limiting classroom capacity and other restrictions related to external visitors. Additionally, we incorporated the Devil’s Advocate approach (Trochim, 2020 ) during data analysis, actively challenging our interpretations of the findings.

This research holds relevance for administrators as they strategize for campus emergencies. Future studies could delve into the optimization of furniture arrangement, considering aspects like privacy and body language, particularly in emergency scenarios necessitating preventive measures like face covering and social distancing. The insights gleaned from our findings might aid administrators in effectively organizing designated spaces for concurrent use or incorporating hybrid modes to ensure instructional continuity during emergencies. A deeper understanding of enhancing hybrid learning environments post-pandemic could contribute to user satisfaction and reduce reliance on lockdown measures.

Conclusions

The pandemic has instilled in us the importance of carefully designing successful learning experiences and programs for our students. It forced us to reevaluate our priorities and life choices, leading to significant changes in communication due to preventive measures like face coverings and social distancing. In times of hardship and uncertainty, telecommunication has become indispensable for businesses, governments, and communities to sustain themselves. As a result, interior environments should be adaptable to accommodate such emergencies.

Our study investigated communication dynamics within a classroom environment adapted to mitigate the spread of the coronavirus while ensuring instructional continuity. We conclude that the impact of preventive measures on classroom communication in a post-pandemic setting is multifaceted and context-dependent. While we have delved into specific aspects we believe are linked to communication, there may be more to consider. Among these aspects, we have explored proxemics, which have evolved beyond its cultural definition to incorporate new physical dimensions to accommodate social distancing. Our findings indicated that psychological concepts like crowding in this socially distanced setting require reassessment. The increased spaciousness in classrooms resulting from the setup with social distancing has reduced crowding. Interestingly, the use of cell phones during class, not resulting in disciplinary action, has served as a positive distraction for students experiencing crowding or stress.

Furthermore, post-COVID spacing mechanisms, including occupant load and furniture arrangement with social distancing in mind, have reshaped our perception of personal space. People became less concerned with non-verbal cues that differ across cultures and define their personal space. Instead, the COVID-preventative measures have introduced new hidden dimensions to our understanding of personal space. These new hidden dimensions encompass factors such as proximity to microphones, the instructor’s desk, the pinup walls, and/or windows, all of which regulate communication within a socially distanced classroom. For instance, adopting a socio-petal layout in the classroom could significantly enhance these new hidden dimensions, thereby facilitating communication in a socially distanced setting. Our findings indicate that crowding, often associated with personal space and spatial density, is less prevalent in the post-COVID setup, as each student benefits from a more spacious personal area dictated by COVID protocols. This reduction in crowding contributes to improved performance as individuals regain control over their social interactions.

In times of emergency, like the pandemic, technology becomes essential to facilitate both verbal and non-verbal communication. This exploratory case study highlights the significance of technology in socially distanced setups in design-studio classrooms, particularly in addressing the communication challenges identified. However, further research is needed to investigate the potential for tailored technology usage and its effectiveness within these distinctive educational environments.

Data availability

The data supporting the findings of this study are accessible upon request from the corresponding author (MA). The data cannot be publicly released as they may contain information that could compromise the privacy or consent of research participants.

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Acknowledgements

We thank all the students who participated in this study for sharing their time and valuable insights. We also appreciate the support and funding provided by Virginia Commonwealth School of the Arts in Qatar for this research.

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Experiences of medical students and faculty regarding the use of long case as a formative assessment method at a tertiary care teaching hospital in a low resource setting: a qualitative study

• Jacob Kumakech 1 ,
• Ian Guyton Munabi 2 ,
• Aloysius Gonzaga Mubuuke 3 &
• Sarah Kiguli 4  

BMC Medical Education volume  24 , Article number:  621 ( 2024 ) Cite this article

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Introduction

The long case is used to assess medical students’ proficiency in performing clinical tasks. As a formative assessment, the purpose is to offer feedback on performance, aiming to enhance and expedite clinical learning. The long case stands out as one of the primary formative assessment methods for clinical clerkship in low-resource settings but has received little attention in the literature.

To explore the experiences of medical students and faculty regarding the use of the Long Case Study as a formative assessment method at a tertiary care teaching hospital in a low-resource setting.

Methodology

A qualitative study design was used. The study was conducted at Makerere University, a low-resource setting. The study participants were third- and fifth-year medical students as well as lecturers. Purposive sampling was utilized to recruit participants. Data collection comprised six Focus Group Discussions with students and five Key Informant Interviews with lecturers. The qualitative data were analyzed by inductive thematic analysis.

Three themes emerged from the study: ward placement, case presentation, and case assessment and feedback. The findings revealed that students conduct their long cases at patients’ bedside within specific wards/units assigned for the entire clerkship. Effective supervision, feedback, and marks were highlighted as crucial practices that positively impact the learning process. However, challenges such as insufficient orientation to the long case, the super-specialization of the hospital wards, pressure to hunt for marks, and inadequate feedback practices were identified.

The long case offers students exposure to real patients in a clinical setting. However, in tertiary care teaching hospitals, it’s crucial to ensure proper design and implementation of this practice to enable students’ exposure to a variety of cases. Adequate and effective supervision and feedback create valuable opportunities for each learner to present cases and receive corrections.

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The long case serves as an authentic assessment method for evaluating medical students’ competence in clinical tasks [ 1 ]. This form of assessment requires students to independently spend time with patients taking their medical history, conducting physical examinations, and formulating diagnosis and management plans. Subsequently, students present their findings to senior clinicians for discussion and questioning [ 2 , 3 ]. While developed countries increasingly adopt simulation-based assessments for formative evaluation, logistical challenges hinder the widespread use of such methods in developing countries [ 4 ]. Consequently, the low-resource countries heavily rely on real patient encounters for formative assessment. The long case is one such method predominantly used as a primary formative assessment method during clinical clerkship and offers a great opportunity for feedback [ 5 ]. The assessment grounds students’ learning into practice by providing them with rich opportunities to interact with patients and have the feel of medical practice. The long case thus bridges the gap between theory and practice, immersing students in the real tasks of a physician [ 1 ]. The complexity of clinical scenarios and the anxiety associated with patient encounters may not be well replicated in simulation-based assessments because diseases often have atypical presentations not found in textbooks. Assessment methods should thus utilize authentic learning experiences to provide learners with applications of learning that they would expect to encounter in real life [ 6 ]. This requires medical education and the curriculum to focus attention on assessment because it plays a significant role in driving learning [ 7 ]. The long case thus remains crucial in medical education as one of the best ways of preparing for practice. It exposes the student repeatedly to taking medical history, examining patients, making clinical judgments, deciding treatment plans, and collaborating with senior clinicians.

The long case, however, has faced significant criticism in the medical education literature due to perceived psychometric deficiencies [ 8 , 9 , 10 ]. Consequently, many universities have begun to adopt assessment methods that yield more reliable and easily defensible results [ 2 ] due to concerns over the low reliability, generalizability, and validity of the long case, coupled with rising litigations and student appeals [ 11 , 12 ]. Despite these shortcomings, the long case remains an educationally valuable assessment tool that provides diagnostic feedback essential for the learning process during clinical clerkship [ 13 ]. Teachers can utilize long-case results to pinpoint neglected areas or teaching deficiencies and align with course outcomes.

However, there is a paucity of research into the long case as a formative assessment tool. A few studies conducted in developed countries highlighted its role in promoting a holistic approach to patient care, fostering students’ clinical skills, and a driving force for students to spend time with patients [ 2 , 13 ], . There is a notable absence of literature on the use of long case as a formative assessment method in low-resource countries, and no published work is available at Makerere University where it has been used for decades. This underscores the importance of conducting research in this area to provide insight into the effectiveness, challenges, and potentials for improvement. Therefore, this study aimed to investigate the experiences of medical students and faculty regarding the utilization of the long case as a formative assessment method within the context of a tertiary care teaching hospital in a low-resource setting.

Study design

This was an exploratory qualitative study.

Study setting

The research was conducted at Makerere University within the Department of Internal Medicine. The Bachelor of Medicine and Bachelor of Surgery (MBChB) degree at Makerere University is a five-year program with the first two years for pre-clinical (biomedical Sciences) course and the last three years dedicated to clinical clerkship. Medical students do Internal Medicine clerkships in third- and fifth-year at the two tertiary teaching hospitals namely; Mulago and Kiruddu National Referral Hospitals. The students are introduced to the long case in third-year as Junior Clerks and later in the fifth-year as Senior Clerks. During clerkship, students are assigned to various medical wards, where they interact with patients, take medical history from them, perform physical examinations, and develop diagnosis and management plans. Subsequently, students present their long cases to lecturers or postgraduate students, often in the presence of their peers, followed by feedback and comprehensive case discussions. Students are afforded ample time to prepare and present their cases during ward rounds, at their discretion. The students are formatively assessed and a mark is awarded on a scale of one to ten in the student’s logbook. Each student is required to make a minimum of ten long cases over the seven weeks of clerkship.

Study participants

The study participants were third- and fifth-year medical students who had completed junior and senior clerkship respectively, as well as lecturers who possessed at least five years of experience with the long case. The participants were selected through purposive sampling. The sample size for the study was determined by data saturation.

Data collection

Data were collected through Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs). A total of 36 medical students participated in FGDs, reflecting on their experiences with the long case. Five faculty members participated in individual KIIs. The students were mobilized by their class representative and a brief recruitment presentation was made at the study site while the lecturers were approached via email and telephone invitation.

Six FGDs were conducted, three for junior clerks and three for senior clerks. Each FGD comprised of 5–7 participants with balanced male and female gender representation. Data saturation was achieved by the fifth FGD, at which point no additional new information emerged. A research assistant proficient in qualitative research methods moderated the FGDs. The discussions lasted between 55 min and 1 h 10 min and were audio recorded. The Principal Investigator attended all the FGDs to document interactions and record his perspectives and non-verbal cues of participants.

Semi-structured KIIs were used to collect data from Internal Medicine faculty. Five KIIs were conducted, and data saturation was achieved by the fourth interview, at which point no new theme emerged. The Principal Investigator conducted the KIIs via Zoom. Each interview lasted between 25 and 50 min and all were audio recorded. A research assistant proficient in qualitative methods attended all the Zoom meetings. The data collected were securely stored on a hard drive and Google Drive with password protection to prevent unauthorized access.

Data analysis

Data analysis was done through inductive thematic analysis method. Following each FGD or KII session, the data collection team listened to the recordings to familiarize themselves with the data and develop general ideas regarding the participants’ perspectives. The data were transcribed verbatim by the researchers to generate text data. Two separate transcripts were generated by the Principal Investigator and a research assistant. The transcripts were then compared and manually reviewed by the research team to compare the accuracy with the audio recordings. After transcript harmonization, data cleaning was done for both FGDs and KIIs transcripts.

The transcribed data from both FGDs and KIIs underwent inductive thematic analysis as aggregated data. This involved initial line-by-line coding, followed by focused coding where the relationships between initial codes were explored and similar codes were grouped. Throughout the analysis, the principle of constant comparison was applied, where emerging codes were compared for similarities and differences.

Study results

Socio-demographics.

A total of 36 medical students participated in the FGDs, comprising 18 junior clerks and 19 senior clerks. The participants were aged between 21 and 25 years except two participants who were aged above 25 (30 and 36 years old). Among the third-year students, there were 10 male and 9 female participants while the fifth-year student comprised of 8 male and 10 female participants.

Five lecturers participated in the Key Informant Interviews, three of whom were females and two male participants. They were aged between 40 and 50 years, and all had over 10 years of experience with the long case. The faculty members included one consultant physician, one associate professor, two senior lecturers, and one lecturer.

Themes that emerged

Three themes emerged from the study: ward placement, case presentations, and case assessment and feedback.

Theme 1: Ward placement

The study findings disclosed that medical students are assigned to specific wards for the duration of their clerkship. The specialization of medical wards was found to significantly restrict students’ exposure to limited disease conditions found only in their allocated ward.

With the super-specialization of the units, there is some bias on what they do learn; if a particular group is rotating on the cardiology unit, they will obviously have a bias to learn the history and physical exam related to cardiovascular disease (KII 1).

The students, particularly junior clerks, expressed dissatisfaction with the lack of proper and standardized orientation to the long case on the wards. This deficiency led to wastage of time and a feeling of being unwelcome in the clerkship.

Some orient you when you reach the ward but others you reach and you are supposed to pick up on your own. I expect orientation, then taking data from us, what they expect us to do, and what we expect from them, taking us through the clerkship sessions (FGD 4 Participant 1).

Students’ exposure to cases in other wards poses significant challenges; the study found that as some lecturers facilitate visits to different wards for scheduled teaching sessions, others don’t, resulting in missed learning opportunities. Additionally, some lecturers leave the burden on students’ personal initiative to explore cases in other wards.

We actually encourage them to go through the different specialties because when you are faced with a patient, you will not have to choose which one to see and not to see (KII 4).

Imagine landing on a stroke patient when you have been in the infectious disease ward or getting a patient with renal condition when you have been in the endocrinology ward can create problems (FGD 6 Participant 3).

Theme 2 Case presentation

Medical students present their long case to lecturers and postgraduate students. However, participants revealed variations among lecturers regarding their preferences on how they want students to present their cases. While some prefer to listen to the entire history and examination, others prefer only a summary, and some prefer starting from the diagnosis.

The practice varies depending on the lecturer, as everyone does it their own way. There are some, who listen to your history, examination, and diagnosis, and then they go into basic discussion of the case; others want only a summary. Some lecturers come and tell you to start straight away from your diagnosis, and then they start treating you backward (FGD 6 Participant 3).

The students reported limited observation of their skills due a little emphasis placed by examiners on physical examination techniques, as well as not providing the students with the opportunity to propose treatment plans.

When we are doing these physical examinations on the ward no one is seeing you. You present your physical examination findings, but no one saw how you did it. You may think you are doing the right thing during the ward rotations, but actually your skills are bad (FGD 4 Participant 6).

They don’t give us time to propose management plans. The only time they ask for how you manage a patient is during the summative long case, yet during the ward rotation, they were not giving us the freedom to give our opinion on how we would manage the patient.(FGD 2Participant 6).

Supervision was reportedly dependent on the ward to which the student was allocated. Additionally, the participants believe that the large student-to-lecturer ratio negatively affects the opportunity to present.

My experience was different in years three and five. In year three, we had a specialist every day on the ward, but in year five, we would have a specialist every other day, sometimes even once a week. When I compare year five with year three, I think I was even a better doctor in year three than right now (FGD 1 Participant 1).

Clinical training is like nurturing somebody to behave or conduct themselves in a certain way. Therefore, if the numbers are large, the impacts per person decrease, and the quality decreases (KII 5).

Theme C: Case assessment and feedback

The study found that a student’s long case is assessed both during the case presentation on the ward and through the case write-up, with marks awarded accordingly.

They present to the supervisor and then also write it up, so at a later time you also mark the sheet where they have written up the cases; so they are assessed at presentation and write up (KII 2).

The mark awarded was reportedly a significant motivator for students to visit wards and clerk patients, but students also believe that the pressure to hunt for marks tends to override the goal of the formative assessment.

Your goal there is to learn, but most of us go with the goal of getting signatures; signature-based learning. The learning, you realize probably comes on later if you have the individual morale to go and learn (FGD 1 participant 1).

Feedback is an integral part of any formative assessment. While students receive feedback from lecturers, the participants were concerned about the absence of a formal channel for soliciting feedback from students.

Of course, teachers provide feedback to students because it is a normal part of teaching. However, it is not a common routine to solicit feedback about how teaching has gone. So maybe that is something that needs to be improved so that we know if we have been effective teachers (KII 3).

Whereas the feedback intrigues students to read more to compensate for their knowledge gap, they decried several encounters with demeaning, intimidating, insulting, demotivating, and embarrassing feedback from assessors.

Since we are given a specific target of case presentation we are supposed to make in my training , if I make the ten, I wouldn’t want to present again. Why would I receive other negative comments for nothing? They truly have a personality effect on the student, and students feel low self-esteem (FGD 1, Participant 4).

This study aimed to investigate the experiences of medical students and faculty regarding the use of the long case as a formative assessment method at a tertiary care teaching hospital in a low-resource setting. This qualitative research provides valuable insights into the current practices surrounding the long case as a formative assessment method in such a setting.

The study highlighted the patient bedside as the primary learning environment for medical students. Bedside teaching plays a crucial role in fostering the development of skills such as history-taking and physical examination, as well as modeling professional behaviors and directly observing learners [ 14 , 15 ]. However, the specialization of wards in tertiary hospitals means that students may not be exposed to certain conditions found in other wards. This lack of exposure can lead to issues of case specificity, which has been reported in various literature as a cause of low reliability and generalizability of the long case [ 16 , 17 ]. Participants in the study expressed feeling like pseudo-specialists based on their ward allocations. This is partly attributed to missing scheduled teachings and poor management of opportunities to clerk and present patients on other wards. Addressing these challenges is essential for enhancing the effectiveness of the long case as a formative assessment method in medical education.

Proper orientation at the beginning of a clerkship is crucial for clarifying the structure and organization, defining students’ roles, and providing insights into clinical supervisors’ perspectives [ 18 ]. However, the study revealed that orientation into the long case was unsatisfactory, resulting in time wastage and potentially hindering learning. Effective orientation requires dedicated time and should involve defining expectations and goals, as well as guiding students through the steps of history-taking and physical examination during the initial weeks of the rotation. Contrary to this ideal approach, the medical students reported being taken through systemic examinations when the clerkship was nearing its end, highlighting a significant gap in the orientation process. Proper orientation is very important since previous studies have also documented the positive impact of orientation on student performance [ 19 ]. Therefore, addressing the shortcomings in orientation practices identified in this study is essential for optimizing learning outcomes and ensuring that students are adequately prepared to engage in the long case.

There was reportedly a significant variation in the way students present their long cases, with some lecturers preferring only a case summary, while others expect a complete presentation or begin with a diagnosis. While this diversity in learning styles may expose students to both familiar and unfamiliar approaches, providing a balance of comfort and tension [ 20 ], it’s essential for students to first be exposed to familiar methods before transitioning to less familiar ones to expand their ability to use diverse learning styles. The variation observed in this context may be attributed to time constraints, as lecturers may aim to accommodate the large number of students within the available time. Additionally, a lack of standardized practices could also contribute to this variation. Therefore, there is a pressing need for standardized long-case practices to ensure a consistent experience for students and to meet the desired goals of the assessment. Standardizing the long case practice would not only provide a uniform experience for students but also enhance the reliability, validity, and perception of fairness of the assessment [ 9 , 21 ]. It would ensure that all students are evaluated using the same criteria, reducing potential biases and disparities in grading. Additionally, standardized practices facilitate better alignment with learning objectives and promote more effective feedback mechanisms [ 22 ].

Related to the above, students reported limited observation of skills and little emphasis placed on them to learn physical examination techniques. This finding resonates with the research conducted by Abdalla and Shorbagi in 2018, where many students reported a lack of observation during history-taking and physical examination [ 23 ]. The importance of observation is underscored by the fact that students often avoid conducting physical examinations, as highlighted in Pavlakis & Laurent’s study among postgraduate trainees in 2001 [ 24 ]. This study sheds more light on the critical role of observation in forcing medical students to master clinical assessment and practical skills. The study also uncovered that students are rarely given the opportunity to propose management plans during case presentations, which hampers their confidence and learning of clinical decision-making. These findings likely stem from the large student-to-lecturer ratio and little attention given to these aspects of the long case during the planning of the assessment method. The result is students not receiving the necessary guidance and support to develop their clinical and decision-making skills. Therefore, addressing these issues by putting more emphasis on observation of student-patient interaction, management plan, and having a smaller student group is vital to ensure that medical students receive comprehensive training and are adequately prepared for their future roles as physicians.

The study found that the marks awarded for the long case serve as the primary motivator for students. This finding aligns with previous research indicating that the knowledge that each long case is part of assessment drives students to perform their duties diligently [ 2 , 25 ]. It underscores the crucial role that assessment plays in driving learning processes. However, the pressures to obtain marks and signatures reportedly hinder students’ engagement in learning. This could be attributed to instances where some lecturers relax on supervision or are absent, leaving students to struggle to find someone to assess them. Inadequate supervision by attending physicians has been identified in prior studies as one of the causes of insufficient clinical experience [ 26 ], something that need to be dealt with diligently. While the marks awarded are a motivating factor, it is essential to understand other underlying motivations of medical students to engage in the long case and their impact on the learning process.

Feedback is crucial for the long case to fulfill its role as an assessment for learning. The study participants reported that feedback is provided promptly as students present their cases. This immediate feedback is essential for identifying errors and learning appropriate skills to enhance subsequent performance. However, the feedback process appears to be unilateral, with students receiving feedback from lecturers but lacking a structured mechanism for providing feedback themselves. One reason for the lack of student feedback may be a perceived intimidating approach from lecturers which discourages students from offering their input. It is thus important to establish a conducive environment where students feel comfortable providing feedback without fear of negative repercussions. The study underscores the significance of feedback from students in improving the learning process. This aligns with the findings of Hattie and Timperley (2007), who emphasized that feedback received from learners contributes significantly to improvements in student learning [ 27 ]. Therefore, it is essential to implement strategies to encourage and facilitate bidirectional feedback between students and lecturers in the context of the long case assessment. This could involve creating formal channels for students to provide feedback anonymously or in a structured format, fostering open communication, and addressing any perceived barriers to feedback exchange [ 28 ]. By promoting a culture of feedback reciprocity, educators can enhance the effectiveness of the long case as an assessment tool.

Conclusions

In conclusion, the long case remains a cornerstone of formative assessment during clerkship in many medical schools, particularly in low-resource countries. However, its effectiveness is challenged by limitations such as case specificity in tertiary care hospitals, which can affect the assessment’s reliability and generalizability. The practice of awarding marks in formative assessment serves as a strong motivator for students but also creates tension, especially when there is inadequate contact with lecturers. This can lead to a focus on hunting for marks at the expense of genuine learning. Thus adequate supervision and feedback practices are vital for ensuring the success of the long case as an assessment for learning.

Furthermore, there is a need to foster standardized long case practice to ensure that scheduled learning activities are completed and that all students clerk and present patients with different conditions from various wards. This will promote accountability among both lecturers and students and ensure a consistent and uniform experience with the long case as an assessment for learning, regardless of the ward a student is assigned.

Data availability

The data supporting the study results of this article can be accessed from the Makerere University repository, titled “Perceptions of Medical Students and Lecturers of the Long Case Practices as Formative Assessment in Internal Medicine Clerkship at Makerere University,” available on DSpace. The identifier is http://hdl.handle.net/10570/13032 . Additionally, the raw data are securely stored with the researchers in Google Drive.

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This research was supported by the Fogarty International Centre of the National Institute of Health under award number 1R25TW011213. The content is solely the responsibility of the author and does not necessarily represent the official views of the National Institute of Health.

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JK contributed to the conception and design of the study, as well as the acquisition, analysis, and interpretation of the data. He also drafted the initial version of the work and approved the submitted version. He agrees to be personally accountable for his contribution and to ensure that any questions related to the accuracy or integrity of any part of the work, even those in which he was not personally involved, are appropriately investigated and resolved, with the resolution documented in the literature.IMG contributed to the analysis and interpretation of the data. He also made major corrections to the first draft of the manuscript and approved the submitted version. He agrees to be personally accountable for his contribution and to ensure that any questions related to the accuracy or integrity of any part of the work, even those in which he was not personally involved, are appropriately investigated and resolved, with the resolution documented in the literature.MA contributed to the analysis and interpretation of the data. He made major corrections to the first draft of the manuscript and approved the submitted version. He agrees to be personally accountable for his contribution and to ensure that any questions related to the accuracy or integrity of any part of the work, even those in which he was not personally involved, are appropriately investigated and resolved, with the resolution documented in the literature.SK made major corrections to the first draft and the final corrections for the submitted version of the work. She agrees to be personally accountable for her contribution and to ensure that any questions related to the accuracy or integrity of any part of the work, even those in which she was not personally involved, are appropriately investigated and resolved, with the resolution documented in the literature.

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Kumakech, J., Munabi, I.G., Mubuuke, A.G. et al. Experiences of medical students and faculty regarding the use of long case as a formative assessment method at a tertiary care teaching hospital in a low resource setting: a qualitative study. BMC Med Educ 24 , 621 (2024). https://doi.org/10.1186/s12909-024-05589-7

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Received : 04 April 2024

Accepted : 22 May 2024

Published : 05 June 2024

DOI : https://doi.org/10.1186/s12909-024-05589-7

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