Case Studies

A case study is a training method using realistic scenarios that focus on a specific issue, topic or problem. Case studies are used in both clinical training and training skills courses. Some clinical case studies describe histories of actual clients while other case studies, particularly those used for training skills, are hypothetical examples based on situations that are known to occur. Participants typically read, study and react to the case study in writing or verbally during a group discussion. Participants may work separately or in small groups to solve or complete a case study.

Case studies are used to encourage the development of sound judgement and problem-solving skills. Whether used in relation to clinical skills (e.g., contraception and its side effects) or training skills (e.g., coaching in a clinical setting), working through the cases supplements actual clinical or training practice and requires participants to think through situations that they may confront in actual practice. The primary advantage of the case study is that it focuses the attention of the participant on a real situation.

Advantages of using a case study are listed below.

  • It is a participatory method of training which actively involves participants and encourages them to interact with each other.
  • Participants react to realistic and relevant cases that directly relate to the training course and often to their work environment.
  • Reactions often provide different perspectives and different solutions to problems presented in the case study.
  • Reacting to a case study helps participants develop problem-solving skills.

Objectives of Using Case Studies

Clinical Case Studies

Participants will be able to:

  • Recommend an appropriate method of contraception for a client.
  • Describe an appropriate management strategy for cases in which a complication has occurred.
  • Recognize inappropriate management practice patterns or client care and describe how they could be improved.

Training Skills Case Studies

Participants will be able to:

  • Identify problems associated with classroom and clinical training situations.
  • Recommend appropriate actions to correct training skills problems.

Using Case Studies

There are a number of ways that case studies can be used. Some examples are:

Didactic SessionsDivide the participants into groups of 2 or 3 and give each group a copy of the case study or present the information on the flipchart or a transparency. Allow 15 minutes for the group to discuss the questions on the study. Then ask each group to present their recommendations and allow the entire group to discuss it.
TestingUse the case study as a test item. This might be useful during and at the end of a course or in an evaluation taking place some months after training is complete.
Clinical PracticeIf time has been scheduled for clinical practice but no clients are present, use the time to discuss cases studies. When cases of a particular type or with a particular difficulty are not present in the clinic during training, use case studies based on these situations to have participants think through the appropriate strategy for managing the case.
EvaluationHave the trainers who will evaluate clinical or training skills review the actions taken on the case and determine if it was handled adequately.
Developing Case StudiesIf you are training people to be trainers, give each participant a case study and ask him or her to write up a similar case study that could be used to train others.

Reaction Exercises

After participants have read the case study, either individually or in small groups, they should be given the opportunity to react to it. Typical reaction exercises include:

  • Analysis of the problem. The participants are asked to analyze the situation presented in the case study and determine the source of the problem.
  • Focused questions. These inquiries ask participants to respond to specific questions.
    Example: "What are three observations suggesting that the client was not counseled properly?"
  • Open-ended questions. These questions provide participants more flexibility in responding.
    Example: "What are some of the consequences of failing to counsel a client properly prior to performing a minilaparotomy?"
  • Problem solutions. The participants are asked to offer suggestions regarding the situation being presented.
    Example: "How could this problem have been avoided?"

Sharing Reactions

Once participants have reacted to the case study they should be given the opportunity to share their reactions. This sharing might take the form of one or more of the following:

  • Reports from individuals or small groups
  • Responses to case study questions
  • Role plays presented by individuals or small groups
  • Recommendations from individuals or small groups

The clinical trainer should summarize the results of the case study activity prior to moving on to the next topic.

Developing a Case Study

Case studies can be developed by the trainer or the participants. Situations for case studies can be found in one or more of the following sources:

  • Clinical experiences
  • Medical histories/records, reference manuals, clinical journals, etc.
  • Experiences from clinic staff, other trainers, participants or clients

The following steps are involved in developing a case study.

  • Identify the topic, issue or problem on which the participants will focus.
  • Ensure that the case study presents a real situation. It should relate directly to the background and experiences of the participants. It is difficult for participants to react to a case study when they have little or no understanding of the situation.
  • Determine whether the case study will be completed by individuals or whether participants will work on it in small groups.
  • Provide the participants with questions or activities that will enable them to focus on the main concept(s) being presented in the case study.
  • Develop instructor’s notes so that trainers know what the focus of discussion should be and can provide participants with correct information.
  • Decide whether participants will report the results of their work on the case study in writing or orally to the entire group.