Case study as ‘an example’

This implies the development of a relationship between complex exemplary material and the theories and principles that relate to it. The task of the student is to make the links between theory and practice. The educational objective is to make the abstract general principles meaningful for students by requiring them to apply them to reality. This suggests that the case must be illustrative of the theories that the educator wishes to explore.

Case study as a ‘vicarious experience’

In this approach the student is in possession of raw, unprocessed material. It might require some additional field research or interviews, but regardless, would oblige students to sift and analyse primary data such as schedules, memoranda and other records. The students can make their own judgment about cause, effect and solutions. The underlying belief holds that the only way for students to develop analytic and judgmental skills is to practise them. To make the vicarious experience more real, small group discussion and role play are also used. While most educators would advocate that this type of case study must be non-directive, Dooley and Skinner (1977) note that educators often bias the outcome in their selection of illustrative material, and even if prescription is unintentional, it occurs while directing case discussion.

Case study as ‘combination of theory and experience’

In this approach both illustrative and experiential problem-solving are combined. The synthesis of theory and experience is a most important educational opportunity offered through case studies, because abstract ideas become more meaningful when applied to real-life situations. The approach used here is to select cases that require working with a complex mass of information, doing analysis and suggesting solutions, but using a specific theoretical framework selected by the educator. Often a series of illustrative and experiential cases are injected at those stages in the educational process where theories and ideas are presented.

Continuity in intellectual content

One of the earliest such debates was the issue of continuity. Crooks (1984) reflects on the need for developing intellectual content from the case-related experiences. He proposed that, as with the scientific method, there should be a testing or validating of a theory against a series of case studies. The evidence thus provided should vindicate, or otherwise, the hypothesis posed by the theoretical principle postulated. In this context the educator was obliged to select a sequence of cases that built an orderly application of knowledge from one case to the next. Yin (1993) on the other hand argues that case studies are not sampling research and each case consists of a whole study with facts gathered from various sources and conclusions drawn on these facts. The ultimate purpose of cases is to describe, understand and explain. Further he suggests that with complex and multivariate cases pattern-matching techniques can be used to determine the knowledge derived.

Incremental cases to enable knowledge building

Consistent with this continuity ideology is the report by Grupe and Jay (2000) regarding an approach called incremental cases, in which a case study approach borrowed from televised panel discussions builds knowledge while reflecting on interesting policy issues. In this instance a series of topics relating to ethics, such as doctor–patient relationships, are addressed but not in normal open discussion. The moderator asks questions from panellists, who are limited to responding from within a specific role assigned to them. Decisions made by panellists are based on information that is increased incrementally during the course of the discussion. This restricted information limits participants’ ability to anticipate and affect the later discussion until it occurs. According to the authors, it infuses a discussion with drama, conflict and excitement while causing students to draw on their current knowledge and to demonstrate how they would respond to these real-life complex situations.

Deductive logic or inductive logic

An extension of the ideology of scientific method was the debate around whether cases should follow deductive logic, whereby theoretical instruction comes before the case study experience, or inductive logic, which implies cases should come first. This has a considerable effect on the way the educator approaches the sequencing of events in the instructional process. Again in Crooks’ work (1984) is the report of a treatise by Rousseau, who offered a third possibility that combines both deductive and inductive approaches. He suggests students might take a general principle formulated by others and validate their experiences as congruent or not with this existing knowledge by using real circumstances via a series of case studies. Clearly one concludes that educators will need to determine the specific context that best reflects their own educational objectives in order to resolve these issues — there is no right answer.

Independent or supervised

The next issue is how much freedom to allow students. The arguments about whether to have the educator work with students to analyse the case, or whether the analysis is left to the students, is normally discussed in cognitive psychology terms. One camp holds with the view that active learning is the most effective form of education, and this implies learning through discovery. This would suggest problem-solving strategies can’t really be taught, so students should be allowed to construct their own organising concepts while instructors act as facilitators only (Hines & Geisinger 1997). Others would argue that learners are not able to successfully construct their own frame of reference without sufficient concepts to provide an organising structure, so the teacher must take a more directive role. The dilemma once again becomes a matter for resolution through considering the educator’s own objectives. For those interested, Bruce and Gerber (1995) provide a useful six-category framework to understand what learning is and how learning gain is demonstrated.

Other considerations

Regardless of the philosophical basis of the main arguments debated here, there seems to be strong support for inclusion of additional teaching devices to supplement the use of case study approaches. Self-assessment, for example, has been suggested as a way of encouraging students to stand back from the specific details and take a broader view (Candy 1991). Another essential device is the opportunity to reflect on the experience itself, which must be built into the design of the learning process (Raju & Sanker 1999). Ensuring students have a clear understanding of what is expected of them in the learning experience is also critical.

Adult learners are a particular group of students who benefit greatly from the use of case study approaches. Not only do they bring a series of work–life skills to the classroom, they need to practise decision-making to re-examine ideas and theories as well as develop new skills. They are more likely to undertake distance education due to full-time work commitments. Consequently, concern is for the ability to provide distance education students with the level of interaction that classroom-based case studies offer. Hines and Geisinger (1997) and Forbes and Geisinger (1997) report on case studies that solve this problem through simulations of health districts incorporating multi-dimensional databases and problems that fit within real locations to enable the examination of both technical and political scenarios.

Educational advantages and disadvantages

One major concern in this appendix is with management students in health. It could be argued that not all management education is benefited by case study, particularly in regard to their usefulness with accounting, statistics and economics. However, the literature particularly supports their use in business and management education. Managers must develop a propensity for action, and cases provide the opportunity for students to grapple with uncertainty, reduce it through critical analysis, apply reasoned judgments and make decisions that must be lived with (Hunt & Entrekin 1977).

Advantages relate essentially to the benefits derived from providing complex real-world simulations of situations requiring response by individuals and groups (Kuntz & Hesslar 1998). This allows analyses, synthesis and invites integration through group discussion and teamwork. Case studies certainly appear to support the processes likely to be confronted by practitioners in their real-work situations.

Some disadvantages should also be considered. Grupe and Jay (2000) note the problem of author bias. This principally results in selecting material, however unintentionally, which tends to suggest what the ‘right’ answer should be. They also believe that cases are inevitably limited in their scope. While not as limited as the example in texts, the need to structure material and reach timely conclusions requires packaging information in ways that are never available to real managers. Schön (1987, p 4) notes:

Cases often tend to focus on the actions of one person or known actors which is not the reality faced by managers, who deal with multiple and unknown actors. Students also have the option of examining cases as neutral participants, taking the luxury of glossing over particular perspectives, which in real life might be at odds with the general good of the organisation in question. It is reasonable to conclude that on balance most authors feel the advantages outweigh the disadvantages; however, these expressed concerns, if not recognised, could create unrealistic views of real business situations.

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