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Case-based learning.

Case-based learning (CBL) is an established approach used across disciplines where students apply their knowledge to real-world scenarios, promoting higher levels of cognition (see Bloom’s Taxonomy ). In CBL classrooms, students typically work in groups on case studies, stories involving one or more characters and/or scenarios.  The cases present a disciplinary problem or problems for which students devise solutions under the guidance of the instructor. CBL has a strong history of successful implementation in medical, law, and business schools, and is increasingly used within undergraduate education, particularly within pre-professional majors and the sciences (Herreid, 1994). This method involves guided inquiry and is grounded in constructivism whereby students form new meanings by interacting with their knowledge and the environment (Lee, 2012).

There are a number of benefits to using CBL in the classroom. In a review of the literature, Williams (2005) describes how CBL: utilizes collaborative learning, facilitates the integration of learning, develops students’ intrinsic and extrinsic motivation to learn, encourages learner self-reflection and critical reflection, allows for scientific inquiry, integrates knowledge and practice, and supports the development of a variety of learning skills.

CBL has several defining characteristics, including versatility, storytelling power, and efficient self-guided learning.  In a systematic analysis of 104 articles in health professions education, CBL was found to be utilized in courses with less than 50 to over 1000 students (Thistlethwaite et al., 2012). In these classrooms, group sizes ranged from 1 to 30, with most consisting of 2 to 15 students.  Instructors varied in the proportion of time they implemented CBL in the classroom, ranging from one case spanning two hours of classroom time, to year-long case-based courses. These findings demonstrate that instructors use CBL in a variety of ways in their classrooms.

The stories that comprise the framework of case studies are also a key component to CBL’s effectiveness. Jonassen and Hernandez-Serrano (2002, p.66) describe how storytelling:

Is a method of negotiating and renegotiating meanings that allows us to enter into other’s realms of meaning through messages they utter in their stories,

Helps us find our place in a culture,

Allows us to explicate and to interpret, and

Facilitates the attainment of vicarious experience by helping us to distinguish the positive models to emulate from the negative model.

Neurochemically, listening to stories can activate oxytocin, a hormone that increases one’s sensitivity to social cues, resulting in more empathy, generosity, compassion and trustworthiness (Zak, 2013; Kosfeld et al., 2005). The stories within case studies serve as a means by which learners form new understandings through characters and/or scenarios.

CBL is often described in conjunction or in comparison with problem-based learning (PBL). While the lines are often confusingly blurred within the literature, in the most conservative of definitions, the features distinguishing the two approaches include that PBL involves open rather than guided inquiry, is less structured, and the instructor plays a more passive role. In PBL multiple solutions to the problem may exit, but the problem is often initially not well-defined. PBL also has a stronger emphasis on developing self-directed learning. The choice between implementing CBL versus PBL is highly dependent on the goals and context of the instruction.  For example, in a comparison of PBL and CBL approaches during a curricular shift at two medical schools, students and faculty preferred CBL to PBL (Srinivasan et al., 2007). Students perceived CBL to be a more efficient process and more clinically applicable. However, in another context, PBL might be the favored approach.

In a review of the effectiveness of CBL in health profession education, Thistlethwaite et al. (2012), found several benefits:

Students enjoyed the method and thought it enhanced their learning,

Instructors liked how CBL engaged students in learning,

CBL seemed to facilitate small group learning, but the authors could not distinguish between whether it was the case itself or the small group learning that occurred as facilitated by the case.

Other studies have also reported on the effectiveness of CBL in achieving learning outcomes (Bonney, 2015; Breslin, 2008; Herreid, 2013; Krain, 2016). These findings suggest that CBL is a vehicle of engagement for instruction, and facilitates an environment whereby students can construct knowledge.

Science – Students are given a scenario to which they apply their basic science knowledge and problem-solving skills to help them solve the case. One example within the biological sciences is two brothers who have a family history of a genetic illness. They each have mutations within a particular sequence in their DNA. Students work through the case and draw conclusions about the biological impacts of these mutations using basic science. Sample cases: You are Not the Mother of Your Children ; Organic Chemisty and Your Cellphone: Organic Light-Emitting Diodes ;   A Light on Physics: F-Number and Exposure Time

Medicine – Medical or pre-health students read about a patient presenting with specific symptoms. Students decide which questions are important to ask the patient in their medical history, how long they have experienced such symptoms, etc. The case unfolds and students use clinical reasoning, propose relevant tests, develop a differential diagnoses and a plan of treatment. Sample cases: The Case of the Crying Baby: Surgical vs. Medical Management ; The Plan: Ethics and Physician Assisted Suicide ; The Haemophilus Vaccine: A Victory for Immunologic Engineering

Public Health – A case study describes a pandemic of a deadly infectious disease. Students work through the case to identify Patient Zero, the person who was the first to spread the disease, and how that individual became infected.  Sample cases: The Protective Parent ; The Elusive Tuberculosis Case: The CDC and Andrew Speaker ; Credible Voice: WHO-Beijing and the SARS Crisis

Law – A case study presents a legal dilemma for which students use problem solving to decide the best way to advise and defend a client. Students are presented information that changes during the case.  Sample cases: Mortgage Crisis Call (abstract) ; The Case of the Unpaid Interns (abstract) ; Police-Community Dialogue (abstract)

Business – Students work on a case study that presents the history of a business success or failure. They apply business principles learned in the classroom and assess why the venture was successful or not. Sample cases: SELCO-Determining a path forward ; Project Masiluleke: Texting and Testing to Fight HIV/AIDS in South Africa ; Mayo Clinic: Design Thinking in Healthcare

Humanities - Students consider a case that presents a theater facing financial and management difficulties. They apply business and theater principles learned in the classroom to the case, working together to create solutions for the theater. Sample cases: .


Finding and Writing Cases

Consider utilizing or adapting open access cases - The availability of open resources and databases containing cases that instructors can download makes this approach even more accessible in the classroom. Instructors can consider in particular the National Center for Case Study Teaching in Science , a database featuring hundreds of accessible STEM- and social science - based case studies.

  • Consider writing original cases - In the event that an instructor is unable to find open access cases relevant to their course learning objectives, they may choose to write their own. See the following resources on case writing: Cooking with Betty Crocker: A Recipe for Case Writing ; The Way of Flesch: The Art of Writing Readable Cases ;   Twixt Fact and Fiction: A Case Writer’s Dilemma ; And All That Jazz: An Essay Extolling the Virtues of Writing Case Teaching Notes .

Implementing Cases

Take baby steps if new to CBL - While entire courses and curricula may involve case-based learning, instructors who desire to implement on a smaller-scale can integrate a single case into their class, and increase the number of cases utilized over time as desired.

Use cases in classes that are small, medium or large - Cases can be scaled to any course size. In large classes with stadium seating, students can work with peers nearby, while in small classes with more flexible seating arrangements, teams can move their chairs closer together. CBL can introduce more noise (and energy) in the classroom to which an instructor often quickly becomes accustomed. Further, students can be asked to work on cases outside of class, and wrap up discussion during the next class meeting.

Encourage collaborative work - Cases present an opportunity for students to work together to solve cases which the historical literature supports as beneficial to student learning (Bruffee, 1993). Allow students to work in groups to answer case questions.

Form diverse teams as feasible - When students work within diverse teams they can be exposed to a variety of perspectives that can help them solve the case. Depending on the context of the course, priorities, and the background information gathered about the students enrolled in the class, instructors may choose to organize student groups to allow for diversity in factors such as current course grades, gender, race/ethnicity, personality, among other items.  

Use stable teams as appropriate - If CBL is a large component of the course, a research-supported practice is to keep teams together long enough to go through the stages of group development: forming, storming, norming, performing and adjourning (Tuckman, 1965).

Walk around to guide groups - In CBL instructors serve as facilitators of student learning. Walking around allows the instructor to monitor student progress as well as identify and support any groups that may be struggling. Teaching assistants can also play a valuable role in supporting groups.

Interrupt strategically - Only every so often, for conversation in large group discussion of the case, especially when students appear confused on key concepts. An effective practice to help students meet case learning goals is to guide them as a whole group when the class is ready. This may include selecting a few student groups to present answers to discussion questions to the entire class, asking the class a question relevant to the case using polling software, and/or performing a mini-lesson on an area that appears to be confusing among students.  

Assess student learning in multiple ways - Students can be assessed informally by asking groups to report back answers to various case questions. This practice also helps students stay on task, and keeps them accountable. Cases can also be included on exams using related scenarios where students are asked to apply their knowledge.

Barrows HS. (1996). Problem-based learning in medicine and beyond: a brief overview. New Directions for Teaching and Learning, 68, 3-12.  

Bonney KM. (2015). Case Study Teaching Method Improves Student Performance and Perceptions of Learning Gains. Journal of Microbiology and Biology Education, 16(1): 21-28.

Breslin M, Buchanan, R. (2008) On the Case Study Method of Research and Teaching in Design.  Design Issues, 24(1), 36-40.

Bruffee KS. (1993). Collaborative learning: Higher education, interdependence, and authority of knowledge. Johns Hopkins University Press, Baltimore, MD.

Herreid CF. (2013). Start with a Story: The Case Study Method of Teaching College Science, edited by Clyde Freeman Herreid. Originally published in 2006 by the National Science Teachers Association (NSTA); reprinted by the National Center for Case Study Teaching in Science (NCCSTS) in 2013.

Herreid CH. (1994). Case studies in science: A novel method of science education. Journal of Research in Science Teaching, 23(4), 221–229.

Jonassen DH and Hernandez-Serrano J. (2002). Case-based reasoning and instructional design: Using stories to support problem solving. Educational Technology, Research and Development, 50(2), 65-77.  

Kosfeld M, Heinrichs M, Zak PJ, Fischbacher U, Fehr E. (2005). Oxytocin increases trust in humans. Nature, 435, 673-676.

Krain M. (2016) Putting the learning in case learning? The effects of case-based approaches on student knowledge, attitudes, and engagement. Journal on Excellence in College Teaching, 27(2), 131-153.

Lee V. (2012). What is Inquiry-Guided Learning?  New Directions for Learning, 129:5-14.

Nkhoma M, Sriratanaviriyakul N. (2017). Using case method to enrich students’ learning outcomes. Active Learning in Higher Education, 18(1):37-50.

Srinivasan et al. (2007). Comparing problem-based learning with case-based learning: Effects of a major curricular shift at two institutions. Academic Medicine, 82(1): 74-82.

Thistlethwaite JE et al. (2012). The effectiveness of case-based learning in health professional education. A BEME systematic review: BEME Guide No. 23.  Medical Teacher, 34, e421-e444.

Tuckman B. (1965). Development sequence in small groups. Psychological Bulletin, 63(6), 384-99.

Williams B. (2005). Case-based learning - a review of the literature: is there scope for this educational paradigm in prehospital education? Emerg Med, 22, 577-581.

Zak, PJ (2013). How Stories Change the Brain. Retrieved from:


Nancy Niemi in conversation with a new faculty member at the Greenberg Center

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  • Open access
  • Published: 21 July 2021

A case study of university student networks and the COVID-19 pandemic using a social network analysis approach in halls of residence

  • José Alberto Benítez-Andrades 1 ,
  • Tania Fernández-Villa 2 ,
  • Carmen Benavides 1 ,
  • Andrea Gayubo-Serrenes 3 ,
  • Vicente Martín 2 , 4 &
  • Pilar Marqués-Sánchez 5  

Scientific Reports volume  11 , Article number:  14877 ( 2021 ) Cite this article

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  • Epidemiology
  • Health care
  • Public health

The COVID-19 pandemic has meant that young university students have had to adapt their learning and have a reduced relational context. Adversity contexts build models of human behaviour based on relationships. However, there is a lack of studies that analyse the behaviour of university students based on their social structure in the context of a pandemic. This information could be useful in making decisions on how to plan collective responses to adversities. The Social Network Analysis (SNA) method has been chosen to address this structural perspective. The aim of our research is to describe the structural behaviour of students in university residences during the COVID-19 pandemic with a more in-depth analysis of student leaders. A descriptive cross-sectional study was carried out at one Spanish Public University, León, from 23th October 2020 to 20th November 2020. The participation was of 93 students, from four halls of residence. The data were collected from a database created specifically at the university to "track" contacts in the COVID-19 pandemic, SiVeUle. We applied the SNA for the analysis of the data. The leadership on the university residence was measured using centrality measures. The top leaders were analyzed using the Egonetwork and an assessment of the key players. Students with higher social reputations experience higher levels of pandemic contagion in relation to COVID-19 infection. The results were statistically significant between the centrality in the network and the results of the COVID-19 infection. The most leading students showed a high degree of Betweenness, and three students had the key player structure in the network. Networking behaviour of university students in halls of residence could be related to contagion in the COVID-19 pandemic. This could be described on the basis of aspects of similarities between students, and even leaders connecting the cohabitation sub-networks. In this context, Social Network Analysis could be considered as a methodological approach for future network studies in health emergency contexts.


Adversities seem to have been a permanent reality in the last decade 1 . Their consequences cause damage to people's lives that deserve the attention of political leaders and researchers. In the context of any disaster, models of human behaviour are constructed that reflect the importance of relationships between actors, between actors and knowledge, and even between actors and beliefs 2 .

The World Health Organization (WHO) declared the COVID-19 a global emergency on January 31, 2020 3 . It is one of the disasters that has had the greatest impact on our history. Recent studies have already shown that the COVID-19 pandemic appears to have an impact on mental health, leading to anxiety, depression, disturbed sleep quality and even increased perceptions of loneliness 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 . In the same sense, the impact of the pandemic has also "hit" young people, who go to school every day but who have seen their social relationships decline. The educational context was always present in the strategies implemented in previous pandemics. Some of the most common measures were the closure of schools to contain the transmission of influenza 12 , support through informal networks on university campuses during the influenza A(H1N1) pandemic 13 , and the need to increase knowledge on the pandemic, as it was found to influence everyday attitudes and practices 14 .

One of the measures that has had the greatest social impact in the COVID-19 pandemic has been the obligation to maintain a physical distance. Specifically, in the field of higher education, it seems to be remarkably complex and more difficult to carry out 15 . University campuses are of interest for studying social behaviour in the context of a pandemic. Numerous studies have shown how university students acquire healthy habits or, conversely, drug and alcohol consumption habits, depending on the type of relationships they have on campus and in the university residences 16 , 17 .

However, there is a lack of studies that analyse the behaviour of university students based on their social structure during a pandemic. Therefore, a quantitative understanding of the behaviour of students in a health emergency situation is necessary as this information could be useful in making decisions about how to prepare for disasters. That is, how to act appropriately during and after an emergency of any kind, since interpersonal relationships, through which supportive and interdependent links are established and which are present in any emergency or disaster.

To address this structural perspective, the SNA method has been applied. The SNA is a distinctive perspective within the social and behavioural sciences. It is distinctive because it is based on the fact that relationships take place between interacting units 18 . For the SNA method, the unit of analysis is not the isolated individual, but the social entity made up of the actor with its possible connections, generating a structure 19 . The main perspective of the SNA focuses on the importance of the relationships between the units that interact in the social networks 18 . A social network is made up of a set of points or nodes that represent individuals or groups, and a set of lines that represent the interaction or otherwise, between the nodes, generating a social structure 20 .

One of the most relevant premises of the SNA, for our study, is that it is not only assumed that individuals are connected through a structure, but that their goals and objectives are as well, because these are only achieved through connections and relationships 19 , 21 , 22 . Thus, the SNA could show us if university students with a more responsible goal form their own networks or mingle with their not-so-responsible peers. In relation to the groups, the actors influence and inform each other in a process that creates a growing homogeneity 21 . This perspective is of interest to this research.

The contacts between actors can be analyzed in two types of networks: sociocentric or complete networks and egocentric networks. The former includes an analysis between actors that belong to a delimited and previously defined census 23 . While the latter analyzes the structure that is generated between an ego and its contacts 24 .

There is an extensive core of studies on SNA and health habits. Some of the most recent are related to contagion in substance use 25 , 26 , physical activity 27 , behavior related to the individual's low weight 28 , engagement in university rooms 29 or eating behaviors 30 among others. SNA has even been applied to disaster scenarios such as droughts, floods, landslides, tsunamis, and cyclones 31 . No one thought that one year after this study, its results would be so useful for another scenario related to a major catastrophe such as the COVID-19 pandemic. Other recent studies shows a social network analysis approach in the problematic internet use among residential college students during COVID-19 lockdown 32 or associations between interpersonal relationships and mental health 33 .

Based on the above, the purpose of this study was to analyse a community of university students and their structural behaviour in their university residences. Halls of residence form micro-communities where very close relationships develop, which can become a context of risk. In other words, university residences could become "places" that facilitate the spread of pandemics if adequate protocols are not followed. However, dormitories can also have a preventive value. Peer support behavioural patterns take place in them, among peers who are exposed to the same risks and circumstances. This sharing of similar situations can generate an enriching coping of personal experiences 34 . However, there is a lack of studies that analyse the structures of university students and their coping in crisis situations.

This study was conducted during one of the waves of the COVID-19 pandemic, where infection rates were at their highest. With the SNA methodology, the aim is to find answers to questions such as: What are the structural characteristics of the leading individuals in the dormitories? How are the contagion outcomes related to the structural positions in the network? For such questions, the proposed objectives were (i) to analyse the relationship between the students' network position and their outcomes with respect to the COVID-19 contagion, (ii) to describe the influential position of student leaders in the network, (iii) to analyse the Egonetwork of the most influential student leaders during the COVID-19 pandemic, and (iv) to visualise the relational behaviour of university students in the global network.

Study design

A descriptive cross-sectional study was carried out at one Spanish Public University. The data was collected during one of the waves of the pandemic, specifically from 23th October 2020 to 20th November 2020.

The measures taken during the pandemic in the different regions of Spain were different, depending on the results of the contagion at each moment. At the time of carried out this study, teaching in the locality of the study was adapted to the situation. That is, there were limitations on the number of people, "mirror" classrooms, identification of QR, etc. In the town there was a limit to the number of people who could meet, pubs and discotheques had been closed, and there was a 10 pm curfew.

Setting and sample

The participation was of 93 students, from 4 university residences. The characteristics of the sample can be seen in Table 1 . Of the total participants, 32.26% were women and 67.74% men.

Ethical consideration

All participants received an informed consent form to participate in the study. Lastly, participants were offered the possibility of retracting consent once they had signed the form, without needing to provide a reason, and an email contact address was given should they require any further information. Participation was voluntary, and subject availability was respected at all times. All the participants that were involved in the study have given their informed consent to participate in this study.

The data for this study are considered health-related data. They comply with Directive 03/2020 of the European Data Protection Committee 35 . The researchers requested anonymised data from the responsible body of the university in charge of contacts COVID-19.

The study was approved by the Ethics Committee of the University of León (ETICA-ULE-008-2021).

Data collection

We collected the data from the database created at the university, SIVeULE, created for the follow-up of cases of COVID-19. This database collates the characteristics of the actors and their RT-qPCR result.

In the university there was a protocol to indicate norms and rules of (i) hygiene and preventive measures, (ii) what to do if you had symptoms, (iii) definitions of what was considered "close contact", "confinement", and " positive result ". There was support staff to collect data, deal with doubts, and assist both positive actors and confined actors. These people were called "trackers." The name defined their role because they identified the student's contacts that were positive, had symptoms, or had been "in close contact” with a positive person.

In the database, other data such as name, residence, gender, grade, name of contacts, and date and result of Polymerase Chain Reaction (PCR) test are also collected.

For the present study, the names were anonymized and registered in matrices for subsequent analysis using the SNA method.

The data obtained were used to construct a 93 × 93 matrix. The matrix was read as follows:

For rows, “A nominates B”;

For columns, “A is nominated by B”.

To carry out this study, the matrix has been symmetrized, determining that if A nominated B, B also nominated A. That is to say, it is an undirected matrix, since, if A had any contact with B, B also had contact with A.

Data analysis

For data analysis, we apply SNA to the 93 × 93 matrix. measures of centrality were applied to analyse leadership from a structural perspective. Centrality is a construct of the SNA that means the position in the network 18 . Previous researchers have applied SNA to the study of leadership, because they have conceptualized leadership as a process that starts from the collective and the interconnections 36 , 37 , 38 . For this study, the centrality measures selected were: degree, betweenness and eigenvector 18 :

The degree is the number of connections adjacent to an actor. Given the centrality of degree \({d}_{i}\) of the actor i and \({x}_{ij}\) is the cell ( i, j ) of the adjacency matrix, then

Betweenness centrality is defined as the Extent to which an actor serves as a potential “go-between” for other pairs of actors in the network by occupying an intermediary position on the shortest paths connecting other actors. The formula for the centrality of node j is given by the:

In this formula, \({g}_{ijk}\) represents the number of geodetic paths that connect i and k and through k while \({g}_{ik}\) is the total number of geodetic paths between i and k .

Eigenvector centrality corresponds to the measure of actor centrality that takes into account the centrality of the actors to whom the focal actor is connected.

Normalized measures were used.

The measures of centrality studied in the SNA have been the normalized degree (nDegree, the normalized degree centrality is the degree divided by the maximum possible degree expressed as a percentage), Eigenvector and nBetweenness (is the normalized betweenness centrality computed as the betweenness divided by the maximum possible betweenness).

To select the most leading students in the network, the measure of normalized nBetweenness was used 39 . This measure becomes more relevant during a pandemic, where the possibility of serving as a bridge or intermediary allows other networks to reach out, transferring good or bad practices and behaviors.

In order to have more information about the behaviour of the student leaders, the Egonetwork analysis of the most leading nodes for each component was carried out. Key players theory has been used to obtain this group of students displaying greater leadership 40 . Egonetwork studies the connections of a given node. This analysis in isolation is less comprehensive than the analysis of the entire network. But the researchers recommend this analysis combined with the analysis of the whole network to go deeper into the behaviour of certain nodes, depending on the objective of the research 24 , 34 , 41 .

Statistical analysis and visualisation

IBM SPSS Statistics (26.0) software. was used for the statistical processing of the data. For the analysis of descriptive data, frequencies and percentages were used for the qualitative variables, whereas the mean and standard deviation were used for the quantitative variables. A chi-square test was carried out to verify whether there was a relationship between the groups, and the Student’s t-test was used to compare the mean scores between the groups. An analysis of variance (ANOVA) was carried out to check the differences for continuous variables divided in groups. The UCINET tool, version 6.679 42 was used for the calculation of the SNA measurements. The tests carried out to study the normality of the distribution were Kolmogorov–Smirnov for populations of more than 55 individuals and the Shapiro–Wilk test for those less than or equal to 55. The level of statistical significance was set at 0.05. For qualitative analysis, a visualization of the global network will be carried out using Gephi, version 0.9.2, software. The key player tool has been used to calculate the key players of the network 43 .

As shown in Table 2 , there was a significant effect of residence on nDegree [F(3,89) = 22.135, p < 0.001] and Eigenvector [F(3,89) = 151.035, p < 0.001] and there was no significant effect of residence on nBetweenness [F = (3,89),p = 0.784].

Students in residence C have significantly higher degrees of centrality in nDegree and Eigenvector compared to the other residences. In the case of nBetweenness, students in residences A and D have higher values, although not significantly so.

Significant differences in all measures of centrality (nDegree, Eigenvector and nBetweenness) measures were found for the groups of people who tested positive for RT-qPCR (PCR +) versus those who tested negative for PCR (PCR-). The PCR + group of people had higher values of centrality than the PCR- group. The degrees of significance of these differences are shown in Table 3 .

Significant differences were found between leaders and non-leaders calculated with the three measures of centrality and the prevalence of people who tested positive or negative for PCRs. Leaders had a higher percentage of people in the PCR + group compared to non-leaders. The degrees of significance of these differences are shown in Table 4 .

Figure  1 A shows the nodes of the study network highlighting in each colour which residence each one belongs to (A,B,C or D). In Fig.  1 B the same network can be seen but the nodes with PCR + appear in red and and the nodes with PCR- in green. The distribution of the network allows us to appreciate the 4 different residences. The size of the nodes is represented by the nBetweenness of each node.

figure 1

Graphs of the university student network differentiating a colour for each residence hall ( A ) and differentiating the positive and negative PCR groups ( B) .

Figure  2 shows the network highlighting the trajectories of the three most important key players. The edges coming out of these key players are thicker than the others. Furthermore, the key players are numbered in order of importance in the network (1, 2 and 3). The size of the nodes is represented by the nBetweenness of each node.

figure 2

The network shown under the Atlas 2 distribution highlighting the 3 most important key players in the network.

Figure  3 shows the Egonetworks of the 3 key players in the network. Figure  3 A shows the most important key player in the network. If this node were eliminated, the two components would be separated (those of the C and D residence). Figure  3 B,C show the Egonetworks of the key players 2 and 3 respectively. These nodes are structurally very similar. If both nodes were removed from the network, there would no longer be a connection between residence C and residences A and B.

figure 3

Egonetworks of the 3 main key players of the network.

This research contributes empirical evidence based on a social network approach to the development of the COVID-19 pandemic on university halls of residence. We have presented a study strategy and results, which link the relationship between the centrality of leaders and the outcome of pandemic infection. There is a significant core of research using the SNA methodology applied to the COVID-19 pandemic. However, there is a lack of research focusing on the structural responses of university students, a population of particular interest given their training experience. A university student "absorbs" experiences that are translated into behaviour, and transfers the resources obtained through their relationships.

Our results demonstrate the relationship between the centrality in the network of student leaders and the outcome of their infection (positive or negative). Not only could leaders spread pandemic behaviour towards their more local peers, they also seem to spread it to other halls of residence. This is demonstrated by the structure of betweenness. Leaders with a higher degree of betweenness could become key players, so that their presence or absence can disconnect the various components of the entire network. This could lead to a disconnection of the contagion process, both on a positive and negative level. The findings are the first to demonstrate that networks in university accommodation develop successful or unsuccessful responses to a pandemic. University managers should take these findings into account when developing response and behavioural strategies in pandemic or disaster situations. Strategies should be designed with a network rather than an individual approach.

Although our study did not ask about the relationship between the actors, we understand that the contacts established between the students are relationships of friendship or good classmates. We only analysed whether or not people had been in contact, during a state of lockdown. But obviously, with the SNA, we can visualise relational behaviours that would be more difficult to appreciate using other methodologies.

Our results show that student leaders have a high degree of centrality not only at the local level, i.e. in the component related to their accommodation, but also at the level of the global network. Our results are in line with studies of Mehra et al. 36 , who highlighted that the integration of a leader into the friendship network in one social circle can be related to the reputation of the leader in other social circles.

Leadership or reputation at the local level is related to the performance of the team, and leadership outside the team is what allows new opportunities to arise and new information to be disseminated 36 . In the case of university students in their accommodation, the aim is to have a friendly atmosphere and to collaborate in difficult moments, to motivate each other, etc. Our results shown a statistically significant relationship between leadership and the positive results of the COVID-19 tests. In this sense, previous studies have already found that having too many resources related to social capital in a group (such as centrality) could negatively affect the efficiency of the group 44 . In other words, the leader will exert an influence on his or her colleagues and this influence could "infect" a certain behaviour, in this case of responsibility or not in a state of health emergency.

Another aspect demonstrated in our research is that there is a similarity between student groupings in terms of their COVID-19 test results. That is, we observe groups where the results are all positive (nodes in red), and others where the results are negative (nodes in green). This finding, could be related to numerous previous studies where actors occupy similar social positions in the classroom. For example, the studies from 45 showed that stuttering students had the same social position as the rest of their peers, because both (stutterers and non-stutterers) tended to design their groups structurally the same.

Homophily theory indicates that individuals associate with those with whom they share aspects of similarity, such as similar beliefs, characteristics and behaviours, which occurs especially in young people and adolescents 46 Therefore, this may partly justify why negative-test college students are more cohesive, and positive-test college students as well.

One of the measures implemented with the greatest impact in this COVID-19 pandemic has been social distancing or isolation. The closure of premises or the reduction in hours of places of leisure has led to this social, or rather physical, distancing, as it is physical contact that is avoided. Studies have shown that the reduction in contacts based on social networks that coexist in social bubbles, and the similarity between contacts, increase social distancing from other actors, and therefore decrease the risks of contagion 47 . But in the case of this research, university accommodation could not be considered as a bubble. We could think of them as big bubbles, where behavioural patterns become contagious, be they positive and negative ones. Therefore, in this sense, the directors of the centres should take note and plan different strategies according to the behaviour of the subnetworks. That is to say, promote those behaviours with negative results of contagion and intervene in those subnetworks with positive results. For this, and as explained previously, the best option would be to plan together with the leaders.

Our results have shown that students with a high degree of Betweenness have a position in the network that gives them great leadership. In this sense, previous studies have used this structural metric as a predictor of leadership due to the strategic position that the actors have in the network and their role in bridging different networks 39 , 48 .

For a better understanding of the role of these actors, in this research we analyse these university students on the basis of two more structural issues. On the one hand, which of them could have a key player role. Secondly, to analyse the Egonetwork of those students with a greater degree of centrality in each of the components.

As regards key players, our results showed that 3 students with a high degree of betweenness, i.e. with an intermediary role, had a key player structure. The importance of the key actor has been explained perfectly by Borgatti (2006) 40 , describing both the negative and positive aspects. The negative is that the network, or networks, actually depend on these nodes, and cohesion between the networks would be diminished if these actors were to disappear 40 . This problem is greater when, in a public health context, we select a small number of individuals to contain a pandemic or to reduce the risk of contagion that links different networks. If these actors disappeared, the number of those infected would increase. As regards the positive role of these actors, they are ideal for spreading attitudes and behaviour, because they quickly gain access to different networks. Borgatti (2006) explains the importance of the structure of the key players, with the same relevance in very different contexts, such as terrorist networks or pandemic contexts 40 . In our case, our results are supported by the justification of this great researcher.

Our findings have shown that student leaders with a higher degree of Betweenness had a higher density than their peers in their Egonetworks . This could facilitate the transmission of social capital in a context such as the COVID-19 pandemic. These students, who serve as bridges, could become key actors with the ability to mobilize and coordinate social activity 49 . Their role is key for other colleagues, since they could serve as a "mirror" to "invite" appropriate behaviors in a health emergency. The key question that remains is, what behavior do they have? Structurally, the present investigation has demonstrated and justified that its position in the network is a model that could be disseminated among the rest of the actors.

To summarize the above, those responsible for universities must take into account the collective behavior of its networks. In a context such as the COVID-19 pandemic, the diffusion of behaviors is very relevant. Authors call for “urban intelligence” as a possible strategy to deal effectively with a pandemic. They understand that the impact of a health emergency is more than just a public health problem since it involves social risks and instability. This situation would be better dealt with by having the best that the social and community structure can offer, the so-called "urban intelligence” 50 .

SNA could provide a set of terms and concepts to explain and describe social phenomena 51 . The method offers a distinctive approach to analysing leadership in disaster processes. Leaders could be like "builders" of social responses and the managers of the universities should take it into account for the intervention processes.

The most important limitations of this study should be considered for future research. For example, it would be of interest to carry out other analyzes focused more on the cohesion of the network and the behavior of the subgroups, in order to draw structural conclusions at the micro level. Future lines of research could focus on comparing the students’ leadership in terms of structure with leadership as perceived by both them and their own peers.


The present research has carried out a study with students in university residences. The aim has been to describe the structural behaviour of students in university residences during the COVID-19 pandemic, with a more in-depth analysis of student leaders. The specific objectives proposed to develop the research were to: (i) analyse the relationship between the position of students in the network and their results with respect to COVID-19 infection, (ii) describe the position of influence of student leaders in the network, (iii) analyzing the Egonetwork of the most influential student leaders on the COVID-19 pandemic, and (iv) visualise the relational behaviour of university students in the global network.

The main conclusions derived from the results are detailed below:

The most central students in the network, had more positive results regarding COVID-19 infection.

The leadership of the confined students was related to higher degree, eigenvector and betweenness.

A small core of leaders are key players, so their role conditions the connection or disconnection between different components of the global network.

Students with a key player structure show a similar Egonetwork if they belong to the same residence.

There is a student leader with the maximum key player power structure, causing a total disconnection between networks if he/she disappears from the global network.

The findings show that strategies to cope with a disaster or pandemic need to be addressed through a network approach. University managers will need to have a profound understanding of students' relational behaviour. Only then will the most restrictive measures be effective. Responsible or irresponsible behaviour is transferred through the connections between students, so Social Network Analysis should be considered as a method of analyzing the evolution of a pandemic at the societal level. Any crisis involves contacts, but in a pandemic, contacts can transfer infection. Also in a pandemic, contacts can transfer habits and behaviours "passed on" by leaders, so that they allow for more effective coping. All of this can be analysed using SNA. Our study provides findings with an innovative approach, achieved with SNA. Among the limitations of the study it should be noted that the sample is very small (n = 93). This means that we cannot state categorically the representativeness of the results presented. However, the results could be used for future research where it is useful to analyse health emergency contexts as a network rather than analysing individuals in isolation.

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V.M. and T.F.-V. conceived the project. J.A.B.-A., P.M.-S. and C.B. performed the analytical calculations. A.G.-S., and J.A.B.-A. performed all the numerical calculations. J.A.B.-A. and P.M.-S. wrote a first draft of the manuscript. All authors reviewed and edited the manuscript.

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Enrich your students’ educational experience with case-based teaching

The NCCSTS Case Collection, created and curated by the National Center for Case Study Teaching in Science, on behalf of the University at Buffalo, contains nearly a thousand peer-reviewed case studies on a variety of topics in all areas of science.

Cases (only) are freely accessible; subscription is required for access to teaching notes and answer keys.

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Development of the NCCSTS Case Collection was originally funded by major grants to the University at Buffalo from the National Science Foundation , The Pew Charitable Trusts , and the U.S. Department of Education .

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Case studies.

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Case studies are stories that are used as a teaching tool to show the application of a theory or concept to real situations. Dependent on the goal they are meant to fulfill, cases can be fact-driven and deductive where there is a correct answer, or they can be context driven where multiple solutions are possible. Various disciplines have employed case studies, including humanities, social sciences, sciences, engineering, law, business, and medicine. Good cases generally have the following features: they tell a good story, are recent, include dialogue, create empathy with the main characters, are relevant to the reader, serve a teaching function, require a dilemma to be solved, and have generality.

Instructors can create their own cases or can find cases that already exist. The following are some things to keep in mind when creating a case:

  • What do you want students to learn from the discussion of the case?
  • What do they already know that applies to the case?
  • What are the issues that may be raised in discussion?
  • How will the case and discussion be introduced?
  • What preparation is expected of students? (Do they need to read the case ahead of time? Do research? Write anything?)
  • What directions do you need to provide students regarding what they are supposed to do and accomplish?
  • Do you need to divide students into groups or will they discuss as the whole class?
  • Are you going to use role-playing or facilitators or record keepers? If so, how?
  • What are the opening questions?
  • How much time is needed for students to discuss the case?
  • What concepts are to be applied/extracted during the discussion?
  • How will you evaluate students?

To find other cases that already exist, try the following websites:

  • The National Center for Case Study Teaching in Science , University of Buffalo. SUNY-Buffalo maintains this set of links to other case studies on the web in disciplines ranging from engineering and ethics to sociology and business
  • A Journal of Teaching Cases in Public Administration and Public Policy , University of Washington

For more information:

  • World Association for Case Method Research and Application

Book Review :  Teaching and the Case Method , 3rd ed., vols. 1 and 2, by Louis Barnes, C. Roland (Chris) Christensen, and Abby Hansen. Harvard Business School Press, 1994; 333 pp. (vol 1), 412 pp. (vol 2).

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Definition and Introduction

Case analysis is a problem-based teaching and learning method that involves critically analyzing complex scenarios within an organizational setting for the purpose of placing the student in a “real world” situation and applying reflection and critical thinking skills to contemplate appropriate solutions, decisions, or recommended courses of action. It is considered a more effective teaching technique than in-class role playing or simulation activities. The analytical process is often guided by questions provided by the instructor that ask students to contemplate relationships between the facts and critical incidents described in the case.

Cases generally include both descriptive and statistical elements and rely on students applying abductive reasoning to develop and argue for preferred or best outcomes [i.e., case scenarios rarely have a single correct or perfect answer based on the evidence provided]. Rather than emphasizing theories or concepts, case analysis assignments emphasize building a bridge of relevancy between abstract thinking and practical application and, by so doing, teaches the value of both within a specific area of professional practice.

Given this, the purpose of a case analysis paper is to present a structured and logically organized format for analyzing the case situation. It can be assigned to students individually or as a small group assignment and it may include an in-class presentation component. Case analysis is predominately taught in economics and business-related courses, but it is also a method of teaching and learning found in other applied social sciences disciplines, such as, social work, public relations, education, journalism, and public administration.

Ellet, William. The Case Study Handbook: A Student's Guide . Revised Edition. Boston, MA: Harvard Business School Publishing, 2018; Christoph Rasche and Achim Seisreiner. Guidelines for Business Case Analysis . University of Potsdam; Writing a Case Analysis . Writing Center, Baruch College; Volpe, Guglielmo. "Case Teaching in Economics: History, Practice and Evidence." Cogent Economics and Finance 3 (December 2015). doi:

How to Approach Writing a Case Analysis Paper

The organization and structure of a case analysis paper can vary depending on the organizational setting, the situation, and how your professor wants you to approach the assignment. Nevertheless, preparing to write a case analysis paper involves several important steps. As Hawes notes, a case analysis assignment “ useful in developing the ability to get to the heart of a problem, analyze it thoroughly, and to indicate the appropriate solution as well as how it should be implemented” [p.48]. This statement encapsulates how you should approach preparing to write a case analysis paper.

Before you begin to write your paper, consider the following analytical procedures:

  • Review the case to get an overview of the situation . A case can be only a few pages in length, however, it is most often very lengthy and contains a significant amount of detailed background information and statistics, with multilayered descriptions of the scenario, the roles and behaviors of various stakeholder groups, and situational events. Therefore, a quick reading of the case will help you gain an overall sense of the situation and illuminate the types of issues and problems that you will need to address in your paper. If your professor has provided questions intended to help frame your analysis, use them to guide your initial reading of the case.
  • Read the case thoroughly . After gaining a general overview of the case, carefully read the content again with the purpose of understanding key circumstances, events, and behaviors among stakeholder groups. Look for information or data that appears contradictory, extraneous, or misleading. At this point, you should be taking notes as you read because this will help you develop a general outline of your paper. The aim is to obtain a complete understanding of the situation so that you can begin contemplating tentative answers to any questions your professor has provided or, if they have not provided, developing answers to your own questions about the case scenario and its connection to the course readings,lectures, and class discussions.
  • Determine key stakeholder groups, issues, and events and the relationships they all have to each other . As you analyze the content, pay particular attention to identifying individuals, groups, or organizations described in the case and identify evidence of any problems or issues of concern that impact the situation in a negative way. Other things to look for include identifying any assumptions being made by or about each stakeholder, potential biased explanations or actions, explicit demands or ultimatums , and the underlying concerns that motivate these behaviors among stakeholders. The goal at this stage is to develop a comprehensive understanding of the situational and behavioral dynamics of the case and the explicit and implicit consequences of each of these actions.
  • Identify the core problems . The next step in most case analysis assignments is to discern what the core [i.e., most damaging, detrimental, injurious] problems are within the organizational setting and to determine their implications. The purpose at this stage of preparing to write your analysis paper is to distinguish between the symptoms of core problems and the core problems themselves and to decide which of these must be addressed immediately and which problems do not appear critical but may escalate over time. Identify evidence from the case to support your decisions by determining what information or data is essential to addressing the core problems and what information is not relevant or is misleading.
  • Explore alternative solutions . As noted, case analysis scenarios rarely have only one correct answer. Therefore, it is important to keep in mind that the process of analyzing the case and diagnosing core problems, while based on evidence, is a subjective process open to various avenues of interpretation. This means that you must consider alternative solutions or courses of action by critically examining strengths and weaknesses, risk factors, and the differences between short and long-term solutions. For each possible solution or course of action, consider the consequences they may have related to their implementation and how these recommendations might lead to new problems. Also, consider thinking about your recommended solutions or courses of action in relation to issues of fairness, equity, and inclusion.
  • Decide on a final set of recommendations . The last stage in preparing to write a case analysis paper is to assert an opinion or viewpoint about the recommendations needed to help resolve the core problems as you see them and to make a persuasive argument for supporting this point of view. Prepare a clear rationale for your recommendations based on examining each element of your analysis. Anticipate possible obstacles that could derail their implementation. Consider any counter-arguments that could be made concerning the validity of your recommended actions. Finally, describe a set of criteria and measurable indicators that could be applied to evaluating the effectiveness of your implementation plan.

Use these steps as the framework for writing your paper. Remember that the more detailed you are in taking notes as you critically examine each element of the case, the more information you will have to draw from when you begin to write. This will save you time.

NOTE : If the process of preparing to write a case analysis paper is assigned as a student group project, consider having each member of the group analyze a specific element of the case, including drafting answers to the corresponding questions used by your professor to frame the analysis. This will help make the analytical process more efficient and ensure that the distribution of work is equitable. This can also facilitate who is responsible for drafting each part of the final case analysis paper and, if applicable, the in-class presentation.

Framework for Case Analysis . College of Management. University of Massachusetts; Hawes, Jon M. "Teaching is Not Telling: The Case Method as a Form of Interactive Learning." Journal for Advancement of Marketing Education 5 (Winter 2004): 47-54; Rasche, Christoph and Achim Seisreiner. Guidelines for Business Case Analysis . University of Potsdam; Writing a Case Study Analysis . University of Arizona Global Campus Writing Center; Van Ness, Raymond K. A Guide to Case Analysis . School of Business. State University of New York, Albany; Writing a Case Analysis . Business School, University of New South Wales.

Structure and Writing Style

A case analysis paper should be detailed, concise, persuasive, clearly written, and professional in tone and in the use of language . As with other forms of college-level academic writing, declarative statements that convey information, provide a fact, or offer an explanation or any recommended courses of action should be based on evidence. If allowed by your professor, any external sources used to support your analysis, such as course readings, should be properly cited under a list of references. The organization and structure of case analysis papers can vary depending on your professor’s preferred format, but its structure generally follows the steps used for analyzing the case.


The introduction should provide a succinct but thorough descriptive overview of the main facts, issues, and core problems of the case . The introduction should also include a brief summary of the most relevant details about the situation and organizational setting. This includes defining the theoretical framework or conceptual model on which any questions were used to frame your analysis.

Following the rules of most college-level research papers, the introduction should then inform the reader how the paper will be organized. This includes describing the major sections of the paper and the order in which they will be presented. Unless you are told to do so by your professor, you do not need to preview your final recommendations in the introduction. U nlike most college-level research papers , the introduction does not include a statement about the significance of your findings because a case analysis assignment does not involve contributing new knowledge about a research problem.

Background Analysis

Background analysis can vary depending on any guiding questions provided by your professor and the underlying concept or theory that the case is based upon. In general, however, this section of your paper should focus on:

  • Providing an overarching analysis of problems identified from the case scenario, including identifying events that stakeholders find challenging or troublesome,
  • Identifying assumptions made by each stakeholder and any apparent biases they may exhibit,
  • Describing any demands or claims made by or forced upon key stakeholders, and
  • Highlighting any issues of concern or complaints expressed by stakeholders in response to those demands or claims.

These aspects of the case are often in the form of behavioral responses expressed by individuals or groups within the organizational setting. However, note that problems in a case situation can also be reflected in data [or the lack thereof] and in the decision-making, operational, cultural, or institutional structure of the organization. Additionally, demands or claims can be either internal and external to the organization [e.g., a case analysis involving a president considering arms sales to Saudi Arabia could include managing internal demands from White House advisors as well as demands from members of Congress].

Throughout this section, present all relevant evidence from the case that supports your analysis. Do not simply claim there is a problem, an assumption, a demand, or a concern; tell the reader what part of the case informed how you identified these background elements.

Identification of Problems

In most case analysis assignments, there are problems, and then there are problems . Each problem can reflect a multitude of underlying symptoms that are detrimental to the interests of the organization. The purpose of identifying problems is to teach students how to differentiate between problems that vary in severity, impact, and relative importance. Given this, problems can be described in three general forms: those that must be addressed immediately, those that should be addressed but the impact is not severe, and those that do not require immediate attention and can be set aside for the time being.

All of the problems you identify from the case should be identified in this section of your paper, with a description based on evidence explaining the problem variances. If the assignment asks you to conduct research to further support your assessment of the problems, include this in your explanation. Remember to cite those sources in a list of references. Use specific evidence from the case and apply appropriate concepts, theories, and models discussed in class or in relevant course readings to highlight and explain the key problems [or problem] that you believe must be solved immediately and describe the underlying symptoms and why they are so critical.

Alternative Solutions

This section is where you provide specific, realistic, and evidence-based solutions to the problems you have identified and make recommendations about how to alleviate the underlying symptomatic conditions impacting the organizational setting. For each solution, you must explain why it was chosen and provide clear evidence to support your reasoning. This can include, for example, course readings and class discussions as well as research resources, such as, books, journal articles, research reports, or government documents. In some cases, your professor may encourage you to include personal, anecdotal experiences as evidence to support why you chose a particular solution or set of solutions. Using anecdotal evidence helps promote reflective thinking about the process of determining what qualifies as a core problem and relevant solution .

Throughout this part of the paper, keep in mind the entire array of problems that must be addressed and describe in detail the solutions that might be implemented to resolve these problems.

Recommended Courses of Action

In some case analysis assignments, your professor may ask you to combine the alternative solutions section with your recommended courses of action. However, it is important to know the difference between the two. A solution refers to the answer to a problem. A course of action refers to a procedure or deliberate sequence of activities adopted to proactively confront a situation, often in the context of accomplishing a goal. In this context, proposed courses of action are based on your analysis of alternative solutions. Your description and justification for pursuing each course of action should represent the overall plan for implementing your recommendations.

For each course of action, you need to explain the rationale for your recommendation in a way that confronts challenges, explains risks, and anticipates any counter-arguments from stakeholders. Do this by considering the strengths and weaknesses of each course of action framed in relation to how the action is expected to resolve the core problems presented, the possible ways the action may affect remaining problems, and how the recommended action will be perceived by each stakeholder.

In addition, you should describe the criteria needed to measure how well the implementation of these actions is working and explain which individuals or groups are responsible for ensuring your recommendations are successful. In addition, always consider the law of unintended consequences. Outline difficulties that may arise in implementing each course of action and describe how implementing the proposed courses of action [either individually or collectively] may lead to new problems [both large and small].

Throughout this section, you must consider the costs and benefits of recommending your courses of action in relation to uncertainties or missing information and the negative consequences of success.

The conclusion should be brief and introspective. Unlike a research paper, the conclusion in a case analysis paper does not include a summary of key findings and their significance, a statement about how the study contributed to existing knowledge, or indicate opportunities for future research.

Begin by synthesizing the core problems presented in the case and the relevance of your recommended solutions. This can include an explanation of what you have learned about the case in the context of your answers to the questions provided by your professor. The conclusion is also where you link what you learned from analyzing the case with the course readings or class discussions. This can further demonstrate your understanding of the relationships between the practical case situation and the theoretical and abstract content of assigned readings and other course content.

Problems to Avoid

The literature on case analysis assignments often includes examples of difficulties students have with applying methods of critical analysis and effectively reporting the results of their assessment of the situation. A common reason cited by scholars is that the application of this type of teaching and learning method is limited to applied fields of social and behavioral sciences and, as a result, writing a case analysis paper can be unfamiliar to most students entering college.

After you have drafted your paper, proofread the narrative flow and revise any of these common errors:

  • Unnecessary detail in the background section . The background section should highlight the essential elements of the case based on your analysis. Focus on summarizing the facts and highlighting the key factors that become relevant in the other sections of the paper by eliminating any unnecessary information.
  • Analysis relies too much on opinion . Your analysis is interpretive, but the narrative must be connected clearly to evidence from the case and any models and theories discussed in class or in course readings. Any positions or arguments you make should be supported by evidence.
  • Analysis does not focus on the most important elements of the case . Your paper should provide a thorough overview of the case. However, the analysis should focus on providing evidence about what you identify are the key events, stakeholders, issues, and problems. Emphasize what you identify as the most critical aspects of the case to be developed throughout your analysis. Be thorough but succinct.
  • Writing is too descriptive . A paper with too much descriptive information detracts from your analysis of the complexities of the case situation. Questions about what happened, where, when, and by whom should only be included as essential information leading to your examination of questions related to why, how, and for what purpose.
  • Inadequate definition of a core problem and associated symptoms . A common error found in case analysis papers is recommending a solution or course of action without adequately defining or demonstrating that you understand the problem. Make sure you have clearly described the problem and its impact and scope within the organizational setting. Ensure that you have adequately described the root causes w hen describing the symptoms of the problem.
  • Recommendations lack specificity . Identify any use of vague statements and indeterminate terminology, such as, “A particular experience” or “a large increase to the budget.” These statements cannot be measured and, as a result, there is no way to evaluate their successful implementation. Provide specific data and use direct language in describing recommended actions.
  • Unrealistic, exaggerated, or unattainable recommendations . Review your recommendations to ensure that they are based on the situational facts of the case. Your recommended solutions and courses of action must be based on realistic assumptions and fit within the constraints of the situation. Also note that the case scenario has already happened, therefore, any speculation or arguments about what could have occurred if the circumstances were different should be revised or eliminated.

Bee, Lian Song et al. "Business Students' Perspectives on Case Method Coaching for Problem-Based Learning: Impacts on Student Engagement and Learning Performance in Higher Education." Education & Training 64 (2022): 416-432; The Case Analysis . Fred Meijer Center for Writing and Michigan Authors. Grand Valley State University; Georgallis, Panikos and Kayleigh Bruijn. "Sustainability Teaching using Case-Based Debates." Journal of International Education in Business 15 (2022): 147-163; Hawes, Jon M. "Teaching is Not Telling: The Case Method as a Form of Interactive Learning." Journal for Advancement of Marketing Education 5 (Winter 2004): 47-54; Georgallis, Panikos, and Kayleigh Bruijn. "Sustainability Teaching Using Case-based Debates." Journal of International Education in Business 15 (2022): 147-163; .Dean,  Kathy Lund and Charles J. Fornaciari. "How to Create and Use Experiential Case-Based Exercises in a Management Classroom." Journal of Management Education 26 (October 2002): 586-603; Klebba, Joanne M. and Janet G. Hamilton. "Structured Case Analysis: Developing Critical Thinking Skills in a Marketing Case Course." Journal of Marketing Education 29 (August 2007): 132-137, 139; Klein, Norman. "The Case Discussion Method Revisited: Some Questions about Student Skills." Exchange: The Organizational Behavior Teaching Journal 6 (November 1981): 30-32; Mukherjee, Arup. "Effective Use of In-Class Mini Case Analysis for Discovery Learning in an Undergraduate MIS Course." The Journal of Computer Information Systems 40 (Spring 2000): 15-23; Pessoa, Silviaet al. "Scaffolding the Case Analysis in an Organizational Behavior Course: Making Analytical Language Explicit." Journal of Management Education 46 (2022): 226-251: Ramsey, V. J. and L. D. Dodge. "Case Analysis: A Structured Approach." Exchange: The Organizational Behavior Teaching Journal 6 (November 1981): 27-29; Schweitzer, Karen. "How to Write and Format a Business Case Study." ThoughtCo. (accessed December 5, 2022); Reddy, C. D. "Teaching Research Methodology: Everything's a Case." Electronic Journal of Business Research Methods 18 (December 2020): 178-188; Volpe, Guglielmo. "Case Teaching in Economics: History, Practice and Evidence." Cogent Economics and Finance 3 (December 2015). doi:

Writing Tip

Ca se Study and Case Analysis Are Not the Same!

Confusion often exists between what it means to write a paper that uses a case study research design and writing a paper that analyzes a case; they are two different types of approaches to learning in the social and behavioral sciences. Professors as well as educational researchers contribute to this confusion because they often use the term "case study" when describing the subject of analysis for a case analysis paper. But you are not studying a case for the purpose of generating a comprehensive, multi-faceted understanding of a research problem. R ather, you are critically analyzing a specific scenario to argue logically for recommended solutions and courses of action that lead to optimal outcomes applicable to professional practice.

To avoid any confusion, here are twelve characteristics that delineate the differences between writing a paper using the case study research method and writing a case analysis paper:

  • Case study is a method of in-depth research and rigorous inquiry ; case analysis is a reliable method of teaching and learning . A case study is a modality of research that investigates a phenomenon for the purpose of creating new knowledge, solving a problem, or testing a hypothesis using empirical evidence derived from the case being studied. Often, the results are used to generalize about a larger population or within a wider context. The writing adheres to the traditional standards of a scholarly research study. A case analysis is a pedagogical tool used to teach students how to reflect and think critically about a practical, real-life problem in an organizational setting.
  • The researcher is responsible for identifying the case to study; a case analysis is assigned by your professor . As the researcher, you choose the case study to investigate in support of obtaining new knowledge and understanding about the research problem. The case in a case analysis assignment is almost always provided, and sometimes written, by your professor and either given to every student in class to analyze individually or to a small group of students, or students select a case to analyze from a predetermined list.
  • A case study is indeterminate and boundless; a case analysis is predetermined and confined . A case study can be almost anything [see item 9 below] as long as it relates directly to examining the research problem. This relationship is the only limit to what a researcher can choose as the subject of their case study. The content of a case analysis is determined by your professor and its parameters are well-defined and limited to elucidating insights of practical value applied to practice.
  • Case study is fact-based and describes actual events or situations; case analysis can be entirely fictional or adapted from an actual situation . The entire content of a case study must be grounded in reality to be a valid subject of investigation in an empirical research study. A case analysis only needs to set the stage for critically examining a situation in practice and, therefore, can be entirely fictional or adapted, all or in-part, from an actual situation.
  • Research using a case study method must adhere to principles of intellectual honesty and academic integrity; a case analysis scenario can include misleading or false information . A case study paper must report research objectively and factually to ensure that any findings are understood to be logically correct and trustworthy. A case analysis scenario may include misleading or false information intended to deliberately distract from the central issues of the case. The purpose is to teach students how to sort through conflicting or useless information in order to come up with the preferred solution. Any use of misleading or false information in academic research is considered unethical.
  • Case study is linked to a research problem; case analysis is linked to a practical situation or scenario . In the social sciences, the subject of an investigation is most often framed as a problem that must be researched in order to generate new knowledge leading to a solution. Case analysis narratives are grounded in real life scenarios for the purpose of examining the realities of decision-making behavior and processes within organizational settings. A case analysis assignments include a problem or set of problems to be analyzed. However, the goal is centered around the act of identifying and evaluating courses of action leading to best possible outcomes.
  • The purpose of a case study is to create new knowledge through research; the purpose of a case analysis is to teach new understanding . Case studies are a choice of methodological design intended to create new knowledge about resolving a research problem. A case analysis is a mode of teaching and learning intended to create new understanding and an awareness of uncertainty applied to practice through acts of critical thinking and reflection.
  • A case study seeks to identify the best possible solution to a research problem; case analysis can have an indeterminate set of solutions or outcomes . Your role in studying a case is to discover the most logical, evidence-based ways to address a research problem. A case analysis assignment rarely has a single correct answer because one of the goals is to force students to confront the real life dynamics of uncertainly, ambiguity, and missing or conflicting information within professional practice. Under these conditions, a perfect outcome or solution almost never exists.
  • Case study is unbounded and relies on gathering external information; case analysis is a self-contained subject of analysis . The scope of a case study chosen as a method of research is bounded. However, the researcher is free to gather whatever information and data is necessary to investigate its relevance to understanding the research problem. For a case analysis assignment, your professor will often ask you to examine solutions or recommended courses of action based solely on facts and information from the case.
  • Case study can be a person, place, object, issue, event, condition, or phenomenon; a case analysis is a carefully constructed synopsis of events, situations, and behaviors . The research problem dictates the type of case being studied and, therefore, the design can encompass almost anything tangible as long as it fulfills the objective of generating new knowledge and understanding. A case analysis is in the form of a narrative containing descriptions of facts, situations, processes, rules, and behaviors within a particular setting and under a specific set of circumstances.
  • Case study can represent an open-ended subject of inquiry; a case analysis is a narrative about something that has happened in the past . A case study is not restricted by time and can encompass an event or issue with no temporal limit or end. For example, the current war in Ukraine can be used as a case study of how medical personnel help civilians during a large military conflict, even though circumstances around this event are still evolving. A case analysis can be used to elicit critical thinking about current or future situations in practice, but the case itself is a narrative about something finite and that has taken place in the past.
  • Multiple case studies can be used in a research study; case analysis involves examining a single scenario . Case study research can use two or more cases to examine a problem, often for the purpose of conducting a comparative investigation intended to discover hidden relationships, document emerging trends, or determine variations among different examples. A case analysis assignment typically describes a stand-alone, self-contained situation and any comparisons among cases are conducted during in-class discussions and/or student presentations.

The Case Analysis . Fred Meijer Center for Writing and Michigan Authors. Grand Valley State University; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Ramsey, V. J. and L. D. Dodge. "Case Analysis: A Structured Approach." Exchange: The Organizational Behavior Teaching Journal 6 (November 1981): 27-29; Yin, Robert K. Case Study Research and Applications: Design and Methods . 6th edition. Thousand Oaks, CA: Sage, 2017; Crowe, Sarah et al. “The Case Study Approach.” BMC Medical Research Methodology 11 (2011):  doi: 10.1186/1471-2288-11-100; Yin, Robert K. Case Study Research: Design and Methods . 4th edition. Thousand Oaks, CA: Sage Publishing; 1994.

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Writing a case study

What is a case study.

A case study requires you to analyse a specific situation and discuss how its different elements relate to theory. The case can refer to a real-life or hypothetical event, organisation, individual or group of people and/or issue. Depending upon your assignment, you will be asked to develop solutions to problems or recommendations for future action.

Generally, a case study is either formatted as an essay or a report. If it is the latter, your assignment is often divided into sections with headings and subheadings to ensure easy access to key points of interest.

There are different approaches to case studies, so always check the specific instructions you have been given. There are two main types of case studies: descriptive and problem-solving .

Case study types accordion

Descriptive case studies.

  • ask you to explore a specific event or issue to identify the key facts, what happened and who was/is involved.
  • can be used to compare two instances of an event to illustrate how one is similar to the other.
  • generally does not include solutions or recommendations as its main purpose is to help the reader or stakeholder to gain greater insight into the different dimensions of the event, etc. and/or to make an informed decision about the event, etc.

For example:

  • In Nursing, you could be asked to select a medical clinic or hospital as your case study and then apply what you have studied in class about wound care approaches. You would then identify and apply the relevant theories of wound care management discussed in class to your case.

Problem-solving case studies

  • ask you to critically examine an issue related to a specific individual or group, and then recommend and justify solutions to the issue, integrating theory and practice.
  • In Business and Economics, you could be asked to describe a critical incident in the workplace. Your role as the manager is to apply your knowledge and skills of key intercultural communication concepts and theories in management to determine the causes of the conflict and propose relevant communication strategies to avoid and/or resolve it.

Tips for undertaking a problem-based case study View

Writing to your audience.

Your language expression should be persuasive and user-centred communication. To do this, you need to carefully research your audience, or your stakeholders . Your stakeholders are not only those people who will read your writing, but also people who will be impacted by any decisions or recommendations you choose to include. In other words, your audience may be varied with different needs and perspectives. This applies to both your case study as an assessment task and a report in your workplace.

Understanding your audience will help you to edit how you express your information, including tailoring your language expression, tone and style to meet the expectations of your stakeholders. For example, if your case study is written for the Minister of Health, then your tone will need to be formal, ensuring that any technical terms are clearly and concisely explained with concrete examples.

Questions to ask yourself:

  • Who will read my case study and why?
  • What are the stakeholders’ needs, preferences, expectations and goals?
  • How can I write clearly and concisely for this particular audience?
  • How will the stakeholders use my case study in their work?
  • What are the relevant technical terms and have I explained them in clear and concise language?

Writing up your case study

If your case study is in the form of a report, you can divide it into 8 main sections, as outlined below. However, these vary depending on discipline-specific requirements and assessment criteria.

1. Executive Summary/Synopsis

  • Introduce the topic area of the report.
  • Outline the purpose of the case study.
  • Outline the key issue(s) and finding(s) without the specific details.
  • Identify the theory used.
  • Summarise recommendations.

2. Introduction

  • Summarise the your task
  • Briefly outline the case to identify its significance.
  • State the report's aim(s).
  • Provide the organisation of the main ideas in the report.
  • Briefly describe the key problem and its significance (You usually do not need to provide details of findings or recommendations. However, it is best to first check your assessment task instructions.)

3. Findings

  • presenting the central issue(s) under analysis,
  • providing your reasoning for your choices such as supporting your findings with facts given in the case, the relevant theory and course concepts
  • highlighting any underlying problems.
  • Identify and justify your methodology and analytical tools.This might not be applicable to your assessment, so you will need to check your assessment instructions.

This section is often divided into sub-sections. Your headings and subheadings need to be ​​informative and concise as they act as a guide for the reader to the contents of that section.

4. Discussion

  • Summarise the major problem(s).
  • Identify alternative solutions to these major problem(s).
  • Briefly outline each alternative solution where necessary and evaluate the advantages and disadvantages.
  • Depending on your assessment criteria, you might need to refer to theory or professional practice here.

Note that as a case study is based on a specific situation, it is difficult to generalise your findings to other situations. Make sure that your discussion focuses on your case and what can be learnt from your specific case analysis for your stakeholders.

5. Conclusion

  • Restate the purpose of the report
  • Sum up the main points from the findings, discussion and recommendations.
  • Restate the limitations if required.

6. Recommendations

  • Choose which of the alternative solutions should be adopted.
  • Briefly justify your choice, explaining how it will solve the major problem/s.
  • Remember to integrate theory and practice as discussed in your unit with respect to the case.
  • If needed, suggest an action plan, including who should take action, when and what steps, and how to assess the action taken.
  • If appropriate include a rough estimate of costs (both financial and time).

This section is sometimes divided into Recommendations and Implementation with details of the action plan placed in the Implementation section.

Recommendations should be written in a persuasive, audience-centred style that communicates your suggestions clearly, concisely and precisely .

7. References

  • List in alphabetical order all the references cited in the report.
  • Make sure to accurately format your references according to the specified referencing style for your unit.

8. Appendices (if any)

  • Attach any original data that relates to your analysis and the case but which would have interrupted the flow of the main body.

Reference list

Ivančević-Otanjac, M., & Milojević, I. (2015). Writing a case report in English. Srpski arhiv za celokupno lekarstvo , 143 (1-2), 116-118.

Take it further

Buseco: report writing.

This resource is designed to assist you in completing a business report. It provides a guide to approaching and structuring your report and includes annotated examples with written feedback.

Engineering: Lab report

This resource expands on the general report structure and provides useful tips and examples on how to turn practical work and lab experiments into a written lab report.

Engineering: Technical report

This resource expands on the general report structure and provides useful tips and examples on how to write a report for key stakeholders, using experimental and practical data.

This resource provides information about what reports look like in IT, and how you might consider structuring your IT report. It includes student samples for each possible section of an IT report, along with video and written feedback.

MNHS: Health sciences case report

This resource provides a guide to approaching and structuring a patient-based case report. It includes an annotated example with written feedback.

MNHS: Comparative report

This resource is designed to assist you in completing your Comparative Report [CR] for Integrating Science and Practice [iSAP] assessment tasks. It provides a guide to approaching and structuring your report and includes an annotated example with written feedback.

MNHS: Psychology case report

This resource provides detailed guidance on the structure and content of the psychology case report, with numerous examples from the recommended reading.

Science: Lab report

Your feedback matters.

We want to hear from you! Let us know what you found most useful or share your suggestions for improving this resource.

  • Case Studies

Teaching Guide

  • Using the Open Case Studies Website
  • Using the UBC Wiki
  • Open Educational Resources
  • Case Implementation
  • Get Involved
  • Process Documentation

Case studies offer a student-centered approach to learning that asks students to identify, explore, and provide solutions to real-world problems by focusing on case-specific examples (Wiek, Xiong, Brundiers, van der Leeuw, 2014, p 434). This approach simulates real life practice in sustainability education in that it illuminates the ongoing complexity of the problems being addressed. Publishing these case studies openly, means they can be re-used in a variety of contexts by others across campus and beyond. Since the cases never “end”; at any time students from all over UBC campus can engage with their content, highlighting their potential as powerful educational tools that can foster inter-disciplinary research of authentic problems. Students contributing to the case studies are making an authentic contribution to a deepening understanding of the complex challenges facing us in terms of environmental ethics and sustainability.

The case studies are housed on the UBC Wiki, and that content is then fed into the Open Case Studies website. The UBC Wiki as a platform for open, collaborative course work enables students to create, respond to and/or edit case studies, using the built in features (such as talk pages, document history and contributor track backs) to make editing transparent. The wiki also also helps students develop important transferable skills such as selection and curation of multimedia (while attending to copyright and re-use specifications), citation and referencing, summarizing research, etc. These activities help build critical thinking, creativity, collaboration, and digital literacy.

This guide is intended to help you get started with your case study project by offering:

  • Information on how to use the UBC Wiki
  • Research that supports case studies as effective tools for active learning
  • Instructional strategies for teaching effectively with case studies
  • Sample case study assignments used by UBC instructors

The UBC Wiki is a set of webpages accessible to anyone with a CWL account and has many unique features in addition to collaborative writing including the ability to revive previous drafts, and notifications setting that can support instructors in monitoring individual student contributions, or support students to better manage their collaborative efforts on their own. Using a wiki successfully in a course, however, requires proper facilitation and support from instructors and TAs.

The following links are helpful in getting started:

General Information:

  • Navigating the Wiki:
  • Wiki Help Table of Contents:
  • Frequently Asked Questions:

Self-Guided Wiki Tutorials:

  • Getting Started With UBC Wiki - short video and links to common formatting needs.
  • Beginner:
  • Intermediate:
  • Advanced:

The idea that learning is "active" is influenced by social constructivism , which emphasizes collaboration in the active co-construction of meaning among learners. Simply put, learning happens when people collaborate and interact with authentic learning tasks and situations. These ideas are becoming increasingly prevalent in the scholarly literature on teaching and learning (see for instance, Wilson 1996) and have important implications for pedagogy, especially in the university where traditional lectures remain the dominant instructional strategy. When students are asked to respond to authentic problems and questions, they assume responsibility for the trajectory of their learning, rather than it being decided upon by the instructor. This practice, also referred to as “student-centered learning” allows the students to become “active” participants in the construction of their understandings.

One of the easiest ways to develop higher order cognitive capacities (critical thinking, problem solving, creativity etc.) is through pedagogies that support inquiry based learning, thereby allowing students the opportunity to “develop [as] inquirers and to use curiosity, the urge to explore and become researchers and lifelong learners” (Justice, Rice, Roy, Hudspith & Jenkins,2009, p. 843). Because case studies are often collaborative, they provide unique inquiry based learning opportunities that will foster active engagement in student learning, while also teaching transferable skills (teamwork, collaboration, technology literacy). That the cases never “end” and that they can be considered by students and faculty from all over the UBC community, highlights their potential as powerful educational tools that can foster inter-disciplinary research of authentic problems.

Using case studies successfully in a course requires purposefully scaffolded support from the instructor and TA's. Instructors must properly introduce assignments, as well as facilitate and monitor the progress of students while they work on assignments. This will help ensure that students understand the purpose and value of the work they are doing and will also allow instructors and TA's to provide appropriate support and guidance.

The following instructional strategies will help you teach effectively using case studies:

1. Getting Started:

  • Outline Your "Big Picture" Goals and Expectations : Communicate to students what you are hoping they will learn (Or have them tell you why they think you would ask them to work with case studies!). It is also important to discuss the quality of work you expect and offer specific examples of what that looks like. If you have any, look at exemplars of past student work, or simply evaluate existing case studies to generate a list of defining characteristics. Doing this will provide students with valuable tangible and visual examples of what you expect.
  • Define "Case Study" : Don't assume that students understand what case-studies are, especially at the undergraduate level. Take the time to talk about what a case study is and why they are powerful teaching/learning tools. This can be facilitated during a tutorial with small group discussion. See Case Study Resources.
  • Pick Case Studies Purposefully : If you are planning on having students evaluate case studies, make sure to read them in advance and have a clear understanding of why you chose it. This will help facilitate discussion and field student questions.
  • Set the Context for the Evaluating or Creating the Case Study : Whether you are having students write the case studies themselves, or you are having them examine an existing case, it is important to set the parameters for how you want students to approach the problem. For instance, you may have them evaluate the case from the perspective of an industry professional, a community group or member, or even from their own perspective of university students. Whatever you choose, make sure you communicate this clearly.
  • Set the Parameters for Evaluating or Creating the Case Study : Clearly outline all the information you want students to find out, and how you want it reported. You may want students to focus on some areas and disregard others, or you may want them to consider all the facts equally. Whatever you choose, make sure you communicate this clearly.

2. Use, Revise, and/or Create

  • Use the case studies as they are : One way to use the case studies in courses is to have students read and discuss them as they are. They can be read on the open case studies website, downloaded from the wiki and embedded into another website, or downloaded in PDF or Microsoft Word format (see this guide for how to embed or download the case studies)
  • If you are only making minor edits such as fixing a broken link or a typo, please go ahead. You could add a note about this to the "discussion" page to explain (see the tab at the top of each wiki page).
  • You could add a section at the bottom of the case study with a perspective on it from your discipline. Some of the case studies already have sections at the bottom that are titled "What would a ___ do?" You can add a new one of those to give a different disciplinary perspective.
  • If you want to make more substantial changes, it would be best if you copied and pasted the wiki content into a new page so as to preserve the original. The original version may be used in other courses by the instructor/students who created it, so making significant changes could be a problem! And those changes might be reverted by the original instructor and students (wiki pages keep all past versions, and those changes can easily be reverted). If you would like to substantially revise a case study, please contact Christina Hendricks, who can help you get started and then get the new version into the collection: [email protected]
  • Create new case studies : We are always looking for new case studies for the collection! If you think you would like to write one, or involve your students in writing one, please contact Christina Hendricks: [email protected]

3. Guiding Case Study Discussions:

  • Ask open-ended questions : Open-ended questions cannot be answered using "yes" or "no". Be careful when wording discussion questions, allowing them to be as open as possible.
  • Listen Actively : Actively listen to students by paraphrasing what they have said to you and saying it back (e.g. "What I heard is....Is this what you meant?"). This will help you pay close attention to what they say and clarify any possible miscommunication.
  • Role Play : Ask students to take on the perspective of different interested parties in considering the case study.
  • Compare and Contrast : Ask students to compare and contrast cases in similar areas from the open case study collection. Discuss whether there are similar problems or possible solutions for the cases.

4. Staying on Track:

  • Develop a Protocol for Collaboration : Have students outline how they will collaborate at the start of the assignment to ensure that the work is shared evenly and that each student has a purposeful role.
  • Set Benchmark Assignments : Make sure students stay on track by requiring smaller assignments or assessments along the way. This can be as simple as coming to tutorial with a portion of the case-study written for peer critique and analysis.
  • Give Students Adequate Time : Allow students enough time to read and consider case-studies thoughtfully. The more time you can provide, the less overwhelmed students will feel. This will encourage them to go deeper with their case study and their learning.
  • Forestry : In this assignment, students in a graduate course wrote their own case studies. This link provides information on the assignment, a handout given to the students, and a grading rubric: Short-Term Assignment: What is Illegal Logging? - Teacher Guide
  • Political Science : Students in a third-year political science class responded to a case study written by the instructor. They worked in groups to create action plans for climate change problems. This link provides information on the assignment as well as a handout given to the students: Class Activity: Action Plans for Climate Change - Teacher Guide
  • Education : Teacher candidates in the Faculty of Education respond to case studies written by students. They discuss a case study and respond to questions with the goal of identifying the issues raised, perspectives involved and possible ways forward. The goal is to support decision making related to online presence and social media engagement. Digital Tattoo Case Studies for Student Teachers Facilitators' Guide
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Education Case Study Examples for Students

Graduate Student Case Study Example

Student Profile Case Study Example

High School Student Case Study Example

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15+ Student Case Study Examples [ High School, Assignment, Classroom ]


Schools especially those that offers degree in medicine, law, public policy and public health teaches students to learn how to conduct a case study . Some students say they love case studies. For what reason? Case studies offer real world challenges. They help in preparing the students how to deal with their future careers. They are considered to be the vehicle for theories and concepts that enables you to be good at giving detailed discussions and even debates. Case studies are useful not just in the field of education, but also in adhering to the arising issues in business, politics and other organizations.

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15+ Student Case Study Examples

1. student case study format template.

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2. Sample Student Case Study Example

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3. Education Case Study Examples for Students

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4. Graduate Student Case Study Example

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Case Study Definition

A case study is defined as a research methodology that allows you to conduct an intensive study about a particular person, group of people, community, or some unit in which the researcher could provide an in-depth data in relation to the variables. Case studies can examine a phenomena in the natural setting. This increases your ability to understand why the subjects act such. You may be able to describe how this method allows every researcher to take a specific topic to narrow it down making it into a manageable research question. The researcher gain an in-depth understanding about the subject matter through collecting qualitative research and quantitative research datasets about the phenomenon.

Benefits and Limitations of Case Studies

If a researcher is interested to study about a phenomenon, he or she will be assigned to a single-case study that will allow him or her to gain an understanding about the phenomenon. Multiple-case study would allow a researcher to understand the case as a group through comparing them based on the embedded similarities and differences. However, the volume of data in case studies will be difficult to organize and the process of analysis and strategies needs to be carefully decided upon. Reporting of findings could also be challenging at times especially when you are ought to follow for word limits.

Example of Case Study

Nurses’ pediatric pain management practices.

One of the authors of this paper (AT) has used a case study approach to explore nurses’ pediatric pain management practices. This involved collecting several datasets:

Observational data to gain a picture about actual pain management practices.

Questionnaire data about nurses’ knowledge about pediatric pain management practices and how well they felt they managed pain in children.

Questionnaire data about how critical nurses perceived pain management tasks to be.

These datasets were analyzed separately and then compared and demonstrated that nurses’ level of theoretical did not impact on the quality of their pain management practices. Nor did individual nurse’s perceptions of how critical a task was effect the likelihood of them carrying out this task in practice. There was also a difference in self-reported and observed practices; actual (observed) practices did not confirm to best practice guidelines, whereas self-reported practices tended to.

What is a Student Case Study?

A student case study is an academic research method that involves an in-depth examination of a specific individual, group, event, organization, or phenomenon. It is commonly used in various fields of study, including business, psychology, education, and social sciences. The primary purpose of a student case study is to gain a comprehensive understanding of the subject under investigation and to draw insights or conclusions from the analysis.

Here are some key characteristics and components of a student case study:

  • Subject Focus : The case study can center on a single person, a small group of individuals, an organization, a particular event, or a broader societal issue. The choice of subject depends on the research question or the goals of the study.
  • In-Depth Exploration: Case studies involve detailed data collection and analysis. Researchers collect various types of information, such as interviews, surveys, documents, observations, and other relevant sources, to build a comprehensive picture of the subject.
  • Contextual Analysis: A significant aspect of a case study is the consideration of the context in which the subject operates. Understanding the background and environment is essential to interpret the findings accurately.
  • Qualitative Research : Case studies often use qualitative research methods to gather and analyze data. This includes open-ended interviews, content analysis, and thematic coding.
  • Rich Description: The case study report provides a rich and detailed description of the subject. It includes narratives, quotes, and empirical evidence to support the analysis.
  • Analysis and Interpretation: Researchers analyze the collected data to identify patterns, themes, or trends. They may use various theoretical frameworks to interpret the information and draw conclusions.
  • Real-World Application: Case studies are often used to address practical problems or real-world situations. They can be used to inform decision-making, offer solutions, or provide insights into specific issues.
  • Ethical Considerations: Researchers must consider ethical principles when conducting case studies, ensuring the protection of participants’ rights and privacy.
  • Findings and Recommendations: A well-structured case study typically concludes with findings, implications, and recommendations based on the analysis.

How do you Write a Case Study for Students?

1. choose an interesting and relevant topic:.

Select a topic that is relevant to your course and interesting to your audience. It should be specific and focused, allowing for in-depth analysis.

2. Conduct Thorough Research :

Gather information from reputable sources such as books, scholarly articles, interviews, and reliable websites. Ensure you have a good understanding of the topic before proceeding.

3. Identify the Problem or Research Question:

Clearly define the problem or research question your case study aims to address. Be specific about the issues you want to explore and analyze.

4. Introduce the Case:

Provide background information about the subject, including relevant historical, social, or organizational context. Explain why the case is important and what makes it unique.

5. Describe the Methods Used:

Explain the methods you used to collect data. This could include interviews, surveys, observations, or analysis of existing documents. Justify your choice of methods.

6. Present the Findings:

Present the data and findings in a clear and organized manner. Use charts, graphs, and tables if applicable. Include direct quotes from interviews or other sources to support your points.

7. Analytical Interpretation:

Analyze the data and discuss the patterns, trends, or relationships you observed. Relate your findings back to the research question. Use relevant theories or concepts to support your analysis.

8. Discuss Limitations:

Acknowledge any limitations in your study, such as constraints in data collection or research methods. Addressing limitations shows a critical awareness of your study’s scope.

9. Propose Solutions or Recommendations:

If your case study revolves around a problem, propose practical solutions or recommendations based on your analysis. Support your suggestions with evidence from your findings.

10. Write a Conclusion:

Summarize the key points of your case study. Restate the importance of the topic and your findings. Discuss the implications of your study for the broader field.

11. Cite Your Sources:

Properly cite all the sources you used in your research. Use a consistent citation style (such as APA, MLA, or Chicago) as per your instructor’s guidelines.

12. Edit and Proofread:

Carefully edit your case study for clarity, coherence, and grammar. Check for spelling and punctuation errors. Ask a peer or a mentor to review your work for feedback.

13. Format Your Case Study:

Format your document according to the required guidelines. Include a title page, abstract (if necessary), introduction, main sections, conclusion, and bibliography.

What are Some Examples of Case Study?

1. business and management:.

  • Apple Inc.’s Marketing Strategy: An analysis of Apple’s marketing approach, including product design, branding, and customer loyalty.
  • McDonald’s Global Expansion: A study on how McDonald’s adapted its business model for success in different international markets.

2. Psychology and Counseling:

  • The Case of “Little Albert”: A classic case study in psychology that examined the conditioning of fear in a young child.
  • Stanford Prison Experiment: An investigation into the psychological effects of role-playing in a simulated prison environment.

3. Education:

  • Inclusive Education in a Primary School: A case study exploring the challenges and benefits of implementing inclusive education for students with disabilities.
  • Online Learning and Student Engagement: An analysis of the impact of online learning on student engagement and academic performance.

4. Medicine and Healthcare:

  • The Tuskegee Syphilis Study: A well-known case study on the ethical issues surrounding a long-term study of untreated syphilis in African American men.
  • Patient X: A Rare Medical Condition: An examination of a patient with a rare medical condition to understand its diagnosis and treatment.

5. Environmental Science:

  • Deepwater Horizon Oil Spill: A case study of the environmental and economic impacts of the 2010 oil spill in the Gulf of Mexico.
  • Deforestation in the Amazon Rainforest: An analysis of the causes, consequences, and possible solutions to deforestation in the Amazon.

6. Social Work and Human Services:

  • Child Welfare Services: A case study examining the challenges and interventions involved in a child welfare case.
  • Substance Abuse and Rehabilitation: An analysis of the recovery journey of an individual with a substance use disorder.

7. Architecture and Urban Planning:

  • Sustainable Urban Development: A case study of a city’s efforts to promote sustainable practices in urban planning, transportation, and architecture.
  • Historical Preservation of Landmarks: An exploration of the restoration and preservation of historic buildings or landmarks.

8. Law and Legal Studies:

  • Landmark Supreme Court Cases: In-depth analyses of important legal cases that have had a significant impact on the legal system and society.
  • Intellectual Property Disputes: Case studies on legal battles involving intellectual property rights, such as patents and copyrights.

9. Engineering and Technology:

  • SpaceX’s Reusable Rockets: A study of SpaceX’s development and use of reusable rocket technology.
  • Failure Analysis of Bridge Structures: An investigation into the causes of structural failures in bridges and their implications.

10. Finance and Economics:

  • Enron Scandal: An examination of the accounting fraud and corporate governance issues that led to the downfall of the Enron Corporation.
  • Microfinance and Poverty Alleviation: A case study on the impact of microfinance institutions on poverty reduction in developing countries.

What are the objectives of a Student Case Study?

1. learning and understanding:.

  • To deepen students’ understanding of a particular concept, theory, or topic within their field of study.
  • To provide real-world context and practical applications for theoretical knowledge.

2. Problem-Solving Skills:

  • To enhance students’ critical thinking and problem-solving abilities by analyzing complex issues or scenarios.
  • To encourage students to apply their knowledge to real-life situations and develop solutions.

3. Research and Analysis:

  • To develop research skills, including data collection, data analysis , and the ability to draw meaningful conclusions from information.
  • To improve analytical skills in interpreting data and making evidence-based decisions.

4. Communication Skills:

  • To improve written and oral communication skills by requiring students to present their findings in a clear, organized, and coherent manner.
  • To enhance the ability to communicate complex ideas effectively to both academic and non-academic audiences.

5. Ethical Considerations:

To promote awareness of ethical issues related to research and decision-making, such as participant rights, privacy, and responsible conduct.

6. Interdisciplinary Learning:

To encourage cross-disciplinary or interdisciplinary thinking, allowing students to apply knowledge from multiple areas to address a problem or issue.

7. Professional Development:

  • To prepare students for future careers by exposing them to real-world situations and challenges they may encounter in their chosen profession.
  • To develop professional skills, such as teamwork, time management, and project management.

8. Reflection and Self-Assessment:

  • To prompt students to reflect on their learning and evaluate their strengths and weaknesses in research and analysis.
  • To foster self-assessment and a commitment to ongoing improvement.

9. Promoting Innovation:

  • To inspire creativity and innovation in finding solutions to complex problems or challenges.
  • To encourage students to think outside the box and explore new approaches.

10. Building a Portfolio:

To provide students with tangible evidence of their academic and problem-solving abilities that can be included in their academic or professional portfolios.

11. Assessment of Learning:

To serve as an assessment tool for instructors to evaluate students’ comprehension, critical thinking skills, and overall academic progress.

12. Contribution to Knowledge:

In advanced cases, such as graduate-level research, the objective may be to contribute new insights or knowledge to the academic or professional field.

What are the Elements of a Case Study?

A case study typically includes an introduction, background information, presentation of the main issue or problem, analysis, solutions or interventions, and a conclusion. It often incorporates supporting data and references.

How Long is a Case Study?

The length of a case study can vary, but it generally ranges from 500 to 1500 words. This length allows for a detailed examination of the subject while maintaining conciseness and focus.

How Big Should a Case Study Be?

The size of a case study should be sufficient to comprehensively cover the topic, typically around 2 to 5 pages. This size allows for depth in analysis while remaining concise and readable.

What Makes a Good Case Study?

A good case study is clear, concise, and well-structured, focusing on a relevant and interesting issue. It should offer insightful analysis, practical solutions, and demonstrate real-world applications or implications.

Case studies bring people into the real world to allow themselves engage in different fields such as in business examples , politics, health related aspect where each individuals could find an avenue to make difficult decisions. It serves to provide framework for analysis and evaluation of the different societal issues. This is one of the best way to focus on what really matters, to discuss about issues and to know what can we do about it.

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Embedding the student voice in decision making by year group

Dr River Riley, Lecturer (Teaching) Department of Chemistry, on nurturing truly collaborative partnerships which make for effective Staff-Student Consultative Committees.

21 November 2023

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Watch the video on MediaCentral . Download the video transcript [Word] .

We are all trying to engage more with the Student Voice but it can be quite difficult in practice to make this work. Students can find our systems confusing or not know how to put across what they want us to respond to. 

Closer partnerships between a staff Year Lead and student reps

In the Department of Chemistry, we reflected that the role and impact student representatives have on staff-student consultative committees can be enhanced by building closer partnerships with staff members that have a specific knowledge of the group those students are elected to represent. We therefore strengthened the partnership between staff Year Leads and the student representatives of each year. 

Focussed discussions

Year Leads were asked to meet with their student representatives prior to the DSSCC to collaboratively decide on items for the agenda. This allowed each year group to reflect on which points were best solved first with their Year Lead and which would benefit from sharing and discussing with the committee. By narrowing down the points representatives wished to raise, more time at DSSCC was dedicated to discussing points that were constructive and solution focused. 

Empowering student voices

Furthermore, as each student representative had previously engaged in discussions with their Year Lead in the focus group, their role and significance on the committee was strengthened and student reps were provided with the skills and confidence to contribute.    This saw the new student co-chair fully lead a subsequent meeting where they made a particular effort to engage all representatives from each year in the discussions. The new format has not only strengthened the engagement of representatives in the meeting, but it has also raised the awareness of how the department operates to the student representatives.

Everyone benefits

Furthermore, the Year Leads reported back that working more closely with their representatives has allowed them to gain a more detailed understanding of the student experience in each year. Consequently, the Year Lead role has developed from its creation and is now better equipped to take a more active approach in improving that experience. 

River's tip : The first step is to reflect with the student representatives and staff on how their roles and the DSSCC are working before making structural changes. This ensures that from the onset, both the student and staff voice contribute equally when building a truly collaborative partnership.  

Further reading

Marie, J. (2018) ‘Students as Partners’ in Davies JP, Pachler N. Teaching and Learning in Higher Education: Perspectives from UCL ,  UCL IOE Press: London, UK. 2018.

Marie J, Mercer-Mapstone, L. (2019) Practical Guide: Scaling up student-staff partnerships in higher education , University of Edinburgh. 

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Machine learning-based predictive modeling of student counseling gratification: a case study of Aligarh Muslim University

  • Ahmad Raza Shibli 1 ,
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Subject counseling may assist students in evaluating their courses and choosing the appropriate career path. This article intends to investigate, create, and apply efficient methods for assessing student course counseling, guidelines, and decision-making. We develop a way to automate the course selection recommendation using machine learning. One can realize what course will suit them based on historical data. We primarily focused on the detailed description and analysis of the dataset collected from the students that have already faced any online admission counseling session. A real dataset based on the diverse perspectives of pupils was designed. Over 100 students participated in the survey; their data were recorded, analyzed, and presented efficiently for the readers to understand. Due to limited data volume, the Synthetic Minority Oversampling Technique (SMOTE) has been used. Our work holds novelty to the existing system and usage. It can be further applied from the department to the university level.

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Comparison of simulation and video-based training for acute asthma

  • Mohamed Habib Grissa 1 ,
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Emergency medicine is particularly well suited to simulation training. However, evidence for the efficacy of simulation-based medical training remains limited especially to manage high-risk cases such as acute asthma.

The objective of our study was to compare the performance of high-fidelity simulation (HFS) and interactive video-case challenge-based training (IVC) for final-year medical students in the management of acute asthma.

This was a prospective randomized controlled study conducted at the emergency department (ED) of Monastir University hospital ( Tunisia). 69 final-year medical students were randomized to HFS ( n  = 34) and IVC ( n  = 35) training on acute asthma topic. The study was conducted over a 1-week period. Efficacy of each teaching method was compared through the use of multiple-choice questionnaires (MCQ) before (pre-test), after (post-test) training and a simulation scenario test conducted 1 week later. The scenario was based on acute asthma management graded on predefined critical actions using two scores: the checklist clinical score (range 0 to 30), and the team skills score (range 0 to 16). Student satisfaction was also evaluated with the Likert 5 points scale. Two years after the post-test, both groups underwent a third MCQ testing to assess sustainability of knowledge.

There were no differences in age between groups. There was no statistically significant difference between the HFS and IVC groups pre-test scores ( p  = 0.07). Both groups demonstrated improvement in MCQ post-test from baseline after training session; the HFS MCQ post-test score increased significantly more than the IVC score ( p  < 0.001). The HFS group performed better than the IVC group on the acute asthma simulation scenario ( p  < 0.001). Mean checklist clinical score and mean team skills score were significantly higher in HFS group compared to IVC group (respectively 22.9 ± 4.8 and 11.5 ± 2.5 in HFS group vs 19.1 ± 3 and 8.4 ± 3.1 in IVC group) ( p  < 0.001). After 2 years, MCQ post-test scores decreased in both groups but the decrease was lower in HFS group compared to the IVC group.

High-fidelity simulation-based training was superior to interactive video-case challenge for teaching final year medical students,and led to more long-term knowledge retention in the management of simulated acute asthma patients.

Trial registration

The study was registered at NCT02776358 on 18/05/2016.

Peer Review reports

The acquisition of clinical skills can be problematic for medical students in a highly demanding environment such as Emergency Department (ED). At the start of their career, these future doctors, inadequately prepared, feel a lot of stress [ 1 , 2 ] and their patients may not receive optimal care [ 3 , 4 ]. In fact, in the emergency environment, medical students have limited opportunities for bedside teaching and this could affect their awareness and self-confidence [ 5 ]. Improving the quality and efficiency of their training is required.

Medical simulation has become a widely spread and effective method of medical education [ 6 , 7 , 8 , 9 ]. Studies thus far showed that the use of simulation for the training of medical students and residents is helpful to access to practical “hands-on” applications of their theoretical knowledge, and to develop their technical and non-technical skills in safe realistic environments [ 10 ] Simulations that present highly realistic performance characteristics, contexts, and scenarios are referred to as high-fidelity, while low-fidelity simulators are partial-task trainer devices and screen-based video game. Higher levels of fidelity can enhance participants’ level of engagement and acceptability of the simulated experience; this will impact the achievement of the desired learning objectives and the ability to transfer the learning to the clinical setting [ 11 ]. This method is capable of both simulating realistic patient encounters and giving real-time physiologically accurate feedback. In another hand, Simulation has become a frequently used evaluation method. It helps to assess the first three levels of learning given the ability to choose the program and select learner-specific findings, conditions, scenarios; providing standardized experiences for all trainees; and measure the outcome with reliable data.

High fidelity simulation was widely used in anesthesiology within a multitude of topics such as airway and hemodynamic management [ 12 ], per and peri-operative anaesthesia, crisis resource management (CRM) [ 13 ] and more recently ultrasound-guided regional anesthesia [ 14 ].

Moreover, high fidelity simulation High fidelity simulation has spread from anesthesiology to other disciplines including emergency medicine [ 15 , 16 , 17 ]. Simulation training has added the advantage of being available whenever needed and does not rely on random patient encounters for medical education [ 10 ]. Emergency medicine is uniquely suited to learning through simulation. Simulation allows medical students to manage rare and high-risk cases in a safe environment without patient risk. It is indeed proven that simulation courses improve the confidence and the performance of doctors [ 8 , 9 ]. The requirements regarding knowledge should focus on the problems that are frequently encountered in the ED, for instance, protocols on acute asthma management. Acute asthma exacerbation is frequently encountered in the ED, and its early diagnosis and treatment is crucial to preventing disease complications [ 18 ]. There have been no studies that prospectively compare a standard method with high-fidelity simulation for acute asthma management training. In addition, no studies to date have evaluated or compared the long-term retention of knowledge with the two learning methods.

The objective of this prospective randomized study was to determine whether simulation training is superior to video case challenge for teaching acute asthma management to final-year medical students. The use of video case challenge as a comparison was selected, as this modality is now frequently used in our ED for undergraduate medical students.

Participants and setting

We conducted this prospective, randomized, non-blinded study during the academic year 2015–2016 in the ED simulation laboratory of the ED of Fattouma Bourguiba University Hospital according to the ICH-GCP guidelines (International Conference on Harmonisation-Good Clinical Practice) as well as the Declaration of Helsinki. Ethics approval was obtained from the Fattouma Bourguiba University Hospital Ethics Committee. The study population included final-year medical students rotating through a 4-week Emergency Medicine attachment as part of their final-year medicine curriculum. The sample was convenience-based. Following informed consent, each group was randomized to one of two teaching methods: high fidelity simulation-based training (HFS group) or interactive video case challenge (IVC group). The topic was the management of an acute asthma patient at the ED. Each method of this teaching session was carefully prepared to give the same key concepts to allow the student to recognize the severity of the disease and manage the patients according to the current guidelines [ 19 ]. The objectives were clinically focused and specifically designed to include elements that would be necessary to successfully care for patients. All teaching sessions were performed by the same emergency physicians seniors.


Both groups underwent a baseline testing (pre-test) including 20 Multiple Choice Questions (MCQ) for 20 min about their baseline knowledge of acute asthma management. The Questions focused on anamnestic and clinical diagnostic management, differential diagnoses recognition,severity assessment and detailed therapeutic management. The MCQ test score range from 0 (minimum) to 20 (maximum). Students completed a second MCQ immediately following the teaching session (MCQ post-test 1). The results of all MCQ examinations were fed back to each participating student upon completion of this teaching session and MCQ examination. After randomization, all students received an equivalent 30 min orientation to the human patient simulator (Laerdal SimMan® full scale patient simulator; Laerdal Medical Corporation, NY), in the ED simulation lab: realistic full-body adult patient simulator SimMan®3G (Laerdal company Prod No: 212–02050 serial NR 21244154781. Made in Norway). This simulator offers a multitude of respiratory signs such as all normal and pathological audible sounds with the stethoscope in 5 anterior and 6 posterior auscultatory sites as well as cyanosis, chest expansion. It is also possible to monitor pulse, oxygen saturation, heart rate and blood pressure non-invasively. These sessionincluded an introduction and a review of the simulator features as well as the physiologic monitoring devices. Students were instructed to verbalize their thoughts, orders, and actions during the simulated patient scenario. Simulation case scenario of acute asthma was developed by the authors and reviewed by an advisory committee. The execution of the simulation scenario required two instructors, one to engage within the scenario with the students, and a second to coordinate computer driven physiological responses dependent on intervention implemented by students. IVC group, attend real video projection filmed in ED after consent of both patient and healthcare team. The students of HFS group participated in a simulation session with an acute asthma scenario including the three known steps: briefing, scenario, and debriefing. The clinical scenario used is the same viewed in the video case as well as practiced on the simulator, however on the high fidelity simulator it was developed and programmed on the mannequin manually using the integrated software (LLEAP® version 5.1.0: 2015). Both teaching sessions lasted approximately 1 h. After the teaching sessions were complete, the students underwent gimmediately the post-test. Students also rated their satisfaction level with a 5 points Likert scale framed as attitude toward simulation compared with control group: dissatisfied (1 point), fairly satisfied (2 points), neither satisfied (3 points), satisfied (4 points) and very satisfied (5 points). The study population flowchart is depicted in Fig.  1 . Seven days after the two teaching procedures, all students participated in a simulation scenario test on another acute asthma case that differs from the previous training scenario. Two emergency senior physicians independently scored each student’s performance during the simulation scenario test. Each rater individually rated the video files using two rating scores. The first rating score (checklist clinical score) included 15 items related to critical actions specific to acute asthma. Individual actions were weighted by consensus. Components of the evaluation grid were history, physical examination, diagnostic of acute asthma exacerbation, severity assessment, and treatment (Supplementary file 1 ). The second rating score (team skills score) used the first 8 items of a previously validated behavioral rating scale, the Mayo High Performance Teamwork Scale [ 20 ] (Supplementary file 2 ). Each item was scored from 0 if not performed, 1 if it was imperfectly performed and 2 if it was performed correctly. The checklist score ranged from 0 to 30, and the team skills score ranged from 0 to 16. No formal inter-rater reliability calculation was performed. Each rater was chosen for his expertise as an acute care physician and crisis resource management instructor. The simulator instructor present for all simulator sessions was excluded from being a rater to preserve the integrity of the blinding process. Differences between the raters’ evaluation were resolved by consensus. The sustainability of the acquired knowledge was assessed through the completion of an MCQ test 2 years following the teaching session (MCQ post-test 2). Students were contacted either by email or private messaging to assess their ability to answer the same MCQ test with an online application for creating and distributing questionnaires and collecting data (ASKABOX ® online free version).

figure 1

The study population flowchart. IVC teaching group: interactive video case teaching group. HSF group: high fidelity simulation-based teaching group. MCQ: multiple choice questions

End point assessment

Primary end point was the combined simulation scenario scores (checklist clinical score and team skills score). Secondary end point included improvement in MCQ test scores (MCQ post-test 1 and MCQ post-test 2) compared to pre-test MCQ and satisfaction among HFS group and IVC group. We defined the delta MCQ score (Δ-score) as the difference between MCQ post-tests and pre-test MCQ scores.

Data analysis

Statistical analysis was performed with SPSS version 21.0. Pre- and post-simulation MCQ test scores, simulation scenario test score, and satisfaction survey responses were summarized by descriptive statistics. Data were analyzed by the Kolmogorov–Smirnov test (K-S test) to assess normality and were expressed as mean ± standard deviation or median and interquartile range (IQR). The Mann–Whitney test was used to analyze differences between the two groups in pre-simulation test scores, post-simulation test scores, simulation scenario test score, and satisfaction scales. The Wilcoxon's Sign Rank test was used to analyze the difference between the pre-test and post-test scores in each group.

Sixty-nine final year medical students were included in the study population, median age was 23 years [ 21 , 22 ] and 67.7% of the participating students were female. Each group was divided into 11 subgroups of 3 to 4 students. Results of all MCQ tests are depicted in Table 1 . There was not a statistically significant difference between HFS group and IVC group mean scores at pre-test MCQ ( p  = 0.07). After training session, the HFS group mean post-test 1 score was higher than the IVC score (14.5 ± 1.6 vs 13.9 ± 1.6, respectively; ( p  < 0.001). Both groups had improved significantly from their pre-test scores with Δ-score 1 in HFS group of 82.4% ± 73.7 and 47.2% ± 32.4 in IVC group ( p  < 0.001) (Table 1 ). On the simulation scenario test, the HFS groups mean checklist clinical score was significantly higher than mean IVC group’s (22.9 ± 4.8 vs 19.1 ± 3; p  < 0.001)). In addition, the mean HFS group’s team skills score was significantly higher than mean IVC group’s score (11.5 ± 2.5 vs 8.4 ± 3.1; p  < 0.001) Table 2 . The results of the satisfaction survey were in favor of HFS teaching compared to IVC teaching (Table 2 ). After 2 years, the MCQ post-test 2 scores were lower in both groups than MCQ post-test 1 results. Although this difference was lower in the HFS group -1.5 [-7,75–0.3] vs -3.5 [-9.2- -1.25], with no statistically significant difference. These MCQ post-test 2 scores were both statistically improved compared with pre-test scores: Δ-score 2 was significantly higher in HFS group than the IVC group (43.7% [11.4- 75] vs 15.5% [1.3- 39.2]) ( p  = 0.017).

This study showed that teaching the management of acute asthma patients by simulation is superior than teaching by interactive video case. This superiority was illustrated by higher improvement of MCQ scores and higher scores of clinical skills and teamwork among medical students during the execution of HF simulation scenario. In addition, our study demonstrated an improved knowledge retention among simulation-based education compared to IVC teaching with a follow-up of 2 years. The student satisfaction was also better among simulation group.

Emergency medicine poses challenges for the education of medical students who often had limited opportunities for bedside teaching during the management of vulnerable and high risk patients with the large numbers of students. Although simulation training is a good alternative, the studies examining its use are limited in the setting of acute care [ 13 , 14 , 23 , 24 ]. The use of simulation in emergency medicine has expanded since 1990s [ 21 , 22 , 25 , 26 ]. A systematic review of emergency medicine training has demonstrated that technology-enhanced simulation is more beneficial than traditional training [ 27 ]. Thereby, HFS was shown effective in a variety of simulated scenarios concerning urgent condition such as airway management [ 12 ], trauma management [ 26 ], and critical care management [ 28 , 29 ]. A study by Steadman et al. [ 30 ] randomized fourth-year medical students to receive a problem-based learning or simulation-based teaching training intervention for the management of acute dyspnea. The results showed that the group receiving the simulation intervention performed significantly better with a greater improvement in scores from baseline than the problem-based learning group. A recent metanalysis had also evaluated the use of HF simulation in ALS training; pooled data from the RCTs demonstrated a benefit in improvement of knowledge and skill performance for HF simulation when compared with low fidelity simulation and traditional training with also greater benefit in knowledge with HF simulation compared with traditional training at the course conclusion [ 31 ]. Our results are similar to those observed in a randomized study conducted by Schroedl et al., which showed that simulator trained residents scored significantly higher on the bedside skills assessment compared with traditionally trained residents (82.5% ± 10 vs 74.8% ± 14). Another study by Ruesseler et al. evaluated the use of studied using simulation training in medical emergencies found superior performance among simulation students compared to controls [ 32 ]. Simulator-trained residents were highly satisfied with the simulation curriculum [ 33 ]. The evaluation on simulator showed that HFS is very suitable for teaching team work management as assessed by the "Mayo high performance teamwork scale". Indeed, simulation significantly increases self-confidence and the acquisition of soft skills such as communication, team interaction and leadership [ 17 , 34 ]. The scenario in our study focused on the management of severe acute asthma. Asthma exacerbation is frequently encountered in respiratory medicine clinic and EDs. Failure to recognize the signs of patient deterioration on time could lead to a fatal outcome. Despite the undeniable improvement in the therapeutic regimens, asthma continues to be associated with high morbidity and mortality rates. There is evidence that the still high mortality of this disease is correlated with poor management by the health care team: prescribing errors, poor control of high-risk patients, non-compliance with recommendations, and poor management of asthma crisis situations [ 35 ]. Therefore, familiarity with the identification and management of asthma exacerbation immediately is mandatory for medical students. Most studies to date have been limited to the immediate benefits and short-term skill retention of simulation. Our study is one of the few that has followed a cohort of future physicians over such a long period of time (two years). Previous studies have shown that HF simulation did not significantly improve long-term retention of resuscitation knowledge [ 36 , 37 , 38 ]. It is known that knowledge and skills deteriorate at 3 months after training course without ongoing practice [ 39 ], this might result from the quality of the content, the limited duration of the training and spaced practice sessions. A study by Wayne et al. assessed the value of using simulation technology and deliberate practice showed statistically significant improvements in education outcomes, including compliance with standard ACLS protocols as well as retention of skills and knowledge after 14 months [ 40 , 41 ]. Results from the two-year test showed a decline in scores after two years, as well as a decline in relative progress. However, the decrease in the IVC group is greater than that observed in the HFS group. These findings confirm the fact that simulation learning is probably more durable than the traditional learning method.

Some limitations could be discussed regarding our study. First, although the students were randomized to two groups that had equal scores on the written pretest, some unrecognized differences may still exist and could influence our results especially with regard to the relatively low sample size. Second, the choice of the IVC as the reference method in our study could be questioned as it is not a usual reference teaching method. We chose this method because it is often used as a teaching technique in our routine practice. Previous studies have revealed that students tend to prefer video cases since they perceive video modality as motivating [ 42 ], and stimulating [ 43 ]. Moreover, in one study, it was shown that video-based learning was as performant as simulation to teach a number of medical emergencies [ 44 ]. Third, objective structured clinical examination (OSCE) is the gold standard assessment method of clinical skills that assess many different qualitative aspects such as efficiency and the students’ skill performance with high reliability. But we did not use this tool in our study. Instead, MCQ were used to assess the participants’ knowledge and skill retention. Of note, MCQ are a widely used method to measure simple and complex intended learning outcomes [ 45 ]. Although better satisfaction regarding simulation training was previously demonstrated [ 46 ], it should be highlighted that it does not predict the students baseline level of clinical performance, and therefore instructors should not rely solely on students' perceptions to reflect their actual level of learning. Finally, transfer of human factor skills from simulation-based training to clinical practice is essential; however, there is limited evidence supporting the impact of simulation on patient outcomes or cost-effectiveness of training programs.

This study showed that high-fidelity simulation-based training of acute asthma management is more performant compared with interactive video case teaching and showed better long term knowledge retention with more student satisfaction. More research is required to increase knowledge about the transfer of competencies to daily clinical practice.

Availability of data and materials

Data will not be shared because we did not obtain participant consent for data sharing. The datasets generated and analyzed during the current study could be requested from the corresponding author on reasonable request.

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The authors acknowledge all of the participating members who contributed greatly to this study.

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Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia

Mohamed Habib Grissa, Randa Dhaoui, Khaoula Bel Haj Ali, Adel Sekma, Sarra Sassi, Hamdi Boubaker, Wahid Bouida, Kaouthar Beltaief & Semir Nouira

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Randa Dhaoui, Khaoula Bel Haj Ali, Adel Sekma, Sarra Sassi, Riadh Boukef, Hamdi Boubaker, Wahid Bouida, Kaouthar Beltaief & Semir Nouira

Emergency Department, Haj Ali Soua Regional Hospital of Ksar Hellal, Ksar Hellal, 5070, Tunisia

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SN designed the study; analyzed and interpreted the data and wrote the original draft; MHG designed the study and interpreted the data; RD collected and interpreted the data, reviewed and revised the manuscript; AS interpreted the data; KBHA analysed; interpreted the data; reviewed and revised the manuscript; MT collected and analysed the data; SS collected and analysed the data; AKS collected the data; AZ collected the data; HB interpreted the data; HS, ZM, RB supervised all aspects of the study; HB, WB, KB collected and interpreted the data, reviewed and revised the manuscript; All authors reviewed the manuscript.

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Correspondence to Semir Nouira .

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Grissa, M.H., Dhaoui, R., Bel Haj Ali, K. et al. Comparison of simulation and video-based training for acute asthma. BMC Med Educ 23 , 873 (2023).

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