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Case Method Teaching and Learning

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

On this page:

What is case method teaching.

• Case Method at Columbia

Why use the Case Method?

Case method teaching approaches, how do i get started.

• Additional Resources

The CTL is here to help!

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

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

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

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

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

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

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Case Method Teaching and Learning at Columbia

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

Faculty Spotlight:

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

Read more  

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Identify learning objectives, determine scope, and anticipate challenges. 

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

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

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

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

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

Plan for the case discussion and an active role for students

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

Student preparation and expectations

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Additional resources 

Teaching with Cases , Harvard Kennedy School of Government. 

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

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

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

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

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

Columbia Resources

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

Center for Teaching and Learning

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

Office of the Provost

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

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

Explore our teaching resources.

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

CTL resources and technology for you.

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

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Case Study Teaching Method Improves Student Performance and Perceptions of Learning Gains †

Associated data.

• Appendix 1: Example assessment questions used to assess the effectiveness of case studies at promoting learning
• Appendix 2: Student learning gains were assessed using a modified version of the SALG course evaluation tool

Following years of widespread use in business and medical education, the case study teaching method is becoming an increasingly common teaching strategy in science education. However, the current body of research provides limited evidence that the use of published case studies effectively promotes the fulfillment of specific learning objectives integral to many biology courses. This study tested the hypothesis that case studies are more effective than classroom discussions and textbook reading at promoting learning of key biological concepts, development of written and oral communication skills, and comprehension of the relevance of biological concepts to everyday life. This study also tested the hypothesis that case studies produced by the instructor of a course are more effective at promoting learning than those produced by unaffiliated instructors. Additionally, performance on quantitative learning assessments and student perceptions of learning gains were analyzed to determine whether reported perceptions of learning gains accurately reflect academic performance. The results reported here suggest that case studies, regardless of the source, are significantly more effective than other methods of content delivery at increasing performance on examination questions related to chemical bonds, osmosis and diffusion, mitosis and meiosis, and DNA structure and replication. This finding was positively correlated to increased student perceptions of learning gains associated with oral and written communication skills and the ability to recognize connections between biological concepts and other aspects of life. Based on these findings, case studies should be considered as a preferred method for teaching about a variety of concepts in science courses.

INTRODUCTION

The case study teaching method is a highly adaptable style of teaching that involves problem-based learning and promotes the development of analytical skills ( 8 ). By presenting content in the format of a narrative accompanied by questions and activities that promote group discussion and solving of complex problems, case studies facilitate development of the higher levels of Bloom’s taxonomy of cognitive learning; moving beyond recall of knowledge to analysis, evaluation, and application ( 1 , 9 ). Similarly, case studies facilitate interdisciplinary learning and can be used to highlight connections between specific academic topics and real-world societal issues and applications ( 3 , 9 ). This has been reported to increase student motivation to participate in class activities, which promotes learning and increases performance on assessments ( 7 , 16 , 19 , 23 ). For these reasons, case-based teaching has been widely used in business and medical education for many years ( 4 , 11 , 12 , 14 ). Although case studies were considered a novel method of science education just 20 years ago, the case study teaching method has gained popularity in recent years among an array of scientific disciplines such as biology, chemistry, nursing, and psychology ( 5 – 7 , 9 , 11 , 13 , 15 – 17 , 21 , 22 , 24 ).

Although there is now a substantive and growing body of literature describing how to develop and use case studies in science teaching, current research on the effectiveness of case study teaching at meeting specific learning objectives is of limited scope and depth. Studies have shown that working in groups during completion of case studies significantly improves student perceptions of learning and may increase performance on assessment questions, and that the use of clickers can increase student engagement in case study activities, particularly among non-science majors, women, and freshmen ( 7 , 21 , 22 ). Case study teaching has been shown to improve exam performance in an anatomy and physiology course, increasing the mean score across all exams given in a two-semester sequence from 66% to 73% ( 5 ). Use of case studies was also shown to improve students’ ability to synthesize complex analytical questions about the real-world issues associated with a scientific topic ( 6 ). In a high school chemistry course, it was demonstrated that the case study teaching method produces significant increases in self-reported control of learning, task value, and self-efficacy for learning and performance ( 24 ). This effect on student motivation is important because enhanced motivation for learning activities has been shown to promote student engagement and academic performance ( 19 , 24 ). Additionally, faculty from a number of institutions have reported that using case studies promotes critical thinking, learning, and participation among students, especially in terms of the ability to view an issue from multiple perspectives and to grasp the practical application of core course concepts ( 23 ).

Despite what is known about the effectiveness of case studies in science education, questions remain about the functionality of the case study teaching method at promoting specific learning objectives that are important to many undergraduate biology courses. A recent survey of teachers who use case studies found that the topics most often covered in general biology courses included genetics and heredity, cell structure, cells and energy, chemistry of life, and cell cycle and cancer, suggesting that these topics should be of particular interest in studies that examine the effectiveness of the case study teaching method ( 8 ). However, the existing body of literature lacks direct evidence that the case study method is an effective tool for teaching about this collection of important topics in biology courses. Further, the extent to which case study teaching promotes development of science communication skills and the ability to understand the connections between biological concepts and everyday life has not been examined, yet these are core learning objectives shared by a variety of science courses. Although many instructors have produced case studies for use in their own classrooms, the production of novel case studies is time-consuming and requires skills that not all instructors have perfected. It is therefore important to determine whether case studies published by instructors who are unaffiliated with a particular course can be used effectively and obviate the need for each instructor to develop new case studies for their own courses. The results reported herein indicate that teaching with case studies results in significantly higher performance on examination questions about chemical bonds, osmosis and diffusion, mitosis and meiosis, and DNA structure and replication than that achieved by class discussions and textbook reading for topics of similar complexity. Case studies also increased overall student perceptions of learning gains and perceptions of learning gains specifically related to written and oral communication skills and the ability to grasp connections between scientific topics and their real-world applications. The effectiveness of the case study teaching method at increasing academic performance was not correlated to whether the case study used was authored by the instructor of the course or by an unaffiliated instructor. These findings support increased use of published case studies in the teaching of a variety of biological concepts and learning objectives.

Student population

This study was conducted at Kingsborough Community College, which is part of the City University of New York system, located in Brooklyn, New York. Kingsborough Community College has a diverse population of approximately 19,000 undergraduate students. The student population included in this study was enrolled in the first semester of a two-semester sequence of general (introductory) biology for biology majors during the spring, winter, or summer semester of 2014. A total of 63 students completed the course during this time period; 56 students consented to the inclusion of their data in the study. Of the students included in the study, 23 (41%) were male and 33 (59%) were female; 40 (71%) were registered as college freshmen and 16 (29%) were registered as college sophomores. To normalize participant groups, the same student population pooled from three classes taught by the same instructor was used to assess both experimental and control teaching methods.

Course material

The four biological concepts assessed during this study (chemical bonds, osmosis and diffusion, mitosis and meiosis, and DNA structure and replication) were selected as topics for studying the effectiveness of case study teaching because they were the key concepts addressed by this particular course that were most likely to be taught in a number of other courses, including biology courses for both majors and nonmajors at outside institutions. At the start of this study, relevant existing case studies were freely available from the National Center for Case Study Teaching in Science (NCCSTS) to address mitosis and meiosis and DNA structure and replication, but published case studies that appropriately addressed chemical bonds and osmosis and diffusion were not available. Therefore, original case studies that addressed the latter two topics were produced as part of this study, and case studies produced by unaffiliated instructors and published by the NCCSTS were used to address the former two topics. By the conclusion of this study, all four case studies had been peer-reviewed and accepted for publication by the NCCSTS ( http://sciencecases.lib.buffalo.edu/cs/ ). Four of the remaining core topics covered in this course (macromolecules, photosynthesis, genetic inheritance, and translation) were selected as control lessons to provide control assessment data.

To minimize extraneous variation, control topics and assessments were carefully matched in complexity, format, and number with case studies, and an equal amount of class time was allocated for each case study and the corresponding control lesson. Instruction related to control lessons was delivered using minimal slide-based lectures, with emphasis on textbook reading assignments accompanied by worksheets completed by students in and out of the classroom, and small and large group discussion of key points. Completion of activities and discussion related to all case studies and control topics that were analyzed was conducted in the classroom, with the exception of the take-home portion of the osmosis and diffusion case study.

Data collection and analysis

This study was performed in accordance with a protocol approved by the Kingsborough Community College Human Research Protection Program and the Institutional Review Board (IRB) of the City University of New York (CUNY IRB reference 539938-1; KCC IRB application #: KCC 13-12-126-0138). Assessment scores were collected from regularly scheduled course examinations. For each case study, control questions were included on the same examination that were similar in number, format, point value, and difficulty level, but related to a different topic covered in the course that was of similar complexity. Complexity and difficulty of both case study and control questions were evaluated using experiential data from previous iterations of the course; the Bloom’s taxonomy designation and amount of material covered by each question, as well as the average score on similar questions achieved by students in previous iterations of the course was considered in determining appropriate controls. All assessment questions were scored using a standardized, pre-determined rubric. Student perceptions of learning gains were assessed using a modified version of the Student Assessment of Learning Gains (SALG) course evaluation tool ( http://www.salgsite.org ), distributed in hardcopy and completed anonymously during the last week of the course. Students were presented with a consent form to opt-in to having their data included in the data analysis. After the course had concluded and final course grades had been posted, data from consenting students were pooled in a database and identifying information was removed prior to analysis. Statistical analysis of data was conducted using the Kruskal-Wallis one-way analysis of variance and calculation of the R 2 coefficient of determination.

Teaching with case studies improves performance on learning assessments, independent of case study origin

To evaluate the effectiveness of the case study teaching method at promoting learning, student performance on examination questions related to material covered by case studies was compared with performance on questions that covered material addressed through classroom discussions and textbook reading. The latter questions served as control items; assessment items for each case study were compared with control items that were of similar format, difficulty, and point value ( Appendix 1 ). Each of the four case studies resulted in an increase in examination performance compared with control questions that was statistically significant, with an average difference of 18% ( Fig. 1 ). The mean score on case study-related questions was 73% for the chemical bonds case study, 79% for osmosis and diffusion, 76% for mitosis and meiosis, and 70% for DNA structure and replication ( Fig. 1 ). The mean score for non-case study-related control questions was 60%, 54%, 60%, and 52%, respectively ( Fig. 1 ). In terms of examination performance, no significant difference between case studies produced by the instructor of the course (chemical bonds and osmosis and diffusion) and those produced by unaffiliated instructors (mitosis and meiosis and DNA structure and replication) was indicated by the Kruskal-Wallis one-way analysis of variance. However, the 25% difference between the mean score on questions related to the osmosis and diffusion case study and the mean score on the paired control questions was notably higher than the 13–18% differences observed for the other case studies ( Fig. 1 ).

Case study teaching method increases student performance on examination questions. Mean score on a set of examination questions related to lessons covered by case studies (black bars) and paired control questions of similar format and difficulty about an unrelated topic (white bars). Chemical bonds, n = 54; Osmosis and diffusion, n = 54; Mitosis and meiosis, n = 51; DNA structure and replication, n = 50. Error bars represent the standard error of the mean (SEM). Asterisk indicates p < 0.05.

Case study teaching increases student perception of learning gains related to core course objectives

Student learning gains were assessed using a modified version of the SALG course evaluation tool ( Appendix 2 ). To determine whether completing case studies was more effective at increasing student perceptions of learning gains than completing textbook readings or participating in class discussions, perceptions of student learning gains for each were compared. In response to the question “Overall, how much did each of the following aspects of the class help your learning?” 82% of students responded that case studies helped a “good” or “great” amount, compared with 70% for participating in class discussions and 58% for completing textbook reading; only 4% of students responded that case studies helped a “small amount” or “provided no help,” compared with 2% for class discussions and 22% for textbook reading ( Fig. 2A ). The differences in reported learning gains derived from the use of case studies compared with class discussion and textbook readings were statistically significant, while the difference in learning gains associated with class discussion compared with textbook reading was not statistically significant by a narrow margin ( p = 0.051).

The case study teaching method increases student perceptions of learning gains. Student perceptions of learning gains are indicated by plotting responses to the question “How much did each of the following activities: (A) Help your learning overall? (B) Improve your ability to communicate your knowledge of scientific concepts in writing? (C) Improve your ability to communicate your knowledge of scientific concepts orally? (D) Help you understand the connections between scientific concepts and other aspects of your everyday life?” Reponses are represented as follows: Helped a great amount (black bars); Helped a good amount (dark gray bars); Helped a moderate amount (medium gray bars); Helped a small amount (light gray bars); Provided no help (white bars). Asterisk indicates p < 0.05.

To elucidate the effectiveness of case studies at promoting learning gains related to specific course learning objectives compared with class discussions and textbook reading, students were asked how much each of these methods of content delivery specifically helped improve skills that were integral to fulfilling three main course objectives. When students were asked how much each of the methods helped “improve your ability to communicate knowledge of scientific concepts in writing,” 81% of students responded that case studies help a “good” or “great” amount, compared with 63% for class discussions and 59% for textbook reading; only 6% of students responded that case studies helped a “small amount” or “provided no help,” compared with 8% for class discussions and 21% for textbook reading ( Fig. 2B ). When the same question was posed about the ability to communicate orally, 81% of students responded that case studies help a “good” or “great” amount, compared with 68% for class discussions and 50% for textbook reading, while the respective response rates for helped a “small amount” or “provided no help,” were 4%, 6%, and 25% ( Fig. 2C ). The differences in learning gains associated with both written and oral communication were statistically significant when completion of case studies was compared with either participation in class discussion or completion of textbook readings. Compared with textbook reading, class discussions led to a statistically significant increase in oral but not written communication skills.

Students were then asked how much each of the methods helped them “understand the connections between scientific concepts and other aspects of your everyday life.” A total of 79% of respondents declared that case studies help a “good” or “great” amount, compared with 70% for class discussions and 57% for textbook reading ( Fig. 2D ). Only 4% stated that case studies and class discussions helped a “small amount” or “provided no help,” compared with 21% for textbook reading ( Fig. 2D ). Similar to overall learning gains, the use of case studies significantly increased the ability to understand the relevance of science to everyday life compared with class discussion and textbook readings, while the difference in learning gains associated with participation in class discussion compared with textbook reading was not statistically significant ( p = 0.054).

Student perceptions of learning gains resulting from case study teaching are positively correlated to increased performance on examinations, but independent of case study author

To test the hypothesis that case studies produced specifically for this course by the instructor were more effective at promoting learning gains than topically relevant case studies published by authors not associated with this course, perceptions of learning gains were compared for each of the case studies. For both of the case studies produced by the instructor of the course, 87% of students indicated that the case study provided a “good” or “great” amount of help to their learning, and 2% indicated that the case studies provided “little” or “no” help ( Table 1 ). In comparison, an average of 85% of students indicated that the case studies produced by an unaffiliated instructor provided a “good” or “great” amount of help to their learning, and 4% indicated that the case studies provided “little” or “no” help ( Table 1 ). The instructor-produced case studies yielded both the highest and lowest percentage of students reporting the highest level of learning gains (a “great” amount), while case studies produced by unaffiliated instructors yielded intermediate values. Therefore, it can be concluded that the effectiveness of case studies at promoting learning gains is not significantly affected by whether or not the course instructor authored the case study.

Case studies positively affect student perceptions of learning gains about various biological topics.

Finally, to determine whether performance on examination questions accurately predicts student perceptions of learning gains, mean scores on examination questions related to case studies were compared with reported perceptions of learning gains for those case studies ( Fig. 3 ). The coefficient of determination (R 2 value) was 0.81, indicating a strong, but not definitive, positive correlation between perceptions of learning gains and performance on examinations, suggesting that student perception of learning gains is a valid tool for assessing the effectiveness of case studies ( Fig. 3 ). This correlation was independent of case study author.

Perception of learning gains but not author of case study is positively correlated to score on related examination questions. Percentage of students reporting that each specific case study provided “a great amount of help” to their learning was plotted against the point difference between mean score on examination questions related to that case study and mean score on paired control questions. Positive point differences indicate how much higher the mean scores on case study-related questions were than the mean scores on paired control questions. Black squares represent case studies produced by the instructor of the course; white squares represent case studies produced by unaffiliated instructors. R 2 value indicates the coefficient of determination.

The purpose of this study was to test the hypothesis that teaching with case studies produced by the instructor of a course is more effective at promoting learning gains than using case studies produced by unaffiliated instructors. This study also tested the hypothesis that the case study teaching method is more effective than class discussions and textbook reading at promoting learning gains associated with four of the most commonly taught topics in undergraduate general biology courses: chemical bonds, osmosis and diffusion, mitosis and meiosis, and DNA structure and replication. In addition to assessing content-based learning gains, development of written and oral communication skills and the ability to connect scientific topics with real-world applications was also assessed, because these skills were overarching learning objectives of this course, and classroom activities related to both case studies and control lessons were designed to provide opportunities for students to develop these skills. Finally, data were analyzed to determine whether performance on examination questions is positively correlated to student perceptions of learning gains resulting from case study teaching.

Compared with equivalent control questions about topics of similar complexity taught using class discussions and textbook readings, all four case studies produced statistically significant increases in the mean score on examination questions ( Fig. 1 ). This indicates that case studies are more effective than more commonly used, traditional methods of content delivery at promoting learning of a variety of core concepts covered in general biology courses. The average increase in score on each test item was equivalent to nearly two letter grades, which is substantial enough to elevate the average student performance on test items from the unsatisfactory/failing range to the satisfactory/passing range. The finding that there was no statistical difference between case studies in terms of performance on examination questions suggests that case studies are equally effective at promoting learning of disparate topics in biology. The observations that students did not perform significantly less well on the first case study presented (chemical bonds) compared with the other case studies and that performance on examination questions did not progressively increase with each successive case study suggests that the effectiveness of case studies is not directly related to the amount of experience students have using case studies. Furthermore, anecdotal evidence from previous semesters of this course suggests that, of the four topics addressed by cases in this study, DNA structure and function and osmosis and diffusion are the first and second most difficult for students to grasp. The lack of a statistical difference between case studies therefore suggests that the effectiveness of a case study at promoting learning gains is not directly proportional to the difficulty of the concept covered. However, the finding that use of the osmosis and diffusion case study resulted in the greatest increase in examination performance compared with control questions and also produced the highest student perceptions of learning gains is noteworthy and could be attributed to the fact that it was the only case study evaluated that included a hands-on experiment. Because the inclusion of a hands-on kinetic activity may synergistically enhance student engagement and learning and result in an even greater increase in learning gains than case studies that lack this type of activity, it is recommended that case studies that incorporate this type of activity be preferentially utilized.

Student perceptions of learning gains are strongly motivating factors for engagement in the classroom and academic performance, so it is important to assess the effect of any teaching method in this context ( 19 , 24 ). A modified version of the SALG course evaluation tool was used to assess student perceptions of learning gains because it has been previously validated as an efficacious tool ( Appendix 2 ) ( 20 ). Using the SALG tool, case study teaching was demonstrated to significantly increase student perceptions of overall learning gains compared with class discussions and textbook reading ( Fig. 2A ). Case studies were shown to be particularly useful for promoting perceived development of written and oral communication skills and for demonstrating connections between scientific topics and real-world issues and applications ( Figs. 2B–2D ). Further, student perceptions of “great” learning gains positively correlated with increased performance on examination questions, indicating that assessment of learning gains using the SALG tool is both valid and useful in this course setting ( Fig. 3 ). These findings also suggest that case study teaching could be used to increase student motivation and engagement in classroom activities and thus promote learning and performance on assessments. The finding that textbook reading yielded the lowest student perceptions of learning gains was not unexpected, since reading facilitates passive learning while the class discussions and case studies were both designed to promote active learning.

Importantly, there was no statistical difference in student performance on examinations attributed to the two case studies produced by the instructor of the course compared with the two case studies produced by unaffiliated instructors. The average difference between the two instructor-produced case studies and the two case studies published by unaffiliated instructors was only 3% in terms of both the average score on examination questions (76% compared with 73%) and the average increase in score compared with paired control items (14% compared with 17%) ( Fig. 1 ). Even when considering the inherent qualitative differences of course grades, these differences are negligible. Similarly, the effectiveness of case studies at promoting learning gains was not significantly affected by the origin of the case study, as evidenced by similar percentages of students reporting “good” and “great” learning gains regardless of whether the case study was produced by the course instructor or an unaffiliated instructor ( Table 1 ).

The observation that case studies published by unaffiliated instructors are just as effective as those produced by the instructor of a course suggests that instructors can reasonably rely on the use of pre-published case studies relevant to their class rather than investing the considerable time and effort required to produce a novel case study. Case studies covering a wide range of topics in the sciences are available from a number of sources, and many of them are free access. The National Center for Case Study Teaching in Science (NCCSTS) database ( http://sciencecases.lib.buffalo.edu/cs/ ) contains over 500 case studies that are freely available to instructors, and are accompanied by teaching notes that provide logistical advice and additional resources for implementing the case study, as well as a set of assessment questions with a password-protected answer key. Case study repositories are also maintained by BioQUEST Curriculum Consortium ( http://www.bioquest.org/icbl/cases.php ) and the Science Case Network ( http://sciencecasenet.org ); both are available for use by instructors from outside institutions.

It should be noted that all case studies used in this study were rigorously peer-reviewed and accepted for publication by the NCCSTS prior to the completion of this study ( 2 , 10 , 18 , 25 ); the conclusions of this study may not apply to case studies that were not developed in accordance with similar standards. Because case study teaching involves skills such as creative writing and management of dynamic group discussion in a way that is not commonly integrated into many other teaching methods, it is recommended that novice case study teachers seek training or guidance before writing their first case study or implementing the method. The lack of a difference observed in the use of case studies from different sources should be interpreted with some degree of caution since only two sources were represented in this study, and each by only two cases. Furthermore, in an educational setting, quantitative differences in test scores might produce meaningful qualitative differences in course grades even in the absence of a p value that is statistically significant. For example, there is a meaningful qualitative difference between test scores that result in an average grade of C− and test scores that result in an average grade of C+, even if there is no statistically significant difference between the two sets of scores.

In the future, it could be informative to confirm these findings using a larger cohort, by repeating the study at different institutions with different instructors, by evaluating different case studies, and by directly comparing the effectiveness of the case studying teaching method with additional forms of instruction, such as traditional chalkboard and slide-based lecturing, and laboratory-based activities. It may also be informative to examine whether demographic factors such as student age and gender modulate the effectiveness of the case study teaching method, and whether case studies work equally well for non-science majors taking a science course compared with those majoring in the subject. Since the topical material used in this study is often included in other classes in both high school and undergraduate education, such as cell biology, genetics, and chemistry, the conclusions of this study are directly applicable to a broad range of courses. Presently, it is recommended that the use of case studies in teaching undergraduate general biology and other science courses be expanded, especially for the teaching of capacious issues with real-world applications and in classes where development of written and oral communication skills are key objectives. The use of case studies that involve hands-on activities should be emphasized to maximize the benefit of this teaching method. Importantly, instructors can be confident in the use of pre-published case studies to promote learning, as there is no indication that the effectiveness of the case study teaching method is reliant on the production of novel, customized case studies for each course.

SUPPLEMENTAL MATERIALS

Acknowledgments.

This article benefitted from a President’s Faculty Innovation Grant, Kingsborough Community College. The author declares that there are no conflicts of interest.

† Supplemental materials available at http://jmbe.asm.org

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The Case Study Teaching Method

It is easy to get confused between the case study method and the case method , particularly as it applies to legal education. The case method in legal education was invented by Christopher Columbus Langdell, Dean of Harvard Law School from 1870 to 1895. Langdell conceived of a way to systematize and simplify legal education by focusing on previous case law that furthered principles or doctrines. To that end, Langdell wrote the first casebook, entitled A Selection of Cases on the Law of Contracts , a collection of settled cases that would illuminate the current state of contract law. Students read the cases and came prepared to analyze them during Socratic question-and-answer sessions in class.

The Harvard Business School case study approach grew out of the Langdellian method. But instead of using established case law, business professors chose real-life examples from the business world to highlight and analyze business principles. HBS-style case studies typically consist of a short narrative (less than 25 pages), told from the point of view of a manager or business leader embroiled in a dilemma. Case studies provide readers with an overview of the main issue; background on the institution, industry, and individuals involved; and the events that led to the problem or decision at hand. Cases are based on interviews or public sources; sometimes, case studies are disguised versions of actual events or composites based on the faculty authors’ experience and knowledge of the subject. Cases are used to illustrate a particular set of learning objectives; as in real life, rarely are there precise answers to the dilemma at hand.

Our suite of free materials offers a great introduction to the case study method. We also offer review copies of our products free of charge to educators and staff at degree-granting institutions.

For more information on the case study teaching method, see:

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What is the Case Method?

The core pedagogy of Harvard Business School since the early 20th century, the case method boasts a unique ability to make complex concepts accessible and develop students’ leadership skills, all while creating an engaging intellectual atmosphere.

A “case” is a short narrative document – a story – that presents a particular challenge facing an individual or organization. Each case reflects the information available to decision-makers at the time, and builds to a particular decision point, but without revealing what decision was actually made. For each class, students are asked to read the case and to put themselves in the shoes of the actual decision-makers to consider what they themselves would have done given the information available at the time.

To help situate the decision, each case also provides background history on the most relevant issues and events leading up to the decision point. For example, a case that focuses on a decision facing Martin Luther King Jr. during the campaign for black voting rights in 1965 also traces the broader civil rights movement, as well as the history of segregation and black disenfranchisement in the U.S. since the Civil War.

In the classroom, the instructor poses questions to guide student discussion. These carefully designed questions are the key to any successful case-method course. An experienced case-method teacher is often thinking several steps ahead, anticipating what points and questions might be raised and standing ready with follow-up questions to guide the group. Active participation in class is essential to the case method’s success, and the grading metrics reflect its importance. Students quickly learn to speak up, to challenge each other, and to build on each other’s ideas.

Any professor or teacher can teach by the case method. Content expertise beyond the case itself is helpful but not required. To assist both experienced and new case-method teachers, each case has its own teaching plan: a flexible road-map for the instructor that suggests specific questions, strategies for eliciting key insights, and ideas for organizing student responses visually on a blackboard. For some cases, more extensive supporting documents known as “teaching notes” are available to fully brief the instructor on the relevant history and the multiple levels of questions he or she might consider.

“ I’ve never had this experience as a teacher before, and it's explicitly due to the case method — it's a game changer. ”

Using Case Studies to Teach

Why Use Cases?

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

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

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

Common Case Elements

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

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

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

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

Advantages to the use of case studies in class

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

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

Guidelines for using case studies in class

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

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

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

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

Accompanying Readings

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

Leading the Case Discussion and Evaluating Performance

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

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

Tips on the Penn State U. website: http://tlt.its.psu.edu/suggestions/cases/

If you are interested in using this technique in a science course, there is a good website on use of case studies in the sciences at the University of Buffalo.

Dunne, D. and Brooks, K. (2004) Teaching with Cases (Halifax, NS: Society for Teaching and Learning in Higher Education), ISBN 0-7703-8924-4 (Can be ordered at http://www.bookstore.uwo.ca/ at a cost of $15.00)

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Harvard T.H. Chan School of Public Health Case-Based Teaching & Learning Initiative

Teaching cases & active learning resources for public health education, teaching & learning with the case method.

2023. Case Compendium, University of California Berkeley Haas School of Business Center for Equity, Gender & Leadership . Visit website This resource, compiled by the Berkeley Haas Center for Equity, Gender & Leadership, is "a case compendium that includes: (a) case studies with diverse protagonists, and (b) case studies that build “equity fluency” by focusing on DEI-related issues and opportunities. The goal of the compendium is to support professors at Haas, and business schools globally, to identify cases they can use in their own classrooms, and ultimately contribute to advancing DEI in education and business."

Kane, N.M. , 2014. Benefits of Case-Based Teaching . Watch video Watch a demonstration of Prof. Nancy Kane teaching public health with the case method. (Part 3 of 3, 3 minutes)

Kane, N.M. , 2014. Case teaching demonstration: Should a health plan cover medical tourism? . Watch video Watch a demonstration of Prof. Nancy Kane teaching public health with the case method. (Part 2 of 3, 17 minutes)

Kane, N.M. , 2014. Case-based teaching at the Harvard T.H. Chan School of Public Health . Watch video Watch a demonstration of Prof. Nancy Kane teaching public health with the case method. (Part 1 of 3, 10 minutes)

2019. The Case Centre . Visit website A non-profit clearing house for materials on the case method, the Case Centre holds a large and diverse collection of cases, articles, book chapters and teaching materials, including the collections of leading business schools across the globe.

Austin, S.B. & Sonneville, K.R. , 2013. Closing the "know-do" gap: training public health professionals in eating disorders prevention via case-method teaching. International Journal of Eating Disorders , 46 (5) , pp. 533-537. Read online Abstract Expansion of our societies' capacity to prevent eating disorders will require strategic integration of the topic into the curricula of professional training programs. An ideal way to integrate new content into educational programs is through the case-method approach, a teaching method that is more effective than traditional teaching techniques. The Strategic Training Initiative for the Prevention of Eating Disorders has begun developing cases designed to be used in classroom settings to engage students in topical, high-impact issues in public health approaches to eating disorders prevention and screening. Dissemination of these cases will provide an opportunity for students in public health training programs to learn material in a meaningful context by actively applying skills as they are learning them, helping to bridge the "know-do" gap. The new curriculum is an important step toward realizing the goal that public health practitioners be fully equipped to address the challenge of eating disorders prevention. "Expansion of our societies' capacity to prevent eating disorders will require strategic integration of the topic into the curricula of professional training programs. An ideal way to integrate new content into educational programs is through the case-method approach, a teaching method that is more effective than traditional teaching techniques." Access full article with HarvardKey . 

Ellet, W. , 2018. The Case Study Handbook, Revised Edition: A Student's Guide , Harvard Business School Publishing. Publisher's Version "If you're like many people, you may find interpreting and writing about cases mystifying and time-consuming. In The Case Study Handbook, Revised Edition , William Ellet presents a potent new approach for efficiently analyzing, discussing, and writing about cases."

Andersen, E. & Schiano, B. , 2014. Teaching with Cases: A Practical Guide , Harvard Business School Publishing. Publisher's Version "The class discussion inherent in case teaching is well known for stimulating the development of students' critical thinking skills, yet instructors often need guidance on managing that class discussion to maximize learning. Teaching with Cases focuses on practical advice for instructors that can be easily implemented. It covers how to plan a course, how to teach it, and how to evaluate it." 

Honan, J. & Sternman Rule, C. , 2002. Case Method Instruction Versus Lecture-Based Instruction R. Reis, ed. Tomorrow's Professor . Read online "Faculty and discussion leaders who incorporate the case study method into their teaching offer various reasons for their enthusiasm for this type of pedagogy over more traditional, such as lecture-based, instructional methods and routes to learning." Exerpt from the book Using Cases in Higher Education: A Guide for Faculty and Administrators , by James P. Honan and Cheryl Sternman Rule.

Austin, J. , 1993. Teaching Notes: Communicating the Teacher's Wisdom , Harvard Business School Publishing. Publisher's Version "Provides guidance for the preparation of teaching notes. Sets forth the rationale for teaching notes, what they should contain and why, and how they can be prepared. Based on the experiences of Harvard Business School faculty."

Abell, D. , 1997. What makes a good case? . ECCHO–The Newsletter of the European Case Clearing House , 17 (1) , pp. 4-7. Read online "Case writing is both art and science. There are few, if any, specific prescriptions or recipes, but there are key ingredients that appear to distinguish excellent cases from the run-of-the-mill. This technical note lists ten ingredients to look for if you are teaching somebody else''s case - and to look out for if you are writing it yourself."

Herreid, C.F. , 2001. Don't! What not to do when teaching cases. Journal of College Science Teaching , 30 (5) , pp. 292. Read online "Be warned, I am about to unleash a baker’s dozen of 'don’ts' for aspiring case teachers willing to try running a classroom discussion armed with only a couple of pages of a story and a lot of chutzpah."

Garvin, D.A. , 2003. Making the case: Professional education for the world of practice . Harvard Magazine , 106 (1) , pp. 56-65. Read online A history and overview of the case-method in professional schools, which all “face the same difficult challenge: how to prepare students for the world of practice. Time in the classroom must somehow translate directly into real-world activity: how to diagnose, decide, and act."

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• Teaching with Cases

At professional schools (like Harvard’s Law, Business, Education, or Medical Schools), courses often adopt the so-called "case method" of teaching , in which students are confronted with real-world problems or scenarios involving multiple stakeholders and competing priorities. Most of the cases which faculty use with their students are written by professionals who have expertise in researching and writing in that genre, and for good reason—writing a truly masterful case, one which can engage students in hours of debate and deliberation, takes a lot of time and effort. It can be effective, nevertheless, for you to try implementing some aspects of the case-teaching approach in your class. Among the benefits which accrue to using case studies are the following:

• the fact that it gives your students the opportunity to "practice" a real-world application;
• the fact that it compels them (and you!) to reconstruct all of the divergent and convergent perspectives which different parties might bring to the scenario;
• the fact that it motivates your students to anticipate a wide range of possible responses which a reader might have; and
• the fact that it invites your students to indulge in metacognition as they revisit the process by which they became more knowledgeable about the scenario.

Features of an Effective Teaching Case

While no two case studies will be exactly alike, here are some of those principles:

• The case should illustrate what happens when a concept from the course could be, or has been, applied in the real world. Depending on the course, a “concept” might mean any one among a range of things, including an abstract principle, a theory, a tension, an issue, a method, an approach, or simply a way of thinking characteristic of an academic field. Whichever you choose, you should make sure to “ground” the case in a realistic setting early in the narrative, so that participants understand their role in the scenario.
• The case materials should include enough factual content and context to allow students to explore multiple perspectives. In order for participants to feel that they are encountering a real-world application of the course material, and that they have some freedom and agency in terms of how they interpret it, they need to be able to see the issue or problem from more than one perspective. Moreover, those perspectives need to seem genuine, and to be sketched in enough detail to seem complex. (In fact, it’s not a bad idea to include some “extraneous” information about the stakeholders involved in the case, so that students have to filter out things that seem relevant or irrelevant to them.) Otherwise, participants may fall back on picking obvious “winners” and “losers” rather than seeking creative, negotiated solutions that satisfy multiple stakeholders.
• The case materials should confront participants with a range of realistic constraints, hard choices, and authentic outcomes. If the case presumes that participants will all become omniscient, enjoy limitless resources, and succeed, they won’t learn as much about themselves as team-members and decision-makers as if they are forced to confront limitations, to make tough decisions about priorities, and to be prepared for unexpected results. These constraints and outcomes can be things which have been documented in real life, but they can also be things which the participants themselves surface in their deliberations.

• The activity should include space to reflect upon the decision-making process and the lessons of the case. Writing a case offers an opportunity to engage in multiple layers of reflection. For you, as the case writer, it is an occasion to anticipate how you (if you were the instructor) might create scenarios that are aligned with, and likely to meet the learning objectives of, a given unit of your course. For the participants whom you imagine using your case down the road, the case ideally should help them (1) to understand their own hidden assumptions, priorities, values, and biases better; and (2) to close the gap between their classroom learning and its potential real-world applications.

For more information...

Kim, Sara et al. 2006. "A Conceptual Framework for Developing Teaching Cases: A Review and Synthesis of the Literature across Disciplines." Medical Education 40: 867–876.

Herreid, Clyde Freeman. 2011. "Case Study Teaching." New Directions for Teaching and Learning 128: 31–40.

Nohria, Nitin. 2021. "What the Case Study Method Really Teaches." Harvard Business Review .

Swiercz, Paul Michael. "SWIF Learning: A Guide to Student Written-Instructor Facilitated Case Writing."

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Teaching with Case Studies

The Case Study method is based on focused stories, rooted in reality, and provides contextual information such as background, characters, setting, and enough specific details to provide some guidance. Cases can be used to illustrate, remediate, and practice critical thinking, teamwork, research, and communication skills. Classroom applications of the case study method include:

• Socratic cross examination
• Directed discussion or research teams
• Public hearings or trials
• Dialogue paper (e.g., 10 exchanges between two characters from opposing sides of an issue that finish with a personal opinion or reflection)

At the Fifth Annual Conference on Case Study Teaching in Science hosted by the University of Buffalo-SUNY, two broad categories of case studies were identified (recognizing potential overlap):

• Open or Closed: Open cases are left to one’s interpretation and may have multiple correct or valid answers depending on the rationale and facts presented in the case analysis. Closed cases have specific, correct answers or processes that must be followed in order to arrive at the correct analysis.
• Analysis or Dilemma: Analysis Cases (Issues Cases) are a general account of “what happened.” Dilemma Cases (Decision Cases) require students to make a decision or take action given certain information.

Case Study Analysis Process

Based on a variety of different case study analysis models, we have identified four basic stages students follow in analyzing a case study. This process may vary depending on discipline and if case studies are being used as part of a problem-based learning exercise.

• Observe the facts and issues that are present without interpretation (“what do we know”).
• Develop hypotheses/questions, formulate predictions, and provide explanations or justifications based on the known information (“what do we need to know”).
• Collect and explore relevant data to answer open questions, reinforce/refute hypotheses, and formulate new hypotheses and questions.
• Communicate findings including citations and documentation.

How to Write a Case Study

Effective case studies tell a story, have compelling and identifiable characters, contain depth and complexity, and have dilemmas that are not easily resolved. The following steps provide a general guide for use in identifying the various issues and criteria comprising a good case study.

• Identify a course and list the teachable principles, topics, and issues (often a difficult or complex concept students just don’t “get”).
• List any relevant controversies and subtopics that further describe your topics.
• Identify stakeholders or those affected by the issue (from that list, consider choosing one central character on which to base the case study).
• Identify teaching methods that might be used (team project, dialogue paper, debate, etc.) as well as the most appropriate assessment method (peer or team assessments, participation grade, etc.).
• Decide what materials and resources will be provided to students.
• Identify and describe the deliverables students will produce (paper, presentation, etc.).
• Select the category of case study (open or closed/analysis or dilemma) that best fits your topic, scenario, learning outcomes, teaching method, and assessment strategy. Write your case study and include teaching notes outlining the critical elements identified above.
• Teach the case and subsequently make any necessary revisions.

Problem-Based Learning (PBL)

PBL uses case studies in a slightly different way by providing a more specific structure for learning. The medical field uses this approach extensively. According to Barrows & Tamblyn (1980), the case problem is presented first in the learning sequence, before any background preparation has occurred. The case study analysis process outlined above is used with PBL; the main difference being that cases are presented in pieces, with increasing amounts of specific detail provided in each layer of the case (e.g., part one of the case may simply be a patient admission form, part two may provide a summary of patient examination notes, part three may contain specific medical test results, and so on).

The problem-based learning approach encourages student-directed learning and allows the instructor to serve as a facilitator. Students frame and identify problems and continually identify and test hypotheses. During group tutorials, case-related questions arise that students are unable to answer. These questions form the basis for learning issues that students will study independently between sessions. This method requires an alert and actively involved instructor to facilitate.

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Making Learning Relevant With Case Studies

The open-ended problems presented in case studies give students work that feels connected to their lives.

To prepare students for jobs that haven’t been created yet, we need to teach them how to be great problem solvers so that they’ll be ready for anything. One way to do this is by teaching content and skills using real-world case studies, a learning model that’s focused on reflection during the problem-solving process. It’s similar to project-based learning, but PBL is more focused on students creating a product.

Case studies have been used for years by businesses, law and medical schools, physicians on rounds, and artists critiquing work. Like other forms of problem-based learning, case studies can be accessible for every age group, both in one subject and in interdisciplinary work.

You can get started with case studies by tackling relatable questions like these with your students:

• How can we limit food waste in the cafeteria?
• How can we get our school to recycle and compost waste? (Or, if you want to be more complex, how can our school reduce its carbon footprint?)
• How can we improve school attendance?
• How can we reduce the number of people who get sick at school during cold and flu season?

Addressing questions like these leads students to identify topics they need to learn more about. In researching the first question, for example, students may see that they need to research food chains and nutrition. Students often ask, reasonably, why they need to learn something, or when they’ll use their knowledge in the future. Learning is most successful for students when the content and skills they’re studying are relevant, and case studies offer one way to create that sense of relevance.

Teaching With Case Studies

Ultimately, a case study is simply an interesting problem with many correct answers. What does case study work look like in classrooms? Teachers generally start by having students read the case or watch a video that summarizes the case. Students then work in small groups or individually to solve the case study. Teachers set milestones defining what students should accomplish to help them manage their time.

During the case study learning process, student assessment of learning should be focused on reflection. Arthur L. Costa and Bena Kallick’s Learning and Leading With Habits of Mind gives several examples of what this reflection can look like in a classroom: 

Journaling: At the end of each work period, have students write an entry summarizing what they worked on, what worked well, what didn’t, and why. Sentence starters and clear rubrics or guidelines will help students be successful. At the end of a case study project, as Costa and Kallick write, it’s helpful to have students “select significant learnings, envision how they could apply these learnings to future situations, and commit to an action plan to consciously modify their behaviors.”

Interviews: While working on a case study, students can interview each other about their progress and learning. Teachers can interview students individually or in small groups to assess their learning process and their progress.

Student discussion: Discussions can be unstructured—students can talk about what they worked on that day in a think-pair-share or as a full class—or structured, using Socratic seminars or fishbowl discussions. If your class is tackling a case study in small groups, create a second set of small groups with a representative from each of the case study groups so that the groups can share their learning.

4 Tips for Setting Up a Case Study

1. Identify a problem to investigate: This should be something accessible and relevant to students’ lives. The problem should also be challenging and complex enough to yield multiple solutions with many layers.

2. Give context: Think of this step as a movie preview or book summary. Hook the learners to help them understand just enough about the problem to want to learn more.

3. Have a clear rubric: Giving structure to your definition of quality group work and products will lead to stronger end products. You may be able to have your learners help build these definitions.

4. Provide structures for presenting solutions: The amount of scaffolding you build in depends on your students’ skill level and development. A case study product can be something like several pieces of evidence of students collaborating to solve the case study, and ultimately presenting their solution with a detailed slide deck or an essay—you can scaffold this by providing specified headings for the sections of the essay.

Problem-Based Teaching Resources

There are many high-quality, peer-reviewed resources that are open source and easily accessible online.

• The National Center for Case Study Teaching in Science at the University at Buffalo built an online collection of more than 800 cases that cover topics ranging from biochemistry to economics. There are resources for middle and high school students.
• Models of Excellence , a project maintained by EL Education and the Harvard Graduate School of Education, has examples of great problem- and project-based tasks—and corresponding exemplary student work—for grades pre-K to 12.
• The Interdisciplinary Journal of Problem-Based Learning at Purdue University is an open-source journal that publishes examples of problem-based learning in K–12 and post-secondary classrooms.
• The Tech Edvocate has a list of websites and tools related to problem-based learning.

In their book Problems as Possibilities , Linda Torp and Sara Sage write that at the elementary school level, students particularly appreciate how they feel that they are taken seriously when solving case studies. At the middle school level, “researchers stress the importance of relating middle school curriculum to issues of student concern and interest.” And high schoolers, they write, find the case study method “beneficial in preparing them for their future.”

• Case Teaching Resources

Teaching With Cases

Included here are resources to learn more about case method and teaching with cases.

What Is A Teaching Case?

This video explores the definition of a teaching case and introduces the rationale for using case method.

Narrated by Carolyn Wood, former director of the HKS Case Program

Learning by the Case Method

Questions for class discussion, common case teaching challenges and possible solutions, teaching with cases tip sheet, teaching ethics by the case method.

The case method is an effective way to increase student engagement and challenge students to integrate and apply skills to real-world problems. In these videos,  Using the Case Method to Teach Public Policy , you'll find invaluable insights into the art of case teaching from one of HKS’s most respected professors, Jose A. Gomez-Ibanez.

Chapter 1: Preparing for Class (2:29)

Chapter 2: How to begin the class and structure the discussion blocks (1:37)

Chapter 3: How to launch the discussion (1:36)

Chapter 4: Tools to manage the class discussion (2:23)

Chapter 5: Encouraging participation and acknowledging students' comments (1:52)

Chapter 6: Transitioning from one block to the next / Importance of body (2:05)

Chapter 7: Using the board plan to feed the discussion (3:33)

Chapter 8: Exploring the richness of the case (1:42)

Chapter 9: The wrap-up. Why teach cases? (2:49)

Teaching History Through the Case Method

Explore more.

• Case Teaching
• Course Materials

T he case method is typically synonymous with business school curriculum. Through active case discussion, students put themselves in the proverbial shoes of a case protagonist, often a manager or leader of a company or organization facing a difficult business challenge. Students apply critical thinking skills to work through complicated problems and process contending points of view, then engage with their classmates in developing a solution together. This intellectual energy is the pedagogical “magic” instructors strive for.

Perhaps a lesser-known power of the case method, however, is in its applicability across a variety of topics and student levels. Take, for instance, history, government, civics, and democracy—topics that feel particularly pertinent given the roller-coaster US election and other polarizing political events around the world.

In an effort to bring these important topics, particularly American history, to life, historian David Moss, the Paul Whiton Cherington Professor of Business Administration at Harvard Business School (HBS), has taken the case method’s magic from the business school to the high school. In 2015, Moss launched a pilot program in 11 public, charter, and private high schools across the United States. He provided 23 history and civics teachers with historical cases that showcase the foundations of US democracy—as well as worksheets, assignment questions, and teaching plans. He then made the cases available for free to high school students to encourage case teaching among this group.

The goal of this program, called the Case Method Project , is to demonstrate that teaching with cases can strengthen high school and college education as well as ensure “a more exciting, relevant, and effective experience for students and teachers across a range of subjects,” according to its site.

“The results [of the Case Method Project] have been incredibly positive, especially in terms of strengthening students’ critical thinking, their retention and understanding of course material, and their civic interest and engagement.” David Moss

Since its initial launch, the program has grown considerably. Today Moss is working with over 350 teachers in more than 250 high schools across 45 states and the District of Columbia. “We’ve now reached well over 30,000 students as part of the initial pilot,” he says. “The project has grown considerably over the last several years, and the results have been incredibly positive, especially in terms of strengthening students’ critical thinking, their retention and understanding of course material, and their civic interest and engagement. Because of this success, we’re aiming to reach much larger numbers of teachers and students going forward through the new Case Method Institute for Education and Democracy, which started up this summer.”

The case method has proven remarkably effective in teaching high schoolers the critical thinking skills that the world’s future leaders so greatly need. Here, to help educators see the different ways and venues in which case teaching can be used, we showcase the collection of cases Moss authored and provided in support of this effort.

Democracy Cases to Use in Class

Here is a list of Moss’s cases , which you can use to engage students in conversations about US history and democracy. We hope you find these cases helpful.

James Madison, the ‘Federal Negative,’ and the Making of the U.S. Constitution (1787) and as a supplement: In Detail: Debt and Paper Money in Rhode Island (1786)

Battle Over a Bank: Defining the Limits of Federal Power Under a New Constitution (1791)

Democracy, Sovereignty, and the Struggle over Cherokee Removal (1836)

Banking and Politics in Antebellum New York (1838)

Property, Suffrage, and the "Right of Revolution" in Rhode Island, 1842

Debt and Democracy: The New York Constitutional Convention of 1846

The Struggle Over Public Education in Early America (1851)

A Nation Divided: The United States and the Challenge of Secession (1861)

Reconstruction A: The Crisis of 1877

Reconstruction B: Jury Rights in Virginia, 1877-1880

An Australian Ballot for California? (1891)

Labor, Capital, and Government: The Anthracite Coal Strike of 1902

The Jungle and the Debate over Federal Meat Inspection in 1906

The Battle Over the Initiative and Referendum in Massachusetts (1918)

Regulating Radio in the Age of Broadcasting (1927)

The Pecora Hearings (1932-34)

Martin Luther King and the Struggle for Black Voting Rights (1965)

Democracy and Women’s Rights in America: The Fight over the ERA (1982)

Manufacturing Constituencies: Race and Redistricting in North Carolina, 1993

Leadership and Independence at the Federal Reserve (2009)

Citizens United and Corporate Speech (2010)

Do you use the case method to spark discussion and debate on topics outside of business disciplines? Let us know .

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The case method is a teaching approach that uses cases to place students in the role of people who were faced with difficult decisions at some point in the past. Below are some resources that may be helpful to instructors who are using the case method.

• The HBS Case Method Brief overview of the HBS case method.
• How They Teach The Case Method At Harvard Business School From the September 29, 2015 issue of Poets & Quants. Provides detailed background on how the case method is taught at Harvard Business School.
• Teaching by the Case Method: Christensen Center for Teaching & Learning Harvard Business School Explores the case method in practice and provides tip sheets for effective case method teaching.
• Teaching with Case Studies: Schreyer Institute for Teaching Excellence ( PennState) Describes how to use case studies as strategies to provide active learning experiences for students.
• Using Case Studies to Teach: BU Center for Teaching & Learning Provides a brief overview of how to most effectively use cases in Boston University classes.

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What is Teaching with the Case Method?

The case method combines two elements: the case itself and the discussion of that case. A teaching case is a rich narrative in which individuals or groups must make a decision or solve a problem. A teaching case is not a "case study" of the type used in academic research. Teaching cases provide information, but neither analysis nor conclusions. The analytical work of explaining the relationships among events in the case, identifying options, evaluating choices and predicting the effects of actions is the work done by students during the classroom discussion.

What are Cases?

Cases are narratives that contain information and invite analysis. Participants are put in the position of making decisions or evaluations based on the information available. Cases can be acquired from the formal, purpose written material available from such sources as the Harvard Business School and the Kennedy School or constructed by faculty members from newspaper articles, cartoons, radio stories and even grocery store coupons and fliers. (See the examples collection .)

Cases can involve situations in which decisions must be made or problems solved, or they can involve evaluation or reconsideration of existing policies, practices or proposals. Effective cases are usually based on real events, but can be drawn from both the present and the past, even the distant past. Cases require students to make choices about what theory or concepts to apply in conducting the analysis, which is distinct from the one to one correspondence between theory and application that they see in their textbooks or hear in lectures.

How do Cases differ from other kinds of examples?

Unlike examples from textbooks or those we insert in lectures, cases include information but provide no analysis. Cases present students with complex, unstructured problems that may include extraneous or irrelevant information and often don't include every piece of information an analyst would like to have. Unlike problem sets, they do not break the problem down into clear steps, and frequently have no single "right" answer. Cases provide a rich contextual way to introduce new material and create opportunities for students to apply the material they have just learned. The same overarching case can even can be used several times in the same course, as students return to the story of the case with new analytical techniques and tools. Cases require students to make choices about what theory or concepts to apply in conducting the analysis, which is distinct from the one to one correspondence between theory and application that they see in their textbooks or hear in lectures.

What happens in a Case Method classroom?

In classroom discussion, students analyze the information in the case and use it to solve the problem set up by the case. The discussion can take many forms, including closely directed questioning by faculty to help students draw out the information from the case and identify the central decisions or evaluations that need to be made, more open-ended questions and discussions as students evaluate options and weigh the evidence, and small group work by students focused on specific analytical tasks. Many faculty members use role-play as a technique to put students completely in the case environment. Ideally, case method discussions involve mostly conversation between and among students, rather than discussion centered on direct participation by the faculty member. Many case method teachers describe their role as conductor, facilitator, or guide, drawing attention to their role in setting up discussion in which students are the primary participants.

In what contexts are cases used?

Faculty members use cases in any environment in which they can effectively manage discussion. There are faculty members using it successfully in very large courses (Steve Lamy at USC teaches cases to as many as 300 introductory IR students) and others who use it in very small graduate classes, though very large classes and very small classes can pose particular challenges in generating sufficient participation, focusing attention, or producing the diverse viewpoints that make discussion rich. Cases are used effectively to teach critical thinking and quantitative reasoning, and have been successfully applied in a wide range of disciplines including political science, economics , law, business, chemistry, history, and linguistics, and in both undergraduate and graduate classrooms.

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Teaching Case Study Methods in Comparative Education

• Lesley Bartlett 2 ,
• Diana Famakinwa 2 &
• Regina Fuller 2  
• Living reference work entry
• First Online: 14 September 2019

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Introduction

What are the limitations in how case studies are conceptualized and conducted in the field of Comparative and International Education? How may comparative case studies address those limitations? This entry addresses those questions, reviews the basic tenets of comparative case studies, and offers two examples of CCS to show the opportunities and constraints of the methodological approach. The entry concludes with implications for teaching case study methods in comparative education.

Case Studies and Comparison

Case studies are widely used in educational research and by scholars who embrace very different epistemological positions. However, the methodological literature on case studies does not reflect these divergent theories of knowledge. While those working in the neo- or post-positivist paradigm may emulate social science traditions, other qualitative approaches on the continuum of paradigms, particularly critical and constructivist ones, adhere to a more inductive...

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Bartlett, L., & Vavrus, F. (2017). Rethinking case study research: A comparative approach . New York: Routledge.

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Maxwell, J. (2013). Qualitative research design: An interactive approach . Thousand Oaks: Sage.

Merriam, S. (2009). Qualitative research: A guide to design and implementation . San Francisco: Jossey-Bass.

Stake, R. (1994). The art of case study research . Thousand Oaks: Sage.

Stake, R. (2003). Case studies. In N. K. Denzin & Y. S. Lincoln (Eds.), Strategies of qualitative inquiry (2nd ed., pp. 134–164). Thousand Oaks: Sage.

Vavrus, F., & Bartlett, L. (2009). Critical approaches to comparative education . New York: Palgrave Macmillan.

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Yin, R. (2014). Case study research (5th ed.). Thousand Oaks: Sage.

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Bartlett, L., Famakinwa, D., Fuller, R. (2019). Teaching Case Study Methods in Comparative Education. In: Peters, M. (eds) Encyclopedia of Teacher Education. Springer, Singapore. https://doi.org/10.1007/978-981-13-1179-6_316-1

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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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• Published: 03 April 2024

Systems approach in planetary health education for medical students: a mixed methods study

• Rafaela Brugalli Zandavalli   ORCID: orcid.org/0000-0002-3636-5808 1 ,
• Airton Tetelbom Stein   ORCID: orcid.org/0000-0002-8756-8699 2 &
• Tatiana Souza de Camargo   ORCID: orcid.org/0000-0001-9179-7470 3  

BMC Medical Education volume  24 , Article number:  365 ( 2024 ) Cite this article

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Metrics details

Introducing students to the "planetary health lenses" perspective is crucial. Comprehensive strategies for teaching this perspective are lacking, especially in the domains of "interconnection within nature (IWN)" and "systems thinking/complexity." There is also a scarcity of studies assessing medical students' opinions on planetary health and evaluating teaching strategies.

To understand Brazilian medical students' perceptions and knowledge of planetary health (PH) and evaluate the application of the educational material "Patient and Clinic through the Lens of Planetary Health," which addresses "IWN" and "complexity" through the sociological lens of Actor-Network Theory, in an integrative course at a medical school in Brazil.

A mixed-methods, quasi-experimental design involving two medical student classes during 2022/2023. Participants completed a questionnaire on sociodemographic data; pre- and post-intervention closed-ended questions about perceptions related to PH, and an open-ended questionnaire on experience and learning. Each student group presented a portfolio under the planetary health lenses regarding a real patient, developing a network diagram that described the social network involving both human and non-human actors with which this person is interconnected. The cohorts participated in "IWN" activities: a contemplative trail or reflection on belonging to the planet.

Ninety-six students and 9 professors participated. The majority of students (66.7%) reported significant or extremely significant learning from the sessions. There was an increase in perception of the need for physicians to incorporate PH into their clinical practice ( p  = 0.002; r  = 0.46) and an intensification of the sense of interconnection with the environment ( p  = 0.003; r  = 0.46). There was a gain in knowledge about how many diseases were related to PH ( p  < 0.02 for all 13 listed diseases). The majority (83%) found the sessions relevant or highly relevant and commented on their impact, both professionally and personally.

Conclusions

Teaching PH in a medical school allowed students to learn from the patient's perspective, considering psychosocial and environmental determinants, about the intrinsic interdependence between population's health and PH. This strategy made a significant contribution by proposing pioneering didactics and offering valuable insights into the challenges and nuances of teaching PH.

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Anthropogenic changes are surpassing planetary boundaries within which humanity can thrive [ 1 ]. Consequently, climate change has emerged as the most significant global threat to public health in this century [ 2 ]. As a result of environmental degradation and the associated intensification of social inequalities, increases in chronic diseases, infectious diseases, and mental health issues are evident [ 3 ]. In this context, Planetary Health (PH) emerges as an expanding transdisciplinary field and social movement. It highlights the intrinsic interdependencies between human health and the health of Earth's ecosystems, with an overarching goal of global equity [ 4 , 5 ].

Despite its paramount importance, the understanding and application of PH principles among healthcare professionals remain limited. Between 2019 and 2020, only approximately 15% and 11% of medical schools worldwide integrated climate change and air pollution, respectively, into their curricula [ 6 ]. A similar trend is evident in Brazil. A 2020 study revealed that 84.8% of healthcare professionals had not been exposed to practical or clinical content on planetary health during their training [ 7 ]. While there have been sporadic efforts to introduce PH in a handful of Brazilian universities [ 8 ], consistent inclusion of this theme in a Brazilian medical school curriculum only materialized in 2021 [ 9 ].

Several educational materials on PH have been developed globally to facilitate its introduction in universities [ 10 ]. However, these resources primarily emphasize the domain of "anthropocene and health" and occasionally addresses "movement building and systems change" [ 11 ]. Moreover, there's a noticeable scarcity of studies evaluating PH teaching strategies in undergraduate programs. The foundation of this study lies in the educational material titled "Patient and Clinic through the Lens of Planetary Health: Learning Guide for Health Education" [ 12 ]. This guide stands out due to its comprehensive coverage of all five domains recommended by the Planetary Health Educational Framework. These include “interconnection within nature (IWN)”, “anthropocene and health”, “systems thinking/complexity-based approaches”, “equity and social justice”, and “movement building and systems change” [ 3 ]. Particularly noteworthy is its emphasis on analyzing real patients and its pioneering approach to the domains of “interconnection within nature (IWN)” and “systems thinking/complexity-based approaches” in PH.

This article aims to glean insights into the perceptions and understanding of Brazilian medical students from a southern university regarding PH while evaluating the impact of implementing the educational guide "Patient and Clinic through the Lens of Planetary Health: Learning Guide for Health Education" in an integrative course of a Brazilian medical school.

Study design

This is a quasi-experimental study with a quali-quantitative methodology.

Participants and survey

All professors and students of the Basic-Clinical Integration 3 course, within the third semester of the Medical School at the Federal University of Rio Grande do Sul , Brazil, during the months of August 2022 (class 1) and January 2023 (class 2), were conveniently invited. This course is part of the compulsory curriculum and seeks to integrate content from both basic and clinical courses, usually allowing students to engage in interviews with patients. Subsequently, students compile a portfolio detailing the disease and the patient interviewed. Students who did not respond to the informed consent form or declined to participate in the study were excluded. Participants who did not adequately respond to either qualitative or quantitative evaluations were also excluded.

The instrument consisted of sociodemographic data; closed questions about PH (adapted from the Brazilian Pilot Massive Open Online Course in Planetary Health Education [ 7 ]); and an open questionnaire with 9 questions regarding the experience and learning. For some questions related to PH, a Likert scale structure ranging from 1 to 5 was used, with 5 representing the highest response values. The instrument (in Portuguese and English) can be found in Supplementary Material 1 .

Intervention

The educational intervention consisted of a module of lessons centered on the theme of PH within the Basic-Clinical Integration 3 course during the third semester at the Medical School of the Federal University of Rio Grande do Sul (Table 1 ). Each class was divided into small groups (1 professor for approximately 8 students), each tasked with interviewing a patient admitted to the university hospital and developing a portfolio [ 13 ] with questions about their clinical case through the lens of PH, covering areas such as epidemiology, basic sciences, clinical, and even inquiries about which individual, community, and health system approaches could be proposed. Generally, the second group of students received a slightly different intervention than the first: an additional lecture was included, and the "IWN" activity was modified.

The final item of this portfolio was the task of drafting a network diagram, placing the patient at the center, and mapping the connections between the various actors that appeared in the case (individual, family, psychosocial, environmental aspects, and PH keywords such as air pollution, deforestation/burning, climate change, heatwaves, natural disasters, equity or inequity, migrations, water/food insecurity, mental health, and infectious diseases). This process created networks, illustrating the complexity of factors present in a society, which includes the influence of non-human actors in its construction.

The "IWN" "Trail" activity (Class 1) consisted of a walk through the university's garden, located in an urban area, where students encountered posters prompting reflections on the subject. The "IWN" activity for Class 2 involved reading a support text followed by each student sharing with their small group a photo and/or account of a moment when they felt part of the planet. All activities are detailed in the published educational materials [ 13 ].

These teaching approaches for "IWN" and "systems thinking/complexity" were developed based on the theoretical foundation of Actor-Network Theory, a sociological theory that discusses the humanity/nature division and considers both humans and non-humans as acting within networks and contributing to the construction of society [ 14 ].

Data analysis

The qualitative data underwent Bardin's content analysis (using NVIVO 1.5 software). For the quantitative data (analyzed using Python), the Likert scale data were considered continuous, and opinions on the 16 different diseases, classified as associated or not with PH, were evaluated categorically. Outcome variables were assessed before and after the intervention, and the Wilcoxon test was conducted. The biserial correlation (r) was calculated for each relationship.

Subgroup analyses were conducted based on age, gender, ethnicity, family income, and class. Additional analyses were carried out with the group of students who scored 1, 2, or 3 on the Likert scale in the pre-test PH questions, examining their learning differences compared to the group that initially scored 4 or 5 on the scale. The Student's T-tests (for continuous data) and Fisher's tests (for categorical data) were used. A p -value of < 0.05 was considered statistically significant for all tests.

Ethical aspects

All participants completed the informed consent form, and the study was approved by the Ethical and Research Committee of the Federal University of Rio Grande do Sul .

Of the 110 students invited, 8 declined to participate (class 1 n  = 7; class 2 n  = 1), and 6 students (class 1 n  = 1; class 2 n  = 6) were disqualified for not responding to the informed consent form or the post-test. Ninety-six students (class 1 n  = 43; class 2 n  = 53) and nine professors were included in the qualitative analyses. Only 90 students (class 1 n  = 43; class 2 n  = 47) were enlisted for the quantitative analyses, as six students did not complete the quantitative pre-test.

Quantitative results

The majority of the students were female (53.12%), white (68.75%), with a family income of 5–10 minimum wages (36.46%), and had not heard of PH before (58.33%); average age ± standard deviation (24.41 ± 5.8). Students who had some prior knowledge of PH from a lesson indicated, in response to an open-ended question, that this lesson took place in another undergraduate course in medicine or veterinary science and was merely a brief mention of the topic (Table 2 ).

In the pre- and post-test analyses of the students, there was a significant improvement in the sense of interconnection with the environment, and the importance of physicians applying PH in their practice. Perceptions about the impact of climate change on patient health, concerns about climate change, and the importance of the topic for the health field did not show significant gains after the intervention (Table S1 (Supplementary Material 2 ); Fig.  1 ). However, a secondary analysis, assessing changes in these areas solely with students in the 1st quartile, revealed statistically significant gains in all these domains ( p  < 0.01 for all domains). The majority felt they learned a lot from the educational sessions (Table S1 (Supplementary Material 2 ); Fig.  1 ). The students significantly enhanced their understanding of the correlation of all diseases with environmental changes (Table S2 (Supplementary Material 2 ); Fig.  2 ).

Pre and post-evaluation of perceptions about planetary health ( n  = 90).  1   p = 0.003;  r = 0.46. 2   p = 0.002;  r = 0.46 

Knowledge about diseases related to environmental changes ( n  = 89). CVD Cardiovascular diseases (stroke and acute myocardial infarction), COPD Chronic obstructive pulmonary disease, SAH Systemic arterial hypertension, DM Diabetes mellitus, PTSD Post-traumatic stress disorder. *  p  < 0.05

There was no statistically significant difference when analyzing each of the questions about perceptions of PH and knowledge of diseases related to PH in general when comparing the subgroups of the first class to the second class. However, in the latter, students more specifically learned that cardiovascular diseases (stroke and acute myocardial infarction) and depression were related to PH ( p  < 0.05). There were also no significant differences in learning among other subgroups (age, gender, ethnicity, and family income), which were analyzed to determine if these demographic factors influenced outcomes.

The graphs (Fig. 1 ) display the number of students who chose each option before (in blue) and after (in green) the intervention. Comparing the average responses before and after, there was a statistically significant increase in the sense of interconnection with the environment ( 1 p  = 0.003; r  = 0.46) and in the perception of the importance for physicians to apply PH in their practice ( 2 p  = 0.002; r  = 0.46). The detailed table corresponding to this figure can be found in Table S1 (Supplementary Material 2 ).

The graph (Fig.  2 ) shows the number of students who identified each disease as related to PH in response to the question: “Which of the following health problems in practice are associated with environmental changes, such as climate change? (select as many as you think appropriate)”. The count before the intervention corresponds to the shape closer to the center of the figure and is in red; the count after the intervention is in blue. The detailed table corresponding to this figure is shown in Table S2 (Supplementary Material 2 ). There was a significant increase ( P  < 0.05) in the number of students who understood the association of each disease as related to PH for all conditions.

Qualitative results

Students' perceptions.

The general perception of the students regarding the relevance of the PH sessions was that the majority (83%) found them relevant or highly relevant (Table 3 ). The methodology was praised for its active participation, creativity, interactivity, the proposal to interview a real patient and reflect on PH from their perspective, the quality and accessibility of the provided study references, and the discussion of clinical cases associated with group portfolio presentations (Table S3 (Supplementary Material 2 )). The few who rated the relevance poorly (13.3%) (Table 3 ) typically justified this due to methodological reasons related to the playfulness of the intervention, the perception that the approach was either too dense/heavy or superficial, and the format of the lecture (both recorded and in-person) (Table S3 (Supplementary Material 2 )).

Personal impacts

In terms of personal impacts, students reported being more aware of the subject after the intervention, rethinking their habits, and, to a lesser extent, seeking to act collectively for system change. It is noteworthy that one student highlighted the benefit of the healthy and respectful debate that the tasks facilitated, a characteristic so vital for contemporary societal life. Other students emphasized that they will cherish the well-being they experience when in contact with green/blue environments. However, one student reported anxiety related to the topic (Table S4 (Supplementary Material 2 )).

Professional impacts

Regarding the impact on the students' professional lives, we observed that they reported an expanded view of the health-disease process. This allowed them to guide individuals about the co-benefits of health and the environment and the change in habits. They felt compelled to learn more about PH, recognized their role in reducing the environmental footprint of the healthcare system, and, to a lesser extent, saw their potential to contribute to broader systemic changes in society (Table S5 (Supplementary Material 2 )).

Timing and module structure

The timing of the PH lessons was considered by several students as not ideal due to the overlap with demands from other courses combined with the requirements of PH activities. Students' suggestions ranged from holding the sessions at the beginning of the semester, in different semesters, or making better use of class time, such as setting aside a week for project development without in-person classes. Suggestions to cover this topic in other courses, or to create separate elective or mandatory courses, were also mentioned (see Supplementary Material 2 ).

The results indicated improvements in various aspects related to the students' knowledge of PH, both in their subjective perception (sense of learning from the sessions; sense of interconnection with the environment and the importance of its practical application) and when objectively measuring how many diseases they could relate to PH. The perception of the impact that environmental changes, such as climate change, have on patients' health; concern about climate change; and the importance for students in health professions of learning about PH did not show significant changes, possibly due to their high prior concern. The secondary analysis, which showed that students whose responses were in the first quartile experienced statistically significant gains in all items, supports this hypothesis. It indicates that those with the least awareness of the connections between environmental changes and health were able to significantly enhance this understanding through the educational intervention.

The qualitative data indicate that, in general, students recognized the relevance of these educational sessions because they addressed this very current and pertinent topic for life in society and expanded one's perspective when facing a patient. Some students displayed limited openness to what was being introduced for teaching, citing that environmental education was already imparted during their school years or seeing no connection with medicine. However, although environmental education and traditional sustainability approaches have been on the rise in both formal and informal educational settings in recent years, PH introduces distinct novel elements. PH emphasizes the connection to human health, addresses climate changes, and adopts a systemic viewpoint on the complexity of relationships, also integrating the issue of inequity.

The innovative methodology was appreciated by the majority of students, but the multitude of diverse methods in a brief period made it dense. Both classes sought deeper exploration and more time to understand the content. Despite the availability of a wide range of materials, from quick multimedia to in-depth articles, they found it challenging to fully engage with these options due to time constraints. Even though the classes had slightly different instructional approaches, both were effective.

The close-ended question, "How interconnected do you feel with the environment?", although in some ways alluding to the unreal division between humanity and nature, showed a statistically significant increase after the intervention. This indicates that the "IWN" activities contributed to feelings of interconnection. However, we did not explore to what extent this reflects a commitment to environmental protection, as another study did with healthcare professionals, where almost half expressed a commitment to protection [ 7 ].

Concerning their personal lives, students indicated that the approach effectively stimulated more thoughtful reflections on their habits, with some considering more collective actions. One student expressed that such lessons can add to students' anxiety about environmental degradation, termed eco-anxiety, something that should be anticipated and addressed when discussing this topic. Some students conveyed feelings of helplessness; others felt a sense of urgency and a call to action to address these issues. However, in general, the educational intervention did not seem to significantly alter the level of concern about climate change, which was already high before the sessions.

Eco-anxiety is a reasonable and functional response and should be channeled to generate momentum, rather than paralysis or mental health pathologies [ 15 ]. It is essential to highlight positive experiences and emphasize that every action now, in any field of knowledge and potential intervention, matters, driving collective movement and fostering hope [ 16 ]. This should be done without losing our ability to appreciate beauty and to approach transformative tasks at a non-debilitating pace [ 17 ]. Perhaps one way to understand the Anthropocene is to treat it as an immense rite of passage, which, while painful and unfair, will result in mature adults accountable for their actions [ 18 ].

Regarding the impact on students' professional lives, there was a significant increase after the intervention. Numerous comments were made about the broadened perspective on the health-disease process, which offers the potential to contemplate new guidance for protection against risk factors and in favor of co-benefits. This also includes reducing the environmental footprint of the healthcare system and making broader, scientifically-backed health recommendations in society. Compared to another study, many healthcare professionals responded affirmatively about the total or partial applicability of PH in their field and very few felt it was not applicable [ 7 ]. To truly assess the personal and professional impacts, this study has limited evaluative capacity, as a prolonged period of observation would be required to gauge the actual repercussions.

One teacher noted that the students did not see themselves as active protagonists for PH, suggesting the addition of a question to the portfolio: “In what actions could you, as a student, engage to promote the health of individuals, such as your interviewed patient?”. In subsequent sessions with a following class, there was also a suggestion that the students develop an intervention project based on the studied case. Regarding this research's assessment, we recognized that we could have evaluated whether the students felt encouraged to initiate change while still in their student roles. To our knowledge, one student mentioned considering the establishment of a University Planetary Health Club or League.

We consider it crucial to situate this educational intervention within the context of Brazil's social and health system realities. It is vital to reflect upon the social issues addressed by PH, encompassing the domain of “equity and social justice” as outlined in the PH Education Framework. Particularly in Brazil, where students are daily witnesses to social inequality, understanding how PH interacts within this context and affects people's lives is imperative. There is a significant overlap between social and environmental health determinants, as both are rooted in historical structures of domination and also mutually influence each other. For instance, deteriorating environmental conditions exacerbate social inequalities, leading to increased food insecurity, restricted access to safe housing prompting population migrations and increased violence, and greater suffering for those in manual labor on hot days. Similarly, social conditions are linked to environmental determinants, as, for example, lower-income populations may live in areas with limited access to green spaces and higher pollution levels [ 3 ].

Reflecting on social and environmental justice, it becomes evident that those who suffer the most from environmental degradation are often those who contribute the least to it. Therefore, recommendations for safeguarding human and planetary health must be contextualized, taking into account social justice and equity promotion [ 3 ]. Health practice within the Brazilian Health System (SUS) needs to acknowledge this reality, recognizing that environmental degradation places an even greater burden on the SUS, from primary health care (PHC) to tertiary care. Strategies for protecting individuals and mitigating environmental determinants that adversely affect health are imperative. PHC plays a pivotal role in surveillance policies and promoting health, as it is closely connected to the communities where people live, allowing for the promotion of health education and social mobilization towards healthier and safer community environments. These important discussions were woven throughout our educational activities.

It is also important to reflect on how the current medical education process has influenced students' learning, including their receptiveness to the topic and the didactic format used, which incorporated reflective and artistic elements under a patient-centered perspective, coupled with theoretical aspects featuring interdisciplinary themes. While the Flexnerian model has greatly contributed to medical education, its emphasis on the biomedical approach, focused on disease, hospitals, and medical specialties, has led medical educational programs to adopt a reductionist view of health, leaving little room to consider the social, psychological, and environmental dimensions of health, as well as the broad spectrum of health that goes beyond medicine and its practitioners [ 19 , 20 ]. The holistic approach we implemented was well-received by many students, but faced resistance from some. This underscores the necessity for greater appreciation within educational systems, among medical teachers, and within society at large for topics related to public health and multidisciplinary work [ 19 , 20 ].

Currently, according to the Brazilian National Curricular Guidelines, there is also a recommendation that specific themes, such as those related to gender, environment, and ethnic-racial issues, permeate the entire medical education [ 21 ]. Consistent with global recommendations of introducing medical students to a perspective termed as "planetary health lenses" [ 22 , 23 , 24 , 25 ], some entities also propose the transversal integration of PH content throughout the course [ 6 , 26 ]. This would significantly contribute to the students' understanding, as their comprehension of any subject would be viewed from the PH perspective. There is a pressing need to take on the challenge of coordinating such an implementation, possibly coupled with the need to train various professors on the topic. However, we believe it is crucial that PH is addressed comprehensively in some course—be it integrative, public health, clinical, or solely focused on PH. This approach ensures that students envision the patient as a whole [ 27 ] and grasp PH’s full scope and its complexity [ 28 ], as was done in this activity. Otherwise, certain PH educational holistic domains, such as “IWN” and “systems thinking/complexity”, run a significant risk of not being addressed throughout the course.

The intervention was generally very significant within the available class time and fulfilled its role of introducing the subject and providing a comprehensive approach to it. Additionally, longer or periodic activities throughout the course may provide a broader understanding of all domains, especially these two domains, allowing more time for content assimilation, exploration, and debate on its nuances and complexities [ 29 ]. They require philosophical reflections [ 30 ] and practice in “connecting the dots”. Moreover, with more time, students could become familiar with more examples of creating momentum and system change, enabling them to see themselves as protagonists and envision creative possibilities for intervention. Planetary Health (PH) addresses issues of knowledge and skills involving cognitive, social, behavioral, and affective processes [ 31 , 32 ]. The journey towards mastery in this new area of expertise unfolds gradually along the learning curve, involving a process of refinement and maturation [ 32 ].

This study contributes to the field of planetary health education, as it qualitatively and quantitatively assessed the first known Brazilian didactic materials on planetary health and elaborates on the challenges and nuances of teaching planetary health to medical students. As a result of the sessions, it is also worth noting that the course teachers adopted permanently this planetary health module and included a question for all interviews/portfolios conducted throughout the course during the whole semester: "Relate aspects of the interviewed patient and the studied disease to Planetary Health.".

The limitations of this study are that it was conducted at only one university and there isn't a validated objective questionnaire about learning in planetary health available in the scientific literature. However, this study adds to the literature by reflecting on the successes and challenges related to the utilized questionnaire, which will serve as a basis for the development of enhanced ones in the future. Future educational interventions on planetary health should consider allocating more time for teaching this subject to students, focusing on listening to and dialoguing more with students, exploring the domain of "movement building and system change" more thoroughly, and considering interviewing real patients in a Primary Health Care (PHC) context, where the "minute for the planet" individual approach [ 33 ] and community approaches can be explored more closely to their territory. Future studies should also consider assessing how students perceive themselves as agents of change in their current role as students.

This study evaluated the implementation of PH teaching strategies in a Brazilian medical school, marking one of the first experiences of its kind in the country. Upon conducting a scoping review, it is also evident that this is among the few global initiatives assessing an educational strategy in undergraduate medical curricula. This research evaluates the use of the first Brazilian educational material on PH for undergraduate studies, which has made a significant contribution to the international PH teaching methodology. This is especially true concerning the pioneering approach to teaching the domains of "IWN" and “systems/complexity thinking”, enabling students to "connect the dots" between real patients and PH.

The results indicated improvements in students' knowledge regarding PH, both in terms of subjective perception (sense of interconnection with the environment, importance for practical application) and in objective measures of how many diseases they could associate with PH. Qualitative data underscored the relevance of the educational sessions, praising the active participation methodology, creativity, and interactivity of the activities. However, some students displayed limited receptiveness to the proposed teachings and there were suggestions for enhancements, such as the need for deeper content exploration in a participatory manner and encouraging student leadership in PH. The authors also encourage future educational approaches to enable students to experience Planetary Health initiatives engaging more closely with the population and community within the PHC setting.

In conclusion, this study offers valuable insights into the challenges and nuances of teaching PH to medical students, contributing to the United Nations (UN) 2030 Agenda for Sustainable Development [ 34 ]. The instruction of PH is essential for future physicians to understand the intricate interconnection between human health and the planet's well-being and to act in various personal and professional realms towards inhabiting this planet in a manner that's more equitable for all beings.

Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

Planetary Health

Interconnection within Nature

Federal University of Rio Grande do Sul

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Acknowledgements

The authors would like to express their gratitude to all the students and teachers of the Federal University of Rio Grande do Sul who actively participated in this study. They also thank Daniel Teixeira dos Santos for his support with the analysis and Enrique Falceto de Barros for his feedback on the article.

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Airton Tetelbom Stein

Postgraduate Program in Science Education (PPgEci), Institute of Health Science, Federal University of Rio Grande Do Sul, Porto Alegre (ICBS-UFRGS), Porto Alegre, Brazil

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RBZ was responsible for the conception, design of the work, acquisition, analysis, interpretation of data and drafted the work. ATS made substantial contributions to the design of the work, acquisition and substantively revised it. TSC made fundamental contributions to the conception of the work, made substantial contributions to the design of the work, acquisition, interpretation of data and substantively revised it. All authors read and approved the final manuscript.

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Zandavalli, R.B., Stein, A.T. & de Camargo, T.S. Systems approach in planetary health education for medical students: a mixed methods study. BMC Med Educ 24 , 365 (2024). https://doi.org/10.1186/s12909-024-05341-1

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Abstract: We present insightful results of a survey on the adoption of generative artificial intelligence (GenAI) by university teachers in their teaching activities. The transformation of education by GenAI, particularly large language models (LLMs), has been presenting both opportunities and challenges, including cheating by students. We prepared the online survey according to best practices and the questions were created by the authors, who have pedagogy experience. The survey contained 12 questions and a pilot study was first conducted. The survey was then sent to all teachers in multiple departments across different campuses of the university of interest in Sweden: Luleå University of Technology. The survey was available in both Swedish and English. The results show that 35 teachers (more than half) use GenAI out of 67 respondents. Preparation is the teaching activity with the most frequency that GenAI is used for and ChatGPT is the most commonly used GenAI. 59% say it has impacted their teaching, however, 55% say there should be legislation around the use of GenAI, especially as inaccuracies and cheating are the biggest concerns.

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Creating a Corporate Social Responsibility Program with Real Impact

• Emilio Marti,
• David Risi,
• Eva Schlindwein,
• Andromachi Athanasopoulou

Lessons from multinational companies that adapted their CSR practices based on local feedback and knowledge.

Exploring the critical role of experimentation in Corporate Social Responsibility (CSR), research on four multinational companies reveals a stark difference in CSR effectiveness. Successful companies integrate an experimental approach, constantly adapting their CSR practices based on local feedback and knowledge. This strategy fosters genuine community engagement and responsive initiatives, as seen in a mining company’s impactful HIV/AIDS program. Conversely, companies that rely on standardized, inflexible CSR methods often fail to achieve their goals, demonstrated by a failed partnership due to local corruption in another mining company. The study recommends encouraging broad employee participation in CSR and fostering a culture that values CSR’s long-term business benefits. It also suggests that sustainable investors and ESG rating agencies should focus on assessing companies’ experimental approaches to CSR, going beyond current practices to examine the involvement of diverse employees in both developing and adapting CSR initiatives. Overall, embracing a dynamic, data-driven approach to CSR is essential for meaningful social and environmental impact.

By now, almost all large companies are engaged in corporate social responsibility (CSR): they have CSR policies, employ CSR staff, engage in activities that aim to have a positive impact on the environment and society, and write CSR reports. However, the evolution of CSR has brought forth new challenges. A stark contrast to two decades ago, when the primary concern was the sheer neglect of CSR, the current issue lies in the ineffective execution of these practices. Why do some companies implement CSR in ways that create a positive impact on the environment and society, while others fail to do so? Our research reveals that experimentation is critical for impactful CSR, which has implications for both companies that implement CSR and companies that externally monitor these CSR activities, such as sustainable investors and ESG rating agencies.

• EM Emilio Marti is an associate professor at the Rotterdam School of Management, Erasmus University. His research focuses on corporate sustainability with a specific focus on sustainable investing.
• DR David Risi is a professor at the Bern University of Applied Sciences and a habilitated lecturer at the University of St. Gallen. His research focuses on how companies organize CSR and sustainability.
• ES Eva Schlindwein is a professor at the Bern University of Applied Sciences and a postdoctoral fellow at the University of Oxford. Her research focuses on how organizations navigate tensions between business and society.
• AA Andromachi Athanasopoulou is an associate professor at Queen Mary University of London and an associate fellow at the University of Oxford. Her research focuses on how individuals manage their leadership careers and make ethically charged decisions.

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A Modified Overset Method in OpenFOAM for Simultaneous Motion and Deformation: A Case Study of a Flexible Flapping Foil

• Karim Ahmed Institut PPRIME UPR 3346 CNRS - Université de Poitiers - ISAE-ENSMA https://orcid.org/0000-0001-6092-3657
• Ahmed A. Hamada Texas A&M University Ocean Engineering Department https://orcid.org/0000-0003-1505-7774
• Ludovic Chatellier Institut PPRIME UPR 3346 CNRS - Université de Poitiers - ISAE-ENSMA https://orcid.org/0000-0003-2026-5527
• Mirjam Furth Texas A&M University Ocean Engineering Departmenet https://orcid.org/0000-0003-0052-3437

The influence of wing deformation in animal propulsion and motion is an intriguing phenomenon that has contributed to a growing interest in biomimetics in both academia and industry. The study focuses on developing a robust numerical tool for analyzing the motion of biological systems in fluid flows, crucial to understanding fluid-structure interaction (FSI) phenomena. The research introduces a new mesh deformation solver, dynamicOversetZoneFvMesh, designed to address limitations in OpenFOAM's conventional Overset method. This solver enables the application of both rigid body motion and deformation at specified patches within certain zones, allowing for more complex motion scenarios. Through meticulous verification, parallelization, validation, and mesh convergence studies, the modified Overset solver's reliability is confirmed. Two cases are examined: a rigid-body flapping foil and a flexible foil with leading-edge deformation. Results demonstrate the adapted solver's proficiency in managing complex fluid dynamics and accommodating simultaneous motion and deformation. Furthermore, the study reveals that leading-edge flexibility improves the power extraction efficiency of flapping foils, aligning with previous literature. Overall, the research lays the foundation for advancing FSI simulations and opens avenues for addressing previously challenging problems in the field.

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Copyright (c) 2024 Karim Ahmed, Ahmed A. Hamada, Ludovic Chatellier, Mirjam Furth

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License .

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