Case Methods in Teaching How case methods work Models for case teaching PBL or CBL? Planning your case teaching What students think about CM References and resources

[You will find some useful references on the References and Resources page. Marianne Nelson’s ‘The art of case teaching’ has some practical tips on how to select, prepare and deliver cases.]

Planning has here been divided into the following considerations:

1. Where to start: what are your objectives?
2. Finding a case to match your objectives
3. Learning activities
4. Space and time
5. Learning resources
6. Assessment

... and some specific notes about Using Case Methods for Distance Learning.

1. Where to start: what are your objectives?

As with all teaching methods, you first have to determine the objectives of your lesson. What is the content you need to cover and what are the outcomes the students need to achieve?

Cases themselves do not teach content knowledge and skills, but they do link them directly to applications. Students must be provided with linked resources they can access to find the content/theory behind the case. Case methods excel in developing analytical ability and attitudinal awareness.

Identify the process (‘learning to learn’) outcomes as well as the content outcomes you expect the students to achieve.

(Read more about 'Writing learning outcomes' on the Teaching & Learning website.)

When do you use cases in a course? Do you use them to introduce a topic or illustrate the theory you have already taught? Classic CBL uses cases at the beginning, to drive the content. But there are good reasons for using them at a later stage too. (Read more about this on another page.)

In the first year of study you might choose to use a case as illustrative or supportive of a theoretical issue; as an introduction or trigger to a topic or a summative example of how theories adapt to practice.

2. Finding a case to match your objectives

A case can be based on a real patient case history, or it can be fictional (but realistic!). It can be developed from original materials or adapted from other sources (and acknowledged appropriately).

Cases can be written as a sequential narrative with a plot, or documented by other means (such as a videotape or role play). If they contain information that builds up over time, they need to be readily broken into several sections at natural points in the narrative where questions can be posed or dilemmas resolved by research and/or discussion (see this in examples from FHS).

Carefully check available case reports that match the required content. Can material be included to enable the desired learning outcomes? This will often be easier than starting from scratch. But beware of including too much in one example! One fictitious character can conveniently end up with such a bizarre range of disorders that it overstretches the imagination to expect this to be a useful scenario. (Remember we are concerned with how theory relates to real people, which doesn't mean we can exchange the textbook for Mr X. See more about this in 'What a case is and what it is not'.)

3. Learning activities

Breaking the case narrative at natural way points provides opportunity to analyse the scenario and consider next options (e.g. in the examination of pathology or the treatment of a patient). After each major section of a longer case students can work individually or in small groups to tackle the learning activities you set. They then reconvene to share their conclusions and agree on the best course of action. At this point you may provide further information on the results of the previous investigation, leading on to the next episode in the ‘story’ and the next learning activity.

The depth of analysis expected of students at each stage will depend on their experience: how far have they progressed in their program; do they have experience of case method; how capable are they of self-direction?

Answering questions, participating in role play and preparing mini-presentations on a key topic are common ways for students to interact with the case material.

Questioning

The wording of learning activities is significant in prompting students to achieve outcomes and indicative of the depth of expected understanding.
For instance:

Question 1 requires discovery of factual information. If not previously covered in lectures this would easily be answered by looking in the right textbook.

Question 2 requires analysis of the background information provided, matched with pre-existing theory. There may be no one correct answer and this would generate class discussion.

Question 3 might present several options. As well as prompting discussion on further diagnostic information, the patient’s history, lifestyle and occupation etc. may be relevant. Opportunity here for further research of the literature before coming to a conclusion.

Role play

Health professionals have to relate directly to clients and to other practitioners in a variety of circumstances. The development of communication skills is now a well recognised component of courses and role play situations are an excellent way to practice.

Setting role play sessions as learning activities at specific points in a group case study emulates real case progression. Armed with appropriate pre-reading as background, students can take turns at playing both roles in a generalist-specialist consultation or delicate practitioner-client interaction imparting difficult news.

(Examples of case role-plays are available on-line from the School of Medicine.)

Presentations

Most health professionals need to acquire skills to make a group presentation – at a case conference, to a funding body or community group.

You can develop students’ presentation skills by including these in a learning activity based on a case study. Students may be allocated related topics for in-depth study which they then present to the whole class. (An example model has been included where the presentation also forms part of formal assessment.)

Note: Most of the content of this website has been designed with regard to face-to-face learning situations – students spend time together in an actual class with a lecturer/ facilitator to guide them. Group work and discussion are central to most case methods, so special thought needs to be given to adapting case methods to distance learning when you have remote students. Some additional notes have been included on 'Using Case Methods for Distance Learning'.

More on planning case teaching