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• What Is a Case Study? | Definition, Examples & Methods

What Is a Case Study? | Definition, Examples & Methods

Published on May 8, 2019 by Shona McCombes . Revised on November 20, 2023.

A case study is a detailed study of a specific subject, such as a person, group, place, event, organization, or phenomenon. Case studies are commonly used in social, educational, clinical, and business research.

A case study research design usually involves qualitative methods , but quantitative methods are sometimes also used. Case studies are good for describing , comparing, evaluating and understanding different aspects of a research problem .

Table of contents

When to do a case study, step 1: select a case, step 2: build a theoretical framework, step 3: collect your data, step 4: describe and analyze the case, other interesting articles.

A case study is an appropriate research design when you want to gain concrete, contextual, in-depth knowledge about a specific real-world subject. It allows you to explore the key characteristics, meanings, and implications of the case.

Case studies are often a good choice in a thesis or dissertation . They keep your project focused and manageable when you don’t have the time or resources to do large-scale research.

You might use just one complex case study where you explore a single subject in depth, or conduct multiple case studies to compare and illuminate different aspects of your research problem.

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Once you have developed your problem statement and research questions , you should be ready to choose the specific case that you want to focus on. A good case study should have the potential to:

• Provide new or unexpected insights into the subject
• Challenge or complicate existing assumptions and theories
• Propose practical courses of action to resolve a problem
• Open up new directions for future research

TipIf your research is more practical in nature and aims to simultaneously investigate an issue as you solve it, consider conducting action research instead.

Unlike quantitative or experimental research , a strong case study does not require a random or representative sample. In fact, case studies often deliberately focus on unusual, neglected, or outlying cases which may shed new light on the research problem.

Example of an outlying case studyIn the 1960s the town of Roseto, Pennsylvania was discovered to have extremely low rates of heart disease compared to the US average. It became an important case study for understanding previously neglected causes of heart disease.

However, you can also choose a more common or representative case to exemplify a particular category, experience or phenomenon.

Example of a representative case studyIn the 1920s, two sociologists used Muncie, Indiana as a case study of a typical American city that supposedly exemplified the changing culture of the US at the time.

While case studies focus more on concrete details than general theories, they should usually have some connection with theory in the field. This way the case study is not just an isolated description, but is integrated into existing knowledge about the topic. It might aim to:

• Exemplify a theory by showing how it explains the case under investigation
• Expand on a theory by uncovering new concepts and ideas that need to be incorporated
• Challenge a theory by exploring an outlier case that doesn’t fit with established assumptions

To ensure that your analysis of the case has a solid academic grounding, you should conduct a literature review of sources related to the topic and develop a theoretical framework . This means identifying key concepts and theories to guide your analysis and interpretation.

There are many different research methods you can use to collect data on your subject. Case studies tend to focus on qualitative data using methods such as interviews , observations , and analysis of primary and secondary sources (e.g., newspaper articles, photographs, official records). Sometimes a case study will also collect quantitative data.

Example of a mixed methods case studyFor a case study of a wind farm development in a rural area, you could collect quantitative data on employment rates and business revenue, collect qualitative data on local people’s perceptions and experiences, and analyze local and national media coverage of the development.

The aim is to gain as thorough an understanding as possible of the case and its context.

In writing up the case study, you need to bring together all the relevant aspects to give as complete a picture as possible of the subject.

How you report your findings depends on the type of research you are doing. Some case studies are structured like a standard scientific paper or thesis , with separate sections or chapters for the methods , results and discussion .

Others are written in a more narrative style, aiming to explore the case from various angles and analyze its meanings and implications (for example, by using textual analysis or discourse analysis ).

In all cases, though, make sure to give contextual details about the case, connect it back to the literature and theory, and discuss how it fits into wider patterns or debates.

If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.

• Normal distribution
• Degrees of freedom
• Null hypothesis
• Discourse analysis
• Control groups
• Mixed methods research
• Non-probability sampling
• Quantitative research
• Ecological validity

Research bias

• Rosenthal effect
• Implicit bias
• Cognitive bias
• Selection bias
• Negativity bias
• Status quo bias

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Home » Case Study – Methods, Examples and Guide

Case Study – Methods, Examples and Guide

Table of Contents

A case study is a research method that involves an in-depth examination and analysis of a particular phenomenon or case, such as an individual, organization, community, event, or situation.

It is a qualitative research approach that aims to provide a detailed and comprehensive understanding of the case being studied. Case studies typically involve multiple sources of data, including interviews, observations, documents, and artifacts, which are analyzed using various techniques, such as content analysis, thematic analysis, and grounded theory. The findings of a case study are often used to develop theories, inform policy or practice, or generate new research questions.

Types of Case Study

Types and Methods of Case Study are as follows:

Single-Case Study

A single-case study is an in-depth analysis of a single case. This type of case study is useful when the researcher wants to understand a specific phenomenon in detail.

For Example , A researcher might conduct a single-case study on a particular individual to understand their experiences with a particular health condition or a specific organization to explore their management practices. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of a single-case study are often used to generate new research questions, develop theories, or inform policy or practice.

Multiple-Case Study

A multiple-case study involves the analysis of several cases that are similar in nature. This type of case study is useful when the researcher wants to identify similarities and differences between the cases.

For Example, a researcher might conduct a multiple-case study on several companies to explore the factors that contribute to their success or failure. The researcher collects data from each case, compares and contrasts the findings, and uses various techniques to analyze the data, such as comparative analysis or pattern-matching. The findings of a multiple-case study can be used to develop theories, inform policy or practice, or generate new research questions.

Exploratory Case Study

An exploratory case study is used to explore a new or understudied phenomenon. This type of case study is useful when the researcher wants to generate hypotheses or theories about the phenomenon.

For Example, a researcher might conduct an exploratory case study on a new technology to understand its potential impact on society. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as grounded theory or content analysis. The findings of an exploratory case study can be used to generate new research questions, develop theories, or inform policy or practice.

Descriptive Case Study

A descriptive case study is used to describe a particular phenomenon in detail. This type of case study is useful when the researcher wants to provide a comprehensive account of the phenomenon.

For Example, a researcher might conduct a descriptive case study on a particular community to understand its social and economic characteristics. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of a descriptive case study can be used to inform policy or practice or generate new research questions.

Instrumental Case Study

An instrumental case study is used to understand a particular phenomenon that is instrumental in achieving a particular goal. This type of case study is useful when the researcher wants to understand the role of the phenomenon in achieving the goal.

For Example, a researcher might conduct an instrumental case study on a particular policy to understand its impact on achieving a particular goal, such as reducing poverty. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of an instrumental case study can be used to inform policy or practice or generate new research questions.

Case Study Data Collection Methods

Here are some common data collection methods for case studies:

Interviews involve asking questions to individuals who have knowledge or experience relevant to the case study. Interviews can be structured (where the same questions are asked to all participants) or unstructured (where the interviewer follows up on the responses with further questions). Interviews can be conducted in person, over the phone, or through video conferencing.

Observations

Observations involve watching and recording the behavior and activities of individuals or groups relevant to the case study. Observations can be participant (where the researcher actively participates in the activities) or non-participant (where the researcher observes from a distance). Observations can be recorded using notes, audio or video recordings, or photographs.

Documents can be used as a source of information for case studies. Documents can include reports, memos, emails, letters, and other written materials related to the case study. Documents can be collected from the case study participants or from public sources.

Surveys involve asking a set of questions to a sample of individuals relevant to the case study. Surveys can be administered in person, over the phone, through mail or email, or online. Surveys can be used to gather information on attitudes, opinions, or behaviors related to the case study.

Artifacts are physical objects relevant to the case study. Artifacts can include tools, equipment, products, or other objects that provide insights into the case study phenomenon.

How to conduct Case Study Research

Conducting a case study research involves several steps that need to be followed to ensure the quality and rigor of the study. Here are the steps to conduct case study research:

• Define the research questions: The first step in conducting a case study research is to define the research questions. The research questions should be specific, measurable, and relevant to the case study phenomenon under investigation.
• Select the case: The next step is to select the case or cases to be studied. The case should be relevant to the research questions and should provide rich and diverse data that can be used to answer the research questions.
• Collect data: Data can be collected using various methods, such as interviews, observations, documents, surveys, and artifacts. The data collection method should be selected based on the research questions and the nature of the case study phenomenon.
• Analyze the data: The data collected from the case study should be analyzed using various techniques, such as content analysis, thematic analysis, or grounded theory. The analysis should be guided by the research questions and should aim to provide insights and conclusions relevant to the research questions.
• Draw conclusions: The conclusions drawn from the case study should be based on the data analysis and should be relevant to the research questions. The conclusions should be supported by evidence and should be clearly stated.
• Validate the findings: The findings of the case study should be validated by reviewing the data and the analysis with participants or other experts in the field. This helps to ensure the validity and reliability of the findings.
• Write the report: The final step is to write the report of the case study research. The report should provide a clear description of the case study phenomenon, the research questions, the data collection methods, the data analysis, the findings, and the conclusions. The report should be written in a clear and concise manner and should follow the guidelines for academic writing.

Examples of Case Study

Here are some examples of case study research:

• The Hawthorne Studies : Conducted between 1924 and 1932, the Hawthorne Studies were a series of case studies conducted by Elton Mayo and his colleagues to examine the impact of work environment on employee productivity. The studies were conducted at the Hawthorne Works plant of the Western Electric Company in Chicago and included interviews, observations, and experiments.
• The Stanford Prison Experiment: Conducted in 1971, the Stanford Prison Experiment was a case study conducted by Philip Zimbardo to examine the psychological effects of power and authority. The study involved simulating a prison environment and assigning participants to the role of guards or prisoners. The study was controversial due to the ethical issues it raised.
• The Challenger Disaster: The Challenger Disaster was a case study conducted to examine the causes of the Space Shuttle Challenger explosion in 1986. The study included interviews, observations, and analysis of data to identify the technical, organizational, and cultural factors that contributed to the disaster.
• The Enron Scandal: The Enron Scandal was a case study conducted to examine the causes of the Enron Corporation’s bankruptcy in 2001. The study included interviews, analysis of financial data, and review of documents to identify the accounting practices, corporate culture, and ethical issues that led to the company’s downfall.
• The Fukushima Nuclear Disaster : The Fukushima Nuclear Disaster was a case study conducted to examine the causes of the nuclear accident that occurred at the Fukushima Daiichi Nuclear Power Plant in Japan in 2011. The study included interviews, analysis of data, and review of documents to identify the technical, organizational, and cultural factors that contributed to the disaster.

Application of Case Study

Case studies have a wide range of applications across various fields and industries. Here are some examples:

Business and Management

Case studies are widely used in business and management to examine real-life situations and develop problem-solving skills. Case studies can help students and professionals to develop a deep understanding of business concepts, theories, and best practices.

Case studies are used in healthcare to examine patient care, treatment options, and outcomes. Case studies can help healthcare professionals to develop critical thinking skills, diagnose complex medical conditions, and develop effective treatment plans.

Case studies are used in education to examine teaching and learning practices. Case studies can help educators to develop effective teaching strategies, evaluate student progress, and identify areas for improvement.

Social Sciences

Case studies are widely used in social sciences to examine human behavior, social phenomena, and cultural practices. Case studies can help researchers to develop theories, test hypotheses, and gain insights into complex social issues.

Law and Ethics

Case studies are used in law and ethics to examine legal and ethical dilemmas. Case studies can help lawyers, policymakers, and ethical professionals to develop critical thinking skills, analyze complex cases, and make informed decisions.

Purpose of Case Study

The purpose of a case study is to provide a detailed analysis of a specific phenomenon, issue, or problem in its real-life context. A case study is a qualitative research method that involves the in-depth exploration and analysis of a particular case, which can be an individual, group, organization, event, or community.

The primary purpose of a case study is to generate a comprehensive and nuanced understanding of the case, including its history, context, and dynamics. Case studies can help researchers to identify and examine the underlying factors, processes, and mechanisms that contribute to the case and its outcomes. This can help to develop a more accurate and detailed understanding of the case, which can inform future research, practice, or policy.

Case studies can also serve other purposes, including:

• Illustrating a theory or concept: Case studies can be used to illustrate and explain theoretical concepts and frameworks, providing concrete examples of how they can be applied in real-life situations.
• Developing hypotheses: Case studies can help to generate hypotheses about the causal relationships between different factors and outcomes, which can be tested through further research.
• Providing insight into complex issues: Case studies can provide insights into complex and multifaceted issues, which may be difficult to understand through other research methods.
• Informing practice or policy: Case studies can be used to inform practice or policy by identifying best practices, lessons learned, or areas for improvement.

Advantages of Case Study Research

There are several advantages of case study research, including:

• In-depth exploration: Case study research allows for a detailed exploration and analysis of a specific phenomenon, issue, or problem in its real-life context. This can provide a comprehensive understanding of the case and its dynamics, which may not be possible through other research methods.
• Rich data: Case study research can generate rich and detailed data, including qualitative data such as interviews, observations, and documents. This can provide a nuanced understanding of the case and its complexity.
• Holistic perspective: Case study research allows for a holistic perspective of the case, taking into account the various factors, processes, and mechanisms that contribute to the case and its outcomes. This can help to develop a more accurate and comprehensive understanding of the case.
• Theory development: Case study research can help to develop and refine theories and concepts by providing empirical evidence and concrete examples of how they can be applied in real-life situations.
• Practical application: Case study research can inform practice or policy by identifying best practices, lessons learned, or areas for improvement.
• Contextualization: Case study research takes into account the specific context in which the case is situated, which can help to understand how the case is influenced by the social, cultural, and historical factors of its environment.

Limitations of Case Study Research

There are several limitations of case study research, including:

• Limited generalizability : Case studies are typically focused on a single case or a small number of cases, which limits the generalizability of the findings. The unique characteristics of the case may not be applicable to other contexts or populations, which may limit the external validity of the research.
• Biased sampling: Case studies may rely on purposive or convenience sampling, which can introduce bias into the sample selection process. This may limit the representativeness of the sample and the generalizability of the findings.
• Subjectivity: Case studies rely on the interpretation of the researcher, which can introduce subjectivity into the analysis. The researcher’s own biases, assumptions, and perspectives may influence the findings, which may limit the objectivity of the research.
• Limited control: Case studies are typically conducted in naturalistic settings, which limits the control that the researcher has over the environment and the variables being studied. This may limit the ability to establish causal relationships between variables.
• Time-consuming: Case studies can be time-consuming to conduct, as they typically involve a detailed exploration and analysis of a specific case. This may limit the feasibility of conducting multiple case studies or conducting case studies in a timely manner.
• Resource-intensive: Case studies may require significant resources, including time, funding, and expertise. This may limit the ability of researchers to conduct case studies in resource-constrained settings.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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A case study research paper examines a person, place, event, condition, phenomenon, or other type of subject of analysis in order to extrapolate  key themes and results that help predict future trends, illuminate previously hidden issues that can be applied to practice, and/or provide a means for understanding an important research problem with greater clarity. A case study research paper usually examines a single subject of analysis, but case study papers can also be designed as a comparative investigation that shows relationships between two or more subjects. The methods used to study a case can rest within a quantitative, qualitative, or mixed-method investigative paradigm.

Case Studies. Writing@CSU. Colorado State University; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010 ; “What is a Case Study?” In Swanborn, Peter G. Case Study Research: What, Why and How? London: SAGE, 2010.

How to Approach Writing a Case Study Research Paper

General information about how to choose a topic to investigate can be found under the " Choosing a Research Problem " tab in the Organizing Your Social Sciences Research Paper writing guide. Review this page because it may help you identify a subject of analysis that can be investigated using a case study design.

However, identifying a case to investigate involves more than choosing the research problem . A case study encompasses a problem contextualized around the application of in-depth analysis, interpretation, and discussion, often resulting in specific recommendations for action or for improving existing conditions. As Seawright and Gerring note, practical considerations such as time and access to information can influence case selection, but these issues should not be the sole factors used in describing the methodological justification for identifying a particular case to study. Given this, selecting a case includes considering the following:

• The case represents an unusual or atypical example of a research problem that requires more in-depth analysis? Cases often represent a topic that rests on the fringes of prior investigations because the case may provide new ways of understanding the research problem. For example, if the research problem is to identify strategies to improve policies that support girl's access to secondary education in predominantly Muslim nations, you could consider using Azerbaijan as a case study rather than selecting a more obvious nation in the Middle East. Doing so may reveal important new insights into recommending how governments in other predominantly Muslim nations can formulate policies that support improved access to education for girls.
• The case provides important insight or illuminate a previously hidden problem? In-depth analysis of a case can be based on the hypothesis that the case study will reveal trends or issues that have not been exposed in prior research or will reveal new and important implications for practice. For example, anecdotal evidence may suggest drug use among homeless veterans is related to their patterns of travel throughout the day. Assuming prior studies have not looked at individual travel choices as a way to study access to illicit drug use, a case study that observes a homeless veteran could reveal how issues of personal mobility choices facilitate regular access to illicit drugs. Note that it is important to conduct a thorough literature review to ensure that your assumption about the need to reveal new insights or previously hidden problems is valid and evidence-based.
• The case challenges and offers a counter-point to prevailing assumptions? Over time, research on any given topic can fall into a trap of developing assumptions based on outdated studies that are still applied to new or changing conditions or the idea that something should simply be accepted as "common sense," even though the issue has not been thoroughly tested in current practice. A case study analysis may offer an opportunity to gather evidence that challenges prevailing assumptions about a research problem and provide a new set of recommendations applied to practice that have not been tested previously. For example, perhaps there has been a long practice among scholars to apply a particular theory in explaining the relationship between two subjects of analysis. Your case could challenge this assumption by applying an innovative theoretical framework [perhaps borrowed from another discipline] to explore whether this approach offers new ways of understanding the research problem. Taking a contrarian stance is one of the most important ways that new knowledge and understanding develops from existing literature.
• The case provides an opportunity to pursue action leading to the resolution of a problem? Another way to think about choosing a case to study is to consider how the results from investigating a particular case may result in findings that reveal ways in which to resolve an existing or emerging problem. For example, studying the case of an unforeseen incident, such as a fatal accident at a railroad crossing, can reveal hidden issues that could be applied to preventative measures that contribute to reducing the chance of accidents in the future. In this example, a case study investigating the accident could lead to a better understanding of where to strategically locate additional signals at other railroad crossings so as to better warn drivers of an approaching train, particularly when visibility is hindered by heavy rain, fog, or at night.
• The case offers a new direction in future research? A case study can be used as a tool for an exploratory investigation that highlights the need for further research about the problem. A case can be used when there are few studies that help predict an outcome or that establish a clear understanding about how best to proceed in addressing a problem. For example, after conducting a thorough literature review [very important!], you discover that little research exists showing the ways in which women contribute to promoting water conservation in rural communities of east central Africa. A case study of how women contribute to saving water in a rural village of Uganda can lay the foundation for understanding the need for more thorough research that documents how women in their roles as cooks and family caregivers think about water as a valuable resource within their community. This example of a case study could also point to the need for scholars to build new theoretical frameworks around the topic [e.g., applying feminist theories of work and family to the issue of water conservation].

Eisenhardt, Kathleen M. “Building Theories from Case Study Research.” Academy of Management Review 14 (October 1989): 532-550; Emmel, Nick. Sampling and Choosing Cases in Qualitative Research: A Realist Approach . Thousand Oaks, CA: SAGE Publications, 2013; Gerring, John. “What Is a Case Study and What Is It Good for?” American Political Science Review 98 (May 2004): 341-354; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Seawright, Jason and John Gerring. "Case Selection Techniques in Case Study Research." Political Research Quarterly 61 (June 2008): 294-308.

Structure and Writing Style

The purpose of a paper in the social sciences designed around a case study is to thoroughly investigate a subject of analysis in order to reveal a new understanding about the research problem and, in so doing, contributing new knowledge to what is already known from previous studies. In applied social sciences disciplines [e.g., education, social work, public administration, etc.], case studies may also be used to reveal best practices, highlight key programs, or investigate interesting aspects of professional work.

In general, the structure of a case study research paper is not all that different from a standard college-level research paper. However, there are subtle differences you should be aware of. Here are the key elements to organizing and writing a case study research paper.

I.  Introduction

As with any research paper, your introduction should serve as a roadmap for your readers to ascertain the scope and purpose of your study . The introduction to a case study research paper, however, should not only describe the research problem and its significance, but you should also succinctly describe why the case is being used and how it relates to addressing the problem. The two elements should be linked. With this in mind, a good introduction answers these four questions:

• What is being studied? Describe the research problem and describe the subject of analysis [the case] you have chosen to address the problem. Explain how they are linked and what elements of the case will help to expand knowledge and understanding about the problem.
• Why is this topic important to investigate? Describe the significance of the research problem and state why a case study design and the subject of analysis that the paper is designed around is appropriate in addressing the problem.
• What did we know about this topic before I did this study? Provide background that helps lead the reader into the more in-depth literature review to follow. If applicable, summarize prior case study research applied to the research problem and why it fails to adequately address the problem. Describe why your case will be useful. If no prior case studies have been used to address the research problem, explain why you have selected this subject of analysis.
• How will this study advance new knowledge or new ways of understanding? Explain why your case study will be suitable in helping to expand knowledge and understanding about the research problem.

Each of these questions should be addressed in no more than a few paragraphs. Exceptions to this can be when you are addressing a complex research problem or subject of analysis that requires more in-depth background information.

II.  Literature Review

The literature review for a case study research paper is generally structured the same as it is for any college-level research paper. The difference, however, is that the literature review is focused on providing background information and  enabling historical interpretation of the subject of analysis in relation to the research problem the case is intended to address . This includes synthesizing studies that help to:

• Place relevant works in the context of their contribution to understanding the case study being investigated . This would involve summarizing studies that have used a similar subject of analysis to investigate the research problem. If there is literature using the same or a very similar case to study, you need to explain why duplicating past research is important [e.g., conditions have changed; prior studies were conducted long ago, etc.].
• Describe the relationship each work has to the others under consideration that informs the reader why this case is applicable . Your literature review should include a description of any works that support using the case to investigate the research problem and the underlying research questions.
• Identify new ways to interpret prior research using the case study . If applicable, review any research that has examined the research problem using a different research design. Explain how your use of a case study design may reveal new knowledge or a new perspective or that can redirect research in an important new direction.
• Resolve conflicts amongst seemingly contradictory previous studies . This refers to synthesizing any literature that points to unresolved issues of concern about the research problem and describing how the subject of analysis that forms the case study can help resolve these existing contradictions.
• Point the way in fulfilling a need for additional research . Your review should examine any literature that lays a foundation for understanding why your case study design and the subject of analysis around which you have designed your study may reveal a new way of approaching the research problem or offer a perspective that points to the need for additional research.
• Expose any gaps that exist in the literature that the case study could help to fill . Summarize any literature that not only shows how your subject of analysis contributes to understanding the research problem, but how your case contributes to a new way of understanding the problem that prior research has failed to do.
• Locate your own research within the context of existing literature [very important!] . Collectively, your literature review should always place your case study within the larger domain of prior research about the problem. The overarching purpose of reviewing pertinent literature in a case study paper is to demonstrate that you have thoroughly identified and synthesized prior studies in relation to explaining the relevance of the case in addressing the research problem.

III.  Method

In this section, you explain why you selected a particular case [i.e., subject of analysis] and the strategy you used to identify and ultimately decide that your case was appropriate in addressing the research problem. The way you describe the methods used varies depending on the type of subject of analysis that constitutes your case study.

If your subject of analysis is an incident or event . In the social and behavioral sciences, the event or incident that represents the case to be studied is usually bounded by time and place, with a clear beginning and end and with an identifiable location or position relative to its surroundings. The subject of analysis can be a rare or critical event or it can focus on a typical or regular event. The purpose of studying a rare event is to illuminate new ways of thinking about the broader research problem or to test a hypothesis. Critical incident case studies must describe the method by which you identified the event and explain the process by which you determined the validity of this case to inform broader perspectives about the research problem or to reveal new findings. However, the event does not have to be a rare or uniquely significant to support new thinking about the research problem or to challenge an existing hypothesis. For example, Walo, Bull, and Breen conducted a case study to identify and evaluate the direct and indirect economic benefits and costs of a local sports event in the City of Lismore, New South Wales, Australia. The purpose of their study was to provide new insights from measuring the impact of a typical local sports event that prior studies could not measure well because they focused on large "mega-events." Whether the event is rare or not, the methods section should include an explanation of the following characteristics of the event: a) when did it take place; b) what were the underlying circumstances leading to the event; and, c) what were the consequences of the event in relation to the research problem.

If your subject of analysis is a person. Explain why you selected this particular individual to be studied and describe what experiences they have had that provide an opportunity to advance new understandings about the research problem. Mention any background about this person which might help the reader understand the significance of their experiences that make them worthy of study. This includes describing the relationships this person has had with other people, institutions, and/or events that support using them as the subject for a case study research paper. It is particularly important to differentiate the person as the subject of analysis from others and to succinctly explain how the person relates to examining the research problem [e.g., why is one politician in a particular local election used to show an increase in voter turnout from any other candidate running in the election]. Note that these issues apply to a specific group of people used as a case study unit of analysis [e.g., a classroom of students].

If your subject of analysis is a place. In general, a case study that investigates a place suggests a subject of analysis that is unique or special in some way and that this uniqueness can be used to build new understanding or knowledge about the research problem. A case study of a place must not only describe its various attributes relevant to the research problem [e.g., physical, social, historical, cultural, economic, political], but you must state the method by which you determined that this place will illuminate new understandings about the research problem. It is also important to articulate why a particular place as the case for study is being used if similar places also exist [i.e., if you are studying patterns of homeless encampments of veterans in open spaces, explain why you are studying Echo Park in Los Angeles rather than Griffith Park?]. If applicable, describe what type of human activity involving this place makes it a good choice to study [e.g., prior research suggests Echo Park has more homeless veterans].

If your subject of analysis is a phenomenon. A phenomenon refers to a fact, occurrence, or circumstance that can be studied or observed but with the cause or explanation to be in question. In this sense, a phenomenon that forms your subject of analysis can encompass anything that can be observed or presumed to exist but is not fully understood. In the social and behavioral sciences, the case usually focuses on human interaction within a complex physical, social, economic, cultural, or political system. For example, the phenomenon could be the observation that many vehicles used by ISIS fighters are small trucks with English language advertisements on them. The research problem could be that ISIS fighters are difficult to combat because they are highly mobile. The research questions could be how and by what means are these vehicles used by ISIS being supplied to the militants and how might supply lines to these vehicles be cut off? How might knowing the suppliers of these trucks reveal larger networks of collaborators and financial support? A case study of a phenomenon most often encompasses an in-depth analysis of a cause and effect that is grounded in an interactive relationship between people and their environment in some way.

NOTE:   The choice of the case or set of cases to study cannot appear random. Evidence that supports the method by which you identified and chose your subject of analysis should clearly support investigation of the research problem and linked to key findings from your literature review. Be sure to cite any studies that helped you determine that the case you chose was appropriate for examining the problem.

IV.  Discussion

The main elements of your discussion section are generally the same as any research paper, but centered around interpreting and drawing conclusions about the key findings from your analysis of the case study. Note that a general social sciences research paper may contain a separate section to report findings. However, in a paper designed around a case study, it is common to combine a description of the results with the discussion about their implications. The objectives of your discussion section should include the following:

Reiterate the Research Problem/State the Major Findings Briefly reiterate the research problem you are investigating and explain why the subject of analysis around which you designed the case study were used. You should then describe the findings revealed from your study of the case using direct, declarative, and succinct proclamation of the study results. Highlight any findings that were unexpected or especially profound.

Explain the Meaning of the Findings and Why They are Important Systematically explain the meaning of your case study findings and why you believe they are important. Begin this part of the section by repeating what you consider to be your most important or surprising finding first, then systematically review each finding. Be sure to thoroughly extrapolate what your analysis of the case can tell the reader about situations or conditions beyond the actual case that was studied while, at the same time, being careful not to misconstrue or conflate a finding that undermines the external validity of your conclusions.

Relate the Findings to Similar Studies No study in the social sciences is so novel or possesses such a restricted focus that it has absolutely no relation to previously published research. The discussion section should relate your case study results to those found in other studies, particularly if questions raised from prior studies served as the motivation for choosing your subject of analysis. This is important because comparing and contrasting the findings of other studies helps support the overall importance of your results and it highlights how and in what ways your case study design and the subject of analysis differs from prior research about the topic.

Consider Alternative Explanations of the Findings Remember that the purpose of social science research is to discover and not to prove. When writing the discussion section, you should carefully consider all possible explanations revealed by the case study results, rather than just those that fit your hypothesis or prior assumptions and biases. Be alert to what the in-depth analysis of the case may reveal about the research problem, including offering a contrarian perspective to what scholars have stated in prior research if that is how the findings can be interpreted from your case.

Acknowledge the Study's Limitations You can state the study's limitations in the conclusion section of your paper but describing the limitations of your subject of analysis in the discussion section provides an opportunity to identify the limitations and explain why they are not significant. This part of the discussion section should also note any unanswered questions or issues your case study could not address. More detailed information about how to document any limitations to your research can be found here .

Suggest Areas for Further Research Although your case study may offer important insights about the research problem, there are likely additional questions related to the problem that remain unanswered or findings that unexpectedly revealed themselves as a result of your in-depth analysis of the case. Be sure that the recommendations for further research are linked to the research problem and that you explain why your recommendations are valid in other contexts and based on the original assumptions of your study.

V.  Conclusion

As with any research paper, you should summarize your conclusion in clear, simple language; emphasize how the findings from your case study differs from or supports prior research and why. Do not simply reiterate the discussion section. Provide a synthesis of key findings presented in the paper to show how these converge to address the research problem. If you haven't already done so in the discussion section, be sure to document the limitations of your case study and any need for further research.

The function of your paper's conclusion is to: 1) reiterate the main argument supported by the findings from your case study; 2) state clearly the context, background, and necessity of pursuing the research problem using a case study design in relation to an issue, controversy, or a gap found from reviewing the literature; and, 3) provide a place to persuasively and succinctly restate the significance of your research problem, given that the reader has now been presented with in-depth information about the topic.

Consider the following points to help ensure your conclusion is appropriate:

• If the argument or purpose of your paper is complex, you may need to summarize these points for your reader.
• If prior to your conclusion, you have not yet explained the significance of your findings or if you are proceeding inductively, use the conclusion of your paper to describe your main points and explain their significance.
• Move from a detailed to a general level of consideration of the case study's findings that returns the topic to the context provided by the introduction or within a new context that emerges from your case study findings.

Note that, depending on the discipline you are writing in or the preferences of your professor, the concluding paragraph may contain your final reflections on the evidence presented as it applies to practice or on the essay's central research problem. However, the nature of being introspective about the subject of analysis you have investigated will depend on whether you are explicitly asked to express your observations in this way.

Problems to Avoid

Overgeneralization One of the goals of a case study is to lay a foundation for understanding broader trends and issues applied to similar circumstances. However, be careful when drawing conclusions from your case study. They must be evidence-based and grounded in the results of the study; otherwise, it is merely speculation. Looking at a prior example, it would be incorrect to state that a factor in improving girls access to education in Azerbaijan and the policy implications this may have for improving access in other Muslim nations is due to girls access to social media if there is no documentary evidence from your case study to indicate this. There may be anecdotal evidence that retention rates were better for girls who were engaged with social media, but this observation would only point to the need for further research and would not be a definitive finding if this was not a part of your original research agenda.

Failure to Document Limitations No case is going to reveal all that needs to be understood about a research problem. Therefore, just as you have to clearly state the limitations of a general research study , you must describe the specific limitations inherent in the subject of analysis. For example, the case of studying how women conceptualize the need for water conservation in a village in Uganda could have limited application in other cultural contexts or in areas where fresh water from rivers or lakes is plentiful and, therefore, conservation is understood more in terms of managing access rather than preserving access to a scarce resource.

Failure to Extrapolate All Possible Implications Just as you don't want to over-generalize from your case study findings, you also have to be thorough in the consideration of all possible outcomes or recommendations derived from your findings. If you do not, your reader may question the validity of your analysis, particularly if you failed to document an obvious outcome from your case study research. For example, in the case of studying the accident at the railroad crossing to evaluate where and what types of warning signals should be located, you failed to take into consideration speed limit signage as well as warning signals. When designing your case study, be sure you have thoroughly addressed all aspects of the problem and do not leave gaps in your analysis that leave the reader questioning the results.

Case Studies. Writing@CSU. Colorado State University; Gerring, John. Case Study Research: Principles and Practices . New York: Cambridge University Press, 2007; Merriam, Sharan B. Qualitative Research and Case Study Applications in Education . Rev. ed. San Francisco, CA: Jossey-Bass, 1998; Miller, Lisa L. “The Use of Case Studies in Law and Social Science Research.” Annual Review of Law and Social Science 14 (2018): TBD; Mills, Albert J., Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Putney, LeAnn Grogan. "Case Study." In Encyclopedia of Research Design , Neil J. Salkind, editor. (Thousand Oaks, CA: SAGE Publications, 2010), pp. 116-120; Simons, Helen. Case Study Research in Practice . London: SAGE Publications, 2009;  Kratochwill,  Thomas R. and Joel R. Levin, editors. Single-Case Research Design and Analysis: New Development for Psychology and Education .  Hilldsale, NJ: Lawrence Erlbaum Associates, 1992; Swanborn, Peter G. Case Study Research: What, Why and How? London : SAGE, 2010; Yin, Robert K. Case Study Research: Design and Methods . 6th edition. Los Angeles, CA, SAGE Publications, 2014; Walo, Maree, Adrian Bull, and Helen Breen. “Achieving Economic Benefits at Local Events: A Case Study of a Local Sports Event.” Festival Management and Event Tourism 4 (1996): 95-106.

Writing Tip

At Least Five Misconceptions about Case Study Research

Social science case studies are often perceived as limited in their ability to create new knowledge because they are not randomly selected and findings cannot be generalized to larger populations. Flyvbjerg examines five misunderstandings about case study research and systematically "corrects" each one. To quote, these are:

Misunderstanding 1 :  General, theoretical [context-independent] knowledge is more valuable than concrete, practical [context-dependent] knowledge. Misunderstanding 2 :  One cannot generalize on the basis of an individual case; therefore, the case study cannot contribute to scientific development. Misunderstanding 3 :  The case study is most useful for generating hypotheses; that is, in the first stage of a total research process, whereas other methods are more suitable for hypotheses testing and theory building. Misunderstanding 4 :  The case study contains a bias toward verification, that is, a tendency to confirm the researcher’s preconceived notions. Misunderstanding 5 :  It is often difficult to summarize and develop general propositions and theories on the basis of specific case studies [p. 221].

While writing your paper, think introspectively about how you addressed these misconceptions because to do so can help you strengthen the validity and reliability of your research by clarifying issues of case selection, the testing and challenging of existing assumptions, the interpretation of key findings, and the summation of case outcomes. Think of a case study research paper as a complete, in-depth narrative about the specific properties and key characteristics of your subject of analysis applied to the research problem.

Flyvbjerg, Bent. “Five Misunderstandings About Case-Study Research.” Qualitative Inquiry 12 (April 2006): 219-245.

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• Volume 21, Issue 1
• What is a case study?
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• Roberta Heale 1 ,
• Alison Twycross 2
• 1 School of Nursing , Laurentian University , Sudbury , Ontario , Canada
• 2 School of Health and Social Care , London South Bank University , London , UK
• Correspondence to Dr Roberta Heale, School of Nursing, Laurentian University, Sudbury, ON P3E2C6, Canada; rheale{at}laurentian.ca

https://doi.org/10.1136/eb-2017-102845

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What is it?

Case study is a research methodology, typically seen in social and life sciences. There is no one definition of case study research. 1 However, very simply… ‘a case study can be defined as an intensive study about a person, a group of people or a unit, which is aimed to generalize over several units’. 1 A case study has also been described as an intensive, systematic investigation of a single individual, group, community or some other unit in which the researcher examines in-depth data relating to several variables. 2

Often there are several similar cases to consider such as educational or social service programmes that are delivered from a number of locations. Although similar, they are complex and have unique features. In these circumstances, the evaluation of several, similar cases will provide a better answer to a research question than if only one case is examined, hence the multiple-case study. Stake asserts that the cases are grouped and viewed as one entity, called the quintain . 6  ‘We study what is similar and different about the cases to understand the quintain better’. 6

The steps when using case study methodology are the same as for other types of research. 6 The first step is defining the single case or identifying a group of similar cases that can then be incorporated into a multiple-case study. A search to determine what is known about the case(s) is typically conducted. This may include a review of the literature, grey literature, media, reports and more, which serves to establish a basic understanding of the cases and informs the development of research questions. Data in case studies are often, but not exclusively, qualitative in nature. In multiple-case studies, analysis within cases and across cases is conducted. Themes arise from the analyses and assertions about the cases as a whole, or the quintain, emerge. 6

Benefits and limitations of case studies

If a researcher wants to study a specific phenomenon arising from a particular entity, then a single-case study is warranted and will allow for a in-depth understanding of the single phenomenon and, as discussed above, would involve collecting several different types of data. This is illustrated in example 1 below.

Using a multiple-case research study allows for a more in-depth understanding of the cases as a unit, through comparison of similarities and differences of the individual cases embedded within the quintain. Evidence arising from multiple-case studies is often stronger and more reliable than from single-case research. Multiple-case studies allow for more comprehensive exploration of research questions and theory development. 6

Despite the advantages of case studies, there are limitations. The sheer volume of data is difficult to organise and data analysis and integration strategies need to be carefully thought through. There is also sometimes a temptation to veer away from the research focus. 2 Reporting of findings from multiple-case research studies is also challenging at times, 1 particularly in relation to the word limits for some journal papers.

Examples of case studies

Example 1: nurses’ paediatric pain management practices.

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

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

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

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

These datasets were analysed separately and then compared 7–9 and demonstrated that nurses’ level of theoretical did not impact on the quality of their pain management practices. 7 Nor did individual nurse’s perceptions of how critical a task was effect the likelihood of them carrying out this task in practice. 8 There was also a difference in self-reported and observed practices 9 ; actual (observed) practices did not confirm to best practice guidelines, whereas self-reported practices tended to.

Example 2: quality of care for complex patients at Nurse Practitioner-Led Clinics (NPLCs)

The other author of this paper (RH) has conducted a multiple-case study to determine the quality of care for patients with complex clinical presentations in NPLCs in Ontario, Canada. 10 Five NPLCs served as individual cases that, together, represented the quatrain. Three types of data were collected including:

Review of documentation related to the NPLC model (media, annual reports, research articles, grey literature and regulatory legislation).

Interviews with nurse practitioners (NPs) practising at the five NPLCs to determine their perceptions of the impact of the NPLC model on the quality of care provided to patients with multimorbidity.

Chart audits conducted at the five NPLCs to determine the extent to which evidence-based guidelines were followed for patients with diabetes and at least one other chronic condition.

The three sources of data collected from the five NPLCs were analysed and themes arose related to the quality of care for complex patients at NPLCs. The multiple-case study confirmed that nurse practitioners are the primary care providers at the NPLCs, and this positively impacts the quality of care for patients with multimorbidity. Healthcare policy, such as lack of an increase in salary for NPs for 10 years, has resulted in issues in recruitment and retention of NPs at NPLCs. This, along with insufficient resources in the communities where NPLCs are located and high patient vulnerability at NPLCs, have a negative impact on the quality of care. 10

These examples illustrate how collecting data about a single case or multiple cases helps us to better understand the phenomenon in question. Case study methodology serves to provide a framework for evaluation and analysis of complex issues. It shines a light on the holistic nature of nursing practice and offers a perspective that informs improved patient care.

• Gustafsson J
• Calanzaro M
• Sandelowski M

Competing interests None declared.

Provenance and peer review Commissioned; internally peer reviewed.

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Continuing to enhance the quality of case study methodology in health services research

Shannon l. sibbald.

1 Faculty of Health Sciences, Western University, London, Ontario, Canada.

2 Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

3 The Schulich Interfaculty Program in Public Health, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

Stefan Paciocco

Meghan fournie, rachelle van asseldonk, tiffany scurr.

Case study methodology has grown in popularity within Health Services Research (HSR). However, its use and merit as a methodology are frequently criticized due to its flexible approach and inconsistent application. Nevertheless, case study methodology is well suited to HSR because it can track and examine complex relationships, contexts, and systems as they evolve. Applied appropriately, it can help generate information on how multiple forms of knowledge come together to inform decision-making within healthcare contexts. In this article, we aim to demystify case study methodology by outlining its philosophical underpinnings and three foundational approaches. We provide literature-based guidance to decision-makers, policy-makers, and health leaders on how to engage in and critically appraise case study design. We advocate that researchers work in collaboration with health leaders to detail their research process with an aim of strengthening the validity and integrity of case study for its continued and advanced use in HSR.

Introduction

The popularity of case study research methodology in Health Services Research (HSR) has grown over the past 40 years. 1 This may be attributed to a shift towards the use of implementation research and a newfound appreciation of contextual factors affecting the uptake of evidence-based interventions within diverse settings. 2 Incorporating context-specific information on the delivery and implementation of programs can increase the likelihood of success. 3 , 4 Case study methodology is particularly well suited for implementation research in health services because it can provide insight into the nuances of diverse contexts. 5 , 6 In 1999, Yin 7 published a paper on how to enhance the quality of case study in HSR, which was foundational for the emergence of case study in this field. Yin 7 maintains case study is an appropriate methodology in HSR because health systems are constantly evolving, and the multiple affiliations and diverse motivations are difficult to track and understand with traditional linear methodologies.

Despite its increased popularity, there is debate whether a case study is a methodology (ie, a principle or process that guides research) or a method (ie, a tool to answer research questions). Some criticize case study for its high level of flexibility, perceiving it as less rigorous, and maintain that it generates inadequate results. 8 Others have noted issues with quality and consistency in how case studies are conducted and reported. 9 Reporting is often varied and inconsistent, using a mix of approaches such as case reports, case findings, and/or case study. Authors sometimes use incongruent methods of data collection and analysis or use the case study as a default when other methodologies do not fit. 9 , 10 Despite these criticisms, case study methodology is becoming more common as a viable approach for HSR. 11 An abundance of articles and textbooks are available to guide researchers through case study research, including field-specific resources for business, 12 , 13 nursing, 14 and family medicine. 15 However, there remains confusion and a lack of clarity on the key tenets of case study methodology.

Several common philosophical underpinnings have contributed to the development of case study research 1 which has led to different approaches to planning, data collection, and analysis. This presents challenges in assessing quality and rigour for researchers conducting case studies and stakeholders reading results.

This article discusses the various approaches and philosophical underpinnings to case study methodology. Our goal is to explain it in a way that provides guidance for decision-makers, policy-makers, and health leaders on how to understand, critically appraise, and engage in case study research and design, as such guidance is largely absent in the literature. This article is by no means exhaustive or authoritative. Instead, we aim to provide guidance and encourage dialogue around case study methodology, facilitating critical thinking around the variety of approaches and ways quality and rigour can be bolstered for its use within HSR.

Purpose of case study methodology

Case study methodology is often used to develop an in-depth, holistic understanding of a specific phenomenon within a specified context. 11 It focuses on studying one or multiple cases over time and uses an in-depth analysis of multiple information sources. 16 , 17 It is ideal for situations including, but not limited to, exploring under-researched and real-life phenomena, 18 especially when the contexts are complex and the researcher has little control over the phenomena. 19 , 20 Case studies can be useful when researchers want to understand how interventions are implemented in different contexts, and how context shapes the phenomenon of interest.

In addition to demonstrating coherency with the type of questions case study is suited to answer, there are four key tenets to case study methodologies: (1) be transparent in the paradigmatic and theoretical perspectives influencing study design; (2) clearly define the case and phenomenon of interest; (3) clearly define and justify the type of case study design; and (4) use multiple data collection sources and analysis methods to present the findings in ways that are consistent with the methodology and the study’s paradigmatic base. 9 , 16 The goal is to appropriately match the methods to empirical questions and issues and not to universally advocate any single approach for all problems. 21

Approaches to case study methodology

Three authors propose distinct foundational approaches to case study methodology positioned within different paradigms: Yin, 19 , 22 Stake, 5 , 23 and Merriam 24 , 25 ( Table 1 ). Yin is strongly post-positivist whereas Stake and Merriam are grounded in a constructivist paradigm. Researchers should locate their research within a paradigm that explains the philosophies guiding their research 26 and adhere to the underlying paradigmatic assumptions and key tenets of the appropriate author’s methodology. This will enhance the consistency and coherency of the methods and findings. However, researchers often do not report their paradigmatic position, nor do they adhere to one approach. 9 Although deliberately blending methodologies may be defensible and methodologically appropriate, more often it is done in an ad hoc and haphazard way, without consideration for limitations.

Cross-analysis of three case study approaches, adapted from Yazan 2015

The post-positive paradigm postulates there is one reality that can be objectively described and understood by “bracketing” oneself from the research to remove prejudice or bias. 27 Yin focuses on general explanation and prediction, emphasizing the formulation of propositions, akin to hypothesis testing. This approach is best suited for structured and objective data collection 9 , 11 and is often used for mixed-method studies.

Constructivism assumes that the phenomenon of interest is constructed and influenced by local contexts, including the interaction between researchers, individuals, and their environment. 27 It acknowledges multiple interpretations of reality 24 constructed within the context by the researcher and participants which are unlikely to be replicated, should either change. 5 , 20 Stake and Merriam’s constructivist approaches emphasize a story-like rendering of a problem and an iterative process of constructing the case study. 7 This stance values researcher reflexivity and transparency, 28 acknowledging how researchers’ experiences and disciplinary lenses influence their assumptions and beliefs about the nature of the phenomenon and development of the findings.

Defining a case

A key tenet of case study methodology often underemphasized in literature is the importance of defining the case and phenomenon. Researches should clearly describe the case with sufficient detail to allow readers to fully understand the setting and context and determine applicability. Trying to answer a question that is too broad often leads to an unclear definition of the case and phenomenon. 20 Cases should therefore be bound by time and place to ensure rigor and feasibility. 6

Yin 22 defines a case as “a contemporary phenomenon within its real-life context,” (p13) which may contain a single unit of analysis, including individuals, programs, corporations, or clinics 29 (holistic), or be broken into sub-units of analysis, such as projects, meetings, roles, or locations within the case (embedded). 30 Merriam 24 and Stake 5 similarly define a case as a single unit studied within a bounded system. Stake 5 , 23 suggests bounding cases by contexts and experiences where the phenomenon of interest can be a program, process, or experience. However, the line between the case and phenomenon can become muddy. For guidance, Stake 5 , 23 describes the case as the noun or entity and the phenomenon of interest as the verb, functioning, or activity of the case.

Designing the case study approach

Yin’s approach to a case study is rooted in a formal proposition or theory which guides the case and is used to test the outcome. 1 Stake 5 advocates for a flexible design and explicitly states that data collection and analysis may commence at any point. Merriam’s 24 approach blends both Yin and Stake’s, allowing the necessary flexibility in data collection and analysis to meet the needs.

Yin 30 proposed three types of case study approaches—descriptive, explanatory, and exploratory. Each can be designed around single or multiple cases, creating six basic case study methodologies. Descriptive studies provide a rich description of the phenomenon within its context, which can be helpful in developing theories. To test a theory or determine cause and effect relationships, researchers can use an explanatory design. An exploratory model is typically used in the pilot-test phase to develop propositions (eg, Sibbald et al. 31 used this approach to explore interprofessional network complexity). Despite having distinct characteristics, the boundaries between case study types are flexible with significant overlap. 30 Each has five key components: (1) research question; (2) proposition; (3) unit of analysis; (4) logical linking that connects the theory with proposition; and (5) criteria for analyzing findings.

Contrary to Yin, Stake 5 believes the research process cannot be planned in its entirety because research evolves as it is performed. Consequently, researchers can adjust the design of their methods even after data collection has begun. Stake 5 classifies case studies into three categories: intrinsic, instrumental, and collective/multiple. Intrinsic case studies focus on gaining a better understanding of the case. These are often undertaken when the researcher has an interest in a specific case. Instrumental case study is used when the case itself is not of the utmost importance, and the issue or phenomenon (ie, the research question) being explored becomes the focus instead (eg, Paciocco 32 used an instrumental case study to evaluate the implementation of a chronic disease management program). 5 Collective designs are rooted in an instrumental case study and include multiple cases to gain an in-depth understanding of the complexity and particularity of a phenomenon across diverse contexts. 5 , 23 In collective designs, studying similarities and differences between the cases allows the phenomenon to be understood more intimately (for examples of this in the field, see van Zelm et al. 33 and Burrows et al. 34 In addition, Sibbald et al. 35 present an example where a cross-case analysis method is used to compare instrumental cases).

Merriam’s approach is flexible (similar to Stake) as well as stepwise and linear (similar to Yin). She advocates for conducting a literature review before designing the study to better understand the theoretical underpinnings. 24 , 25 Unlike Stake or Yin, Merriam proposes a step-by-step guide for researchers to design a case study. These steps include performing a literature review, creating a theoretical framework, identifying the problem, creating and refining the research question(s), and selecting a study sample that fits the question(s). 24 , 25 , 36

Data collection and analysis

Using multiple data collection methods is a key characteristic of all case study methodology; it enhances the credibility of the findings by allowing different facets and views of the phenomenon to be explored. 23 Common methods include interviews, focus groups, observation, and document analysis. 5 , 37 By seeking patterns within and across data sources, a thick description of the case can be generated to support a greater understanding and interpretation of the whole phenomenon. 5 , 17 , 20 , 23 This technique is called triangulation and is used to explore cases with greater accuracy. 5 Although Stake 5 maintains case study is most often used in qualitative research, Yin 17 supports a mix of both quantitative and qualitative methods to triangulate data. This deliberate convergence of data sources (or mixed methods) allows researchers to find greater depth in their analysis and develop converging lines of inquiry. For example, case studies evaluating interventions commonly use qualitative interviews to describe the implementation process, barriers, and facilitators paired with a quantitative survey of comparative outcomes and effectiveness. 33 , 38 , 39

Yin 30 describes analysis as dependent on the chosen approach, whether it be (1) deductive and rely on theoretical propositions; (2) inductive and analyze data from the “ground up”; (3) organized to create a case description; or (4) used to examine plausible rival explanations. According to Yin’s 40 approach to descriptive case studies, carefully considering theory development is an important part of study design. “Theory” refers to field-relevant propositions, commonly agreed upon assumptions, or fully developed theories. 40 Stake 5 advocates for using the researcher’s intuition and impression to guide analysis through a categorical aggregation and direct interpretation. Merriam 24 uses six different methods to guide the “process of making meaning” (p178) : (1) ethnographic analysis; (2) narrative analysis; (3) phenomenological analysis; (4) constant comparative method; (5) content analysis; and (6) analytic induction.

Drawing upon a theoretical or conceptual framework to inform analysis improves the quality of case study and avoids the risk of description without meaning. 18 Using Stake’s 5 approach, researchers rely on protocols and previous knowledge to help make sense of new ideas; theory can guide the research and assist researchers in understanding how new information fits into existing knowledge.

Practical applications of case study research

Columbia University has recently demonstrated how case studies can help train future health leaders. 41 Case studies encompass components of systems thinking—considering connections and interactions between components of a system, alongside the implications and consequences of those relationships—to equip health leaders with tools to tackle global health issues. 41 Greenwood 42 evaluated Indigenous peoples’ relationship with the healthcare system in British Columbia and used a case study to challenge and educate health leaders across the country to enhance culturally sensitive health service environments.

An important but often omitted step in case study research is an assessment of quality and rigour. We recommend using a framework or set of criteria to assess the rigour of the qualitative research. Suitable resources include Caelli et al., 43 Houghten et al., 44 Ravenek and Rudman, 45 and Tracy. 46

New directions in case study

Although “pragmatic” case studies (ie, utilizing practical and applicable methods) have existed within psychotherapy for some time, 47 , 48 only recently has the applicability of pragmatism as an underlying paradigmatic perspective been considered in HSR. 49 This is marked by uptake of pragmatism in Randomized Control Trials, recognizing that “gold standard” testing conditions do not reflect the reality of clinical settings 50 , 51 nor do a handful of epistemologically guided methodologies suit every research inquiry.

Pragmatism positions the research question as the basis for methodological choices, rather than a theory or epistemology, allowing researchers to pursue the most practical approach to understanding a problem or discovering an actionable solution. 52 Mixed methods are commonly used to create a deeper understanding of the case through converging qualitative and quantitative data. 52 Pragmatic case study is suited to HSR because its flexibility throughout the research process accommodates complexity, ever-changing systems, and disruptions to research plans. 49 , 50 Much like case study, pragmatism has been criticized for its flexibility and use when other approaches are seemingly ill-fit. 53 , 54 Similarly, authors argue that this results from a lack of investigation and proper application rather than a reflection of validity, legitimizing the need for more exploration and conversation among researchers and practitioners. 55

Although occasionally misunderstood as a less rigourous research methodology, 8 case study research is highly flexible and allows for contextual nuances. 5 , 6 Its use is valuable when the researcher desires a thorough understanding of a phenomenon or case bound by context. 11 If needed, multiple similar cases can be studied simultaneously, or one case within another. 16 , 17 There are currently three main approaches to case study, 5 , 17 , 24 each with their own definitions of a case, ontological and epistemological paradigms, methodologies, and data collection and analysis procedures. 37

Individuals’ experiences within health systems are influenced heavily by contextual factors, participant experience, and intricate relationships between different organizations and actors. 55 Case study research is well suited for HSR because it can track and examine these complex relationships and systems as they evolve over time. 6 , 7 It is important that researchers and health leaders using this methodology understand its key tenets and how to conduct a proper case study. Although there are many examples of case study in action, they are often under-reported and, when reported, not rigorously conducted. 9 Thus, decision-makers and health leaders should use these examples with caution. The proper reporting of case studies is necessary to bolster their credibility in HSR literature and provide readers sufficient information to critically assess the methodology. We also call on health leaders who frequently use case studies 56 – 58 to report them in the primary research literature.

The purpose of this article is to advocate for the continued and advanced use of case study in HSR and to provide literature-based guidance for decision-makers, policy-makers, and health leaders on how to engage in, read, and interpret findings from case study research. As health systems progress and evolve, the application of case study research will continue to increase as researchers and health leaders aim to capture the inherent complexities, nuances, and contextual factors. 7

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What Is a Case Study?

Weighing the pros and cons of this method of research

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Cara Lustik is a fact-checker and copywriter.

Verywell / Colleen Tighe

• Pros and Cons

What Types of Case Studies Are Out There?

Where do you find data for a case study, how do i write a psychology case study.

A case study is an in-depth study of one person, group, or event. In a case study, nearly every aspect of the subject's life and history is analyzed to seek patterns and causes of behavior. Case studies can be used in many different fields, including psychology, medicine, education, anthropology, political science, and social work.

The point of a case study is to learn as much as possible about an individual or group so that the information can be generalized to many others. Unfortunately, case studies tend to be highly subjective, and it is sometimes difficult to generalize results to a larger population.

While case studies focus on a single individual or group, they follow a format similar to other types of psychology writing. If you are writing a case study, we got you—here are some rules of APA format to reference.  

At a Glance

A case study, or an in-depth study of a person, group, or event, can be a useful research tool when used wisely. In many cases, case studies are best used in situations where it would be difficult or impossible for you to conduct an experiment. They are helpful for looking at unique situations and allow researchers to gather a lot of˜ information about a specific individual or group of people. However, it's important to be cautious of any bias we draw from them as they are highly subjective.

What Are the Benefits and Limitations of Case Studies?

A case study can have its strengths and weaknesses. Researchers must consider these pros and cons before deciding if this type of study is appropriate for their needs.

One of the greatest advantages of a case study is that it allows researchers to investigate things that are often difficult or impossible to replicate in a lab. Some other benefits of a case study:

• Allows researchers to capture information on the 'how,' 'what,' and 'why,' of something that's implemented
• Gives researchers the chance to collect information on why one strategy might be chosen over another
• Permits researchers to develop hypotheses that can be explored in experimental research

On the other hand, a case study can have some drawbacks:

• It cannot necessarily be generalized to the larger population
• Cannot demonstrate cause and effect
• It may not be scientifically rigorous
• It can lead to bias

Researchers may choose to perform a case study if they want to explore a unique or recently discovered phenomenon. Through their insights, researchers develop additional ideas and study questions that might be explored in future studies.

It's important to remember that the insights from case studies cannot be used to determine cause-and-effect relationships between variables. However, case studies may be used to develop hypotheses that can then be addressed in experimental research.

Case Study Examples

There have been a number of notable case studies in the history of psychology. Much of  Freud's work and theories were developed through individual case studies. Some great examples of case studies in psychology include:

• Anna O : Anna O. was a pseudonym of a woman named Bertha Pappenheim, a patient of a physician named Josef Breuer. While she was never a patient of Freud's, Freud and Breuer discussed her case extensively. The woman was experiencing symptoms of a condition that was then known as hysteria and found that talking about her problems helped relieve her symptoms. Her case played an important part in the development of talk therapy as an approach to mental health treatment.
• Phineas Gage : Phineas Gage was a railroad employee who experienced a terrible accident in which an explosion sent a metal rod through his skull, damaging important portions of his brain. Gage recovered from his accident but was left with serious changes in both personality and behavior.
• Genie : Genie was a young girl subjected to horrific abuse and isolation. The case study of Genie allowed researchers to study whether language learning was possible, even after missing critical periods for language development. Her case also served as an example of how scientific research may interfere with treatment and lead to further abuse of vulnerable individuals.

Such cases demonstrate how case research can be used to study things that researchers could not replicate in experimental settings. In Genie's case, her horrific abuse denied her the opportunity to learn a language at critical points in her development.

This is clearly not something researchers could ethically replicate, but conducting a case study on Genie allowed researchers to study phenomena that are otherwise impossible to reproduce.

There are a few different types of case studies that psychologists and other researchers might use:

• Collective case studies : These involve studying a group of individuals. Researchers might study a group of people in a certain setting or look at an entire community. For example, psychologists might explore how access to resources in a community has affected the collective mental well-being of those who live there.
• Descriptive case studies : These involve starting with a descriptive theory. The subjects are then observed, and the information gathered is compared to the pre-existing theory.
• Explanatory case studies : These   are often used to do causal investigations. In other words, researchers are interested in looking at factors that may have caused certain things to occur.
• Exploratory case studies : These are sometimes used as a prelude to further, more in-depth research. This allows researchers to gather more information before developing their research questions and hypotheses .
• Instrumental case studies : These occur when the individual or group allows researchers to understand more than what is initially obvious to observers.
• Intrinsic case studies : This type of case study is when the researcher has a personal interest in the case. Jean Piaget's observations of his own children are good examples of how an intrinsic case study can contribute to the development of a psychological theory.

The three main case study types often used are intrinsic, instrumental, and collective. Intrinsic case studies are useful for learning about unique cases. Instrumental case studies help look at an individual to learn more about a broader issue. A collective case study can be useful for looking at several cases simultaneously.

The type of case study that psychology researchers use depends on the unique characteristics of the situation and the case itself.

There are a number of different sources and methods that researchers can use to gather information about an individual or group. Six major sources that have been identified by researchers are:

• Archival records : Census records, survey records, and name lists are examples of archival records.
• Direct observation : This strategy involves observing the subject, often in a natural setting . While an individual observer is sometimes used, it is more common to utilize a group of observers.
• Documents : Letters, newspaper articles, administrative records, etc., are the types of documents often used as sources.
• Interviews : Interviews are one of the most important methods for gathering information in case studies. An interview can involve structured survey questions or more open-ended questions.
• Participant observation : When the researcher serves as a participant in events and observes the actions and outcomes, it is called participant observation.
• Physical artifacts : Tools, objects, instruments, and other artifacts are often observed during a direct observation of the subject.

If you have been directed to write a case study for a psychology course, be sure to check with your instructor for any specific guidelines you need to follow. If you are writing your case study for a professional publication, check with the publisher for their specific guidelines for submitting a case study.

Here is a general outline of what should be included in a case study.

Section 1: A Case History

This section will have the following structure and content:

Background information : The first section of your paper will present your client's background. Include factors such as age, gender, work, health status, family mental health history, family and social relationships, drug and alcohol history, life difficulties, goals, and coping skills and weaknesses.

Description of the presenting problem : In the next section of your case study, you will describe the problem or symptoms that the client presented with.

Describe any physical, emotional, or sensory symptoms reported by the client. Thoughts, feelings, and perceptions related to the symptoms should also be noted. Any screening or diagnostic assessments that are used should also be described in detail and all scores reported.

Your diagnosis : Provide your diagnosis and give the appropriate Diagnostic and Statistical Manual code. Explain how you reached your diagnosis, how the client's symptoms fit the diagnostic criteria for the disorder(s), or any possible difficulties in reaching a diagnosis.

Section 2: Treatment Plan

This portion of the paper will address the chosen treatment for the condition. This might also include the theoretical basis for the chosen treatment or any other evidence that might exist to support why this approach was chosen.

• Cognitive behavioral approach : Explain how a cognitive behavioral therapist would approach treatment. Offer background information on cognitive behavioral therapy and describe the treatment sessions, client response, and outcome of this type of treatment. Make note of any difficulties or successes encountered by your client during treatment.
• Humanistic approach : Describe a humanistic approach that could be used to treat your client, such as client-centered therapy . Provide information on the type of treatment you chose, the client's reaction to the treatment, and the end result of this approach. Explain why the treatment was successful or unsuccessful.
• Psychoanalytic approach : Describe how a psychoanalytic therapist would view the client's problem. Provide some background on the psychoanalytic approach and cite relevant references. Explain how psychoanalytic therapy would be used to treat the client, how the client would respond to therapy, and the effectiveness of this treatment approach.
• Pharmacological approach : If treatment primarily involves the use of medications, explain which medications were used and why. Provide background on the effectiveness of these medications and how monotherapy may compare with an approach that combines medications with therapy or other treatments.

This section of a case study should also include information about the treatment goals, process, and outcomes.

When you are writing a case study, you should also include a section where you discuss the case study itself, including the strengths and limitiations of the study. You should note how the findings of your case study might support previous research. 

In your discussion section, you should also describe some of the implications of your case study. What ideas or findings might require further exploration? How might researchers go about exploring some of these questions in additional studies?

Need More Tips?

Here are a few additional pointers to keep in mind when formatting your case study:

• Never refer to the subject of your case study as "the client." Instead, use their name or a pseudonym.
• Read examples of case studies to gain an idea about the style and format.
• Remember to use APA format when citing references .

Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach .  BMC Med Res Methodol . 2011;11:100.

Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach . BMC Med Res Methodol . 2011 Jun 27;11:100. doi:10.1186/1471-2288-11-100

Gagnon, Yves-Chantal.  The Case Study as Research Method: A Practical Handbook . Canada, Chicago Review Press Incorporated DBA Independent Pub Group, 2010.

Yin, Robert K. Case Study Research and Applications: Design and Methods . United States, SAGE Publications, 2017.

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

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Writing a Case Study

What is a case study?

A Case study is: 

• An in-depth research design that primarily uses a qualitative methodology but sometimes​​ includes quantitative methodology.
• Used to examine an identifiable problem confirmed through research.
• Used to investigate an individual, group of people, organization, or event.
• Used to mostly answer "how" and "why" questions.

What are the different types of case studies?

Note: These are the primary case studies. As you continue to research and learn

about case studies you will begin to find a robust list of different types. 

Who are your case study participants?

What is triangulation ? 

Validity and credibility are an essential part of the case study. Therefore, the researcher should include triangulation to ensure trustworthiness while accurately reflecting what the researcher seeks to investigate.

How to write a Case Study?

When developing a case study, there are different ways you could present the information, but remember to include the five parts for your case study.

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Case Study Research Method in Psychology

Saul Mcleod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul Mcleod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

Learn about our Editorial Process

Olivia Guy-Evans, MSc

Associate Editor for Simply Psychology

BSc (Hons) Psychology, MSc Psychology of Education

Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.

On This Page:

Case studies are in-depth investigations of a person, group, event, or community. Typically, data is gathered from various sources using several methods (e.g., observations & interviews).

The case study research method originated in clinical medicine (the case history, i.e., the patient’s personal history). In psychology, case studies are often confined to the study of a particular individual.

The information is mainly biographical and relates to events in the individual’s past (i.e., retrospective), as well as to significant events that are currently occurring in his or her everyday life.

The case study is not a research method, but researchers select methods of data collection and analysis that will generate material suitable for case studies.

Freud (1909a, 1909b) conducted very detailed investigations into the private lives of his patients in an attempt to both understand and help them overcome their illnesses.

This makes it clear that the case study is a method that should only be used by a psychologist, therapist, or psychiatrist, i.e., someone with a professional qualification.

There is an ethical issue of competence. Only someone qualified to diagnose and treat a person can conduct a formal case study relating to atypical (i.e., abnormal) behavior or atypical development.

 Famous Case Studies

• Anna O – One of the most famous case studies, documenting psychoanalyst Josef Breuer’s treatment of “Anna O” (real name Bertha Pappenheim) for hysteria in the late 1800s using early psychoanalytic theory.
• Little Hans – A child psychoanalysis case study published by Sigmund Freud in 1909 analyzing his five-year-old patient Herbert Graf’s house phobia as related to the Oedipus complex.
• Bruce/Brenda – Gender identity case of the boy (Bruce) whose botched circumcision led psychologist John Money to advise gender reassignment and raise him as a girl (Brenda) in the 1960s.
• Genie Wiley – Linguistics/psychological development case of the victim of extreme isolation abuse who was studied in 1970s California for effects of early language deprivation on acquiring speech later in life.
• Phineas Gage – One of the most famous neuropsychology case studies analyzes personality changes in railroad worker Phineas Gage after an 1848 brain injury involving a tamping iron piercing his skull.

Clinical Case Studies

• Studying the effectiveness of psychotherapy approaches with an individual patient
• Assessing and treating mental illnesses like depression, anxiety disorders, PTSD
• Neuropsychological cases investigating brain injuries or disorders

Child Psychology Case Studies

• Studying psychological development from birth through adolescence
• Cases of learning disabilities, autism spectrum disorders, ADHD
• Effects of trauma, abuse, deprivation on development

Types of Case Studies

• Explanatory case studies : Used to explore causation in order to find underlying principles. Helpful for doing qualitative analysis to explain presumed causal links.
• Exploratory case studies : Used to explore situations where an intervention being evaluated has no clear set of outcomes. It helps define questions and hypotheses for future research.
• Descriptive case studies : Describe an intervention or phenomenon and the real-life context in which it occurred. It is helpful for illustrating certain topics within an evaluation.
• Multiple-case studies : Used to explore differences between cases and replicate findings across cases. Helpful for comparing and contrasting specific cases.
• Intrinsic : Used to gain a better understanding of a particular case. Helpful for capturing the complexity of a single case.
• Collective : Used to explore a general phenomenon using multiple case studies. Helpful for jointly studying a group of cases in order to inquire into the phenomenon.

Where Do You Find Data for a Case Study?

There are several places to find data for a case study. The key is to gather data from multiple sources to get a complete picture of the case and corroborate facts or findings through triangulation of evidence. Most of this information is likely qualitative (i.e., verbal description rather than measurement), but the psychologist might also collect numerical data.

1. Primary sources

• Interviews – Interviewing key people related to the case to get their perspectives and insights. The interview is an extremely effective procedure for obtaining information about an individual, and it may be used to collect comments from the person’s friends, parents, employer, workmates, and others who have a good knowledge of the person, as well as to obtain facts from the person him or herself.
• Observations – Observing behaviors, interactions, processes, etc., related to the case as they unfold in real-time.
• Documents & Records – Reviewing private documents, diaries, public records, correspondence, meeting minutes, etc., relevant to the case.

2. Secondary sources

• News/Media – News coverage of events related to the case study.
• Academic articles – Journal articles, dissertations etc. that discuss the case.
• Government reports – Official data and records related to the case context.
• Books/films – Books, documentaries or films discussing the case.

3. Archival records

Searching historical archives, museum collections and databases to find relevant documents, visual/audio records related to the case history and context.

Public archives like newspapers, organizational records, photographic collections could all include potentially relevant pieces of information to shed light on attitudes, cultural perspectives, common practices and historical contexts related to psychology.

4. Organizational records

Organizational records offer the advantage of often having large datasets collected over time that can reveal or confirm psychological insights.

Of course, privacy and ethical concerns regarding confidential data must be navigated carefully.

However, with proper protocols, organizational records can provide invaluable context and empirical depth to qualitative case studies exploring the intersection of psychology and organizations.

• Organizational/industrial psychology research : Organizational records like employee surveys, turnover/retention data, policies, incident reports etc. may provide insight into topics like job satisfaction, workplace culture and dynamics, leadership issues, employee behaviors etc.
• Clinical psychology : Therapists/hospitals may grant access to anonymized medical records to study aspects like assessments, diagnoses, treatment plans etc. This could shed light on clinical practices.
• School psychology : Studies could utilize anonymized student records like test scores, grades, disciplinary issues, and counseling referrals to study child development, learning barriers, effectiveness of support programs, and more.

How do I Write a Case Study in Psychology?

Follow specified case study guidelines provided by a journal or your psychology tutor. General components of clinical case studies include: background, symptoms, assessments, diagnosis, treatment, and outcomes. Interpreting the information means the researcher decides what to include or leave out. A good case study should always clarify which information is the factual description and which is an inference or the researcher’s opinion.

1. Introduction

• Provide background on the case context and why it is of interest, presenting background information like demographics, relevant history, and presenting problem.
• Compare briefly to similar published cases if applicable. Clearly state the focus/importance of the case.

2. Case Presentation

• Describe the presenting problem in detail, including symptoms, duration,and impact on daily life.
• Include client demographics like age and gender, information about social relationships, and mental health history.
• Describe all physical, emotional, and/or sensory symptoms reported by the client.
• Use patient quotes to describe the initial complaint verbatim. Follow with full-sentence summaries of relevant history details gathered, including key components that led to a working diagnosis.
• Summarize clinical exam results, namely orthopedic/neurological tests, imaging, lab tests, etc. Note actual results rather than subjective conclusions. Provide images if clearly reproducible/anonymized.
• Clearly state the working diagnosis or clinical impression before transitioning to management.

3. Management and Outcome

• Indicate the total duration of care and number of treatments given over what timeframe. Use specific names/descriptions for any therapies/interventions applied.
• Present the results of the intervention,including any quantitative or qualitative data collected.
• For outcomes, utilize visual analog scales for pain, medication usage logs, etc., if possible. Include patient self-reports of improvement/worsening of symptoms. Note the reason for discharge/end of care.

4. Discussion

• Analyze the case, exploring contributing factors, limitations of the study, and connections to existing research.
• Analyze the effectiveness of the intervention,considering factors like participant adherence, limitations of the study, and potential alternative explanations for the results.
• Identify any questions raised in the case analysis and relate insights to established theories and current research if applicable. Avoid definitive claims about physiological explanations.
• Offer clinical implications, and suggest future research directions.

5. Additional Items

• Thank specific assistants for writing support only. No patient acknowledgments.
• References should directly support any key claims or quotes included.
• Use tables/figures/images only if substantially informative. Include permissions and legends/explanatory notes.
• Provides detailed (rich qualitative) information.
• Provides insight for further research.
• Permitting investigation of otherwise impractical (or unethical) situations.

Case studies allow a researcher to investigate a topic in far more detail than might be possible if they were trying to deal with a large number of research participants (nomothetic approach) with the aim of ‘averaging’.

Because of their in-depth, multi-sided approach, case studies often shed light on aspects of human thinking and behavior that would be unethical or impractical to study in other ways.

Research that only looks into the measurable aspects of human behavior is not likely to give us insights into the subjective dimension of experience, which is important to psychoanalytic and humanistic psychologists.

Case studies are often used in exploratory research. They can help us generate new ideas (that might be tested by other methods). They are an important way of illustrating theories and can help show how different aspects of a person’s life are related to each other.

The method is, therefore, important for psychologists who adopt a holistic point of view (i.e., humanistic psychologists ).

Limitations

• Lacking scientific rigor and providing little basis for generalization of results to the wider population.
• Researchers’ own subjective feelings may influence the case study (researcher bias).
• Difficult to replicate.
• Time-consuming and expensive.
• The volume of data, together with the time restrictions in place, impacted the depth of analysis that was possible within the available resources.

Because a case study deals with only one person/event/group, we can never be sure if the case study investigated is representative of the wider body of “similar” instances. This means the conclusions drawn from a particular case may not be transferable to other settings.

Because case studies are based on the analysis of qualitative (i.e., descriptive) data , a lot depends on the psychologist’s interpretation of the information she has acquired.

This means that there is a lot of scope for Anna O , and it could be that the subjective opinions of the psychologist intrude in the assessment of what the data means.

For example, Freud has been criticized for producing case studies in which the information was sometimes distorted to fit particular behavioral theories (e.g., Little Hans ).

This is also true of Money’s interpretation of the Bruce/Brenda case study (Diamond, 1997) when he ignored evidence that went against his theory.

Breuer, J., & Freud, S. (1895).  Studies on hysteria . Standard Edition 2: London.

Curtiss, S. (1981). Genie: The case of a modern wild child .

Diamond, M., & Sigmundson, K. (1997). Sex Reassignment at Birth: Long-term Review and Clinical Implications. Archives of Pediatrics & Adolescent Medicine , 151(3), 298-304

Freud, S. (1909a). Analysis of a phobia of a five year old boy. In The Pelican Freud Library (1977), Vol 8, Case Histories 1, pages 169-306

Freud, S. (1909b). Bemerkungen über einen Fall von Zwangsneurose (Der “Rattenmann”). Jb. psychoanal. psychopathol. Forsch ., I, p. 357-421; GW, VII, p. 379-463; Notes upon a case of obsessional neurosis, SE , 10: 151-318.

Harlow J. M. (1848). Passage of an iron rod through the head.  Boston Medical and Surgical Journal, 39 , 389–393.

Harlow, J. M. (1868).  Recovery from the Passage of an Iron Bar through the Head .  Publications of the Massachusetts Medical Society. 2  (3), 327-347.

Money, J., & Ehrhardt, A. A. (1972).  Man & Woman, Boy & Girl : The Differentiation and Dimorphism of Gender Identity from Conception to Maturity. Baltimore, Maryland: Johns Hopkins University Press.

Money, J., & Tucker, P. (1975). Sexual signatures: On being a man or a woman.

Further Information

• Case Study Approach
• Case Study Method
• Enhancing the Quality of Case Studies in Health Services Research
• “We do things together” A case study of “couplehood” in dementia
• Using mixed methods for evaluating an integrative approach to cancer care: a case study

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• Case Study | Definition, Examples & Methods

Case Study | Definition, Examples & Methods

Published on 5 May 2022 by Shona McCombes . Revised on 30 January 2023.

A case study is a detailed study of a specific subject, such as a person, group, place, event, organisation, or phenomenon. Case studies are commonly used in social, educational, clinical, and business research.

A case study research design usually involves qualitative methods , but quantitative methods are sometimes also used. Case studies are good for describing , comparing, evaluating, and understanding different aspects of a research problem .

Table of contents

When to do a case study, step 1: select a case, step 2: build a theoretical framework, step 3: collect your data, step 4: describe and analyse the case.

A case study is an appropriate research design when you want to gain concrete, contextual, in-depth knowledge about a specific real-world subject. It allows you to explore the key characteristics, meanings, and implications of the case.

Case studies are often a good choice in a thesis or dissertation . They keep your project focused and manageable when you don’t have the time or resources to do large-scale research.

You might use just one complex case study where you explore a single subject in depth, or conduct multiple case studies to compare and illuminate different aspects of your research problem.

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Once you have developed your problem statement and research questions , you should be ready to choose the specific case that you want to focus on. A good case study should have the potential to:

• Provide new or unexpected insights into the subject
• Challenge or complicate existing assumptions and theories
• Propose practical courses of action to resolve a problem
• Open up new directions for future research

Unlike quantitative or experimental research, a strong case study does not require a random or representative sample. In fact, case studies often deliberately focus on unusual, neglected, or outlying cases which may shed new light on the research problem.

If you find yourself aiming to simultaneously investigate and solve an issue, consider conducting action research . As its name suggests, action research conducts research and takes action at the same time, and is highly iterative and flexible. 

However, you can also choose a more common or representative case to exemplify a particular category, experience, or phenomenon.

While case studies focus more on concrete details than general theories, they should usually have some connection with theory in the field. This way the case study is not just an isolated description, but is integrated into existing knowledge about the topic. It might aim to:

• Exemplify a theory by showing how it explains the case under investigation
• Expand on a theory by uncovering new concepts and ideas that need to be incorporated
• Challenge a theory by exploring an outlier case that doesn’t fit with established assumptions

To ensure that your analysis of the case has a solid academic grounding, you should conduct a literature review of sources related to the topic and develop a theoretical framework . This means identifying key concepts and theories to guide your analysis and interpretation.

There are many different research methods you can use to collect data on your subject. Case studies tend to focus on qualitative data using methods such as interviews, observations, and analysis of primary and secondary sources (e.g., newspaper articles, photographs, official records). Sometimes a case study will also collect quantitative data .

The aim is to gain as thorough an understanding as possible of the case and its context.

In writing up the case study, you need to bring together all the relevant aspects to give as complete a picture as possible of the subject.

How you report your findings depends on the type of research you are doing. Some case studies are structured like a standard scientific paper or thesis, with separate sections or chapters for the methods , results , and discussion .

Others are written in a more narrative style, aiming to explore the case from various angles and analyse its meanings and implications (for example, by using textual analysis or discourse analysis ).

In all cases, though, make sure to give contextual details about the case, connect it back to the literature and theory, and discuss how it fits into wider patterns or debates.

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What the Case Study Method Really Teaches

• Nitin Nohria

Seven meta-skills that stick even if the cases fade from memory.

It’s been 100 years since Harvard Business School began using the case study method. Beyond teaching specific subject matter, the case study method excels in instilling meta-skills in students. This article explains the importance of seven such skills: preparation, discernment, bias recognition, judgement, collaboration, curiosity, and self-confidence.

During my decade as dean of Harvard Business School, I spent hundreds of hours talking with our alumni. To enliven these conversations, I relied on a favorite question: “What was the most important thing you learned from your time in our MBA program?”

• Nitin Nohria is the George F. Baker Jr. Professor at Harvard Business School and the former dean of HBS.

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• Open access
• Published: 07 September 2020

A tutorial on methodological studies: the what, when, how and why

• Lawrence Mbuagbaw   ORCID: orcid.org/0000-0001-5855-5461 1 , 2 , 3 ,
• Daeria O. Lawson 1 ,
• Livia Puljak 4 ,
• David B. Allison 5 &
• Lehana Thabane 1 , 2 , 6 , 7 , 8  

BMC Medical Research Methodology volume  20 , Article number:  226 ( 2020 ) Cite this article

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Methodological studies – studies that evaluate the design, analysis or reporting of other research-related reports – play an important role in health research. They help to highlight issues in the conduct of research with the aim of improving health research methodology, and ultimately reducing research waste.

We provide an overview of some of the key aspects of methodological studies such as what they are, and when, how and why they are done. We adopt a “frequently asked questions” format to facilitate reading this paper and provide multiple examples to help guide researchers interested in conducting methodological studies. Some of the topics addressed include: is it necessary to publish a study protocol? How to select relevant research reports and databases for a methodological study? What approaches to data extraction and statistical analysis should be considered when conducting a methodological study? What are potential threats to validity and is there a way to appraise the quality of methodological studies?

Appropriate reflection and application of basic principles of epidemiology and biostatistics are required in the design and analysis of methodological studies. This paper provides an introduction for further discussion about the conduct of methodological studies.

Peer Review reports

The field of meta-research (or research-on-research) has proliferated in recent years in response to issues with research quality and conduct [ 1 , 2 , 3 ]. As the name suggests, this field targets issues with research design, conduct, analysis and reporting. Various types of research reports are often examined as the unit of analysis in these studies (e.g. abstracts, full manuscripts, trial registry entries). Like many other novel fields of research, meta-research has seen a proliferation of use before the development of reporting guidance. For example, this was the case with randomized trials for which risk of bias tools and reporting guidelines were only developed much later – after many trials had been published and noted to have limitations [ 4 , 5 ]; and for systematic reviews as well [ 6 , 7 , 8 ]. However, in the absence of formal guidance, studies that report on research differ substantially in how they are named, conducted and reported [ 9 , 10 ]. This creates challenges in identifying, summarizing and comparing them. In this tutorial paper, we will use the term methodological study to refer to any study that reports on the design, conduct, analysis or reporting of primary or secondary research-related reports (such as trial registry entries and conference abstracts).

In the past 10 years, there has been an increase in the use of terms related to methodological studies (based on records retrieved with a keyword search [in the title and abstract] for “methodological review” and “meta-epidemiological study” in PubMed up to December 2019), suggesting that these studies may be appearing more frequently in the literature. See Fig.  1 .

Trends in the number studies that mention “methodological review” or “meta-

epidemiological study” in PubMed.

The methods used in many methodological studies have been borrowed from systematic and scoping reviews. This practice has influenced the direction of the field, with many methodological studies including searches of electronic databases, screening of records, duplicate data extraction and assessments of risk of bias in the included studies. However, the research questions posed in methodological studies do not always require the approaches listed above, and guidance is needed on when and how to apply these methods to a methodological study. Even though methodological studies can be conducted on qualitative or mixed methods research, this paper focuses on and draws examples exclusively from quantitative research.

The objectives of this paper are to provide some insights on how to conduct methodological studies so that there is greater consistency between the research questions posed, and the design, analysis and reporting of findings. We provide multiple examples to illustrate concepts and a proposed framework for categorizing methodological studies in quantitative research.

What is a methodological study?

Any study that describes or analyzes methods (design, conduct, analysis or reporting) in published (or unpublished) literature is a methodological study. Consequently, the scope of methodological studies is quite extensive and includes, but is not limited to, topics as diverse as: research question formulation [ 11 ]; adherence to reporting guidelines [ 12 , 13 , 14 ] and consistency in reporting [ 15 ]; approaches to study analysis [ 16 ]; investigating the credibility of analyses [ 17 ]; and studies that synthesize these methodological studies [ 18 ]. While the nomenclature of methodological studies is not uniform, the intents and purposes of these studies remain fairly consistent – to describe or analyze methods in primary or secondary studies. As such, methodological studies may also be classified as a subtype of observational studies.

Parallel to this are experimental studies that compare different methods. Even though they play an important role in informing optimal research methods, experimental methodological studies are beyond the scope of this paper. Examples of such studies include the randomized trials by Buscemi et al., comparing single data extraction to double data extraction [ 19 ], and Carrasco-Labra et al., comparing approaches to presenting findings in Grading of Recommendations, Assessment, Development and Evaluations (GRADE) summary of findings tables [ 20 ]. In these studies, the unit of analysis is the person or groups of individuals applying the methods. We also direct readers to the Studies Within a Trial (SWAT) and Studies Within a Review (SWAR) programme operated through the Hub for Trials Methodology Research, for further reading as a potential useful resource for these types of experimental studies [ 21 ]. Lastly, this paper is not meant to inform the conduct of research using computational simulation and mathematical modeling for which some guidance already exists [ 22 ], or studies on the development of methods using consensus-based approaches.

When should we conduct a methodological study?

Methodological studies occupy a unique niche in health research that allows them to inform methodological advances. Methodological studies should also be conducted as pre-cursors to reporting guideline development, as they provide an opportunity to understand current practices, and help to identify the need for guidance and gaps in methodological or reporting quality. For example, the development of the popular Preferred Reporting Items of Systematic reviews and Meta-Analyses (PRISMA) guidelines were preceded by methodological studies identifying poor reporting practices [ 23 , 24 ]. In these instances, after the reporting guidelines are published, methodological studies can also be used to monitor uptake of the guidelines.

These studies can also be conducted to inform the state of the art for design, analysis and reporting practices across different types of health research fields, with the aim of improving research practices, and preventing or reducing research waste. For example, Samaan et al. conducted a scoping review of adherence to different reporting guidelines in health care literature [ 18 ]. Methodological studies can also be used to determine the factors associated with reporting practices. For example, Abbade et al. investigated journal characteristics associated with the use of the Participants, Intervention, Comparison, Outcome, Timeframe (PICOT) format in framing research questions in trials of venous ulcer disease [ 11 ].

How often are methodological studies conducted?

There is no clear answer to this question. Based on a search of PubMed, the use of related terms (“methodological review” and “meta-epidemiological study”) – and therefore, the number of methodological studies – is on the rise. However, many other terms are used to describe methodological studies. There are also many studies that explore design, conduct, analysis or reporting of research reports, but that do not use any specific terms to describe or label their study design in terms of “methodology”. This diversity in nomenclature makes a census of methodological studies elusive. Appropriate terminology and key words for methodological studies are needed to facilitate improved accessibility for end-users.

Why do we conduct methodological studies?

Methodological studies provide information on the design, conduct, analysis or reporting of primary and secondary research and can be used to appraise quality, quantity, completeness, accuracy and consistency of health research. These issues can be explored in specific fields, journals, databases, geographical regions and time periods. For example, Areia et al. explored the quality of reporting of endoscopic diagnostic studies in gastroenterology [ 25 ]; Knol et al. investigated the reporting of p -values in baseline tables in randomized trial published in high impact journals [ 26 ]; Chen et al. describe adherence to the Consolidated Standards of Reporting Trials (CONSORT) statement in Chinese Journals [ 27 ]; and Hopewell et al. describe the effect of editors’ implementation of CONSORT guidelines on reporting of abstracts over time [ 28 ]. Methodological studies provide useful information to researchers, clinicians, editors, publishers and users of health literature. As a result, these studies have been at the cornerstone of important methodological developments in the past two decades and have informed the development of many health research guidelines including the highly cited CONSORT statement [ 5 ].

Where can we find methodological studies?

Methodological studies can be found in most common biomedical bibliographic databases (e.g. Embase, MEDLINE, PubMed, Web of Science). However, the biggest caveat is that methodological studies are hard to identify in the literature due to the wide variety of names used and the lack of comprehensive databases dedicated to them. A handful can be found in the Cochrane Library as “Cochrane Methodology Reviews”, but these studies only cover methodological issues related to systematic reviews. Previous attempts to catalogue all empirical studies of methods used in reviews were abandoned 10 years ago [ 29 ]. In other databases, a variety of search terms may be applied with different levels of sensitivity and specificity.

Some frequently asked questions about methodological studies

In this section, we have outlined responses to questions that might help inform the conduct of methodological studies.

Q: How should I select research reports for my methodological study?

A: Selection of research reports for a methodological study depends on the research question and eligibility criteria. Once a clear research question is set and the nature of literature one desires to review is known, one can then begin the selection process. Selection may begin with a broad search, especially if the eligibility criteria are not apparent. For example, a methodological study of Cochrane Reviews of HIV would not require a complex search as all eligible studies can easily be retrieved from the Cochrane Library after checking a few boxes [ 30 ]. On the other hand, a methodological study of subgroup analyses in trials of gastrointestinal oncology would require a search to find such trials, and further screening to identify trials that conducted a subgroup analysis [ 31 ].

The strategies used for identifying participants in observational studies can apply here. One may use a systematic search to identify all eligible studies. If the number of eligible studies is unmanageable, a random sample of articles can be expected to provide comparable results if it is sufficiently large [ 32 ]. For example, Wilson et al. used a random sample of trials from the Cochrane Stroke Group’s Trial Register to investigate completeness of reporting [ 33 ]. It is possible that a simple random sample would lead to underrepresentation of units (i.e. research reports) that are smaller in number. This is relevant if the investigators wish to compare multiple groups but have too few units in one group. In this case a stratified sample would help to create equal groups. For example, in a methodological study comparing Cochrane and non-Cochrane reviews, Kahale et al. drew random samples from both groups [ 34 ]. Alternatively, systematic or purposeful sampling strategies can be used and we encourage researchers to justify their selected approaches based on the study objective.

Q: How many databases should I search?

A: The number of databases one should search would depend on the approach to sampling, which can include targeting the entire “population” of interest or a sample of that population. If you are interested in including the entire target population for your research question, or drawing a random or systematic sample from it, then a comprehensive and exhaustive search for relevant articles is required. In this case, we recommend using systematic approaches for searching electronic databases (i.e. at least 2 databases with a replicable and time stamped search strategy). The results of your search will constitute a sampling frame from which eligible studies can be drawn.

Alternatively, if your approach to sampling is purposeful, then we recommend targeting the database(s) or data sources (e.g. journals, registries) that include the information you need. For example, if you are conducting a methodological study of high impact journals in plastic surgery and they are all indexed in PubMed, you likely do not need to search any other databases. You may also have a comprehensive list of all journals of interest and can approach your search using the journal names in your database search (or by accessing the journal archives directly from the journal’s website). Even though one could also search journals’ web pages directly, using a database such as PubMed has multiple advantages, such as the use of filters, so the search can be narrowed down to a certain period, or study types of interest. Furthermore, individual journals’ web sites may have different search functionalities, which do not necessarily yield a consistent output.

Q: Should I publish a protocol for my methodological study?

A: A protocol is a description of intended research methods. Currently, only protocols for clinical trials require registration [ 35 ]. Protocols for systematic reviews are encouraged but no formal recommendation exists. The scientific community welcomes the publication of protocols because they help protect against selective outcome reporting, the use of post hoc methodologies to embellish results, and to help avoid duplication of efforts [ 36 ]. While the latter two risks exist in methodological research, the negative consequences may be substantially less than for clinical outcomes. In a sample of 31 methodological studies, 7 (22.6%) referenced a published protocol [ 9 ]. In the Cochrane Library, there are 15 protocols for methodological reviews (21 July 2020). This suggests that publishing protocols for methodological studies is not uncommon.

Authors can consider publishing their study protocol in a scholarly journal as a manuscript. Advantages of such publication include obtaining peer-review feedback about the planned study, and easy retrieval by searching databases such as PubMed. The disadvantages in trying to publish protocols includes delays associated with manuscript handling and peer review, as well as costs, as few journals publish study protocols, and those journals mostly charge article-processing fees [ 37 ]. Authors who would like to make their protocol publicly available without publishing it in scholarly journals, could deposit their study protocols in publicly available repositories, such as the Open Science Framework ( https://osf.io/ ).

Q: How to appraise the quality of a methodological study?

A: To date, there is no published tool for appraising the risk of bias in a methodological study, but in principle, a methodological study could be considered as a type of observational study. Therefore, during conduct or appraisal, care should be taken to avoid the biases common in observational studies [ 38 ]. These biases include selection bias, comparability of groups, and ascertainment of exposure or outcome. In other words, to generate a representative sample, a comprehensive reproducible search may be necessary to build a sampling frame. Additionally, random sampling may be necessary to ensure that all the included research reports have the same probability of being selected, and the screening and selection processes should be transparent and reproducible. To ensure that the groups compared are similar in all characteristics, matching, random sampling or stratified sampling can be used. Statistical adjustments for between-group differences can also be applied at the analysis stage. Finally, duplicate data extraction can reduce errors in assessment of exposures or outcomes.

Q: Should I justify a sample size?

A: In all instances where one is not using the target population (i.e. the group to which inferences from the research report are directed) [ 39 ], a sample size justification is good practice. The sample size justification may take the form of a description of what is expected to be achieved with the number of articles selected, or a formal sample size estimation that outlines the number of articles required to answer the research question with a certain precision and power. Sample size justifications in methodological studies are reasonable in the following instances:

Comparing two groups

Determining a proportion, mean or another quantifier

Determining factors associated with an outcome using regression-based analyses

For example, El Dib et al. computed a sample size requirement for a methodological study of diagnostic strategies in randomized trials, based on a confidence interval approach [ 40 ].

Q: What should I call my study?

A: Other terms which have been used to describe/label methodological studies include “ methodological review ”, “methodological survey” , “meta-epidemiological study” , “systematic review” , “systematic survey”, “meta-research”, “research-on-research” and many others. We recommend that the study nomenclature be clear, unambiguous, informative and allow for appropriate indexing. Methodological study nomenclature that should be avoided includes “ systematic review” – as this will likely be confused with a systematic review of a clinical question. “ Systematic survey” may also lead to confusion about whether the survey was systematic (i.e. using a preplanned methodology) or a survey using “ systematic” sampling (i.e. a sampling approach using specific intervals to determine who is selected) [ 32 ]. Any of the above meanings of the words “ systematic” may be true for methodological studies and could be potentially misleading. “ Meta-epidemiological study” is ideal for indexing, but not very informative as it describes an entire field. The term “ review ” may point towards an appraisal or “review” of the design, conduct, analysis or reporting (or methodological components) of the targeted research reports, yet it has also been used to describe narrative reviews [ 41 , 42 ]. The term “ survey ” is also in line with the approaches used in many methodological studies [ 9 ], and would be indicative of the sampling procedures of this study design. However, in the absence of guidelines on nomenclature, the term “ methodological study ” is broad enough to capture most of the scenarios of such studies.

Q: Should I account for clustering in my methodological study?

A: Data from methodological studies are often clustered. For example, articles coming from a specific source may have different reporting standards (e.g. the Cochrane Library). Articles within the same journal may be similar due to editorial practices and policies, reporting requirements and endorsement of guidelines. There is emerging evidence that these are real concerns that should be accounted for in analyses [ 43 ]. Some cluster variables are described in the section: “ What variables are relevant to methodological studies?”

A variety of modelling approaches can be used to account for correlated data, including the use of marginal, fixed or mixed effects regression models with appropriate computation of standard errors [ 44 ]. For example, Kosa et al. used generalized estimation equations to account for correlation of articles within journals [ 15 ]. Not accounting for clustering could lead to incorrect p -values, unduly narrow confidence intervals, and biased estimates [ 45 ].

Q: Should I extract data in duplicate?

A: Yes. Duplicate data extraction takes more time but results in less errors [ 19 ]. Data extraction errors in turn affect the effect estimate [ 46 ], and therefore should be mitigated. Duplicate data extraction should be considered in the absence of other approaches to minimize extraction errors. However, much like systematic reviews, this area will likely see rapid new advances with machine learning and natural language processing technologies to support researchers with screening and data extraction [ 47 , 48 ]. However, experience plays an important role in the quality of extracted data and inexperienced extractors should be paired with experienced extractors [ 46 , 49 ].

Q: Should I assess the risk of bias of research reports included in my methodological study?

A : Risk of bias is most useful in determining the certainty that can be placed in the effect measure from a study. In methodological studies, risk of bias may not serve the purpose of determining the trustworthiness of results, as effect measures are often not the primary goal of methodological studies. Determining risk of bias in methodological studies is likely a practice borrowed from systematic review methodology, but whose intrinsic value is not obvious in methodological studies. When it is part of the research question, investigators often focus on one aspect of risk of bias. For example, Speich investigated how blinding was reported in surgical trials [ 50 ], and Abraha et al., investigated the application of intention-to-treat analyses in systematic reviews and trials [ 51 ].

Q: What variables are relevant to methodological studies?

A: There is empirical evidence that certain variables may inform the findings in a methodological study. We outline some of these and provide a brief overview below:

Country: Countries and regions differ in their research cultures, and the resources available to conduct research. Therefore, it is reasonable to believe that there may be differences in methodological features across countries. Methodological studies have reported loco-regional differences in reporting quality [ 52 , 53 ]. This may also be related to challenges non-English speakers face in publishing papers in English.

Authors’ expertise: The inclusion of authors with expertise in research methodology, biostatistics, and scientific writing is likely to influence the end-product. Oltean et al. found that among randomized trials in orthopaedic surgery, the use of analyses that accounted for clustering was more likely when specialists (e.g. statistician, epidemiologist or clinical trials methodologist) were included on the study team [ 54 ]. Fleming et al. found that including methodologists in the review team was associated with appropriate use of reporting guidelines [ 55 ].

Source of funding and conflicts of interest: Some studies have found that funded studies report better [ 56 , 57 ], while others do not [ 53 , 58 ]. The presence of funding would indicate the availability of resources deployed to ensure optimal design, conduct, analysis and reporting. However, the source of funding may introduce conflicts of interest and warrant assessment. For example, Kaiser et al. investigated the effect of industry funding on obesity or nutrition randomized trials and found that reporting quality was similar [ 59 ]. Thomas et al. looked at reporting quality of long-term weight loss trials and found that industry funded studies were better [ 60 ]. Kan et al. examined the association between industry funding and “positive trials” (trials reporting a significant intervention effect) and found that industry funding was highly predictive of a positive trial [ 61 ]. This finding is similar to that of a recent Cochrane Methodology Review by Hansen et al. [ 62 ]

Journal characteristics: Certain journals’ characteristics may influence the study design, analysis or reporting. Characteristics such as journal endorsement of guidelines [ 63 , 64 ], and Journal Impact Factor (JIF) have been shown to be associated with reporting [ 63 , 65 , 66 , 67 ].

Study size (sample size/number of sites): Some studies have shown that reporting is better in larger studies [ 53 , 56 , 58 ].

Year of publication: It is reasonable to assume that design, conduct, analysis and reporting of research will change over time. Many studies have demonstrated improvements in reporting over time or after the publication of reporting guidelines [ 68 , 69 ].

Type of intervention: In a methodological study of reporting quality of weight loss intervention studies, Thabane et al. found that trials of pharmacologic interventions were reported better than trials of non-pharmacologic interventions [ 70 ].

Interactions between variables: Complex interactions between the previously listed variables are possible. High income countries with more resources may be more likely to conduct larger studies and incorporate a variety of experts. Authors in certain countries may prefer certain journals, and journal endorsement of guidelines and editorial policies may change over time.

Q: Should I focus only on high impact journals?

A: Investigators may choose to investigate only high impact journals because they are more likely to influence practice and policy, or because they assume that methodological standards would be higher. However, the JIF may severely limit the scope of articles included and may skew the sample towards articles with positive findings. The generalizability and applicability of findings from a handful of journals must be examined carefully, especially since the JIF varies over time. Even among journals that are all “high impact”, variations exist in methodological standards.

Q: Can I conduct a methodological study of qualitative research?

A: Yes. Even though a lot of methodological research has been conducted in the quantitative research field, methodological studies of qualitative studies are feasible. Certain databases that catalogue qualitative research including the Cumulative Index to Nursing & Allied Health Literature (CINAHL) have defined subject headings that are specific to methodological research (e.g. “research methodology”). Alternatively, one could also conduct a qualitative methodological review; that is, use qualitative approaches to synthesize methodological issues in qualitative studies.

Q: What reporting guidelines should I use for my methodological study?

A: There is no guideline that covers the entire scope of methodological studies. One adaptation of the PRISMA guidelines has been published, which works well for studies that aim to use the entire target population of research reports [ 71 ]. However, it is not widely used (40 citations in 2 years as of 09 December 2019), and methodological studies that are designed as cross-sectional or before-after studies require a more fit-for purpose guideline. A more encompassing reporting guideline for a broad range of methodological studies is currently under development [ 72 ]. However, in the absence of formal guidance, the requirements for scientific reporting should be respected, and authors of methodological studies should focus on transparency and reproducibility.

Q: What are the potential threats to validity and how can I avoid them?

A: Methodological studies may be compromised by a lack of internal or external validity. The main threats to internal validity in methodological studies are selection and confounding bias. Investigators must ensure that the methods used to select articles does not make them differ systematically from the set of articles to which they would like to make inferences. For example, attempting to make extrapolations to all journals after analyzing high-impact journals would be misleading.

Many factors (confounders) may distort the association between the exposure and outcome if the included research reports differ with respect to these factors [ 73 ]. For example, when examining the association between source of funding and completeness of reporting, it may be necessary to account for journals that endorse the guidelines. Confounding bias can be addressed by restriction, matching and statistical adjustment [ 73 ]. Restriction appears to be the method of choice for many investigators who choose to include only high impact journals or articles in a specific field. For example, Knol et al. examined the reporting of p -values in baseline tables of high impact journals [ 26 ]. Matching is also sometimes used. In the methodological study of non-randomized interventional studies of elective ventral hernia repair, Parker et al. matched prospective studies with retrospective studies and compared reporting standards [ 74 ]. Some other methodological studies use statistical adjustments. For example, Zhang et al. used regression techniques to determine the factors associated with missing participant data in trials [ 16 ].

With regard to external validity, researchers interested in conducting methodological studies must consider how generalizable or applicable their findings are. This should tie in closely with the research question and should be explicit. For example. Findings from methodological studies on trials published in high impact cardiology journals cannot be assumed to be applicable to trials in other fields. However, investigators must ensure that their sample truly represents the target sample either by a) conducting a comprehensive and exhaustive search, or b) using an appropriate and justified, randomly selected sample of research reports.

Even applicability to high impact journals may vary based on the investigators’ definition, and over time. For example, for high impact journals in the field of general medicine, Bouwmeester et al. included the Annals of Internal Medicine (AIM), BMJ, the Journal of the American Medical Association (JAMA), Lancet, the New England Journal of Medicine (NEJM), and PLoS Medicine ( n  = 6) [ 75 ]. In contrast, the high impact journals selected in the methodological study by Schiller et al. were BMJ, JAMA, Lancet, and NEJM ( n  = 4) [ 76 ]. Another methodological study by Kosa et al. included AIM, BMJ, JAMA, Lancet and NEJM ( n  = 5). In the methodological study by Thabut et al., journals with a JIF greater than 5 were considered to be high impact. Riado Minguez et al. used first quartile journals in the Journal Citation Reports (JCR) for a specific year to determine “high impact” [ 77 ]. Ultimately, the definition of high impact will be based on the number of journals the investigators are willing to include, the year of impact and the JIF cut-off [ 78 ]. We acknowledge that the term “generalizability” may apply differently for methodological studies, especially when in many instances it is possible to include the entire target population in the sample studied.

Finally, methodological studies are not exempt from information bias which may stem from discrepancies in the included research reports [ 79 ], errors in data extraction, or inappropriate interpretation of the information extracted. Likewise, publication bias may also be a concern in methodological studies, but such concepts have not yet been explored.

A proposed framework

In order to inform discussions about methodological studies, the development of guidance for what should be reported, we have outlined some key features of methodological studies that can be used to classify them. For each of the categories outlined below, we provide an example. In our experience, the choice of approach to completing a methodological study can be informed by asking the following four questions:

What is the aim?

Methodological studies that investigate bias

A methodological study may be focused on exploring sources of bias in primary or secondary studies (meta-bias), or how bias is analyzed. We have taken care to distinguish bias (i.e. systematic deviations from the truth irrespective of the source) from reporting quality or completeness (i.e. not adhering to a specific reporting guideline or norm). An example of where this distinction would be important is in the case of a randomized trial with no blinding. This study (depending on the nature of the intervention) would be at risk of performance bias. However, if the authors report that their study was not blinded, they would have reported adequately. In fact, some methodological studies attempt to capture both “quality of conduct” and “quality of reporting”, such as Richie et al., who reported on the risk of bias in randomized trials of pharmacy practice interventions [ 80 ]. Babic et al. investigated how risk of bias was used to inform sensitivity analyses in Cochrane reviews [ 81 ]. Further, biases related to choice of outcomes can also be explored. For example, Tan et al investigated differences in treatment effect size based on the outcome reported [ 82 ].

Methodological studies that investigate quality (or completeness) of reporting

Methodological studies may report quality of reporting against a reporting checklist (i.e. adherence to guidelines) or against expected norms. For example, Croituro et al. report on the quality of reporting in systematic reviews published in dermatology journals based on their adherence to the PRISMA statement [ 83 ], and Khan et al. described the quality of reporting of harms in randomized controlled trials published in high impact cardiovascular journals based on the CONSORT extension for harms [ 84 ]. Other methodological studies investigate reporting of certain features of interest that may not be part of formally published checklists or guidelines. For example, Mbuagbaw et al. described how often the implications for research are elaborated using the Evidence, Participants, Intervention, Comparison, Outcome, Timeframe (EPICOT) format [ 30 ].

Methodological studies that investigate the consistency of reporting

Sometimes investigators may be interested in how consistent reports of the same research are, as it is expected that there should be consistency between: conference abstracts and published manuscripts; manuscript abstracts and manuscript main text; and trial registration and published manuscript. For example, Rosmarakis et al. investigated consistency between conference abstracts and full text manuscripts [ 85 ].

Methodological studies that investigate factors associated with reporting

In addition to identifying issues with reporting in primary and secondary studies, authors of methodological studies may be interested in determining the factors that are associated with certain reporting practices. Many methodological studies incorporate this, albeit as a secondary outcome. For example, Farrokhyar et al. investigated the factors associated with reporting quality in randomized trials of coronary artery bypass grafting surgery [ 53 ].

Methodological studies that investigate methods

Methodological studies may also be used to describe methods or compare methods, and the factors associated with methods. Muller et al. described the methods used for systematic reviews and meta-analyses of observational studies [ 86 ].

Methodological studies that summarize other methodological studies

Some methodological studies synthesize results from other methodological studies. For example, Li et al. conducted a scoping review of methodological reviews that investigated consistency between full text and abstracts in primary biomedical research [ 87 ].

Methodological studies that investigate nomenclature and terminology

Some methodological studies may investigate the use of names and terms in health research. For example, Martinic et al. investigated the definitions of systematic reviews used in overviews of systematic reviews (OSRs), meta-epidemiological studies and epidemiology textbooks [ 88 ].

Other types of methodological studies

In addition to the previously mentioned experimental methodological studies, there may exist other types of methodological studies not captured here.

What is the design?

Methodological studies that are descriptive

Most methodological studies are purely descriptive and report their findings as counts (percent) and means (standard deviation) or medians (interquartile range). For example, Mbuagbaw et al. described the reporting of research recommendations in Cochrane HIV systematic reviews [ 30 ]. Gohari et al. described the quality of reporting of randomized trials in diabetes in Iran [ 12 ].

Methodological studies that are analytical

Some methodological studies are analytical wherein “analytical studies identify and quantify associations, test hypotheses, identify causes and determine whether an association exists between variables, such as between an exposure and a disease.” [ 89 ] In the case of methodological studies all these investigations are possible. For example, Kosa et al. investigated the association between agreement in primary outcome from trial registry to published manuscript and study covariates. They found that larger and more recent studies were more likely to have agreement [ 15 ]. Tricco et al. compared the conclusion statements from Cochrane and non-Cochrane systematic reviews with a meta-analysis of the primary outcome and found that non-Cochrane reviews were more likely to report positive findings. These results are a test of the null hypothesis that the proportions of Cochrane and non-Cochrane reviews that report positive results are equal [ 90 ].

What is the sampling strategy?

Methodological studies that include the target population

Methodological reviews with narrow research questions may be able to include the entire target population. For example, in the methodological study of Cochrane HIV systematic reviews, Mbuagbaw et al. included all of the available studies ( n  = 103) [ 30 ].

Methodological studies that include a sample of the target population

Many methodological studies use random samples of the target population [ 33 , 91 , 92 ]. Alternatively, purposeful sampling may be used, limiting the sample to a subset of research-related reports published within a certain time period, or in journals with a certain ranking or on a topic. Systematic sampling can also be used when random sampling may be challenging to implement.

What is the unit of analysis?

Methodological studies with a research report as the unit of analysis

Many methodological studies use a research report (e.g. full manuscript of study, abstract portion of the study) as the unit of analysis, and inferences can be made at the study-level. However, both published and unpublished research-related reports can be studied. These may include articles, conference abstracts, registry entries etc.

Methodological studies with a design, analysis or reporting item as the unit of analysis

Some methodological studies report on items which may occur more than once per article. For example, Paquette et al. report on subgroup analyses in Cochrane reviews of atrial fibrillation in which 17 systematic reviews planned 56 subgroup analyses [ 93 ].

This framework is outlined in Fig.  2 .

A proposed framework for methodological studies

Conclusions

Methodological studies have examined different aspects of reporting such as quality, completeness, consistency and adherence to reporting guidelines. As such, many of the methodological study examples cited in this tutorial are related to reporting. However, as an evolving field, the scope of research questions that can be addressed by methodological studies is expected to increase.

In this paper we have outlined the scope and purpose of methodological studies, along with examples of instances in which various approaches have been used. In the absence of formal guidance on the design, conduct, analysis and reporting of methodological studies, we have provided some advice to help make methodological studies consistent. This advice is grounded in good contemporary scientific practice. Generally, the research question should tie in with the sampling approach and planned analysis. We have also highlighted the variables that may inform findings from methodological studies. Lastly, we have provided suggestions for ways in which authors can categorize their methodological studies to inform their design and analysis.

Availability of data and materials

Data sharing is not applicable to this article as no new data were created or analyzed in this study.

Abbreviations

Consolidated Standards of Reporting Trials

Evidence, Participants, Intervention, Comparison, Outcome, Timeframe

Grading of Recommendations, Assessment, Development and Evaluations

Participants, Intervention, Comparison, Outcome, Timeframe

Preferred Reporting Items of Systematic reviews and Meta-Analyses

Studies Within a Review

Studies Within a Trial

Chalmers I, Glasziou P. Avoidable waste in the production and reporting of research evidence. Lancet. 2009;374(9683):86–9.

PubMed   Google Scholar  

Chan AW, Song F, Vickers A, Jefferson T, Dickersin K, Gotzsche PC, Krumholz HM, Ghersi D, van der Worp HB. Increasing value and reducing waste: addressing inaccessible research. Lancet. 2014;383(9913):257–66.

PubMed   PubMed Central   Google Scholar  

Ioannidis JP, Greenland S, Hlatky MA, Khoury MJ, Macleod MR, Moher D, Schulz KF, Tibshirani R. Increasing value and reducing waste in research design, conduct, and analysis. Lancet. 2014;383(9912):166–75.

Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.

Moher D, Schulz KF, Altman DG. The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials. Lancet. 2001;357.

Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6(7):e1000100.

Shea BJ, Hamel C, Wells GA, Bouter LM, Kristjansson E, Grimshaw J, Henry DA, Boers M. AMSTAR is a reliable and valid measurement tool to assess the methodological quality of systematic reviews. J Clin Epidemiol. 2009;62(10):1013–20.

Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, Moher D, Tugwell P, Welch V, Kristjansson E, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. Bmj. 2017;358:j4008.

Lawson DO, Leenus A, Mbuagbaw L. Mapping the nomenclature, methodology, and reporting of studies that review methods: a pilot methodological review. Pilot Feasibility Studies. 2020;6(1):13.

Puljak L, Makaric ZL, Buljan I, Pieper D. What is a meta-epidemiological study? Analysis of published literature indicated heterogeneous study designs and definitions. J Comp Eff Res. 2020.

Abbade LPF, Wang M, Sriganesh K, Jin Y, Mbuagbaw L, Thabane L. The framing of research questions using the PICOT format in randomized controlled trials of venous ulcer disease is suboptimal: a systematic survey. Wound Repair Regen. 2017;25(5):892–900.

Gohari F, Baradaran HR, Tabatabaee M, Anijidani S, Mohammadpour Touserkani F, Atlasi R, Razmgir M. Quality of reporting randomized controlled trials (RCTs) in diabetes in Iran; a systematic review. J Diabetes Metab Disord. 2015;15(1):36.

Wang M, Jin Y, Hu ZJ, Thabane A, Dennis B, Gajic-Veljanoski O, Paul J, Thabane L. The reporting quality of abstracts of stepped wedge randomized trials is suboptimal: a systematic survey of the literature. Contemp Clin Trials Commun. 2017;8:1–10.

Shanthanna H, Kaushal A, Mbuagbaw L, Couban R, Busse J, Thabane L: A cross-sectional study of the reporting quality of pilot or feasibility trials in high-impact anesthesia journals Can J Anaesthesia 2018, 65(11):1180–1195.

Kosa SD, Mbuagbaw L, Borg Debono V, Bhandari M, Dennis BB, Ene G, Leenus A, Shi D, Thabane M, Valvasori S, et al. Agreement in reporting between trial publications and current clinical trial registry in high impact journals: a methodological review. Contemporary Clinical Trials. 2018;65:144–50.

Zhang Y, Florez ID, Colunga Lozano LE, Aloweni FAB, Kennedy SA, Li A, Craigie S, Zhang S, Agarwal A, Lopes LC, et al. A systematic survey on reporting and methods for handling missing participant data for continuous outcomes in randomized controlled trials. J Clin Epidemiol. 2017;88:57–66.

CAS   PubMed   Google Scholar  

Hernández AV, Boersma E, Murray GD, Habbema JD, Steyerberg EW. Subgroup analyses in therapeutic cardiovascular clinical trials: are most of them misleading? Am Heart J. 2006;151(2):257–64.

Samaan Z, Mbuagbaw L, Kosa D, Borg Debono V, Dillenburg R, Zhang S, Fruci V, Dennis B, Bawor M, Thabane L. A systematic scoping review of adherence to reporting guidelines in health care literature. J Multidiscip Healthc. 2013;6:169–88.

Buscemi N, Hartling L, Vandermeer B, Tjosvold L, Klassen TP. Single data extraction generated more errors than double data extraction in systematic reviews. J Clin Epidemiol. 2006;59(7):697–703.

Carrasco-Labra A, Brignardello-Petersen R, Santesso N, Neumann I, Mustafa RA, Mbuagbaw L, Etxeandia Ikobaltzeta I, De Stio C, McCullagh LJ, Alonso-Coello P. Improving GRADE evidence tables part 1: a randomized trial shows improved understanding of content in summary-of-findings tables with a new format. J Clin Epidemiol. 2016;74:7–18.

The Northern Ireland Hub for Trials Methodology Research: SWAT/SWAR Information [ https://www.qub.ac.uk/sites/TheNorthernIrelandNetworkforTrialsMethodologyResearch/SWATSWARInformation/ ]. Accessed 31 Aug 2020.

Chick S, Sánchez P, Ferrin D, Morrice D. How to conduct a successful simulation study. In: Proceedings of the 2003 winter simulation conference: 2003; 2003. p. 66–70.

Google Scholar  

Mulrow CD. The medical review article: state of the science. Ann Intern Med. 1987;106(3):485–8.

Sacks HS, Reitman D, Pagano D, Kupelnick B. Meta-analysis: an update. Mount Sinai J Med New York. 1996;63(3–4):216–24.

CAS   Google Scholar  

Areia M, Soares M, Dinis-Ribeiro M. Quality reporting of endoscopic diagnostic studies in gastrointestinal journals: where do we stand on the use of the STARD and CONSORT statements? Endoscopy. 2010;42(2):138–47.

Knol M, Groenwold R, Grobbee D. P-values in baseline tables of randomised controlled trials are inappropriate but still common in high impact journals. Eur J Prev Cardiol. 2012;19(2):231–2.

Chen M, Cui J, Zhang AL, Sze DM, Xue CC, May BH. Adherence to CONSORT items in randomized controlled trials of integrative medicine for colorectal Cancer published in Chinese journals. J Altern Complement Med. 2018;24(2):115–24.

Hopewell S, Ravaud P, Baron G, Boutron I. Effect of editors' implementation of CONSORT guidelines on the reporting of abstracts in high impact medical journals: interrupted time series analysis. BMJ. 2012;344:e4178.

The Cochrane Methodology Register Issue 2 2009 [ https://cmr.cochrane.org/help.htm ]. Accessed 31 Aug 2020.

Mbuagbaw L, Kredo T, Welch V, Mursleen S, Ross S, Zani B, Motaze NV, Quinlan L. Critical EPICOT items were absent in Cochrane human immunodeficiency virus systematic reviews: a bibliometric analysis. J Clin Epidemiol. 2016;74:66–72.

Barton S, Peckitt C, Sclafani F, Cunningham D, Chau I. The influence of industry sponsorship on the reporting of subgroup analyses within phase III randomised controlled trials in gastrointestinal oncology. Eur J Cancer. 2015;51(18):2732–9.

Setia MS. Methodology series module 5: sampling strategies. Indian J Dermatol. 2016;61(5):505–9.

Wilson B, Burnett P, Moher D, Altman DG, Al-Shahi Salman R. Completeness of reporting of randomised controlled trials including people with transient ischaemic attack or stroke: a systematic review. Eur Stroke J. 2018;3(4):337–46.

Kahale LA, Diab B, Brignardello-Petersen R, Agarwal A, Mustafa RA, Kwong J, Neumann I, Li L, Lopes LC, Briel M, et al. Systematic reviews do not adequately report or address missing outcome data in their analyses: a methodological survey. J Clin Epidemiol. 2018;99:14–23.

De Angelis CD, Drazen JM, Frizelle FA, Haug C, Hoey J, Horton R, Kotzin S, Laine C, Marusic A, Overbeke AJPM, et al. Is this clinical trial fully registered?: a statement from the International Committee of Medical Journal Editors*. Ann Intern Med. 2005;143(2):146–8.

Ohtake PJ, Childs JD. Why publish study protocols? Phys Ther. 2014;94(9):1208–9.

Rombey T, Allers K, Mathes T, Hoffmann F, Pieper D. A descriptive analysis of the characteristics and the peer review process of systematic review protocols published in an open peer review journal from 2012 to 2017. BMC Med Res Methodol. 2019;19(1):57.

Grimes DA, Schulz KF. Bias and causal associations in observational research. Lancet. 2002;359(9302):248–52.

Porta M (ed.): A dictionary of epidemiology, 5th edn. Oxford: Oxford University Press, Inc.; 2008.

El Dib R, Tikkinen KAO, Akl EA, Gomaa HA, Mustafa RA, Agarwal A, Carpenter CR, Zhang Y, Jorge EC, Almeida R, et al. Systematic survey of randomized trials evaluating the impact of alternative diagnostic strategies on patient-important outcomes. J Clin Epidemiol. 2017;84:61–9.

Helzer JE, Robins LN, Taibleson M, Woodruff RA Jr, Reich T, Wish ED. Reliability of psychiatric diagnosis. I. a methodological review. Arch Gen Psychiatry. 1977;34(2):129–33.

Chung ST, Chacko SK, Sunehag AL, Haymond MW. Measurements of gluconeogenesis and Glycogenolysis: a methodological review. Diabetes. 2015;64(12):3996–4010.

CAS   PubMed   PubMed Central   Google Scholar  

Sterne JA, Juni P, Schulz KF, Altman DG, Bartlett C, Egger M. Statistical methods for assessing the influence of study characteristics on treatment effects in 'meta-epidemiological' research. Stat Med. 2002;21(11):1513–24.

Moen EL, Fricano-Kugler CJ, Luikart BW, O’Malley AJ. Analyzing clustered data: why and how to account for multiple observations nested within a study participant? PLoS One. 2016;11(1):e0146721.

Zyzanski SJ, Flocke SA, Dickinson LM. On the nature and analysis of clustered data. Ann Fam Med. 2004;2(3):199–200.

Mathes T, Klassen P, Pieper D. Frequency of data extraction errors and methods to increase data extraction quality: a methodological review. BMC Med Res Methodol. 2017;17(1):152.

Bui DDA, Del Fiol G, Hurdle JF, Jonnalagadda S. Extractive text summarization system to aid data extraction from full text in systematic review development. J Biomed Inform. 2016;64:265–72.

Bui DD, Del Fiol G, Jonnalagadda S. PDF text classification to leverage information extraction from publication reports. J Biomed Inform. 2016;61:141–8.

Maticic K, Krnic Martinic M, Puljak L. Assessment of reporting quality of abstracts of systematic reviews with meta-analysis using PRISMA-A and discordance in assessments between raters without prior experience. BMC Med Res Methodol. 2019;19(1):32.

Speich B. Blinding in surgical randomized clinical trials in 2015. Ann Surg. 2017;266(1):21–2.

Abraha I, Cozzolino F, Orso M, Marchesi M, Germani A, Lombardo G, Eusebi P, De Florio R, Luchetta ML, Iorio A, et al. A systematic review found that deviations from intention-to-treat are common in randomized trials and systematic reviews. J Clin Epidemiol. 2017;84:37–46.

Zhong Y, Zhou W, Jiang H, Fan T, Diao X, Yang H, Min J, Wang G, Fu J, Mao B. Quality of reporting of two-group parallel randomized controlled clinical trials of multi-herb formulae: A survey of reports indexed in the Science Citation Index Expanded. Eur J Integrative Med. 2011;3(4):e309–16.

Farrokhyar F, Chu R, Whitlock R, Thabane L. A systematic review of the quality of publications reporting coronary artery bypass grafting trials. Can J Surg. 2007;50(4):266–77.

Oltean H, Gagnier JJ. Use of clustering analysis in randomized controlled trials in orthopaedic surgery. BMC Med Res Methodol. 2015;15:17.

Fleming PS, Koletsi D, Pandis N. Blinded by PRISMA: are systematic reviewers focusing on PRISMA and ignoring other guidelines? PLoS One. 2014;9(5):e96407.

Balasubramanian SP, Wiener M, Alshameeri Z, Tiruvoipati R, Elbourne D, Reed MW. Standards of reporting of randomized controlled trials in general surgery: can we do better? Ann Surg. 2006;244(5):663–7.

de Vries TW, van Roon EN. Low quality of reporting adverse drug reactions in paediatric randomised controlled trials. Arch Dis Child. 2010;95(12):1023–6.

Borg Debono V, Zhang S, Ye C, Paul J, Arya A, Hurlburt L, Murthy Y, Thabane L. The quality of reporting of RCTs used within a postoperative pain management meta-analysis, using the CONSORT statement. BMC Anesthesiol. 2012;12:13.

Kaiser KA, Cofield SS, Fontaine KR, Glasser SP, Thabane L, Chu R, Ambrale S, Dwary AD, Kumar A, Nayyar G, et al. Is funding source related to study reporting quality in obesity or nutrition randomized control trials in top-tier medical journals? Int J Obes. 2012;36(7):977–81.

Thomas O, Thabane L, Douketis J, Chu R, Westfall AO, Allison DB. Industry funding and the reporting quality of large long-term weight loss trials. Int J Obes. 2008;32(10):1531–6.

Khan NR, Saad H, Oravec CS, Rossi N, Nguyen V, Venable GT, Lillard JC, Patel P, Taylor DR, Vaughn BN, et al. A review of industry funding in randomized controlled trials published in the neurosurgical literature-the elephant in the room. Neurosurgery. 2018;83(5):890–7.

Hansen C, Lundh A, Rasmussen K, Hrobjartsson A. Financial conflicts of interest in systematic reviews: associations with results, conclusions, and methodological quality. Cochrane Database Syst Rev. 2019;8:Mr000047.

Kiehna EN, Starke RM, Pouratian N, Dumont AS. Standards for reporting randomized controlled trials in neurosurgery. J Neurosurg. 2011;114(2):280–5.

Liu LQ, Morris PJ, Pengel LH. Compliance to the CONSORT statement of randomized controlled trials in solid organ transplantation: a 3-year overview. Transpl Int. 2013;26(3):300–6.

Bala MM, Akl EA, Sun X, Bassler D, Mertz D, Mejza F, Vandvik PO, Malaga G, Johnston BC, Dahm P, et al. Randomized trials published in higher vs. lower impact journals differ in design, conduct, and analysis. J Clin Epidemiol. 2013;66(3):286–95.

Lee SY, Teoh PJ, Camm CF, Agha RA. Compliance of randomized controlled trials in trauma surgery with the CONSORT statement. J Trauma Acute Care Surg. 2013;75(4):562–72.

Ziogas DC, Zintzaras E. Analysis of the quality of reporting of randomized controlled trials in acute and chronic myeloid leukemia, and myelodysplastic syndromes as governed by the CONSORT statement. Ann Epidemiol. 2009;19(7):494–500.

Alvarez F, Meyer N, Gourraud PA, Paul C. CONSORT adoption and quality of reporting of randomized controlled trials: a systematic analysis in two dermatology journals. Br J Dermatol. 2009;161(5):1159–65.

Mbuagbaw L, Thabane M, Vanniyasingam T, Borg Debono V, Kosa S, Zhang S, Ye C, Parpia S, Dennis BB, Thabane L. Improvement in the quality of abstracts in major clinical journals since CONSORT extension for abstracts: a systematic review. Contemporary Clin trials. 2014;38(2):245–50.

Thabane L, Chu R, Cuddy K, Douketis J. What is the quality of reporting in weight loss intervention studies? A systematic review of randomized controlled trials. Int J Obes. 2007;31(10):1554–9.

Murad MH, Wang Z. Guidelines for reporting meta-epidemiological methodology research. Evidence Based Med. 2017;22(4):139.

METRIC - MEthodological sTudy ReportIng Checklist: guidelines for reporting methodological studies in health research [ http://www.equator-network.org/library/reporting-guidelines-under-development/reporting-guidelines-under-development-for-other-study-designs/#METRIC ]. Accessed 31 Aug 2020.

Jager KJ, Zoccali C, MacLeod A, Dekker FW. Confounding: what it is and how to deal with it. Kidney Int. 2008;73(3):256–60.

Parker SG, Halligan S, Erotocritou M, Wood CPJ, Boulton RW, Plumb AAO, Windsor ACJ, Mallett S. A systematic methodological review of non-randomised interventional studies of elective ventral hernia repair: clear definitions and a standardised minimum dataset are needed. Hernia. 2019.

Bouwmeester W, Zuithoff NPA, Mallett S, Geerlings MI, Vergouwe Y, Steyerberg EW, Altman DG, Moons KGM. Reporting and methods in clinical prediction research: a systematic review. PLoS Med. 2012;9(5):1–12.

Schiller P, Burchardi N, Niestroj M, Kieser M. Quality of reporting of clinical non-inferiority and equivalence randomised trials--update and extension. Trials. 2012;13:214.

Riado Minguez D, Kowalski M, Vallve Odena M, Longin Pontzen D, Jelicic Kadic A, Jeric M, Dosenovic S, Jakus D, Vrdoljak M, Poklepovic Pericic T, et al. Methodological and reporting quality of systematic reviews published in the highest ranking journals in the field of pain. Anesth Analg. 2017;125(4):1348–54.

Thabut G, Estellat C, Boutron I, Samama CM, Ravaud P. Methodological issues in trials assessing primary prophylaxis of venous thrombo-embolism. Eur Heart J. 2005;27(2):227–36.

Puljak L, Riva N, Parmelli E, González-Lorenzo M, Moja L, Pieper D. Data extraction methods: an analysis of internal reporting discrepancies in single manuscripts and practical advice. J Clin Epidemiol. 2020;117:158–64.

Ritchie A, Seubert L, Clifford R, Perry D, Bond C. Do randomised controlled trials relevant to pharmacy meet best practice standards for quality conduct and reporting? A systematic review. Int J Pharm Pract. 2019.

Babic A, Vuka I, Saric F, Proloscic I, Slapnicar E, Cavar J, Pericic TP, Pieper D, Puljak L. Overall bias methods and their use in sensitivity analysis of Cochrane reviews were not consistent. J Clin Epidemiol. 2019.

Tan A, Porcher R, Crequit P, Ravaud P, Dechartres A. Differences in treatment effect size between overall survival and progression-free survival in immunotherapy trials: a Meta-epidemiologic study of trials with results posted at ClinicalTrials.gov. J Clin Oncol. 2017;35(15):1686–94.

Croitoru D, Huang Y, Kurdina A, Chan AW, Drucker AM. Quality of reporting in systematic reviews published in dermatology journals. Br J Dermatol. 2020;182(6):1469–76.

Khan MS, Ochani RK, Shaikh A, Vaduganathan M, Khan SU, Fatima K, Yamani N, Mandrola J, Doukky R, Krasuski RA: Assessing the Quality of Reporting of Harms in Randomized Controlled Trials Published in High Impact Cardiovascular Journals. Eur Heart J Qual Care Clin Outcomes 2019.

Rosmarakis ES, Soteriades ES, Vergidis PI, Kasiakou SK, Falagas ME. From conference abstract to full paper: differences between data presented in conferences and journals. FASEB J. 2005;19(7):673–80.

Mueller M, D’Addario M, Egger M, Cevallos M, Dekkers O, Mugglin C, Scott P. Methods to systematically review and meta-analyse observational studies: a systematic scoping review of recommendations. BMC Med Res Methodol. 2018;18(1):44.

Li G, Abbade LPF, Nwosu I, Jin Y, Leenus A, Maaz M, Wang M, Bhatt M, Zielinski L, Sanger N, et al. A scoping review of comparisons between abstracts and full reports in primary biomedical research. BMC Med Res Methodol. 2017;17(1):181.

Krnic Martinic M, Pieper D, Glatt A, Puljak L. Definition of a systematic review used in overviews of systematic reviews, meta-epidemiological studies and textbooks. BMC Med Res Methodol. 2019;19(1):203.

Analytical study [ https://medical-dictionary.thefreedictionary.com/analytical+study ]. Accessed 31 Aug 2020.

Tricco AC, Tetzlaff J, Pham B, Brehaut J, Moher D. Non-Cochrane vs. Cochrane reviews were twice as likely to have positive conclusion statements: cross-sectional study. J Clin Epidemiol. 2009;62(4):380–6 e381.

Schalken N, Rietbergen C. The reporting quality of systematic reviews and Meta-analyses in industrial and organizational psychology: a systematic review. Front Psychol. 2017;8:1395.

Ranker LR, Petersen JM, Fox MP. Awareness of and potential for dependent error in the observational epidemiologic literature: A review. Ann Epidemiol. 2019;36:15–9 e12.

Paquette M, Alotaibi AM, Nieuwlaat R, Santesso N, Mbuagbaw L. A meta-epidemiological study of subgroup analyses in cochrane systematic reviews of atrial fibrillation. Syst Rev. 2019;8(1):241.

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LM conceived the idea and drafted the outline and paper. DOL and LT commented on the idea and draft outline. LM, LP and DOL performed literature searches and data extraction. All authors (LM, DOL, LT, LP, DBA) reviewed several draft versions of the manuscript and approved the final manuscript.

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Mbuagbaw, L., Lawson, D.O., Puljak, L. et al. A tutorial on methodological studies: the what, when, how and why. BMC Med Res Methodol 20 , 226 (2020). https://doi.org/10.1186/s12874-020-01107-7

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Interventions, methods and outcome measures used in teaching evidence-based practice to healthcare students: an overview of systematic reviews

• Lea D. Nielsen 1 ,
• Mette M. Løwe 2 ,
• Francisco Mansilla 3 ,
• Rene B. Jørgensen 4 ,
• Asviny Ramachandran 5 ,
• Bodil B. Noe 6 &
• Heidi K. Egebæk 7  

BMC Medical Education volume  24 , Article number:  306 ( 2024 ) Cite this article

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To fully implement the internationally acknowledged requirements for teaching in evidence-based practice, and support the student’s development of core competencies in evidence-based practice, educators at professional bachelor degree programs in healthcare need a systematic overview of evidence-based teaching and learning interventions. The purpose of this overview of systematic reviews was to summarize and synthesize the current evidence from systematic reviews on educational interventions being used by educators to teach evidence-based practice to professional bachelor-degree healthcare students and to identify the evidence-based practice-related learning outcomes used.

An overview of systematic reviews. Four databases (PubMed/Medline, CINAHL, ERIC and the Cochrane library) were searched from May 2013 to January 25th, 2024. Additional sources were checked for unpublished or ongoing systematic reviews. Eligibility criteria included systematic reviews of studies among undergraduate nursing, physiotherapist, occupational therapist, midwife, nutrition and health, and biomedical laboratory science students, evaluating educational interventions aimed at teaching evidence-based practice in classroom or clinical practice setting, or a combination. Two authors independently performed initial eligibility screening of title/abstracts. Four authors independently performed full-text screening and assessed the quality of selected systematic reviews using standardized instruments. Data was extracted and synthesized using a narrative approach.

A total of 524 references were retrieved, and 6 systematic reviews (with a total of 39 primary studies) were included. Overlap between the systematic reviews was minimal. All the systematic reviews were of low methodological quality. Synthesis and analysis revealed a variety of teaching modalities and approaches. The outcomes were to some extent assessed in accordance with the Sicily group`s categories; “skills”, “attitude” and “knowledge”. Whereas “behaviors”, “reaction to educational experience”, “self-efficacy” and “benefits for the patient” were rarely used.

Conclusions

Teaching evidence-based practice is widely used in undergraduate healthcare students and a variety of interventions are used and recognized. Not all categories of outcomes suggested by the Sicily group are used to evaluate outcomes of evidence-based practice teaching. There is a need for studies measuring the effect on outcomes in all the Sicily group categories, to enhance sustainability and transition of evidence-based practice competencies to the context of healthcare practice.

Peer Review reports

Evidence-based practice (EBP) enhances the quality of healthcare, reduces the cost, improves patient outcomes, empowers clinicians, and is recognized as a problem-solving approach [ 1 ] that integrates the best available evidence with clinical expertise and patient preferences and values [ 2 ]. A recent scoping review of EBP and patient outcomes indicates that EBPs improve patient outcomes and yield a positive return of investment for hospitals and healthcare systems. The top outcomes measured were length of stay, mortality, patient compliance/adherence, readmissions, pneumonia and other infections, falls, morbidity, patient satisfaction, patient anxiety/ depression, patient complications and pain. The authors conclude that healthcare professionals have a professional and ethical responsibility to provide expert care which requires an evidence-based approach. Furthermore, educators must become competent in EBP methodology [ 3 ].

According to the Sicily statement group, teaching and practicing EBP requires a 5-step approach: 1) pose an answerable clinical question (Ask), 2) search and retrieve relevant evidence (Search), 3) critically appraise the evidence for validity and clinical importance (Appraise), 4) applicate the results in practice by integrating the evidence with clinical expertise, patient preferences and values to make a clinical decision (Integrate), and 5) evaluate the change or outcome (Evaluate /Assess) [ 4 , 5 ]. Thus, according to the World Health Organization, educators, e.g., within undergraduate healthcare education, play a vital role by “integrating evidence-based teaching and learning processes, and helping learners interpret and apply evidence in their clinical learning experiences” [ 6 ].

A scoping review by Larsen et al. of 81 studies on interventions for teaching EBP within Professional bachelor-degree healthcare programs (PBHP) (in English undergraduate/ bachelor) shows that the majority of EBP teaching interventions include the first four steps, but the fifth step “evaluate/assess” is less often applied [ 5 ]. PBHP include bachelor-degree programs characterized by combined theoretical education and clinical training within nursing, physiotherapy, occupational therapy, radiography, and biomedical laboratory students., Furthermore, an overview of systematic reviews focusing on practicing healthcare professionals EBP competencies testifies that although graduates may have moderate to high level of self-reported EBP knowledge, skills, attitudes, and beliefs, this does not translate into their subsequent EBP implementation [ 7 ]. Although this cannot be seen as direct evidence of inadequate EBP teaching during undergraduate education, it is irrefutable that insufficient EBP competencies among clinicians across healthcare disciplines impedes their efforts to attain highest care quality and improved patient outcomes in clinical practice after graduation.

Research shows that teaching about EBP includes different types of modalities. An overview of systematic reviews, published by Young et al. in 2014 [ 8 ] and updated by Bala et al. in 2021 [ 9 ], synthesizes the effects of EBP teaching interventions including under- and post graduate health care professionals, the majority being medical students. They find that multifaceted interventions with a combination of lectures, computer lab sessions, small group discussion, journal clubs, use of current clinical issues, portfolios and assignments lead to improvement in students’ EBP knowledge, skills, attitudes, and behaviors compared to single interventions or no interventions [ 8 , 9 ]. Larsen et al. find that within PBHP, collaboration with clinical practice is the second most frequently used intervention for teaching EBP and most often involves four or all five steps of the EBP teaching approach [ 5 ]. The use of clinically integrated teaching in EBP is only sparsely identified in the overviews by Young et al. and Bala et al. [ 8 , 9 ]. Therefore, the evidence obtained within Bachelor of Medicine which is a theoretical education [ 10 ], may not be directly transferable for use in PBHP which combines theoretical and mandatory clinical education [ 11 ].

Since the overview by Young et al. [ 8 ], several reviews of interventions for teaching EBP used within PBHP have been published [ 5 , 12 , 13 , 14 ].

We therefore wanted to explore the newest evidence for teaching EBP focusing on PBHP as these programs are characterized by a large proportion of clinical teaching. These healthcare professions are certified through a PBHP at a level corresponding to a University Bachelor Degree, but with strong focus on professional practice by combining theoretical studies with mandatory clinical teaching. In Denmark, almost half of PBHP take place in clinical practice. These applied science programs qualify “the students to independently analyze, evaluate and reflect on problems in order to carry out practice-based, complex, and development-oriented job functions" [ 11 ]. Thus, both the purpose of these PBHP and the amount of clinical practice included in the educations contrast with for example medicine.

Thus, this overview, identifies the newest evidence for teaching EBP specifically within PBHP and by including reviews using quantitative and/or qualitative methods.

We believe that such an overview is important knowledge for educators to be able to take the EBP teaching for healthcare professions to a higher level. Also reviewing and describing EBP-related learning outcomes, categorizing them according to the seven assessment categories developed by the Sicily group [ 2 ], will be useful knowledge to educators in healthcare professions. These seven assessment categories for EBP learning including: Reaction to the educational experience, attitudes, self-efficacy, knowledge, skills, behaviors and benefits to patients, can be linked to the five-step EBP approach. E.g., reactions to the educational experience: did the educators teaching style enhance learners’ enthusiasm for asking questions? (Ask), self-efficacy: how well do learners think they critically appraise evidence? (Appraise), skills: can learners come to a reasonable interpretation of how to apply the evidence? (Integrate) [ 2 ]. Thus, this set of categories can be seen as a basic set of EBP-related learning outcomes to classify the impact from EBP educational interventions.

Purpose and review questions

A systematic overview of which evidence-based teaching interventions and which EBP-related learning outcomes that are used will give teachers access to important knowledge on what to implement and how to evaluate EBP teaching.

Thus, the purpose of this overview is to synthesize the latest evidence from systematic reviews about EBP teaching interventions in PBHP. This overview adds to the existing evidence by focusing on systematic reviews that a) include qualitative and/ or quantitative studies regardless of design, b) are conducted among PBHP within nursing, physiotherapy, occupational therapy, midwifery, nutrition and health and biomedical laboratory science, and c) incorporate the Sicily group's 5-step approach and seven assessment categories when analyzing the EBP teaching interventions and EBP-related learning outcomes.

The questions of this overview of systematic reviews are:

Which educational interventions are described and used by educators to teach EBP to Professional Bachelor-degree healthcare students?

What EBP-related learning outcomes have been used to evaluate teaching interventions?

The study protocol was guided by the Cochrane Handbook on Overviews of Reviews [ 15 ] and the review process was reported in accordance with The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement [ 16 ] when this was consistent with the Cochrane Handbook.

Inclusion criteria

Eligible reviews fulfilled the inclusion criteria for publication type, population, intervention, and context (see Table  1 ). Failing a single inclusion criterion implied exclusion.

Search strategy

On January 25th 2024 a systematic search was conducted in; PubMed/Medline, CINAHL (EBSCOhost), ERIC (EBSCOhost) and the Cochrane library from May 2013 to January 25th, 2024 to identify systematic reviews published after the overview by Young et al. [ 8 ]. In collaboration with a research librarian, a search strategy of controlled vocabulary and free text terms related to systematic reviews, the student population, teaching interventions, teaching context, and evidence-based practice was developed (see Additional file 1 ). For each database, the search strategy was peer reviewed, revised, modified and subsequently pilot tested. No language restrictions were imposed.

To identify further eligible reviews, the following methods were used: Setting email alerts from the databases to provide weekly updates on new publications; backward and forward citation searching based on the included reviews by screening of reference lists and using the “cited by” and “similar results” function in PubMed and CINAHL; broad searching in Google Scholar (Advanced search), Prospero, JBI Evidence Synthesis and the OPEN Grey database; contacting experts in the field via email to first authors of included reviews, and by making queries via Twitter and Research Gate on any information on unpublished or ongoing reviews of relevance.

Selection and quality appraisal process

Database search results were merged, duplicate records were removed, and title/abstract were initially screened via Covidence [ 17 ]. The assessment process was pilot tested by four authors independently assessing eligibility and methodological quality of one potential review followed by joint discussion to reach a common understanding of the criteria used. Two authors independently screened each title/abstract for compliance with the predefined eligibility criteria. Disagreements were resolved by a third author. Four authors were paired for full text screening, and each pair assessed independently 50% of the potentially relevant reviews for eligibility and methodological quality.

For quality appraisal, two independent authors used the AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews) for reviews including intervention studies [ 18 ] and the Joanna Briggs Institute Checklist for systematic reviews and research Synthesis (JBI checklist) [ 19 ] for reviews including both quantitative and qualitative or only qualitative studies. Uncertainties in assessments were resolved by requesting clarifying information from first authors of reviews and/or discussion with co-author to the present overview.

Overall methodological quality for included reviews was assessed using the overall confidence criteria of AMSTAR 2 based on scorings in seven critical domains [ 18 ] appraised as high (none or one non-critical flaw), moderate (more than one non-critical flaw), low (one critical weakness) or critically low (more than one critical weakness) [ 18 ]. For systematic reviews of qualitative studies [ 13 , 20 , 21 ] the critical domains of the AMSTAR 2, not specified in the JBI checklist, were added.

Data extraction and synthesis process

Data were initially extracted by the first author, confirmed or rejected by the last author and finally discussed with the whole author group until consensus was reached.

Data extraction included 1) Information about the search and selection process according to the PRISMA statement [ 16 , 22 ], 2) Characteristics of the systematic reviews inspired by a standard in the Cochrane Handbook (15), 3) A citation index inspired by Young et al. [ 8 ] used to illustrate overlap of primary studies in the included systematic reviews, and to ensure that data from each primary study were extracted only once [ 15 ], 4) Data on EBP teaching interventions and EBP-related outcomes. These data were extracted, reformatted (categorized inductively into two categories: “Collaboration interventions” and “  Educational interventions ”) and presented as narrative summaries [ 15 ]. Data on outcome were categorized according to the seven assessment categories, defined by the Sicily group, to classify the impact from EBP educational interventions: Reaction to the educational experience, attitudes, self-efficacy, knowledge, skills, behaviors and benefits to patients [ 2 ]. When information under points 3 and 4 was missing, data from the abstracts of the primary study articles were reviewed.

Results of the search

The database search yielded 691 references after duplicates were removed. Title and abstract screening deemed 525 references irrelevant. Searching via other methods yielded two additional references. Out of 28 study reports assessed for eligibility 22 were excluded, leaving a total of six systematic reviews. Screening resulted in 100% agreement among the authors. Figure  1 details the search and selection process. Reviews that might seem relevant but did not meet the eligibility criteria [ 15 ], are listed in Additional file 2 . One protocol for a potentially relevant review was identified as ongoing [ 23 ].

PRISMA flow diagram on search and selection of systematic reviews

Characteristics of included systematic reviews and overlap between them

The six systematic reviews originated from the Middle East, Asia, North America, Europe, Scandinavia, and Australia. Two out of six reviews did not identify themselves as systematic reviews but did fulfill this eligibility criteria [ 12 , 20 ]. All six represented a total of 64 primary studies and a total population of 6649 students (see Table  2 ). However, five of the six systematic reviews contained a total of 17 primary studies not eligible to our overview focus (e.g., postgraduate students) (see Additional file 3 ). Results from these primary studies were not extracted. Of the remaining primary studies, six were included in two, and one was included in three systematic reviews. Data from these studies were extracted only once to avoid double-counting. Thus, the six systematic reviews represented a total of 39 primary studies and a total population of 3394 students. Nursing students represented 3280 of these. One sample of 58 nutrition and health students and one sample of 56 mixed nursing and midwife students were included but none from physiotherapy, occupational therapy, or biomedical laboratory scientists. The majority ( n  = 28) of the 39 primary studies had a quantitative design whereof 18 were quasi-experimental (see Additional file 4 ).

Quality of systematic review

All the included systematic reviews were assessed as having critically low quality with 100% concordance between the two designed authors (see Fig.  2 ) [ 18 ]. The main reasons for the low quality of the reviews were a) not demonstrating a registered protocol prior to the review [ 13 , 20 , 24 , 25 ], b) not providing a list of excluded studies with justification for exclusion [ 12 , 13 , 21 , 24 , 25 ] and c) not accounting for the quality of the individual studies when interpreting the result of the review [ 12 , 20 , 21 , 25 ].

Overall methodological quality assessment for systematic reviews. Quantitative studies [ 12 , 24 , 25 ] were assessed following the AMSTAR 2 critical domain guidelines. Qualitative studies [ 13 , 20 , 21 ] were assessed following the JBI checklist. For overall classification, qualitative studies were also assessed with the following critical AMSTAR 2 domains not specified in the JBI checklist (item 2. is the protocol registered before commencement of the review, item 7. justification for excluding individual studies and item 13. consideration of risk of bias when interpreting the results of the review)

Missing reporting of sources of funding for primary studies and not describing the included studies in adequate detail were, most often, the two non-critical items of the AMSTAR 2 and the JBI checklist, not met.

Most of the included reviews did report research questions including components of PICO, performed study selection and data extraction in duplicate, used appropriate methods for combining studies and used satisfactory techniques for assessing risk of bias (see Fig.  2 ).

Main findings from the systematic reviews

As illustrated in Table  2 , this overview synthesizes evidence on a variety of approaches to promote EBP teaching in both classroom and clinical settings. The systematic reviews describe various interventions used for teaching in EBP, which can be summarized into two themes: Collaboration Interventions and Educational Interventions.

Collaboration interventions to teach EBP

In general, the reviews point that interdisciplinary collaboration among health professionals and/or others e.g., librarian and professionals within information technologies is relevant when planning and teaching in EBP [ 13 , 20 ].

Interdisciplinary collaboration was described as relevant when planning teaching in EBP [ 13 , 20 ]. Specifically, regarding literature search Wakibi et al. found that collaboration between librarians, computer laboratory technicians and nurse educators enhanced students’ skills [ 13 ]. Also, in terms of creating transfer between EBP teaching and clinical practice, collaboration between faculty, library, clinical institutions, and teaching institutions was used [ 13 , 20 ].

Regarding collaboration with clinical practice, Ghaffari et al. found that teaching EBP integrated in clinical education could promote students’ knowledge and skills [ 25 ]. Horntvedt et al. found that during a six-week course in clinical practice, students obtained better skills in reading research articles and orally presenting the findings to staff and fellow students [ 20 ]. Participation in clinical research projects combined with instructions in analyzing and discussing research findings also “led to a positive approach and EBP knowledge” [ 20 ]. Moreover, reading research articles during the clinical practice period enhances the students critical thinking skills. Furthermore, Horntvedt et al. mention, that students found it meaningful to conduct a “mini” – research project in clinical settings, as the identified evidence became relevant [ 20 ].

Educational interventions

Educational interventions can be described as “Framing Interventions” understood as different ways to set up a framework for teaching EBP, and “  Teaching methods ” understood as specific methods used when teaching EBP.

Various educational interventions were described in most reviews [ 12 , 13 , 20 , 21 ]. According to Patelarou et al., no specific educational intervention regardless of framing and methods was in favor to “ increase knowledge, skills and competency as well as improve the beliefs, attitudes and behaviors of nursing students”  [ 12 ].

Framing interventions

The approaches used to set up a framework for teaching EBP were labelled in different ways: programs, interactive teaching strategies, educational programs, courses etc. Approaches of various durations from hours to months were described as well as stepwise interventions [ 12 , 13 , 20 , 21 , 24 , 25 ].

Some frameworks [ 13 , 20 , 21 , 24 ] were based on the assessments categories described by the Sicily group [ 2 ] or based on theory [ 21 ] or as mentioned above clinically integrated [ 20 ]. Wakibi et al. identified interventions used to foster a spirit of inquiry and EBP culture reflecting the “5-step approach” of the Sicily group [ 4 ], asking PICOT questions, searching for best evidence, critical appraisal, integrating evidence with clinical expertise and patient preferences to make clinical decisions, evaluating outcomes of EBP practice, and disseminating outcomes useful [ 13 ]. Ramis et al. found that teaching interventions based on theory like Banduras self-efficacy or Roger’s theory of diffusion led to positive effects on students EBP knowledge and attitudes [ 21 ].

Teaching methods

A variety of teaching methods were used such as, lectures [ 12 , 13 , 20 ], problem-based learning [ 12 , 20 , 25 ], group work, discussions [ 12 , 13 ], and presentations [ 20 ] (see Table  2 ). The most effective method to achieve the skills required to practice EBP as described in the “5-step approach” by the Sicely group is a combination of different teaching methods like lectures, assignments, discussions, group works, and exams/tests.

Four systematic reviews identified such combinations or multifaceted approaches [ 12 , 13 , 20 , 21 ]. Patelarou et al. states that “EBP education approaches should be blended” [ 12 ]. Thus, combining the use of video, voice-over, PowerPoint, problem-based learning, lectures, team-based learning, projects, and small groups were found in different studies. This combination had shown “to be effective” [ 12 ]. Similarly, Horntvedt et al. found that nursing students reported that various teaching methods improved their EBP knowledge and skills [ 20 ].

According to Ghaffari et al., including problem-based learning in teaching plans “improved the clinical care and performance of the students”, while the problem-solving approach “promoted student knowledge” [ 25 ]. Other teaching methods identified, e.g., flipped classroom [ 20 ] and virtual simulation [ 12 , 20 ] were also characterized as useful interactive teaching interventions. Furthermore, face-to-face approaches seem “more effective” than online teaching interventions to enhance students’ research and appraisal skills and journal clubs enhance the students critically appraisal-skills [ 12 ].

As the reviews included in this overview primarily are based on qualitative, mixed methods as well as quasi-experimental studies and to a minor extent on randomized controlled trials (see Table  2 ) it is not possible to conclude of the most effective methods. However, a combination of methods and an innovative collaboration between librarians, information technology professionals and healthcare professionals seem the most effective approach to achieve EBP required skills.

EBP-related outcomes

Most of the systematic reviews presented a wide array of outcome assessments applied in EBP research (See Table  3 ). Analyzing the outcomes according to the Sicily group’s assessment categories revealed that assessing “knowledge” (used in 19 out of 39 primary studies), “skills” (used in 18 out of 39 primary studies) and “attitude” (used in 17 out of 39) were by far the most frequently used assessment categories, whereas outcomes within the category of “behaviors” (used in eight studies) “reaction to educational experience” (in five studies), “self-efficacy” (in two studies), and “benefits for the patient” (in one study), were used to a far lesser extent. Additionally, outcomes, that we were not able to categorize within the seven assessment categories, were “future use” and “Global EBP competence”.

The purpose of this overview of systematic reviews was to collect and summarize evidence of the diversity of EBP teaching interventions and outcomes measured among professional bachelor- degree healthcare students.

Our results give an overview of “the state of the art” of using and measuring EBP in PBHP education. However, the quality of included systematic reviews was rated critically low. Thus, the result cannot support guidelines of best practice.

The analysis of the interventions and outcomes described in the 39 primary studies included in this overview, reveals a wide variety of teaching methods and interventions being used and described in the scientific literature on EBP teaching of PBHP students. The results show some evidence of the five step EBP approach in accordance with the inclusion criteria “interventions aimed at teaching one or more of the five EBP steps; Ask, Search, Appraise, Integrate, Assess/evaluate”. Most authors state, that the students´ EBP skills, attitudes and knowledge improved by almost any of the described methods and interventions. However, descriptions of how the improvements were measured were less frequent.

We evaluated the described outcome measures and assessments according to the seven categories proposed by the Sicily group and found that most assessments were on “attitudes”, “skills” and “knowledge”, sometimes on “behaviors” and very seldom on” reaction to educational experience”, “self-efficacy” and “benefits to the patients”. To our knowledge no systematic review or overview has made this evaluation on outcome categories before, but Bala et al. [ 9 ] also stated that knowledge, skills, and attitudes are the most common evaluated effects.

Comparing the outcomes measured between mainly medical [ 9 ] and nursing students, the most prevalent outcomes in both groups are knowledge, skills and attitudes around EBP. In contrast, measuring on the students´ patient care or on the impact of the EBP teaching on benefits for the patients is less prevalent. In contrast Wu et al.’s systematic review shows that among clinical nurses, educational interventions supporting implementation of EBP projects can change patient outcomes positively. However, they also conclude that direct causal evidence of the educational interventions is difficult to measure because of the diversity of EBP projects implemented [ 26 ]. Regarding EBP behavior the Sicily group recommend this category to be assessed by monitoring the frequency of the five step EBP approach, e.g., ASK questions about patients, APPRAISE evidence related to patient care, EVALUATE their EBP behavior and identified areas for improvement [ 2 ]. The results also showed evidence of student-clinician transition. “Future use” was identified in two systematic reviews [ 12 , 13 ] and categorized as “others”. This outcome is not included in the seven Sicily categories. However, a systematic review of predictive modelling studies shows, that future use or the intention to use EBP after graduation are influenced by the students EBP familiarity, EBP capability beliefs, EBP attitudes and academic and clinical support [ 27 ].

Teaching and evaluating EBP needs to move beyond aiming at changes in knowledge, skills, and attitudes, but also start focusing on changing and assessing behavior, self-efficacy and benefit to the patients. We recommend doing this using validated tools for the assessment of outcomes and in prospective studies with longer follow-up periods, preferably evaluating the adoption of EBP in clinical settings bearing in mind, that best teaching practice happens across sectors and settings supported and supervised by multiple professions.

Based on a systematic review and international Delphi survey, a set of interprofessional EBP core competencies that details the competence content of each of the five steps has been published to inform curriculum development and benchmark EBP standards [ 28 ]. This consensus statement may be used by educators as a reference for both learning objectives and EBP content descriptions in future intervention research. The collaboration with clinical institutions and integration of EBP teaching components such as EBP assignments or participating in clinical research projects are important results. Specifically, in the light of the dialectic between theoretical and clinical education as a core characteristic of Professional bachelor-degree healthcare educations.

Our study has some limitations that need consideration when interpreting the results. A search in the EMBASE and Scopus databases was not added in the search strategy, although it might have been able to bring additional sources. Most of the 22 excluded reviews included primary studies among other levels/ healthcare groups of students or had not critically appraised their primary studies. This constitutes insufficient adherence to methodological guidelines for systematic reviews and limits the completeness of the reviews identified. Often, the result sections of the included reviews were poorly reported and made it necessary to extract some, but not always sufficient, information from the primary study abstracts. As the present study is an overview and not a new systematic review, we did not extract information from the result section in the primary studies. Thus, the comprehensiveness and applicability of the results of this overview are limited by the methodological limitations in the six included systematic reviews.

The existing evidence is based on different types of study designs. This heterogeneity is seen in all the included reviews. Thus, the present overview only conveys trends around the comparative effectiveness of the different ways to frame, or the methods used for teaching EBP. This can be seen as a weakness for the clarity and applicability of the overview results. Also, our protocol is unpublished, which may weaken the transparency of the overview approach, however our search strategies are available as additional material (see Additional file 1 ). In addition, the validity of data extraction can be discussed. We extracted data consecutively by the first and last author and if needed consensus was reached by discussion with the entire research group. This method might have been strengthened by using two blinded reviewers to extract data and present data with supporting kappa values.

The generalizability of the results of this overview is limited to undergraduate nursing students. Although, we consider it a strength that the results represent a broad international perspective on framing EBP teaching, as well as teaching methods and outcomes used among educators in EBP. Primary studies exist among occupational therapy and physiotherapy students [ 5 , 29 ] but have not been systematically synthesized. However, the evidence is almost non-existent among midwife, nutrition and health and biomedical laboratory science students. This has implications for further research efforts because evidence from within these student populations is paramount for future proofing the quality assurance of clinical evidence-based healthcare practice.

Another implication is the need to compare how to frame the EBP teaching, and the methods used both inter-and mono professionally among these professional bachelor-degree students. Lastly, we support the recommendations of Bala et al. of using validated tools to increase the focus on measuring behavior change in clinical practice and patient outcomes, and to report in accordance with the GREET guidelines for educational intervention studies [ 9 ].

This overview demonstrates a variety of approaches to promote EBP teaching among professional bachelor-degree healthcare students. Teaching EBP is based on collaboration with clinical practice and the use of different approaches to frame the teaching as well as different teaching methods. Furthermore, this overview has elucidated, that interventions often are evaluated according to changes in the student’s skills, knowledge and attitudes towards EBP, but very rarely on self-efficacy, behaviors, benefits to the patients or reaction to the educational experience as suggested by the Sicily group. This might indicate that educators need to move on to measure the effect of EBP on outcomes comprising all categories, which are important to enhance sustainable behavior and transition of knowledge into the context of practices where better healthcare education should have an impact. In our perspective these gaps in the EBP teaching are best met by focusing on more collaboration with clinical practice which is the context where the final endpoint of teaching EBP should be anchored and evaluated.

Availability of data and materials

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

Abbreviations

Evidence-Based Practice

Professional bachelor-degree healthcare programs

Mazurek Melnyk B, Fineout-Overholt E. Making the Case for Evidence-Based Practice and Cultivalting a Spirit of Inquiry. I: Mazurek Melnyk B, Fineout-Overholt E, redaktører. Evidence-Based Practice in Nursing and Healthcare A Guide to Best Practice. 4. ed. Wolters Kluwer; 2019. p. 7–32.

Tilson JK, Kaplan SL, Harris JL, Hutchinson A, Ilic D, Niederman R, et al. Sicily statement on classification and development of evidence-based practice learning assessment tools. BMC Med Educ. 2011;11(78):1–10.

Google Scholar  

Connor L, Dean J, McNett M, Tydings DM, Shrout A, Gorsuch PF, et al. Evidence-based practice improves patient outcomes and healthcare system return on investment: Findings from a scoping review. Worldviews Evid Based Nurs. 2023;20(1):6–15.

Article   PubMed   Google Scholar  

Dawes M, Summerskill W, Glasziou P, Cartabellotta N, Martin J, Hopayian K, et al. Sicily statement on evidence-based practice. BMC Med Educ. 2005;5(1):1–7.

Article   PubMed   PubMed Central   Google Scholar  

Larsen CM, Terkelsen AS, Carlsen AF, Kristensen HK. Methods for teaching evidence-based practice: a scoping review. BMC Med Educ. 2019;19(1):1–33.

Article   CAS   Google Scholar  

World Health Organization. Nurse educator core competencies. 2016 https://apps.who.int/iris/handle/10665/258713 Accessed 21 Mar 2023.

Saunders H, Gallagher-Ford L, Kvist T, Vehviläinen-Julkunen K. Practicing healthcare professionals’ evidence-based practice competencies: an overview of systematic reviews. Worldviews Evid Based Nurs. 2019;16(3):176–85.

Young T, Rohwer A, Volmink J, Clarke M. What Are the Effects of Teaching Evidence-Based Health Care (EBHC)? Overview of Systematic Reviews PLoS ONE. 2014;9(1):1–13.

Bala MM, Poklepović Peričić T, Zajac J, Rohwer A, Klugarova J, Välimäki M, et al. What are the effects of teaching Evidence-Based Health Care (EBHC) at different levels of health professions education? An updated overview of systematic reviews. PLoS ONE. 2021;16(7):1–28.

Article   Google Scholar  

Copenhagen University. Bachelor in medicine. 2024 https://studier.ku.dk/bachelor/medicin/undervisning-og-opbygning/ Accessed 31 Jan 2024.

Ministery of Higher Education and Science. Professional bachelor programmes. 2022 https://ufm.dk/en/education/higher-education/university-colleges/university-college-educations Accessed 31 Jan 2024.

Patelarou AE, Mechili EA, Ruzafa-Martinez M, Dolezel J, Gotlib J, Skela-Savič B, et al. Educational Interventions for Teaching Evidence-Based Practice to Undergraduate Nursing Students: A Scoping Review. Int J Env Res Public Health. 2020;17(17):1–24.

Wakibi S, Ferguson L, Berry L, Leidl D, Belton S. Teaching evidence-based nursing practice: a systematic review and convergent qualitative synthesis. J Prof Nurs. 2021;37(1):135–48.

Fiset VJ, Graham ID, Davies BL. Evidence-Based Practice in Clinical Nursing Education: A Scoping Review. J Nurs Educ. 2017;56(9):534–41.

Pollock M, Fernandes R, Becker L, Pieper D, Hartling L. Chapter V: Overviews of Reviews. I: Higgins J, Thomas J, Chandler J, Cumpston M, Li T, Page M, et al., editors. Cochrane Handbook for Systematic Reviews of Interventions version 62. 2021 https://training.cochrane.org/handbook Accessed 31 Jan 2024.

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, m.fl. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:1-9

Covidence. Covidence - Better systematic review management. https://www.covidence.org/ Accessed 31 Jan 2024.

Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;21(358):1–9.

Joanna Briggs Institute. Critical Appraisal Tools. https://jbi.global/critical-appraisal-tools Accessed 31 Jan 2024.

Horntvedt MT, Nordsteien A, Fermann T, Severinsson E. Strategies for teaching evidence-based practice in nursing education: a thematic literature review. BMC Med Educ. 2018;18(1):1–11.

Ramis M-A, Chang A, Conway A, Lim D, Munday J, Nissen L. Theory-based strategies for teaching evidence-based practice to undergraduate health students: a systematic review. BMC Med Educ. 2019;19(1):1–13.

Rethlefsen ML, Kirtley S, Waffenschmidt S, Ayala AP, Moher D, Page MJ, et al. PRISMA-S: an extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews. Syst Rev. 2021;10(1):1–19.

Song CE, Jang A. Simulation design for improvement of undergraduate nursing students’ experience of evidence-based practice: a scoping-review protocol. PLoS ONE. 2021;16(11):1–6.

Cui C, Li Y, Geng D, Zhang H, Jin C. The effectiveness of evidence-based nursing on development of nursing students’ critical thinking: A meta-analysis. Nurse Educ Today. 2018;65:46–53.

Ghaffari R, Shapoori S, Binazir MB, Heidari F, Behshid M. Effectiveness of teaching evidence-based nursing to undergraduate nursing students in Iran: a systematic review. Res Dev Med Educ. 2018;7(1):8–13.

Wu Y, Brettle A, Zhou C, Ou J, Wang Y, Wang S. Do educational interventions aimed at nurses to support the implementation of evidence-based practice improve patient outcomes? A systematic review. Nurse Educ Today. 2018;70:109–14.

Ramis MA, Chang A, Nissen L. Undergraduate health students’ intention to use evidence-based practice after graduation: a systematic review of predictive modeling studies. Worldviews Evid Based Nurs. 2018;15(2):140–8.

Albarqouni L, Hoffmann T, Straus S, Olsen NR, Young T, Ilic D, et al. Core competencies in evidence-based practice for health professionals: consensus statement based on a systematic review and Delphi survey. JAMA Netw Open. 2018;1(2):1–12.

Hitch D, Nicola-Richmond K. Instructional practices for evidence-based practice with pre-registration allied health students: a review of recent research and developments. Adv Health Sci Educ Theory Pr. 2017;22(4):1031–45.

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Acknowledgements

The authors would like to acknowledge research librarian Rasmus Sand for competent support in the development of literature search strategies.

This work was supported by the University College of South Denmark, which was not involved in the conduct of this study.

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Nursing Education & Department for Applied Health Science, University College South Denmark, Degnevej 17, 6705, Esbjerg Ø, Denmark

Lea D. Nielsen

Department of Oncology, Hospital of Lillebaelt, Beriderbakken 4, 7100, Vejle, Denmark

Mette M. Løwe

Biomedical Laboratory Science & Department for Applied Health Science, University College South Denmark, Degnevej 17, 6705, Esbjerg Ø, Denmark

Francisco Mansilla

Physiotherapy Education & Department for Applied Health Science, University College South Denmark, Degnevej 17, 6705, Esbjerg Ø, Denmark

Rene B. Jørgensen

Occupational Therapy Education & Department for Applied Health Science, University College South Denmark, Degnevej 17, 6705, Esbjerg Ø, Denmark

Asviny Ramachandran

Department for Applied Health Science, University College South Denmark, Degnevej 17, 6705, Esbjerg Ø, Denmark

Bodil B. Noe

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Nielsen, L.D., Løwe, M.M., Mansilla, F. et al. Interventions, methods and outcome measures used in teaching evidence-based practice to healthcare students: an overview of systematic reviews. BMC Med Educ 24 , 306 (2024). https://doi.org/10.1186/s12909-024-05259-8

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• Volume 14, Issue 3
• What impact has the Centre of Research Excellence in Digestive Health made in the field of gastrointestinal health in Australia and internationally? Study protocol for impact evaluation using the FAIT framework
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• http://orcid.org/0000-0002-8647-5933 Natasha Koloski 1 , 2 , 3 ,
• Kerith Duncanson 1 , 4 ,
• http://orcid.org/0000-0003-1374-5565 Shanthi Ann Ramanathan 1 , 4 ,
• Melanie Rao 4 ,
• Gerald Holtmann 3 , 5 ,
• Nicholas J Talley 1 , 4
• 1 School of Medicine and Public Health , University of Newcastle , Callaghan , New South Wales , Australia
• 2 School of Health & Behavioural Sciences , University of Queensland , St Lucia , Queensland , Australia
• 3 Department of Gastroenterology & Hepatology , Princess Alexandra Hospital , Woolloongabba , Queensland , Australia
• 4 Hunter Medical Research Institute , Newcastle , New South Wales , Australia
• 5 School of Medicine , University of Queensland , St Lucia , Queensland , Australia
• Correspondence to Nicholas J Talley; nicholas.talley{at}newcastle.edu.au

Introduction The need for public research funding to be more accountable and demonstrate impact beyond typical academic outputs is increasing. This is particularly challenging and the science behind this form of research is in its infancy when applied to collaborative research funding such as that provided by the Australian National Health and Medical Research Council to the Centre for Research Excellence in Digestive Health (CRE-DH).

Methods and analysis In this paper, we describe the protocol for applying the Framework to Assess the Impact from Translational health research to the CRE-DH. The study design involves a five-stage sequential mixed-method approach. In phase I, we developed an impact programme logic model to map the pathway to impact and establish key domains of benefit such as knowledge advancement, capacity building, clinical implementation, policy and legislation, community and economic impacts. In phase 2, we have identified and selected appropriate, measurable and timely impact indicators for each of these domains and established a data plan to capture the necessary data. Phase 3 will develop a model for cost–consequence analysis and identification of relevant data for microcosting and valuation of consequences. In phase 4, we will determine selected case studies to include in the narrative whereas phase 5 involves collation, data analysis and completion of the reporting of impact.

We expect this impact evaluation to comprehensively describe the contribution of the CRE-DH for intentional activity over the CRE-DH lifespan and beyond to improve outcomes for people suffering with chronic and debilitating digestive disorders.

Ethics and dissemination This impact evaluation study has been registered with the Hunter New England Human Research Ethics Committee as project 2024/PID00336 and ethics application 2024/ETH00290. Results of this study will be disseminated via medical conferences, peer-reviewed publications, policy submissions, direct communication with relevant stakeholders, media and social media channels such as X (formely Twitter).

• Protocols & guidelines
• Irritable Bowel Syndrome
• Inflammatory bowel disease

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https://doi.org/10.1136/bmjopen-2023-076839

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STRENGTHS AND LIMITATIONS OF THIS STUDY

This protocol provides a prospective view of the application of the Framework to Assess the Impact of Translational health research to the Centre for Research Excellence in Digestive Health (CRE-DH with the explicit aim of optimising research impact and providing direction for future digestive health planning and prioritisation.

This protocol describes three validated methods of impact assessment including the Payback Framework that describes impact using quantified metrics in different domains, economic analyses to quantify the return on research investment and narratives to describe the pathway to impact and provide qualitative evidence of impact.

There is always a lag in the health research translation process resulting in delays in reporting the full extent of research impact. This lag will limit the reporting of the longer-term benefits of the CRE-DH, for which evidence will not be available.

Introduction

Chronic gastrointestinal (GI) diseases are a major health burden in Australia and worldwide. 1 2 More than one-third of Australians experience chronic or relapsing unexplained GI symptoms. 3 4 In half of these cases, symptoms are serious enough to require a medical consultation usually at a general practitioner clinic or an emergency department. These cases also currently make up half of all referrals to GI specialists. 5 For the majority of cases, however, no structural or biochemical abnormality is found after comprehensive and costly diagnostic workup resulting in a diagnosis of a disorder of gut-brain interaction (DGBI) most notably irritable bowel syndrome (IBS) or functional dyspepsia. 6 7 Currently, there is no cure and for DGBIs treatment approaches are suboptimal, leading to frequent healthcare consultations by these patients. 8 IBS alone has been estimated to cost more than US$41 billion annually in the USA. 2 For other chronic GI conditions, including gastro-oesophageal reflux disease and inflammatory bowel disease (IBD), the prevalence is increasing, placing pressure on the healthcare system. 9 10 Chronic GI diseases are also associated with significantly impaired quality of life, reduced work productivity, work absenteeism, relationship problems, higher levels of psychological distress and extraintestinal symptoms. 11–16

While there have been impressive advancements into the underlying pathology of chronic GI diseases in recent years, 17 18 there have been delays in the development of novel, pathology-based, subtyping of DGBI to facilitate improved integrated care and rationalised therapeutic strategies in clinical practice. This critical need was recognised by the Australian National Health and Medical Research Council (NHMRC) which funded the Centre for Research Excellence in Digestive Health (CRE-DH) from 2019 to 2024. The CRE’s vision is to advance the understanding, identification and treatment of chronic digestive diseases by implementing a risk-based and pathophysiology-based categorisation of patients and targeted treatments that are suitable for all sectors of the healthcare system (including primary care).

The specific objectives of the CRE scheme are to improve health-related outcomes and enhance translation of research outcomes into policy and/or practice while also building capacity in the health and medical research workforce. 19 This is aligned with the NHMRC definition of the impact of research as ‘the verifiable outcomes that research makes to knowledge, health, the economy and/or society, and not the prospective or anticipated effects of the research’. 20 However, the NHMRC also recognises that ‘the relationship between research and impact is often indirect, non-linear and not well understood and depends on complex interactions and collaboration across the health innovation system. 20 ’ This emphasis on research impact arises from the growing pressure on grant funding bodies to be accountable for taxpayer-funded research and provide evidence of the wider benefits of research above and beyond traditional academic outputs (eg, publications). Examples include evidence of translation to new drugs and devices, changes to policy and practice and ultimately the social and economic impacts on society including the return on research investment, in order to support continued research funding.

In light of the complexities involved in assessing the impact from research, a myriad of Research Impact Assessment Frameworks (RIAFs) have been developed that provide a conceptual framework and methods against which the translation and impact of research can be assessed. 21 22 However, most RIAFs tend to focus on specific research studies rather than research programmes such as CREs and are typically used retrospectively to justify past research investments. In contrast, the Framework to Assess the Impact from Translational health research (FAIT), developed by a team of health economists and health and medical researchers from the Hunter Medical Research Institute, is prospective in design and incorporates monitoring and feedback with the specific aim of increasing translation and impact. 23 Ramanathan et al applied FAIT to the CRE in Stroke Rehabilitation and Brain Recovery and assessed its validity and feasibility. 24 Overall, they found FAIT allowed a wide range of impacts to be reliably reported beyond the standard academic achievements. Thus, to take advantage of FAIT’s comprehensive design and prospective application, and allow for better benchmarking with other CREs, we have selected FAIT to assess the impact of the CRE-DH. This paper describes the protocol of a mixed methods study to:

Demonstrate the research impact and monetise the return on investment in the CRE-DH.

Provide a prospective view of optimising research impact.

Assess the suitability of FAIT.

The anticipated outcomes will be greater transparency and translation of research within CRE-DH, and the data will set the direction for future digestive health planning and prioritisation. In addition, this paper will contribute to this growing area of research impact assessment.

We prospectively applied FAIT to measure the impact of the CRE-DH. FAIT incorporates three validated methods of impact assessment. The Payback Framework describes impact within domains of benefit. Within FAIT, it has been modified to capture impact using quantitative indicators rather than qualitative data. Economic analyses are applied to quantify the return on research investment and narratives are used to describe the pathway to impact and provide qualitative evidence of impact. The assessment of the suitability of FAIT will take the form of a facilitated discussion among authors, at the conclusion of the impact evaluation, to identify the strengths and limitations of FAIT in the context of its application to the CRE and to make suggestions, if appropriate, for its future application

Details of FAIT have been previously published. 23

The setting is the CRE-DH, which is composed of senior, mid-career, early career and student researchers, clinicians, consumers and other key stakeholders in the fields of gastroenterology, immunology, microbiology, epidemiology, dietetics, psychology and biostatistics primarily from four major research centres across Australia. These include the University of Newcastle and Macquarie University in New South Wales, Princess Alexandra Hospital and University of Queensland in Queensland, and Monash University in Victoria, along with substantial international contributions from the University of Leuven in Belgium, McMaster University in Canada, Mayo Clinic in USA and Kings College in the UK. The CRE-DH researchers pool their highly complementary expertise and capabilities for projects within the CRE-DH, which facilitates recruitment of large representative patient cohorts, the availability of cutting-edge methodologies and translation of findings into practice and policy. The CRE-DH was funded ($A2.5 million) from 2019 to 2024.

Participants

These include a mix of experienced, early career and student researchers associated with the CRE-DH and end users of the findings and outputs of the CRE-DH including other DGBI researchers, patients, consumers more broadly, clinicians, health services, policy-makers and industry partners.

Patient and public involvement

Development of the FAIT model involved extensive and broad end user engagement including interviews with the following key stakeholder groups—researchers from across the research spectrum, multiple Australian medical research institutes, health and medical research funders including the NHMRC, Australian Research Council, The Medical Research Futures Fund, NSW Office for Health and Medical Research, Brunel University, UK and Karolinska Institute, Sweden who were leaders in the field at the time and policy-makers. All interviews were conducted by staff from the Health Economics and Impact team at HMRI and covered attitudes to impact measurements, barriers and enablers, what was being done at the time and opinions about what should be done. There was a diversity of views and differences which were reconciled by designing a comprehensive framework (FAIT) that addressed all their needs. There is an absolute bias to selecting and reporting metrics for which there are data and this is addressed by impact planning that ensures as much data as possible is collected from the start. Other ways this bias is mitigated is by expressing the limitations and bias inherent in an impact assessment framework like FAIT.

This was supplemented by broad consumer representation on the CRE-DH advisory board that provided feedback at all stages of CRE-DH impact framework development. The use of the existing Payback domains and input from consumers with a range of conditions and experiences will ensure that the metrics selected reflect a broad range of potential impacts beyond academic impacts.

The study involves a five-stage sequential mixed method design, summarised as follows:

Phase 1: Development of a programme logic model (PLM) to map the pathway to impact and establish domains of benefit and aspirational impacts.

Phase 2: Identifying and selecting appropriate, measurable and timely impact indicators for each of these domains and establishing a data plan to capture the necessary data.

Phase 3: Developing a model for the cost–consequence analysis and identification of relevant data for micro costing and valuation of consequences (where appropriate).

Phase 4: Determining selected case studies to include in the narrative including the data collection for these.

Phase 5: Collation, data analysis and completion of the reporting of impact using the three methods.

Phase 1: development of a logic model to map the pathway to impact and establish domains of benefit

A PLM is a critical component of any FAIT impact assessment. The PLM used in FAIT is a map that follows the pathway from the need for the CRE through its aims, activities, outputs and aspirational impacts. The CRE-DH logic model ( figure 1 ) shows how the needs and aims drive CRE activities. These activities should produce outputs that, when used by an end user, creates an opportunity for the generation of impact. These impacts are articulated as both short-term and medium-long-term impacts under broad domains of benefit such as impacts on knowledge advancement, capacity building, clinical implementation, policy legislation, community and economic impacts. While the PLM appears linear, its application over the lifetime of the CRE-DH will most likely be non-linear and subject to change.

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Logic model for the CRE-DH. CRE-DH, Centre for Research Excellence in Digestive Health; DGBI, disorder of gut brain interaction; GI, gastrointestinal; QOL, quality of life; TGA, Therapeutic Goods Administratio; EMCR, Early/Mid career researchers

Phase 2: identifying and selecting appropriate, measurable and timely impact indicators for each of these domains and establishing a data plan to capture the necessary data

The PLM ( figure 1 ) identifies the Payback domains of benefits under which the CRE’s impact will be assessed. Impact metrics have been developed and customised for the CRE-DH taking into account their appropriateness for the CRE-DH and its aims and their ability to be measured in a timely manner. Table 1 shows the list of Payback metrics under each domain for which evidence is captured.

• View inline

Payback metrics table for the CRE-DH

Routine monitoring of implementation embedded into each project stream

The purpose of this data collection method is to collect quantitative data to monitor and measure the impact of specific studies within the CRE-DH and its capacity building and translational activities. Initial data collection involves annual distribution of a CRE-DH impact data survey via REDCap to chief investigators and associate investigators to be populated for all their CRE-DH affiliated researchers. Results of the survey are being collated into an Excel file that includes individual spreadsheets that are aligned with impact indicators. Additional data are being retrieved from available sources including publicly available online data from researchers’ university profiles, data collected for triannual CRE-DH advisory board meetings, through ethics systems, publication tracking and evaluation of CRE-DH organised capacity building and translational activities. The Excel spreadsheets for each project stream are being emailed annually to each CI to add any data that has not been captured using the above methods.

Reports during the regular team meetings

This data collection method aims to collect quantitative and qualitative data to monitor and measure the translation, implementation and impact of CRE-DH that are not obtained from routine monitoring. The data are collected online by accessing the recorded monthly CRE-DH meeting minutes and added to project stream spreadsheets or flagged for further discussion in semistructured interviews for vignettes or case study examples of CRE-DH impact, described as part of phase 4.

Phase 3: developing a model for the cost–consequence analysis and identification of relevant data for microcosting and valuation of consequences (where appropriate)

To determine whether the cost associated with the delivery and participation in activities associated with the CRE-DH and the consequences achieved represent a good return on investment, a cost–consequence analysis will be undertaken. 25

First, we will detail out the activities funded by the NHMRC investment. Second, we will microcost any activity and other costs not covered by the US$2.5 million NHMRC research investment and add these to the NHMRC investment as implementation costs. This will include costing all in-kind investigator time and capacity building participation time not directly funded by the CRE monies.

Microcosting data will involve a log of all intervention activities including the individual’s involved, their roles and wages and the time taken for implementation. Other resources such as travel and consumables will also be costed. The proportion of cost attributable to CRE-DH activity will be estimated where feasible.

In collaboration with the lead investigators of the CRE-DH, the consequences of the CRE-DH will be established including the consequences that cannot be monetised and appear in their natural units in the Payback metrics table. For those consequences that can be monetised, economic methods will be employed to adequately monetise their value and determine the appropriate level of attribution to the CRE-DH. This will include a search of the literature for established values for these consequences (where they occur), clearly defined assumptions about these values and sensitivity analyses to account for any variance in these values. Given that CRE-DH activity will be occurring concurrently with other research activities supported by the research institutions from which CRE-DH researchers are affiliated, attribution of consequences (eg, leveraged funding) will take this into account. Where practical, researchers will be asked for their own assessment of CRE-DH attribution to a particular consequence or a conservative attribution percentage will be applied to avoid overclaiming the consequences and impacts of CRE-DH. All values will be converted into Australian dollars and valued in the year that the final analysis is conducted.

Phase 4: determining selected case studies to include in the narrative including the data collection for these

During the course of the CRE-DH, the pathways to adoption of the outputs will be documented by the team and team meetings will be used to highlight potential case studies that can be developed to demonstrate outstanding impacts of the CRE-DH or case studies that describe key learnings. Semistructured interviews will be conducted to collect relevant data that will inform these case studies. It is anticipated that these interviews will be with CRE-DH researchers and key end users, where appropriate.

Semistructured interviews involving CRE-DH staff, collaborative investigators, advisory group members and other key stakeholders

Qualitative data will be collected, to provide context and a richer, more comprehensive overall understanding of the impact of the CRE-DH. Topics of interest will be flagged through the quantitative data collection and in meeting discussions, based on the underlying question of ‘How did this publication, conference presentation, collaboration, capacity building activity or project lead to an impactful outcome that would not have been achieved without the CRE-DH?’ Interviews will be facilitated by the HMRI FAIT team, who have expertise in qualitative data collection for impact evaluation. These data will be narratively synthesised and triangulated with quantitative data and incorporated into impact evaluation reporting within the narrative method and include specific quotes from the researchers and end-users.

Impact assessment data will be collected for the 5-year period from November 2019 to October 2024.

Phase 5: collation, data analysis and completion of the reporting of impact using the three FAIT methods

The data collected over the course of the CRE-DH using the various methods described above will be reported using the FAIT scorecard format. 23

Results for the metrics table will be collated and where bibliometric results are required, a cut-off date will be established after which time, the results will not be updated. The cost–consequence will be reported by way of a cost–consequence table that will only include the consequences that can be monetised. Other consequences will be reported in their natural units in the Payback metrics tables. The narratives will be reported as vignettes highlighting some of the outstanding achievements of the CRE-DH including the pathway to translation and impact.

Ethics and dissemination

This impact evaluation study has been registered with Hunter New England Human Research Ethics Committee as project 2024/PID00336 and ethics application 2024/ETH00290. Results of this study will be disseminated via medical conferences, peer-reviewed publications, policy submissions, direct communication with relevant stakeholders, media and social media channels such as X (formerly Twitter).

This protocol aims to define and describe processes to collect, collate and synthesise data for the CRE-DH to evaluate the impact of the CRE-DH from inception in November 2019 to final data collection in mid-2024 for reporting of outcomes in October 2024. We plan to operationalise this protocol as a mixed-methods study by applying a PLM to the original aims and needs identified in our CRE-DH application, to use that modelling to review CRE-DH progress towards our aims, and to inform prospective direction for the CRE-DH based on ongoing progress and at specified annual data collection review time points. Therefore, our impact evaluation will be an organic, prospective, informative and responsive process, as well as providing an overall final and retrospective account of CRE-DH impact by the end of 2024. Impact will be reported and used to inform future funding applications and direction for digestive health research in Australia, and position the CI, AI and affiliate team as leaders in the field internationally. This impact evaluation will also inform future directions for DGBI and other digestive diseases research, which we expect to overlap and integrate more with related fields such as immune and microbiome research in coming years. The prospective design of our impact evaluation will facilitate expansion into new fields throughout the life of the CRE-DH, which will enhance translation potential, impact and transformative research and clinical practice change.

Although, there are other frameworks from various medical fields 26 to assess evaluation of research outcomes, this evaluation applied the FAIT to the CRE-DH with the explicit aim of optimising research impact and providing direction for future digestive health planning and prioritisation.

Despite the benefits of comprehensively assessing the impact of the CRE-DH using three distinct methods namely quantified impact metrics, a cost–consequence analysis and a narrative of the impact there are some potential risks and limitations. These include (1) Lag in translation could impact on the ability to capture and demonstrate longer-term impacts. (2) Data collection for impact reporting while feasible, does require additional commitment by CRE partners to ensure it is comprehensive and complete. Therefore, this could be seen as an added administrative burden and may not be completed as required. However, the desire to continue the collaboration and the fact that CRE affiliates have been engaged with the impact assessment from the start should provide a counterbalance to the burden. The inclusion of the HMRI Research Impact Team as expert advisors will also ensure that multiple strategies previously used in other CRE impact assessments are employed to enhance data collection. (3) Attribution of impacts is challenging and will have to rely on researchers to attribute the contribution of CRE-DH to a particular consequence. (4) Selection of case studies means other potential impact stories may be foregone.

The novelty of this work is that the application of FAIT is still very much in its infancy with only two protocol papers (both using very different framings for the application) 24 27 and only one results paper published. 28 There is still much to learn and reflect on in the application of such a comprehensive framework, and this protocol paper will provide a useful roadmap for other GI research collaborations planning formal impact evaluations. A deepened understanding about what enhances the impact of a CRE will only be possible when we have benchmarked protocols and outcomes. We will then have the ability to undertake meta-analyses to ascertain what works under what circumstances in order to further enhance the impact in a large and complex research collaborative such as a CRE. Contribution to a larger bank of metrics will give visibility to the potential capacity and capability impacts from CREs.

This study will capture outputs and impacts that have been initiated or enhanced as a result of the CRE-DH’s collaborative efforts of basic scientists, allied health and medical clinician researchers, translational scientists, consumers and advisors across the spectrum from animal, preclinical laboratory research to health service delivery from acute to integrated and primary care settings. All costs for CRE-DH activity will be valued and where possible, the economic analysis will monetise reportable CRE-DH outcomes and impacts. If this is not possible, these impacts will be reported in their natural units. We expect this impact evaluation to comprehensively describe the contribution of the CRE-DH to a range of impacts including any improved outcomes for people suffering with chronic and debilitating digestive disorders. The impact evaluation will inform future directions for digestive health research and assessment of its impact.

Ethics statements

Patient consent for publication.

Not applicable.

• Camilleri M ,
• Williams DE
• Talley NJ ,
• Burke C , et al
• Koloski NA ,
• Thompson WG ,
• Heaton KW ,
• Smyth GT , et al
• Chang L , et al
• Stanghellini V ,
• Hasler WL , et al
• Tornkvist NT ,
• Whitehead WE , et al
• Sepanlou SG ,
• Ikuta K , et al
• Li Z , et al
• Knowles SR ,
• Wilding H , et al
• Loundou A ,
• Hamdani N , et al
• Barberio B ,
• Black CJ , et al
• Canavan C ,
• Pimentel M ,
• Lazaridis N ,
• Germanidis G
• ↵ Available : https://www.nhmrc.gov.au/funding/find-funding/centres-research-excellence
• ↵ Available : https://www.nhmrc.gov.au/research-policy/research-translation-and-impact/research-impact
• Ramanathan S ,
• Angell B , et al
• Bauman AE ,
• Searles A ,
• Attia J , et al
• Deeming S , et al
• Brazier J ,
• Ratcliffe J ,
• Saloman J , et al
• Moldovan F ,
• Moldovan L ,
• Bernhardt J , et al

Twitter @Ramanathan

Contributors NK was involved in conceptualisation, methodology, project administration, writing of the original draft, revisions and editing. KD contributed to conceptualisation, writing of the original draft,revisions and editing. SAR was involved in the conceptualisation, methodology and writing of the original draft. MR, GH and NT were involved in the writing of the original draft, revisions and editing. In addition, GH and NT were involved in funding acquisition and resources.

Funding This work was supported by National Health and Medical Research Council of Australia, APP1170893.

Competing interests NK, KD, SAR and MR disclose no conflicts. NT is Emeritus Editor-in-Chief of Medical Journal of Australia, Section Editor of Up to Date and has research collaborations with Intrinsic Medicine (human milk oligosaccharide), Alimentry (gastric mapping) and is a consultant for Agency for Health Care Research and Quality (fiber and laxation), outside the submitted work. In addition, he has licenced Nepean Dyspepsia Index (NDI) to MAPI, and Talley Bowel Disease Questionnaire licensed to Mayo/Talley, 'Diagnostic marker for functional gastrointestinal disorders' Australian Provisional Patent Application 2021901692, 'Methods and compositions for treating age-related neurodegenerative disease associated with dysbiosis' US Patent Application No. 63/537,725. GH received unrestricted educational support from the Falk Foundation. Research support was provided via the Princess Alexandra Hospital, Brisbane by GI Therapies, Takeda Development Center Asia, Eli Lilly Australia, F. Hoffmann-La Roche, MedImmune, Celgene, Celgene International II Sarl, Gilead Sciences, Quintiles, Vital Food Processors, Datapharm Australia Commonwealth Laboratories, Prometheus Laboratories, FALK GmbH & Co KG, Nestle, Mylan and Allergan (prior to acquisition by AbbVie). GH is also a patent holder for a biopsy device to take aseptic biopsies (US 20150320407 A1).

Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

Provenance and peer review Not commissioned; externally peer reviewed.

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Amplifying Indigenous Voices in Decolonial Research: A Case Study of West Papua

• By: Camellia Webb-Gannon
• Product: Sage Research Methods: Diversifying and Decolonizing Research
• Publisher: SAGE Publications Ltd
• Publication year: 2024
• Online pub date: March 21, 2024
• Discipline: Political Science and International Relations
• Methods: Case study research , Ethnography , Participant observation
• DOI: https:// doi. org/10.4135/9781529683387
• Keywords: decolonization , knowledge , movement , Papua New Guinea Show all Show less
• Online ISBN: 9781529683387 Copyright: © 2024 SAGE Publications Ltd More information Less information

This case study is based on an advocacy research project exploring the politics of decolonization within the West Papuan independence movement. To carry out the research, I undertook semistructured interviews with more than 70 West Papuan activists living in West Papua and in diaspora and participated in a sustained activist/advocacy program for a decolonized West Papua. This case study outlines the ways in which I have engaged with West Papuans’ accounts of their decolonization struggle and worked to use my positionality as an Australian researcher to amplify West Papuan voices as they assert their right to self-determination. It highlights challenges I encountered along the way and foregrounds the extraordinary generosity and courage of the West Papuan people who have shared their stories with me.

Learning Outcomes

By the end of this case study, readers should be able to

• identify key ethical considerations involved in carrying out decolonization or decolonial-related research.
• evaluate their own positionality in relation to various decolonization or decolonial research projects.
• propose ways in which they can use research processes and outputs to support decolonization and/or decoloniality.

Project Overview and Context

I stood at the head of a long table, around which were seated 15 of West Papua’s most esteemed leaders. Among those present were the supreme commander of the West Papuan guerrilla army, Richard Yoweni, and senior West Papuan diplomats Otto Ondawame and Rex Rumakiek, who had traveled the world for decades campaigning for self-determination. It was a humid afternoon in Port Vila, Vanuatu, in 2008, and the heads of (most of) West Papua’s preeminent independence-seeking organizations had gathered to determine how they might work together as a unified coalition (the West Papua National Coalition for Liberation). My PhD supervisor, Peter King, a recognized expert on West Papuan politics, had been invited to observe this landmark meeting, but he had asked whether he could send me in his stead. The leaders in the room wanted to know why I was there. My mouth felt dry, and my heart was hammering. What could I say to justify my presence at this summit of powerful political figures? I explained that I had grown up in Papua New Guinea and so was very interested in the Melanesian region, had worked briefly in East Timor and so was well versed in the effects of Indonesian nationalism and colonialism, and because of these experiences, wanted to better understand the West Papuan self-determination movement by making it the subject of my PhD research. What did they think about this, I asked?

West Papua has been under Indonesian military occupation since 1962. The territory’s previous colonizer, the Dutch, had buckled under pressure from the United States to hand over administration of West Papua to the expansionist regime of the highly nationalistic president of Indonesia, Sukarno. This was to avoid Indonesia seeking communist assistance in order to wrest from the Dutch the western half of the island of New Guinea, which Indonesia considered to be part of its own sovereign territory. Indonesia (formerly the Dutch East Indies) also had been a Dutch colony, and Indonesia authorities purported that Indonesian state borders should encompass all Dutch colonial territory in the region. The United Nations was responsible for overseeing a referendum in 1969 in which West Papuans were to cast a vote for independence or permanent Indonesian annexation. The Indonesian military hand-picked 1025 West Papuans to vote, threatening them with violence if they chose independence. The United Nations turned a blind eye to the sham plebiscite, and from that time on, the international community has largely considered West Papua to be part of the Indonesian state. Since that time, West Papuans have been subject to crimes against humanity and what they call a “slow-motion genocide” ( Elmslie & Webb-Gannon 2013 ) at the hand of Indonesian security forces. They have carried out a six-decades-long campaign for decolonization from Indonesia.

When I had finished pleading my case for my presence at the West Papua National Coalition for Liberation summit to its leaders, requesting their permission to observe the meeting, I was met with silence and averted gazes. After a long moment, one elder at the table explained to me that the group had had plenty of experience in previous decades of researchers and journalists wanting to write about their struggle only to disappear shortly thereafter with no discernible benefits from their publications for West Papuans. Indeed, published portrayals of Melanesian people in the past three decades have often primitivized and exoticized them while maligning their political frameworks and struggles (see Kabutaulaka 2015 , pp. 118–119). Do not collect our stories, obtain your PhD, and forget about us, the leaders in front of me cautioned. Anthropologist Eben Kirsksey was similarly warned by a prospective research participant during a fieldwork encounter: “Don’t use your data as a pillow and go to sleep when you get back to America. . . . Don’t just use this as a bridge to your own professional opportunities” ( Kirksey, 2009 , p. 149; on this point, see also Smith, 1999 , pp. 24–25). It was clear to me that I would need to earn my place as an observer at that table and as a researcher and ally of the movement. It was at that moment that I made a commitment to myself and to the group in the room that my research would be academic and activist—part of a greater solidarity effort to work alongside West Papuans for decolonization—if and for as long as those present thought this would be useful.

Tunisian decolonization writer Albert Memmi recognized “what help to fighting [people] the simple, ordered description of their misery and humiliation could be . . . [and] how explosive the objective revelation to the colonized and the colonizer of an essentially explosive condition could be” ( Memmi, 1965 , p. x). As I have expressed elsewhere, it is my hope that my ethnography (written field observations and analysis of interview data), often pared back to take the form of a “simple and ordered description” of West Papuans’ struggle and unflagging agency, can be of assistance to the West Papuan pursuit of decolonization ( Webb-Gannon, 2021 ).

Section Summary

• Your interlocutors and their communities may well ask you to justify your reasons for undertaking decolonization-focused research—be prepared to state these.
• Embarking on decolonization-focused research requires a positionality regarding your research topic that commits you to “taking the side” of the oppressed to work for justice.
• Do not assume that your presence and research will be welcome. Consider it a privilege, if invited to do so, to develop relationships with the people and communities you are researching alongside. This can take time.

Research Design

Decolonial research acknowledges that although a place and its peoples may not have been formally colonized or, in contrast, may have been formally de colonized, it may still be subject to the power matrix of coloniality , that is, the “intersectionality of multiple and heterogeneous global hierarchies . . . [including] sexual, political, epistemic, economic, spiritual, linguistic and racial forms of domination and exploitation” ( Grosfoguel, 2011 , p. 17). Decolonial research involves using research methods that emphasize the sovereignty of colonized and/or colonialized peoples and that recognizes the expertise of research participants as coproducers of knowledge, as central agents in their decolonization struggles, and as the owners of their own stories.

To undertake research about decolonization in a decolonial way (following methods that avoid imposing coloniality and that may be able to effect decolonial change), I decided to employ ethnographic methods that would afford me opportunities to “bear witness” ( Kirsch, 2010 , p. 58; Scheper-Hughes, 1995) to the colonial violence West Papuans had survived and continued to endure. These methods included participant observation (carrying out advocacy for self-determination together with West Papuans) and semistructured interviews to document and then amplify West Papuan stories, ideas, and aspirations. There is a prevalent essentialist colonialist narrative that the West Papuan decolonization movement is hopelessly mired in debilitating internal conflict, a result, at least in part, it has been asserted, of innate Melanesian social-cultural disunity (on this, see Webb-Gannon, 2021 , p. 15; McGibbon, 2004 , pp. 27–28; Sidik, 2018 ). I would present what I had learned to support a contrapuntal perspective to this narrative. This endeavor would require me to take a partial rather than a neutral stance in my ethnographic account of the West Papuan movement for self-determination—to analyze and speak out against the unjust power differential between the Indonesian establishment and the West Papuans resisting colonialism.

To situate my research as decolonial, I undertook to ensure that

• 1. its guiding research question was developed through conversation with West Papuans and was one that West Papuans wanted addressed and believed they would benefit from. This question, broadly, asked how might the West Papuan decolonization movement become more strategically unified to accomplish its decolonization goals.
• 2. the knowledge that my research participants and I coproduced would be publicly available as resources so that any decolonial insights could be leveraged by West Papuans and others with similar goals.
• 3. I would be reflexive about my own positionality as a non-Indigenous researcher to avoid reproducing structures of coloniality by establishing myself as an “expert” and West Papuan research participants as “subjects.”

Taking on political leadership positions in West Papua is dangerous (prominent leaders have experienced imprisonment and/or assassination; Budiardjo, 2010). To escape such dangers, many West Papuan leaders and communities have sought refuge around the world. As a result, my research involved interviews with Papuan leaders and diaspora communities in Papua New Guinea, Indonesia, Vanuatu, Australia, the Netherlands, Sweden, and England. While I attempted to individualize interview questions to some extent based on what I knew of participants’ biographies in advance, the sheer range of experiences of people who participated in my study (living in seven countries and representing at least three generations) required that the interviews be at least partially unstructured to capture the depth and richness of the diversity of participants. More than 70 West Papuan decolonization leaders took part in the research project. The criterion for West Papuan research participants was that they must be community-recognized leaders working toward decolonization from a political, cultural, religious, gender-focused, or other self-identified perspective. To make contact with participants, I used previously established connections with West Papuans and advocacy groups in Australia and worked within their networks using a snowballing approach.

I was fortunate in 2008 to be accepted as a volunteer on a social-cultural visa for 6 weeks in Merauke, West Papua, by two local human rights organizations. Having professional experience in the development sector in HIV prevention, I was able to assist these organizations to provide education in sex-work venues, with community health initiatives in nearby villages, and with the preparation of funding proposals. After this work was completed, I was given an opportunity to attend a week-long nonviolence campaign development workshop in Sentani, West Papua, for young women, hosted by the Jayapura (capital of Papua Province) counterpart of one of the organizations with which I had volunteered in Merauke. During this time, news spread by word of mouth concerning the research project on decolonization in West Papua I was undertaking, and many people made opportunities to share their perspectives with me in locations they deemed safe or at my own lodgings in the evenings. Following the conclusion of the workshop, I took some time to travel to the highlands town of Wamena and then to visit with several West Papuan friends I had made in Jayapura. These experiences in West Papua and with diaspora groups provided me with opportunities for participant observation.

• Ensure that your research objective is established in consultation with your research participants.
• Use your decolonial objective to guide your research design, including your selection of research methods.
• Take opportunities to contribute your own skills and resources to the communities with which you are researching.

Research Practicalities

Ethical considerations were paramount during the entire research process. I continually needed to weigh the ethical benefits of documenting important but frequently overlooked perspectives to fulfill the decolonial objective of the research project while being aware that I was carrying out research in the context of a military regime (this was particularly so in West Papua but also in Papua New Guinea given its proximity to West Papua). I had to be circumspect about how, where, and how much I communicated about my research to protect the people entrusting me with their stories. In contrast to a more traditional ethnographic study, due to the nature of my research objective (to work in solidarity with West Papuans toward decolonization), it was not safe for me to spend extended periods of time in West Papua. I was cognizant at all times of keeping data (i.e., recorded interviews, fieldnotes, and photographs) confidential by coding file names and by carrying digital interview files and fieldnotes on my person rather than leaving them in my lodgings and out of my sight.

I was conscious of the formal underrepresentation of women’s voices as I carried out interviews with West Papuans in various locations. Most of my initial contacts were men who, in turn, generally referred me to other male participants. Within West Papua’s patriarchal societies, as in some other Melanesian societies, women occupy fewer formal leadership positions than men ( White, 2007 , p. 12; Macintyre, 2000, p. 146). This holds true within the West Papuan decolonization movement, too. In mixed-gender group interviews, women tended to be more reluctant to speak. In casual settings, though, because of my female gender, I formed closer relationships with women and developed greater insight into their daily living conditions and decolonization aspirations than I did with men, even though I was not able to formally interview as many women.

Another challenge I faced in my research at times was an unrealistic expectation among research participants or their broader communities of my ability to influence political outcomes for West Papuans or to provide research participants with any tangible, immediate benefits as reciprocity for sharing their experiences with me. I found myself, time and again, being invited (not necessarily as a researcher but as a White Westerner) into communities’ halls and people’s homes and being asked to provide guns (by members of the guerilla army) and other expensive technologies. Having no intention or capacity to provide weapons—I sympathize with the aims of the movement but am an advocate of nonviolence—and as an at that time unsalaried researcher with no access to spare laptops and the like, I discovered at these moments during my research that whatever capital I carried with me as a foreign researcher and could share was underwhelming to some West Papuan independence seekers. This was despite my efforts to dispel false expectations prior to interviews and while I spent time in communities about the potential of the research project to deliver near-term material benefits.

• Considering the ethical implications of your research methods is an ongoing research process rather than a one-off activity at the commencement of the project.
• Structural inequalities can exist within social justice—including decolonization—movements. It may take more effort to draw out voices from groups that are not frequently consulted on their views.
• It is important to be aware of the limited benefits your research may be able to offer research participants and to make those limitations clear.

Method in Action

Commencing as a PhD project, my research with West Papuan people, of whom many have become lifelong friends, has continued over a decade and a half. As long as my West Papuan co-researchers persist in their struggle for justice, my commitment to this project continues. My research project has encountered many obstacles and challenges but also was able to elicit moments of joy, connection, and decolonial progress in the form of raising greater awareness outside of West Papua about the decolonization struggle taking place within (and in the diaspora). Certainly my ability to talk about decolonization safely with research participants in West Papua was an initial and primary challenge. Meetings often took place at night. I was advised to wear long sleeves and a hat to detract attention from my white skin and to switch taxis/modes of transport enroute to appointments. During daylight, I followed further advice and hired a car with tinted windows as well as “safe” drivers (known to trusted West Papuan interlocuters) to take me to meetings. These were not formal interviews per se but rather opportunities for West Papua activists to brief me on their aspirations and activities. It would have been altogether easier not to take part in these interactions given the challenges involved. I chose to participate in such conversations, however, despite the circumstances because they revealed stories of years of human rights abuses, threats, and injustices but also of audacity, tenacity, and hope. By showing up, I hoped to demonstrate my solidarity with West Papuans’ struggles and to gather perspectives that threats and acts of violence had tried but failed to silence.

As Soyini Madison points out, critical ethnography (which I extend here to include decolonial ethnography) “is always a meeting of multiple sides in an encounter with and among the Other(s), in which there is negotiation and dialogue toward substantial and viable meanings that make a difference in the Other’s world” ( Madison, 2005 , p. 9). When carrying out interviews, the questions that I thought mattered did not always matter (or even make sense) to the research participants. During one interview in Port Moresby, Papua New Guinea, I asked a series of questions to a group of West Papuan university students studying at the University of Papua New Guinea, and after each question, I was met with awkward silence. At first I tried being “comfortable” in the silences, and then I assured the students that they could take as long as they wanted to answer (or that they could choose not to answer), but I still felt as if something was off. Finally, the group leader intervened, informing me that my questions (about official university politics regarding West Papua’s independence movement and in relation to identity politics) were not issues the students thought about or cared to discuss. They wanted to tell me about a funeral for a West Papuan student held on campus and about West Papuan culture—how they celebrated it through music and dancing groups and social events. Ultimately, we were discussing the same issues but were approaching them from different framings. Mutual meaning was arrived at through negotiation, dialogue, and generous intervention from a research participant.

Following Linda Tuhiwai Smith’s schema for self-determination-centered research that holds a strong decolonial imperative, I have worked to create research opportunities for participants to “reclaim” lost histories ( Smith, 1999 , p. 143), histories ignored in dominant outsider narratives of the conflict. An example of this is the 2021 conference hosted by the West Papua Project at the University of Wollongong (which I coordinated) examining the history of West Papua at the United Nations. The West Papua Project opened the floor to West Papuan political leaders in West Papua and in the diaspora to reflect on Papuans’ and their allies’ attempts since 1969 to engage the United Nations in their decolonization journey. We heard from those present at the conference, in person and online, who were able to recount their past tragedies and triumphs on the international stage (at the United Nations and beyond), highlighting the unceasing agency of decolonization activists against a historical backdrop of oppression ( West Papua Project, 2021 ).

Smith exhorts that research with a decolonial objective should provide space for research participants to give “testimonies” to recount experiences of “rage and dignity and sorrow” ( Smith, 1999 , pp. 144–145). In an effort to provide this space, through the West Papua Project at the University of Wollongong, I hosted a West Papua Talks seminar series in 2022, an online event in which Gustaf Kawer, the West Papuan lawyer for imprisoned activist Victor Yeimo; Rode Wanimbo, a West Papuan women’s advocate; and Elvira Rumkabu, an academic focusing on women’s rights, conflict resolution, and the #PapuanLivesMatter movement, were invited to offer testimonies from their work ( West Papua Project, 2022 ). These testimonies detailing the failure of the legal system in West Papua, entrenched structural-colonial violence against women, and conflict-fueling racism against West Papuans, allowed listeners online to better calibrate solidarity strategies from Australia with West Papuan needs. One listener, Emeritus Professor Stuart Rees, founder of the Centre for Peace and Conflict Studies at the University of Sydney, penned an advocacy piece for an Australian audience about Victor Yeimo’s political imprisonment ( Rees, 2022 ), others contacted Rode Wanimbo to support her work with women victim-survivors of violence, and I have since partnered with Elvira Rumkabu on a different research project of mutual interest.

Smith also advocates for decolonial research that “celebrates survival” ( Smith, 1999 , p. 146). I have collaborated in this vein with West Papuan diplomat and musician Ronny Kareni and ethnomusicologist Michael Webb to curate an exhibition of songs and sounds from West Papua that celebrate Papuan identity, history, culture, struggle, and survival. This exhibition was commissioned by the Chau Chak Wing Museum at the University of Sydney in 2022 as the launch event for their Pacific Views exhibition. It was offered by Kareni and the many collaborating artists featured in the event to “celebrate [West Papuan] peoples’ recognition of song and spoken word as one of the most powerful tools humans have to keep communities strong and carry ideas forward through adversity and the good times” ( Chau Chak Wing, 2022 ). The exhibition took the form of an online performance (Kareni, Webb, and I introduced each artist and song, providing context for the significance of each piece) that attracted viewers from around the world. A West Papuan activist living in the Netherlands emailed me to express appreciation for the exhibition, which showcased the vitality, strength, and beauty of her culture. Such research outputs demonstrate the ongoing resilience of West Papuan people through their decolonization initiatives and provide inspiration to people within the movements themselves and outside observers.

• As a researcher, you cannot assume that the questions you want to ask are the questions your research participants want to or are in a position to answer. In decolonial research, let your participants decide what they want to talk about and how.
• To develop the decolonial possibilities planned for in your research project, it can be helpful to follow the guidance of prominent decolonization thinkers, including Linda Tuhiwai Smith.
• Listening to stories from research participants who have been silenced, despite the challenges and barriers to doing so, can constitute a critical component of a decolonial research methodology.

Practical Lessons Learned

There are several key practical lessons I can highlight from this methodologic case study. First, decolonial research requires a significant time and emotional investment from both the researcher and the other research participants. You may notice that some of the method-in-action research activities I write about in the preceding section have taken place relatively recently, although I originally commenced research related to this case study in 2008. The lengthy span of this research case study is a result of two factors. First, when undertaking research with people who have had their cultural knowledge and practices denied, denigrated, and/or appropriated for decades due to colonialism, community trust takes time to earn. A researcher’s actions are observed—do they listen to and respect the community and cultural differences? Do they show up for the community, contributing skills and sharing privileges? Do they stand with the community at events or at protests or in the media? Developing trust requires emotional investment. Emmanuel Levinas argues that our existence is defined through relationship with and responsibility to others (Levins, 1985, p. 98). This leads into the second factor for the lengthy span of this project. As a researcher who takes research relationships seriously, my life has become entwined, over time, with the lives of the people with whom I have been conducting research. Decolonial research is not a one-time event but a long-term commitment. As a result, many of the research outputs of this project are emerging more than a decade after the project started. One of the more difficult parts of a project involving emotional investment in others’ lives and relationships built over time, particularly when working with people who have experienced sustained trauma and who live in oppressive conditions, is bearing witness to their premature deaths. Distressingly for their communities and for me as a researcher, 14 of the people I interviewed or worked alongside have died “before their time” since I embarked on this research journey. Decolonization in West Papua is imperative for Papuans to be able to live long, healthy lives.

A further challenge in remaining engaged with a single decolonial research case study over the longue duration is staying abreast of continually changing politics affecting research participants and the research topic. In my experience, this has required keeping up to date with West Papua–related media stories and participating in activist and advocacy campaigns; staying active on social media with West Papuan research interlocuters, friends, and colleagues; and communicating via Zoom (especially during the COVID-19 years when travel was not possible). Remaining engaged with the West Papuan decolonization struggle in these somewhat tangential ways has meant that I have been able to take up opportunities for further research with West Papuan partners on issues intersectional to decolonization as they have presented themselves over the years. These have included investigations into climate change and resource exploitation (see Pacific Waves, 2016 ), the different roles women take on in the decolonization movement (this is an ongoing project), the strategic benefits of pressing for change based on indigenous rights versus nation-state rights ( Webb-Gannon, 2022a ), and the correlations between the #BlackLivesMatter movement and the #PapuanLivesMatter movement ( Webb-Gannon, 2022b ).

Another important practical lesson in decolonial research is that academic publication of research data may be a goal, but it is not the ultimate goal. Pierre Bourdieu avers, “Those who have the good fortune to be able to devote their lives to the study of the social world cannot stand aside, neutral and indifferent, from the struggles in which the future of that world is at stake” ( Bourdieu, 2003 , p. 11). Regarding questions such as “knowledge for what” and “knowledge in whose interest” ( Singer, 1990 , p. 549), knowledge in the decolonial context must be used to support advocacy for the interests of the communities coproducing the knowledge for the project to be ethical. In the context of this case study, using knowledge to support action has involved presenting research findings to the Australian Parliament; discussing research findings in international, national, and local media; speaking about my research to secondary school students; teaching my research to university students; and responding to public invitations to speak about my research to populations in bars and churches and at various other diverse gatherings. As often as I could, I shared this knowledge at these forums in partnership with the West Papuan people. The knowledge is theirs. My job has been to gather their stories, apply my theoretical “value added” (Phil Carspecken asserts that “all research is always only an interpretation strongly colored by the value orientation and social position of the researcher” [2001, p. 38]), and broadcast these to as broad an audience as possible.

• Building research relationships requires time and emotional investment in decolonial research.
• The politics of and within decolonial research projects shift over time. It is incumbent on the researcher to remain abreast of these to continue to coproduce relevant research together with research communities.
• The ultimate goal of decolonial research is to leverage research knowledge in the form of advocacy.

Decolonial research methodologies can be applied to research that attends to former or ongoing decolonization struggles or to research contexts, peoples, and/or problems that are subject to the technologies of coloniality. This case study has outlined key considerations in designing a decolonial research project, some fundamental practicalities involved in such projects, what decolonial methods can look like in action, and core lessons learned from my own participation in a sustained decolonial research project in the still-colonized territory of West Papua. At the outset, when thinking about a decolonial research agenda, as an outsider researcher, it is important to be clear about your motivations for undertaking decolonial research and to be prepared to discuss these with the potential communities with whom you would like to collaborate. When commencing your research, ensure that your research objective and methods have been designed in consultation with your research participants or your research may be an imposition on rather than a benefit to them. In decolonial research, consider the ethical implications of your research, including the methods you are employing on an ongoing basis. People change, communities change, and politics change, so what might constitute an ethical pathway at one point in the research journey also may change. It is important to “dig deep” to uncover hidden perspectives from people whose voices are not often heard, even within social justice movements. In the context of this case study, for example, I found that it was necessary to work harder to elicit views from women about decolonization than from men. It is also imperative to be realistic about and upfront with research participants regarding the limitations of any benefits your research may be able to deliver in the short and long term. Decolonial research requires an emotional, intellectual, and time commitment to building relationships, standing up for and with communities when appropriate, and ultimately translating knowledge coproduced with communities into advocacy. It is about processes (methods) and outputs (advocacy actions) that prioritize the sovereignty and agency of groups experiencing colonization or oppression stemming from coloniality.

Discussion Questions

• 1. In what research contexts is it appropriate to apply a decolonial research methodology?
• 2. What roles and responsibilities can and should an “outsider” researcher (in other words, a researcher not belonging to the community in which they are undertaking research) take on in a decolonial research project?
• 3. At what point, if any, should a decolonial research project conclude?
• 4. With whom and how should research goals and methods be negotiated?
• 5. In what ways might decolonial research relationships be fostered between researchers and research participants?

Multiple Choice Quiz Questions

1. The concept of coloniality refers to

Correct Answer

Feedback: Well done, correct answer

Incorrect Answer

Feedback: This is not the correct answer. The correct answer is A.

2. Which of the following sets of methods provides opportunities for spending time with research participants to understand how and why they pursue specific decolonial objectives?

Feedback: This is not the correct answer. The correct answer is B.

3. Why were the leaders of the West Papua National Coalition for Liberation initially wary of the researcher?

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