tion, qualitative research, naturalistic inquiry, grounded theory, or exploratory The prevalence of qualitative case study research and the lin- gering uncertainty about first edition of this book, I have concluded that the single most defining .. investigator lhas over “a contemporary set of events," and/or if the variables are.
Table of contents
- Introduction
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- Qualitative Research: Case Study Guidelines
- Case Study Research: design and methods.
Preventive measures for researchers who carry out sensitive qualitative studies should include official arrangements for a peer support program consisting of a list of researchers who are involved, or a constellation of researcher support activities aiming at improving psychological fitness in the form of a professional confidence building module.
Other such measures include offering adequate supervision to provide opportunities for self-development and self-care, and facilitating the process of self-reflection and self-monitoring. Strategies for emotional distancing need to be considered and adopted if the research topic or participants have the potential to be emotionally challenging. An appropriate planning should be in place before the commencement of the fieldwork, and it must be perfectly clear how the study should be conducted and what level of relationship development is necessary. Measures must also be taken so that levels of self-disclosure, objective displays of emotion during the interviews, and strategies to end the relationships are well defined and communicated.
One of the most prominent tasks of qualitative researchers is to minimize the flaws in observation and endeavor to gain truthful knowledge. Therefore, it is necessary for researchers to continuously update their investigation skills in terms of methodology and find novel techniques to better carry out studies in the field of health and sociology. As explained before, qualitative research is carried out in natural settings, which requires researchers to work in close collaboration with other members of the team and under direct supervision to discuss and resolve issues as they arise.
Therefore, development of practical strategies and communicating them to researchers can be of great benefit and assist them in conducting more perceptive qualitative studies. As a result of the extensive body of research in the field of medical sciences, patients comprise a large proportion of the public who are frequently subjects of studies. In the history of social and medical science, there have been a few research studies that seriously injured people, and many more in which their welfare was not sufficiently protected.
Nations and research associations have taken steps to prevent hurtful and intrusive research. To return to the matter of privacy, the researcher should not rely solely on the informant to identify possible intrusion, but needs to work at anticipating it in advance. Investigators should refrain from soliciting private information that is not closely related to the research question. Considering the aforementioned challenges, it is recommended to conduct further research in order to provide meticulous and explicit ethical protocols, guidelines and codes with respect to qualitative studies.
The authors would like to offer special thanks to Dr.
- Case Study Research: design and methods.!
- As Is Where Is;
- Merriam-Websters English-Italian Translation Dictionary.
Ali Tootee for his assistance in the language editing of this article. National Center for Biotechnology Information , U. J Med Ethics Hist Med. Find articles by Mohammad Ali Cheraghi. Mohammad Ali Cheraghi, Address: Received Jan 1; Accepted Jul 7. This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.
This article has been cited by other articles in PMC. Abstract Considering the nature of qualitative studies, the interaction between researchers and participants can be ethically challenging for the former, as they are personally involved in different stages of the study. Introduction In the recent millennium, the constant trend of change in the demands of the community as well as transforming the trend of knowledge production has highlighted the necessity for researchers to adopt a more comprehensive approach.
An overview on qualitative research in health care Up to the s, qualitative research was solely employed by anthropologists and sociologists. Role of researchers in qualitative studies In the case of nurses who perform qualitative research, ethical issues are raised when the nurse-patient relationship in the research area leads to some degree of therapeutic communication for the participants 9. They bring individual experiences into words in data collection, and then attempt to understand those experiences based on the statements, and to categorize the themes in the next stage.
In the last stage, investigators record the essence in writing, which results in a comprehensive description of the phenomena 6 , Grounded theory Considering the significance of personal relations in grounded theory, researchers act as a component of daily events and must therefore be completely aware of their values. Since there is no control in this natural field, investigators are not detached from the research process, and ought to be conscious of their prejudices and potential influence on the study.
Researchers need to be able to perform data admission and coding concurrently, and should consequently be equipped with proper analysis skills in order to criticize and conduct abstract thinking 16 , Ethnography In ethnographic studies, researchers function as instruments that understand and analyze the culture. Therefore, ethnographic investigators need to be immersed in the culture and to live among the study population.
However, ethnographers have to be notified of their role as research instruments while collecting and analyzing data Open in a separate window. Ethical challenges in qualitative studies: The researcher-participant relationship The relationship and intimacy that is established between the researchers and participants in qualitative studies can raise a range of different ethical concerns, and qualitative researchers face dilemmas such as respect for privacy, establishment of honest and open interactions, and avoiding misrepresentations Research design The qualitative method is utilized to explain, clarify and elaborate the meanings of different aspects of the human life experience.
Data gathering and data analysis In qualitative research, data are collected with a focus on multifaceted interviews and narratives to produce a description of the experiences. Conclusion In qualitative studies, researchers have a great responsibility and play many different roles. Acknowledgments The authors would like to offer special thanks to Dr. Why do qualitative research? The Sage Handbook of Qualitative Research.
Studying How Things Work. Pope C, Mays N. Qualitative Research in Health Care. Holloway I, Wheeler S. Qualitative Research in Nursing and Healthcare. Qualitative Research in Nursing: Advancing the Humanistic Imperative. Wolters Kluwer health; Qualitative Research in Health: Grove SK, Burns N. The Practice of Nursing Research. Eide P, Kahn D. Ethical issues in the qualitative researcher—participant relationship. A Guide for Fieldworkers. The role of the researcher in the qualitative research process: Forum Qual Soc Res. A Guide to Methods. Contributions of qualitative research to the validity of intervention research.
Ethical and methodologic benefits of using a reflexive journal in hermeneutic-phenomenologic research. Image J Nurs Sch. Corbin J, Strauss A. Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Chiovitti RF, Piran N. Rigour and grounded theory research. Ethical challenges in participant observation: Ethical issues in qualitative research. Van den Hoonaard WC, editor.
Ethical Issues for Qualitative Researchers. University of Toronto Press; Politics and ethics in qualitative research. Handbook of Qualitative Research. Fieldwork, participation and practice: Ethics of qualitative research: Guillemin M, Gillam L. Int J Qual Methods. Conflicting notions of research ethics: Ethics in qualitative research. Bloor M, Wood F. Keywords in Qualitative Methods: A Vocabulary of Research Concepts. Ethics in Human Subjects Research. University North California Press; Interviewing in educational research. Handbook of Complementary Methods in Education Research.
Todres L, Holloway I.
Introduction
Conducting an in-depth interview. Tolich M, Fitzgerald MH. The objective was to locate published qualitative case studies suitable for assessment using the adapted criterion. Viewpoints, commentaries, and other article types were excluded from review. Title and abstracts of the 45 retrieved articles were read by the first author, who identified 34 empirical case studies for review.
All authors reviewed the 34 studies to confirm selection and categorization. In Table III , we present the 34 case studies grouped by journal, and categorized by research topic, including health sciences, social sciences and anthropology, and methods research. Consensus was to allocate to the methods category. In Table III , the number of studies located, and final numbers selected for review have been reported. In the health category, there were 12 case studies of health conditions, health services, and health policy issues, all published in Qualitative Health Research.
Seven case studies were categorized as social sciences and anthropology research, which combined case study with biography and ethnography methodologies. All three journals published case studies on methods research to illustrate a data collection or analysis technique, methodological procedure, or related issue. The methodological descriptions of 34 case studies were critically reviewed using the adapted criteria. All articles reviewed contained a description of study methods; however, the length, amount of detail, and position of the description in the article varied. Few studies provided an accurate description and rationale for using a qualitative case study approach.
In the 34 case studies reviewed, three described a theoretical framework informed by Stake , two by Yin , and three provided a mixed framework informed by various authors, which might have included both Yin and Stake. Few studies described their case study design, or included a rationale that explained why they excluded or added further procedures, and whether this was to enhance the study design, or to better suit the research question. In 26 of the studies no reference was provided to principal case study authors.
From reviewing the description of methods, few authors provided a description or justification of case study methodology that demonstrated how their study was informed by the methodological literature that exists on this approach. The methodological descriptions of each study were reviewed using the adapted criteria, and the following issues were identified: An outline of how the issues were developed from the critical review is provided, followed by a discussion of how these relate to the current methodological literature.
A third of the case studies reviewed appeared to use a case report method, not case study methodology as described by principal authors Creswell, b ; Merriam, ; Stake, ; Yin, Case studies were identified as a case report because of missing methodological detail and by review of the study aims and purpose. These reports presented data for small samples of no more than three people, places or phenomenon. Case reports were not a case of something, instead were a case demonstration or an example presented in a report.
These reports presented outcomes, and reported on how the case could be generalized. Descriptions focussed on the phenomena, rather than the case itself, and did not appear to study the case in its entirety. This does not suggest that case study methodology cannot be multimethod, however, methodology should be consistent in design, be clearly described Meyer, ; Stake, , and maintain focus on the case Creswell, b.
To demonstrate how case reports were identified, three examples are provided. The findings were a historical case report, which resulted from an ethnographic study of vegetarianism. This case study reported how digital storytelling can be used with indigenous communities as a participatory method to illuminate the benefits of this method for other studies. Case selection is a precursor to case analysis, which needs to be presented as a convincing argument Merriam, Descriptions of the case were often not adequate to ascertain why the case was selected, or whether it was a particular exemplar or outlier Thomas, There were exceptions in the methods category Table III , where cases were selected by researchers to report on a new or innovative method.
Possible limitations of a convenience sample were not acknowledged. Purposeful sampling was used to recruit participants within the case of one study, but not of the case itself Gallagher et al. To demonstrate how researchers provided a good justification for the selection of case study approaches, four examples are provided. The final example, Coltart and Henwood , provided a detailed account of how they selected two cases from a sample of 46 fathers based on personal characteristics and beliefs.
They described how the analysis of the two cases would contribute to their larger study on first time fathers and parenting. Adequate contextual description is required to understand the setting or context in which the case is revealed. In these case studies, contextual boundaries, such as physical and institutional descriptions, were not sufficient to understand the case as a holistic system, for example, the general practitioner GP clinic in Gallagher et al. Missing contextual boundaries suggests that the case might not be adequately defined.
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Additional information, such as the physical, institutional, political, and community context, would improve understanding of the case Stake, In Boxes 1 and 2 , we present brief synopses of two studies that were reviewed, which demonstrated a well bounded case. In Box 1 , Ledderer used a qualitative case study design informed by Stake's tradition. By providing a brief outline of the case studies in Boxes 1 and 2 , we demonstrate how effective case boundaries can be constructed and reported, which may be of particular interest to prospective case study researchers.
Ledderer used a qualitative case study research design, informed by modern ethnography. The study is bounded to 10 general practice clinics in Denmark, who had received federal funding to implement preventative care services based on a Motivational Interviewing intervention.
The study context was adequately described, providing detail on the general practitioner GP clinics and relevant political and economic influences. Methodological decisions are described in first person narrative, providing insight on researcher perspectives and interaction with the case. Forty-four interviews were conducted, which focussed on how GPs conducted consultations, and the form, nature and content, rather than asking their opinion or experience Ledderer, , p.
The duration and intensity of researcher immersion in the case enhanced depth of description and trustworthiness of study findings. Analysis was consistent with Stake's tradition, and the researcher provided examples of inquiry techniques used to challenge assumptions about emerging themes. Several other seminal qualitative works were cited.
The themes and typology constructed are rich in narrative data and storytelling by clinic staff, demonstrating individual clinic experiences as well as shared meanings and understandings about changing from a biomedical to psychological approach to preventative health intervention. Conclusions make note of social and cultural meanings and lessons learned, which might not have been uncovered using a different methodology.
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The context of the case is bounded by the three summer camps of which the researchers had prior professional involvement. A case study protocol was developed that used multiple methods to gather information at three data collection points coinciding with three youth camps Teen Forum, Discover Camp, and Camp Strong. Gillard and colleagues followed Yin's principles, using a consistent data protocol that enhanced cross-case analysis. Data described the young people, the camp physical environment, camp schedule, objectives and outcomes, and the staff of three youth camps.
The findings provided a detailed description of the context, with less detail of individual participants, including insight into researcher's interpretations and methodological decisions throughout the data collection and analysis process. There is evidence of researcher immersion in the case, and Gillard reports spending significant time in the field in a naturalistic and integrated youth mentor role. This case study is not intended to have a significant impact on broader health policy, although does have implications for health professionals working with adolescents.
Study conclusions will inform future camps for young people with chronic disease, and practitioners are able to compare similarities between this case and their own practice for knowledge translation. No limitations of this article were reported. Limitations related to publication of this case study were that it was 20 pages long and used three tables to provide sufficient description of the camp and program components, and relationships with the research issue.
Researcher and case interactions and transactions are a defining feature of case study methodology Stake, Narrative stories, vignettes, and thick description are used to provoke vicarious experience and a sense of being there with the researcher in their interaction with the case. The role and position of the researcher needed to be self-examined and understood by readers, to understand how this influenced interactions with participants, and to determine what triangulation is needed Merriam, ; Stake, Triangulation of sources was used to reveal as much depth as possible in the study by Nagar-Ron and Motzafi-Haller , while also enhancing confirmation validity.
Methodological justification was insufficient in several of the studies reviewed Barone, ; Bronken et al. This was judged by the absence, or inadequate or inconsistent reference to case study methodology in-text. In six studies, the methodological justification provided did not relate to case study. There were common issues identified.
This occurred when researchers cited Stake or Yin, or both Mawn et al. In 26 studies there were no citations for a case study methodological approach. The findings of this study have highlighted a number of issues for researchers. A considerable number of case studies reviewed were missing key elements that define qualitative case study methodology and the tradition cited.
A significant number of studies did not provide a clear methodological description or justification relevant to case study. Case studies in health and social sciences did not provide sufficient information for the reader to understand case selection, and why this case was chosen above others. The context of the cases were not described in adequate detail to understand all relevant elements of the case context, which indicated that cases may have not been contextually bounded. There were inconsistencies between reported methodology, study design, and paradigmatic approach in case studies reviewed, which made it difficult to understand the study methodology and theoretical foundations.
Poorly described methodological descriptions may lead the reader to misinterpret or discredit study findings, which limits the impact of the study, and, as a collective, hinders advancements in the broader qualitative research field. The issues highlighted in our review build on current debates in the case study literature, and queries about the value of this methodology.
Case study research can be situated within different paradigms or designed with an array of methods. In order to maintain the creativity and flexibility that is valued in this methodology, clearer descriptions of paradigm and theoretical position and methods should be provided so that study findings are not undervalued or discredited. Case study research is an interdisciplinary practice, which means that clear methodological descriptions might be more important for this approach than other methodologies that are predominantly driven by fewer disciplines Creswell, b.
Authors frequently omit elements of methodologies and include others to strengthen study design, and we do not propose a rigid or purist ideology in this paper. On the contrary, we encourage new ideas about using case study, together with adequate reporting, which will advance the value and practice of case study. The implications of unclear methodological descriptions in the studies reviewed were that study design appeared to be inconsistent with reported methodology, and key elements required for making judgements of rigour were missing. It was not clear whether the deviations from methodological tradition were made by researchers to strengthen the study design, or because of misinterpretations.
Morse recommended that innovations and deviations from practice are best made by experienced researchers, and that a novice might be unaware of the issues involved with making these changes. To perpetuate the tradition of case study research, applications in the published literature should have consistencies with traditional methodological constructions, and deviations should be described with a rationale that is inherent in study conduct and findings. Providing methodological descriptions that demonstrate a strong theoretical foundation and coherent study design will add credibility to the study, while ensuring the intrinsic meaning of case study is maintained.
The value of this review is that it contributes to discussion of whether case study is a methodology or method. We propose possible reasons why researchers might make this misinterpretation. If the rich meaning that naming a qualitative methodology brings to the study is not recognized, a case study might appear to be inconsistent with the traditional approaches described by principal authors Creswell, a ; Merriam, ; Stake, ; Yin, If case studies are not methodologically and theoretically situated, then they might appear to be a case report.
Case reports are promoted by university and medical journals as a method of reporting on medical or scientific cases; guidelines for case reports are publicly available on websites http: The various case report guidelines provide a general criteria for case reports, which describes that this form of report does not meet the criteria of research, is used for retrospective analysis of up to three clinical cases, and is primarily illustrative and for educational purposes. Case reports can be published in academic journals, but do not require approval from a human research ethics committee.
Traditionally, case reports describe a single case, to explain how and what occurred in a selected setting, for example, to illustrate a new phenomenon that has emerged from a larger study. A case report is not necessarily particular or the study of a case in its entirety, and the larger study would usually be guided by a different research methodology.
This description of a case report is similar to what was provided in some studies reviewed. This form of report lacks methodological grounding and qualities of research rigour. The case report has publication value in demonstrating an example and for dissemination of knowledge Flanagan, However, case reports have different meaning and purpose to case study, which needs to be distinguished.
Findings of our review suggest that the medical understanding of a case report has been confused with qualitative case study approaches.
In this review, a number of case studies did not have methodological descriptions that included key characteristics of case study listed in the adapted criteria, and several issues have been discussed. Adequate page space for case study description would contribute to better publications Gillard et al.
Capitalizing on the ability to publish complementary resources should be considered. There is a level of subjectivity involved in this type of review and this should be considered when interpreting study findings. Qualitative methods journals were selected because the aims and scope of these journals are to publish studies that contribute to methodological discussion and development of qualitative research.
Generalist health and social science journals were excluded that might have contained good quality case studies. Journals in business or education were also excluded, although a review of case studies in international business journals has been published elsewhere Piekkari et al. The criteria used to assess the quality of the case studies were a set of qualitative indicators. A numerical or ranking system might have resulted in different results. Stake's criteria have been referenced elsewhere, and was deemed the best available Creswell, b ; Crowe et al.
Case study research is an increasingly popular approach among qualitative researchers, which provides methodological flexibility through the incorporation of different paradigmatic positions, study designs, and methods. However, whereas flexibility can be an advantage, a myriad of different interpretations has resulted in critics questioning the use of case study as a methodology.
Using an adaptation of established criteria, we aimed to identify and assess the methodological descriptions of case studies in high impact, qualitative methods journals. Few articles were identified that applied qualitative case study approaches as described by experts in case study design. There were inconsistencies in methodology and study design, which indicated that researchers were confused whether case study was a methodology or a method. Commonly, there appeared to be confusion between case studies and case reports.
Without clear understanding and application of the principles and key elements of case study methodology, there is a risk that the flexibility of the approach will result in haphazard reporting, and will limit its global application as a valuable, theoretically supported methodology that can be rigorously applied across disciplines and fields. The authors have not received any funding or benefits from industry or elsewhere to conduct this study.
National Center for Biotechnology Information , U. Published online May 7. Box , Bendigo, Victoria , Australia. Accepted Apr 7. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC.
Qualitative Research: Case Study Guidelines
Abstract Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. Case studies, health research, research design, interdisciplinary research, qualitative research, literature review. Definitions of qualitative case study research Case study research is an investigation and analysis of a single or collective case, intended to capture the complexity of the object of study Stake, Current methodological issues in qualitative case study research The future of qualitative research will be influenced and constructed by the way research is conducted, and by what is reviewed and published in academic journals Morse, Methods Assessment of rigour The purpose of this study was to analyse the methodological descriptions of case studies published in qualitative methods journals.
Table I Framework for assessing quality in qualitative case study research. Checklist for assessing the quality of a case study report Relevant for all qualitative research 1. Is this report easy to read? Does it fit together, each sentence contributing to the whole? Does this report have a conceptual structure i. Are its issues developed in a series and scholarly way?
Have quotations been used effectively? Has the writer made sound assertions, neither over- or under-interpreting? Are headings, figures, artefacts, appendices, indexes effectively used? Was it edited well, then again with a last minute polish? Were sufficient raw data presented? Is the nature of the intended audience apparent? Does it appear that individuals were put at risk? High relevance to qualitative case study research Is the case adequately defined? Is there a sense of story to the presentation? Is the reader provided some vicarious experience?
Has adequate attention been paid to various contexts? Were data sources well-chosen and in sufficient number? Do observations and interpretations appear to have been triangulated?
Case Study Research: design and methods.
Is the role and point of view of the researcher nicely apparent? Is empathy shown for all sides? Are personal intentions examined? Added from Merriam Is the case study particular? Is the case study descriptive? Is the case study heuristic? Added from Creswell b Was study design appropriate to methodology? Open in a separate window. Study design The critical review method described by Grant and Booth was used, which is appropriate for the assessment of research quality, and is used for literature analysis to inform research and practice.
Journal title impact factor 5-year impact factor Qualitative Health Research 2. Table III Outcomes of search of qualitative methods journals. Journal title Date of search Number of studies located Number of full text studies extracted Health sciences Social sciences and anthropology Methods Qualitative Health Research 4 Mar 18 16 Barone ; Bronken et al. Findings The methodological descriptions of 34 case studies were critically reviewed using the adapted criteria.
Case study methodology or method A third of the case studies reviewed appeared to use a case report method, not case study methodology as described by principal authors Creswell, b ; Merriam, ; Stake, ; Yin, Case study of something particular and case selection Case selection is a precursor to case analysis, which needs to be presented as a convincing argument Merriam, Box 1 Article synopsis of case study research using Stake's tradition. Box 2 Article synopsis of case study research using Yin's tradition. Researcher and case interactions and triangulation Researcher and case interactions and transactions are a defining feature of case study methodology Stake, Discussion The findings of this study have highlighted a number of issues for researchers.
Limitations of the review There is a level of subjectivity involved in this type of review and this should be considered when interpreting study findings. Conclusion Case study research is an increasingly popular approach among qualitative researchers, which provides methodological flexibility through the incorporation of different paradigmatic positions, study designs, and methods.
Conflict of interest and funding The authors have not received any funding or benefits from industry or elsewhere to conduct this study. References Adamson S, Holloway M. Negotiating sensitivities and grappling with intangibles: Experiences from a study of spirituality and funerals.