2c. Case-Based Learning
Myra Blackmon, Yi-Chun Hong, and Ikseon Choi
Department of Educational Psychology and Instructional Technology, University of Georgia
|This video provides an overview of the application of the Case-Based Learning method as an instructional model. The video reviews the steps in the Case-Based Learning process, and highlights the functions of the teacher who serves as a facilitator. This video was created by Denise Wilson, Carrie Margaret Moore, and Pasha Souvorin (2010).|
Dr. David’s Accounting Class
Dr. David is a retired accounting professor who has been hired by a large nonprofit organization to teach basic organizational accounting as part of a week-long training conference for its local units’ new CEOs. Most of the branches are located in small communities and have only two or three staff members to handle all administrative and program delivery functions. For many in the group, this is their first experience as a CEO.
At the first meeting, Dr. David runs through some fundamental principles and tells the students how important it is for them to be able to understand basic accounting; he explains that many critical decisions are based on information found in income statements and balance sheets. Then he uses a PowerPoint lecture with definitions and explanations of various income, expense, asset and liability categories. At the end of the session, when he asks if there are questions, the students all look confused. One finally says, “I don’t know enough to know what I need to ask. I need to understand all this in the context of my little organization. This doesn’t mean anything to me.”
During the afternoon and evening, Dr. David reflects on the class and is puzzled that the students had such a hard time understanding such simple concepts. He thinks about the student’s comment, “This doesn’t mean anything to me.” Then he realizes that the students will understand better if the information is presented in the context of their own organizations. He consults with the training director and they determine a different course of action. Dr. David works late into the night, searching the Internet for materials and revising his plans for the following day.
At the second meeting, Dr. David gives the students a news story about a small nonprofit which has recently discovered that its bookkeeper was embezzling funds. The discovery was made when the CEO noticed that items in the income statement and balance sheet had discrepancies. Dr. David then walks the students through the case, pointing out the examples of income, expense, asset and liability categories and offers an explanation of how those items relate to one another and their meaning in financial statements.
He invites student questions and there are many. Most of the questions are about what the organization should do about the situation, not about accounting. He explains that the focus of the case should be about accounting issues, not the organization. However, Dr. David offers his analysis of the situation, suggests a course of action and presents steps the organization could have taken to avoid the problem.
At the end of this session, students’ comments include things like, “I think I’m starting to get this.” Dr. David takes this as an indicator of success and uses a similar process on the remaining three days. For each session he finds a news story about a particular situation and uses it to illustrate other concepts in his lectures, such as accounting for pledged and uncollected donations and differentiating between capital and operating expenses.
On the last day, the students politely thank him for the class. He responds, “Thank you for the feedback. I was hoping the case method would work better for you.”
Dr. Miller’s Pharmacy Class
Dr. Miller is in her second year teaching pharmacotherapy in the pharmacy school. She observes that many senior pharmacy students have difficulty applying their acquired knowledge in real-life situations. Even though students perform well on tests, they have problems applying their preclinical learning in their rotations in the hospital. Over time, students become inured to their classroom learning and thus see little connection between the classroom and clinical settings. In addition, she notices that students tend to experience high anxiety when they first enter the hospital setting for their rotations, because they are not confident that their knowledge is sufficient to complete their assigned tasks. Many previous students had shared with her the difficulty of their learning journey. Even though they finally learned to use patients’ situations to suggest the appropriate dosages to their teams and work professionally with doctors and nurses during the rotation program, they struggled to get through.
All these observations bring to mind Dr. Miller’s experience as a pharmacy student. She had joined a study group with her cohort. They prepared for tests using the patients’ cases in a handout provided by the instructors. The cases were the centers of their discussion. She found the processes of analysis and synthesis particularly helpful in developing a deeper understanding of the topic. By doing so, she not only earned good test grades, but also honed her ability to apply facts in the assigned tasks during her later rotation experiences.
Now, Dr. Miller thinks her previous learning experiences may help close the gap between what students learn and the skills they need in the hospital setting. She decides to introduce an alternative way of learning that she believes can really help students and eliminate much of the frustration in their rotation experiences.
She decides to have students use authentic patients’ problems during their preclinical education. She uses case-based learning with real-life situations in the clinical setting by providing profiles of three patients who are currently receiving kidney dialysis and have different complications. She assigns students to groups of five and has them discuss the appropriate medication and the appropriate doses of the suggested medications based on patients’ situations. Through working in groups, students learn to work collaboratively with others, which simulates the out-of-school environment. In the beginning phase of solving the complex problems in the case, students need to assess each patient’s kidney situation, complications, current medication, previous medication, and other physical factors, such as weight and age.
Meanwhile, Dr. Miller poses some questions to lead and challenge students’ understanding of each patient’s situation. After students clearly identify the patients’ state, they begin to identify resources online and from professional journals for the appropriate therapy. The students have to play an active role in their learning process. During students’ involvement in the cases, Dr. Miller functions as a facilitator. In the next class, students suggest not only the appropriate medication and the reasonable dosage for each patient, but also describe their rationales for the medication they suggested. Dr. Miller thinks that with case-based learning, her students are more engaged in the process of examining patients’ cases and suggesting appropriate medications to the doctors. She also believes that students are more comfortable working on the authentic problems.
What is Case-Based Learning?
Case-based learning is not a new idea. Storytelling to share history, teach morals and illuminate concepts is ancient. What is modern is the use of narratives developed to provide authentic learning for students.
Defining case-based learning is not an easy task. Cases are used for different purposes, fields, and forms. Despite their very different approaches, Dr. Miller and Dr. David both believed they were using case-based learning. No consensus exists across fields on how cases can be used in learning, increasing the difficulty in defining case methods. Even though divergent views in case-based learning illustrate the difficulty of a universal definition, we can still capture two shared emphases of case-based learning across fields. These two are the cases themselves and the discussion of them (Merseth, 1991).
According to Shulman (1992), “a case has a narrative, a story, a set of events that unfolds over time in a particular place” (p. 21).
The content of cases has to be written with the narrative form and to demonstrate the contextualization and specificity of cases. To provide well-written content for cases is not sufficient for successful case-based learning. Christensen (1987) and Wetley (1989) both argued that the key to the case method is discussion. Discussion has to be integrated into students’ learning process. Engaging learners in discussion provides students opportunities to analyze, propose solutions, evaluate potential solutions, solve problems, or make decisions. These activities give students an active role in the learning process. Case-based learning is a pedagogy which helps learners improve higher-order thinking ability and achieve deeper understanding of the to-be-learned content. The content of cases and the process of discussion are inseparable in case-based learning.
The examples of Dr. David and Dr. Miller illustrate the diverse spectrum of applications in case-based learning. Some might call Dr. David’s approach “Case-Based Learning Lite,” because he used the stories only as examples. Teachers and learners have used cases in myriad ways that range from the case as an example to support lecture and traditional instruction to immersing students in a case and using it as the primary tool for instruction and learning. Along that spectrum are other uses. Some teachers use a case as the basis for a follow-up assignment after presentation of the lesson content. Cases are frequently used as a supplement to textbooks or lectures in class as tools for small group discussions.
As Hoag, Brickley and Cawley (2001) wrote, “While the claims in the discourse conclude that case-based instruction is superior for skill development in managers and teachers, these conclusions are based largely on instructor perceptions” (p. 52). Although the earliest users of case-based learning began without any research, subsequent research has confirmed that case-based learning can overcome many of the limitations of the traditional lecture-based class (Bolt, 1998; Stoiber, 1991).
There are a variety of research efforts that document quantitative and qualitative evaluations of the effectiveness of case-based learning in higher-order learning as compared to didactic methods. In what they termed a “quasi-experiment” with 81 students, a control group and a study group, in a media management class, Hoag et al (2001) concluded that the case method improves problem-solving skills. Using a leadership course for 182 cadets at the United States Military Academy, Zbylut (2007) found that the quality of answers and diagnosis of leadership problems was better using a case and discussion.The findings were consistent with self-reports from the instructors. Using three groups of students in a business statistics course, a control group, a group that used one case study and a group that used three case studies, Pariseau and Kezim (2007) found that the students who had used the case studies scored significantly higher on their comprehensive final examinations. Though measuring different outcomes, all three studies support the contention that case-based learning is more effective in high-order learning than other methods.
Case-based learning can cover a wide variety of instructional strategies, including but not limited to, role plays, simulations, debates, analysis and reflection, group projects and problem-solving. It provides a great deal of flexibility at the practical level. Regardless of the varied beliefs about case-based learning, there are some basic commonalities among beliefs, most of which arise from the situated cognition theory of learning.
Among those beliefs about case-based learning are the following advantages:
• It provides students with authentic situations in which to explore and apply a range of behaviors and information that can strengthen the transfer of learning. (Lombardi, 2007).
• When students participate in analysis and discussion of alternative solutions they better understand difficult or complicated issues and analyze them more effectively (Lombardi, 2007).
• The emphasis on the process of decision making requires students to synthesize information from a variety of social disciplines ( David, 1954).
• Narratives or story-telling can be effective instructional supports in a variety of settings (Herreid, 1997).
|When examining the concept of case-based learning, it is important to first capture the essential components of the method. Anyone can tell a story, but according to Wasserman (1994) and Herried (1997) effective cases for learning share a number of characteristics:
|Watch the video. Caption:The animation above illustrates the use of story or case as an essential element of Cased-based Learning (CBL) that distinguishes it from other inquiry-based models. There are at least seven general characteristics of a good story or case in CBL. A story should: (1) be factually-based, realistic, and appropriate for the age level of students; (2) align with the goals of the class; (3) be expressed in a narrative form that is compelling and creates empathy with the main character; (4) be as detailed as possible, readable, and specific to contexts; (5) engage students for interaction, discussions, analysis, and problem-solving; (6) expose a dilemma to students and stimulate students’ critical and higher-order thinking to solve the problem; (7) stimulate students’ decision-making, give students’ active roles, and encourage students to find solutions from a variety of resources. Animation created and developed by Stephen Blake Hudgins, Lana Garner, Mutlu Sen, and Muhammad Nazil Iqdami (2014).|
Using Case-Based Learning
As stated earlier, case-based learning has long been used by many professions including law, medicine and business education. The strong belief in effective learning through case methods is supported by several theories, including situated cognition, which Collins (1988) described as “the notion of learning knowledge and skills in contexts that reflect the way they will be used in real life” (p.2); cognitive flexibility or the “ability to spontaneously restructure one’s knowledge in many ways, in adaptive response to radically changing situational demands (Spiro, 1995, cited in Graddy, 2001), and social constructivism, the importance of culture and circumstances in constructing knowledge.
Case methods of teaching require careful preparation by the teacher, but can be used in many different situations, across many domains, as we saw when Dr. David and Dr. Miller used cases in their classes. And it may take time for a teacher, particularly one who has used more traditional methods, to become comfortable with the process of case-based learning. Even though there are different instructional methods of learning with cases, there are a set of guidelines for both teachers’ and students’ role in case methods based on the description from Shulman (1992) and Sudzina (1999).
“However his judgment prompts him to behave in the classroom, the instructor plays a multiple role. He is student, listener, and analyst. He is questioner, paraphraser, and minuteman lecturer. He plays those parts without costume changes, and he never steals the show from the rest of the cast.” (Andrews, 1954, p.109) We can look at the teacher’s role in case-based learning in two broad general categories: setting up the learning environment and facilitating discussion and exploration. The two categories are interdependent, but give us a framework for a look at the teacher’s complex role. To establish an environment for open discussion requires attention to many details. Those details may include arranging the room, such as setting up chairs in a circle or horseshoe or some other configuration that is conducive to discussion. The teacher needs to establish a friendly environment for open discussion, making clear the ground rules for open, respectful debate. Another part of that environment is the teacher’s own behavior. It can be challenging, but essential for the instructor to withhold personal judgments or personal and professional opinions during learners’ discussions. While the instructor’s behavior can have a direct bearing on the environment, the role of facilitator is not an easy one. In addition to preparing the case, the teacher needs to facilitate the discussion in a way that collects as many different issues, perceptions, and solutions as possible. The basic questions, “who, what, why, when and where” help engage the learners in the activity. However, facilitation involves more than just getting learners engaged. The instructor should summarize key issues and ask questions that help students identify issues and stay on track, but do not lead them to a specific conclusion. It can be helpful to use the same cases from more than one perspective to help students understand the multi-dimensionality of real-life situations. Facilitating student discussion may appear to be simple, but in reality requires the teacher to use great skill in helping students explore and discuss the case in ways that maximize their learning. According to Andrews (1954) these abilities include the following: • Keep the proceedings orderly. • Ask questions that encourage better thinking and at the same time reveal the relevance of the discussion that has gone on before. • Weave together the threads of individual contributions into a pattern the class can perceive. • Use a good sense of timing to be that a discussion is not moving fast enough, or is moving too fast for all students to comprehend. • Exercise control over an essentially “undirected” activity while staying out of the way.
Finally, in Andrews’ role of “minuteman lecturer” the instructor needs to fill in with relevant information and be able to direct students to resources appropriate to the topic.
|Watch the video. Caption:The animation above illustrates the role of a teacher in a Cased-based Learning (CBL) environment which is quite different from the traditional environment. In CBL, a teacher should position himself as a student, listener, analyst, questioner, paraphraser, and minuteman lecturer. In addition to these roles, a teacher utilizing CBL in his/her classroom has two main tasks, which are: (1) setting up the learning environment, and (2) facilitating discussion and exploration. Setting up the environment includes arranging the room, establishing an active and friendly discussion environment, and facilitating the students’ discussion. Animation created and developed by Stephen Blake Hudgins, Lana Garner, Mutlu Sen, and Muhammad Nazil Iqdami (2014).|
Although some instructors assign cases as the basis for individual assignments, many scholars contend that group discussion is at the core of the success of case-based learning. Flynn and Klein (2001, p. 83) studied the effect of discussion groups and wrote, “…the use of discussion groups in case-based classes can be an effective and motivating method of instruction if students are prepared and time is available for both individual preparation and group discussion.” [emphasis ours] participate in the discussion. Thus, one might conclude that the student’s role is as important as that of the instructor. The student’s role involves preparation and participation. Students who take their “jobs” seriously in case-based learning will prepare by reading cases and describing the issues, perceptions, and possible courses of action. The student should also review literature relevant to the case.
In addition to preparation, the successful student will continually evaluate the proposed solutions and reflect on what is learned and what needs to be learned. For, in evaluating and reflecting, the student takes more control of his or her own learning.
Finally, the student must commit to collaborative work with peers. In their research, Flynn and Klein (2001) reported that even students who professed to dislike group work were more satisfied with their learning experience than those who worked alone.
Writing a good case for teaching is neither simple nor quick, but sometimes is preferable to using one of the thousands that are now available. Wasserman (1994) offers some helpful guidance about writing a good case. After first being clear in your own mind about the “big idea” of the story, use the following guidelines:
• Draw the reader into the story during the opening.
• Build the case around an event of consequence.
• Elevate the tension between conflicting points of view
• Write the story so that readers grow to care.
• Be sure the case is believable.
• End the case on the “horns of the dilemma.”
Designing Learning Activities
Just writing the story is not finishing the job. Developing discussion and study questions is also important. They help to keep the discussion on track and the focus on the pertinent issues.
Again, Wasserman (1994) offers some helpful guidance:
Sequence questions to provoke developmental analysis
1. Begin with an examination of the events, issues and characters
2. Move to an analysis of what lies behind the surface of events
3. Pull the students deeper into the case with generative questions that call for evaluations and judgments, applications and proposed solutions.
Student Assessment in Case-Based Learning
Initially, assessment and performance evaluation in case-based learning may seem daunting. It can be more subjective than some other methods and some teachers may be uncomfortable with that. However, with careful lesson planning and preparation, assessment in case-based learning can be done efficiently, effectively and fairly.
Students, too, can be uncomfortable with assessment, especially those who are accustomed to multiple choice or other kids of assessment that always have clear right and wrong answers. Wasserman (1994) asserts that the learning goals and objectives established at the beginning are key. Once those are clear, the next step is to establish standards and let students know exactly what is expected of them (Wasserman,1994.
An example of a rubric for “Quality of Thinking” as shown in Table 2, might use successful and unsuccessful descriptions. The former could include things like “gets the big picture; focuses on key issues; appreciates the complexities of ideas.” The latter might use phrases like, “gets bogged down in details;concentrates on the superficial or trivial; unable to differentiate main ideas and details.” (Wasserman, 1994 p. 139.) Some teachers may want to use incremental ratings between the two categories.
Wasserman (1994) devotes several chapters to a detailed approach that includes evaluations of student behavior, generative activities and analysis activities, as summarized in Table 2. Teachers and students alike can find scoring rubrics particularly helpful. These help to paint a picture of successful behavior or work quality, which can remove subjectivity and some of the ambiguity inherent in using this method. When the teacher has thoroughly described the behavior or other criteria, and students have access to that detailed information, assessment becomes not only smoother, but the learning process can be enriched as well.
|Student Behavior||Intellectual Development||Quality of thinking|
|Skills||Communication, research and interpersonal skills|
|Attitudes||Personal perspectives, beliefs and values, self-evaluation|
|Generative Activities||Projects||Evidence of research; analysis of information; organization & layout; creativity and originality|
|Written & Oral Presentations||Organization; fresh perspective; use of examples; development of ideas; use of facts to substantiate arguments; quality of thought and analysis|
|Field Study||Hypothesis; systematic data collection; relevance of conclusions; identification of relationships|
|Analytical Activities||Making Comparisons||Ability to zero in on significant factors; extensive comparison|
|Applying Principals||Recognize principles or rules that apply; logical connection of principles and situations|
|Evaluating and Judging||Specific, reasonable, sound and appropriate criteria; clear relationship|
|Interpreting||Comprehension of big ideas; analyses focused on important meaning; articulation of importance; discernment of implicit content and making inferences; speculation presented with caution|
|Summarizing||Reflection of key ideas; succinct, accurate representation of key issues; articulate and intelligible summaries|
|Classifying||Connected attributes; larger purpose; enable new meaning; beyond the obvious|
|Decision-Making||Articulated values behind choices; humanly sound values; informed choice using best available data; carefully thought out|
|Creating and Inventing||Cognitive risks; truly new, fresh and imaginative; appropriate to demands of the task|
|Designing Investigations||Frame problem for thoughtful investigation; logical, thoughtful investigation plans; data will yield information about the problem; viability; built-in evaluation; clear relationship between plan and problem|
Based on Wasserman (1994)
Case-based learning provides opportunities for richer, deeper exploration of concepts and ideas. Students gain experience with analyzing ideas and applying concepts to solve problems or achieve goals as opposed to acquiring abstract knowledge. Case-based learning requires careful preparation and skilled facilitation on the part of teachers. It also requires students to become engaged with one another and their environment and improve a wide range of social and cognitive skills. Assessing student learning and evaluating performance requires much more than the traditional multiple-choice or short-answer tests, but clear learning objectives, performance standards and relevant criteria can enable teachers to use a more holistic approach and to better tailor activities to students’ needs.
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APA Citation: Blackmon, M., Hong, Y., & Choi, I.. (2007). Case-Based Learning. In M. Orey (Ed.), Emerging perspectives on learning, teaching, and technology. Retrieved <insert date>, from http://epltt.coe.uga.edu/