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Case discussions can be a big departure from the norm for students who are used to lecture-based classes. The Case Analysis Coach is an interactive tutorial on reading and analyzing a case study. The Case Study Handbook covers key skills students need to read, understand, discuss and write about cases. The Case Study Handbook is also available as individual chapters to help your students focus on specific skills.

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The case method can be used in an online environment without sacrificing its benefits. We have compiled a few resources to help you create transformative online learning experiences with the case method. Learn how HBS brought the case method online in this podcast , gather some quick guidance from the article " How to Teach Any Case Online ", review the Teaching Cases Online Guide for a deep dive, and check out our Teaching Online Resources Page for more insights and inspiration.

After 35 years as an academic, I have come to the conclusion that there is a magic in the way Harvard cases are written. Cases go from specific to general, to show students that business situations are amenable to hard headed analysis that then generalize to larger theoretical insights. The students love it! Akshay Rao Professor, General Mills Chair in Marketing at the University of Minnesota

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Hertz CEO Kathryn Marinello with CFO Jamere Jackson and other members of the executive team in 2017

Top 40 Most Popular Case Studies of 2021

Two cases about Hertz claimed top spots in 2021's Top 40 Most Popular Case Studies

Two cases on the uses of debt and equity at Hertz claimed top spots in the CRDT’s (Case Research and Development Team) 2021 top 40 review of cases.

Hertz (A) took the top spot. The case details the financial structure of the rental car company through the end of 2019. Hertz (B), which ranked third in CRDT’s list, describes the company’s struggles during the early part of the COVID pandemic and its eventual need to enter Chapter 11 bankruptcy. 

The success of the Hertz cases was unprecedented for the top 40 list. Usually, cases take a number of years to gain popularity, but the Hertz cases claimed top spots in their first year of release. Hertz (A) also became the first ‘cooked’ case to top the annual review, as all of the other winners had been web-based ‘raw’ cases.

Besides introducing students to the complicated financing required to maintain an enormous fleet of cars, the Hertz cases also expanded the diversity of case protagonists. Kathyrn Marinello was the CEO of Hertz during this period and the CFO, Jamere Jackson is black.

Sandwiched between the two Hertz cases, Coffee 2016, a perennial best seller, finished second. “Glory, Glory, Man United!” a case about an English football team’s IPO made a surprise move to number four.  Cases on search fund boards, the future of malls,  Norway’s Sovereign Wealth fund, Prodigy Finance, the Mayo Clinic, and Cadbury rounded out the top ten.

Other year-end data for 2021 showed:

  • Online “raw” case usage remained steady as compared to 2020 with over 35K users from 170 countries and all 50 U.S. states interacting with 196 cases.
  • Fifty four percent of raw case users came from outside the U.S..
  • The Yale School of Management (SOM) case study directory pages received over 160K page views from 177 countries with approximately a third originating in India followed by the U.S. and the Philippines.
  • Twenty-six of the cases in the list are raw cases.
  • A third of the cases feature a woman protagonist.
  • Orders for Yale SOM case studies increased by almost 50% compared to 2020.
  • The top 40 cases were supervised by 19 different Yale SOM faculty members, several supervising multiple cases.

CRDT compiled the Top 40 list by combining data from its case store, Google Analytics, and other measures of interest and adoption.

All of this year’s Top 40 cases are available for purchase from the Yale Management Media store .

And the Top 40 cases studies of 2021 are:

1.   Hertz Global Holdings (A): Uses of Debt and Equity

2.   Coffee 2016

3.   Hertz Global Holdings (B): Uses of Debt and Equity 2020

4.   Glory, Glory Man United!

5.   Search Fund Company Boards: How CEOs Can Build Boards to Help Them Thrive

6.   The Future of Malls: Was Decline Inevitable?

7.   Strategy for Norway's Pension Fund Global

8.   Prodigy Finance

9.   Design at Mayo

10. Cadbury

11. City Hospital Emergency Room

13. Volkswagen

14. Marina Bay Sands

15. Shake Shack IPO

16. Mastercard

17. Netflix

18. Ant Financial

19. AXA: Creating the New CR Metrics

20. IBM Corporate Service Corps

21. Business Leadership in South Africa's 1994 Reforms

22. Alternative Meat Industry

23. Children's Premier

24. Khalil Tawil and Umi (A)

25. Palm Oil 2016

26. Teach For All: Designing a Global Network

27. What's Next? Search Fund Entrepreneurs Reflect on Life After Exit

28. Searching for a Search Fund Structure: A Student Takes a Tour of Various Options

30. Project Sammaan

31. Commonfund ESG

32. Polaroid

33. Connecticut Green Bank 2018: After the Raid

34. FieldFresh Foods

35. The Alibaba Group

36. 360 State Street: Real Options

37. Herman Miller

38. AgBiome

39. Nathan Cummings Foundation

40. Toyota 2010

Case studies

hands typing on a laptop, open research concept

.css-7qmtvr{overflow:hidden;max-height:108px;text-indent:0px;} Sharing qualitative research through open access

Nathaniel D. Porter

Virginia Tech

US notes and coins

Making higher education accessible for students with unmet financial need

volunteers packing food supplies

A food pantry can help support your campus through the cost-of-living crisis

Lauren Dinour, Fatima deCarvalho, Karina Escobar

Montclair State University

box of groceries

Nourishing bodies and minds: the vital role of a student food pantry

Isabelle Largen

A lifesaver represents career support for academics on extended leave

Support for faculty on long-term leave is a career lifeline

Theresa Mercer , Jim Harris, Ron Corstanje, Chhaya Kerai-Jones

Cranfield University

Three designers discussing ideas at a table in an office

Use design thinking principles to create a human-centred digital strategy

Joe Holland

University of Exeter

Film set

Film storytelling can enhance learning in STEM subjects

Arijit Mukhopadhyay

University of Salford

Euros in wallet

Creating safe spaces for students to talk about financial difficulties

Caroline Deylaud Koukabi, Joanna West

University of Luxembourg

Students playing table tennis

How our Study Together programme promotes belonging and improves well-being

Gemma Standen

University of East Anglia

Class of students using Etherpad to discuss learning points

Use Etherpad to improve engagement in large transnational classes

Xi’an Jiaotong-Liverpool University 

Crowd at Euston station, London

How to harness community knowledge to tackle complex policy challenges

Saffron Woodcraft, Joseph Cook

University College London

Male pharmacist at work

What we learned from a pilot study aimed at getting first-generation students into pharmacy

Carl Harrington, Rosemary Norton

Pottery wheel

Fostering student co-creation to give back to the community

Martha Sullivan

College students in the library

How to keep first-generation students engaged throughout the academic year

Araceli Martinez , Athina Cuevas

Chapman University

Students working together at a laptop

We used a hybrid escape room to dramatically boost student attendance

Erick Purwanto, Na Li, Ting Ting Tay

A teacher shows a students how to code

A road map for advancing digital inclusion for your students, staff and community

Raheel Nawaz

Staffordshire University

Group of three multiracial people talking

Building trust in research: how effective patient and public involvement can help

Gary Hickey

University of Southampton

Community meeting

Community organising: a case study in parent engagement

Michael Bennett

King’s College London

Students sitting together against a wall

Designing 24/7 hubs for students

Kieron Broadhead

Sheet music lying on moss

Using partnerships to establish and build on project success

Dominic Wood

Royal Northern College of Music (RNCM)

A street crowd in Bangalore

Case study: how to do an independent evaluation on homelessness on six continents

Suzanne Fitzpatrick

Heriot-Watt University

Young male journalism student

Embrace the chaos of real-world learning experiences

Jim Entwistle

Teesside University

Small business owner working in inventory

Teaching business students how to prepare sustainability reports for SMEs

Ven Tauringana

Book with tree and compass green concept

How storytelling boosts environmental impact and engagement

Denise Baden

Female waste pickers in India

Bring the SDGs into the classroom through role play and gamification

Shelini Surendran, Kat Mack, Anand Mistry

University of Surrey

Group of happy multiracial students

How to support international students’ smooth transition to a new country

Mengping Cheng

Te Whare Wānanga o Waitaha | University of Canterbury

Fingers on keyboard, trolling concept

Dealing with abuse after public commentary

Michael Head, Larisa Yarovaya , Ashton Kingdon , Millie Downer

Student in chemistry lab

Messy decisions and creative science in the classroom

Charlotte Dodson, Steve Flower

University of Bath

Female engineering students working on a robotics project

Transforming the classroom through experiential learning

Kate Williams

Georgia Tech’s Center for 21st Century Universities

Therapy dog

How to combat the mental health crisis on campus

Jonathan Koppell

Asian student addressing class with microphone

Using the power of debate to enhance critical thinking

M. C. Zhang

Macau University of Science and Technology

High school students in lab

A case study in developing the next STEM generation

Michael Head, Jessica Boxall, Winfred Dotse-Gborgbortsi, Kathryn Woods-Townsend

Online learning in project management

Why we need a new model for professional development credentials

Mick Grimley

Dentistry procedure

Lessons learned from a fellowship year as a dentist and early career researcher

Dániel Végh

Semmelweis University

Lightbulb learning to learn

Learning to learn: developing students into effective lifelong learners

Kevinia Cheung

The Hong Kong Polytechnic University

youth panel

Using co-creation to make young people equal research partners

Kathryn Woods-Townsend

Mentoring session

Six lessons from facilitating a formalised mentoring programme

Karen Mather

Aerial view of students sitting on steps

Perfect doesn’t exist and other lessons from developing a whole-university well-being strategy

Ben Goose, Cassie Wilson

Vintage movie projector

Using film to prompt discussion in legal studies

Michael Randall

University of Strathclyde

Group of students in discussion

How supported social groups create safe spaces

Hannah Moore

Young women campaigning for more action on climate change

A practical approach to tackling eco-anxiety

Helen Hicks, Dawn Lees

young smiling woman using laptop

Nudge technology can help students re-engage

Group of multiracial students

A whole-campus approach to boost belonging for student success

Lorett Swank, Catherine Thomas

Medical student in virtual reality headset

Using VR to change medical students’ attitudes towards older patients

János Kollár

Mural showing diversity of Australia’s Indigenous people

Recognising First Nations through place: creating an inclusive university environment

Angela Leitch

Queensland University of Technology

Young teacher working with child

Undergraduate research to enrich teacher education

Molly Riddle, Jacquelyn J. Singleton, Cathy Johnson

Indiana University Southeast

high school student watching remote mathematics lecture on laptop

How to make dual-enrolment programmes work

Laura Brown Simmons

Ntarama church massacre memorial in Rwanda

A case for bringing ethics of friendship and care to academic research

Noam Schimmel

University of California, Berkeley

Teacher helping black student in computer class

Co-creation as a liberating activity

Terry Greene

Trent University

Group of three women talking

Steps to address the operational challenges of widening participation

Angus Howat

Students drinking coffee

From cohort to community: how to support student-led initiatives

Ranita Thompson, Joanne Walmsley, Ben Graham

The University of Queensland

Man climbing up-and-down graph-like staircase

How to sustain a journal and beat the academic publishing racket

James Williams, Asma Mohseni

University of Derby

Watering can with daisies

Grow your own accessibility allies

Luke Searle

“Feedback” appears in white text with a yellow background, with a contrast ratio of 1.7:1. The image has a reflection of an open window on it, making the text much harder to read. In some places the contrast of the text is as low as 1.0001:1

A colour matrix to make visual content more accessible

Matthew Deeprose

Three architecture students and an instructor work on a project

What is authentic enquiry learning?

Kate Black, Jonny Hall

Northumbria University

Illustration of man in keyhole-shaped light from hole in wall, escape concept

You wake up in a locked room… Using digital escape rooms to promote student engagement

Steven Montagu-Cairns

University of Leeds

row of seedlings with arrow to plant-covered globe

Charting a shared path to net zero universities

Shreejan Pandey, Rebecca Powell

Monash University

multiracial group of students eating burgers outside

Creating a reusable takeout dish programme on campus

Rojine McVea

University of Alberta

Two female students working together

Power to the people through automation of peer support programmes

Amanda Pocklington

Young girl school pupil looking through a microscope

How can universities get more school pupils enthusiastic about science?

Carl Harrington

Female medical student examining slide

Unifying theoretical and clinical education in a medical curriculum

László Köles

Woman holding light bulb with symbols of academic fields surrounding it

A campaign to communicate the impact of university research

Paul M. Rand

The University of Chicago

line of blocks with arrows on top face against blue background

‘I just wish all lecturers would use the VLE in the same way’

Alison Torn

Leeds Trinity University

Bag of groceries

A ‘grocery store’ model can help your campus food bank reduce waste

Erin O’Neil

Male healthcare working giving a presentation

Advice for lecturers on how to keep students’ attention

Kinga Györffy, András Matolcsy

Cropped image of hands of PhD candidate receiving their certificate

Individual consultations can help PhD students to complete their studies

Szabolcs Várbíró , Judit Réka Hetthéssy, Marianna Török

Young male entrepreneur working in a cafe with coffee and laptop

How to support students considering self-employment

Victoria Prince

Nottingham Trent University

Individual writing in a notepad with phone and ipad set aside

Silence is golden when you ‘shut up and write’ together

Kelly Louise Preece, Jo Sutherst

Group of young people in a circle all joining hands in the centre

Why we start undergraduate transdisciplinary research from day one

Gray Kochhar-Lindgren, Julian Tanner

The University of Hong Kong

Primary school children with raised hands

Raising aspirations: lessons in running a young scholars programme

Valsa Koshy

Brunel University London

Summit of Ha Ling Mountain with Rundle Range and Banff National Park, Alberta, Canadian Rockies in the background

Restructuring a university, part one

Bill Flanagan

illustration of a man climbing a mountain with flag on top

Restructuring a university, part two

How to write more compelling awards entries

How to write better awards entries

Sam Russell

Arden University

Young Asian woman in red top happy in front of laptop

Using gamification as an incentive for revision

Teegan Green, Iliria Stenning, Rasheda Keane

illustration-photo composite of people seated around jigsaw pieces

Phenomenon-based learning: what, why and how

Sue Lee, Kate Cuthbert

Back view of students walking in autumnal park

Student support takes a village – but you need to create one first

Melissa Leaupepe

University of Auckland

Student immersed in a hospital VR setting in the FMH Media Lab at University of Sydney

AI or VR? Matching emerging tech to real-world learning

Martin Brown , Philip Poronnik, Claudio Corvalan-Diaz, William Havellas

University of Sydney

Group of women working together online via teleconferencing

Virtually writing together: creating community while supporting individual endeavour

Karen Kenny

two young women walk up a rainbow-coloured footpath

Supporting LGBTQ+ aspiring leaders in universities

Catherine Lee, Daniel Burman

Anglia Ruskin University

Man doing a back bend while looking at laptop

Making space for innovation: a higher education challenge

Michelle Prawer

Victoria University

illustration of laptop with speech bubbles oral examinations

Can online oral exams prevent cheating?

Temesgen Kifle, Anthony Jacobs

A patent document being stamped

A help desk to protect intellectual property

Frank Soodeen

The University of the West Indies

Asian students working at a laptop

Autonomy, fun and other benefits of student-centred learning design

A light guiding the way along a winding road

A tool to navigate information overload

Shonagh Douglas

Robert Gordon University

Black male student happy looking at laptop

How university leaders can use an ‘innovation for’ mindset to drive enrolment

Nivine Megahed

National Louis University

Illustration of different aspects of university life

To improve the admission process, get faculty involved

Students enjoying an informal get together over coffee

The power of events to build belonging among students

Xiaotong Lu

Skip song button in neon

Full circle: using the cycle of teaching, module design and research

Glenn Fosbraey

University of Winchester

Internet of Things concept

Matching technology training to industry needs: a case study

Daniel Garrote

Nuclio Digital School

Woman speaking in front of room

My experience of speaking in front of a select committee

Nicola Searle

Goldsmiths, University of London, Universities Policy Engagement Network (UPEN)

Student support

A holistic approach to student support

Fran Hornsby, Rebecca Clark

University of York

Peer mentoring in action

Peer mentoring to support staff well-being: lessons from a pilot

Fiona Cust, Jessica Runacres

history of mathematics concept

Decolonising learning through access to primary sources

June Barrow-Green , Brigitte Stenhouse

The Open University

Female student writing in the university library

Mini virtual writing retreats to support and connect tutees

Aspasia Eleni Paltoglou

Manchester Metropolitan University

Image of a digital brain representing AI

A model for deploying AI across a university and region

Cheryl Martin

Two ribbons represent a university twinning programme in Ukraine

A collective action framework to help Ukraine’s universities survive and rebuild

Charles Cormack, Blanca Torres-Olave

Cormack Consultancy Group

Image of diverse groups forming supportive circles

How to train university staff to become anti-racist agents of change

Adam Danquah

University of Manchester

Three adult students working at a shared desk

A guide to promoting equity in HE for refugees and asylum seekers

Yeşim Deveci, Claire Mock-Muñoz de Luna , Jess Oddy

University of East London

Young Indian man with phone and laptop

Mix technology and personal contact to support students

Jonathan Powles

University of the West of Scotland

Young woman holding digital impression of globe

Virtual mobility: a first step to creating global graduates

Coventry University

A man building a machine on his desk

Home labs and simulations to spark curiosity and exploration

Francesco Fornetti

University of Bristol

Basket of pumpkins with sign "buy local"

Food for thought: advice for building a university-community collaboration

]oshua Gruver

Ball State University

Community outreach like the Great Science Share for Schools requires listening

Flip the script: why listening is the best form of outreach

Lynne Bianchi

Sustainable internship programme

How a sustainable internship programme can support social mobility

Fiona Hudson, Inís Fitzpatrick , Cathy Mcloughlin

Dublin City University

Women posting anti-harassment posters

Collective voices, zero tolerance

Louise Crowley

University College Cork

Young girl doing chemistry experiment

So, you want to reach out? Lessons from a ‘science for all’ programme

Mary Gagen , Will Bryan, Rachel Bryan

Swansea University

Student exploring a city using a map

Counter-mapping as a pedagogical tool

Daniel Gutiérrez-Ujaque , Dharman Jeyasingham

Brunel University London , University of Manchester

Woman taking part in an online teaching workshop

The practicalities of delivering a multi-institutional online workshop

Kelly Edmunds , Richard Bowater

Virtual summit

Experiential education through a simulated summit to combat human trafficking

Clara Chapdelaine-Feliciati

A crime investigation board

How professional practitioners help connect crime theory with real-world investigations

Paul McFarlane

Group of researchers collaborating on a project

Lessons from completing an award-winning knowledge transfer project

Rachel McCrindle, Richard Mitchell, Yota Dimitriadi

University of Reading

smiley face on head cut-out in hands

In the loop: how formative feedback supports remote teaching

Jonna Lee , Meryem Yilmaz Soylu

Image of a lecturer teaching a class of adult students

Tutor training for architect-educators: twinning, observation, reflection and testing

Martin W. Andrews, Mary Caddick

The University of Portsmouth

Image of students being support to cross a gap in their learning

Planning forward: whole system support for marginalised learners in higher education

Carrie Bauer, Cindy Bonfini-Hotlosz, Charley Wright

Arizona State University, Centreity

Image of a researcher conducting fieldwork

How to develop a code of conduct for ethical research fieldwork

Catherine Fallon Grasham, Laura Picot

University of Oxford


Pedagogical wellness specialist: the role that connects teaching and well-being

Andrea Aebersold

University of California, Irvine

Ants building a bridge

Bridges to study: how to create a successful online foundation course

Jane Habner , Pablo Munguia

Flinders University

Image of the red curtains opening at the start of a theatre performance

What’s the story? Creative ways to communicate your research

Steven Beschloss

Arizona State University

Picture of a woman teaching English

A STEAM adventure: running a hybrid English immersion camp

Rossana Mántaras , Eugenia Balseiro, Lorena Calzoni

Technological University of Uruguay (UTEC)

Image representing creative inspiration

Creative projects as a way of bringing students together

Karen Amanda Harris

University of the Arts London

alarm clock on blocks

Block to the future: why block scheduling has taken so long to catch on

Carl Flattery, Simon Thomson

Leeds Beckett University, University of Manchester

Young Åsian woman examines artefact

Outside in: use your students’ curiosity to invigorate your teaching

M. C. Zhang, Aliana Leong


The role of complementary higher education pathways for refugees

Manal Stulgaitis , Gül İnanç

UNHCR, University of Auckland

A remote student working in a group with other students via an online meeting

Lessons in helping remote students obtain practical work experience

Ewout van der Schaft, Alex Mackrell

Image of two people at a refugee volunteer centre working online

Education for humanity: designing learner-centric solutions for refugee students

Nicholas Sabato, Joanna Zimmerman

University tutor marking assessments

How to turn a PhD project into a commercial venture

Manjinder Kainth, Nicola Wilkin

Graide, University of Birmingham

Image of the Atme refugee camp in Idlib

Increasing access to higher education for refugees through digital learning

Rabih Shibli

American University of Beirut

Syrian refugees after arriving in Turkey

Helping refugees get their qualifications recognised

Sjur Bergan

Council of Europe

Diversity statements in higher education can embed inequality more deeply

Embedding equality, diversity and inclusion within public policy training for academics

Image showing a young research assistant

Making undergraduate access to research experience transparent and inclusive

Saloni Krishnan, Nura Sidarus

Royal Holloway, University of London

Man on ball juggling balls in front of a city

How a rich extracurricular campus life nurtures well-rounded individuals

Image representing the uncertainty of the future

How we used a business management theory to help students cope with uncertainty

Zheng Feei Ma, Jian Li Hao, Yu Song, Peng Liu

Young women with Ukrainian flags

Eight ways UK academics can help students and researchers from Ukrainian universities

Anna K. Bobak, Valentina Mosienko, Igor Potapov

University of Stirling, University of Bristol, University of Liverpool

Image showing a box of essential items being handed to two Ukrainian women

How can universities support Ukrainian students? Advice from a Polish institution

Paweł Śpiechowicz

University of Lodz

Bridge made of cogs with red connecting section

Blended professionals: how to make the most of ‘third space’ experts

Emily McIntosh, Diane Nutt

Middlesex University

Image of refugees walking on their way to Europe

How universities can support refugee students and academics

Naimatullah Zafary

University of Sussex

Candidates waiting for a job interview

Recruiting university tutors using an interactive group activity

Carl Sherwood

Image depicting work to achieve net zero emissions

Tackling climate change requires university, government and industry collaboration – here’s how

Anna Skarbek

Monash University, Climateworks Centre

Image depicting plans for a multidisciplinary research centre

The challenges of creating a multidisciplinary research centre and how to overcome them

Andrew Tobin, Laura Tyler

University of Glasgow

A student playing the part of a teacher to represent the revolving roles pedagogy

Revolving roles: creating inclusive, engaging, participant-led learning activities

Pablo Dalby

Image representing communication between different members of a team

Asynchronous communication strategies for successful learning design partnerships

Rae Mancilla , Nadine Hamman

University of Pittsburgh, University of Cape Town

An image representing a faculty member calling for IT support on a technical problem

Developing a faculty-IT partnership for seamless teaching support

Medical students discuss issues of decolonisation relating to medicine

Decolonising medicine, part two: empowering students

Musarrat Maisha Reza

Image of people learning in different modalities - online, in-person and hybrid learning

The evolution of activeflex learning: why and how

Athens State University

A robot holding tools to illustrate a resource offering advice for universities on using 'bots'

Lessons for universities from using ‘bots’ in the NHS

Carol Glover

KFM, a subsidiary of King’s College Hospital NHS Foundation Trust

Man working with laptop, pen and paper and coffee, OERs

A guide to using open educational resources: an experiential case study

Innocent Chirisa

University of Zimbabwe

Advice on developing higher education programmes that meet the skills needs of Gen Z students

Catering to Gen Z’s needs: creating a flexible and adaptable education programme

Eric Chee, Roy Ying, Winnie Chan

The Hang Seng University of Hong Kong

Advice on creating opportunities for early career researchers to develop their teaching skills

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Case studies.

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Case studies are stories that are used as a teaching tool to show the application of a theory or concept to real situations. Dependent on the goal they are meant to fulfill, cases can be fact-driven and deductive where there is a correct answer, or they can be context driven where multiple solutions are possible. Various disciplines have employed case studies, including humanities, social sciences, sciences, engineering, law, business, and medicine. Good cases generally have the following features: they tell a good story, are recent, include dialogue, create empathy with the main characters, are relevant to the reader, serve a teaching function, require a dilemma to be solved, and have generality.

Instructors can create their own cases or can find cases that already exist. The following are some things to keep in mind when creating a case:

  • What do you want students to learn from the discussion of the case?
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To find other cases that already exist, try the following websites:

  • The National Center for Case Study Teaching in Science , University of Buffalo. SUNY-Buffalo maintains this set of links to other case studies on the web in disciplines ranging from engineering and ethics to sociology and business
  • A Journal of Teaching Cases in Public Administration and Public Policy , University of Washington

For more information:

  • World Association for Case Method Research and Application

Book Review :  Teaching and the Case Method , 3rd ed., vols. 1 and 2, by Louis Barnes, C. Roland (Chris) Christensen, and Abby Hansen. Harvard Business School Press, 1994; 333 pp. (vol 1), 412 pp. (vol 2).

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  • Published: 21 July 2021

A case study of university student networks and the COVID-19 pandemic using a social network analysis approach in halls of residence

  • José Alberto Benítez-Andrades 1 ,
  • Tania Fernández-Villa 2 ,
  • Carmen Benavides 1 ,
  • Andrea Gayubo-Serrenes 3 ,
  • Vicente Martín 2 , 4 &
  • Pilar Marqués-Sánchez 5  

Scientific Reports volume  11 , Article number:  14877 ( 2021 ) Cite this article

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  • Epidemiology
  • Health care
  • Public health

The COVID-19 pandemic has meant that young university students have had to adapt their learning and have a reduced relational context. Adversity contexts build models of human behaviour based on relationships. However, there is a lack of studies that analyse the behaviour of university students based on their social structure in the context of a pandemic. This information could be useful in making decisions on how to plan collective responses to adversities. The Social Network Analysis (SNA) method has been chosen to address this structural perspective. The aim of our research is to describe the structural behaviour of students in university residences during the COVID-19 pandemic with a more in-depth analysis of student leaders. A descriptive cross-sectional study was carried out at one Spanish Public University, León, from 23th October 2020 to 20th November 2020. The participation was of 93 students, from four halls of residence. The data were collected from a database created specifically at the university to "track" contacts in the COVID-19 pandemic, SiVeUle. We applied the SNA for the analysis of the data. The leadership on the university residence was measured using centrality measures. The top leaders were analyzed using the Egonetwork and an assessment of the key players. Students with higher social reputations experience higher levels of pandemic contagion in relation to COVID-19 infection. The results were statistically significant between the centrality in the network and the results of the COVID-19 infection. The most leading students showed a high degree of Betweenness, and three students had the key player structure in the network. Networking behaviour of university students in halls of residence could be related to contagion in the COVID-19 pandemic. This could be described on the basis of aspects of similarities between students, and even leaders connecting the cohabitation sub-networks. In this context, Social Network Analysis could be considered as a methodological approach for future network studies in health emergency contexts.

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Adversities seem to have been a permanent reality in the last decade 1 . Their consequences cause damage to people's lives that deserve the attention of political leaders and researchers. In the context of any disaster, models of human behaviour are constructed that reflect the importance of relationships between actors, between actors and knowledge, and even between actors and beliefs 2 .

The World Health Organization (WHO) declared the COVID-19 a global emergency on January 31, 2020 3 . It is one of the disasters that has had the greatest impact on our history. Recent studies have already shown that the COVID-19 pandemic appears to have an impact on mental health, leading to anxiety, depression, disturbed sleep quality and even increased perceptions of loneliness 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 . In the same sense, the impact of the pandemic has also "hit" young people, who go to school every day but who have seen their social relationships decline. The educational context was always present in the strategies implemented in previous pandemics. Some of the most common measures were the closure of schools to contain the transmission of influenza 12 , support through informal networks on university campuses during the influenza A(H1N1) pandemic 13 , and the need to increase knowledge on the pandemic, as it was found to influence everyday attitudes and practices 14 .

One of the measures that has had the greatest social impact in the COVID-19 pandemic has been the obligation to maintain a physical distance. Specifically, in the field of higher education, it seems to be remarkably complex and more difficult to carry out 15 . University campuses are of interest for studying social behaviour in the context of a pandemic. Numerous studies have shown how university students acquire healthy habits or, conversely, drug and alcohol consumption habits, depending on the type of relationships they have on campus and in the university residences 16 , 17 .

However, there is a lack of studies that analyse the behaviour of university students based on their social structure during a pandemic. Therefore, a quantitative understanding of the behaviour of students in a health emergency situation is necessary as this information could be useful in making decisions about how to prepare for disasters. That is, how to act appropriately during and after an emergency of any kind, since interpersonal relationships, through which supportive and interdependent links are established and which are present in any emergency or disaster.

To address this structural perspective, the SNA method has been applied. The SNA is a distinctive perspective within the social and behavioural sciences. It is distinctive because it is based on the fact that relationships take place between interacting units 18 . For the SNA method, the unit of analysis is not the isolated individual, but the social entity made up of the actor with its possible connections, generating a structure 19 . The main perspective of the SNA focuses on the importance of the relationships between the units that interact in the social networks 18 . A social network is made up of a set of points or nodes that represent individuals or groups, and a set of lines that represent the interaction or otherwise, between the nodes, generating a social structure 20 .

One of the most relevant premises of the SNA, for our study, is that it is not only assumed that individuals are connected through a structure, but that their goals and objectives are as well, because these are only achieved through connections and relationships 19 , 21 , 22 . Thus, the SNA could show us if university students with a more responsible goal form their own networks or mingle with their not-so-responsible peers. In relation to the groups, the actors influence and inform each other in a process that creates a growing homogeneity 21 . This perspective is of interest to this research.

The contacts between actors can be analyzed in two types of networks: sociocentric or complete networks and egocentric networks. The former includes an analysis between actors that belong to a delimited and previously defined census 23 . While the latter analyzes the structure that is generated between an ego and its contacts 24 .

There is an extensive core of studies on SNA and health habits. Some of the most recent are related to contagion in substance use 25 , 26 , physical activity 27 , behavior related to the individual's low weight 28 , engagement in university rooms 29 or eating behaviors 30 among others. SNA has even been applied to disaster scenarios such as droughts, floods, landslides, tsunamis, and cyclones 31 . No one thought that one year after this study, its results would be so useful for another scenario related to a major catastrophe such as the COVID-19 pandemic. Other recent studies shows a social network analysis approach in the problematic internet use among residential college students during COVID-19 lockdown 32 or associations between interpersonal relationships and mental health 33 .

Based on the above, the purpose of this study was to analyse a community of university students and their structural behaviour in their university residences. Halls of residence form micro-communities where very close relationships develop, which can become a context of risk. In other words, university residences could become "places" that facilitate the spread of pandemics if adequate protocols are not followed. However, dormitories can also have a preventive value. Peer support behavioural patterns take place in them, among peers who are exposed to the same risks and circumstances. This sharing of similar situations can generate an enriching coping of personal experiences 34 . However, there is a lack of studies that analyse the structures of university students and their coping in crisis situations.

This study was conducted during one of the waves of the COVID-19 pandemic, where infection rates were at their highest. With the SNA methodology, the aim is to find answers to questions such as: What are the structural characteristics of the leading individuals in the dormitories? How are the contagion outcomes related to the structural positions in the network? For such questions, the proposed objectives were (i) to analyse the relationship between the students' network position and their outcomes with respect to the COVID-19 contagion, (ii) to describe the influential position of student leaders in the network, (iii) to analyse the Egonetwork of the most influential student leaders during the COVID-19 pandemic, and (iv) to visualise the relational behaviour of university students in the global network.

Study design

A descriptive cross-sectional study was carried out at one Spanish Public University. The data was collected during one of the waves of the pandemic, specifically from 23th October 2020 to 20th November 2020.

The measures taken during the pandemic in the different regions of Spain were different, depending on the results of the contagion at each moment. At the time of carried out this study, teaching in the locality of the study was adapted to the situation. That is, there were limitations on the number of people, "mirror" classrooms, identification of QR, etc. In the town there was a limit to the number of people who could meet, pubs and discotheques had been closed, and there was a 10 pm curfew.

Setting and sample

The participation was of 93 students, from 4 university residences. The characteristics of the sample can be seen in Table 1 . Of the total participants, 32.26% were women and 67.74% men.

Ethical consideration

All participants received an informed consent form to participate in the study. Lastly, participants were offered the possibility of retracting consent once they had signed the form, without needing to provide a reason, and an email contact address was given should they require any further information. Participation was voluntary, and subject availability was respected at all times. All the participants that were involved in the study have given their informed consent to participate in this study.

The data for this study are considered health-related data. They comply with Directive 03/2020 of the European Data Protection Committee 35 . The researchers requested anonymised data from the responsible body of the university in charge of contacts COVID-19.

The study was approved by the Ethics Committee of the University of León (ETICA-ULE-008-2021).

Data collection

We collected the data from the database created at the university, SIVeULE, created for the follow-up of cases of COVID-19. This database collates the characteristics of the actors and their RT-qPCR result.

In the university there was a protocol to indicate norms and rules of (i) hygiene and preventive measures, (ii) what to do if you had symptoms, (iii) definitions of what was considered "close contact", "confinement", and " positive result ". There was support staff to collect data, deal with doubts, and assist both positive actors and confined actors. These people were called "trackers." The name defined their role because they identified the student's contacts that were positive, had symptoms, or had been "in close contact” with a positive person.

In the database, other data such as name, residence, gender, grade, name of contacts, and date and result of Polymerase Chain Reaction (PCR) test are also collected.

For the present study, the names were anonymized and registered in matrices for subsequent analysis using the SNA method.

The data obtained were used to construct a 93 × 93 matrix. The matrix was read as follows:

For rows, “A nominates B”;

For columns, “A is nominated by B”.

To carry out this study, the matrix has been symmetrized, determining that if A nominated B, B also nominated A. That is to say, it is an undirected matrix, since, if A had any contact with B, B also had contact with A.

Data analysis

For data analysis, we apply SNA to the 93 × 93 matrix. measures of centrality were applied to analyse leadership from a structural perspective. Centrality is a construct of the SNA that means the position in the network 18 . Previous researchers have applied SNA to the study of leadership, because they have conceptualized leadership as a process that starts from the collective and the interconnections 36 , 37 , 38 . For this study, the centrality measures selected were: degree, betweenness and eigenvector 18 :

The degree is the number of connections adjacent to an actor. Given the centrality of degree \({d}_{i}\) of the actor i and \({x}_{ij}\) is the cell ( i, j ) of the adjacency matrix, then

Betweenness centrality is defined as the Extent to which an actor serves as a potential “go-between” for other pairs of actors in the network by occupying an intermediary position on the shortest paths connecting other actors. The formula for the centrality of node j is given by the:

In this formula, \({g}_{ijk}\) represents the number of geodetic paths that connect i and k and through k while \({g}_{ik}\) is the total number of geodetic paths between i and k .

Eigenvector centrality corresponds to the measure of actor centrality that takes into account the centrality of the actors to whom the focal actor is connected.

Normalized measures were used.

The measures of centrality studied in the SNA have been the normalized degree (nDegree, the normalized degree centrality is the degree divided by the maximum possible degree expressed as a percentage), Eigenvector and nBetweenness (is the normalized betweenness centrality computed as the betweenness divided by the maximum possible betweenness).

To select the most leading students in the network, the measure of normalized nBetweenness was used 39 . This measure becomes more relevant during a pandemic, where the possibility of serving as a bridge or intermediary allows other networks to reach out, transferring good or bad practices and behaviors.

In order to have more information about the behaviour of the student leaders, the Egonetwork analysis of the most leading nodes for each component was carried out. Key players theory has been used to obtain this group of students displaying greater leadership 40 . Egonetwork studies the connections of a given node. This analysis in isolation is less comprehensive than the analysis of the entire network. But the researchers recommend this analysis combined with the analysis of the whole network to go deeper into the behaviour of certain nodes, depending on the objective of the research 24 , 34 , 41 .

Statistical analysis and visualisation

IBM SPSS Statistics (26.0) software. was used for the statistical processing of the data. For the analysis of descriptive data, frequencies and percentages were used for the qualitative variables, whereas the mean and standard deviation were used for the quantitative variables. A chi-square test was carried out to verify whether there was a relationship between the groups, and the Student’s t-test was used to compare the mean scores between the groups. An analysis of variance (ANOVA) was carried out to check the differences for continuous variables divided in groups. The UCINET tool, version 6.679 42 was used for the calculation of the SNA measurements. The tests carried out to study the normality of the distribution were Kolmogorov–Smirnov for populations of more than 55 individuals and the Shapiro–Wilk test for those less than or equal to 55. The level of statistical significance was set at 0.05. For qualitative analysis, a visualization of the global network will be carried out using Gephi, version 0.9.2, software. The key player tool has been used to calculate the key players of the network 43 .

As shown in Table 2 , there was a significant effect of residence on nDegree [F(3,89) = 22.135, p < 0.001] and Eigenvector [F(3,89) = 151.035, p < 0.001] and there was no significant effect of residence on nBetweenness [F = (3,89),p = 0.784].

Students in residence C have significantly higher degrees of centrality in nDegree and Eigenvector compared to the other residences. In the case of nBetweenness, students in residences A and D have higher values, although not significantly so.

Significant differences in all measures of centrality (nDegree, Eigenvector and nBetweenness) measures were found for the groups of people who tested positive for RT-qPCR (PCR +) versus those who tested negative for PCR (PCR-). The PCR + group of people had higher values of centrality than the PCR- group. The degrees of significance of these differences are shown in Table 3 .

Significant differences were found between leaders and non-leaders calculated with the three measures of centrality and the prevalence of people who tested positive or negative for PCRs. Leaders had a higher percentage of people in the PCR + group compared to non-leaders. The degrees of significance of these differences are shown in Table 4 .

Figure  1 A shows the nodes of the study network highlighting in each colour which residence each one belongs to (A,B,C or D). In Fig.  1 B the same network can be seen but the nodes with PCR + appear in red and and the nodes with PCR- in green. The distribution of the network allows us to appreciate the 4 different residences. The size of the nodes is represented by the nBetweenness of each node.

figure 1

Graphs of the university student network differentiating a colour for each residence hall ( A ) and differentiating the positive and negative PCR groups ( B) .

Figure  2 shows the network highlighting the trajectories of the three most important key players. The edges coming out of these key players are thicker than the others. Furthermore, the key players are numbered in order of importance in the network (1, 2 and 3). The size of the nodes is represented by the nBetweenness of each node.

figure 2

The network shown under the Atlas 2 distribution highlighting the 3 most important key players in the network.

Figure  3 shows the Egonetworks of the 3 key players in the network. Figure  3 A shows the most important key player in the network. If this node were eliminated, the two components would be separated (those of the C and D residence). Figure  3 B,C show the Egonetworks of the key players 2 and 3 respectively. These nodes are structurally very similar. If both nodes were removed from the network, there would no longer be a connection between residence C and residences A and B.

figure 3

Egonetworks of the 3 main key players of the network.

This research contributes empirical evidence based on a social network approach to the development of the COVID-19 pandemic on university halls of residence. We have presented a study strategy and results, which link the relationship between the centrality of leaders and the outcome of pandemic infection. There is a significant core of research using the SNA methodology applied to the COVID-19 pandemic. However, there is a lack of research focusing on the structural responses of university students, a population of particular interest given their training experience. A university student "absorbs" experiences that are translated into behaviour, and transfers the resources obtained through their relationships.

Our results demonstrate the relationship between the centrality in the network of student leaders and the outcome of their infection (positive or negative). Not only could leaders spread pandemic behaviour towards their more local peers, they also seem to spread it to other halls of residence. This is demonstrated by the structure of betweenness. Leaders with a higher degree of betweenness could become key players, so that their presence or absence can disconnect the various components of the entire network. This could lead to a disconnection of the contagion process, both on a positive and negative level. The findings are the first to demonstrate that networks in university accommodation develop successful or unsuccessful responses to a pandemic. University managers should take these findings into account when developing response and behavioural strategies in pandemic or disaster situations. Strategies should be designed with a network rather than an individual approach.

Although our study did not ask about the relationship between the actors, we understand that the contacts established between the students are relationships of friendship or good classmates. We only analysed whether or not people had been in contact, during a state of lockdown. But obviously, with the SNA, we can visualise relational behaviours that would be more difficult to appreciate using other methodologies.

Our results show that student leaders have a high degree of centrality not only at the local level, i.e. in the component related to their accommodation, but also at the level of the global network. Our results are in line with studies of Mehra et al. 36 , who highlighted that the integration of a leader into the friendship network in one social circle can be related to the reputation of the leader in other social circles.

Leadership or reputation at the local level is related to the performance of the team, and leadership outside the team is what allows new opportunities to arise and new information to be disseminated 36 . In the case of university students in their accommodation, the aim is to have a friendly atmosphere and to collaborate in difficult moments, to motivate each other, etc. Our results shown a statistically significant relationship between leadership and the positive results of the COVID-19 tests. In this sense, previous studies have already found that having too many resources related to social capital in a group (such as centrality) could negatively affect the efficiency of the group 44 . In other words, the leader will exert an influence on his or her colleagues and this influence could "infect" a certain behaviour, in this case of responsibility or not in a state of health emergency.

Another aspect demonstrated in our research is that there is a similarity between student groupings in terms of their COVID-19 test results. That is, we observe groups where the results are all positive (nodes in red), and others where the results are negative (nodes in green). This finding, could be related to numerous previous studies where actors occupy similar social positions in the classroom. For example, the studies from 45 showed that stuttering students had the same social position as the rest of their peers, because both (stutterers and non-stutterers) tended to design their groups structurally the same.

Homophily theory indicates that individuals associate with those with whom they share aspects of similarity, such as similar beliefs, characteristics and behaviours, which occurs especially in young people and adolescents 46 Therefore, this may partly justify why negative-test college students are more cohesive, and positive-test college students as well.

One of the measures implemented with the greatest impact in this COVID-19 pandemic has been social distancing or isolation. The closure of premises or the reduction in hours of places of leisure has led to this social, or rather physical, distancing, as it is physical contact that is avoided. Studies have shown that the reduction in contacts based on social networks that coexist in social bubbles, and the similarity between contacts, increase social distancing from other actors, and therefore decrease the risks of contagion 47 . But in the case of this research, university accommodation could not be considered as a bubble. We could think of them as big bubbles, where behavioural patterns become contagious, be they positive and negative ones. Therefore, in this sense, the directors of the centres should take note and plan different strategies according to the behaviour of the subnetworks. That is to say, promote those behaviours with negative results of contagion and intervene in those subnetworks with positive results. For this, and as explained previously, the best option would be to plan together with the leaders.

Our results have shown that students with a high degree of Betweenness have a position in the network that gives them great leadership. In this sense, previous studies have used this structural metric as a predictor of leadership due to the strategic position that the actors have in the network and their role in bridging different networks 39 , 48 .

For a better understanding of the role of these actors, in this research we analyse these university students on the basis of two more structural issues. On the one hand, which of them could have a key player role. Secondly, to analyse the Egonetwork of those students with a greater degree of centrality in each of the components.

As regards key players, our results showed that 3 students with a high degree of betweenness, i.e. with an intermediary role, had a key player structure. The importance of the key actor has been explained perfectly by Borgatti (2006) 40 , describing both the negative and positive aspects. The negative is that the network, or networks, actually depend on these nodes, and cohesion between the networks would be diminished if these actors were to disappear 40 . This problem is greater when, in a public health context, we select a small number of individuals to contain a pandemic or to reduce the risk of contagion that links different networks. If these actors disappeared, the number of those infected would increase. As regards the positive role of these actors, they are ideal for spreading attitudes and behaviour, because they quickly gain access to different networks. Borgatti (2006) explains the importance of the structure of the key players, with the same relevance in very different contexts, such as terrorist networks or pandemic contexts 40 . In our case, our results are supported by the justification of this great researcher.

Our findings have shown that student leaders with a higher degree of Betweenness had a higher density than their peers in their Egonetworks . This could facilitate the transmission of social capital in a context such as the COVID-19 pandemic. These students, who serve as bridges, could become key actors with the ability to mobilize and coordinate social activity 49 . Their role is key for other colleagues, since they could serve as a "mirror" to "invite" appropriate behaviors in a health emergency. The key question that remains is, what behavior do they have? Structurally, the present investigation has demonstrated and justified that its position in the network is a model that could be disseminated among the rest of the actors.

To summarize the above, those responsible for universities must take into account the collective behavior of its networks. In a context such as the COVID-19 pandemic, the diffusion of behaviors is very relevant. Authors call for “urban intelligence” as a possible strategy to deal effectively with a pandemic. They understand that the impact of a health emergency is more than just a public health problem since it involves social risks and instability. This situation would be better dealt with by having the best that the social and community structure can offer, the so-called "urban intelligence” 50 .

SNA could provide a set of terms and concepts to explain and describe social phenomena 51 . The method offers a distinctive approach to analysing leadership in disaster processes. Leaders could be like "builders" of social responses and the managers of the universities should take it into account for the intervention processes.

The most important limitations of this study should be considered for future research. For example, it would be of interest to carry out other analyzes focused more on the cohesion of the network and the behavior of the subgroups, in order to draw structural conclusions at the micro level. Future lines of research could focus on comparing the students’ leadership in terms of structure with leadership as perceived by both them and their own peers.


The present research has carried out a study with students in university residences. The aim has been to describe the structural behaviour of students in university residences during the COVID-19 pandemic, with a more in-depth analysis of student leaders. The specific objectives proposed to develop the research were to: (i) analyse the relationship between the position of students in the network and their results with respect to COVID-19 infection, (ii) describe the position of influence of student leaders in the network, (iii) analyzing the Egonetwork of the most influential student leaders on the COVID-19 pandemic, and (iv) visualise the relational behaviour of university students in the global network.

The main conclusions derived from the results are detailed below:

The most central students in the network, had more positive results regarding COVID-19 infection.

The leadership of the confined students was related to higher degree, eigenvector and betweenness.

A small core of leaders are key players, so their role conditions the connection or disconnection between different components of the global network.

Students with a key player structure show a similar Egonetwork if they belong to the same residence.

There is a student leader with the maximum key player power structure, causing a total disconnection between networks if he/she disappears from the global network.

The findings show that strategies to cope with a disaster or pandemic need to be addressed through a network approach. University managers will need to have a profound understanding of students' relational behaviour. Only then will the most restrictive measures be effective. Responsible or irresponsible behaviour is transferred through the connections between students, so Social Network Analysis should be considered as a method of analyzing the evolution of a pandemic at the societal level. Any crisis involves contacts, but in a pandemic, contacts can transfer infection. Also in a pandemic, contacts can transfer habits and behaviours "passed on" by leaders, so that they allow for more effective coping. All of this can be analysed using SNA. Our study provides findings with an innovative approach, achieved with SNA. Among the limitations of the study it should be noted that the sample is very small (n = 93). This means that we cannot state categorically the representativeness of the results presented. However, the results could be used for future research where it is useful to analyse health emergency contexts as a network rather than analysing individuals in isolation.

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V.M. and T.F.-V. conceived the project. J.A.B.-A., P.M.-S. and C.B. performed the analytical calculations. A.G.-S., and J.A.B.-A. performed all the numerical calculations. J.A.B.-A. and P.M.-S. wrote a first draft of the manuscript. All authors reviewed and edited the manuscript.

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Benítez-Andrades, J.A., Fernández-Villa, T., Benavides, C. et al. A case study of university student networks and the COVID-19 pandemic using a social network analysis approach in halls of residence. Sci Rep 11 , 14877 (2021).

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Case-based learning.

Case-based learning (CBL) is an established approach used across disciplines where students apply their knowledge to real-world scenarios, promoting higher levels of cognition (see Bloom’s Taxonomy ). In CBL classrooms, students typically work in groups on case studies, stories involving one or more characters and/or scenarios.  The cases present a disciplinary problem or problems for which students devise solutions under the guidance of the instructor. CBL has a strong history of successful implementation in medical, law, and business schools, and is increasingly used within undergraduate education, particularly within pre-professional majors and the sciences (Herreid, 1994). This method involves guided inquiry and is grounded in constructivism whereby students form new meanings by interacting with their knowledge and the environment (Lee, 2012).

There are a number of benefits to using CBL in the classroom. In a review of the literature, Williams (2005) describes how CBL: utilizes collaborative learning, facilitates the integration of learning, develops students’ intrinsic and extrinsic motivation to learn, encourages learner self-reflection and critical reflection, allows for scientific inquiry, integrates knowledge and practice, and supports the development of a variety of learning skills.

CBL has several defining characteristics, including versatility, storytelling power, and efficient self-guided learning.  In a systematic analysis of 104 articles in health professions education, CBL was found to be utilized in courses with less than 50 to over 1000 students (Thistlethwaite et al., 2012). In these classrooms, group sizes ranged from 1 to 30, with most consisting of 2 to 15 students.  Instructors varied in the proportion of time they implemented CBL in the classroom, ranging from one case spanning two hours of classroom time, to year-long case-based courses. These findings demonstrate that instructors use CBL in a variety of ways in their classrooms.

The stories that comprise the framework of case studies are also a key component to CBL’s effectiveness. Jonassen and Hernandez-Serrano (2002, p.66) describe how storytelling:

Is a method of negotiating and renegotiating meanings that allows us to enter into other’s realms of meaning through messages they utter in their stories,

Helps us find our place in a culture,

Allows us to explicate and to interpret, and

Facilitates the attainment of vicarious experience by helping us to distinguish the positive models to emulate from the negative model.

Neurochemically, listening to stories can activate oxytocin, a hormone that increases one’s sensitivity to social cues, resulting in more empathy, generosity, compassion and trustworthiness (Zak, 2013; Kosfeld et al., 2005). The stories within case studies serve as a means by which learners form new understandings through characters and/or scenarios.

CBL is often described in conjunction or in comparison with problem-based learning (PBL). While the lines are often confusingly blurred within the literature, in the most conservative of definitions, the features distinguishing the two approaches include that PBL involves open rather than guided inquiry, is less structured, and the instructor plays a more passive role. In PBL multiple solutions to the problem may exit, but the problem is often initially not well-defined. PBL also has a stronger emphasis on developing self-directed learning. The choice between implementing CBL versus PBL is highly dependent on the goals and context of the instruction.  For example, in a comparison of PBL and CBL approaches during a curricular shift at two medical schools, students and faculty preferred CBL to PBL (Srinivasan et al., 2007). Students perceived CBL to be a more efficient process and more clinically applicable. However, in another context, PBL might be the favored approach.

In a review of the effectiveness of CBL in health profession education, Thistlethwaite et al. (2012), found several benefits:

Students enjoyed the method and thought it enhanced their learning,

Instructors liked how CBL engaged students in learning,

CBL seemed to facilitate small group learning, but the authors could not distinguish between whether it was the case itself or the small group learning that occurred as facilitated by the case.

Other studies have also reported on the effectiveness of CBL in achieving learning outcomes (Bonney, 2015; Breslin, 2008; Herreid, 2013; Krain, 2016). These findings suggest that CBL is a vehicle of engagement for instruction, and facilitates an environment whereby students can construct knowledge.

Science – Students are given a scenario to which they apply their basic science knowledge and problem-solving skills to help them solve the case. One example within the biological sciences is two brothers who have a family history of a genetic illness. They each have mutations within a particular sequence in their DNA. Students work through the case and draw conclusions about the biological impacts of these mutations using basic science. Sample cases: You are Not the Mother of Your Children ; Organic Chemisty and Your Cellphone: Organic Light-Emitting Diodes ;   A Light on Physics: F-Number and Exposure Time

Medicine – Medical or pre-health students read about a patient presenting with specific symptoms. Students decide which questions are important to ask the patient in their medical history, how long they have experienced such symptoms, etc. The case unfolds and students use clinical reasoning, propose relevant tests, develop a differential diagnoses and a plan of treatment. Sample cases: The Case of the Crying Baby: Surgical vs. Medical Management ; The Plan: Ethics and Physician Assisted Suicide ; The Haemophilus Vaccine: A Victory for Immunologic Engineering

Public Health – A case study describes a pandemic of a deadly infectious disease. Students work through the case to identify Patient Zero, the person who was the first to spread the disease, and how that individual became infected.  Sample cases: The Protective Parent ; The Elusive Tuberculosis Case: The CDC and Andrew Speaker ; Credible Voice: WHO-Beijing and the SARS Crisis

Law – A case study presents a legal dilemma for which students use problem solving to decide the best way to advise and defend a client. Students are presented information that changes during the case.  Sample cases: Mortgage Crisis Call (abstract) ; The Case of the Unpaid Interns (abstract) ; Police-Community Dialogue (abstract)

Business – Students work on a case study that presents the history of a business success or failure. They apply business principles learned in the classroom and assess why the venture was successful or not. Sample cases: SELCO-Determining a path forward ; Project Masiluleke: Texting and Testing to Fight HIV/AIDS in South Africa ; Mayo Clinic: Design Thinking in Healthcare

Humanities - Students consider a case that presents a theater facing financial and management difficulties. They apply business and theater principles learned in the classroom to the case, working together to create solutions for the theater. Sample cases: David Geffen School of Drama


Finding and Writing Cases

Consider utilizing or adapting open access cases - The availability of open resources and databases containing cases that instructors can download makes this approach even more accessible in the classroom. Two examples of open databases are the Case Center on Public Leadership and Harvard Kennedy School (HKS) Case Program , which focus on government, leadership and public policy case studies.

  • Consider writing original cases - In the event that an instructor is unable to find open access cases relevant to their course learning objectives, they may choose to write their own. See the following resources on case writing: Cooking with Betty Crocker: A Recipe for Case Writing ; The Way of Flesch: The Art of Writing Readable Cases ;   Twixt Fact and Fiction: A Case Writer’s Dilemma ; And All That Jazz: An Essay Extolling the Virtues of Writing Case Teaching Notes .

Implementing Cases

Take baby steps if new to CBL - While entire courses and curricula may involve case-based learning, instructors who desire to implement on a smaller-scale can integrate a single case into their class, and increase the number of cases utilized over time as desired.

Use cases in classes that are small, medium or large - Cases can be scaled to any course size. In large classes with stadium seating, students can work with peers nearby, while in small classes with more flexible seating arrangements, teams can move their chairs closer together. CBL can introduce more noise (and energy) in the classroom to which an instructor often quickly becomes accustomed. Further, students can be asked to work on cases outside of class, and wrap up discussion during the next class meeting.

Encourage collaborative work - Cases present an opportunity for students to work together to solve cases which the historical literature supports as beneficial to student learning (Bruffee, 1993). Allow students to work in groups to answer case questions.

Form diverse teams as feasible - When students work within diverse teams they can be exposed to a variety of perspectives that can help them solve the case. Depending on the context of the course, priorities, and the background information gathered about the students enrolled in the class, instructors may choose to organize student groups to allow for diversity in factors such as current course grades, gender, race/ethnicity, personality, among other items.  

Use stable teams as appropriate - If CBL is a large component of the course, a research-supported practice is to keep teams together long enough to go through the stages of group development: forming, storming, norming, performing and adjourning (Tuckman, 1965).

Walk around to guide groups - In CBL instructors serve as facilitators of student learning. Walking around allows the instructor to monitor student progress as well as identify and support any groups that may be struggling. Teaching assistants can also play a valuable role in supporting groups.

Interrupt strategically - Only every so often, for conversation in large group discussion of the case, especially when students appear confused on key concepts. An effective practice to help students meet case learning goals is to guide them as a whole group when the class is ready. This may include selecting a few student groups to present answers to discussion questions to the entire class, asking the class a question relevant to the case using polling software, and/or performing a mini-lesson on an area that appears to be confusing among students.  

Assess student learning in multiple ways - Students can be assessed informally by asking groups to report back answers to various case questions. This practice also helps students stay on task, and keeps them accountable. Cases can also be included on exams using related scenarios where students are asked to apply their knowledge.

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Breslin M, Buchanan, R. (2008) On the Case Study Method of Research and Teaching in Design.  Design Issues, 24(1), 36-40.

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Herreid CF. (2013). Start with a Story: The Case Study Method of Teaching College Science, edited by Clyde Freeman Herreid. Originally published in 2006 by the National Science Teachers Association (NSTA); reprinted by the National Center for Case Study Teaching in Science (NCCSTS) in 2013.

Herreid CH. (1994). Case studies in science: A novel method of science education. Journal of Research in Science Teaching, 23(4), 221–229.

Jonassen DH and Hernandez-Serrano J. (2002). Case-based reasoning and instructional design: Using stories to support problem solving. Educational Technology, Research and Development, 50(2), 65-77.  

Kosfeld M, Heinrichs M, Zak PJ, Fischbacher U, Fehr E. (2005). Oxytocin increases trust in humans. Nature, 435, 673-676.

Krain M. (2016) Putting the learning in case learning? The effects of case-based approaches on student knowledge, attitudes, and engagement. Journal on Excellence in College Teaching, 27(2), 131-153.

Lee V. (2012). What is Inquiry-Guided Learning?  New Directions for Learning, 129:5-14.

Nkhoma M, Sriratanaviriyakul N. (2017). Using case method to enrich students’ learning outcomes. Active Learning in Higher Education, 18(1):37-50.

Srinivasan et al. (2007). Comparing problem-based learning with case-based learning: Effects of a major curricular shift at two institutions. Academic Medicine, 82(1): 74-82.

Thistlethwaite JE et al. (2012). The effectiveness of case-based learning in health professional education. A BEME systematic review: BEME Guide No. 23.  Medical Teacher, 34, e421-e444.

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Zak, PJ (2013). How Stories Change the Brain. Retrieved from:


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What the Case Study Method Really Teaches

  • Nitin Nohria

case study with university students

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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  • 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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Organizing Your Social Sciences Research Assignments

  • Annotated Bibliography
  • Analyzing a Scholarly Journal Article
  • Group Presentations
  • Dealing with Nervousness
  • Using Visual Aids
  • Grading Someone Else's Paper
  • Types of Structured Group Activities
  • Group Project Survival Skills
  • Leading a Class Discussion
  • Multiple Book Review Essay
  • Reviewing Collected Works
  • Writing a Case Analysis Paper
  • Writing a Case Study
  • About Informed Consent
  • Writing Field Notes
  • Writing a Policy Memo
  • Writing a Reflective Paper
  • Writing a Research Proposal
  • Generative AI and Writing
  • Acknowledgments

Definition and Introduction

Case analysis is a problem-based teaching and learning method that involves critically analyzing complex scenarios within an organizational setting for the purpose of placing the student in a “real world” situation and applying reflection and critical thinking skills to contemplate appropriate solutions, decisions, or recommended courses of action. It is considered a more effective teaching technique than in-class role playing or simulation activities. The analytical process is often guided by questions provided by the instructor that ask students to contemplate relationships between the facts and critical incidents described in the case.

Cases generally include both descriptive and statistical elements and rely on students applying abductive reasoning to develop and argue for preferred or best outcomes [i.e., case scenarios rarely have a single correct or perfect answer based on the evidence provided]. Rather than emphasizing theories or concepts, case analysis assignments emphasize building a bridge of relevancy between abstract thinking and practical application and, by so doing, teaches the value of both within a specific area of professional practice.

Given this, the purpose of a case analysis paper is to present a structured and logically organized format for analyzing the case situation. It can be assigned to students individually or as a small group assignment and it may include an in-class presentation component. Case analysis is predominately taught in economics and business-related courses, but it is also a method of teaching and learning found in other applied social sciences disciplines, such as, social work, public relations, education, journalism, and public administration.

Ellet, William. The Case Study Handbook: A Student's Guide . Revised Edition. Boston, MA: Harvard Business School Publishing, 2018; Christoph Rasche and Achim Seisreiner. Guidelines for Business Case Analysis . University of Potsdam; Writing a Case Analysis . Writing Center, Baruch College; Volpe, Guglielmo. "Case Teaching in Economics: History, Practice and Evidence." Cogent Economics and Finance 3 (December 2015). doi:

How to Approach Writing a Case Analysis Paper

The organization and structure of a case analysis paper can vary depending on the organizational setting, the situation, and how your professor wants you to approach the assignment. Nevertheless, preparing to write a case analysis paper involves several important steps. As Hawes notes, a case analysis assignment “ useful in developing the ability to get to the heart of a problem, analyze it thoroughly, and to indicate the appropriate solution as well as how it should be implemented” [p.48]. This statement encapsulates how you should approach preparing to write a case analysis paper.

Before you begin to write your paper, consider the following analytical procedures:

  • Review the case to get an overview of the situation . A case can be only a few pages in length, however, it is most often very lengthy and contains a significant amount of detailed background information and statistics, with multilayered descriptions of the scenario, the roles and behaviors of various stakeholder groups, and situational events. Therefore, a quick reading of the case will help you gain an overall sense of the situation and illuminate the types of issues and problems that you will need to address in your paper. If your professor has provided questions intended to help frame your analysis, use them to guide your initial reading of the case.
  • Read the case thoroughly . After gaining a general overview of the case, carefully read the content again with the purpose of understanding key circumstances, events, and behaviors among stakeholder groups. Look for information or data that appears contradictory, extraneous, or misleading. At this point, you should be taking notes as you read because this will help you develop a general outline of your paper. The aim is to obtain a complete understanding of the situation so that you can begin contemplating tentative answers to any questions your professor has provided or, if they have not provided, developing answers to your own questions about the case scenario and its connection to the course readings,lectures, and class discussions.
  • Determine key stakeholder groups, issues, and events and the relationships they all have to each other . As you analyze the content, pay particular attention to identifying individuals, groups, or organizations described in the case and identify evidence of any problems or issues of concern that impact the situation in a negative way. Other things to look for include identifying any assumptions being made by or about each stakeholder, potential biased explanations or actions, explicit demands or ultimatums , and the underlying concerns that motivate these behaviors among stakeholders. The goal at this stage is to develop a comprehensive understanding of the situational and behavioral dynamics of the case and the explicit and implicit consequences of each of these actions.
  • Identify the core problems . The next step in most case analysis assignments is to discern what the core [i.e., most damaging, detrimental, injurious] problems are within the organizational setting and to determine their implications. The purpose at this stage of preparing to write your analysis paper is to distinguish between the symptoms of core problems and the core problems themselves and to decide which of these must be addressed immediately and which problems do not appear critical but may escalate over time. Identify evidence from the case to support your decisions by determining what information or data is essential to addressing the core problems and what information is not relevant or is misleading.
  • Explore alternative solutions . As noted, case analysis scenarios rarely have only one correct answer. Therefore, it is important to keep in mind that the process of analyzing the case and diagnosing core problems, while based on evidence, is a subjective process open to various avenues of interpretation. This means that you must consider alternative solutions or courses of action by critically examining strengths and weaknesses, risk factors, and the differences between short and long-term solutions. For each possible solution or course of action, consider the consequences they may have related to their implementation and how these recommendations might lead to new problems. Also, consider thinking about your recommended solutions or courses of action in relation to issues of fairness, equity, and inclusion.
  • Decide on a final set of recommendations . The last stage in preparing to write a case analysis paper is to assert an opinion or viewpoint about the recommendations needed to help resolve the core problems as you see them and to make a persuasive argument for supporting this point of view. Prepare a clear rationale for your recommendations based on examining each element of your analysis. Anticipate possible obstacles that could derail their implementation. Consider any counter-arguments that could be made concerning the validity of your recommended actions. Finally, describe a set of criteria and measurable indicators that could be applied to evaluating the effectiveness of your implementation plan.

Use these steps as the framework for writing your paper. Remember that the more detailed you are in taking notes as you critically examine each element of the case, the more information you will have to draw from when you begin to write. This will save you time.

NOTE : If the process of preparing to write a case analysis paper is assigned as a student group project, consider having each member of the group analyze a specific element of the case, including drafting answers to the corresponding questions used by your professor to frame the analysis. This will help make the analytical process more efficient and ensure that the distribution of work is equitable. This can also facilitate who is responsible for drafting each part of the final case analysis paper and, if applicable, the in-class presentation.

Framework for Case Analysis . College of Management. University of Massachusetts; Hawes, Jon M. "Teaching is Not Telling: The Case Method as a Form of Interactive Learning." Journal for Advancement of Marketing Education 5 (Winter 2004): 47-54; Rasche, Christoph and Achim Seisreiner. Guidelines for Business Case Analysis . University of Potsdam; Writing a Case Study Analysis . University of Arizona Global Campus Writing Center; Van Ness, Raymond K. A Guide to Case Analysis . School of Business. State University of New York, Albany; Writing a Case Analysis . Business School, University of New South Wales.

Structure and Writing Style

A case analysis paper should be detailed, concise, persuasive, clearly written, and professional in tone and in the use of language . As with other forms of college-level academic writing, declarative statements that convey information, provide a fact, or offer an explanation or any recommended courses of action should be based on evidence. If allowed by your professor, any external sources used to support your analysis, such as course readings, should be properly cited under a list of references. The organization and structure of case analysis papers can vary depending on your professor’s preferred format, but its structure generally follows the steps used for analyzing the case.


The introduction should provide a succinct but thorough descriptive overview of the main facts, issues, and core problems of the case . The introduction should also include a brief summary of the most relevant details about the situation and organizational setting. This includes defining the theoretical framework or conceptual model on which any questions were used to frame your analysis.

Following the rules of most college-level research papers, the introduction should then inform the reader how the paper will be organized. This includes describing the major sections of the paper and the order in which they will be presented. Unless you are told to do so by your professor, you do not need to preview your final recommendations in the introduction. U nlike most college-level research papers , the introduction does not include a statement about the significance of your findings because a case analysis assignment does not involve contributing new knowledge about a research problem.

Background Analysis

Background analysis can vary depending on any guiding questions provided by your professor and the underlying concept or theory that the case is based upon. In general, however, this section of your paper should focus on:

  • Providing an overarching analysis of problems identified from the case scenario, including identifying events that stakeholders find challenging or troublesome,
  • Identifying assumptions made by each stakeholder and any apparent biases they may exhibit,
  • Describing any demands or claims made by or forced upon key stakeholders, and
  • Highlighting any issues of concern or complaints expressed by stakeholders in response to those demands or claims.

These aspects of the case are often in the form of behavioral responses expressed by individuals or groups within the organizational setting. However, note that problems in a case situation can also be reflected in data [or the lack thereof] and in the decision-making, operational, cultural, or institutional structure of the organization. Additionally, demands or claims can be either internal and external to the organization [e.g., a case analysis involving a president considering arms sales to Saudi Arabia could include managing internal demands from White House advisors as well as demands from members of Congress].

Throughout this section, present all relevant evidence from the case that supports your analysis. Do not simply claim there is a problem, an assumption, a demand, or a concern; tell the reader what part of the case informed how you identified these background elements.

Identification of Problems

In most case analysis assignments, there are problems, and then there are problems . Each problem can reflect a multitude of underlying symptoms that are detrimental to the interests of the organization. The purpose of identifying problems is to teach students how to differentiate between problems that vary in severity, impact, and relative importance. Given this, problems can be described in three general forms: those that must be addressed immediately, those that should be addressed but the impact is not severe, and those that do not require immediate attention and can be set aside for the time being.

All of the problems you identify from the case should be identified in this section of your paper, with a description based on evidence explaining the problem variances. If the assignment asks you to conduct research to further support your assessment of the problems, include this in your explanation. Remember to cite those sources in a list of references. Use specific evidence from the case and apply appropriate concepts, theories, and models discussed in class or in relevant course readings to highlight and explain the key problems [or problem] that you believe must be solved immediately and describe the underlying symptoms and why they are so critical.

Alternative Solutions

This section is where you provide specific, realistic, and evidence-based solutions to the problems you have identified and make recommendations about how to alleviate the underlying symptomatic conditions impacting the organizational setting. For each solution, you must explain why it was chosen and provide clear evidence to support your reasoning. This can include, for example, course readings and class discussions as well as research resources, such as, books, journal articles, research reports, or government documents. In some cases, your professor may encourage you to include personal, anecdotal experiences as evidence to support why you chose a particular solution or set of solutions. Using anecdotal evidence helps promote reflective thinking about the process of determining what qualifies as a core problem and relevant solution .

Throughout this part of the paper, keep in mind the entire array of problems that must be addressed and describe in detail the solutions that might be implemented to resolve these problems.

Recommended Courses of Action

In some case analysis assignments, your professor may ask you to combine the alternative solutions section with your recommended courses of action. However, it is important to know the difference between the two. A solution refers to the answer to a problem. A course of action refers to a procedure or deliberate sequence of activities adopted to proactively confront a situation, often in the context of accomplishing a goal. In this context, proposed courses of action are based on your analysis of alternative solutions. Your description and justification for pursuing each course of action should represent the overall plan for implementing your recommendations.

For each course of action, you need to explain the rationale for your recommendation in a way that confronts challenges, explains risks, and anticipates any counter-arguments from stakeholders. Do this by considering the strengths and weaknesses of each course of action framed in relation to how the action is expected to resolve the core problems presented, the possible ways the action may affect remaining problems, and how the recommended action will be perceived by each stakeholder.

In addition, you should describe the criteria needed to measure how well the implementation of these actions is working and explain which individuals or groups are responsible for ensuring your recommendations are successful. In addition, always consider the law of unintended consequences. Outline difficulties that may arise in implementing each course of action and describe how implementing the proposed courses of action [either individually or collectively] may lead to new problems [both large and small].

Throughout this section, you must consider the costs and benefits of recommending your courses of action in relation to uncertainties or missing information and the negative consequences of success.

The conclusion should be brief and introspective. Unlike a research paper, the conclusion in a case analysis paper does not include a summary of key findings and their significance, a statement about how the study contributed to existing knowledge, or indicate opportunities for future research.

Begin by synthesizing the core problems presented in the case and the relevance of your recommended solutions. This can include an explanation of what you have learned about the case in the context of your answers to the questions provided by your professor. The conclusion is also where you link what you learned from analyzing the case with the course readings or class discussions. This can further demonstrate your understanding of the relationships between the practical case situation and the theoretical and abstract content of assigned readings and other course content.

Problems to Avoid

The literature on case analysis assignments often includes examples of difficulties students have with applying methods of critical analysis and effectively reporting the results of their assessment of the situation. A common reason cited by scholars is that the application of this type of teaching and learning method is limited to applied fields of social and behavioral sciences and, as a result, writing a case analysis paper can be unfamiliar to most students entering college.

After you have drafted your paper, proofread the narrative flow and revise any of these common errors:

  • Unnecessary detail in the background section . The background section should highlight the essential elements of the case based on your analysis. Focus on summarizing the facts and highlighting the key factors that become relevant in the other sections of the paper by eliminating any unnecessary information.
  • Analysis relies too much on opinion . Your analysis is interpretive, but the narrative must be connected clearly to evidence from the case and any models and theories discussed in class or in course readings. Any positions or arguments you make should be supported by evidence.
  • Analysis does not focus on the most important elements of the case . Your paper should provide a thorough overview of the case. However, the analysis should focus on providing evidence about what you identify are the key events, stakeholders, issues, and problems. Emphasize what you identify as the most critical aspects of the case to be developed throughout your analysis. Be thorough but succinct.
  • Writing is too descriptive . A paper with too much descriptive information detracts from your analysis of the complexities of the case situation. Questions about what happened, where, when, and by whom should only be included as essential information leading to your examination of questions related to why, how, and for what purpose.
  • Inadequate definition of a core problem and associated symptoms . A common error found in case analysis papers is recommending a solution or course of action without adequately defining or demonstrating that you understand the problem. Make sure you have clearly described the problem and its impact and scope within the organizational setting. Ensure that you have adequately described the root causes w hen describing the symptoms of the problem.
  • Recommendations lack specificity . Identify any use of vague statements and indeterminate terminology, such as, “A particular experience” or “a large increase to the budget.” These statements cannot be measured and, as a result, there is no way to evaluate their successful implementation. Provide specific data and use direct language in describing recommended actions.
  • Unrealistic, exaggerated, or unattainable recommendations . Review your recommendations to ensure that they are based on the situational facts of the case. Your recommended solutions and courses of action must be based on realistic assumptions and fit within the constraints of the situation. Also note that the case scenario has already happened, therefore, any speculation or arguments about what could have occurred if the circumstances were different should be revised or eliminated.

Bee, Lian Song et al. "Business Students' Perspectives on Case Method Coaching for Problem-Based Learning: Impacts on Student Engagement and Learning Performance in Higher Education." Education & Training 64 (2022): 416-432; The Case Analysis . Fred Meijer Center for Writing and Michigan Authors. Grand Valley State University; Georgallis, Panikos and Kayleigh Bruijn. "Sustainability Teaching using Case-Based Debates." Journal of International Education in Business 15 (2022): 147-163; Hawes, Jon M. "Teaching is Not Telling: The Case Method as a Form of Interactive Learning." Journal for Advancement of Marketing Education 5 (Winter 2004): 47-54; Georgallis, Panikos, and Kayleigh Bruijn. "Sustainability Teaching Using Case-based Debates." Journal of International Education in Business 15 (2022): 147-163; .Dean,  Kathy Lund and Charles J. Fornaciari. "How to Create and Use Experiential Case-Based Exercises in a Management Classroom." Journal of Management Education 26 (October 2002): 586-603; Klebba, Joanne M. and Janet G. Hamilton. "Structured Case Analysis: Developing Critical Thinking Skills in a Marketing Case Course." Journal of Marketing Education 29 (August 2007): 132-137, 139; Klein, Norman. "The Case Discussion Method Revisited: Some Questions about Student Skills." Exchange: The Organizational Behavior Teaching Journal 6 (November 1981): 30-32; Mukherjee, Arup. "Effective Use of In-Class Mini Case Analysis for Discovery Learning in an Undergraduate MIS Course." The Journal of Computer Information Systems 40 (Spring 2000): 15-23; Pessoa, Silviaet al. "Scaffolding the Case Analysis in an Organizational Behavior Course: Making Analytical Language Explicit." Journal of Management Education 46 (2022): 226-251: Ramsey, V. J. and L. D. Dodge. "Case Analysis: A Structured Approach." Exchange: The Organizational Behavior Teaching Journal 6 (November 1981): 27-29; Schweitzer, Karen. "How to Write and Format a Business Case Study." ThoughtCo. (accessed December 5, 2022); Reddy, C. D. "Teaching Research Methodology: Everything's a Case." Electronic Journal of Business Research Methods 18 (December 2020): 178-188; Volpe, Guglielmo. "Case Teaching in Economics: History, Practice and Evidence." Cogent Economics and Finance 3 (December 2015). doi:

Writing Tip

Ca se Study and Case Analysis Are Not the Same!

Confusion often exists between what it means to write a paper that uses a case study research design and writing a paper that analyzes a case; they are two different types of approaches to learning in the social and behavioral sciences. Professors as well as educational researchers contribute to this confusion because they often use the term "case study" when describing the subject of analysis for a case analysis paper. But you are not studying a case for the purpose of generating a comprehensive, multi-faceted understanding of a research problem. R ather, you are critically analyzing a specific scenario to argue logically for recommended solutions and courses of action that lead to optimal outcomes applicable to professional practice.

To avoid any confusion, here are twelve characteristics that delineate the differences between writing a paper using the case study research method and writing a case analysis paper:

  • Case study is a method of in-depth research and rigorous inquiry ; case analysis is a reliable method of teaching and learning . A case study is a modality of research that investigates a phenomenon for the purpose of creating new knowledge, solving a problem, or testing a hypothesis using empirical evidence derived from the case being studied. Often, the results are used to generalize about a larger population or within a wider context. The writing adheres to the traditional standards of a scholarly research study. A case analysis is a pedagogical tool used to teach students how to reflect and think critically about a practical, real-life problem in an organizational setting.
  • The researcher is responsible for identifying the case to study; a case analysis is assigned by your professor . As the researcher, you choose the case study to investigate in support of obtaining new knowledge and understanding about the research problem. The case in a case analysis assignment is almost always provided, and sometimes written, by your professor and either given to every student in class to analyze individually or to a small group of students, or students select a case to analyze from a predetermined list.
  • A case study is indeterminate and boundless; a case analysis is predetermined and confined . A case study can be almost anything [see item 9 below] as long as it relates directly to examining the research problem. This relationship is the only limit to what a researcher can choose as the subject of their case study. The content of a case analysis is determined by your professor and its parameters are well-defined and limited to elucidating insights of practical value applied to practice.
  • Case study is fact-based and describes actual events or situations; case analysis can be entirely fictional or adapted from an actual situation . The entire content of a case study must be grounded in reality to be a valid subject of investigation in an empirical research study. A case analysis only needs to set the stage for critically examining a situation in practice and, therefore, can be entirely fictional or adapted, all or in-part, from an actual situation.
  • Research using a case study method must adhere to principles of intellectual honesty and academic integrity; a case analysis scenario can include misleading or false information . A case study paper must report research objectively and factually to ensure that any findings are understood to be logically correct and trustworthy. A case analysis scenario may include misleading or false information intended to deliberately distract from the central issues of the case. The purpose is to teach students how to sort through conflicting or useless information in order to come up with the preferred solution. Any use of misleading or false information in academic research is considered unethical.
  • Case study is linked to a research problem; case analysis is linked to a practical situation or scenario . In the social sciences, the subject of an investigation is most often framed as a problem that must be researched in order to generate new knowledge leading to a solution. Case analysis narratives are grounded in real life scenarios for the purpose of examining the realities of decision-making behavior and processes within organizational settings. A case analysis assignments include a problem or set of problems to be analyzed. However, the goal is centered around the act of identifying and evaluating courses of action leading to best possible outcomes.
  • The purpose of a case study is to create new knowledge through research; the purpose of a case analysis is to teach new understanding . Case studies are a choice of methodological design intended to create new knowledge about resolving a research problem. A case analysis is a mode of teaching and learning intended to create new understanding and an awareness of uncertainty applied to practice through acts of critical thinking and reflection.
  • A case study seeks to identify the best possible solution to a research problem; case analysis can have an indeterminate set of solutions or outcomes . Your role in studying a case is to discover the most logical, evidence-based ways to address a research problem. A case analysis assignment rarely has a single correct answer because one of the goals is to force students to confront the real life dynamics of uncertainly, ambiguity, and missing or conflicting information within professional practice. Under these conditions, a perfect outcome or solution almost never exists.
  • Case study is unbounded and relies on gathering external information; case analysis is a self-contained subject of analysis . The scope of a case study chosen as a method of research is bounded. However, the researcher is free to gather whatever information and data is necessary to investigate its relevance to understanding the research problem. For a case analysis assignment, your professor will often ask you to examine solutions or recommended courses of action based solely on facts and information from the case.
  • Case study can be a person, place, object, issue, event, condition, or phenomenon; a case analysis is a carefully constructed synopsis of events, situations, and behaviors . The research problem dictates the type of case being studied and, therefore, the design can encompass almost anything tangible as long as it fulfills the objective of generating new knowledge and understanding. A case analysis is in the form of a narrative containing descriptions of facts, situations, processes, rules, and behaviors within a particular setting and under a specific set of circumstances.
  • Case study can represent an open-ended subject of inquiry; a case analysis is a narrative about something that has happened in the past . A case study is not restricted by time and can encompass an event or issue with no temporal limit or end. For example, the current war in Ukraine can be used as a case study of how medical personnel help civilians during a large military conflict, even though circumstances around this event are still evolving. A case analysis can be used to elicit critical thinking about current or future situations in practice, but the case itself is a narrative about something finite and that has taken place in the past.
  • Multiple case studies can be used in a research study; case analysis involves examining a single scenario . Case study research can use two or more cases to examine a problem, often for the purpose of conducting a comparative investigation intended to discover hidden relationships, document emerging trends, or determine variations among different examples. A case analysis assignment typically describes a stand-alone, self-contained situation and any comparisons among cases are conducted during in-class discussions and/or student presentations.

The Case Analysis . Fred Meijer Center for Writing and Michigan Authors. Grand Valley State University; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Ramsey, V. J. and L. D. Dodge. "Case Analysis: A Structured Approach." Exchange: The Organizational Behavior Teaching Journal 6 (November 1981): 27-29; Yin, Robert K. Case Study Research and Applications: Design and Methods . 6th edition. Thousand Oaks, CA: Sage, 2017; Crowe, Sarah et al. “The Case Study Approach.” BMC Medical Research Methodology 11 (2011):  doi: 10.1186/1471-2288-11-100; Yin, Robert K. Case Study Research: Design and Methods . 4th edition. Thousand Oaks, CA: Sage Publishing; 1994.

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How we’re supporting university students with their mental health

case study with university students

Going to university is a fun and exciting time for most students – but it comes with unique challenges and stresses. We believe that all students’ mental health and wellbeing should be properly supported during their time at university.

There is a range of mental health support available to students, from online mental health and wellbeing platform Student Space to counselling and one-to-one support. Here’s what you need to know.

What action are you taking to support students’ mental health?

Students struggling with their mental health can access  Student Space , a mental health and wellbeing hub supporting students.

Funded by £3.6 million from the Office for Students (OfS), Student Space provides dedicated one-to-one text and web chat support services. It’s also an online platform providing vital mental health and wellbeing resources.

This service is part of the £15 million we have asked the OfS to allocate towards student mental health in 2023/2024. This funding will also be used to give additional support for those making the transition from school or college to university, in particular through counselling services.

It will also be used to address any challenges that students may face in accessing local support services through their university, by establishing better partnerships between universities and local NHS services.

To ensure all the information is readily available for students and young people, we have put together some useful links and sources of mental health support so that everyone can get the advice and help they need. This information is available  here .

We are also asking universities to take a whole university approach to mental health by setting a target for all universities to sign up to the  University Mental Health Charter Programme by September 2024.

To support this target t he Office for Students ( OfS ) is providing £400,000 additional funding to Student Minds to support expansion of the Programme . You can read more about it on the OfS website . 

What is the University Mental Health Charter Programme? 

Universities that are part of the University Mental Health Charter programme will be supported to make cultural change so that all aspects of university life promote and support mental health.

Both students and staff will benefit from better support for their mental health and wellbeing as a result.

The Charter Award is given to the universities that are part of the Programme members which demonstrate excellent practice in supporting student mental health.

What is the Department doing to reduce suicides at universities?

Every student death is a tragedy and preventing suicide and self-harm in our student populations is a key priority.

So that students are better protected we have asked universities to fully implement best practice including the  Suicide Safer Universities  guidance, led by Universities UUK and Papyrus.

This includes guidance for universities on sharing information with family and friends in the event of a mental health crisis and practical advice on compassionate, confident, and timely support when a tragedy occurs.

Understanding student suicide data and risk factors is central to informing preventative action, which is why we have worked with the Office for National Statistics, which has published updated  data and analysis .

We appointed Professor Edward Peck as Higher Education Student Support Champion in May 2022 for a two-year term and extended the appointment for another year until 31 May 2025 . Professor Peck has been speaking to bereaved parents to understand where improvements can be made.    

To deliver better practice in mental health support across the higher education sector Professor Peck is chairing a Higher Education Mental Health Implementation Taskforce, which will include bereaved parents, students, mental health experts, charities and sector representatives.

It has been asked to deliver a report with a plan for better early identification of students at risk, a University Student Commitment on dealing with students sensitively on disciplinary issues, and a set of clear targets for improvements in practice by providers.

Its first stage report has been published outlining progress so far and setting out new areas of focus, including improving join up between higher education and NHS mental health services. It is due to publish a second stage report by July 2024.

We have also appointed the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) to carry out a National Review of Higher Education Suicides.

This will ensure that valuable lessons from past tragedies can be learnt to help us better protect students in future. Its findings report will be published by Spring 2025 outlining good practice and areas for improvement around suicide prevention in higher education.

Providers’ participation in the National Review of HE Suicides will be supported by the additional one-off £10m funding we have asked the OfS to allocate on mental health and hardship, which comes top of the £15 million already distributed this year on HE student mental health.

What should I do if I’m worried about a friend or family member at university?

We understand that helping a friend or family member with mental health issues can be difficult. It is important that students feel supported at this difficult time. There is support in place and people who are available to listen.

If for any reason you have cause to believe that someone you know is struggling with mental health and wellbeing issues at university, we recommend following NHS guidance .

Universities have support services in place for their students which can be accessed via their website, or by looking up your university on the  Student Space support pages .

You may also be interested in:

  • Mental health resources for children, students, parents, carers and school/college staff
  • What we are doing to improve the mental health of children and young people
  • Five things you didn’t know about mental health support in schools

Tags: Mental health , mental health resources , Office for Students , Pupil mental health , Universities UK , University , Wellbeing

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Student Case Study

Student Case Study 1

Delving into student case studies offers invaluable insights into educational methodologies and student behaviors. This guide, complete with detailed case study examples , is designed to help educators, researchers, and students understand the nuances of creating and analyzing case studies in an educational context. By exploring various case study examples, you will gain the tools and knowledge necessary to effectively interpret and apply these studies, enhancing both teaching and learning experiences in diverse academic settings.

What is a Student Case Study? – Meaning A student case study is an in-depth analysis of a student or a group of students to understand various educational, psychological, or social aspects. It involves collecting detailed information through observations, interviews, and reviewing records, to form a comprehensive picture. The goal of a case study analysis is to unravel the complexities of real-life situations that students encounter, making it a valuable tool in educational research. In a case study summary, key findings are presented, often leading to actionable insights. Educators and researchers use these studies to develop strategies for improving learning environments. Additionally, a case study essay allows students to demonstrate their understanding by discussing the analysis and implications of the case study, fostering critical thinking and analytical skills.

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Schools especially those that offers degree in medicine, law, public policy and public health teaches students to learn how to conduct a case study. Some students say they love case studies . For what reason? Case studies offer real world challenges. They help in preparing the students how to deal with their future careers. They are considered to be the vehicle for theories and concepts that enables you to be good at giving detailed discussions and even debates. Case studies are useful not just in the field of education, but also in adhering to the arising issues in business, politics and other organizations.

Student Case Study Format

Case Study Title : Clear and descriptive title reflecting the focus of the case study. Student’s Name : Name of the student the case study is about. Prepared by : Name of the person or group preparing the case study. School Name : Name of the school or educational institution. Date : Date of completion or submission.


Background Information : Briefly describe the student’s background, including age, grade level, and relevant personal or academic history. Purpose of the Case Study : State the reason for conducting this case study, such as understanding a particular behavior, learning difficulty, or achievement.

Case Description

Situation or Challenge : Detail the specific situation, challenge, or condition that the student is facing. Observations and Evidence : Include observations from teachers, parents, or the students themselves, along with any relevant academic or behavioral records.
Problem Analysis : Analyze the situation or challenge, identifying potential causes or contributing factors. Impact on Learning : Discuss how the situation affects the student’s learning or behavior in school.

Intervention Strategies

Action Taken : Describe any interventions or strategies implemented to address the situation. This could include educational plans, counseling, or specific teaching strategies. Results of Intervention : Detail the outcome of these interventions, including any changes in the student’s behavior or academic performance.

Conclusion and Recommendations

Summary of Findings : Summarize the key insights gained from the case study. Recommendations : Offer suggestions for future actions or strategies to further support the student. This might include recommendations for teachers, parents, or the student themselves.

Best Example of Student Case Study

Overcoming Reading Challenges: A Case Study of Emily Clark, Grade 3 Prepared by: Laura Simmons, Special Education Teacher Sunset Elementary School Date: May 12, 2024   Emily Clark, an 8-year-old student in the third grade at Sunset Elementary School, has been facing significant challenges with reading and comprehension since the first grade. Known for her enthusiasm and creativity, Emily’s struggles with reading tasks have been persistent and noticeable. The primary purpose of this case study is to analyze Emily’s reading difficulties, implement targeted interventions, and assess their effectiveness.   Emily exhibits difficulty in decoding words, reading fluently, and understanding text, as observed by her teachers since first grade. Her reluctance to read aloud and frustration with reading tasks have been consistently noted. Assessments indicate that her reading level is significantly below the expected standard for her grade. Parental feedback has also highlighted Emily’s struggles with reading-related homework.   Analysis of Emily’s situation suggests a potential learning disability in reading, possibly dyslexia. This is evidenced by her consistent difficulty with word recognition and comprehension. These challenges have impacted not only her reading skills but also her confidence and participation in class activities, especially those involving reading.   To address these challenges, an individualized education plan (IEP) was developed. This included specialized reading instruction focusing on phonemic awareness and decoding skills, multisensory learning approaches, and regular sessions with a reading specialist. Over a period of six months, Emily demonstrated significant improvements. She engaged more confidently in reading activities, and her reading assessment scores showed notable progress.   In conclusion, the intervention strategies implemented for Emily have been effective. Her case highlights the importance of early identification and the implementation of tailored educational strategies for students with similar challenges. It is recommended that Emily continues to receive specialized instruction and regular monitoring. Adjustments to her IEP should be made as necessary to ensure ongoing progress. Additionally, fostering a positive reading environment at home is also recommended.

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18. Student Case Study in DOC Example

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19. Case Study Of a Student with Anxiety

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Case Study Definition

A case study is defined as a research methodology that allows you to conduct an intensive study about a particular person, group of people, community, or some unit in which the researcher could provide an in-depth data in relation to the variables. Case studies can examine a phenomena in the natural setting. This increases your ability to understand why the subjects act such. You may be able to describe how this method allows every researcher to take a specific topic to narrow it down making it into a manageable research question. The researcher gain an in-depth understanding about the subject matter through collecting qualitative research and quantitative research datasets about the phenomenon.

Benefits and Limitations of Case Studies

If a researcher is interested to study about a phenomenon, he or she will be assigned to a single-case study that will allow him or her to gain an understanding about the phenomenon. Multiple-case study would allow a researcher to understand the case as a group through comparing them based on the embedded similarities and differences. However, the volume of data in case studies will be difficult to organize and the process of analysis and strategies needs to be carefully decided upon. Reporting of findings could also be challenging at times especially when you are ought to follow for word limits.

Example of Case Study

Nurses’ pediatric pain management practices.

One of the authors of this paper (AT) has used a case study approach to explore nurses’ pediatric 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 pediatric 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 analyzed separately and then compared and demonstrated that nurses’ level of theoretical did not impact on the quality of their pain management practices. Nor did individual nurse’s perceptions of how critical a task was effect the likelihood of them carrying out this task in practice. There was also a difference in self-reported and observed practices; actual (observed) practices did not confirm to best practice guidelines, whereas self-reported practices tended to.

How do you Write a Case Study for Students?

1. choose an interesting and relevant topic:.

Select a topic that is relevant to your course and interesting to your audience. It should be specific and focused, allowing for in-depth analysis.

2. Conduct Thorough Research :

Gather information from reputable sources such as books, scholarly articles, interviews, and reliable websites. Ensure you have a good understanding of the topic before proceeding.

3. Identify the Problem or Research Question:

Clearly define the problem or research question your case study aims to address. Be specific about the issues you want to explore and analyze.

4. Introduce the Case:

Provide background information about the subject, including relevant historical, social, or organizational context. Explain why the case is important and what makes it unique.

5. Describe the Methods Used:

Explain the methods you used to collect data. This could include interviews, surveys, observations, or analysis of existing documents. Justify your choice of methods.

6. Present the Findings:

Present the data and findings in a clear and organized manner. Use charts, graphs, and tables if applicable. Include direct quotes from interviews or other sources to support your points.

7. Analytical Interpretation:

Analyze the data and discuss the patterns, trends, or relationships you observed. Relate your findings back to the research question. Use relevant theories or concepts to support your analysis.

8. Discuss Limitations:

Acknowledge any limitations in your study, such as constraints in data collection or research methods. Addressing limitations shows a critical awareness of your study’s scope.

9. Propose Solutions or Recommendations:

If your case study revolves around a problem, propose practical solutions or recommendations based on your analysis. Support your suggestions with evidence from your findings.

10. Write a Conclusion:

Summarize the key points of your case study. Restate the importance of the topic and your findings. Discuss the implications of your study for the broader field.

What are the objectives of a Student Case Study?

1. learning and understanding:.

  • To deepen students’ understanding of a particular concept, theory, or topic within their field of study.
  • To provide real-world context and practical applications for theoretical knowledge.

2. Problem-Solving Skills:

  • To enhance students’ critical thinking and problem-solving abilities by analyzing complex issues or scenarios.
  • To encourage students to apply their knowledge to real-life situations and develop solutions.

3. Research and Analysis:

  • To develop research skills, including data collection, data analysis , and the ability to draw meaningful conclusions from information.
  • To improve analytical skills in interpreting data and making evidence-based decisions.

4. Communication Skills:

  • To improve written and oral communication skills by requiring students to present their findings in a clear, organized, and coherent manner.
  • To enhance the ability to communicate complex ideas effectively to both academic and non-academic audiences.

5. Ethical Considerations:

To promote awareness of ethical issues related to research and decision-making, such as participant rights, privacy, and responsible conduct.

6. Interdisciplinary Learning:

To encourage cross-disciplinary or interdisciplinary thinking, allowing students to apply knowledge from multiple areas to address a problem or issue.

7. Professional Development:

  • To prepare students for future careers by exposing them to real-world situations and challenges they may encounter in their chosen profession.
  • To develop professional skills, such as teamwork, time management, and project management.

8. Reflection and Self-Assessment:

  • To prompt students to reflect on their learning and evaluate their strengths and weaknesses in research and analysis.
  • To foster self-assessment and a commitment to ongoing improvement.

9. Promoting Innovation:

  • To inspire creativity and innovation in finding solutions to complex problems or challenges.
  • To encourage students to think outside the box and explore new approaches.

10. Building a Portfolio:

To provide students with tangible evidence of their academic and problem-solving abilities that can be included in their academic or professional portfolios.

What are the Elements of a Case Study?

A case study typically includes an introduction, background information, presentation of the main issue or problem, analysis, solutions or interventions, and a conclusion. It often incorporates supporting data and references.

How Long is a Case Study?

The length of a case study can vary, but it generally ranges from 500 to 1500 words. This length allows for a detailed examination of the subject while maintaining conciseness and focus.

How Big Should a Case Study Be?

The size of a case study should be sufficient to comprehensively cover the topic, typically around 2 to 5 pages. This size allows for depth in analysis while remaining concise and readable.

What Makes a Good Case Study?

A good case study is clear, concise, and well-structured, focusing on a relevant and interesting issue. It should offer insightful analysis, practical solutions, and demonstrate real-world applications or implications.

Case studies bring people into the real world to allow themselves engage in different fields such as in business examples, politics, health related aspect where each individuals could find an avenue to make difficult decisions. It serves to provide framework for analysis and evaluation of the different societal issues. This is one of the best way to focus on what really matters, to discuss about issues and to know what can we do about it.

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Case Western Reserve University

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  • Faces of medicine: Meet six students shaping their fields

Faces of medicine

Meet six students shaping their fields—and their futures.

Across 25 doctoral, master’s, and certificate programs, more than 2,800 students are gaining the experience for which Case Western Reserve University School of Medicine is known: for its rigorous, customizable, and contemporary curriculum, state-of-the-art technology, exceptional clinical and laboratory opportunities, and an inclusive, diverse community.

But these students know the full Case Western Reserve experience is what you make of it.

They’re finding breakthroughs in labs, providing exceptional clinical care, supporting their peers, and helping the Cleveland community—all while preparing for the realities and demands of the ever-changing healthcare field that await them after graduation.

Get to know six of these outstanding scholars.

Medical Scientist Training Program

Case Western Reserve University School of Medicine student Uriel Kim poses in a white coat

In less than a decade, Uriel Kim will have earned four degrees: a bachelor’s from the University of Southern California in 2015, a Ph.D. from Case Western Reserve in 2020, an MBA from Northwestern University in 2023, and, this spring, an MD from CWRU.

This seemingly insatiable thirst for knowledge is motivated, Kim says, by one goal: “to provide the best care for my future patients.”

It’s why he sought out the MD/PhD Medical Scientist Training Program at Case Western Reserve and even took a break from his MD studies to pursue his MBA gaining the business, commercialization, and leadership insights that he hopes will enhance his clinical care and research.

Kim’s research, which landed him on Crain’s Cleveland Business ' “20 in Their 20s” list, has focused on identifying and understanding health disparities from myriad angles. His dissertation looked at the impact of the Affordable Care Act on cancer outcomes in individuals from low-income communities. He’s published on the effects of expanding Medicaid. He developed a new statistical methodology to accurately estimate the income of patients based on census data—a critical missing piece in understanding the impact of income on health outcomes.

“While delivering excellent clinical care is important, understanding and addressing barriers to receiving care are equally crucial,” said Kim, who hopes his next step is a dermatology residency. “The key challenge we face now is making sure our research findings make their way to key decision-makers who can influence policies or systems that will improve health outcomes for patients.”

Kimberly Parker

Biomedical sciences training program.

Case Western Reserve University School of Medicine student Kimberly Parker poses

Kimberly Parker always imagined she’d be an editor.

That passion for the written word has paid off—literally—even when Parker pursued an entirely different career path. Today, she’s less than six months away from completing her PhD in pharmacology, studying the role of long non-coding RNA in breast cancer metastasis.

Through impressive grant-writing skills, honed with the support of her mentor, Vice Dean for Research Bill Schiemann, PhD, Parker secured two highly competitive National Cancer Institute grants that cover both her doctoral and postdoctoral work.

Parker’s latest award—the Predoctoral to Postdoctoral Fellow Transition Award (F99/ K00)—funds the last two years of her doctoral studies, plus up to four years of postdoctoral work. “Essentially,” Parker said, “it gives me the opportunity to find the best postdoc lab for what I want to do.”

Writing the grant application helped her better fine-tune that goal: running a lab in which members of her team look at RNA processing in the tumor microenvironment to better understand how metastasis occurs.

“I got to think about [my goals] in a big, broad picture,” Parker explained. “And then I realized: This is up to me now. I am the scientist in the driver’s seat.”

As she takes on more advanced positions, it’s important to Parker that she continue the culture of support and knowledge sharing that drew her to Case Western Reserve in the first place. She advises other students on successful grant writing, edits their work for Journal Club, and guides them in the lab, where they’re all aiming to bring breakthroughs to patients.

“Cancer research is extremely complex, but that’s part of the reason why I like it,” Parker said. “You can embrace the chaos in the research.”

Physician Assistant Program

Case Western Reserve University School of Medicine student Maya Sinjo poses in a white coat

Growing up in an impoverished neighborhood in Lebanon, Maya Sinjo became acutely aware of medical care privileges—and how her community lacked them.

Her family was the only one in the area to own a manual blood pressure monitor a luxury that led to middle-of-the-night visits from ill neighbors. “In most cases, ‘feeling unwell’ actually equated to a heart attack,” Sinjo said. “In which case, my mom’s blood pressure monitor could not help.”

Such disparities—in healthcare as well as in education—led Sinjo’s family to immigrate to Canada when she was 18. (Her parents persisted through multiple immigration processes to ensure their children could have greater educational access.) There, she earned a bachelor’s in kinesiology from York University before learning on social media about the role of a physician assistant (PA) in healthcare.

Sinjo knew immediately that the mix of challenges PAs face daily would align well with her inquisitive nature, driving her to find diagnoses and treatments for her future patients.

Now a second-year PA student at Case Western Reserve, she focuses especially on underserved communities. She is active in volunteering, whether conducting screenings at farmer's markets, educating residents at local shelters, testing students’ vision in inner-city schools, or helping bridge the gap between healthcare providers and their immigrant patients.

She’s seen the need to be that connector firsthand—both in her work as a medical assistant and when attending appointments with her mother, who isn’t fluent in English and is often, Sinjo said, excluded from conversations because of it.

“My career goal is to advocate for patients like my mom who are experiencing health barriers,” Sinjo said, “and to provide a safe place for medically underserved patients to be heard and acknowledged."

Master of Arts in Bioethics and Medical Humanities (Integrated Studies)

Case Western Reserve University School of Medicine student Feyi Rufai poses

Most high schoolers enter their college search looking for a home for the next four years—a place at which they’ll earn a degree and gain valuable life experiences before moving on in their journey.

Not Feyi Rufai. As a high school senior, she applied to Case Western Reserve’s Pre-Professional Scholars Program, which offers exceptionally promising students undergraduate admission plus conditional admission to CWRU’s medical or dental schools. Rufai’s goal: eight years, two degrees.

Even before Rufai begins her MD studies in July, she’ll have earned three degrees: a bachelor’s in psychology and another in sociology, plus a master’s in bioethics and medical humanities from the School of Medicine.

In this master’s program, which she’s completing as part of an integrated studies option for driven undergraduate students, Rufai has excelled in classroom and clinical experiences. She’s tackled tough bioethical topics, such as end-of-life care, mental health stigmas, abortion, and drug legalization. She’s been active with the Black Student Union, multiple research projects, and Cheza Nzuri, an African dance team.

And, most importantly, Rufai has enhanced her bachelor’s degree studies with knowledge and perspectives that will drive her future, including significant interaction with “role models of physicians who work at the intersection of health and social justice work.” It’s a crucial experience for the aspiring OB/GYN who hopes to focus on better understanding and combating health disparities.

“If I want to be a good physician—one who people not only respect but also trust—I need to be able to make decisions for my patients based on their best needs and considering multiple perspectives,” Rufai said. “The bioethics program has really helped me learn how to advocate for someone else and communicate that effectively."

Emily Manning

Md–university program.

Case Western Reserve University School of Medicine student Emily Manning poses in a white coat

On the way home from taekwondo class, 8-year-old Emily Manning’s world was upended: Her mom suffered a seizure and drove into a ditch, leaving Manning calling for help on the roadside. Shortly after, her mother had a stroke and, later, was diagnosed with HIV. At age 14, Manning became the sole caretaker for her mother, living “on the poverty line.”

“This infiltrated pretty much every aspect of my life,” Manning said, whether it was paying for groceries, juggling school, work, and caretaking, or seeing the healthcare disparities her mother faced as a woman with low income. Still, Manning became the first in her family to graduate high school, before earning a bachelor’s in public policy analysis from the University of North Carolina at Chapel Hill and a master’s in physiology from North Carolina State University.

When it came time to apply to medical school, Case Western Reserve was the first to “really embrace me for my personality and my experiences,” Manning said. “I had been told throughout my life that because I was low-income, maybe I shouldn’t apply to college, and maybe medicine wouldn’t be the best fit for me. But Case [Western Reserve]’s admissions team looked at me for me and said, ‘What do you need to succeed?’”

Now in her fourth year, Manning has not only succeeded in the classroom and in clinical, but she’s also enhanced the school’s community, developing a mentoring system, serving on a team to improve the curriculum, serving on the alumni diversity committee, and leading a first-generation club for students whose families are new to medicine. After graduation, she hopes to study and combat healthcare disparities related to gender and low socioeconomic status, or even work in academic medicine to build pipeline programs for low-income students looking to enter medicine— like she once was.

“I lived on the other side of medicine where I was the caretaker, sleeping in the vinyl chairs. I know what it means to hang on to every word the physician says,” said Manning, who is applying for internal medicine residencies. “That’s something that really informs the way I practice. I can’t fix everything, but I might be able to make one person’s day a little bit better.”

Master of Science in Translational Pharmaceutical Science

Case Western Reserve University School of Medicine student Derek Lake poses

Derek Lake was summiting a mountain in South America when he realized he wanted to pursue a career in medicine.

Well, perhaps it wasn’t that precise moment. But as Lake was backpacking from Mexico to Patagonia—often volunteering as an emergency medical technician to accompany climbers on their mountaintop quest she saw the disparities plaguing certain regions, especially related to healthcare access.

He knew medicine was how he could make a difference.

Five years later, after earning a bachelor’s degree in biomedical sciences and gaining extensive genomics research experience at Northern Arizona University, Lake is pursuing one of CWRU’s newest degree offerings, the Master of Science in Translational Pharmaceutical Science.

As Lake expands his pharmaceutical, bioinformatics and entrepreneurial knowledge in the program, he has quickly jumped into the opportunities available: He’s a researcher in a pharmacology lab working on protein purification and cryo-electron microscopy, he’s part of the National Institutes of Health’s I-Corps entrepreneurship training program, and he’s a Case Venture Mentorship Program fellow.

Just a few months into the master’s program, Lake has gained invaluable experiences whether networking with pharmaceutical company founders, working in a wet lab, or learning how to conduct market research.

“I’m looking to apply my research in the real world,” Lake said, “and this program has already given me the practical, applicable skills to do exactly what I want to do.”

His goal: returning to Mexico to open a precision medicine clinic working to improve the healthcare disparities he’d witnessed years ago.

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  • Front Psychol

Procrastination Among University Students: Differentiating Severe Cases in Need of Support From Less Severe Cases

Alexander rozental.

1 Department of Psychology, Uppsala University, Uppsala, Sweden

2 Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

3 Great Ormond Street Institute of Child Health, University College London, London, United Kingdom

David Forsström

4 Department of Psychology, Stockholm University, Stockholm, Sweden

Ayah Hussoon

Katrin b. klingsieck.

5 Department of Psychology, Faculty of Arts and Humanities, Paderborn University, Paderborn, Germany

Associated Data

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Procrastination refers to voluntarily postponing an intended course of action despite expecting to be worse off for this delay, and students are considered to be especially negatively affected. According to estimates in the literature, at least half of the students believe procrastination impacts their academic achievements and well-being. As of yet, evidence-based ideas on how to differentiate severe from less severe cases of procrastination in this population do not exist, but are important in order to identify those students in need of support. The current study recruited participants from different universities in Sweden to participate in an anonymous online survey investigating self-rated levels of procrastination, impulsivity, perfectionism, anxiety, depression, stress, and quality of life. Furthermore, diagnostic criteria for pathological delay (PDC) as well as self-report items and open-ended questions were used to determine the severity of their procrastination and its associated physical and psychological issues. In total, 732 participants completed the survey. A median-split on the Pure Procrastination Scale (PPS) and the responses to the PDC were used to differentiate two groups; “less severe procrastination” (PPS ≤ 2.99; n = 344; 67.7% female; M age = 30.03; SD age = 9.35), and “severe procrastination” (PPS ≥ 3.00; n = 388; 66.2% female; M age = 27.76; SD age = 7.08). For participants in the severe group, 96–97% considered procrastination to a problem, compared to 42–48% in the less severe group. The two groups also differed with regard to considering seeking help for procrastination, 35–38% compared to 5–7%. Participants in the severe group also reported more problems of procrastination in different life domains, greater symptoms of psychological issues, and lower quality of life. A thematic analysis of the responses on what physical issues were related to procrastination revealed that these were characterized by stress and anxiety, e.g., tension, pain, and sleep and rest, while the psychological issues were related to stress and anxiety, but also depression, e.g., self-criticism, remorse, and self-esteem. The current study recommends the PPS to be used as an initial screening tool, while the PDC can more accurately determine the severity level of procrastination for a specific individual.


In academia, procrastination is a well-known, almost commonplace phenomenon. Students often delay tasks and activities inherent to learning and studying, despite knowing that they will be worse off because of the delay (cf. Steel, 2007 ; Steel and Klingsieck, 2016 ). For some students, academic procrastination can be specific to a situation (i.e., state procrastination), for others it takes on features of a habit or a disposition (i.e., trait procrastination). Studies estimate that almost all students engage in procrastination once in a while, while 75% consider themselves habitual procrastinators ( Steel, 2007 ). For almost half of these habitual procrastinators, procrastination is a real and persistent problem ( Steel, 2007 ), and something they would like to tackle ( Grunschel and Schopenhauer, 2015 ). It can be assumed, however, that not all of them seek help due to the self-regulative problems inherent to procrastination, and, even more so, due to feelings of shame associated with procrastination ( Giguère et al., 2016 ).

In light of the negative consequences, procrastination can have for academic achievement (e.g., Kim and Seo, 2015 ), and well-being (cf. Sirios and Pychyl, 2016 ), it seems important to screen for cases of severe procrastination in a student population in order to offer the support needed. In the case of students who do seek help in student health centers, it is also helpful to see whether they represent a case of severe or less severe procrastination so that support can be tailored to their specific needs.

The aim of the current study is, thus, to differentiate between students who might be in need of professional help from those with less pressing concerns. This is done by determining what characterizes severe and less severe procrastinators with regard to their level of anxiety, depression, stress, quality of life, impulsivity, perfectionism, and demographic variables. Procrastination itself is also assessed by two different self-report measures with the intention of proposing ways of screening in a student population. This could help therapists identify those in need of guidance so that effective interventions can be introduced. For college and university students this would be particularly useful as they find themselves in a setting where procrastination is particularly endemic, often lack the necessary resources or strategies to overcome problems on their own, and procrastination can have dire consequences not only for their academic achievements but also physical and psychological well-being.

Conceptual Framework

Academic procrastination.

The prominent definition of procrastination as “to voluntarily delay an intended course of action despite expecting to be worse off for the delay” ( Steel, 2007 , p. 66) reflects two important aspects of the phenomenon. First, procrastination is a post-decisional phenomenon in goal-directed behavior in that an intention (e.g., to study for an exam) has been formed. Second, procrastination is acratic in nature since individuals put of the intended course of action contrary to knowing better. This acratic nature is reflected by feelings such as regret, shame, guilt, worry, and anxiety (e.g., Giguère et al., 2016 ). It is important to acknowledge that a delay is not procrastination if it is strategic or results from causes not under the control of the individual (cf. Klingsieck, 2013 ). Taking these aspects – post-decisional, acratic, and non-strategic – together, suggests that procrastination is a failure in self-regulation (cf. Steel, 2007 ), This is the most popular conceptualization of procrastination in the literature. In fact, the dispositional, the motivational-volitional, the clinical, and the situational perspective on procrastination can be boiled down to this understanding of procrastination ( Klingsieck, 2013 ). As for students, while academic procrastination is just a little nuisance for some, it entails serious problems for others.

Procrastination’s Link to Depression, Anxiety, Stress, and Quality of Life

Procrastination is associated with negative consequences concerning performance as well as physical and psychological well-being. However, although never a particularly helpful behavior, the relationship with performance is probably not as strong as most would expect. Among students, the correlation with academic achievement is weak, r s = –0.13 to –0.19 ( Steel, 2007 ; Kim and Seo, 2015 ), and perhaps not the main reason for why individuals regard procrastination as a problem. Instead, it might be its effects on physical and psychological well-being that eventually makes someone seek professional help ( Rozental and Carlbring, 2014 ). In a qualitative study of 36 students, for instance, the most frequently reported negative consequences were anger, anxiety, feelings of discomfort, shame, sadness, feeling remorse, mental stress, and negative self-concept ( Grunschel et al., 2013 ). Systematic reviews and meta-analyses on the link between procrastination and symptoms of psychiatric conditions have also found a weak but nonetheless clinically meaningful correlation with depression, r s = 0.28 to 0.30 ( van Eerde, 2003 ; Steel, 2007 ). The same also goes for anxiety, r = 0.22 ( van Eerde, 2003 ). Studies investigating the connection between self-report measures in different populations have demonstrated stronger correlations, such as Rozental et al. (2015) in a clinical trial of adults seeking treatment for procrastination ( n = 710), r = 0.35 for depression and r = 0.42 for anxiety. Similar results were also obtained by Beutel et al. (2016) in an adult community sample ( n = 2527), r = 0.36 for depression and r = 0.32 for anxiety. Although both lower mood and increased unrest can, in themselves, cause procrastination, it is assumed that procrastination also creates a downward spiral characterized by negative thoughts and feelings ( Rozental and Carlbring, 2014 ).

Apart from depression and anxiety, students generally tend to regard procrastination as something stressful. Stead et al. (2010) investigated this association using self-report measures in a sample of students ( n = 200), demonstrating a weak but nonetheless significant correlation between procrastination and stress, r = 0.20. Similar findings were reported by Sirois et al. (2003) for students ( n = 122), and Sirois (2007) for a sample of community-dwelling adults ( n = 254), r s = 0.13 to 0.20. Further, Beutel et al. (2016) found somewhat stronger correlations with stress, r = 0.39, as well as with burnout, r = 0.27. Stress might also play a role as mediator between procrastination and illness, as proposed by the so-called procrastination-health model by Sirois (2007) , implying that procrastination not only leads to more stress, but that the increase in stress in turn leads to many physical issues. Meanwhile, in terms of quality of life and satisfaction with life, procrastination exhibits a weak negative correlation, r = −0.32 ( Rozental et al., 2014 ), and r = −0.35 ( Beutel et al., 2016 ), meaning that procrastination could take its toll on how one appreciates current circumstances.

However, despite the fact that procrastination might be affecting physical and psychological well-being negatively, it is still unclear when it goes from being a more routine form of postponement to becoming something that warrants support, for instance in the realm of counseling or therapy. The literature suggests that as many as 20% of the adult population could be regarded as “chronic procrastinators” ( Harriot and Ferrari, 1996 , p. 611), a number that is easily surpassed by the 32% of students that were characterized as “severe, general procrastinators” ( Day et al., 2000 , p. 126). Students are generally considered worse-off when it comes to recurrently and problematically delaying important curricular activities, with more than half of this population stating that they would like to reduce their procrastination ( Solomon and Rothblum, 1984 ). Still, all of these rates rely on arbitrary cutoffs on specific self-report measures, such as exceeding a certain score, or do not define what is meant by procrastination, which may not correspond to something that requires clinical attention ( Rozental and Carlbring, 2014 ). Establishing a more valid cutoff is therefore needed in order to separate the less severe cases of procrastination from those having problems to the degree that it severely affects everyday life.

Procrastination’s Link to Impulsivity and Perfectionism

Two other variables that are frequently explored in relation to procrastination involve impulsivity and perfectionism. These might be especially pertinent to examine in the context of students who, due to their age, are more impulsive and engage in more reckless behaviors, such as binge drinking ( Lannoy et al., 2017 ), but also tend to perceive the relentless pursuit of high standards as socially desirable despite the fact it can become maladaptive ( Stoeber and Hotham, 2013 ). Research has found that impulsivity is moderately correlated with procrastination, r = 0.41 ( Steel, 2007 ), making it one of the strongest predictors among the personality traits. A twin study by Gustavson et al. (2014) confirmed this association ( n = 663), suggesting that the genetic correlation between impulsivity and procrastination is perfect, r = 1.0. However, this was later questioned by a twin study with a much larger sample ( n = 2012), demonstrating a weak but nonetheless noteworthy correlation, r = 0.29 ( Loehlin and Martin, 2014 ). Rozental et al. (2014) also examined the link between impulsivity and procrastination, but using a self-report measure of susceptibility to temptation, indicating a moderate correlation, r = 0.53. At its core, impulsivity shares many features with procrastination (i.e., self-regulatory failure), making it reasonable to expect a strong connection between the two constructs. Meanwhile, the relationship between perfectionism and procrastination has been disputed. Originally, Steel (2007) demonstrated a non-significant correlation, r = −0.03. Similarly, the correlation by van Eerde (2003) was weak, r = 0.12. This goes against the clinical impression by many therapists that perfectionism often leads to procrastination. However, in both of these cases perfectionism was perceived as a unidimensional construct. There is currently consensus that perfectionism in fact has two higher-order dimensions; (1) perfectionistic strivings, i.e., setting high standards and expecting no less than perfection from yourself, and (2) perfectionistic concerns, i.e., being highly self-critical and overly concerned about others’ perception of you, and having a hard time enjoying your achievements. A recent systematic review and meta-analysis separating these two demonstrated a more complex relationship with procrastination ( Sirois et al., 2017 ). Perfectionistic strivings had a weak negative correlation with procrastination, r = −0.22, while perfectionistic concerns had a weak positive correlation with procrastination, r = 0.23. In other words, setting and striving for high standards might actually be associated with less procrastination, while the more neurotic aspects of perfectionism are related to more procrastination.

To what extent impulsivity and perfectionism might differ between cases of less severe and severe cases of procrastination is currently unknown. However, just as physical and psychological well-being is expected to be more negatively affected among those who exhibit higher levels of procrastination, impulsivity and perfectionism should be more pronounced.

The Current Study

The aim of the current study is to investigate all of these aspects in a sample of students with the purpose of trying to differentiate between those who might be in need for professional help from those with less pressing matters. The idea is to outline their respective characteristics with regard to scores on self-report measures on anxiety, depression, stress, quality of life, impulsivity, and perfectionism, and demographics. Procrastination itself is assessed by two different self-report measures. This first measure is the Pure Procrastination Scale (PPS; Steel, 2010 ) which is a widely used self-report measure. The second measure are the recently proposed diagnostic criteria for pathological delay (Pathological Delay Criteria; PDC; Höcker et al., 2017 ).

The second aim of the current study is to explore the physical and psychological issues related to procrastination on a deeper level. This is made possible through a qualitatively analysis of the responses to two open-ended questions regarding the impact of recurrently putting off activities that need to be completed. Prior research has by qualitative means primarily studied the antecedents of procrastination ( Klingsieck et al., 2013 ), but rarely its implications for physical and psychological well-being. One notable exception is the interview study by Grunschel et al. (2013) cited in the introduction. Investigating these experiences in detail and how often they occur could provide a better understanding of how procrastination affects someone physically and psychologically, and in turn when further assistance might be necessary.

Materials and Methods

The study received ethical approval from the Swedish Ethical Review Authority in June 2020 (Dnr: 2020-00555). Advertisements for the study were initially sent out in October 2020 via the communications office of Karolinska Institutet, which is a medical university in Stockholm, Sweden. However, in order to recruit students from other backgrounds, information about the study was also forwarded to two additional universities in Sweden and posted on various student forums on Facebook, LinkedIn, Accindi, and Instagram. Using a link to a website created specifically for the study, the student could then read about the research aims and design, procedures for data collection and management, ethics, and the principal investigator. The student was also informed that a 45-min pre-recorded lecture with the first author on procrastination would follow once the survey was completed, as a small token of gratitude for the student’s participation. After submitting informed consent, the student was forwarded to an anonymous survey managed through Limesurvey. Both, the website and the survey itself, were available in Swedish and English. The whole survey took on average 21 min for the participants to complete ( SD = 16 min), and always followed the same order of presentation, i.e., no randomization of self-report measures or items were made. Every item of a self-report measure had to be completed to progress to the next, presenting only one self-report measure per page and using a progress bar on top of the screen to convey how much was left on the survey.

In total, 806 students decided to open the link and 797 actually started filling out the survey, resulting in 732 complete survey responses (90.8%). There were no systematic differences between completers and non-completers concerning their demographic information and procrastination, with the exception of civil status (see Appendix for the specifics). Of those who finished the survey, 66.6% were female, which corresponds with the most recent numbers on the gender distribution of newly admitted university students in Sweden (58% female; Swedish Higher Education Authority, 2020 ). The mean age was 28.8 years ( SD = 8.30; range 18–65). They were either single (44%) or married (54%), and the vast majority had no children (78%). In terms of their education, 6.8% attended just a single course, (e.g., Nutrition, the nutrients, and metabolism, 7.5 higher education credits), 63.7% underwent a complete study program, such as the study program in dental hygiene (180 higher education credits), 9.1% were enrolled in post graduate studies, for example the study program in psychotherapy (90 higher education credits), and 3.4% were admitted as doctoral candidates. Of note, 30 higher education credits correspond to one semester full-time. The participants had, on average, achieved 195 higher education credits ( SD = 141), which thus corresponds to 3.25 years of full-time education. With regard to psychiatric disorders, 115 self-reported having a diagnosis (15.7%). These were grouped according to the responses to an open-ended question, with mixed conditions representing the largest category (40%, i.e., having more than one diagnosis, mostly a combination of depression and anxiety), followed by depression (13.9%), and ADHD (13%). As for questions regarding procrastination, 71% considered it to be a problem, with a mean age of 17.5 years ( SD = 5.7; range 10–53) for when they first started perceiving it as problematic, and 29.4% of this group had considered seeking help for procrastination. None of these variables differed between genders, see Table 1 for an overview.

Descriptive statistics for whole sample and results of t -tests of gender differences.

*p < 0.002 (Bonferroni correction); Calculations based on sum scores for GAD-7, PHQ-9, and BBQ.



In order to differentiate and classify the more severe cases of procrastination, a widely used self-report measure is applied, the Pure Procrastination Scale (PPS), which was originally introduced and validated by Steel (2010) , and translated to a large number of languages since ( Svartdal et al., 2016 ). The PPS was developed from several other self-report measures, retaining only those items that demonstrated the strongest factor loadings on the core construct of procrastination (i.e., not other forms of delay), hence the name “pure.” The PPS has 12 items, e.g., “I often find myself performing tasks that I had intended to do days before” (item 6), is scored according to a 5-point Likert-scale (1–5), and has an internal consistency in the current study of Cronbach’s α = 0.92.

Secondly, diagnostic criteria for pathological delay (Pathological Delay Criteria; PDC), which were put forward in a therapy manual by Höcker et al. (2017) , are also used to differentiate between less and more severe cases of procrastination. According to the PDC, procrastination can be considered pathological if the following two criteria are met:

Over the past 6 months…

  • (1) On at least half of the days, important tasks were delayed past the adequate point in time, even though there was sufficient time to complete them.
  • (2) Procrastination has strongly interfered with reaching personally relevant goals.

In addition, at least three of following criteria also need to be fulfilled:

  • (1) More than half of the time available for completing a task was wasted by procrastinating.
  • (2) On at least half of the days, other less important tasks were preferred, even though the individual wanted to start working on the more pressing tasks.
  • (3) On at least half of the days, the delay caused aversion and animosity.
  • (4) At least half of the tasks that were to be completed were finished only under great time pressure or not at all due to procrastination.
  • (5) At least half of the individual’s performance potential was impaired due to procrastination.
  • (6) The individual has experienced physical issues due to procrastination (e.g., tensed muscles, sleeping disorders, cardiovascular problems, gastric, and digestive problems), or psychological issues due to procrastination (e.g., restlessness, feeling of being pressured, feeling of being helpless, inner tension, and anxiety).*

* At least five of these issues need to be reported to meet this criterium.

The criteria above were developed as a diagnostic instrument for differential diagnosis and as a basis for clinical decision making. During its development, the authors followed the definition and structure of psychiatric disorders used by the Diagnostic and Statistical Manual of Mental Disorders ( American Psychiatric Association, 2013 ). In order to select the criteria with the best predictive value, large samples of university students seeking help at a procrastination clinic at the University of Münster, Germany, were used (e.g., Engberding et al., 2011 ). The authors used the methods of best subset regression and ROC-analyses to select the criteria with the highest scores on sensitivity and specificity for identifying pathological delay. These criteria and the corresponding questionnaire were subsequently published in the therapist manual ( Höcker et al., 2017 ).

Further variables of meaningful aspects concerning procrastination were assessed: (1) if the participant itself believes procrastination is a problem and, if yes, (2) at what age the participant started perceiving procrastination as a problem, (3) if the participant has ever considered seeking help for procrastination, and (4) the impact of procrastination on various life domains. In order to assess how procrastination had affected the participants, its negative effects on eight different life domains were probed for: “To what degree do you think procrastination has affected you negatively in the following life domains?”. The life domains were: interest/leisure, work/studies, friendships/social life, community/engagement/spirituality, family life/parenting, rest/sleep, love/intimate relationships, and physical activity/diet. Participants rated each life domain using a 10-point Likert-scale ranging from 0 = not at all to 10 = very much. The life domains were inspired by the type of value measures often used in Acceptance and Commitment Therapy ( Reilly et al., 2019 ), and are commonly employed in many clinical trials (e.g., Buhrman et al., 2020 ; Ehlers et al., 2020 ).


Impulsivity was assessed using the Susceptibility to Temptation Scale (STS; Steel, 2010 ; Svartdal et al., 2016 ), which is comprised of 11 items regarding the inclination to fall for more immediate gratifications, e.g., “I will crave a pleasurable diversion so sharply that I find it increasingly hard to stay on track” (item 1). The STS is scored on a 5-point Likert-scale (1–5), and has an internal consistency in the current study of α = 0.93.


Perfectionism was assessed by the Clinical Perfectionism Questionnaire ( Dickie et al., 2012 ). This scale assesses the frequency of dysfunctional self-imposed standards in the last 4 weeks by a subscale covering the personal standards (i.e., perfectionistic standards), and a second subscale covering emotional concerns and consequences (i.e., perfectionistic concerns). Item 9 of the original scale (“Have you repeatedly checked how well you are doing at meeting your standards [for example, by comparing your performance with that of others]?”) was omitted because it did not load on the factor perfectionistic standards as in the original version by the authors. Item 2 of the subscale perfectionistic concerns (“Have you tended to focus on what you have achieved, rather than on what you have not achieved?”) was omitted due to a very low item-scale-correlation. Thus, the subscale Personal Standards (CPQ_PS) was composed of five items (α in current study = 0.71; sample item “Have you been told that your standards are too high?”). The subscale Emotional Concerns (CPQ_EC) was composed of three items (α in current study = 0.76; sample item “Have you been afraid that you might not reach your standards?”). The CPQ is scored on a four-point Likert-scale (1–4).

Anxiety was examined using the Generalized Anxiety Disorder – 7 Items (GAD-7; Spitzer et al., 2006 ). It consists of seven items concerning the general level of anxiety and worry experienced during the last 2 weeks, and is often used as a screening tool for anxiety disorders, e.g., “Over the last 2 weeks, how often have you been bothered by the following problems: Worrying too much about different thing” (item 3). The GAD-7 is scored on a four-point Likert-scale (0–3), and has an internal consistency in the current study of α = 0.90. A score of 5 points indicate mild anxiety, 10 moderate anxiety, and 15 severe anxiety.

Depression was assessed by the Patient Health Questionnaire – 9 Items (PHQ-9; Kroenke et al., 2001 ). It has nine items on depressive symptoms experienced during the last 2 weeks, in accordance with the diagnostic criteria for major depressive disorder ( American Psychiatric Association, 2013 ), e.g., “Over the last 2 weeks, how often have you been bothered by any of the following problems? Little interest or pleasure in doing things” (item 1). The PHQ-9 is scored on a four-point Likert-scale (0–3), and has an internal consistency in the current study of α = 0.88. A score of 5 points indicate mild depression, 10 moderate depression, 15 moderately severe depression, and 20 severe depression.

Stress was explored using the Perceived Stress Scale (PSS; Cohen et al., 1983 ). It is comprised of 14 items regarding stress in different situations, as experienced during the last month, e.g., “In the last month, how often have you felt that you were unable to control important things in your life?” (Item 2). The PSS is scored on a five-point Likert-scale (1–5), and has an internal consistency in the current study of α = 0.85.

Quality of Life

Quality of life was determined by the Brunnsviken Brief Quality of Life Scale (BBQ; Lindner et al., 2016 ). It features six life domains (leisure time, view of one’s own life, learning, creativity, friends and friendship, yourself as a person), and is rated on both importance and how satisfied one is with each domain, e.g., “I am satisfied with my leisure time; I have the opportunity to do what I want in order to relax and enjoy myself.” (domain 1). The BBQ is scored on a 5-point Likert-scale (0–4), where importance and satisfaction in each domain are multiplied and summing the products for a total score (range 0–96). These weighted ratings as well as the total score for quality of life was used for the current study. The BBQ has an internal consistency of α = 0.79 in the current study.

In addition, achieved higher education credits was assessed to differentiate the two groups by their academic achievement. Age and gender were assessed as demographic variables but only used to characterize the sample and not to differentiate the groups.

Quantitative Analysis

Multiple t -tests and Chi 2 -tests were performed by SPSS Version 27. The significance level was corrected (Bonferroni) to p < 0.002 ( t -tests) and 0.007 (Chi 2 -Tests). In order to differentiate severe cases from less severe cases of procrastination, the sample was split along the median ( Med. = 3.00) of the PPS. This created two groups, which are referred to as: “less severe procrastination” (PPS ≤ 2.99; n = 344; 67.7% female; M age = 30.03; SD age = 9.35), and “severe procrastination” (PPS ≥ 3.00; n = 388; 66.2% female; M age = 27.76; SD age = 7.08). For the second differentiation, the PDC was used to split the sample into the corresponding groups (i.e., based on whether the participants fulfilled all of the necessary criteria or not): “less severe procrastination” ( n = 398; 71.5% female; M age = 29.94; SD age = 9.03), and “severe procrastination” ( n = 344; 61.6% female; M age = 27.51; SD age = 7.11).

Qualitative Analysis

Two items of the PDC were open-ended and therefore analyzed qualitatively. Given the nature of these variables and their manifest content, that is, being short text-based survey responses with little room for elaboration, inductive thematic analysis was deemed appropriate to use. Inductive refers to generating a new understanding of the subject matter, rather than testing a predefined theoretical framework during the analysis ( Thomas, 2006 ). Meanwhile, thematic analysis is a procedure for qualitative analysis considered suitable for exploring recurrent patterns or themes within data. Braun and Clark (2006) provide an overview of the steps in the analytic process, which usually includes familiarizing yourself with your data by reading it repeatedly and taking notes, extracting meaningful entities of relevance to the purpose of the study, generating codes representing important issues for further inquiry, collating the codes to explore potential themes, reviewing the themes by going back and forward to your data, naming the themes, and reporting and discussing the results. The first author conducted the thematic analysis and discussed the results with the last author, but no further attempt at cross-validation was considered necessary given the characteristics of the data. The first author is a Swedish clinical psychologist and researcher with extensive experience of treating and researching procrastination, perfectionism, anxiety disorders, and exhaustion disorder, and has worked with both quantitative and qualitative methods.

The first qualitative item of the PDC concerned the physical issues of procrastination and involved a dataset of 2304 words (the average number of characters per response was 59.8, SD = 92.7). The second qualitative item of the PDC concerned the psychological issues of procrastination and was comprised of 4022 words (the average number of characters per response was 55.8, SD = 67.5). Because of a high degree of overlap in the responses, such as a vast majority reporting experiencing anxiety regardless of being a severe procrastinator or not, and that each response could entail a large number of physical as well as psychological issues, the variables could only be analyzed and presented qualitatively, rather than being part of the quantitative analysis.

Descriptive Statistics

Table 1 presents the descriptive statistics for each self-report measure as well as their respective gender differences (female vs. male). There were only statistically significant gender differences on the CPQ (Cohen’s d = 0.30 and 0.41), and GAD-7 ( d = 0.28), with female students scoring higher than male students. As for procrastination, the average score was 3.00 ( SD = 0.91), which is the same as the median split used for grouping the participants into severe and less severe procrastinators, while 46% of the sample fulfilled the PDC criteria. Negative effects of procrastination were most prominent in the life domains of work/studies, physical activity/diet, and rest/sleep, and being considerably lower in the life domains of family life/parenting and community/engagement/spirituality. The average scores on the GAD-7 and PHQ-9 correspond to mild anxiety and mild depression.

Differentiating Severe Cases From Less Severe Cases of Procrastination

The results of differentiating severe cases from less severe cases of procrastination are presented in detail in Tables 2 – 4 . The two groups diverged with regard to their perception of procrastination. In the group “severe procrastination,” almost every participant (96–97%) considered procrastination to be a problem, while those participants belonging to the group “less severe procrastination” did so to a much lesser extent (42–48%). In addition, 35–38% of the severe procrastinators had considered seeking help for their problems, compared to just 5–7% among the less severe procrastinators. There were also statistically significant differences with regard to the negative impact of procrastination on different life domains between the two groups, especially work/studies, d = 1.20–1.23.

Differentiating severe procrastination from less severe procrastination.

GAD, Generalized Anxiety Disorder Questionnaire; PHQ, Patient Health Questionnaire. *p < 0.007 (Bonferroni correction).

*p < 0.002 (Bonferroni correction).

*p < 0.002 (Bonferroni correction)

With the exception of perfectionism scores, severe cases and less severe cases of procrastination differed on all of the self-report measures, with severe procrastinators scoring higher on all measures and lower on quality of life. Moreover, the participants in the group “severe procrastination” also had a higher proportion of psychiatric disorders, and met the criteria for moderate and severe anxiety, and moderate and severe depression. From a demographic perspective, participants with severe procrastination were generally older and had achieved fewer higher education credits. When using the PPS to differentiate the groups, there were no gender differences. However, based on the PDC, the portion of female participants with severe procrastination was significantly lower than the portion of females in the group of less severe procrastination.

Differential Overlap

Based on a median split on the PPS, 53% of the participants were considered to be severe procrastinators while applying the PDC, 46% of the participants were regarded as severe procrastinators. Combining the two revealed that among those being classified as severe procrastinators on the PPS, 74% were also identified as such based on the criteria of the PDC. Likewise, 86% of the participants being severe procrastinators on the PDC were recognized as such on the PPS. Overall, there was an overlap of 80% between the two methods for differentiating severe procrastination from less severe procrastination. Also, the 20% non-overlap was not equally distributed between the severe cases (32% of non-overlap), and less severe cases (68% of non-overlap) of procrastination. In other words, both ways might be reliable in identifying cases of severe procrastination, but the PPS could potentially overreport the number of severe cases. Furthermore, the PDC might be more sensitive to gender differences as it demonstrates that the proportion of female participants in the group “severe procrastination” is lower than the proportion of female non-severe procrastinators.

Physical and Psychological Issues of Procrastination

Physical issues.

The participants reported a large number of physical issues that are considered emblematic of Stress and anxiety , see Table 5 for an overview. These could in turn be organized according to six subthemes; Tension (e.g., feeling tensed around your shoulders, neck, and back), Pain (e.g., bruxism, muscular pain, and experiencing recurrent headaches or migraine), Sickness (e.g., nausea, dizziness, and shudders), Stomach (e.g., increased or decreased appetite, stomach aches, and diarrhea), and Sleep and rest (e.g., insomnia, tiredness, and restlessness). In a majority of the cases, participants described having more than one symptom, such as feeling stressed out, having difficulties sleeping, and being restless.

Physical issues of procrastination.

Among the less common physical issues, Other , these were characterized by the worsening of an already underlying condition, such as eczema, causing flare ups or exacerbated problems. However, a few participants also mentioned biting their nails when under stress or experiencing problems with gastritis or becoming numb.

Psychological Issues

In terms of the psychological issues, there was a clear overlap with many of the physical symptoms described above, see Table 6 for an overview. One of the overarching themes, Stress and anxiety , included four subthemes; Sleep and rest (e.g., insomnia, tiredness, restlessness, and feeling exhausted), Fear (e.g., worrying about your current situation or the future and feelings of panic), Cognitive load (e.g., having difficulties concentrating and remembering things), and Performance (e.g., experiencing performance anxiety or having difficulties achieving high standards).

Psychological issues of procrastination.

Apart from being stressed out and anxious, most participants also described having a lower mood, and feelings of hopelessness and despair. This overarching theme, Depression , consisted of three subthemes; Self-criticism (e.g., self-loathing, feelings of disappointment with oneself, and negative thoughts), Remorse (e.g., anger, frustration, and feelings of shame), and Self-esteem (e.g., feeling inadequate and experiencing a loss of self-confidence).

Less prevalent were signs of Other conditions and symptoms, such as eating disorders, compulsions, and social anxiety, although a few participants experienced these issues in relation to their procrastination.

General Discussion

The first aim of the current study was to explore ways of differentiating students who might require professional help for procrastination from those with less pressing matters. Overall, the findings suggest that cases of severe procrastination, as determined using either the PPS or the PDC, are characterized by higher levels of anxiety, depression, and stress than the less severe cases, representing moderate to large between-group effect sizes. Given the magnitude of these differences, severe procrastinators could therefore warrant further assessment and possibly even treatment, such as via a student health center. Furthermore, severe procrastination was associated with greater self-reported negative effects on all of the life-domains that were examined, most notably for work/studies, but also for physical activity/diet and rest/sleep, which resemble previous research on the impact of procrastination on both academic achievement and health (e.g., Grunschel et al., 2013 ; Kim and Seo, 2015 ). In addition, quality of life was more negatively affected among severe procrastinators, corresponding to moderate between-group effect sizes, although, the level of quality of life was not as impaired as has been found in clinical samples ( Lindner et al., 2016 ). As for impulsivity, those with severe procrastination were far more susceptible to temptation, a difference consistent with a large between-group effect sizes, which is in line with the idea of impulsivity being one of the strongest personality traits predictive of procrastination ( Steel, 2007 ). With regard to perfectionism, only emotional concerns differed between severe and less severe procrastinators, corresponding to large between-group effect sizes. Similar to the findings by Sirois et al. (2017) , emotional, or, neurotic, aspects of perfectionism thus appear to be much more strongly related to severe procrastination, suggesting that students who are concerned about making mistakes and not living up to certain standards might need treatment that specifically target these issues.

When explicitly asked about it, severe procrastinators seem to regard procrastination as a problem to a much greater extent than less severe procrastinators (96 and 97%, in comparison to 42 and 48%, depending on whether the PPS or the PDC was used for differentiation), something they also report having been more inclined to seek help for (35 and 38% compared to 5 and 7%). This is the first time such direct queries have been used to determine if someone might need further assistance, giving some credence to the results and pointing toward the utility of using either the PPS or the PDC to identify severe cases of procrastination. However, as indicated in the current study, the PPS could potentially overreport the number of severe cases. Meanwhile, the PDC might be more sensitive to gender differences as it demonstrates that the proportion of female participants among the severe procrastinators is significantly lower than the proportion of female participants among the less severe procrastinators.

Another aim of the current study was to understand the physical and psychological issues related to procrastination by investigating the responses to two open-ended items. In terms of the former, the results demonstrate that many students who procrastinate experience symptoms that are commonly seen in stress and anxiety, such as being tensed, having sleeping problems, and struggling with different forms of pain. These issues are in line with the findings by Grunschel et al. (2013) who also reported a high incidence of such consequences from procrastinating. In addition, it corroborates the procrastination-health model by Sirois (2007) , which proposed that stress might act as a mediator between procrastination and many physical issues. The idea that procrastination is associated with stress, and, in turn, leads to other concerns, is reasonable given the nature of procrastination. While it may decrease discomfort temporarily (cf. Sirois and Pychyl, 2013 ), the activity being postponed still has to be performed on a later occasion, causing more stress overall ( Tice and Baumeister, 1997 ).

As for the psychological issues, these were also characterized by symptoms of stress and anxiety, for example, insomnia, restlessness, and worry, suggesting a high degree of overlap with the physical issues. Again, this corresponds to the results by Grunschel et al. (2013) , and should be seen as the affective and somatic effects of being anxious and stressed out from procrastinating. Furthermore, difficulties concentrating and remembering things are not uncommon when under stress, thereby affecting the possibility to pursue a given action ( Marin et al., 2011 ), as reported by many participants in the current study. However, a noticeable difference between the physical and psychological issues are aspects related to performance, self-criticism, remorse, and self-esteem. These might portray the more depressogenic impact of procrastination, such as being disappointed with oneself, experiencing lower self-confidence, and exhibiting negative self-evaluation. This goes in line with the notion of efficacy-performance spirals, whereby the inability to execute goal-directed behaviors and progress toward a given end-point can lead to lower mood, self-loathing, and decreased motivation ( Lindsley et al., 1995 ). In other words, procrastination does not only appear to cause stress and anxiety in the aftermath of a procrastination episode, but also negatively impacts the general state of the individual by inducing self-doubt, frustration, shame, rumination, and feelings of inadequacy (cf. Giguère et al., 2016 ; Constantin et al., 2018 ). When demonstrating such depressive thoughts and feelings, it is then not unreasonable to expect the person to be less inclined to take care of the assignments that need to be done, further perpetuating a downward cycle.

Practical Implications and Recommendations

Based on the results from the current study, the PPS is recommended as an initial screening tool for large samples, such as when admitting new students to a study program or as a general assessment of well-being at a university. As a second step, students who score higher than a certain cut-off (e.g., 3.00 like in the present study) on the items should be advised to fill out the PDC to more accurately determine the severity level of procrastination and its associated physical and psychological issues. This procedure could, for instance, be implemented at a student health center in order to identify those students in need of professional help, although it should be noted that the PDC has so far only been used in this way in Germany. In addition, administering the GAD-7 and PHQ-9 on the same occasion gives some indication of symptoms of anxiety and depression. This would inform therapists of other possible conditions that might warrant their attention, such as major depressive disorder, which sometimes have to be dealt with first in treatment. Furthermore, for those who seek support for procrastination, discussing the criteria of the PDC and the physical and psychological issues presented in the current study might help them understand what they are experiencing and how to overcome their problems. This type of psychoeducation can often have a normalizing effect, reducing shame and stigma, and, in turn, motivate behavior change. Similarly, career counselors might use the PDC in relation to discussing study satisfaction and dropout intentions in order to prevent students ending their studies prematurely ( Scheunemann et al., 2021 ).

Apart from aiding the identification of severe procrastinators, the findings from the current study may also have implications for treatment. The physical and psychological issues reported by the participants suggest that symptoms of stress and anxiety are common. On the one hand, procrastination can sometimes be a response to this discomfort. On the other hand, procrastinating an activity can also give rise to this distress ( Rozental and Carlbring, 2014 ). In both cases, interventions targeting symptoms of stress and anxiety seem important in order to overcome many difficulties experienced by students, which can involve goal-setting, problem-solving, time management, and exposure to negative emotions, as have been tested in clinical trials (e.g., Rozental et al., 2015 , 2018 ). The basic tenet is to lower stress levels and help endure those feelings that might otherwise lead one astray. Moreover, the depressogenic impact of procrastination may cause the individual to feel less willing to initiate goal-directed behaviors. Similar to the actions of someone suffering from major depressive disorder, this however, prevents the person from experiencing mastery and joy, furthering a vicious process of passivity and negative self-evaluation. Interventions that focus on activity scheduling and step-wise performance of activities might therefore be key to overcoming inaction and self-loathing, i.e., behavioral activation ( Ramsay, 2002 ). Likewise, students who may be experiencing low self-efficacy due to their procrastination could benefit from study skills training ( Svartdal et al., 2021 ). Concerning the different phases of a procrastination episodes ( Svartdal et al., 2020b ), it might even be worthwhile to differentiate between strategies that upregulate motivation as in motivational regulation strategies ( Grunschel et al., 2016 ), and strategies that downregulate negative affect ( Eckert et al., 2016 ), thus, tailoring them to the specific needs of the student. Furthermore, the environment for many students also seems to result in procrastination and might have to be targeted. Svartdal et al. (2020a) provide an overview of the measures that could be taken by course coordinators and lecturers, such as study skills training, group work, and courses in self-regulation.


The current study is, to the knowledge of the authors, the first attempt at differentiating the more severe from less severe procrastinators among university students. It has furthered the understanding of what characterizes problematic forms of procrastination and provided recommendations on how to screen and support those experiencing difficulties completing their commitments. However, there are also several limitations that need to be addressed.

First, recruitment of participants was made via advertisements and information distributed universities and in relevant forums. Although a reasonable way of reaching university students, it might also have attracted proportionally more individuals with greater problems of procrastination or, the other way around, those for whom procrastination is just a little nuisance. This self-selection bias might have affected the possibility to differentiate between “severe procrastination” and “less severe procrastination.” The distribution of scores on the self-report measures do not seem to suggest that this is the case, but future research should try alternative methods of recruiting participants, such as stratified random sampling. Similarly, the current study focused on students in university settings only, making it unclear whether the results can be generalized to an adult working population or younger students in elementary school or high-school. Replicating the approach used here should be feasible in other settings in order to determine if the same type of classification is possible to make elsewhere. Replicating the approach in a longitudinal design would, furthermore, deliver information on causal relationships between procrastination and psychopathological symptoms.

Second, the current study was conducted during the fall semester of 2020, which is about 6 months into the COVID-19 pandemic. Similar to other countries, universities in Sweden shut down on-campus education during the spring of the same year, meaning that most curricular activity was performed online when the participants responded to the survey. Whether this has affected university students’ levels of procrastination is not known, but given the lack of routines and social support it is reasonable to assume that it has been detrimental to some. Furthermore, the COVID-19 pandemic itself, and its effects of everyday life, might have affected the physical and psychological well-being of some participants, thereby inflating the scores of the self-report measures somewhat.

Third, we used a median split on the PPS for differentiating the more severe from less severe procrastinators. In general, median splits, as practice for dichotomizing a continuous variable, have a long tradition of being criticized for the loss of information and reduction in power (e.g., Cohen, 1983 ). However, newer studies weaken this criticism considerably (e.g., Iacobucci et al., 2015a , b ) by showing that this is in fact a robust method. For our purpose, it was very important to retain all information of the sample. Splitting the sample into three groups and only using the two extreme one would have resulted in a considerable loss of information, albeit useful for therapists. The median split of the PPS, however, and the diagnostic criteria used in the PDC, have not previously been tested regarding their classification accuracy for identifying more severe procrastinators. It is therefore unknown if these two methods can be applied for this purpose. Usually, a gold standard is used for comparison and validation, such as a structured clinical interview for determining major depressive disorder. However, such a diagnostic procedure is not possible for procrastination because it is not considered to be a diagnosis. Instead, the current study asked questions on whether the participants themselves regarded procrastination as a problem and if they ever considered seeking help for procrastination as a proxy for diagnosis. An idea for future research is to corroborate this method by interviews, which may provide additional insights on where to place the cutoff between severe and less severe procrastination.

Data Availability Statement

Ethics statement.

The studies involving human participants were reviewed and approved by Swedish Ethical Review Authority (Dnr: 2020-00555). The patients/participants provided their online informed consent to participate in this study.

Author Contributions

AR and KK designed the study and outlined its research aims and drafted the manuscript. AR and DF applied for ethics approval, set up the study, and monitored the data collection. AH advertised the study and managed the recruitment of participants. KK was responsible for the quantitative analyses. AR and DF was responsible for the qualitative analyses. DF and AH commented on the manuscript and approved its submission. All the authors contributed to the article and approved the submitted version.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer TD declared a past co-authorship with one of the authors KK to the handling editor. The handling editor declared a past co-authorship with one of the authors KK.

Publisher’s Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Comparing completers with non-completers.

Appendix II

Descriptive statistics and correlations for the whole sample ( N = 732).

Age_problematic, age procrastination started to be perceived as problematic; PPS, Pure Procrastination Scale; STS, Susceptibility to Temptation Scale; CPQ, Clinical Perfectionism Scale; GAD, General Anxiety Scale; PHQ, Patient Health Questionnaire; PSS, Perceived Stress Scale; BBQ, Brunnsviken Brief Quality of Life Scale. *p ≤ 0.5, **p ≤ 0.1.

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Study Tracks Shifts in Student Mental Health During College

Dartmouth study followed 200 students all four years, including through the pandemic.

Andrew Campbell seated by a window in a blue t-shirt and glasses

Phone App Uses AI to Detect Depression From Facial Cues

A four-year study by Dartmouth researchers captures the most in-depth data yet on how college students’ self-esteem and mental health fluctuates during their four years in academia, identifying key populations and stressors that the researchers say administrators could target to improve student well-being. 

The study also provides among the first real-time accounts of how the coronavirus pandemic affected students’ behavior and mental health. The stress and uncertainty of COVID-19 resulted in long-lasting behavioral changes that persisted as a “new normal” even as the pandemic diminished, including students feeling more stressed, less socially engaged, and sleeping more.

The researchers tracked more than 200 Dartmouth undergraduates in the classes of 2021 and 2022 for all four years of college. Students volunteered to let a specially developed app called StudentLife tap into the sensors that are built into smartphones. The app cataloged their daily physical and social activity, how long they slept, their location and travel, the time they spent on their phone, and how often they listened to music or watched videos. Students also filled out weekly behavioral surveys, and selected students gave post-study interviews. 

The study—which is the longest mobile-sensing study ever conducted—is published in the Proceedings of the ACM on Interactive, Mobile, Wearable and Ubiquitous Technologies .

The researchers will present it at the Association of Computing Machinery’s UbiComp/ISWC 2024 conference in Melbourne, Australia, in October. 

These sorts of tools will have a tremendous impact on projecting forward and developing much more data-driven ways to intervene and respond exactly when students need it most.

The team made their anonymized data set publicly available —including self-reports, surveys, and phone-sensing and brain-imaging data—to help advance research into the mental health of students during their college years. 

Andrew Campbell , the paper’s senior author and Dartmouth’s Albert Bradley 1915 Third Century Professor of Computer Science, says that the study’s extensive data reinforces the importance of college and university administrators across the country being more attuned to how and when students’ mental well-being changes during the school year.

“For the first time, we’ve produced granular data about the ebb and flow of student mental health. It’s incredibly dynamic—there’s nothing that’s steady state through the term, let alone through the year,” he says. “These sorts of tools will have a tremendous impact on projecting forward and developing much more data-driven ways to intervene and respond exactly when students need it most.”

First-year and female students are especially at risk for high anxiety and low self-esteem, the study finds. Among first-year students, self-esteem dropped to its lowest point in the first weeks of their transition from high school to college but rose steadily every semester until it was about 10% higher by graduation.

“We can see that students came out of high school with a certain level of self-esteem that dropped off to the lowest point of the four years. Some said they started to experience ‘imposter syndrome’ from being around other high-performing students,” Campbell says. “As the years progress, though, we can draw a straight line from low to high as their self-esteem improves. I think we would see a similar trend class over class. To me, that’s a very positive thing.”

Female students—who made up 60% of study participants—experienced on average 5% greater stress levels and 10% lower self-esteem than male students. More significantly, the data show that female students tended to be less active, with male students walking 37% more often.

Sophomores were 40% more socially active compared to their first year, the researchers report. But these students also reported feeling 13% more stressed during their second year than during their first year as their workload increased, they felt pressure to socialize, or as first-year social groups dispersed.

One student in a sorority recalled that having pre-arranged activities “kind of adds stress as I feel like I should be having fun because everyone tells me that it is fun.” Another student noted that after the first year, “students have more access to the whole campus and that is when you start feeling excluded from things.” 

In a novel finding, the researchers identify an “anticipatory stress spike” of 17% experienced in the last two weeks of summer break. While still lower than mid-academic year stress, the spike was consistent across different summers.

In post-study interviews, some students pointed to returning to campus early for team sports as a source of stress. Others specified reconnecting with family and high school friends during their first summer home, saying they felt “a sense of leaving behind the comfort and familiarity of these long-standing friendships” as the break ended, the researchers report. 

“This is a foundational study,” says Subigya Nepal , first author of the study and a PhD candidate in Campbell’s research group. “It has more real-time granular data than anything we or anyone else has provided before. We don’t know yet how it will translate to campuses nationwide, but it can be a template for getting the conversation going.”

The depth and accuracy of the study data suggest that mobile-sensing software could eventually give universities the ability to create proactive mental-health policies specific to certain student populations and times of year, Campbell says.

For example, a paper Campbell’s research group published in 2022 based on StudentLife data showed that first-generation students experienced lower self-esteem and higher levels of depression than other students throughout their four years of college.

“We will be able to look at campus in much more nuanced ways than waiting for the results of an annual mental health study and then developing policy,” Campbell says. “We know that Dartmouth is a small and very tight-knit campus community. But if we applied these same methods to a college with similar attributes, I believe we would find very similar trends.”

Weathering the pandemic

When students returned home at the start of the coronavirus pandemic, the researchers found that self-esteem actually increased during the pandemic by 5% overall and by another 6% afterward when life returned closer to what it was before. One student suggested in their interview that getting older came with more confidence. Others indicated that being home led to them spending more time with friends talking on the phone, on social media, or streaming movies together. 

The data show that phone usage—measured by the duration a phone was unlocked—indeed increased by nearly 33 minutes, or 19%, during the pandemic, while time spent in physical activity dropped by 52 minutes, or 27%. By 2022, phone usage fell from its pandemic peak to just above pre-pandemic levels, while engagement in physical activity had recovered to exceed the pre-pandemic period by three minutes. 

Despite reporting higher self-esteem, students’ feelings of stress increased by more than 10% during the pandemic. By the end of the study in June 2022, stress had fallen by less than 2% of its pandemic peak, indicating that the experience had a lasting impact on student well-being, the researchers report. 

In early 2021, as students returned to campus, their reunion with friends and community was tempered by an overwhelming concern about the still-rampant coronavirus. “There was the first outbreak in winter 2021 and that was terrifying,” one student recalls. Another student adds: “You could be put into isolation for a long time even if you did not have COVID. Everyone was afraid to contact-trace anyone else in case they got mad at each other.”

Female students were especially concerned about the coronavirus, on average 13% more than male students. “Even though the girls might have been hanging out with each other more, they are more aware of the impact,” one female student reported. “I actually had COVID and exposed some friends of mine. All the girls that I told tested as they were worried. They were continually checking up to make sure that they did not have it and take it home to their family.”

Students still learning remotely had social levels 16% higher than students on campus, who engaged in activity an average of 10% less often than when they were learning from home. However, on-campus students used their phones 47% more often. When interviewed after the study, these students reported spending extended periods of time video-calling or streaming movies with friends and family.

Social activity and engagement had not yet returned to pre-pandemic levels by the end of the study in June 2022, recovering by a little less than 3% after a nearly 10% drop during the pandemic. Similarly, the pandemic correlates with students sticking closer to home, with their distance traveled nearly cut in half during the pandemic and holding at that level since then.

Campbell and several of his fellow researchers are now developing a smartphone app known as MoodCapture that uses artificial intelligence paired with facial-image processing software to reliably detect the onset of depression before the user even knows something is wrong.

Morgan Kelly can be reached at [email protected] .

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Portrait of Montgomery Fellow Vinzenz Hediger

After a Year of Turmoil, Harvard’s Applications Drop

Elizabeth Blackwell Institute for Health Research

Inclusion, decolonising and dentistry.

case study with university students

Bristol Dental School students

27 March 2024

A new study from the University of Bristol seeks to understand the barriers and facilitators of inclusion for dental students, ensuring that every new student, regardless of gender, ethnicity, religion or background, has access to the same opportunities and facilities.

Dr Nilu Ahmed , Senior Lecturer in Social Sciences at the University of Bristol’s Dental School , built on existing research she and her coresearchers have conducted on decolonising the Dental Curriculum, she explains: 

“My studies at the Dental School involve working closely with students to understand what decolonising and inclusion means for us. These are fundamental, but poorly understood challenges for academia, and at present there is little guidance available for health professionals. This study, building on my previous work, aimed to address this by building evidence-based recommendations.” 

Students and staff 

Using funds from the Elizabeth Blackwell Institute, Dr Ahmed was able to extend her research on decolonising to bring a wider focus on intersectionality. Student co-researchers first recruited twelve students from across all the year groups to a focus group, and seven key staff members were interviewed. In total, across the research Dr Ahmed and her colleagues thus interviewed 103 students and 43 members of staff regarding decolonisation and inclusion. 

“The students we spoke to highlighted a number of areas they felt were important areas of inclusion,” said Dr Ahmed. “They spoke about racism, Islamophobia and lack of a sense of safety. Students from lower socio-economic backgrounds discussed the disadvantages faced by students; the lack of representation among staff;  a lack of support for mental health and well-being issues within the School of Dentistry, and they spoke of a disconnect between students of different year groups – a lack of sense of belonging and connection.” 


How to address these issues was the next concern. While Dr Ahmed shared the findings with the School of Dentistry’s Dental Education Committee, the students were also consulted. 

“The students suggested a number of measures,” said Dr Ahmed. “Students felt that issues around racism needed to be handled better. They felt current systems were unsupportive. Some of this was down to the lack of representation of diversity among staff, meaning students felt even when they raised issues around racism and her exclusions they were dismissed. Staff should be instructed not to insist that new students need not buy expensive and unnecessary equipment, such as loupes - which can cost thousands of pounds - as has happened in the past. A guide should be created for new students which incorporates tips from existing students, and there should be a celebration that brings together the staff and all years of the dental school together,” said Dr Ahmed. 


A full data analysis of the data from the project (and its ‘decolonising the curriculum’ siblings) is still ongoing; a number of papers are in progress on inclusion and microaggressions as a result of these investigations. There are also plans for ‘building an inclusive curriculum’ publication, and a peer-reviewed paper with the co-researching students. Students in an all years focus group recalled that a Year One lecture by Dr Ahmed on cross-cultural communication where students shared cultural connections was one their favourite lectures for feeling connected with others. They asked for something similar to involve all year groups.  In October 2023,  an all school event was held to celebrate the Dental School community.  Over 120 people attended with food from different cultures, crafts, games and lots of connections across year groups being made. 

“Elizabeth Blackwell Institute funding was extremely useful. The study was vital in teasing out wider intersectional identities, and it played an important role in the wider work.

Students discussed how the school sometimes felt like it was a place that was designed for those who were wealthier, and from white privileged backgrounds – it was less encouraging for anyone from a poor background or with mental or physical health issues, who could become excluded. The outcomes of the study can hopefully improve the experience of studying at the Dental School, and will make for a more inclusive space for all”. 

Related work 

In addition to these aims of more inclusive educational spaces and practices, Dr Ahmed has undertaken research using decolonial research methods such as storytelling with communities to devise new representative vignettes and scenarios for training health care professionals. She has also worked with students and local community organisations to build partnerships for community engaged pedagogy. She says “with the drive for civic engagement and greater emphasis on community engaged pedagogy, there is the risk of undertaking this work in a way that can cause harm to students and communities. This research explored how we can do this safely. Community engagement must be done in a way that ensures safety. It is skilled work, and like decolonising, we should think carefully about who does the work and whether the right people are involved. Student and community engagment is key”.


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    Bring excitement into your classroom with engaging case discussions and introduce students to the challenge and fun of making important decisions. Illustrate business concepts. Help students learn by doing with over 50,000+ cases featuring real-world business scenarios spanning across multiple areas of business. Encourage new ways of thinking.

  2. NCCSTS Case Studies

    Enrich your students' educational experience with case-based teaching. The NCCSTS Case Collection, created and curated by the National Center for Case Study Teaching in Science, on behalf of the University at Buffalo, contains over a thousand peer-reviewed case studies on a variety of topics in all areas of science.

  3. Case Studies

    Stanford case studies with diverse protagonists, along with case studies that build "equity fluency" by focusing on DEI-related issues and opportunities are listed in the Case Compendium developed by the Center for Equity, Gender and Leadership at the Berkeley Haas School of Business. Search by title, author, case ID, or keyword.

  4. Top 40 Most Popular Case Studies of 2021

    Fifty four percent of raw case users came from outside the U.S.. The Yale School of Management (SOM) case study directory pages received over 160K page views from 177 countries with approximately a third originating in India followed by the U.S. and the Philippines. Twenty-six of the cases in the list are raw cases.

  5. Case studies

    Support for faculty on long-term leave is a career lifeline. Institutions and academics both benefit when support frameworks are in place to help extended leavers back into work. Four educators offer a case study in what one might look like. Theresa Mercer , Jim Harris, Ron Corstanje, Chhaya Kerai-Jones.

  6. Case Studies

    Case Studies. Case studies are stories that are used as a teaching tool to show the application of a theory or concept to real situations. Dependent on the goal they are meant to fulfill, cases can be fact-driven and deductive where there is a correct answer, or they can be context driven where multiple solutions are possible.

  7. A case study of university student networks and the COVID-19 ...

    A case study of university student networks and the COVID-19 pandemic using a social network analysis approach in halls of residence. Sci Rep 11, 14877 (2021). https://doi ...

  8. Case-Based Learning

    Case-Based Learning. Case-based learning (CBL) is an established approach used across disciplines where students apply their knowledge to real-world scenarios, promoting higher levels of cognition (see Bloom's Taxonomy ). In CBL classrooms, students typically work in groups on case studies, stories involving one or more characters and/or ...

  9. What the Case Study Method Really Teaches

    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.

  10. Case Studies

    A collection of management case studies from an independent, not-for-profit organization dedicated to promoting the case method in business education (formerly the European Case Clearing House). Harvard Business Publishing. A range of collections, including Brief Cases, multimedia cases, partner case collections, the Premier Case Collection ...

  11. Entrepreneurial Resilience: A Case Study on University Students

    The present research is a multiple case study that was developed through a mixed methodology. The methodological sequence was quantitative and qualitative, with priority given to the qualitative phase of the research. Ten university students with high levels of resilience were interviewed. The data were analysed using thematic analysis.

  12. Writing a Case Study

    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.

  13. What Is a Case Study?

    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 ...

  14. A Case Study of Developing Research Competency in University Students

    The research featured the measures required to plan scientific and research activities that develop research competency in university students. The authors explained the necessity to plan research activities in the way that would allow students to master educational and cognitive techniques and perform practical actions aimed at solving personal and socially significant tasks.

  15. Case study

    The case can refer to a real-life or hypothetical event, organisation, individual or group of people and/or issue. Depending upon your assignment, you will be asked to develop solutions to problems or recommendations for future action. Generally, a case study is either formatted as an essay or a report. If it is the latter, your assignment is ...

  16. Natural Light Influence on Intellectual Performance. A Case Study on

    The present research consists in a case study that adds some data on that question. The experiment processed the data on the performance of 278 university students in one theoretical course ...

  17. Writing a Case Analysis Paper

    University of Potsdam; Writing a Case Study Analysis. University of Arizona Global Campus Writing Center; Van Ness, Raymond K. A Guide to Case Analysis. School of Business. ... Bee, Lian Song et al. "Business Students' Perspectives on Case Method Coaching for Problem-Based Learning: Impacts on Student Engagement and Learning Performance in ...

  18. How we're supporting university students with their mental health

    Going to university is a fun and exciting time for most students - but it comes with unique challenges and stresses. We believe that all students' mental health and wellbeing should be properly supported during their time at university. There is a range of mental health support available to students, from online mental health and wellbeing platform Student Space to counselling and one-to ...

  19. Student Case Study

    A student case study is an in-depth analysis of a student or a group of students to understand various educational, psychological, or social aspects. It involves collecting detailed information through observations, interviews, and reviewing records, to form a comprehensive picture. The goal of a case study analysis is to unravel the ...

  20. University of Kentucky Sharpen Case Study

    over 3 years ago Supercharging A Static OER Textbook with Learning Resources at Northern Arizona University Hoping for better student outcomes, the faculty at Northern Arizona University partnered with the McGraw Hill Custom Courseware Solutions (CCS) team to build a psychology course to meet their needs.

  21. Case study example

    Atlanta public schools case study. In 2011, an external investigation of the performance evaluation strategies of the Atlanta Public Schools System revealed that schools had been cheating to obtain high results. For this example case analysis, the student has identified the problems faced by the organisation, outlined factors that contributed ...

  22. School of Medicine

    Meet six students shaping their fields—and their futures. Across 25 doctoral, master's, and certificate programs, more than 2,800 students are gaining the experience for which Case Western Reserve University School of Medicine is known: for its rigorous, customizable, and contemporary curriculum, state-of-the-art technology, exceptional clinical and laboratory opportunities, and an ...

  23. Procrastination Among University Students: Differentiating Severe Cases

    Similarly, the current study focused on students in university settings only, making it unclear whether the results can be generalized to an adult working population or younger students in elementary school or high-school. ... Steps towards delineating a case definition," in Proceeding of the Presentation at the 7th Biennal Conference on ...

  24. Teach college students to navigate unexpected life moments

    A workshop series at George Mason University gives students the tools to "adult" and tackle unfamiliar situations with confidence. One of the challenges students in college and after graduation is learning to be independent and manage tasks, colloquially known as "adulting." George Mason University's recreation department created a life-skills series called "Now What?" to answer ...

  25. Sport Administration Master's Students Win First Place in National Case

    The national competition is part of the annual CSRI conference, held March 20-22 at the University of South Carolina in Columbia, S.C. Georgia State's team members included graduate students Anna Lipsman, Ashley Hohmann, Michelle Vazquez and Rachel Moss. The case study team was advised by kinesiology Ph.D. students Natalie Bunch and Jackson ...

  26. Study Tracks Shifts in Student Mental Health During College

    The team made their anonymized data set publicly available—including self-reports, surveys, and phone-sensing and brain-imaging data—to help advance research into the mental health of students during their college years.. Andrew Campbell, the paper's senior author and Dartmouth's Albert Bradley 1915 Third Century Professor of Computer Science, says that the study's extensive data ...

  27. Inclusion, decolonising and dentistry

    Dr Nilu Ahmed, Senior Lecturer in Social Sciences at the University of Bristol's Dental School, built on existing research she and her coresearchers have conducted on decolonising the Dental Curriculum, she explains: "My studies at the Dental School involve working closely with students to understand what decolonising and inclusion means for us.