How to Write a Case Study Paper for Nursing
A well-written case study paper for a nursing program requires some planning and consideration. All too often students begin writing before they complete appropriate, preliminary steps. Ideally, before you begin a paper, you should already have determined the focus and format of it. You will then follow this up with a fact-gathering step in which you will gather and collate the content of your paper. Finally, there is the construction/execution step in which you will write the paper in a standard format (such as the APA style) and edit it.
A nursing case study paper contains several sections that fall into three categories:
1. The status of the patient
- Demographic data
- Medical History
- Current diagnosis and treatment
2. The nursing assessment of the patient
- Vital signs and test results
- Nursing observations (i.e., range of motion, mental state)
3. Current Care Plan and Recommendations
- Details of the nursing care plan (including nursing goals and interventions)
- Evaluation of the current care plan
- Recommendations for changes of the current care plan
The first portion of the case study paper will talk about the patient — who they are, why they are being included in the study, their demographic data (i.e., age, race), the reason(s) they sought medical attention and the subsequent diagnosis. It will also discuss the role that nursing plays in the care of this patient.
Next, fully discuss any disease process. Make sure you outline causes, symptoms, observations and how preferred treatments can affect nursing care. Also describe the history and progression of the disease. Some important questions for you to answer are: 1) What were the first indications that there was something wrong, and 2) What symptoms convinced the patient to seek help?
When you are discussing the nursing assessment of the patient describe the patient’s problems in terms of nursing diagnoses. Be specific as to why you have identified a particular diagnosis. For example, is frequent urination causing an alteration in the patient’s sleep patterns? The nursing diagnoses you identify in your assessment will help form the nursing care plan.
Current Care Plan and Recommendations for Improvement
Describe the nursing care plan and goals, and explain how the nursing care plan improves the quality of the patient’s life. What positive changes does the nursing care plan hope to achieve in the patient’s life? How will the care plan be executed? Who will be responsible for the delivery of the care plan? What measurable goals will they track to determine the success of the plan?
The final discussion should be your personal recommendations. Based on the current status of the patient, the diagnosis, prognosis and the nursing care plan, what other actions do you recommend can be taken to improve the patient’s chances of recovery? It is important that you support your recommendations with authoritative sources and cited appropriately per APA style guidelines.
Creating a well-written nursing case study paper doesn’t need to be a grueling challenge. It can actually be very rewarding, and it’s good practice for assessing patients while out in the field, too. Keep in mind that your instructor will not only grade you on the quality of the content of your paper, but by how you apply the APA style, as well. If you find that you are spending too much time formatting your paper, consider using formatting software as a helpful tool to ensure accuracy so you don’t lose points on a well written paper because of some formatting errors.
David Plaut is the founder of Reference Point Software (RPS). RPS offers a complete suite of easy-to-use formatting template products featuring MLA and APA style templates, freeing up time to focus on substance while ensuring formatting accuracy. For more information, log onto http://www.referencepointsoftware.com/ or write to:
info @ referencepointsoftware.com
Reference Point Software is not associated with, endorsed by, or affiliated with the American Psychological Association (APA) or with the Modern Language Association (MLA).
Many faculty members consider using case studies but not all end up using them. We provide a brief review of what cases are intended to do and identify three ways in which they can be used. We then use an example to illustrate how we have used the case study method in teaching business demography. Among other benefits, we note that the case studies method not only encourages the acquisition of skills by students, but can be used to promote “deep structure learning,” an approach naturally accommodates other features associated with the case studies method—the development of critical thinking skills, the use of real world problems, the emphasis of concepts over mechanics, writing and presentation skills, active cooperative learning and the “worthwhileness” of a course. As noted by others, we understand the limitations of the case study method. However, given its strengths, we believe it has a place in the instructional toolbox for courses in business demography. The fact that courses we teach is a testament to our perceived efficacy of this tool.
Keywords: Deep structure learning, Historical narrative, Skill acquisition, Decision-making
Although the idea of business demography has been around for at least 25 years (Kintner et al. 1994), pedagogical issues regarding the training of business demographers are only now emerging (Swanson and Pol 2005). As university faculty and others involved in the training of business demographers develop and refine appropriate pedagogical approaches for this task, we suggest that the case study method be taken under consideration. We make this suggestion knowing that while business school faculty are well aware of the case study approach, faculty in social sciences, where most of the training of business and other applied demographers is done, are less aware of it. We also note that our suggestion is not meant to imply that the case study method should be used to the exclusion of other approaches, but that it should constitute one of several tools in the training kit. To help put this in perspective for social science faculty, especially those in sociology (where much of the training of demographers is done), the case study method can be viewed as a ‘qualitative technique.’
Like many qualitative methods, a case tells a ‘story’ that, in turn, can be used in the classroom as a basis for learning (Broder et al. 2003; Patten and Swanson 2003). Case study research, according to Soy (1997), “excels at bringing us to an understanding of a complex issue or object and can extend experience or add strength to what is already known through previous research.” A major strength of the case study method is that its focus encompasses richly detailed contexts. Sociologists have long used this approach under the heading “qualitative research” (Feagin et al. 1991). However, this very strength is viewed as the method’s major weakness: Critics of the case study method note the difficulty in demonstrating that case study findings are both generalizable and reliable because of the limited “sample size” (Soy 1997). Despite this perceived weakness, the case study method has been used in many fields of study, including, demography and business (Kintner et al. 1994). Although they may extend into fictional realms, cases typically build on real situations in the life of an individual, a profit-seeking company, or a non-profit organization (Feagin et al. 1991). Examples of this approach on topics combining demography and business or demography and government are found in Demographics: A Casebook for Business and Government (Kintner et al. 1994) and academic journals (see, for example, Morrison and Abrahamse 1996; Morrison 1998, 1999). These examples range from market research applications (Billings and Pol 1997) to site selection problems (Thomas 1994).
There is, in addition, an important benefit that appears to accrue from using the case study method terms of “Deep Structure Learning” (Patten and Swanson 2003; Swanson 2005; Swanson and McKibben 1999), which is aimed at the development of critical thinking skills (Roberts 2002; Swanson 2005). Students view it more positively than courses not designed using this approach. Part of this reason may be that the deep structure learning approach naturally accommodates other features associated with the case studies method—the development of critical thinking skills, the use of real world problems, the emphasis of concepts over mechanics, writing and presentation skills, active cooperative learning and the “worthwhileness” of a course (Patten and Swanson 2003; Swanson 2005; Swanson and McKibben 1999).
So, how can cases be used in the classroom? We identify three distinct applications: (1) as an historical narration, (2) as a focal point for acquiring specific skills, or (3) to build decision making skills (Patten and Swanson 2003). After Identifying these three applications, we provide a concrete example that is based largely on the third application.1
Because a case tells a story, it can be used to teach an historical narrative. By this we mean that the student is expected to learn what has happened historically in the life of the entity. Consider a Swiss manufacturing company faced with shrinking demand for its products. The company responds by changing the product design, thereby returning to profitability. The student reading this case learns how the company discovered and described the problem, evaluates the various actions the company contemplated taking, and considers how and why the company finally responded as it did. In using this case study, the instructor has a choice of what to emphasize: (1) analyzing the entire sequence of events; (2) focusing students’ attention on the alternatives and how they were formulated; or (3) exploring the actions that returned the company to profitability.
Acquiring Specific Skills
The second application of cases described in Patten and Swanson (2003) is to enable students to acquire specific skill. The typical format here is a question that the instructor constructs, which students must answer through some research exercise (e.g., a series of calculations, downloading and assembling data). In doing so, the student acquires specific skills by analyzing the question and manipulating relevant data. This approach has the advantage of using a real-life situation, which helps to enliven the learning experience for the student and simultaneously emphasizes the learning experience that the instructor wants to achieve.
To illustrate, assume the faculty member wishes to focus on learning about channels of distribution. A case could be selected that describes a company and the product it manufactures. Information about the cost of manufacturing and the desired profit margin could be provided. The student could then be asked to identify possible ways in which the manufacturer could distribute its product to the consumer. This can be as extensive an analysis as the faculty member decides is appropriate given the level and objectives of the course. Given a certain problem that the case has identified, the student then learns that, she or he must now discover various alternatives to solving the problem. Since the alternatives all must concern distribution channels, the student ends up acquiring a specific skill—in this case, knowledge of how distribution works.
As an example of this approach, here is a brief description of a case approach that hones specific skills used in evaluating global consumer markets using data available from the U.S. Census Bureau and the World Bank. The prospects of rising incomes destined to transform massive populations into rapidly expanding consumer markets spurred a rush of U.S.-based corporations into China, India, and other markets during the 1990s. These expanding consumer markets continue to attract corporations whose present-day business derives largely from mature markets with limited prospects for further growth. In their efforts to globalize, corporations need to anticipate the future growth of these emerging consumer markets. Such markets pose distinctive problems amenable to applied demographic analysis. The case centers on a study to refine and expand a corporation’s global view of the “middle class” consumer. In this case, the student is called upon to develop data on the preceding points and prepare an analysis to be presented to a client who is contemplating entry into one of several emerging markets and looking for guidance on the comparative demographic strengths and weaknesses of each market.
In this case, the student is called upon to develop data on the above points and prepare an analysis to be presented to a client who is a builder interested in foreseeing future homebuyer preferences. [Data on all of these issues are readily available on the Internet].
The third instructional application focuses on the art of decision-making. How does one identify problems? What needs to be solved? How does one formulate possible courses of action? What criteria can be used in evaluating solutions or courses of action? Notice that under this approach, the student must discover the problem—it is not identified as such in the case. Not all students will succeed in doing so, but the more discerning ones will lead the discovery process. A case with multiple problems enables the instructor to focus on problem clarification as a key learning outcome. Consequently, this approach is very popular when teaching courses such as strategic management, where it is desirable to encompass the problems involving a variety of subject matter fields. The process of identifying the problem, enumerating possible solutions, establishing criteria to be incorporated in the solution that is selected, and selecting the solution along with the supporting rationale makes for an important experience. Cases are distinctively able to deliver a valuable learning experience in this type of situation. We turn now to a specific example that incorporates the decision-making approach to using cases that illustrates not only the structure of this approach, but also one of many ways in which it can be implemented in the classroom.
An Example of Teaching with the Case Study Method
The following example was developed by Morrison and extended by Swanson for use in a market demographics course taught for the Helsinki School of Economics. It largely represents the ‘decision-making’ approach, but it contains elements of skill acquisition. It has the following structure:
The Decision-maker: The Decision-maker is the entity responsible for selecting a course of action—making the decision. The decision-maker could be a person, or a group of persons, informally or formally constituted. It could also be something designed by people—computer algorithm, for example.
The alternative decisions (courses of action): The decision involves selecting one of two or more identified courses of action. The goal is to choose the course of action that is “best.”
Events: These are occurrences that are beyond the control of the decision-maker but yet can have an effect on the course of action selected. The events are subject to uncertainty but ideally they are mutually exclusive and exhaustive so that one and only one can occur.
Return or Payoff: is a measure of net benefit to the decision-maker.
Uncertainty: is measured by the probabilities assigned to the identified events. These may be subjective.
The central ideas of the example we use here (as well as Exhibits 1 and 2) are taken from the book, Dealing with Darwin: How Great Companies Innovate at Every Phase of Their Evolution, by Geoffrey A. Moore (2005), for which PowerPoint slides and other materials can be found at the website www.dealingwithdarwin.com.2 They are as follows.
A Declining market represents a period in the maturity of a market when, setting aside cyclical fluctuations, growth rates are negative. Strategically, a time to either reinvigorate the category or harvest and exit.
Growth market. A period in the development of a market when growth rates are significantly in excess of 10%. Strategically, a time when gains in market share create more shareholder value than maximizing profits.
Mature market. A period in the development of a market when, setting aside cyclical fluctuations, growth rates are modest, typically less than 10%. Strategically, a time when profits take precedence over revenues and market share.
Now as we enter the latter half of the decade, yet another set of new issues confront us. The great growth market opportunities have been transplanted to Asia and with them local economic advantage as well. Moreover, offers incubated in low-cost economies can be expected to disrupt business models in established markets. How can today’s leading enterprises compete successfully for revenues and profits in a globalized, commoditized, deregulated marketplace?
- Market (or industry) life cycles describe the evolution of the market. These cycles have a similar shape to the product life cycle and similarly, have three distinct stages:
embryonic-the product class and industry definitions are virtually synonymous, diffusion rates are gradual, and there is considerable uncertainty about the product;
growth-the industry structure develops, the introduction of new product classes becomes easier as consumers become more knowledgeable, and the channels facilitate the marketing of new product classes established; and
maturity and established infrastructure facilitates rapid introduction and diffusion of new product variants or product classes, competitors jockey for position, and older products have to make adjustments to protect their declining position.”
Moore’s view of the market life cycle
The preceding concepts are summarized in Moore’s (2005) view of the Market Life Cycle, as shown in Exhibit 1.
To add more of the information you need to see how this works, we continue with the critical concepts Geoffrey Moore (2005) overlays on the market life cycle, “Context,” “Core,” and “Core/Context analysis.” It is the latter the case study is aimed at getting the students to process and understand.
Context. Any activity which does not differentiate the company from the customers’ viewpoint in the target market. Context management seeks to meet (but not exceed) appropriate accepted standards in as productive a manner as possible.
Core. Any activity which creates sustainable differentiation in the target market resulting in premium prices or increased volume. Core management seeks to dramatically outperform all competitors within the domain of core.
Core/context analysis. A resource prioritization framework that discriminated differentiating processes from all other work. Core/context management advocates funding differentiating initiatives in growth markets by extracting resources (carefully) from mission-critical context initiatives in mature markets.
The preceding concepts are summarized in an analytic framework, as shown in Exhibit 2.
The implementation of Moore’s ideas in terms of an actual case study used in a business demography class uses real data derived from Billings and Pol (1994), under the pseudonym, “Weasel Cellular, Inc.,” a company “providing cell phone service in the United States.” Students are told that the company has recently adopted the perspective of Geoffrey Moore to analyze its existing and potential market and that each of them is a finalist for a position as a market research analyst at Weasel Cellular. The students have been informed that they have made it through the initial screening and a series of interviews and are now being given a test to see how well they understand the market life cycle and related concepts developed by Geoffrey Moore that they claimed to have knowledge of in their resumes and interviews. The test consists of conducting a “Core/Context Analysis” using the data contained in Tables 1, 2, 3, and 4, which provide information at two points in time (“now” and 10 years in the future) for two hypothetical counties in Florida (K and S) on cellular phone subscriptions by age, people by age, and “market attractiveness index” by age.
Current population by age (number and percent) in county K and county S
Current cellular phone subscriptions (%) by age, population by age (%), and market attractiveness index (% subscriptions × % age) by age: county K and county S
Forecasted population 10 years from now by age (number and percent) in county K and county S
Forecasted cellular phone subscriptions 10 years from now (%) by age, population by age (%), and market attractiveness index (% subscriptions × % age) by age: county K and county S
In the test, students are asked to examine the information for these two counties from the perspective of a high level executive in Weasel Cellular and determine which of the two should be considered as “core” and which one should be considered as “context.” A key issue here is how the students view the changing demographics in the two counties. Should they focus more on size, on the age-distribution, or try to achieve a balance between the two? Whichever of these characteristics they choose, the students are required to provide a justification for their determinations in the form of memos. Exhibits 3 and 4 provide responses from two students, “A,” and “B,” to the “test” comprising this case study. The two students both used a demographic perspective to come up with a recommendation, but their recommendations are very different. As you read through these two exhibits, keep in mind not only that the demographic and related analyses are well-considered and justified by the two students, but also that they are upper division undergraduates who are non-native English speakers.
Response from student “A”
Response from student “B”
We believe that these two examples (selected randomly from the entire set) not only illustrate the points we have made earlier about the acquisition of demographic and related analytic skills, but also a point we again turn to at the end of this paper—the development of critical thinking skills.
As can be seen from the discussion and the example, there are particular features of the case study method that are appealing, both to students and to instructors. A major feature is that case studies support using “a real-world” scenario. That is, a scenario that uses real data in the context of grappling with an open ended problem. The fact that this can be nicely handled in group work also is appealing (Penn State 2002). Besides acquiring skills, the fact that cases can be used to illustrate and understand decision-making, means that case studies can be used to promote “Deep Structure Learning,” a learning outcome we have advocated elsewhere (Swanson 2005; Swanson and McKibben 1999).3
As noted at the start of this paper, there is, in addition, an important benefit that appears to accrue from using the case studies method in conjunction with the goal of Deep Structure Learning: Students view it more positively than courses not designed using it (Patten and Swanson 2003; Swanson 2005; Swanson and McKibben 1999). Part of this reason may be that the deep structure learning approach naturally accommodates other features associated with the case studies method—the development of critical thinking skills, the use of real world problems, the emphasis of concepts over mechanics, writing and presentation skills, active cooperative learning and the “worthwhileness” of a course (Patten and Swanson 2003; Swanson 2005; Swanson and McKibben 1999).
The skills acquired by students in conjunction with this case study are largely conceptual in that they become sensitized to issues involving population size and composition, as can be seen in Exhibits 3 and 4. They also develop an appreciation for the components of population change because the case study involves examining populations over time.
In conclusion, while we recognize the limitations of the case study method (Soy 1997), we believe it as a place in the instructional toolbox for training business demographers. One important benefit for social science faculty is that a case study can be used in isolation or as part of an overall teaching strategy. For our part, we tend to use a series of case studies in courses we have taught, such that all three approaches are covered—historical narration, skill acquisition, and decision-making. The fact that we use cases in business demography (and other) courses we teach is a testament to our perception of the efficacy of this tool.4
The authors are grateful for comments made by Farhat Yusuf and anonymous reviewers.
Open Access This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
1Because of space limitations, we are not able to provide the rich details of each of the three types of case studies we describe. These details are available on request from either of the authors.
2We thank Geoffrey Moore for giving us permission to use his materials in the classroom and in this paper.
3“Deep structure learning” is a term developed by Keith Roberts (2002). Using a framework developed by Patricia King and Karen Kitchener (1994), Roberts views the development of critical thinking as a progression that starts with a stage labeled “pre-reflective thinking,” moves to “quasi-reflective thinking”, and culminates in the third and final stage, “reflective thinking.” King and Kitchener (1994) describe the final stage of the process - reflective thinking - as the ability to reason about unstructured questions that have no absolute answers.
4Syllabi and class materials for courses that use case studies can be obtained from either of the two authors.
David A. Swanson, Email: email@example.comD.
Peter A. Morrison, Email: moc.loa@6363mreteP.
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- Feagin J, Orum A, Sjoberg G, editors. A case for the case study. Chapel Hill, NC: The University of North Carolina Press; 1991.
- King P, Kitchener K. Developing reflective thinking: Understanding and promoting intellectual growth and critical thinking in adolescents and adults. San Francisco, CA: Jossey-Bass; 1994.
- Kintner P, Merrick T, Morrison P, Voss P, editors. Demographics: A casebook for business and government. Santa Monica, CA: RAND; 1994.
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- Penn State. (2002). Using cases in teaching. Teaching and learning with technology website. http://tlt.its.psu.edu/suggestions/cases. Accessed December, 2002.
- Roberts, K. (2002). Ironies of effective teaching: Deep structure learning and constructions of the classroom. Teaching Sociology, 30 (January), 1–25.
- Soy, S. (1997). The case study as a research method. Unpublished Paper. University of Texas Austin. http://fiat.gslis.utexas.edu~ssoy/useusers/1391d1b.htm. Accessed June, 2009.
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- Swanson, D., & McKibben, J. (1999). Teaching statistics to non-specialists: A course aimed at increasing both learning and retention (pp. 159–166). In L. Pereira-Mondoza, L. Kea, T. Kee, & W. Wong (Eds.), Statistical education—expanding the network: Proceedings of the fifth international conference on teaching statistics. International Association for Statistical Education, International Statistical Institute, Voorburg, Netherlands.
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- Thomas R. Using demographic analysis in health service planning: A case study in obstetrical services. In: Kintner H, Merrick T, Morrison P, Voss P, editors. Demographics: A casebook for business and government. Santa Monica, CA: RAND; 1994. pp. 159–179.