Making the case for case study research: what research methodology to use is an important question for nursing researchers. Here a nurse researcher details the strengths of case study research and looks at some of the criticisms.(RESEARCH)

Research occupies a central role in the transformation of nursing practice and nursing interventions in contemporary health care with its emphasis on evidence-based practice. New nursing knowledge produced through research contributes to the development of the discipline of nursing and to best practice health care outcomes. The choice of which methodology will best suit the research purpose ought not to be a random one. The research purpose must guide and inform the process of determining the most appropriate methodology. In this article, the usefulness of case study research (CSR) methodology is discussed, and shown to be an approach suitable for research by nurses across a wide spectrum of clinical settings and specialty practice.

During the course of the 20th century, CSR emerged as a useful research methodology, a(though this process did not occur without contest. In the 1920s, the Chicago School was at the forefront of the evolution of CSR. (1,2) Researchers began to use particular cases to investigate social phenomena, such as poverty and delinquency, in the context of rapid urban growth and a large immigrant population. (1) Data was gathered from multiple sources, ranging from field observations to statistical analysis of city records. This use of multiple sources of data, along with the study of defined cases within defined contexts over a defined period of time, remain the key distinguishing features of this methodology. Other institutions (notably academics from Columbia University) challenged this methodology for its perceived lack of quantitative rigour and its inability to provide representativeness to populations. (1,2) However, key advocates argued that although information derived from cases could not be generalised to populations, it could be generalised to theory. (3,4,5,6)

A range of disciplines have recognised the utility of CSR, not only as a research methodology, but also as a teaching method. In 1954, Harvard Business School published its seminal work The case study method at the Harvard Business School It established a strong argument for the advantages of case study, in particular its potential to allow professionals from applied disciplines to study and learn from "real world" events. (7)

Literature review process

In order to determine the potential usefulness of CSR in contemporary health care, a literature search was undertaken using the key words: case study research, nursing, health care and research methodology. The Cumulative Index of Nursing and Allied Health Literature database was the source of English language journal material between 1990 and 2006. In addition, Te Puna National Library catalogue was searched for published texts using the key words: case study research. After reading primary search material, a secondary search was conducted to review any new references identified.

The wide range of literature netted in the review was reviewed and categorised under the following criteria: definition and classification, applications of CSR, key criticisms, managing data quality and research design. Papers were excluded because they did not give an example of nursing research using this methodology or they did not provide discussion or analysis of this methodology under the inclusion criteria Results were tabulated under the following headings: research purpose, nursing context, publication, and research outcome (see Table 2, p22). The literature review revealed …