A Reflective Review on
A case for case studies: exploring the use of case
study design in community nursing research .
Bergen A. and While A. (2000) .
An analysis of the effectiveness of focus groups as
a method of qualitative data collection with Chinese
populations in nursing research.
Twinn S. (1998)
Moshe Ebenstein
Gila Kadosh-Dadon
Nir Shani
Joseph Waks
Two research methods will be Introduced as
presented in two Readings
Reading 1 - The use of case study design in
community nursing research. Overview,
Reading 2 – Focus groups as a method of
qualitative data collection. Overview, analysis
A reflective comparative evaluation , validation
and analysis between the two readings.
Summary and Conclusions
A case for Case Study
This paper
Explores the suitability of community nurses for the role
via a case study research method.( research question)
Clarifies the Case Study research method through its
characteristics and other issues arising by its use.
Refers to the theory of Case Study Method, literature and
arguments concerning the issue.
Discusses the relationship of the case study to theory
Concentrates on issues arising from the definition of case
study research method , used in a study by R.K.Yin
(1993,1998) with reference to design in community
nursing research.
Explores the use of case study and Puts Emphasis on the
research method theory rather then on the case itself.
Yin’s Approach
A case study Investigates a contemporary
phenomenon within its real-life context, when the
boundaries between phenomenon and context are
not clearly evident.
Copes with the technically distinctive situation in
which there will be many more variables of interest
than data points, and as one result
Should Rely on multiple sources of evidence, with
data converging in a triangulating fashion.
Benefits from the prior development of theoretical
propositions to guide data collection and analysis.
The case research has to be designed carefully and
A case design requires attention for the issues :
Case Study Design
Case and context: A clear definition of the case
(unit of analysis = the case itself). Sources of
data collection (sub-unit) – subjects or variables
to be measured.
External validity: Searching for external support
to the theory, creating theory generalization
Triangulation (multiple methods of data
collection): documentation, archival records,
direct observation, participant observation,
interviews and physical artifacts.
Relationship to theory: The theory has to be
developed, prior to the data collection, and
evolved if findings contradict tit
This article focuses on Case study design based
on Yin’s approach.
Definition of the case ,context ,units of
measurement and analysis are not clear
There is no reference and no answer to the
research question.
Triangulation is a valuable resource of research
Yin’s approach is suitable for the specific
research. (but since the research conducted in
one method only it could not be compared to
other methods)
Focus groups
Focus groups interviews are now used in exploratory
studies & the evaluation of health programs
A focus group is a group of people with a common
area of interest, occupation, opinion etc. gathered to
discuss this subject.
The Article explores the contribution of focus groups
as a qualitative method of data collection amongst
Hong Kong Chinese women.
The Research conducted in two concurrent projects.
focused on different subjects.
In both projects the participants grouped into groups
between 3-9 members in each group.
As a result The focus is a suitable method to get
quality data on Chinese population .
The research design and process
Data collected from 2 research projects
both used a case study design and each study used
focus groups as a major method of data collection.
In addition both studies involved samples of Hong
Kong Chinese women
Project A
Multiple embedded design: case study design in 3
1st stage: focus group interviews
4 community clinics – 26 nurses
9 focus groups- 3 to 9 members each
Homogeneity groups: Registered nurses- Nursing
Project B
Multiple embedded design: two case studies in 3
12 focus groups- 6 related to each case study, size
3-8 members
Factors Influencing the quality
of data in focus groups
Recruitment of participants.
Group Homogeneity.
Dominant participant.
Number of participants in a group.( Not too
small not too big 4-6).
Group guide . Has to have leadership
Language .(unique to this research)
Interaction of the participants
Contribution of individuals
Relationships between participants and
The advantage of Focus groups
A major advantages of focus groups as a method of
data collection results from the group process and
the interaction of groups members
The synergism created from the interaction is
considered significant to the stimulation of new
ideas and high levels of energy in discussion.
This approach to data collection provides the
opportunity of collecting in depth-information
about complex topics in a relatively short space of
time particularly since the aim of focus is not
necessarily to achieve consensus amongst group
There is no definition of focus group( in this
research context).
There is no reference to the research
question (deliberately).
The technique used to compare between the
2 concurrent researches is unclear.
What is quality data?
The theoretical base ground of focus groups
method is not solid.
No mention about validity & reliability .
The generalization of the case results is not
The research conducted in one language the
analysis in another one.
Common issues in the
In Both There are two main subjects: the research
method and the research question.
In Both the major conclusion refers to the research
The authors (in both) claim that the research method
used is suitable for the Conducted research, therefore
they both deliver the required results.
The Design method in Both: embedded multi case
design method.
There is no hard evidence that the research gives the
answers to the research question.
There is no Description of the complete design process.
Both apply to the research community in the areas of
nursing ,education Ethnographic sciences and
professionals in the nursing area.
Both Generalize the research results.
case Study
focus group
Introduces the theory and
the debate on case study
research method.
Concentrates on the
theory of the research
Generalization Based on
Introduces some references
to questions in focus groups
Concentrates on the issues
arising the research process
in details .
Generalization based on
Descriptive: recruitment,
organization & work frame
The Quest for Theory
Projection from singularity to commonality.
The importance a general theory is a source of
knowledge and reference.
A case study deals with local and limited sources
of data.
In order to generalize a theory, a lot of
experiments and case study researches have to be
Replication logic has to be taken into
consideration as part of the solution, together
with supporting and contradicting theories and
external sources of data .
Extend or change the theory in accordance to new
Data, theories.
Determine the Limiting conditions to the
What Can we learn from the articles ?
what is required for a research method design
Are those articles suitable for WBP?
Research method design
Accurate definition of the Phenomena, the case
and its context.
Definition of the research Objective/Question
(What is the research for?).
Theoretical approach and support (to the research
method and to the research question).
Participants (Who is involved? ).
Reliability of Data and results .Triangulation, cross
reference data methods and external validity .
Define units of measurement.
Design the research process, based on the factors
mentioned. How to operate the research ?how to
save data?
Data analysis. (methods, theories)
Two different research methods.
Both utilize the research as a vehicle for
promotion reserch method in practice.
Any research method requires careful
definition, design and analysis.
The research method is suitable for the
conducted research .
The preferred research method for WBP is the
case method.
Thanks for Attention
Case and Context
Units of analysis
Case Study
A case for case studies: exploring the use
of case study design in community nursing
research . Bergen A. and While A. Journal
of Advanced Nursing 2000,31(4),926-934.
Focus Groups
An analysis of the effectiveness of
focus groups as a method of qualitative
data collection with Chinese
populations in nursing research. Twinn
S. (1998) – Journal of advanced
nursing, 28(3), 654-661
Reading 1
A practical study
Research design, findings & conclusions fully described
Descriptive: recruitment, organization & work frame
Non explorative
validity & reliability: unfounded scientific research base
Clear research design & data collection methods
Fundaments a reliable case study research method
Case studies examines objects as well as processes
Reading 2
Reading 2
Readg 2
No mention about validity & reliability
Two languages, diverse case studies
Different Data analysis to find categories & subcategories:
Semi structured interviews – matrices (Miles &
Huberman, 1994)
Less structured interviews – coding system (Polit
& Hunger,1995)
Case study The research design
Case and context: a clear definition of the case (unit of analysis=the case itself). Case within the
case (teacher & pupil in order to build the school’s picture). Sources of data collection (sub-unit) –
subjects or variables to be measured.
External validity: not just case study approaches, is seldom an entirely new understanding of
phenomena, but rather a `refinement of understanding‘. `by counter example [each] case study
invites modification of the generalization.
Pattern matching: whereby several pieces of information from the same case may be related to some
theoretical proposition' (Yin 1994) & the results of the entire case are compared both with other
cases and with the proposed theory. Literal replication occurs where there are predicted similar
Triangulation: documentation, archival records, direct observation, participant observation,
interviews and physical artifacts.
Relationship to theory: The role of theory development, prior to the conduct of data collection, is one
point of difference, to Yin (1994), between case studies and related methods, such as ethnography
and grounded theory, although, like these, the case study may also be used for theory-building.
Focus group Research design
Define the research Objective: get quality data using
focus groups.
Participants : Nurses, patients, Group leaders.
How to recruit participants ? interviews,Lectures.
The research process. How to operate it ?how to save
data?( by tapes and semi structured forms).
Data analysis.
Summary and Conclusions