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Home » Desain Penelitian: Pengertian, Jenis, dan Contoh

Desain Penelitian: Pengertian, Jenis, dan Contoh

• Maret 30, 2023
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Agar penelitian bisa berjalan sesuai dengan pedoman dan tidak menyimpang, maka desain penelitian merupakan salah satu strategi yang bisa dilakukan. Dengan adanya desain penelitian, tujuan penelitian bisa lebih mudah dicapai

Kita dapat menerapkan desain penelitian mana yang paling cocok digunakan untuk penelitian, baik penelitian kualitatif atau kuantitatif . Pada artikel ini kita akan membahas seputar desain penelitian. Jika kamu mencari informasi yang sama, maka baca artikel selengkapnya! 

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Apa Itu Desain Penelitian?

Mari bahas pengertian desain penelitian terlebih dahulu. Desain penelitian adalah rangkaian prosedur dan metode yang dipakai untuk menganalisis dan menghimpun data untuk menentukan variabel yang akan menjadi topik penelitian. 

Desain penelitian juga didefinisikan sebagai strategi yang dilakukan peneliti untuk menghubungkan setiap elemen penelitian dengan sistematis sehingga dalam menganalisis dan menentukan fokus penelitian menjadi lebih efektif dan efisien.

Masalah pada sebuah penelitian akan menentukan jenis apa yang cocok untuk dipilih. Hal tersebut juga menentukan alat dan cara apa yang cocok digunakan untuk mengatasi masalah dalam penelitian.

Desain Penelitian Menurut Para Ahli

Berikut pengertian desain penelitian menurut para ahli:

1. Silaen (2018) 

Menurut Silaen, desain penelitian adalah desain mengenai keseluruhan proses yang diperlukan dalam perencanaan dan pelaksanaan penelitian.

2. Umar (2007)

Menurut para ahli, desain penelitian dapat diartikan sebagai suatu rencana kerja yang terstruktur dalam hal hubungan-hubungan antara variabel secara komprehensif agar hasil risetnya dapat memberikan jawaban atas pertanyaan-pertanyaan riset.

Rencana tersebut mencakup hal-hal yang akan dilakukan preset, mulai dari membuat hipotesis dan implikasinya secara operasional sampai analisis akhir 

3. Nachmias dan Nachmias (1976)

Menurut Nachmias dan Nachmias, desain penelitian merupakan suatu rencana yang membimbing peneliti dalam proses pengumpulan, analisis, dan interpretasi observasi. Maksudnya, suatu model pembuktian logis yang memungkinkan peneliti untuk mengambil inferensi mengenai hubungan kausal antar variabel di dalam suatu penelitian.

4 Jenis Desain Penelitian

Pemilihan jenis desain penelitian didasari oleh tujuan penelitian yang akan dilakukan. Terdapat empat jenis desain penelitian yang kerap digunakan, diantaranya:

1. Desain Penelitian Eksperimental

Sesuai namanya, desain penelitian eksperimental berarti peneliti sedang melakukan penelitian eksperimental. Menurut Arifin (2009:127), penelitian eksperimen diartikan sebagai penelitian yang di dalamnya melibatkan manipulasi terhadap kondisi subjek yang diteliti, disertai upaya kontrol yang ketat terhadap faktor-faktor luar serta melibatkan subjek pembanding atau metode ilmiah yang sistematis yang dilakukan untuk membangun hubungan yang melibatkan fenomena sebab akibat.

Desain penelitian eksperimen ditentukan oleh bagaimana cara peneliti mengatur subjek ke dalam kondisi dan kelompok yang berbeda. Terdapat tiga jenis desain penelitian eksperimen, yaitu pre-eksperimental, quasi-eksperimental, dan true experimental research.

a. Desain Penelitian Pre-eksperimental

Pada desain penelitian pre-eksperimental, baik satu atau berbagai kelompok variabel terikat diamati untuk mengetahui ada tidaknya pengaruh dari aplikasi suatu variabel bebas yang sebelumnya dianggap dapat menyebabkan perubahan. Desain ini merupakan yang desain penelitian eksperimen yang paling sederhana dan tidak terdapat kelompok kontrol. Lebih lanjut lagi, desain pre-eksperimental dibagi menjadi tiga, yaitu:

1) One-shot Case Study Research Design

Dalam penelitian eksperimen jenis ini, hanya ada satu kelompok variabel terikat yang dipertimbangkan. Penelitiannya dilakukan setelah memberikan beberapa perlakuan yang sebelumnya dianggap menimbulkan perubahan, sehingga desain ini merupakan suatu posttest study.

2) One-group Pretest-posttest Research Design

Desain penelitian ini mengkombinasikan posttest dan pretest study dengan mengadakan suatu tes pada satu kelompok sebelum diberi perlakuan dan setelah diberikan perlakuan. Pretest dilakukan pada awal penelitian dan posttest diberikan saat penelitian selesai.

3) Static-group Comparison

Pada desain ini, 2 atau lebih kelompok diberikan pengawasan, dimana hanya ada satu kelompok yang diberi perlakuan. Kelompok sisanya dibiarkan statis tanpa diberi perlakuan khusus. Semua kelompok yang ada kemudian diberikan posttest, kemudian adanya perbedaan yang tampak diantara kelompok-kelompok tersebut diasumsikan sebagai hasil dari perlakuan yang diberikan.

b. Desain Penelitian Quasi-eksperimental

Kata “quasi” memiliki arti parsial, setengah, atau pseudo (palsu). Sehingga penelitian quasi-eksperimental memiliki kemiripan dengan true experimental research, tetapi tidak sama. Pada quasi-eksperimen, partisipan tidak dipilih secara acak, sehingga desain penelitian ini digunakan pada kondisi dimana randomisasi sulit atau tidak mungkin dilakukan.

c. True Experimental Research Design

Desain penelitian ini bergantung pada analisis statistik untuk menerima atau menolak hipotesis. True experimental research design merupakan desain penelitian eksperimen yang paling akurat dan dapat dilakukan dengan atau tanpa pretest pada paling tidak 2 kelompok subjek variabel terikat yang dipilih secara acak.

True experimental research design harus memiliki kelompok kontrol, variabel yang dapat dimanipulasi oleh peneliti, dan distribusinya harus secara acak atau random. Klasifikasi dari true experimental research design meliputi:

1) The Posttest-only Control Group Design

Desain ini memilih subjek secara acak atau random dan dikelompokkan menjadi 2 kelompok (kontrol dan eksperimental), dan hanya kelompok eksperimental yang diberi perlakuan. Setelah observasi mendalam, kedua kelompok diberi post-test, dan suatu kesimpulan diambil dari perbedaan yang terjadi di antara kedua kelompok.

2) The Pretest-posttest Control Group Design

Pada desain kelompok kontrol ini, subjek dipilih dan dibagi menjadi 2 kelompok secara acak, kemudian kedua kelompok diberi pretest, namun hanya kelompok eksperimental yang diberikan perlakuan. Di akhir penelitian, kedua kelompok diberi post-test untuk mengukur derajat perubahan di tiap kelompok.

3) Solomon Four-group Design

Desain ini merupakan kombinasi dari pretest-only dan pretest-posttest control groups. Dalam desain ini, subjek yang telah dipilih secara acak atau random ditempatkan menjadi 4 kelompok. Dua kelompok pertama diuji menggunakan metode posttest-only, sementara dua kelompok yang lain diuji menggunakan metode pretest-posttest.

2. Desain Penelitian Survey

Penelitian survei adalah penelitian yang dilakukan pada populasi besar maupun kecil, tetapi data yang dipelajari adalah data dari sampel yang diambil dari populasi tersebut, untuk menemukan kejadian-kejadian relatif, distribusi, dan hubungan-hubungan antar variabel sosiologis maupun psikologis.

Menurut para ahli, terdapat beberapa desain penelitian survey, yaitu desain pembagian silang atau cross sectional design dan desain survey berkepanjangan atau longitudinal survey (Widodo, 2008), sample survey, dan sensus survei (Irawan Soehartono, 2000). Dengan demikian desain penelitian survey di antaranya adalah sebagai berikut.

a. Cross Sectional Survey

Desain penelitian silang atau cross sectional survey digunakan untuk mengetahui isu-isu yang bersifat temporer melalui pengumpulan data yang dilakukan satu kali saja. Desain jenis ini paling banyak digunakan oleh peneliti.

Desain penelitian berkepanjangan atau longitudinal survey digunakan untuk memahami suatu isu secara berkelanjutan. Populasi yang digunakan dalam desain ini tidaklah banyak. Adapun pengambilan data dilakukan secara berkala. Desain jenis ini dibedakan atas kajian kecenderungan atau trend studies, studi panel atau panel studies, sosiometrik, dan desain kontekstual atau contextual design. 

b. Sample Survey

Sample survey adalah survey yang dilakukan pada sebagian populasi atau sampel.

c. Sensus Survey

Sensus survey adalah survey yang dilakukan pada seluruh populasi.

3. Desain Penelitian Longitudinal

Penelitian longitudinal merupakan penelitian yang menggunakan data dengan rentang waktu yang panjang. Berapa lamakah panjang waktu yang dimaksud bersifat sangat relatif. Namun, penekanan riset longitudinal sebenarnya pada ekstensi atau perpanjangan dari survey yang dilakukan. Perpanjangan tersebut bersifat periodik.

Jadi, penelitian longitudinal dapat pula dipahami sebagai perpanjangan penelitian survey yang bersifat periodik. Sedikitnya, survey dilakukan dua kali dengan rentang waktu yang ditentukan dari awal. Teknik pengumpulan data penelitian ini biasanya menggunakan kuesioner atau interview terstruktur. 

Desain penelitiannya pun tidak jauh berbeda dengan penelitian lain seperti survey. Sebagai contoh, kita akan melakukan penelitian tentang perubahan karakteristik kekerasan pemuda di suatu kota yang kerap terjadi tawuran.

Untuk melakukan riset longitudinal, pertama-tama kita melakukan survey dengan kuesioner dan atau wawancara terhadap anak muda yang terpilih sebagai sampel. Identitas partisipan atau anak muda tersebut kita catat baik-baik dan disimpan dengan rapi di dalam arsip. Survey pertama dilakukan dengan variabel yang telah disusun matang.

Riset ini menggunakan rentang waktu yang jelas. Misalnya, setiap lima tahun kita mendatangi anak muda yang sama untuk dilihat perubahan atau perkembangan dalam karakteristiknya. Tak ada ketentuan berapa kali partisipan didatangi kembali untuk disurvey, namun biasanya sedikitnya dua kali mereka disurvey kembali.

Hasil survei kedua, ketiga dan seterusnya akan memperlihatkan perubahan apa yang terjadi pada anak muda tersebut yang barangkali di survey yang ketiga dan seterusnya bukan lagi tergolong anak muda. Dengan desain penelitian ini, perubahan karakteristik kekerasan sebagaimana yang menjadi fokus penelitian sangat mungkin diketahui.

4. Desain Penelitian Studi Kasus

Studi kasus menjadi metode paling sesuai untuk fase penyelidikan dari sebuah penelitian karena mengedepankan survey dan proses historis sebagai jalan untuk penjelasan yang bersifat sebab musabab (kausalitas). Meskipun demikian, metode studi kasus hanya merupakan persiapan metode penelitian dan tidak dapat digunakan untuk menggambarkan atau menguji suatu masalah.

Kriteria penetapan desain penelitian studi kasus sangat berpengaruh terhadap suatu penelitian. Demikian juga untuk penelitian studi kasus. Kriteria kualitas desain penelitian berkaitan dengan:

• Validitas konstruk yakni menetapkan ukuran operasional yang benar untuk konsep-konsep yang akan diteliti. Dalam studi kasus, dapat digunakan teknik multi sumber bukti, memberikan kesempatan kepada informan kunci untuk meninjau kembali draft laporan studi kasus yang bersangkutan.
• Validitas internal merupakan hubungan sebab-akibat, dimana kondisi-kondisi tertentu diperhatikan guna mengarahkan kondisi-kondisi lain, untuk membedakan dari hubungan semu.
• Validitas eksternal yaitu menetapkan ranah dimana temuan suatu penelitian dapat divisualisasikan.
• Reliabilitas  yaitu bahwa suatu penelitian seperti prosedur pengumpulan data dapat diinterpretasikan dengan hasil yang sama pada waktu yang berbeda.
• Desain penelitian komparatif

Menurut Menurut Robert K. Yin, desain penelitian studi kasus secara umum menjadi 2 (dua) jenis, yaitu penelitian studi kasus dengan menggunakan kasus tunggal dan jamak/ banyak. Disamping itu, ia juga mengelompokkannya berdasarkan jumlah unit analisisnya, yaitu (1) penelitian studi kasus tunggal holistik (holistic) yang menggunakan satu unit analisis.(2) Desain kasus tunggal terjalin (embedded) yang menggunakan beberapa atau banyak unit analisis. 

Penelitian studi kasus disebut terpancang (embedded), karena terikat (terpancang) pada unit-unit analisisnya yang telah ditentukan. Perbedaan antara penelitian studi kasus holistik (jenis 1) dan terpancang (jenis 2) adalah pada jumlah unit analisis yang digunakan.

Contoh Desain Penelitian

1. penelitian kualitatif.

Penelitian deskriptif kualitatif ditujukan untuk mendeskripsikan dan menggambarkan fenomena-fenomena yang ada, baik bersifat alamiah maupun rekayasa manusia, yang lebih memperhatikan mengenai karakteristik, kualitas, keterkaitan antar kegiatan. Selain itu, Penelitian deskriptif tidak memberikan perlakuan, manipulasi atau pengubahan pada variabel-variabel yang diteliti, melainkan menggambarkan suatu kondisi yang apa adanya. 

Seperti contoh penelitian sebagai berikut ini: 

Judul penelitian: Mengeksplor fenomena kejujuran di SD Negeri 3 Purwodadi, Kabupaten Banyumas

Satu-satunya perlakuan yang diberikan hanyalah penelitian itu sendiri, yang dilakukan melalui observasi, wawancara, dan dokumentasi. Berdasarkan keterangan dari beberapa ahli di atas, dapat ditarik kesimpulan bahwa penelitian deskriptif kualitatif yaitu rangkaian kegiatan untuk memperoleh data yang bersifat apa adanya tanpa ada dalam kondisi tertentu yang hasilnya lebih menekankan makna. Di sini, peneliti menggunakan metode penelitian deskriptif kualitatif karena penelitian ini

mengeksplor fenomena proses pembentukan karakter peserta didik melalui penyelenggaraan kantin kejujuran di SD Negeri 3 Purwodadi Kecamatan Tambak Kabupaten Banyumas. Selain itu penelitian ini juga bersifat induktif dan hasilnya lebih menekankan makna.

2. Penelitian Eksperimen

Eksperimen dalam penelitian sosial sering digunakan untuk menemukan aspek penyebab atau penyebab fenomena sosial. Seringkali desain eksperimental digunakan sebagai dasar untuk mengimplementasikan suatu program atau kebijakan.

Misalnya, sebagai contoh sederhana dari penelitian eksperimental, peneliti ingin mengetahui efektivitas penggunaan sistem alarm rokok di ruang publik untuk mengurangi konsumsi rokok di tempat umum. Beberapa ruang publik dibangun menjadi rokok, yang lain dengan fitur yang sama tidak dilengkapi dengan alarm rokok.

Eksperimen ini akan menunjukkan hasil seberapa efektif alarm rokok dapat mengurangi konsumsi rokok di tempat umum.

3. Penelitian Kuantitatif

Desain penelitian kuantitatif membuat proyek eksperimental lebih bebas. Maka peneliti sosial umumnya menerapkan desain eksperimental untuk melakukan penelitian kuantitatif. Penelitian kuantitatif bisa dipergunakan guna membandingkan kelompok yang diperlakukan sebagai subjek eksperimen dan kontrol.

Misalnya, percobaan konsumsi vitamin C untuk meningkatkan daya tahan siswa. Beberapa subjek diminta untuk mengonsumsi vitamin C, yang lain tidak memiliki kelompok kontrol. Hasilnya adalah hasil percobaan.

Dalam pembuatan makalah ilmiah juga ada yang namanya penerapan metode penelitian. Dengan metode penelitian yang bagus, maka makalah ilmiah pun juga bisa terwujud dengan kualitas yang tinggi.

Berbicara mengenai metode penelitian makalah, sebenarnya dalam hal ini sama saja dengan metode yang digunakan pada karya ilmiah secara umum. Termasuk yang sudah disinggung dalam poin sebelumnya. Jadi, di dalamnya bisa menggunakan metode penelitian dengan pendekatan kualitatif maupun kuantitatif. Hanya saja mayoritas contoh makalah menggunakan metode kualitatif.

Selain pendekatan secara umum tersebut, dalam makalah juga biasa menerapkan metode penelitian karya ilmiah pada umumnya. Sebagaimana disebutkan di atas, yakni seperti metode deskriptif dan eksperimen. Jika kasusnya berkaitan dengan fenomena sosial pun bisa mengusung metode penelitian sosial. Dan ketiga metode tersebut selanjutnya akan dibahas secara lebih detail lagi.

Pertanyaan Seputar Desain Penelitian :

Menurut Silaen, desain penelitian adalah desain mengenai keseluruhan proses yang diperlukan dalam perencanaan dan pelaksanaan penelitian. Ketahui definisi desain penelitian menurut para ahli lainnya di artikel ini!

Desain penelitian terdapat 4 jenis, yaitu desain penelitian eksperimental, desain penelitian survey, desain penelitian longitudinal, dan desain penelitian studi kasus. Setiap jenis tersebut terbagi menjadi berbagai jenis lagi. Baca selengkapnya di artikel!

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Jenis Dat a Penelitian

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Metode Penelitian Studi Kasus: Metodologi, Jenis, dan Manfaatnya

Studi kasus – Bagi kamu yang sedang duduk di bangku kuliah, frasa “studi kasus” pasti terdengar tidak asing. Salah satu metode penelitian ini banyak digunakan oleh mahasiswa di tingkat Sarjana (S1), Magister (S2), maupun Doktoral (S3). Meski begitu, sudah sejak lama kalau studi kasus dianggap sebagai metode penelitian yang “lemah” karena objektivitas, kekuatan penelitian, dan ketepatannya yang tidak memadai.

Anehnya, fakta di lapangan membuktikan sebaliknya. Studi kasus banyak menghasilkan pengetahuan baru dalam ilmu-ilmu sosial, seperti psikologi, antropologi, sosiologi, sejarah, ekonomi, ilmu politik, pendidikan, dan lain sebagainya.

Terlepas dari perdebatan mengenai kelemahan metode penelitian studi kasus, Grameds pasti ingin memahami lebih jauh tentang metode ini. Untuk itu, dalam artikel ini kita akan membahas beberapa hal, mulai dari pengertian dan jenis-jenis studi kasus, hingga langkah-langkah membuat penelitian studi kasus.

Apa Itu Studi Kasus?

Secara singkat, studi kasus merupakan penelitian tentang suatu kasus yang setiap prosesnya dilakukan secara rinci, tajam, dan mendalam. Kasus di sini bisa berupa individu, kelompok, organisasi, maupun lembaga. Dari penelitian kasus tersebut, diharapkan peneliti akan mendapatkan pengetahuan mendalam tentang kasus yang diteliti tersebut.

Kasus yang diteliti biasanya harus hal yang sedang terjadi sekarang (aktual), bukan yang sudah terlewati dan harus benar-benar spesifik atau “unik”. Dengan kata lain, peneliti lebih disarankan untuk memilih satu kasus saja, baik yang sangat sederhana maupun yang kompleks.

Lantas bagaimana sebuah kasus bisa dikatakan “unik”? Prof. Dr. H. Mudjia Rahardjo, M.Si menyebutkan 6 rambu-rambu yang bisa dijadikan pertimbangan oleh peneliti, yaitu:

• Hakikat atau sifat kasus yang akan diteliti
• Latar belakang atau alasan kasus tersebut muncul
• Setting fisik dari kasus tersebut
• Konteks yang mengelilinginya, seperti faktor ekonomi, politik, dan sebagainya.
• Kasus lain yang bisa menerangkan kasus tersebut
• Informan yang benar-benar menguasai kasus yang akan diteliti

Dengan rambu-rambu ini, bisa disimpulkan bahwa studi kasus menjadi metode penelitian yang tepat untuk memahami sebuah fenomena.

Tujuan Studi Kasus

Pada dasarnya, studi kasus dirancang untuk menggali informasi yang dapat dipelajari dari suatu kasus, karena itu peneliti tidak bisa sembarangan memilih kasus yang akan dijadikan tema penelitiannya.

Stake, dalam bukunya yang berjudul The Art of Research (1995) menjelaskan tujuan utama dari penelitian studi kasus adalah untuk “ mengungkapkan keunikan karakteristik yang ada di dalam suatu kasus ”.

Maka dari itu, seperti yang sudah disebutkan oleh Prof. Rahardjo, semua hal yang berhubungan dengan kasus harus diteliti agar peneliti dapat memahami kasus secara komprehensif.

Jenis-Jenis Penelitian Studi Kasus

Prof. Dr. H. Mudjia Rahardjo, M.Si, dalam STUDI KASUS DALAM PENELITIAN KUALITATIF: KONSEP DAN PROSEDURNYA (2017) menyebut lima jenis penelitian studi kasus, diantaranya:

1. Studi Kasus Kolektif ( Collective Case Study )

Studi kasus kolektif merupakan jenis studi kasus yang meneliti lebih dari satu kasus. Dengan catatan bahwa kasus-kasus tersebut harus saling berhubungan dan peneliti harus menguasai semuanya. Dengan begitu, peneliti dapat membandingkan satu kasus dengan kasus yang lainnya.

2. Studi Kasus Retrospektif ( Retrospective Case Study )

Studi kasus retrospektif merupakan studi kasus yang memungkinkan adanya perbaikan atau treatment pada kasus yang diteliti. Treatment ini harus diselesaikan oleh orang lain yang benar-benar kompeten di bidang tersebut, peneliti hanya menyumbang masukan dari hasil penelitiannya.

3. Studi Kasus Prospektif ( Prospective Case Study )

Studi kasus prospektif umumnya digunakan agar peneliti bisa mengetahui arah perkembangan dari suatu kasus. Tindak lanjut dari studi kasus ini adalah Penelitian Tindakan atau Action Research yang dilakukan oleh orang lain yang sudah ahli.

4. Instrumental Case Study

Instrumental Case Study merupakan jenis penelitian yang mengharuskan peneliti memilih kasus dengan hati-hati. Maksudnya, peneliti yakin bahwa dia bisa mendapatkan pengetahuan yang mendalam dari kasus tersebut.

5. Studi Kasus Intrinsik ( Intrinsic Case Study )

Dalam studi kasus yang terakhir, studi kasus intrinsik, peneliti bisa memilih kasus berdasarkan pada minat pribadi atau ketertarikannya pada suatu persoalan. Misalnya, kenakalan remaja, cyber bullying , fenomena single parents , bahkan fenomena “ Citayam Fashion Week ”.

Grameds bisa mempelajari lebih dalam tentang kelima jenis studi kasus ini dalam buku Studi Kasus (Desain & Metode) yang ditulis oleh Robert K. Yin.

Langkah-langkah Melakukan Penelitian Studi Kasus

Saat Grameds memilih metode penelitian studi kasus, maka kamu harus menyelesaikan semua prosesnya secara teratur dan berkelanjutan. Adapun tahapan dalam proses melakukan penelitian studi kasus, yaitu:

1. Memilih Tema, Topik, dan Kasus

Dalam tahap ini, peneliti harus bisa menemukan kasus yang menjadi bagian dari bidang yang dipelajari. Misalnya, saat ini kamu sedang menyelesaikan studi di jurusan Ilmu Sosial, maka Grameds bisa mencari kasus yang terjadi di kantor pemerintahan di daerah tempat tinggalmu.

Mengapa demikian? Karena secara logika, Grameds hanya dapat menghasilkan penelitian yang baik dalam bidang yang kamu kuasai. Kasusnya bisa kamu dapatkan dengan cara membaca buku, majalah ilmiah, koran, atau hasil penelitian terdahulu.

Bisa juga melalui pengamatan yang kamu lakukan sendiri, berdasarkan pengalaman yang kamu rasakan. Misalnya saat magang atau mengurus administrasi di kantor pemerintah atau hasil diskusi dengan teman dan dosen pembimbing.

Jika kamu ingin mencari kasus dengan membaca buku atau penelitian terdahulu, maka Grameds harus memahami seluruh isinya terlebih dahulu agar bisa menentukan tema besar penelitian. Dari tema ini, nantinya akan dipersempit lagi menjadi beberapa topik.

Selanjutnya, dari topik penelitian tersebut, kamu bisa memberikan penekanan pada objek kajiannya. Dengan begitu, maka kamu akan mendapatkan sebuah kasus. Dari tiga hal ini, Grameds bisa merumuskan judul penelitian. Jadi, judul penelitian harus dibuat setelah kamu mendapatkan tema, topik, dan objek kajian.

2. Kajian Literatur

Kajian literatur ini selain bisa membuat wawasan dalam bidang yang akan diteliti semakin luas, juga bisa semakin mempertajam rumusan masalah yang akan kamu ajukan. Maka dari itu, carilah bahan bacaan sebanyak-banyaknya. Bisa berupa penelitian dan jurnal yang relevan, majalan ilmiah, buku, atau surat kabar yang berhubungan dengan kasus tersebut.

Dalam proses pengumpulan bahan bacaan, kamu harus memperhatikan dua aspek penting. Pertama, relevansi dengan kasus yang diteliti dan kedua, kemutakhiran. Idealnya, semakin mutakhir bahan bacaannya, maka kamu semakin tahu perkembangan paling up to date dalam bidang yang kamu geluti.

3. Merumuskan Fokus dan Masalah Penelitian

Fokus penelitian sangat membantu untuk memusatkan perhatian Grameds pada satu titik. Disamping itu, kamu juga harus lebih teliti saat merumuskan pokok masalah yang akan diteliti. Soalnya, rumusan masalah ini akan membuat masalah yang kamu hadapi jadi makin jelas dan menghindari hasil penelitian yang “biasa saja” atau kurang mendalam atau kurang detail.

Oleh sebab itu, penelitian studi kasus harus dapat menjawab pertanyaan “apa”, “bagaimana”, dan “mengapa”. Pertanyaan “apa” bertujuan agar kamu mendapatkan pengetahuan deskriptif terkait masalah penelitian, pertanyaan “bagaimana” agar kamu mendapatkan pengetahuan eksplanatif, dan “mengapa” untuk mendapatkan pengetahuan eksploratif.

Mudahnya, pertanyaan “bagaimana” ini menanyakan proses terjadinya suatu peristiwa sementara pertanyaan “mengapa” mencari alasan yang menyebabkan suatu peristiwa bisa terjadi.

4. Pengumpulan Data

Dalam penelitian studi kasus, objek penelitian harus dapat mendeskripsikan dirinya sendiri secara detail, sehingga kamu mendapatkan gambaran yang utuh. Dengan kata lain, data-data yang kamu kumpulkan akan dipelajari sebagai sebuah kesatuan yang utuh dan terintegrasi.

Jadi, kamu tidak bisa hanya sekadar paham kasus yang diteliti pada permukaannya saja, tapi juga bagian dalamnya. Itulah sebabnya, teknik pengumpulan data yang disarankan pada studi kasus adalah:

• Dokumentasi
• Observasi terlibat
• Observasi langsung,
• Artefak fisik.

Dalam proses pengumpulan data, kamu juga harus memperhatikan tiga hal penting, yaitu alamiah, holistik, dan mendalam. Alamiah di sini maksudnya, proses mengumpulkan data dilangsungkan secara alamiah dan dalam konteks kehidupan nyata. Kamu tidak harus memberikan perlakuan tertentu pada subjek atau konteks tempat penelitian berlangsung atau bisa dibilang biarkan saja semuanya berjalan secara alami.

Sementara itu, holistik berarti kamu harus dapat menghasilkan data yang lengkap dari sebanyak mungkin informasi atau sumber yang bisa didapatkan. Kemudian, mendalam berarti kamu harus bisa mengungkap makna yang tersurat dan tersirat dari semua data yang telah dikumpulkan.

Misalnya begini, anggaplah kamu sedang menyusun penelitian yang melibatkan Kepala Sekolah sebagai partisipannya. Setelah melakukan wawancara, kamu akan mendapatkan informasi berdasarkan apa yang disebutkan oleh kepala sekolah tersebut. Nah, kamu harus bisa menangkap makna tersirat dari ucapannya.

5. Penyempurnaan Data

Setelah semua data yang Grameds perlukan terkumpul, kamu harus menyempurnakannya terlebih dulu. Dalam artian, cek seluruh datanya dan lihat apakah sudah bisa menjawab rumusan masalah yang kamu tentukan atau belum.

Jika sudah, maka data dianggap sempurna dan kamu bisa melanjutkan ke tahap berikutnya. Sebaliknya, jika belum maka kamu wajib kembali ke lapangan dan mengumpulkan data tambahan untuk melengkapinya.

6. Mengolah Data

Sebelum melakukan analisis, olah dulu data yang sudah dianggap sempurna. Cek kebenaran dari data-data tersebut, susun dan klasifikasi berdasarkan kategori yang sesuai dengan penelitianmu, dan lakukan penyandian atau coding, bila perlu koreksi jawaban wawancara yang dianggap belum jelas. Seluruh proses dalam tahapan ini akan membantu memudahkan proses analisis data.

7. Analisis Data

Analisis data bisa dibilang sebagai “inti” dari penelitian. Oleh karena itu, harus dilakukan dengan benar dan sesuai tuntunan. Tidak sedikit peneliti, baik mahasiswa sarjana, pascasarjana, maupun doktoral mengalami kesulitan dalam tahap ini.

Akan tetapi, jika dilakukan dengan benar, analisis data akan menghasilkan informasi penting, yaitu temuan penelitian. Artinya, jika analisis data gagal, maka penelitian dianggap gagal. Kesulitan terbesar yang dihadapi oleh peneliti dalam tahapan ini adalah kemampuan analisis data dari peneliti itu sendiri.

For your information , analisis data dalam penelitian studi kasus hanya dapat dilakukan oleh peneliti sendiri karena hanya peneliti yang mengetahui semua masalah secara mendalam. Jadi baik teman, keluarga, orang lain, bahkan dosen pembimbing sekalipun tidak akan dapat menyelesaikan tahap ini.

Supaya kamu dapat menyelesaikan tahap ini, maka kamu memerlukan wawasan teoretik yang luas, pengalaman penelitian yang cukup, bimbingan dosen yang jelas, dan minat yang sangat kuat. Tanpa itu semua, besar kemungkinan penelitianmu akan sulit diselesaikan atau bahkan gagal.

Mengingat langkah ini menjadi inti dari penelitian studi kasus, maka kamu disarankan untuk membaca buku Implementasi Metode Penelitian Studi Kasus Dengan Pendekatan Kualitatif yang ditulis oleh S. Arifianto sebagai panduan lengkapnya.

8. Proses Analisis Data

Secara prinsip, proses analisis data merupakan kegiatan yang bertujuan memberikan makna pada data dengan cara mengatur, mengelompokkan, mengurutkan, memberi kode, serta mengkategorikannya sesuai dengan pengelompokkan tertentu. Hal ini perlu dilakukan agar peneliti mendapatkan temuan pada rumusan masalah yang diajukan.

Dengan banyaknya proses yang dilewati, biasanya data yang terkumpul menjadi berserakan dan harus disederhanakan kembali agar lebih mudah dipahami. Berikut ini langkah-langkah yang bisa kamu jadikan pedoman dalam tahap ini:

• Peneliti harus membaca seluruh transkrip untuk mendapatkan informasi umum (general)
• Kumpulkan semua pesan umum yang didapatkan, kemudian ambil pesan khususnya (spesifik)
• Dari pesan khusus yang ada akan ditemukan pola umum data, maka selanjutnya data tersebut bisa dikelompokkan kembali menurut kategori, topologi, dan urutan kejadiannya.

9. Konfirmabilitas atau Triangulasi Temuan

Supaya temuan penelitian dari data tidak dianggap bias, maka kamu harus melakukan konfirmabilitas atau triangulasi pertemuan. Caranya adalah dengan melaporkan temuan tersebut pada orang yang telah kamu wawancarai.

Banyak sekali mahasiswa yang menggunakan metode studi kasus melewatkan tahap ini. Biasanya karena takut hasil konfirmasi berbeda dengan temuan penelitian. Padahal, seorang peneliti harus jujur agar temuannya bisa dipertanggungjawabkan secara ilmiah.

10. Kesimpulan Penelitian

Ada satu kesalahan umum pada bagian ini yang terus dilakukan oleh mahasiswa. Mahasiswa kerap meringkas pernyataan yang ada di bagian-bagian sebelumnya. Idealnya, kesimpulan penelitian harus berisi sintesis atau dari semua pernyataan yang diuraikan sebelumnya. Termasuk uraian deskriptif tentang fakta-fakta di lapangan yang sesuai dengan pertanyaan penelitian.

11. Laporan Penelitian

Tahap terakhir dari penelitian studi kasus adalah membuat laporan penelitian. Laporan ini dianggap sebagai salah satu bentuk pertanggungjawaban dari penelitian yang telah dilakukan. Umumnya, laporan ini ditulis dengan bahasa yang mudah dipahami oleh semua orang.

Satu hal penting yang harus kamu perhatikan saat membuat laporan ilmiah adalah memastikan bahwa penelitian yang telah dilakukan memenuhi syarat-syarat berikut ini:

• Mengikuti metode ilmiah

Objektif berarti data benar-benar didapatkan dari subjek penelitian, bukan dari peneliti maupun pandangan peneliti. Sistematik berarti urut atau setiap bagian penelitian harus saling terkait satu sama lain dan menjadi satu kesinambungan yang logis.

Sementara itu, mengikuti metode ilmiah berarti seluruh kegiatan dalam penelitian yang kamu lakukan telah mengikuti prosedur ilmiah yang sudah disepakati oleh ilmuwan.

Manfaat dari Penelitian Studi Kasus

Meski dianggap lemah, bukan berarti penelitian “studi kasus” tidak mempunyai manfaat sama sekali. Lincoln dan Guba, menjabarkan manfaat metode ini sebagai berikut:

• Studi kasus adalah sarana utama untuk penelitian emik yang mengutarakan pandangan subjek penelitian
• Studi kasus memberikan uraian utuh yang sama dengan apa yang dialami oleh pembaca dalam kehidupan sehari-harinya.
• Studi kasus sangat efektif dalam menunjukkan hubungan antara peneliti dengan subjek penelitian
• Pembaca dapat memperoleh konsistensi gaya, faktual, dan juga kepercayaan dari penelitian studi kasus
• Penelitian ini menyajikan uraian tebal yang dibutuhkan untuk penilaian transferabilitas
• Studi kasus sangat terbuka terhadap penilaian atas konteks yang nantinya penilaian ini dapat berperan terhadap fenomena yang ada di dalam konteks tersebut.

Manfaat lain dari metode penelitian studi kasus bisa kamu temukan dalam buku Memahami Metodologi Studi Kasus, Grounded Theory, dan Mixed-Method karangan Nuriman, S.Pd.I., M.Ed., Ph.D.

Tantangan Melakukan Penelitian Studi Kasus

Sejauh ini, menurut Prof. Rahardjo (2017), paling tidak ada tiga persoalan yang akan menjadi tantangan bagi peneliti yang memilih metode penelitian studi kasus. Tantangan tersebut adalah:

• Memastikan bahwa kasus yang akan diteliti dianggap “berbobot” secara akademik
• Menemukan data yang relevan untuk keperluan penelitian
• Apa yang harus dilakukan setelah semua data terkumpul

Studi kasus adalah metode penelitian yang bisa dipilih oleh mahasiswa atau peneliti untuk mencari kebenaran ilmiah yang tentatif atau tidak absolut. Dengan kata lain, kebenaran ini masih bisa diuji, dikritik, atau direvisi. Namun, biar bagaimanapun, studi kasus merupakan metode penelitian yang cukup menantang.

Di samping itu, studi kasus juga sangat tepat untuk menemukan hal-hal tersembunyi dari fenomena sosial dan budaya untuk kemudian disebarkan hingga menjadi pengetahuan publik.

Saat Grameds mencari informasi tentang studi kasus di internet, mungkin ada perbedaan antara tulisan ini dengan yang lainnya. Namun, perbedaan tersebut merupakan hal yang wajar sebab penelitian kualitatif tidak memiliki standar yang baku.

Selesai sudah pembahasan tentang metode penelitian studi kasus ini, semoga bermanfaat dan sampai jumpa di tulisan lainnya!

Bagi Grameds yang ingin mencari buku karya ilmiah, metode penelitian, maka bisa menemukannya di Gramedia.com . Bersama Gramedia kamu bisa dapatkan informasi #LebihDenganMembaca

Penulis: Gilang

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About the author.

Pengertian Studi Kasus: Jenis, Cara Membuat dan Contoh

Pengertian Studi Kasus : Cara Membuat dan Contoh — Banyak dari kamu tentunya pernah mendengar kata studi kasus. Terutama bagi kamu yang masih berstatus mahasiswa dan pelajar. Kamu pastinya kerap mendengar kata ini selama masa sekolah dan perkuliahan. Terlebih lagi, kamu akan lebih akrab dengan studi kasus ketika membahas tentang penelitian.

Kira-kira kamu sudah tahu belum apa sih sebenarnya studi kasus itu? Ternyata studi kasus memiliki banyak pengertian loh. studi kasus juga sering digunakan dalam penelitian kualitatif. Meskipun tidak sebanyak dalam penelitian kualitatif, studi kasus juga digunakan di dalam penelitian kuantitatif. Supaya kamu tidak bingung, artikel ini akan membantu kamu dalam memahami studi kasus. Penasaran? Yuk langsung saja baca di bawah ini.

Pengertian Studi Kasus

Studi kasus secara sederhana diartikan sebagai proses penyelidikan atau pemeriksaan secara mendalam, terperinci, dan detail pada suatu peristiwa tertentu atau khusus yang terjadi. Studi kasus dapat diperoleh dari metode-metode penelitian formal. Banyak disiplin ilmu yang menggunakan studi kasus dalam proses penelitiannya, baik itu ilmu sosial maupun ilmu eksakta. 

Kata kasus yang terdapat di dalam studi kasus bisa merujuk pada individu, kelompok, peristiwa, fenomena, perilaku dan banyak lainnya. Makna yang dirujuk oleh kata kasus, dapat berbeda pada setiap penelitian atau topik. Hal ini tergantung dari si peneliti memaknainya dalam penelitian yang ia lakukan.

Menukil dari penelitian “ Studi kasus dalam Penelitian Kualitatif: Konsep dan Prosedurnya ” karya Mudjia Rahardjo, studi kasus berasal dari terjemahan dalam bahasa Inggris “A Case Study” atau “Case Studies”. Kata “Kasus” diambil dari kata “Case” yang menurut Kamus Oxford Advanced Learner’s Dictionary of Current English 3 (1989; 173), diartikan sebagai:

• instance or example of the occurrence of sth (contoh kejadian) 
• actual state of affairs; situation (kondisi aktual dari keadaan lain)
• circumstances or special conditions relating to a person or thing (lingkungan atau kondisi tertentu tentang orang atau sesuatu”

Pengertian Studi Kasus Menurut Para Ahli

1. robert k. yin.

Yin mendefinisikan studi kasus sebagai proses pencarian pengetahuan untuk menyelidiki dan memeriksa fenomena yang terjadi di dalam kehidupan nyata. Ia menjelaskan bahwa studi kasus dapat digunakan ketika fenomena dan kehidupan nyata memiliki batas yang samar atau kabur.

Selain batas yang samar, studi kasus juga harus memiliki berbagai sumber untuk dijadikan alat pencarian bukti dan informasi. Jika syarat tersebut tidak terpenuhi maka penelitian tersebut tidak dapat menggunakan studi kasus.

2. Polit dan Hungler

Studi kasus menurut Polit dan Hungler, adalah fokus untuk menentukan dinamika terkait pertanyaan mengapa individu berpikir dan bertindak, serta mengembangkan dirinya. Mereka menilai bahwa fokus tersebut merupakan sesuatu yang penting.

3. Susilo Rahardjo dan Gudnanto

Sedangkan menurut Susilo Rahardjo dan Gudnanto, studi kasus merupakan metode untuk mengetahui dan memahami seseorang dengan menggunakan praktek inklusif dan menyeluruh atau komprehensif. 

Dalam prakteknya, peneliti akan mengumpulkan individu yang dijadikan sebagai subjek penelitian. Selanjutnya, peneliti akan melakukan penggalian informasi pada subjek agar dapat memperoleh pemahaman lebih dalam lagi. Jika sudah didapatkan, pemahaman dan informasi tersebut dapat digunakan oleh subjek sendiri ketika melakukan penyelesaian terhadap masalah yang dihadapi. Sehingga subjek dapat berkembang lagi setelah dapat menyelesaikan permasalahan tersebut.

4. Bimo Walgito

Sedangkan menurut Bimo Walgito, studi kasus adalah metode yang ditujukan untuk menyelidiki dan mempelajari peristiwa dan fenomena terkait individu merupakan pengertian dari studi kasus. Individu yang dijadikan objek penelitian tersebut nantinya akan diselidiki lebih lanjut.

Hasil penyelidikan bisa berbentuk beberapa laporan, salah satunya seperti biografi atau riwayat hidup. Menurut Bimo Walgito, dalam melakukan studi kasus, dibutuhkan banyak informasi dan akurasi data agar diperoleh hasil data yang sesuai, mendalam dan akurat. 

5. Winston M. Tellis

Studi kasus didefinisikan oleh Tellis sebagai metode penelitian yang memiliki unit analisis yang lebih mengacu pada tindakan individu atau lembaga dibandingkan dengan diri individu maupun lembaga itu sendiri. Dapat dikatakan studi kasus lebih berfokus pada tindakan atau perilaku yang dihasilkan. Sehingga menghindari bias atas penilaian diri pada individu atau lembaga tertentu yang menjadi subjek penelitian. Selain itu, unit analisis dapat berbeda dan bervariasi pada setiap individu dan lembaga.

6. Feagin, Anthonly M.  Orum dan Andree F. Sjoberg

Feagin, Orum dan Sjoberg mendefinisikan studi kasus sebagai metode penelitian yang bersifat multi-perspectival analyses. Multi-perspectival analyses sendiri merupakan penelitian yang membutuhkan analisis dari berbagai sudut pandang dan tidak hanya berfokus pada satu hal.

Misalnya saja, tidak hanya berfokus pada individu itu sendiri. Tetapi harus menggunakan analisis dari hal-hal selain individu tersebut, seperti alasan perilaku, faktor eksternal dan lain sebagainya. Selain itu, peneliti juga harus memperhatikan kelompok yang memiliki kaitan dengan individu tersebut.

7. Bogdan dan Biklen

Terakhir Bogdan dan Biklien secara singkat mengartikan studi kasus sebagai tes yang rinci dan detail dari suatu topik, penyimpanan dokumen dan dari suatu peristiwa tertentu.

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Jenis Studi Kasus

Setelah membaca mengenai beberapa pengertian studi kasus dari para ahli, tentunya kamu lebih memahami maknanya. Selain pengertian, ada baiknya kamu juga memahami jenis-jenis dari studi kasus. Ada tiga jenis studi kasus yakni:

1. Intrinsik

Studi kasus jenis ini digunakan pada kasus yang akan dipelajari dengan mendalam. Dimana, kasus tersebut memiliki sesuatu yang menarik dan mengandung minat intrinsik atau yang biasa disebut sebagai intrinsic interest .

2. Instrumental

Studi kasus instrumental ditujukan untuk mempelajari suatu kasus yang mana hasilnya akan digunakan untuk memperbaiki atau melengkapi suatu teori yang sudah ada. Selain untuk menyempurnakan teori yang sudah ada, hasil penelitian studi kasus Instrumental juga dapat digunakan untuk mencetuskan teori baru. 

3. Kolektif

Jenis studi kasus ini digunakan ketika dalam penelitian, subjek yang diteliti terdiri dari beberapa kolektif atau kelompok. Akan tetapi tidak hanya semata kelompok itu yang dipelajari. Individu-individu di dalamnya juga akan tetap dipelajari secara mendalam. hal ini bertujuan guna memperoleh karakter umum yang bervariasi. Baik itu dari kelompok maupun individu-individu di dalamnya.

Di dalam penelitian kualitatif , studi kasus sangat sering digunakan. Penelitian kualitatif yang bersifat menggali pertanyaan mengapa dan bagaimana, menjadi paduan yang tepat dengan studi kasus. Hal ini karena sifat studi kasus yang mempelajari secara mendalam hingga dapat menemukan realitas.

Data kasus dalam penelitian kualitatif dapat dikumpulkan dengan beberapa metode. Seperti halnya penelitian kualitatif pada umumnya, data dapat diperoleh dari wawancara, observasi, dokumentasi, forum group discussion (FGD), dan lainnya. Data ini nantinya akan diperdalam dan dipertajam hingga dapat memahami permasalahan yang sedang diteliti.

Kasus yang diteliti juga merupakan kasus atau fenomena atau kejadian yang sedang berlangsung dan sangat khas. Kekhasan kasus dapat dilihat dari segi subjek, fenomena, lokasi dan lainnya yang terbilang jarang terjadi. Untuk memperoleh pemahaman, data juga dapat diperoleh dari pihak lain yang mengetahui kasus tersebut dengan baik. Sehingga akan melengkapi data yang sudah diperoleh dari data utama.

Meskipun tidak sebanyak dalam penelitian kualitatif, nyatanya studi kasus juga dapat digunakan dalam penelitian kuantitatif . Pada penelitian kuantitatif, studi kasus dapat memberikan data yang memungkinkan peneliti untuk memperluas bukti. Bukti yang dimaksud adalah data yang memperkuat hipotesis penelitian . Tentunya, bukti ini akan membahas tentang tema atau topik yang sedang diteliti.

Langkah-Langkah Cara Membuat Penelitian Studi Kasus 

Nah itu dia pembahasan singkat tentang studi kasus yang digunakan dalam penelitian kualitatif dan penelitian kuantitatif. Sekarang kamu akan masuk tahap selanjutnya yakni membuat kerangka penelitian dengan menggunakan metode studi kasus. Di bawah ini sudah ada cara mudah untuk membuat penelitian studi kasus.

Berikut langkah-langkahnya yang bisa kamu ikuti:

1. Memilih tema atau kasus yang akan diteliti.

Pemilihan kasus juga harus didasarkan pada kekhasan kasus dan juga tujuan. Selain itu, kamu juga harus mempertimbangkan peluang dan resiko yang akan dihadapi saat memilih kasus, tema atau topik tersebut. Waktu pengerjaan dan keterjangkauan juga harus diperhitungkan dalam pemilihan kasus.

2. Referensi

Jika sudah memilih kasus apa yang akan diteliti, maka kamu perlu untuk mengumpulkan bahan untuk referensi.

3. Kerangka Penelitian

Selanjutnya, kamu dapat menyusun kerangka penelitianmu. Kamu juga bisa membuat daftar informasi apa yang akan kamu butuhkan. Serta, kamu perlu untuk membuat kerangka agar dapat mengerucutkan informasi yang akan digali lebih dalam lagi.

Baca juga : Sistematika Penulisan Skripsi Dari Bab 1 sampai Bab 5

4. Data Primer dan Data Sekunder

Jika kerangkanya sudah jadi, lakukan pengambilan data primer dan data sekunder.

Baca : Data Kualitatif dan Kuantitatif dalam Penelitian

5. Analisa Data

Setelah memperoleh data yang kamu butuhkan, lakukan analisis data berdasarkan teori yang kamu peroleh pada langkah kedua.

6. Validasi Data

Uji Validitas dan Kredibilitas data yang sudah dianalisis.

Baca : Validasi Data Penelitian : Pengertian, Manfaat dan Contoh

7. Laporan Penelitian

Yang terakhir, kamu perlu membuat laporan hasil dari penelitian yang kamu lakukan tersebut.

Jika kamu masih bingung bagaimana membuat studi kasus,

untuk lebih memudahkanmu lagi,

Contoh Studi Kasus

kamu bisa membaca contoh singkat dari studi kasus di bawah ini:

Resiliensi Pada Penyintas Kasus Perdagangan Manusia

Penutup : apa itu studi kasus.

Itu dia pembahasan tentang studi kasus pada artikel ini. Dimulai dari pengertian, jenis-jenis, penggunaan studi kasus pada penelitian kualitatif dan kuantitatif, langkah-langkah, hingga contohnya. Semoga artikel ini bisa membantu kamu untuk lebih memahami apa itu studi kasus, ya.

Rekomendasi Buku Metode Penelitian (PROMO)

Baca juga artikel terkait “Pengertian Studi Kasus” berikut :

• Pengertian Subjek Penelitian
• Data Kualitatif dan Kuantitatif
• Validasi Data Penelitian
• Pengertian Roadmap Penelitian
• Pengertian Objek Penelitian
• Pengertian Etika Penelitian
• Pengertian Manfaat Penelitian
• Pengertian Instrumen Penelitian
• Pengertian Paradigma Penelitian
• Pengertian Populasi dan Sampel
• Teknik Pengambilan Sampel
• Pengertian Metodologi Penelitian
• Pengertian Variabel Penelitian

FAQ mengenai studi kasus

Isi dari studi kasus, antara lain ada tema atau topik yang diteliti, referensi yang jelas, kerangka penelitian, data dan laporan yang jelas.

Bentuk dari penelitian studi kasus adalah penelitian yang fokusnya bagaimana mendeskripsikan sebuah studi kasus sedetail mungkin dengan memberikan alternatif pilihan yang mudah diterapkan.

Banyak cara untuk menjalankan penelitian studi kasus, antara lain dengan data studi kasus dapat diperoleh dari semua pihak yang bersangkutan, baik melalui wawancara, observasi, partisipasi, dan dokumentasi.

Kontributor : Ana W | Penyunting : Ridwan Karim

Tinggalkan komentar Batalkan balasan

Simpan nama, email, dan situs web saya pada peramban ini untuk komentar saya berikutnya.

The Ultimate Guide to Qualitative Research - Part 1: The Basics

• Introduction and overview
• What is qualitative research?
• What is qualitative data?
• Examples of qualitative data
• Qualitative vs. quantitative research
• Mixed methods
• Qualitative research preparation
• Theoretical perspective
• Theoretical framework
• Literature reviews

Research question

• Conceptual framework
• Conceptual vs. theoretical framework

Data collection

• Qualitative research methods
• Focus groups
• Observational research

What is a case study?

Applications for case study research, what is a good case study, process of case study design, benefits and limitations of case studies.

• Ethnographical research
• Ethical considerations
• Confidentiality and privacy
• Power dynamics
• Reflexivity

Case studies

Case studies are essential to qualitative research , offering a lens through which researchers can investigate complex phenomena within their real-life contexts. This chapter explores the concept, purpose, applications, examples, and types of case studies and provides guidance on how to conduct case study research effectively.

Whereas quantitative methods look at phenomena at scale, case study research looks at a concept or phenomenon in considerable detail. While analyzing a single case can help understand one perspective regarding the object of research inquiry, analyzing multiple cases can help obtain a more holistic sense of the topic or issue. Let's provide a basic definition of a case study, then explore its characteristics and role in the qualitative research process.

Definition of a case study

A case study in qualitative research is a strategy of inquiry that involves an in-depth investigation of a phenomenon within its real-world context. It provides researchers with the opportunity to acquire an in-depth understanding of intricate details that might not be as apparent or accessible through other methods of research. The specific case or cases being studied can be a single person, group, or organization – demarcating what constitutes a relevant case worth studying depends on the researcher and their research question .

Among qualitative research methods , a case study relies on multiple sources of evidence, such as documents, artifacts, interviews , or observations , to present a complete and nuanced understanding of the phenomenon under investigation. The objective is to illuminate the readers' understanding of the phenomenon beyond its abstract statistical or theoretical explanations.

Characteristics of case studies

Case studies typically possess a number of distinct characteristics that set them apart from other research methods. These characteristics include a focus on holistic description and explanation, flexibility in the design and data collection methods, reliance on multiple sources of evidence, and emphasis on the context in which the phenomenon occurs.

Furthermore, case studies can often involve a longitudinal examination of the case, meaning they study the case over a period of time. These characteristics allow case studies to yield comprehensive, in-depth, and richly contextualized insights about the phenomenon of interest.

The role of case studies in research

Case studies hold a unique position in the broader landscape of research methods aimed at theory development. They are instrumental when the primary research interest is to gain an intensive, detailed understanding of a phenomenon in its real-life context.

In addition, case studies can serve different purposes within research - they can be used for exploratory, descriptive, or explanatory purposes, depending on the research question and objectives. This flexibility and depth make case studies a valuable tool in the toolkit of qualitative researchers.

Remember, a well-conducted case study can offer a rich, insightful contribution to both academic and practical knowledge through theory development or theory verification, thus enhancing our understanding of complex phenomena in their real-world contexts.

What is the purpose of a case study?

Case study research aims for a more comprehensive understanding of phenomena, requiring various research methods to gather information for qualitative analysis . Ultimately, a case study can allow the researcher to gain insight into a particular object of inquiry and develop a theoretical framework relevant to the research inquiry.

Why use case studies in qualitative research?

Using case studies as a research strategy depends mainly on the nature of the research question and the researcher's access to the data.

Conducting case study research provides a level of detail and contextual richness that other research methods might not offer. They are beneficial when there's a need to understand complex social phenomena within their natural contexts.

The explanatory, exploratory, and descriptive roles of case studies

Case studies can take on various roles depending on the research objectives. They can be exploratory when the research aims to discover new phenomena or define new research questions; they are descriptive when the objective is to depict a phenomenon within its context in a detailed manner; and they can be explanatory if the goal is to understand specific relationships within the studied context. Thus, the versatility of case studies allows researchers to approach their topic from different angles, offering multiple ways to uncover and interpret the data .

The impact of case studies on knowledge development

Case studies play a significant role in knowledge development across various disciplines. Analysis of cases provides an avenue for researchers to explore phenomena within their context based on the collected data.

This can result in the production of rich, practical insights that can be instrumental in both theory-building and practice. Case studies allow researchers to delve into the intricacies and complexities of real-life situations, uncovering insights that might otherwise remain hidden.

Types of case studies

In qualitative research , a case study is not a one-size-fits-all approach. Depending on the nature of the research question and the specific objectives of the study, researchers might choose to use different types of case studies. These types differ in their focus, methodology, and the level of detail they provide about the phenomenon under investigation.

Understanding these types is crucial for selecting the most appropriate approach for your research project and effectively achieving your research goals. Let's briefly look at the main types of case studies.

Exploratory case studies

Exploratory case studies are typically conducted to develop a theory or framework around an understudied phenomenon. They can also serve as a precursor to a larger-scale research project. Exploratory case studies are useful when a researcher wants to identify the key issues or questions which can spur more extensive study or be used to develop propositions for further research. These case studies are characterized by flexibility, allowing researchers to explore various aspects of a phenomenon as they emerge, which can also form the foundation for subsequent studies.

Descriptive case studies

Descriptive case studies aim to provide a complete and accurate representation of a phenomenon or event within its context. These case studies are often based on an established theoretical framework, which guides how data is collected and analyzed. The researcher is concerned with describing the phenomenon in detail, as it occurs naturally, without trying to influence or manipulate it.

Explanatory case studies

Explanatory case studies are focused on explanation - they seek to clarify how or why certain phenomena occur. Often used in complex, real-life situations, they can be particularly valuable in clarifying causal relationships among concepts and understanding the interplay between different factors within a specific context.

Intrinsic, instrumental, and collective case studies

These three categories of case studies focus on the nature and purpose of the study. An intrinsic case study is conducted when a researcher has an inherent interest in the case itself. Instrumental case studies are employed when the case is used to provide insight into a particular issue or phenomenon. A collective case study, on the other hand, involves studying multiple cases simultaneously to investigate some general phenomena.

Each type of case study serves a different purpose and has its own strengths and challenges. The selection of the type should be guided by the research question and objectives, as well as the context and constraints of the research.

The flexibility, depth, and contextual richness offered by case studies make this approach an excellent research method for various fields of study. They enable researchers to investigate real-world phenomena within their specific contexts, capturing nuances that other research methods might miss. Across numerous fields, case studies provide valuable insights into complex issues.

Critical information systems research

Case studies provide a detailed understanding of the role and impact of information systems in different contexts. They offer a platform to explore how information systems are designed, implemented, and used and how they interact with various social, economic, and political factors. Case studies in this field often focus on examining the intricate relationship between technology, organizational processes, and user behavior, helping to uncover insights that can inform better system design and implementation.

Health research

Health research is another field where case studies are highly valuable. They offer a way to explore patient experiences, healthcare delivery processes, and the impact of various interventions in a real-world context.

Case studies can provide a deep understanding of a patient's journey, giving insights into the intricacies of disease progression, treatment effects, and the psychosocial aspects of health and illness.

Asthma research studies

Specifically within medical research, studies on asthma often employ case studies to explore the individual and environmental factors that influence asthma development, management, and outcomes. A case study can provide rich, detailed data about individual patients' experiences, from the triggers and symptoms they experience to the effectiveness of various management strategies. This can be crucial for developing patient-centered asthma care approaches.

Other fields

Apart from the fields mentioned, case studies are also extensively used in business and management research, education research, and political sciences, among many others. They provide an opportunity to delve into the intricacies of real-world situations, allowing for a comprehensive understanding of various phenomena.

Case studies, with their depth and contextual focus, offer unique insights across these varied fields. They allow researchers to illuminate the complexities of real-life situations, contributing to both theory and practice.

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Understanding the key elements of case study design is crucial for conducting rigorous and impactful case study research. A well-structured design guides the researcher through the process, ensuring that the study is methodologically sound and its findings are reliable and valid. The main elements of case study design include the research question , propositions, units of analysis, and the logic linking the data to the propositions.

The research question is the foundation of any research study. A good research question guides the direction of the study and informs the selection of the case, the methods of collecting data, and the analysis techniques. A well-formulated research question in case study research is typically clear, focused, and complex enough to merit further detailed examination of the relevant case(s).

Propositions

Propositions, though not necessary in every case study, provide a direction by stating what we might expect to find in the data collected. They guide how data is collected and analyzed by helping researchers focus on specific aspects of the case. They are particularly important in explanatory case studies, which seek to understand the relationships among concepts within the studied phenomenon.

Units of analysis

The unit of analysis refers to the case, or the main entity or entities that are being analyzed in the study. In case study research, the unit of analysis can be an individual, a group, an organization, a decision, an event, or even a time period. It's crucial to clearly define the unit of analysis, as it shapes the qualitative data analysis process by allowing the researcher to analyze a particular case and synthesize analysis across multiple case studies to draw conclusions.

Argumentation

This refers to the inferential model that allows researchers to draw conclusions from the data. The researcher needs to ensure that there is a clear link between the data, the propositions (if any), and the conclusions drawn. This argumentation is what enables the researcher to make valid and credible inferences about the phenomenon under study.

Understanding and carefully considering these elements in the design phase of a case study can significantly enhance the quality of the research. It can help ensure that the study is methodologically sound and its findings contribute meaningful insights about the case.

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Conducting a case study involves several steps, from defining the research question and selecting the case to collecting and analyzing data . This section outlines these key stages, providing a practical guide on how to conduct case study research.

Defining the research question

The first step in case study research is defining a clear, focused research question. This question should guide the entire research process, from case selection to analysis. It's crucial to ensure that the research question is suitable for a case study approach. Typically, such questions are exploratory or descriptive in nature and focus on understanding a phenomenon within its real-life context.

Selecting and defining the case

The selection of the case should be based on the research question and the objectives of the study. It involves choosing a unique example or a set of examples that provide rich, in-depth data about the phenomenon under investigation. After selecting the case, it's crucial to define it clearly, setting the boundaries of the case, including the time period and the specific context.

Previous research can help guide the case study design. When considering a case study, an example of a case could be taken from previous case study research and used to define cases in a new research inquiry. Considering recently published examples can help understand how to select and define cases effectively.

Developing a detailed case study protocol

A case study protocol outlines the procedures and general rules to be followed during the case study. This includes the data collection methods to be used, the sources of data, and the procedures for analysis. Having a detailed case study protocol ensures consistency and reliability in the study.

The protocol should also consider how to work with the people involved in the research context to grant the research team access to collecting data. As mentioned in previous sections of this guide, establishing rapport is an essential component of qualitative research as it shapes the overall potential for collecting and analyzing data.

Collecting data

Gathering data in case study research often involves multiple sources of evidence, including documents, archival records, interviews, observations, and physical artifacts. This allows for a comprehensive understanding of the case. The process for gathering data should be systematic and carefully documented to ensure the reliability and validity of the study.

Analyzing and interpreting data

The next step is analyzing the data. This involves organizing the data , categorizing it into themes or patterns , and interpreting these patterns to answer the research question. The analysis might also involve comparing the findings with prior research or theoretical propositions.

Writing the case study report

The final step is writing the case study report . This should provide a detailed description of the case, the data, the analysis process, and the findings. The report should be clear, organized, and carefully written to ensure that the reader can understand the case and the conclusions drawn from it.

Each of these steps is crucial in ensuring that the case study research is rigorous, reliable, and provides valuable insights about the case.

The type, depth, and quality of data in your study can significantly influence the validity and utility of the study. In case study research, data is usually collected from multiple sources to provide a comprehensive and nuanced understanding of the case. This section will outline the various methods of collecting data used in case study research and discuss considerations for ensuring the quality of the data.

Interviews are a common method of gathering data in case study research. They can provide rich, in-depth data about the perspectives, experiences, and interpretations of the individuals involved in the case. Interviews can be structured , semi-structured , or unstructured , depending on the research question and the degree of flexibility needed.

Observations

Observations involve the researcher observing the case in its natural setting, providing first-hand information about the case and its context. Observations can provide data that might not be revealed in interviews or documents, such as non-verbal cues or contextual information.

Documents and artifacts

Documents and archival records provide a valuable source of data in case study research. They can include reports, letters, memos, meeting minutes, email correspondence, and various public and private documents related to the case.

These records can provide historical context, corroborate evidence from other sources, and offer insights into the case that might not be apparent from interviews or observations.

Physical artifacts refer to any physical evidence related to the case, such as tools, products, or physical environments. These artifacts can provide tangible insights into the case, complementing the data gathered from other sources.

Ensuring the quality of data collection

Determining the quality of data in case study research requires careful planning and execution. It's crucial to ensure that the data is reliable, accurate, and relevant to the research question. This involves selecting appropriate methods of collecting data, properly training interviewers or observers, and systematically recording and storing the data. It also includes considering ethical issues related to collecting and handling data, such as obtaining informed consent and ensuring the privacy and confidentiality of the participants.

Data analysis

Analyzing case study research involves making sense of the rich, detailed data to answer the research question. This process can be challenging due to the volume and complexity of case study data. However, a systematic and rigorous approach to analysis can ensure that the findings are credible and meaningful. This section outlines the main steps and considerations in analyzing data in case study research.

Organizing the data

The first step in the analysis is organizing the data. This involves sorting the data into manageable sections, often according to the data source or the theme. This step can also involve transcribing interviews, digitizing physical artifacts, or organizing observational data.

Categorizing and coding the data

Once the data is organized, the next step is to categorize or code the data. This involves identifying common themes, patterns, or concepts in the data and assigning codes to relevant data segments. Coding can be done manually or with the help of software tools, and in either case, qualitative analysis software can greatly facilitate the entire coding process. Coding helps to reduce the data to a set of themes or categories that can be more easily analyzed.

Identifying patterns and themes

After coding the data, the researcher looks for patterns or themes in the coded data. This involves comparing and contrasting the codes and looking for relationships or patterns among them. The identified patterns and themes should help answer the research question.

Interpreting the data

Once patterns and themes have been identified, the next step is to interpret these findings. This involves explaining what the patterns or themes mean in the context of the research question and the case. This interpretation should be grounded in the data, but it can also involve drawing on theoretical concepts or prior research.

Verification of the data

The last step in the analysis is verification. This involves checking the accuracy and consistency of the analysis process and confirming that the findings are supported by the data. This can involve re-checking the original data, checking the consistency of codes, or seeking feedback from research participants or peers.

Like any research method , case study research has its strengths and limitations. Researchers must be aware of these, as they can influence the design, conduct, and interpretation of the study.

Understanding the strengths and limitations of case study research can also guide researchers in deciding whether this approach is suitable for their research question . This section outlines some of the key strengths and limitations of case study research.

Benefits include the following:

• Rich, detailed data: One of the main strengths of case study research is that it can generate rich, detailed data about the case. This can provide a deep understanding of the case and its context, which can be valuable in exploring complex phenomena.
• Flexibility: Case study research is flexible in terms of design , data collection , and analysis . A sufficient degree of flexibility allows the researcher to adapt the study according to the case and the emerging findings.
• Real-world context: Case study research involves studying the case in its real-world context, which can provide valuable insights into the interplay between the case and its context.
• Multiple sources of evidence: Case study research often involves collecting data from multiple sources , which can enhance the robustness and validity of the findings.

On the other hand, researchers should consider the following limitations:

• Generalizability: A common criticism of case study research is that its findings might not be generalizable to other cases due to the specificity and uniqueness of each case.
• Time and resource intensive: Case study research can be time and resource intensive due to the depth of the investigation and the amount of collected data.
• Complexity of analysis: The rich, detailed data generated in case study research can make analyzing the data challenging.
• Subjectivity: Given the nature of case study research, there may be a higher degree of subjectivity in interpreting the data , so researchers need to reflect on this and transparently convey to audiences how the research was conducted.

Being aware of these strengths and limitations can help researchers design and conduct case study research effectively and interpret and report the findings appropriately.

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Single Case Research Design

• First Online: 04 January 2024

Cite this chapter

• Stefan Hunziker 3 &
• Michael Blankenagel 3  

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2 Citations

This chapter addresses single-case research designs’ peculiarities, characteristics, and significant fallacies. A single case research design is a collective term for an in-depth analysis of a small non-random sample. The focus of this design is in-depth. This characteristic distinguishes the case study research from other research designs that understand the individual case as a relatively insignificant and interchangeable aspect of a population or sample. Also, researchers find relevant information on writing a single case research design paper and learn about typical methods used for this research design. The chapter closes by referring to overlapping and adjacent research designs.

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Barratt, M., Choi, T. Y., & Li, M. (2011). Qualitative case studies in operations management: Trends, research outcomes, and future research implications. Journal of Operations Management, 29 (4), 329–342.

Google Scholar  

Baškarada, S. (2014). Qualitative case studies guidelines. The Qualitative Report, 19 (40), 1–25.

Berg, B., & Lune, H. (2012). Qualitative research methods for the social sciences . Pearson.

Berry, L. L., Conant, J. S. & Parasuraman, A. (1991), “A framework for conducting a servicemarketing audit”. Journal of the Academy of Marketing Science, 19 , 255–266.

Bryman, A. (2004). Social research methods 2nd edn. Oxford University Press, 592.

Burns, R. B. (2000). Introduction to research methods . United States of America.

Boos, M., (1992). A Typologie of Case Studies, in: M. O’S´uilleabhain, E.A. Stuhler, D. de Tombe (Eds.), Research on Cases and Theories , (Vol. I), München.

Creswell, J. W. (2013). Qualitative inquiry and research design. Choosing among five approaches (3rd ed.). SAGE.

Darke, P., Shanks, G., & Broadbent, M. (1998). Successfully completing case study research: Combining rigour, relevance and pragmatism. Inform Syst J, 8 (4), 273–289.

Article   Google Scholar  

Dey, I. (1999). Grounding grounded theory: Guidelines for qualitative inquiry . Academic Press.

Dick, B. (2005). Grounded theory: A thumbnail sketch. Retrieved 11 June 2021 from http://www.scu.edu.au/schools/gcm/ar/arp/grounded.html .

Dooley, L. M. (2002). Case study research and theory building. Advances in Developing Human Resources, 4 (3), 335–354.

Dubé, L., & Paré, G. (2003). Rigor in information systems positivist case research: Current practices, trends, and recommendations. MIS Quarterly, 27, 597–635.

Edmonds, W. A., & Kennedy, T. D. (2012). An applied reference guide to research designs: Quantitative, qualitative, and mixed methods . Sage.

Edmondson, A. & McManus, S. (2007). Methodological fit in management field research. The Academy of Management Review, 32 (4), 1155–1179.

Eisenhardt, K. M. (1989). Building theories from case study research. Academy of Management Review, 14 (4), 532–550.

Flynn, B. B., Sakakibara, S., Schroeder, R. G., Bates, K. A., & Flynn, E. J. (1990). Empirical research methods in operations management. Journal of Operations Management, 9 (2), 250–284.

Flyvbjerg, B. (2001). Making social science matter: Why social inquiry fails and how it can succeed again . Cambridge University Press.

Flyvbjerg, B. (2006). Five misunderstandings about case-study research. Qualitative Inquiry, 12 (2), 219–245.

General Accounting Office. (1990). Case study evaluations. Retrieved May 15, 2021, from https://www.gao.gov/assets/pemd-10.1.9.pdf .

Gerring, J. (2004). What is a case study and what is it good for? American Political Science Review, 98 (2), 341–354.

Glaser, B. G. (1978). Theoretical sensitivity: Advances in the methodology of grounded theory . Sociology Press.

Glaser, B., & Strauss, A. (1967). The discovery of grounded theory: Strategies for qualitative research . Sociology Press.

Gomm, R. (2000). Case study method. Key issues, key texts . SAGE.

Halaweh, M., Fidler, C., & McRobb, S. (2008). Integrating the Grounded Theory Method and Case Study Research Methodology Within IS Research: A Possible ‘Road Map’, ICIS 2008 Proceedings

Halaweh, M. (2012). Integration of grounded theory and case study: An exemplary application from e-commerce security perception research. Journal of Information Technology Theory and Application (JITTA), 13 (1).

Hancock, D., & Algozzine, B. (2016). Doing case study research: A practical guide for beginning researchers (3rd ed.). Teachers College Press.

Hekkala, R. (2007). Grounded theory—the two faces of the methodology and their manifestation in IS research. In Proceedings of the 30th Information Systems Research Seminar in Scandinavia IRIS, 11–14 August, Tampere, Finland (pp. 1–12).

Horton, J., Macve, R., & Struyven, G. (2004). Qualitative Research: Experiences in Using Semi-Structured Interviews. In: Humphrey, Christopher and Lee, Bill H. K., (eds.) The Real Life Guide to Accounting Research: a Behind-The-Scenes View of Using Qualitative Research Methods. Elsevier Science (Firm) , (pp. 339–358 ), Amsterdam, The Netherlands.

Hyett, N., Kenny, A., & Dickson-Swift, V. (2014). Methodology or method? A critical review of qualitative case study reports. International Journal of Qualitative Studies on Health and Well-Being, 9, 23606.

Keating, P. J. (1995). A framework for classifying and evaluating the theoretical contributions of case research in management accounting. Journal of Management Accounting Research, 7, 66.

Levy, J. S. (2008). Case studies: Types, designs, and logics of inference. Conflict Management and Peace Science, 25 (1), 1–18.

Maoz, Z. (2002). Case study methodology in international studies: from storytelling to hypothesis testing. In F. P. Harvey & M. Brecher (Eds.). Evaluating methodology in international studies . University of Michigan Press.

Mayring, P. (2010). Design. In G. Mey & K. Mruck (Hrsg.), Handbuch qualitative Forschung in der Psychologie (S. 225–237). VS Verlag für Sozialwissenschaften.

May, T. (2011). Social research: Issues, methods and process . Open University Press/Mc.

Merriam, S. B. (2002). Qualitative Research in Practice: Examples For discussion and Analysis . Jossey-Bass Publishers.

Merriam, S. B. (2009). Qualitative research in practice: Examples for discussion and analysis . Jossey-Bass publishers.

Meyer, J.-A., & Kittel-Wegner, E. (2002a). Die Fallstudie in der betriebswirtschaftlichen Forschung und Lehre . Stiftungslehrstuhl für ABWL, insb. kleine und mittlere Unternehmen, Universität.

Meyer, J.-A., & Kittel-Wegner, E. (2002b). Die Fallstudie in der betriebswirtschaftlichen Forschung und Lehre, Schriften zu Management und KMU, Nr. 2/02, Universität Flensburg, Mai 2002.

Mitchell, J. C. (1983). Case and situation analysis. The Sociological Review, 31 (2), 187–211.

Ng. (2005). A principal-distributor collaboration moden in the crane industry. Ph.D. Thesis, Graduate College of Management, Southern Cross University, Australia.

Ng, Y. N. K. & Hase, S. (2008). Grounded suggestions for doing a grounded theory business research. Electronic Journal on Business Research Methods, 6 (2).

Otley, D., Anthony J.B. (1994), “Case study research in management accounting and control”. Management Accounting Research, 5 , 45–65.

Onwuegbuzie, A. J., Leech, N. L., & Collins, K. M. (2012). Qualitative analysis techniques for the review of the literature. Qualitative Report, 17 (56).

Piekkari, R., Welch, C., & Paavilainen, E. (2009). The case study as disciplinary convention. Organizational Research Methods, 12 (3), 567–589.

Ridder, H.-G. (2016). Case study research. Approaches, methods, contribution to theory. Sozialwissenschaftliche Forschungsmethoden (vol. 12). Rainer Hampp Verlag.

Ridder, H.-G. (2017). The theory contribution of case study research designs. Business Research, 10 (2), 281–305.

Stake, R. E. (1995). The art of case study research . Sage.

Stake, R. E. (2005). Qualitative case studies. The SAGE handbook of qualitative research (3rd ed.), eds. N. K. Denzin & Y. S. Lincoln (pp. 443–466).

Strauss, A. L., & Corbin, J. (1990). Basics of qualitative research: Grounded theory procedures and techniques . Sage publications.

Strauss, A. L., & Corbin, J. (1998). Basics of qualitative research techniques and procedures for developing grounded theory . Sage.

Tight, M. (2003). Researching higher education . Society for Research into Higher Education; Open University Press.

Tight, M. (2010). The curious case of case study: A viewpoint. International Journal of Social Research Methodology, 13 (4), 329–339.

Walsham, G. (1995). Interpretive case studies in IS research: nature and method. Eur J Inf Syst 4, 74–81.

Walsham, G. (2006). Doing interpretive research. European Journal of Information Systems, 15 (3), 320–330.

Welch, C., Piekkari, R., Plakoyiannaki, E., & Paavilainen-Mäntymäki, E. (2011). Theorising from case studies: Towards a pluralist future for international business research. Journal of International Business Studies, 42 (5), 740–762.

Woods, M. (2009). A contingency theory perspective on the risk management control system within Birmingham city council. Management Accounting Research, 20 (1), 69–81.

Yin, R. K. (1994). Discovering the future of the case study. Method in evaluation research. American Journal of Evaluation, 15 (3), 283–290.

Yin, R. K. (2004). Case study research: Design and methods (3rd ed.). Chongqing University Press.

Yin, R. K. (2009). Case study research: Design and methods (4th ed.). SAGE.

Yin, R. K. (2014). Case study research. Design and methods (5th ed.). SAGE.

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Research Guides

Multiple Case Studies

Nadia Alqahtani and Pengtong Qu

Description

The case study approach is popular across disciplines in education, anthropology, sociology, psychology, medicine, law, and political science (Creswell, 2013). It is both a research method and a strategy (Creswell, 2013; Yin, 2017). In this type of research design, a case can be an individual, an event, or an entity, as determined by the research questions. There are two variants of the case study: the single-case study and the multiple-case study. The former design can be used to study and understand an unusual case, a critical case, a longitudinal case, or a revelatory case. On the other hand, a multiple-case study includes two or more cases or replications across the cases to investigate the same phenomena (Lewis-Beck, Bryman & Liao, 2003; Yin, 2017). …a multiple-case study includes two or more cases or replications across the cases to investigate the same phenomena

The difference between the single- and multiple-case study is the research design; however, they are within the same methodological framework (Yin, 2017). Multiple cases are selected so that “individual case studies either (a) predict similar results (a literal replication) or (b) predict contrasting results but for anticipatable reasons (a theoretical replication)” (p. 55). When the purpose of the study is to compare and replicate the findings, the multiple-case study produces more compelling evidence so that the study is considered more robust than the single-case study (Yin, 2017).

To write a multiple-case study, a summary of individual cases should be reported, and researchers need to draw cross-case conclusions and form a cross-case report (Yin, 2017). With evidence from multiple cases, researchers may have generalizable findings and develop theories (Lewis-Beck, Bryman & Liao, 2003).

Creswell, J. W. (2013). Qualitative inquiry and research design: Choosing among five approaches (3rd ed.). Los Angeles, CA: Sage.

Lewis-Beck, M., Bryman, A. E., & Liao, T. F. (2003). The Sage encyclopedia of social science research methods . Los Angeles, CA: Sage.

Yin, R. K. (2017). Case study research and applications: Design and methods . Los Angeles, CA: Sage.

Key Research Books and Articles on Multiple Case Study Methodology

Yin discusses how to decide if a case study should be used in research. Novice researchers can learn about research design, data collection, and data analysis of different types of case studies, as well as writing a case study report.

Chapter 2 introduces four major types of research design in case studies: holistic single-case design, embedded single-case design, holistic multiple-case design, and embedded multiple-case design. Novice researchers will learn about the definitions and characteristics of different designs. This chapter also teaches researchers how to examine and discuss the reliability and validity of the designs.

Creswell, J. W., & Poth, C. N. (2017). Qualitative inquiry and research design: Choosing among five approaches . Los Angeles, CA: Sage.

This book compares five different qualitative research designs: narrative research, phenomenology, grounded theory, ethnography, and case study. It compares the characteristics, data collection, data analysis and representation, validity, and writing-up procedures among five inquiry approaches using texts with tables. For each approach, the author introduced the definition, features, types, and procedures and contextualized these components in a study, which was conducted through the same method. Each chapter ends with a list of relevant readings of each inquiry approach.

This book invites readers to compare these five qualitative methods and see the value of each approach. Readers can consider which approach would serve for their research contexts and questions, as well as how to design their research and conduct the data analysis based on their choice of research method.

Günes, E., & Bahçivan, E. (2016). A multiple case study of preservice science teachers’ TPACK: Embedded in a comprehensive belief system. International Journal of Environmental and Science Education, 11 (15), 8040-8054.

In this article, the researchers showed the importance of using technological opportunities in improving the education process and how they enhanced the students’ learning in science education. The study examined the connection between “Technological Pedagogical Content Knowledge” (TPACK) and belief system in a science teaching context. The researchers used the multiple-case study to explore the effect of TPACK on the preservice science teachers’ (PST) beliefs on their TPACK level. The participants were three teachers with the low, medium, and high level of TPACK confidence. Content analysis was utilized to analyze the data, which were collected by individual semi-structured interviews with the participants about their lesson plans. The study first discussed each case, then compared features and relations across cases. The researchers found that there was a positive relationship between PST’s TPACK confidence and TPACK level; when PST had higher TPACK confidence, the participant had a higher competent TPACK level and vice versa.

Recent Dissertations Using Multiple Case Study Methodology

Milholland, E. S. (2015). A multiple case study of instructors utilizing Classroom Response Systems (CRS) to achieve pedagogical goals . Retrieved from ProQuest Dissertations & Theses Global. (Order Number 3706380)

The researcher of this study critiques the use of Classroom Responses Systems by five instructors who employed this program five years ago in their classrooms. The researcher conducted the multiple-case study methodology and categorized themes. He interviewed each instructor with questions about their initial pedagogical goals, the changes in pedagogy during teaching, and the teaching techniques individuals used while practicing the CRS. The researcher used the multiple-case study with five instructors. He found that all instructors changed their goals during employing CRS; they decided to reduce the time of lecturing and to spend more time engaging students in interactive activities. This study also demonstrated that CRS was useful for the instructors to achieve multiple learning goals; all the instructors provided examples of the positive aspect of implementing CRS in their classrooms.

Li, C. L. (2010). The emergence of fairy tale literacy: A multiple case study on promoting critical literacy of children through a juxtaposed reading of classic fairy tales and their contemporary disruptive variants . Retrieved from ProQuest Dissertations & Theses Global. (Order Number 3572104)

To explore how children’s development of critical literacy can be impacted by their reactions to fairy tales, the author conducted a multiple-case study with 4 cases, in which each child was a unit of analysis. Two Chinese immigrant children (a boy and a girl) and two American children (a boy and a girl) at the second or third grade were recruited in the study. The data were collected through interviews, discussions on fairy tales, and drawing pictures. The analysis was conducted within both individual cases and cross cases. Across four cases, the researcher found that the young children’s’ knowledge of traditional fairy tales was built upon mass-media based adaptations. The children believed that the representations on mass-media were the original stories, even though fairy tales are included in the elementary school curriculum. The author also found that introducing classic versions of fairy tales increased children’s knowledge in the genre’s origin, which would benefit their understanding of the genre. She argued that introducing fairy tales can be the first step to promote children’s development of critical literacy.

Asher, K. C. (2014). Mediating occupational socialization and occupational individuation in teacher education: A multiple case study of five elementary pre-service student teachers . Retrieved from ProQuest Dissertations & Theses Global. (Order Number 3671989)

This study portrayed five pre-service teachers’ teaching experience in their student teaching phase and explored how pre-service teachers mediate their occupational socialization with occupational individuation. The study used the multiple-case study design and recruited five pre-service teachers from a Midwestern university as five cases. Qualitative data were collected through interviews, classroom observations, and field notes. The author implemented the case study analysis and found five strategies that the participants used to mediate occupational socialization with occupational individuation. These strategies were: 1) hindering from practicing their beliefs, 2) mimicking the styles of supervising teachers, 3) teaching in the ways in alignment with school’s existing practice, 4) enacting their own ideas, and 5) integrating and balancing occupational socialization and occupational individuation. The study also provided recommendations and implications to policymakers and educators in teacher education so that pre-service teachers can be better supported.

Multiple Case Studies Copyright © 2019 by Nadia Alqahtani and Pengtong Qu is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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Case Study – Methods, Examples and Guide

Table of Contents

A case study is a research method that involves an in-depth examination and analysis of a particular phenomenon or case, such as an individual, organization, community, event, or situation.

It is a qualitative research approach that aims to provide a detailed and comprehensive understanding of the case being studied. Case studies typically involve multiple sources of data, including interviews, observations, documents, and artifacts, which are analyzed using various techniques, such as content analysis, thematic analysis, and grounded theory. The findings of a case study are often used to develop theories, inform policy or practice, or generate new research questions.

Types of Case Study

Types and Methods of Case Study are as follows:

Single-Case Study

A single-case study is an in-depth analysis of a single case. This type of case study is useful when the researcher wants to understand a specific phenomenon in detail.

For Example , A researcher might conduct a single-case study on a particular individual to understand their experiences with a particular health condition or a specific organization to explore their management practices. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of a single-case study are often used to generate new research questions, develop theories, or inform policy or practice.

Multiple-Case Study

A multiple-case study involves the analysis of several cases that are similar in nature. This type of case study is useful when the researcher wants to identify similarities and differences between the cases.

For Example, a researcher might conduct a multiple-case study on several companies to explore the factors that contribute to their success or failure. The researcher collects data from each case, compares and contrasts the findings, and uses various techniques to analyze the data, such as comparative analysis or pattern-matching. The findings of a multiple-case study can be used to develop theories, inform policy or practice, or generate new research questions.

Exploratory Case Study

An exploratory case study is used to explore a new or understudied phenomenon. This type of case study is useful when the researcher wants to generate hypotheses or theories about the phenomenon.

For Example, a researcher might conduct an exploratory case study on a new technology to understand its potential impact on society. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as grounded theory or content analysis. The findings of an exploratory case study can be used to generate new research questions, develop theories, or inform policy or practice.

Descriptive Case Study

A descriptive case study is used to describe a particular phenomenon in detail. This type of case study is useful when the researcher wants to provide a comprehensive account of the phenomenon.

For Example, a researcher might conduct a descriptive case study on a particular community to understand its social and economic characteristics. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of a descriptive case study can be used to inform policy or practice or generate new research questions.

Instrumental Case Study

An instrumental case study is used to understand a particular phenomenon that is instrumental in achieving a particular goal. This type of case study is useful when the researcher wants to understand the role of the phenomenon in achieving the goal.

For Example, a researcher might conduct an instrumental case study on a particular policy to understand its impact on achieving a particular goal, such as reducing poverty. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of an instrumental case study can be used to inform policy or practice or generate new research questions.

Case Study Data Collection Methods

Here are some common data collection methods for case studies:

Interviews involve asking questions to individuals who have knowledge or experience relevant to the case study. Interviews can be structured (where the same questions are asked to all participants) or unstructured (where the interviewer follows up on the responses with further questions). Interviews can be conducted in person, over the phone, or through video conferencing.

Observations

Observations involve watching and recording the behavior and activities of individuals or groups relevant to the case study. Observations can be participant (where the researcher actively participates in the activities) or non-participant (where the researcher observes from a distance). Observations can be recorded using notes, audio or video recordings, or photographs.

Documents can be used as a source of information for case studies. Documents can include reports, memos, emails, letters, and other written materials related to the case study. Documents can be collected from the case study participants or from public sources.

Surveys involve asking a set of questions to a sample of individuals relevant to the case study. Surveys can be administered in person, over the phone, through mail or email, or online. Surveys can be used to gather information on attitudes, opinions, or behaviors related to the case study.

Artifacts are physical objects relevant to the case study. Artifacts can include tools, equipment, products, or other objects that provide insights into the case study phenomenon.

How to conduct Case Study Research

Conducting a case study research involves several steps that need to be followed to ensure the quality and rigor of the study. Here are the steps to conduct case study research:

• Define the research questions: The first step in conducting a case study research is to define the research questions. The research questions should be specific, measurable, and relevant to the case study phenomenon under investigation.
• Select the case: The next step is to select the case or cases to be studied. The case should be relevant to the research questions and should provide rich and diverse data that can be used to answer the research questions.
• Collect data: Data can be collected using various methods, such as interviews, observations, documents, surveys, and artifacts. The data collection method should be selected based on the research questions and the nature of the case study phenomenon.
• Analyze the data: The data collected from the case study should be analyzed using various techniques, such as content analysis, thematic analysis, or grounded theory. The analysis should be guided by the research questions and should aim to provide insights and conclusions relevant to the research questions.
• Draw conclusions: The conclusions drawn from the case study should be based on the data analysis and should be relevant to the research questions. The conclusions should be supported by evidence and should be clearly stated.
• Validate the findings: The findings of the case study should be validated by reviewing the data and the analysis with participants or other experts in the field. This helps to ensure the validity and reliability of the findings.
• Write the report: The final step is to write the report of the case study research. The report should provide a clear description of the case study phenomenon, the research questions, the data collection methods, the data analysis, the findings, and the conclusions. The report should be written in a clear and concise manner and should follow the guidelines for academic writing.

Examples of Case Study

Here are some examples of case study research:

• The Hawthorne Studies : Conducted between 1924 and 1932, the Hawthorne Studies were a series of case studies conducted by Elton Mayo and his colleagues to examine the impact of work environment on employee productivity. The studies were conducted at the Hawthorne Works plant of the Western Electric Company in Chicago and included interviews, observations, and experiments.
• The Stanford Prison Experiment: Conducted in 1971, the Stanford Prison Experiment was a case study conducted by Philip Zimbardo to examine the psychological effects of power and authority. The study involved simulating a prison environment and assigning participants to the role of guards or prisoners. The study was controversial due to the ethical issues it raised.
• The Challenger Disaster: The Challenger Disaster was a case study conducted to examine the causes of the Space Shuttle Challenger explosion in 1986. The study included interviews, observations, and analysis of data to identify the technical, organizational, and cultural factors that contributed to the disaster.
• The Enron Scandal: The Enron Scandal was a case study conducted to examine the causes of the Enron Corporation’s bankruptcy in 2001. The study included interviews, analysis of financial data, and review of documents to identify the accounting practices, corporate culture, and ethical issues that led to the company’s downfall.
• The Fukushima Nuclear Disaster : The Fukushima Nuclear Disaster was a case study conducted to examine the causes of the nuclear accident that occurred at the Fukushima Daiichi Nuclear Power Plant in Japan in 2011. The study included interviews, analysis of data, and review of documents to identify the technical, organizational, and cultural factors that contributed to the disaster.

Application of Case Study

Case studies have a wide range of applications across various fields and industries. Here are some examples:

Business and Management

Case studies are widely used in business and management to examine real-life situations and develop problem-solving skills. Case studies can help students and professionals to develop a deep understanding of business concepts, theories, and best practices.

Case studies are used in healthcare to examine patient care, treatment options, and outcomes. Case studies can help healthcare professionals to develop critical thinking skills, diagnose complex medical conditions, and develop effective treatment plans.

Case studies are used in education to examine teaching and learning practices. Case studies can help educators to develop effective teaching strategies, evaluate student progress, and identify areas for improvement.

Social Sciences

Case studies are widely used in social sciences to examine human behavior, social phenomena, and cultural practices. Case studies can help researchers to develop theories, test hypotheses, and gain insights into complex social issues.

Law and Ethics

Case studies are used in law and ethics to examine legal and ethical dilemmas. Case studies can help lawyers, policymakers, and ethical professionals to develop critical thinking skills, analyze complex cases, and make informed decisions.

Purpose of Case Study

The purpose of a case study is to provide a detailed analysis of a specific phenomenon, issue, or problem in its real-life context. A case study is a qualitative research method that involves the in-depth exploration and analysis of a particular case, which can be an individual, group, organization, event, or community.

The primary purpose of a case study is to generate a comprehensive and nuanced understanding of the case, including its history, context, and dynamics. Case studies can help researchers to identify and examine the underlying factors, processes, and mechanisms that contribute to the case and its outcomes. This can help to develop a more accurate and detailed understanding of the case, which can inform future research, practice, or policy.

Case studies can also serve other purposes, including:

• Illustrating a theory or concept: Case studies can be used to illustrate and explain theoretical concepts and frameworks, providing concrete examples of how they can be applied in real-life situations.
• Developing hypotheses: Case studies can help to generate hypotheses about the causal relationships between different factors and outcomes, which can be tested through further research.
• Providing insight into complex issues: Case studies can provide insights into complex and multifaceted issues, which may be difficult to understand through other research methods.
• Informing practice or policy: Case studies can be used to inform practice or policy by identifying best practices, lessons learned, or areas for improvement.

Advantages of Case Study Research

There are several advantages of case study research, including:

• In-depth exploration: Case study research allows for a detailed exploration and analysis of a specific phenomenon, issue, or problem in its real-life context. This can provide a comprehensive understanding of the case and its dynamics, which may not be possible through other research methods.
• Rich data: Case study research can generate rich and detailed data, including qualitative data such as interviews, observations, and documents. This can provide a nuanced understanding of the case and its complexity.
• Holistic perspective: Case study research allows for a holistic perspective of the case, taking into account the various factors, processes, and mechanisms that contribute to the case and its outcomes. This can help to develop a more accurate and comprehensive understanding of the case.
• Theory development: Case study research can help to develop and refine theories and concepts by providing empirical evidence and concrete examples of how they can be applied in real-life situations.
• Practical application: Case study research can inform practice or policy by identifying best practices, lessons learned, or areas for improvement.
• Contextualization: Case study research takes into account the specific context in which the case is situated, which can help to understand how the case is influenced by the social, cultural, and historical factors of its environment.

Limitations of Case Study Research

There are several limitations of case study research, including:

• Limited generalizability : Case studies are typically focused on a single case or a small number of cases, which limits the generalizability of the findings. The unique characteristics of the case may not be applicable to other contexts or populations, which may limit the external validity of the research.
• Biased sampling: Case studies may rely on purposive or convenience sampling, which can introduce bias into the sample selection process. This may limit the representativeness of the sample and the generalizability of the findings.
• Subjectivity: Case studies rely on the interpretation of the researcher, which can introduce subjectivity into the analysis. The researcher’s own biases, assumptions, and perspectives may influence the findings, which may limit the objectivity of the research.
• Limited control: Case studies are typically conducted in naturalistic settings, which limits the control that the researcher has over the environment and the variables being studied. This may limit the ability to establish causal relationships between variables.
• Time-consuming: Case studies can be time-consuming to conduct, as they typically involve a detailed exploration and analysis of a specific case. This may limit the feasibility of conducting multiple case studies or conducting case studies in a timely manner.
• Resource-intensive: Case studies may require significant resources, including time, funding, and expertise. This may limit the ability of researchers to conduct case studies in resource-constrained settings.

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Pre-experimental designs.

Pre-experiments are the simplest form of research design. In a pre-experiment either a single group or multiple groups are observed subsequent to some agent or treatment presumed to cause change.

Types of Pre-Experimental Design

One-shot case study design, one-group pretest-posttest design, static-group comparison.

A single group is studied at a single point in time after some treatment that is presumed to have caused change. The carefully studied single instance is compared to general expectations of what the case would have looked like had the treatment not occurred and to other events casually observed. No control or comparison group is employed.

A single case is observed at two time points, one before the treatment and one after the treatment. Changes in the outcome of interest are presumed to be the result of the intervention or treatment. No control or comparison group is employed.

A group that has experienced some treatment is compared with one that has not. Observed differences between the two groups are assumed to be a result of the treatment.

Validity of Results

An important drawback of pre-experimental designs is that they are subject to numerous threats to their  validity . Consequently, it is often difficult or impossible to dismiss rival hypotheses or explanations. Therefore, researchers must exercise extreme caution in interpreting and generalizing the results from pre-experimental studies.

One reason that it is often difficult to assess the validity of studies that employ a pre-experimental design is that they often do not include any control or comparison group. Without something to compare it to, it is difficult to assess the significance of an observed change in the case. The change could be the result of historical changes unrelated to the treatment, the maturation of the subject, or an artifact of the testing.

Even when pre-experimental designs identify a comparison group, it is still difficult to dismiss rival hypotheses for the observed change. This is because there is no formal way to determine whether the two groups would have been the same if it had not been for the treatment. If the treatment group and the comparison group differ after the treatment, this might be a reflection of differences in the initial recruitment to the groups or differential mortality in the experiment.

Advantages and Disadvantages

As exploratory approaches, pre-experiments can be a cost-effective way to discern whether a potential explanation is worthy of further investigation.

Disadvantages

Pre-experiments offer few advantages since it is often difficult or impossible to rule out alternative explanations. The nearly insurmountable threats to their validity are clearly the most important disadvantage of pre-experimental research designs.

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Study designs: Part 1 – An overview and classification

Priya ranganathan.

Department of Anaesthesiology, Tata Memorial Centre, Mumbai, Maharashtra, India

Rakesh Aggarwal

1 Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

There are several types of research study designs, each with its inherent strengths and flaws. The study design used to answer a particular research question depends on the nature of the question and the availability of resources. In this article, which is the first part of a series on “study designs,” we provide an overview of research study designs and their classification. The subsequent articles will focus on individual designs.

INTRODUCTION

Research study design is a framework, or the set of methods and procedures used to collect and analyze data on variables specified in a particular research problem.

Research study designs are of many types, each with its advantages and limitations. The type of study design used to answer a particular research question is determined by the nature of question, the goal of research, and the availability of resources. Since the design of a study can affect the validity of its results, it is important to understand the different types of study designs and their strengths and limitations.

There are some terms that are used frequently while classifying study designs which are described in the following sections.

A variable represents a measurable attribute that varies across study units, for example, individual participants in a study, or at times even when measured in an individual person over time. Some examples of variables include age, sex, weight, height, health status, alive/dead, diseased/healthy, annual income, smoking yes/no, and treated/untreated.

Exposure (or intervention) and outcome variables

A large proportion of research studies assess the relationship between two variables. Here, the question is whether one variable is associated with or responsible for change in the value of the other variable. Exposure (or intervention) refers to the risk factor whose effect is being studied. It is also referred to as the independent or the predictor variable. The outcome (or predicted or dependent) variable develops as a consequence of the exposure (or intervention). Typically, the term “exposure” is used when the “causative” variable is naturally determined (as in observational studies – examples include age, sex, smoking, and educational status), and the term “intervention” is preferred where the researcher assigns some or all participants to receive a particular treatment for the purpose of the study (experimental studies – e.g., administration of a drug). If a drug had been started in some individuals but not in the others, before the study started, this counts as exposure, and not as intervention – since the drug was not started specifically for the study.

Observational versus interventional (or experimental) studies

Observational studies are those where the researcher is documenting a naturally occurring relationship between the exposure and the outcome that he/she is studying. The researcher does not do any active intervention in any individual, and the exposure has already been decided naturally or by some other factor. For example, looking at the incidence of lung cancer in smokers versus nonsmokers, or comparing the antenatal dietary habits of mothers with normal and low-birth babies. In these studies, the investigator did not play any role in determining the smoking or dietary habit in individuals.

For an exposure to determine the outcome, it must precede the latter. Any variable that occurs simultaneously with or following the outcome cannot be causative, and hence is not considered as an “exposure.”

Observational studies can be either descriptive (nonanalytical) or analytical (inferential) – this is discussed later in this article.

Interventional studies are experiments where the researcher actively performs an intervention in some or all members of a group of participants. This intervention could take many forms – for example, administration of a drug or vaccine, performance of a diagnostic or therapeutic procedure, and introduction of an educational tool. For example, a study could randomly assign persons to receive aspirin or placebo for a specific duration and assess the effect on the risk of developing cerebrovascular events.

Descriptive versus analytical studies

Descriptive (or nonanalytical) studies, as the name suggests, merely try to describe the data on one or more characteristics of a group of individuals. These do not try to answer questions or establish relationships between variables. Examples of descriptive studies include case reports, case series, and cross-sectional surveys (please note that cross-sectional surveys may be analytical studies as well – this will be discussed in the next article in this series). Examples of descriptive studies include a survey of dietary habits among pregnant women or a case series of patients with an unusual reaction to a drug.

Analytical studies attempt to test a hypothesis and establish causal relationships between variables. In these studies, the researcher assesses the effect of an exposure (or intervention) on an outcome. As described earlier, analytical studies can be observational (if the exposure is naturally determined) or interventional (if the researcher actively administers the intervention).

Directionality of study designs

Based on the direction of inquiry, study designs may be classified as forward-direction or backward-direction. In forward-direction studies, the researcher starts with determining the exposure to a risk factor and then assesses whether the outcome occurs at a future time point. This design is known as a cohort study. For example, a researcher can follow a group of smokers and a group of nonsmokers to determine the incidence of lung cancer in each. In backward-direction studies, the researcher begins by determining whether the outcome is present (cases vs. noncases [also called controls]) and then traces the presence of prior exposure to a risk factor. These are known as case–control studies. For example, a researcher identifies a group of normal-weight babies and a group of low-birth weight babies and then asks the mothers about their dietary habits during the index pregnancy.

Prospective versus retrospective study designs

The terms “prospective” and “retrospective” refer to the timing of the research in relation to the development of the outcome. In retrospective studies, the outcome of interest has already occurred (or not occurred – e.g., in controls) in each individual by the time s/he is enrolled, and the data are collected either from records or by asking participants to recall exposures. There is no follow-up of participants. By contrast, in prospective studies, the outcome (and sometimes even the exposure or intervention) has not occurred when the study starts and participants are followed up over a period of time to determine the occurrence of outcomes. Typically, most cohort studies are prospective studies (though there may be retrospective cohorts), whereas case–control studies are retrospective studies. An interventional study has to be, by definition, a prospective study since the investigator determines the exposure for each study participant and then follows them to observe outcomes.

The terms “prospective” versus “retrospective” studies can be confusing. Let us think of an investigator who starts a case–control study. To him/her, the process of enrolling cases and controls over a period of several months appears prospective. Hence, the use of these terms is best avoided. Or, at the very least, one must be clear that the terms relate to work flow for each individual study participant, and not to the study as a whole.

Classification of study designs

Figure 1 depicts a simple classification of research study designs. The Centre for Evidence-based Medicine has put forward a useful three-point algorithm which can help determine the design of a research study from its methods section:[ 1 ]

Classification of research study designs

• Does the study describe the characteristics of a sample or does it attempt to analyze (or draw inferences about) the relationship between two variables? – If no, then it is a descriptive study, and if yes, it is an analytical (inferential) study
• If analytical, did the investigator determine the exposure? – If no, it is an observational study, and if yes, it is an experimental study
• If observational, when was the outcome determined? – at the start of the study (case–control study), at the end of a period of follow-up (cohort study), or simultaneously (cross sectional).

In the next few pieces in the series, we will discuss various study designs in greater detail.

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Conflicts of interest.

There are no conflicts of interest.

• Open access
• Published: 09 May 2024

Evaluation of integrated community case management of the common childhood illness program in Gondar city, northwest Ethiopia: a case study evaluation design

• Mekides Geta 1 ,
• Geta Asrade Alemayehu 2 ,
• Wubshet Debebe Negash 2 ,
• Tadele Biresaw Belachew 2 ,
• Chalie Tadie Tsehay 2 &
• Getachew Teshale 2  

BMC Pediatrics volume  24 , Article number:  310 ( 2024 ) Cite this article

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Metrics details

Integrated Community Case Management (ICCM) of common childhood illness is one of the global initiatives to reduce mortality among under-five children by two-thirds. It is also implemented in Ethiopia to improve community access and coverage of health services. However, as per our best knowledge the implementation status of integrated community case management in the study area is not well evaluated. Therefore, this study aimed to evaluate the implementation status of the integrated community case management program in Gondar City, Northwest Ethiopia.

A single case study design with mixed methods was employed to evaluate the process of integrated community case management for common childhood illness in Gondar town from March 17 to April 17, 2022. The availability, compliance, and acceptability dimensions of the program implementation were evaluated using 49 indicators. In this evaluation, 484 mothers or caregivers participated in exit interviews; 230 records were reviewed, 21 key informants were interviewed; and 42 observations were included. To identify the predictor variables associated with acceptability, we used a multivariable logistic regression analysis. Statistically significant variables were identified based on the adjusted odds ratio (AOR) with a 95% confidence interval (CI) and p-value. The qualitative data was recorded, transcribed, and translated into English, and thematic analysis was carried out.

The overall implementation of integrated community case management was 81.5%, of which availability (84.2%), compliance (83.1%), and acceptability (75.3%) contributed. Some drugs and medical equipment, like Cotrimoxazole, vitamin K, a timer, and a resuscitation bag, were stocked out. Health care providers complained that lack of refreshment training and continuous supportive supervision was the common challenges that led to a skill gap for effective program delivery. Educational status (primary AOR = 0.27, 95% CI:0.11–0.52), secondary AOR = 0.16, 95% CI:0.07–0.39), and college and above AOR = 0.08, 95% CI:0.07–0.39), prescribed drug availability (AOR = 2.17, 95% CI:1.14–4.10), travel time to the to the ICCM site (AOR = 3.8, 95% CI:1.99–7.35), and waiting time (AOR = 2.80, 95% CI:1.16–6.79) were factors associated with the acceptability of the program by caregivers.

Conclusion and recommendation

The overall implementation status of the integrated community case management program was judged as good. However, there were gaps observed in the assessment, classification, and treatment of diseases. Educational status, availability of the prescribed drugs, waiting time and travel time to integrated community case management sites were factors associated with the program acceptability. Continuous supportive supervision for health facilities, refreshment training for HEW’s to maximize compliance, construction clean water sources for HPs, and conducting longitudinal studies for the future are the forwarded recommendation.

Peer Review reports

Integrated Community Case Management (ICCM) is a critical public health strategy for expanding the coverage of quality child care services [ 1 , 2 ]. It mainly concentrated on curative care and also on the diagnosis, treatment, and referral of children who are ill with infectious diseases [ 3 , 4 ].

Based on the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) recommendations, Ethiopia adopted and implemented a national policy supporting community-based treatment of common childhood illnesses like pneumonia, Diarrhea, uncomplicated malnutrition, malaria and other febrile illness and Amhara region was one the piloted regions in late 2010 [ 5 ]. The Ethiopian primary healthcare units, established at district levels include primary hospitals, health centers (HCs), and health posts (HPs). The HPs are run by Health Extension Workers (HEWs), and they have function of monitoring health programs and disease occurrence, providing health education, essential primary care services, and timely referrals to HCs [ 6 , 7 ]. The Health Extension Program (HEP) uses task shifting and community ownership to provide essential health services at the first level using the health development army and a network of woman volunteers. These groups are organized to promote health and prevent diseases through community participation and empowerment by identifying the salient local bottlenecks which hinder vital maternal, neonatal, and child health service utilization [ 8 , 9 ].

One of the key steps to enhance the clinical case of health extension staff is to encourage better growth and development among under-five children by health extension. Healthy family and neighborhood practices are also encouraged [ 10 , 11 ]. The program also combines immunization, community-based feeding, vitamin A and de-worming with multiple preventive measures [ 12 , 13 ]. Now a days rapidly scaling up of ICCM approach to efficiently manage the most common causes of morbidity and mortality of children under the age of five in an integrated manner at the community level is required [ 14 , 15 ].

Over 5.3 million children are died at a global level in 2018 and most causes (75%) are preventable or treatable diseases such as pneumonia, malaria and diarrhea [ 16 ]. About 99% of the global burden of mortality and morbidity of under-five children which exists in developing countries are due to common childhood diseases such as pneumonia, diarrhea, malaria and malnutrition [ 17 ].

In 2013, the mortality rate of under-five children in Sub-Saharan Africa decreased to 86 deaths per 1000 live birth and estimated to be 25 per 1000live births by 2030. However, it is a huge figure and the trends are not sufficient to reach the target [ 18 ]. About half of global under-five deaths occurred in sub-Saharan Africa. And from the top 26 nations burdened with 80% of the world’s under-five deaths, 19 are in sub-Saharan Africa [ 19 ].

To alleviate the burden, the Ethiopian government tries to deliver basic child care services at the community level by trained health extension workers. The program improves the health of the children not only in Ethiopia but also in some African nations. Despite its proven benefits, the program implementation had several challenges, in particular, non-adherence to the national guidelines among health care workers [ 20 ]. Addressing those challenges could further improve the program performance. Present treatment levels in sub-Saharan Africa are unacceptably poor; only 39% of children receive proper diarrhea treatment, 13% of children with suspected pneumonia receive antibiotics, 13% of children with fever receive a finger/heel stick to screen for malaria [ 21 ].

To improve the program performance, program gaps should be identified through scientific evaluations and stakeholder involvement. This evaluation not only identify gaps but also forward recommendations for the observed gaps. Furthermore, the implementation status of ICCM of common childhood illnesses has not been evaluated in the study area yet. Therefore, this work aimed to evaluate the implementation status of integrated community case management program implementation in Gondar town, northwest Ethiopia. The findings may be used by policy makers, healthcare providers, funders and researchers.

Method and material

Evaluation design and settings.

A single-case study design with concurrent mixed-methods evaluation was conducted in Gondar city, northwest Ethiopia, from March 17 to April 17, 2022. The evaluability assessment was done from December 15–30, 2021. Both qualitative and quantitative data were collected concurrently, analyzed separately, and integrated at the result interpretation phase.

The evaluation area, Gondar City, is located in northwest Ethiopia, 740 km from Addis Ababa, the capital city of the country. It has six sub-cities and thirty-six kebeles (25 urban and 11 rural). In 2019, the estimated total population of the town was 338,646, and 58,519 (17.3%) were under-five children. In the town there are eight public health centers and 14 health posts serving the population. All health posts provide ICCM service for more than 70,852 populations.

Evaluation approach and dimensions

Program stakeholders.

The evaluation followed a formative participatory approach by engaging the potential stakeholders in the program. Prior to the development of the proposal, an extensive discussion was held with the Gondar City Health Department to identify other key stakeholders in the program. Service providers at each health facility (HCs and HPs), caretakers of sick children, the Gondar City Health Office (GCHO), the Amhara Regional Health Bureau (ARHB), the Minister of Health (MoH), and NGOs (IFHP and Save the Children) were considered key stakeholders. During the Evaluability Assessment (EA), the stakeholders were involved in the development of evaluation questions, objectives, indicators, and judgment criteria of the evaluation.

Evaluation dimensions

The availability and acceptability dimensions from the access framework [ 22 ] and compliance dimension from the fidelity framework [ 23 ] were used to evaluate the implementation of ICCM.

Population and samplings

All under-five children and their caregivers attended at the HPs; program implementers (health extension workers, healthcare providers, healthcare managers, PHCU focal persons, MCH coordinators, and other stakeholders); and ICCM records and registries in the health posts of Gondar city administration were included in the evaluation. For quantitative data, the required sample size was proportionally allocated for each health post based on the number of cases served in the recent one month. But the qualitative sample size was determined by data saturation, and the samples were selected purposefully.

The data sources and sample size for the compliance dimension were all administrative records/reports and ICCM registration books (230 documents) in all health posts registered from December 1, 2021, to February 30, 2022 (three months retrospectively) included in the evaluation. The registries were assessed starting from the most recent registration number until the required sample size was obtained for each health post.

The sample size to measure the mothers’/caregivers’ acceptability towards ICCM was calculated by taking prevalence of caregivers’ satisfaction on ICCM program p  = 74% from previously similar study [ 24 ] and considering standard error 4% at 95% CI and 10% non- responses, which gave 508. Except those who were seriously ill, all caregivers attending the ICCM sites during data collection were selected and interviewed consecutively.

The availability of required supplies, materials and human resources for the program were assessed in all 14HPs. The data collectors observed the health posts and collected required data by using a resources inventory checklist.

A total of 70 non-participatory patient-provider interactions were also observed. The observations were conducted per each health post and for health posts which have more than one health extension workers one of them were selected randomly. The observation findings were used to triangulate the findings obtained through other data collection techniques. Since people may act accordingly to the standards when they know they are observed for their activities, we discarded the first two observations from analysis. It is one of the strategies to minimize the Hawthorne effect of the study. Finally a total of 42 (3 in each HPs) observations were included in the analysis.

Twenty one key informants (14 HEWs, 3 PHCU focal person, 3 health center heads and one MCH coordinator) were interviewed. These key informants were selected since they are assumed to be best teachers in the program. Besides originally developed key informant interview questions, the data collectors probed them to get more detail and clear information.

Variables and measurement

The availability of resources, including trained healthcare workers, was examined using 17 indicators, with weighted score of 35%. Compliance was used to assess HEWs’ adherence to the ICCM treatment guidelines by observing patient-provider interactions and conducting document reviews. We used 18 indicators and a weighted value of 40%.

Mothers’ /caregivers’/ acceptance of ICCM service was examined using 14 indicators and had a weighted score of 25%. The indicators were developed with a five-point Likert scale (1: strongly disagree, 2: disagree, 3: neutral, 4: agree and 5: strongly agree). The cut off point for this categorization was calculated using the demarcation threshold formula: ( \(\frac{\text{t}\text{o}\text{t}\text{a}\text{l}\, \text{h}\text{i}\text{g}\text{h}\text{e}\text{s}\text{t}\, \text{s}\text{c}\text{o}\text{r}\text{e}-\,\text{t}\text{o}\text{t}\text{a}\text{l}\, \text{l}\text{o}\text{w}\text{e}\text{s}\text{t} \,\text{s}\text{c}\text{o}\text{r}\text{e}}{2}) +total lowest score\) ( 25 – 27 ). Those mothers/caregivers/ who scored above cut point (42) were considered as “satisfied”, otherwise “dissatisfied”. The indicators were adapted from the national ICCM and IMNCI implementation guideline and other related evaluations with the participation of stakeholders. Indicator weight was given by the stakeholders during EA. Indicators score was calculated using the formula \(\left(achieved \,in \%=\frac{indicator \,score \,x \,100}{indicator\, weight} \right)\) [ 26 , 28 ].

The independent variables for the acceptability dimension were socio-demographic and economic variables (age, educational status, marital status, occupation of caregiver, family size, income level, and mode of transport), availability of prescribed drugs, waiting time, travel time to ICCM site, home to home visit, consultation time, appointment, and source of information.

The overall implementation of ICCM was measured by using 49 indicators over the three dimensions: availability (17 indicators), compliance (18 indicators) and acceptability (14 indicators).

Program logic model

Based on the constructed program logic model and trained health care providers, mothers/caregivers received health information and counseling on child feeding; children were assessed, classified, and treated for disease, received follow-up; they were checked for vitamin A; and deworming and immunization status were the expected outputs of the program activities. Improved knowledge of HEWs on ICCM, increased health-seeking behavior, improved quality of health services, increased utilization of services, improved data quality and information use, and improved child health conditions are considered outcomes of the program. Reduction of under-five morbidity and mortality and improving quality of life in the society are the distant outcomes or impacts of the program (Fig.  1 ).

Integrated community case management of childhood illness program logic model in Gondar City in 2022

Data collection tools and procedure

Resource inventory and data extraction checklists were adapted from standard ICCM tool and check lists [ 29 ]. A structured interviewer administered questionnaire was adapted by referring different literatures [ 30 , 31 ] to measure the acceptability of ICCM. The key informant interview (KII) guide was also developed to explore the views of KIs. The interview questionnaire and guide were initially developed in English and translated into the local language (Amharic) and finally back to English to ensure consistency. All the interviews were done in the local language, Amharic.

Five trained clinical nurses and one BSC nurse were recruited from Gondar zuria and Wegera district as data collectors and supervisors, respectively. Two days training on the overall purpose of the evaluation and basic data collection procedures were provided prior to data collection. Then, both quantitative and qualitative data were gathered at the same time. The quantitative data were gathered from program documentation, charts of ICCM program visitors and, exit interview. Interviews with 21 KIIs and non-participatory observations of patient-provider interactions were used to acquire qualitative data. Key informant interviews were conducted to investigate the gaps and best practices in the implementation of the ICCM program.

A pretest was conducted to 26 mothers/caregivers/ at Maksegnit health post and appropriate modifications were made based on the pretest results. The data collectors were supervised and principal evaluator examined the completeness and consistency of the data on a daily basis.

Data management and analysis

For analysis, quantitative data were entered into epi-data version 4.6 and exported to Stata 14 software for analysis. Narration and tabular statistics were used to present descriptive statistics. Based on established judgment criteria, the total program implementation was examined and interpreted as a mix of the availability, compliance, and acceptability dimensions. To investigate the factors associated with ICCM acceptance, a binary logistic regression analysis was performed. During bivariable analysis, variables with p-values less than 0.25 were included in multivariable analysis. Finally, variables having a p-value less than 0.05 and an adjusted odds ratio (AOR) with a 95% confidence interval (CI) were judged statistically significant. Qualitative data were collected recorded, transcribed into Amharic, then translated into English and finally coded and thematically analyzed.

Judgment matrix analysis

The weighted values of availability, compliance, and acceptability dimensions were 35, 40, and 25 based on the stakeholder and investigator agreement on each indicator, respectively. The judgment parameters for each dimension and the overall implementation of the program were categorized as poor (< 60%), fair (60–74.9%), good (75-84.9%), and very good (85–100%).

Availability of resources

A total of 26 HEWs were assigned within the fourteen health posts, and 72.7% of them were trained on ICCM to manage common childhood illnesses in under-five children. However, the training was given before four years, and they didn’t get even refreshment training about ICCM. The KII responses also supported that the shortage of HEWs at the HPs was the problem in implementing the program properly.

I am the only HEW in this health post and I have not been trained on ICCM program. So, this may compromise the quality of service and client satisfaction.(25 years old HEW with two years’ experience)

All observed health posts had ICCM registration books, monthly report and referral formats, functional thermometer, weighting scale and MUAC tape meter. However, timer and resuscitation bag was not available in all HPs. Most of the key informant finding showed that, in all HPs there was no shortage of guideline, registration book and recording tool; however, there was no OTP card in some health posts.

“Guideline, ICCM registration book for 2–59 months of age, and other different recording and reporting formats and booklet charts are available since September/2016. However, OTP card is not available in most HPs.”. (A 30 years male health center director)

Only one-fifth (21%) of HPs had a clean water source for drinking and washing of equipment. Most of Key-informant interview findings showed that the availability of infrastructures like water was not available in most HPs. Poor linkage between HPs, HCs, town health department, and local Kebele administer were the reason for unavailability.

Since there is no water for hand washing, or drinking, we obligated to bring water from our home for daily consumptions. This increases the burden for us in our daily activity. (35 years old HEW)

Most medicines, such as anti-malaria drugs with RDT, Quartem, Albendazole, Amoxicillin, vitamin A capsules, ORS, and gloves, were available in all the health posts. Drugs like zinc, paracetamol, TTC eye ointment, and folic acid were available in some HPs. However, cotrimoxazole and vitamin K capsules were stocked-out in all health posts for the last six months. The key informant also revealed that: “Vitamin K was not available starting from the beginning of this program and Cotrimoxazole was not available for the past one year and they told us they would avail it soon but still not availed. Some essential ICCM drugs like anti malaria drugs, De-worming, Amoxicillin, vitamin A capsules, ORS and medical supplies were also not available in HCs regularly.”(28 years’ Female PHCU focal)

The overall availability of resources for ICCM implementation was 84.2% which was good based on our presetting judgment parameter (Table  1 ).

Health extension worker’s compliance

From the 42 patient-provider interactions, we found that 85.7%, 71.4%, 76.2%, and 95.2% of the children were checked for body temperature, weight, general danger signs, and immunization status respectively. Out of total (42) observation, 33(78.6%) of sick children were classified for their nutritional status. During observation time 29 (69.1%) of caregivers were counseled by HEWs on food, fluid and when to return back and 35 (83.3%) of children were appointed for next follow-up visit. Key informant interviews also affirmed that;

“Most of our health extension workers were trained on ICCM program guidelines but still there are problems on assessment classification and treatment of disease based on guidelines and standards this is mainly due to lack refreshment training on the program and lack of continuous supportive supervision from the respective body.” (27years’ Male health center head)

From 10 clients classified as having severe pneumonia cases, all of them were referred to a health center (with pre-referral treatment), and from those 57 pneumonia cases, 50 (87.7%) were treated at the HP with amoxicillin or cotrimoxazole. All children with severe diarrhea, very severe disease, and severe complicated malnutrition cases were referred to health centers with a pre-referral treatment for severe dehydration, very severe febrile disease, and severe complicated malnutrition, respectively. From those with some dehydration and no dehydration cases, (82.4%) and (86.8%) were treated at the HPs for some dehydration (ORS; plan B) and for no dehydration (ORS; plan A), respectively. Moreover, zinc sulfate was prescribed for 63 (90%) of under-five children with some dehydration or no dehydration. From 26 malaria cases and 32 severe uncomplicated malnutrition and moderate acute malnutrition cases, 20 (76.9%) and 25 (78.1%) were treated at the HPs, respectively. Of the total reviewed documents, 56 (93.3%), 66 (94.3%), 38 (84.4%), and 25 (78.1%) of them were given a follow-up date for pneumonia, diarrhea, malaria, and malnutrition, respectively.

Supportive supervision and performance review meetings were conducted only in 10 (71.4%) HPs, but all (100%) HPs sent timely reports to the next supervisory body.

Most of the key informants’ interview findings showed that supportive supervision was not conducted regularly and for all HPs.

I had mentored and supervised by supportive supervision teams who came to our health post at different times from health center, town health office and zonal health department. I received this integrated supervision from town health office irregularly, but every month from catchment health center and last integrated supportive supervision from HC was on January. The problem is the supervision was conducted for all programs.(32 years’ old and nine years experienced female HEW)

Moreover, the result showed that there was poor compliance of HEWs for the program mainly due to weak supportive supervision system of managerial and technical health workers. It was also supported by key informants as:

We conducted supportive supervision and performance review meeting at different time, but still there was not regular and not addressed all HPs. In addition to this the supervision and review meeting was conducted as integration of ICCM program with other services. The other problem is that most of the time we didn’t used checklist during supportive supervision. (Mid 30 years old male HC director)

Based on our observation and ICCM document review, 83.1% of the HEWs were complied with the ICCM guidelines and judged as fair (Table  2 ).

Acceptability of ICCM program

Sociodemographic and obstetric characteristics of participants.

A total of 484 study participants responded to the interviewer-administered questionnaire with a response rate of 95.3%. The mean age of study participants was 30.7 (SD ± 5.5) years. Of the total caregivers, the majority (38.6%) were categorized under the age group of 26–30 years. Among the total respondents, 89.3% were married, and regarding religion, the majorities (84.5%) were Orthodox Christian followers. Regarding educational status, over half of caregivers (52.1%) were illiterate (unable to read or write). Nearly two-thirds of the caregivers (62.6%) were housewives (Table  3 ).

All the caregivers came to the health post on foot, and most of them 418 (86.4%) arrived within one hour. The majority of 452 (93.4%) caregivers responded that the waiting time to get the service was less than 30 min. Caregivers who got the prescribed drugs at the health post were 409 (84.5%). Most of the respondents, 429 (88.6%) and 438 (90.5%), received counseling services on providing extra fluid and feeding for their sick child and were given a follow-up date.

Most 298 (61.6%) of the caregivers were satisfied with the convenience of the working hours of HPs, and more than three-fourths (80.8%) were satisfied with the counseling services they received. Most of the respondents, 366 (75.6%), were satisfied with the appropriateness of waiting time and 431 (89%) with the appropriateness of consultation time. The majority (448 (92.6%) of caregivers were satisfied with the way of communicating with HEWs, and 269 (55.6%) were satisfied with the knowledge and competence of HEWs. Nearly half of the caregivers (240, or 49.6%) were satisfied with the availability of drugs at health posts.

The overall acceptability of the ICCM program was 75.3%, which was judged as good. A low proportion of acceptability was measured on the cleanliness of the health posts, the appropriateness of the waiting area, and the competence and knowledge of the HEWs. On the other hand, high proportion of acceptability was measured on appropriateness of waiting time, way of communication with HEWs, and the availability of drugs (Table  4 ).

Factors associated with acceptability of ICCM program

In the final multivariable logistic regression analysis, educational status of caregivers, availability of prescribed drugs, time to arrive, and waiting time were factors significantly associated with the satisfaction of caregivers with the ICCM program.

Accordingly, the odds of caregivers with primary education, secondary education, and college and above were 73% (AOR = 0.27, 95% CI: 0.11–0.52), 84% (AOR = 0.16, 95% CI: 0.07–0.39), and 92% (AOR = 0.08, 95% CI: 0.07–0.40) less likely to accept the program as compared to mothers or caregivers who were not able to read and write, respectively. The odds of caregivers or mothers who received prescribed drugs were 2.17 times more likely to accept the program as compared to their counters (AOR = 2.17, 95% CI: 1.14–4.10). The odds of caregivers or mothers who waited for services for less than 30 min were 2.8 times more likely to accept the program as compared to those who waited for more than 30 min (AOR = 2.80, 95% CI: 1.16–6.79). Moreover, the odds of caregivers/mothers who traveled an hour or less for service were 3.8 times more likely to accept the ICCM program as compared to their counters (AOR = 3.82, 95% CI:1.99–7.35) (Table  5 ).

Overall ICCM program implementation and judgment

The implementation of the ICCM program in Gondar city administration was measured in terms of availability (84.2%), compliance (83.1%), and acceptability (75.3%) dimensions. In the availability dimension, amoxicillin, antimalarial drugs, albendazole, Vit. A, and ORS were available in all health posts, but only six HPs had Ready-to-Use Therapeutic Feedings, three HPs had ORT Corners, and none of the HPs had functional timers. In all health posts, the health extension workers asked the chief to complain, correctly assessed for pneumonia, diarrhea, malaria, and malnutrition, and sent reports based on the national schedule. However, only 70% of caretakers counseled about food, fluids, and when to return, 66% and 76% of the sick children were checked for anemia and other danger signs, respectively. The acceptability level of the program by caretakers and caretakers’/mothers’ educational status, waiting time to get the service and travel time ICCM sites were the factors affecting its acceptability. The overall ICCM program in Gondar city administration was 81.5% and judged as good (Fig.  2 ).

Overall ICCM program implementation and the evaluation dimensions in Gondar city administration, 2022

The implementation status of ICCM was judged by using three dimensions including availability, compliance and acceptability of the program. The judgment cut of points was determined during evaluability assessment (EA) along with the stakeholders. As a result, we found that the overall implementation status of ICCM program was good as per the presetting judgment parameter. Availability of resources for the program implementation, compliance of HEWs to the treatment guideline and acceptability of the program services by users were also judged as good as per the judgment parameter.

This evaluation showed that most medications, equipment and recording and reporting materials available. This finding was comparable with the standard ICCM treatment guide line [ 10 ]. On the other hand trained health care providers, some medications like Zink, Paracetamol and TTC eye ointment, folic acid and syringes were not found in some HPs. However the finding was higher than the study conducted in SNNPR on selected health posts [ 33 ] and a study conducted in Soro district, southern Ethiopia [ 24 ]. The possible reason might be due to low interruption of drugs at town health office or regional health department stores, regular supplies of essential drugs and good supply management and distribution of drug from health centers to health post.

The result of this evaluation showed that only one fourth of health posts had functional ORT Corner which was lower compared to the study conducted in SNNPR [ 34 ]. This might be due poor coverage of functional pipe water in the kebeles and the installation was not set at the beginning of health post construction as reported from one of ICCM program coordinator.

Compliance of HEWs to the treatment guidelines in this evaluation was higher than the study done in southern Ethiopia (65.6%) [ 24 ]. This might be due to availability of essential drugs educational level of HEWs and good utilization of ICCM guideline and chart booklet by HEWs. The observations showed most of the sick children were assessed for danger sign, weight, and temperature respectively. This finding is lower than the study conducted in Rwanda [ 35 ]. This difference might be due to lack of refreshment training and regular supportive supervision for HEWs. This also higher compared to the study done in three regions of Ethiopia indicates that 88%, 92% and 93% of children classified as per standard for Pneumonia, diarrhea and malaria respectively [ 36 ]. The reason for this difference may be due to the presence of medical equipment and supplies including RDT kit for malaria, and good educational level of HEWs.

Moreover most HPs received supportive supervision and performance review meeting was conducted and all of them send reports timely to next level. The finding of this evaluation was lower than the study conducted on implementation evaluation of ICCM program southern Ethiopia [ 24 ] and study done in three regions of Ethiopia (Amhara, Tigray and SNNPR) [ 37 ]. This difference might be due sample size variation.

The overall acceptability of the ICCM program was less than the presetting judgment parameter but slightly higher compared to the study in southern Ethiopia [ 24 ]. This might be due to presence of essential drugs for treating children, reasonable waiting and counseling time provided by HEWs, and smooth communication between HEWs and caregivers. In contrast, this was lower than similar studies conducted in Wakiso district, Uganda [ 38 ]. The reason for this might be due to contextual difference between the two countries, inappropriate waiting area to receive the service and poor cleanness of the HPs in our study area. Low acceptability of caregivers to ICCM service was observed in the appropriateness of waiting area, availability of drugs, cleanness of health post, and competence of HEWs while high level of caregiver’s acceptability was consultation time, counseling service they received, communication with HEWs, treatment given for their sick children and interest to return back for ICCM service.

Caregivers who achieved primary, secondary, and college and above were more likely accept the program services than those who were illiterate. This may more educated mothers know about their child health condition and expect quality service from healthcare providers which is more likely reduce the acceptability of the service. The finding is congruent with a study done on implementation evaluation of ICCM program in southern Ethiopia [ 24 ]. However, inconsistent with a study conducted in wakiso district in Uganda [ 38 ]. The possible reason for this might be due to contextual differences between the two countries. The ICCM program acceptability was high in caregivers who received all prescribed drugs than those did not. Caregivers those waited less than 30 min for service were more accepted ICCM services compared to those more than 30 minutes’ waiting time. This finding is similar compared with the study conducted on implementation evaluation of ICCM program in southern Ethiopia [ 24 ]. In contrary, the result was incongruent with a survey result conducted by Ethiopian public health institute in all regions and two administrative cities of Ethiopia [ 39 ]. This variation might be due to smaller sample size in our study the previous one. Moreover, caregivers who traveled to HPs less than 60 min were more likely accepted the program than who traveled more and the finding was similar with the study finding in Jimma zone [ 40 ].

Strengths and limitations

This evaluation used three evaluation dimensions, mixed method and different data sources that would enhance the reliability and credibility of the findings. However, the study might have limitations like social desirability bias, recall bias and Hawthorne effect.

The implementation of the ICCM program in Gondar city administration was measured in terms of availability (84.2%), compliance (83.1%), and acceptability (75.3%) dimensions. In the availability dimension, amoxicillin, antimalarial drugs, albendazole, Vit. A, and ORS were available in all health posts, but only six HPs had Ready-to-Use Therapeutic Feedings, three HPs had ORT Corners, and none of the HPs had functional timers.

This evaluation assessed the implementation status of the ICCM program, focusing mainly on availability, compliance, and acceptability dimensions. The overall implementation status of the program was judged as good. The availability dimension is compromised due to stock-outs of chloroquine syrup, cotrimoxazole, and vitamin K and the inaccessibility of clean water supply in some health posts. Educational statuses of caregivers, availability of prescribed drugs at the HPs, time to arrive to HPs, and waiting time to receive the service were the factors associated with the acceptability of the ICCM program.

Therefore, continuous supportive supervision for health facilities, and refreshment training for HEW’s to maximize compliance are recommended. Materials and supplies shall be delivered directly to the health centers or health posts to solve the transportation problem. HEWs shall document the assessment findings and the services provided using the registration format to identify their gaps, limitations, and better performances. The health facilities and local administrations should construct clean water sources for health facilities. Furthermore, we recommend for future researchers and program evaluators to conduct longitudinal studies to know the causal relationship of the program interventions and the outcomes.

Data availability

Data will be available upon reasonable request from the corresponding author.

Abbreviations

Ethiopian Demographic and Health Survey

Health Center/Health Facility

Health Extension Program

Health Extension Workers

Health Post

Health Sector Development Plan

Integrated Community Case Management of Common Childhood Illnesses

Information Communication and Education

Integrated Family Health Program

Integrated Management of Neonatal and Childhood Illness

Integrated Supportive Supervision

Maternal and Child Health

Mid Upper Arm Circumference

Non-Government Organization

Oral Rehydration Salts

Outpatient Therapeutic program

Primary health care unit

Rapid Diagnostics Test

Ready to Use Therapeutic Foods

Sever Acute Malnutrition

South Nation Nationalities People Region

United Nations International Child Emergency Fund

World Health Organization

Brenner JL, Barigye C, Maling S, Kabakyenga J, Nettel-Aguirre A, Buchner D, et al. Where there is no doctor: can volunteer community health workers in rural Uganda provide integrated community case management? Afr Health Sci. 2017;17(1):237–46.

Article   PubMed   PubMed Central   Google Scholar  

Mubiru D, Byabasheija R, Bwanika JB, Meier JE, Magumba G, Kaggwa FM, et al. Evaluation of integrated community case management in eight districts of Central Uganda. PLoS ONE. 2015;10(8):e0134767.

Samuel S, Arba A. Utilization of integrated community case management service and associated factors among mothers/caregivers who have sick eligible children in southern Ethiopia. Risk Manage Healthc Policy. 2021;14:431.

Article   Google Scholar  

Kavle JA, Pacqué M, Dalglish S, Mbombeshayi E, Anzolo J, Mirindi J, et al. Strengthening nutrition services within integrated community case management (iCCM) of childhood illnesses in the Democratic Republic of Congo: evidence to guide implementation. Matern Child Nutr. 2019;15:e12725.

Miller NP, Amouzou A, Tafesse M, Hazel E, Legesse H, Degefie T, et al. Integrated community case management of childhood illness in Ethiopia: implementation strength and quality of care. Am J Trop Med Hyg. 2014;91(2):424.

WHO. Annual report 2016: Partnership and policy engagement. World Health Organization, 2017.

Banteyerga H. Ethiopia’s health extension program: improving health through community involvement. MEDICC Rev. 2011;13:46–9.

Article   PubMed   Google Scholar  

Wang H, Tesfaye R, Ramana NV, Chekagn G. CT. Ethiopia health extension program: an institutionalized community approach for universal health coverage. The World Bank; 2016.

Donnelly J. Ethiopia gears up for more major health reforms. Lancet. 2011;377(9781):1907–8.

Legesse H, Degefie T, Hiluf M, Sime K, Tesfaye C, Abebe H, et al. National scale-up of integrated community case management in rural Ethiopia: implementation and early lessons learned. Ethiop Med J. 2014;52(Suppl 3):15–26.

Google Scholar  

Miller NP, Amouzou A, Hazel E, Legesse H, Degefie T, Tafesse M et al. Assessment of the impact of quality improvement interventions on the quality of sick child care provided by Health Extension workers in Ethiopia. J Global Health. 2016;6(2).

Oliver K, Young M, Oliphant N, Diaz T, Kim JJNYU. Review of systematic challenges to the scale-up of integrated community case management. Emerging lessons & recommendations from the catalytic initiative (CI/IHSS); 2012.

FMoH E. Health Sector Transformation Plan 2015: https://www.slideshare.net . Accessed 12 Jan 2022.

McGorman L, Marsh DR, Guenther T, Gilroy K, Barat LM, Hammamy D, et al. A health systems approach to integrated community case management of childhood illness: methods and tools. The American Journal of Tropical Medicine and Hygiene. 2012;87(5 Suppl):69.

Young M, Wolfheim C, Marsh DR, Hammamy D. World Health Organization/United Nations Children’s Fund joint statement on integrated community case management: an equity-focused strategy to improve access to essential treatment services for children. The American journal of tropical medicine and hygiene. 2012;87(5 Suppl):6.

Ezbakhe F, Pérez-Foguet A. Child mortality levels and trends. Demographic Research.2020;43:1263-96.

UNICEF, Ending child deaths from pneumonia and diarrhoea. 2016 report: Available at https://data.unicef.org. accessed 13 Jan 2022.

UNITED NATIONS, The Millinium Development Goals Report 2015: Available at https://www.un.org.Accessed 12 Jan 2022

Bent W, Beyene W, Adamu A. Factors Affecting Implementation of Integrated Community Case Management Of Childhood Illness In South West Shoa Zone, Central Ethiopia 2015.

Abdosh B. The quality of hospital services in eastern Ethiopia: Patient’s perspective.The Ethiopian Journal of Health Development. 2006;20(3).

Young M, Wolfheim C, Marsh DR, Hammamy DJTAjotm, hygiene. World Health Organization/United Nations Children’s Fund joint statement on integrated community case management: an equity-focused strategy to improve access to essential treatment services for children.2012;87(5_Suppl):6–10.

Obrist B, Iteba N, Lengeler C, Makemba A, Mshana C, Nathan R, et al. Access to health care in contexts of livelihood insecurity: a framework for analysis and action.PLoS medicine. 2007;4(10):e308.

Carroll C, Patterson M, Wood S, Booth A, Rick J, Balain S. A conceptual framework for implementation fidelity. Implementation science. 2007;2(1):1–9.

Dunalo S, Tadesse B, Abraham G. Implementation Evaluation of Integrated Community Case Management of Common Childhood Illness (ICCM) Program in Soro Woreda, Hadiya Zone Southern Ethiopia 2017 2017.

Asefa G, Atnafu A, Dellie E, Gebremedhin T, Aschalew AY, Tsehay CT. Health System Responsiveness for HIV/AIDS Treatment and Care Services in Shewarobit, North Shewa Zone, Ethiopia. Patient preference and adherence. 2021;15:581.

Gebremedhin T, Daka DW, Alemayehu YK, Yitbarek K, Debie A. Process evaluation of the community-based newborn care program implementation in Geze Gofa district,south Ethiopia: a case study evaluation design. BMC pregnancy and childbirth. 2019;19(1):1–13.

Pitaloka DS, Rizal A. Patient’s satisfaction in antenatal clinic hospital Universiti Kebangsaan Malaysia. Jurnal Kesihatan Masyarakat (Malaysia). 2006;12(1):1–10.

Teshale G, Debie A, Dellie E, Gebremedhin T. Evaluation of the outpatient therapeutic program for severe acute malnourished children aged 6–59 months implementation in Dehana District, Northern Ethiopia: a mixed-methods evaluation. BMC pediatrics. 2022;22(1):1–13.

Mason E. WHO’s strategy on Integrated Management of Childhood Illness. Bulletin of the World Health Organization. 2006;84(8):595.

Shaw B, Amouzou A, Miller NP, Tafesse M, Bryce J, Surkan PJ. Access to integrated community case management of childhood illnesses services in rural Ethiopia: a qualitative study of the perspectives and experiences of caregivers. Health policy and planning.2016;31(5):656 – 66.

Organization WH. Annual report 2016: Partnership and policy engagement. World Health Organization, 2017.

Berhanu D, Avan B. Community Based Newborn Care Baseline Survey Report Ethiopia,October 2014.

Save the children, Enhancing Ethiopia’s Health Extension Package in the Southern Nations and Nationalities People’s Region (SNNPR) Shebedino and Lanfero Woredas report.Hawassa;. 2012: Avalable at https://ethiopia.savethechildren.net

Kolbe AR, Muggah R, Hutson RA, James L, Puccio M, Trzcinski E, et al. Assessing Needs After the Quake: Preliminary Findings from a Randomized Survey of Port-au-Prince Households. University of Michigan/Small Arms Survey: Available at https://deepbluelibumichedu PDF. 2010.

Teferi E, Teno D, Ali I, Alemu H, Bulto T. Quality and use of IMNCI services at health center under-five clinics after introduction of integrated community-based case management (ICCM) in three regions of Ethiopia. Ethiopian Medical Journal. 2014;52(Suppl 3):91 – 8.

Last 10 Km project, Integrated Community Case Management (iCCM) Survey report in Amhara, SNNP, and Tigray Regions, 2017: Avaialable at https://l10k.jsi.com

Tumuhamye N, Rutebemberwa E, Kwesiga D, Bagonza J, Mukose A. Client satisfaction with integrated community case management program in Wakiso District, Uganda, October 2012: A cross sectional survey. Health scrip org. 2013;2013.

EPHI. Ethiopia service provision assessment plus survey 2014 report: available at http://repository.iifphc.org

Gintamo B. EY, Assefa Y. Implementation Evaluation of IMNCI Program at Public Health Centers of Soro District, Hadiya Zone, Southern Ethiopia,. 2017: Available at https://repository.ju.edu.et

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Acknowledgements

We are very grateful to University of Gondar and Gondar town health office for its welcoming approaches. We would also like to thank all of the study participants of this evaluation for their information and commitment. Our appreciation also goes to the data collectors and supervisors for their unreserved contribution.

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Geta Asrade Alemayehu, Wubshet Debebe Negash, Tadele Biresaw Belachew, Chalie Tadie Tsehay & Getachew Teshale

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All authors contributed to the preparation of the manuscript. M.G. conceived and designed the evaluation and performed the analysis then T.B.B., W.D.N., G.A.A., C.T.T. and G.T. revised the analysis. G.T. prepared the manuscript and all the authors revised and approved the final manuscript.

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Geta, M., Alemayehu, G.A., Negash, W.D. et al. Evaluation of integrated community case management of the common childhood illness program in Gondar city, northwest Ethiopia: a case study evaluation design. BMC Pediatr 24 , 310 (2024). https://doi.org/10.1186/s12887-024-04785-0

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Developing a survey to measure nursing students’ knowledge, attitudes and beliefs, influences, and willingness to be involved in Medical Assistance in Dying (MAiD): a mixed method modified e-Delphi study

• Jocelyn Schroeder 1 ,
• Barbara Pesut 1 , 2 ,
• Lise Olsen 2 ,
• Nelly D. Oelke 2 &
• Helen Sharp 2  

BMC Nursing volume  23 , Article number:  326 ( 2024 ) Cite this article

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Metrics details

Medical Assistance in Dying (MAiD) was legalized in Canada in 2016. Canada’s legislation is the first to permit Nurse Practitioners (NP) to serve as independent MAiD assessors and providers. Registered Nurses’ (RN) also have important roles in MAiD that include MAiD care coordination; client and family teaching and support, MAiD procedural quality; healthcare provider and public education; and bereavement care for family. Nurses have a right under the law to conscientious objection to participating in MAiD. Therefore, it is essential to prepare nurses in their entry-level education for the practice implications and moral complexities inherent in this practice. Knowing what nursing students think about MAiD is a critical first step. Therefore, the purpose of this study was to develop a survey to measure nursing students’ knowledge, attitudes and beliefs, influences, and willingness to be involved in MAiD in the Canadian context.

The design was a mixed-method, modified e-Delphi method that entailed item generation from the literature, item refinement through a 2 round survey of an expert faculty panel, and item validation through a cognitive focus group interview with nursing students. The settings were a University located in an urban area and a College located in a rural area in Western Canada.

During phase 1, a 56-item survey was developed from existing literature that included demographic items and items designed to measure experience with death and dying (including MAiD), education and preparation, attitudes and beliefs, influences on those beliefs, and anticipated future involvement. During phase 2, an expert faculty panel reviewed, modified, and prioritized the items yielding 51 items. During phase 3, a sample of nursing students further evaluated and modified the language in the survey to aid readability and comprehension. The final survey consists of 45 items including 4 case studies.

Systematic evaluation of knowledge-to-date coupled with stakeholder perspectives supports robust survey design. This study yielded a survey to assess nursing students’ attitudes toward MAiD in a Canadian context.

The survey is appropriate for use in education and research to measure knowledge and attitudes about MAiD among nurse trainees and can be a helpful step in preparing nursing students for entry-level practice.

Peer Review reports

Medical Assistance in Dying (MAiD) is permitted under an amendment to Canada’s Criminal Code which was passed in 2016 [ 1 ]. MAiD is defined in the legislation as both self-administered and clinician-administered medication for the purpose of causing death. In the 2016 Bill C-14 legislation one of the eligibility criteria was that an applicant for MAiD must have a reasonably foreseeable natural death although this term was not defined. It was left to the clinical judgement of MAiD assessors and providers to determine the time frame that constitutes reasonably foreseeable [ 2 ]. However, in 2021 under Bill C-7, the eligibility criteria for MAiD were changed to allow individuals with irreversible medical conditions, declining health, and suffering, but whose natural death was not reasonably foreseeable, to receive MAiD [ 3 ]. This population of MAiD applicants are referred to as Track 2 MAiD (those whose natural death is foreseeable are referred to as Track 1). Track 2 applicants are subject to additional safeguards under the 2021 C-7 legislation.

Three additional proposed changes to the legislation have been extensively studied by Canadian Expert Panels (Council of Canadian Academics [CCA]) [ 4 , 5 , 6 ] First, under the legislation that defines Track 2, individuals with mental disease as their sole underlying medical condition may apply for MAiD, but implementation of this practice is embargoed until March 2027 [ 4 ]. Second, there is consideration of allowing MAiD to be implemented through advanced consent. This would make it possible for persons living with dementia to receive MAID after they have lost the capacity to consent to the procedure [ 5 ]. Third, there is consideration of extending MAiD to mature minors. A mature minor is defined as “a person under the age of majority…and who has the capacity to understand and appreciate the nature and consequences of a decision” ([ 6 ] p. 5). In summary, since the legalization of MAiD in 2016 the eligibility criteria and safeguards have evolved significantly with consequent implications for nurses and nursing care. Further, the number of Canadians who access MAiD shows steady increases since 2016 [ 7 ] and it is expected that these increases will continue in the foreseeable future.

Nurses have been integral to MAiD care in the Canadian context. While other countries such as Belgium and the Netherlands also permit euthanasia, Canada is the first country to allow Nurse Practitioners (Registered Nurses with additional preparation typically achieved at the graduate level) to act independently as assessors and providers of MAiD [ 1 ]. Although the role of Registered Nurses (RNs) in MAiD is not defined in federal legislation, it has been addressed at the provincial/territorial-level with variability in scope of practice by region [ 8 , 9 ]. For example, there are differences with respect to the obligation of the nurse to provide information to patients about MAiD, and to the degree that nurses are expected to ensure that patient eligibility criteria and safeguards are met prior to their participation [ 10 ]. Studies conducted in the Canadian context indicate that RNs perform essential roles in MAiD care coordination; client and family teaching and support; MAiD procedural quality; healthcare provider and public education; and bereavement care for family [ 9 , 11 ]. Nurse practitioners and RNs are integral to a robust MAiD care system in Canada and hence need to be well-prepared for their role [ 12 ].

Previous studies have found that end of life care, and MAiD specifically, raise complex moral and ethical issues for nurses [ 13 , 14 , 15 , 16 ]. The knowledge, attitudes, and beliefs of nurses are important across practice settings because nurses have consistent, ongoing, and direct contact with patients who experience chronic or life-limiting health conditions. Canadian studies exploring nurses’ moral and ethical decision-making in relation to MAiD reveal that although some nurses are clear in their support for, or opposition to, MAiD, others are unclear on what they believe to be good and right [ 14 ]. Empirical findings suggest that nurses go through a period of moral sense-making that is often informed by their family, peers, and initial experiences with MAID [ 17 , 18 ]. Canadian legislation and policy specifies that nurses are not required to participate in MAiD and may recuse themselves as conscientious objectors with appropriate steps to ensure ongoing and safe care of patients [ 1 , 19 ]. However, with so many nurses having to reflect on and make sense of their moral position, it is essential that they are given adequate time and preparation to make an informed and thoughtful decision before they participate in a MAID death [ 20 , 21 ].

It is well established that nursing students receive inconsistent exposure to end of life care issues [ 22 ] and little or no training related to MAiD [ 23 ]. Without such education and reflection time in pre-entry nursing preparation, nurses are at significant risk for moral harm. An important first step in providing this preparation is to be able to assess the knowledge, values, and beliefs of nursing students regarding MAID and end of life care. As demand for MAiD increases along with the complexities of MAiD, it is critical to understand the knowledge, attitudes, and likelihood of engagement with MAiD among nursing students as a baseline upon which to build curriculum and as a means to track these variables over time.

Aim, design, and setting

The aim of this study was to develop a survey to measure nursing students’ knowledge, attitudes and beliefs, influences, and willingness to be involved in MAiD in the Canadian context. We sought to explore both their willingness to be involved in the registered nursing role and in the nurse practitioner role should they chose to prepare themselves to that level of education. The design was a mixed-method, modified e-Delphi method that entailed item generation, item refinement through an expert faculty panel [ 24 , 25 , 26 ], and initial item validation through a cognitive focus group interview with nursing students [ 27 ]. The settings were a University located in an urban area and a College located in a rural area in Western Canada.

Participants

A panel of 10 faculty from the two nursing education programs were recruited for Phase 2 of the e-Delphi. To be included, faculty were required to have a minimum of three years of experience in nurse education, be employed as nursing faculty, and self-identify as having experience with MAiD. A convenience sample of 5 fourth-year nursing students were recruited to participate in Phase 3. Students had to be in good standing in the nursing program and be willing to share their experiences of the survey in an online group interview format.

The modified e-Delphi was conducted in 3 phases: Phase 1 entailed item generation through literature and existing survey review. Phase 2 entailed item refinement through a faculty expert panel review with focus on content validity, prioritization, and revision of item wording [ 25 ]. Phase 3 entailed an assessment of face validity through focus group-based cognitive interview with nursing students.

Phase I. Item generation through literature review

The goal of phase 1 was to develop a bank of survey items that would represent the variables of interest and which could be provided to expert faculty in Phase 2. Initial survey items were generated through a literature review of similar surveys designed to assess knowledge and attitudes toward MAiD/euthanasia in healthcare providers; Canadian empirical studies on nurses’ roles and/or experiences with MAiD; and legislative and expert panel documents that outlined proposed changes to the legislative eligibility criteria and safeguards. The literature review was conducted in three online databases: CINAHL, PsycINFO, and Medline. Key words for the search included nurses , nursing students , medical students , NPs, MAiD , euthanasia , assisted death , and end-of-life care . Only articles written in English were reviewed. The legalization and legislation of MAiD is new in many countries; therefore, studies that were greater than twenty years old were excluded, no further exclusion criteria set for country.

Items from surveys designed to measure similar variables in other health care providers and geographic contexts were placed in a table and similar items were collated and revised into a single item. Then key variables were identified from the empirical literature on nurses and MAiD in Canada and checked against the items derived from the surveys to ensure that each of the key variables were represented. For example, conscientious objection has figured prominently in the Canadian literature, but there were few items that assessed knowledge of conscientious objection in other surveys and so items were added [ 15 , 21 , 28 , 29 ]. Finally, four case studies were added to the survey to address the anticipated changes to the Canadian legislation. The case studies were based upon the inclusion of mature minors, advanced consent, and mental disorder as the sole underlying medical condition. The intention was to assess nurses’ beliefs and comfort with these potential legislative changes.

Phase 2. Item refinement through expert panel review

The goal of phase 2 was to refine and prioritize the proposed survey items identified in phase 1 using a modified e-Delphi approach to achieve consensus among an expert panel [ 26 ]. Items from phase 1 were presented to an expert faculty panel using a Qualtrics (Provo, UT) online survey. Panel members were asked to review each item to determine if it should be: included, excluded or adapted for the survey. When adapted was selected faculty experts were asked to provide rationale and suggestions for adaptation through the use of an open text box. Items that reached a level of 75% consensus for either inclusion or adaptation were retained [ 25 , 26 ]. New items were categorized and added, and a revised survey was presented to the panel of experts in round 2. Panel members were again asked to review items, including new items, to determine if it should be: included, excluded, or adapted for the survey. Round 2 of the modified e-Delphi approach also included an item prioritization activity, where participants were then asked to rate the importance of each item, based on a 5-point Likert scale (low to high importance), which De Vaus [ 30 ] states is helpful for increasing the reliability of responses. Items that reached a 75% consensus on inclusion were then considered in relation to the importance it was given by the expert panel. Quantitative data were managed using SPSS (IBM Corp).

Phase 3. Face validity through cognitive interviews with nursing students

The goal of phase 3 was to obtain initial face validity of the proposed survey using a sample of nursing student informants. More specifically, student participants were asked to discuss how items were interpreted, to identify confusing wording or other problematic construction of items, and to provide feedback about the survey as a whole including readability and organization [ 31 , 32 , 33 ]. The focus group was held online and audio recorded. A semi-structured interview guide was developed for this study that focused on clarity, meaning, order and wording of questions; emotions evoked by the questions; and overall survey cohesion and length was used to obtain data (see Supplementary Material 2  for the interview guide). A prompt to “think aloud” was used to limit interviewer-imposed bias and encourage participants to describe their thoughts and response to a given item as they reviewed survey items [ 27 ]. Where needed, verbal probes such as “could you expand on that” were used to encourage participants to expand on their responses [ 27 ]. Student participants’ feedback was collated verbatim and presented to the research team where potential survey modifications were negotiated and finalized among team members. Conventional content analysis [ 34 ] of focus group data was conducted to identify key themes that emerged through discussion with students. Themes were derived from the data by grouping common responses and then using those common responses to modify survey items.

Ten nursing faculty participated in the expert panel. Eight of the 10 faculty self-identified as female. No faculty panel members reported conscientious objector status and ninety percent reported general agreement with MAiD with one respondent who indicated their view as “unsure.” Six of the 10 faculty experts had 16 years of experience or more working as a nurse educator.

Five nursing students participated in the cognitive interview focus group. The duration of the focus group was 2.5 h. All participants identified that they were born in Canada, self-identified as female (one preferred not to say) and reported having received some instruction about MAiD as part of their nursing curriculum. See Tables  1 and 2 for the demographic descriptors of the study sample. Study results will be reported in accordance with the study phases. See Fig.  1 for an overview of the results from each phase.

Fig. 1  Overview of survey development findings

Phase 1: survey item generation

Review of the literature identified that no existing survey was available for use with nursing students in the Canadian context. However, an analysis of themes across qualitative and quantitative studies of physicians, medical students, nurses, and nursing students provided sufficient data to develop a preliminary set of items suitable for adaptation to a population of nursing students.

Four major themes and factors that influence knowledge, attitudes, and beliefs about MAiD were evident from the literature: (i) endogenous or individual factors such as age, gender, personally held values, religion, religiosity, and/or spirituality [ 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ], (ii) experience with death and dying in personal and/or professional life [ 35 , 40 , 41 , 43 , 44 , 45 ], (iii) training including curricular instruction about clinical role, scope of practice, or the law [ 23 , 36 , 39 ], and (iv) exogenous or social factors such as the influence of key leaders, colleagues, friends and/or family, professional and licensure organizations, support within professional settings, and/or engagement in MAiD in an interdisciplinary team context [ 9 , 35 , 46 ].

Studies of nursing students also suggest overlap across these categories. For example, value for patient autonomy [ 23 ] and the moral complexity of decision-making [ 37 ] are important factors that contribute to attitudes about MAiD and may stem from a blend of personally held values coupled with curricular content, professional training and norms, and clinical exposure. For example, students report that participation in end of life care allows for personal growth, shifts in perception, and opportunities to build therapeutic relationships with their clients [ 44 , 47 , 48 ].

Preliminary items generated from the literature resulted in 56 questions from 11 published sources (See Table  3 ). These items were constructed across four main categories: (i) socio-demographic questions; (ii) end of life care questions; (iii) knowledge about MAiD; or (iv) comfort and willingness to participate in MAiD. Knowledge questions were refined to reflect current MAiD legislation, policies, and regulatory frameworks. Falconer [ 39 ] and Freeman [ 45 ] studies were foundational sources for item selection. Additionally, four case studies were written to reflect the most recent anticipated changes to MAiD legislation and all used the same open-ended core questions to address respondents’ perspectives about the patient’s right to make the decision, comfort in assisting a physician or NP to administer MAiD in that scenario, and hypothesized comfort about serving as a primary provider if qualified as an NP in future. Response options for the survey were also constructed during this stage and included: open text, categorical, yes/no , and Likert scales.

Phase 2: faculty expert panel review

Of the 56 items presented to the faculty panel, 54 questions reached 75% consensus. However, based upon the qualitative responses 9 items were removed largely because they were felt to be repetitive. Items that generated the most controversy were related to measuring religion and spirituality in the Canadian context, defining end of life care when there is no agreed upon time frames (e.g., last days, months, or years), and predicting willingness to be involved in a future events – thus predicting their future selves. Phase 2, round 1 resulted in an initial set of 47 items which were then presented back to the faculty panel in round 2.

Of the 47 initial questions presented to the panel in round 2, 45 reached a level of consensus of 75% or greater, and 34 of these questions reached a level of 100% consensus [ 27 ] of which all participants chose to include without any adaptations) For each question, level of importance was determined based on a 5-point Likert scale (1 = very unimportant, 2 = somewhat unimportant, 3 = neutral, 4 = somewhat important, and 5 = very important). Figure  2 provides an overview of the level of importance assigned to each item.

Ranking level of importance for survey items

After round 2, a careful analysis of participant comments and level of importance was completed by the research team. While the main method of survey item development came from participants’ response to the first round of Delphi consensus ratings, level of importance was used to assist in the decision of whether to keep or modify questions that created controversy, or that rated lower in the include/exclude/adapt portion of the Delphi. Survey items that rated low in level of importance included questions about future roles, sex and gender, and religion/spirituality. After deliberation by the research committee, these questions were retained in the survey based upon the importance of these variables in the scientific literature.

Of the 47 questions remaining from Phase 2, round 2, four were revised. In addition, the two questions that did not meet the 75% cut off level for consensus were reviewed by the research team. The first question reviewed was What is your comfort level with providing a MAiD death in the future if you were a qualified NP ? Based on a review of participant comments, it was decided to retain this question for the cognitive interviews with students in the final phase of testing. The second question asked about impacts on respondents’ views of MAiD and was changed from one item with 4 subcategories into 4 separate items, resulting in a final total of 51 items for phase 3. The revised survey was then brought forward to the cognitive interviews with student participants in Phase 3. (see Supplementary Material 1 for a complete description of item modification during round 2).

Phase 3. Outcomes of cognitive interview focus group

Of the 51 items reviewed by student participants, 29 were identified as clear with little or no discussion. Participant comments for the remaining 22 questions were noted and verified against the audio recording. Following content analysis of the comments, four key themes emerged through the student discussion: unclear or ambiguous wording; difficult to answer questions; need for additional response options; and emotional response evoked by questions. An example of unclear or ambiguous wording was a request for clarity in the use of the word “sufficient” in the context of assessing an item that read “My nursing education has provided sufficient content about the nursing role in MAiD.” “Sufficient” was viewed as subjective and “laden with…complexity that distracted me from the question.” The group recommended rewording the item to read “My nursing education has provided enough content for me to care for a patient considering or requesting MAiD.”

An example of having difficulty answering questions related to limited knowledge related to terms used in the legislation such as such as safeguards , mature minor , eligibility criteria , and conscientious objection. Students were unclear about what these words meant relative to the legislation and indicated that this lack of clarity would hamper appropriate responses to the survey. To ensure that respondents are able to answer relevant questions, student participants recommended that the final survey include explanation of key terms such as mature minor and conscientious objection and an overview of current legislation.

Response options were also a point of discussion. Participants noted a lack of distinction between response options of unsure and unable to say . Additionally, scaling of attitudes was noted as important since perspectives about MAiD are dynamic and not dichotomous “agree or disagree” responses. Although the faculty expert panel recommended the integration of the demographic variables of religious and/or spiritual remain as a single item, the student group stated a preference to have religion and spirituality appear as separate items. The student focus group also took issue with separate items for the variables of sex and gender, specifically that non-binary respondents might feel othered or “outed” particularly when asked to identify their sex. These variables had been created based upon best practices in health research but students did not feel they were appropriate in this context [ 49 ]. Finally, students agreed with the faculty expert panel in terms of the complexity of projecting their future involvement as a Nurse Practitioner. One participant stated: “I certainly had to like, whoa, whoa, whoa. Now let me finish this degree first, please.” Another stated, “I'm still imagining myself, my future career as an RN.”

Finally, student participants acknowledged the array of emotions that some of the items produced for them. For example, one student described positive feelings when interacting with the survey. “Brought me a little bit of feeling of joy. Like it reminded me that this is the last piece of independence that people grab on to.” Another participant, described the freedom that the idea of an advance request gave her. “The advance request gives the most comfort for me, just with early onset Alzheimer’s and knowing what it can do.” But other participants described less positive feelings. For example, the mature minor case study yielded a comment: “This whole scenario just made my heart hurt with the idea of a child requesting that.”

Based on the data gathered from the cognitive interview focus group of nursing students, revisions were made to 11 closed-ended questions (see Table  4 ) and 3 items were excluded. In the four case studies, the open-ended question related to a respondents’ hypothesized actions in a future role as NP were removed. The final survey consists of 45 items including 4 case studies (see Supplementary Material 3 ).

The aim of this study was to develop and validate a survey that can be used to track the growth of knowledge about MAiD among nursing students over time, inform training programs about curricular needs, and evaluate attitudes and willingness to participate in MAiD at time-points during training or across nursing programs over time.

The faculty expert panel and student participants in the cognitive interview focus group identified a need to establish core knowledge of the terminology and legislative rules related to MAiD. For example, within the cognitive interview group of student participants, several acknowledged lack of clear understanding of specific terms such as “conscientious objector” and “safeguards.” Participants acknowledged discomfort with the uncertainty of not knowing and their inclination to look up these terms to assist with answering the questions. This survey can be administered to nursing or pre-nursing students at any phase of their training within a program or across training programs. However, in doing so it is important to acknowledge that their baseline knowledge of MAiD will vary. A response option of “not sure” is important and provides a means for respondents to convey uncertainty. If this survey is used to inform curricular needs, respondents should be given explicit instructions not to conduct online searches to inform their responses, but rather to provide an honest appraisal of their current knowledge and these instructions are included in the survey (see Supplementary Material 3 ).

Some provincial regulatory bodies have established core competencies for entry-level nurses that include MAiD. For example, the BC College of Nurses and Midwives (BCCNM) requires “knowledge about ethical, legal, and regulatory implications of medical assistance in dying (MAiD) when providing nursing care.” (10 p. 6) However, across Canada curricular content and coverage related to end of life care and MAiD is variable [ 23 ]. Given the dynamic nature of the legislation that includes portions of the law that are embargoed until 2024, it is important to ensure that respondents are guided by current and accurate information. As the law changes, nursing curricula, and public attitudes continue to evolve, inclusion of core knowledge and content is essential and relevant for investigators to be able to interpret the portions of the survey focused on attitudes and beliefs about MAiD. Content knowledge portions of the survey may need to be modified over time as legislation and training change and to meet the specific purposes of the investigator.

Given the sensitive nature of the topic, it is strongly recommended that surveys be conducted anonymously and that students be provided with an opportunity to discuss their responses to the survey. A majority of feedback from both the expert panel of faculty and from student participants related to the wording and inclusion of demographic variables, in particular religion, religiosity, gender identity, and sex assigned at birth. These and other demographic variables have the potential to be highly identifying in small samples. In any instance in which the survey could be expected to yield demographic group sizes less than 5, users should eliminate the demographic variables from the survey. For example, the profession of nursing is highly dominated by females with over 90% of nurses who identify as female [ 50 ]. Thus, a survey within a single class of students or even across classes in a single institution is likely to yield a small number of male respondents and/or respondents who report a difference between sex assigned at birth and gender identity. When variables that serve to identify respondents are included, respondents are less likely to complete or submit the survey, to obscure their responses so as not to be identifiable, or to be influenced by social desirability bias in their responses rather than to convey their attitudes accurately [ 51 ]. Further, small samples do not allow for conclusive analyses or interpretation of apparent group differences. Although these variables are often included in surveys, such demographics should be included only when anonymity can be sustained. In small and/or known samples, highly identifying variables should be omitted.

There are several limitations associated with the development of this survey. The expert panel was comprised of faculty who teach nursing students and are knowledgeable about MAiD and curricular content, however none identified as a conscientious objector to MAiD. Ideally, our expert panel would have included one or more conscientious objectors to MAiD to provide a broader perspective. Review by practitioners who participate in MAiD, those who are neutral or undecided, and practitioners who are conscientious objectors would ensure broad applicability of the survey. This study included one student cognitive interview focus group with 5 self-selected participants. All student participants had held discussions about end of life care with at least one patient, 4 of 5 participants had worked with a patient who requested MAiD, and one had been present for a MAiD death. It is not clear that these participants are representative of nursing students demographically or by experience with end of life care. It is possible that the students who elected to participate hold perspectives and reflections on patient care and MAiD that differ from students with little or no exposure to end of life care and/or MAiD. However, previous studies find that most nursing students have been involved with end of life care including meaningful discussions about patients’ preferences and care needs during their education [ 40 , 44 , 47 , 48 , 52 ]. Data collection with additional student focus groups with students early in their training and drawn from other training contexts would contribute to further validation of survey items.

Future studies should incorporate pilot testing with small sample of nursing students followed by a larger cross-program sample to allow evaluation of the psychometric properties of specific items and further refinement of the survey tool. Consistent with literature about the importance of leadership in the context of MAiD [ 12 , 53 , 54 ], a study of faculty knowledge, beliefs, and attitudes toward MAiD would provide context for understanding student perspectives within and across programs. Additional research is also needed to understand the timing and content coverage of MAiD across Canadian nurse training programs’ curricula.

The implementation of MAiD is complex and requires understanding of the perspectives of multiple stakeholders. Within the field of nursing this includes clinical providers, educators, and students who will deliver clinical care. A survey to assess nursing students’ attitudes toward and willingness to participate in MAiD in the Canadian context is timely, due to the legislation enacted in 2016 and subsequent modifications to the law in 2021 with portions of the law to be enacted in 2027. Further development of this survey could be undertaken to allow for use in settings with practicing nurses or to allow longitudinal follow up with students as they enter practice. As the Canadian landscape changes, ongoing assessment of the perspectives and needs of health professionals and students in the health professions is needed to inform policy makers, leaders in practice, curricular needs, and to monitor changes in attitudes and practice patterns over time.

Availability of data and materials

The datasets used and/or analysed during the current study are not publicly available due to small sample sizes, but are available from the corresponding author on reasonable request.

Abbreviations

British Columbia College of Nurses and Midwives

Medical assistance in dying

Nurse practitioner

Registered nurse

University of British Columbia Okanagan

Nicol J, Tiedemann M. Legislative Summary: Bill C-14: An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying). Available from: https://lop.parl.ca/staticfiles/PublicWebsite/Home/ResearchPublications/LegislativeSummaries/PDF/42-1/c14-e.pdf .

Downie J, Scallion K. Foreseeably unclear. The meaning of the “reasonably foreseeable” criterion for access to medical assistance in dying in Canada. Dalhousie Law J. 2018;41(1):23–57.

Nicol J, Tiedeman M. Legislative summary of Bill C-7: an act to amend the criminal code (medical assistance in dying). Ottawa: Government of Canada; 2021.

Google Scholar  

Council of Canadian Academies. The state of knowledge on medical assistance in dying where a mental disorder is the sole underlying medical condition. Ottawa; 2018. Available from: https://cca-reports.ca/wp-content/uploads/2018/12/The-State-of-Knowledge-on-Medical-Assistance-in-Dying-Where-a-Mental-Disorder-is-the-Sole-Underlying-Medical-Condition.pdf .

Council of Canadian Academies. The state of knowledge on advance requests for medical assistance in dying. Ottawa; 2018. Available from: https://cca-reports.ca/wp-content/uploads/2019/02/The-State-of-Knowledge-on-Advance-Requests-for-Medical-Assistance-in-Dying.pdf .

Council of Canadian Academies. The state of knowledge on medical assistance in dying for mature minors. Ottawa; 2018. Available from: https://cca-reports.ca/wp-content/uploads/2018/12/The-State-of-Knowledge-on-Medical-Assistance-in-Dying-for-Mature-Minors.pdf .

Health Canada. Third annual report on medical assistance in dying in Canada 2021. Ottawa; 2022. [cited 2023 Oct 23]. Available from: https://www.canada.ca/en/health-canada/services/medical-assistance-dying/annual-report-2021.html .

Banner D, Schiller CJ, Freeman S. Medical assistance in dying: a political issue for nurses and nursing in Canada. Nurs Philos. 2019;20(4): e12281.

Article   PubMed   Google Scholar  

Pesut B, Thorne S, Stager ML, Schiller CJ, Penney C, Hoffman C, et al. Medical assistance in dying: a review of Canadian nursing regulatory documents. Policy Polit Nurs Pract. 2019;20(3):113–30.

Article   PubMed   PubMed Central   Google Scholar  

College of Registered Nurses of British Columbia. Scope of practice for registered nurses [Internet]. Vancouver; 2018. Available from: https://www.bccnm.ca/Documents/standards_practice/rn/RN_ScopeofPractice.pdf .

Pesut B, Thorne S, Schiller C, Greig M, Roussel J, Tishelman C. Constructing good nursing practice for medical assistance in dying in Canada: an interpretive descriptive study. Global Qual Nurs Res. 2020;7:2333393620938686. https://doi.org/10.1177/2333393620938686 .

Article   Google Scholar  

Pesut B, Thorne S, Schiller CJ, Greig M, Roussel J. The rocks and hard places of MAiD: a qualitative study of nursing practice in the context of legislated assisted death. BMC Nurs. 2020;19:12. https://doi.org/10.1186/s12912-020-0404-5 .

Pesut B, Greig M, Thorne S, Burgess M, Storch JL, Tishelman C, et al. Nursing and euthanasia: a narrative review of the nursing ethics literature. Nurs Ethics. 2020;27(1):152–67.

Pesut B, Thorne S, Storch J, Chambaere K, Greig M, Burgess M. Riding an elephant: a qualitative study of nurses’ moral journeys in the context of Medical Assistance in Dying (MAiD). Journal Clin Nurs. 2020;29(19–20):3870–81.

Lamb C, Babenko-Mould Y, Evans M, Wong CA, Kirkwood KW. Conscientious objection and nurses: results of an interpretive phenomenological study. Nurs Ethics. 2018;26(5):1337–49.

Wright DK, Chan LS, Fishman JR, Macdonald ME. “Reflection and soul searching:” Negotiating nursing identity at the fault lines of palliative care and medical assistance in dying. Social Sci & Med. 2021;289: 114366.

Beuthin R, Bruce A, Scaia M. Medical assistance in dying (MAiD): Canadian nurses’ experiences. Nurs Forum. 2018;54(4):511–20.

Bruce A, Beuthin R. Medically assisted dying in Canada: "Beautiful Death" is transforming nurses' experiences of suffering. The Canadian J Nurs Res | Revue Canadienne de Recherche en Sci Infirmieres. 2020;52(4):268–77. https://doi.org/10.1177/0844562119856234 .

Canadian Nurses Association. Code of ethics for registered nurses. Ottawa; 2017. Available from: https://www.cna-aiic.ca/en/nursing/regulated-nursing-in-canada/nursing-ethics .

Canadian Nurses Association. National nursing framework on Medical Assistance in Dying in Canada. Ottawa: 2017. Available from: https://www.virtualhospice.ca/Assets/cna-national-nursing-framework-on-maidEng_20170216155827.pdf .

Pesut B, Thorne S, Greig M. Shades of gray: conscientious objection in medical assistance in dying. Nursing Inq. 2020;27(1): e12308.

Durojaiye A, Ryan R, Doody O. Student nurse education and preparation for palliative care: a scoping review. PLoS ONE. 2023. https://doi.org/10.1371/journal.pone.0286678 .

McMechan C, Bruce A, Beuthin R. Canadian nursing students’ experiences with medical assistance in dying | Les expériences d’étudiantes en sciences infirmières au regard de l’aide médicale à mourir. Qual Adv Nurs Educ - Avancées en Formation Infirmière. 2019;5(1). https://doi.org/10.17483/2368-6669.1179 .

Adler M, Ziglio E. Gazing into the oracle. The Delphi method and its application to social policy and public health. London: Jessica Kingsley Publishers; 1996

Keeney S, Hasson F, McKenna H. Consulting the oracle: ten lessons from using the Delphi technique in nursing research. J Adv Nurs. 2006;53(2):205–12.

Keeney S, Hasson F, McKenna H. The Delphi technique in nursing and health research. 1st ed. City: Wiley; 2011.

Willis GB. Cognitive interviewing: a tool for improving questionnaire design. 1st ed. Thousand Oaks, Calif: Sage; 2005. ISBN: 9780761928041

Lamb C, Evans M, Babenko-Mould Y, Wong CA, Kirkwood EW. Conscience, conscientious objection, and nursing: a concept analysis. Nurs Ethics. 2017;26(1):37–49.

Lamb C, Evans M, Babenko-Mould Y, Wong CA, Kirkwood K. Nurses’ use of conscientious objection and the implications of conscience. J Adv Nurs. 2018;75(3):594–602.

de Vaus D. Surveys in social research. 6th ed. Abingdon, Oxon: Routledge; 2014.

Boateng GO, Neilands TB, Frongillo EA, Melgar-Quiñonez HR, Young SL. Best practices for developing and validating scales for health, social, and behavioral research: A primer. Front Public Health. 2018;6:149. https://doi.org/10.3389/fpubh.2018.00149 .

Puchta C, Potter J. Focus group practice. 1st ed. London: Sage; 2004.

Book   Google Scholar  

Streiner DL, Norman GR, Cairney J. Health measurement scales: a practical guide to their development and use. 5th ed. Oxford: Oxford University Press; 2015.

Hsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88.

Adesina O, DeBellis A, Zannettino L. Third-year Australian nursing students’ attitudes, experiences, knowledge, and education concerning end-of-life care. Int J of Palliative Nurs. 2014;20(8):395–401.

Bator EX, Philpott B, Costa AP. This moral coil: a cross-sectional survey of Canadian medical student attitudes toward medical assistance in dying. BMC Med Ethics. 2017;18(1):58.

Beuthin R, Bruce A, Scaia M. Medical assistance in dying (MAiD): Canadian nurses’ experiences. Nurs Forum. 2018;53(4):511–20.

Brown J, Goodridge D, Thorpe L, Crizzle A. What is right for me, is not necessarily right for you: the endogenous factors influencing nonparticipation in medical assistance in dying. Qual Health Res. 2021;31(10):1786–1800.

Falconer J, Couture F, Demir KK, Lang M, Shefman Z, Woo M. Perceptions and intentions toward medical assistance in dying among Canadian medical students. BMC Med Ethics. 2019;20(1):22.

Green G, Reicher S, Herman M, Raspaolo A, Spero T, Blau A. Attitudes toward euthanasia—dual view: Nursing students and nurses. Death Stud. 2022;46(1):124–31.

Hosseinzadeh K, Rafiei H. Nursing student attitudes toward euthanasia: a cross-sectional study. Nurs Ethics. 2019;26(2):496–503.

Ozcelik H, Tekir O, Samancioglu S, Fadiloglu C, Ozkara E. Nursing students’ approaches toward euthanasia. Omega (Westport). 2014;69(1):93–103.

Canning SE, Drew C. Canadian nursing students’ understanding, and comfort levels related to medical assistance in dying. Qual Adv Nurs Educ - Avancées en Formation Infirmière. 2022;8(2). https://doi.org/10.17483/2368-6669.1326 .

Edo-Gual M, Tomás-Sábado J, Bardallo-Porras D, Monforte-Royo C. The impact of death and dying on nursing students: an explanatory model. J Clin Nurs. 2014;23(23–24):3501–12.

Freeman LA, Pfaff KA, Kopchek L, Liebman J. Investigating palliative care nurse attitudes towards medical assistance in dying: an exploratory cross-sectional study. J Adv Nurs. 2020;76(2):535–45.

Brown J, Goodridge D, Thorpe L, Crizzle A. “I am okay with it, but I am not going to do it:” the exogenous factors influencing non-participation in medical assistance in dying. Qual Health Res. 2021;31(12):2274–89.

Dimoula M, Kotronoulas G, Katsaragakis S, Christou M, Sgourou S, Patiraki E. Undergraduate nursing students’ knowledge about palliative care and attitudes towards end-of-life care: A three-cohort, cross-sectional survey. Nurs Educ Today. 2019;74:7–14.

Matchim Y, Raetong P. Thai nursing students’ experiences of caring for patients at the end of life: a phenomenological study. Int J Palliative Nurs. 2018;24(5):220–9.

Canadian Institute for Health Research. Sex and gender in health research [Internet]. Ottawa: CIHR; 2021 [cited 2023 Oct 23]. Available from: https://cihr-irsc.gc.ca/e/50833.html .

Canadian Nurses’ Association. Nursing statistics. Ottawa: CNA; 2023 [cited 2023 Oct 23]. Available from: https://www.cna-aiic.ca/en/nursing/regulated-nursing-in-canada/nursing-statistics .

Krumpal I. Determinants of social desirability bias in sensitive surveys: a literature review. Qual Quant. 2013;47(4):2025–47. https://doi.org/10.1007/s11135-011-9640-9 .

Ferri P, Di Lorenzo R, Stifani S, Morotti E, Vagnini M, Jiménez Herrera MF, et al. Nursing student attitudes toward dying patient care: a European multicenter cross-sectional study. Acta Bio Medica Atenei Parmensis. 2021;92(S2): e2021018.

PubMed   PubMed Central   Google Scholar  

Beuthin R, Bruce A. Medical assistance in dying (MAiD): Ten things leaders need to know. Nurs Leadership. 2018;31(4):74–81.

Thiele T, Dunsford J. Nurse leaders’ role in medical assistance in dying: a relational ethics approach. Nurs Ethics. 2019;26(4):993–9.

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We would like to acknowledge the faculty and students who generously contributed their time to this work.

JS received a student traineeship through the Principal Research Chairs program at the University of British Columbia Okanagan.

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Schroeder, J., Pesut, B., Olsen, L. et al. Developing a survey to measure nursing students’ knowledge, attitudes and beliefs, influences, and willingness to be involved in Medical Assistance in Dying (MAiD): a mixed method modified e-Delphi study. BMC Nurs 23 , 326 (2024). https://doi.org/10.1186/s12912-024-01984-z

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New CAS Class Teaches the History of Empires Through Fashion and Beauty

Students design and construct custom outfits based on historical case studies.

Jilene Chua’s Fashion and Beauty Under War and Empire is a course on how clothing and makeup provided insights into war and empire in the 20th century.

Sam Thomas (COM’24)

Jackie ricciardi.

A skirt made of newspaper. A blonde wig with brown roots. A headband made of crocheted “plarn” (yarn made of repurposed plastic bags). A pair of army green pants with extra pockets sewn around the ankles.

In lieu of a traditional exam, Jilene Chua , a College of Arts & Sciences assistant professor of history, assigned her students a different kind of final for their Fashion and Beauty Under War and Empire class: designing and constructing an entire outfit. The course, which wrapped earlier this month, spans the time periods from settler colonialism in the 1800s to the modern day and sets out to examine how clothing and makeup can provide insights into war and empire in the 20th century.

During the final two meetings of the class, groups presented their creations, accompanied by historical case studies they wrote reflecting on the symbolism of each piece. While some students had sewing experience, others were crafting outfits for the first time.

Chua, who came to BU this year, says she designed the Fashion and Beauty Under War and Empire class as a way to unite her research interests of history, fashion, and empire. “I wanted to figure out a way to have students learn about [this history], but in a way that wasn’t just constant violence,” she says. “Sometimes, histories of empires can be really dark and involve a lot of brutal things, so I wanted the students to think about how unexpected things like clothing, fashion, and beauty can be ways of analyzing this form of power.”

Sometimes, histories of empires can be really dark and involve a lot of brutal things, so I wanted the students to think about how unexpected things like clothing, fashion, and beauty can be ways of analyzing this form of power. Jilene Chua

Chua says the students in the class—which attracted different majors and class years—made connections she hadn’t even considered. For example, one class discussion on the prevalence of camouflage in fashion turned into an analysis of military recruitment—specifically, how it affected students during their high school experience.

In a presentation titled “Sustainability & Empire Through Time,” students investigated how different populations utilized resources readily available around them for clothing. For example, one student created a crocheted wrap to reflect how some Native American tribes used the fur of Churro sheep for clothing since it was a by-product of a food source. Another student made a shirt and attached a Kirkland jasmine rice bag, representing how people repurposed food sacks during the Great Depression.

In another presentation, titled “Combat Couture: The American Culture of War,” students examined how fashion in the United States is based on a military aesthetic. They discussed the Bikini Atoll , a coral reef in the Pacific Ocean that the US government used as a nuclear testing site and how it displaced and harmed its inhabitants. The bikini swimsuit was introduced and named just four days after the testing. Now, when someone says “bikini,” it conjures images of summer days and swimming rather than nuclear waste. 

“It started to make me think about how I didn’t have that on my syllabus, so I changed it to adapt,” Chua said. “It made sense to add because they have all these experiences with militarism in their own lives that they’re bringing in.” 

During the presentation, one student displayed a fuzzy green jacket with a camo pattern with “Are you registered for the draft?” and only a “Yes” checkbox, painted on the back. This, the student explained, was meant to represent how the draft was not optional, as well as how “fashion can reframe ugly parts of an empire into something soft and fuzzy.”

Reflecting on the course, Kal Hawley (CAS’27) says they were excited to create outfits with the added historical context from the course. Their outfit included a blazer with sewn lace hanging from about waist level, a commentary on softness—that is, not being afraid of being vulnerable or perceived as weak.

Among other topics in the course are the commodification of human products such as hair, skincare during chemical warfare, and profit as a connection between war and beauty. 

Throughout the semester, Chua encouraged students to engage in sustainable practices. The class went together to Goodwill to pick out raw materials and clothing items and they discussed the environmental impacts of the fashion industry—for example, 87 percent of garments made each year end up in a landfill. The material they thrifted or recycled was then used to construct their final outfits.

Students were able to use BU’s Engineering Product Innovation Center (EPIC), right on the Charles River Campus, when crafting their clothes. EPIC spans 15,000 square feet and offers students access to a variety of engineering and manufacturing tools, such as laser cutters, welding equipment, drill presses, sewing machines, and more. 

Ivan Perez (CAS’24) had no experience making clothes and had no background in fashion before enrolling. He says he took the class as a creative outlet and because he wanted “to see how and what a class like this could offer.” His enrollment in the course was a “happy accident,” he says.

“Aside, of course, from the material covered throughout the semester, the class really helped me express myself creatively through an unfamiliar yet incredibly cool medium,” Perez says. “It certainly was a unique experience, and an obscure class that made the semester very memorable. It is something quite niche that BU offers. I was just fortunate enough to stumble upon a new diamond in the rough.”

Although the class focuses specifically on fashion and beauty, Chua says she hopes this kind of critical societal analysis carries over to other parts of her students’ lives.

“I think they’re already starting to make connections to how this is a culture of militarism all around us even today,” she says. “But with these big topics like war and empire, students can see how they also appear in everyday life, not just through clothing and beauty. We are still living this culture out, right now.”

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Houston’s flood problems offer lessons for cities trying to adapt to a changing climate

Professor Emeritus of Climate and Space Sciences and Engineering, University of Michigan

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Richard Rood receives funding from the National Oceanographic and Atmospheric Administration and the National Science Foundation. He is a co-principal investigator at the Great Lakes Integrated Sciences and Assessment Center at the University of Michigan.

University of Michigan provides funding as a founding partner of The Conversation US.

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Scenes from the Houston area looked like the aftermath of a hurricane in early May after a series of powerful storms flooded highways and neighborhoods and sent rivers over their banks north of the city.

Hundreds of people had to be rescued from homes, rooftops and cars, according to The Associated Press. Huntsville registered nearly 20 inches of rain from April 29 to May 4, 2024.

Floods are complex events, and they are about more than just heavy rain. Each community has its own unique geography and climate that can exacerbate flooding. On top of those risks, extreme downpours are becoming more common as global temperatures rise.

I work with a center at the University of Michigan that helps communities turn climate knowledge into projects that can reduce the harm of future climate disasters. Flooding events like the Houston area experienced provide case studies that can help cities everywhere manage the increasing risk.

Flood risks are rising

The first thing recent floods tell us is that the climate is changing.

In the past, it might have made sense to consider a flood a rare and random event – communities could just build back. But the statistical distribution of weather events and natural disasters is shifting.

What might have been a 1-in-500-years event may become a 1-in-100-years event , on the way to becoming a 1-in-50-years event. When Hurricane Harvey hit Texas in 2017, it delivered Houston’s third 500-year flood in the span of three years.

Basic physics points to the rising risks: Global greenhouse gas emissions are increasing global average temperatures. Warming leads to increasing precipitation and more intense downpours, and increased flood potential, particularly when storms hit on already saturated ground.

Communities aren’t prepared

Recent floods are also revealing vulnerabilities in how communities are designed and managed.

Pavement is a major contributor to urban flooding, because water cannot be absorbed and it runs off quickly. The Houston area’s frequent flooding illustrates the risks. Its impervious surfaces expanded by 386 square miles between 1997 and 2017, according to data collected by Rice University . More streets, parking lots and buildings meant more standing water with fewer places for rainwater to sink in.

If the infrastructure is well designed and maintained, flood damage can be greatly reduced. However, increasingly, researchers have found that the engineering specifications for drainage pipes and other infrastructure are no longer adequate to handle the increasing severity of storms and amounts of precipitation. This can lead to roads being washed out and communities being cut off . Failures in maintaining infrastructure, such as levees and storm drains, are a common contributor to flooding.

In the Houston area, reservoirs are also an essential part of flood management, and many were at capacity from persistent rain. This forced managers to release more water when the storms hit.

For a coastal metropolis such as the Houston-Galveston area, rapidly rising sea levels can also reduce the downstream capacity to manage water. These different factors compound to increase flooding risk and highlight the need to not only move water but to find safe places to store it.

The increasing risks affect not only engineering standards, but zoning laws that govern where homes can be built and building codes that describe minimum standards for safety, as well as permitting and environmental regulations.

By addressing these issues now, communities can anticipate and avoid damage rather than only reacting when it’s too late.

Four lessons from case studies

The many effects associated with flooding show why a holistic approach to planning for climate change is necessary, and what communities can learn from one another. For example, case studies show that:

Floods can damage resources that are essential in flood recovery, such as roads, bridges and hospitals . Considering future risks when determining where and how to build these resources enhances the ability to recover from future disasters . Jackson, Mississippi’s water treatment plant was knocked offline by flooding in 2022, leaving people without safe running water. Houston’s Texas Medical Center famously prepared to manage future flooding by installing floodgates, elevating backup generators and taking other steps after heavy damage during Tropical Storm Allison in 2001.

Flood damage does not occur in isolation. Downpours can trigger mudslides , make sewers more vulnerable and turn manufacturing facilities into toxic contamination risks . These can become broad-scale dangers, extending far beyond individual communities.

It is difficult for an individual or a community to take on even the technical aspects of flood preparation alone – there is too much interconnectedness. Protective measures like levees or channels might protect one neighborhood but worsen the flood risk downstream . Planners should identify the appropriate regional scale, such as the entire drainage basin of a creek or river, and form important relationships early in the planning process.

Natural disasters and the ways communities respond to them can also amplify disparities in wealth and resources. Social justice and ethical considerations need to be brought into planning at the beginning.

Learning to manage complexity

In communities that my colleagues and I have worked with , we have found an increasing awareness of the challenges of climate change and rising flood risks.

In most cases, local officials’ initial instinct has been to protect property and persist without changing where people live. However, that might only buy time for some areas before people will have little option but to move .

When they examine their vulnerabilities, many of these communities have started to recognize the interconnectedness of zoning, storm drains and parks that can absorb runoff, for example. They also begin to see the importance of engaging regional stakeholders to avoid fragmented efforts to adapt that could worsen conditions for neighboring areas.

This is an updated version of an article originally published Aug. 25, 2022 .

• Climate change
• Infrastructure
• Extreme weather
• Extreme rainfall
• Disaster mitigation
• Flash flooding

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