Spotlight on Teaching: Making a Case for Case Studies

Teaching with case studies is a powerful and effective method for engaging graduate students in active learning and preparing them for professional environments, where critical thinking and decision-making in ambiguous situations are crucial.

By placing students in the shoes of decision-makers, case studies enable them to apply theoretical knowledge to real-world problems, fostering a deeper understanding of the material.

"Cases are designed to put theory into practice and give students the opportunity to apply critical thinking to their area of study,” said Zerrin Cetin, MPH ’15, MBA ’15, a lecturer in the Yale School of Public Health’s (YSPH) Department of Health Policy and Management. Cetin teaches a case-based course, HPM 571 Designing Health Systems of Tomorrow.

Case-based teaching has several benefits. It prepares students to act in the face of ambiguity and to make decisions when clear answers are not available. Employers seek graduates who are grounded in practice and capable of thinking about how problems might arise in the real world. This approach ensures that students can transfer their knowledge to a variety of contexts, which is essential for their future careers.

Case studies can be classified as traditional ("cooked") or raw. Traditional cases are created by experts who provide detailed, structured scenarios based on real-life dilemmas. These cases include sufficient background information to ensure that even students new to the field can engage meaningfully with the problem.

Kaakpema “KP” Yelpaala, MPH ’06, an avid case-study advocate and the instructor of another case-based course, HPM 546: The Future of Health: Emerging Themes in Health Innovation, is the author of several traditional case studies. While traditional case studies are impactful in the classroom, they require intensive research, active collaboration, and significant infrastructure. They are a core part of pedagogy in business and public policy programs, but they are not a common model in schools of public health.

Raw cases, on the other hand, present students with primary sources and data similar to what a decision-maker would encounter in the real world. This approach helps students develop their research, synthesis, and analytical skills as they navigate complex information to devise solutions. Unlike traditional cases, raw cases can easily be developed by any YSPH instructor.

Two examples of raw and traditional case studies can be found at the Yale School of Management. In one instance, the school provides students with a raw case study illustrating how the Mayo Clinic improved doctor-patient interactions using ‘design thinking.’ In another, the school uses more traditional case study model to show students how the Yale New Haven Health System improved the way hip and knee replacements are done.

Dr. Susan Nappi, DrPH, MPH ’01, Executive Director of the YSPH Office of Community & Practice, and Randi McCray, MS, PhD (C), YSPH Associate Director of School Community & Culture, are co-instructors of a new case-based course, SBS 532: Leadership in Public Health Practice. Working in collaboration with the YSPH Office of Academic Affairs, they created six raw case studies that their students will use throughout the course to apply the frameworks being taught.

“These case studies serve as such a valuable tool to connect our students to public health practice work,” said Nappi, noting the case studies are based on both her and McCray's personal experiences in public health practice. “And after having developed these case studies, we realized that developing raw case studies is within reach of any YSPH instructor.”

To implement case studies effectively, it is important to establish a safe learning environment where students feel comfortable expressing their thoughts and making mistakes.

“The one thing that I emphasize to students early in the semester is that it is important and expected that their opinions will change over time,” said Yelpaala, a YSPH Lecturer and Senior Fellow in Public Health (Health Policy). “My classroom is a safe space where they can express their thoughts one day and change their minds as they gain more information and insight.

“Once this idea sinks in, I find that students are much more willing to engage in intellectually nuanced, multi-optional thinking,” Yelpaala continued. “The inherent ambiguity requires that students are willing to try out ideas and explore strategic thinking, an important aspect of leadership development for real-world scenarios.”

Setting up an explicit classroom culture encourages students to contribute their ideas without fear and encourages them to exercise creative and critical thinking. In the first class of the semester, Cetin asks her students to establish class norms that they will collectively adhere to throughout the semester. She also sets the expectation that she will run class discussions as though they are board meetings – therefore, students should come to class prepared for discussion.

Reflection assignments throughout the semester help reinforce these norms and support a positive classroom culture. In these assignments, students are reminded of the norms and asked to reflect on how they—and the class as a whole—are doing in upholding them. This communicates to students that these norms are, by definition, aspirational, and it is normal to be challenged when trying to uphold them, Cetin said. But by engaging with this challenge, students are continually focused on collectively elevating their learning community.

“It encourages them to be accountable, since they were empowered to decide what the norms were going to be in the first place,” Cetin said.

Incorporating diverse student perspectives into class discussions is another important strategy for enhancing case-based learning. Using online discussion boards ensures that perspectives from all students—including those who may be less inclined to express their views in class—are represented in the learning experience. For instance, Yelpaala uses the discussion board on the Canvas course site to periodically respond to student comments and bring their insights into class discussions, thereby enriching the in-class problem-solving process. He will explicitly call on individual students, encouraging them to share comments they made on the discussion board. In doing so, he actively fosters a classroom culture in which students feel their perspectives are valued.

The instructor’s role is crucial in optimizing the case study approach in the classroom. Encouraging open and supportive discussion and fostering an environment centered on intellectual diversity and inclusion are key to classroom success. The instructor is also critical in helping students learn how to think about the problems they encounter. In leading a case studies course, instructors teach students how to recognize patterns for efficient problem-solving, apply appropriate tools, and acquire the flexibility to see both the big picture and the relevant details underlying a challenge.

In conclusion, teaching with case studies is a valuable method for developing the skills necessary for public health students' professional success. By bridging theory and practice, preparing students for ambiguity, and fostering critical thinking, case studies enhance students’ educational experience at YSPH. If you would like to learn more about case-based teaching or are interested in developing your own cases, please reach out to me (Michael.honsberger@yale.edu).

Dr. Mike Honsberger, PhD, is the Yale School of Public Health’s Director of Academic Affairs.