Case-Method Teaching: An Overview of the Pedagogy and Rationale for Its Use in Physical Therapy Education

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ABSTRACT. This paper presents an overview of case-method teaching, followed by a brief historical perspective of its use. Different representations of the pedagogy of case-method teaching are presented, identifying the unique roles required of teachers and students. A variety of educational theories of learning explaining its perceived effectiveness are explored, and its unique appropriateness for adult learners is probed. Finally, the author advocates for the application of case-method teaching in the education of health care providers, specifically physical therapists.

INTRODUCTION

"Principles are powerful but cases are memorable."[(p 201) The statement quoted from educator Lee Shulman is the underlying rationale for the use of all case-method teaching. Wassermann2 calls case-method teaching a "pedagogy for all seasons." This paper presents an overview of case-method teaching. Different representations of the pedagogy are presented, identifying the roles required of teachers and students. A variety of educational theories of learning explaining the effectiveness of the methodology are then explored. The paper postulates that case-method teaching is uniquely appropriate for adult learners and for the professional education of health care providers, specifically physical therapists.

Case-method teaching is popular and pervasive. Utilizing case-method teaching, one constructs a curriculum with cases or problems encountered by professionals in specific settings. Meyers and Jones state that a case study "is a narrative of an actual event that brings students and teachers together in an attempt to examine, discuss, and advance solutions to a realistic problem situation."3(p103) Cases lend realism and contextual relevance to study.

Built from meaningful events, cases tell a story with actual facts, not opinion. An analysis of the issues within a case reveals fundamental principles and assumptions upon which the practice or work of a profession is based. Case-method teaching is intended to develop students' abilities to solve problems using knowledge, concepts, and skills relevant to a specific discipline. Students are expected to be motivated by the contextual relevance of the case. It is a process-oriented method of instruction that is intended to bridge the gap between theory and practice. Students are expected to reflect on the practice of a discipline and develop new knowledge through collaboration, contemplation, and deliberation.2

Case-method teaching began early in this country with the Harvard Law School in 1871, and in 1910, the Harvard Medical School faculty adopted the methodology. Flexner, an early medical educator, reflected, "... teaching the student how to gather his facts, is valuable, so, it is urged, a formal training in the inductive handling of ascertained data may be of use to students whose logical habit has been none too strictly formed:'4(p7) He went on to observe that "the case method, a method, by the way, excellently adapted to class use, calculated there to develop the friction, competition, and interest which are powerful pedagogical stimulants."4(p7) Cases have been utilized in teacher education since 1925, and they have been the primary mode of teaching in the fields of business and law since the 1960s.4,5

THE PEDAGOGY

In utilizing case-method teaching, specific methodology may vary. The one constant that seems pervasive in the literature is there is not one way of doing case-method teaching. The pedagogy of case-method teaching extends from a highly structured framework (eg, problem-based learning so prevalent in physical therapy education today) to the more casual use of narrative to enhance classroom discussion. The defining elements seem to depend on the extent of case use and the educational goals within a given curriculum.

Sperle4 contended that the case study has a clearly defined structure. Regardless of discipline, that structure includes three primary steps: (1) students receive information about a case or problem in advance and initially study it by themselves, (2) students then participate in group discussions facilitated by a faculty member (sometimes preceded by small-group work), and (3) students and faculty then reflect on the case, discuss any proposed solutions, and reflect on actions, attitudes, and behaviors. …