22 Cases and Articles to Help Bring Diversity Issues into Class Discussions

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  • Diversity, Equity, and Inclusion

T he recent civic unrest in the United States following the death of George Floyd has elevated the urgency to recognize and study issues of diversity and the needs of underrepresented groups in all aspects of public life.

Business schools—and educational institutions across the spectrum—are no exception. It’s vital that educators facilitate safe and productive dialogue with students about issues of inclusion and diversity. To help, we’ve gathered a collection of case studies (all with teaching notes) and articles that can encourage and support these critical discussions.

These materials are listed across three broad topic areas: leadership and inclusion, cases featuring protagonists from historically underrepresented groups, and women and leadership around the world. This list is hardly exhaustive, but we hope it provides ways to think creatively and constructively about how educators can integrate these important topics in their classes. HBP will continue to curate and share content that addresses these equity issues and that features diverse protagonists.

Editors’ note: To access the full text of these articles, cases, and accompanying teaching notes, you must be registered with HBP Education. We invite you to sign up for a free educator account here . Verification may take a day; in the meantime, you can read all of our Inspiring Minds content .

Leadership and Inclusion

John Rogers, Jr.—Ariel Investments Co.

—by Steven S. Rogers and Greg White

Gender and Free Speech at Google (A)

—by Nien-hê Hsieh, Martha J. Crawford, and Sarah Mehta

The Massport Model: Integrating Diversity and Inclusion into Public-Private Partnerships

—by Laura Winig and Robert Livingston

“Numbers Take Us Only So Far”

—by Maxine Williams

For Women and Minorities to Get Ahead, Managers Must Assign Work Fairly

—by Joan C. Williams and Marina Multhaup

How Organizations Are Failing Black Workers—and How to Do Better

—by Adia Harvey Wingfield

To Retain Employees, Focus on Inclusion—Not Just Diversity

—by Karen Brown

From HBR 's The Big Idea:

Toward a Racially Just Workplace: Diversity efforts are failing black employees. Here’s a better approach.

—by Laura Morgan Roberts and Anthony J. Mayo

Cases with Protagonists from Historically Underrepresented Groups

Arlan Hamilton and Backstage Capital

—by Laura Huang and Sarah Mehta

United Housing—Otis Gates

—by Steven Rogers and Mercer Cook

Eve Hall: The African American Investment Fund in Milwaukee

—by Steven Rogers and Alterrell Mills

Dylan Pierce at Peninsula Industries

—by Karthik Ramanna

Maggie Lena Walker and the Independent Order of St. Luke

—by Anthony J. Mayo and Shandi O. Smith

Multimedia Cases:

Enterprise Risk Management at Hydro One, Multimedia Case

—by Anette Mikes

Women and Leadership Around the World

Monique Leroux: Leading Change at Desjardins

—by Rosabeth Moss Kanter and Ai-Ling Jamila Malone

Kaweyan: Female Entrepreneurship and the Past and Future of Afghanistan

—by Geoffrey G. Jones and Gayle Tzemach Lemmon

Womenomics in Japan

—by Boris Groysberg, Mayuka Yamazaki, Nobuo Sato, and David Lane

Women MBAs at Harvard Business School: 1962-2012

—by Boris Groysberg, Kerry Herman, and Annelena Lobb

Beating the Odds

—by Laura Morgan Roberts, Anthony J. Mayo, Robin J. Ely, and David A. Thomas

Rethink What You “Know” About High-Achieving Women

—by Robin J. Ely, Pamela Stone, and Colleen Ammerman

“I Try to Spark New Ideas”

—by Christine Lagarde and Adi Ignatius

How Women Manage the Gendered Norms of Leadership

—by Wei Zheng, Ronit Kark, and Alyson Meister

Is this list helpful to you? What other topics or materials would you like to see featured in our next curated list? Let us know .

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CASE TEACHING

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Organizing Your Social Sciences Research Assignments

  • Annotated Bibliography
  • Analyzing a Scholarly Journal Article
  • Group Presentations
  • Dealing with Nervousness
  • Using Visual Aids
  • Grading Someone Else's Paper
  • Types of Structured Group Activities
  • Group Project Survival Skills
  • Leading a Class Discussion
  • Multiple Book Review Essay
  • Reviewing Collected Works
  • Writing a Case Analysis Paper
  • Writing a Case Study
  • About Informed Consent
  • Writing Field Notes
  • Writing a Policy Memo
  • Writing a Reflective Paper
  • Writing a Research Proposal
  • Generative AI and Writing
  • Acknowledgments

A case study research paper examines a person, place, event, condition, phenomenon, or other type of subject of analysis in order to extrapolate  key themes and results that help predict future trends, illuminate previously hidden issues that can be applied to practice, and/or provide a means for understanding an important research problem with greater clarity. A case study research paper usually examines a single subject of analysis, but case study papers can also be designed as a comparative investigation that shows relationships between two or more subjects. The methods used to study a case can rest within a quantitative, qualitative, or mixed-method investigative paradigm.

Case Studies. Writing@CSU. Colorado State University; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010 ; “What is a Case Study?” In Swanborn, Peter G. Case Study Research: What, Why and How? London: SAGE, 2010.

How to Approach Writing a Case Study Research Paper

General information about how to choose a topic to investigate can be found under the " Choosing a Research Problem " tab in the Organizing Your Social Sciences Research Paper writing guide. Review this page because it may help you identify a subject of analysis that can be investigated using a case study design.

However, identifying a case to investigate involves more than choosing the research problem . A case study encompasses a problem contextualized around the application of in-depth analysis, interpretation, and discussion, often resulting in specific recommendations for action or for improving existing conditions. As Seawright and Gerring note, practical considerations such as time and access to information can influence case selection, but these issues should not be the sole factors used in describing the methodological justification for identifying a particular case to study. Given this, selecting a case includes considering the following:

  • The case represents an unusual or atypical example of a research problem that requires more in-depth analysis? Cases often represent a topic that rests on the fringes of prior investigations because the case may provide new ways of understanding the research problem. For example, if the research problem is to identify strategies to improve policies that support girl's access to secondary education in predominantly Muslim nations, you could consider using Azerbaijan as a case study rather than selecting a more obvious nation in the Middle East. Doing so may reveal important new insights into recommending how governments in other predominantly Muslim nations can formulate policies that support improved access to education for girls.
  • The case provides important insight or illuminate a previously hidden problem? In-depth analysis of a case can be based on the hypothesis that the case study will reveal trends or issues that have not been exposed in prior research or will reveal new and important implications for practice. For example, anecdotal evidence may suggest drug use among homeless veterans is related to their patterns of travel throughout the day. Assuming prior studies have not looked at individual travel choices as a way to study access to illicit drug use, a case study that observes a homeless veteran could reveal how issues of personal mobility choices facilitate regular access to illicit drugs. Note that it is important to conduct a thorough literature review to ensure that your assumption about the need to reveal new insights or previously hidden problems is valid and evidence-based.
  • The case challenges and offers a counter-point to prevailing assumptions? Over time, research on any given topic can fall into a trap of developing assumptions based on outdated studies that are still applied to new or changing conditions or the idea that something should simply be accepted as "common sense," even though the issue has not been thoroughly tested in current practice. A case study analysis may offer an opportunity to gather evidence that challenges prevailing assumptions about a research problem and provide a new set of recommendations applied to practice that have not been tested previously. For example, perhaps there has been a long practice among scholars to apply a particular theory in explaining the relationship between two subjects of analysis. Your case could challenge this assumption by applying an innovative theoretical framework [perhaps borrowed from another discipline] to explore whether this approach offers new ways of understanding the research problem. Taking a contrarian stance is one of the most important ways that new knowledge and understanding develops from existing literature.
  • The case provides an opportunity to pursue action leading to the resolution of a problem? Another way to think about choosing a case to study is to consider how the results from investigating a particular case may result in findings that reveal ways in which to resolve an existing or emerging problem. For example, studying the case of an unforeseen incident, such as a fatal accident at a railroad crossing, can reveal hidden issues that could be applied to preventative measures that contribute to reducing the chance of accidents in the future. In this example, a case study investigating the accident could lead to a better understanding of where to strategically locate additional signals at other railroad crossings so as to better warn drivers of an approaching train, particularly when visibility is hindered by heavy rain, fog, or at night.
  • The case offers a new direction in future research? A case study can be used as a tool for an exploratory investigation that highlights the need for further research about the problem. A case can be used when there are few studies that help predict an outcome or that establish a clear understanding about how best to proceed in addressing a problem. For example, after conducting a thorough literature review [very important!], you discover that little research exists showing the ways in which women contribute to promoting water conservation in rural communities of east central Africa. A case study of how women contribute to saving water in a rural village of Uganda can lay the foundation for understanding the need for more thorough research that documents how women in their roles as cooks and family caregivers think about water as a valuable resource within their community. This example of a case study could also point to the need for scholars to build new theoretical frameworks around the topic [e.g., applying feminist theories of work and family to the issue of water conservation].

Eisenhardt, Kathleen M. “Building Theories from Case Study Research.” Academy of Management Review 14 (October 1989): 532-550; Emmel, Nick. Sampling and Choosing Cases in Qualitative Research: A Realist Approach . Thousand Oaks, CA: SAGE Publications, 2013; Gerring, John. “What Is a Case Study and What Is It Good for?” American Political Science Review 98 (May 2004): 341-354; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Seawright, Jason and John Gerring. "Case Selection Techniques in Case Study Research." Political Research Quarterly 61 (June 2008): 294-308.

Structure and Writing Style

The purpose of a paper in the social sciences designed around a case study is to thoroughly investigate a subject of analysis in order to reveal a new understanding about the research problem and, in so doing, contributing new knowledge to what is already known from previous studies. In applied social sciences disciplines [e.g., education, social work, public administration, etc.], case studies may also be used to reveal best practices, highlight key programs, or investigate interesting aspects of professional work.

In general, the structure of a case study research paper is not all that different from a standard college-level research paper. However, there are subtle differences you should be aware of. Here are the key elements to organizing and writing a case study research paper.

I.  Introduction

As with any research paper, your introduction should serve as a roadmap for your readers to ascertain the scope and purpose of your study . The introduction to a case study research paper, however, should not only describe the research problem and its significance, but you should also succinctly describe why the case is being used and how it relates to addressing the problem. The two elements should be linked. With this in mind, a good introduction answers these four questions:

  • What is being studied? Describe the research problem and describe the subject of analysis [the case] you have chosen to address the problem. Explain how they are linked and what elements of the case will help to expand knowledge and understanding about the problem.
  • Why is this topic important to investigate? Describe the significance of the research problem and state why a case study design and the subject of analysis that the paper is designed around is appropriate in addressing the problem.
  • What did we know about this topic before I did this study? Provide background that helps lead the reader into the more in-depth literature review to follow. If applicable, summarize prior case study research applied to the research problem and why it fails to adequately address the problem. Describe why your case will be useful. If no prior case studies have been used to address the research problem, explain why you have selected this subject of analysis.
  • How will this study advance new knowledge or new ways of understanding? Explain why your case study will be suitable in helping to expand knowledge and understanding about the research problem.

Each of these questions should be addressed in no more than a few paragraphs. Exceptions to this can be when you are addressing a complex research problem or subject of analysis that requires more in-depth background information.

II.  Literature Review

The literature review for a case study research paper is generally structured the same as it is for any college-level research paper. The difference, however, is that the literature review is focused on providing background information and  enabling historical interpretation of the subject of analysis in relation to the research problem the case is intended to address . This includes synthesizing studies that help to:

  • Place relevant works in the context of their contribution to understanding the case study being investigated . This would involve summarizing studies that have used a similar subject of analysis to investigate the research problem. If there is literature using the same or a very similar case to study, you need to explain why duplicating past research is important [e.g., conditions have changed; prior studies were conducted long ago, etc.].
  • Describe the relationship each work has to the others under consideration that informs the reader why this case is applicable . Your literature review should include a description of any works that support using the case to investigate the research problem and the underlying research questions.
  • Identify new ways to interpret prior research using the case study . If applicable, review any research that has examined the research problem using a different research design. Explain how your use of a case study design may reveal new knowledge or a new perspective or that can redirect research in an important new direction.
  • Resolve conflicts amongst seemingly contradictory previous studies . This refers to synthesizing any literature that points to unresolved issues of concern about the research problem and describing how the subject of analysis that forms the case study can help resolve these existing contradictions.
  • Point the way in fulfilling a need for additional research . Your review should examine any literature that lays a foundation for understanding why your case study design and the subject of analysis around which you have designed your study may reveal a new way of approaching the research problem or offer a perspective that points to the need for additional research.
  • Expose any gaps that exist in the literature that the case study could help to fill . Summarize any literature that not only shows how your subject of analysis contributes to understanding the research problem, but how your case contributes to a new way of understanding the problem that prior research has failed to do.
  • Locate your own research within the context of existing literature [very important!] . Collectively, your literature review should always place your case study within the larger domain of prior research about the problem. The overarching purpose of reviewing pertinent literature in a case study paper is to demonstrate that you have thoroughly identified and synthesized prior studies in relation to explaining the relevance of the case in addressing the research problem.

III.  Method

In this section, you explain why you selected a particular case [i.e., subject of analysis] and the strategy you used to identify and ultimately decide that your case was appropriate in addressing the research problem. The way you describe the methods used varies depending on the type of subject of analysis that constitutes your case study.

If your subject of analysis is an incident or event . In the social and behavioral sciences, the event or incident that represents the case to be studied is usually bounded by time and place, with a clear beginning and end and with an identifiable location or position relative to its surroundings. The subject of analysis can be a rare or critical event or it can focus on a typical or regular event. The purpose of studying a rare event is to illuminate new ways of thinking about the broader research problem or to test a hypothesis. Critical incident case studies must describe the method by which you identified the event and explain the process by which you determined the validity of this case to inform broader perspectives about the research problem or to reveal new findings. However, the event does not have to be a rare or uniquely significant to support new thinking about the research problem or to challenge an existing hypothesis. For example, Walo, Bull, and Breen conducted a case study to identify and evaluate the direct and indirect economic benefits and costs of a local sports event in the City of Lismore, New South Wales, Australia. The purpose of their study was to provide new insights from measuring the impact of a typical local sports event that prior studies could not measure well because they focused on large "mega-events." Whether the event is rare or not, the methods section should include an explanation of the following characteristics of the event: a) when did it take place; b) what were the underlying circumstances leading to the event; and, c) what were the consequences of the event in relation to the research problem.

If your subject of analysis is a person. Explain why you selected this particular individual to be studied and describe what experiences they have had that provide an opportunity to advance new understandings about the research problem. Mention any background about this person which might help the reader understand the significance of their experiences that make them worthy of study. This includes describing the relationships this person has had with other people, institutions, and/or events that support using them as the subject for a case study research paper. It is particularly important to differentiate the person as the subject of analysis from others and to succinctly explain how the person relates to examining the research problem [e.g., why is one politician in a particular local election used to show an increase in voter turnout from any other candidate running in the election]. Note that these issues apply to a specific group of people used as a case study unit of analysis [e.g., a classroom of students].

If your subject of analysis is a place. In general, a case study that investigates a place suggests a subject of analysis that is unique or special in some way and that this uniqueness can be used to build new understanding or knowledge about the research problem. A case study of a place must not only describe its various attributes relevant to the research problem [e.g., physical, social, historical, cultural, economic, political], but you must state the method by which you determined that this place will illuminate new understandings about the research problem. It is also important to articulate why a particular place as the case for study is being used if similar places also exist [i.e., if you are studying patterns of homeless encampments of veterans in open spaces, explain why you are studying Echo Park in Los Angeles rather than Griffith Park?]. If applicable, describe what type of human activity involving this place makes it a good choice to study [e.g., prior research suggests Echo Park has more homeless veterans].

If your subject of analysis is a phenomenon. A phenomenon refers to a fact, occurrence, or circumstance that can be studied or observed but with the cause or explanation to be in question. In this sense, a phenomenon that forms your subject of analysis can encompass anything that can be observed or presumed to exist but is not fully understood. In the social and behavioral sciences, the case usually focuses on human interaction within a complex physical, social, economic, cultural, or political system. For example, the phenomenon could be the observation that many vehicles used by ISIS fighters are small trucks with English language advertisements on them. The research problem could be that ISIS fighters are difficult to combat because they are highly mobile. The research questions could be how and by what means are these vehicles used by ISIS being supplied to the militants and how might supply lines to these vehicles be cut off? How might knowing the suppliers of these trucks reveal larger networks of collaborators and financial support? A case study of a phenomenon most often encompasses an in-depth analysis of a cause and effect that is grounded in an interactive relationship between people and their environment in some way.

NOTE:   The choice of the case or set of cases to study cannot appear random. Evidence that supports the method by which you identified and chose your subject of analysis should clearly support investigation of the research problem and linked to key findings from your literature review. Be sure to cite any studies that helped you determine that the case you chose was appropriate for examining the problem.

IV.  Discussion

The main elements of your discussion section are generally the same as any research paper, but centered around interpreting and drawing conclusions about the key findings from your analysis of the case study. Note that a general social sciences research paper may contain a separate section to report findings. However, in a paper designed around a case study, it is common to combine a description of the results with the discussion about their implications. The objectives of your discussion section should include the following:

Reiterate the Research Problem/State the Major Findings Briefly reiterate the research problem you are investigating and explain why the subject of analysis around which you designed the case study were used. You should then describe the findings revealed from your study of the case using direct, declarative, and succinct proclamation of the study results. Highlight any findings that were unexpected or especially profound.

Explain the Meaning of the Findings and Why They are Important Systematically explain the meaning of your case study findings and why you believe they are important. Begin this part of the section by repeating what you consider to be your most important or surprising finding first, then systematically review each finding. Be sure to thoroughly extrapolate what your analysis of the case can tell the reader about situations or conditions beyond the actual case that was studied while, at the same time, being careful not to misconstrue or conflate a finding that undermines the external validity of your conclusions.

Relate the Findings to Similar Studies No study in the social sciences is so novel or possesses such a restricted focus that it has absolutely no relation to previously published research. The discussion section should relate your case study results to those found in other studies, particularly if questions raised from prior studies served as the motivation for choosing your subject of analysis. This is important because comparing and contrasting the findings of other studies helps support the overall importance of your results and it highlights how and in what ways your case study design and the subject of analysis differs from prior research about the topic.

Consider Alternative Explanations of the Findings Remember that the purpose of social science research is to discover and not to prove. When writing the discussion section, you should carefully consider all possible explanations revealed by the case study results, rather than just those that fit your hypothesis or prior assumptions and biases. Be alert to what the in-depth analysis of the case may reveal about the research problem, including offering a contrarian perspective to what scholars have stated in prior research if that is how the findings can be interpreted from your case.

Acknowledge the Study's Limitations You can state the study's limitations in the conclusion section of your paper but describing the limitations of your subject of analysis in the discussion section provides an opportunity to identify the limitations and explain why they are not significant. This part of the discussion section should also note any unanswered questions or issues your case study could not address. More detailed information about how to document any limitations to your research can be found here .

Suggest Areas for Further Research Although your case study may offer important insights about the research problem, there are likely additional questions related to the problem that remain unanswered or findings that unexpectedly revealed themselves as a result of your in-depth analysis of the case. Be sure that the recommendations for further research are linked to the research problem and that you explain why your recommendations are valid in other contexts and based on the original assumptions of your study.

V.  Conclusion

As with any research paper, you should summarize your conclusion in clear, simple language; emphasize how the findings from your case study differs from or supports prior research and why. Do not simply reiterate the discussion section. Provide a synthesis of key findings presented in the paper to show how these converge to address the research problem. If you haven't already done so in the discussion section, be sure to document the limitations of your case study and any need for further research.

The function of your paper's conclusion is to: 1) reiterate the main argument supported by the findings from your case study; 2) state clearly the context, background, and necessity of pursuing the research problem using a case study design in relation to an issue, controversy, or a gap found from reviewing the literature; and, 3) provide a place to persuasively and succinctly restate the significance of your research problem, given that the reader has now been presented with in-depth information about the topic.

Consider the following points to help ensure your conclusion is appropriate:

  • If the argument or purpose of your paper is complex, you may need to summarize these points for your reader.
  • If prior to your conclusion, you have not yet explained the significance of your findings or if you are proceeding inductively, use the conclusion of your paper to describe your main points and explain their significance.
  • Move from a detailed to a general level of consideration of the case study's findings that returns the topic to the context provided by the introduction or within a new context that emerges from your case study findings.

Note that, depending on the discipline you are writing in or the preferences of your professor, the concluding paragraph may contain your final reflections on the evidence presented as it applies to practice or on the essay's central research problem. However, the nature of being introspective about the subject of analysis you have investigated will depend on whether you are explicitly asked to express your observations in this way.

Problems to Avoid

Overgeneralization One of the goals of a case study is to lay a foundation for understanding broader trends and issues applied to similar circumstances. However, be careful when drawing conclusions from your case study. They must be evidence-based and grounded in the results of the study; otherwise, it is merely speculation. Looking at a prior example, it would be incorrect to state that a factor in improving girls access to education in Azerbaijan and the policy implications this may have for improving access in other Muslim nations is due to girls access to social media if there is no documentary evidence from your case study to indicate this. There may be anecdotal evidence that retention rates were better for girls who were engaged with social media, but this observation would only point to the need for further research and would not be a definitive finding if this was not a part of your original research agenda.

Failure to Document Limitations No case is going to reveal all that needs to be understood about a research problem. Therefore, just as you have to clearly state the limitations of a general research study , you must describe the specific limitations inherent in the subject of analysis. For example, the case of studying how women conceptualize the need for water conservation in a village in Uganda could have limited application in other cultural contexts or in areas where fresh water from rivers or lakes is plentiful and, therefore, conservation is understood more in terms of managing access rather than preserving access to a scarce resource.

Failure to Extrapolate All Possible Implications Just as you don't want to over-generalize from your case study findings, you also have to be thorough in the consideration of all possible outcomes or recommendations derived from your findings. If you do not, your reader may question the validity of your analysis, particularly if you failed to document an obvious outcome from your case study research. For example, in the case of studying the accident at the railroad crossing to evaluate where and what types of warning signals should be located, you failed to take into consideration speed limit signage as well as warning signals. When designing your case study, be sure you have thoroughly addressed all aspects of the problem and do not leave gaps in your analysis that leave the reader questioning the results.

Case Studies. Writing@CSU. Colorado State University; Gerring, John. Case Study Research: Principles and Practices . New York: Cambridge University Press, 2007; Merriam, Sharan B. Qualitative Research and Case Study Applications in Education . Rev. ed. San Francisco, CA: Jossey-Bass, 1998; Miller, Lisa L. “The Use of Case Studies in Law and Social Science Research.” Annual Review of Law and Social Science 14 (2018): TBD; Mills, Albert J., Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Putney, LeAnn Grogan. "Case Study." In Encyclopedia of Research Design , Neil J. Salkind, editor. (Thousand Oaks, CA: SAGE Publications, 2010), pp. 116-120; Simons, Helen. Case Study Research in Practice . London: SAGE Publications, 2009;  Kratochwill,  Thomas R. and Joel R. Levin, editors. Single-Case Research Design and Analysis: New Development for Psychology and Education .  Hilldsale, NJ: Lawrence Erlbaum Associates, 1992; Swanborn, Peter G. Case Study Research: What, Why and How? London : SAGE, 2010; Yin, Robert K. Case Study Research: Design and Methods . 6th edition. Los Angeles, CA, SAGE Publications, 2014; Walo, Maree, Adrian Bull, and Helen Breen. “Achieving Economic Benefits at Local Events: A Case Study of a Local Sports Event.” Festival Management and Event Tourism 4 (1996): 95-106.

Writing Tip

At Least Five Misconceptions about Case Study Research

Social science case studies are often perceived as limited in their ability to create new knowledge because they are not randomly selected and findings cannot be generalized to larger populations. Flyvbjerg examines five misunderstandings about case study research and systematically "corrects" each one. To quote, these are:

Misunderstanding 1 :  General, theoretical [context-independent] knowledge is more valuable than concrete, practical [context-dependent] knowledge. Misunderstanding 2 :  One cannot generalize on the basis of an individual case; therefore, the case study cannot contribute to scientific development. Misunderstanding 3 :  The case study is most useful for generating hypotheses; that is, in the first stage of a total research process, whereas other methods are more suitable for hypotheses testing and theory building. Misunderstanding 4 :  The case study contains a bias toward verification, that is, a tendency to confirm the researcher’s preconceived notions. Misunderstanding 5 :  It is often difficult to summarize and develop general propositions and theories on the basis of specific case studies [p. 221].

While writing your paper, think introspectively about how you addressed these misconceptions because to do so can help you strengthen the validity and reliability of your research by clarifying issues of case selection, the testing and challenging of existing assumptions, the interpretation of key findings, and the summation of case outcomes. Think of a case study research paper as a complete, in-depth narrative about the specific properties and key characteristics of your subject of analysis applied to the research problem.

Flyvbjerg, Bent. “Five Misunderstandings About Case-Study Research.” Qualitative Inquiry 12 (April 2006): 219-245.

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What Is a Case Study?

Weighing the pros and cons of this method of research

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

social issues case study

Cara Lustik is a fact-checker and copywriter.

social issues case study

Verywell / Colleen Tighe

  • Pros and Cons

What Types of Case Studies Are Out There?

Where do you find data for a case study, how do i write a psychology case study.

A case study is an in-depth study of one person, group, or event. In a case study, nearly every aspect of the subject's life and history is analyzed to seek patterns and causes of behavior. Case studies can be used in many different fields, including psychology, medicine, education, anthropology, political science, and social work.

The point of a case study is to learn as much as possible about an individual or group so that the information can be generalized to many others. Unfortunately, case studies tend to be highly subjective, and it is sometimes difficult to generalize results to a larger population.

While case studies focus on a single individual or group, they follow a format similar to other types of psychology writing. If you are writing a case study, we got you—here are some rules of APA format to reference.  

At a Glance

A case study, or an in-depth study of a person, group, or event, can be a useful research tool when used wisely. In many cases, case studies are best used in situations where it would be difficult or impossible for you to conduct an experiment. They are helpful for looking at unique situations and allow researchers to gather a lot of˜ information about a specific individual or group of people. However, it's important to be cautious of any bias we draw from them as they are highly subjective.

What Are the Benefits and Limitations of Case Studies?

A case study can have its strengths and weaknesses. Researchers must consider these pros and cons before deciding if this type of study is appropriate for their needs.

One of the greatest advantages of a case study is that it allows researchers to investigate things that are often difficult or impossible to replicate in a lab. Some other benefits of a case study:

  • Allows researchers to capture information on the 'how,' 'what,' and 'why,' of something that's implemented
  • Gives researchers the chance to collect information on why one strategy might be chosen over another
  • Permits researchers to develop hypotheses that can be explored in experimental research

On the other hand, a case study can have some drawbacks:

  • It cannot necessarily be generalized to the larger population
  • Cannot demonstrate cause and effect
  • It may not be scientifically rigorous
  • It can lead to bias

Researchers may choose to perform a case study if they want to explore a unique or recently discovered phenomenon. Through their insights, researchers develop additional ideas and study questions that might be explored in future studies.

It's important to remember that the insights from case studies cannot be used to determine cause-and-effect relationships between variables. However, case studies may be used to develop hypotheses that can then be addressed in experimental research.

Case Study Examples

There have been a number of notable case studies in the history of psychology. Much of  Freud's work and theories were developed through individual case studies. Some great examples of case studies in psychology include:

  • Anna O : Anna O. was a pseudonym of a woman named Bertha Pappenheim, a patient of a physician named Josef Breuer. While she was never a patient of Freud's, Freud and Breuer discussed her case extensively. The woman was experiencing symptoms of a condition that was then known as hysteria and found that talking about her problems helped relieve her symptoms. Her case played an important part in the development of talk therapy as an approach to mental health treatment.
  • Phineas Gage : Phineas Gage was a railroad employee who experienced a terrible accident in which an explosion sent a metal rod through his skull, damaging important portions of his brain. Gage recovered from his accident but was left with serious changes in both personality and behavior.
  • Genie : Genie was a young girl subjected to horrific abuse and isolation. The case study of Genie allowed researchers to study whether language learning was possible, even after missing critical periods for language development. Her case also served as an example of how scientific research may interfere with treatment and lead to further abuse of vulnerable individuals.

Such cases demonstrate how case research can be used to study things that researchers could not replicate in experimental settings. In Genie's case, her horrific abuse denied her the opportunity to learn a language at critical points in her development.

This is clearly not something researchers could ethically replicate, but conducting a case study on Genie allowed researchers to study phenomena that are otherwise impossible to reproduce.

There are a few different types of case studies that psychologists and other researchers might use:

  • Collective case studies : These involve studying a group of individuals. Researchers might study a group of people in a certain setting or look at an entire community. For example, psychologists might explore how access to resources in a community has affected the collective mental well-being of those who live there.
  • Descriptive case studies : These involve starting with a descriptive theory. The subjects are then observed, and the information gathered is compared to the pre-existing theory.
  • Explanatory case studies : These   are often used to do causal investigations. In other words, researchers are interested in looking at factors that may have caused certain things to occur.
  • Exploratory case studies : These are sometimes used as a prelude to further, more in-depth research. This allows researchers to gather more information before developing their research questions and hypotheses .
  • Instrumental case studies : These occur when the individual or group allows researchers to understand more than what is initially obvious to observers.
  • Intrinsic case studies : This type of case study is when the researcher has a personal interest in the case. Jean Piaget's observations of his own children are good examples of how an intrinsic case study can contribute to the development of a psychological theory.

The three main case study types often used are intrinsic, instrumental, and collective. Intrinsic case studies are useful for learning about unique cases. Instrumental case studies help look at an individual to learn more about a broader issue. A collective case study can be useful for looking at several cases simultaneously.

The type of case study that psychology researchers use depends on the unique characteristics of the situation and the case itself.

There are a number of different sources and methods that researchers can use to gather information about an individual or group. Six major sources that have been identified by researchers are:

  • Archival records : Census records, survey records, and name lists are examples of archival records.
  • Direct observation : This strategy involves observing the subject, often in a natural setting . While an individual observer is sometimes used, it is more common to utilize a group of observers.
  • Documents : Letters, newspaper articles, administrative records, etc., are the types of documents often used as sources.
  • Interviews : Interviews are one of the most important methods for gathering information in case studies. An interview can involve structured survey questions or more open-ended questions.
  • Participant observation : When the researcher serves as a participant in events and observes the actions and outcomes, it is called participant observation.
  • Physical artifacts : Tools, objects, instruments, and other artifacts are often observed during a direct observation of the subject.

If you have been directed to write a case study for a psychology course, be sure to check with your instructor for any specific guidelines you need to follow. If you are writing your case study for a professional publication, check with the publisher for their specific guidelines for submitting a case study.

Here is a general outline of what should be included in a case study.

Section 1: A Case History

This section will have the following structure and content:

Background information : The first section of your paper will present your client's background. Include factors such as age, gender, work, health status, family mental health history, family and social relationships, drug and alcohol history, life difficulties, goals, and coping skills and weaknesses.

Description of the presenting problem : In the next section of your case study, you will describe the problem or symptoms that the client presented with.

Describe any physical, emotional, or sensory symptoms reported by the client. Thoughts, feelings, and perceptions related to the symptoms should also be noted. Any screening or diagnostic assessments that are used should also be described in detail and all scores reported.

Your diagnosis : Provide your diagnosis and give the appropriate Diagnostic and Statistical Manual code. Explain how you reached your diagnosis, how the client's symptoms fit the diagnostic criteria for the disorder(s), or any possible difficulties in reaching a diagnosis.

Section 2: Treatment Plan

This portion of the paper will address the chosen treatment for the condition. This might also include the theoretical basis for the chosen treatment or any other evidence that might exist to support why this approach was chosen.

  • Cognitive behavioral approach : Explain how a cognitive behavioral therapist would approach treatment. Offer background information on cognitive behavioral therapy and describe the treatment sessions, client response, and outcome of this type of treatment. Make note of any difficulties or successes encountered by your client during treatment.
  • Humanistic approach : Describe a humanistic approach that could be used to treat your client, such as client-centered therapy . Provide information on the type of treatment you chose, the client's reaction to the treatment, and the end result of this approach. Explain why the treatment was successful or unsuccessful.
  • Psychoanalytic approach : Describe how a psychoanalytic therapist would view the client's problem. Provide some background on the psychoanalytic approach and cite relevant references. Explain how psychoanalytic therapy would be used to treat the client, how the client would respond to therapy, and the effectiveness of this treatment approach.
  • Pharmacological approach : If treatment primarily involves the use of medications, explain which medications were used and why. Provide background on the effectiveness of these medications and how monotherapy may compare with an approach that combines medications with therapy or other treatments.

This section of a case study should also include information about the treatment goals, process, and outcomes.

When you are writing a case study, you should also include a section where you discuss the case study itself, including the strengths and limitiations of the study. You should note how the findings of your case study might support previous research. 

In your discussion section, you should also describe some of the implications of your case study. What ideas or findings might require further exploration? How might researchers go about exploring some of these questions in additional studies?

Need More Tips?

Here are a few additional pointers to keep in mind when formatting your case study:

  • Never refer to the subject of your case study as "the client." Instead, use their name or a pseudonym.
  • Read examples of case studies to gain an idea about the style and format.
  • Remember to use APA format when citing references .

Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach .  BMC Med Res Methodol . 2011;11:100.

Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach . BMC Med Res Methodol . 2011 Jun 27;11:100. doi:10.1186/1471-2288-11-100

Gagnon, Yves-Chantal.  The Case Study as Research Method: A Practical Handbook . Canada, Chicago Review Press Incorporated DBA Independent Pub Group, 2010.

Yin, Robert K. Case Study Research and Applications: Design and Methods . United States, SAGE Publications, 2017.

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Hertz CEO Kathryn Marinello with CFO Jamere Jackson and other members of the executive team in 2017

Top 40 Most Popular Case Studies of 2021

Two cases about Hertz claimed top spots in 2021's Top 40 Most Popular Case Studies

Two cases on the uses of debt and equity at Hertz claimed top spots in the CRDT’s (Case Research and Development Team) 2021 top 40 review of cases.

Hertz (A) took the top spot. The case details the financial structure of the rental car company through the end of 2019. Hertz (B), which ranked third in CRDT’s list, describes the company’s struggles during the early part of the COVID pandemic and its eventual need to enter Chapter 11 bankruptcy. 

The success of the Hertz cases was unprecedented for the top 40 list. Usually, cases take a number of years to gain popularity, but the Hertz cases claimed top spots in their first year of release. Hertz (A) also became the first ‘cooked’ case to top the annual review, as all of the other winners had been web-based ‘raw’ cases.

Besides introducing students to the complicated financing required to maintain an enormous fleet of cars, the Hertz cases also expanded the diversity of case protagonists. Kathyrn Marinello was the CEO of Hertz during this period and the CFO, Jamere Jackson is black.

Sandwiched between the two Hertz cases, Coffee 2016, a perennial best seller, finished second. “Glory, Glory, Man United!” a case about an English football team’s IPO made a surprise move to number four.  Cases on search fund boards, the future of malls,  Norway’s Sovereign Wealth fund, Prodigy Finance, the Mayo Clinic, and Cadbury rounded out the top ten.

Other year-end data for 2021 showed:

  • Online “raw” case usage remained steady as compared to 2020 with over 35K users from 170 countries and all 50 U.S. states interacting with 196 cases.
  • Fifty four percent of raw case users came from outside the U.S..
  • The Yale School of Management (SOM) case study directory pages received over 160K page views from 177 countries with approximately a third originating in India followed by the U.S. and the Philippines.
  • Twenty-six of the cases in the list are raw cases.
  • A third of the cases feature a woman protagonist.
  • Orders for Yale SOM case studies increased by almost 50% compared to 2020.
  • The top 40 cases were supervised by 19 different Yale SOM faculty members, several supervising multiple cases.

CRDT compiled the Top 40 list by combining data from its case store, Google Analytics, and other measures of interest and adoption.

All of this year’s Top 40 cases are available for purchase from the Yale Management Media store .

And the Top 40 cases studies of 2021 are:

1.   Hertz Global Holdings (A): Uses of Debt and Equity

2.   Coffee 2016

3.   Hertz Global Holdings (B): Uses of Debt and Equity 2020

4.   Glory, Glory Man United!

5.   Search Fund Company Boards: How CEOs Can Build Boards to Help Them Thrive

6.   The Future of Malls: Was Decline Inevitable?

7.   Strategy for Norway's Pension Fund Global

8.   Prodigy Finance

9.   Design at Mayo

10. Cadbury

11. City Hospital Emergency Room

13. Volkswagen

14. Marina Bay Sands

15. Shake Shack IPO

16. Mastercard

17. Netflix

18. Ant Financial

19. AXA: Creating the New CR Metrics

20. IBM Corporate Service Corps

21. Business Leadership in South Africa's 1994 Reforms

22. Alternative Meat Industry

23. Children's Premier

24. Khalil Tawil and Umi (A)

25. Palm Oil 2016

26. Teach For All: Designing a Global Network

27. What's Next? Search Fund Entrepreneurs Reflect on Life After Exit

28. Searching for a Search Fund Structure: A Student Takes a Tour of Various Options

30. Project Sammaan

31. Commonfund ESG

32. Polaroid

33. Connecticut Green Bank 2018: After the Raid

34. FieldFresh Foods

35. The Alibaba Group

36. 360 State Street: Real Options

37. Herman Miller

38. AgBiome

39. Nathan Cummings Foundation

40. Toyota 2010

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Social Media

Study: Social media use linked to decline in mental health

Dylan Walsh

Sep 14, 2022

Mark Zuckerberg launched TheFacebook at Harvard University in February 2004. Days later, 650 students had made accounts. Today, there are roughly two billion daily active users.

Concurrent with Facebook’s meteoric expansion has been growing concern over the mental well-being of adolescents and young adults. According to data from the Centers for Disease Control , the suicide rate among 10- to 24-year-olds was stable from 2000 to 2007; it then increased 57% between 2007 and 2017.

Given these parallel trends, it’s important to understand the relationship between mental health and technology use, especially how youths use social media. But there have been few causal studies.

“There may be hundreds of papers that present correlations between social media and well-being, and many of them are great and highly informative, but we still know little about which way the effect runs,” said Alexey Makarin,  an assistant professor at MIT Sloan. People who use more social media may become more depressed, or, conversely, people who are more depressed may be more active on social media. “There is a lack of true causal evidence.”

Makarin and colleagues Luca Braghieri of Bocconi University and Ro’ee Levy of Tel Aviv University aim to fill this gap with a new paper , forthcoming in the American Economic Review . The researchers paired the staggered rollout of Facebook in colleges with 430,000 responses from the National College Health Assessment , a semi-annual survey of mental health and well-being on campuses across the U.S. (The survey looks at other dimensions of student health, as well, like substance use and exercise habits.) The researchers found a significant link between the presence of Facebook and a deterioration in mental health among college students.

Facebook access leads to more anxiety and depression

When Facebook began, access was restricted to people with a Harvard email address. Less than a month later, the website had expanded to Columbia, Stanford, and Yale. This progressive opening continued until September of 2006, when anybody over 13 years old was able to create an account.

College-wide Facebook access led to a 7% increase in severe depression among students, researchers found.

“We were able to use the fact that Facebook rolled out at different universities at different times, together with the fact that we have this huge survey already conducted at universities, to understand the causal impact of Facebook on student mental health,” Makarin said.

Most broadly, the researchers found a sizable increase in the number of students who reported mental distress at some time in the preceding year. College-wide access to Facebook led to an increase in severe depression by 7% and anxiety disorder by 20%. Beyond these results, a greater percentage of the most susceptible students also treated symptoms with either psychotherapy or antidepressants. In total, the negative effect of Facebook on mental health appeared to be roughly 20% the magnitude of what is experienced by those who lose their job.

The researchers posit that social comparison with peers is behind those results, and it is an effect that appears to grow stronger as people are exposed to Facebook for greater lengths. “The effects seem to increase with time,” Makarin said. “If, in late fall 2004, a freshman at Harvard had Facebook available to him for one semester and a sophomore for two semesters, it appears as though the effect is stronger with the sophomore, who had greater exposure.”

Trying to solve a “truly bad” situation

Given Makarin and his coauthors are looking at Facebook in its earliest form, they’ve faced questions about the salience of these findings. “People wonder how much this tells us about Facebook, or Instagram, right now,” Makarin said. “And that’s a fair criticism — but there are a few things in our defense.”

Related Articles

First, to the degree that social comparison drives these results, Makarin notes there is reason to believe the effect has not diminished; looking at and interpreting the curated posts of others remains a fundamental operating principle on Facebook and other, similar forms of social media. (Makarin also suspects that the ubiquity of smartphones could make this channel of influence stronger.)

Second, even if the study pertains to a particular period, the paucity of experimental data on how social media affects its users means any contribution should be considered worthwhile. “Whatever causal evidence we are able to provide is, by its nature, useful,” he said.

Makarin and his coauthors also take care to delimit the scope of their study. The mental health of Facebook’s users is only one dimension on which to measure the overall effect of social media. People may derive benefits, like connection with old friends or access to likeminded groups or good deals on products, that, in total, outweigh the costs.

But even if this is the case, Makarin believes that social media companies and policymakers should still work to alleviate the potentially harmful effects on mental well-being. As of 2021, 4.5 billion people — more than half of the global population — had a social media account.

“When I came to this work, I knew that mental health was an important issue, but to be honest, I thought of it as just one more outcome to study in our social media agenda,” he said. “When I started to really look into the trends of deteriorating mental health among the young adults, though, I came to realize how truly bad the situation is, and that stuck with me. Any insights that this paper, or others, can offer into what’s behind this trend will be very valuable to society.”

Read next: 5 social media trends experts are watching

2023 Working Definitions including "patient capital," "cultural detox," "greenhushing," and "culture of heroics."

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Ethics: To Tell or Not to Tell-A Case Study

By: Lee J. Zook

Winter 2001, Vol. 8, No. 1

by Lee J. Zook, Ph.D.

Some years ago, prior to teaching in undergraduate social work, I was working with families and children in an outpatient psychiatric setting, Children' Agency. In the previous year, I had completed my MSW, having practiced social work several years with an undergraduate degree. The Director of Social Services at the Children' Agency was my supervisor. We used a team model in our work, with any particular team consisting of at least a social worker, a psychologist, and a psychiatrist. Sometimes other professionals, such as educational specialists, early childhood development specialists, and social group workers were also on the teams. I had first-rate colleagues in whom I could confide about clinical and ethical issues. Continuous learning was valued, especially as it related to clinical practice.

While I was at Children' Agency, Mary Jones (a fictitious name) applied for a job as a social worker. Four years earlier, I had seen Mary as a client while working for an emergency service at Adult Hospital, a psychiatric facility for adults.

My contact with Mary had been rather brief at Adult Hospital. She came to be admitted to the hospital as her psychiatric condition was deteriorating. Mary told me she was a social worker with an MSW and had been in and out of psychiatric hospitals for many years. I located her chart, noted that she was previously diagnosed with schizophrenia, undifferentiated type, did the basic paperwork that social workers did on admission, consulted with the admitting psychiatrist, and took her to the hospital ward. It was a rather simple, routine admission; there were no police or court documents, and she was a voluntary client. However, the situation was a bit unsettling. My feelings had to do with the fact that I was leaving my position in the near future to pursue an MSW, and here I was, a young, rather inexperienced, “untrained” social worker, admitting an older, more experienced social worker with an MSW to a psychiatric hospital. However, I went on with my business and put the event in perspective. After all, academic degrees do not preclude a person from having a mental illness.

So now, three years later, I had my MSW, and Mary came for a job interview at Children' Agency where I was employed. I had no responsibility for employment decisions. My supervisor, who was the Director of Social Services, and the psychiatrist, who was also the Executive Director, made these decisions. But I was faced with an uncomfortable dilemma-an ethical dilemma for which I did not see any clear answer.

On one hand, I was concerned about whether Mary would function as a competent professional colleague. Was her illness in remission? If so, would it remain in remission? If not, what would the impact be on clients? Would she be able to function adequately to work with clients who came to the agency? If she would not, would harm come to clients?

On the other hand, my knowledge of her illness was unquestionably confidential. Further, what right or responsibility did I have to suggest that a person who had a mental illness should not be hired? What right or responsibility did I have to divulge information about her (past) condition to anyone?

There was also the possibility that I could speak to Mary and verbalize my concerns to her. Would this be appropriate? Would Mary remember who I was? After three years, did the brief encounter we had give me the prerogative to confront her about her past or ask about her present condition?

The following discussion focuses on the NASW Code of Ethics and how it may be useful in this situation. At the time, I was not this thorough and did not think much about the Code of Ethics. I struggled in my own mind about what to do. If this were occurring now, I would first of all confer with the Code of Ethics. The first sentence of the preamble of the Code states:

The primary mission of the social work profession is to enhance human well-being and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty.

In this situation, one could contend that clients coming to Children' Agency were the vulnerable people referred to in the Preamble. On the other hand, one could also make a case that Mary, a person who is living with a persistent and long-term mental illness, is a vulnerable person.

As a social worker, I am particularly concerned about creating opportunity for persons with disability. And in this instance, vulnerability of a specific person could be viewed as more important than vulnerability of a general client population.

In further examination of the Code, Section 1.07 Privacy and Confidentiality, paragraph (c) is instructive.

Social workers should protect the confidentiality of all information obtained in the course of professional service, except for compelling professional reasons. The general expectation that social workers will keep information confidential does not apply when disclosure is necessary to prevent serious, foreseeable, and imminent harm to a client or other identifiable person.

This paragraph seems to suggest intervention in the situation with Mary is not appropriate. Do not break confidentiality. However, it also says that there are situations in which confidentiality is not the primary concern. Disclosure of confidential information may be made when it is crucial to “prevent serious, foreseeable, and imminent harm to a client or other identifiable person.” But could I argue that there was such serious, foreseeable and imminent harm to anyone? Would it be appropriate, with the knowledge that I had, to suggest such harm would occur? If the answer to the last question is affirmative, what does that infer about persons with a mental illness?

Other paragraphs in Section 2.09, Impairment of Colleagues, are also on point.

(a) Social workers who have direct knowledge of a social work colleague' impairment that is due to personal problems, psychosocial distress, substance abuse, or mental health difficulties and that interferes with practice effectiveness should consult with that colleague when feasible and assist the colleague in taking remedial action.

(b) Social workers who believe that a social work colleague' impairment interferes with practice effectiveness and that the colleague has not taken adequate steps to address the impairment should take action through appropriate channels established by employers, agencies, NASW, licensing and regulatory bodies, and other professional organizations.

I did have knowledge of Mary' impairment. However, to infer that her impairment would interfere with her work as a professional social worker could be seen as prejudiced toward persons with a mental illness. Did I have enough information about Mary to “consult” with Mary as paragraph (a) suggests?

Further, Section 4.02, Discrimination, states that: “Social workers should not practice, condone, facilitate, or collaborate with any form of discrimination on the basis of race, ethnicity, national origin, color, sex, sexual orientation, age, marital status, political belief, religion, or mental or physical disability.” (Italics added.) This suggests that revealing anything about Mary' condition or even confronting Mary with the situation would be discriminatory.

Finally, since Mary was a professional, didn’t she have the responsibility to make sure her “mental health difficulties” did not interfere with her professional judgment and performance as is stated in Section 4.05, Impairment, paragraph a?

(a) Social workers should not allow their own personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties to interfere with their professional judgment and performance or to jeopardize the best interests of people for whom they have a professional responsibility.

Paragraph b. of Section 4.05, Impairment goes on to say, in part, that social workers whose “mental health difficulties interfere with their professional judgment and performance” need to seek help, make adjustments in their work situation, or quit practicing.

Doesn’t this mean that since Mary is a professional, she needs to deal with these issues? If that is the case, what is my role?

Obviously, the Code is not a clear set of rules. Rather, it gives guidance to social workers. While it is instructive, the Code does not specify what course of action is best in all instances. As stated in the Preamble, “Core values, and the principles that flow from them, must be balanced within the context and complexity of the human experience.” Professional judgment also comes into play in making ethical decisions.

In summary, there seemed to be no ideal course of action in this situation. I did not know how to predict what would happen if I talked with Mary. It is conceivable that I would have a colleague who was less than happy with my reminding her of her illness. If I did intervene by reporting to persons responsible for hiring, confidential information would be divulged. I could be identified as practicing discrimination toward persons with a mental illness. If I did not intervene, and she was hired, harm could come to clients.

There seemed to be no ideal answer and no way to avoid the situation. There may have been other options, but none seemed apparent to me at the time.

When I relate this case in class, I ask students to work in groups, make a decision, and explain to the rest of the class how they came to their conclusion. Obviously, the Code of Ethics should be a guide in such decisions. But other questions about how to make these types of decisions are also important. Is it appropriate to discuss such issues with my other colleagues? If yes, under what circumstances should such issues be discussed, formally or informally? Should a professional social worker consult with the National Association of Social Workers about such a decision? In general, should a supervisor be consulted about such decisions? In this instance, this would not have seemed appropriate, as the supervisor was also the person in charge of hiring.

In conclusion, there are times in social work practice when professionals are placed in situations, through no wrongdoing on anybody' part, in which dilemmas occur because of a conflict in values or ethical principles within the situation itself. In those situations, it is not a matter of choosing good versus evil, or choosing right versus wrong. It is a matter of choosing between the better of two goods or, possibly more often, the lesser of two evils. Making those decisions is often not pleasant. In fact, it can be quite anxiety provoking. But it is also impossible to side step the issue when doing nothing will predictably yield a certain outcome.

I would welcome a discussion about this case. What would you do? How would you decide what you would do? What besides the Code of Ethics should aid one in making this decision? These are some of the questions that we could discuss together.

National Association of Social Workers. (1999). NASW Code of Ethics. Available online at http://www.socialworkers.org/Code/ethics.htm .

Lee J. Zook, Ph.D., is Associate Professor of Social Work at Luther College in Decorah, Iowa.

Copyright © 2001 White Hat Communications. All rights reserved. From THE NEW SOCIAL WORKER , Winter 2001, Vol. 8, No. 1. For reprints of this or other articles from THE NEW SOCIAL WORKER (or for permission to reprint), contact Linda Grobman, publisher/editor, at P.O. Box 5390, Harrisburg, PA 17110-0390, or at [email protected] .

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College of Nursing

Driving change: a case study of a dnp leader in residence program in a gerontological center of excellence.

View as pdf A later version of this article appeared in Nurse Leader , Volume 21, Issue 6 , December 2023 . 

The American Association of Colleges of Nursing (AACN) published the Essentials of Doctoral Education for Advanced Practice Nursing in 2004 identifying the essential curriculum needed for preparing advanced practice nurse leaders to effectively assess organizations, identify systemic issues, and facilitate organizational changes. 1 In 2021, AACN updated the curriculum by issuing The Essentials: Core Competencies for Professional Nursing Education to guide the development of competency-based education for nursing students. 1 In addition to AACN’s competency-based approach to curriculum, in 2015 the American Organization of Nurse Leaders (AONL) released Nurse Leader Core Competencies (updated in 2023) to help provide a competency based model to follow in developing nurse leaders. 2

Despite AACN and AONL competency-based curriculum and model, it is still common for nurse leaders to be promoted to management positions based solely on their work experience or exceptional clinical skills, rather than demonstration of management and leadership competencies. 3 The importance of identifying, training, and assessing executive leaders through formal leadership development programs, within supportive organizational cultures has been discussed by national leaders. As well as the need for nurturing emerging leaders through fostering interprofessional collaboration, mentorship, and continuous development of leadership skills has been identified. 4 As Doctor of Nursing Practice (DNP) nurse leaders assume executive roles within healthcare organizations, they play a vital role within complex systems. Demonstration of leadership competence and participation in formal leadership development programs has become imperative for their success. However, models of competency-based executive leadership development programs can be hard to find, particularly programs outside of health care systems.

The implementation of a DNP Leader in Residence program, such as the one designed for The Barbara and Richard Csomay Center for Gerontological Excellence, addresses many of the challenges facing new DNP leaders and ensures mastery of executive leadership competencies and readiness to practice through exposure to varied experiences and close mentoring. The Csomay Center , based at The University of Iowa, was established in 2000 as one of the five original Hartford Centers of Geriatric Nursing Excellence in the country. Later funding by the Csomay family established an endowment that supports the Center's ongoing work. The current Csomay Center strategic plan and mission aims to develop future healthcare leaders while promoting optimal aging and quality of life for older adults. The Csomay Center Director created the innovative DNP Leader in Residence program to foster the growth of future nurse leaders in non-healthcare systems. The purpose of this paper is to present a case study of the development and implementation of the Leader in Residence program, followed by suggested evaluation strategies, and discussion of future innovation of leadership opportunities in non-traditional health care settings.

Development of the DNP Leader in Residence Program

The Plan-Do-Study-Act (PDSA) cycle has garnered substantial recognition as a valuable tool for fostering development and driving improvement initiatives. 5 The PDSA cycle can function as an independent methodology and as an integral component of broader quality enhancement approaches with notable efficacy in its ability to facilitate the rapid creation, testing, and evaluation of transformative interventions within healthcare. 6 Consequently, the PDSA cycle model was deemed fitting to guide the development and implementation of the DNP Leader in Residence Program at the Csomay Center.

PDSA Cycle: Plan

Existing resources. The DNP Health Systems: Administration/Executive Leadership Program offered by the University of Iowa is comprised of comprehensive nursing administration and leadership curriculum, led by distinguished faculty composed of national leaders in the realms of innovation, health policy, leadership, clinical education, and evidence-based practice. The curriculum is designed to cultivate the next generation of nursing executive leaders, with emphasis on personalized career planning and tailored practicum placements. The DNP Health Systems: Administration/Executive Leadership curriculum includes a range of courses focused on leadership and management with diverse topics such as policy an law, infrastructure and informatics, finance and economics, marketing and communication, quality and safety, evidence-based practice, and social determinants of health. The curriculum is complemented by an extensive practicum component and culminates in a DNP project with additional hours of practicum.

New program. The DNP Leader in Residence program at the Csomay Center is designed to encompass communication and relationship building, systems thinking, change management, transformation and innovation, knowledge of clinical principles in the community, professionalism, and business skills including financial, strategic, and human resource management. The program fully immerses students in the objectives of the DNP Health Systems: Administration/Executive Leadership curriculum and enables them to progressively demonstrate competencies outlined by AONL. The Leader in Residence program also includes career development coaching, reflective practice, and personal and professional accountability. The program is integrated throughout the entire duration of the Leader in Residence’s coursework, fulfilling the required practicum hours for both the DNP coursework and DNP project.

The DNP Leader in Residence program begins with the first semester of practicum being focused on completing an onboarding process to the Center including understanding the center's strategic plan, mission, vision, and history. Onboarding for the Leader in Residence provides access to all relevant Center information and resources and integration into the leadership team, community partnerships, and other University of Iowa College of Nursing Centers associated with the Csomay Center. During this first semester, observation and identification of the Csomay Center Director's various roles including being a leader, manager, innovator, socializer, and mentor is facilitated. In collaboration with the Center Director (a faculty position) and Center Coordinator (a staff position), specific competencies to be measured and mastered along with learning opportunities desired throughout the program are established to ensure a well-planned and thorough immersion experience.

Following the initial semester of practicum, the Leader in Residence has weekly check-ins with the Center Director and Center Coordinator to continue to identify learning opportunities and progression through executive leadership competencies to enrich the experience. The Leader in Residence also undertakes an administrative project for the Center this semester, while concurrently continuing observations of the Center Director's activities in local, regional, and national executive leadership settings. The student has ongoing participation and advancement in executive leadership roles and activities throughout the practicum, creating a well-prepared future nurse executive leader.

After completing practicum hours related to the Health Systems: Administration/Executive Leadership coursework, the Leader in Residence engages in dedicated residency hours to continue to experience domains within nursing leadership competencies like communication, professionalism, and relationship building. During residency hours, time is spent with the completion of a small quality improvement project for the Csomay Center, along with any other administrative projects identified by the Center Director and Center Coordinator. The Leader in Residence is fully integrated into the Csomay Center's Leadership Team during this phase, assisting the Center Coordinator in creating agendas and leading meetings. Additional participation includes active involvement in community engagement activities and presenting at or attending a national conference as a representative of the Csomay Center. The Leader in Residence must mentor a master’s in nursing student during the final year of the DNP Residency.

Implementation of the DNP Leader in Residence Program

PDSA Cycle: Do

Immersive experience. In this case study, the DNP Leader in Residence was fully immersed in a wide range of center activities, providing valuable opportunities to engage in administrative projects and observe executive leadership roles and skills during practicum hours spent at the Csomay Center. Throughout the program, the Leader in Residence observed and learned from multidisciplinary leaders at the national, regional, and university levels who engaged with the Center. By shadowing the Csomay Center Director, the Leader in Residence had the opportunity to observe executive leadership objectives such as fostering innovation, facilitating multidisciplinary collaboration, and nurturing meaningful relationships. The immersive experience within the center’s activities also allowed the Leader in Residence to gain a deep understanding of crucial facets such as philanthropy and community engagement. Active involvement in administrative processes such as strategic planning, budgeting, human resources management, and the development of standard operating procedures provided valuable exposure to strategies that are needed to be an effective nurse leader in the future.

Active participation. The DNP Leader in Residence also played a key role in advancing specific actions outlined in the center's strategic plan during the program including: 1) the creation of a membership structure for the Csomay Center and 2) successfully completing a state Board of Regents application for official recognition as a distinguished center. The Csomay Center sponsored membership for the Leader in Residence in the Midwest Nurse Research Society (MNRS), which opened doors to attend the annual MNRS conference and engage with regional nursing leadership, while fostering socialization, promotion of the Csomay Center and Leader in Residence program, and observation of current nursing research. Furthermore, the Leader in Residence participated in the strategic planning committee and engagement subcommittee for MNRS, collaborating directly with the MNRS president. Additional active participation by the Leader in Residence included attendance in planning sessions and completion of the annual report for GeriatricPain.org , an initiative falling under the umbrella of the Csomay Center. Finally, the Leader in Residence was involved in archiving research and curriculum for distinguished nursing leader and researcher, Dr. Kitty Buckwalter, for the Benjamin Rose Institute on Aging, the University of Pennsylvania Barbara Bates Center for the Study of the History of Nursing, and the University of Iowa library archives.

Suggested Evaluation Strategies of the DNP Leader in Residence Program

PDSA Cycle: Study

Assessment and benchmarking. To effectively assess the outcomes and success of the DNP Leader in Residence Program, a comprehensive evaluation framework should be used throughout the program. Key measures should include the collection and review of executive leadership opportunities experienced, leadership roles observed, and competencies mastered. The Leader in Residence is responsible for maintaining detailed logs of their participation in center activities and initiatives on a semester basis. These logs serve to track the progression of mastery of AONL competencies by benchmarking activities and identifying areas for future growth for the Leader in Residence.

Evaluation. In addition to assessment and benchmarking, evaluations need to be completed by Csomay Center stakeholders (leadership, staff, and community partners involved) and the individual Leader in Residence both during and upon completion of the program. Feedback from stakeholders will identify the contributions made by the Leader in Residence and provide valuable insights into their growth. Self-reflection on experiences by the individual Leader in Residence throughout the program will serve as an important measure of personal successes and identify gaps in the program. Factors such as career advancement during the program, application of curriculum objectives in the workplace, and prospects for future career progression for the Leader in Residence should be considered as additional indicators of the success of the program.

The evaluation should also encompass a thorough review of the opportunities experienced during the residency, with the aim of identifying areas for potential expansion and enrichment of the DNP Leader in Residence program. By carefully examining the logs, reflecting on the acquired executive leadership competencies, and studying stakeholder evaluations, additional experiences and opportunities can be identified to further enhance the program's efficacy. The evaluation process should be utilized to identify specific executive leadership competencies that require further immersion and exploration throughout the program.

Future Innovation of DNP Leader in Residence Programs in Non-traditional Healthcare Settings

PDSA Cycle: Act

As subsequent residents complete the program and their experiences are thoroughly evaluated, it is essential to identify new opportunities for DNP Leader in Residence programs to be implemented in other non-health care system settings. When feasible, expansion into clinical healthcare settings, including long-term care and acute care environments, should be pursued. By leveraging the insights gained from previous Leaders in Residence and their respective experiences, the program can be refined to better align with desired outcomes and competencies. These expansions will broaden the scope and impact of the program and provide a wider array of experiences and challenges for future Leaders in Residency to navigate, enriching their development as dynamic nurse executive leaders within diverse healthcare landscapes.

This case study presented a comprehensive overview of the development and implementation of the DNP Leader in Residence program developed by the Barbara and Richard Csomay Center for Gerontological Excellence. The Leader in Residence program provided a transformative experience by integrating key curriculum objectives, competency-based learning, and mentorship by esteemed nursing leaders and researchers through successful integration into the Center. With ongoing innovation and application of the PDSA cycle, the DNP Leader in Residence program presented in this case study holds immense potential to help better prepare 21 st century nurse leaders capable of driving positive change within complex healthcare systems.

Acknowledgements

         The author would like to express gratitude to the Barbara and Richard Csomay Center for Gerontological Excellence for the fostering environment to provide an immersion experience and the ongoing support for development of the DNP Leader in Residence program. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

  • American Association of Colleges of Nursing. The essentials: core competencies for professional nursing education. https://www.aacnnursing.org/Portals/42/AcademicNursing/pdf/Essentials-2021.pdf . Accessed June 26, 2023.
  • American Organization for Nursing Leadership. Nurse leader core competencies. https://www.aonl.org/resources/nurse-leader-competencies . Accessed July 10, 2023.
  • Warshawsky, N, Cramer, E. Describing nurse manager role preparation and competency: findings from a national study. J Nurs Adm . 2019;49(5):249-255. DOI:  10.1097/NNA.0000000000000746
  • Van Diggel, C, Burgess, A, Roberts, C, Mellis, C. Leadership in healthcare education. BMC Med. Educ . 2020;20(465). doi: 10.1186/s12909-020-02288-x
  • Institute for Healthcare Improvement. Plan-do-study-act (PDSA) worksheet. https://www.ihi.org/resources/Pages/Tools/PlanDoStudyActWorksheet.aspx . Accessed July 4, 2023.
  • Taylor, M, McNicolas, C, Nicolay, C, Darzi, A, Bell, D, Reed, J. Systemic review of the application of the plan-do-study-act method to improve quality in healthcare. BMJ Quality & Safety. 2014:23:290-298. doi: 10.1136/bmjqs-2013-002703

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If you visit a doctor virtually through a commercial app, the information you submit in the app could be used to promote a particular drug or service, says the leader of a new Canadian study involving industry insiders.

The industry insiders "were concerned that care might not be designed to be the best care for patients, but rather might be designed to increase uptake of the drug or vaccine to meet the pharmaceutical company objectives," said Dr. Sheryl Spithoff, a physician and scientist at Women's College Hospital in Toronto.

Virtual care took off as a convenient way to access health care during the COVID-19 pandemic, allowing patients to consult with a doctor by videoconference, phone call or text.

It's estimated that more than one in five adults in Canada —  or 6.5 million people — don't have a family physician or nurse practitioner they can see regularly, and virtual care is helping to fill the void.

But the study's researchers and others who work in the medical field have raised concerns that some virtual care companies aren't adequately protecting patients' private health information from being used by drug companies and shared with third parties that want to market products and services.

A female doctor with long, brown hair standing in a medical office.

Spithoff co-authored the study in this week's BMJ Open , based on interviews with 18 individuals employed or affiliated with the Canadian virtual care industry between October 2021 and January 2022. The researchers also analyzed 31 privacy documents from the websites of more than a dozen companies.

The for-profit virtual care industry valued patient data and "appears to view data as a revenue stream," the researchers found.

One employee with a virtual care platform told the researchers that the platform, "at the behest of the pharmaceutical company, would conduct 'A/B testing' by putting out a new version of software to a percentage of patients to see if the new version improved uptake of the drug."

social issues case study

Many virtual care apps pushing products, selling personal data, research finds

Concerns about how data might be shared.

Matthew Herder, director of the Health Law Institute at Dalhousie University in Halifax, said he hopes the study draws the public's attention to what's behind some of these platforms.

"All of this is happening because of a business model that sees value in collecting that data and using it in a variety of ways that have little to do with patient care and more to do in building up the assets of that company," Herder said.

Bearded man standing in front of a chalkboard.

Other industry insiders were concerned about how data, such as browsing information, might be shared with third parties such as Google and Meta, the owner of Facebook, for marketing purposes, Spithoff said.

The study's authors said companies placed data in three categories:

  • Registration data, such as name, email address and date of birth.
  • User data, such as how, when and where you use the website, on what device and your internet protocol or IP address.
  • De-identified personal health information, such as removing the name and date of birth and modifying the postal code.

Some companies considered the first two categories as assets that could be monetized, employees told the researchers.

  • Many Canadians welcomed virtual health care. Where does it fit in the system now?
  • Virtual urgent care didn't divert Ontario patients from ER visits during pandemic, study suggests

Not all of the companies treated the third category the same way. Some used personal health information only for the primary purpose of a patient's virtual exchange with a physician, while others used it for commercial reasons, sharing analytics or de-identified information with third parties.

The study's authors said while each individual data point may not provide much information, advertisers and data analytic companies amalgamate data from browsing history and social media accounts to provide insights into an individual's mental health status, for example.

One study participant described how a partnership for targeted ads might work: "If an individual is coming through our service looking for mental health resources, how can we lean them into some of our partnerships with corporate counselling services?"

social issues case study

Nurses’ union says virtual care is a move toward privatization of health care

Conflict-of-interest questions.

Lorian Hardcastle, an associate professor of law and medicine at the University of Calgary, studied  uptake of virtual care in 2020. She highlighted issues of continuity of care, privacy legislation and consent policies.

Since then, she said, uptake in virtual care accelerated during the COVID-19 pandemic.

"I think that the commercialization of the health-care system raises concerns around conflicts of interest between what is best for patients on the one hand and then on the other hand, what has the best return for shareholders," said Hardcastle, who was not involved in the BMJ Open study.

A woman with long brown hair wearing a blouse and jacket.

Hardcastle said it is helpful to have industry insiders acknowledge problems that health professionals and academics have expressed about commercialization.

The Office of the Privacy Commissioner of Canada, which funded the study, said in an email that privately funded health professionals are generally considered to be conducting commercial activities.

Hospitals, long-term care facilities and home care services that are publicly funded are not considered to be engaged in commercial activities and are covered by provincial privacy legislation, the office said. Health information falls into many categories and may be subject to different privacy laws across various jurisdictions.

Hardcastle also suggested that self-regulatory bodies, such as provincial colleges of physicians and surgeons, may need to revisit policies around relationships between health providers and industry.

Virtual care industry responds

CBC News heard from some Canadian virtual care companies that said they take the privacy of individuals seriously.

"Patient data is only used with patients' explicit consent and only when it's required for health-care interactions between a patient and a doctor," a spokesperson for virtual care platform Maple said. "We do not exploit patient data for marketing or commercial gain."

  • Is virtual care a cure for Canada's battered health-care system?

In a statement, Rocket Doctor said it is important to note that the company "does not do any of the things listed by the researchers as common in the telehealth industry."

Telus said that all of the data collected from its virtual care service is treated as personal health information.

"Telus Health doesn't receive any funds from pharmaceutical companies for our virtual care service and we do not sell any patient data collected," said Pamela Snively, the company's chief data and trust officer.

Source of information hard to pin down

Hardcastle said it may be difficult for some people to distinguish between receiving reliable and accurate information from a health-care provider on an app and getting services marketed to them that the health provider may or may not find useful.

"Your family doctor isn't trying to collect superfluous information in order to market services to you," she said.

Some provinces and territories pay for the virtual services. In other cases, patients pay themselves or are covered by employer or private insurance.

  • Patients tapping into alternative care options, but N.S. emergency departments still face challenges

Nova Scotia's government, for example, has a contract with Maple to provide residents without a primary care provider with unlimited virtual visits. Those who do have a regular provider can have two visits per year paid for by the province.

Tara Sampalli, senior scientific director at Nova Scotia Health Innovation Hub, said the province's contract with Maple means residents' data can't be used in other ways, such as by third-party providers.

The province doesn't have that level of control over other providers of virtual care, said Sampalli, who holds a PhD in health informatics.

Calls for an opt-out choice

Herder, of Dalhousie University, said users should be able to easily opt out of having their data used for commercial purposes. He also said that if the data doesn't represent the full diversity of Canada, algorithms shaping clinical decision-making could be racially biased.

Spithoff said while patient awareness is important, patients aren't in a position to fix this problem.

  • 140,000 Nova Scotians are waiting for a family doctor. Can virtual care help?

"We need better legislation, regulation, and we need better funding for primary care," she said. "Or people can get virtual care integrated into their offline care."

Spithoff and her co-authors said self-regulation by the industry is unlikely to lead to change. 

The researchers acknowledged they were limited to publicly available documents and that they did not interview those affiliated with the third-party advertisers.

social issues case study

Canadian Medical Association calls for health-care system overhaul

Corrections.

  • An earlier version of this story suggested that all health professionals conduct commercial activities under federal legislation. In fact, some publicly funded health services are not commercial and are covered by various other legislation. Feb 12, 2024 6:11 PM ET

ABOUT THE AUTHOR

social issues case study

Amina Zafar covers medical sciences and health topics, including infectious diseases, for CBC News. She holds an undergraduate degree in environmental science and a master's in journalism.

With files from CBC's Christine Birak

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The jea scandal: a closer look at jacksonville’s largest fraud case, it was a scheme to defraud taxpayers of millions of dollars.

Jim Piggott , Reporter

JACKSONVILLE, Fla. – Jacksonville is gearing up for a trial some would say focuses on the biggest planned fraud against the city, a proposed sale of JEA that could have led to millions in bonuses for some executives. Former JEA CEO Aaron Zahn and his CFO Ryan Wannemacher face federal charges of conspiracy and wire fraud and if found guilty they could spend up to 25 years in prison.

Six years ago, at the old headquarters, officials announced the possibility of selling JEA. The planned sale of JEA shocked many, including News4JAX political analyst, Rick Mullaney. Mullaney is the Founding Director of the Public Policy Institute at Jacksonville University and a former city lawyer.

TIMELINE: The federal case against two former JEA executives

“If you look back at the 200-year history of Jacksonville, this by far and away, as I’ve said before, is the greatest scheme to defraud the taxpayers in the history of Jacksonville. And by the way, it’s one of the greatest schemes to defraud a municipality in the history of our country,” Mullaney said.

The first talk of a sale was in 2017. News4JAX anchor Tom Wills said on the news, “A new study will be done to see if selling JEA would be good for customers and taxpayers.” The idea created an uproar at city hall, with protests basically saying JEA is ours and don’t sell it.

WATCH: The JEA Scandal, as seen on This Week in Jacksonville, Feb. 2020 | Times-Union says columnist Nate Monroe was under surveillance while covering attempted sale of JEA

This created a rift between city council and the office of then Mayor Lenny Curry. Curry appeared in support of a sale to pay off some of Jacksonville’s pension debt. It died down during the 2019 election cycle, but the sale idea grew once again.

Aaron Zahn was appointed to the JEA board at the request of Mayor Curry. Then, he became the Interim CEO, then CEO. It was after that the board began hearing JEA was in trouble. And heard Zahn’s idea of selling JEA. News4JAX tried to ask about that in 2019.

“I can’t believe you are not going to talk to the viewers sir,” Jim Piggott said to Zahn in July of 2019.

RELATED: Trial of former JEA execs on track for opening statements Wednesday | Ex-JEA CEO Zahn faces 25 years in prison for fraud, but first, a family trip to the Bahamas

“The leadership of JEA began to make the case that JEA was in trouble. This was false. But, they began to make the case that they were in trouble and in a death spiral, and that there was no realistic alternative,” Mullaney said.

It was later we learned about a controversial bonus plan that would have benefited Zahn and others, had the sale gone through.

“Just think of what that would have meant to the taxpayers. A scheme to potentially defraud nearly a billion dollars,” Mullaney said.

In December of 2019, Zahn was removed as CEO and later other executives were let go, including Ryan Wannemacher.

The city council investigated, as well as the state attorney’s office. But it was then turned over to the feds who later indicted Zahn and Wannemacher in March of 2022. Both pleaded not guilty. Zahn has made reference to the fact that he was a scape goat.

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Covid vaccines linked to slight increases in heart, brain, blood disorders: study.

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COVID vaccines from companies like Pfizer, Moderna and AstraZeneca have been linked to rare occurrences of heart, brain and blood disorders, according to the largest vaccine study to date.

Researchers from the  Global Vaccine Data Network analyzed 99 million people who received jabs in eight countries and monitored for increases in 13 medical conditions, Bloomberg News reported .

The study, which was published in the journal Vaccine last week, found the vaccines were linked to a slight spike in neurological, blood and heart-related medical conditions.

COVID shot

Rare cases of myocarditis — inflammation of the heart muscle — were found in the first, second and third doses of Pfizer-BioNTech’s and Moderna’s mRNA vaccines.

Another heart condition, ​pericarditis, the inflammation of the cardiac muscle, had a 6.9-fold increased risk in those who received a third dose of AstraZeneca’s viral-vector shot, the study found.

Meanwhile, a first and fourth dose of Moderna’s jab had a 1.7-fold and 2.6-fold increased risk, respectively.

An increased risk also was identified of a type of blood clot in the brain from viral-vector shots such as the one developed by the University of Oxford and manufactured by AstraZeneca, Bloomberg said.

There was a 2.5 times greater risk of developing Guillain-Barre syndrome, a rare neurological disorder in which the immune system attacks the nerves, among people who received AstraZeneca’s jab, according to the study.

More than 13.5 billion doses have been administered worldwide since the start of the pandemic.

Possible safety signals for ​transverse myelitis, a spinal cord inflammation, were identified after viral-vector vaccines, as was acute disseminated encephalomyelitis, the inflammation and swelling in the brain and spinal cord, after both viral-vector and mRNA vaccines, the researchers found.

The experts at GVDV in New Zealand — a research arm of the World Health Organization — examined 13 medical conditions that they considered “adverse events of special interest” among the subjects, aiming to identify higher-than-expected cases after a vaccine.  

More than 13.5 billion doses have been administered worldwide since the start of the pandemic. A small proportion of those immunized were harmed by the shots, stoking debate about the benefits of the jabs versus the risks.

“The size of the population in this study increased the possibility of identifying rare potential vaccine safety signals,” lead author Kristýna Faksová of the Department of Epidemiology Research, Statens Serum Institut in Denmark, said in a release.

social issues case study

“Single sites or regions are unlikely to have a large enough population to detect very rare signals,” she added.

One expert who was not involved in the study maintained that the benefits of the vaccines outweigh the risks.

“The odds of all of these adverse events is still much, much higher when infected with SARS-CoV-2 (COVID-19), so getting vaccinated is still by far the safer choice,” Jacob Glanville, CEO of biotech company Centivax, told Forbes .

Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center, shared a similar conclusion.

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“The massive study and review of the data reveals some rare association of the mRNA vaccines and myocarditis, especially after the second shot, as well as an association between the Oxford Astra Zeneca adenovirus vector vaccines and Guillain-Barre syndrome,” Siegel, who was not involved in the study, told Fox News Digital . “But these risks are rare and other studies show that the vaccine decreases the risk of myocarditis from COVID itself dramatically,” he said, adding that all vaccines have side effects.

“It always comes down to a risk/benefit analysis of what you are more afraid of — the vaccine’s side effects or the virus itself, which can have long-term side effects in terms of brain fog, fatigue, cough, and also heart issues,” Siegel said. “Denying or exaggerating a vaccine’s side effects is not good science — nor is underestimating the risks of the virus, especially in high-risk groups,” Siegel added.

Pfizer told The Post in a statement that while it “was not involved in this study, we welcome independent research and academic discourse to advance the study of COVID-19. 

“Safety is a top concern for all of us and Pfizer and BioNTech take reports of side effects that are potentially associated with our COVID-19 vaccine very seriously,” it said in the email.

“Since its initial authorization for use in December 2020, the Pfizer-BioNTech COVID-19 vaccine has been administered to more than 1.5 billion people, has demonstrated a favorable safety profile in all age groups, and has helped protect against severe COVID-19 outcomes, including hospitalization and death,” the company added.

Moderna and AstraZeneca did not immediately respond to requests for comment.

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