This blog is based on content presented by Scott Kober, MBA, and Eve Wilson, PhD, ELS, FACEHP, at the AMWA Medical Writing & Communication Conference, as well as a panel discussion co‑hosted by AMWA’s Delaware Valley and Mid‑Atlantic chapters.
Crafting compelling case studies is a marketable skill for medical writers, especially those working in continuing medical education (CME). Demand is strong among medical education companies for freelance writers who can write brief screenplays for patient case simulations delivered via proprietary computer platforms.
Well‑crafted case studies allow adult learners—especially physicians but also pharmacists and nurses—to learn new knowledge and skills. They help people to integrate previous experiences and create a sense of immediacy and authenticity during the learning process. The authenticity is heightened by multimedia delivery platforms that present clinician–patient interactions. Some platforms present these interactions using short segments of recorded video, while others use 3D animations based on lifelike characters.
But a good case study—especially one that includes dialogue between clinicians and patients—doesn’t just write itself. It takes planning, organization, research, and writing skill. A medical writer has to ensure that the learning exercise is engaging, accurate, and appropriate to the learner’s level of expertise. It also must look, feel, and sound authentic.
Let’s break it down.
What Is The Purpose of a Case Study?
Case studies are learning opportunities for practitioners that allow them to apply knowledge and skills relevant to a clinical situation. They include learning activities that connect to the challenges they face in their everyday practice.
The purpose of case studies is to advance knowledge and practice by providing interactive learning experiences for health care professionals.
The Journal of Medical Case Reports offers guidelines for creating case studies. That publication describes a case study as “a detailed narrative that describes, for medical, scientific, or educational purposes, a medical problem experienced by one or several patients.”
In short, case studies are narratives that describe a medical problem and pose possible solutions.
MedCaseWriter.com provides a great description: “A good case study brings clinicians into the virtual classroom, allowing them to make mistakes and play/replay scenarios in a protected environment that they can then incorporate into their day‑to‑day practice.”
What Is Included in a CME Case Study?
A typical teaching case proceeds through a series of stages. Those stages include
- A narrative that describes the history and symptoms of a patient.
- A decision point, often conveyed as a multiple‑choice question, that sparks further discussion and moves the case to the next stage.
- More narrative that describes how the decision affects the patient.
- Subsequent events that lead to more decision points and multiple‑choice questions.
How Do You Write an Excellent Case Study?
The number one rule is: Make it interesting. This is not a skill that comes naturally to everyone, but readers and learners need to connect with the material, not sort through confusing data. You need to figure out a way to present the information in a way that resonates with the learners. You are essentially writing a short story, so think about the cast of characters and the plot.
Most case studies for accredited CME are written in tandem with a subject matter expert who serves as faculty for the activity. It’s good practice to draft a case outline in advance of a faculty call that addresses the approved learning objectives. Be sure to ask your client for the needs assessment that accompanied the funded application for commercial support. This will help you quickly come up to speed on many of the scientific and medical aspects of the case.
As with all writing tasks, think about the intended audience.
Be a Journalist—Ask Questions
Ask plenty of questions beforehand.
- Who are the learners? Are they physicians? Nurses? Pharmacists?
- What key learning objectives will the case address?
- What can the writer assume learners already know?
- What new information does the case study need to convey?
- What is the time sequence? (More complicated case studies may include flashbacks.)
Equally important, you need to ask (and answer) questions about the patients portrayed in the case study. MedCaseWriter emphasizes that the following questions must always be answered:
- What is the patient’s medical, family, racial, and socioeconomic background?
- What is notable about the patient’s situation?
- What is the problem the practitioners are trying to solve?
- What are the challenges of the diagnosis?
- What tools are available to reach potential diagnoses?
- What steps can be taken to manage or treat the patient?
- Why is one choice better than another?
- What is the final outcome?
You’ll want to add enough human interest details to make the case engaging, but avoid details that distract learners.
If you can be entertaining and still get your message across, all the better.
Be a Scientist—Do Research
Conducting thorough research is key to writing a strong case study.
- Search the Internet for other cases published in the same therapeutic area.
- Consult current clinical practice guidelines.
- Familiarize yourself with pertinent laboratory tests and standard and abnormal lab values.
- If you are a freelance medical writer, ask clients if they have a template for case studies.
- When writing the decision‑point questions, be sure the correct answer is evidence‑based, supported by clinical practice guidelines, and tied to specific learning objectives.
Be a Clinician—Use EMR Vocabulary
Allison Armagan, PharmD, director of clinical strategy for Medscape and veteran of many virtual patient simulations, advises medical writers not to get too hung up on conforming to AMA style. Instead, she advises studying the writing style, vocabulary, and common abbreviations used in electronic medical records (EMR). This vocabulary, she suggests, is much closer to what clinicians actually use each day, so it will seem more realistic to your learners. If you need an example of an EMR study, simply obtain a copy of your own and start from there, Armagan advises.
Add Visual Appeal
As the saying goes, “A picture is worth a thousand words.” Many learners benefit from visual illustrations that relate to the case. Many case studies include photographs and medical images, adding realism and visual appeal. You can expect to interact with other creative professionals who will help with artistic design, illustration, and programming. You may also be required to obtain permissions to reproduce previously published work. Case studies may include
- Magnetic resonance imaging
- Positron emission tomographic or computed tomographic scans
- 3‑D computer models
- Snapshots of lab reports or treatment diaries (with all identifying information removed, of course)
Check—and Double-Check—for Accuracy
Attention to detail is essential, according to Jill Herr, MD, an AMWA member who writes case studies for Syandus Inc., a small simulation company in Pennsylvania. It’s important to proofread text carefully, she advises, since something as small as a stray period or space can cause a program to malfunction. Information on drug dosing must also be accurate and appropriate, Kober advises. There is no quicker way to lose credibility with learners than to draft a multiple‑choice question in which the correct answer involves a dosing schedule or administration route that clinicians never use.
Learn How to Write Effective Multiple‑Choice Questions
The best multiple‑choice questions are challenging, align with learning objectives, and have a single correct answer. If possible, ask your client for samples from past activities to use as a template.
Lists of answers that include “all of the above” and “none of the above” should be used sparingly, if at all.
Revisit and rewrite questions that are only tangentially related to the learning objectives. Revise if the language meanders through a series of confusing negations.
East Tennessee University’s “Tips for Case Studies and Case Scenarios” provides some question stems to guide the process.
- What is the most likely diagnosis?
- What is the most appropriate next step in treatment?
- Which medication would represent the best treatment option?
- Which lab test would confirm the probable diagnosis?
- What is the most likely cause of the symptoms?
The Result—Learning and Health
It is worthwhile to spend hours perfecting the art of writing case studies and simulations. When practitioners experience well‑crafted, engaging case studies, they have better learning experiences.
Better learning experiences lead to improved health outcomes.
From our perspective, it’s another example of why medical communicators are so crucial to the health and well‑being of our society.