Building Capacity for Case Study Research in Occupational Therapy Practice (CSOT): A Two Phase Multi-Methods Study
Authors:   , Gray Leona 
Published: January 2025

Background:
Occupational therapists face many challenges in evidencing their impact and evaluating the complexity of practice including resource constraints, capability and capacity issues. Case study research may offer a potential solution. To date, however, research on the use of case study research within occupational therapy has been anecdotal or limited to a specific type of case study research, which has added to a lack of clarity on what case study research is. There is a need for high-quality, evidence-informed studies that explore what case study research is and how it can be used to contribute to the evidence-base. Whilst literature on case study research is growing in the complex intervention field, there is limited research specific to occupational therapy and no research has yet considered practitioner perceptions of it. This body of work aims to address this gap by building capability for the use of case study research in contributing to the occupational therapy evidence-base.

Methodology:
This thesis uses a multi-method methodology, consisting of two studies and is underpinned by pragmatism. A scoping review explored the range and characteristics of case study research methodologies used to contribute to the evidence-base for occupational therapy. A search of opinion, text and empirical studies from 2016 onwards within an occupational therapy context was carried out using the Joanna Briggs Institute method. A qualitative appreciative inquiry study explored occupational therapists’ perceptions of case study research and co-created resources to increase the capability for the conduct of case study research in occupational therapy practice. University ethical approval was granted and eight occupational therapists with a range of practice experience were recruited from a Scottish Health Board. Data collection consisted of six online appreciative inquiry workshops, including methods of group discussion, break-out groups and whiteboard activities. Collaborative software MURAL was also used for the co-creation of resources using idea generation, prioritisation and prototyping creative group activities. Data was analysed in Computer-Assisted Qualitative Data Analysis Software using reflexive thematic analysis.

Findings:
The scoping review identified 88 studies consisting of 84 empirical and four non-empirical papers. Findings suggested case study research has been conducted globally, adopted quantitative, qualitative and mixed-methods designs and were used across a range of occupational therapy settings. It identified methodological inconsistencies, particularly identifying the ‘case’. This led to the development of a novel conceptual model and definition for case study research in occupational therapy. Four themes were generated from the appreciative inquiry study; understanding case study research as similar to practice, the benefits of case study research create buy-in, embedding case study research into practice and co-created resources for capability building. Practitioners co-created a video resource explaining the GAS-light outcome measure, an overview of training for case study research in practice and case examples. Overall findings suggest practitioners perceived case study research to be of value to practice but it also highlighted broader issues about the use of outcome measures and professional identity within occupational therapy practice.

Conclusion:
Case study research appears to be viable for developing the occupational therapy evidence-base, particularly when large scale inquiry is not appropriate. It is perceived positively by practitioners due to its perceived similarity to practice however the feasibility of collecting case data in practice with a larger sample requires exploration to substantiate these findings.