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Casing the Future

For years, the "technology" of cases remained static. They were written documents consisting of text, tables, and illustrations. Today, however, information and communication technologies are transforming cases—and with them, the processes of class preparation and discussion—in ways that produce greater realism, engagement, and interaction.

The business school has invested heavily in "multimedia" cases. Faculty members, working closely with information-technology experts, have produced approximately 35 to date, on subjects ranging from the choice of an advertising strategy for Mountain Dew to the launch of a new software product by Microsoft. In addition to text, these cases include videos, simulations, and animated exhibits, all available on-line and navigable in multiple ways. Judy Stahl, the school’s chief information officer, says, "Students love them because they’re different—even though they require more time to prepare."

The school’s first multimedia case, "Pacific Dunlap," developed in 1996, examines the challenges of running a textile factory in China; it includes a video tour of the manufacturing floor, video interviews with case protagonists, and an interactive spreadsheet that students use to explore possible changes in the production process. The most recent multimedia case, "Paul Levy: Taking Charge of the Beth Israel Deaconess Medical Center," contains hours of video interviews with the hospital’s new CEO, recorded during his first six months as he led a turnaround of the hospital, which had been losing more than $50 million annually. Every two to four weeks, Levy met with the casewriters and camera crew for lengthy question-and-answer sessions, thus diminishing the usual problem of first-person narratives, which are infused with the wisdom of hindsight. He also provided excerpts from his daily calendar, selected e-mail correspondence, internal memoranda and reports, and news coverage, all of which are available through a single website. Students access these materials through a calendar of events that presents activities chronologically, as Levy worked through problems. The students can also follow his work by category—such as dealing with the board or formulating the recovery plan. And they can retrieve supplemental material on leadership style, managing diverse constituencies, and so on.

Multimedia materials add richness and depth to cases, bringing students that much closer to reality. The medical school has carried the idea a step further, using technology to mimic real life. An experiment named ICON ("interactive case-based online network") puts all case materials, research papers, and associated references on the Web for ready access and includes a module called "Virtual Contact" that allows students to interact directly with the protagonists in the case, who are played by medical-school faculty. Students pose questions, and the faculty members respond—true to form and wholly in character. A renowned specialist might curtly dismiss a naive question, while a family member might provide intimate details about a patient’s condition. Students in one tutorial were paged in the middle of class and told that their patient had been admitted unexpectedly to the emergency room at two the previous morning. How did they plan to respond?

Efforts like these bring students into the case problem, causing them to invest heavily in the outcome. For even greater realism, the medical school relies on Stan the man(nequin), a high-fidelity patient simulator. Stan is the ultimate in realistic cases: a life-size, computerized dummy with a heart that beats, lungs that breathe, pupils that dilate, and vital signs that are readily visible on nearby digital monitors. He has been programmed to experience a wide range of medical conditions, such as acute asthma attacks, renal failures, and congestive heart disease. On command, Stan’s breathing becomes labored, his pulse erratic; then, the monitors spring to life, with all the accompanying bells and whistles that indicate a real emergency. A voice transmitter, operated by a nurse or doctor in a back room, ensures that Stan airs his feelings personally.

Students respond as they would to a real patient: they check Stan’s blood pressure, administer drugs, insert breathing tubes, and give supplemental oxygen. The simulator then recovers (or dies) exactly as a patient would in real life—but with none of the risk. Many tutors now use Stan to supplement their written cases, providing students with a deeper, more experiential sense of the conditions they are studying. In the process, says James Gordon, director of the program on medical simulation, "They become emotionally attached, and learn at a different level."

The law school has done the least to jazz up its curriculum with multimedia and simulation technologies. Appellate court decisions, after all, rely heavily on the written word. Instead, the school has used networks to improve connectivity, build community, and tighten the links between students and faculty. One tool is H2O, created by the law school’s Berkman Center for Internet and Society, a polling and messaging system with the ability to swap comments among students. A professor might ask members of her class to take a position on a hypothetical law, for example: are they for it or against it, and for what reasons? Arguments must be written up and submitted to the system. Then, at a preset time, H2O randomly trades students’ comments: every student in favor of the law is sent an argument from a student who is opposed, and vice-versa. Students must then frame rebuttals to the arguments they have received.

This process gives students the opportunity to engage each other during the preparation process, building a more cohesive group. It enables them to practice legal writing, an essential lawyerly skill. And it provides instructors a better sense of the diversity of students’ opinions, as well as a preview of the most common and cogent arguments. Class time, says Jonathan Zittrain, Berkman assistant professor of entrepreneurial legal studies, is that much more productive: "I get to see where the fault lines are. Sometimes, it’s 90 percent for and 10 percent against, when I expected it to be completely different."

In his course on "The Internet and Society," held in one of the school’s wired classrooms, Zittrain uses the network to stimulate class participation. Students can contribute verbally or via the Internet. Rather than raising their hands, they can e-mail questions and comments to a teaching fellow sitting with an open computer at the front of class. Periodically, Zittrain turns to the teaching fellow and asks if anything interesting has come in; if so, those comments become fodder for discussion. Foreign students, in particular, find the opportunity to put their thoughts in writing helpful, as do those who are least comfortable speaking extemporaneously.

As these examples suggest, technology is slowly infusing the case method. Used wisely, it offers greater realism, a closer connection with the external world, and a heightened sense of community. But it is not a panacea. Technology can enhance and deepen cases, but only a skilled teacher can bring them to life.