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Identify key issues

Identifying the major issues and their causes is vital to proposing appropriate solutions later. Let's explore how we can do this.

From your annotation and note-taking you should have an understanding of what the problems are.

Summarise or list the issues in your own words

Make sure you:

  • sort the major problems from the minor problems
  • identify evidence from the case which relates to each of the problems
  • identify underlying causes of the problems.

A useful strategy to start with is to represent the problems and their relationships as a mind map.

This example is from a management case study assessment.

Management mind map - major issues and their sub-issues are listed with arrows showing relationships
Management mind map, by RMIT, licensed under CC BY-NC 4.0

The image shows handwritten text. At the top there are two groups labelled "Staff" and "Communication". They both have arrows pointing to a large piece of text, "Problems/issues", in a circle in the centre.

The group labelled "Staff" has the following sub-topics:

  • treated as numbers
  • only there for the money
  • no initiative allowed
  • unsupported
  • underutilised

The group labelled "Communication" has the following sub-topics:

  • top down only
  • 'memos'
  • no feedback
  • no updates on company policy changes

From the "Problems/issues" circle there are arrows to two more groups, labelled "Management culture" and "Leadership". In addition, there are arrows between each of these groups.

The group labelled "Management culture" has the following sub-topics:

  • top down: hierarchical
  • distrust staff
  • no respect
  • controlling / no initiative allowed
  • gender: no senior women
  • no understanding of what frontline staff do
  • staff are 'low-skilled clerks'

The group labelled "Leadership" has the following sub-topics:

  • CEO/ Owner
  • autocratic style
  • results focussed
  • controls
  • no interaction with staff

Finally, each of these groups has arrows which lead to the last group, labelled "Control". It has the following sub-topics:

  • 'super snoops' are spies
  • monitor computer hits to measure productivity
  • no initiative to make improvements
  • 'us and them' mentality

In this example, the student has used the case questions to help create their mindmap as a way of organising their evidence and research.

Review the presentation and management of Mr Rogers ensuring you address the following:

  • Identify the evidence for the management of Ulcerative colitis in relation to diet and drug therapies.
  • Discuss the potential post-procedure complications you would need to monitor Mr Rogers for in the immediate recovery period.
  • Discuss the evidence for the management of GORD.
Nursing mind map - major issues and their sub-issues are listed with arrows showing relationships
Nursing mind map, by RMIT, licensed under CC BY-NC 4.0

The image shows handwritten text. At the top there are two groups labelled "Drug therapies" and "Diet therapies". There's also an additional label "what is UC (define)?". All three arrows pointing to circled text, "Ulcerative Colitis", which then points to large circled text, "Case study, Mr Rogers".

The group labelled "Drug therapies" has the following sub-topics:

  • Corticosteroids
    • Vedolizumab (side effects)
    • Mesalazine
    • Budesonide (oral)
    • Prednisolone & aminosalicylates
  • Antimicrobials
  • Consider:
    • side effects
    • cost
    • practicality

The group labelled "Diet therapies" has the following sub-topics:

  • Use with drug therapies
  • Education & lifestyle changes
  • Exclude caffeine, high fat spicy food, ALCOHOL
  • Probiotics (?)
  • Healthy food habits

From the "Case study, Mr Rogers" circle there are arrows to two more groups, labelled "GORD" and "Colonoscopy". In addition, there are arrows between each of these groups.

The group labelled "Management culture" has the following sub-topics:

  • top down: hierarchical
  • distrust staff
  • no respect
  • controlling / no initiative allowed
  • gender: no senior women
  • no understanding of what frontline staff do
  • staff are 'low-skilled clerks'

The group labelled "GORD" has the following sub-topics:

What is GORD (define)?

Symptom control

  • Impact on quality of life (difficult to work, travel and exercise)
  • Require diet and drug therapies
    • (PPI) Proton Pump Inhibitor
    • (H2RA) Histamine 2-receptor antagonists
    • Antacids
    • Surgery

Colonoscopy

  • Surgical procedure
    • analgesia
    • allergies (amoxycillin)
  • Hypotension
    • laxatives

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