Source: Journal of Early Childhood Teacher Education, 42:2, 182-202
(Reviewed by the Portal Team)
In this study the authors examined a professional development initiative focused on trauma-informed care (TIC) in urban Early care and education (ECE) programs serving high numbers of children exposed to trauma in a Northeast U.S. city.
This initiative took a novel approach to ECE professional development in its use of the Breakthrough Series Collaborative (BSC) methodology for improvement (Institute for Healthcare Improvement, 2003; Kaplan et al., 2010; Nadeem et al., 2013).
The BSC approach engages cross- role teams, not just individuals, so that change is led through distributed leadership from all levels of the organizational system.
In the TIC BSC, these cross-role teams included program administrators, teachers, parents, and others.
The BSC elevates the leadership of team members as the primary driver of change.
This inter-organizational learning is a process that research has shown can accelerate improvement.
Using the BSC methodology and the evidence-based framework for trauma informed early childhood practices, the TIC BSC engaged and supported five urban ECE programs over an 18-month period to adopt new TIC practices.
In this study, the authors examined the implementation of the TIC BSC with the five programs, and in this paper they address three research questions from that study:
(1) How did BSC participants change as a result of their involvement in BSC?
(2) How did participants make changes in ECE programs to improve trauma-informed practices as a result of the BSC?
(3) How did organizational practices and systems change as a result of agency involvement in the BSC?
This study contributes to an emerging literature that is rooted in organizational change research and reflects a paradigm shift in ECE from individually-oriented professional development to job-embedded collaborative learning and continuous improvement methods that have the additional benefit of enhancing the working environment to support and sustain practice changes (Pacchiano et al., 2016a).
This study used a structured, qualitative, case study design with embedded cases and an inductive thematic approach to analysis (Braun & Clark, 2006; Yin, 2014).
The unit for analysis was the TIC BSC initiative and each of the five ECE programs that completed the BSC constituted an embedded case.
Data collection and participants
The research team collected multiple sources of data including in-depth qualitative interviews of the ECE program participants and the BSC staff and coaches, meeting observations, and document review.
All five sites that participated in the BSC agreed to participate in this study.
A research team of four research assistants and the principal investigator collected the data between 2013–2015.
Research assistants took notes on the following meetings: learning sessions, metric meetings, monthly affinity group meetings, monthly all team meetings, and coaches meetings.
Interviews were also conducted with team members from each site as well as with the BSC coaches.
They attempted to interview each team member mid and post BSC.
Finally, they collected documents from the BSC process that included team metrics data, along with yammer postings (online forum), and PDSA tracking worksheets.
Results and discussions
This study’s findings suggest that the BSC facilitated the adoption of TIC at a system level, with changes among individuals, in classroom teaching, and in organizational structures and processes.
In this section, the authors consider the implications of this kind of multi-level change when it comes to implementing TIC, and highlight four insights about the potential benefits of the BSC approach in supporting changes in practice:
1) the development of shared knowledge about TIC at all levels of the organization;
2) empowerment and shared leadership among staff;
3) a shift in organizational culture that promotes an empathic, people-centered orientation; and
4) interagency connections among child welfare, mental health, and ECE that may create a more coordinated system to meet the needs of children and families.
The authors found that education about trauma is an important foundation for practice change, and that engaging in professional learning together made a unique difference.
Shared knowledge enabled staff to come together around goals and the testing of new practices.
Participants highlighted the value of this collaborative learning both within their teams and also with the other ECE program teams.
Exploring the impact of team-based and job-embedded professional learning is an important area for further research.
Empowerment and distributed leadership
The authors found that ECE program team members often experienced increased empowerment and engagement in their collaborative professional learning that they applied to their improvement efforts.
This fostered a shift in motivation toward TIC in many teams.
When staff can voice their ideas, and feel heard and respected by others, they feel valued and are therefore able to engage more meaningfully in their work (Douglass, 2017; Gittell & Douglass, 2012).
Empathic, people-centered relational systems
Another insight from this study is that the BSC can support programs to shift toward a more empathic and people-centered approach at a systems level: with staff, children, and families.
This parallel process is a key characteristic of relational organizational systems, where positive relationships at one level, such as among children and teachers, are mirrored at other levels, such as among staff or between teachers and families (Douglass & Klerman, 2012; Parlakian, 2002).
Lastly, they saw new interagency connections between child welfare, mental health, and ECE that hold promise for a more coordinated service delivery system.
Being aware of and coordinating prevention, family support, mental health, and child protective services is essential for meeting the needs of children who have experienced trauma (Loomis, 2018; National Child Traumatic Stress Network, 2016; Szente, 2016).
A cornerstone for effective interagency collaboration is relationships, and the BSC built those relationships through new structures for routine communication and information sharing, providing ECE staff with greater access to support and guidance.
This study contributes to an understanding about how newer forms of collaborative professional learning such as the BSC might complement traditional training and coaching models in providing a full range of professional development supports in ECE.
Professional development delivered at the organizational level can promote the coordinated implementation of new TIC practices by both teachers and administrators, enhancing shared leadership and building organizational capacity to improve and sustain new practices.
Giving voice to those who are not traditionally given power to lead change is a unique contribution of the BSC.
The BSC influenced transformative shifts in team members’ mind-sets, empowerment, and self-efficacy about TIC, and fostered a more relational and empathic organizational culture.
The BSC methodology may be a powerful new strategy to add to the ECE field’s professional development “toolkit.”
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative research in psychology, 3(2), 77–101.
Douglass, A. (2017). Leading for change in early care and education: Cultivating leadership from within. New York: Teachers College Press.
Douglass, A., & Klerman, L. (2012). The strengthening families initiative and child care quality improvement: How Strengthening families influenced change in child care programs in one state. Early Education and Development, 23, 373–392.
Institute for Healthcare Improvement. (2003). Innovation series 2003: The breakthrough series: IHI’s collaborative model for achieving breakthrough improvement. (White paper). Cambridge, MA: Author. http://www.ihi.org/
Gittell, J. H., & Douglass, A. (2012). Relational bureaucracy: Structuring reciprocal relationships into roles. Academy of Management Review, 37(4), 709–733.
Kaplan, H. C., Brady, P. W., Dritz, M. C., Hooper, D. K., Linam, W., Froehle, C. M., & Margolis, P. (2010). The influence of context on quality improvement success in health care: A systematic review of the literature. Milbank Quarterly, 88(4), 500–559.
Loomis, A. M. (2018). The role of preschool as a point of intervention and prevention for trauma-exposed children: Recommendations for practice, policy, and research. Topics in Early Childhood Special Education, 38(3), 134–145.
Nadeem, E., Olin, S. S., Hill, L. C., Hoagwood, K. E., & Horwitz, S. M. (2013). Understanding the components of quality improvement collaboratives: A systematic literature review. Milbank Quarterly, 91(2), 354–394.
National Child Traumatic Stress Network. (2016). What is a trauma-informed child and family service system? [Fact sheet]. Retrieved from https://www.nctsn.org/resources/what-traumainformed-child-and-family-ser...
Pacchiano, D., Klein, R., & Hawley, M. S. (2016a). Job-embedded professional learning essential to improving teaching and learning in early education. Chicago, Illinois: Ounce of Prevention Fund.
Parlakian, R. Ed.. (2002). Reflective supervision in practice: Stories from the field. Washington DC, US: Zero to Three.
Szente, J. (2016). Assisting children caught in disasters: Resources and suggestions for practitioners. Early Childhood Education Journal, 44(3), 201–207.
Yin, R. K. (2014). Case study research: Design and methods. Thousand Oaks, CA : Sage Publications