Review Reports - Workforce Development and Multiagency Collaborations: A Presentation of Two Case Studies in Child Welfare

Round 1

Reviewer 1 Report

This paper reports the findings of an evaluation of two education elements designed to improve the qualities of training for child welfare workers in the United States. Using case studies, one programme explores the use of virtual reality the other, an arrangement designed to improve collaboration between the some of the differing sectors involved in case management.

Overall, the paper is well written and the case made for exploring in more detail how technology (the VR case study) and the process development (the outlined programme) to help improve shortcomings in current practice. However, the paper is for an international journal and the value of the work is reduced through the authors current approach of presenting both issues in a single paper. Given the importance of their work and the value for, in the case of VR, an international audience, and, for the cross collaboration aspects, other elements of care systems whether those found in the United States or worldwide, I would suggest the paper is split into two exploring each aspect in more detail. Not least, the work would benefit from providing an overview of the actual problem faced by the child welfare system: for example, how big a problem is it; how is it changing, what factors are associated with it etc..

In particular, the collaborative section of the present paper would benefit for a more detailed presentation of exactly which crafts were included in the work, for example were pharmacists or dental workers involved. The paper would also benefit from a description of how the issues are drawn to the attention of the child welfare services at present. Such data would provide a stronger basis for ensuring that the relevant personnel were included in any cross sector training arrangements.

The above may sound rather negative but I would urge the authors to develop their present submission as the issues are of major importance and their work of value.

Author Response

Thank you very much for the comments from the reviewers. We have made a good faith effort to address each of the points in the reviewers’ feedback. Since some of the comments from the three reviewers were similar, we are addressing the request for changes in this bulleted format. We made a decision not to submit two separate manuscripts because our work was to highlight the need for workforce development in the overall area of child welfare in the United States. The area of workforce development includes understanding the factors that impact decision making, whether from a social worker or a healthcare provider perspective. The concepts presented in the manuscript highlight how collaborative and open discussion about child and family needs are crucial for creating a more effective system for meeting these needs. The attached document shows all of our tracked changes that were made to the manuscript.

Below is a summary of the changes in the document:

Revised the title of the manuscript.
Increased clarity around our study being situated in the context of the child welfare system in the United States, though added language regarding the implications for an international application.
Provided more detail around the problem of inadequate workforce development efforts in many child welfare jurisdictions due to a lack of practice opportunities around assessment skills and collaboration with health professionals.
Provided more information about the different applications of VR technology in various industries.
Provided a table showing the complete NES data, to provide clarity on the results of the participant feedback.
Included more context about the types of open text statements that were quoted and added to the discussion regarding the relationship between the participant comments and the NES data. Statements regarding some challenges and drawbacks of the VHS experience are included.
Provided more discussion around the limitations and future research agenda of the VR technology.
Provided more clarity that we are discussing a cross-sector collaboration between public child welfare agencies and health care systems.
Included more content around who the cross-sector participants were and how they were recruited.
Added more language around the drawbacks of the collaboration such as risks of confidentiality violations, and other client-related possible difficulties.
Provided more discussion around lessons learned or what was changed in the collaboration as a result of the lessons learned from the collaboration project.
Completed general grammar and copy editing throughout for better flow and clarity.
Added in two new references to the reference list since they were cited in the body.

We hope these changes address the concerns of the reviewers. Again, we appreciate the comments in making our manuscript stronger.

Reviewer 2 Report

This submission provides some very valuable insights into issues about training and development of child protection workers in the USA. I think it needs to make clear that this is within the context of the USA, and how any lessons from it might relate to wider than that country.

The relationship to practice is strong, and it is clearly set out in the abstract and the article itself about how there are deficiencies at present in terms of these areas of practice in child protection, and how the training approach examined in this article can help produce better practice and safety for children.

The theory used is set out well and the basis of using this to explore virtual reality tools is also set out well.

There might be more on the general value of virtual reality training, and rather more on what can be drawn on from similar disciplines and areas in terms of the value of virtual reality, but also some of the difficulties with / challenges in using it too.

In terms of the two case studies, in relation to the first one, re the innovative learning and professional responsiveness for example, the use of training initiatives in terms of simulation is valuable; however, whilst there is lots on positive feedback- although these are largely bullet points at the moment and needs more analysis in relation to a wider knowledge about the value of virtual reality and any drawbacks from its use in training in such areas- any (if so there are) drawbacks / challenges for those participating from their feedback also needs to be included.

In the second case study there was a good account of why it is important to have the areas covered in interprofessional working, but again, it could be more analysis in relation to some of the drawbacks from feedback (if so there are). This would be important in order to be able to draw learning from these case studies in how such work can be undertaken, for others to use in their own developments in similar areas.

There needs to be more in each of the case studies about who was involved , how they were chosen, numbers, process undertaken to get them to take part and how the evaluation took place.

Also in relation to the second case study SEEK was used, but this is just a statement and there was no discussion of why this was the best model to use.

So if the authors provide revisions in these ways, I recommend it to be considered for publication.

Author Response

Below is a summary of the changes in the document:

Revised the title of the manuscript.
Increased clarity around our study being situated in the context of the child welfare system in the United States, though added language regarding the implications for an international application.
Provided more detail around the problem of inadequate workforce development efforts in many child welfare jurisdictions due to a lack of practice opportunities around assessment skills and collaboration with health professionals.
Provided more information about the different applications of VR technology in various industries.
Provided a table showing the complete NES data, to provide clarity on the results of the participant feedback.
Included more context about the types of open text statements that were quoted and added to the discussion regarding the relationship between the participant comments and the NES data. Statements regarding some challenges and drawbacks of the VHS experience are included.
Provided more discussion around the limitations and future research agenda of the VR technology.
Provided more clarity that we are discussing a cross-sector collaboration between public child welfare agencies and health care systems.
Included more content around who the cross-sector participants were and how they were recruited.
Added more language around the drawbacks of the collaboration such as risks of confidentiality violations, and other client-related possible difficulties.
Provided more discussion around lessons learned or what was changed in the collaboration as a result of the lessons learned from the collaboration project.
Completed general grammar and copy editing throughout for better flow and clarity.
Added in two new references to the reference list since they were cited in the body.

We hope these changes address the concerns of the reviewers. Again, we appreciate the comments in making our manuscript stronger.

Reviewer 3 Report

This paper, in my opinion, intended to highlight children welfare-workforce development, in contemporary time, by focusing on two key issues. One, a virtual reality (VR) tool, and two, a multidisciplinary collaboration exemplified by cases 1 and 2 respectively. Hence the author’s ambition to highlight the need for contemporary tools or technologies for child welfare systems is commendable! However, the aim of the manuscript has not been properly executed according to required standards.

First, the title seems badly composed! For example, “Children Welfare-Workforce Development and Multidisciplinary Collaborations…(lines 2-4)” may help to integrate the idea of ‘child welfare workforce development vis-à-vis a VR tool and needed collaborations in a child welfare arena (line 11). The child welfare workers and child healthcare providers constitute the main multidisciplinary collaborations in this study. In other words, the concept of multi-agency collaborations may not be suitable for the referenced child welfare arena, which was established and supported by an Acts of parliament (lines 34-39). Therefore, it is worthwhile to study how the different professions are learning and interacting to solve child related problems, and how VR tools are contributing to problem solving, but by using the appropriate concepts.

Second, if my descriptions of the manuscript’s concepts, as in the paragraph above, are accepted, you may let them serve as the framework for their usage in all the sections of the manuscript. In particular, the lack of focus on the appropriate relationships between the two main professionals in the child welfare arena have an overall effect on how development and collaborations are understood in this context. That is, is it multi-agency collaborations or collaborations in a multidisciplinary agency?

Third, the manuscript also seems badly structured if viewed from a general scholarly standard! The reporting of cases muddled up the essence of having the paper divided into Introduction, Methods, Results, Discussion, and Conclusion sections. The authors may need to re-insert issues reported in the two cases in the right sections of an article journal.

Four, the restructuring of the manuscript may help in putting the Introduction section and other sections of the paper in a better perspective in relation to the purpose of the study. Therefore, I will not be able to make any further comment until the fundamental issues of concepts and restructuring are addressed, which may create an opportunity to assess the conclusion of the study in relation to other sections of the manuscript.

Author Response

Below is a summary of the changes in the document:

Revised the title of the manuscript.
Increased clarity around our study being situated in the context of the child welfare system in the United States, though added language regarding the implications for an international application.
Provided more detail around the problem of inadequate workforce development efforts in many child welfare jurisdictions due to a lack of practice opportunities around assessment skills and collaboration with health professionals.
Provided more information about the different applications of VR technology in various industries.
Provided a table showing the complete NES data, to provide clarity on the results of the participant feedback.
Included more context about the types of open text statements that were quoted and added to the discussion regarding the relationship between the participant comments and the NES data. Statements regarding some challenges and drawbacks of the VHS experience are included.
Provided more discussion around the limitations and future research agenda of the VR technology.
Provided more clarity that we are discussing a cross-sector collaboration between public child welfare agencies and health care systems.
Included more content around who the cross-sector participants were and how they were recruited.
Added more language around the drawbacks of the collaboration such as risks of confidentiality violations, and other client-related possible difficulties.
Provided more discussion around lessons learned or what was changed in the collaboration as a result of the lessons learned from the collaboration project.
Completed general grammar and copy editing throughout for better flow and clarity.
Added in two new references to the reference list since they were cited in the body.

We hope these changes address the concerns of the reviewers. Again, we appreciate the comments in making our manuscript stronger.

Round 2

Reviewer 1 Report

This present version of the paper is a substantial improvement over that previously submitted. However a number of minor issues remain. First is the use of the use of the word ‘exciting’ on line 77. This is entirely value based and should be removed. Second, the two projects have highlighted the potential benefits that the projects offer to improve the outcomes of care. While this is stated in the abstract, I would like to see changes in the last sentence of the introduction besides the word removal above. The article provides a rationale for the work and highlights the initial findings based on identified issues. This would add strength to what is a useful and informative paper.

Author Response

Thank you again for your thoughtful comments. We have reviewed all reviewer feedback for this second revision and believe we have adequately addressed each point made.

Our changes include:

Removing unnecessary words and revising sentences for accuracy
Fixing general grammar issues
Completing a final copy-editing review

We seriously discussed possible options to combine the results sections as suggested by one of the reviewers. It seemed to us that combining these sections would make the results not as clearly linked to the specific case study. Therefore, we decided to leave the format of the sections as is so that it provides the most potential for clarity and understanding of each case study.

Reviewer 3 Report

By reemphasizing the prevailing siloed approach to the child welfare system (lines 25-41), this manuscript seems to have been well-reviewed to an acceptable standard! Thus, the new title, the introduction cum its implied aim of the study, the methods, and the new conclusion section are now easy to follow. In other words, two crucial childcare determinants in the child welfare system—child welfare workforce development and multiagency collaborations—for meeting and sustaining the needs of families and children in contemporary time coherently and cohesively run throughout the paper.

The sections of the paper are still divided into four main sections and the reference section. The Introduction provides the context (I think line 29 ought to read: CECANF, 2016), that is, the problem with the siloed approach to childcare in the United States. Nevertheless, the context provides two seemingly relevant and contemporarily appropriate solutions: leveraging technology and multiagency collaborations, which are relevant to other contexts, nowadays, across the world.

The Methods section is very precise! It focused on (as in the Abstract section [line 14], maybe the authors can replace “description” [line 89] with) the demonstrations of two case studies. One, leveraging the VR for child welfare workforce training, which is rather innovative for childcare givers in recent times. And two, focusing on multiagency collaborative training amid the challenges of siloed approach in the US child welfare system. However, (the reference to the discussion section in) lines 96-98 are no longer relevant in this manuscript as they were.

Sections 3 and 4 and their concomitant subsections comprise the background to each project, theories that served as frameworks, the technology leveraged in Case #1 and learning collaborative model in Case #2, and the approach and results subsection in each case. Lastly, the lessons learned /next steps in each case. In particular, we have the results sections incorporated in these sections and constituting a challenge to widely accepted journal article structure. Perhaps, the authors think that presenting the sections in a story format and the subsections close together would help the audience to understand their demonstrations of the two projects better! In my opinion, the results subsections #1 and #2 can form the Results section, while the remaining subsections can come under a section before the Results. This recommendation can be implemented in a way that does not jeopardize the cohesiveness and coherency of the paper. Nevertheless, while the structure of this manuscript looks innovative in tune with its innovative cases of concern, the Journal Editor would have to make the final decision.

Conclusion section! The previous discussion section is now converted and edited as the study’s conclusion section. And there is a strong connection between this section the new title and other sections of the manuscript.

Author Response

Thank you again for your thoughtful comments. We have reviewed all reviewer feedback for this second revision and believe we have adequately addressed each point made.

Our changes include:

Removing unnecessary words and revising sentences for accuracy
Fixing general grammar issues
Completing a final copy-editing review