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Teacher collaboration is at the center of many instructional reform efforts. While studies have examined the role of instructional coaches in supporting teachers, research exploring connections between collaboration, coaching, and instructional improvement in low-performing schools is scant. However, collaborative efforts to build teacher capacity are shaped by school context. In this qualitative case study, we explore how team collaboration with an instructional coach impacts teachers’ conceptualizations of mathematics instruction in low-performing schools. Findings show that the coach inspired teachers to adopt conceptual approaches to math instruction and facilitated connections across schools, but encountered challenges related to teachers’ content knowledge. Contextual factors including accountability pressures and conflicting priorities between teachers and administrators mediated coaching efforts to improve instruction through collaboration.