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Instructional coaching can support teachers’ adoption of effective mathematics instruction, and in turn, positively impact student achievement. This study provides a quasi-experimental design on prospectively matched mathematics teachers receiving job-embedded one-on-one coaching designed to improve conceptual math instruction. Utilizing multiple imputation methods, we present evidence to support an effect of high-quality coaching on ambitious math instruction for a full representative sample of 250 mathematics teachers. This paper demonstrates treatment effects from survey-based and observation measures of the effect of this coaching model to improve teachers’ instructional practices along two central features of effective mathematics teaching and underlying constructs. This contributes to research on the effects of coaching to change instruction and promote students’ conceptual understanding of mathematics.