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STEM education within North America has become a popular pedagogy, however teachers identify tensions that arise when planning for and implementing STEM education. The purpose of this study was to investigate how exemplary elementary teachers support integrated STEM teaching and learning. Through an in-depth qualitative methodology, drawing on interview and artefact data from 14 purposefully selected elementary teachers, this study identified tensions that teachers faced as they navigated planning for and implemented integrated STEM teaching: (a) content versus skills; (b) guided instruction versus inquiry; (c) process versus task; and (d) collaboration versus individual. In line with a Wordly Perspective (Rennie et al., 2021) balancing these tensions leads to enhanced integration.