Examining Educators' Understanding and Application of Learnings From an Online Brain Injury Professional Development Module—TeachABI

ABSTRACT

Background

Acquired brain injury (ABI) in childhood can lead to complex and lasting challenges that affect educational participation and outcomes. Despite the central role of educators in supporting students post‐ABI in the classroom, educators receive little to no formal training pertaining to ABI.

Objective

This study explored how educators understand and apply knowledge gained from TeachABI, a brief, virtual professional development module designed to enhance educator capacity to support students with ABI in school settings.

Methods

Semistructured interviews were conducted with 29 educators in Ontario, Canada, following their completion of the TeachABI module. Data were analysed by two independent raters using directed content analysis guided by the theoretical domains framework to identify key categories related to knowledge acquisition, application and contextual influences.

Results

Educators reported increased knowledge of ABI and classroom strategies, enhanced confidence and intentions to apply the material in practice. Educators connected new learning to prior personal and professional experiences, highlighting the value of reflection. Internal factors (e.g., perceived competence and motivation) and external factors (e.g., classroom size, school resources and family engagement) influenced the feasibility of applying strategies. Educators also expressed a desire for continued learning and access to additional ABI‐related resources.

Conclusions

TeachABI is a promising tool for improving educator knowledge and preparedness to support students with ABI in the classroom. However, systemic and environmental barriers may impact educators' ability to apply knowledge and strategies learned in the classroom environment. Findings underscore the need for ongoing professional development and structural supports to facilitate inclusive education for students with ABI.

Key Messages

• Educators identified new learnings about acquired brain injury (ABI) from TeachABI, including recognition of symptoms, classroom impacts and strategies to support students in the classroom following ABI.

• Educators reported increased confidence and preparedness to support students with ABI, while recognizing the importance of individualized approaches and ongoing learning.

• Reflection on prior professional and personal experiences helped educators connect new knowledge from TeachABI to their existing classroom practice.

• The application of strategies and knowledge gained from TeachABI may be influenced by contextual factors beyond educators' control, including class size, staffing, resources and collaboration with families and school teams.

• Although online professional development modules such as TeachABI show promise as accessible tools to help build educator capacity, they should be complemented by ongoing supports and collaborative school‐based implementation processes.

1. Introduction

1.1. Educators and ABI Knowledge

Acquired brain injury (ABI) can lead to profound and lasting physical, cognitive, behavioural and social impacts on the lives of children, youth and their families (Heverly‐Fitt et al. ²⁰¹⁴; Ryan et al. ²⁰²¹; Ankrett et al. ²⁰²³; Hartman et al. ²⁰¹⁵; Roscigno et al. ²⁰¹⁵; Gfroerer et al. ²⁰⁰⁸; Allonsius et al. ²⁰²⁴; Aitken et al. ²⁰⁰⁹; Philipson et al. ²⁰²³). This is evident when students return to school, where they spend a significant amount of time learning and interacting with peers (Statistics Canada ²⁰²⁰). When students return to school post‐ABI, their primary support in the education system is from classroom educators (Zinga et al. 2008). Previous literature indicates that teacher perceptions and expectations can positively or negatively influence a student's academic achievement (Babad 1993; Brophy ¹⁹⁸²; Jussim ¹⁹⁸⁹). Specifically, teachers' knowledge and identification of ABI influence student success in academic and social domains, independent of their teaching approach (Wlodarczyk et al. 2015). Educators are largely underprepared to accommodate and support the learning needs of students with ABI and hold many misconceptions about working with students post‐ABI in the classroom (Bullock et al. 2005; Mohr and Bullock ²⁰⁰⁵; Mealings and Douglas ²⁰¹⁰; Linden et al. ²⁰¹³; Ettel et al. ²⁰¹⁶). Parents and students report that teachers' poor understanding of ABI and low knowledge of accommodations are factors impacting students' school re‐entry post‐ABI (Wan and Nasr 2021; Sharp et al. ²⁰⁰⁶; Andersson et al. ²⁰¹⁶).

Given the significant gap in educator understanding of ABI, focused education for school personnel is imperative to develop a strong return‐to‐school plan for students following ABI (Lindsay et al. 2015). However, educator training in ABI can be difficult to achieve, as many school systems globally (e.g., Canada, Australia and Northern Ireland), do not recognize ABI as an area of exceptionality, therefore, students' learning needs are not formally identified (Ettel et al. 2016; Nagele et al. ²⁰¹⁹; Zinga et al. ²⁰⁰⁵; Kahn et al. ²⁰¹⁸). In fact, even in countries where some aspects of ABI (e.g., traumatic brain injury) are recognized in the school system (e.g., United States), educator knowledge still remains markedly low, and students' needs remain unmet in the classroom (Ettel et al. 2016; Nagele et al. ²⁰¹⁹; Glang et al. ²⁰⁰⁸). Despite receiving training for other developmental (e.g., autism spectrum disorder) and medical (e.g., asthma) conditions, teachers are not provided with formal ABI training to address the educational needs of students with ABI (Zinga et al. 2008; Bennett et al. ²⁰⁰⁴). Thus, students with ABI are often poorly identified in the school system, leading to inadequate supports and programming for both the student and their educators (Bennett et al. 2004).

1.2. Professional Development for Educators

Professional development enhances educator knowledge and provides strategies to improve teaching quality and student outcomes in the classroom (Holloway 2006; Zhaohui and Anning ²⁰²⁰; Kennedy ²⁰¹⁶). The literature highlights that online professional development for educators significantly enhances knowledge, self‐efficacy, skills and classroom practices, leading to more effective teaching strategies and improvements in student outcomes (Morina et al. 2025; Guerrero ²⁰²⁵; Ventista and Brown ²⁰²³; Randel et al. ²⁰¹⁶). Importantly, the translation of professional development into educator practice appears to be influenced by internal and external factors (Wrenn and Wrenn 2009; Nīmante et al. ²⁰²⁵; Sahin and Yildirim ²⁰¹⁶). Internally, educators' motivation, prior experiences and perceived relevance of the training influence their engagement in the training and likelihood of implementation in the classroom (Appova and Arbaugh 2018; Kraft et al. ²⁰²⁴; Halal Orfali et al. ²⁰²⁴). A critical component of effective professional development is the opportunity for educators to reflect on previous classroom experiences and connect newly learned material to their existing pedagogical frameworks (Roberts 2009; Korthagen ²⁰¹⁷; Borko ²⁰⁰⁴). This reflective process supports deeper understanding and more meaningful integration of new practices into daily instruction (Roberts 2009; Korthagen ²⁰¹⁷; Borko ²⁰⁰⁴). In the school system and broader environment, various external factors may play a role in educators' application of professional development in the classroom, such as time restraints, school team, available resources, among others (Silva Didier et al. 2025; Avalos ²⁰¹¹). It is therefore important to understand how educators are interacting with the training material during professional development activities and to consider external factors beyond educators' control in the school environment.

1.3. TeachABI

To address the significant training and knowledge gap pertaining to ABI for educators, our team created an online professional development module called TeachABI. TeachABI is a short (approximately 45 min), engaging, virtual professional development module about ABI created for educators by teachers, clinicians and families with lived experience of ABI. TeachABI uses a case‐based learning approach and is composed of a case study, videos of individuals with lived experiences, downloadable tip sheets and links to additional resources. The professional development module aims to build educator capacity and improve educator confidence in supporting students with ABI in the classroom; it offers targeted information and strategies to better support student reintegration following ABI. See Saly, Provvidenza, et al. (2023) for comprehensive details about TeachABI and its development. Initial results from a usability study revealed a high satisfaction level with TeachABI among elementary school educators, with an average System Usability Scale score of 86.25, out of 100 (Saly, Provvidenza, et al. ²⁰²³). Semistructured interviews revealed that TeachABI content was valuable, useful and aligned with the realities of their profession (Saly, Provvidenza, et al. ²⁰²³). Participants also indicated an appreciation for the visual design, organization and varying use of education strategies in TeachABI (Saly, Provvidenza, et al. ²⁰²³). Further research was conducted to investigate the impact of TeachABI on elementary school educators' knowledge of paediatric ABI and self‐efficacy for supporting students with ABI in the classroom (Marshall et al. 2025). In a sample of 50 educators, knowledge of paediatric ABI, knowledge of the module learning objectives and self‐efficacy increased premodule to postmodule, and gains were maintained 60 days after training (Marshall et al. 2025). Although these results are promising, it is also important to understand how educators might apply TeachABI materials in the classroom setting, and the educator experience of TeachABI broadly. Therefore, the aim of the current study is to understand educators' key learnings following TeachABI module completion, specifically: educators' understanding of the material presented in TeachABI, educators' intentions to apply strategies learned in TeachABI in their classroom setting, and internal and external factors that may facilitate or impede educators' ability to apply TeachABI material in their classroom.

2. Methods

2.1. Participants

This study reports on a subset of participants from a larger study, which comprised qualitative and quantitative components. Fifty participants completed questionnaires (ABI knowledge, knowledge application case study and self‐efficacy) at three time points: prior to completing TeachABI (T1), immediately following completion (T2) and 2 months after completion (T3). For more information regarding the quantitative data, please see (Marshall et al. 2025). A subset of these participants (n = 29) also participated in interviews at T2. Data collection for this study included educators and preservice teachers in Ontario, Canada.

Inclusion criteria included individuals fluent in English reading and writing and who were either (1) working as an Ontario College of Teachers (OCT) certified educator (e.g., classroom educator, special educator, principal and occasional teacher); or (2) enrolled in an Ontario Teacher's Education program that will provide certification with the OCT (i.e., preservice teacher). Participants were invited to participate in interviews. Data collection was guided by data saturation (interviews were conducted until no new categories or ideas emerged (Sandelowski 1995)), while purposively inviting participants to seek a balanced representation of backgrounds and experiences (i.e., < 5 years of teaching experience, preservice teachers and male educators).

2.2. Procedure

Informed consent was obtained from all participants (Holland Bloorview Research Ethics Board #0414). Educators met with a research assistant in a secure virtual meeting via Zoom. Participants completed the full TeachABI module at their own pace, with the opportunity to explore additional links or resources in the module, while sharing their screen with the research assistant. At T2, the individual participated in a semi‐structured exit interview. Participants were provided with the opportunity to describe their overall thoughts about TeachABI and its case study approach, provide feedback about the topics discussed throughout the module (e.g., ABI knowledge, ABI in the classroom and classroom strategies) and describe any content that they found confusing or difficult to understand. Participants indicated if the information in TeachABI was new to them, if they experienced any significant learnings (labelled ‘aha’ moments) when completing the module and if they felt that the module helped them to achieve the following learning objectives: (1) define ABI; (2) identify potential challenges for students with ABI in the classroom; (3) discuss the importance of taking an individualized approach for students with ABI; and (4) describe how to support a student with an ABI in the Ontario education system. Finally, they reported on if the module impacted their knowledge of ABI and how to best support students with ABI in the classroom, if the information in the module will be useful to them in future education settings, if they would be able to successfully apply the strategies and knowledge learned in TeachABI in their teaching (and if not, the barriers to applying the material) and if they would recommend the module to other educators.

2.3. Positionality

The primary author (C.M.) acknowledges her positionality as a PhD student and speech‐language pathologist working clinically with children and youth following ABI. The primary author has been involved in the return‐to‐learn transition for students as a clinician and has a vested interest in improving this transition for students with ABI. She acknowledges that she is not an educator and does not know the school environment intimately. The secondary coders (S.M. and A.I.) also acknowledge that they are not educators and recognize their positionality as a PhD student in school/applied child psychology and a research coordinator, with an educational background in epidemiology and applied health research, respectively. To mitigate potential bias, rigour was prioritized throughout the process, including double coding of the data and collaboration of the primary and secondary coders with a multidisciplinary authorship team (i.e., neuropsychology, occupational therapy, education and speech‐language pathology). The authors overall recognize that their diverse professional and academic backgrounds inevitably shape their perspectives and view this diversity as a strength that enriches the depth and nuance of the qualitative interpretation.

2.4. Analysis and Framework

Each interview was recorded using Zoom and transcribed verbatim, removing any identifying participant information. Multiple readings of transcripts supported data familiarization across all coders (Naeem et al. 2023; Nowell et al. ²⁰¹⁷). A directed (deductive) content analysis was used to analyse participant interviews (Hsieh and Shannon 2005; Assarroudi et al. ²⁰¹⁸). Responses were coded by hand and codes were grouped to form larger categories, where appropriate. Data were coded by three independent reviewers (C.M., S.M. and A.I.).

Following Hsieh and Shannon's (2005) approach, our directed approach used existing theory (theoretical domains framework) (Atkins et al. 2017) to identify key concepts or variables during the coding of initial categories. Data that were relevant to the research questions but did not fit into pre‐existing categories were included in additional categories and subcategories (Hsieh and Shannon 2005). The guiding framework for this analysis was the theoretical domains framework (TDF) (Atkins et al. 2017). The TDF is a comprehensive framework that considers numerous factors or influences (i.e., barriers and facilitators) at various levels (i.e., cognitive, affective, social and environmental) that may influence behaviours (Leggett 2025). The TDF provides a useful conceptual basis for assessing implementation problems, designing interventions to enhance healthcare practice and understanding behaviour‐change processes (Blatchford et al. 2009). It encompasses 33 theories of behaviour, and behaviour change, which have been merged into 14 domains. Given our objectives centre on understanding educators' behaviour after viewing TeachABI (i.e., their potential application of learnings from TeachABI in their classroom), the TDF was chosen as the framework to guide this analysis. The TDF has been used across various health care settings and clinical behaviours and has been shown in previous research to be considered a useful framework for understanding the factors that influence behaviour in a given context (Atkins et al. 2017; French et al. ²⁰¹²; De Leo et al. ²⁰²¹; Phillips et al. ²⁰¹⁵).

The TDF was used as a guide for coding the data (Hsieh and Shannon 2005). The codebook was iteratively developed with the coding team, with ongoing dialogue used to refine codes and code definitions. All TDF domains were considered in the initial code development. However, the final codes included only constructs of the TDF that were agreed upon by the research team as relevant to the primary research objective. Where possible, TDF constructs were expanded to fit research objectives and data. For example, the TDF construct of ‘knowledge’ was divided into pre‐existing knowledge, new knowledge and general knowledge, related to educator completion of the TeachABI module. Furthermore, data that were relevant to the research questions, but did not fit into pre‐existing TDF constructs were included in additional categories and subcategories. Any newly identified codes were documented systematically, added to the codebook and discussed collaboratively. To ensure newly developed codes were consistently and retroactively applied, early coded transcripts were recoded following the finalization of the codebook.

The first 10 transcripts were coded collaboratively by two coders (five coded by C.M. and S.M. and five coded by C.M. and A.I.) to establish data familiarization, codes for the formal codebook and coding consistency across the three coders. The remaining 19 transcripts were coded independently by C.M., with a secondary coder (S.M. or A.I.) reviewing each transcript. After review by two authors, intercoder agreement was 96%. Conflicts were discussed among all three coders to reach consensus (Merriam and Tisdell 2015; Elo et al. ²⁰¹⁴; Patton ²⁰¹⁵; Halpin ²⁰²⁴). These meetings also helped monitor potential drift and coder consistency throughout the coding process. Discussion and consensus across team members helped ensure rigour and trustworthiness of coding. An intercoder agreement percentage of 96% was calculated across the coding team (Halpin 2024). Once data were coded, data were inputted into NVivo (Jackson and Bazeley 2019). The Nvivo Software was used exclusively for data management (Jackson and Bazeley 2019). Transcripts were imported into NVivo to organize the dataset, consolidate excerpts under each code and facilitate viewing of the coded data holistically.

Throughout the analysis, coders incorporated multiple strategies addressing credibility, dependability and confirmability (Nowell et al. 2017). Credibility was enhanced through iterative codebook development, in which transcripts were coded by two members of the research team (collaboratively or separate coding) and regular research team meetings to reach consensus and refine formal codes. Dependability was promoted by maintaining a comprehensive audit trail, documenting codebook revisions, analytic decisions and team meeting notes. Confirmability was supported through reflexive memoing and the systematic use of verbatim participant quotations to ground interpretations in the data. Together, these practices strengthen the transparency, rigour and trustworthiness of the analysis.

3. Results

3.1. Participants

Twenty‐nine individuals (n = 25 female, n = 4 males) participated in the study. The first 22 participants were invited to complete an interview. From the 22 invited, 20 participants agreed to partake in interviews. Following the first 20 interviews, an additional set of targeted participants (n = 9) were invited to complete an interview, to ensure a more balanced representation of educator backgrounds and experiences (i.e., < 5 years of teaching experience, preservice teachers and male educators).

Participants' highest education level included a bachelor (n = 14) or master's degree (n = 15). Participants included preservice teachers (n = 3), special educators (n = 12), classroom teachers (n = 12), one occasional teacher and one principal (Table 1). Educators varied in their grade certifications, including primary (kindergarten to grade 3; n = 17), junior (grades 4–6; n = 22), intermediate (grades 7–10; n = 13) and senior (grades 11–12; n = 7) grades. Participants taught in public (n = 18), public catholic (n = 1) and private (n = 10) schools in Ontario, Canada (Table 1).

TABLE 1.

Participant demographic characteristics (N = 29).

Characteristic	n (%)
Gender
Male	4 (13.79%)
Female	25 (86.21%)
Education
Bachelor's a	14 (48.28%)
Master's	15 (51.72%)
Current roles in education
Classroom teacher	12 (41.38%)
Preservice teacher	3 (10.34%)
Principal	1 (3.45%)
Special educator b	12 (41.38%)
Occasional teacher c	1 (3.45%)
Grade certifications d
Primary (kindergarten to grade 3)	17 (58.62%)
Junior (grade 4–6)	22 (75.86%)
Intermediate (grade 7–10)	13 (44.83%)
Senior (grade 11 and 12)	7 (24.14%)
Years of teaching
0–4 years	11 (37.93%)
5–9 years	3 (10.34%)
10–19 years	6 (20.69%)
20+ years	8 (27.59%)
Not reported	1 (3.45%)
School setting
Public	18 (62.07%)
Private	10 (34.48%)
Catholic	1 (3.45%)
Special education experience
Yes	17 (58.62%)
No	12 (41.38%)
Additional ABI training
Yes	0 (0%)
No	29 (100%)
Personal experience with ABI (self or known person)
Yes	7 (24.14%)
No	22 (75.86%)
Professional experience with ABI
Yes	12 (41.38%)
No	13 (44.83%)
Unsure	4 (13.79%)

^a In Ontario, Canada, teacher education programs are delivered at the undergraduate (bachelor of education) and master's levels. Both levels of education lead to teacher certification by the Ontario College of Teachers.

^b A special educator may include a classroom teacher in a developmental education class, learning support teacher, learning resource teacher or teacher on special assignment.

^c An occasional teacher is a teacher employed by a board to teach as a substitute for a teacher or temporary teacher who is employed by the board in a position that is part of its regular teaching staff (Ontario 1990).

^d In Ontario, Canada, teachers are certified to teach more than one grade level (kindergarten to grade 6, grade 4–10 and grade 7–12).

3.2. Identified Categories

Qualitative content analysis of interview data summarized the main concepts expressed by educators into four categories and 22 subcategories. Figure 1 highlights the key categories identified throughout participant interviews: (1) baseline knowledge and experiences: information and/or experiences that educators had prior to completing the module, (2) TeachABI factors: internal (i.e., in the educator's control) and external (i.e., in the educator's environment) factors identified as facilitators or barriers to applying learned knowledge and strategies following educator completion of TeachABI. (3) ABI knowledge gap: The questions and/or gap in knowledge that educators had following the completion of the module. (4) Future learning and experiences: educators' future learning experiences that will be impacted by both the completion of TeachABI and their gap in ABI knowledge. These categories are discussed in turn below.

FIGURE 1.

Key categories from participant interviews.

3.3. Baseline Knowledge and Experiences

When reflecting on the content of TeachABI, educators related the material to their pre‐existing use of strategies in the classroom (for students with ABI and/or other exceptionalities), pre‐existing knowledge of ABI and previous classroom and personal experiences.

Educators came into the module with varying degrees of knowledge pertaining to ABI: some identified an overlap of TeachABI material with pre‐existing knowledge and strategies already used in the classroom (pre‐existing knowledge and pre‐existing strategies; Table 2). Educators reported that pre‐existing knowledge was a result of experience working with students post‐ABI or students with other exceptionalities. Educators' experience working in special education or specialized classrooms prior to completing the module influenced the level of pre‐existing knowledge of ABI. Educators with less teaching experience or no experience working with students post‐ABI generally reported less pre‐existing knowledge of ABI and ABI strategies prior to completing the module. Those with more experience working with students post‐ABI generally reported more pre‐existing knowledge of ABI and ABI strategies prior to completing the module. They also indicated that completion of the module reinforced their pre‐existing knowledge and validated their use of strategies in the classroom.

TABLE 2.

Table highlights the results of this study. Key information includes the categories, subcategories, definition, key findings and sample quotations.

Categories	Subcategories	Definition	Key findings	Sample quotations
Baseline knowledge and experiences	ABI knowledge (pre‐existing)	The educator's knowledge of ABI prior to the completion of TeachABI.	ABI information from the module overlapped with pre‐existing educator knowledge related to other exceptionalities. Educators' roles (i.e., working in special education classrooms) impacted their prior knowledge of ABI. Previously acquired information was reinforced through key messages and objectives outlined in TeachABI.	‘Overall, there might have been things I sort of knew already, but just hearing and seeing, and the different modalities in the module—there was the audio, the text, the charts, the videos—it all, reinforced the key messages and the objectives.’ – Participant 8; 13.5 years of teaching experience ‘I think it's just because I had prior knowledge of it that I did not even know that I really had. I was like okay I do not really know what I'm talking about here …,” but “oh wait, I do.’ – Participant 10; 13 years of teaching experience
	Strategies (pre‐existing)	An awareness pertaining to strategies for students in the classroom (similar or the same as ABI specific strategies) prior to the completion of TeachABI. Note: This includes nonspecific ABI strategies used with other exceptionalities.	Educators reported using some of the strategies presented in the module with students of other exceptionalities (e.g., ADHD or ASD) in their classroom. The module reinforced that strategies educators are already using are similar or the same as strategies that can be applied to students post‐ABI.	‘A lot of the things that they have said I have implemented. I'm a bit more knowledgeable about acquired brain injury and kind of some of the “look fors.” It was good to know, the strategies that help kids with ABI I've already implemented and used. Especially being from a special education background, I'm sure a lot of special education teachers do have that knowledge, and I mean the reality is every classroom teacher is going to have IEPs and things, so it applies to everyone.’ – Participant 4; 11 years of teaching experience
	Previous classroom experiences	Educators' experiences working with students with an ABI.	Educators reflected on previous and/or current students when completing the module by relating information from TeachABI to their students. Educators reported the use of some of the presented strategies from TeachABI in their previous classroom experiences. Educators noted the importance of the case study approach, which enabled them to reflect on their own classroom experiences.	‘As I was going through the entire module a bunch of students of mine in the past 5,6 years that I've taught popped into my head.’ – Participant 12; 6 years of teaching experience ‘Yeah, I thought back to students that I would have had, and maybe this was one of those unanswered questions that we never even thought to ask parents, because again parents would never think to something from 5 years ago, 4 years ago, would be an issue today.’ – Participant 25; 8 years of teaching experience
	Personal experiences with ABI	Educators' personal experiences with ABI (i.e., personal ABI lived experience, family member with ABI).	Participants related material from TeachABI to personal experiences associated with ABI.	‘I've had a concussion, I know a lot of people have that, concussions, but these are things that could seriously impact students down the road.’ – Participant 25; 8 years of teaching experience ‘I'm trying to reflect on why I already knew it, it's just from my personal experience, and, like I have a family member with an ABI who's actually a teacher.’ – Participant 27; 3 years of teaching experience ‘I think it [TeachABI] really connected to my own personal experiences, and kind of things I've gone through. So, kind of solidified it a little bit, as well as really informed me as to how I can help my students…’ – Participant 28; 1 year of teaching experience
TeachABI factors—internal factors	ABI knowledge (new)	New (i.e., post‐TeachABI completion) ABI‐related knowledge.	Educators identified that TeachABI provided them with new ABI knowledge that will help them in their teaching. New ABI knowledge included concepts such as: the term ABI, ABI definition, traumatic vs. non traumatic, the incidence of ABI in children and youth, different presentation of ABI across children and youth with ABI, potential challenges post‐ABI, growing into deficits, cognitive fatigue, the importance of an individualized approach.	‘One thing I will take from this course is to ask about an injury, recent or an old one. That's something I have not thought of asking or putting out on the table… The other thing I found … the strategies, whether it's ADHD or brain injury, they can work 1 day or another … So it does not really matter as long as we keep the lines of communication open with the other teachers, with the students, with parents and we keep trying different strategies and assessing them.’ – Participant 3, 25 years of teaching experience ‘I can think of students that I teach right now and based on their interaction with myself and their peers, I would now re‐evaluate some of the assumptions I've made and consider whether ABI is involved.’ – Participant 6; 4 years of teaching experience ‘I think something new for me was the specifics to ABI. So, the definition, what it might look like, how might not appear right away. Sort of the definitions and the two different types … all the specifics to ABI.’ – Participant 3; 25 years of teaching experience ‘I really liked the cognitive fatigue section. I did not really know if there was an injury at an earlier time how it might present later, and I think that's really important, particularly with like the OSR checking and the families and things like that and disclosure.’ – Participant 14; 12 years of teaching experience ‘[TeachABI] reinforced that everyone is different, but I think also that you really communicated that through the advocacy piece, and the inclusion piece as well because I think you were able to show that it's really important to understand that everybody learns differently. But that students with ABI really do need a structured and mindful approach to supporting them and needs to be individualized.’ – Participant 14; 12 years of teaching experience
	ABI strategies (new)	An awareness of ABI strategies following the completion of TeachABI. Note: This includes nonspecific ABI strategies that educators have used with students of other exceptionalities.	Self‐advocacy was reported as one of the strategies for educators to work with their students. Educators reported that some of these new strategies could be applied in the classroom right away. Strategies learned in the module can be implemented or applied for the whole classroom, not just for one specific student.	‘Another piece that I felt was really important and critical in the way [TeachABI] was laid out with how strategies were broken down it wasn't just: here's some strategies for people who have acquired brain injury, it was really you know thought out like “it affects cognitive functioning, so how do we address cognitive functioning?” It just dug deep that it's not a one for all situation, like there's many strategies that here that are going to help all students as a whole group, but every kid with ABI is one kid with ABI …’ – Participant 4; 11 years of teaching experience ‘I was really happy to hear that one of the last strategies was really about self‐advocacy and educators, to help promote children and how to do that, you know, like you may not have a parent who's an advocate for you or an educators and add if you know you have a brain injury, how to do that for yourself.’ – Participant 4; 11 years of teaching experience ‘[The strategies in TeachABI] are really easy strategies to implement right away. So, it's not like we need, you know, something physical or, you know, something that's not attainable or expensive like there's a lot of cheap and cheerful strategies here that can I could go into a classroom tomorrow and I think help a student feel more supported than they were the day before.’ – Participant 4; 11 years of teaching experience ‘I know kind of the strategies and things I can implement that would help benefit all my students.’ – Participant 5; 18 years of teaching experience ‘You could accommodate your entire class with that and it might actually, you know, make things run smooth as a whole, with everyone. … instead of accommodating just the individual, accommodate the whole room you'll make everyone a part of that environment.’ – Participant 15; 4 years of teaching experience
	Procedural knowledge (new)	Awareness or understanding of the process (es) to support a student with ABI in the classroom.	Educators identified an enhanced understanding of supporting students with ABI in the Ontario education system (e.g., importance of strong communication between the educator and caregivers, reviewing the Ontario Student Record, etc.).	‘I did like your systematic idea as with everything, so I think it's good for all teachers to go back to. It's like oh student has an issue, what do I do? I think it's always important to back to basics and be like go to the [Ontario Student Record], talk to the parents, start documenting, create the [Independent Learning Plan]. And just remembering the systematic steps because I think you can get overwhelmed with all the things you are juggling.’ – Participant 2; 9 years of teaching experience ‘I found the knowledge of the Ontario system really helpful to have, you do not always have location specific or geography specific modules available so it's really nice to have something that I could I understood the language, and I could easily implement what I learned immediately. I really appreciated that.’ – Participant 6; 4 years of teaching experience
	Perceived competence	Educators' belief that they have the necessary skills and knowledge to apply the strategies learned in the TeachABI module.	The module provided educators with the necessary background knowledge and strategies about ABI to work with students post‐ABI in the classroom. Educators recognized that hands‐on experience (i.e., working with and applying the strategies learned in the module with students post‐ABI) would help to solidify their ability to put the knowledge and strategies learned in the module into action.	‘I have more of a wealth of knowledge to pull from but, again, like because they, every student or child present so differently with ABI it's like you really do not know what to expect, and I think that element of it, I do not think your module could have done anything different or better it's just the element of the situation itself and really not knowing how a student is going to respond and if it's going to be emotional or there's going to be an outburst or there's going to be things that they could do and now they cannot do. So that that is like very unpredictable.’ – Participant 21; 4 years of teaching experience ‘As a newer teacher too, I think it's my own hesitation of saying “I've got this great training,” but I still feel like I'm only like eight out of 10 prepared, but that's just my nervousness I think, I do not think it's anything specifically module related because, like I said… as far as eLearning goes, I like really enjoyed it. I think that's my own personal hesitation.’ – Participant 15; 4 years of teaching experience
	Self‐ or professional confidence	Educators' general assurance in their ability to successfully implement and adapt these strategies in a real classroom setting.	Learning about the overlap of strategies used for students with ABI and other exceptionalities increased educators' confidence in their ability to apply strategies learned in the module in their classroom. Although educators reported an increase in confidence following the completion of the module, they noted that application of the learned strategies and knowledge in their classroom setting would further increase their confidence to apply the knowledge and strategies. The complexity and diversity of symptoms following ABI impacted educator confidence in being able to apply knowledge and strategies learned throughout the module.	‘It made me feel “oh, good” because I have been doing self‐regulation, I do break cards. It made me feel like “okay, so this is good,” because these are things that I have done in the past, I have implemented, and it wasn't for ABI.’ – Participant 5; 18 years of teaching experience ‘I do not feel fully confident until I actually worked with a student who has an ABI, which obviously a module cannot do.’ – Participant 23; preservice teacher ‘You learn a lot but until you have to actually apply it, you do not really learn it. So I feel like I would be more confident trying some of these things, but until I actually had to do it, I cannot say that I would be 100% comfortable with trying.’ – Participant 11; years of teaching experience unknown
	Intentions—refer to module resources	The educator indicates that they will refer to resources provided or linked in the module.	Module resources are accessible for educators to refer to. Many educators noted that it is helpful to have all the information in one place that they can refer to when needed.	‘I downloaded all of the resources so that I can go back and look at it when I have time to. Like I said earlier, I think that it would be helpful, even in just my classroom that I have now, just there's a lot of helpful resources, about how to be more inclusive and how to treat the classroom as a whole and kind of allow them to build like unity in the classroom and be accepting of others and understanding of others with exceptionalities in your class and I think that that can be used for anything. I think so yeah, I would like to go back and even just look at the resources that I download all the resources from the module as well.’ – Participant 16; < 1 year of teaching experience ‘I still have the tab open and I liked the feature of being able to open up the different PDFs, like certain ones I opened, certain ones I did not. But, especially at the end it told me I could download them all as a zip file and I was like “I might need these later” or the ones that I thought pertain, like inclusive classroom one, things like that I still have them open because I'm like these are good to keep in my back pocket, and you know just putting a file on my computer and read them, of course, after and everything, but then I'm saving for a rainy day in case I feel like I need to brush up on that or anything. So, I like that we could you know, not necessarily in the moment have to spend the whole time reading it, but can download and keep it for later.’ – Participant 15; 4 years of teaching experience
TeachABI factors—external factors	Physical classroom space	Physical classroom space that facilitates or hinders the use of learned TeachABI knowledge and/or strategies in the classroom.	Physical classroom space was identified as a possible barrier to being able to implement strategies for students post‐ABI.	‘I also think the space, like I know, um, a quiet zone for students is so important. But I know in my classroom, it's very small and it's hard to carve out that space, especially even just to make it like quiet and calm enough within the classroom environment, I think that's a tricky one.’ – Participant 29; 2 years of teaching experience ‘Just the limits on that are sometimes beyond the actual teacher educator if the physical environment, I feel comfortable with it, as long as it's a good physical environment for that student as well.’ – Participant 15; < 1 year of teaching experience
	Student × classroom environment	Interplay between the student and their classroom environment.	The interaction between the student and the classroom environment was a possible barrier identified by educators.	‘Yeah. It's good I guess like with anything it's like it sounds so good in theory but in practice this like, oh my gosh, it's like that kid is waving their [break] card at you but maybe you are already dealing with another student flipping their desk and some other ones who do not speak English and they are trying to help. So it's like how effective will it be, in implementation can be hard. Or that student is now so far gone because so many other things have gone in the classroom that cards aren't going to [do] the trick, now they need a calm space they can go.’ – Participant 2; 9 years of teaching experience ‘I think, with like, for example the physical, like having students take breaks. I've been at schools where they do not want students wandering the halls. Like they do not want them walking to the office or doing like teacher errands, so like depending on like the school climate and the school environment like that might not be allowed.’ – Participant 21; 4 years of teaching experience ‘So yes, I can be like, “Oh, yeah, I can easily implement that” but depending on my classroom structure, the students and the specific student that I'm working with, those strategies may not be effective. So kind of depends on the kids.’ – Participant 16; 1 year of teaching experience
	Class size	Classroom size (large or small) that facilitate or hinder the use of learned TeachABI knowledge and/or strategies in the classroom setting.	The ability to apply strategies learned for students post‐ABI was reported to be impacted by the size of the educator's class.	‘Um, and so discuss the importance of taking individualized approach. So as I said earlier in our interview that yes of course you want to do it individualized and I feel like in the setting I work in right now, I have opportunity to do that with relative ease. I only have 8 students in my classroom, I have amazing support, two [educational assistants], biweekly meetings with speech and language that I can always get that feedback.’ – Participant 2; 9 years of teaching experience ‘I'm fortunate enough to only have 10 students in my class, so I'm able to give them more one‐on‐one support and I'm able to give them each more attention and I'm kind of more conscious of the things that they are doing because they are right in front of me and there's only 10 of them.’ – Participant 16; < 1 year of teaching experience ‘I think a barrier is always, um, like the actual space you are working with, and the time and the number of students you have.’ – Participant 19; 2 years of teaching experience
	Multiple exceptionalities	Number of students in the classroom with other exceptionalities that may facilitate or hinder the use of knowledge and strategies learned in TeachABI in the classroom setting.	Having many students with exceptionalities in the classroom can impact the amount of time the educator has to dedicate to students post‐ABI. The ability to use the strategies provided in the module with multiple exceptionalities was a facilitator reported by educators.	‘A lot of those strategies overlap other exceptionalities right. Um, but they were– like to me that was excellent, like you can have as many refreshers … to keep you, keep reminding you right? Like I circled break cards on my notes here because right, never thought about again. I use break cards for a student few years back, but you know what those break cards are excellent, to look into. Social stories. Yeah I just found that was really great. But also being an experience, being an experienced teacher that helped too, right.’ – Participant 17; 39 years of teaching experience ‘Um, I'm just thinking of like what my potential classroom could be like in the future. I guess it would kind of come down to sheer number of [independent education plans] in a room. Um, you do your best to support all of them, but you probably cannot give each student the amount of time they need. Um, considering there's only one, there could be only one adult in the classroom.’ – Participant 26; Preservice teacher
	Material resources	Resources (i.e., staffing, finances, etc.) available through the school that may facilitate and/or hinder the use of learned knowledge or strategies from TeachABI.	Educators noted the importance of resources that are out of their control. Access to resources in publicly funded school boards can sometimes be difficult. Limited time was also identified as a possible barrier to applying knowledge and strategies in their classroom. Educators reported that Ontario not recognizing ABI as an exceptionality may impact a student's access to resources.	‘So if, say if I had a student, you know who needed some more support, say such as even um just kind of like the physical aspects of the classroom, say a specific chair or a specific um say physical tool, sometimes that might not be available. Um so I think that can kind of be a barrier. Usually we all, we are able to work around it, we are able to kind of figure it out, but I think that would be probably the biggest barrier is the resources available to us teachers.’ – Participant 28; 1 year of teaching experience
TeachABI factors—external factors—social influences	Family relationships	Support (facilitator) or no support (barrier) from the student's family.	Educators highlight the importance of sitting down with parents to talk about what is being seen in the classroom versus at home. Educators highlight the importance of having parents' support. Partnership with parents is out of the control of the educator.	‘I cannot see any barriers specific here [i.e., her school] other than the partnership with parents and that's not something we can control right? So if the family is, either has stigma attached to it, or feels that they are not ready to talk about it, or maybe do not even understand themselves. So if there's you know, a parent component I guess that would fully, you know, support us being able to do our work as well. Like would parents typically, when I'm approaching this I'm wondering if there's times that there might be a brain injury that parents do not even know about, versus working with families who share that with you.’ – Participant 20; 20 years of teaching experience ‘The relationship with the family. If you are able to have a successful working relationship. I think that would be the biggest one like if they are, um, on board and ready to work as a team, I think that will make it much more successful. But that's not always the case with every family.’ – Participant 29; 2 years of teaching experience
	School team	Support (facilitator) or no support (barrier) from the student's school team.	Educators report the importance of collaboration and communication among members of the school team.	‘We've not paid attention to the complexity of ABI and how, when you sit down in a school [in school team] there should be like “okay let us look at the behaviour, emotional, social, what types of accommodations or supports are we doing in that domain? And then physical, what medical information do we have, times of day, fatigue, those types of things. And then how are we targeting that and the communication and cognitive, academics.” I really liked that, and I think that makes the way in which you support students more holistic. I think she does communicate that the whole child needs to be supported. So, if you are going to have a student with ABI in your classroom you need to be thinking through all these different lenses and tracking data on all these different lenses.’ – Participant 28; 1 year of teaching experience
	Intergroup conflict	Disagreement or confrontation between two or more groups and their members. This may involve interpersonal discord or psychological tension.	Educators identified the lack of collaboration and communication, and conflict among the school team and/or the student's caregivers is a possible barrier to being able to apply ABI specific knowledge and strategies for students.	‘Um, and my position like not wanting to be forceful and pushy because it does not feel like my place to tell them what's wrong with their child or tell them what their child is struggling with. Um, so that's a big barrier for me, at least, like I have a hard time telling parents that … not that they are wrong, but, like I do not like telling them what they do not want to hear, I guess I'll say.’ – Participant 27; 3 years of teaching experience ‘Whereas I've had other teachers say in my school building, where they are like “Why are you implementing, like why are you doing that? They do not need that. They're fine.”’ – Participant 28; 1 year of teaching experience
Other	ABI knowledge gap	Gap in ABI knowledge.	Following the completion of the module, educators had different levels of ABI knowledge. Some educators left the module seeking out more ABI specific information. Other educators left the module with further questions about ABI.	‘I would need to know a bit more specifically about what's happening in the brain…’ – Participant 2; 9 years of teaching experience

‘Some of the strategies described and some of the other content are so similar to what we're already doing, or things we know from other from other accommodations and modifications we would provide. It was easy to reference what I already know and make inferences based on that.’

– Participant 6; 4 years of experience

While completing the module, many educators related the material learned to personal (e.g., self, family, friend) and professional (students with ABI or with signs of ABI) experiences of ABI and noted that the module led to deeper reflection about ABI symptom presentation (personal experiences and professional experiences; Table 2). Educators highlighted the importance of the case study approach, which facilitated their reflection on these personal and professional experiences.

‘I liked the case study to kind of reflect. I think it allows for me to connect to my own case studies that I've seen in my own classroom and teaching.’– Participant 28; 1 year of experience

‘Other than teaching students with acquired brain injury and seeing how different they present; my own son had a fall.’– Participant 3; 25 years of experience

3.4. TeachABI Factors—Internal Educator Factors

Qualitative analysis of educator interviews revealed internal factors influencing educators' ability to apply ABI knowledge and strategies in the classroom, including: ABI knowledge (Table 2), perceived competence, self‐ or professional confidence and future intentions to refer to the resources presented in the module (i.e., module slides, handouts and resource links).

Educators identified that the module provided them with new knowledge and strategies pertaining to ABI that they will be able to apply in their classrooms (new ABI knowledge and new ABI strategies; Table 2). They reported that TeachABI provided them with the following information: foundational knowledge pertaining to ABI (i.e., definition of ABI, prevalence of ABI for young people, signs and symptoms of ABI), information about ABI not being officially recognized as an exceptionality in Ontario's education system, ‘growing into deficits’ following an ABI at a young age, potential ABI symptoms, cognitive fatigue, the importance of an individualized approach when working with students post‐ABI and the importance of collaboration between the school team, the student and caregivers. Participants also identified procedures (procedural knowledge; Table 2) for supporting students with ABI in the Ontario education system (e.g., importance of strong communication between the educator and caregivers, reviewing the Ontario Student Record, etc.). With respect to learned strategies, participants indicated that strategies could be applied in the classroom immediately. For many educators, completion of the module facilitated recognition that the strategies presented can be beneficial for all students, not just those with ABI (e.g., movement breaks, visual aids, etc.). Participants reported a better understanding that the success of a given strategy may vary day‐to‐day for a given student and noted the importance of trialling a variety of strategies as needed necessary. Self‐advocacy was reported as a newly learned strategy, where educators indicated the importance of working with the student to increase their ability to advocate for themselves in the classroom setting.

‘I was surprised to see the parallels and effective strategies for kids with ABI with other kids … And thinking about the cognitive fatigue. I wouldn't have known that before this module at all … I think I would just assume this person is just tired, lazy.’– Participant 4; 11 years of experience

‘I think I'll be looking at students from a different lens or just like new knowledge in that lens. ABI wasn't even on my radar when looking at some of those symptoms … Now I will look much more acutely at [the OSR].’– Participant 4; 11 years of experience

Overall, qualitative analyses suggest that the module provided educators with key knowledge and strategies for working with students post‐ABI in the classroom (perceived competence; Table 2). Participants identified an overlap in strategies that can be used for students post‐ABI and for students with other exceptionalities, increasing the likelihood of applying these strategies in the future (self or professional confidence; Table 2). Educators indicated that practicing the application of the newly learned material would further increase their ability to apply the information in their classroom.

‘Now, I have some strategies. Of course, the best way to learn is to actually teach the students with an ABI, but I think now that I've got this [ABI education], once I actually do have a student with an ABI, I think I can actually start to implement it and then learn a lot better.’

– Participant 23; pre‐service teacher

On the other hand, some participants reported that following the module, their increased understanding of the complexity and diversity of symptoms observed in students following ABI negatively impacted their level of confidence to apply the newly learned information in their class.

‘I would not make it [confidence rating] a 10 because [ABI] sounds very diverse and so finding the right approaches seems like it's going to be a challenge of itself … it reminds me a lot of dealing with students who have learning disabilities and behavioural issues and just recognizing a good plan, a toolbox and being ready to adapt is necessity for this kind of approach.’

– Participant 25; 8 years of teaching experience

Educators acknowledged that it was helpful to have the module resources all in one place and easily accessible to refer to in their own time. The educators expressed intentions to refer to the module resources in the future, noting that they downloaded the documents and saved embedded links in the module (intentions, refer to module resources; Table 2).

‘I've seen bits and pieces, but I think it's nice to have access to all of these PDFs and they're all in one place. I don't need to go find them, which can be tricky. I think I saved them all, I think this is something that I would be looking at 100%. Having the PDFs, which are very straight to the point and easy to read and look at when I need them. I think that was very helpful too.’

– Participant 16; < 1 year of experience

3.5. TeachABI Factors—External Factors

Educators revealed external factors, outside of the educator's control, that may influence their ability to apply ABI knowledge and strategies learned from TeachABI in the classroom, including: environmental context (physical classroom space, student interactions with the classroom environment, size of the class and multiple exceptionalities in the classroom; Table 2), material resources available to the educator through the school and/or school board and social influences (school team, family relationship and intergroup conflict; Table 2). Educators also reported potential barriers in the application of ABI‐specific knowledge and strategies in their classroom related to the environmental context (physical space, number of students in their class and student interaction with the classroom environment; Table 2) available to them. In addition, they noted that the number of students with exceptionalities (i.e., learning needs, accommodations and modifications) in the classroom can often impact the amount of time educators have to dedicate to students (multiple exceptionalities; Table 2). Participants further reported a possible barrier in the material resources available to educators, such as having large class sizes with limited educational support for students (resources; Table 2). Some educators noted that Ontario not recognizing ABI as an exceptionality may negatively impact students' access to resources in publicly funded school boards in the province (resources; Table 2). On the other hand, external factors described by educators that may facilitate the application of material learned in TeachABI to their classroom included the following: smaller class sizes (class size; Table 2), such as special education or specialized classrooms, where educators noted that they are able to provide their students with more direct support and the overlap of ABI strategies with strategies used for students with other exceptionalities (multiple exceptionalities; Table 2).

‘It's so hard when you have a class of thirty students. For example, I have thirty students. When you're in the primary division, you're between twenty and twenty‐five students. How do you not hand hold, but help that student, because you have twenty‐four other students that you have to help as well.’

– Participant 28; 1 year of experience

Educators highlighted the importance of collaboration and communication with the student's caregivers. They reported that a possible barrier to applying the knowledge and strategies from TeachABI into the classroom includes their partnership with caregivers, where educators acknowledged that ABI support starts at home and relies on home‐school collaboration. For example, some parents may not disclose a child's injury or may not want their child to receive accommodations (family relationship; Table 2). Educators further reported the importance of collaboration and communication in the school team (school team; Table 2) to facilitate their application of ABI knowledge and strategies with their students post‐ABI. They reported that a lack of collaboration and communication and conflict among the school team and/or the student's caregivers (intergroup conflict; Table 2) is a barrier to being able to apply ABI specific knowledge and strategies for students.

‘I've unfortunately had the experience of parents not being on board… Parents are worried about labelling their kid, which in teachers' college, I always thought that was not really a thing. In my three years of teaching, it's happened literally every single year. So that is a huge barrier, just parents being fearful of that label.’

– Participant 27; 3 years of experience

3.6. ABI Knowledge Gap

Upon completion of the module, some educators identified a need for additional learnings and/or ABI specific courses due to gaps in ABI knowledge following the completion of the module (ABI knowledge gap; Table 2). Primarily, educators expressed gaps in topics related to the understanding of their procedural role in navigating conversations with caregivers in the school system (knowledge gap and procedural knowledge; Table 2).

‘I wonder [about] suggestions for follow up … how could we then keep going and keep thinking about [ABI], keep learning about it? Could we revisit that manual? Are there other case studies out there? Are there ways we can go back and revisit and add to what we've learned now that we've done this?’

– Participant 13; 26 years of experience

4. Discussion

This study explored educators' key takeaways from the TeachABI module, focusing on their intentions to apply TeachABI learnings in their classrooms. Specifically, the study aimed to understand educators' key learnings following TeachABI module completion, including: (1) educators' understanding of the material presented in TeachABI, (2) educators' intentions to apply strategies learned in TeachABI in their classroom setting, as well as (3) internal and external factors that may facilitate or impede educators' ability to apply TeachABI material in their classroom.

Consistent with the first study aim, educators described an enhanced understanding of ABI and ABI‐specific classroom strategies following module completion. Overall, educators reported an increase in ABI knowledge and strategies, including increased confidence in their ability to apply the module learnings in the future. While completing TeachABI, educators reflected on their prior knowledge, use of classroom strategies and personal or professional experiences with ABI, actively linking these insights to the module's content. Existing literature supports the value of reflection as a learning tool, noting that reflection helps build upon previous experiences and fosters a deeper understanding of the subject (Randel et al. 2016; Ash et al. ²⁰⁰⁵; Radović et al. ²⁰²³). Therefore, by integrating the module material with their existing expertise and experiences, educators likely achieved a more comprehensive understanding of the module's content.

In relation to the second study aim, educators reported their intentions to apply learned strategies from the TeachABI module into their classroom. Participants reported experiencing internal changes through engaging with the TeachABI module. Of note, educators' reports pertaining to internal factors, including their increased knowledge and confidence of working with students following ABI in the classroom, were predominantly positive. Educators reported increased competence and self/professional competence following module completion, and increased knowledge about ABI and ABI‐specific strategies that they could immediately apply in their classroom following the completion of TeachABI. Despite these positive changes, educators discussed that practice using the learned strategies in their classroom setting would further increase their confidence in applying the material learned. These findings are consistent with previous literature, indicating that educators who actively trial teaching strategies in their classrooms experience increased confidence, deeper understanding and improved instructional effectiveness through real‐world application and feedback (Paolini 2015; Tomaszewski et al. ²⁰²²). Furthermore, many educators reported their intent to keep and refer back to the module materials. Research shows that educators who intentionally keep and revisit professional development resources are more likely to deepen their understanding, retain new strategies and effectively apply them in the classroom, as supported by research emphasizing reflective practice, purposeful engagement and sustained learning (Leggett 2025; Noonan ²⁰¹⁹; El Islami et al. ²⁰²²).

In relation to the third study aim, educators identified several factors that could either facilitate or impede the implementation of TeachABI learnings. External factors were identified by educators as a key variable in their ability to apply the knowledge and skills learned in TeachABI. Educators identified many barriers associated with implementing knowledge and strategies from the module, including limited classroom space, multiple students with exceptionalities, the interaction between students and the classroom environment, class size and the availability of material resources. Importantly, those teaching in smaller or specialized classrooms also noted environmental factors as possible barriers. However, these participants recognized that environmental factors are less of an obstacle in their smaller classrooms, where they have more resources and staffing (compared to classrooms with more students, less space and fewer resources available). These findings are consistent with broader research highlighting the significant influence of class size on teaching strategies, student‐teacher interactions and classroom management (Blatchford et al. 2009). In particular, large class sizes and the presence of students with diverse and complex needs can overwhelm educators, especially when additional supports and/or resources are lacking (Bascia and Rottmann 2011; Laitsch et al. ²⁰²¹). Although educators reported that ABI strategies could be applied universally across the classroom, they also emphasized that the effectiveness of such strategies may be constrained by systemic factors in the school system. These findings are consistent with literature emphasizing the importance of manageable class sizes and access to resources for educators to enhance student learning outcomes (Laitsch et al. 2021; Bascia and Faubert ²⁰¹²). In Ontario boards the average class size ranges from a maximum of 26 for kindergarten (with an upper cap of 29 or 32 in exceptional circumstances), 23 students in primary (grades 1–3) and an average cap of 24.5 students for intermediate (grades 4–8) classrooms. Of additional relevance, the class size regulations do not take into consideration the number of students with an Individual Education Plan (IEP) in the classroom. In 2022–2023, approximately 17.6% of all students in publicly funded elementary and secondary schools in Ontario had an IEP (Data Ontario ²⁰²³). Students with IEPs require more time, resources and staffing to support their learning. Without these supports, educators face significant challenges in meeting the needs of all students, particularly when there is not enough funding, staffing and large class sizes (Birdwell et al. 2016; Vaz et al. ²⁰¹⁵; Gal et al. ²⁰²⁵; DeSpain ²⁰²¹). Overall, these external factors, largely beyond the control of individual educators, are shaped by broader school board policies and systemic structures. As such, they represent a possible barrier in the practical application of knowledge and strategies learned in TeachABI.

Participants also identified social influences, including the school team and intergroup conflict, as key factors that may facilitate or impact an educator's ability to apply the knowledge and skills learned through their completion of TeachABI. These findings align with research emphasizing the importance of collaborative school cultures and strong professional networks in supporting the implementation of professional development. For example, literature shows that strong social–emotional skills, supportive leadership and a collaborative school culture foster educators' application of professional development learnings effectively (Brown et al. 2020; Ettenhofer et al. ²⁰¹⁹). Another factor described by educators that may impact the application of knowledge and strategies from TeachABI is their relationship with the student's family. Many educators reported that caregivers are often reluctant to disclose health information, making it difficult for educators to work with parents to help their child. According to a systematic review of parents' experiences during the first year after their child's ABI, parents reported hesitation in fully disclosing their child's condition and/or medical history due to fear of stigma (Fernandes et al. 2024).

Although some educators indicated remaining gaps in their knowledge after completing TeachABI, others suggested that TeachABI motivated them to learn more about ABI and requested additional educational materials. Of note, additional ABI‐specific programs and resources are linked in the module to allow for additional and/or future learnings for educators. An environmental scan of ABI resources highlights that a number of online resources exist to support educators in understanding ABI (Saly, Marshall, et al. ²⁰²³). TeachABI was designed to address a gap in Ontario's educator training landscape, as identified in a needs assessment (Stevens et al. 2021). As such, it is expected that educators may have further questions following module completion, which can be addressed through the additional resources provided throughout the module.

Although educators indicated that TeachABI increased their ABI knowledge and confidence, many also acknowledged the complexity and heterogeneity of ABI. Importantly, participants highlighted challenges related to accessing student‐specific information and collaboration across school teams and with caregivers. These findings suggest that TeachABI may be most effective when embedded within a broader continuum of support that includes collaboration among educators, families and healthcare professionals. Specifically, future research should investigate the integration of TeachABI into hospital discharge planning that occurs with clinicians, families and educators. Integration of TeachABI into existing hospital transition processes could help address the highly individualized nature of ABI by encouraging communication between families and educators while maintaining the accessibility of TeachABI.

The development of TeachABI is iterative. Educator feedback from the current study will be considered and changes will be made to the module prior to future research. Next steps in this project include the adaptation of the elementary TeachABI module for high school educators and implementing the module for educators across Ontario (Provvidenza et al. 2024). The implementation of this module has also begun in other countries around the world, including Australia (Drake et al. 2024).

5. Limitations

The findings from this study should be considered with acknowledgement of relevant limitations. First, all educator interviews were conducted after participants completed TeachABI. Therefore, educators' pretraining knowledge of ABI and ABI strategies in the classroom was captured retrospectively, which may have influenced their answers. Furthermore, our sample may not fully reflect Ontario's educator population as many participants had prior professional or personal experience with ABI. Additionally, the study sample included a higher number of female educators; this aligns with the educator workforce: in 2022–2023 there was a higher percentage of female compared to male educators in Ontario (76.60% female, 23.40% male) (Statistics Canada ²⁰²⁴). Educators completed the module with the research assistant online. Although the research assistant had their camera off, their presence may have impacted how much time the educator spent reviewing TeachABI and supporting resources. Finally, completing a qualitative interview where participants engaged in reflection of the module and their professional and personal experiences may have increased uptake of professional development learnings for educators following completion of TeachABI.

6. Conclusions

Overall, this study highlights TeachABI as an effective tool for increasing ABI‐specific knowledge and strategies for educators in the classroom. Educators highlighted increased competence and self/professional confidence for working with young people post‐ABI, following their completion of TeachABI. The results also demonstrate the importance of considering the external factors, which may facilitate and/or act as barriers towards implementing certain strategies for students post‐ABI in the classroom and are outside the control of the educator. Future research should explore how TeachABI may be implemented into existing hospital‐to‐school transition processes.

Author Contributions

Christine C. Muscat: writing – original draft, writing – review and editing, visualization, formal analysis. Sara A. Marshall: investigation, writing – review and editing, formal analysis. Alexa Irvin: writing – review and editing, formal analysis. Andrea Hickling: conceptualization, methodology, writing – review and editing, project administration. Tijana Simic: conceptualization, writing – review and editing. Kathryn Broad: conceptualization, writing – review and editing. Shannon E. Scratch: conceptualization, funding acquisition, writing – original draft, writing – review and editing, supervision, methodology.

Funding

This work was supported by the Social Sciences and Humanities Research Council of Canada (430‐2019‐0714), the Ontario Early Researcher Award (ER22‐17‐050) and Doctoral Research Award: Canada Graduate Scholarship.

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.