Concerted efforts have been made within teacher preparation programs to integrate teaching with technology into the curriculum. Unfortunately, these efforts continue to fall short as teachers' application of educational technology is unsophisticated and not well integrated. The most prevalent approaches to integrating technology tend to ignore pedagogy and content and assume that the technology integration knowledge for all contexts is the same. One theoretical framework that does acknowledge content, pedagogy, and context in conjunction with technology is Technological Pedagogical Content Knowledge (TPACK) and was the lens through which teacher development was measured and interpreted in this study. The purpose of this study was to investigate graduate teacher education students' knowledge and practice of teaching with technology as well as how that knowledge and practice changes after participation in an educational technology course. This study used a mixed-methods sequential explanatory research design in which both quantitative and qualitative data were gathered from 82 participants. TPACK pre- and postcourse surveys were administered to a treatment group enrolled in an educational technology course and to a nonequivalent control group enrolled in a learning theories course. Additionally, pre- and postcourse lesson plans were collected from the treatment group. Select treatment group participants also participated in phone interviews. Analyses compared pre- and post-course survey response differences within and between the treatment and control groups. Pre- and postlesson plan rubric score differences were compared within the treatment group. Quantitative text analyses were performed on the collected lesson plans. Open and axial coding procedures were followed to analyze interview transcripts. The results of the study revealed five significant findings: 1) graduate students entering an educational technology course reported lower ability in constructs related to teaching with technology than in constructs related to teaching in a traditional setting; 2) TPACK was malleable and TPACK instruments were sensitive to that malleability; 3) significant gains in reported and demonstrated TPACK constructs were found after participating in an educational technology course; 4) TPACK construct ability levels vary significantly by participant characteristics; and 5) influences on teaching knowledge and practice range from internet resources, to mentor teachers, and to standardized curriculum packages.