Prior studies have documented an association between reading comprehension and arithmetical skills. However, the underlying processes that might moderate these associations, particularly while accounting for general cognitive abilities, remain unclear. This study investigated whether grade level moderated the relationship between reading comprehension and mental subtraction in deaf and hard of hearing (DHH) children, after controlling for intelligence. A sample of 257 DHH children from Grades 3 to 9 in China completed measures of reading comprehension, single-digit subtraction, double-digit subtraction, and a test of non-verbal intelligence. Results indicated that after controlling for intelligence, the direct effect of reading comprehension on subtraction performance was not significant. However, moderation analyses using the PROCESS macro revealed that grade level significantly moderated this relationship for both single-digit and double-digit subtraction. Simple slope analyses showed that for children in higher grades, reading comprehension was a strong and significant predictor of subtraction performance. In contrast, for children in lower grades, the association was significantly weaker for single-digit subtraction and non-existent for double-digit subtraction. These findings highlight grade level as a critical developmental moderator, suggesting that the role of reading comprehension in arithmetic emerges and strengthens in later school years among DHH children.
Introduction: Continuous quality improvement (QI) is crucial for successful curricular implementation and innovation in health professions education (HPE). Central to this is a favorable Quality Culture (QC), one that promotes people's beliefs, commitment, engagement, communication, and collaboration. However, the concept of QC remains underexplored in low-income settings, resulting in a limited understanding of its constitutive elements and how to foster them. This study was conducted to identify elements considered essential for fostering QC in Ethiopia's HPE institutions. Methods: In June-July 2024, we conducted a Modified Delphi study with a panel of 31 academic leaders, faculty, and students who had an interest and three years of experience in QI, accreditation, and/or HPE management. Using the Quality Culture Inventory tool, we identified 31 elements. Over three rounds, the panelists used a three-point scale to rate online the importance of targeting each element to foster QC, and proportions were calculated. We retained elements with ≥70% agreement as "essential" and discarded those with ≥70% agreement as "not so important." We reviewed the remaining elements in light of the panel's comments. At the end of each Delphi round, we shared feedback reports with the panelists, which guided the subsequent Delphi rounds. We concluded the ratings after the third round. Results: Of the 31 elements, 18 were considered "essential" to foster QC. Five elements reflected the individual psychological dimension: belief, commitment, participation, connectedness to quality goals, and leading change. Three elements reflected the collective psychological dimension: strong peer support, functional working groups, and experience-sharing practices. In the formal structural quality assurance (QA) dimension, priority was given to the presence of decentralized quality departments that facilitate regular self-assessments. Seven other elements were related to academic leadership and human resources development. Conclusions: To foster QC, HPE institutions enhance academic leadership, staff development, and motivation. Addressing people's psychological factors strengthens their beliefs, commitment, participation, connectedness to the quality agenda, and mentality for leading change. Equally important is decentralization of quality departments to enhance their responsiveness and ownership.
Health Professions Education (HPE) cannot rely on assumptions of stability. Fragile contexts - wars, disasters, political upheaval, and systemic weakness - disrupt teaching and learning, assessment, accreditation, and the well-being of learners and faculty. This AMEE Guide provides a framework for building resilient HPE that survive crises and use them as opportunities for reform. The Guide identifies three types of fragility and explores their impact on institutions, human capital, clinical training, and social accountability. To boost resilience, the guide recommended adaptive strategies that include creating crisis management committees, implementing modular and competency-based curricula, allowing credit transfers for displaced learners, and incorporating tailored training programs. For curriculum delivery innovations range from hybrid and low-tech methods to peer-assisted approaches, diaspora involvement, and community-based services. A practical model for fair and feasible assessment in disrupted environments is suggested, with a focus on outcomes, flexibility, and cross-border recognition for rethinking accreditation and quality assurance. Systems thinking underpins the Guide, highlighting how destructive cycles such as brain drain can erode capacity, while virtuous cycles - driven by technology adoption, partnerships, and community integration - can foster recovery and growth. The guide also calls on educators, institutional leaders, and policymakers to move from reactive responses to proactive preparedness.
Using Artificial Intelligence (AI) to review academic papers is happening and cannot be ignored by journals. There is a need to find a balance between outright banning and uncontrolled usage. Medical Teacher recognises this need, and this commentary views the problem within the general context of authorship, discusses some of the problems surrounding AI-reviewing, and offers a middle ground of practice and disclosure that will assist authors, reviewers, and the journal in ensuring that the review process is not compromised.
This article examines how deaf students and interpreters experience positioning within mainstream educational settings, with a focus on environments where a critical mass-defined as multiple deaf students and interpreters-is present. Drawing on interviews with 41 formerly mainstreamed deaf individuals and interpreters, the study explores how critical mass influences engagement, participation, and perceived membership in the school community. Findings suggest that critical mass enhances access to Deaf Community Cultural Wealth (DCCW) and fosters collaborative positioning. These environments strengthen support systems for both deaf students and interpreters. These environments also promote professional development among interpreters and contribute to more inclusive school climates. The study is framed by positioning theory and DCCW, offering insights into how systemic and interpersonal dynamics shape educational experiences. Implications are discussed for both deaf education and interpreter education communities.

