Measuring Adaptive Expertise in Radiology Residents: A Multicenter Study

Introduction: Adaptive expertise is the ability of individuals to create innovative solutions when they come across novel problems or workplace challenges. Clinicians are often adept at handling routine clinical procedures but lack confidence and a proper strategy when previously un-encountered situations arise. Lots of research has been conducted on basic concepts and development of adaptive expertise however major chunk of literature belongs to non- medical fields. Little is studied about assessment of adaptive expertise in medical professionals and postgraduate residents. Objective: To measure adaptive expertise (AE) of radiology residents and to assess any association between the AE of postgraduate radiology residents (PGR) and their years of training. Methods: This multicenter correlational study involved 181 radiology residents from nine major teaching hospital of Lahore, Pakistan from May to October 2019. Katerina Bohle Carbonell Adaptive Expertise Inventory was used as a data collection tool. The questionnaire contained a total of eleven items encompassing two dimensions of AE: domain-specific and innovative skills. Total scores representing AE of PGRs were measured. AE scores and years of training were correlated using Spearman rho correlation. One-way ANOVA was conducted to further evaluate the association between AE and years of postgraduate training. Results: Out of 181 residents there were 78 (43.1%) males and 103 (56.9%) females. Most of them, 97 (53.6%) were enrolled in four years fellowship (FCPS) program and 62 (34.3%) were in the first year of their residency. Total AE scores of all radiology residents ranged from 33 to 54. AE scores and years of residency were positively correlated (rs= 0.4, p < 0.01). One-way ANOVA and Post hoc comparisons using Tukey HSD test further revealed significant pairwise differences between mean scores of residents’ groups (p = < 0.05) rejecting the null hypothesis. Conclusion: Overall, this study concludes that residents acquire adaptive expertise perpetually with progression in their training. KEYWORDS: Adaptive Expertise (AE), Radiology, Postgraduate Residents (PGRs)

Phytosociology, Floral Diversity and Conservation Status of Murree-Kotli Sattian-Kahuta National Park

To understand the ecosystem dynamics with respect to plant ecology it is inevitable to understand floristic composition, spatial and temporal distribution and all the related phytosociological aspects of plants in an ecosystem. Murree-Kotli Sattian-Kahuta national park (MKSKNP) is located on the lateral spur of the sub-Himalayan Mountains and declared as a national park in 2009. MKSKNP is rich in plant biodiversity but have not been previously subjected to quantitative ecological studies through statistical tools and techniques. The present study was conducted from August, 2013 till September, 2015 to fill the research gap. Species attributes were measured by stratified random sampling design. Three hundred and fifty two plant species were recorded from 246 samples using the quadrat method. There were seven plant communities, identified by using classification and ordination techniques (PC-ORD and CANOCO) viz., 1) Themeda-Galium-Gerbera commun-ity, 2) Dodonaea-Carissa-Dalbergia community, 3) Adiantum-Olea-Xylosma community, 4) Justicia-Mallotus-Asplenium community, 5) Micromeria-Taraxacum-Dichanthium community, 6) Myrsine-Oplismenus-Pinus community and 7) Pinus-Viburnum-Daphne community. Indicator species of each community were determined by Indicator species analysis. Multi-Response Permutation Procedure detected a significant difference (p 0.05) in species composition of plant communities. Biodiversity of the communities were established by different diversity and evenness indices, while the conservation status was ascertained according to the categories of IUCN. Plant species composition and distribution dynamics were mainly determined by al- 2 itude, latitude and soil texture, as shown by Detrended correspondence analysis (DCA) and canonical correspondence analysis (CCA). CCA detected nine significant [p (adj) < 0.5] environmental variables which cumulatively explain 13.10% of variation in species data the species composition The dominant life forms were the Hemicryptophytes (28.89%) and Therophytes (27.98%), whereas Microphylls (35.41%) and Nanophylls (35.41%) were the prevailing leaf spectra of the study area. Overall, 624 plant species comprised of 361 genera and 106 families. (Including 24 ferns species, 4 species of gymnosperms, 144 monocots and 452 dicots), were recorded from the study area. Comparing with regional floras, most of the species were native to the area (508 Spp.). The individuality of the region is depicted by the endemic flora, which is quite significant because of limited distribution (Ali, 2008), are of great interest for taxonomists and ecologist (Khan, 2013). The Western Himalayas is endowed with rich endemic flora (300 species), (Ali et al.,1972–2009), of which five plant species viz. Viola makranica, Buxus papillosa, Rydingia limbata, and Gentiana argentea which are endemic to Pakistan were also reported from the study area. There were 16 plant species recorded for the first time from MKSKNP, Rawalpindi. The study helps understanding the plant diversity and related biodiversity issues of the MKSKNP. The finding of the study will help the ecologist, conservationist and foresters to tackle biodiversity crises and improving the bioresource basis of the study area.