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)

Role of Community Based Education Committee Ec in the School Management and its Effect on School Performance

Community participation has become an essential part of school reform, particularly in the educational policies and school management. Community participation in the school management has become a taken for granted reform, which is based on the assumptions that it will improve the educational delivery at the school level by harmonizing activities, utilizing resources more effectively and mobilizing the additional human and financial resources. This reform is widely adopted in the developing countries, including Pakistan. The notion seems to be acceptable but in practice it might prove problematic. The structure, functions and mechanism of community management, and its impact on school performance is not well known. I carried out a systematic research on community-based Education Committees' (EC) role, function and the relationship between the role and school performance, in the context of Pakistan. I employed qualitative and quantitative research approaches in order to obtain some generalizable information about the EC's management structure and role in the community schools in Karachi, Pakistan. Findings from the studies revealed that ECs had been involved at the administrative and operational level. The management structure, mechanism, background of the committee members and location of the school, had a great influence on the school performance. The ECs had performed a significant role in improving physical resources, retaining teachers' moral and students performance, through maximum participation of the key stakeholders, particularly the school staff in the school management. On the contrary those community management structures with little understanding of the school processes, exclusion of headteachers from the decision-making, and unnecessary monitoring of the school staff had a negative impact on the school performance. Thus the study findings have an implication for the ECs with regard to the structure of the committee, its composition and the mechanism required and effective involvement in the school management. The study also suggested some recommendation for the ECs, schools and policy makers, based on the findings.