key: cord-0731490-cfi2p5xo authors: Rastogi, Sanjeev; Sharma, Krishna Gopal; Varma, Sonam; Verma, Sharmishtha title: Institutional library reforms are needed to improve ayurveda education, practice and research: Inferences from a case study date: 2020-12-17 journal: J Ayurveda Integr Med DOI: 10.1016/j.jaim.2020.10.009 sha: db1896aca5a4cd618539f135a756952ad089def2 doc_id: 731490 cord_uid: cfi2p5xo Libraries have always been the integral components of the academic institutions world over. Earlier known for housing the spectrum of books permitting their ready access to knowledge seekers, libraries of current age are no more confined spaces with limited functions. With the advancing information technology, the conventional definition of a library is changing to accommodate newer roles and challenges. Twenty-first century academic libraries are extending beyond the walls of their individual institutions and are evolving as open access information spaces, dealing with intelligent sharing through social communication and networking technologies. Despite such massive changes in the information storage and retrieval patterns across the globe, libraries at Ayurveda institutions in India seem by and large unbothered and unaffected. Poor educational and research standards in Ayurveda seem to have direct links with libraries contributing minimally to academic exchange and progress. An SCONUL survey conducted for the first time in any ayurvedic library setting in the country came as an eye opener stating clearly that Ayurveda institutional libraries require a major reform first to bring them at par with other academic libraries and subsequently to evolve them as the nucleus of knowledge fostering. These setups direly need a hand of help to become eligible for contributing what they are really meant to. While thinking of a library we immediately think about a serene place having scholars deeply immersed in the studies behind the big piles of books. Libraries since ages have been the nurseries planting and nurturing the new ideas in minds by enriching them through the glimpses of world views and allowing them to extract their own perceptions and ideologies through intellectual churning. Libraries of ancient Indian universities had been the extraordinary treasures of books and were the places of scholarly worship for thousands of their inhabitants. Nalanda University in 12th century was told to have a collection of over 9 million books [1] . Carrying the important books from India to their respective countries was considered to be one most important agenda to all foreign travelers and scholars who visited India in ancient time. Naturally, since the earliest history known to mankind, the books had been the sheet anchors of spreading the knowledge across the globe. An easy access to reliable, relevant, contextual and updated information is the dire necessity for advancing in any given area of knowledge and library epitomizes such opportunity. Although, in current digital age where information are more easily sought and retrieved through internet, and where the conventional utility of libraries is losing its relevance, their due transformation with advancing technologies can still make them the nucleus of the change through allowing the people acquiring the knowledge most meaningful to them. For any higher education institution (HEI) involved in education and research, library acts as a facilitator and a resource provider giving a cutting edge to the net thought process. This is however obvious to think that this role of library can only be served if it truly harbors the authentic and relevant sources of information and emerges as a facilitator allowing its users an easy access to all what they need. In this context, this is highly pertinent to look at if the libraries of our age truly serve the purpose for what these are primarily designed to be. The libraries and their functioning are required to be reviewed thoroughly for improving them as the instrument of change spread across the Indian HEI including Ayurveda institutions. This argument about Indian libraries seems more meaningful when we find Indian universities and HEIs functioning much lower than the global standards in context of the quality of education and research meaningful to the society [2] . Ayurveda education in India can be taken as a case to see how ignorance of institutional libraries has played decisively in its qualitative downfall over the years. Ayurveda education in India currently is in shambles and needs a total transformation to become responsive to Indian health care needs [3, 4] . This is imperative to think that such poor state of Ayurveda education in India is not limited to the inadequacies of funds, infrastructure and human resources but is also related to the lack of connectedness of Ayurveda knowledge with rest of the world. Lack of connectedness in context to Ayurveda seems the master evil as it disallows the people to oversee the things in their contemporary and global relevance. This is one important reason why the Ayurvedic fraternity at large still lives in illusion of their past without realizing their roles and relevance to the health care needs of present and future. Under-functioning libraries in Ayurveda institutions play crucially to bring and sustain this impasse in Ayurveda education and research. The impact of library in health education, patient care and research has been studied well in number of settings and populations. Health library information is found to affect patient care outcomes through various ways. It is found to have high cognitive and clinical value in diagnosing and treating patients [5] . The impact of library on health care and research is so obvious that a 'clinical librarian' having a mix of clinical knowledge along with library skills is now being positioned at many medical institutional libraries [6] . Library's influence on health care education, patient care and health care research is multidimensional adopting multiple pathways. Where amount, quality and relevance of information available in library acts as one crucial component to this impact, ease and swiftness of getting an access to the desired information is another. Assistance provided at the library to novices may help them finding the most appropriate information generating new ideas of patient care, educational tools and research questions. Medical libraries have further emerged as clearing houses to disseminate information needed by patients, health care providers or the care givers in order to increase the awareness needed for an evidence based decision making. National Library of Medicine (NLM) of National Institute of Health (NIH), US has emerged as a unique official institution in the world serving the medical world through variety of services including that of acting as a repository to millions of published articles from the journals included in its data base [7]. Academic libraries are passing through a phase of transformation globally. Information technology has emerged as a versatile tool to contemporary libraries which is helping them to look far beyond their conventional role as a physical book store. Role of IT utilities in the transformation of academic library services is now a thoroughly evaluated area allowing looking at newer challenges and opportunities for academic libraries. Use of IT is helping the libraries reducing their physical book stock and is shifting their focus to emerge as collaborative learning spaces. Libraries are also emerging as the work stations for innovative technological developments for learning and data management. This shifting focus also proposes for the changing roles of the library staff from a mere book keeper to an embedded librarian or a clinical librarian having diverse skills meeting the contemporary IT requirements merged with conventional library and clinical knowledge [8] . The concept of library without walls has been mooted in the past decade to extend the library services irrespective of their physical locations [9, 10] . With the advances of IT and innovation in book formats like e-books, this was predicted that physical libraries are soon going to die out. Researches however have confirmed the steady or increasing footfall at academic libraries ensuring their need in institutions of higher learning. This is however noted that the user behavior including the borrowing pattern has changed significantly over past few years [11] . How the libraries of future will look like and what roles they will be playing in advancing the knowledge is yet under speculation although it has already picked up a few new roles emerged during the process of transformation which is still on. Libraries which have initially been mooted as the philanthropic acts surviving through the generosity of the state and society have also been perceived by many as a wasteful expenditure without a tangible productivity. Since libraries have been envisaged as an essential mean of quality based education, Central Council for Indian Medicine (CCIM), the regulatory authority of educational standards in Ayurveda has made mandatory provisions for libraries in Ayurvedic institutions and their phase wise escalation to meet the demands as per increasing number of students in the college. These provisions mainly relate to the number of books, space, seating capacity and staff required. We see that these provisions actually spell the bare minimum needs to make an Ayurveda library functional [12] . For a well established institution having standing of over 5 years, a need of over 10,000 physical books and a seating capacity for 80 users is such bare minimum need (Table 1 ). There is no bar in looking beyond the minimum needs if an institution has its own vision and means to realize it. Regarding the type of books to be stocked in the library, MSR however makes a general remark of inclusion of books of different titles in Ayurveda, modern medicine and allied sciences. Absence of the clarity about the quality of books and a large focus upon their numbers opens up the manipulative possibilities to college authorities who consider the libraries a wasteful expenditure. No wonder, one may find many Ayurveda institutional libraries meeting with the desired book number through accumulation of stuff available in the market at the lowest cost. CCIM also envisages the libraries to have facilities like computer, photo copying, printing, ventilation, lights, drinking water and toilet in order to provide a comfortable use of library for academic pursuits. Barring a few, this is however hard to find such facilities commonly available in Ayurveda libraries in the country. Libraries at most Ayurveda institutions are not actually conceived and structured as a facilitator to education, patient care and research. At most places barring a few, these are erected and run to comply with the CCIM-MSR conditions needed to get the permission for operating the college. To get the real feel of functioning of Ayurveda libraries, we carried out a case study focusing upon various infrastructural and functional aspects of a library in a post graduate Ayurveda institution in North India. Library at State Ayurvedic College and Hospital, Lucknow chosen for this case study was found to set a striking example of underutilization of library as an academic utility by showing its inability to play the role of a real resource provider. With a meager stock of 13,900 books (including a large bulk of obsolete books), with no book lending facility, without computer, internet, printer and photocopier, without any access to online or print copies of research journals, this library is more like a rendezvous rather than a place for serious academic pursuits. An average foot fall and book borrowing of 20e25 in a day for a college having a capacity of about 500 medical, nursing and pharma students, trainees and research scholars and over 60 faculty members, verifies the minimal contribution of this library to the quality and standard of Ayurveda patient care, education and research. The case study also carried a SCONUL (Society of College, National and University Libraries) survey [13] for this library to see the quality of its services provided to its users. The survey was conducted utilizing a modified SCONUL survey format (Original SCONUL survey had 14 questions. In modified version, 2 questions related to ethnicity and branch of information sought by the users were excluded for their contextual irrelevance) upon active users of college library which included undergraduates, post graduates and faculty members. The survey was executed by three MD scholars (SV, SV, KGS) from the institute who have been trained about method of using the survey sheet. The survey was conducted during routine library hours on working days during the month of NovembereDecember 2019. Survey was actually conducted within the library premise in a one to one manner by the surveyors contacting the respondents in the library. During the survey period, 56 actual library users have been contacted for the purpose of survey. 6 of them refused to participate due to the reasons like lack of interest, scarcity of time or not interested to point out the limitations of the existing system. Out of 50 respondents who have completed the survey, 33 (66%) were research scholars, 15 (30%) were under graduate students and 2 (4%) were faculty members. Besides knowing the academic profiles of the users to see who forms the major part of the library users, the survey further identified the common activities conducted by the users in this library and has rated their satisfaction in performing such activities. Major areas screened in the survey for the purpose of user satisfaction were Range of books, Course books and essential texts, Range of e-books, Range of print journals, Range of electronic journals, Photocopying and printing facility, study facility, Provision of PC and their reliability, Library catalogue, Library website, Range of electronic resources, Library working hours, Library environment, Helpfulness of the library staff and expertise of library staff. Every user participated in survey endorsed the importance of every point enquired from the perspectives of a library utility. Among these, however no comments could be obtained about the points like range of e-books, range of print journals, range of electronic journals, photocopying and printing facility, provision of PC and their reliability, library website, range of electronic resources etc since these were unavailable in the surveyed library. For remaining points, in any of the category the user satisfaction did not cross the level of 60% (neither satisfactory nor unsatisfactory) and the overall rating of the library for its services by most users was well below 40% (disagreeing the statement that overall, the library provides a good service to its users). This is agreed that on the basis of a survey conducted at a single Ayurveda institutional library, any authoritative conclusion cannot be made but the observations made in this survey are worrying enough to put a heed towards this erstwhile neglected area of action in a composite of improving Ayurveda education and research as a whole. Libraries world over are no more the sacred places housing the physical books but rather emerging as the vibrant spaces for dynamic interconnection of the user with the world of his ultimate concern [14] . Ayurveda libraries can find the same vigor and role to play in their own academics as it can be for any other institutional library related to biomedicine or other streams of knowledge. Looking at the minimal contributory status of Ayurveda libraries in the growth of their own science, these are needed to be overhauled at two levels. The first simple target is to bring these at par with any other current age library in terms of resources and facilities it owns. The later part is more demanding and requires a critical analysis about how these libraries can truly be transformed as a nucleus of continuous evolution in Ayurveda. There are certain basic requirements needed to be imbibed by every library to set the environment of academic dynamism. These needs may compose flexible library hours to meet the diverse user requirements, digital cataloguing enabled for multiple modes of searching using number of key words. Most significant of these could be the book title, author's name, publisher, year of the publication, and subject area. Facilities of printing, photocopying and downloading the soft copies are the common tools seem essential for every good library. Availability and access to online resources like e books and online journals is of utmost importance in today's world and every Ayurveda library should essentially have this. Having an Ayurveda clinical librarian acquainted with the knowledge of Ayurveda along with the library science may bring much ease to the whole operation of the library. Many such recommendations are already mentioned in the CCIM eMSR document but are found largely missing as is observed in the SCONUL survey conducted by the authors (SR) at State Ayurvedic College and Hospital, Lucknow library. Relevance of the books available in the library is also a key factor which signifies the utility of a library among its users. Since current book number requirement specified by CCIM for an Ayurvedic institutional library do not embark upon real utility of the available books for the library users, most private institutions fill their libraries comply with the requirements by spending least. Their natural choice therefore is towards the low cost books which may be bought in adequate numbers. Institutions in the govt. sector are found to crave for the library related funds and hence find it difficult to improve their book stock status due to budget constraints [15] . There had not been any real operational mechanisms in the Ayurveda libraries to find most relevant books in the segments which a library should essentially keep. Ayurveda libraries across the country do not perform any user survey to find what are the subjects, books or information sources most sought by its users. Library user surveys have globally emerged as trusted tools to improve the quality of library services including resources and quality of information it is delivering to its users and its ultimate impact. Unfortunately Ayurveda libraries are far away from such new age ideas of self improvements. Although observed in this case study alone and hence can be generalized unless similarly found in many other libraries, absence of book lending facilities in an Ayurvedic library has emerged as a substantial reason of disinterest of readers to turn to library. As observed through the case study, this absence of book lending is partially because of limited number of book copies available in the library disallowing them to be lend for longer periods and restricting their use by a single user. The other reason is the disinterest of library staff in library business. We see that the first limitation can easily be handled by making a small survey for most demanded books and arranging their adequate copies to allow their smooth lending without affecting the library business. There can be a segregation of the books as reference books not allowed for lending and common books allowed for lending. Most libraries allow a self search by the readers in the prospective subject sections for finding the most suitable books relevant to their need. This search can largely be facilitated by open shelves in the library allowing the readers to pick the books and see what they need. This self searching is however not available in the library taken as a case study and here users are required to make a request with the library staff every time they need a book. Once equipped with the services and facilities common to most libraries, Ayurveda libraries may think of embracing new ideas by finding new roles and challenges to increase their share in the quality of Ayurveda education, practice and research. Opening the Ayurveda library for inter disciplinary use may be a unique way to initiate the dialogues between multiple disciplines having Ayurveda as a subject of common interest. Such libraries can also be transformed as a place for close circle academic debates by inviting people across the disciplines discussing a common agenda. A rich information resource available both in the physical and online form may prove to be highly inductive for such debates. In such case, a library may regularly organize close circle debates on the initiation of the faculty members of the institution. Ayurveda library can also emerge as a center to house the rare manuscripts. A separate section focusing upon Indology may be created for the purpose in Ayurveda libraries. The library can further house the prescriptions of renowned Ayurveda physicians, records from patients and hospital having a possibility of meaningful utilization in future. It can house separately the contributions of institutional faculties in the form of impacts they have created upon the ayurvedic health care. This section may house all the publications the institutional faculties may have on their names. The library may further extend its roles by serving as a museum for rare manuscripts and rare historical evidences from the past. This will eventually increase the foot fall in the library and will increase the interest in Ayurveda among the people not directly related to Ayurveda. Ayurvedic library can also be duly involved in digitalization of ancient manuscripts and making their copies accessible to the people who need it. Making its resources useable online by opening an online membership facility may increase the use of an Ayurveda library many fold. This will not only show what all is available in the library but will also allow to get an online access to the selected material available online. In the current context of COVID-19 pandemic and its consequential closure of academic institutions including their libraries and patient care services, such online access to library facilities may have created a large impact upon quality of knowledge sought during such restrictive times [16] . An Ayurveda institutional library may expand its services to patients and their family members also during the period of their stay in the hospital. A separate reading section for patients may be erected in such libraries. This section may be enriched with common information helping the patient or their attendants to reach at evidence based decision about their treatment choices and possible benefits. The information about comparative effectiveness of various health care systems in context to particular clinical conditions, if made available to patients, can prove to be highly useful in making an informed decision about their health care choices [17, 18] . Conducting regular surveys for improving its services, regarding the book and subject choices and improving its contents as per the emerging requirements can make Ayurveda libraries truly evolving and dynamic. In the rapidly changing world, the way information is sought and retrieved is also rapidly changing. The conventional ways of knowledge seeking are repeatedly challenged by the newer tools from the information technology where information is made available at one click. Conventional libraries in this evolving scenario are needed to brush them up with newer challenges and roles. Ayurveda institutional libraries conceptually are no different from any other institutional library where the intention is to become a facilitator to knowledge seekers. Ayurvedic Institutional libraries however currently are found much below than the average library standards in terms of their resources and services delivered. This is largely and globally conceptualized that libraries can truly emerge as a nucleus of change if these can be appropriately managed for their resources and methods of their service delivery. Firstly, by coming at par with the average standards in terms of physical assets and methods of functioning and secondly by finding ways to expand their services to multidisciplinary and multilevel knowledge seekers can be the ultimate method to make the best use of Ayurveda libraries in their institutional settings. If we are thinking to improve the quality of Ayurveda education, research and patient care, it's the library which may hold the key. We however need to realize that Ayurveda libraries are sick currently and are in urgent need of a helping hand to get evolved to their fullest potential. More studies of this kind involving multiple institutions and their libraries may eventually be needed to give a more comprehensive and generalizable picture to chart any plan for their effective utilization in Ayurveda education, research and patient care. This case study till then gives us a substantial reason to ponder upon. None. Education in ancient India. Isha Books Indian university in global ranking Exploring issues in contemporary Ayurvedic education Ayurveda education in India: addressing the human resource barriers to optimize the delivery Determining the impact of health library services on patient care: a review of the literature The impact of clinical librarian services on patients and health care organisations Libraries for the future: the role of IT utilities in the transformation of academic libraries Being there: the library as place Hybrid place making in the library: designing digital technology to enhance users' on-site experience SCONUL. Changing trends in loans, visits & the use of e-books Research on the value of medical library services: does it make an impact in the health care literature Current status of libraries in India On the brighter side of COVID-19 induced Lockdown: devising the collateral methods to provide Ayurveda consultation during impasse Comparative effectiveness research: appropriating the benefits of traditional health care referring Ayurveda Comparative effectiveness research: implication deeper than it may Be felt The authors are thankful to Prof Makhan Lal, Department of Dravya Guna State Ayurvedic College and Hospital, Lucknow for providing necessary information related to the library of State Ayurvedic College, Lucknow. Authors are also much thankful to Dr Raj Kamal Yadav, IAS, Special secretary, Department of AYUSH, Government of Uttar Pradesh for his kind inputs on the initial draft of the article. None.