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Educational Research in Ayurveda: Our Experiences

This is a summary of the entire work that we have carried out during the past decade in the area of Ayurveda Education.

Educational Research in Ayurveda: Our Experiences

  1. 1. Educational Research in Ayurveda: Our Experiences Kishor Patwardhan Department of Kriya Sharir Faculty of Ayurveda, IMS, BHU
  2. 2. Educational research  Systematic collection and analysis of data related to the field of education. It often involves the following aspects:  Student learning  Teaching methods  Teacher training  Classroom dynamics  Assessment and Examination
  3. 3. Status of Ayurveda Education in India  At present there are 318 Ayurveda colleges that run UG programs  190 colleges run PG programs  Out of these, more than 220 colleges were established in the past 30 to 35 years  Mushrooming still continues because this sector is treated as a good business avenue
  4. 4. Commonly perceived challenges  Quantity vs. quality of education  Poor infrastructure and poor clinical exposure  More of text-based teaching and less practical training  Redundant methods of teaching-learning  Redundant methods of examination and assessment  Poor exposure to good research and publication  Academic Dishonesty
  5. 5. Where is the evidence?  Nation-wide survey (2005 to 2008)  Population: All Interns, PG Students and Teachers  Random Cluster Sampling method  All colleges in one zone (N,E,S,W) were considered as one cluster  A list of 242 Ayurveda colleges was taken as the sample frame  At least 10% of Colleges from each geographical zone covering the maximum number of states (32 Colleges)  A total of 1022 participants from 18 states responded to the questionnaire.
  6. 6. Domains investigated  Exposure to basic clinical skills  Job opportunities  Relevance of the Curriculum  Teaching methods  Global Challenges  Entrepreneurship opportunities  Perception regarding an ideal model of Medical Education for India.  Personal relevance of Ayurveda
  7. 7. The questionnaire: validation  The preliminary questionnaire was distributed to 150 respondents  Each section (related to one domain) was considered as an independent scale and these scales were tested for their reliability using ‘Cronbach's Coefficient Alpha’.  While validating the scales value of alpha greater than 0.7 and item-total correlation greater than 0.2 were considered to be acceptable.
  8. 8. Results: Clinical Skills  Not trained to handle clinical emergencies of primary healthcare level through Ayurvedic methods  Inadequate clinical exposure to basic procedures like incision and drainage, suturing and catheterization  Most of the times they cannot conduct normal delivery  No exposure to a variety of cases
  9. 9. Results: Clinical Skills  Inadequate exposure to modern diagnostic tools  Not trained in areas like genetic counseling, sexual medicine, care of terminally ill patients, geriatrics, and drug and alcohol abuse  Not trained well in procedures such as “Panchakarma” “Kshara Sutra” etc.  Poor basic skills of physical examination, diagnosis and management of common clinical conditions.
  10. 10. Curriculum not in tune with Global Challenges  Laws governing the intellectual property rights  Basic procedures of standardization of medicinal products  Fundamental methods of evaluating the toxicity of the medicinal products  Essentials of healthcare management  Basics of cultivation and marketing of medicinal plants  Training in standard methods of research and communication
  11. 11. Curriculum and Teaching Methods  Textbook-based teaching, mostly memory-based  Application aspect is neglected  Many outdated topics are still there  Too much of subjectivity in understanding / teaching the subject  Examinations are memory-based and are not analysis-oriented
  12. 12. Major Areas Chosen  Generating the teaching Resources  Teaching-Learning Methods  Developing standard clinical assessment tools  Publication standards  Examination and Assessment  Policy Issues
  13. 13. Major Areas Chosen  Generating the teaching Resources  Teaching-Learning Methods  Developing standard clinical assessment tools  Publication standards  Examination and Assessment  Policy Issues
  14. 14. Generating Teaching Resources
  15. 15. Circulation  Errors in understanding  Food being converted in liver to blood on day-to-day basis  Porous inter-ventricular septum  Arteries carried air (pneuma) derived from breath  Veins carried blood from the heart towards periphery  William Harvey’s contributions  Contributions of Ayurveda  Bhela Samhita, Chakrapani, Charaka, Sushruta, Sharngadhara, Vagbhata
  16. 16. Blood: Rasa? Rakta?
  17. 17. Major Areas Chosen  Generating the teaching Resources  Teaching-Learning Methods  Developing standard clinical assessment tools  Publication standards  Examination and Assessment  Policy Issues
  18. 18. Teaching-Learning Methods We evaluated three integrative methods of interventions:  Integrative module on cardiovascular physiology (IMCP)  Case-stimulated learning (CSL)  Classroom small group discussion (CSGD).
  19. 19. ‘Integrative methods’  The instructional methods that help in bridging the gaps between the two streams of sciences, that is, ‘Ayurveda physiology’ and ‘contemporary biomedical physiology’  The instructional methods that help in integrating the theoretical knowledge with the clinically relevant application  The instructional methods that help in understanding the links between different organ systems and Dosha-Dhatu- Mala highlighting their role in maintaining the homeostasis.
  20. 20.  Population  Students who were registered in the first professional BAMS program for the academic years 2011-2012 and 2012-2013.  Sampling and randomization  Students of both the academic years were randomized and grouped separately into two equal groups: ‘Experimental’ and ‘control’.  We used the = RAND() function available with Microsoft Excel 2007 workbook for this purpose.
  21. 21. Module on cardiovascular physiology  First stage: ‘Discrete’ and ‘Integrative’ teaching  “An introduction to cardiovascular physiology” was the title of the module that was evaluated in this experiment.  In this method, the experiment was done to compare the effectiveness of ‘discrete’ and ‘integrative’ teaching methods.  We decided to use this term (Discrete) to highlight the position of ‘detachment’ while viewing the two streams of science. In this method, Ayurveda and contemporary biomedicine portion of the topic was delivered without discussing any correlation or integration.
  22. 22. Intervention  The experimental group was introduced to a new way of instruction, that is, integrative method.  In this method, the concepts of Ayurveda and contemporary medical science were correlated using the ideas derived from different sources of scholarly literature authored by various contemporary scholars.  Duration of each teaching session was 1 hour. In total, both the groups received instructions for 5 hours each.  For ethical purposes, cross-over was done so that each student received instructions by both the methods
  23. 23. Evaluation  The learning outcome was assessed in the form of a short written test of 1 hour duration conducted after the completion of the first stage of the experiment.  Attendance pattern and total human hours spent during entire period of experiment were also taken into account.  Feedback on structured questionnaire (Likert scale) was also taken
  24. 24. Case-Stimulated Learning  This experiment was designed with an aim of achieving integration between ‘theory’ and ‘application’ along with achieving ‘Ayurveda-Biomedicine’ integration.  The students were first introduced to an imaginary clinical case scenario (IHD). A brief history of the patient, symptoms, and investigation reports were provided, and thereafter, the physiology was described in a conventional manner. At the end of the lecture, the case was taken up once again and the students were asked to solve the mystery of the case.
  25. 25. Classroom Small Group Discussion  Students were distributed into multiple groups comprising of about 6 students each. They were then assigned a topic and were provided with the reference material in the form of textbooks and review articles.  “Microcirculation and edema” was selected as the topic for this experiment. Students were asked to study, understand and discuss the topic for 1 hour within the group.  The instructor acted as a facilitator and helped students in studying and understanding the physiological principles regulating the microcirculation, while also introducing them to the integrative way of understanding the concepts of ‘Edema’ and ‘shotha’.
  26. 26. Strengths of the study  The study shows that development of testable integrative methods of teaching is possible in the context of Ayurveda education.  The study shows that bringing the scholarly literature into the graduate level classrooms is possible with the meticulously planned interventions.  The study also shows that integrative approaches make the topics likable and help in avoiding cognitive dissonance.
  27. 27. Major Areas Chosen  Generating the teaching Resources  Teaching-Learning Methods  Developing standard clinical assessment tools  Publication standards  Examination and Assessment  Policy Issues
  28. 28. Development of tool to assess Prakriti  Based on Charaka Samhita  Self-assessment type  Statistically validated to a reasonable extent  The normalizing algorithm used to convert different traits into a scores was based on the notion that all traits need not carry equal weightage and total number of traits assigned to a particular Parakriti are not equal for Vata- Pitta-Kapha
  29. 29. The tool segregates individuals efficiently
  30. 30.  106 healthy volunteers were subjected to various autonomic function tests such as cold pressor test, standing- to-lying ratio, Valsalva ratio and pupillary responses  The results suggest that, the autonomic function tests in the healthy individuals correlate with Prakriti  In particular, people with Kapha Prakriti showed a tendency to have either a higher parasympathetic activity or a lower sympathetic activity with respect to their cardiovascular reactivity in comparison to the individuals with Pitta or Vata Prakriti
  31. 31. Major Areas Chosen  Generating the teaching Resources  Teaching-Learning Methods  Developing standard clinical assessment tools  Publication standards  Examination and Assessment  Policy Issues
  32. 32.  Analyzed 47 journals that publish Ayurveda  AYUSH Journals being published in India were found to be deficient in many ways  Those indexed with PubMed were better  Many claimed bogus impact factors and other journal metrics  Many faked peer review, published plagiarized content  Quality of published articles was not uniform in standard  Ethical issues, research violations were common
  33. 33. Major Areas Chosen  Generating the teaching Resources  Teaching-Learning Methods  Developing standard clinical assessment tools  Publication standards  Examination and Assessment  Policy Issues
  34. 34. Major Areas Chosen  Generating the teaching Resources  Teaching-Learning Methods  Developing standard clinical assessment tools  Publication standards  Examination and Assessment  Policy Issues
  35. 35. Major Areas Chosen  Generating the teaching Resources  Teaching-Learning Methods  Developing standard clinical assessment tools  Publication standards  Examination and Assessment  Policy Issues
  36. 36. IMPACT
  37. 37. IRSA-2014, Germany  “Certain Autonomic Responses in Healthy individuals may have some Association with Constitutional types defined in Ayurveda”  Dr. Sunil Rapolu
  38. 38. Japan Ayurveda School, Tokyo
  39. 39. EWAC#@, Koblenz, Germany
  40. 40. Our co-authors HCS Rathore Sangeeta Gehlot Girish Singh Priyanka Jadhav Supriya Bhalerao Bhushan Patwardhan Pratap Thakur Suresh Kumar Sunil Rapolu Girish Tillu Himanshu Joshi R Galib CP Gunawat Piyush Tripathi Aparna Singh Deepti Singh Sonam Agrawal Abha SinghManoj Kumar

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