Learning from evidence-based medicine: exclusions and opportunities within health care environments research

ABSTRACT

The development of evidence-based design (EBD) has been heavily influenced by evidence-based medicine, particularly the research methods and ontological positions associated with it. While EBD is the dominant paradigm within health care environments research, the rules and conditions that determine knowledge production within this field have not been opened to interrogation. This paper examines the value paradigm that underpins evidence-based decision-making and the disciplinary research methods that have been undervalued in the translation of this paradigm from medicine to design. Specifically it will address subjective self-report data and design-based research methods that could serve to productively challenge existing approaches to the design of health care environments. This paper does not aspire to discredit the current practices of EBD but to encourage a broader methodological approach toward an understanding of the relationship between architecture and wellbeing.

KEYWORDS:

• Evidence-based design
• research methods
• design research
• speculative design

Acknowledgments

The author extends her appreciation to Julie Willis for providing critical feedback on this paper, and to Alan Pert, Jason Thompson, Jared Green and Jason M. Lodge for providing guidance on various aspects in the development of this paper.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1. EBM emerged from McMaster University (Ontario) in 1992 with the work of the Evidence Based Medicine Working Group (refer Champagne, Lemieux-Charles and McGuire, 2004). While Ulrich's 1984 study, ‘View through a window may influence recovery’ is broadly accepted as the formative study within the field of EBD, The Centre for Health Design, a driving force within this field of research, was not formed until 1993; https://www.healthdesign.org/about-us accessed: 12 January 2017.

2. The creation of associations like the Academy of Neuroscience for Architecture (formed in 2003) attest to this: http://www.anfarch.org/mission/ date accessed: 19 January 2017.

3. To review the various Maggie's Centre designs, refer: https://www.maggiescentres.org/our-centres/

Additional information

Funding

This research is supported under the Australian Research Council's Linkage funding scheme [project number LP140100202]. Research partner: Lyons architects.

Notes on contributors

Rebecca McLaughlan

Rebecca McLaughlan's research takes place at the intersection of architecture, medicine, media, psychology and pedagogy. She is a New Zealand registered architect and teaches at the Melbourne School of Design where, in collaboration with Alan Pert, the Victorian Department of Health and Human Services and the Centre for Palliative Care, her work explores speculative design as a research method for health care environments research. She is engaged as a research fellow on the Australian Research Council Linkage project ‘Designing for Wellbeing’ (University of Melbourne and Lyons Architecture) exploring the relationship between architecture and wellbeing within contemporary Australian paediatric hospitals, and is currently collaborating with Parallel Practice (Alan Pert and Andrew Simpson) on redevelopment proposals for Very Special Kids, the Melbourne Children's Hospice.