Design Collaboration: Practice and Academic Perspectives

I have been an advocate of evidence-based, or research-influenced, design process and increased rigor in practice for nearly two decades. After 30 years of active practice as a hospital architect, I am currently beginning my tenth year in the academic arena. After experi- ence in both arenas, it is clear to me that there are important differenc- es in the way practitioners and aca- demics view design problems.Differences of PerceptionA stereotype might be that design professionals are practical while academics are theoretical. This is an exaggerated generalization that doesn't entirely ring true. As Kurt Lewin said, "There is nothing quite so practical as a good the- ory" (1951, p. 169), and in my personal opinion, healthcare design is woefully short of good, strong theory. We do have strong theory from Roger Ulrich (1992) on supportive design, and something close to theory from John Reiling (2005) about design for safety, as well as recommendations that verge on theory from Janet Carpman (2001) about wayfinding.One obvious difference in perspec- tive between practice and academia is the pace. The world of practice, with its service to clients and the constraints of budget and schedule, moves swiftly and demands imme- diate answers, or in the absence of an answer, at least a thoughtful deci- sion based on best practice. The pace in the world of academia is mea- sured by semesters and time divid- ed across multiple commitments to teaching and research. Graduate student assistants, while smart and inexpensive, are only available part of the time. In the academic world, there is a mis- sion to find answers, but not at the pace demanded by real-life projects.There are also differences in the perception of rigor. Architects work hard to gather information and to do what is right for their clients. Academic researchers are likely to feel that what an architect calls "research" consists of exploring the profession- al (not scholarly) literature, referencing documen- tation of a firm's past experience, and referring to catalogues of manufacturers' biased descriptions of their products. To an academic researcher, this does not constitue sufficient rigor. An academic will want to have searched for all relevant scholarly literature, and to have interpreted the findings for a project's unique circumstances.An example from my own experience is what I considered "research" while designing critical care units during my practice years. I would hold meet- ings with nurses, physicians, respiratory therapists, pharmacists, and other representatives to ask what was needed, how they worked, and what they want- ed in the way of process improvement. I would ask the nurses to show me an empty room, and ask them to tell me what they thought of its features. As a practitioner, I never entered a room with a patient in it.Now, as an academic researcher, I shadow criti- cal care nurses with permis- sion from the Institutional Review Board (IRB) and I follow the nurses into patient rooms over the course of a 12-hour shift, while wearing scrubs and a hospital badge. Although I make no notes about patients, their conditions, or their families, and the nurses are anonymous in my recording, through close and careful observa- tion I gain a far more thorough understanding of how these nurses use the features of that designed environment.There is also a difference in access to scholarship. Academic and university-based researchers have ready access to the world of scholarly literature. They may also have access to graduate student assis- tants, skilled at searching the library for research papers, and who work at comparatively low wages. The practitioner, on the other hand, struggles to find the articles, and must pay $20-$40 to down- load a single paper before reading more than an abstract.In spite of their differences, or perhaps because of them, collaboration between practitioners and aca- demics is possible and desirable. …