This study aims to investigate the elements of wayfinding in indoor complex healthcare environments.
Background:
The study replicates Ghamari and Pati’s 2018 study to identify the environmental attributes that attract eye fixation during wayfinding by objectively tracking eye movements and fixation as healthy subjects navigate through a complex, unfamiliar indoor healthcare setting. The study addressed what do people look at while navigating in unfamiliar healthcare environments? What are the relative time periods of eye fixations on different visual environmental elements of the healthcare-designed environments? And what role do visual environmental attributes in healthcare facilities, such as configuration, color, art, directories, maps, furniture, and so on, play during the wayfinding process.
Method:
Twenty-four adults in different genders and various age groups participated in this study and navigated five routes with different degrees of difficulty. The sequence of the destinations in this study was randomized. The data were collected by tracking gaze fixations while human subjects navigated an indoor complex healthcare environment.
Results:
The findings show that identifying signs (29.1%), informative signs (20.8%), and architectural features (11.3%) constituted the most frequent elements attracting gaze, substantially more than the other classes of information. Four types of signage (identifying signs, informative signs, directional, and safety/regulatory signs) were accounted for 62.3% of the total gaze fixation time.
Conclusions:
The comparison of the ordered list based on frequencies and time of eye fixations on various elements developed in Ghamari and Pati’s study shows a vast degree of similarities.
AhnJ. (2006). Wayfinding at the east campus of Cayuga medical center in Ithaca, NY(DEA 453 Project 2). Cornell University.
2.
BarM.NetaM. (2007). Visual elements of subjective preference modulate amygdala activation. Neuropsychologia, 45(10), 2191–2200.
3.
BaskayaA.WilsonC.ÖzcanY. Z. (2004). Wayfinding in an unfamiliar environment: Different spatial settings of two polyclinics. Environment and Behavior, 36(6), 839–867.
4.
CañigueralR.HamiltonA. F. D. C. (2019). The role of eye gaze during natural social interactions in typical and autistic people. Frontiers in Psychology, 10(560). https://doi.org.10.3389/fpsyg.2019.00560
5.
CarlsonL. A.HölscherC.ShipleyT. F.DaltonR. C. (2010). Getting lost in buildings. Current Directions in Psychological Science, 19(5), 284–289.
6.
CarpmanJ.GrantM. (2002). Wayfinding woes: Common obstacles to a successful wayfinding system. Health Facilities Management, 15(2), 22–25.
7.
ChiuY. C.AlgaseD.WhallA.LiangJ.LiuH. C.LinK. N.WangP. N. (2004). Getting lost: directed attention and executive functions in early Alzheimer’s disease patients. Dementia and Geriatric Cognitive Disorders, 17(3), 174–180.
8.
CooperR. (2010). Successful signage: How hospitals have solved wayfinding challenges. Health Facilities Management, 23(11), 27–30.
9.
CubukcuE. (2004). Investigating wayfinding using virtual environments(65), ProQuest Information & Learning.
10.
DevlinA. S. (2014). Wayfinding in healthcare facilities: Contributions from environmental psychology. Behavioral Sciences (2076-328X), 4(4), 423–436.
EagleA. (2009). Sprucing up wayfinding. From traditional signs to electronic kiosks, designers are making it easier to get patients to their destinations. Health Facilities Management, 22(9), 32–35.
13.
EvansG. W.MarreroD. G.ButlerP. A. (1981). Environmental learning and cognitive mapping. Environment & Behavior, 13(1), 83–104.
14.
FordP.FisherJ.Paxman-ClarkeL.MinichielloM. (2020). Effective wayfinding adaptation in an older National Health Service hospital in the United Kingdom: Insights from mobile eye-tracking. Design for Health, 4(1), 1–17.
15.
GalleyN.BetzD.BiniossekC. (2015). Fixation durations: Why are they so highly variable. Advances in Visual Perception Research, 83–106.
16.
GamberiniL.ChittaroL.SpagnolliA.CarlessoC. (2015). Psychological response to an emergency in virtual reality: Effects of victim ethnicity and emergency type on helping behavior and navigation. Computers in Human Behavior, 48, 104–113.
17.
GarlingT.BookA.LindbergE. (1986). Spatial orientation and wayfinding in the designed environment: A conceptual analysis and some suggestion for post-occupancy evaluation. Journal of Architectural and Planning Research, 3(1), 55–64.
18.
GarlingT.LindbergE.MantylaT. (1983). Orientation in buildings: Effects of familiarity, visual access, and orientation aids. Journal of Applied Psychology, 68(1), 177–186.
19.
GhamariH.PatiD. (2018). Examining eye-fixations during wayfinding in unfamiliar indoor environments. The International Journal of Designed Objects, 12(2), 15–33.
20.
GhamariH.SharifiA. (2021). Mapping the evolutions and trends of literature on wayfinding in indoor environments. European Journal of Investigation in Health, Psychology and Education, 11(2), 585–606.
21.
GiannopoulosI.KieferP.RaubalM.RichterK.-F.ThrashT. (2014). Wayfinding decision situations: A conceptual model and evaluation. Cham.
22.
GibsonJ. J. (2015). The ecological approach to visual perception. (Classic ed.). Psychology Press.
23.
GolledgeR. (1991). Cognition of physical and built environments. In GarlingT.EvansG. W. (Ed.), Environment, cognition, and action (pp. 35–63). Oxford University Press.
24.
GoodeJ. P. (1904). The human response to the physical environment. In The elementary school teacher (Vol. 4, No. 5, pp. 271–282). The University of Chicago Press. https://www.jstor.org/stable/992499
25.
GordonI. E. (2004). Theories of visual perception (3rd ed.). Psychology Press.
26.
HashimM.SaidI. (2013). Effectiveness of wayfinding towards spatial space and human behavior in theme park. Procedia—Social and Behavioral Sciences, 85, 282–295.
27.
HeftH. (2012). Wayfinding, navigation, and spatial cognition from a naturalist’s stance. In WallerD.NadelL. (Eds.), The handbook of spatial cognition (pp. 265–294). American Psychological Association.
28.
HölscherC.MeilingerT.VrachliotisG.BrösamleM.KnauffM. (2006). Up the down staircase: Wayfinding strategies in multi-level buildings. Journal of Environmental Psychology, 26(4), 284–299.
29.
HuelatB. J. (2007). Wayfinding: Design for understanding. A position paper for the environmental standards council of the center for health design. The Center for Health Design.
30.
IshikawaT.FujiwaraH.ImaiO.OkabeA. (2008). Wayfinding with a GPS-based mobile navigation system: A comparison with maps and direct experience. Journal of Environmental Psychology, 28(1), 74–82.
31.
Livingstone-LeeS. A.MurchisonS.ZemanP. M.GandhiM.van GervenD.StewartL.SkeltonR. W. (2011). Simple gaze analysis and special design of a virtual Morris water maze provides a new method for differentiating egocentric and allocentric navigational strategy choice. Behavioral Brain Research, 225(1), 117–125.
32.
MarquardtG. (2011). Wayfinding for people with dementia: A review of the role of architectural design. Health Environments Research & Design Journal (Vendome Group LLC), 4(2), 75–90.
33.
MarquezD. X.HunterR. H.GriffithM. H.BryantL. L.JanicekS. J.AtherlyA. J. (2017). Older adult strategies for community wayfinding. Journal of Applied Gerontology, 36(2), 213–233.
34.
MollerupP. (2010). Wayshowing in hospital. Australasian Medical Journal, 2, 112–114. https://10.4066/AMJ.2009.85
35.
MustikawatiT.YatmoY.AtmodiwirjoP. (2017). Reading the visual environment: Wayfinding in healthcare facilities. Environment-Behaviour Proceedings Journal, 2(5). 169. https://doi.org.10.21834/e-bpj.v2i5.670
36.
O’NeillM. J. (1991a). Effects of signage and floor plan configuration on wayfinding accuracy. Environment and Behavior, 23(5), 553.
37.
O’NeillM. J. (1991b). Evaluation of a conceptual model of architectural legibility. Environment and Behavior, 23(3), 259.
38.
PassiniR.ArthurP. (1992). Wayfinding: People, signs and architecture. McGrawHill.
39.
PatiD.HarveyT. E.JrWillisD. A.PatiS. (2015). Identifying elements of the health care environment that contribute to wayfinding. Health Environments Research & Design Journal, 8(3), 44–67.
RodriguesR.CoelhoR.TavaresJ. M. R. (2019). Healthcare signage design: A review on recommendations for effective signing systems. Health Environments Research & Design Journal, 12(3), 45–65.
42.
RodriguesR.CoelhoR.TavaresJ. M. R. (2020). Users’ perceptions of signage systems at three Portuguese hospitals. Health Environments Research & Design Journal, 13(3), 36–53.
43.
RollinsJ. A. (2004). Evidence-based hospital design improves health care outcomes for patients, families, and staff. Pediatric Nursing, 30(4), 338–340.
44.
RousekJ. B.HallbeckM. S. (2011). The use of simulated visual impairment to identify hospital design elements that contribute to wayfinding difficulties. International Journal of Industrial Ergonomics, 41(5), 447–458.
45.
RoweM. A. (2003). People with Dementia who become lost: Preventing injuries and death. AJN—The American Journal of Nursing, 103(7), 32–39.
46.
SalmiP.GinthnerD.GuerinD. (2002). An exploration of critical factors for accessibility and wayfinding for adults with mental retardation [Paper presentation]. The Interior Design Educators Council (IDEC).
47.
SchuchardR. A.ConnellB. R.GriffithsP. (2006). An environmental investigation of wayfinding in a nursing home. Proceedings of the 2006 Symposium on Eye Tracking Research & Applications, March 27–29, San Diego, CA, United States.
48.
SimonS. L.WalshD. A.RegnierV. A.KraussI. K. (1992). Spatial cognition and neighborhood use: The relationship in older adults. Psychology and Aging, 7(3), 389.
49.
SpiersH. J.MaguireE. A. (2008). The dynamic nature of cognition during wayfinding. Journal of Environmental Psychology, 28(3), 232–249.
50.
VembarD.IyengarN.DuchowskiA.ClarkK.HewittJ.PaulsK. (2004). Effect of visual cues on human performance in navigating through a virtual maze[Paper presentation]. Proceedings of the Tenth Eurographics conference on Virtual Environments, Grenoble, France.
51.
WeismanJ. (1981). Evaluating architectural legibility: Way-finding in the built environment. Environment and Behavior, 13(2), 189–204.
52.
WienerJ.HölscherC.BüchnerS.KoniecznyL. (2012). Gaze behavior during space perception and spatial decision making. Psychological Research, 76(6), 713–729.
53.
ZimringC., (1990). The cost of confusion: Non-monetary and monetary costs of the Emory University Hospital Wayfinding System [Unpublished manuscript].Georgia Institute of Technology.
