Forward-Looking Space Metrics

July 16, 2020
Share

As colleges and universities think through back-to-campus scenarios and their path forward as the COVID-19 pandemic continues, it is important to consider just what metrics inform the space analytics that are foundational to understanding a campus.

We have asked experts from across our firm to share their thoughts on:

  • Learning Environments
  • Student Housing
  • Higher Education Workplace Environments
  • Schools of Nursing

Q: What factors should be considered when developing forward-looking space metrics?

Three major trends have driven instructional space metrics over the past decade as higher education has shifted toward student-centered learning.

Autonomy: Information is now instant and mobile. Now that content can be acquired fast, free, and digitally, the new purpose of the classroom experience is to explore knowledge. This type of learning environment requires an increase of net assignable square foot per student. An instructional space that meets these guidelines will provide greater agility in adjusting to 6-foot social distance requirements, as well. Flexible furniture also allows institutions to rearrange or de-densify rooms.

Experience: The customization of the educational experience has led students to prioritize experience and hands-on learning. This type of learning often occurs in class laboratories, open laboratories, maker spaces, and research labs. Laboratory environments are rich with learning experiences that cannot easily be duplicated via online courses even prior to COVID-19, and we often recommended that institutions increase the amount of laboratory and maker space on campus.

Porosity: If you strip away the curriculum and the credits, a campus exists for serendipitous encounters between students and scholars where creativity happens, ideas are explored, and learning experiences are created. Porous learning environments allow learning to take place inside and outside the classroom and at multiple scales and comfort levels to create an equitable and adaptable learning environment for all learners. Post-COVID, experiential campus experiences may allow universities to differentiate themselves and offer an alternative to online lecture-based learning. Universities should consider dedicated space for student-centered study, group learning, and gathering space to represent approximately 15-20% of the instructional space found on campus.

Q: How is this affecting students?

Physical distancing in the classroom limits an instructor’s ability to “reach and teach” every student. By distancing students in the classroom and limiting instructor/student and peer-to-peer interactions, the learning environment favors students closest to the instructor. In this situation, a virtual synchronous environment may offer a better learning environment. In the virtual environment, the distribution of students on each screen is random, students appear the same size, and multiple modes of interaction are available via microphones, chat features, and interactive whiteboard exercises. Moreover, asynchronous virtual opportunities give students the flexibility to learn on their schedule. Learning does not compete with other priorities, such as jobs or families. Students can watch material multiple times to take notes and absorb information.

Q: Are there any fundamental differences for student housing during the pandemic?

Schools are exploring how to move forward, and it’s easy to imagine certain scenarios: relying more on single units, including converting traditional doubles to singles, for instance. Many schools, however, have planned and built in swing space for special accommodations that develop during the academic year. The pandemic adds another layer to this complexity and highlights the need for a flexible framework from which to work.

Many colleges and universities plan to start the fall semester at full occupancy, while leaving a certain number of beds or residence halls vacant as COVID-bed surge space. Other institutions are relying on the off-campus market to relieve pressure on their housing stock to best align their bed capacity with social distancing goals. Regardless, many are considering significant operational, policy, and infrastructure measures, such as reducing the occupancy capacity of their residence hall common spaces, more restrictive visitation privileges, providing much more frequent cleaning, or putting locks on common bathrooms to limit the number of students sharing each one.

As students return to living on-campus, schools will have a plan in place in case there are resurgences. Institutions with medical schools and requisite facilities may opt to provide their own testing and care, while others are partnering with their local medical community. While hopefully anything of that nature is only momentary, these measures may need to be in place for some time. When it comes to what makes a successful residence hall, though, the recipe remains the same: community leads to better student outcomes, so it remains crucial to provide the proper balance of outside-the-unit space and manage them responsibly in these trying times.



Q: Beyond physical distancing guidelines, how do we create workplace environments for the campus community that promote a sense of safety, inclusion, and collaboration for both in-person and remote participants?

On average 25% of a campus’ non-residential space inventory is devoted to office space and are part of most buildings’ programs. Small changes to office space metrics can have widespread impact, so it is critical that decision-making be grounded in data. An analysis of the anticipated needs of the workforce and the past utilization of existing space is a good starting point. Employee data and room-by-room space inventories can provide great insight and help identify opportunities to build a program that provides appropriate space per person for individual work, storage, circulation, and collaboration.

Also, consider how remote work, social distancing, and staggered or flexible schedules may impact space needs. Campuses should still be sprinkled with spaces that foster collaboration—both informal, spontaneous encounters, and more formally scheduled meetings. They should, however, anticipate increased virtual participation, both from those working remotely and those on-campus not ready for face-to-face interaction. Technology should be ubiquitous, and capacities and furniture layouts should be reviewed to ensure adequate space per person and good camera sightlines.

Q : What could this mean for offices moving forward?

Faculty-student interaction, which is critical for student success, will require a different setting. Looking forward, I anticipate increased demand for spaces that can safely accommodate one-on-one or small group interactions. In-office meetings already have made some uncomfortable and will likely now make many feel unsafe. I recommend identifying underutilized spaces in academic buildings (ideally in highly visible areas frequented by students) and repurposing them as dedicated, reservable faculty-student spaces.

Q: How are the skills lab and simulation spaces for nursing being altered by COVID-19?

Many schools have taken a detailed look at how to effectively prioritize and use specialized spaces safely while keeping the importance of a rigorous education front and center. After March 2020, nursing programs lost their clinical placements, and as a supplement to clinical practicum, nurse educators shifted to virtual and screen-based simulation through a variety of resourceful methods to supply all of their students remaining clinical learning hours. Immersive simulation using VR and projection is one way to transform any space into a simulation environment offering more utility from existing spaces and facilitating endless simulation scenarios.

For in-person lab courses in Fall 2020, nursing programs must calculate the useable area of their labs, less fixed equipment such as hospital beds and exam tables, to determine the reduced space allowance per student. Students can continue to work within their clinical groups that are normally 8-10 people, except they are spread out into different spaces. Flexibility and adaptability have long been key to designing success health science education spaces, and the COVID-19 pandemic is highlighting this importance.    

Q: What kind of methods are being implemented?

Some things are now common in the broader world–smaller groups, temperature monitoring, face masks, daily sanitization of space and equipment—but there are some creative new ideas and methods. Skills and health assessment can be supplemented with customized lab packs sent to students to use at home. The expense of the lab kit can be offset with invention—one schools is discussing 3D printing their own objects and anatomical models for students to use at home. Some programs deferred skills training from spring to fall in hopes to have more hands-on opportunities. Virtually, students have been able to demonstrate skills competency through Zoom break out rooms, after viewing instructor demonstrations. Objective structured clinical examinations, key measures of a student’s competency, can be reimagined virtually as telehealth appointments with simulated patients. Telehealth has seen expanded use during the pandemic, so this has an additional benefit to train students in the way in which they may be working. Overall, some of the new teaching methodologies were found to be more successful than originally thought, and will continue in the fall semester.

Q: What about Nursing, Multidisciplinary Research, and Public Health?

Community based research in nursing has evolved since the onset of COVID-19. Here are some examples of how Duke University School of Nursing is providing outreach and creating partnerships with social work and public health organizations during this pandemic.

  • Homelessness: With the same goal to improve community health, partnerships such as the DCHIPP (Duke Community Health Improvement Partnership Program) is connecting the school of nursing and the community. Students transitioned from their traditional clinical setting of screening patients to working with the Durham Homeless Care Transitions (DHCT) organization that offers temporary housing, a case manager, and access to rapid testing for those who are homeless.
  • Spanish Speaking Populations: Multidisciplinary teams lead by the school of nursing have been established to work with the county health department to inform public service announcements by developing culturally and linguistically appropriate educational materials to the Spanish speaking population.
  • Aging Populations: To assist seniors and the geriatric population, the school of nursing research team is facilitating virtual teaching sessions on effective communication with seniors so that volunteers can effectively communicate and provide reassurance during telephone encounters with seniors.
  • Global Healthcare Initiatives: With global clinical placement trips cancelled, nursing students partnered with Cureamericas contacting hundreds of Guatemalan residents and speaking to them informally about COVID. They are developing a database, referring them to local resources and creating an evaluation plan.

All of these efforts showcase really important work and the power of research and multidisciplinary teams.

Best Practices in Nursing School Design: Culture of Well-Being

May 30, 2019
Share

Ayers Saint Gross designs top-tier spaces to support educating nurses equipped to handle the future as healthcare delivery systems continue to transform. This two-part series dives into the influences that are changing the way nursing students learn and the way nursing faculty teach. Read Part 1.

Culture of Well-Being

Perhaps more than any other building type, schools of nursing and allied health have the special ability to promote health literacy and reflect the core values of their programs and the profession through building design and architecture. As healthcare delivery systems focus more on preventative approaches to health, lifestyle, and behavior, the design of the built environment should exemplify core values and be mindful of its impact on human health and wellness. Projects that want to advance healthy building strategies can seek WELL Certification to improve the health and well-being of its occupants.

Healthy building strategies that engage the mind and body include: incorporating biophilia through exposure to nature, activating interior circulation with prominent staircases, utilizing ergonomic and kinesthetic furniture to encourage occupant comfort, and addressing environmental needs for air, water, nourishment, and light. For example, designing flexible classrooms or exterior plazas to host fitness, wellness, or interprofessional events could be showcased as part of the building and professional outreach. Access to green spaces and natural light create healthier work and learning spaces for students, faculty, and staff. These design features become popular congregation spots, supporting a lively and collaborative culture.

Opening soon, the Duke University Physical Therapy / School of Nursing Education Building (designed by Ayers Saint Gross) will include a flexible seminar and wellness space for a variety of student activities. The room will function as a large seminar room for instruction, two small conference rooms for group meetings, or as a wellness hub for fitness and community outreach events. In the same vicinity, reservable low-speed treadmill workstations overlooking a landscaped garden will offer active furnishings to reduce the time faculty and students spend seated. Ergonomic furniture selection for both office and study areas is another important way that universities are promoting wellness.

Treadmill Workstations, Duke University Physical Therapy / School of Nursing Education Building
Low-speed treadmill workstations support wellness at Duke University

This type of flexibility in spaces has already proved successful at the University of West Georgia School of Nursing. A flexible seminar room off the building’s commons was designed as both a classroom and a yoga studio, utilizing an oversized barn-style door to allow overflow into the public spaces during a large wellness event.

Flexible Seminar Room, University of West Georgia School of Nursing
Flexible, multipurpose space at the University of West Georgia

Just as important, landscaped outdoor study areas provide meditative environments to support the well-being of students who will soon be supporting the well-being of so many others. 

University of West Georgia School of Nursing
Meditative outdoor space at the University of West Georgia

The culture of wellness in nursing and allied health extends beyond the school walls. Increasingly, schools want to be engaged in community health and gear curricula towards the regions they serve. This approach better prepares the workforce for local healthcare cases they will face in their careers. Whether it’s reaching patients in remote areas, screening clinics for a disease that’s especially prevalent in the community, or providing care at the student health clinic, it is a best practice of clinical education to consider these spaces.

University of Pikeville Health Professions Education Building
Skills learned at the University of Pikeville HPEB
help fulfill the health needs of the community

Community integration was embedded in the programming and mission of the recently launched Kentucky College of Optometry at the University of Pikeville Health Professions Education Building (HPEB). The school is in eastern Kentucky, a region with one of the highest rates of preventable blindness in the country. The HPEB includes a flexible classroom, assembly space, student lounge, study and meeting spaces, faculty offices, clinical skills labs, and an extensive primary care clinic with specialty operatory equipment. The project fulfills the university’s mission of service and defines the standard for excellence in optometric education and vision care in an area with an acute need.

Looking to the future, exciting developments in nursing education will broaden the impacts of community engagement and wellness. Interprofessional and cross-disciplinary education that engages other allied health disciplines and university majors like engineering can create dynamic teams to solve complex issues. Assistive technology and robotic solutions are continuing to advance healthcare. The built environment must support these developments with makerspaces and cross-disciplinary education labs to enable collaborations with engineering programs.

Understanding the latest technology and methodologies is crucial for students. Practical applications are seen in dementia care, where technology is facilitating seniors to live independently longer. To allow for easy monitoring, in-home devices record and send data about daily patterns to caregivers. Assistive devices are being developed to facilitate timely reminders for medication, locate items, or can trigger a comforting audio recording of a family member. Telepresence robots and companion robots can help improve mood or quality of life for people with dementia, to serve patients in a health crisis, and are finding their way into simulation-based education as a tool to practice communication and better prepare students for a career in nursing. Among the spaces that will be
located in the Duke University Physical Therapy / School of Nursing Education Building is the new Health Innovation Lab, which will provide for this interdisciplinary innovation and education.

As nursing schools plan for future curricula and building projects, Ayers Saint Gross will continue to lead the ways architecture can and should support the efforts of students, faculty, and staff to prepare the next generation of nurses for their careers. Educating highly qualified nurses and healthcare professionals fulfills a critical need, and well-designed spaces help meet this challenge. We look forward to seeing what the future holds, and working to create it.

Laura Hall, AIA, LEED AP BD+C, WELL AP is an associate principal based out of the Baltimore office. Contact Laura.

Best Practices in Nursing School Design: Flexible and Adaptable Learning Environments

May 2, 2019
Share

Ayers Saint Gross designs top-tier spaces to support educating nurses equipped to handle the future as healthcare delivery systems continue to transform. This two-part series dives into the influences that are changing the way nursing students learn and the way nursing faculty teach. Read Part 2.

Flexible and Adaptable Learning Environments
Our allied health projects have flexibility embedded in the planning and organization of the spaces. Spaces that adapt to evolving methodology is essential as pedagogy, technology, healthcare demand, and specialized care needs shift. A well-designed building can be the framework that allows a program to endure changes and remain at the forefront of educating the modern workforce.

Creative and thoughtful design ensures clinical learning environments are both flexible (easily modified) and adaptable (able to serve a new use), while leveraging synergies and shared resources to maximize efficiencies. Considerate yet simple diagrams communicate the specific departmental aspects while illustrating where overlap exists and are the parti that translate into practical space layouts.

Concept Design – Frostburg State University Education & Health Sciences Center Department of Nursing
Concept Design – Frostburg State University Education & Health Sciences Center
Department of Nursing

Working with Frostburg State University, Ayers Saint Gross devised a concept to meet long-term goals for the Department of Nursing while adhering to the programmed space allocation. The inaugural Nursing program growth had surpassed the initial concepts outlined in the Part II program and future degree offerings necessitated a greater variety of space types. Understanding their drivers, we conceived two versions of an open skills lab that could also function as four dedicated simulation labs. Key adjacency to a flexible classroom essentially acts as a flex space to serve three functions: (1) a fully functional classroom, (2) a clinical learning class lab facilitating skills instruction and demonstration on the classroom side and hands-on implementation on the adjacent bays, and (3) a generous footprint for future simulation lab growth and program expansion. Providing a heightened level of flexibility with operable walls, mobile equipment, etc., allows instructors freedom to be creative in imagining scenarios.

As the healthcare delivery models evolve, Interprofessional Education (IPE) is becoming indispensable to modern health professions for the value it brings to education – providing hands-on collaborative clinical learning where students apply critical thinking to learn about and communicate with other disciplines in a safe environment. Initial space planning design should consider how the learning environments perform and transform to allow for a multitude of IPE scenarios and an influx of students and faculty from other health professions programs.

During design for the Auburn University School of Nursing, there was a distinct adjacency established between the large active learning classrooms, the building commons, and the outdoor greenspace for opportunities to host a variety of events. One success of this concept was realized during their inaugural Disaster Day Drill IPE event where Nursing and Osteopathic medicine students worked together to triage and treat patients in a large-format simulation. This scale and realism would not have been possible without Auburn and Ayers Saint Gross’s close collaboration and holistic approach to designing a building equipped to do more than standard skills training and instruction. The green space was transformed into triage spaces filled with simulated victims to be evaluated by the practicing students and the buildings’ EAGLES Center was transformed into the simulated hospital ER. “During the disaster drill, this spacious simulation area allowed for a total of 48 patients with 32 utilizing beds and 12 seated in chairs. The simulation area was divided into four “pods,” which acted as four separate hospital emergency departments.” Notably, the realism of this event prepared the osteopathic medical students to be tested for their Basic Disaster Life Support certification. The finale to the drill concluded in the dividable, flexible active learning classroom for a comprehensive group debrief.

As a formal learning environment, this space integrates technology and team-based learning, while also being flexible enough to test new pedagogies. A vertically folding operable partition expands the teaching environment to support a range of clinical learning scenarios. Down the hall, two collaborative tiered lecture classrooms allow for multiple learning arrangements, live demonstrations, and remote broadcasting.

Faculty and students acclaim that the new nursing building brings them together and note the impact of active learning environments being a “critical part of nursing education… specifically tailored to provide the necessary resources.” The space for informal learning, outside the classroom, was equally important to consider as classes scheduled in long segments necessitate spaces to inhabit during breaks. To maximize these options, the traditional prebrief and debrief rooms embedded in the simulation suite serve during off-hours as private or group study rooms. Occupants find that these spaces (with great daylight and views to campus) encourage faculty and students to engage for day-to-day interaction, capstone projects, and student organization meetings that supplement nursing training, such as global health initiative trips.

Adaptable Briefing Room Concept
Adaptable Briefing Room Concept

Ayers Saint Gross has designed three phases for Duke University’s School of Nursing. The Physical Therapy /School of Nursing Education Building bridges to the School of Nursing, continuing the expansion and consolidation of the school’s programs under one roof. The design team and user group worked extensively to conceive adaptable and flexible learning environments to meet their needs, focusing on strategies to mitigate resources taxed by the influx of distance learners during On-Campus Intensives. The design for a typical active learning classroom was adapted into three collaborative seminar spaces to supplement clinical learning, host workshops, and enable development in a state-of-the art learning environment.

Active Learning Classroom in Typical Configuration vs. On Campus Intensive Seminar Room Configuration
Active Learning Classroom in Typical Configuration vs. On Campus Intensive Seminar Room Configuration

The concept Ayers Saint Gross developed for Duke’s Standardized Patient Suite follows suit with maximizing adaptability and space utility. An “ante room” functions for charting, observation, post-exam evaluation, reflection, and as the separate entrance for the student or patient actor. The exam room side is fit out for a patient actor connected to a dedicated lounge and entry zone. Exam rooms are integrated with A/V capabilities and can also function for high-fidelity simulation utilizing a manikin.

Flexibility and adaptability are crucial, but these concepts are just the beginning. Join us for our next entry as we illustrate the importance and value of integrating wellness and community outreach into the design of nursing and health professions programs.

Laura Hall, AIA, LEED AP BD+C, WELL AP is an associate principal based out of the Baltimore office. Contact Laura.