More Evidence-Based Design Guidelines
There’s Evidence-based Design, and then there’s NOT Evidence-based Design.
Here are more evidence-based design art guidelines. Many of these guidelines come from “A Guide to Evidence-based Art” from The Center For Health Design, research by Ulrich and Gilpin, a case study on best practices in evidence-based design by the Mays Clinic at the MD Anderson Cancer Center, and so much more.
Waterscapes
They can be regional, generic, or seasonal. They should be calm and non-turbulent. Dramatic seascapes should be avoided, and flowing or trickling water might negatively impact full or non-functioning bladders.
Landscapes
They can be regional, generic, or seasonal. They should have visual depth or open foreground. Trees should have a broad canopy. Savannah and park-like landscapes are preferred by many. Vegetation should be lush. Empty park benches and sunsets should be avoided. The empty park bench might remind someone of loss and loneliness. A sunset might represent the end of life.
Figurative Art
Figurative art should be observational rather than interpersonal. This art should show smiling or emotionally positive faces. Figures can be diverse and appear in relaxed natural surroundings. However, figures that are too relaxed might negatively impact positive outcomes, especially for people with low motivation or in need of physical therapy.
Wildlife
Any wildlife imagery should be of animals widely considered non-threatening. Close-ups of large mammals looking directly at viewers should be avoided.
Still-life
Still-life can be used sparingly for variety.
Early in my evidence-based design career, I decided NOT to do Still-Life. I dislike drawing or painting Realism, especially as they did in the Middle Ages. I enjoy Impressionism and Expressionism, but I am an Abstract artist at heart. I have relatives who are super masterful at capturing hyper-realism. I greatly appreciate them and what they do, but it’s not anything I am interested in creating.
My studio is in Northern Michigan, and as much as I love all the wildlife, I prefer not to paint them. To capture their amazing beauty, I’ll leave that to my many local artist and photographer friends.
Figurative Art is another category I choose not to do. When I was a teen, people were often amazed at my ability to capture a person’s likeness with a Number 2 pencil. Again, it’s not something I am artistically interested in.
As an evidence-based design artist, I specialize in Waterscapes, Floralscapes (which AI says is a real word), and Landscapes. I like to go deep inside these categories and create art that strategically triggers the brain for health and happiness in others.
Mysteries In The Morning by Dorothea Sandra, EDAC 36”x36”
At first glance of this painting, it may seem as if there isn’t much deep strategy involved, but there is.
If you look at the sky, it’s a pretty blue, and it doesn’t shout or make too much of an impact on the brain. The sun and horizon are bright and cheerful, but their edges are soft and gentle. The evidence-based design purpose is to establish beauty without much impact and with no trauma. My goal was not to overwhelm the brain with too much beauty. The brain should register this area of the canvas as beautiful but mostly safe.
Photo of Lake Huron, one of the world’s largest lakes
Based on medical and scientific studies, hospital/medical facility patients also highly regard familiar nature scenes.
As our eyes see the water in the painting, there is a gradation of color. Very typical of Lake Huron (a familiar nature location for people in this area), the water remains mostly calm and non-turbulent.
I got trained to paint along New England's rocky, violent shores. Dramatic seascapes, which must be avoided in evidence-based design, are what I learned.
It was difficult, especially for my ego, but I chose to keep the water almost flat. I decided to use color (darker to lighter to almost aqua, much like Lake Huron) and brush movement to create water that is enjoyable to view but also calm and non-turbulent.
To create impact, I almost always choose abundant flowers (lush vegetation). Flowers almost always register in the brain as beautiful, representative of love, and safe. By de-emphasizing the sky and water (two areas of safety or potentially profound danger) and emphasizing the flowers (with little to no history of causing harm to humans), the overall composition helps to create feelings of well-being and happiness.
When I paint, my evidence-based design goal is not to create overwhelming beauty. This is what I was taught an artist should do. When I create evidence-based design compositions, my goal is to create art that triggers the brain to create dopamine (happiness chemicals).
Sometimes, I will add a little drama to the sky, as with this cloud below, which often appears like this over Lake Huron in the morning. Even though the cloud is loud, the colors are still soft and happy and the horizon line gently blends into the waveless water. The flowers, on the other hand, pop with color and a diversity of shapes of Impressionism.
Mackinac Memories by Dorothea Sandra, EDAC. Sold in 2025 to a collector in Fort Worth, Texas.
Is Evidence-Based Design Legitimate Or Just Another For-Profit Buzzword?
Not long ago, I left a positive comment about a Dopamine Decor article at a homes and gardens magazine. Then, I got attacked by some troll saying that Dopamine Decor was just some new way for companies to make money off people.
Usually, I do not get involved with things like this, but I felt a strong urge to explain that a lot of Dopamine Decor and Evidence-based Design art is based on real, authentic, legitimate science and medical studies.
In my book, 100 Days Of Happy Happy Art, Evidence-Based Design, I wrote: “From the 1960s until today, serious researchers with very serious studies…from different countries…from different multidisciplinary fields have converged to create a new field called Evidence-based Design.”
Even the National Library of Medicine at NIH, the National Institutes of Health, has a definition of it. “Evidence-based design is scientific analysis methodology that emphasizes the use of data acquired in order to influence the design process in hospitals. It measures the physical and psychological effects of the built environment on its users.”
In cancer center lobby.
Today, Evidence-based Design isn’t just for hospitals. It’s for all of us. It is for many of the places humans go.
What is my role in all of this? A very small one—but I think an important one. Today, my art hangs in hospitals, businesses, organizations, and homes. Using my talent and evidence-based design training and certification, I very deliberately and very strategically create HAPPY HAPPY HAPPY art for built environments.
Here’s one of my paintings as it hangs in the lobby of a cancer wing in one of the U.S. hospitals.
The person in charge of art placement at the hospital apologized for its location on a side wall in the lobby.
She thought I might be offended by not having it centered over the main mantlepiece in the waiting area. I wasn’t offended at all. In fact, people come face-to-face with it as they enter the blood draw area. Putting all artist ego aside—and focusing on patient/people needs—I thought it was perfectly located.
Too Beautiful For Words, 36”x36”
Too Beautiful For Words is a super cheerful “distraction” piece. Getting cancer and getting treated for it is often horrific, and at times, it can make patients and others feel as if they are about to lose their minds or are living through some “other world” reality. I thought adding an upbeat quirkiness to the art would help—in a positive way—identify with the circumstances and would also help release some dopamine (happiness brain chemicals).
Patients, their families, and the staff kept telling me—all the time—how happy this painting made them feel, so I decided to donate two other paintings that evolved over the years into a new evidence-based design series called Symphonies of Love.
Both paintings below are placed today in cancer patient examination rooms. People in this community with cancer or with a loved one with cancer continue to tell me how much they appreciate the heart shape, which simply but beautifully communicates to patients that they are loved.
One of these 61” x 78” evidence-based design heart paintings recently got featured on one of the world’s most prominent online art gallery websites. I was listed as one of sixty-one American artists to follow.
In patient examination room #1.
In patient examination room #2.
Click on the photo below to go to the website.
Different Types Of Evidence-Based Design
There’s Evidence-based Design, and then there’s NOT Evidence-based Design.
Here are a few evidence-based design art guidelines. Many of these guidelines come from “A Guide to Evidence-based Art” from The Center For Health Design, research by Ulrich and Gilpin, a case study on best practices in evidence-based design by the Mays Clinic at the MD Anderson Cancer Center, and so much more.
Landscapes
They can be regional, generic, or seasonal. They should have visual depth or open foreground. Trees should have a broad canopy. Savannah and park-like landscapes are preferred by many. Vegetation should be lush. Empty park benches and sunsets should be avoided. The empty park bench might remind someone of loss and loneliness. A sunset might represent the end of life.
Florals
Florals should include familiar shapes of plants and flowers. They should appear healthy and fresh, and flower colors should be vibrant. Gardens and bouquet styles are acceptable. Flowers in vases should be used sparingly and only for variety.
Taking scientific or medical study results and turning them into artistic creations is not the easiest thing to do. There are no step-by-step guides to follow, and the rules need to be there, but sometimes they need a little bending.
The painting above, Healing Flowers, spent time on exhibit in a museum and then in a gallery. It recently sold, in 2025, to an art collector in Fort Worth, Texas. Also, in Jan/Feb 2025, it was featured on the cover of Healthcare Design Magazine. In addition, in 2024, I was also asked to show it in another issue of Healthcare Design Magazine issue. On one international art gallery website, this painting received thousands of views.
While creating it, I tried to adhere to the evidence-based landscape design guidelines for healthy outcomes. By following the rules, I figured I could trigger the brain to create dopamine, which would produce in its viewers feelings of happiness.
If you look closely, you can see through the stems, which gives viewers visual depth. According to the research, seeing through the stems helps humans feel safe. It takes us back to our days of hunting on the Savannah, where dangerous animals could hide in thick grass and then attack us. While the stems were thin, I ensured the flowers appeared lush and abundant. Again, this would suggest an abundance of food.
Healing Abundance by Dorothea Sandra, EDAC
Using the same evidence-based design guidelines, Healing Abundance also sold in early 2025. It was sold from a gallery in Paris, France, and shipped to a company in Hong Kong with television channels in Hong Kong, mainland China, Macau, and other Chinese-speaking areas. The soil and stems are there, but I wanted to add lush vegetation through the flowers.
Years ago, when I was living in Asia, a good friend who was also a medical doctor ended up in the hospital. I went to visit her with a bouquet of cut flowers in hand. After she got out of the hospital, she told me that a bouquet of flowers was not the best gift. A potted plant would have been more appropriate. When I asked why, she explained that cut flowers will soon die, while a plant in soil continues to live on.
Most everything I do in the creation of an evidence-based design painting is for the health and happiness of viewers.
What Is The Definition Of Evidence-Based Design?
There are broad and specific definitions of evidence-based design.
Here is the definition from the National Library of Medicine:
“Evidence-based design is scientific analysis methodology that emphasizes the use of data acquired in order to influence the design process in hospitals. It measures the physical and psychological effects of the built environment on its users.” (National Library of Medicine, National Institutes of Health)
Even Wikipedia now has a definition:
“Evidence-based design (EBD) is the process of constructing a building or physical environment based on scientific research to achieve the best possible outcomes.” (Wikipedia)
The definition I like best is from The Center For Health Design.
“…the process of basing decisions about the built environment on credible research to achieve the best possible outcomes.” (www.healthdesign.org/edac)
The built environment (people-built surroundings where human activity occurs) includes art, and since my EDAC (evidence-based design) training and certification, I have sold hundreds of paintings based on these definitions.
Some of my first Great Lakes/Lakeside Lovelies paintings using Evidence-Based Design training.
Based on medical and scientific studies, hospital/medical facility patients highly regard familiar nature scenes.
When I first started creating art using evidence-based design, my first creations were what I called Lakeside Lovelies and Great Lakes Lovelies (above). They were familiar nature scenes, mainly along Highway 23 in Northern Michigan. Half of my inspiration came from Lake Huron and the Straits of Mackinac. The air in this area is clear and clean, so my eyes can almost always catch super-crisp images.
The other half of my inspiration came from the abundance and variety of flowers around town, the Upper Penisula and Northern counties, and within my own art studio’s yard. Who would have thought it? Here is a bush—and of all places—next to my garage that inspired many of my paintings. In this area, this bush is a plentiful sight in the Spring, which also makes its stems a familiar nature scene.
Credible research told me that local natural landscapes helped to achieve the best possible health outcomes, and I strongly dislike painting realism (which isn’t a requirement in evidence-based design), so I happily went with a floral contemporary Impressionism style. (Thank you, Monsieur Monet.)
At the beginning of my journey as an evidence-based design artist and having a studio in Northern Michigan (where a few people still have trophy deer heads and bear skins on their living room walls), I decided to have a little fun and help promote art in the area with the new evidence-based design paintings and videos. Here’s an older video. Enjoy!
Inside Evidence-Based Design Art
I do not have the expertise of a neuroscientist or medical researcher or practitioner, but I do LOVE to study their evidence-based design results and find ways to experiment with them in art.
In Symphonies Of Love Number 11 my goal was to create a beautiful work of art without much impact.
To create the beauty, I chose the shape of a heart because I wanted a very clear, strong message that instantly communicated, “You are loved.” I find too much evidence-based design art today a little too wispy and without form. Sometimes people, and especially children, need a clear, up-in-your-face message, especially one of love.
Can you imagine a child in a patient bed or waiting area? Fear, worry, doubt can be big factors within a healthcare setting. I think an image of a heart outperforms a typical biophilic design when it comes to encouraging feelings of love, safety, and care.
Also for this painting, I chose to blend the inner area of each flower mostly with each flower’s petal color. What this does is create beauty without impact/stress, something super valuable within many healthcare environment locations. Some people are at the outer limits of their emotions in this setting, so creating beautiful art that does not stress is often welcome and greatly appreciated.
