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.
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.
Why Did I Become Evidence-Based Design Certified?
A couple of years ago, I was on a very popular—and seemingly legitimate—New York City art website that was promoting art for health and healing.
Get this—misshapen and horrifically disfigured images; spread open naked human legs and rolls of unhealthy body fat; abstracts of daggers and dripping blood—all amazing works in their categories—just nothing I would consider appropriate for the elimination of stress or the recovery of human health.
This set me on a course for knowledge. I wanted to discover if I could actually learn to design/create with your health and healing in mind. I found The Center For Health Design with its excellent EDAC (Evidence-based Design) courses and certification. Imagine thousands of doctors, hospital administrators, health facility architects, hospital room designers, and many more professionals worldwide basing their creative/artistic decisions and designs on actual medical studies.
Instead of some untrained art critic or consultant setting the standards for art, health, and healing, I now had real medical professionals to learn from and follow. The EDAC exam was the most challenging test I ever took (and I’m a university graduate with high grades), but the knowledge I gained—which I now incorporate into my designs—was absolutely worth all the hard work.
It’s amazing how many people who buy my evidence-based designs tell me how this “evidence-based” art actually shifts their moods and creates positive and uplifting feelings/states of mind.
Here are four examples of what should never be promoted as evidence-based art for health and healing. Two of the pieces sold within minutes to a collector. They had merit, just not as evidence-based design art.
The first painting is titled Anguish and is part of a series I created about child abuse. This painting artistically reflects the mental and emotional suffering that children experience when they are not nurtured in healthy ways.
The second work, Killed Opportunities, shows how barren and tragic a child’s life becomes as opportunities for health and happiness are killed.
The third painting, Death By Power, reflects negative power winning. The face of a hideous creature looking at the viewer (top center) and a hand with the middle finger raised up (lower center) are perceptible.
In February 2025, I sold The Tempest, the fourth painting, again to a collector.
All four paintings have merit as works of abstract art. The art itself, however, does not de-stress or promote health and healing. In fact, it does the opposite.
Can you imagine the added stress and trauma of looking at any one of these paintings while recovering in a hospital bed? Before training to become evidence-based design certified, I wondered why influential people in the art world were calling paintings like this art for health and art for healing. It just didn’t make any sense to me.
Here are more beautiful paintings that would not be considered 100% appropriate evidence-based designs. Some I sold, some are for sale through a Paris, France international gallery, my website, Galleri Soho in Sweden, and more.
When I create evidence-based design art, I use design suggestions and strategies based on credible scientific and medical research. I get my information from a variety of sources, but I enjoy and value the trainings (which are required for EDAC recertification) at the Center For Health Design and their journals and repository information.
There’s a difference between pretty art that makes us feel happy and art that triggers our brains to feel happy based on medical and scientific research. Evidence-based design is that kind of art.
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!
Today’s Mood Busting Art
Is it possible to bust through a bad mood with art?
Garden Holiday by Dorothea Sandra, EDAC
As many of you know, we live in “interesting” times. So many people today are stressed or sad or deeply troubled by something or someone. I like to use my art to fight against this by creating credible pieces that bust through these moods and create upward movement feelings of happiness and hope and joy. Using well-researched guidelines, I like to reach inside the brain through art and help shift a negative mood into something positive.
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 of art called Evidence-based Design. According to the National Library of Medicine at the National Institute of Health, “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.”
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 artistic talents and evidence-based design training and certification—just as I did in this triptych art called Happy Garden—I very deliberately and very strategically create happy, happy art for today’s built environments.
People often ask me where I get my inspiration for this style of painting I call Bubble Art. These photos of flowers come from just two of my yards in Northern Michigan. I live in a super clean, healthy environment and inspiration always seems to be all around me—everywhere I seem to look. Nature is a truly powerful healer. When we can’t be out in it, putting art on our walls that captures nature’s fun and beauty often helps.
(I keep 100 percent pesticide-free yards with many bee and butterfly friendly plants. The bees this years are plentiful. I have even seen up to 8-10 bees on one bush.)
In a Garden Holiday, I used my evidence-based knowledge to select the cheerful background color. I painted the flowers in soil to give the artwork a rooted to our life-giving earth feel. Flowers and stems are never similar or boring in nature, so I gave this work an abundance of fun-filled stem twists and turns, pops full of flowery color, and many hints of humor.
If you would like to learn a bit more about evidence-based design and see how I applied it to my art, my new book, 100 Days Of Happy Happy Art, Evidence-Based Design, is available through Amazon.
Bubbling With Happy Smiles
Today’s art to make us smile.
Creating happiness is a gift, and I love to use my artistic talents to help others smile.
Bubbling With Happy Smiles by Dorothea Sandra
What Happens To Our Brains On Art?
The research results are in: according to The Telegraph in the United Kingdom, “Looking at a gorgeous painting, sculpture, or other artwork, increases blood flow to the brain by as much as 10 percent—the equivalent of looking at someone you love.”
According to professor Pierre Lemarquis, the French neuroscientist who wrote L’art Qui Guérit (Art That Heals) “art of all kinds acts on our brains in a multi-faceted, dynamic way. Neural networks are formed to achieve heightened, complex states of connectivity. Art can sculpt and even caress our brains.”
Isn’t This Exciting?
My goal was to create a work of art that would trigger our brains for fun and laughter and smiles. There’s enough reality in the soil to ground the painting, while the stems take off playfully up and down and around and side to side. The colors are bright and cheerful and full of dynamism and diversity.
So many people have told me this piece instantly busts through bad moods and makes them smile inside. Others have said the flowers communicate that one is perfectly beautiful even when super odd or different or not traditionally formed.
So much of my art is influenced by nature’s water movements and flowers. Here is Bubbling With Happy Smiles, as well as other pieces, on display at the Art In The Loft Gallery in Alpena, Michigan.
People often think of small northern towns as boring. This “authentic arts town” busts with summer activities. Festivals, art, music, water activities, cruise ships docking, amazing natural areas, wildlife, and truly friendly and fun (and open minded) people makes Alpena, Michigan a place I spend lots of time visiting. I’m in two galleries there, and I love it!
Here are some photos of one of the marinas and just one of the many colorful side alleys and back parking lots.
In such a fun and friendly “authentic” place, it’s so easy to get inspired to create happy art. Many of the paintings in my book, 100 Days Of Happy Happy Art, Evidence-Based Design, were influenced by this clean, healthy, and super beautiful area.
This book is not a marketing push. (There are no painting prices published.) It is visually pleasing, as well as an informative journey into a new art field based on science and medical studies called Evidence-based Design.
Welcome
Welcome to the wonderful world of Dorothea Sandra Art.
YOU HAVE ARRIVED AT THE WONDERFUL WORLD OF DOROTHEA SANDRA ART!
BLOG #1—From Death To Life
A number of years ago I got diagnosed with two potentially life-ending illnesses. I was surprised when most family, friends, and people I had known for years politely dumped me. Essentially, I was left on my own and alone (with the exception of one brother) to go off into the wilderness and die somewhere.
Well—not only did I not die—I ended up creating a super fun, happy, and absolutely amazing new life. Welcome to the wonderful world of Dorothea Sandra art. Today I’d like to share the power of abstract art and photos and excerpts from my new book 100 Days Of Happy Happy Art, Evidence-Based Design.
Power In Action by Dorothea Sandra
Power In Action is a bold abstract. It reflects the awesomeness and diversity of real power. Done mostly with palette knives, it has intense movement and edge, while still maintaining balance, beauty, and grace. I really like the gold touches. They are there to show that having an abundance of wealth is a fun thing.
I was trained as a child to paint in oil, but today I find super high quality professional-level acrylic paint to be so much more fun. I love the ease in which it goes on, and the colors can be truly amazing. In this painting you can see the influence of the late Roger William Curtis, the famous New England seascape artist. My earliest teachers were trained by him. I still remember wiggling my toes in the damp Gloucester sand while listening to the paint mixing instructions for creating sea spray, water depth, and ominous rocky shores.
In addition to my love of abstract art, I also wrote a book called 100 Days Of Happy Happy Art, Evidence-Based Design. My brush with death had opened my eyes to the importance art can have on the brain, which helps with health, healing, and happiness. I got trained and EDAC (evidence-based design) certified through the Center For Health Design, and it has been one happy artistic adventure after another ever since.
Did you know evidence-based designs use credible medical/scientific studies in their design guidelines? Here is Section 1.1 from my new book.
IS EVIDENCE-BASED DESIGN SOMETHING TOTALLY NEW?
“If you asked the sixth-century BCE Greeks of Epidaurus, they might take you to one of the most celebrated healing centers of the classical world—the Asclepieion hospital. In their hospital, patient rooms faced eastward. Why? It is believed the rooms were intuitively designed and placed toward the sun to promote healing.
Many centuries later, many movements from different countries came together in the 1970s to create a new field called Evidence-based Design.
Who are the people whose forces created this new discipline? Doctors, scientists, architects, interior designers, psychologists, sociologists, anthropologists, and many, many others.
DAY ONE of 100 DAYS OF HAPPY HAPPY ART
The Healing Window, 36”x48”
I’m known as many things in the art world—an artist of hope, an artist who modernizes traditional woodsy compositions, a New England trained artist, a Great Lakes artist, and a 21st century experimental artist.
As a 21st century experimental artist, I like bringing together totally new or different things. Bringing together today’s health, while also thinking of the ancient Greeks, Day One of 100 Days Of Happy Happy Art features a painting of a window view a patient might see from a hospital room.
This painting’s background is of Little Traverse Bay from the back parking lot of the McLaren Northern Hospital in Petoskey, Michigan.
As I composed my images, I imagined I was inside one of the McLaren Northern patient rooms looking out. The flowers are modern and cheerful and uplifting, but I wanted to honor the achievements of those before us by giving elements within the composition a more rough, ancient Greek Asclepieion feel to it.”