The use of simulated visual impairment to identify hospital design elements that contribute to wayfinding difficulties

J. B. Rousek, M. S. Hallbeck

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Many public facility layouts have been developed with little consideration of the visually impaired, producing difficult and unpleasant wayfinding experiences. Not all wayfinding elements can be applied universally to all environments; several wayfinding elements are specific to the type of industry being considered. No known research has been conducted within healthcare systems to find wayfinding limitations among visually impaired users during the navigation process. The purpose of this study was to analyze the current issues in a wayfinding task for the visually impaired and normally sighted to identify wayfinding design deficits. Normally-sighted participants (m = 25, f = 25) wore one of five different vision simulator goggles to simulate a specific visual impairment (diabetic retinopathy, glaucoma, cataracts, macular degeneration, and hemianopsia) and were then given directions how to get to specific series of departments within a hospital campus. Participants then navigated a second time (using a different, but similar series of paths) without the vision simulator goggles (normal vision) so comparisons could be made. During participant wayfinding, behaviors such as stopping, looking around, touching walls, becoming lost and/or confused were recorded by location of each instance on a map. Questionnaires asking about the surrounding environment were completed after each condition. The results of this study identified several design elements involving signage, paths/target sites, lighting and flooring that created wayfinding issues for both experimental conditions. The effects of the wayfinding issues on participants ranged from tripping to becoming lost in the surrounding environment. Enhancing wayfinding for the most highly visually impacted individuals may also improve wayfinding for those with normal vision via universal design. The hospital design flaws identified by this study provide key areas and elements (not previously investigated) for further research studies to analyze more comprehensively and ultimately provide sound design recommendations to enhance effective wayfinding. Relevance to the industry: This paper offers information relevant to a growing healthcare sector facing an aging population with growing needs. Applying organizational, architectural and design principles from this paper can lead to improved patient satisfaction, safety and patient flow within the hospital setting for the visually impaired and others without visual impairment.

Original languageEnglish (US)
Pages (from-to)447-458
Number of pages12
JournalInternational Journal of Industrial Ergonomics
Issue number5
StatePublished - Sep 2011


  • Architecture
  • Design elements
  • Healthcare
  • Vision simulation
  • Visual impairment
  • Wayfinding

ASJC Scopus subject areas

  • Human Factors and Ergonomics
  • Public Health, Environmental and Occupational Health


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