title: Using clinical simulation centers to test design interventions: a pilot study of lighting and color modifications.
abstract: OBJECTIVE
  The aim of this pilot study was to test design interventions such as lighting, color, and spatial color patterning on nurses' stress, alertness, and satisfaction, and to provide an example of how clinical simulation centers can be used to conduct research.
  
  
  BACKGROUND
  The application of evidence-based design research in healthcare settings requires a transdisciplinary approach. Integrating approaches from multiple fields in real-life settings often proves time consuming and experimentally difficult. However, forums for collaboration such as clinical simulation centers may offer a solution. In these settings, identical operating and patient rooms are used to deliver simulated patient care scenarios using automated mannequins.
  
  
  METHODS
  Two identical rooms were modified in the clinical simulation center. Nurses spent 30 minutes in each room performing simulated cardiac resuscitation. Subjective measures of nurses' stress, alertness, and satisfaction were collected and compared between settings and across time using matched-pair t-test analysis.
  
  
  RESULTS
  Nurses reported feeling less stressed after exposure to the experimental room than nurses who were exposed to the control room (2.22, p = .03). Scores post-session indicated a significant reduction in stress and an increase in alertness after exposure to the experimental room as compared to the control room, with significance levels below .10. (Change in stress scores: 3.44, p = .069); (change in alertness scores: 3.6, p = .071).
  
  
  CONCLUSIONS
  This study reinforces the use of validated survey tools to measure stress, alertness, and satisfaction. Results support human-centered design approaches by evaluating the effect on nurses in an experimental setting.
authors.affiliation: Building Science Services, Medstar Institute for Innovation, Medstar Health, 3007 Tilden Avenue NW, Suite 700, Washington, DC, USA. whitney.a.gray@medstar.net
authors.forename: Whitney Austin
authors.initials: WA
authors.lastname: Gray
authors.forename: Karen S
authors.initials: KS
authors.lastname: Kesten
authors.forename: Stephen
authors.initials: S
authors.lastname: Hurst
authors.forename: Tama Duffy
authors.initials: TD
authors.lastname: Day
authors.forename: Laura
authors.initials: L
authors.lastname: Anderko
mesh_terms: D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D003116:Color; D055317:Evidence-Based Practice; D005260:Female; D017144:Focus Groups; D006801:Humans; D007374:Interior Design and Furnishings / Q000379:methods*; D007588:Job Satisfaction; D008029:Lighting; D009741:Nursing Staff, Hospital / Q000523:psychology*; D010865:Pilot Projects; D013315:Stress, Psychological