Using shadowing for architectural research in healthcare environments: Opportunities and Challenges

Abstract

Observation methods, including shadowing, are increasingly used in research. However, studies critically examining the shadowing method's versatility and applicability to various research fields are scarce. It is a rarely employed method in architectural research with some distinct advantages and challenges in the healthcare context, primarily when used in patient populations. This paper aims to provide an overview of the main approaches to shadowing in healthcare environment research so far and illustrate the potential of this method when objective and interpretive approaches are combined via an example of mixed-method practice-based research using shadowing. In a research study investigating stroke patients' mobility in rehabilitation centres, shadowing was used in an exploratory way. In total, 840 hours were spent observing 70 patients in seven rehabilitation clinics. Different data types were collected, such as patients' activities, interactions with the built environment, covered daily distances, most commonly visited spaces in their free time and patient surveys. The data collection procedure and the different collected data types are presented and discussed, together with the accompanying fieldwork challenges and strategies to analyse the collected qualitative and quantitative data. Shadowing was found to be a valuable method for practice-based research, especially when not closely adhering to paradigmatic views. It enables obtaining insights into patients' activities and experiences and recording interactions with the built environment that could otherwise be overlooked using other methods. Furthermore, shadowing enables the inclusion of participants who have difficulties expressing themselves verbally, which helps explore various patient perspectives in healthcare environments.