Revisiting the Landmark Paoli Hospital Patient Study

Roger Ulrich’s landmark study of hospital inpatients, “View Through a Window May Influence Recovery from Surgery,” was pivotal in establishing not only the benefits of contact with nature for building occupants but also the value of evidence-based environmental design. A large body of subsequent research has since confirmed its central thesis—that contact with nature is psychologically and physiologically good for us. While that conclusion is now beyond doubt, this follow-up study suggests that there may have been other factors involved in the Paoli Hospital Patient Study beyond the presence and absence of nature. It is postulated that significant differences in both the depth of the two views compared and the amount of visible movement they contained may also have contributed to the results of the Paoli study. Visual evidence of these differences is presented, followed by the results of a series of studies by the authors indicating that both of these factors affect stress. It is suggested that further studies, actively controlling for view depth and visible natural movement would be valuable in order to determine their relative contributions to stress reduction and how they might interact. The potential implications of these findings for the design of windows in general, and those in healthcare spaces in particular, are then discussed.