Many of us Gen Xers are at the cusp of car ing for our community in a t ime

when our healthcare system is at the edge of a major breakthrough or on

the verge of a major breakdown. As a result , there are mult iple concepts

gaining progress related to aesthet ics in the healthcare environment. One

of these earl iest concepts is Evidence-based Design or Evidence-based Art.

“Evidence-based Art is the process of bas ing decisions about art in health-

care on credible research to achieve the best possible outcomes.” The

quest ion should be what is the credible research? Art ist and phys ician,

Henry Domke, MD has an art ic le on his blog t it led Where’s the Beef? The

Evidence for Evidence-based Art and Dr. Ruth Brent Tofle suggests

“designers are embracing it without real iz ing that this is such a new field

that we don’t know much [about] yet.”

+ EVIDENCE

BASED AR

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By GK Rowe, XD

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While Evidence-based Art has elevated the importance

art plays in the enhanced care of patients, I think much

of the research lacks the inclusion and credentials from

fine art professionals. Within my studies of Evidence-

based art, there is little attention given to art educators,

artist, curators or historians; yet, when you compare the

studies done in neuroscience with art history, it is

apparent that science is behind the times when it comes

to understanding the relationship between woman or

man and art. With the advancement of technology and

neuroscience, scientists are rapidly gaining more

information about the master “minds” of artists. Most

of the findings in Evidence-based Art today are done

through controlled-group questionnaires developed from

healthcare professionals, academics and art consultants.

While their findings are significant, I think it is danger-

ously premature to begin establishing standardized

processes used in patient-focused aesthetics. Making

such claims as “abstract art is the worst” is inconsistent

with our cultural evolution with visual images. Further-

more, there is power in both knowledge and fear and I

would suggest that many art consultants will be eager to

own a piece of this conceptual pie.

Formulating guidelines for Evidence-based Art is

problematic because it attempts to define measureable

outcomes based on a fraction of information gathered

under diverse situations. According to studies reported

by the Center for Health Design: A Guide to Evidence-

based Art by Kathy Hathorn, MA, and Upali Nanda,

Phd., reports “In the Biological Origins of Art, Aiken

(1998) makes a scientific as well as philosophical

argument for the emotional impact of art and its impor-

tance to humankind’s survival as a species.” Art has

been an integral component of human evolution, both as

a species and as a society. The report presents that

images of nature are more appropriate in healing art

based on the concept of “biophilia,” which was coined

by Edward O. Wilson. Dr. Roger Ulrich, Ph.D., EDAC,

further interprets this by explaining that “humankind’s

evolutionary survival skills in a natural world have hard-

wired humans to find nature calming and restorative.”

Furthermore, it is suggested that as modern humans we

have an inherent connection to nature derived through

our ancestors.

Evid enc e -based Art | GK Rowe pag e 2

The research presented fails to comprehensively

examine the evolutionary process of art and its impact

on modern societies to more specifically enhance

patients’ recovery through a process inclusive of

nueroaesthetic concepts and experience design

practices.

Taking a look back 30,000 years ago to the time when

Nomadic people started making statues and images of

the human body, we can begin to understand our con-

nection to abstract art. The Venus of Willendorf, a

relic of our ancient past, provides the first clue as to

why our modern world is so dominated by unrealistic

images. The Venus of Willendorf’s features are gro-

tesquely exaggerated with the breast, stomach, hips,

and thighs prominently enhanced. Carved with great

care, the statue has no arms and the face is non-

existent. The statue would have been easy to carry and

may have served as a symbol of fertility or mother-

hood. These features provide clues as to what was

most important to the Nomadic peoples that lived in the

harsh ice-age environment where fertility and fattiness

would have been highly desired. In our modern soci-

ety, we live in a world of abundance and can see exam-

ples all around us where we have continued to empha-

size those features we most desire that are extremely

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contradictory to the environments in prehistoric times

which was mostly defined by scarcity. It would be un-

realistic to claim that modern people respond to the

same types of images that were important to their

ancestors particularly if the images reflect our relation-

ship to the environment in which we live. While early

hunter-gatherers valued and emphasized fertility and

fattiness in their culture, our modern knowledge-worker

culture values are expressed in vastly different ways

than those defining the Venus of Willendorf. “Over

10.2 million cosmetic surgical and nonsurgical proce-

dures were performed in the United States in 2008. The

overall number of cosmetic procedures has increased

162 percent since the collection of the statistics began in

1997. The most frequently performed nonsurgical

procedure was Botox injections and the most popular

surgical procedure was breast augmentation.” This

statistic alone reflects the values most important to our

modern culture and the ways in which we have

embraced aesthetics. As our modern society became

more culturally diverse, what we chose to exaggerate

changed even further. Similar historic references to the

use of visual images are evident in the advancement of

societies from gatherer-hunter to the conceptual age.

Evid enc e -based Art | GK Rowe 3

As one of the first settled civilizations, the Egyptians

relied heavily on agricultural means of survival and

adopted behaviors that led to the investigation and ex-

ploration of mathematics as it related to the human

body. Their visual communication reflected that which

was most fundamental to the civilization’s survival

which thrived through structures, organization, and

order. The images created consistently depict the

values of their culture for more than 3,000 years until

Egyptians started trading with the Greeks by way of the

Mediterranean Sea.

The ancient Greeks were preoccupied with mathemat-

ics and philosophy and with a fixation on perfection

and beauty of the human body, inspired by their belief

that Gods took human form. Similar to the Nomadic

ancestors approach and purpose, the Greeks developed

a highly skilled athletic body – filling their temples

with life-like statues of their Gods and Goddesses to

achieve an exaggerated reality; thus, exemplifying the

values most important to their culture.

It wasn’t until the Renaissance period, late 14th to early

15th century, that art became Art and the creative

thinkers gained the ranks of the elite and established

themselves as Artists. Simultaneously, the influence

of religion and humanism integrated with power and

authority, gave way to narrative imagery with allegoric

references throughout the Renaissance. Italy would

experience the bubonic plague or the “Black Death”

which would affect the economy, cause rapid

expansion of hospitals and stimulate commissioned

work of religious images.

Most of the theories developed for Evidence-based Art

encourage the use of natural images derived from

evolutionary concepts that support human connection

to shelter and protection instilled from our ancestors;

and, through emotional congruence or mood-

congruence processing which implies that in a stressful

situation negative emotions are likely to be projected

on to the surrounding environment by a patient, which

explains the adverse reaction to abstract or ambiguous

art. The Guide for Evidence-based Art reports,

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“Visual art can be traced as far back as the Paleolithic

man’s cave art and continues to be an integral part of

people’s live[s].” It’s a small wonder then, that the use

of art in hospitals dates back to the 14th century, when

they were church operated. “ While it is apparent that

Prehistoric humans had an affinity to their environment

especially as it pertained to shelter and protection, it is

more important to evaluate the relationship between

artist and woman or man. It is also important to note

that viewing appropriate nature images can reduce stress

and reduce pain as reported through psychological

testing and self-reporting surveys. So, why have we

spent years producing abstract images that reflect our

most fundamental values when they are reportedly

inappropriate for enhancing our connection to our

recovery process in a healthcare setting? Jeff Hawkins,

founder of Redwood Center for Theoretical Neurosci-

ence suggests, “Modern art, in its tendency toward

abstraction, does not depict anything less realistic than

art that depicts a human form or any other place or

object in a more photo-realistic manner. Rather, it is

just depicting a different place in our brain: a place be-

tween the invariant (photo-realist) representations at the

top of hierarchies, and the essential, raw sensory data of

incoming input.”

Applying science to the arts expands the “evidence” in

Evidence-based Art principles by identifying more

acutely the impact art can have on clinical and

behavioral outcomes for patient focused aesthetics. V.S.

Ramachandran, Director of the Center for Brain and

Cognition and Professor with the Psychology Depart-

ment and Neurosciences Program at the University of

California, San Diego, is best known for his work in

behavioral neurology. Ramachandran has explored the

connection between the brain and art and has begun the

investigative journey with the four-inch oolitic lime-

stone sculpture Venus of Willendorf to better understand

the “human artistic experience and the neural

mechanisms that mediate it.” Ramchandran uses the

Peak Shift Theory to explain the behavioral response to

images as they relate to life’s most fundamental

necessities.

Evid enc e -based Art | GK Rowe pag e 4

The Peak-Shift theory, a principle in animal discrimina-

tion, helps explain human pattern recognition and

aesthetic preference. This is a fundamental resource to

consider when practicing Evidence-based Art to fully

understand human experiences with works of “art”

from the Paleolithic period to modern day culture.

This theory gives insight to behavioral responses to an

aesthetic environment as it relates to survival. The

study, using herring gulls, was demonstrated to explain

neuro responses to abstraction. Adult herring gulls

have large yellow beaks with a red dot that is signifi-

cant to the visual response from herring gull chicks as it

relates to their survival. The process of how young

chicks respond to their mother’s beak for food is an

important principle in understanding the evocativeness

of much of visual art. When an adult herring gull has a

grub in its beak, young chicks respond by opening their

mouths wide and cheeping excitedly. This might seem

like intelligent behavior on the part of a hungry young-

ster seeing food, but herring gull chicks are not very

intelligent. If the red spot was painted yellow, the

chicks ignore the food. Show them an empty beak with

a red spot and they gape and cheep as before. In fact a

bright red dot on a vivid yellow pencil elicits extra

strong gaping and when presented with the option of

large yellow stick with three red bands, the chicks

favored the more abstract over the mother’s beak.

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The peak shift effect can be applied to human

recognition and aesthetic preference throughout the

history of man creating images. Consider the way a

skilled cartoonist produces a caricature of a famous face.

The cartoonist takes the average of all faces, subtracts it

from the subject’s face and then amplifies the

differences to produce a caricature. The final result is a

drawing that is even more like the original. The

cartoonist uses the same fundamental principles learned

and used by the Nomadic peoples to create the Venus of

Willendorf. In our modern culture, we respond to

caricatures in much the same way sea gull chicks

responded to the exaggerated abstraction of their

mother’s beak. It can be argued that a Picasso portrait

is nothing more than a caricature - when you compare

the subjects to the paintings, their similarities become

obvious.

“Despite all that has been said, there might appear to be

an important disanalogy between science and art.

Scientific understanding has an object – the natural

world or physical universe. This is what the scientists’

theories are about. But we have yet to state clearly what

artistic understanding is about. In terms of focus, an

artistic process is concerned with issues of look-and-

feel, whereas a scientific approach focuses on deeper,

more systematic issues like underlying architecture. In

terms of methodology, art relies on intuition and experi-

ence, whereas science depends on rigorous investigation

and analysis. In terms of validation, an art-led process

often rests on subjective or personal evaluation, whereas

a process that’s grounded in science relies on rigorous

testing using quantitative metrics.”

I don’t disagree with the concept of nature-based art and

being sensitive to subject matter that will potentially

enhance a patient’s recovery process; however, I’m not

convinced by the data presented that “ambiguous or

detrimental visual elements (including art) may have

emotionally, and even physiologically, harmful

effects.”12 Most of the data collected has been through

focus groups, questionnaires and surveys, which are

poor tools for learning about behavior since they are

documented by actual use; and, what people actually do

Evid enc e -based Art | GK Rowe pag e 5

can be different from how they think they do or what

they say. There needs to be more quantitative data

collected through neuroscience to make these types of

judgments; that said, since we all judge the world

through our own experiences it may be that we will

never be able to properly define what artwork is

appropriate for a patient other than the patients them-

selves. For now, it is important to continue the dia-

logue between artists and scientists about the possibili-

ties and limitations surrounding aesthetics in health-

care. Reports indicate that less than two percent of

design decisions are based off of solid evidence.

Evidence-based Art is significant to the role art will

have in the future development of healthcare facilities.

Having the best research is not enough. It is imperative

to the process that observations, insights and practices

carry over to advance aesthetic decisions. At the end

of the day, I think all art consultants that work in the

healthcare industry should be participating in the

practices of Evidence-based Art by continuing to learn

as much as possible about the field by implementing,

evaluating and questioning the research to improve and

enhance the aesthetic environment in healthcare.

Artwork by Alex Hughes

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Evid enc e -based Art | GK Rowe pag e 6

references

Domke, Henry. "Where's the Beef? The Evidence for

Evidence-based Art". Health Care Fine Art. May 2006

<http://www.healthcarefineart.com>.

Gordon, Graham. Philosophy of the Arts: An Introduction to

Aesthetics. New York: Routledge Taylor and Francis

Group, 2005.

Jeff , Hawkins. "The Cellular Architecture of Abstract Art".

The Beuatiful Brain. 2009

<http://www.thebeautifulbrain.com>.

Kathy, Hathorn. "A Guide to Evidence-based Art".

The Center for Health Design 2008: 1-20.

"Liposuction No Longer the Most Popular Surgical

Procedure According to New Statistics". American

Society for Aesthetic Plastic Surgery. 2008

<http://www.surgery.org>.

Peck, Richard. "Emerging trends in healthcare". Health Care

Design Magazine March 30, 2010.

V.S., Ramachandran. "The Cellular Architecture of Abstract

Art". The Journal of Consciousness Studies. 1999

<http://www.imprint.co.uk/rama/art.pdf>.

GK ROWE, XD is an Experience Designer and Principal Partner,

Director of Creative Development for Q7 Associates a multimedia

marketing and design firm located in Indianapolis Indiana. GK has

formal education in Fine Arts, Design, Natural Wellness and

Education including studies abroad in Italy, London and Paris. He

continues to infuse creative solutions and experience design

concepts into the business world through multidiscipline

mediums applying neuroaesthetics in the healthcare, hospitality

and corporate industries.

Committed to a higher level of aesthetics, GK serves as the

President for the Indianapolis Museum of Contemporary Art

Society, co-developed the art program for the InterContinental

Chicago-O’hare hotel and continues to support art education as a

faculty member at the Art Institute of Indianapolis and is a

member of the National Arts Education Association.

TIFFANY GARRITANO is the lead for graphic and web design for

Q7. Her experience as designer, webmaster, art director, project

manager and copywriter allows her to creatively deliver effective

solutions. She also helps solidify Q7's unified cross-platform

marketing strategy by having a combination of design and techni-

cal knowledge. By designing for communication, she ensures that

all projects exceed client objectives and inspire a wide range of

audiences.

SCOTT ALLEN TUCKER is a Principal Partner, Director of Media

and Communications for Q7 Associates. Degreed in Telecommu-

nications and English, Scott has worked in a multitude of business

and marketing development projects. From the sets of independ-

ent films to the conference rooms of corporate America, Scott

possesses a wide array of talents within the communications

field. As a writer, Scott has experience in screenplays, training

manuals, marketing content and magazine publications, copy

editing and content management. He has also worked as a

director, actor and producer for various film and video projects.

Scott oversees the content development for clients’ projects,

including any media and press.